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Prognostic Value of Genetic Mutations in Thyroid Cancer: A Meta-Analysis
Pak, Kyoungjune,Suh, Sunghwan,Kim, Seong Jang,Kim, In-Joo Mary Ann Liebert 2015 Thyroid Vol.25 No.1
<P>Genetic mutations have been found to be associated with thyroid cancer. Previous studies have been focused on the relation between genetic mutations and thyroid cancer. We sought to evaluate the prognostic value of the three most common genetic mutations (BRAF, RAS, and RET) in patients with thyroid cancer.</P>
Pak, Kyoungjune,Kim, Seong-Jang,Kim, In Joo,Kim, Keunyoung,Kim, Heeyoung,Kim, So Jung The Korea Society of Nuclear Medicine 2012 핵의학 분자영상 Vol.46 No.3
Purpose We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG) uptake of the liver measured by maximum or mean standardized uptake value. Methods We retrospectively analyzed 96 consecutive records of positron emission tomography/computed tomography (PET/CT) performed for cancer screening between May 2011 and December 2011. Subjects were divided into 2 groups according to Hounsfield unit (HU) of the liver comparing with that of the spleen. The control group (20 women, 56 men) demonstrating HU of the liver equal or greater than that of the spleen included 76 patients, while the fatty liver group (2 women, 18 men) showing HU of the liver less than that of the spleen included 20 patients. We compared FDG uptake of the liver and visceral fat volume between two groups. We evaluated correlation of hepatic FDG uptake measured by maximum or mean standardized uptake value (SUV) with visceral fat volume and attenuation. Results The fatty liver disease group showed higher aspartate aminotransferase (AST)of ($24.42{\pm}7.22$, p=0.012), alanine aminotransferase (ALT) of ($25.16{\pm}11.68$, p=0.001), body mass index (BMI) of ($24.58{\pm}3.29$, p=0.021), and visceral fat volume ($3063.53{\pm}1561.43$, p=0.011) than the control group. There were no statistically significant differences of mean standardized uptake value of the liver (liver $SUV_{mean}$) ($2.73{\pm}0.19$, p=0.723), maximum standardized uptake value of the liver (liver $SUV_{max}$) ($3.39{\pm}0.53$, p=0.8248) and liver $SUV_{mean}$/spleen $SUV_{mean}$ ($1.13{\pm}0.10$, p=0.081) between the two groups. Strong correlations were shown between liver $SUV_{mean}$ and BMI (r=0.609, p<0.001) and between liver $SUV_{mean}$ and visceral fat volume (r=0.457, p<0.001). Liver $SUV_{max}$ was also strongly correlated with BMI (r=0.622, p=0.001) and visceral fat volume (r=0.547, p<0.001). There was no significant association of mean attenuation value of the liver (liver $HU_{mean}$) with liver $SUV_{mean}$ (r=-0.003, p=0.979) or liver $SUV_{max}$ (r=-0.120, p=0.244). Conclusion Hepatic FDG uptake quantified as $SUV_{mean}$ or $SUV_{max}$ is not correlated with hepatic steatosis but with visceral fat volume in cancer screening.
Pak, Kyoungjune,Park, Sohyun,Cheon, Gi Jeong,Kang, Keon Wook,Kim, In-Joo,Lee, Dong Soo,Kim, E Edmund,Chung, June-Key Japanese Society of Nuclear Medicine 2015 Annals of nuclear medicine Vol.29 No.5
<P>Nowadays, the number of primary studies on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been increasing rapidly. Thus, we updated meta-analysis to evaluate the test performance of FDG PET/CT for nodal staging in non-small cell lung cancer (NSCLC) including the most recent studies.</P>
Pak, Kyoungjune,Cheon, Gi Jeong,Kang, Keon Wook,Chung, June-Key,Kim, E. Edmund,Lee, Dong Soo Lippincott 2015 Clinical nuclear medicine Vol.40 No.1
PURPOSE: We investigated whether SUV parameters, from PET, can provide prognostic information for patients with oropharyngeal or hypopharyngeal cancer. PATIENTS AND METHODS: Forty-eight patients with oropharyngeal or hypopharyngeal cancer who underwent PET before treatment were enrolled. A volume of interest was placed on PET images covering the entire tumor volume and metastatic lymph nodes, and the SUVmax, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. RESULTS: With the use of Kaplan-Meier analysis, age, SUVmean, MTV, and TLG predicted decreased disease-free survival (DFS). However, SUVmax was not associated with DFS. In multivariate analysis, the variables were included in 3 separate models. An SUVmean2.5 was an independent prognostic factor for DFS. Other SUV parameters, such as MTV and TLG, were associated with trends toward a decreasing DFS. CONCLUSIONS: SUVmean of PET was an independent prognostic factor for DFS in patients with oropharyngeal and hypopharyngeal cancer.
Obesity and Brain Positron Emission Tomography
Pak, Kyoungjune,Kim, Seong-Jang,Kim, In Joo 대한핵의학회 2018 핵의학 분자영상 Vol.52 No.1
Obesity, an increasingly common problem in modern societies, results from energy intake chronically exceeding energy expenditure. This imbalance of energy can be triggered by the internal state of the caloric equation (homeostasis) and non-homeostatic factors, such as social, cultural, psychological, environmental factors or food itself. Nowadays, positron emission tomography (PET) radiopharmaceuticals have been examined to understand the cerebral control of food intake in humans. Using $^{15}O-H_2$ PET, changes in regional cerebral blood flow (rCBF) coupled to neuronal activity were reported in states of fasting, satiation after feeding, and sensory stimulation. In addition, rCBF in obese subjects showed a greater increase in insula, the primary gustatory cortex. $^{18}F$-fluorodeoxyglucose PET showed higher metabolic activity in postcentral gyrus of the parietal cortex and lower in prefrontal cortex and anterior cingulate cortex in obese subjects. In addition, dopamine receptor (DR) PET demonstrated lower DR availability in obese subjects, which might lead to overeating to compensate. Brain PET has been utilized to reveal the connectivity between obesity and brain. This could improve understanding of obesity and help develop a new treatment for obesity.
Pak, Kyoungjune,Cheon, Gi Jeong,Lee, Kyu Eun,Park, Young Joo,Choi, Hoon Sung,Min, Hye Sook,Kang, Keon Wook,Chung, June-Key,Kim, Euishin E.,Lee, Dong Soo Chapman and Hall in association with the British N 2014 Nuclear medicine communications Vol.35 No.5
<P>ObjectivesThe prevalence and risk of malignancy in thyroid incidentalomas has been investigated in previous studies; however, these studies have not looked at the characteristics of incidental thyroid cancer (ITC) detected by fluorine-18 fluorodeoxyglucose PET. Therefore, we aimed to assess the clinicopathologic features of ITC.MethodsFrom March 2008 to December 2011, a total of 2892 patients underwent total thyroidectomy for papillary thyroid cancer. Among them, patients belonging to the ITC group were defined as those in whom focal thyroid uptake was reported as an incidental finding on PET imaging and further evaluation revealed the presence of malignancy. In addition, two control groups with non-PET incidental thyroid cancer (NITC) were selected: NITC-A patients (n=48) who underwent a total thyroidectomy in March 2008 and NITC-B patients (n=48) who underwent a total thyroidectomy for papillary thyroid cancer and were matched for the confounding effects of age and sex.ResultsThere were no significant differences in clinicopathologic features, except for age and tumour node metastasis (TNM) staging, between ITC and NITC-A patients. More ITC than NITC-A patients were aged 45 years or older. Although T, N, or M staging was not different between ITC and NITC-A, there were more ITC patients with stage III/IV tumours. After matching for age and sex, none of the clinicopathologic features showed significant differences between ITC and NITC-B patients.ConclusionNo significant differences were observed between ITC and NITC patients except for age and TNM staging. More ITC patients had advanced TNM stage most likely due to patient age.</P>
Pak, Kyoungjune,Cheon, Gi Jeong,Nam, Hyun-Yeol,Kim, Seong-Jang,Kang, Keon Wook,Chung, June-Key,Kim, E. Edmund,Lee, Dong Soo Society of Nuclear Medicine 2014 The Journal of nuclear medicine Vol.55 No.6
<P>We conducted a comprehensive systematic review of the literature on volumetric parameters and a meta-analysis of the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with head and neck cancer (HNC). <B>Methods:</B> A systematic search of MEDLINE and EMBASE was performed using the key words PET, head and neck, and volume. Inclusion criteria were <SUP>18</SUP>F-FDG PET used as an initial imaging tool; studies limited to HNC; patients who had not undergone surgery, chemotherapy, or radiotherapy before PET scans; and studies reporting survival data. Event-free survival and overall survival were considered markers of outcome. The impact of MTV or TLG on survival was measured by the effect size hazard ratio (HR). Data from each study were analyzed using Review Manager. <B>Results:</B> Thirteen studies comprising 1,180 patients were included in this study. The combined HR for adverse events was 3.06 (2.33–4.01, <I>P</I> < 0.00001) with MTV and 3.10 (2.27–4.24, <I>P</I> < 0.00001) with TLG, meaning that tumors with high volumetric parameters were associated with progression or recurrence. Regarding overall survival, the pooled HR was 3.51 (2.62–4.72, <I>P</I> < 0.00001) with MTV and 3.14 (2.24–4.40, <I>P</I> < 0.00001) with TLG. There was no evidence of significant statistical heterogeneity at an I<SUP>2</SUP> of 0%. <B>Conclusion:</B> MTV and TLG are prognostic predictors of outcome in patients with HNC. Despite clinically heterogeneous HNC and the various methods adopted between studies, we can confirm that patients with a high MTV or TLG have a higher risk of adverse events or death.</P>
Development of a risk scoring system for patients with papillary thyroid cancer
Pak, Kyoungjune,Kim, Yun Hak,Suh, Sunghwan,Goh, Tae Sik,Jeong, Dae Cheon,Kim, Seong Jang,Kim, In Joo,Han, Myoung‐,Eun,Oh, Sae‐,Ock John Wiley and Sons Inc. 2019 JOURNAL OF CELLULAR AND MOLECULAR MEDICINE Vol.23 No.4
<P><B>Abstract</B></P><P>As the importance of personalized therapeutics in aggressive papillary thyroid cancer (PTC) increases, accurate risk stratification is required. To develop a novel prognostic scoring system for patients with PTC (n = 455), we used mRNA expression and clinical data from The Cancer Genome Atlas. We performed variable selection using Network‐Regularized high‐dimensional Cox‐regression with gene network from pathway databases. The risk score was calculated using a linear combination of regression coefficients and mRNA expressions. The risk score and clinical variables were assessed by several survival analyses. The risk score showed high discriminatory power for the prediction of event‐free survival as well as the presence of metastasis. In multivariate analysis, the risk score and presence of metastasis were significant risk factors among the clinical variables that were examined together. In the current study, we developed a risk scoring system that will help to identify suitable therapeutic options for PTC.</P>