• 대한영상의학회지
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• 제83권1호
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• pp.239-245
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• 2022

이시성 반대쪽 액와 림프절 전이는 유방암에서 드물게 발생하며, 현재 원격 전이로 분류되어 있다. 그러나 최근 연구들은 이것이 국소 질환으로 간주될 수 있기 때문에 적극적으로 완치를 위한 치료를 할 것을 제안했다. 이에 저자들은 유방암을 진단받은 지 22개월 후에 반대쪽 액와 림프절 전이가 확인된 67세 여성의 증례를 영상 소견과 함께 보고하고자 한다. 환자는 액와 림프절 절제 수술 후 보조 항암화학요법 및 방사선치료를 받았다. 수술 6개월 후 추적검사에서 종양 재발이나 전이의 증거는 없었다.

• Investigative Magnetic Resonance Imaging
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• 제21권4호
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• pp.269-272
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• 2017

Periductal stromal sarcoma (PSS) is a type of rare malignant fibroepithelial tumor. PSS is a recently introduced diagnostic entity and there are few reports about radiological features of this tumor. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific radiologic findings. We present a woman age 30 that underwent mammotome biopsy for a BI-RADS 4 lesion on her left breast and received histopathology diagnosis of a phyllodes tumor. Additionally, she underwent a wide excision depending on her histopathology diagnosis. Her final diagnosis was PSS. Six months later, no recurrence was detected. However, frequent follow-up is needed because PSS can develop into phyllodes tumor or entity of breast cancer.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.291-293
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• 1997

A new quadrature RF coil is designed for Breast MR Imaging. Quadrature RF coils for MRI have been useful to improve the signal-to-noise ratio (SNR) by "$\sqrt{2}$" using two orthogonal RF coils in combination. A modified Breast Quadrature coil is designed. It is a modified type of the high-pass birdcage coil. To reduce the field distortion, by using current feeding, the field pattern is optimized to achieve a quadrature circularly-polarized field pattern. The coil has been implemented for receive-only mode, and tested by phantom imaging. The experimental results show the utility of the proposed RF coil.

• 대한영상의학회지
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• 제82권5호
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• pp.1310-1314
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• 2021

유방의 혈관육종은 매우 드문 악성 육종으로, 영상 소견이 비특이적이며 지금까지의 보고가 제한적이다. 또한 진단 당시 유방 및 비장 각각에서 하나의 큰 병변으로 보인 혈관육종은 거의 보고되지 않았다. 이에 저자들은 과거력이 없는 건강한 젊은 여성의 유방 및 비장에서 함께 관찰된 혈관육종 증례를 영상 및 병리학적 소견과 함께 보고하고자 한다.

• 대한영상의학회지
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• 제81권4호
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• pp.886-898
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• 2020

목적 본 연구는 부인암을 가진 여성에서 유방암의 선별검사로서의 디지털 유방단층 촬영술을 평가하였다. 대상과 방법 부인암을 가진 환자들 중 검진 목적으로 디지털 유방단층 촬영술을 촬영한 환자들을 대상으로 후향적 연구를 시행하였으며 유방암 발견율, 소환율, 민감도, 특이도, 양성예측도를 계산하였다. 양성예측도 1은 모든 양성 선별검사 중 1년 이내에 조직 검사에서 유방암을 진단받은 환자의 백분율로 정의되었다. 양성예측도 2는 진단 검사에서 조직검사의 필요 판정을 받은 후(그리고 선별 검사에서 Breast Imaging Reporting and Data System 카테고리 4, 5를 받은 후) 1년 이내에 조직검사에서 유방암을 진단받은 환자의 백분율로 정의되었다. 양성예측도 3은 실제로 조직검사를 시행 받은 환자 중 1년 이내에 조직검사에서 유방암을 진단받은 환자의 백분율로 정의되었다. 검진으로 발견된 암의 각 경우에 대해 환자의 나이, 부인암의 종류, 유방 밀도, 영상의 특징, 최종 Breast Imaging Reporting and Data System 평가, 조직학적 유형, T 및 N 병기, 분자아형 및 Ki-67 지수를 분석했다. 결과 전체 508명 중 7개의 유방암이 발견되었으며 유방암 발견율은 1000건 당 암 13.8이었다. 민감도는 100%, 특이도는 83.2%였으며 위음성률은 1000건 당 0이었다. 양성예측도 1, 양성예측도 2, 양성예측도 3은 각각 7.7, 31.8, 31.8이었으며 소환율은 17.9%였다. 결론 본 연구에서 디지털 유방단층 촬영술은 높은 유방암 발견율, 높은 민감도, 높은 양성예측도를 보이며 T, N 병기가 낮은 초기 암에 대해 높은 발견율을 보였다. 따라서 부인암 환자와 같은 고위험군에서 유방암의 선별검사로서 디지털 유방단층 촬영술이 유용할 수 있다.

• Investigative Magnetic Resonance Imaging
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• 제26권2호
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• pp.83-95
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• 2022

The purpose of this study was to establish and provide guidelines for the standardized acquisition and interpretation of diffusion-weighted magnetic resonance imaging (DW-MRI) to improve the image quality and reduce the variability of the results interpretation. The standardized protocol includes the use of high-resolution DW-MRI with advanced techniques and post-processing. The aim of the protocol is to increase the effectiveness of the medical image information exchange involved in the construction, activation, and exchange of clinical information for healthcare use. An organized interpretation form could make DW-MRIs' interpretation easier and more familiar. Herein, the authors briefly review the basic principles, optimized image acquisition, standardized interpretation guidelines, false negative and false positive cases of DW-MRI, and provide a standard interpretation form and examples of various cases to help users become more familiar with the DW-MRI.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.99-103
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• 2018

Mammary Paget's disease (MPD) is usually accompanied by underlying breast malignancy; however, a few cases have been reported as only skin lesions without any evidence of malignancy of the breast on imaging tests and microscopic examination of surgical specimen. Here, we describe a 47-year-old woman who visited our hospital who had an eczematous lesion on right nipple and areola for over 10 years. The lesion was diagnosed as Paget's disease by punch biopsy; however, imaging studies demonstrated no breast malignancy or lymph node metastasis. The patient underwent surgery of on the nipple and areola including underlying breast tissue. No underlying malignancy was found upon microscopic examination, except for Paget's disease. Immunohistochemical stains revealed that the tumor cells were positive for cytokeratin 7, and negativity for p63, cytokeratin 5/6, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We report a case of MPD without underlying malignancy. To the best of our knowledge, this is the third case reported in Korea.

• Korean Journal of Radiology
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• 제22권6호
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• pp.867-879
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• 2021

Objective: To compare the screening performance of diffusion-weighted (DW) MRI and combined mammography and ultrasound (US) in detecting clinically occult contralateral breast cancer in women with newly diagnosed breast cancer. Materials and Methods: Between January 2017 and July 2018, 1148 women (mean age ± standard deviation, 53.2 ± 10.8 years) with unilateral breast cancer and no clinical abnormalities in the contralateral breast underwent 3T MRI, digital mammography, and radiologist-performed whole-breast US. In this retrospective study, three radiologists independently and blindly reviewed all DW MR images (b = 1000 s/mm² and apparent diffusion coefficient map) of the contralateral breast and assigned a Breast Imaging Reporting and Data System category. For combined mammography and US evaluation, prospectively assessed results were used. Using histopathology or 1-year follow-up as the reference standard, cancer detection rate and the patient percentage with cancers detected among all women recommended for tissue diagnosis (positive predictive value; PPV2) were compared. Results: Of the 30 cases of clinically occult contralateral cancers (13 invasive and 17 ductal carcinoma in situ [DCIS]), DW MRI detected 23 (76.7%) cases (11 invasive and 12 DCIS), whereas combined mammography and US detected 12 (40.0%, five invasive and seven DCIS) cases. All cancers detected by combined mammography and US, except two DCIS cases, were detected by DW MRI. The cancer detection rate of DW MRI (2.0%; 95% confidence interval [CI]: 1.3%, 3.0%) was higher than that of combined mammography and US (1.0%; 95% CI: 0.5%, 1.8%; p = 0.009). DW MRI showed higher PPV2 (42.1%; 95% CI: 26.3%, 59.2%) than combined mammography and US (18.5%; 95% CI: 9.9%, 30.0%; p = 0.001). Conclusion: In women with newly diagnosed breast cancer, DW MRI detected significantly more contralateral breast cancers with fewer biopsy recommendations than combined mammography and US.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1715-1718
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• 2015

Background: Magnetic resonance imaging of breast, reported to be a high sensitivity of 94% to 100%, is the most sensitive method for detection of breast cancer. The purpose of this study was to investigate our clinical experience in MRI-guided breast lesion wire localization in Chinese women. Materials and Methods: A total of 44 patients with 46 lesions undergoing MRI-guided breast lesion localization were prospectively entered into this study between November 2013 and September 2014. Samples were collected using a 1.5-T magnet with a special MR biopsy positioning frame device. We evaluated clinical lesion characteristics on pre-biopsy MRI, pathologic results, and dynamic curve type baseline analysis. Results: Of the total of 46 wire localization excision biopsied lesions carried out in 44 female patients, pathology revealed fourteen malignancies (14/46, 30.4%) and thirty-two benign lesions (32/46, 69.6%). All lesions were successfully localized followed by excision biopsy and assessed for morphologic features highly suggestive of malignancy according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category of MRI (C4a=18, C4b=17, C4c=8,C5=3). Of 46 lesions, 37 were masses and 9 were non-mass enhancement lesions. Thirty-two lesions showed a continuous kinetics curve, 11 were plateau and 3 were washout. Conclusions: Our study showed success in MRI-guided breast lesion wire localization with a satisfactory cancer diagnosis rate of 30.4%. MRI-guided wire localization breast lesion open biopsy is a safe and effective tool for the workup of suspicious lesions seen on breast MRI alone without major complications. This may contribute to increasing the diagnosis rate of early breast cancer and improve the prognosis in Chinese women.

• 대한방사성의약품학회지
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• 제1권1호
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• pp.62-73
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• 2015

We developed an evans blue-indocyanine green-$^{99m}Tc$-human serum albumin conjugate for sentinel lymph node mapping and we describe its unique potential usage for clinical implications. This conjugate has combined the strengths of visible blue dye, near-infrared fluorescence and radioisotope into one single conjugate without any additional weakness/disadvantage. All the components of evans blue-indocyanine green-$^{99m}Tc$-human serum albumin are safe and of low cost, and they have already been clinically used. This conjugate was stable in the serum, it showed a long retention time in the lymphatic system and the lymph nodes showed a much higher signal-to-noise ratio after the conjugate was injected intradermally into the paw of mice. Both the single-photon emission computed tomography and near-infrared fluorescent images of the mice were successfully obtained at the same time as the excised sentinel lymph nodes showed blue color. The visual color, near-infrared fluorescence and gamma ray from this agent could be complementary for each other in all the steps of sentinel lymph node sampling: exploring and planning sentinel lymph node before excision with visualization of the exact sentinel lymph node location during an operation. Therefore, the triple modal agent will possibly be very ideal for sentinel lymph node mapping because of the high signal-to-noise ratio for non-invasive imaging and its complementary multimodal nature, easy preparation and safety. It is promising for clinical applications and it may have great advantages over the traditional single modal methods.