Publications (21)50.78 Total impact
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Article: Estimation of true serum thyroglobulin concentration using simultaneous measurement of serum antithyroglobulin antibody.
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ABSTRACT: We investigated the analytical interference of antithyroglobulin antibody (TgAb) to thyroglobulin (Tg) measurement and tried to convert measured Tg concentration to true Tg concentration using a mathematical equation which includes a concentration of TgAb. Methods. Tg was measured by immunoradiometric assay and TgAb by radioimmunoassy. Experimental samples were produced by mixing Tg and TgAb standard solutions or mixing patients' serum with high Tg or high TgAb. Mathematical equations for prediction of expected Tg concentration with measured Tg and TgAb concentrations were deduced. The Tg concentration calculated using the equations was compared with the expected Tg concentration. Results. Measured Tg concentrations of samples having high TgAb were significantly lower than their expected Tg concentration. Magnitude of TgAb interference with the Tg assay showed a positive correlation with concentration of TgAb. Mathematical equations for estimation of expected Tg concentration using measured Tg and TgAb concentrations were successfully deduced and the calculated Tg concentration showed excellent correlation with expected Tg concentration. Conclusions. A mathematic equation for estimation of true Tg concentration using measured Tg and TgAb concentration was deduced. Tg concentration calculated by use of the equation might be more valuable than measured Tg concentration in patients with differentiated thyroid cancer.International Journal of Endocrinology 01/2013; 2013:210639. · 1.87 Impact Factor -
Article: Salivary Gland Function Five Years after a Radioiodine Ablation in Patients with Differentiated Thyroid Cancer: Direct Comparison of Pre and Post-Ablation Scintigraphies and Their Relation to Xerostomia Symptoms.
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ABSTRACT: Background Chronic sialadenitis is one of the most frequent chronic complications after radioiodine (RAI) therapy for thyroid cancer. To evaluate the long-term effects of RAI ablation on salivary gland function, we investigated scintigraphic changes in salivary glands by direct comparison of two salivary gland scintigraphies (SGS) taken before and at 5 yrs after a RAI ablation. Methods SGS was performed just before RIA (pre-SGS) and approximately 5 years after RAI ablation (F/U SGS) in 213 subjects who underwent thyroidectomy for thyroid cancer. The uptake score (US) was graded, and the ejection fraction (EF) was quantified for the parotid and submandibular glands at pre-SGS and F/U SGS. Changes in salivary gland function were graded as mild, moderate, or severe according to the differences in US and EF between the two SGS. Xerostomia were assessed and compared with the SGS findings. Results Worsening of the US was observed in 182 of 852 salivary glands (total: 21.3%; mild: 4.2%, moderate: 7.4%, severe: 9.7%), and 47.4% of the patients showed a worsening US for at least 1 of 4 salivary glands. A decrease in EF was observed in 173 of 852 salivary glands (total: 20.3%; mild: 5.4%, moderate: 6.8%, severe: 8.1%), and 43.7% of the patients experienced a decrease in the EF of at least 1 of the 4 salivary glands. Bilateral parotid gland dysfunction was the most commonly observed condition. Thirty-five (16.4%) patients complained of xerostomia at 5 years after RAI ablation. Scintigraphic changes in salivary gland function and xerostomia were more common in patients receiving 5.55 GBq, compared with 3.7 GBq. Xerostomia were more common in patients with submandibular gland dysfunction than those with parotid gland dysfunction (68.8% vs. 33.3%, P<0.05). The number of dysfunctional salivary glands was correlated with xerostomia (P<0.01). Conclusion About 20% of the salivary glands were dysfunctional on SGS at 5 years after a single RAI ablation, especially in patients who received higher doses of radioiodine. While parotid glands are more susceptible to I-131 related damage, xerostomia was more associated with submandibular gland dysfunction and the prevalence of dysfunctional salivary glands.Thyroid: official journal of the American Thyroid Association 11/2012; · 2.60 Impact Factor -
Article: 18F-FDG Uptake by Metastatic Axillary Lymph Nodes on Pretreatment PET/CT as a Prognostic Factor for Recurrence in Patients with Invasive Ductal Breast Cancer.
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ABSTRACT: This study assessed the maximum standardized uptake value of metastatic axillary lymph nodes in patients with invasive ductal breast cancer (IDC) to determine the pretreatment prognostic value of (18)F-FDG PET/CT for disease-free survival (DFS). Sixty-five female IDC patients who had undergone pretreatment (18)F-FDG PET/CT and had pathologically confirmed axillary lymph node involvement without distant metastasis were enrolled. All patients showed complete remission after first-line treatment. To obtain nodal SUVmax, a transaxial image representing the highest (18)F-FDG uptake was carefully selected and a region of interest was manually drawn on the (18)F-FDG-accumulating lesion. Clinicopathologic parameters such as age, TNM stage, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, and primary-tumor and nodal SUVmax on PET were analyzed for their usefulness in predicting recurrence. Combinatorial effects and interactions between variables that were significant by univariate analysis were examined using multivariate Cox proportional-hazards models. Twelve of 65 patients (18.5%) experienced recurrence during follow-up (median follow-up, 36 mo; range, 21-57 mo). Nodal SUVmax was significantly higher in patients with recurrence than in those who were disease-free (recurrence group: 5.2 ± 2.3, vs. disease-free group: 1.9 ± 1.9, P < 0.0001). A receiver-operating-characteristic curve demonstrated a nodal SUVmax of 2.8 (sensitivity, 91.7%; specificity, 86.8%; area under the curve, 0.890) to be the optimal cutoff for predicting DFS. Univariate analysis revealed that T stage, N stage, estrogen receptor status, and primary-tumor and nodal SUVmax correlated significantly with DFS. Among these 5 variables, only nodal SUVmax was found to be a single determinant of DFS by multivariate analysis (hazard ratio, 31.54; 95% confidence interval, 2.66-373.39; P = 0.0065). Nodal SUVmax on pretreatment (18)F-FDG PET/CT may be an independent prognostic factor for disease recurrence in patients with IDC.Journal of Nuclear Medicine 06/2012; 53(9):1337-44. · 6.38 Impact Factor -
Article: Prognostic Value of Primary Tumor Uptake on F-18 FDG PET/CT in Patients with Invasive Ductal Breast Cancer
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ABSTRACT: PurposeTo determine the prognostic implications of pretreatment F-18 FDG PET/CT in patients with invasive ductal breast cancer (IDC), we evaluated the relationship between FDG uptake of the primary tumor and known prognostic parameters of breast cancer. Prognostic significance of tumoral FDG uptake for the prediction of progression-free survival (PFS) was also assessed. Materials and MethodsFifty-five female patients with IDC who underwent pretreatment F-18 FDG PET/CT were enrolled. The maximum standardized uptake value of the primary tumor (pSUVmax) was compared with clinicopathological parameters including tumor size, grade, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor2 (HER2), axillary lymph node (LN) metastasis, and stage. The prognostic value of pSUVmax for PFS was assessed using the Kaplan-Meier method. ResultsA high pSUVmax was significantly related to a higher stage of tumor size (P < 0.05), grade (P < 0.001), and stage (P < 0.001). pSUVmax was significantly higher in ER-negative tumors (P < 0.001), PR-negative tumors (P < 0.001), and positive LN metastasis (P < 0.01), but not different according to HER2 status. pSUVmax was significantly higher in patients with progression compared to patients who were disease-free (10.6 ± 5.1 vs. 4.7 ± 3.5, P < 0.001). A receiver-operating characteristic curve demonstrated a pSUVmax of 6.6 to be the optimal cutoff for predicting PFS (sensitivity; 86.7%, specificity; 82.5%). The patients with a high pSUVmax (more than 6.6) had significantly shorter PFS compared to patients with a low pSUVmax (P < 0.0001). ConclusionspSUVmax on pretreatment F-18 FDG PET/CT could be used as a good surrogate marker for the prediction of progression in patients with IDC. KeywordsF-18 FDG PET/CT–Invasive ductal breast cancer–SUVmax–Prognosis04/2012; 45(2):117-124. -
Article: F-18 FDG PET Images of the Cervix at Various Time Points after the Loop Electrosurgical Excision Procedure
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ABSTRACT: F-18 FDG PET is useful for monitoring residual or recurrent tumors after surgical resection. We describe five F-18 FDG PET images of three patients who had cervical carcinoma and then underwent a loop electrosurgical excision procedure (LEEP). Two of the images were taken within 15days and three at least 2months after LEEP. The earlier F-18 FDG PET images revealed linear hypermetabolic lesions in the cervix that were produced by inflammation. This was confirmed by pathological analysis. The later F-18 FDG PET images did not reveal any remarkable hypermetabolism in the cervix without any treatment. These observations suggest that, to determine the response to LEEP therapy, F-18 FDG PET should not be performed within 15days of the procedure. KeywordsLoop electrosurgical excision procedure-Cervical carcinoma-F-18 FDG PET04/2012; 44(1):82-86. -
Article: False-Positive Axillary Lymph Node on F-18 FDG PET/CT due to Moxibustion Therapy
04/2012; 44(4):307-308. -
Article: Radiation Sialadenitis Induced by High-dose Radioactive Iodine Therapy
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ABSTRACT: Radioactive iodine (131I) is accumulated in the thyroid tissue and plays an important role in the treatment of differentiated papillary and follicular cancers after thyroidectomy. Simultaneously, 131I is concentrated in the salivary glands and secreted into the saliva. Dose-related damage to the salivary parenchyma results from the 131I irradiation. Salivary gland swelling and pain, usually involving the parotid, can be seen. The symptoms may develop immediately after a therapeutic dose of 131I and/or months later and progress in intensity with time. In conjunction with the radiation sialadenitis, secondary complications reported include xerostomia, taste alterations, infection, increases in caries, facial nerve involvement, candidiasis, and neoplasia. Prevention of 131I sialadenitis may involve the use of sialogogic agents to hasten the transit time of the radioactive iodine through the salivary glands. However, studies are not available to delineate the efficacy of this approach. Treatment of the varied complications that may develop encompass numerous approaches and include gland massage, sialogogic agents, duct probing, antibiotics, mouthwashes, good oral hygiene, and adequate hydration. Recently interventional sialoendoscopy has been introduced an effective tool for the management of patients with 131I-induced sialadenitis that is unresponsive to medical treatment. KeywordsSalivary gland-Radioiodine04/2012; 44(2):102-109. -
Article: Improved Detection of Lung or Bone Metastases with an I-131 Whole Body Scan on the 7th Day After High-Dose I-131 Therapy in Patients with Thyroid Cancer
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ABSTRACT: PurposeThe purpose of this study is to compare post-therapy third day and seventh day I-131 whole body scans (3DWBS and 7DWBS) in detecting lung or bone metastasis from well-differentiated thyroid cancer. Materials and MethodsWe enrolled 52 patients with lung or bone metastasis out of 1,152 patients who were treated with high-dose I-131 therapy from January 2008 to June 2009. All patients underwent 3DWBS and 7DWBS. I-131 avidity was classified into three grades: no uptake, suspicious for uptake, and definite uptake. We compared the presence and grades of metastatic lesions on each scan. We categorized all cases into three groups based on I-131 uptake on each scan and compared several clinical parameters including FDG uptake and thyroglobulin (Tg) level among the groups. ResultsSixty metastatic cases from 52 patients (45 lung and 15 bone metastases) were included. In 35 cases, I-131-avid metastatic lesions were detected by both 3DWBS and 7DWBS (group A). In 15 cases, metastatic lesions were missed on 3DWBS but detected on 7DWBS (group B). In 10 cases, I-131 uptake was not detected on either 3DWBS or 7DWBS (group C). Ten of 45 cases (22.2%) of lung metastasis that were negative on 3DWBS were detected on 7DWBS (p = 0.002). Five of 15 cases (33.3%) of bone metastasis that were negative on 3DWBS were detected on 7DWBS (p = 0.0625). The serum Tg level (TSH stimulated) was significantly different among groups A, B, and C (p = 0.0030). However, after exclusion of cases without a history of I-131 therapy, there was no significant difference in serum Tg level among the groups (p = 0.2330). The number of cases with a prior history of metastasis was higher in group A than in group B (p = 0.0069). However, there was no significant difference in prior history of metastasis between groups A and C (p = 0.8107). Conclusion7DWBS showed more lung or bone metastatic lesions than 3DWBS. After high-dose I-131 therapy, 7DWBS should be considered regardless of the results of the 3DWBS for the diagnosis of lung or bone metastasis from well-differentiated thyroid cancer. KeywordsThyroid cancer-Distant metastasis-I-131-Post-therapy scan-Scan time04/2012; 44(4):273-281. -
Article: Neurolymphomatosis on F-18 FDG PET/CT and MRI Findings: A Case Report
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ABSTRACT: Neurolymphomatosis is a rare manifestation of malignant lymphoma. A 74-year-old man, in complete remission from diffuse large B cell lymphoma, presented with a loss of pain and temperature sensation in the left hemiface and left upper extremity, and motor weakness in the left upper and both lower extremities. Cerebrospinal fluid analysis and brain magnetic resonance imaging (MRI) findings were negative. Combined fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) revealed multiple linear hypermetabolic lesions along the mandibular branch of the left trigeminal nerve, left brachial plexus, right axillary nerve, right suprarenal plexus, right adrenal gland, right femoral nerve, and both sciatic nerves, which corresponded to the patient’s complex neurologic symptoms. C-spine and pelvic MRI revealed diffuse thickening with enhancement in the left brachial plexus and in the proximal portion of the left sciatic nerve, but negative findings for other sites identified by FDG-PET/CT. These findings suggest that FDG-PET/CT can detect peripheral nerve infiltration by malignant lymphoma earlier than MRI. Thus, if a patient with a history of lymphoma presents with neurologic symptoms, FDG-PET/CT should be performed to evaluate neurolymphomatosis. KeywordsNeurolymphomatosis–FDG-PET/CT–Lymphoma04/2012; 45(1):76-78. -
Article: Prognostic implications of microscopic involvement of surgical resection margin in patients with differentiated papillary thyroid cancer after high-dose radioactive iodine ablation.
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ABSTRACT: To evaluate the relationship between microscopic cancerous involvement of surgical margin and recurrence in patients with differentiated papillary thyroid cancer (PTC) who underwent total thyroidectomy followed by high-dose radioactive iodine ablation (HDRIA). Consecutive 197 PTC patients (184 women; mean age 44.9 years) who underwent total thyroidectomy without gross residual tumor followed by HDRIA were retrospectively reviewed. Resection margin involvement was evaluated and recurrence of the disease was assessed with clinicopathologically. Recurrence detected within 12 months after HDRIA were defined as early recurrence, detected after 12 months were defined as late recurrence. The mean follow-up was 85.9 ± 16.6 months. Twelve patients (6.1%) had microscopic cancerous involvement of surgical margin [margin (+) group], and 185 patients had negative surgical resection margins [margin (-) group]. Three patients (25.0%) in the margin (+) group and 11 patients (5.9%) in the margin (-) group had early recurrence. Margin (+) group showed higher incidence of early recurrence and lower incidence of disease free compared to margin (-) group (25.0 vs. 5.9%, p < 0.01; 66.7 vs. 81.1%, p < 0.01, respectively); however, there was no difference in incidence of late recurrence between the two groups (p = 1.00). There were no significant differences in the disease-free survival between the margin (+) and margin (-) groups after exclusion of early recurrence (p = 0.78). After high-dose radioactive iodine ablation, PTC patients with microscopic cancerous surgical margin involvement had a higher incidence of early recurrence and no different late recurrence rate compared to patients without microscopic cancerous surgical margin involvement.Annals of Nuclear Medicine 02/2012; 26(4):311-8. · 1.50 Impact Factor -
Article: Combined E7-dendritic cell-based immunotherapy and human sodium/iodide symporter radioiodine gene therapy with monitoring of antitumor effects by bioluminescent imaging in a mouse model of uterine cervical cancer.
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ABSTRACT: Using a uterine cervical cancer cell line expressing human papillomavirus (HPV) 16 E7 antigen and bioluminescent imaging (BLI), we evaluated the therapeutic potential of combined immunotherapy using transfected dendritic cells (DC-E7) and human sodium/iodide symporter (hNIS) radioiodine gene therapy in a xenograft animal cancer model. Dendritic cells expressing either E7 antigen (DC-E7) or no-insert (DC-no insert) were made for immunization materials, and murine uterine cervical cancer cell line coexpressing E7, firefly luciferase, hNIS, and EGFP genes (TC-1/FNG) were prepared for the animal tumor model. C57BL/6 mice were divided into five therapy groups (phosphate-buffered saline [PBS], DC-no insert, DC-E7, I-131, and DC-E7+I-131 groups). Single therapy with either DC-E7 or I-131 induced greater retardation in tumor growth compared with PBS or DC-no insert groups, and it resulted in some tumor-free mice (DC-E7 and I-131 groups, 40% and 20%, respectively). Combination therapy with DC-E7 and I-131 dramatically inhibited tumor growth, thus causing complete disappearance of tumors in all mice, and these effects were further confirmed by BLI in vivo. In conclusion, complete disappearance of the tumor was achieved with combined DC-E7 vaccination and hNIS radioiodine gene therapy in a mouse model with E7-expressing uterine cervical cancer, and serial BLIs successfully demonstrated antitumor effects in vivo.Cancer Biotherapy & Radiopharmaceuticals 11/2011; 26(6):671-9. · 1.44 Impact Factor -
Article: Combined RNA interference of hexokinase II and (131)I-sodium iodide symporter gene therapy for anaplastic thyroid carcinoma.
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ABSTRACT: The purpose of this study was to investigate the enhanced therapeutic effect of the combined use of shRNA (small hairpin RNA) therapy for the hexokinase II (HKII) gene and (131)I human sodium iodide symporter (hNIS) as a gene therapy for in vitro and in vivo treatment of anaplastic thyroid carcinoma cells (ARO) in an animal model. A recombinant lentivirus containing a plasmid with the hNIS gene driven by phosphoglycerate kinase promoter and green fluorescent protein (GFP) linked with an internal ribosome entry site sequence was produced. ARO cells were transfected with the virus and sorted by fluorescent activated cell sorting using GFP (ARO-NG). The messenger RNA expression of hNIS and GFP were evaluated with reverse-transcriptase polymerase chain reaction, and the function of hNIS was verified by (125)I uptake. The lentiviral vector expressing shRNA against HKII (Lenti-HKII shRNA) was constructed and used to infect ARO-NG cells. The effect of Lenti-HKII shRNA was evaluated by reverse-transcriptase polymerase chain reaction, (18)F-FDG uptake, and HK activity. An in vitro clonogenic assay was performed after Lenti-HKII shRNA therapy, (131)I therapy, and a combined therapy. The therapies were also applied in vivo to an animal model with an ARO-NG xenograft, and the effects were assessed with caliper measurements and (18)F-FDG PET. ARO-NG cells showed an (125)I uptake 76-fold higher than the parent ARO cells. Compared with the uninfected ARO-NG cells, ARO-NG cells infected with Lenti-HKII shRNA had lower HKII messenger RNA expression, lower (18)F-FDG uptake, and HK activity. The proliferation of ARO-NG cells was inhibited by (131)I and Lenti-HKII shRNA therapies and further inhibited by the combined (131)I and Lenti-HKII shRNA therapy. Both the Lenti-HKII shRNA therapy and the (131)I therapy inhibited in vivo tumor growth in the tumor xenograft model. The combined Lenti-HKII shRNA and (131)I therapy resulted in a further decrease of tumor growth. Our results suggest that the combined HKII shRNA and (131)I therapy has a stronger antitumor effect than either the (131)I therapy or the HKII shRNA alone. Therefore, this combined therapy could be used as a powerful strategy for treating anaplastic thyroid carcinoma.Journal of Nuclear Medicine 11/2011; 52(11):1756-63. · 6.38 Impact Factor -
Article: Simultaneous uptake of I-131 and F-18 FDG by a renal metastasis of thyroid papillary cancer.
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ABSTRACT: Renal metastasis of thyroid papillary cancer is rare and only a few cases have been reported. Most metastases of well-differentiated thyroid cancer alternatively accumulate either I-131 or F-18 fluorodeoxyglucose (FDG), according to tumor differentiation, and only a few metastases exhibit simultaneous I-131 and F-18 FDG uptake. This study shows the simultaneous I-131 and F-18 FDG uptake of metastatic renal mass in a patient with a 10-year history of thyroid papillary cancer. In our knowledge, this is the first report of thyroid cancer with renal metastasis as imaged by both I-131 SPECT/CT and F-18 FDG PET/CT.Clinical nuclear medicine 09/2011; 36(9):798-9. · 3.92 Impact Factor -
Article: Combined Cerenkov luminescence and nuclear imaging of radioiodine in the thyroid gland and thyroid cancer cells expressing sodium iodide symporter: initial feasibility study.
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ABSTRACT: Radioiodine (RI) such as (131)I or (124)I, can generate luminescent emission and be detected with an optical imaging (OI) device. To evaluate the possibility of a novel Cerenkov luminescence imaging (CLI) for application in thyroid research, we performed feasibility studies of CLI by RI in the thyroid gland and human anaplastic thyroid carcinoma cells expressing sodium iodide symporter gene (ARO-NIS). For in vitro study, FRTL-5 and ARO-NIS were incubated with RI, and the luminometric and CLI intensity was measured with luminometer and OI device. Luminescence intensity was compared with the radioactivity measured with γ-counter. In vivo CLI of the thyroid gland was performed in mice after intravenous injection of RI with and without thyroid blocking. Mice were implanted with ARO-NIS subcutaneously, and CLI was performed with injection of (124)I. Small animal PET or γ-camera imaging was also performed. CLI intensities of thyroid gland and ARO-NIS were quantified, and compared with the radioactivities measured from nuclear images (NI). Luminometric assay and OI confirmed RI uptake in the cells in a dose-dependent manner, and luminescence intensity was well correlated with radioactivity of the cells. CLI clearly demonstrated RI uptake in thyroid gland and xenografted ARO-NIS cells in mice, which was further confirmed by NI. A strong positive correlation was observed between CLI intensity and radioactivity assessed by NI. We successfully demonstrated dual molecular imaging of CLI and NI using RI both in vitro and in vivo. CLI can provide a new OI strategy in preclinical thyroid studies.Endocrine Journal 05/2011; 58(7):575-83. · 2.03 Impact Factor -
Article: Metabolic response of pelvic and para-aortic lymph nodes during radiotherapy for carcinoma of the uterine cervix: using positron emission tomography/computed tomography.
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ABSTRACT: We evaluated the metabolic response of lymph nodes (LNs) using consecutive F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) and correlated the metabolic response with the volumetric response measured by consecutive CT. Twenty-two patients with cervical cancer that had positive LNs underwent preradiotherapy (pre-RT) and inter-RT PET/CT. The metabolic response of the LNs was assessed quantitatively and semiquantitatively by measurement of the maximal standardized uptake value. All patients underwent inter-RT CT simulation after 45 Gy to the whole pelvis and inter-RT PET/CT scans after median 63 Gy to the gross LNs. A total of 48 pelvic and para-aortic LNs were found on the pre-RT PET/CT. The mean maximal standardized uptake value of nodal disease decreased from the pre-RT of 5.2 (SD, 3.1; range, 1.8-15.6) to the inter-RT of 1.1 (SD, 2.1; range, 0-11.1). Classifying the metabolic response of all 48 nodal lesions on the inter-RT PET/CT, 38 had a complete metabolic response. The initial volume of LNs had no correlation with the metabolic response (r = 0.194, P = 0.186). The metabolic response between the pre-RT PET/CT and inter-RT PET/CT was significantly associated with the volume response between the pre-RT CT and inter-RT CT (r = 0.314, P < 0.05). However, 18 (38%) LNs showed discrepancy between metabolic response and residual LN volume. Six (27%) patients had modified RT during treatment based on inter-RT PET/CT. We suggest that the PET/CT can be a useful tool for the evaluation of the interim response of the LNs and aid in selecting patients that need further treatment. The results showed a significant correlation between the metabolic and volumetric responses during RT, although the anatomical changes of LNs would not always represent the metabolic status.International Journal of Gynecological Cancer 05/2011; 21(4):699-705. · 1.65 Impact Factor -
Article: Incidental pituitary uptake on whole-body 18F-FDG PET/CT: a multicentre study.
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ABSTRACT: The purpose of this study was to determine the incidence of incidental pituitary uptake on whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and to investigate its clinical significance. The files of 40,967 patients who underwent whole-body FDG PET/CT were retrospectively reviewed. Quantification of pituitary metabolic activity was obtained by using the maximum standardized uptake value (SUVmax). Hormone assays and pituitary MRIs were performed to assess pituitary lesions. Focally increased pituitary FDG uptake on PET/CT was found in 30 of 40,967 patients, accounting for an incidence of 0.073%. The mean SUVmax of 30 patients was 8.9±6.6 (range: 3.2-32.6). Histological diagnosis was obtained in three patients and included two growth hormone-secreting adenomas and one non-functioning adenoma. Hormone assays were performed on serum samples from 11 patients, 2 of whom were shown to have hypersecretion of pituitary hormone. MRI was performed on 19 patients. Abnormal MRI findings suggesting a pituitary mass were found in 18 of 19 cases (94.7%). The mean SUV(max) calculated without correction for partial volume effect for macroadenomas was significantly higher than the SUVmax for microadenomas (11.5±8.4 vs 4.8±1.3; p<0.05). There were no cases diagnosed with metastasis to the pituitary gland during clinical follow-up. Incidental pituitary FDG uptake was a very rare finding. Cases with incidental pituitary FDG uptake were diagnosed primarily with clinically non-functioning adenomas, and there were also a few functioning adenomas. Further evaluations, including hormone assays and pituitary MRI, are warranted when pituitary uptake is found on FDG PET/CT.European Journal of Nuclear Medicine 12/2010; 37(12):2334-43. · 4.53 Impact Factor -
Article: Impact of medication discontinuation on increased intestinal FDG accumulation in diabetic patients treated with metformin.
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ABSTRACT: We evaluated the impact of stopping medication for 2 days on reductions in the high intestinal FDG uptake induced by metformin. One hundred thirty-eight diabetic patients were divided into two groups: one in which the antihyperglycemic drug regimen included metformin (group A; n = 107) and one in which the regimen did not include metformin (group B; n = 31). Fifty-two patients without diabetes mellitus served as the control group (group C). Group A was divided into two subgroups: 77 patients (group A1) were taking metformin at the time of FDG PET/CT scans, whereas the remaining 30 patients (group A2) were asked to stop taking metformin for 2 days before PET/CT scans. In addition, 10 diabetic patients underwent two consecutive PET/CT scans before and after the discontinuation of metformin. The intestinal FDG uptake and blood glucose levels were compared among the four groups, as well as before and after the discontinuation of metformin. The high intestinal FDG uptake in group A1 was significantly reduced after the discontinuation of metformin (p < 0.001 vs group A2); thus, there were no significant differences among group A2, group B, and group C (p = 0.581-0.872). There were also no statistically significant differences in the blood glucose levels among the three groups of diabetic patients (p > 0.9). In 10 patients who underwent serial PET/CT scans, mean intestinal FDG uptake decreased by 64% without significant changes in the blood glucose level. Hidden colorectal malignancies were revealed in two patients after the discontinuation of medication. The discontinuation of metformin for 2 days is feasible for reducing the high intestinal FDG uptake induced by metformin.American Journal of Roentgenology 12/2010; 195(6):1404-10. · 2.78 Impact Factor -
Article: Trafficking macrophage migration using reporter gene imaging with human sodium iodide symporter in animal models of inflammation.
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ABSTRACT: The aim of this study was to investigate the feasibility of nuclear molecular imaging using the human sodium iodide symporter (hNIS) as a reporter gene to monitor macrophage migration toward the inflammatory foci. A stable macrophage cell line coexpressing hNIS and green fluorescent protein (GFP) genes (RAW264.7/hNIS-GFP and R(NIS) cell) was established from an immortalized macrophage cell line (RAW264.7 cells). (125)I uptake was determined (for hNIS protein functional activity), and flow cytometry analysis (to examine GFP gene expression), a cell proliferation assay, a cytokine assay, and a phagocytic activity assay were performed. (99m)Tc-pertechnetate images were acquired at 1 d after subcutaneous inoculation of R(NIS) cells in nude mice. Chemical inflammation was induced for in vivo imaging in the thigh of nude mice by turpentine oil injection. Small-animal PET with (18)F-FDG and (124)I was performed with an intravenous administration of RAW264.7 or R(NIS) cells in inflammation-induced animals. The expression of hNIS and GFP genes was confirmed in R(NIS) cells by flow cytometry and immunofluorescent staining. (125)I uptake was about 67 times higher in R(NIS) cells than in RAW264.7 cells. No significant difference was observed in cell proliferation, cytokine production, and phagocytic activity between RAW264.7 and R(NIS) cells. (99m)Tc-pertechnetate imaging revealed increased tracer uptake at the inoculation site. PET with (124)I demonstrated a donut-shaped uptake, correlating with uptake shown by the (18)F-FDG PET images, at the inflammation site of mice administered R(NIS) cells. (124)I uptake (percentage injected dose per gram) was about 2.12 times higher at the inflammation site in the R(NIS) mice than in RAW264.7 mice. By immunohistochemistry, the migration of macrophages was further confirmed by positive staining for GFP and hNIS at the inflammation site of R(NIS) mice. These data support the feasibility of hNIS reporter gene imaging to monitor the macrophage migration toward an inflammatory lesion. Macrophages expressing hNIS may provide a new strategy to investigate the cellular behavior seen with inflammatory response in a preclinical model.Journal of Nuclear Medicine 10/2010; 51(10):1637-43. · 6.38 Impact Factor -
Article: Rituximab-induced pneumonitis on F-18 FDG PET/CT in patient with non-Hodgkin lymphoma.
Clinical nuclear medicine 08/2010; 35(8):601-3. · 3.92 Impact Factor -
Article: Isolated facial muscle metastasis from renal cell carcinoma on F-18 FDG PET/CT.
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ABSTRACT: Facial muscle is a very rare site for distant metastasis of renal cell carcinoma (RCC). We present a 71-year-old man with isolated facial muscle metastasis 12 years after right nephrectomy for RCC. Magnetic resonance imaging showed a soft-tissue mass in the masticator space. F-18 fluorodeoxyglucose positron emission tomography/computed tomography showed a large hypermetabolic lesion in the right masticator space without other hypermetabolic lesion in the whole body. Subsequent biopsy and histologic study confirmed metastatic cancer from RCC.Clinical nuclear medicine 04/2010; 35(4):263-4. · 3.92 Impact Factor
Top co-authors
Top Journals
Institutions
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2011–2013
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Kyungpook National University Hospital
Seoul, Seoul, South Korea
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2011–2012
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Chonnam National University
Yeoju, Gyeonggi, South Korea
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2010–2011
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Kyungpook National University
- Department of Nuclear Medicine
Sangju, North Gyeongsang, South Korea
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2009
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Chonnam National University Hospital
Seoul, Seoul, South Korea
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