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- 발행기관 : Thieme (NuklearMedizin/NuclearMedicine) (검색결과 2 건)
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Hong, C. M.,Ahn, B.-C.,Jeong, S. Y.,Lee, S.-W.,Lee, J. Thieme (NuklearMedizin/NuclearMedicine) 2013 Nuklearmedizin. Nuclear medicine Vol.52 No.4
<B>Summary</B><P> Aim: Many investigators have reported an inverse relationship between iodine and glucose utilization of differentiated thyroid carcinoma (DTC) according to its degree of differentiation; however, not every DTC is compatible with this phenomenon. This study was conducted to evaluate the clinical implication of iodine and glucose uptake at distant metastatic lesions in DTC patients. Patients, methods: 64 DTC patients (women 47; mean age 49.9 ± 16.4 years) with distant metastasis who underwent post 131I treatment whole-body scan (RxWBS) and FDG PET/CT were included in the study. Radioiodine (RAI) and FDG uptake of metastatic lesions were evaluated. TSH stimulated serum thyroglobulin (s-Tg) were obtained. Results: 53 of 64 patients (82.8%) were RAI(+) group, and 37 patients (57.8%) were FDG(+) group. Patients in the RAI(-) group showed a higher rate of FDG uptake than RAI(+) group (100.0% vs. 49.1%, p = 0.002). Patients in the FDG(-) group showed a higher rate of RAI uptake than FDG(+) group (100.0% vs. 70.3%, p = 0.002). Patients with s-Tg < 100 ng/ml were frequently observed in the FDG(-)/RAI(+) group and the FDG(+)/ RAI(-) group (p = 0.023). And patients with s-Tg ≥ 500 ng/ml were more frequently observed in the FDG(+)/RAI(+) group, compared with the FDG(+)/RAI(-) group (p = 0.036). Reduced disease-specific survival (DSS) was observed in patients with RAI(-) (p = 0.003), FDG(+) (p = 0.006), SUVmax > 3.6 (p<0.001), and s-Tg > 75.8 ng/ml (p = 0.009). In multivariate analysis, only a SUVmax > 3.6 was significantly predictive of DSS (p = 0.006). Conclusion: An inverse relationship between RAI and FDG uptake, flip-flop phenomenon, was observed in patients with metastatic lesions of DTC. Reduced disease-specific survival was observed in patients with FDG(+), RAI(-) in metastatic lesions, or high s-Tg value.</P>
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Preoperative risk stratification using 18F-FDG PET/CT in women with endometrial cancer
Lee, H. J.,Ahn, B.-C.,Hong, C. M.,Song, B. I.,Kim, H. W.,Kang, S.,Jeong, S. Y.,Lee, S.-W.,Lee, J. Thieme (NuklearMedizin/NuclearMedicine) 2011 Nuklearmedizin. Nuclear medicine Vol.50 No.5
<B>Summary</B><P>The aim of this study is to evaluate the usefulness of 18F-FDG PET/CT for preoperative stratification of high-risk and low-risk carcinomas in patients with endometrial cancer. Patients, methods: 60 women (mean age 53.8 ± 9.9 years) with endometrial cancer, who underwent 18F-FDG PET/CT for preoperative staging work-up, followed by primary cytoreductive surgery, were enrolled in this study. Maximum and mean standardized uptake values (SUVmax, SUVmean) of endometrial tumors were measured, and compared with the various clinicopathologic findings obtained after surgery. Tumour aggressiveness was classified as high-risk and low-risk carcinomas. Patients with stage I or II, endometrioid adenocarcinoma, histologic grade 1 or 2, invasion of less than half of the myometrium, maximum tumor size less than 2.0 cm, and absence of cervical invasion and lymphovascular space involvement (LVSI) were classified as the lowrisk carcinoma group. The remaining patients were classified as the high-risk carcinoma group. Results: In univariate analysis, SUVmax of the primary endometrial tumor was significantly higher in patients who were in a postmenopausal state (p = 0.047), large (> 2 cm) primary tumor (p <0.001), nonendometrioid subtype (p = 0.024), invasion of more than half of the myometrium (p = 0.020), or LVSI (p = 0.004). SUVmax differed significantly according to FIGO stage (p = 0.013) and histologic grade (p <0.001). In multivariate analysis, FIGO stage, histologic grade, LVSI, and maximum tumor size demonstrated a significant association with SUVmax (p <0.001; r = 0.843, r2 = 0.711). SUVmean showed similar results. Forty-one (68.3%) patients were diagnosed postoperatively as high-risk and 19 patients (31.7%) as low-risk carcinoma. Patients with high-risk carcinoma (12.1 ± 6.1) showed significantly higher SUVmax than patients with low-risk carcinoma (5.8 ± 2.8, p <0.001). The optimal SUVmax cut-off value of 8.7, determined by ROC analysis, revealed 75.6% sensitivity, 89.5% specificity, and 81.7% accuracy for risk stratification. Conclusion: High-risk endometrial cancer might be differentiated by means of higher SUVmax from low-risk endometrial cancer. 18F-FDG FDG PET/CT can be applied preoperatively for stratification of risk in patients with endometrial cancer.</P>
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