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FDG-PET (2007) PET

FDG PET * 2 * PET FDG PET PET/CT PET PET PET PET PET PET PET CT PET QOL PET PET PET PET 2

1. 2. 3. 4. 5. 6. 7. 8. 9. 9-1) 9-2) 9-3) FDG-PET 9-4) 9-5) A. CT B. PET/CT 9-6) MRI 9-7) 10. 11. 12. 12-1) 12-2) 12-3) 12-4) 12-5) 12-6) 12-7) 12-8) 12-9) 12-10) 12-11) 13. 14. 15. 16. 3

PET 1994 PET PET PET FDG-PET QOL PET PET PET PET/CT PET 2005 2007 FDG-PET PET 3-1) FDG-PET 50 10 39 (0.54%) 40 49 (0.66%) 50 59 (0.97%) 60 69 (1.43%) 70 79 (2.31%) 50 60 61% 50 3-2) 3-3) PET PET PET PET 4

PET (1) (2) (3) PET 26.2% 1 1 FDG-PET PET 1 1 2 2 5 1 (1) (2) (3) (1) (2) (3) (4) (1) PET PET/CT 5

(2) CT (3) MRI (4) (5) (6) (7) (8) (9) (10) (1) PET (2) (1) (2) 24 12 (3) BMI A. (1) (2) HDL HbA1 c BUNCRP H. (3) B. CEA AFP PSA CA125 CA19-9 NCC-ST-439 SCC C. FDG-PET FDG FDG PET PET PET/CT 4 FDG 6

150 mg/dl 200 mg/dl FDG 30 FDG 3.7 MBq/kg FDG 60 2D 3D FDG 2 Delayed scan SAC (Segmented Attenuation Correction) FDG-PET FDG-PET 7.5 10 MHz FDG-PET MRI 7

PET/CT FDG-PET FDG-PET FDG-PET FDG-PET CT MRI MRI CT CT PET/CT CT CT 10 mm 10 mm MDCT MPR PET CT 6 CT 120 kv 20 50 ma 10 mm 2.0 10 mm CT 4 120 kv 10 30 ma 2 5 mm 3.0 3.5 2 8 mm 8 16 MDCT PET/CT CT MDCT CT CT CT CT CT CT CT CT CT (http://www.jscts.org) CT CT 8

PET/CT CT PET/CT PET/CT PET CT PET/CT CT CT PET PET/CT (1) PET/CT PET CT 20 (2) CT PET/CT CT CT PET CT 3 PET/CT PET/CT PET CT MR PET/CT CT PET/CT CT CT CT PET CT 9

PET/CT CT PET CT PET PET/CT (3) PET/CT PET SUV MIP 3 PET/CT PET/CT CT PET 2 CT PET CT PET CT SUV PET (4) PET CT (5) PET/CT PET CT CT 2 msv 12 msv PET/CT (6) PET/CT PET FDG CT delayed scan 10

PET PET/CT PET/CT delayed scan FDG-PET FDG-PET 1.0 T phased-array coil 5 mm SE T2 T1 (1) T2 T2 (T2 ) T1 T1 (2) T2 T2 T2 T1 FDG-PET MRS (MR spectroscopy) MRS FDG-PET 16% 12% 3 FDG-PET PET PET PET PET PET PET PET PET PET (1) (3) (4) PET 11

PET ID (1) PET PET/CT PET/CT CT PET (2) (3) PET PET/CT (4) PET PET/CT 1 1 1 PET 1 PET 2 3 1 PET PET PET 12

PET PET 1994 10 2003 12 7,793 52 11 18,919 FDG-PET 204 FDG-PET 104 FDG-PET 100 2000 10 2004 6 10,567 55.0 FDG-PET 167 FDG-PET 107 FDG-PET 60 glucose-6-phosphatase FDG-PET FDG 43,996 6 0.014% 500 0.12% FDG-PET FDG FDG-PET FDG-PET 21/33 (63%) FDG-PET PET 2005 500 107 50 60 FDG-PET 87.9% 13

32.9% PET 80.6% 28.9% PET/CT 100% 40.4% PET/CT (p 0.01) FDG 1 PET PET 10 mm FDG-PET CT FDG-PET 5 33% 2005 12% FDG-PET FDG-PET FDG 10% 9% PET H. 4 FDG-PET 26.6% 15.5% PET 3 FDG FDG 50 60 FDG-PET 90.2% 22.6% PET/ CT PET II 35 31 (88.6%) 14

PET FDG-PET PET PET (CEA) PET 10 mm 13 mm 90% PET FDG 2 PET hot spot 50% 90% N Engl J Med 2000; 343: 1603 7 50 FOBT sigmoidoscopy or colonoscopy USPSTF Ann Intern Med 2002; 137: 129 131 CT CT CT FDG-PET 9 5 (56%) CT FDG-PET PET/CT PET CT FDG-PET CT PET MDCT 1 X CT 2005 60 FDG-PET IIA 35 23 PET 65.7% IIB 100% FDG IIA 35 12 CT 44 24 CT 15

FDG PET PET/CT 59% 25.0% 100% 47.1% FDG-PET FDG FDG FDG CT FDG FDG-PET CT FDG 1) 2) CT FDG CT FDG-PET 25 35% PET/CT PET PET CT (fusion image) PET FDG-PET fusion image GGO 2 FDG CT FDG fusion image 30 fusion image PET/CT fusion image 1) FDG CT FDG-PET CT FDG FDG CT 16

2) PET/CT CT FDG PET/CT GGO CT PET/CT PET/CT CT CT 1993 9 CT CT 10 CT 1994 2006 CT CT decision tree CT 5 mm pure GGO mixed GGO pure GGO CT CT 3) CT FDG FDG FDG FDG volume CT Single slice helical CT CT CT http://www.jscts.org CT Multislice CT CT CT CT CT (A, B, C, D1, D2, D3, 17

D4, E1, E2) PET 4) CT CT I 1 2 X CT CT CT CT CT CT 18

19

PET 40 60 FDG-PET 87.2% 42% PET PET/CT 0 66.7% I 99% II 100% FDG-PET 0.56% (0.09%) FDG 71% 6 1 PET CT 8 mm implant FDG 40 dense breast FDG-PET CT MRI FDG-PET 8 32% CT MRI FDG-PET FDG-PET (glucose-6-phosphatase) FDG-6- FDG FDG PDG-PET PET-CT 20

SUV SUV CT MRI ERCP FDG FDG-PET MRI 10 mm MRI MRCP 65 0.43% 65 (0.08%) 5 65.6 73% PET FDG-PET (PSA) MRI PET MRI PET PSA PET OSEM PET FDG- PET 44.7% 58.3% FDG-PET PSA MRI T2 PSA MRI 21

PSA MRI MRI 66.7% 53.3% PSA 100% 52.5% MRI CT 7% PET CT MRI CT MRI MRI CA125 CA19-9 FDG PET 4 stage I PET MRI T2 22

MRI T2 FDG FDG-PET MRI 1 16 mm 1 2 mm 7 16 mm 5 mm FDG-PET Staging FDG MALToma FDG-PET CT MRI CT MRI MRI FDG-PET 67 88% FDG-PET MRI MRI MRI FDG-PET 100% FDG-PET http://www.jsnm.org/ report/pet-anzen-gl.pdf A. FDG-PET PET/CT CT PET CT 1 FDG B. 3 23

(1) FDG (2) FDG C. (1) FDG (2) 24 10 (3) FDG-PET 16 8 PET 2004 FDG-PET 18 PET FDG-PET PET/ CT MRI 2007 CT CT PET FDG-PET 16 11 19 11 3 24

1 FDG-PET 1) FDG-PET MRI MRI 2) FDG-PET 3) CT, MDCT MDCT 4) MMG MRI 5) AFP CT FDG-PET MRI 6) CA19-9 CT MRI 7) FDG-PET 8) 9) PSA TUR PSA MRI FDG-PET 10) MRI MRI CA125 CT CA125 11) MRI MRI CT CA125 12) FDG-PET CT MRI CT 13) MR, CT, CT FDG-PET NMP22 MRI CA125

1., : Transmission Scan PET. 1996; 33: 367 373. 2. Yasuda S, et al: Application of positron emission tomography imaging to cancer screening. Br J Cancer 2000; 83: 1607 1611. 3., : FDG PET.. 2001; 38: 131 137. 4. Shreve PD, et al: Normal variants in FDG PET imaging. Principles and practice of positron emission tomography. Lippincott Williams & Wilkins, 2002: 111 136. 5., : FDG-PET. 2002; 47: 1137 1148. 6. Nakai K, et al: Cancer screening with 18 F FDG-PET, In PET and PET/CT in Oncology, Springer, Berlin, 2003: 309 320. 7., : FDG-PET. 2004; 31: 66 72. 8., : FDG-PET. 2004; 49: 835 840. 9. : PET. 2004: 11: 9 15. 10. : FDG-PET 2004; 49: 855 863. 11., : DWIBS FDG-PET. 2005; 50: 678 690. 12., : FDG-PET (PET ). 2005; 37: 1101 1105. 13. : PET/CT PET/CT. 2006; 21: 52 55. 14. : PET/CT PET, CT. RadFan 2006; 4: 20 23. 15. : PET. Pharma Medica 2006; 24: 71 75. 16. Delbeke D, et al: Procedure guideline for tumor imaging with 18 F-FDG PET/CT 1.0. J Nucl Med 2006; 47: 885 895. 17. FDG-PET (2005 ). 16 ( ) PET 2005; 42 (2): 1 26. 18. : PET PET/CT. 2007; 14: 104 108. 19., : FDG-PET. 2007; 44: 105 124. 20. Ono K, et al: The detection rates and tumor clinical/pathological stages of whole-body FDG-PET cancer screening. Ann Nucl Med 2007; 21: 65 72. 21. FDG. 22. Himeno S, et al: Evaluation of esophageal cancer by positron emission tomography. Jpn J Clin Oncol 2002; 32: 340 346. 23. Yasuda S, et al: Factors influencing physiological FDG uptake in the intestine. Tokai J Exp Clin Med 1998; 23: 241 244. 24. Kobori O, et al: Positron emission tomography of esophageal carcinoma using 11 C-choline and 18 F-fluorodeoxyglucose. Cancer 1999; 86: 1638 1648. 25. Fujii H, et al: Factors influencing nonpathological FDG uptake in various organs. In Positron Emission Tomography in the Millennium, Amsterdam, Elsevier, 2000. 26. Yasuda S, et al: 18 F-FDG PET detection of colonic adenomas. J Nucl Med 2001; 42: 989 992. 27., : FDG-PET. 2001; 28: 85 90. 28., : PET. 2003; 61: 168 172. 29. Uno K, et al: FDG-PET in the diagnosis of colorectal cancer as a cancer screening approach. J Nucl Med 2004; 45: 32p. 30. : FDG-PET.,, 2004. 31., : FDG-PET GLUT-1. 63 26

383. 32., : PET CEA. 2007; 14: 150 155. 33., : F-18 FDG PET. 1999; 16: 47 50. 34., : F-18 FDG PET. 1999; 44: 199 206. 35., : FDG-PET. 2001; 17: 548 555. 36. Nomori H, et al: Evaluation of F-18 fluorodeoxyglucose (FDG) PET scanning for pulmonary nodules less than 3 cm in diameter, with special reference to the CT images. Lung Cancer 2004; 45: 19 27. 37. Tsukamoto E, Ochi S: PET/CT today: System and its impact on cancer diagnosis. Ann Nucl Med 2006; 20 (4): 255 267. 38. CT 2003., 6,,, 2003: 190 202. 39. CT CT. CT,,, 2004. 40. :. CT 2004; 10: 221 226. 41. Single slice helical CT CT. 1, 2005. 42. CT. CT, 2004. 43., : CT.,,,,,, 2003: 142 147. 44. : CT. 2007; 14: 132 136. 45. : FDG-PET. 2007; 29: 170 176. 46. Uno K, et al: FDG-PET evaluation of fibrocystic mastopathy in patients with breast tumor. Eur J Nucl Med 1994; 21: S197. 47., : 18 F-FDG PET. 1997; 12: 168 170. 48. Noh DY, et al: Detection of cancer in augmented breasts by positron emission tomography. Eur J Surg 1999; 165: 847 851. 49., : FDG PET. Radioisotopes 2000; 49: 51 57. 50. Hicks RJ, et al: Pattern of uptake and excretion of 18 F-FDG in the lactating breast. J Nucl Med 2001; 42: 1238 1242. 51., : F-18 FDG-PET. 2001; 46: 205 211. 52. Hurwitz R: F-18 FDG positron emission tomographic imaging in a case of ruptured breast implant: inflammation or recurrent tumor? Clin Nucl Med 2003; 28: 755 756. 53. : 5. PET.,, 2004: 88 92. 54. Iwata Y, et al: Clinical usefulness of positron emission tomography with fluorine-18-fluorodeoxyglucose in the diagnosis of liver tumors. Ann Nucl Med 2000; 14: 121 126. 55. Ho CL, et al: 11 C-acetate PET imaging in hepatocellular carcinoma and other liver masses. J Nucl Med 2003; 44: 213 221. 56. Delbeke D, et al: Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma. 27

J Nucl Med 1999; 40: 1784 1791. 57. Papos M, et al: The possible role of F-18 FDG positron emission tomography in the differential diagnosis of focal pancreatic lesions. Clin Nucl Med 2002; 27: 197 201. 58. Higashi T, et al: Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) usefulness and limitations in clinical reality. Ann Nucl Med 2003; 17: 261 279. 59. Nakajo M, et al: FDG PET and PET/CT monitoring of autoimmune pancreatitis associated with extrapanceratic autoimmune disease. Clin Nucl Med 2007; 32: 282 285. 60. Seltzer MA, et al: Comparison of whole body 11 C-acetate and FDG PET in patients with prostate cancer. J Nucl Med 2000; 41: 142. 61. Kotzerke J, et al: 11 C-acetate positron emission tomography (PET) of prostate cancer-first clinical experience. J Nucl Med 2001; 42: 121. 62. Yen TC, et al: Value of dual-phase 2-fluoro-2-deoxy-D-glucose positron emission tomography in cervical cancer. J Clin Oncol 21 (19): 3651 3658. 63. : 15.. FDG-PET.,, 2004: 203 208. 64. Okada J, et al: The use of FDG-PET in the detection and management of malignant lymphoma: correlation of uptake with prognosis. J Nucl Med 1991; 32: 686 691. 65. Kosuda S, et al: Preliminary assessment of fluorine-18 fluorodeoxyglucose positron emission tomography in patients with bladder cancer. Eur J Nucl Med 1997; 24: 615 620. 66. Ramdave S, et al: Clinical role of F-18 fluorodeoxyglucose positron emission tomography for detection and management of renal cell carcinoma. J Urol 2001; 166: 825 830. 28