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Chung HW, Park KS, Lim I, Noh WC, Yoo YB, Nam SE, So Y, Lee EJ. PET/MRI and Novel Targets for Breast Cancer. Biomedicines 2024; 12:172. [PMID: 38255277 PMCID: PMC10813582 DOI: 10.3390/biomedicines12010172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Breast cancer, with its global prevalence and impact on women's health, necessitates effective early detection and accurate staging for optimal patient outcomes. Traditional imaging modalities such as mammography, ultrasound, and dynamic contrast-enhanced magnetic resonance imaging (MRI) play crucial roles in local-regional assessment, while bone scintigraphy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) aid in evaluating distant metastasis. Despite the proven utility of 18F-FDG PET/CT in various cancers, its limitations in breast cancer, such as high false-negative rates for small and low-grade tumors, have driven exploration into novel targets for PET radiotracers, including estrogen receptor, human epidermal growth factor receptor-2, fibroblast activation protein, and hypoxia. The advent of PET/MRI, which combines metabolic PET information with high anatomical detail from MRI, has emerged as a promising tool for breast cancer diagnosis, staging, treatment response assessment, and restaging. Technical advancements including the integration of PET and MRI, considerations in patient preparation, and optimized imaging protocols contribute to the success of dedicated breast and whole-body PET/MRI. This comprehensive review offers the current technical aspects and clinical applications of PET/MRI for breast cancer. Additionally, novel targets in breast cancer for PET radiotracers beyond glucose metabolism are explored.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea; (H.W.C.); (Y.S.)
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea; (W.C.N.); (Y.B.Y.); (S.E.N.)
- Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Ilhan Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), 75 Nowon-ro, Nowon-gu, Seoul 07812, Republic of Korea;
| | - Woo Chul Noh
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea; (W.C.N.); (Y.B.Y.); (S.E.N.)
| | - Young Bum Yoo
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea; (W.C.N.); (Y.B.Y.); (S.E.N.)
| | - Sang Eun Nam
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea; (W.C.N.); (Y.B.Y.); (S.E.N.)
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea; (H.W.C.); (Y.S.)
| | - Eun Jeong Lee
- Department of Nuclear Medicine, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 02053, Republic of Korea;
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Chung HW, Chang H, Hong D, Yun HJ, Chung HS. Optimal ropivacaine concentration for ultrasound-guided erector spinae plane block in patients who underwent video-assisted thoracoscopic lobectomy surgery. Niger J Clin Pract 2023; 26:1139-1146. [PMID: 37635608 DOI: 10.4103/njcp.njcp_63_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background An ultrasound-guided erector spinae plane block (ESPB) has emerged as an effective way to control postoperative pain and may be a good alternative way to an epidural block. However, relevant research on the appropriate concentration of local anesthetics for an ESPB remains scarce. Aims This study aimed to investigate the optimal concentration of ropivacaine for an ESPB in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods A total of 68 patients who underwent a VATS lobectomy were enrolled. An ipsilateral ultrasound-guided ESPB was performed with three different ropivacaine concentrations as a local anesthetic: 0.189% (G1), 0.375% (G2), and 0.556% (G3). The total amount of perioperative remifentanil administered, patient-controlled analgesia (PCA) applied, and rescue drugs for postoperative analgesia during the 24 h after surgery were acquired, and numeric rating scale (NRS) scores were obtained. Results The total amount of intraoperative remifentanil administered was 7.20 ± 3.04 mcg/kg, 5.32 ± 2.70 mcg/kg, and 4.60 ± 1.75 in the G1, G2, and G3 groups, respectively. G2 and G3 had significantly lower amounts of remifentanil administered than the G1 group (P = 0.02 vs. G2; P = 0.003 vs. G3). The G3 group needed more inotropes than the G1 and G2 groups in the perioperative period (P = 0.045). The NRS scores, PCA, and rescue drug were not significantly different in the three groups. Conclusion The optimal concentration of ropivacaine recommended for an ESPB was 0.375%, which was effective in controlling pain and reducing the intraoperative opioid requirements with minimal adverse reactions such as hypotension.
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Affiliation(s)
- H W Chung
- Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H Chang
- Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - D Hong
- Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H J Yun
- Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H S Chung
- Department of Anesthesiology and Pain Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Jo JH, Chung HW, Kim SY, Lee MH, So Y. FDG PET/CT Maximum Tumor Dissemination to Predict Recurrence in Patients with Diffuse Large B-Cell Lymphoma. Nucl Med Mol Imaging 2023; 57:26-33. [PMID: 36643943 PMCID: PMC9832207 DOI: 10.1007/s13139-022-00782-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/19/2022] [Accepted: 10/23/2022] [Indexed: 01/30/2023] Open
Abstract
Purpose We investigated the prognostic value of maximum tumor dissemination (Dmax), the distance between malignant lesions that were farthest apart, as assessed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), and other clinical factors in patients with diffuse large B-cell lymphoma (DLBCL).We investigated the prognostic value of maximum tumor dissemination (Dmax), the distance between malignant lesions that were farthest apart, as assessed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), and other clinical factors in patients with diffuse large B-cell lymphoma (DLBCL). Methods Patients who underwent FDG PET/CT for initial staging and treatment response evaluation of DLBCL were reviewed retrospectively. Baseline Dmax, maximum standardized uptake value, total summation of all metabolic tumor volumes (tMTV), and total summation of all total lesion glycolysis (tTLG) were measured. The treatment response was evaluated at the interim and end of first-line treatment (EOT) using the Deauville score (DS). FDG PET/CT parameters and other clinical factors including sex, age, serum lactate dehydrogenase (LDH) level, stage, performance status, and the International Prognostic Index (IPI) were analyzed to identify factors prognostic of the time to progression (TTP) and disease-specific survival (DSS). Results A total of 63 patients were included. Univariate survival analysis identified Dmax (> 275 mm), tMTV (> 180 mL), tTLG (> 1300), interim DS (≥ 4), and EOT DS (≥ 4) as significant predictors of poor TTP. Serum LDH level (> 640 IU/L), IPI (≥ 4), tMTV (> 180 mL), tTLG (> 1300), interim DS (≥ 4), and EOT DS (≥ 4) were significant predictors of DSS. After multivariate survival analysis, Dmax (P = 0.008) and EOT DS (P = 0.005) were independent predictors of TTP. EOT DS was an independent predictor of DSS (P = 0.029). Conclusions Dmax at the time of diagnosis and the EOT response assessed by FDG PET/CT provide useful prognostic information additive to the IPI in patients with DLBCL.
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Affiliation(s)
- Joon-Hyung Jo
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030 South Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030 South Korea
- Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, 05030 South Korea
| | - Sung-Yong Kim
- Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, 05030 South Korea
- Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Mark Hong Lee
- Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, 05030 South Korea
- Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030 South Korea
- Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, 05030 South Korea
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Lee SH, Chung HW, Lee TY, Cheon YK. Effect of Rowachol on the Gallbladder Dysmotility Disorder Based on Gallbladder Ejection Fraction. Medicina (Kaunas) 2023; 59:medicina59010105. [PMID: 36676729 PMCID: PMC9862614 DOI: 10.3390/medicina59010105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023]
Abstract
Background and Objectives: Although laparoscopic cholecystectomy is the preferred treatment method in patients who experience typical biliary pain with or without gallstones, medical treatment has not been extensively studied. Rowachol is a potent choleretic agent, comprising six cyclic monoterpenes. This study aimed to investigate the clinical improvement and changes in gallbladder ejection fraction (GBEF) by Rowachol treatment in patients with typical biliary pain. Materials and Methods: We retrospectively reviewed 138 patients with typical biliary pain who underwent cholescintigraphy from July 2016 to April 2022. We included patients who received Rowachol for more than 2 months and underwent follow-up GBEF measurements. Finally, we analyzed pre- and post-treatment symptoms and GBEF. GBEF was calculated using the fatty meal-stimulated cholescintigraphy. Results: This retrospective observational study included 31 patients; their median age was 46.0 (range, 26.0-72.7) years, and 22 (71.0%) were female. Overall, 9 (29.0%) patients had gallbladder stones or sludges (maximum size: 2 mm) on initial transabdominal ultrasonography. During a median follow-up of 23.3 months, the symptoms of 21 (67.7%) patients were resolved after a median Rowachol treatment of 10.0 months. The mean GBEF was significantly improved after Rowachol treatment (initial cholescintigraphy: 42.6% ± 16.2%; follow-up cholescintigraphy: 53.0% ± 18.1%, p = 0.012). In patients with a GBEF ≤35% (n = 9), Rowachol significantly increased the GBEF from 21.3% ± 8.3% to 49.1% ± 20.7% (p = 0.008). Conclusions: Rowachol may have beneficial medical effects that can improve gallbladder dysfunction and treatment response.
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Affiliation(s)
- Sang Hoon Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Tae Yoon Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Young Koog Cheon
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
- Correspondence: ; Tel.: +82-2-2030-7490
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Leung KH, Rowe SP, Leal JP, Ashrafinia S, Sadaghiani MS, Chung HW, Dalaie P, Tulbah R, Yin Y, VanDenBerg R, Werner RA, Pienta KJ, Gorin MA, Du Y, Pomper MG. Deep learning and radiomics framework for PSMA-RADS classification of prostate cancer on PSMA PET. EJNMMI Res 2022; 12:76. [PMID: 36580220 PMCID: PMC9800682 DOI: 10.1186/s13550-022-00948-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Accurate classification of sites of interest on prostate-specific membrane antigen (PSMA) positron emission tomography (PET) images is an important diagnostic requirement for the differentiation of prostate cancer (PCa) from foci of physiologic uptake. We developed a deep learning and radiomics framework to perform lesion-level and patient-level classification on PSMA PET images of patients with PCa. METHODS This was an IRB-approved, HIPAA-compliant, retrospective study. Lesions on [18F]DCFPyL PET/CT scans were assigned to PSMA reporting and data system (PSMA-RADS) categories and randomly partitioned into training, validation, and test sets. The framework extracted image features, radiomic features, and tissue type information from a cropped PET image slice containing a lesion and performed PSMA-RADS and PCa classification. Performance was evaluated by assessing the area under the receiver operating characteristic curve (AUROC). A t-distributed stochastic neighbor embedding (t-SNE) analysis was performed. Confidence and probability scores were measured. Statistical significance was determined using a two-tailed t test. RESULTS PSMA PET scans from 267 men with PCa had 3794 lesions assigned to PSMA-RADS categories. The framework yielded AUROC values of 0.87 and 0.90 for lesion-level and patient-level PSMA-RADS classification, respectively, on the test set. The framework yielded AUROC values of 0.92 and 0.85 for lesion-level and patient-level PCa classification, respectively, on the test set. A t-SNE analysis revealed learned relationships between the PSMA-RADS categories and disease findings. Mean confidence scores reflected the expected accuracy and were significantly higher for correct predictions than for incorrect predictions (P < 0.05). Measured probability scores reflected the likelihood of PCa consistent with the PSMA-RADS framework. CONCLUSION The framework provided lesion-level and patient-level PSMA-RADS and PCa classification on PSMA PET images. The framework was interpretable and provided confidence and probability scores that may assist physicians in making more informed clinical decisions.
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Affiliation(s)
- Kevin H. Leung
- grid.21107.350000 0001 2171 9311Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 601 N Caroline St. JHOC 4263, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Steven P. Rowe
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Jeffrey P. Leal
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Saeed Ashrafinia
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Mohammad S. Sadaghiani
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Hyun Woo Chung
- grid.258676.80000 0004 0532 8339Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Pejman Dalaie
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Rima Tulbah
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Yafu Yin
- grid.16821.3c0000 0004 0368 8293Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ryan VanDenBerg
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Rudolf A. Werner
- grid.411760.50000 0001 1378 7891Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Kenneth J. Pienta
- grid.21107.350000 0001 2171 9311The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Michael A. Gorin
- grid.59734.3c0000 0001 0670 2351The Milton and Carroll Petrie Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Yong Du
- grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Martin G. Pomper
- grid.21107.350000 0001 2171 9311Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 601 N Caroline St. JHOC 4263, Baltimore, MD 21287 USA ,grid.21107.350000 0001 2171 9311The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD USA
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Garg T, Werner RA, Chung HW, Khatri W, Pienta KJ, Pomper MG, Gorin MA, Saad E, Rowe SP. Association of True Positivity with Serum Prostate-Specific Antigen Levels and Other Clinical Factors in Indeterminate PSMA-RADS-3A Lesions Identified on 18F-DCFPyL PET/CT Scans. Tomography 2022; 8:2639-2647. [PMID: 36412679 PMCID: PMC9680499 DOI: 10.3390/tomography8060220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022] Open
Abstract
The use of prostate-specific membrane antigen targeted PET imaging for the evaluation of prostate cancer has increased significantly in the last couple of decades. When evaluating these imaging findings based on the PSMA reporting and data system version 1.0, which categorize lesions based on their likelihood of prostate cancer involvement, PSMA-RADS-3A lesions are commonly seen, which are indeterminate for the presence of disease. A total of 28 patients with 171 PSMA-RADS-3A lesions on 18F-DCFPyL PET/CT scans from June 2016 to May 2017 who had follow-up cross-sectional imaging over time were included in this study. The PSA levels of patients with PSMA-RADS-3A lesions were categorized into four groups, 0-0.2, 0.2-1, 1-2, and >2 ng/mL. The pre-operative Gleason score of these patients was categorized into two groups, Gleason score < 7 or ≥7. The median age for these patients was 72.5 years (range 59-81). The median PSA value for patients with positive lesions was significantly higher than those with negative lesions (5.8 ng/mL vs. 0.2 ng/mL, p < 0.0001). The lesion positivity rate was significantly higher in patients with PSA > 1 ng/mL (18.2% vs. 81.9%, p < 0.001). On ROC analysis, the highest classification accuracy was seen at PSA ≥ 0.6 ng/mL of 80.12% (95% CI = 73.69-86.16%), and the area under the curve was 71.32% (95% CI = 61.9-80.7%, p < 0.0001). A total of 96.4% (108/112) of patients with positive lesions and 86.4% (51/59) of patients with negative lesions had a PSMA-RADS-4/5 lymph node on the initial 18F-DCFPyL PET/CT scan (p = 0.02). In patients with a Gleason score ≥ 7, the presence of positive PSMA-RADS-3A lesions was higher, compared to negative PSMA-RADS-3A lesions (p = 0.049). Higher PSA levels in patients with PSMA-RADS-3A lesions can point towards the presence of true positivity. PSA levels may be considered in deciding whether to call an indeterminate lesion on PSMA PET.
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Affiliation(s)
- Tushar Garg
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rudolf A. Werner
- Department of Nuclear Medicine, University Hospital Würzbürg, 97080 Würzburg, Germany
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Wajahat Khatri
- Department of Radiology, Harlem Hospital, New York, NY 10037, USA
| | - Kenneth J. Pienta
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Martin G. Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael A. Gorin
- The Milton and Carroll Petrie Department of Urology, Mount Sinai Health System, New York, NY 10029, USA
| | - Elie Saad
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Correspondence: (E.S.); (S.P.R.); Tel.: +1-14-109-555152 (E.S.); +1-14-105-028052 (S.P.R.)
| | - Steven P. Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Correspondence: (E.S.); (S.P.R.); Tel.: +1-14-109-555152 (E.S.); +1-14-105-028052 (S.P.R.)
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Min HK, Kim SH, Lee KA, Jo JH, So Y, Chung HW, Lee SH, Kim HR. Correlation between salivary gland ultrasonography and scintigraphy in primary Sjögren's Syndrome. Rheumatology (Oxford) 2021; 61:3414-3419. [PMID: 34888620 DOI: 10.1093/rheumatology/keab881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/19/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To compare findings on salivary gland ultrasonography (SGUS) and salivary gland scintigraphy in patients with primary Sjögren's syndrome (pSS). METHODS The study cohort included patients newly diagnosed with pSS who underwent SGUS and salivary gland scintigraphy at the same time at our tertiary care hospital. Baseline demographics, laboratory data, clinical data, and SGUS and salivary gland scintigraphy findings were collected. The SGUS cut-off score ≥14 defined positive SGUS findings and was used to classify patients in SGUS (+) and (-) groups. Salivary gland scintigraphy findings quantified by the parotid/submandibular uptake ratio (PU/SU) and percentage parotid/submandibular excretion (%PE/%SE). The correlation between SGUS and salivary gland scintigraphy findings was evaluated. RESULTS For analysis, 18 patients with SGUS (+) findings and 18 with SGUS (-) findings were recruited, for a total study cohort of 36 patients. There were no between-group differences in baseline demographics, clinical, and laboratory data. The PU, %PE, SU, and %SE were significantly lower in the SGUS (+) than SGUS (-) group. The SGUS score for the parotid gland was negatively correlated to the PU (r= -0.36, p = 0.03) and %PE (r= -0.35, p = 0.04). The SGUS score of the submandibular gland was negatively correlated to the SU (r= -0.42, p = 0.01) and %SE (r= -0.39, p = 0.02). CONCLUSIONS Patients with a higher SGUS score had lower salivary gland function. The SGUS score showed a significant correlation with PU, %PE, SU, and %SE. These findings are indicative of a possible predictive role of SGUS to diagnose salivary gland dysfunction.
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Affiliation(s)
- Hong-Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, 05030, Republic of Korea
| | - Se Hee Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, 05030, Republic of Korea
| | - Kyung-Ann Lee
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul hospital, Seoul, 04401, Republic of Korea
| | - Joon-Hyung Jo
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Sang-Heon Lee
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science,Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science,Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
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Abstract
Background To investigate the incidence of absent Bell’s phenomenon (BP) and the relationship between absent BP and inferior rectus muscle hypertrophy and other clinical features in patients with thyroid eye disease (TED). Methods A total of 104 patients who were first diagnosed with TED between January and December 2014 were included. Inferior rectus muscle area and associations with clinical features of TED and thyroid function test including thyroid specific antibodies were compared between patients with TED with and without BP. The volume of the inferior rectus muscle was calculated by adding up all the cross-sectional areas measured on sagittal CT images. Results Among the 104 patients, 14 had absent BP (13.5%), 12 with bilateral and two with unilateral. There was no significant difference in thyroid function test, presence of TSIs, exophthalmos, or volume of inferior rectus muscle measured in CT scans (P > 0.05). Incidence of diplopia, elevation limitation, and upper eyelid retraction were risk factors of absent BP in TED patients (by logistic regression analysis, P < 0.05). Conclusions Inferior rectus muscle hypertrophy was not the cause of absent BP in TED patients. Fibrosis and tightening of the inferior rectus muscle, lower eyelid, and surrounding orbital tissues, rather than inferior rectus muscle hypertrophy, might be related to absent BP in TED patients.
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Affiliation(s)
- Hyun Woo Chung
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, 123 Jeokkumro, Ansan-shi, Kyunggi-do, 15355, Republic of Korea.,Department of Ophthalmology, Guro Hospital, Korea University College of Medicine, 148 Gurodongro, Seoul, 08308, Republic of Korea
| | - Hwa Lee
- Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine, 123 Jeokkumro, Ansan-shi, Kyunggi-do, 15355, Republic of Korea.
| | - Sehyun Baek
- Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea
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Nam KT, Chung HW, Jang S, Hwang SY, Kim SW, Oh J, Yun C. GANGLION CELL-INNER PLEXIFORM LAYER THICKNESS IN EYES WITH NONEXUDATIVE AGE-RELATED MACULAR DEGENERATION OF DIFFERENT DRUSEN SUBTYPES. Retina 2021; 41:1686-1696. [PMID: 33411476 DOI: 10.1097/iae.0000000000003100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We sought to investigate the ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with nonexudative age-related macular degeneration. METHODS We classified eyes into four categories-pachydrusen, soft drusen, subretinal drusenoid deposit (SDD), and soft drusen with SDD-and compared the baseline mean macular GCIPL thickness according to the Early Treatment Diabetic Retinopathy Study grid and its change between groups. RESULTS We classified 53, 29, 36, and 34 eyes into the four categories, respectively. The mean GCIPL thickness values in the 3-mm area were 82.61 ± 9.54 µm for the pachydrusen group, 79.11 ± 10.26 µm for the soft drusen group, 77.72 ± 6.04 µm for the SDD group, and 71.63 ± 8.69 µm for the soft drusen with SDD group (P < 0.001). The soft drusen with the SDD group showed a greater change in GCIPL thickness (-2.50 ± 0.29 µm/year) in the 3-mm area as compared with the pachydrusen group (-0.18 ± 0.35 µm/year), soft drusen group (-0.55 ± 0.36 µm/year), and SDD group (-0.55 ± 0.37) (all P < 0.001). CONCLUSION The GCIPL thickness varied according to the type of nonexudative age-related macular degeneration. The thinner baseline GCIPL and its greater change in eyes with soft drusen with SDD may suggest that these eyes are experiencing more prominent neuroretinal degeneration in the central 3-mm area than those in the other groups.
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Affiliation(s)
- Ki Tae Nam
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Hyun Woo Chung
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Sungmin Jang
- Department of Ophthalmology, Saevit Eye Hospital, Goyang, Korea; and
| | - Soon-Young Hwang
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Seong-Woo Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Cheolmin Yun
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Chen J, Li Y, Luna LP, Chung HW, Rowe SP, Du Y, Solnes LB, Frey EC. Learning fuzzy clustering for SPECT/CT segmentation via convolutional neural networks. Med Phys 2021; 48:3860-3877. [PMID: 33905560 PMCID: PMC9973404 DOI: 10.1002/mp.14903] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/01/2021] [Accepted: 04/12/2021] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Quantitative bone single-photon emission computed tomography (QBSPECT) has the potential to provide a better quantitative assessment of bone metastasis than planar bone scintigraphy due to its ability to better quantify activity in overlapping structures. An important element of assessing the response of bone metastasis is accurate image segmentation. However, limited by the properties of QBSPECT images, the segmentation of anatomical regions-of-interests (ROIs) still relies heavily on the manual delineation by experts. This work proposes a fast and robust automated segmentation method for partitioning a QBSPECT image into lesion, bone, and background. METHODS We present a new unsupervised segmentation loss function and its semi- and supervised variants for training a convolutional neural network (ConvNet). The loss functions were developed based on the objective function of the classical Fuzzy C-means (FCM) algorithm. The first proposed loss function can be computed within the input image itself without any ground truth labels, and is thus unsupervised; the proposed supervised loss function follows the traditional paradigm of the deep learning-based segmentation methods and leverages ground truth labels during training. The last loss function is a combination of the first and the second and includes a weighting parameter, which enables semi-supervised segmentation using deep learning neural network. EXPERIMENTS AND RESULTS We conducted a comprehensive study to compare our proposed methods with ConvNets trained using supervised, cross-entropy and Dice loss functions, and conventional clustering methods. The Dice similarity coefficient (DSC) and several other metrics were used as figures of merit as applied to the task of delineating lesion and bone in both simulated and clinical SPECT/CT images. We experimentally demonstrated that the proposed methods yielded good segmentation results on a clinical dataset even though the training was done using realistic simulated images. On simulated SPECT/CT, the proposed unsupervised model's accuracy was greater than the conventional clustering methods while reducing computation time by 200-fold. For the clinical QBSPECT/CT, the proposed semi-supervised ConvNet model, trained using simulated images, produced DSCs of 0.75 and 0.74 for lesion and bone segmentation in SPECT, and a DSC of 0.79 bone segmentation of CT images. These DSCs were larger than that for standard segmentation loss functions by > 0.4 for SPECT segmentation, and > 0.07 for CT segmentation with P-values < 0.001 from a paired t-test. CONCLUSIONS A ConvNet-based image segmentation method that uses novel loss functions was developed and evaluated. The method can operate in unsupervised, semi-supervised, or fully-supervised modes depending on the availability of annotated training data. The results demonstrated that the proposed method provides fast and robust lesion and bone segmentation for QBSPECT/CT. The method can potentially be applied to other medical image segmentation applications.
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Affiliation(s)
- Junyu Chen
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD,Corresponding author
| | - Ye Li
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD
| | - Licia P. Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Steven P. Rowe
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD
| | - Yong Du
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD
| | - Lilja B. Solnes
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD
| | - Eric C. Frey
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD
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Chung HW, Park JH, Yoo C, Kim YY. Effects of Trabecular Meshwork Width and Schlemm's Canal Area on Intraocular Pressure Reduction in Glaucoma Patients. Korean J Ophthalmol 2021; 35:311-317. [PMID: 34162183 PMCID: PMC8357607 DOI: 10.3341/kjo.2021.0007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/18/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate the effects of baseline trabecular meshwork (TM) and Schlemm's canal (SC) microstructures on intraocular pressure (IOP) reduction amount in treatment-naïve patients with primary open-angle glaucoma (POAG). METHODS A total 69 eyes of POAG patients who had not been treated with IOP-lowering agent were enrolled in this retrospective study. The patients had been prescribed topical IOP-lowering agent and used it for 1 year. The morphologic features of the TM and SC were collected using anterior segment module of spectral-domain optical coherence tomography with enhanced depth imaging at baseline. Images of the nasal and temporal corneoscleral limbus were obtained with serial horizontal enhanced depth imaging B-scans and TM width and SC area were measured in each scan. We investigated the effects of baseline TM and SC microstructures on IOP reduction amount. RESULTS The baseline IOP of 69 glaucomatous eyes was 17.9 ± 3.8 mmHg, and the mean amount of IOP reduction was 3.5 ± 2.1 mmHg after 1 year. Mean TM widths of nasal and temporal sector were 470.33 ± 80.05 and 479.74 ± 79.59 μm, respectively. SC area was measured as 4,818.50 ± 1,464.28, 4,604.23 ± 1,567.73 μm2 at nasal sector and temporal sector, respectively. The correlation analysis revealed a positive correlation between SC area and average amount of IOP reduction, indicating that the larger baseline SC area, the greater the IOP drop with topical IOP-lowering agents. However, no correlation was found between TM width and IOP lowering amount in patients with POAG. CONCLUSIONS The baseline SC area showed positive correlation with the IOP reduction amount in patients with POAG. This finding suggests that the SC area can be a clinical parameter to predict the IOP reduction amount before using IOP-lowering agents in POAG patient.
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Affiliation(s)
- Hyun Woo Chung
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Ji-Hye Park
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Chungkwon Yoo
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Yong Yeon Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Min HK, Kim HR, So Y, Chung HW, Lee SH. Semiquantitative analysis of sacroiliac joint to sacrum ratio of bone scintigraphy to predict spinal progression in early axial spondyloarthritis: a pilot study. Clin Exp Rheumatol 2021. [DOI: 10.55563/clinexprheumatol/jkytz1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
| | - Sang-Heon Lee
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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Khatri W, Chung HW, Werner RA, Leal JP, Pienta KJ, Lodge MA, Gorin MA, Pomper MG, Rowe SP. Effect of Point-Spread Function Reconstruction for Indeterminate PSMA-RADS-3A Lesions on PSMA-Targeted PET Imaging of Men with Prostate Cancer. Diagnostics (Basel) 2021; 11:diagnostics11040665. [PMID: 33917238 PMCID: PMC8067967 DOI: 10.3390/diagnostics11040665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is emerging as an important modality for imaging patients with prostate cancer (PCa). As with any imaging modality, indeterminate findings will arise. The PSMA reporting and data system (PSMA-RADS) version 1.0 codifies indeterminate soft tissue findings with the PSMA-RADS-3A moniker. We investigated the role of point-spread function (PSF) reconstructions on categorization of PSMA-RADS-3A lesions. Methods: This was a post hoc analysis of an institutional review board approved prospective trial. Around 60 min after the administration of 333 MBq (9 mCi) of PSMA-targeted 18F-DCFPyL, patients underwent PET/computed tomography (CT) acquisitions from the mid-thighs to the skull vertex. The PET data were reconstructed with and without PSF. Scans were categorized according to PSMA-RADS version 1.0, and all PSMA-RADS-3A lesions on non-PSF images were re-evaluated to determine if any could be re-categorized as PSMA-RADS-4. The maximum standardized uptake values (SUVs) of the lesions, mean SUVs of blood pool, and the ratios of those values were determined. Results: A total of 171 PSMA-RADS-3A lesions were identified in 30 patients for whom both PSF reconstructions and cross-sectional imaging follow-up were available. A total of 13/171 (7.6%) were re-categorized as PSMA-RADS-4 lesions with PSF reconstructions. A total of 112/171 (65.5%) were found on follow-up to be true positive for PCa, with all 13 of the re-categorized lesions being true positive on follow-up. The lesions that were re-categorized trended towards having higher SUVmax-lesion and SUVmax-lesion/SUVmean-blood-pool metrics, although these relationships were not statistically significant. Conclusions: The use of PSF reconstructions for 18F-DCFPyL PET can allow the appropriate re-categorization of a small number of indeterminate PSMA-RADS-3A soft tissue lesions as more definitive PSMA-RADS-4 lesions. The routine use of PSF reconstructions for PSMA-targeted PET may be of value at those sites that utilize this technology.
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Affiliation(s)
- Wajahat Khatri
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (W.K.); (J.P.L.); (M.A.L.); (M.G.P.)
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea;
| | - Rudolf A. Werner
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany;
| | - Jeffrey P. Leal
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (W.K.); (J.P.L.); (M.A.L.); (M.G.P.)
| | - Kenneth J. Pienta
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Martin A. Lodge
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (W.K.); (J.P.L.); (M.A.L.); (M.G.P.)
| | - Michael A. Gorin
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15232, USA;
- Urology Associates and UPMC Western Maryland, Cumberland, MD 21502, USA
| | - Martin G. Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (W.K.); (J.P.L.); (M.A.L.); (M.G.P.)
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
| | - Steven P. Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (W.K.); (J.P.L.); (M.A.L.); (M.G.P.)
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA;
- Correspondence:
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Kim JW, Eom Y, Chung HW, Song JS, Jeong JW, Park SK, Kim HM. Factors for good near and distance visual outcomes of multifocal intraocular lens with inferior segmental near add. Graefes Arch Clin Exp Ophthalmol 2020; 258:1735-1743. [DOI: 10.1007/s00417-020-04761-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 11/28/2022] Open
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Lee EJ, Chung HW, Jo JH, So Y. Radioembolization for the Treatment of Primary and Metastatic Liver Cancers. Nucl Med Mol Imaging 2019; 53:367-373. [PMID: 31867071 DOI: 10.1007/s13139-019-00615-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/23/2019] [Accepted: 09/20/2019] [Indexed: 02/08/2023] Open
Abstract
Radioembolization using 90Y microspheres (glass or resin) has been introduced as an effective intraarterial therapy for unresectable primary and metastatic liver cancers. Although the basic therapeutic effect of chemoembolization results from ischemia, the therapeutic efficacy of radioembolization comes from radiation. Furthermore, compared with surgical resection and local ablation therapy, radioembolization is available with less limitation on the sites or number of liver cancers. The radioisotope 90Y is a β-radiation emitter without γ-radiation, with the emission of secondary bremsstrahlung photons and small numbers of positrons. Administration of 90Y microspheres into the hepatic artery can deliver a high dose of radiation selectively to the target tumor with limited radiation exposure to the surrounding normal parenchyma, and has low systemic toxicity. In general, radioembolization has been considered for patients with unresectable primary or metastatic liver-only or liver-dominant cancers with no ascites or other clinical signs of liver failure, life expectancy of > 12 weeks, and good performance status. Here, we review the current radioactive compounds, pretreatment assessment, and indications for radioembolization in patients with hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and liver metastases from colorectal cancer.
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Affiliation(s)
- Eun Jeong Lee
- 1Department of Nuclear Medicine, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul, South Korea
| | - Hyun Woo Chung
- 2Departments of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, South Korea
| | - Joon-Hyung Jo
- 2Departments of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, South Korea
| | - Young So
- 2Departments of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, South Korea
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Lee JY, Kim YH, Park YJ, Park SB, Chung HW, Zo JI, Shim YM, Lee KS, Choi JY. Improved detection of metastatic lymph nodes in oesophageal squamous cell carcinoma by combined interpretation of fluorine-18-fluorodeoxyglucose positron-emission tomography/computed tomography. Cancer Imaging 2019; 19:40. [PMID: 31227017 PMCID: PMC6588863 DOI: 10.1186/s40644-019-0225-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/13/2019] [Indexed: 12/19/2022] Open
Abstract
Background We sought to evaluate the diagnostic performance of fluorine-18-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) in the detection of metastatic lymph nodes by combined interpretation of PET/CT images in patients with oesophageal squamous cell carcinoma. Methods Two hundred three patients with oesophageal squamous cell carcinoma underwent 18F-FDG PET/CT before oesophagectomy and lymph node dissection. Maximum standardized uptake value (SUVmax), mean Hounsfield unit (HU), short axis diameter (size), and visual CT attenuation (high, iso-, low) were evaluated on noncontrast CT and PET images following PET/CT scan. In this combined interpretation protocol, the high attenuated lymph nodes were considered benign, even if the SUVmax value was high. The diagnostic accuracy of each method was compared using the postoperative histologic result as a reference standard. Results A total of 1099 nodal stations were dissected and 949 nodal stations were proven to demonstrate metastasis. SUVmax and size of the malignant lymph nodes were higher than those of the benign nodes, and visual CT attenuation was significantly different among the two groups (P < 0.001). Using cutoff values of 2.6 for SUVmax and 10.2 mm for size, the combined interpretation of an SUVmax of more than 2.6 with iso- or low CT attenuation [area under the curve (AUC): 0.846, 95% confidence interval (CI): 0.824–0.867] showed significantly better diagnostic performance for detecting malignant lymph nodes than SUVmax only (AUC: 0.791, 95% CI: 0.766–0.815) and size (AUC: 0.693, 95% CI: 0.665–0.720) methods (P < 0.001) in a receiver operating characteristic curve analysis. Conclusions The diagnostic accuracy of PET/CT for nodal metastasis in oesophageal squamous cell carcinoma was improved by the combined interpretation of 18F-FDG uptake and visual CT attenuation pattern.
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Affiliation(s)
- Ji Young Lee
- Department of Nuclear Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Young Hwan Kim
- Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong-Jin Park
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Soo Bin Park
- Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jae Il Zo
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Chung HW, Kim JH, Sung IK, Lee SY, Park HS, Shim CS, Bang HY, So Y, Lee EJ. FDG PET/CT to predict the curability of endoscopic resection for early gastric cancer. J Cancer Res Clin Oncol 2019; 145:759-764. [DOI: 10.1007/s00432-018-02832-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022]
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Lee HJ, Choi NY, Park YS, Lee SW, Bang JS, Lee Y, Ryu JS, Choi SJ, Lee SH, Kim GS, Chung HW, Ko K, Lee K, Ko K. Multigenerational effects of maternal cigarette smoke exposure during pregnancy on sperm counts of F1 and F2 male offspring. Reprod Toxicol 2018; 78:169-177. [PMID: 29689290 DOI: 10.1016/j.reprotox.2018.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 04/03/2018] [Accepted: 04/18/2018] [Indexed: 11/15/2022]
Abstract
Animal models and human studies showed that in utero cigarette smoke exposure decreases sperm counts of offspring. This study used a mouse model to investigate the effects of maternal exposure to cigarette smoke on reproductive systems in F1 and F2 male offspring. Female ICR mice were exposed either to clean air or to cigarette smoke during pregnancy at the post-implantation stage. Epididymal sperm counts were decreased in a cigarette smoke dose-dependent manner in F1 (by 40-60%) and F2 males (by 23-40%) at postnatal day 56. In F1, the seminiferous epithelium heights were lower in the cigarette smoke-exposed groups than in the control group, and these effects were sustained in F2 males. Results suggest that maternal cigarette smoke exposure during pregnancy can have a multigenerational adverse effect on sperm counts in male offspring, which is mediated through in utero exposure of fetal germ cells to cigarette smoke.
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Affiliation(s)
- Hye Jeong Lee
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea
| | - Na Young Choi
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea
| | - Yo Seph Park
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea
| | - Seung-Won Lee
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea
| | - Jin Seok Bang
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea
| | - Yukyeong Lee
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea
| | - Jae-Sung Ryu
- Stem Cell Research Center, Korea Research Institute of Bioscience & Biotechnology, Daejeon, Republic of Korea
| | - Seong-Jin Choi
- Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Sang-Hyub Lee
- Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea
| | - Gwang Soo Kim
- Department of Nuclear Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Seoul, Republic of Korea; Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Kisung Ko
- Department of Medicine, Therapeutic Protein Engineering Lab, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Kyuhong Lee
- Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup, Jeonbuk, Republic of Korea; Department of Human and Environment Toxicology, University of Science and Technology, Daejeon, Republic of Korea
| | - Kinarm Ko
- Department of Stem Cell Biology, Konkuk University School of Medicine, Seoul, Republic of Korea; Center for Stem Cell Research, Institute of Advanced Biomedical Science, Konkuk University, Seoul, Republic of Korea; Research Institute of Medical Science, Konkuk University, Seoul, Republic of Korea.
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Lee KP, Baek S, Jung SH, Cui L, Lee D, Lee DY, Choi WS, Chung HW, Lee BH, Kim B, Won KJ. DJ-1 is involved in epigenetic control of sphingosine-1-phosphate receptor expression in vascular neointima formation. Pflugers Arch 2018; 470:1103-1113. [DOI: 10.1007/s00424-018-2132-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/12/2018] [Accepted: 02/21/2018] [Indexed: 01/30/2023]
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Abstract
AIMS Adjuvant treatment after intralesional curettage for atypical cartilaginous tumours (ACTs) of long bones is widely accepted for extending surgical margins. However, evaluating the isolated effect of adjuvant treatment is difficult, and it is unclear whether not using such adjuvants provides poor oncological outcomes. Hence, we analyzed whether intralesional curettage without cryosurgery or chemical adjuvants provides poor oncological outcomes in patients with an ACT. PATIENTS AND METHODS A total of 24 patients (nine men, 15 women) (mean age 45 years; 18 to 62) were treated for ACTs of long bones and followed up for a median of 66 months (interquartile range 50 to 84). All patients were treated with extensive manual curettage and limited burring. Bone cement and grafts were used to fill bone defects in 16 and eight patients, respectively. No chemical adjuvants or cryosurgery were used. RESULTS No local recurrence was detectable on plain radiographs and MRI or CT images. At the last follow-up, there were no distant metastases or disease-specific deaths. No procedure-related complications or postoperative fractures developed. CONCLUSION Intralesional curettage without cryosurgery or chemical adjuvants may provide excellent oncological outcomes for patients with ACTs of long bones, without the risk of complications related to adjuvant use. Our investigation suggests thorough curettage alone is a reasonable treatment option for ACT. However, we acknowledge the limited size of our investigation warrants a multicentre collaborative study to confirm our findings. Cite this article: Bone Joint J 2018;100-B:256-61.
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Affiliation(s)
- W Kim
- Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - J S Lee
- Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
| | - H W Chung
- Asan Medical Center, University of Ulsan College of Medicine , 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea
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Chung HW, So Y, Yang JH, Park KS, Yoo YB, Choi N, Kim MY, Kim J, Lee EJ. Adjunctive Breast-Specific Gamma Imaging for Detecting Cancer in Women with Calcifications at Mammography. Ann Surg Oncol 2017; 24:3541-3548. [PMID: 28819909 DOI: 10.1245/s10434-017-6058-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Mammography detects calcium deposits sensitively, but the specificity for differentiating malignancy from benign calcifications is low. Thus, we investigated whether adjunctive breast-specific gamma imaging (BSGI) has incremental value for detecting cancer in women with suspicious calcifications detected by mammography, and compared BSGI with adjunctive ultrasonography (US). METHODS The medical records of women without a personal history of breast cancer who underwent mammography for breast evaluation from 2009 to 2014 were reviewed retrospectively. Patients who had calcifications detected by mammography, with a result of Breast Imaging Reporting and Data System (BI-RADS) categories 3-5, underwent adjunctive US and BSGI and were included in this study. A total of 302 breast lesions in 266 women (mean age ± standard deviation 49 ± 9 years) were selected for this study. RESULTS For detecting breast cancer using mammography plus BSGI, the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve with 95% confidence intervals were 94% (91-96), 90% (86-93), 91% (87-94), 94% (90-96), and 0.92 (0.89-0.95), respectively. For mammography plus US, the respective values were 97% (94-98), 51% (46-57), 68% (63-73), 94% (90-96), and 0.74 (0.70-0.78). CONCLUSIONS Adjunctive BSGI had higher specificity than adjunctive US without loss of sensitivity. This finding suggests that adjunctive BSGI may be a useful complementary initial imaging method to improve the detection of breast cancer in women who have calcifications with suspicious morphology at mammography.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Jung-Hyun Yang
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Nami Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Mi Young Kim
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Jayoun Kim
- Research Coordinating Center, Konkuk University Medical Center, Seoul, Korea
| | - Eun Jeong Lee
- Department of Nuclear Medicine, Seoul Medical Center, Seoul, Korea.
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22
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Lee WW, So Y, Kang SY, So MK, Kim H, Chung HW, Kim WS, Kim SE. F-18 fluorodeoxyglucose positron emission tomography for differential diagnosis and prognosis prediction of vascular tumors. Oncol Lett 2017; 14:665-672. [PMID: 28693219 PMCID: PMC5494675 DOI: 10.3892/ol.2017.6192] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 03/10/2017] [Indexed: 12/26/2022] Open
Abstract
The spectrum of vascular tumors ranges from hemangioma (HEM), to epithelioid hemangioendothelioma (EHE) and to angiosarcoma (AS). To the best of our knowledge, the usefulness of F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for vascular tumors has never been comprehensively studied. The present study investigated the usefulness of FDG-PET for pathologically diagnosed vascular tumors. The present study included 26 patients with vascular tumor (male:female, 17:9; age, 60.9±14.4 years; 7 HEM, 6 EHE and 13 AS) who underwent FDG-PET between January 2007 and May 2014 at the Seoul National University Bundang Hospital (Seongnam, Korea) and Konkuk University Medical Center, (Seoul, Korea). Representative FDG uptake was measured as the maximum standardized uptake value (SUVmax) over the lesion with the highest FDG uptake. Disease progression was clinically defined as the aggravation of known lesions or novel lesion development during follow-up on computed tomography, magnetic resonance imaging, or FDG-PET. FDG-PET revealed multi-organ involvement only in AS (6/13 [46.2%]), whereas HEM and EHE involved a single organ. Tumor SUVmax was significantly greater in AS (6.32±4.84) compared with EHE (3.10±2.68) and HEM (2.33±0.76) (P=0.0284). There was no difference in tumor SUVmax between HEM and EHE (P>0.05). Disease progression was primarily noticed in AS (9/13 [69.2%]). Only 1 patient with EHE (1/6=16.7%) and no patients with HEM (0/7=0%) experienced disease progression. Mortality was reported only in patients with AS (4/13 [30.8%]). Using the cutoff SUVmax of 3.0, the two-year progression-free survival rate of 14 patients with tumor SUVmax <3.0 (75.0%) was significantly higher compared with that of 12 patients with tumor SUVmax ≥3.0 (0%) (P=0.0053). In conclusion, FDG-PET is useful for the differential diagnosis and prognosis prediction of vascular tumors.
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Affiliation(s)
- Won Woo Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do 13620, Republic of Korea.,Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Seo Young Kang
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do 13620, Republic of Korea
| | - Min-Kyung So
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do 13620, Republic of Korea
| | - Haeryoung Kim
- Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do 13620, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea
| | - Sang Eun Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do 13620, Republic of Korea
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Chung HW, Ko SM, Hwang HK, So Y, Yi JG, Lee EJ. Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Cardiac MRI. Korean J Radiol 2017; 18:476-486. [PMID: 28458600 PMCID: PMC5390617 DOI: 10.3348/kjr.2017.18.3.476] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 09/07/2016] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. Materials and Methods We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. Results For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. Conclusion The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Sung Min Ko
- Department of Radiology, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Hweung Kon Hwang
- Department of Internal Medicine, Division of Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Jeong Geun Yi
- Department of Radiology, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Eun Jeong Lee
- Department of Nuclear Medicine, Seoul Medical Center, Seoul 02053, Korea
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Wan S, Kim CK, Choi YH, Chung HW, Lee CU, Na JP, Jeon HG, Jeong BC, Seo SI, Jeon SS, Choi HY, Lee HM. MP18-04 ROLE OF PI-RADS VERSION 2 FOR PREDICTION OF UPGRADING AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH PROSTATE BIOPSY GLEASON SCORE 6. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wan S, Park BK, Kim CK, Choi YH, Chung HW, Lee CU, Na JP, Jeon HG, Jeong BC, Seo SI, Jeon SS, Choi HY, Lee HM. MP100-07 COMPARISON OF ONCOLOGIC RESULTS, FUNCTIONAL OUTCOMES AND COMPLICATIONS AFTER PARTIAL NEPHRECTOMY VERSUS PERCUTANEOUS RADIOFREQUENCY ABLATION IN SMALL SIZED (4CM OR LESS) BOSNIAK III OR IV CYSTIC RENAL LESIONS. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.3114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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26
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Kim SK, So Y, Chung HW, Yoo YB, Park KS, Hwang TS, Kim B, Lee WW. Analysis of predictability of F-18 fluorodeoxyglucose-PET/CT in the recurrence of papillary thyroid carcinoma. Cancer Med 2016; 5:2756-2762. [PMID: 27539659 PMCID: PMC5083728 DOI: 10.1002/cam4.867] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/22/2016] [Accepted: 07/25/2016] [Indexed: 11/19/2022] Open
Abstract
Whether preoperative F‐18 fluorodeoxyglucose (FDG)‐positron emission tomography/computed tomography (PET/CT) can predict recurrence of papillary thyroid carcinoma (PTC) remains unclear. Herein, we evaluated the potential of primary tumor FDG avidity for the prediction of tumor recurrence in PTC patients. A total of 412 PTC patients (72 males, 340 females; age: 47.2 ± 12.2 years; range: 17–84 years) who underwent FDG‐PET/CT prior to total thyroidectomy (n = 350), subtotal thyroidectomy (n = 2), or lobectomy (n = 60) from 2007 to 2011 were analyzed. The predictive ability for recurrence was investigated among various clinicopathological factors, BRAFV600E mutation, and preoperative FDG avidity of the primary tumor using Kaplan–Meier (univariate) and Cox proportional hazards regression (multivariate) analyses. Of the 412 patients, 19 (4.6%) experienced recurrence, which was confirmed either by pathology (n = 17) or high serum thyroglobulin level (n = 2), during a mean follow‐up period of 43.9 ± 16.6 months. Of the 412 patients, 237 (57.5%) had FDG‐avid tumors (maximum standardized uptake value, 7.1 ± 7.0; range: 1.6–50.5). Kaplan–Meier analysis revealed that tumor size (P = 0.0054), FDG avidity of the tumor (P = 0.0049), extrathyroidal extension (P = 0.0212), and lymph node (LN) stage (P < 0.0001) were significant predictors for recurrence. However, only LN stage remained a significant predictor in the multivariate analysis (P < 0.0001). Patients with FDG‐avid tumors had higher LN stage (P < 0.0001), larger tumor size (P < 0.0001), and more frequent extrathyroidal extension (P < 0.0001). In conclusion, FDG avidity of the primary tumor in preoperative FDG‐PET/CT could not predict the recurrence of PTC. LN stage was the only identified predictor of PTC recurrence.
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Affiliation(s)
- Suk Kyeong Kim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Korea. .,Bioimaging Translational Open Innovation Center, Konkuk University School of Medicine, Seoul, Korea.
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Kyung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, Korea
| | - Tae Sook Hwang
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
| | - Bokyung Kim
- Bioimaging Translational Open Innovation Center, Konkuk University School of Medicine, Seoul, Korea.,Department of Physiology, Konkuk University School of Medicine, Seoul, Korea
| | - Won Woo Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
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Cho MJ, Yang JH, Yu YB, Park KS, Chung HW, So Y, Choi N, Kim MY. Validity of breast-specific gamma imaging for Breast Imaging Reporting and Data System 4 lesions on mammography and/or ultrasound. Ann Surg Treat Res 2016; 90:194-200. [PMID: 27073789 PMCID: PMC4826981 DOI: 10.4174/astr.2016.90.4.194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/24/2015] [Accepted: 01/11/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to assess the breast-specific gamma imaging (BSGI) in Breast Imaging Reporting and Data System (BI-RADS) 4 lesions on mammography and/or ultrasound. Methods We performed a retrospective review of 162 patients who underwent BSGI in BI-RADS 4 lesions on mammography and/or ultrasound. Results Of the 162 breast lesions, 66 were malignant tumors and 96 were benign tumors. Sensitivity and specificity of BSGI were 90.9% and 78.1%, and positive predictive value and negative predictive value were 74.1% and 92.6%. The sensitivity or specificity of mammography and ultrasound were 74.2% and 56.3% and 87.9% and 19.8%, respectively. The sensitivity and specificity of BSGI for breast lesions ≤1 cm were 88.0% and 86.8%, while the values of beast lesions >1 cm were 92.7% and 61.5%. The sensitivity or specificity of BSGI and mammography for patients with dense breasts were 92.0% and 81.3% and 72.0% and 50.0%, respectively. 26 patients showed neither a nodule nor microcalcification on ultrasound, but showed suspicious calcification on mammography. The sensitivity and specificity of BSGI with microcalcification only lesion were 75.0% and 94.4%. Conclusion This study demonstrated that BSGI had shown high sensitivity and specificity, as well as positive and negative predictive values in BI-RADS 4 lesions on ultrasound and/or mammography. BSGI showed excellent results in dense breasts, in lesions that are less than 1 cm in size and lesions with suspicious microcalcification only.
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Affiliation(s)
- Min Jeng Cho
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Jung-Hyun Yang
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yeong Beom Yu
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Nami Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Mi Young Kim
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Lee EJ, Chang SH, Lee TY, Yoon SY, Cheon YK, Shim CS, So Y, Chung HW. Prognostic Value of FDG-PET/CT Total Lesion Glycolysis for Patients with Resectable Distal Bile Duct Adenocarcinoma. Anticancer Res 2015; 35:6985-6991. [PMID: 26637926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM We investigated the prognostic value of clinicopathological factors in patients with a distal bile duct adenocarcinoma after curative resection. PATIENTS AND METHODS This retrospective study included 25 patients who underwent (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) before surgery. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using FDG-PET/CT. FDG-PET/CT parameters and other clinicopathological factors were assessed to evaluate survival. RESULTS Univariate survival analysis showed that high TLG, high MTV, and high SUVmax were significant prognostic predictors for poor overall survival. For progression-free survival, high TLG and large tumor size were significant predictors for a poor prognosis. After multivariate survival analysis, only high TLG was an independent prognostic predictor for poor overall survival (p=0.025). CONCLUSION Preoperative assessment of TLG by FDG-PET/CT might be a useful prognostic predictor in patients with a distal bile duct adenocarcinoma after curative resection.
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Affiliation(s)
- Eun Jeong Lee
- Department of Nuclear Medicine, Seoul Medical Center, Seoul, Republic of Korea
| | - Seong-Hwan Chang
- Department of Surgery, Digestive Disease Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Tae Yoon Lee
- Department of Internal Medicine, Digestive Disease Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - So Young Yoon
- Division of Hematooncology, Department of Internal Medicine, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young Koog Cheon
- Department of Internal Medicine, Digestive Disease Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Chan Sup Shim
- Department of Internal Medicine, Digestive Disease Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
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So Y, Yi JG, Song I, Lee WW, Chung HW, Park JH, Moon SG. Detection of skeletal muscle metastasis: torso FDG PET-CT versus contrast-enhanced chest or abdomen CT. Acta Radiol 2015; 56:860-6. [PMID: 25406434 DOI: 10.1177/0284185114556927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 09/26/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Skeletal muscle metastasis (SMM) in cancer patients has not been sufficiently evaluated regarding prevalence and proper method of detection. PURPOSE To determine the prevalence of SMM and compare the diagnostic competencies for SMM of torso F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) and contrast-enhanced chest or abdomen CT. MATERIAL AND METHODS We investigated 18,225 PET-CT studies of 6359 cancer patients performed from 2005 to 2012. The PET-CT studies describing potential SMM were retrieved and the corresponding medical records were reviewed. The gold standard for SMM was histopathologically-proven SMM or imaging study-based disease progression. The detectability of SMM was compared between PET-CT and contrast-enhanced CT. RESULTS Twenty-six patients had 84 SMM lesions, representing a SMM prevalence of 0.41%. Lung cancer was the most common SMM-associated malignancy (54%) and the gluteal/pelvic girdle muscle was the most frequently involved SMM site (37%). All 84 SMM lesions were visualized on PET-CT (100%). Of these PET-CT positive 84 SMM lesions, 51 lesions were in the CT field of view (FOV) (61%), whereas 33 lesions were out of the CT FOV (39%). Among these 51 lesions, 17 lesions showed rim-enhancing nodules/masses (33%), eight lesions showed homogeneously enhancing nodules (16%), three lesions showed heterogeneously enhancing nodules (6%), and 23 SMM lesions (45%) were non-diagnostic by CT. All 51 SMM lesions within CT FOV were detected on PET-CT (100%), whereas only 28 were visualized on CT (54.9%), resulting in a significant difference (P < 0.005). On average, 2.6 more organs with concomitant metastases were found when SMM was revealed by PET-CT. CONCLUSION The prevalence of SMM was as low as 0.41% in the current large cohort of cancer patients. Torso PET-CT was a more competent modality than contrast-enhanced CT in the detection of SMM.
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Affiliation(s)
- Young So
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jeong Geun Yi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Inyoung Song
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Won Woo Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jeong Hee Park
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sung Gyu Moon
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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Kim HJ, Kang SH, Chung HW, Lee JS, Kim SJ, Yoo KH, Lee KY. Clinical features of lung adenocarcinomas with epidermal growth factor receptor mutations and miliary disseminated carcinomatosis. Thorac Cancer 2015; 6:629-35. [PMID: 26445612 PMCID: PMC4567009 DOI: 10.1111/1759-7714.12234] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/22/2014] [Indexed: 11/28/2022] Open
Abstract
Background We have occasionally encountered advanced lung cancer patients with disseminated carcinomatosis throughout the body and/or within the lung. This study investigated the clinical characteristics and outcomes of advanced lung adenocarcinoma patients with miliary disseminated carcinomatosis. Methods Patients with adenocarcinomas harboring epidermal growth factor receptor (EGFR) mutations who presented with miliary disseminated carcinomatosis (either intrapulmonary or distant site) were enrolled in the study. Clinical characteristics, treatment responses, and survival outcomes were collected from medical records. Results The most frequent EGFR mutation was an in-frame deletion in exon 19 (n = 44, 68.8%). Arginine substitution of leucine 858 in exon 21 and alanine substitution of glycine 719 in exon 18 were detected in 19 patients (29.7%) and one patient (1.6%), respectively. Patients with miliary disseminated carcinomatosis tended to be female and non-smokers. They expressed the E19 deletion more frequently than patients without miliary dissemination and had shorter progression-free survival times in response to EGFR tyrosine kinase inhibitors (9.7 vs. 12.8 months, P = 0.003) and poorer overall survival (15.9 vs. 29.0 months, P = 0.077). Multivariate analyses revealed that metabolic tumor volume correlated with shorter overall survival time. Conclusions Our data indicate that lung adenocarcinoma patients with miliary dissemination have relatively shorter survival times than those without miliary dissemination. The poor prognosis of patients with miliary dissemination may reflect a high tumor burden, as represented by metabolic tumor volume.
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Affiliation(s)
- Hee Joung Kim
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine Seoul, Korea
| | - Seong Hui Kang
- Department of Internal Medicine, Korea University School of Medicine, Guro Hospital Seoul, Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine Seoul, Korea
| | - Jong Sik Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine Seoul, Korea
| | - Sun Jong Kim
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine Seoul, Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine Seoul, Korea
| | - Kye Young Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine Seoul, Korea
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Choi JW, Moon WJ, Choi N, Roh HG, Kim MY, Kim NR, Moon SG, Chung HW, Lim SD, Yang JH. Charcoal-induced granuloma that mimicked a nodal metastasis on ultrasonography and FDG-PET/CT after neck dissection. Korean J Radiol 2015; 16:196-200. [PMID: 25598690 PMCID: PMC4296270 DOI: 10.3348/kjr.2015.16.1.196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/17/2014] [Indexed: 11/20/2022] Open
Abstract
Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.
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Affiliation(s)
- Jin Woo Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Won-Jin Moon
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Nami Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Hong Gee Roh
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Mi Young Kim
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Na Ra Kim
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Sung Gyu Moon
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - So Dug Lim
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
| | - Jung-Hyun Yang
- Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea
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Cho SH, Lim JY, Kim SN, Hong S, Chung HW, So Y, Kim WY, Lee SJ. The prognostic significance of pretreatment [18F]FDG-PET/CT imaging in patients with uterine cervical cancer: preliminary results. EUR J GYNAECOL ONCOL 2015; 36:30-35. [PMID: 25872331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE OF INVESTIGATION To evaluate the prognostic significance of positron emission tomography/computed tomography (PET/CT) in patients diagnosed with cervical cancer. MATERIALS AND METHODS Patients with cervical cancer in FIGO Stages IB1 to IVB were imaged with PET/CT prior to treatment during one of the staging work-ups. The patients were observed for a median of 31.4 months (range, six to 89 months) after the initial treatment. The standardized uptake value (SUV) max of the primary cervical tumor mass was compared with the prognostic factors. RESULTs: A total of 81 patients who were primarily treated with radical hysterectomy (RH, n = 45) or concurrent chemoradiation (CCRT, n = 36) were analyzed. Multivariate analysis indicated that larger tumor size (> 4 cm, OR 8.694, 95% CI, 1.638-46.146), deep stromal invasion (≥ 1 cm, OR 7.249, 95% CI, 1.141-46.039) by the primary tumor, and pathologically confirmed pelvic lymph node involvement (positive, OR 14.586, 95% CI, 2.072-102.674) were significantly associated with recurrence after treatment. However, pretreatment SUVmax was not a significant independent predictor of disease recurrence (OR 1.058, 95% CI, 0.255-4.398). CONCLUSION [18F]Fluorodeoxyglucose (FDG) uptake by the primary tumor showed a significant association with several risk factors that have been identified as treatment predictors. However, a high pretreatment SUVmax was not predictive of recurrence in uter- ine cervical cancer patients.
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Chung HW, Yun CM, Kim JT, Kim SW, Oh J, Huh K. Retinal sensitivity assessed by microperimetry and corresponding retinal structure and thickness in resolved central serous chorioretinopathy. Eye (Lond) 2014; 28:1223-30. [PMID: 25081286 DOI: 10.1038/eye.2014.185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 06/26/2014] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To investigate the relationship between retinal sensitivity (RS) assessed by microperimetry (MP) and retinal structural changes in patients with resolved central serous chorioretinopathy (CSC). METHODS Spectral domain optical coherence tomography (OCT) examination and MP tests were performed in patients with resolved CSC. Point-to-point correlation was performed between RS and corresponding retinal structural changes using Pearson's correlation analysis. In addition, in a 1-mm zone in the central fovea, a correlation was calculated between the mean RS and the mean central retinal thickness (CRT). RESULTS Eighty-four eyes were analyzed. The total number of MP test points was 1092 (84 eyes × 13 points). The mean RS and retinal point thickness (RPT) of all test points were 13.53±3.84 dB and 208.6±48.0 μm, respectively. The RS and RPT were significantly decreased in the test points with loss of the ellipsoid portion of the inner segments (EPIS) (P<0.0001). Within the 1-mm foveal center zone, there was a significant correlation between mean RS and mean CRT (r=0.432, P<0.0001) and between RS and the corresponding RPT (r=0.339, P<0.0001). CONCLUSION RS was dependent on the status of the EPIS in patients with resolved CSC. The correlation between mean RS and mean CRT was compatible with the point-to-point correlation between RS and the corresponding RPT.
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Affiliation(s)
- H W Chung
- Korea University College of Medicine, Seoul, Korea
| | - C M Yun
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - J T Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S-W Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - J Oh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - K Huh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Yoon SY, Kim JH, Kim WS, Chung HW, Lee MH, Kim SY, Cho YH. Pleural Metastasis as Initial Presentation of Occult Gastric Cardia Cancer: A Possible Role of PET-CT in Diagnosis. Cancer Res Treat 2014; 46:415-8. [PMID: 25036578 PMCID: PMC4206069 DOI: 10.4143/crt.2013.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 06/20/2013] [Indexed: 11/21/2022] Open
Abstract
We report on a case of malignant pleural effusion as initial metastatic presentation of occult gastric cardia cancer in a young woman. To the best of our knowledge, this is the first report of gastric adenocarcinoma metastasized to pleura as an initial presentation. Location of cardia and signet ring cell histology may contribute to the manifestation. Utilization of positron emission tomography-computed tomography was helpful for proper diagnosis. For patients with such distinct clinical presentations, it would be appropriate to consider gastric cancer as one of the possible primary sites.
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Affiliation(s)
- So Young Yoon
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Jeong Hwan Kim
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Wan Seop Kim
- Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Mark Hong Lee
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Sung Yong Kim
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yo Han Cho
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Chung HW, Park JW, Lee EJ, Jung KH, Paik JY, Lee KH. 131I-MIBG targeting of neuroblastoma cells is acutely enhanced by KCl stimulation through the calcium/calmodulin-dependent kinase pathway. Cancer Biother Radiopharm 2013; 28:488-93. [PMID: 23763646 DOI: 10.1089/cbr.2012.1353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The efficacy of (131)I-metaiodobenzylguanidine (MIBG) therapy relies on norepinephrine transporter (NET) function. The ionic make-up of the extracellular fluid critically controls neuronal cell activity and can also affect substrate transport. In this study, we explored the effect of treatment with elevated KCl concentration on MIBG uptake in SK-N-SH neuroblastoma cells. KCl stimulation caused a rapid increase of (131)I-MIBG uptake in a manner that was calcium-dependent and accompanied by activation of calcium/calmodulin-dependent protein kinase (CaMK)II. The effect was completely abolished by KN93, an inhibitor of CaMKI, II, and IV. STO609, a selective inhibitor of CaMK kinase required for activation of CaMKI and IV, but not CaMKII, only modestly attenuated the response. The KCl effect was also completely abrogated by ML7, a selective inhibitor of myosin light chain kinase (MLCK). This restricted form of CaMK activates myosin, which is required for vesicle trafficking. Saturation kinetic analysis revealed KCl stimulation to increase maximal transport velocity without affecting substrate affinity. In conclusion, KCl stimulation rapidly upregulates NET function through the CaMK pathway via activation of CaMKII and MLCK. These findings allow a better understanding of how NET function is acutely modulated by the ionic environment, which in turn may ultimately help improve the efficacy of (131)I-MIBG therapy.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul, Korea
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Chung HW, Lee SY, Han HS, Park HS, Yang JH, Lee HH, So Y. Gastric cancers with microsatellite instability exhibit high fluorodeoxyglucose uptake on positron emission tomography. Gastric Cancer 2013; 16:185-92. [PMID: 22692466 DOI: 10.1007/s10120-012-0165-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Accepted: 05/11/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gastric cancers exhibit various degrees of (18)F-fluorodeoxyglucose (FDG) uptakes on positron emission tomography/computed tomography (PET/CT) imaging. The aim of this study was to evaluate whether FDG uptake in gastric cancer varies according to the microsatellite instability (MSI) status. METHODS Consecutive gastric cancer patients who underwent PET/CT imaging and MSI analysis were included in the study. The maximum standardized uptake value (SUVmax) of gastric cancer was assessed using PET/CT imaging. RESULTS Of 131 gastric cancers, 16 exhibited a high incidence of MSI (MSI-H) and 3 exhibited a low incidence of MSI (MSI-L). In 29 subjects who showed no uptake on PET/CT imaging the gastric cancers were all microsatellite stable (MSS). Gastric cancers with MSI were related to age older than 60 years (p = 0.002), cancer volume larger than 10 cm(3) (p = 0.015), and the presence of FDG uptake on PET/CT imaging (p = 0.001). A higher SUVmax of gastric cancer was linked to the presence of MSI (p < 0.001). CONCLUSION The presence of MSI is related to FDG uptake in gastric cancer. Care should be taken with MSS gastric cancers, because they show lower SUVmax on PET/CT imaging than MSI gastric cancers.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Korea
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Park JW, Chung HW, Lee EJ, Jung KH, Paik JY, Lee KH. α2-Adrenergic agonists including xylazine and dexmedetomidine inhibit norepinephrine transporter function in SK-N-SH cells. Neurosci Lett 2013; 541:184-9. [PMID: 23485735 DOI: 10.1016/j.neulet.2013.02.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/14/2013] [Accepted: 02/15/2013] [Indexed: 01/12/2023]
Abstract
α2-Adrenergic agonists simulate norepinephrine (NE) action on α2 receptors of sympathetic neurons to mediate feedback inhibition of NE release. These agents are used as valuable adjuncts for management of hypertension and for anesthesia. Their action, equivalent to NE on α2 adrenergic receptors, raises the question whether α2 agonists may also target NE transporters (NETs), another major control mechanism for noradrenergic neurotransmission. We thus investigated the effect of α2 agonists on transport of the NE analog, (131)I-metaiodobenzylguanidine (MIBG). Results from this investigation showed that xylazine and dexmedetomidine dose-dependently blocked [(3)H]nisoxetine binding in neuron-like SK-N-SH cells. Furthermore, the agents acutely suppressed cellular MIBG uptake in a dose-dependent manner. This effect was uninfluenced by the α2 antagonist yohimbine, but was completely reversed by drug removal. There was no change in membrane NET density by the agents. Moreover, saturation analysis showed that xylazine and dexmedetomidine significantly increased Km without affecting Vmax, indicating competitive inhibition of MIBG transport. Thus, the α2 adrenergic agonists xylazine and dexmedetomidine, acutely suppress NET function through competitive inhibition of substrate transport, likely by direct interaction on a region that over-laps with the nisoxetine binding site.
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Affiliation(s)
- Jin Won Park
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kim JI, Lee YA, Lee JW, Jeong SM, Chung HW, Han JS. Use of ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography in a miniature pig (Sus scrofa domestica) with pneumonia. Comp Med 2012; 62:203-208. [PMID: 22776053 PMCID: PMC3364705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/08/2011] [Accepted: 12/29/2011] [Indexed: 06/01/2023]
Abstract
A 1-y-old male miniature pig housed in our laboratory facility was evaluated for weight loss and rough coat condition. CBC results revealed neutrophilia. Radiography of the thoracic area showed increased opacity throughout the thoracic cavity except for the right caudal lobe. ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) revealed elevated standard uptake values in the area corresponding to the radiologic findings. Follow-up thoracic radiography taken 2 wk after FDG-PET-CT showed several interval changes, including markedly decreased opacity throughout the entire thoracic cavity. Necropsy revealed adhesions between the upper portion of the caudal lobe of the left lung and thoracic wall. ELISA for several closely related infectious species confirmed the presence of antibody to Actinobacillus pleuropneumoniae serovar V.
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Affiliation(s)
- Jong-In Kim
- Departments of Laboratory Animal Medicine & Institute for the 3Rs
| | - Young Ah Lee
- Departments of Laboratory Animal Medicine & Institute for the 3Rs
| | - Jae Won Lee
- Departments of Laboratory Animal Medicine & Institute for the 3Rs
| | - Sang Min Jeong
- Biochemistry and Molecular Cell Biology, College of Veterinary Medicine
| | - Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk Medical Center, Konkuk University, Seoul, Republic of Korea
| | - Jin Soo Han
- Departments of Laboratory Animal Medicine & Institute for the 3Rs
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Chung WJ, Chung HW, Shin MJ, Lee SH, Lee MH, Lee JS, Kim MJ, Lee WK. MRI to differentiate benign from malignant soft-tissue tumours of the extremities: a simplified systematic imaging approach using depth, size and heterogeneity of signal intensity. Br J Radiol 2012; 85:e831-6. [PMID: 22553293 DOI: 10.1259/bjr/27487871] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Differentiating between malignant and benign lesions on the basis of MR images depends on the experience of the radiologist. For non-experts, we aimed to develop a simplified systematic MRI approach that uses depth, size and heterogeneity on T(2) weighted MR images (T(2)WI) to differentiate between malignant and benign lesions, and evaluated its diagnostic accuracy. METHODS MR images of 266 patients with histologically proven soft-tissue tumours of the extremities (102 malignant, 164 benign) were analysed according to depth (superficial or deep), size (<50, ≥50 mm) and signal intensity (homogeneous or heterogeneous) on T(2)WI, to determine the ability of each to predict benign and malignant tumours. These three parameters were categorised into systematic combinations of different orders of application, and each combination was assessed for its ability to differentiate between benign and malignant lesions. RESULTS Univariate analysis showed that depth, size and heterogeneity on T(2)WI differed significantly between benign and malignant masses (p<0.0001 each). Multiple logistic regression analysis, however, showed that depth was not helpful in distinguishing benign from malignant lesions. The systematic combination of signal intensity, size and depth, in that order, was superior to other combinations, resulting in higher diagnostic values for malignancy, with a sensitivity of 64%, a specificity of 85%, a positive predictive value of 32%, a negative predictive value of 59% and an accuracy of 77%. CONCLUSION A simplified systematic imaging approach, in the order signal intensity, size and depth, would be a reference to distinguish between benign and malignant soft-tissue tumours for non-experts.
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Affiliation(s)
- W J Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
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Lee YA, Kim JI, Lee JW, Cho YJ, Lee BH, Chung HW, Park KK, Han JS. Effects of various anesthetic protocols on 18F-flurodeoxyglucose uptake into the brains and hearts of normal miniature pigs (Sus scrofa domestica). J Am Assoc Lab Anim Sci 2012; 51:246-252. [PMID: 22776126 PMCID: PMC3314529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 08/09/2011] [Accepted: 10/17/2011] [Indexed: 06/01/2023]
Abstract
This study used positron emission tomography-computed tomography (PET-CT) to evaluate the effects of 4 anesthetic protocols on 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG) accumulation in the brains and hearts of miniature pigs (Sus scrofa domestica). The 18F-FDG standard uptake value was quantified by dividing the brain into 6 regions: cerebellum, brainstem, and frontal, parietal, temporal, and occipital lobes. Five (2 female and 3 male) clinically normal miniature pigs were premedicated with medetomidine (200 μg/kg IM) after which the following 4 anesthetic protocols were administered by using a crossover design: 1) propofol (4 mg/kg IV)-isoflurane inhalation; 2) propofol (4 mg/kg IV); 3) ketamine (5 mg/kg IV); 4) tiletamine-zolazepam (4.4 mg/kg IM). Compared with levels after other protocols, brain accumulation of 18F-FDG increased during propofol anesthesia but decreased with tiletamine-zolazepam. Relative to that due to other protocols, heart accumulation of 18F-FDG increased with propofol-isoflurane anesthesia but decreased with tiletamine-zolazepam. Comparing glucose accumulation in the brain and heart of miniature pigs by using PET-CT, we found that glucose accumulation varied according to the anesthetic protocol and between the 2 organs. These results can be used to evaluate how different anesthetic agents affect glucose metabolism in brain and heart of miniature pigs. Furthermore, these data should be considered when selecting an anesthetic agent for miniature pigs that will undergo PET-CT imaging with 18F-FDG.
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Affiliation(s)
- Young Ah Lee
- Department of Laboratory Animal Medicine and The Institute for the 3Rs, College of Veterinary Medicine, and
| | - Jong-In Kim
- Department of Laboratory Animal Medicine and The Institute for the 3Rs, College of Veterinary Medicine, and
| | - Jae-Won Lee
- Department of Laboratory Animal Medicine and The Institute for the 3Rs, College of Veterinary Medicine, and
| | - Yoon Ju Cho
- Department of PET Science, Seojeong College University, Gyeonggi-do, Republic of Korea
| | - Byeong Han Lee
- Laboratory of Animal Research, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | | | - Keun-Kyu Park
- Department of Animal Resources Research Center, School of Animal Life and Science, Konkuk University, and
| | - Jin Soo Han
- Department of Laboratory Animal Medicine and The Institute for the 3Rs, College of Veterinary Medicine, and
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Kim YH, Kim JY, Jang SJ, Chung HW, Jang KS, Paik SS, Song SY, Choi YY. F-18 FDG uptake in focal fatty infiltration of liver mimicking hepatic malignancy on PET/CT images. Clin Nucl Med 2012; 36:1146-8. [PMID: 22064098 DOI: 10.1097/rlu.0b013e3182335f60] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Young Hwan Kim
- Department of Nuclear Medicine, Hanyang University Medical Center, Seoul, Korea
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Lai PH, Chang HC, Chuang TC, Chung HW, Li JY, Weng MJ, Fu JH, Wang PC, Li SC, Pan HB. Susceptibility-weighted imaging in patients with pyogenic brain abscesses at 1.5T: characteristics of the abscess capsule. AJNR Am J Neuroradiol 2012; 33:910-4. [PMID: 22282449 DOI: 10.3174/ajnr.a2866] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE SWI is a high-resolution 3D, fully velocity-compensated gradient-echo sequence that uses both magnitude and phase data. The purpose of this study was to investigate the phase behavior of the capsule of pyogenic brain abscesses with noncontrast SWI. MATERIALS AND METHODS Fourteen patients with pyogenic brain abscesses were studied at 1.5T. In all of the patients, SWI images were obtained and reviewed in addition to conventional MR images. Phase values within the abscess capsule were measured and compared with those from the abscess cavities and contralateral normal white matter using 1-way repeated measures ANOVA with post hoc Bonferroni analysis. RESULTS SWI phase images showed mild hypointesity in 6 patients, isointensity in 3 patients, and mixed iso- to mild hypointensity in 5 patients. The means of phase in the cavity, rim of abscesses, and contralateral normal white matter were -7.552 × 10(-3) ± 0.024, -0.105 ± 0.080, and +0.029 ± 0.011 radians, respectively. Post hoc comparisons showed significant differences between any pair of the 3 regions (abscess cavity, rim capsule, and normal white matter) in SWI (all Ps < .005). CONCLUSIONS SWI phase imaging shows evidence of paramagnetic substances in agreement with the presence of free radicals from phagocytosis. SWI may provide additional information valuable in the characterization of pyogenic brain abscesses.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd., Kaohsiung, Taiwan 813, Republic of China.
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Cha JH, Chung HW, Kwon JW, Choi BK, Lee SH, Shin MJ. Longitudinal split of the posterior cruciate ligament: description of a new MR finding and evaluation of its potential clinical significance. Clin Radiol 2011; 66:269-74. [PMID: 21295207 DOI: 10.1016/j.crad.2010.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 11/22/2010] [Accepted: 11/24/2010] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the clinical significance of the intra-substance longitudinal split of the posterior cruciate ligament (LS-PCL) and to evaluate its potential clinical significance on MRI. MATERIALS AND METHODS The databases of two centres were searched for LS-PCL, 6917 knee magnetic resonance imaging (MRI) examinations undertaken were retrospectively reviewed. LS-PCL was defined as increased signal intensity in a PCL in the longitudinal direction, but with an intact ligament outer surface on MRI. Twelve patients were enrolled in this study. Available arthroscopic results, degree of posterior knee instability, and changes in MRI findings, or the degree of instability during follow-up (FU), were reviewed from the patients medical records and via their MRI images. MRI images were reviewed by two musculoskeletal radiologists in consensus for presence and location of LS-PCL and any combined injuries: menisci lesions, ligament injuries, and bone marrow changes. RESULTS Seven of 12 patients (58.3%) had morphological or functional evidence of PCL injury or insufficiency according to the change of posterior instability on FU stress testing (n=3), insufficiency during arthroscopy (n=2), or decreased extent and altered shape of the PCL split on the FU MRI (n=3). One patient revealed both change of posterior instability on FU stress testing and insufficiency during arthroscopy. Combined injuries were revealed in seven patients. Five patients had isolated LS-PCL: two patients underwent arthroscopic PCL reconstructions; and another three patients revealed knee instability on stress testing. CONCLUSION Although LS-PCL has not been described before, it can be a type of partial tear of the PCL, which causes PCL insufficiency.
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Affiliation(s)
- J H Cha
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Cullen JF, Chung HW. Mistaken diagnosis of optic neuritis and the possible role of phosphodiasterase-5 inhibitors (Sildenafil/Viagra). Med J Malaysia 2010; 65:315-316. [PMID: 21901956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The diagnosis of optic neuritis and particularly retrobulbar optic neuritis when atypical and not responsive to corticosteroid treatment may need to be revised. This is now especially so in male patients who should be questioned regarding their taking a phosphodiasterase-5 inhibitor in particular Viagra. The case history of such a patient is presented who sustained posterior ischaemic optic neuropathy mistaken for retrobulbar neuritis resulting in bilateral severe visual loss.
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Affiliation(s)
- J F Cullen
- Neuro-Ophthalmology Service, Singapore National Eye Centre, 11 Third Hospital, Avenue, Singapore 168751.
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Ko SM, Choi JW, Song MG, Shin JK, Chee HK, Chung HW, Kim DH. Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography. Eur Radiol 2010; 21:26-35. [PMID: 20658242 DOI: 10.1007/s00330-010-1897-1] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the feasibility and diagnostic accuracy of adenosine-stress dual-energy computed tomography (DECT) for detecting haemodynamically significant stenosis causing reversible myocardial perfusion defect (PD) compared with stress perfusion magnetic resonance imaging (SP-MRI) and conventional coronary angiography (CCA). METHODS Fifty patients with known coronary artery disease (CAD) detected by dual-source CT (DSCT) were investigated by contrast-enhanced, stress DECT with high- and low-energy x-ray spectra settings during adenosine infusion. A colour-coded iodine map was used for evaluation of myocardial PDs compared with rest DSCT perfusion images. Reversible myocardial PDs according to the stress DECT/rest DSCT were compared with SP-MRI on a segmental basis and CCA on a vascular territorial basis. RESULTS A total of 697 myocardial segments and 123 vascular territories of 41 patients were analysed. Three hundred one segments and 72 vascular territories in 38 patients showed reversible PDs on stress DECT. Stress DECT had 89% sensitivity, 78% specificity and 82% accuracy for detecting segments with reversible PDs seen on SP-MRI (n=28). Compared with CCA (n=41), stress DECT had 89% sensitivity, 76% specificity and 83% accuracy for the detection of vascular territories with reversible myocardial PDs that had haemodynamically relevant CAD. CONCLUSION Adenosine stress DECT can identify stress-induced myocardial PD in patients with CAD.
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Affiliation(s)
- Sung Min Ko
- Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea.
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Schagemann JC, Chung HW, Mrosek EH, Stone JJ, Fitzsimmons JS, O'Driscoll SW, Reinholz GG. Poly-epsilon-caprolactone/gel hybrid scaffolds for cartilage tissue engineering. J Biomed Mater Res A 2010; 93:454-63. [PMID: 19582837 DOI: 10.1002/jbm.a.32521] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of this study was to determine the suitability of hybrid scaffolds composed of naturally derived biopolymer gels and macroporous poly-epsilon-caprolactone (PCL) scaffolds for neocartilage formation in vitro. Rabbit articular chondrocytes were seeded into PCL/HA (1 wt % hyaluronan), PCL/CS (0.5 wt % chitosan), PCL/F (1:3 fibrin sealant plus aprotinin), and PCL/COL1 (0.24% type I collagen) hybrids and cultured statically for up to 50 days. Growth characteristics were evaluated by histological analysis, scanning electron microscopy, and confocal laser scanning microscopy. Neocartilage was quantified using a dimethyl-methylene blue assay for sulfated glycosaminoglycans (sGAG) and an enzyme-linked immunosorbent assay for type II collagen (COL2), normalized to dsDNA content by fluorescent PicoGreen assay. Chondrocytes were homogenously distributed throughout the entire scaffold and exhibited a predominantly spheroidal shape 1 h after being seeded into scaffolds. Immunofluorescence depicted expanding proteoglycan deposition with time. The sGAG per dsDNA increased in all hybrids between days 25 and 50. PCL/HA scaffolds consistently promoted highest yields. In contrast, total sGAG and total COL2 decreased in all hybrids except PCL/CS, which favored increasing values and a significantly higher total COL2 at day 50. Overall, dsDNA content decreased significantly with time, and particularly between days 3 and 6. The PCL/HA hybrid displayed two proliferation peaks at days 3 and 25, and PCL/COL1 displayed one proliferation peak at day 12. The developed hybrids provided distinct short-term environments for implanted chondrocytes, with not all of them being explicitly beneficial (PCL/F, PCL/COL1). The PCL/HA and PCL/CS hybrids, however, promoted specific neocartilage formation and initial cell retention and are thus promising for cartilage tissue engineering.
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Affiliation(s)
- J C Schagemann
- Cartilage and Connective Tissue Research Laboratory, Department of Orthopedic Research, Mayo Clinic College of Medicine, Rochester, Minnesota
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Abstract
An 8-year-old Shih Tzu developed abdominal pain and hyperglobulinemia. A round splenic mass was noted radiographically and sonographically. The patient was evaluated by fluorodeoxyglucose positron emission tomography coupled with computed tomography (FDG-PET/CT). There was no evidence of metastasis or bone marrow involvement on PET/CT images. The standardized uptake value (SUV) of the splenic mass was increased over the reference range (SUV = 4.83). The patient was diagnosed as splenic extramedullary plasmacytoma through immunohistopathologic study. After the splenectomy, the globulin level normalized and the patient is alive without complications.
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Affiliation(s)
- Ah Ra Lee
- Department of Veterinary Radiology and Diagnostic Imaging, College of Veterinary Medicine, Konkuk University 1, Hwayang-dong, Kwangjin-ku, Seoul 143-701, Korea
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Chung HW, Lee EJ, Cho YH, Yoon SY, So Y, Kim SY, Lee MH, Kim JH, Lee SY, Sung IK, Park HS, Yoo MW, Lee KY. High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma. J Cancer Res Clin Oncol 2010; 136:1929-35. [PMID: 20306088 DOI: 10.1007/s00432-010-0852-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Accepted: 02/17/2010] [Indexed: 12/20/2022]
Abstract
PURPOSE We evaluated the role of FDG-PET/CT in patients with metastatic gastric adenocarcinoma before palliative chemotherapy to predict prognosis and chemotherapeutic response. METHODS The study included 35 consecutive newly diagnosed patients with metastatic gastric adenocarcinoma who underwent FDG-PET/CT before palliative chemotherapy. Maximum standardized uptake value (SUVmax) of the primary tumor was assessed to evaluate survival and chemotherapeutic response. Survival analysis was performed for time to progression and overall survival using the Kaplan-Meier method. Cox proportional hazard models were used to determine independent prognostic factors. RESULTS All primary tumors were visualized using FDG-PET/CT (mean SUVmax = 8.1 ± 4.5, range 2.5-22.1). Sensitivity, specificity, and accuracy of FDG-PET/CT in detection of solid organ metastasis were 95.2% (20/21), 100% (14/14), and 97.1% (34/35), respectively. No significant difference of primary tumor SUVmax was found among the chemotherapeutic response groups. Univariate survival analysis demonstrated ECOG performance status (≥2), presence of solid organ metastasis, number of organs involved in distant metastasis (≥2), and SUVmax of the primary tumor (>8) as significant predictors for poor overall survival. Multivariate survival analysis showed SUVmax of the primary tumor (P = 0.048), presence of solid organ metastasis (P = 0.015), and ECOG performance status (P = 0.002) as significant independent prognostic predictors for overall survival. CONCLUSIONS High FDG uptake of the primary tumor in patients with metastatic gastric adenocarcinoma is associated with poor overall survival. Assessment of tumor FDG uptake has limited value for prediction of chemotherapeutic response, but provides useful information regarding prognosis.
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Affiliation(s)
- Hyun Woo Chung
- Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 4-12 Hwayang-dong, Kwangjin-gu, Seoul, Korea.
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Lim JM, Lee JS, Chung HW, Bahng HW, Yamaguchi K, Toganoh M, Furuta H, Kim D. Photophysical properties of N-confused hexaphyrins: effects of confusion of pyrrole rings and molecular shape on electronic structures. Chem Commun (Camb) 2010; 46:4357-9. [DOI: 10.1039/c0cc00001a] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Yoon SY, Kim SY, Cho YH, Chung HW, So Y, Lee HM. Hepatic metastases of gastric adenocarcinoma showing metabolic remission on FDG-PET despite an increase in size on CT. Cancer Res Treat 2009; 41:100-3. [PMID: 19707508 DOI: 10.4143/crt.2009.41.2.100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 04/23/2009] [Indexed: 12/29/2022] Open
Abstract
We report a gastric adenocarcinoma patient with liver metastases. The metastases showed progression on computed tomography (CT), but this was not true progression in terms of metabolic activity according to (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). Discordance between size criteria and metabolic criteria has been reported in liver gastrointestinal stromal tumors, hepatomas, and renal cell carcinomas after dramatic responses with targeted therapies such as imatinib, sorafenib, and sunitinib (1-6). However, this discordance has been rarely reported in liver metastases of gastric adenocarcinoma when treated with conventional chemotherapy.
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Affiliation(s)
- So Young Yoon
- Department of Hematooncology, Konkuk University Medical Center, Seoul, Korea.
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