18F-FDG PET/CT Findings of Scrub Typhus

Kim, Jahae,Kwon, Seong Young,Kang, Sae-Ryung,Cho, Sang-Geon,Song, Ho-Chun Lippincott 2015 Clinical nuclear medicine Vol.40 No.10

ABSTRACT: Scrub typhus is an acute infectious disease caused by Orienta tsutsugamushi, which is clinically manifested by fever, generalized lymphadenopathy, diffuse myalgia, headache, maculopapular rash, and eschars at the site of chigger feedings. Diagnosis of scrub typhus requires compatible clinical features, history of exposure, and result of selorogic testing. In recent years, F-FDG PET/CT is seen as having increasing potential for use in examination and management of patients with infectious or inflammatory disorders. This is a PET/CT case demonstrating scrub typhus in a patient without evidence of recurrence of thyroid papillary cancer.

Prognostic Significance of Metabolic Tumor Volume Measured by $^{18}F$-FDG PET/CT in Operable Primary Breast Cancer

Kim, Jahae,Yoo, Su Woong,Kang, Sae-Ryung,Cho, Sang-Geon,Oh, Jong-Ryool,Chong, Ari,Min, Jung-Joon,Bom, Hee-Seung,Yoon, Jung-Han,Song, Ho-Chun The Korea Society of Nuclear Medicine 2012 핵의학 분자영상 Vol.46 No.4

Purpose We investigated whether PET indices measured by $^{18}F$-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can predict prognosis in patients with operable primary breast cancer. Methods We reviewed 53 patients with operable primary breast cancer who underwent pretreatment FDG PET/CT. PET indices, maximum standardized uptake value (SUV) and metabolic tumor volume (MTV), were measured in the primary breast tumor (P), metastatic lymph nodes (N) and total tumor (T). The Cox proportional hazards model was used with age, tumor size, clinical lymph node status, method of surgery, presence or absence of neoadjuvant chemotherapy, histological type, histological grade, hormone receptors and HER2 status to predict disease-free survival (DFS) and overall survival (OS). Results Median follow-up period was 50 months (range, 17-73 months), during which 17 patients had recurrent disease and nine of whom died. The univariate analysis showed that high SUV of N ($N_{SUV}$, P=0.011), MTV of N ($N_{MTV}$, P=0.011) and MTV of T ($T_{MTV}$, P=0.045) as well as high histological grade (P=0.008), negative estrogen (P=0.045) and negative progesterone (P=0.029) receptor status were associated with shorter DFS. High $N_{SUV}$ (P=0.035), $N_{MTV}$ (P=0.035) and $T_{MTV}$ (P=0.035) as well as high histological grade (P=0.012) and negative estrogen receptor status (P=0.009)were associated with shorter OS. $N_{SUV}$, $N_{MTV}$ and $T_{MTV}$ were found to be significantly associated with high histological grade (P=0.005). However, those failed to be statistically significant prognostic factors on multivariate analysis. Conclusions PET indices seem to be useful in the preoperative evaluation of prognosis in patients with operable primary breast cancer. $N_{SUV}$, $N_{MTV}$ and $T_{MTV}$ might be considerable factors associated with patient outcome in operable breast cancer.

18F-FDG PET/CT imaging factors that predict ischaemic stroke in cancer patients

Kim, Jahae,Choi, Kang-Ho,Song, Ho-Chun,Kim, Joon-Tae,Park, Man-Seok,Cho, Ki-Hyun Springer-Verlag 2016 European Journal of Nuclear Medicine and Molecular Vol.43 No.12

Clinical implication of F-18 FDG PET/CT in patients with secondary hemophagocytic lymphohistiocytosis

Kim, Jahae,Yoo, Su Woong,Kang, Sae-Ryung,Bom, Hee-Seung,Song, Ho-Chun,Min, Jung-Joon Springer-Verlag 2014 Annals of hematology Vol.93 No.4

Metabolic Tumor Volume Measured by F-18 FDG PET/CT can Further Stratify the Prognosis of Patients with Stage IV Non-Small Cell Lung Cancer

Yoo, Su Woong,Kim, Jahae,Chong, Ari,Kwon, Seong-Young,Min, Jung-Joon,Song, Ho-Chun,Bom, Hee-Seung The Korea Society of Nuclear Medicine 2012 핵의학 분자영상 Vol.46 No.4

Purpose This study aimed to further stratify prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Materials and Methods The subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F-18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were measured by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival curves were used for evaluation of progression-free survival (PFS). The univariate and multivariate Cox proportional hazards models were used to select the significant prognostic factors. Results Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV-lung and TLG-lung) were significant factors for prediction of PFS (P<0.001, P=0.038, respectively). Patients showing lower values of MTV-lung and TLG-lung than the cutoff values had significantly longer mean PFS than those with higher values. Hazard ratios (95 % confidence interval) of MTV-lung and TLG-lung measured by univariate analysis were 6.4 (2.5-16.3) and 2.4 (1.0-5.5), respectively. Multivariate analysis revealed that MTV-lung was the only significant factor for prediction of prognosis. Hazard ratio was 13.5 (1.6-111.1, P=0.016). Conclusion Patients with stage IV NSCLC could be further stratified into subgroups of significantly better and worse prognosis by MTVof primary lung lesion.

Brain Metastases Mimicking Hyperostosis Frontalis Interna on 99mTc HDP Bone Scintigraphy

Kang, Sae-Ryung,Kim, Jahae,Kwon, Seong Young,Min, Jung-Joon,Bom, Hee-Seung,Sohn, Myung-Hee,Song, Ho-Chun Wolters Kluwer Health, Inc. All rights reserved. 2016 Clinical nuclear medicine Vol.41 No.10

<P>Symmetric bifrontal uptake of bone-seeking agents is usually considered as the main feature of hyperostosis frontalis interna in postmenopausal elderly women. This finding is not uncommon in elderly women because of the change in their hormonal level. However, in the present case, a 66-year-old woman with intra-axial brain metastases of breast cancer showed symmetric bifrontal uptake on bone scintigraphy. Therefore, symmetric bifrontal uptake should not always be considered as a definite indicator of hyperostosis frontalis interna. Further evaluation such as SPECT/CT is needed for evaluation of brain metastases especially in cancer patients.</P>

Applying Pix2pix to Translate Hyperemia in Blood Pool Image into Corresponding Increased Bone Uptake in Delayed Image in Three-Phase Bone Scintigraphy

박기성,Jang Bae Moon,Sang‑Geon Cho,Jahae Kim,Ho‑Chun Song 대한핵의학회 2023 핵의학 분자영상 Vol.57 No.2

Purpose Delayed images may not be acquired due to severe pain, drowsiness, or worsening vital signs while waiting afterblood pool imaging in three-phase bone scintigraphy. If the hyperemia in the blood pool image contains information fromwhich increased uptake on the delayed images can be inferred, the generative adversarial network (GAN) can generate theincreased uptake from the hyperemia. We attempted to apply pix2pix, a type of conditional GAN, to transform hyperemiainto increased bone uptake. Methods We enrolled 1464 patients who underwent three-phase bone scintigraphy for inflammatory arthritis, osteomyelitis,complex regional pain syndrome (CRPS), cellulitis, and recent bone injury. Blood pool images were acquired 10 minafter intravenous injection of Tc-99 m hydroxymethylene diphosphonate, and delayed bone images were obtained after 3 h. The model was based on the open-source code of the pix2pix model with perceptual loss. Increased uptake in the delayedimages generated by the model was evaluated using lesion-based analysis by a nuclear radiologist in areas consistent withhyperemia in the blood pool images. Results The model showed sensitivities of 77.8% and 87.5% for inflammatory arthritis and CRPS, respectively. In osteomyelitisand cellulitis, their sensitivities of about 44% were observed. However, in cases of recent bone injury, the sensitivitywas only 6.3% in areas consistent with focal hyperemia. Conclusion The model based on pix2pix generated increased uptake in delayed images matching the hyperemia in the bloodpool image in inflammatory arthritis and CRPS.

Tc-99m DMSA SPECT for Follow-Up of Non-Operative Treatments in Renal Injuries: A Prospective Single-Center Study

Cho Sang-Geon,Park Ki Seong,Kim Jahae,Moon Jang Bae,Song Ho-Chun,Kang Taek Won,Yu Seong Hyeon 대한영상의학회 2023 Korean Journal of Radiology Vol.24 No.10

Objective: The assessment of cortical integrity following renal injuries with planar Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy depends on measuring relatively decreased cortical uptake (i.e., split renal function [SRF]). We analyzed the additive values of the volumetric and quantitative analyses of the residual cortical integrity using single-photon emission computed tomography (SPECT) compared to the planar scintigraphy. Materials and Methods: This prospective study included 47 patients (male:female, 32:15; age, 47 ± 22 years) who had nonoperatively managed renal injuries and underwent DMSA planar and SPECT imaging 3–6 months after the index injury. In addition to planar SRF, SPECT SRF, cortical volume, and absolute cortical uptake were measured for the injured kidney and both kidneys together. The correlations of planar SRF with SPECT SRF and those of SRF with volumetric/quantitative parameters obtained with SPECT were analyzed. The association of SPECT parameters with renal function, grades of renal injuries, and the risk of renal failure was also analyzed. Results: SPECT SRF was significantly lower than planar SRF, with particularly higher biases in severe renal injuries. Planar and SPECT SRF (dichotomized with a cutoff of 45%) showed 19%–36% of discrepancies with volumetric and quantitative DMSA indices (when dichotomized as either high or low). Absolute cortical uptake of the injured kidney best correlated with glomerular filtration rate (GFR) at follow-up (ρ = 0.687, P < 0.001) with significant stepwise decreases by GFR strata (90 and 60 mL/min/1.73 m2). Total renal cortical uptake was significantly lower in patients with moderate-to-high risk of renal failure than those with low risk. However, SRF did not reflect GFR decrease below 60 mL/min/1.73 m2 or the risk of renal failure, regardless of planar or SPECT (count- or volume-based SRF) imaging. Conclusion: Quantitative measurements of renal cortical integrity assessed with DMSA SPECT can provide more clinically relevant and comprehensive information than planar imaging or SRF alone.

Poster Session : PS 0022 ; Cardiology : Cardioprotective Effect of Fimasartan, A New Angiotensin Receptor Blocker, In a Porcine Model of Acute Myocardial Infarction

( Doo Sun SIM ),( Myung Ho JEONG ),( Ho Chun SONG ),( Jahae KIM ),( Hee Seung BOM ),( In Seok JEONG ),( Sang Gi OH ),( Sang Hyung KIM ),( Dae Sung PARK ),( Jung Ha KIM ),( Kyung Seob LIM ),( Min Suk K 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: The present study evaluated cardiop rotective effect of fi masartan, a new angiotensin receptor blocker (ARB), in a porcine model of acute myocardial infarction (MI). Methods: Fifty swine were randomized to group 1 (sham operation, n = 10), group 2 (no angiotensin-converting enzyme inhibitor (ACEI) or ARB, n = 10), group 3 (perindopril 2 mg daily, n = 10), group 4 (valsartan 40 mg daily, n = 10), or group 5 (fi masartan 30 mg daily, n = 10). Study medications were started orally after induction of acute MI by occlusion of the left anterior descending artery for 50 minutes and the dosage of medications was doubled at 2 weeks. Echocardiography, single photon emission computed tomography (SPECT) with technetium-99m sestamibi, and F-18 fl uorodeoxyglucose cardiac positron emission tomography (PET) were performed at baseline, 1 week, and 4 weeks to assess left ventricular (LV) function, infarct size, and viability. Iodine-123 meta-iodobenzylguanidine (MIBG) scan was done at 6 weeks for visualization of cardiac sympathetic activity. Results: No difference was observed in SPECT perfusion defect, matched and mismatched segments between SPECT and PET across the groups at baseline, 1 week, and 4 weeks. MIBG scan showed similar uptake without difference in washout rate. On echocardiography, LV ejection fraction was lower in groups 2 to 5, compared to group 1 at 1 week but not different at 4 weeks. Pathologic analysis showed similar infarct size in groups 2 to 5. Conclusions: Infarct size reduction was not observed with use of fi masartan as well as other ACEI and ARB in a porcine model of acute MI.

Open-Mouth Bone Scintigraphy Is Better than Closed-Mouth Bone Scintigraphy in the Diagnosis of Temporomandibular Osteoarthritis

Park, Ki Seong,Song, Ho-Chun,Cho, Sang-Geon,Kang, Sae-Ryung,Kim, Jahae,Jun, Haeng Man,Song, Minchul,Jeong, Geum-Cheol,Park, Hee Jeong,Kwon, Seong Young,Min, Jung-Joon,Bom, Henry Hee-Seung The Korea Society of Nuclear Medicine 2016 핵의학 분자영상 Vol.50 No.3

Purpose Closed-mouth bone scintigraphy (CM scan) and closed-mouth single-photon emission computed tomography (CM SPECT) are used for conventional evaluation of osteoarthritis of the temporomandibular joint (TMJ). However, the adequacy of open-mouth bone scintigraphy (OM scan) has not yet been evaluated. Therefore, the purpose of this study was to compare the diagnostic performance of CM scan, CM SPECT, and OM scan. Methods Thirty-six patients with suspicion of an abnormality of the TMJ and who underwent a $^{99m}Tc-HDP$ CM scan, CM SPECT, and an OM scan were enrolled. The scans were assessed visually for the presence of positive focal uptake in the TMJ. Osteoarthritis was defined as arthralgia plus crepitus or radiologic signs of arthrosis. Results Of 72 TMJs, 21 (29.2 %) were diagnosed with osteoarthritis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.5 %, 49.0 %, 42.2 %, 92.6 % and 61.1 % for the CM scan, 81.0 %, 58.8 %, 44.7 %, 88.2 % and 65.3 % for CM SPECT, and 81.0 %, 82.4 %, 65.4 %, 91.3 % and 81.9 % for the OM scan, respectively. The accuracy of the OM scan was higher than that of CM SPECT and the CM scans (p = 0.004 and p < 0.001, respectively). Conclusions The OM scan was more accurate than the conventional CM scan and even CM SPECT for diagnosing TMJ osteoarthritis.