• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2021년도 춘계학술대회
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• pp.134-136
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• 2021

인공지능 알고리즘을 이용한 유방암의 조기진단에 관련된 연구는 최근들어 활발하게 진행되고 있다. 이는 연구용으로 공개된 초음파 유방 이미지를 활용하여 다양하게 개발되고 있으나, 사용자의 목적에 맞는 처리 속도 및 정확도 등에 다양한 한계점을 보인다. 이러한 문제를 해결하기 위해, 본 논문에서는 ImageNet에서 학습된 ResNet 모델을 현미경 기반 암세포 이미지에서 활용이 가능한 다단계 전이 학습을 제안하고, 이를 다시 전이 학습하여 초음파 유방암 영상을 양성 및 악성으로 분류하는 실험을 진행하였다. 실험을 위한 영상은 양성과 악성이 포함된 250장의 유방암 초음파 영상과 27,200장의 암 세포주 영상으로 구성되었다. 제안된 다단계 전이 학습 알고리즘은 초음파 유방암 영상을 분류하였을 때 96% 이상의 정확도를 보였으며, 향후 암 세포주 및 실시간 영상처리 등의 추가를 통해 보다 높은 활용도와 정확도를 보일 것으로 기대한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4463-4467
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• 2016

Purpose: To review the impact of using intra-operative ultrasound guided breast conserving surgery with frozen sections on final pathological margin outcome with the current guidelines set forth by the Society of Surgical Oncology (SSO) and the American Society of Surgical Oncology (ASTRO). Materials and Methods: A retrospective review including all cases of intra-operative ultrasound guided breast conserving surgery was performed at the National Cancer Institute Thailand between 2013 and 2016. Patient demographics, tumor variables, intraoperative frozen section and final pathological margin outcomes were collected. Factors for positive or close margins were analyzed. Results: A total of 86 patients aged between 27 and 75 years with intra-operative ultrasound guided breast conserving surgery were included. Three cases (3.5%) of positive margin were detected by intra-operative frozen section and 4 cases (4.7%) by final pathology reports. There were 18 cases (20.9%) with a close margin (<1 mm). Factors affecting this result comprised multi-foci, presence of invasive ductal carcinoma (IDC) combined with ductal carcinoma in situ (DCIS) and invasive lobular carcinoma (ILC). Conclusions: With the current SSO/ASTRO for adequate margin guidelines, using intra-operative ultrasound to locate the boundary for resection with breast conserving surgery provided a high success rate in obtaining final pathology free margin outcomes and minimizing re-operation risks especially when combined with intra-operative frozen section assessment. The chance of finding positive or close margins appears higher in cases of IDC combined with DCIS, ILC and with multi-foci cancers.

• Korean Journal of Radiology
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• 제25권2호
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• pp.134-145
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• 2024

Abnormalities on breast ultrasound (US) images which do not meet the criteria for masses are referred to as nonmass lesions. These features and outcomes have been investigated in several studies conducted by Asian researchers. However, the term "nonmass" is not included in the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) 5th edition for US. According to the Japan Association of Breast and Thyroid Sonology guidelines, breast lesions are divided into mass and nonmass. US findings of nonmass abnormalities are classified into five subtypes: abnormalities of the ducts, hypoechoic areas in the mammary glands, architectural distortion, multiple small cysts, and echogenic foci without a hypoechoic area. These findings can be benign or malignant; however, focal or segmental distributions and presence of calcifications suggest malignancy. Intraductal, invasive ductal, and lobular carcinomas can present as nonmass abnormalities. For the nonmass concept to be included in the next BI-RADS and be widely accepted in clinical practice, standardized terminologies, an interpretation algorithm, and outcome-based evidence are required for both screening and diagnostic US.

• Physical Therapy Rehabilitation Science
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• 제9권1호
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• pp.43-48
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• 2020

Objective: Breast cancer-related lymphedema (BCRL) is a major sequela after surgery or radiotherarpy for breast cancer. Manual lymphatic drainage (MLD) is designed to reduce lymph swelling by facilitating lymphatic drainage. This study attempted to determine the histologic changes in the skin and subcutaneous layer, and the immediate effect of MLD in decreasing lymphedema using ultrasound imaging, which is the method used most commonly to eliminate BCRL. Design: A single-group experimental study. Methods: Five subjects who were diagnosed with hemiparetic upper extremity lymphedema more than six months after breast cancer surgery participated in the study. MLD was performed for 60 minutes in the order of the thorax, breast, axilla, and upper arm of the affected side. In order to determine the effect of MLD, ultrasound imaging and limb volume were assessed. Two measurement tools were used for asessing lymphedema thickness among the pretest, posttest, and 30-minute follow-up period. Results: Significant diferences in ultrasound imaging and upper limb volume were found between the affected side and non-affected side (p<0.05). On the affected side, although ultrasound imaging showed a significant decrease after MLD (p<0.05), there were no significant difference in upper limb volume when compared to the baseline. Conclusions: In this study, a significant decrease in lymphedema by MLD was demonstrated by ultrasound imaging, which is considered to be more useful in assessing histological changes than limb volume measurements. Further research on the protocol for eliminating lymphedema will be needed.

• 대한방사선기술학회지:방사선기술과학
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• 제41권3호
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• pp.231-240
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• 2018

Automated breast ultrasound (ABUS) equipment is a new innovative technique for 3D automatic breast scanning, but limited for the examination in the concave axillary region. The purpose of this study was to determine feasible candidate materials for the ultrasonic wave propagation media in ABUS, enabling the evaluation of the axillary region. Ultrasonography was performed using an ABUS system ($Invenia^{TM}ABUS$, GE, USA) on the ultrasound-specific phantom (UC-551M-0.5, ATS Laboratories, USA) covered by different candidate materials. The validity of feasible candidate materials was evaluated by image quality. Three independent radiological technologists, with more than 10 years of experience, visually assessed on the images. The inter-observer agreements according to the candidate materials were tested using Cronbach's alpha. Unenveloped solidified carrageenan can be a feasible material for the use of ABUS with excellent test reliability. Therefore, the coverage of the axillary region with carrageenan may be effective for ABUS which was originally developed for the convex anatomic structure as female breast.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1269-1274
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• 2014

Breast tubular adenomas are rare benign breast tumors and detailed descriptions of their sonographic appearance are necessary for differential diagnosis from fibroadenomas or breast cancers. This study investigated twenty-one histology-proved tubular adenomas in 17 patients and also included 48 fibroadenomas in 35 patients as a control group. There was no significant difference between the two groups with clinical presentation, which was age, tumor location, tumor number (p>0.05). Statistic analysis showed three significant factors in the differential diagnosis of tubular adenomas and fibroadenomas, including macro-lobulation (p=0.01), "tiny branch like" patterns (p=0.001) and vascularity (p=0.02). Other ultrasonographic features such as echogenicity, border, uniformity of echotexture, posterior acoustic enhancement, lateral wall shadowing were of no clinical significance (p>0.05). Calcifications were seen in three tubular adenomas which were different from those of carcinomas. Although tubular adenomas have some typical characteristics on sonography, surgery and core needle biopsy are still needed for complex cases to exclude progress to malignancy.

• 대한영상의학회지
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• 제84권2호
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• pp.332-344
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• 2023

비촉지성 유방 병변의 발견이 늘어나고 유방암에서도 유방 보존 수술이나 선행항암화학요법이 증가하면서, 유방 병변의 진단과 처치에 있어서 초음파 유도하 중재 시술은 갈수록 그 역할이 중요해지고 이용이 늘어나고 있다. 본 종설에서는 유방 초음파 유도하 중재 시술 중 가장 많이 쓰이는 조직검사와 조직 마커 삽입, 수술 전 위치결정술에 대해 종류와 시술 방법, 적응증, 장단점 등을 알아보고 실제 진료 현장에서 시행하는 데에 도움을 주고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8149-8153
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• 2014

Background: To compare the value of contrast-enhanced ultrasound (CEUS) qualitative and quantitative analysis in the identification of breast tumor lumps. Materials and Methods: Qualitative and quantitative indicators of CEUS for 73 cases of breast tumor lumps were retrospectively analyzed by univariate and multivariate approaches. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. Results: The CEUS qualitative indicator-generated regression equation contained three indicators, namely enhanced homogeneity, diameter line expansion and peak intensity grading, which demonstrated prediction accuracy for benign and malignant breast tumor lumps of 91.8%; the quantitative indicator-generated regression equation only contained one indicator, namely the relative peak intensity, and its prediction accuracy was 61.5%. The corresponding areas under the ROC curve for qualitative and quantitative analyses were 91.3% and 75.7%, respectively, which exhibited a statistically significant difference by the Z test (P<0.05). Conclusions: The ability of CEUS qualitative analysis to identify breast tumor lumps is better than with quantitative analysis.

• 대한방사선기술학회지:방사선기술과학
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• 제30권4호
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• pp.349-356
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• 2007

2006년 7월 1일부터 2007년 4월 30일까지 10개월간 1,969명의 유방 X-선 검사 환자와 동일기간 1,531명의 유방 초음파 검사 현지에 대한 분석결과 다음과 같은 결론을 얻었다. 1. 검사자에 대한 연령별 분포를 보면 40, 50대가 많으며, 유방 X-선 검사자 중 68.57%, 유방 초음파 검사자의 71.32%를 차지하였다. 2. 전체 환자 중 질환이 있는 것으로 판정된 환자는 유방 X-선 검사 환자의 31.95%, 유방 초음파 검사자의 45.79%로 나타났다. 3. 질환의 연령별 분포는 유방 X-선 검사 환자는 $30{\sim}60$대, 유방 초음파 검사 환자는 $30{\sim}50$대로 나타났지만, 두 검사법 모두 40대에서 가장 질환이 많은 것으로 나타났으므로 철저한 검사가 필요하다. 4. 유방 X-선 검사와 유방 초음파 검사 시, 질환의 발병부위는 오른쪽과 왼쪽의 차이는 크지 않으나, 유방 X-선 검사에서 양쪽 유방에 질환이 있는 경우가 유방 초음파 검사보다 많은 것으로 나타났다. 5. 전문의에 의한 판독 결과 유방 X-선 검사에서 질환은 Calcification, Nodular, Mass 순이고, 유방 초음파 검사에서 질환은 Cyst, Nodular, Mass 순으로 발견율이 높았다. 6. 판독결과 유방 X-선 검사에서는 1가지 질환으로 판정되는 율이 89.3%로 높으나, 유방 초음파 검사에서는 2가지 이상의 질환을 가진 환자가 16.7%로 유방 X-선 검사의 10.7% 보다 많았다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.481-484
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• 2002

In every cancer early detection and early treatment is the best way to decrease mortality of patients. Moreover early detection of breast cancer increases the possibility of breast conservation treatment. Although mammography is the most powerful modality for early detection, it is hazardous to be used for young women due to X-ray exposure. Another modality of image diagnosis is ultrasound echo technique. But it is not so powerful to detect breast cancer compared to mammography. Palpation is another modality, but is largely dependent on the skill and experience of medical doctors. A new technique is tested its validity in phantom experiments with good results.