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Web of Science

Language：English   Publisher：Radiology  

Background: While current guidelines require lung ventilation-perfusion (V/Q) scanning as the first step to diagnose chronic pulmonary embolism in pulmonary hypertension (PH), its use may be limited by low availability and/or exposure to ionizing radiation. Purpose: To compare the performance of dynamic chest radiography (DCR) and lung V/Q scanning for detection of chronic thromboembolic PH (CTEPH). Materials and Methods: Patients with PH who underwent DCR and V/Q scanning in the supine position from December 2019 to July 2021 were retrospectively screened. The diagnosis of CTEPH was confirmed with right heart catheterization and invasive pulmonary angiography. Observer tests were conducted to evaluate the diagnostic accuracy of DCR and V/Q scanning. The lungs were divided into six areas (upper, middle, and lower for both) in the anteroposterior image, and the number of lung areas with thromboembolic perfusion defects was scored. Diagnostic performance was compared between DCR and V/Q scanning using the area under the receiver operating characteristic curve. Agreement between the interpretation of DCR and that of V/Q scanning was assessed using the Cohen kappa coefficient and percent agreement. Results: A total of 50 patients with PH were analyzed: 29 with CTEPH (mean age, 64 years ± 15 [SD]; 19 women) and 21 without CTEPH (mean age, 61 years ± 22; 14 women). The sensitivity, specificity, and accuracy of DCR were 97%, 86%, and 92%, respectively, and those of V/Q scanning were 100%, 86%, and 94%, respectively. Areas under the receiver operating characteristic curve for DCR and V/Q scanning were 0.92 (95% CI: 0.79, 0.97) and 0.93 (95% CI: 0.78, 0.98). Agreement between the consensus interpretation of DCR and that of V/Q scanning was substantial (κ = 0.79 [95% CI: 0.61, 0.96], percent agreement = 0.9 [95% CI: 0.79, 0.95]). Conclusion: Dynamic chest radiography had similar efficacy to ventilation-perfusion scanning in the detection of chronic thromboembolic pulmonary hypertension.

DOI： 10.1148/radiol.220908

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PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Anticancer Research  

Background/Aim: Differentiated thyroid cancer (DTC) has a good prognosis, except in the case of patients with radioiodine therapy (RIT)-refractory cancer. However, since DTC is essentially a slowly progressing cancer, it is usually judged to be a DTC with a poor prognosis after multiple RITs and yearly follow-up with echo, computed tomography (CT), and serum thyroglobulin values. This study investigated whether fluorodeoxyglucose-positron emission tomography/CT (FDG PET/CT) combined with initial RIT could identify early-stage patients with poor prognosis. Patients and Methods: We evaluated 100 patients with high-risk DTC who underwent total thyroidectomy and received RIT at our institution. We analyzed the clinical outcomes of patients and 18F-FDG accumulation using univariate and multivariate Cox proportional hazards regression models. Results: The 10-year overall survival (OS) was 87.9%, with no significant difference in OS between 18F-FDG accumulation at pre-total or near-total thyroidectomy (NTT) (p=0.180) and 131I accumulation at initial RIT (p=0.577). However, 18F-FDG positive patients had a significantly worse prognosis than negative patients (p=0.005) at initial RIT. Conclusion: 18F-FDG PET/CT plays an important role in both the diagnosis and prognostic prediction of RIT refractory disease in DTC patients. 18F-FDG PET/CT can be a useful tool particularly at the time of initial RIT since the 18F-FDG accumulation enables the screening of high-risk DTC with poor prognosis at a very early time stage.

DOI： 10.21873/anticanres.16148

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Scopus

PubMed

Language：English   Publisher：Clinical Radiology  

AIM: To determine whether the pathological response to preoperative chemotherapy for pancreatic ductal adenocarcinoma (PDAC) can be predicted using 2-[18F]-fluoro-2-deoxy-D-glucose positron-emission tomography (F-18 FDG-PET). MATERIALS AND METHODS: Twenty-eight patients with PDAC who underwent only neoadjuvant chemotherapy (NAC) before surgery were enrolled in the study. All patients had F-18 FDG-PET examinations before NAC. The resected specimen was pathologically evaluated according to the Classification of Pancreatic Carcinoma (7th edn). Patients were categorised into a non-response group and a response group based on the pathological findings. The non-response group (Grades 1a and 1b) showed ≤50% necrosis in the specimen, while the specimens of the response group (Grades 2–3) showed >50% necrosis. The maximum standardised uptake values (SUVmax) of the tumours on F-18 FDG-PET were measured. The mean values of SUVmax were compared between the two groups. The diagnostic performance of SUVmax in distinguishing the two groups was also evaluated using receiver operating characteristic analysis. RESULTS: The mean SUVmax of the response group was higher than that of the non-response group (9.00 ± 1.78 versus 4.26 ± 2.35; p<0.001). The optimal cut-off value of SUVmax was 9.28 for distinguishing the two groups. The sensitivity, specificity, and accuracy for the prediction in the response group were 80%, 95.7%, and 92.9%, respectively. CONCLUSIONS: SUVmax on F-18 FDG-PET may be useful as a biomarker to predict the pathological response to NAC in patients with PDAC.

DOI： 10.1016/j.crad.2022.03.001

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PubMed

Language：English   Publisher：Physica Medica  

Purpose: Recently developed and commercialized dual-layer flat panel detectors (DL-FPDs) with two indirect scintillators are capable of acquiring dual-energy X-ray images. However, in clinical practice, they are utilized to perform conventional radiography using diagnostic X-rays with a wide energy spectrum. The two layers of the DL-FPD may affect the obtained image quality, even when only using one layer for conventional image acquisition, and these effects are yet to be substantiated. Therefore, in this study, we quantitatively evaluated the image quality of a conventional chest radiography using DL-FPD and visually verified the characteristics of the chest anthropomorphic phantom images. Methods: The physical characteristics of the system were evaluated using the pre-sampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE), for beam quality RQA 7 and RQA 9. In addition, the subjective visibility of the anthropomorphic chest phantom and simple objects images were compared with those of a conventional single-layer flat-panel detector (SL-FPD). Results: No significant differences were found in the MTF between the SL-FPD and DL-FPD images. In addition, a higher DQE was observed at some exposure doses and in the high spatial frequency regions wherein NNPSs were lower for DL-FPD than for SL-FPD. Furthermore, no significant differences were found in the subjective visibility of the chest phantoms in each system. Conclusions: We concluded that the image quality of the conventional radiography acquired with DL-FPD is comparable to or better than that of the SL-FPD.

DOI： 10.1016/j.ejmp.2022.02.004

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PubMed

Language：English   Publisher：(一社)日本核医学会  

2011年1月～2015年2月までの期間内に、当院で123I MIBG SPECT/CT検査を受けた、褐色細胞腫(PHEO)患者21例(男性10例、女性11例、年齢24～80歳)と、副腎皮質腺腫(CA)患者23例(男性15例、女性8例、年齢30～78歳)を対象に調査した。123Iメタヨードベンジルグアニジン(MIBG) SPECT/CT所見から、腫瘍と肝臓へ集積最大値の比(T/Lmax)、腫瘍と肝臓への集積平均値の比(T/Lmean)、腫瘍と骨格筋への集積最大値の比(T/Mmax)、腫瘍と骨格筋への集積平均値の比(T/Mmean)について、半定量的に解析した。その結果、ROC解析によるAUCでは、123I MIBGのプラナー画像の視覚スコアが0.833、SPECT画像の視覚スコアが0.813で、T/Lmaxが0.986、T/Lmeanが0.975、T/Mmaxが0.955、T/Mmeanが0.933であった。なかでも、T/MmaxのAUCでは、123I MIBGのプラナー画像の視覚スコアや、SPECT画像の視覚スコアに比べ、有意に高値が検出された。以上の解析結果から、PHEOとCAの鑑別に、123I MIBG SPECT/CTによる半定量分析が有用と判断された。

Language：English   Publisher：Annals of Nuclear Medicine  

Objective: 123I metaiodobenzylguanidine (MIBG) scintigraphy is a useful tool for the diagnosis of pheochromocytomas (PHEOs), but some PHEOs are difficult to differentiate from cortical adenoma (CA) or normal adrenal uptake by visual evaluation alone. A new semi-quantitative analysis using 123I MIBG SPECT/CT is thus expected. Herein, we introduce the tumor-to-liver count ratio (T/L) and the tumor-to-muscle count ratio (T/M). Methods: We examined the cases of 21 patients with PHEOs (10 males, 11 females; age 24–80, median 61 years) and 23 patients with CA (15 males and 8 females, age 30–78, median 58 years). The visual scoring based on 123I MIBG planar images (planar score) and SPECT images (SPECT score) was used as the conventional evaluation. Using 123I MIBG SPECT/CT findings, we calculated the semi-quantitative values of the count ratio using the maximum or mean count of the tumor and the liver or muscle as the reference organ (T/Lmax, T/Lmean, T/Mmax and T/Mmean). Each evaluation of the PHEOs and CAs was compared, and the diagnosing performance was evaluated based on an ROC analysis. Results: The area under curve (AUC) values were as follows: the planar score, 0.833; SPECT score, 0.813; T/Lmax, 0.986; T/Lmean, 0.975; T/Mmax, 0.955; and T/Mmean, 0.933. The AUC for T/Mmax was significantly higher than those of the planar score, and SPECT score by ROC analysis (p < 0.01 each). Conclusion: The semi-quantitative value of 123I MIBG SPECT/CT is more useful than the conventional visual evaluation for differentiating PHEOs from CAs.

DOI： 10.1007/s12149-021-01690-9

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PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Introduction: Radioiodine therapy with ¹³¹I (¹³¹I therapy) after total or near-total thyroidectomy has been established as an effective treatment for Differentiated Thyroid Carcinoma (DTC), but can induce dry mouth symptoms by salivary gland damage and impair the patients’ quality of life. Aim: To propose a functional scoring system based on Salivary Gland Scintigraphy (SGS) findings that evaluates development of salivary gland dysfunction secondary to ¹³¹I therapy in patients with DTC. Materials and Methods: This retrospective study evaluated the records of 279 DTC patients who underwent SGS after one or more round(s) of ¹³¹I therapy, using 370 MBqof ^99mTc-pertechnetate. The SGS results were assessed using a novel functional scoring system in the Parotid Glands (PGs) and Submandibular Glands (SMGs) according to visual evaluations based on a three-point uptake score, Washout Rate (%WR) score after lemon-juice stimulation, and functional score. The scores were compared among pretreatment, low-dose (<10 GBq), and high-dose (>10 GBq) groups and among pretreatment, symptom-positive, and symptom-negative groups. Risk factors for dry mouth were analyzed by univariate and multivariate logistic regression analyses. Results: Dry mouth symptoms developed in 15.4% of the DTC patients after ¹³¹I therapy. The three-point uptake, %WR, and functional scores in both the PG and SMG were statistically significant between low-dose and high-dose groups, and between symptom-positive and symptom-negative groups. The PG/SMG functional scores were independent risk factors for dry mouth (odds ratio, 0.03 and 0.0007 respectively). Conclusion: SGS-based PG and SMG functional scores were effective biomarkers to objectively evaluate salivary gland dysfunction, with the high strength of association with dry mouth symptoms.

DOI： 10.7860/JCDR/2017/27340.10431

Language：English   Publishing type：Research paper (scientific journal)  

Purpose: Lung metastases (LMs) and their radioiodine uptake affect prognosis in patients with differentiated thyroid carcinoma (DTC). We herein investigate the value of metabolic tumor volume (MTV) in LMs on positron emission tomography/computed tomography (PET/CT) using 2-[F-18]-fluoro-2-deoxy-D-glucose (F-18 FDG PET/CT) in predicting short-term progression after initial I-131 therapy in DTC patients. Materials and Methods: We retrospectively evaluated 111 DTC patients with LMs. Diagnostic CT and I-131 scintigraphy were performed within 1 week of I-131 therapy. Maximum standardized uptake value (SUVmax) and total MTV (MTVtotal) were compared between patients with I-131-positive and I-131-negative LMs and between patients with and without short-term progression. Correlation analyses were performed between F-18 FDG PET/CT parameters and thyroglobulin (TG) level, and predictive factors for short-term progression were analyzed by logistic regression and receiver operating characteristic curve analysis.Results: Patients with short-term progression had significantly higher SUVmax and MTVtotal than those without. TG levels were significantly correlated with SUVmax (r = 0.21) and MTVtotal (r = 0.51) after I-131 therapy. MTVtotal showed significant association (χ² = 16.5, odds ratio = 0.02) with short-term progression after initial I-131 therapy and had the highest predictive value of all the putative risk factors. Conclusions: MTVtotal in LMs on F-18 FDG PET/CT is an independent predictive factor with a high predictive value for short-term progression of DTC after initial I-131 therapy. It is recommended that F-18 FDG PET/CT be performed before planning therapy during the evaluation of DTC patients with LM.

DOI： 10.4103/ijnm.IJNM_43_17

Language：English   Publishing type：Research paper (scientific journal)  

Objective Balloon pulmonary angioplasty (BPA) is used for inoperable chronic thromboembolic pulmonary hypertension (CTEPH), but its effect cannot be evaluated noninvasively. We devised a noninvasive quantitative index of response to BPA using three-dimensional fractal analysis (3D-FA) of technetium-99m-macroaggregated albumin (99m Tc-MAA) single-photon emission computed tomography (SPECT). Patients and methods Forty CTEPH patients who underwent pulmonary perfusion scintigraphy and mean pulmonary arterial pressure (mPAP) measurement by right heart catheterization before and after BPA were studied. The total uptake volume (TUV) in bilateral lungs was determined from maximum intensity projection 99m Tc-MAA SPECT images. Fractal dimension was assessed by 3D-FA. Parameters were compared before and after BPA, and between patients with post-BPA mPAP more than 30 mmHg and less than or equal to 30 mmHg. Receiver operating characteristic analysis was carried out. Results BPA significantly improved TUV (595±204-885±214 ml, P<0.001) and reduced the laterality of uptake (238±147-135±131 ml, P<0.001). Patients with poor therapeutic response (post-BPA mPAP≥30 mmHg, n=16) showed a significantly smaller TUV increase (P=0.044) and a significantly greater post-BPA fractal dimension (P<0.001) than the low-mPAP group. Fractal dimension correlated with mPAP values before and after BPA (P=0.013 and 0.001, respectively). A post-BPA fractal dimension threshold of 2.4 distinguished between BPA success and failure with 75% sensitivity, 79% specificity, 78% accuracy, and area under the curve of 0.85. Conclusion 3D-FA using 99m Tc-MAA SPECT pulmonary perfusion scintigraphy enables a noninvasive evaluation of the response of CTEPH patients to BPA.

DOI： 10.1097/MNM.0000000000000673

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.22038/aojnmb.2016.7747

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.22038/aojnmb.2016.7606

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND PURPOSE: Primary malignant spine/spinal tumors (PMSTs) are rare and life-threatening diseases. In this study, we demonstrated the advantage of volume-based (18)F-FDG PET/CT metabolic parameter, metabolic tumor volume (MTV), for assessing the aggressiveness of PMSTs.
MATERIALS AND METHODS: We retrospectively reviewed 27 patients with PMSTs and calculated SUVmax, MTV, and total lesion glycolysis (TLG) to compare their accuracy in predicting progression-free survival (PFS) and overall survival (OS) by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were used to compare the reliability of the metabolic parameters and various clinical factors.
RESULTS: MTV exhibited greater accuracy than SUVmax or TLG. The cut-off values for PFS and OS derived from the AUC data were MTV 45 ml and 83 ml and TLG 250 SUV⁎ml and 257 SUV⁎ml, respectively. MTV above cut-off value, but not TLG, was identified as significant prognostic factor for PFS by log-lank test (p = 0.04). In addition, MTV was the only significant predictive factors for PFS and OS in the multivariate analysis.
CONCLUSIONS: MTV was a more accurate predictor of PFS and OS in PMSTs compared to TLG or SUVmax and helped decision-making for guiding rational treatment options.

DOI： 10.1155/2017/8132676

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1002/jmri.25261

Language：English   Publishing type：Research paper (scientific journal)  

Objectives: Radioiodine therapy is an effective treatment for lung metastasis from thyroid cancer. However, cases of lung metastasis without iodine uptake are often encountered. In such cases, FDG accumulation in lung lesions is often observed. There is a reverse relationship between iodine and FDG accumulation in thyroid cancer lesions, the so-called “flip-flop” phenomenon. The aim of this study was to assess the relationship between patient age and the occurrence of the flip-flop phenomenon. Methods: Eighty-six patients who underwent radioiodine therapy for lung metastasis were studied retrospectively (age 17–73 years; median 60 years; males:females 22:64). We compared the clinical data and imaging findings (size and FDG uptake of lung nodules) between patients with (n = 44) and without (n = 42) iodine uptake in lung metastasis. Results: Significantly more young patients showed iodine accumulation in lung metastasis than old patients (p = 0.0025). Lung metastases with larger size or greater FDG uptake showed no iodine uptake more frequently with significant difference (p = 0.015 and <0.001, respectively). Among patients with FDG uptake in the lung metastasis, 57.1 % of young patients (<60 years) and 24.3 % of the old patients (≥60 years) showed iodine uptake (p = 0.0029). Conclusions: Higher patient age and lung nodules with large size or FDG accumulation are negative factors for iodine accumulation in lung metastases from thyroid cancer. In addition, our results show that young patients have a greater likelihood of iodine uptake even when FDG accumulates in lung metastasis, in contrast to old patients.

DOI： 10.1007/s12149-016-1104-9

Language：English   Publishing type：Research paper (scientific journal)  

Objectives Anatomical coronary stenosis is not always indicative of functional stenosis, particularly for intermediate coronary lesions. The purpose of this study is to propose a new method for quantifying coronary flow using dynamic CT angiography for the whole heart (heart-DCT) and investigate its ability for detecting ischemia from intermediate coronary stenosis. Methods Participants comprised 36 patients with coronary artery disease who underwent heart-DCT using 320-detector CT with tube voltage of 80 kV and myocardial perfusion scintigraphy (MPS). Heart-DCT was continuously performed at mid-diastole throughout 15-25 cardiac cycles with prospective ECG-gating after bolus injection of contrast media (12-24 ml). Dynamic datasets were computed into 90-100 data sets by motion coherence image processing (MCIP). Next, time-density curves (TDCs) for coronary arteries with a diameter >3 mm were automatically calculated for all phases using MCIP. On the basis of the maximum slope method, coronary flow index (CFI) was defined as the ratio of the maximum upslope of coronary artery attenuation to the upslope of ascending aorta attenuation on the TDC, and was used to quantify coronary flow. CFIs for the proximal and distal sites of coronary arteries with mild-to-moderate stenosis were calculated. Coronary territories were categorized as non-ischemic or ischemic by MPS. Receiver-operating-characteristic (ROC) analysis was performed to determine the optimal cutoff for CFI to detect ischemia. Results Distal CFI was significantly lower for ischemia (0.26 ± 0.08) than for non-ischemia (0.50 ± 0.17, p < 0.0001). No significant difference in proximal CFI was seen between ischemia (0.55 ± 0.23) and non-ischemia (0.62 ± 0.24). ROC analysis revealed 0.39 as the optimal cutoff for distal CFI to detect ischemia, with C-statistics of 0.91, 100% sensitivity, and 75% specificity. Conclusions This novel imaging technique allows coronary flow quantification using heart-DCT. Distal CFI can detect myocardial ischemia derived from intermediate coronary stenosis.

DOI： 10.1016/j.ejrad.2016.02.027

Language：English   Publishing type：Research paper (scientific journal)  

Iron deficiency and cardiac sympathetic impairment play a role in the worsening of heart failure, and these two conditions may be linked. The present study aimed to clarify the relationship between myocardial iron deficiency, cardiac sympathetic activity, and major adverse cardiac events (MACE) in patients with dilated cardiomyopathy (DCM). Cardiac T2* MRI for iron deficiency and ¹²³I-Metaiodobenzylguanidine (MIBG) imaging for cardiac sympathetic activity were performed in 46 patients with DCM. Myocardial T2* value (M-T2*) was calculated by fitting signal intensity data for mid-left ventricular septum to a decay curve using 3-Tesla scanner. ¹²³I-MIBG washout rate (MIBG-WR) was calculated using a polar-map technique with tomographic data. We analyze the ability of M-T2* and MIBG-WR to predict MACE. MIBG-WR and M-T2* were significantly greater in DCM patients with MACE than in patients without MACE. Receiver-operating-characteristics curve analysis showed that the optimal MIBG-WR and M-T2* thresholds of 35 % and 28.1 ms, and the two combination predict MACE with C-statics of 0.69, 0.73, and 0.82, respectively. Patients with MIBG-WR <35 % and M-T2* <28.1 ms had significantly lower event-free rates than those with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (log-rank value = 4.35, p < 0.05). Cox hazard regression analysis showed that χ² and the hazard ratio were 3.99 and 2.15 for development of MACE in patients with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (p < 0.05). Iron deficiency, expressed by a high M-T2*, and MIBG-WR were both independent predictors of MACE in patients with DCM. The two combination was a more powerful predictor of MACE than either parameter alone.

DOI： 10.1007/s10554-014-0562-1

Language：English   Publishing type：Research paper (scientific journal)  

A 74-year-old woman underwent contrast-enhanced (CE) computed tomography (CT) that revealed an enlarging splenic lesion. This splenic tumor was suspected as metastasis because the patient had been diagnosed with right breast cancer with lung and right axillary lymph node metastases 4 years earlier and had undergone surgery and hormone therapy at another hospital. T₂-weighted imaging of magnetic resonance (MR) imaging demonstrated the tumor with slightly high intensity with a rim of low intensity at the margin. On dynamic contrast-enhanced (DCE)-MR imaging after intravenous administration of gadolinium diethylenetriamine pentaacetic acid, delayed enhancement was observed in the center and margin of the tumor. On positron emission tomography with 2-deoxy-2-[¹⁸F] fluoro-Dglucose (FDG) integrated with CT, the tumor showed high FDG uptake. Splenic metastasis was considered based on the imaging findings, lack of inflammation on laboratory data, and clinical course, so she underwent splenectomy. Histopathologically, the tumor was encapsulated by a fibrous structure, which was depicted as the rim at the tumor margin on T₂-weighted imaging and DCE-MR imaging. Immunohistochemical study allowed the diagnosis of inflammatory pseudotumor (IPT)-like follicular dendritic cell tumor (FDCT). FDCT is a primary neoplasm of lymph nodes that shows features of follicular dendritic cell differentiation, and it is rare at the spleen. Differential diagnosis is difficult between IPTlike FDCT and similar splenic tumors, such as IPT, splenic metastases, hamartoma and hemangioma. However, in addition to the enhancement pattern within a tumor on DCEMR imaging, detection of the capsular-like rim on MR imaging might aid the diagnosis of splenic IPT-like FDCT.

DOI： 10.2463/mrms.2014-0052

Language：English   Publishing type：Research paper (scientific journal)  

FDG-PET is increasingly being used for assessment of the staging, for evaluating the response to treatment, and for monitoring the reactions to therapy in malignant lymphoma. This review will highlight the most important applications of FDG-PET in lymphoma, focusing on the advantages and pitfalls of this imaging, and past and ongoing efforts to standardize the use of FDG-PET, particularly in response to assessment and therapy monitoring.

Language：English   Publishing type：Research paper (scientific journal)  

In oncology, the apparent diffusion coefficient (ADC) measured by diffusion-weighted MR imaging (DWI) and the standardized uptake value (SUV) from ^18F-FDG PET have similar clinical applications. The purpose of this study was to assess the correlation between the ADC and SUV and compare their potential in the diagnosis and prediction of prognosis in breast tumors. Methods: Seventy-nine female patients (age range, 19-69 y; average, 49.1 y) with 83 pathologically proven breast tumors were recruited. The diagnoses consisted of 70 malignant breast tumors (65 cases of invasive ductal carcinoma, 1 of medullary carcinoma, 1 of mucinous carcinoma, 1 of squamous cell carcinoma, and 2 of micropapillary carcinoma) and 13 benign breast tumors (4 cases of fibroadenoma, 4 of mastopathy, 3 of adenosis with atypia, and 2 of benign phyllodes tumor). All patients underwent mammary gland MR imaging with DWI and ^18F-FDG PET within a 2-wk interval. The patients' ADCs and SUVs were measured within the tumor by DWI and ^18F-FDG PET, respectively. For the malignant tumors, we evaluated the relationships among ADC, SUV, histopathologic appearance, and long-term prognosis. Results: A significant difference (P < 0.05) was observed in both parameters (ADC and SUV) between the benign and malignant breast tumors, and the difference was more significant when we introduced a new parameter, SUV/ADC. There was a weak inverse correlation between ADC and SUV (r = -0.36; P = 0.06) among the total tumors; however, this correlation was not significant within the group of malignant tumors. High SUV was found to correlate with larger tumor size, higher nuclear grade, and the triple-negative hormonal receptor profile. High ADC was revealed to be correlated with negative progesterone receptor and positive human epidermal growth factor receptor 2 profile. Higher SUVs also showed a correlation with poor prognosis. No correlation was seen between ADC and prognosis. Conclusion: Both SUV and ADC are helpful parameters in differentiating benign from malignant breast tumors. The use of SUV and ADC in combination may help in the diagnosis because of their inverse relationship. High preoperative SUV was associated with poor prognosis, but the contribution of ADC to prognosis prediction was small.

DOI： 10.2967/jnumed.113.129395

Language：English   Publishing type：Research paper (scientific journal)  

Objective: We evaluated the accuracy of amplitude gating PET (AG-PET) compared with phase gating PET (PG-PET) in relation to respiratory motion patterns based on a phantom analysis.
Method: We used a NEMA IEC body phantom filled with an ¹⁸F solution with a 4:1 sphere-to-background radioactivity ratio (12.6 and 2.97 kBq/mL). PET/CT scans were acquired in a motionless and moving state on a Biograph mCT. The respiratory movements were simulated by four different waveform patterns consisting of ideal breathing, breathing with a pause period, breathing with a variable amplitude and breathing with a changing baseline. AG-PET selects the narrow bandwidth containing 20 % of the respiratory cycle. PG-PET was reconstructed with five gates. The image quality was physically assessed using the percent contrast (Q_H,10mm), background variability (N_10mm) recovery coefficient (RC), and sphere volumes.
Result: In regular motion patterns with ideal breathing and breathing with a pause period, the Q_H,10mm, RC and sphere volumes were not different between AG-PET and PG-PET. In the variable amplitude pattern, the Q_H,10mm of AG-PET was higher than that of PG-PET (35.8 vs 28.2 %), the RC of AG-PET was higher than that of PG-PET and sphere volume of AG-PET was smaller than that of PG-PET (6.4 vs 8.6 mL). In the changing baseline pattern, the Q_H,10mm of AG-PET was higher than that of PG-PET (42.4 vs 16.7 %), the RC of AG-PET was higher than that of PG-PET and sphere volume of AG-PET was smaller than that of PG-PET (6.2 vs 9.8 mL). The N_10mm did not differ between AG-PET and PG-PET, irrespective of the motion pattern.
Conclusion: Amplitude gating PET is considered to be more accurate than phase gating PET for examining unstable respiratory motion patterns, such as those involving a variable amplitude or changing baseline.

DOI： 10.1007/s12149-014-0870-5

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Many cases of unexpected radioiodine uptake have been reported, including physiological uptake in healthy tissue and in both benign and malignant nonthyroidal lesions. However, iodine uptake in the uterus has not been well assessed. In this article, we systemically analyzed iodine uptake in the uterus and identified the site in which uptake occurred. MATERIALS AND METHODS: Seventy-six female patients who underwent SPECT/CT from neck to pelvis were included in this study; 5 patients with uterine uptake received pelvic MRI. Iodine uptake in the uterus was diagnosed with SPECT/CT and compared with the findings of the MRI. Serum TSH level, administered dose of iodine-131 and number of radioiodine therapies were compared between the 2 groups with and without iodine uptake in the uterus. RESULTS: Twenty (26.3%) of 76 patients showed iodine uptake in the uterine cervix on SPECT/CT. It was difficult to distinguish the uptake in the uterus from that in the urinary bladder or rectum using only planar images. The patients with the uterine uptake were younger than those without (median age, 46.5 vs. 62, P = 0.011). There were no significant differences in serum TSH level, administered dose of iodine-131, or number of radioiodine therapies between the 2 groups. In all instances of the 5 patients who underwent pelvic MRI, iodine uptake in the uteri was located in nabothian cysts. CONCLUSION: Iodine uptake in the uterus is frequently found if pelvic SPECT/CT is performed. Nabothian cysts are a predominant cause of iodine uptake in the uterine cervix.

DOI： 10.1097/RLU.0000000000000504

Language：English   Publishing type：Research paper (scientific journal)  

Purpose: The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 FDG PET/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC). Methods: Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. SUVmax and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax <3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared. Results: For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p < 0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p = 0.0001) and 14 mLNs with weak FDG uptake (p = 0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92 %) than SUVmax (62 %) (p < 0.0001). Conclusion: PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT.

DOI： 10.1007/s12149-013-0767-8

Event date： 2023.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：久留米市, 福岡   Country：Japan  

Event date： 2022.6

Language：English  

Venue：online   Country：United States  

Event date： 2022.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：オンライン   Country：Japan  

Event date： 2020.11

Language：Japanese  

Venue：神戸市、兵庫   Country：Japan  

Event date： 2020.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：佐賀市   Country：Japan  

Event date： 2020.6

Language：English  

Venue：Anaheim, CA   Country：United States  

Event date： 2019.11

Language：Japanese  

Venue：松山市、愛媛   Country：Japan  

Event date： 2019.11

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：松山市、愛媛   Country：Japan  

Event date： 2019.7

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市、福岡   Country：Japan  

Event date： 2019.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：鹿児島市   Country：Japan  

【目的】去勢抵抗性前立腺癌骨転移に対する223RaCl2内用療法の客観的な治療効果評価には血中ALPが用いられる。骨トレーサーであるF-18 Sodium Fluoride（NaF）を用いたPET/CT（以下18F-NaF PET/CT）では半定量値の測定が可能である。本研究では18F-NaF PET/CTの半定量値とRa-223 RaCl治療における血中ALPとの関係を調べ、治療効果予測の有用性を検証した。
【方法】2017年3月から2018年10月までにRa-223 RaCl内用療法を施行され、治療開始時に18F-NaF PET/CTを施行し、治療開始時および治療終了後に血中ALPを測定した男性6名（年齢 65-77歳、中央値 68歳）。18F-NaF PET/CT半定量値としてSUVmax、SUVmax≧10となる領域を病変と仮定したMTVおよびTLGを測定し、ALPおよび治療前後のALP比（ALP%）との相関をそれぞれ調べた。
【結果】ALPとSUVmax、MTV、TLGの間には弱い正の相関がみられた。ALP%とSUVmax、MTV、TLGの間には負の相関が見られ、特にALP%とSUVmaxで強い相関がみられた(R2=0.84)。
【結語】18F-NaF PET/CTのSUVmaxが高いほどALPの減少率が高く、去勢抵抗性前立腺癌骨転移に対する223RaCl2内用療法の治療効果予測に有用である可能性が示唆された。

Event date： 2018.6

Language：English   Presentation type：Oral presentation (general)  

Venue：神奈川県横浜市 パシフィコ横浜   Country：Japan  

Objective: A large amount of injected 18F-Sodium fluoride (NaF) is thought to be excreted by kidney. The effect of excretion rate of NaF on SUV is not well known in NaF PET/CT. We evaluated the relationship between urinary excretion rate of NaF and bone SUV in normal volunteers.
Materials and Methods: Whole body PET/CT scan was performed 30 and 70 min after the injection with a mean dose of 58 MBq of NaF in five male volunteers (age:32-48) with normal renal function. The SUV of all thoracolumbar vertebras and blood pool (aortic arch and left ventricle) were measured in both scans. Increase rates of SUV between first and second scan were also calculated. Urinary excretion rate of each volunteer was calculated using direct measurement of radioactivity of urine which acquired after the first scan and total injected dose. Correlation of excretion rate and SUV were evaluated.
Results: Significant variation was seen in urinary excretion rate (25.6-77.2 % ; mean: 52.9%, coefficient of variation: 0.40). No significant correlation was seen between urinary excretion rate and SUV (R2=0.02, p=0.17) nor increased rate (R2=0.06, p<0.05) in thoracolumbar vertebras. Inverse correlation was seen between urinary excretion rate and increased rate in blood pool(R2=0.53, p=0.16).
Conclusion: The bone SUV in NaF PET/CT is stable despite urinary excretion rate of NaF which have a significant individual difference. On the other hand, uptake of blood pool is susceptible to excretion rate. So attention is needed when we use it as background reference.

Event date： 2018.6

Language：Japanese  

Venue：福岡県久留米市　久留米シティプラザ   Country：Japan  

【背景】F-18 NaF（Sodium Fluoride）を用いたPET/CT（以下NaF PET）は主に骨代謝亢進を反映するトレーサーであり、半定量値(SUV：Standardarized uptake value)の計測が可能である。しかし骨の部位によってSUVが異なることが知られている。特に脊椎、骨盤骨など赤色骨髄が分布する骨で集積程度が強く、これらの骨は加齢に伴い集積が変化する可能性がある。
【目的】若年と老年それぞれの成人男性におけるNaF PETの集積を比較し、骨の部位ごとの半定量値と年齢との相関を検証する。
【方法】4名の正常成人男性および2名の前立腺癌患者に対してNaF PETを施行した。60歳以下を若年群、60歳以上を老年群として、投与60分後に撮像を行い、骨の各部位でSUVmaxおよびSUVmeanを測定し、それぞれの部位について2群間で比較を行った。
【結果】測定した骨のうち、脊椎や骨盤骨では若年群に比べ老年群で集積が低かった。頭蓋骨、大腿骨、上腕骨では若年群と老年群に有意な差は認めなかった。腰椎では年齢とSUVmaxおよびSUVmeanで有意な相関を認め(p=0.01)、高齢者ほど集積が低かった。
【結論】NaF PETにおいて、特に赤色骨髄を有しうる骨では病変の半定量解析の際に年齢を考慮する必要がある。

Event date： 2018.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：神奈川県横浜市 パシフィコ横浜   Country：Japan  

Event date： 2017.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：那覇市   Country：Japan  

Event date： 2016.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名古屋国際会議場   Country：Japan  

Event date： 2016.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名古屋市   Country：Japan  

Event date： 2016.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名古屋市   Country：Japan  

Event date： 2016.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：宮崎市   Country：Japan  

Event date： 2016.6

Language：English   Presentation type：Symposium, workshop panel (public)  

Venue：San diego   Country：United States  

Event date： 2016.6

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：San diego   Country：United States  

Event date： 2016.6

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：San diego   Country：United States  

Event date： 2016.4

Language：English   Presentation type：Oral presentation (general)  

Venue：横浜市   Country：Japan  

Language：Japanese  

Language：English  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：English  

Language：Japanese  

Language：English  

Language：Japanese  

Language：Japanese