• Korean Journal of Radiology
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• 제20권4호
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• pp.533-541
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• 2019

Breast magnetic resonance imaging (MRI) has been increasingly utilized, especially in screening for high-risk cases, because of its high sensitivity and superior ability to detect cancers as compared with mammography and ultrasound. Several limitations such as higher cost, longer examination time, longer interpretation time, and low availability have hindered the wider application of MRI, especially for screening of average-risk women. To overcome some of these limitations and increase access to MRI screening, an abbreviated breast MRI protocol has been introduced. Abbreviated breast MRI is becoming popular and challenges the status quo. This review aims to present an overview of abbreviated MRI, discuss the current findings, and introduce ongoing prospective trials.

• 대한영상의학회지
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• 제82권2호
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• pp.280-297
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• 2021

간세포암 위험이 있는 환자들에 대해 국제 가이드라인들은 6개월마다 초음파로 감시할 것을 권고하고 있다. 그러나 초음파는 초기 간세포암을 발견하는 데에 낮은 민감도를 보인다. 한편, 자기공명영상(MRI)은 간세포암을 비침습적으로 진단하는 데 중요한 역할을 하지만, 검사 시간이 길고 비용이 높아서 감시 검사로는 적합하지 않다. 따라서 비조영증강 단축 MRI, 역동적 조영증강 단축 MRI, 그리고 간담도기영상을 포함한 단축 MRI 등 다양한 단축 MRI 전략들을 간세포암 감시에 이용한 여러 연구들이 있었다. 이 종설에서는 다양한 단축 MRI 전략들을 살펴보고, 비용-효과적인 측면을 고려하여 간세포암 감시의 앞으로 나아가야 할 방향에 대해 살펴보고자 한다.

• Korean Journal of Radiology
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• 제22권3호
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• pp.297-307
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• 2021

Objective: To compare the performance of simulated abbreviated breast MRI (AB-MRI) and full diagnostic (FD)-MRI in distinguishing between benign and malignant lesions detected by MRI and investigate the features of discrepant lesions of the two protocols. Materials and Methods: An AB-MRI set with single first postcontrast images was retrospectively obtained from an FD-MRI cohort of 111 lesions (34 malignant, 77 benign) detected by contralateral breast MRI in 111 women (mean age, 49.8. ± 9.8; range, 28-75 years) with recently diagnosed breast cancer. Five blinded readers independently classified the likelihood of malignancy using Breast Imaging Reporting and Data System assessments. McNemar tests and area under the receiver operating characteristic curve (AUC) analyses were performed. The imaging and pathologic features of the discrepant lesions of the two protocols were analyzed. Results: The sensitivity of AB-MRI for lesion characterization tended to be lower than that of FD-MRI for all readers (58.8-82.4% vs. 79.4-100%), although the findings of only two readers were significantly different (p < 0.05). The specificity of AB-MRI for lesion characterization was higher than that of FD-MRI for 80% of readers (39.0-74.0% vs. 19.5-45.5%, p ≤ 0.001). The AUC of AB-MRI was comparable to that of FD-MRI for all readers (p > 0.05). Fifteen percent (5/34) of the cancers were false-negatives on AB-MRI. More suspicious margins or internal enhancement on the delayed phase images were related to the discrepancies. Conclusion: The overall performance of AB-MRI was similar to that of FD-MRI in distinguishing between benign and malignant lesions. AB-MRI showed lower sensitivity and higher specificity than FD-MRI, as 15% of the cancers were misclassified compared to FD-MRI.

• Korean Journal of Radiology
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• 제23권6호
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• pp.598-614
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• 2022

While ultrasound (US) is considered an important tool for hepatocellular carcinoma (HCC) surveillance, it has limited sensitivity for detecting early-stage HCC. Abbreviated MRI (AMRI) has recently gained popularity owing to better sensitivity in its detection of early-stage HCC than US, while also minimizing the time and cost in comparison to complete contrast-enhanced MRI, as AMRI includes only a few essential sequences tailored for detecting HCC. Currently, three AMRI protocols exist, namely gadoxetic acid-enhanced hepatobiliary-phase AMRI, dynamic contrast-enhanced AMRI, and non-enhanced AMRI. In this study, we discussed the rationale and technical details of AMRI techniques for achieving optimal surveillance performance. The strengths, weaknesses, and current issues of each AMRI protocol were also elucidated. Moreover, we scrutinized previously performed AMRI studies regarding clinical and technical factors. Reporting and recall strategies were discussed while considering the differences in AMRI protocols. A risk-stratified approach for the target population should be taken to maximize the benefits of AMRI and the cost-effectiveness should be considered. In the era of multiple HCC surveillance tools, patients need to be fully informed about their choices for better adherence to a surveillance program.

• 대한영상의학회지
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• 제82권5호
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• pp.1218-1230
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• 2021

목적 고위험 환자에서 초기 간암 선별 검사로써 단축 자기공명영상 검사의 환자별 진단능을 기존의 고식적 간 자기공명영상검사와 비교하고자 한다. 대상과 방법 간암 고위험군에서 간 자기공명영상 검사를 시행 받은 총 201명의 환자에 대해 연구를 시행하였다. 단축 자기공명영상 검사 군의 프로토콜은 T2 강조영상, 담도기 T1 강조영상, 확산강조영상 등으로 구성되며, 두 명의 영상의학과 의사가 각각의 환자에 대해 후향적으로 단축 자기공명영상검사 군 및 고식적 자기공명영상검사 군, 두 군의 영상을 독립적으로 평가하였다. 두 연구자 간 일관성은 Cohen's kappa 값을 이용하여 비교하였다. 복합적인 참조표준을 이용하여 두 군에서 각각 진단능을 평가하여 비교하였다. 결과 79 명의 환자에서 총 93개의 간암이 발견되었다. 두 연구자 간 일관성은 두 군에서 모두 매우 양호하였다(κ = 0.839, 0.948). 단축 자기공명영상검사 군에서 민감도 및 음성예측도는 각각 94.9% 및 96.4%였으며, 이는 고식적 자기공명영상검사 군과 큰 차이를 보이지 않았다(96.2%, 97.5%). 결론 단축 자기공명영상검사는 고식적 자기공명영상검사에 비교하여 임상적으로 허용 가능한 민감도와 음성예측도를 갖는다. 따라서 간암 고위험군 환자에서 간암 선별검사로써 새로운 대안이 될 수 있을 것이다.

• Investigative Magnetic Resonance Imaging
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• 제26권1호
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• pp.43-47
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• 2022

Encapsulated papillary carcinoma (EPC) is an uncommon breast malignancy that is known to be indolent and associated with an excellent prognosis. However, there is a rare possibility of locoregional relapse or metastasis. Here, we present a case of recurrent EPC in the ipsilateral internal mammary lymph node (IMLN) that was detected in the postoperative magnetic resonance imaging with abbreviated protocol (AB-MRI). AB-MRI could facilitate the early detection of recurrent disease in the IMLN and may provide prognostic gain for such patients.