• Journal of the Korean Society of Radiology
• /
• v.15 no.2
• /
• pp.147-152
• /
• 2021

This study is a retrospective analysis of the results of tests at three general hospitals in Busan that perform mammography using digital mammography devices. There were 5,320 people in the study, and the results of their breast cancer screening were analyzed to verify the efficacy of breast cancer screening for digital mammography. The average age of patients who performed breast cancer screening was 57.7 years (range 30 to 87 years), and the cancer detection rate was 26, with 4.6 cases per 1,000 people. According to the cancer detection rate by risk factor in patients who conducted breast cancer screening, breast cancer was found in patients without underlying diseases more than in patients with underlying diseases. Additional ultrasound examinations show that the gastronomic rate identified is 3.6%, which is relatively very low compared to that of the Film-Screen system.

• Investigative Magnetic Resonance Imaging
• /
• v.21 no.4
• /
• pp.233-241
• /
• 2017

Purpose: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. Materials and Methods: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. Results: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. Conclusion: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.18
• /
• pp.8335-8338
• /
• 2016

Purpose: To make a comparison of single voxel magnetic resonance spectroscopy (SV-MRS) and dynamic contrast enhancement (DCE) MRI for differentiation of benign and malignant breast lesions in a sample of Iranian women. Materials and Methods: A total of 30 women with abnormal breast lesions detected in mammography, ultrasound, or clinical breast exam were examined with DCE and SV-MRS. tCho (total choline) resonance in MRS spectra was qualitatively evaluated and detection of a visible tCho peak at 3.2 ppm was defined as a positive finding for malignancy. Different types of DCE curves were persistent (type 1), plateau (type 2), and washout (type 3). At first, lesions were classified according to choline findings and types of DCE curve, finally being compared to pathological results as the standard reference. Results: this study included 19 patients with malignant lesions and 11 patients with benign ones. While 63.6 % of benign lesions (7 of 11) showed type 1 DCE curves and 36.4% (4 of 11) showed type 2, 57.9% (11of 19) of malignant lesions were type 3 and 42.1% (8 of 19) type 2. Choline peaks were detected in 18 of 19 malignant lesions and in 3 of 11 benign counterparts. 1 malignant and 8 benign cases did not show any visible resonance at 3.2 ppm so SV-MRS featured 94.7% sensitivity, 72.7 % specificity and 86.7% accuracy.Conclusions: The present findings indicate that a combined approach using MRS and DCE MRI can improve the specificity of MRI for differentiation of benign and malignant breast lesions.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.7
• /
• pp.3179-3183
• /
• 2014

Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

• Journal of the Korean Society of Radiology
• /
• v.84 no.1
• /
• pp.275-279
• /
• 2023

Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.

• Physical Therapy Korea
• /
• v.10 no.1
• /
• pp.15-27
• /
• 2003

Therapeutic ultrasound is commonly applied for deep heating in physical therapy setting. However, it is difficult to determine the exact application dosage and to confirm the immediate heating effect. Microwave Radio-Thermometer (MRT) can measure the temperature by the electromagnetic energy in the microwave region of the object that emits above absolute zero temperature. MRT was used for early diagnosis of breast cancer since it was not harmful, non-invasive, and non-ionizing to the human body. The purposes of this study were to investigate how accurately 1.1 GHz RTM (RES Ltd. Russia) measures the change of average temperature in the tissue, and to determine the depth of temperature change measurement. Therapeutic ultrasound was applied (continuous wave for 5 minutes, 1 MHz, intensity of 1.5 $W/cm^2$ [in vitro] and 1.0 $W/cm^2$ [in vivo]) in four different conditions: (1) 30 cases of in vitro specimen of pork, (2) 30 cases of in vitro specimen of pork ankle joint, (3) 10 cases of in vivo canine thigh, and (4) 30 cases of in vivo human body. Intraclass Correlation Coeffients (ICC[3,1]) between average needle probe thermometer below surface and MRT temperature was revealed as followed: (1) Before ultrasound application ICCs ranges above .8 in specimen of pork (15 mm underneath the skin) and above .82 in specimen of pork ankle joint (10~30 mm underneath the skin). (2) After ultrasound application ICCs ranges above .7 in both specimens of pork and pork ankle joint. (3) Before ultrasound application ICCs ranges above .8 in canine thigh (20 mm underneath the skin). (4) After ultrasound application ICCs ranges above .82 in canine thigh. The temperature of the human body increased significantly with the mean of $15^{\circ}C$ in muscle tissue and with the mean of $3.5^{\circ}C$ in joint (p<.00). It was revealed that the average depth of temperature measurement of the tissue by MRT was in between 10 and 35 mm, and determined that the proper temperature measurement band was $36.5{\sim}37.0^{\circ}C$.

• Journal of the Korean Society of Radiology
• /
• v.13 no.1
• /
• pp.9-14
• /
• 2019

This study aimed to investigate the performance of the S-detect method in breast ultrasonography and to determine how to reduce unnecessary biopsy by comparing the results of the S-detect method and biopsy. Thirty patients who had undergone breast ultrasonography between August and October 2018 and were scheduled to undergo biopsy because of the presence of breast nodules were retrospectively analyzed. The McNemar test was performed to determine whether detection of a malignant breast mass significantly differed between the S-detect method and biopsy. The following results were obtained from the analysis of the S-detect method: sensitivity, 90.9%; specificity, 84.21%; validity, 86.66%; positive predictive value, 76.92%; and negative predictive value, 94.11%. Analysis of the degree of agreement between the S-detect method and biopsy revealed a kappa value as high as 0.724 (p < 0.05), exhibiting good agreement between the two methods. The S-detect method in breast ultrasonography is diagnostically valuable in terms of distinguishing between malignant and benign breast masses, and if used properly before breast biopsy, unnecessary biopsy can be reduced.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3185-3190
• /
• 2016

Background: This study was designed to compare radioguided versus routine wire localization of nonpalpable non-malignant breast lesions in terms of efficacy for complete excision, ease of use, time saving, and cosmetic outcome. Materials and Methods: Patients with non-palpable breast masses and non-malignant core biopsy results who were candidates for complete surgical lumpectomy were enrolled and randomly assigned to radioguided or wire localization groups. Radiologic, surgical, and pathologic data were collected and analyzed to determine the difficulty and duration of each procedure, ease of use, accuracy, and cosmetic outcomes. Results: This prospective randomized study included 60 patients, randomly divided into wire guided localization (WGL) or radioguided occult lesion localization (ROLL) groups. The mean duration of localization under ultrasound guidance was shorter in the ROLL group (14.4 min) than in the WGL group (16.5 min) (p<0.001). The ROLL method was significantly easier for radiologists (p=0.0001). The mean duration of the surgical procedure was 22.6 min (${\pm}10.3min$) for ROLL and 23.6 min (${\pm}9.6min$) for WGL (p=0.6), a non-significant difference. Radiography of the surgical specimens showed 100% lesion excision with clear margins, as proved by pathologic examination, with both techniques. The surgical specimens were slightly heavier in the ROLL group, but the difference was not significant (p=0.06). Conclusions: The ROLL technique provides effective, fast, and simple localization and excision of non-palpable non-malignant breast lesions.

• Archives of Plastic Surgery
• /
• v.47 no.1
• /
• pp.20-25
• /
• 2020

Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

• Journal of the Korean Society of Radiology
• /
• v.84 no.2
• /
• pp.345-360
• /
• 2023

In Korea, the number of institutions providing breast MRI, as well as the number of breast MRIs, has recently increased. However, MRI-guided procedures, including biopsy and needle localization, are rarely performed compared to ultrasound-guided or stereotactic biopsy. As breast MRI has high sensitivity but limited specificity, lesions detected only on MRI require pathologic confirmation through MRI-guided biopsy or surgical excision with MRI-guided needle localization. Thus, we aimed to review MRI-guided procedures, including their indications, techniques, procedural considerations, and limitations.