• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.737-742
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• 2021

Primary neuroendocrine carcinomas of the breast are a rare, distinct category of breast carcinomas that require immunohistochemical staining for diagnosis. Currently, there is not enough evidence on the clinical pattern, prognosis, and proper management of the disease. Only few case series have described the imaging findings of neuroendocrine carcinomas of the breast. We herein present a case of a primary neuroendocrine carcinoma of the breast (small cell) presenting as a locally aggressive tumor with metastatic disease, and describe the radiologic findings.

• Korean Journal of Radiology
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• v.25 no.1
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• pp.11-23
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• 2024

Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm² was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive. The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4-79.9), 90.8% (95% CI: 85.6-94.2), and 83.5% (95% CI: 78.6-87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8-97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9-89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1-79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52-0.63) before training and 0.68 (95% CI: 0.62-0.74) after training, with a difference of 0.11 (95% CI: 0.02-0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69-0.74) before training and 0.79 (95% CI: 0.76-0.80) after training (P = 0.002). Conclusion: Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.47-50
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• 2010

Fibrous dysplasia is a common benign disorder of bone in which normal bone marrow is replaced with fibro-osseous tissue. As PET/CT is increasingly used for the staging of different malignant disease, incidentally found fibrous dysplasia with increased FDG uptake may mimic metastasis. We report on a 46-year-old woman with fibrous dysplasia who underwent PET/CT because of suspected recurrence of breast cancer and was misdiagnosed as a bony metastasis with a focal FDG uptake on left proximal femur. This lesion was interpreted as fibrous dysplasia based on MRI in addition to the plain radiographs. We conclude that MRI in addition to radiography may help to differentiate fibrous dysplasia mimicking metastasis on PET/CT in the patients with malignancy.

• Journal of the Korean Society of Radiology
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• v.85 no.2
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• pp.421-427
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• 2024

Ectopic breast tissue can develop along the mammary ridge from the axilla to the groin, and the most common site is the axillae. Primary carcinoma of ectopic breast tissue is extremely rare. We report a rare case of a 61-year-old woman with a palpable mass in her left axilla who had a history of surgical excision of accessory breast tissue in the same area. Mammography (MMG), including axillary tail view, ultrasound (US), and breast MRI were performed. We evaluated the extent and characteristics of the microcalcifications in the axillary tail view. A US-guided biopsy was done, and histopathology revealed an invasive ductal carcinoma. Enhanced abdominal CT revealed multiple hepatic masses consistent with metastases, and the patient received palliative chemotherapy. Herein, we present a rare case of breast cancer arising from accessory breast tissue in the axilla, best appreciated on the axillary tail view of the patient's MMG.

• The KIPS Transactions:PartB
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• v.14B no.6
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• pp.431-436
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• 2007

Magnetic Resonance Imaging(MRI) has chemical shift phenomenon between fat and water, and the phenomenon has influence on structure enclosed by fat. Strong signals emitted from fat often generate false artefact, which reflects the importance of fat suppression techniques. There have been a number of researches on fat suppression techniques, but using fat suppression method alone in MRI can cause difficultproblems in diagnosis. This paper aims to study a fat suppression method by Chemical Shift Selective saturation(CHESS). This research describes the theoretical background and the experiment on water and fat phantom with MR instruments. In the experiment, CHESS pulse was designed by utilising Matlap program, and the pulse diagram was generated for the Pre-saturation process. The experiment using water and fat phantom was applied to C-spine, L-spine and Breast, and produced successful fat suppression results. This experiment has proved that the CHESSpulse fat suppression is a very helpful technique in diagnosing medical imaging. This method is a robust and useful technique for both clinical and basic investigators..(Experiment with Chungnam national university hospital G.E 1.5T MR)

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1189-1194
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• 2022

Carcinoma of the axillary tail of Spence is a rare type of breast cancer that develops at a specific anatomical position in the breast, with an incidence of approximately 0.3%. It should be differentiated from axillary soft tissue tumor, axillary ectopic breast cancer, and lymph node metastases of breast and other primary cancers. Here, we report a case of carcinoma of the axillary tail of Spence in a 47-year-old patient who visited our clinic with a lower axillary mass and was diagnosed based on mammography, US, CT, and MRI findings.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.767-769
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• 2005

Late capsular hematoma is one of the rare complication of augmentation mammoplasty. Although the cause has not unfolded yet, the possible damage of capsular vessels chafed against the textured prostheses is questioned. Reviewing the literatures, we present a 23-year-old female subjects to incidental swelling of the right breast a year later after augmentation mammaplasty with saline-filled textured prostheses. An MRI study confirmed intracapsular fluid collection sparing the prostheses. The exploration was followed and serosanguinous fluids was drained out of the intracapsular space, and then the existing prostheses were replaced with the smooth surface ones. In the 9 months since the last surgery the patient remained well without any further problem. Intensive massage of the breasts might be accounted to the probable cause of late hematoma in this case.

• Journal of Korea Association of Health Promotion
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• v.2 no.1
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• pp.9-25
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• 2004

Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items of major health screening program in Korea. Most, of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis), cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infections diseases(hepatitis, tuberculosis, sexually-transmitted diseases, parasites), chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress and earlypsychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests( CBC, urinalysis, liver function tests, lipid tests, glucose, HbA1c, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT) endoscopy(gastroscopy, colonoscopy), sonography (abdomen, thyroid, pelvis, breast), cytology(cervix), bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA125, PSA and eye tests. Advanced technologies, like CT, PET, MRI, MRI/Angio, molecular testing were widly used in hospital based health screening programmes. In summary, a variety of tests were untilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few programs used tests excessvely disregarding health screening subjects.

• Korean Journal of Radiology
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• v.25 no.6
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• pp.511-517
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• 2024

Objective: To prospectively investigate the influence of the menstrual cycle on the background parenchymal signal (BPS) and apparent diffusion coefficient (ADC) of the breast on diffusion-weighted MRI (DW-MRI) in healthy premenopausal women. Materials and Methods: Seven healthy premenopausal women (median age, 37 years; range, 33-49 years) with regular menstrual cycles participated in this study. DW-MRI was performed during each of the four phases of the menstrual cycle (four examinations in total). Three radiologists independently assessed the BPS visual grade on images with b-values of 800 sec/mm² (b800), 1200 sec/mm² (b1200), and a synthetic 1500 sec/mm² (sb1500). Additionally, one radiologist conducted a quantitative analysis to measure the BPS volume (%) and ADC values of the BPS (ADC_BPS) and fibroglandular tissue (ADC_FGT). Changes in the visual grade, BPS volume (%), ADC_BPS, and ADC_FGT during the menstrual cycle were descriptively analyzed. Results: The visual grade of BPS in seven women varied from mild to marked on b800 and from minimal to moderate on b1200 and sb1500. As the b-value increased, the visual grade of BPS decreased. On b800 and sb1500, two of the seven volunteers showed the highest visual grade in the early follicular phase (EFP). On b1200, three of the seven volunteers showed the highest visual grades in EFP. The BPS volume (%) on b800 and b1200 showed the highest value in three of the six volunteers with dense breasts in EFP. Three of the seven volunteers showed the lowest ADC_BPS in the EFP. Four of the seven volunteers showed the highest ADC_BPS in the early luteal phase (ELP) and the lowest ADC_FGT in the late follicular phase (LFP). Conclusion: Most volunteers did not exhibit specific BPS patterns during their menstrual cycles. However, the highest BPS and lowest ADC_BPS were more frequently observed in EFP than in the other menstrual cycle phases, whereas the highest ADC_BPS was more common in ELP. The lowest ADC_FGT was more frequent in LFP.

• Journal of Life Science
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• v.30 no.6
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• pp.563-569
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• 2020

Oncoplastic surgery (OPS) combines oncologically safe tumor resection with aesthetically satisfying reconstruction of defects using established plastic surgery techniques. OPS is characterized by initial excision as extensive as is beneficial for oncological safety, and, once sufficient resection is complete, displacement or replacement techniques are selected based on remnant volume. The size of the lesion and the individual patient are important factors when considering the appropriate approach, and when pre-operative imaging, including MRI, is used to determine the technique, the complete removal of cancer cells by permanent pathology is essential. A frozen section is used during the operation to reduce the reoperation rate, but it is difficult to cover the entire margin surface theoretically and even harder in practice. A recent report about adequate margins has empowered OPS in its oncological safety. Considering the patients to whom each modality could be applied, basic breast volume is an important factor, and this is influenced by ethnic differences. In Europe or the US, for example, the average breast size is 36D (600 ㎤) and reduction mammoplasty is predominantly used. However, the average size of patients in our institution is 33A (300 ㎤), and so quite different approaches are selected in most cases. New techniques involving radiofrequency and fluorescence have been proposed as safe and easily accessible ways of reducing complications.