Sungmin Jun

Limited Cytoprotective Effects of Amifostine in High-Dose Radioactive Iodine 131-Treated Well-Differentiated Thyroid Cancer Patients : Analysis of Quantitative Salivary Scan

PURPOSE The aim of present study was to investigate the cytoprotective effect of amifostine on salivary glands in 131I-treated differentiated thyroid cancer (DTC) patients using serial quantitative analysis of salivary gland scans. METHODS Serial quantitative salivary scintigraphies were performed in 80 newly diagnosed DTC patients (9 men, 71 women; mean age, 43.2 years old; range, 21-58 years old). Forty-two patients were assigned randomly to the amifostine treatment group, which received 300 mg/m2 amifostine intravenously before 131I administration. RESULTS In both amifostine-treated and nontreated groups statistically significant declines of functional parameters after 131I treatment were revealed by quantitative salivary scintigraphy in DTC patients. Amifostine pretreatment did not prevent the parenchymal damage to major salivary gland function after 131I treatment (F = 1.37, p = 0.2461). However, the dose of 131I had significant effects on salivary gland function after 131I treatment (F = 9.72, p = 0.0002). CONCLUSION The present study did not show cytoprotective effects of amifostine for DTC patients treated with 131I.

Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography imaging in pyogenic and tuberculous spondylitis: preliminary study.

Objective: The purpose of this study was to compare the effectiveness of positron emission tomography (PET)/computed tomography (CT) in distinguishing between tuberculous and pyogenic spondylitis with that of magnetic resonance imaging (MRI). Methods: Twenty-two consecutive patients confirmed to have tuberculous or pyogenic spondylitis were examined with both MRI and dual-time point PET/CT. The serum C-reactive protein (CRP) level was measured. The early and delayed PET/CT data were analyzed using the standardized uptake value (SUV). The radiologists scored the MRI findings and differentiated between tuberculous and pyogenic spondylitis. Each MRI result and CRP value was compared with the SUVs of PET/CT. Results: The reviewers identified tuberculous spondylitis (n = 11) on MRI, with a sensitivity, specificity, and positive predictive values of 90%, 100%, and 100%, respectively. For pyogenic spondylitis (n = 11), the corresponding values were 100%, 90%, and 92%, respectively. There was a significant difference in the maximum SUVs of the early phase between tuberculous and pyogenic spondylitis (P = 0.028). Magnetic resonance imaging was superior to PET/CT in differentiating between tuberculous and pyogenic spondylitis (P = 0.043). A comparison of the maximum SUVs of the early phase and CRP values revealed a correlation coefficient of 0.581 (P = 0.006). Conclusions: The maximum SUVs of early-phase PET/CT may be complementary to MRI for differentiating pyogenic and tuberculous spondylitis and reflecting the activity of infectious spondylitis.

Probabilistic Anatomic Mapping of Cerebral Blood Flow Distribution of the Middle Cerebral Artery

Probabilistic atlases are more representative of the population than single brain atlases. They allow anatomic and functional labeling of the results of group studies in stereotactic space and, hence, the automated anatomic labeling of individual brain imaging data. Methods: In the current study, probabilistic maps of the blood flow distribution of the middle cerebral artery (MCA) were developed using the basal and MCA brain SPECT images. Twenty-nine patients (mean age ± SD, 54.6 ± 6.1 y) who previously received placement of a stent for MCA stenosis (right MCA stenosis, 15 patients; left MCA stenosis, 14 patients) were included in the current study. Of the 29 MCA SPECT images, 18 were analyzed for the final result because 11 MCA SPECT images revealed an uneven uptake distribution of 99mTc-ethylcysteinate dimer in the brain. MCA brain SPECT images were coregistered to basal brain SPECT images, and spatial normalization parameters used for basal brain SPECT images were reapplied to MCA brain SPECT for anatomic standardization. Pixel counts of the MCA brain SPECT images were then normalized, and the probabilistic map of cerebral perfusion distribution (perfusion probabilistic map) for each hemisphere was determined by averaging the spatial- and count-normalized MCA brain SPECT images. Population-based probabilistic maps representing the extent of MCA territory (extent probabilistic map) were also composed by averaging the binary images obtained by thresholding the spatially normalized MCA brain SPECT images. Results: The blood supply from the MCA to the basal ganglia area was largest (probability, 0.6∼0.8), followed by the insular cortex (probability, 0.3∼0.5), and various cerebral cortical areas (probability, 0.2∼0.4). The MCA reached to deep structures of the brain, including the internal capsule, caudate nucleus, putamen, globus pallidus, insular cortex, and thalamus with a high-extent probability. Conclusion: A population-based probabilistic map of MCA flow distribution was generated by using MCA brain SPECT images. This map could be a potential tool for the analysis of major cerebral artery distribution, especially the MCA. Furthermore, the probabilistic MCA atlas could be used to define the object delineation of the MCA territory, to quantify ischemic disease affecting the MCA, to predict prognosis, and to risk stratification of cerebrovascular diseases, especially affecting the MCA.

Association between active brown adipose tissue and coronary artery calcification in healthy men

AIM We compared various clinical factors between persons with active brown adipose tissue (ABAT) and matched controls, and investigated the relationship between the presence of ABAT and coronary artery calcification (CAC) with respect to arterial inflammation. METHODS We retrospectively reviewed fluorine-18-labeled fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) data from men who underwent general health check-ups. Sixty-seven men with ABAT were identified and were matched with controls at a 1:1 ratio. Peripheral blood samples were obtained and the levels of various laboratory parameters were measured just before FDG PET/CT studies. Arterial inflammation was measured in the ascending aorta, venous mean standardized uptake value (SUV) was collected from the superior vena cava as FDG uptake on PET, and background-corrected SUV was calculated as the target-to-background ratio (TBR) and blood-subtracted SUVmax (bsSUVmax). CAC was assessed using CT images acquired from a PET/CT scanner. RESULTS The prevalence of fatty liver (p = 0.048) and CAC (p = 0.026) was lower in men with ABAT compared to matched controls. Arterial SUVmax (1.72 ± 0.23 vs. 1.88 ± 0.23, p < 0.001), TBR (1.18 ± 0.14 vs. 1.29 ± 0.13, p < 0.001), and bsSUVmax (0.25 ± 0.18 vs. 0.41 ± 0.16, p < 0.001) were significantly lower in men with ABAT. ABAT (odds ratio [OR] = 0.19, p = 0.024) and high-density lipoprotein cholesterol (OR = 0.95, p = 0.037) were independent factors associated with CAC according to multiple logistic regression analysis. CONCLUSION ABAT is associated with down-regulated arterial inflammation and may exert a protective effect against the development of atherosclerosis. (p = 0,026) war geringer bei Männern mit ABAT im Vergleich zu gematchten Kontrollen. Arterieller SUVmax (1,72 ± 0,23 vs. 1,88 ± 0,23, p < 0,001), TBR (1,18 ± 0,14 vs. 1,29 ± 0,13, p < 0,001) und bsSUVmax (0,25 ± 0,18 vs. 0,41 ± 0,16, p < 0,001) waren bei Männern mit ABAT signifikant geringer. ABAT (Odds ratio [OR] = 0,19, p = 0,024) und HDL-Cholesterol (OR = 0,95, p = 0,037) waren in einer multiplen logistischen Regressionsanalyse unabhängige Faktoren, die mit CAC assoziiert waren. Schlussfolgerung : ABAT ist assoziiert mit einer herunterregulierten arteriellen Entzündung und übt möglicherweise einen schützenden Effekt gegen die Entwicklung einer Atherosklerose aus.

Concurrent Low Brain and High Liver Uptake on FDG PET Are Associated with Cardiovascular Risk Factors.

Objective Concurrent low brain and high liver uptake are sometimes observed on fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET). We investigated the potential clinical significance of this uptake pattern related to metabolic syndrome (MS). Materials and Methods We retrospectively reviewed data from 264 consecutive males who had undergone general health check-ups, including FDG PET/CT scans. After an overnight fast, the men had their peripheral blood drawn and the levels of various laboratory parameters measured; an FDG PET/CT scan was performed on the same day. We measured the maximum standardized uptake values of the brain and liver from regions of interest manually placed over the frontal cortex at the level of the centrum semiovale and the right lobe of the liver parenchyma, respectively. Results Fasting blood glucose (FBG; odds ratio [OR] = 1.063, p < 0.001) and glycated hemoglobin (HbA1c; OR = 3.634, p = 0.010) were the strongest predictive factors for low brain FDG uptake, whereas waist circumference (OR = 1.200, p < 0.001) and γ-glutamyl transpeptidase (OR = 1.012, p = 0.001) were the strongest predictive factors for high liver uptake. Eleven subjects (4.2%) showed concurrent low brain and high liver FDG uptake, and all but one of these subjects (90.9%) had MS. Systolic blood pressure, waist circumference, FBG, triglyceride, alanine aminotransferase, insulin resistance (measured by homeostasis model assessment), insulin, HbA1c, and body mass index were higher in subjects with this FDG uptake pattern than in those without (all, p < 0.001). Conclusion Concurrent low brain and high liver FDG uptake were closely associated with MS. Moreover, subjects with this pattern had higher values for various cardiovascular risk factors than did those without.

Prognostic significance of standardized uptake value on F18-FDG PET/CT in patients with extranodal nasal type NK/T cell lymphoma: A multicenter, retrospective analysis

OBJECTIVES The purpose of this study was to evaluate the value of parameters assessed with F18-flurodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in predicting relapse free survival and overall survival in patients with extranodal nasal type NK/T cell lymphoma. METHODS Thirty-six patients with extranodal nasal type NK/T cell lymphoma, and who underwent PET/CT prior to curative treatment, were enrolled at five institutions. Volumes of interest covering the entire tumor volume were delineated on PET/CT images, and the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using thresholds of 40% of SUVmax. Furthermore, we compared the difference in F18-FDG avidity according to Epstein-Barr virus (EBV) infection status. RESULTS The SUVmax (p=0.041) and SUVmean (p=0.049) in patients who died were higher than the respective values of those who survived. A higher TLG (>45.8) was associated with relapse free survival (HR 7.856, p=0.034). Ann Arbor stage (III-IV, HR 14.12, p=0.004), and a higher SUVmax (>12.6, p=0.024) and SUVmean (>6.4, p=0.024) were associated with poor survival. However, neither the MTV nor the TLG (volumetric parameters) were significant predictors of death. The PET parameters SUVmax (p=0.181), SUVmean (p=0.237), MTV (p=0.636), and TLG (p=0.469) did not differ significantly between patients with and without EBV infections. CONCLUSIONS High TLG was the only significant predictive factor on relapse free survival. The SUVmax and SUVmean measured by F18-FDG PET/CT could be significant prognostic factors in patients with extranodal nasal type NK/T cell lymphoma.