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Poor uptake to pulmonary rehabilitation (PR) is still challenging around the world. There have been few nationwide studies investigating whether PR impacts patient outcomes in COPD. We investigated the change of annual PR implementation rate, medical costs, and COPD outcomes including exacerbation rates and mortality between 2015 and 2019.

In recent years, fibroblast activation protein (FAP) has emerged as an important target for the diagnosis and therapy of various tumors due to its high expression on the cell surface of cancer-associated fibroblasts, which are the major components of the tumor stroma. In this study, we synthesized and evaluated 18F-labeled FAP inhibitors (FAPIs) for FAP imaging. Two silicon fluoride acceptor (SiFA)-conjugated FAPIs were synthesized: one containing a γ-carboxy-l-glutamic acid (Gla) residue (1) and another containing two Gla residues (2). Both ligands exhibited high binding affinities for FAP. 18F/19F exchange reactions on both ligands were performed in the presence of 2% water. This resulted in the formation of radioligands [18F]1and [18F]2in high radiochemical yields. Radioligand [18F]2, with a more favorable partition coefficient, was selected for the U87MG cell binding study, and the results showed FAP-specific binding of the radioligand to the cells. An ex vivobiodistribution study in U87MG tumor-bearing mice 60 min after injection demonstrated a 5.8-fold higher tumor accumulation of [18F]2than that of [18F]1. Furthermore, PET and ex vivobiodistribution studies of [18F]2in U87MG tumor-bearing mice showed high and persistent tumor uptake over time, which was significantly blocked by the preinjection of FAPI-04. Our results indicate that [18F]SiFA-(Gla)2-conjugated FAPI ([18F]2) has the potential for FAP imaging.

Purpose: 99mTc-labeled sestamibi scintigraphy combined with single-photon emission computed tomography (SPECT) has a high positive predictive value for localizing hyperfunctioning parathyroid lesions in primary hyperparathyroidism (pHPT) but relatively low sensitivity and specificity in secondary hyperparathyroidism (sHPT) and tertiary hyperparathyroidism (tHPT). The purpose of this study is to investigate the usefulness of 99mTc-sestamibi scintigraphy in persistent hyperparathyroidism after kidney transplant (KT). Methods: Retrospectively evaluated 50 patients who received parathyroidectomy after KT at a single medical center. The parathyroid lesion with the highest sestamibi uptake intensity of a patient was graded from 0 to 3. Uptake intensity was analyzed in correlation with parathyroid hormone (PTH), calcium, ionized calcium, phosphorus, and vitamin D. Results: Per-patient analysis, 43 patients had hyperplasia, 6 patients had adenomas, and 1 patient had a carcinoma. Only 3 patients with hyperplasia did not demonstrate any sestamibi uptake in the parathyroid scans. Out of the 148 pathologically confirmed parathyroid lesions, SPECT/CT images were able to identify 89 lesions (60%) and planar images of 71 lesions (48%). The average of sestamibi uptake intensity was mild at grade 1.6. Uptake intensity showed a positive correlation with parathyroid hormone (PTH) level but not with phosphorus, calcium, ionized calcium, or vitamin D levels. The largest lesion showed a high positive predictive value, especially in lesions with a diameter over 1.0 cm. Conclusions: Regardless of relatively low and less discrete uptake in KT patients, it well depicts the largest and the most hyperfunctioning lesion.

Hypoxia is a representative tumor characteristic associated with malignant progression in clinical patients. Engineered in vitro models have led to significant advances in cancer research, allowing for the investigation of cells in physiological environments and the study of disease mechanisms and processes with enhanced relevance. In this study, we propose a U-shape pillar strip for a 3D cell-lumped organoid model (3D-COM) to study the effects of hypoxia on lung cancer in a high-throughput manner. We developed a U-pillar strip that facilitates the aggregation of PDCs mixed with an extracellular matrix to make the 3D-COM in 384-plate array form. The response to three hypoxia-activated prodrugs was higher in the 3D-COM than in the 2D culture model. The protein expression of hypoxia-inducible factor 1 alpha (HIF-1α) and HIF-2α, which are markers of hypoxia, was also higher in the 3D-COM than in the 2D culture. The results show that 3D-COM better recapitulated the hypoxic conditions of lung cancer tumors than the 2D culture. Therefore, the U-shape pillar strip for 3D-COM is a good tool to study the effects of hypoxia on lung cancer in a high-throughput manner, which can efficiently develop new drugs targeting hypoxic tumors.

The use of tumor-informed circulating tumor DNA (ctDNA) testing in patients with early-stage disease before surgery is limited, mainly owing to restricted tissue access and extended turnaround times. This study aimed to evaluate the clinical value of a tumor-naïve, methylation-based cell-free DNA assay in a large cohort of patients with resected NSCLC.

Since the foundation of the Korean Society of Nuclear Medicine in 1961, clinical nuclear oncology has been a major part of clinical nuclear medicine in Korea. There are several important events for the development of clinical nuclear oncology in Korea. First, a scintillating type gamma camera was adopted in 1969, which enabled to perform modern oncological gamma imaging. Second, Tc-99 m generator was imported to Korea since 1979, which promoted the wide clinical use of gamma camera imaging by using various kinds of Tc-99 m labeled radiopharmaceuticals. Third, a gamma camera with single photon emission tomography (SPECT) capability was first installed in 1980, which has been used for various kinds of tumor SPECT imaging. Fourth, in 1994, clinical positron emission tomography (PET) scanner and cyclotron with a production of F-18 fluorodeoxyglucose were first installed in Korea. Fifth, Korean Board of Nuclear Medicine was established in 1995, which contributed in the education and manpower training of dedicated nuclear medicine physicians in Korea. Finally, an integrated PET/CT scanner was first installed in 2002. Since that, PET/CT imaging has been a major imaging tool in clinical nuclear oncology in Korea. In this review, a brief history of clinical nuclear oncology in Korea is described.

This study investigates a brazing method for manufacturing PbTe thermoelectric modules using a Ag-based filler metal with a melting point of about 650 °C. To improve the bonding strength between the Ag-based brazing layer and the PbTe thermoelectric module, an electroless Ni-P plating layer is formed on the surface of the thermoelectric module as a diffusion barrier layer. The bonding strength of the PbTe thermoelectric module manufactured by the electroless Ni-P plating and Ag-based brazing has a high value of approximately 8.3 MPa. No defects such as pores or cracks were observed at the bonding interface between the thermoelectric element and the brazing layer. Furthermore, because of the high bonding strength of the manufactured thermoelectric module, fractures occur inside the thermoelectric element rather than at the bonding interface. Accordingly, the electroless Ni-P plating and Ag-based brazing method proposed in this study is found to be effective in manufacturing PbTe-based thermoelectric modules with high bonding strength.

Background: F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is useful in multiple myeloma (MM) for initial workup and treatment response evaluation. Herein, we evaluated the prognostic value of semi-quantitative FDG parameters for predicting the overall survival (OS) of MM patients with or without autologous stem cell transplantation (ASCT). Methods: Study subjects comprised 227 MM patients who underwent baseline FDG PET/CT. Therein, 123 underwent ASCT while 104 did not. Volumes of interest (VOIs) of bones were drawn on CT images using a threshold of 150 Hounsfield units. FDG parameters of maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and number of focal lesions (FLs) were measured. Kaplan-Meier survival analysis with log-rank tests and Cox proportional hazards regression analyses were performed for overall survival (OS). Results: In the ASCT cohort, R-ISS stage, MTV, and TLG were associated with survival. In the non-ASCT cohort, however, R-ISS stage was not associated with patient outcomes. In contrast, high SUVmax, SUVmean, MTV, TLG, and FL could predict worse OS (hazard ratio [HR] = 2.569, 2.649, 2.506, 2.839, and 1.988, respectively). Importantly, combining FDG parameters with R-ISS stage provided a new risk classification system that discriminated worse OS in the non-ASCT cohort significantly better than did R-ISS stage alone. Conclusions: In the non-ASCT cohort, semi-quantitative FDG parameters were significant predictors of worse OS. Furthermore, combining FDG parameters with R-ISS stage may provide a new risk staging system that can better stratify the survival of MM patients without ASCT.

Multimodality imaging measurements of treatment response are critical for clinical practice, oncology trials, and the evaluation of new treatment modalities. The current standard for determining treatment response in non–small cell lung cancer (NSCLC) is based on tumor size using the RECIST criteria. Molecular targeted agents and immunotherapies often cause morphological change without reduction of tumor size. Therefore, it is difficult to evaluate therapeutic response by conventional methods. Radiomics is the study of cancer imaging features that are extracted using machine learning and other semantic features. This method can provide comprehensive information on tumor phenotypes and can be used to assess therapeutic response in this new age of immunotherapy. Delta radiomics, which evaluates the longitudinal changes in radiomics features, shows potential in gauging treatment response in NSCLC. It is well known that quantitative measurement methods may be subject to substantial variability due to differences in technical factors and require standardization. In this review, we describe measurement variability in the evaluation of NSCLC and the emerging role of radiomics.

The maximum standardized uptake values and the Prostate Imaging Reporting and Data System version 2 scores of primary tumors at fluorine 18 fluorocholine PET/MR imaging show good correlation with clinical-pathologic characteristics, such as postsurgical Cancer of the Prostate Risk Assessment scores, which are related to prognosis in patients with newly diagnosed intermediate-to high-risk prostate cancer.

An 8-inch commercial spiral wound forward osmosis (FO) module was tested to investigate the effect of transmembrane pressure on the performance of the FO membrane. A coupon taken from the FO module was tested in a lab-scale FO system to determine water and solute permeability of the membrane. The positive transmembrane pressure enhances the water flux of the FO module, and interestingly the amount of the flux enhancement exceeds the multiplication of the water permeability and the transmembrane pressure. This abnormal flux enhancement is caused by the shrunken draw solution (DS) channel height, which is clearly verified by the hydraulic tests in this work. The shrunken DS channel height makes the effect of external concentration polarization smaller, which should be one of the potent reasons for the additional flux enhancement. This finding suggests that an adequate transmembrane is effective to operate FO systems using spiral wound modules to extract better performance of the modules.

The two different types (flat sheet and spiral wound) of commercial forward osmosis (FO) elements with thin film composite membrane were tested to understand the effects of concentrations and crossflow velocities of feed solution (FS) and draw solution (DS) on the performance of the element. An FO element tester was customized for reliable measurements of water flux and reverse solute flux during operation time when the concentration difference between DS and FS was decreased. The test results reveal that: (1) the water flux and reverse solute flux increases at higher concentration differences between FS and DS, (2) the higher crossflow velocity increases water flux by decreasing the effects of external concentration polarization, (3) the pressure differential between the inlet and the outlet of the FO element increases at higher crossflow velocities, which may limit the crossflow velocity in a full-scale FO design, (4) the flat sheet element exhibits up to 25 LMH of water flux comparable to the water flux (30–35 LMH) in the coupon tests, and (5) the spiral wound FO element shows a peculiar flux pattern in which the increasing rate of water flux becomes retarded when water flux exceeds a critical value maybe because the DS channel in the FO membrane envelop may not allow a flow rate higher than a critical value due to complexity in the DS flow direction.

In the 2015 World Health Organization classification, invasive mucinous adenocarcinoma (IMA) is categorized as one of various subtypes of lung invasive adenocarcinoma (ADC). However, no comprehensive analysis regarding the clinicoradiologic and prognostic features of IMA has been reported. We aimed to report prognostic factors in IMA and to compare the prognosis of IMAs with that of nonmucinous ADCs.

Lymph node metastasis (LNM) in many solid cancers is a well-known prognostic factor; however, it has been debated whether regional LNM simply reflects tumor aggressiveness or is a source for further tumor dissemination. Similarly, the metastatic process in head and neck cancer (HNC) has not been fully evaluated. Thus, we aimed to investigate the relative significance of LNM in metastatic cascade of HNC using functional imaging of HNC patients and molecular imaging in in vivomodels. First, we analyzed 18Fluorodeoxyglucose positron emission tomography (PET) parameters of 117 patients with oral cancer. The primary tumor and nodal PET parameters were measured separately, and survival analyses were conducted on the basis of clinical and PET variables to identify significant prognostic factors. In multivariate analyses, we found that only the metastatic node PET values were significant. Next, we compared the relative frequency of lung metastasis in primary ear tumors versuslymph node (LN) tumors, and we tested the rate of lung metastasis in another animal model, in which each animal had both primary and LN tumors that were expressing different colors. As a result, LN tumors showed higher frequencies of lung metastasis compared to orthotopic primary tumors. In color-matched comparisons, the relative contribution to lung metastasis was higher in LN tumors than in primary tumors, although both primary and LN tumors caused lung metastases. In summary, tumors growing in the LN microenvironment spread to systemic sites more commonly than primary tumors in HNC, suggesting that the adequate management of LNM can reduce further systemic metastasis.

Assessment of tumour viability after treatment is essential for prediction of treatment failure in patients with extranodal natural killer/T-cell lymphoma (ENKTL). We aimed to assess the use of the post-treatment Deauville score on PET-CT and Epstein-Barr virus DNA as a predictor of residual tumour, to establish the risk of treatment failure in patients with newly diagnosed ENKTL.

Because magnetic resonance imaging and angiography are inappropriate for whole-body screening because of high cost or invasiveness, we investigated the potential of whole-body blood pool scintigraphy (WBBPS) as a screening and diagnostic tool for congenital vascular malformations (CVMs).

We retrospectively investigated the value of dynamic 99mTc-diisopropyl-iminodiacetic acid hepatobiliary scintigraphy (HBS) in discriminating postsurgical complications following liver transplantation (LT).

In the present study, 2‐methoxyestradiol‐3,17β‐O,O‐bissulfamate (1), a known angiogenesis inhibitor, was prepared in a radiolabeled form by 11C‐methylation of 2‐hydroxyestradiol‐3,17β‐O,O‐bis(N‐trityl)sulfamate (6) followed by detritylation. Synthesis of precursor 6 required a rather long step because of the presence of two sulfamoyl groups. The decay‐corrected radiochemical yield of [11C]1 was 19 ± 2% based on [11C]CH3I, and the specific activity was 34–39 GBq/µmol. Although 1 is known to significantly inhibit the proliferation of human umbilical vascular endothelial cells (HUVECs), its radiolabeled form, [11C]1 was not avidly taken up by HUVECs, and the uptake increased slightly in a time‐dependent manner (156% at 60 min relative to a value of 100% at 5 min). These results suggest that further studies are warranted to determine the molecular target for [11C]1. Copyright © 2011 John Wiley & Sons, Ltd.

Exploration of the Appropriate NT-proBNP Level for AL Amyloidosis Staging

No relevant conflicts of interest to declare.

Alzheimer's disease (AD) is characterized by reduced acetylcholinesterase (AChE) activity in the post-mortem tissues of AD patients. Therefore, AChE has been an attractive target for the diagnosis of AD. In the present study, 5,7-dihydro-3-2-(1-(phenylmethyl)-4-piperidinyl)ethyl-6H-pyrrolo3,2-f-1,2-benzisoxazol-6-one (CP-118,954), a potent AChE inhibitor, was labelled with radioiodine and evaluated as an AChE imaging agent for SPECT.

Objective:To evaluate the hypothesis that the [18F]‐fluorodeoxyglucose (FDG) standardized uptake values (SUVs) of positron emission tomographic (PET) imaging can predict pathologic extrathyroid invasion of thyroid papillary microcarcinomas (TPMC)

We prospectively investigated the incidence of femoral head avascular osteonecrosis (AVN) and radio-uptake patterns of femoral heads on bone scintigraphy at 1 year after renal transplantation.

We investigated the clinical significance of thyroid visualization on technegas (TcG) ventilation scintigraphy (TcGS) based on the hypothesis that this visualization may be correlated with thyroid disease with high radioactive thyroid uptake (RATU).

One of the most important issues in AC PDP is the improvement of luminous efficiency. One possible method for achieving this aim is by increasing Xe partial pressure in discharge gas mixture. The increase of Xe ratio, however, causes the driving voltage to rise, even if brightness is increased. In this study, a new electrode shape is proposed. A test panel fabricated by using a new electrode shows that efficacy has improved by 25 % and sustain voltage has decreased by 20 % compared with the conventional structure.

One of the important problems in ac PDP in recent years is the misfiring of ac PDP at high ambient temperatures which consequently degrades the image quality of the ac PDP. This may be due to the change of working gas pressure and/or MgO surface characteristics at high ambient temperatures. This paper deals with the effect of working gas pressure on the misfiring of ac PDP at high ambient temperature. From this study, we found that the main cause of the misfiring at high ambient temperature is the increase in discharge firing voltage induced by increased working gas pressure

Background: We examined whether cardiac sympathetic imaging with iodine-123 metaiodobenzylguanidine (MIBG) would predict improvement of left ventricular (LV) function and exercise capacity in patients with heart failure after treatment with carvedilol. Methods and Results: Eighteen patients with heart failure and 5 control subjects underwent 1–123 MIBG imaging. Heart-to-mediastinum ratios at 20 minutes and 3 hours and myocardial washout rates (WR) were measured. Of the 18 patients, 11 were randomized to receive carvedilol medication, whereas the remaining 7 received a placebo. Only the carvedilol group demonstrated a significant improvement in both heart failure functional class and LV ejection fraction (EF) 1 year after the start of medication. Within the carvedilol group, MIBG WR showed a significant inverse correlation with improvement in LVEF (ρ = -0.74, P = 02). The diagnostic accuracy of WR for predicting EF response to carvedilol was 91%. WR also appeared to be inversely related to the peak oxygen consumption rate (ρ = -0.65, P = 08), although this did not reach statistical significance. Conclusion: 1–123 MIBG imaging appears useful in predicting which patients with heart failure are likely to show the most improvement in LV function and exercise capacity after carvedilol treatment. Further studies in this area appear to be warranted.

Background: Because equivocal fixed perfusion defects on single photon emission computed tomography (SPECT) often cause a diagnostic dilemma in patients with suspected coronary artery disease (CAD), we used receiver-operating characteristic (ROC) curve analysis to evaluate the degree of increased accuracy provided by adding gated images for interpretation of such cases. Methods and results: One hundred five (29%) of 365 consecutive patients undergoing technetium 99m tetrofosmin gated SPECT for evaluation of CAD demonstrated an equivocal fixed defect. Two independent observers graded the probability for true lesion with a 5-point system over 3 steps of interpretation: reviewing tomographic images alone (step 1), adding projection images (step 2), and adding gated cine images (step 3). Based on clinical criteria, 66 patients were categorized as disease negative and 25 as disease positive, while the final diagnosis was undetermined in 14 cases. Diagnostic performance was significantly higher at step 3 than at step 1 for both observers (p<0.05 and <0.0001) and at step 2 for observer B (p<0.005). The maximum accuracy increased from 78.0% to 80.2% at step 2 to 84.6% to 86.8% at step 3. Moreover, the agreement of interpretation between the 2 observers was higher at step 3 (κ=0.53) than at step 1 (ϰ=0.29) or step 2 (ϰ=0.25). Conclusion: In patients showing an equivocal fixed defect on 99mTc tetrofosmin SPECT, gated cine images provide improved differential accuracy and enhanced objectivity of interpretation by reducing interobserver variance.

To demonstrate semantic, radiomics, and the combined risk models related to the prognoses of pulmonary pleomorphic carcinomas (PCs).