• Korean Journal of Radiology
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• v.23 no.11
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• pp.1031-1043
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• 2022

Objective: To compare digital breast tomosynthesis (DBT) and MRI as an adjunct to full-field digital mammography (FFDM) for the preoperative evaluation of women with breast cancer based on mammographic density. Materials and Methods: This retrospective study enrolled 280 patients with breast cancer who had undergone FFDM, DBT, and MRI for preoperative local tumor staging. Three radiologists independently sought the index cancer and additional ipsilateral and contralateral breast cancers using either FFDM alone, DBT plus FFDM, or MRI plus FFDM. Diagnostic performances across the three radiologists were compared among the reading modes in all patients and subgroups with dense (n = 186) and non-dense breasts (n = 94) according to mammographic density. Results: Of 280 patients, 46 (16.4%) had 48 additional (39 ipsilateral and nine contralateral) cancers in addition to the index cancer. For index cancers, both DBT plus FFDM and MRI plus FFDM showed sensitivities of 100% in the non-dense group. In the dense group, DBT plus FFDM showed lower sensitivity than that of MRI plus FFDM (94.6% vs. 99.6%, p < 0.001). For additional ipsilateral cancers, DBT plus FFDM showed specificity and positive predictive value (PPV) of 100% in the non-dense group, but sensitivity and negative predictive value (NPV) were not statistically different from those of MRI plus FFDM (p > 0.05). In the dense group, DBT plus FFDM showed higher specificity (98.2% vs. 94.1%, p = 0.005) and PPV (83.1% vs. 65.4%; p = 0.036) than those of MRI plus FFDM, but lower sensitivity (59.9% vs. 75.3%; p = 0.049). For contralateral cancers, DBT plus FFDM showed higher specificity than that of MRI plus FFDM (99.0% vs. 96.7%, p = 0.014), however, the other values did not differ (all p > 0.05) in the dense group. Conclusion: DBT plus FFDM showed an overall higher specificity than that of MRI plus FFDM regardless of breast density, perhaps without substantial loss in sensitivity and NPV in the diagnosis of additional cancers. Thus, DBT may have the potential to be used as a preoperative breast cancer staging tool.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7607-7612
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• 2015

Aims: The purpose of our study was to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in the evaluation of contralateral breast in patients with diagnosed breast cancer. A secondary objective was to determine accuracy of breast MRI in diagnosing multi-focal and multicentric lesions in the ipsilateral breast. Materials and Methods: Using a non-probability convenience sampling technique, patients with histopathologically diagnosed breast cancer with MRI of breast performed to exclude additional lesions were included. MRI findings were correlated with histopathology. In addition, follow-up imaging with mammography and ultrasound was also assessed for establishing stability of negative findings and for the detected of benign lesions. Results: Out of 157 MRI breast conducted during the period of 2008 to 2013, 49 were performed for patients with diagnosed breast cancer. The sample comprised of all females with mean age $50.7{\pm}11.0years$. The patient follow-up imaging was available for a period of 2-5 years. The sensitivity, specificity, and positive and negative predictive values of MRI in the detection of multifocal/multicenteric lesions was 85.7%, 88.8%, 60% and 96.6% respectively and for the detection of lesions in the contralateral breast were 100%, 97%, 83.3% and 100% respectively. Conclusions: Our study highlights the diagnostic performance and the added value of MRI in the detection of multifocal/multicenteric and contralateral malignant lesions. In patients with diagnosed breast cancer having dense breast parenchyma and with infiltrating lobular carcinoma as the index lesion MRI is particularly useful with excellent negative predictive value in the exclusion of additional malignant foci in the ipsilateral and contralateral breasts.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4929-4932
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• 2014

Objective: To compare the mammogarphic appearance between breast cancer patients aged <40 and ${\geq}40$ years. Methods: Needle localization and biopsy of suspicious mammographic lesions identified 1,959 breast carcinomas in a single institution from Jun 2012 to Apr 2013. According to the age, we divided patients into two groups: <40 and ${\geq}40$ years old, and analyzed mammographic appearance separately. Results: Young patients had 44.2% foci with calcification, but old patients only had 39.4% (P<0.001). In younger group, the ratios of cases according to mass density were 41.8% or higher, 58.2% equivalent and lower. In older group, the ratios were 55.5 % and 44.5%, respectively. There were statistical differences between high density and others (P<0.05). The ratios of cases according to mass margin were 13.9% circumscribed and microlobulated, 86.1% indistinct and spiculated in the younger group, as compared to 6.5% and 93.5%, respectively, in the older group (P<0.05). Conclusions: Mammographic findings differ between young and old patients with breast cancer, for example regarding mass density, mass margin and microcalcification ratios.

• Investigative Magnetic Resonance Imaging
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• v.20 no.1
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• pp.9-26
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• 2016

The purpose of this paper is to show the radiologic features of various lesions appearing as skin thickening or enhancement under the breast MRI. And histopathologic results of the skin lesions were correlated. Radiologist must be familiar with normal appearance of the breast skin under the MRI and a wide variety of conditions may affect the skin of the breast.

• Investigative Magnetic Resonance Imaging
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• v.22 no.2
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• pp.110-112
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• 2018

We report the case of a patient who presented with rupture of a silicone breast implant showing acute and chronic inflammation. Magnetic resonance imaging (MRI) showed silicone foci outside the implant shell and inside the pectoralis muscles that represented intra- and extracapsular ruptures of the implant and silicone granuloma. There were distinct fluid-fluid levels of various signal intensities and no signs of implant collapse such as 'linguine sign.' Rather, we detected enlargement of both the implant shell and the breast.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.3-14
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• 2023

Breast Imaging Reporting and Data System (BI-RADS) is a communication and data tracking system that standardizes and controls the quality of reporting by presenting lexicon descriptors, assessment categories, and recommendations for managing breast lesions. Using standardized terminology recommended by BI-RADS, radiologists can concisely and reproducibly communicate breast imaging results to clinicians. They can also provide the estimated malignant probability of the lesions found and guide management for them by determining the final assessment category. The limitations of BI-RADS 5th edition currently in use are that there are some areas for which standardized terminologies still need to be established, and that the diagnostic criteria of MRI assessment categories 3 and 4 are ambiguous compared to those for mammography or ultrasound. The next revision of BI-RADS is expected to include solutions for overcoming current limitations.

• Kosin Medical Journal
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• v.33 no.3
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• pp.297-306
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• 2018

Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

• Journal of radiological science and technology
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• v.41 no.1
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• pp.33-38
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• 2018

There are limits to check the lesion as inserting a breast implant patients. So the application of BSGI based on Nuclear Medicine examination has increased. In this study, therefore we confirmed the effect of the image applying to breast implants in Breast Specific Gamma Imaging. We utilized Dilon 6800 BSGI scanner and developed the phantom. The self-development phantom was a rectangular shape of $230{\times}190{\times}80mm$ size and had 5 spheres which consisted of diameters of 10, 13, 17, 22, 28 mm in central part. We injected $^{99m}TcO_4$ into the self-development phantom in the proportion of four to one and made each additional phantom filled with 0.9 % sodium chloride, silicon and paraffin. Each additional phantom was placed between detector and self-development phantom. Each image was acquired five times depending on the type and thickness of the additional phantom. Statistical analysis with SPSS ver.18 was applied. In the test of variation according to the thickness of all additional phantoms, as the phantoms which 0.9% sodium chloride, silicon and paraffin increased, the attenuation variation was higher(P<0.005). There was no significant difference in the attenuation variation and the quality of image for type of the additional phantom. Therefore, if the effect of the image applying to breast implants in Breast Specific Gamma Imaging is confirmed, the higher diagnostic value can be achieved.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.76-79
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• 2012

Purpose: This study was to evaluate usefulness of $^{99m}Tc$-MIBI scintimammography for dense breast by comparing concordance in test results between Tc-99m MIBI scintimammography and mammography whose effect was proved the most as an imaging tool depending on breast density and at the same time by examining limitation on evaluation depending on density of breast tissue. [Materials and Methods] In the period from December 2010 to July 2011, this study targeted 150 patients who took both of $^{99m}Tc$-MIBI scintimammography and mammography conducted by using breast gamma camera in this hospital. Breast density was classified to the four levels of pattern 1~4 based on the results of mammography. $^{99m}Tc$-MIBI scintimammography was conducted with the LCC, the RCC, the LMLO, and the RML one minute after intravenous injection of 99mTc-MIBI 7400 MBq (20 mCi) while analysis was made for concordance in test results of $^{99m}Tc$-MIBI scintimammography and mammography. [Results] Among the 150 patients, pattern 1 was found in 3 patients, pattern 2 in 44 patients, pattern 3 in 61 patients, and pattern 4 in 37 patients. There were 5 patients who showed the case where it was impossible to determine density of breast tissue due to foreign body inserted to breast. The concordance ratio of the results between $^{99m}Tc$-MIBI scintimammography and mammography was 95.5% for pattern 2, 95.1% for pattern 3 and 94.6% for pattern 4. This demonstrated that the concordance rate decreased according to the increase in breast density. [Conclusion] When there was limitation on evaluation of breast specific gamma imaging test results due to increased intake in breast tissue or surgical site, the concordance rate was 6.8% for pattern 2, 16.3% for pattern 3 and 18.9% for pattern 4. This demonstrated that the degree of limitation on evaluation of breast specific gamma imaging test results increased according to the increase in breast density.

• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.175-178
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• 2019

Juvenile hypertrophy of the breast is a rare condition, leading to hyperplastic breast anomalies in adolescents. Here, we report a case involving a 15-year-old girl, presented with asymmetric enlargement of the left breast. Pronounced parenchymal thickening was found on initial ultrasonography (US). MRI and second-look US revealed a focal mass-like lesion on the left mid-lateral breast, confirmed as juvenile hypertrophy of the breast on pathology.