• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1083-1102
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• 2021

Uterine cervical cancer is a common gynecological cancer prevalent in Korea. Early detection, precise diagnosis, and appropriate treatment can affect its prognosis. Imaging approaches play an important role in staging, treatment planning, and follow-up. MRI specifically provides the advantage of assessing tumor size and disease severity with high soft tissue contrast. The revised version of the International Federation of Gynecology and Obstetrics (FIGO) staging system has been introduced in 2018, which incorporates subdivided primary tumor size and lymph node metastasis. In this review, the staging of uterine cervical cancer based on previous studies, the recently revised FIGO staging, and various post-treatment images are primarily described using MRI.

• Radiation Oncology Journal
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• v.30 no.2
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• pp.70-77
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• 2012

Purpose: To evaluate the patterns of tumor shape and to compare tumor volume derived from simple diameter-based ellipsoid measurement with that derived from tracing the entire tumor contour using region of interest (ROI)-based 3D volumetry with respect to the prediction outcome in cervical cancer patients treated with concurrent chemotherapy and radiotherapy. Materials and Methods: Magnetic resonance imaging was performed in 98 patients with cervical cancer (stage IB-IIIB). The tumor shape was classified into two categories: ellipsoid and non-ellipsoid shape. ROI-based volumetry was derived from each magnetic resonance slice on the work station. For the diameter-based surrogate "ellipsoid volume," the three orthogonal diameters were measured to calculate volume as an ellipsoid. Results: The more than half of tumor (55.1%) had a non-ellipsoid configuration. The predictions for outcome were consistent between two volume groups, with overall survival of 93.6% and 87.7% for small tumor (<20 mL), 62.9% and 69.1% for intermediate-size tumor (20-39 mL), and 14.5% and 16.7% for large tumors (${\geq}$40 mL) using ROI and diameter based measurement, respectively. Disease-free survival was 93.8% and 90.6% for small tumor, 54.3% and 62.7% for intermediate-size tumor, and 13.7% and 10.3% for large tumor using ROI and diameter based method, respectively. Differences in outcome between size groups were statistically significant, and the differences in outcome predicted by the tumor volume by two different methods. Conclusion: Our data suggested that large numbers of cervical cancers are not ellipsoid. However, simple diameter-based tumor volume measurement appears to be useful in comparison with ROI-based volumetry for predicting outcome in cervical cancer patients.

• The Korean Journal of Nuclear Medicine
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• v.18 no.2
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• pp.77-85
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• 1984

Monoclonal antibodies have become widely investigated in the Nuclear Oncology, especially in the radioimmunosassay of tumor markers and in vivo radioimmunoimaging of cancer. However, there are numerous factors as to whether radioimmunoimaging will ultimately successful. For imaging of tumors, metallic radionuclides such as In-111, Ga-67, Tc-99m have favorable nuclear properties than widely used I-131. These radioistopes have characteristics of the useful radiation for imaging, convenient short half-lives and the simple and rapid radiolabeling of monoclonal antibodies by using bifunctional chelaing agents. The obtained chelate-tagged antibodies are quite stable both in vitro and in vivo, without interfering antibody activities and animal experiments provided a good basis for its clinical applicability for the radioimmunoimaging of cancer. Much attention has also been given to the possibility, only beginning to be exploited, of the specific treatment of malignant neoplasms with these agents. Although specific antibody has not been developed that is uniquely specific for cancer alone and there are still many questions to be answered and problems to be overcome before radioimmunoimaging can be successfully used in ptients with cancer, these methods can be applied to the coupling of monoclonal antibodies with anti-neoplastic drugs or radionuclides suitable for internal radiation therapy of cancer.

• Investigative Magnetic Resonance Imaging
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• v.26 no.1
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• pp.32-42
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• 2022

Purpose: To evaluate the clinical benefit of 2D contrast-enhanced T2 fluid-attenuated inversion recovery (CE-T2 FLAIR) image for detecting leptomeningeal metastasis (LM) in the brain metastasis work-up for lung cancer. Materials and Methods: From June 2017 to July 2019, we collected all consecutive patients with lung cancer who underwent brain magnetic resonance image (MRI), including contrast-enhanced 3D fast spin echo T1 black-blood image (CE-T1WI) and CE-T2 FLAIR; we recruited clinico-radiologically suspected LM cases. Two independent readers analyzed the images for LM in three sessions: CE-T1WI, CE-T2 FLAIR, and their combination. Results: We recruited 526 patients with suspected lung cancer who underwent brain MRI; of these, we excluded 77 (insufficient image protocol, unclear pathology, different contrast media, poor image quality). Of the 449 patients, 34 were clinico-radiologically suspected to have LM; among them, 23 were diagnosed with true LM. The calculated detection performance of CE-T1WI, CE-T2 FLAIR, and combined analysis obtained from the 34 suspected LM were highest in the combined analysis (AUC: 0.80, 0.82, and 0.89, respectively). The inter-observer agreement was also the highest in the combined analysis (0.68, 0.72, and 0.86, respectively). In quantitative analyses, CNR of CE-T2 FLAIR was significantly higher than that of CE-T1WI (Wilcoxon signed rank test, P < 0.05). Conclusion: Adding CE-T2 FLAIR might provide better detection for LM in the brain-metastasis screening for lung cancer.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.550-564
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• 2023

MRI is currently the imaging modality of choice to evaluate rectal cancer after neoadjuvant treatment. The purposes of restaging MRI are to assess the resectability of rectal cancer and to decide whether organ preservation strategies can be applied in patients with a complete clinical response. This review article indicates the key MRI features needed to evaluate rectal cancer after neoadjuvant treatment using a systematic approach. Assessment of primary tumor response including MRI findings to predict a complete response is discussed. Additionally, MRI evaluation of the relationship between the primary tumor and adjacent structures, lymph node response, extramural venous invasion, and tumor deposits after neoadjuvant treatment is presented. Knowledge of these imaging features and their clinical relevance may help radiologists provide an accurate and clinically valuable interpretation of restaging rectal MRI.

• Korean Journal of Radiology
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• v.21 no.1
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• pp.77-87
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• 2020

Objective: To assess the feasibility of simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) of the rectum in comparison with conventional DWI (C-DWI) in rectal cancer patients. Materials and Methods: This study included 65 patients with initially-diagnosed rectal cancer. All patients underwent C-DWI and SMS-DWI with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) using a 3T scanner. Acquisition times of the three DWI sequences were measured. Image quality in the three DWI sequences was reviewed by two independent radiologists using a 4-point Likert scale and subsequently compared using the Friedman test. Apparent diffusion coefficient (ADC) values for rectal cancer and the normal rectal wall were compared among the three sequences using repeated measures analysis of variance. Results: Acquisition times using C-DWI, SMS2-DWI, and SMS3-DWI were 173 seconds, 107 seconds, (38.2% shorter than C-DWI), and 77 seconds (55.5% shorter than C-DWI), respectively. For all image quality parameters other than distortion (margin sharpness, artifact, lesion conspicuity, and overall image quality), C-DWI and SMS2-DWI yielded better results than did SMS3-DWI (Ps < 0.001), with no significant differences observed between C-DWI and SMS2-DWI (Ps ≥ 0.054). ADC values of rectal cancer (p = 0.943) and normal rectal wall (p = 0.360) were not significantly different among C-DWI, SMS2-DWI, and SMS3-DWI. Conclusion: SMS-DWI using an acceleration factor of 2 is feasible for rectal MRI resulting in substantial reductions in acquisition time while maintaining diagnostic image quality and similar ADC values to those of C-DWI.

• ETRI Journal
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• v.32 no.6
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• pp.901-910
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• 2010

As a supplement to X-ray mammography, microwave imaging is a new and promising technique for breast cancer detection. Through solving the nonlinear inverse scattering problem, microwave tomography (MT) creates images from measured signals using antennas. In this paper, we describe a developed MT system and an iterative Gauss-Newton algorithm. At each iteration, this algorithm determines the updated values by solving the set of normal equations using Tikhonov regularization. Some examples of successful image reconstruction are presented.

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.161-171
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• 2018

Purpose: This study assessed the feasibility of near-infrared (NIR) imaging with indocyanine green (ICG) in investigating the completeness of laparoscopic lymph node (LN) dissection for gastric cancer. Materials and Methods: Patients scheduled for laparoscopic gastrectomy for treating gastric cancer were enrolled in the study. After intraoperative submucosal ICG injection (0.05 mg/mL), LN dissection was performed under conventional laparoscopic light. After dissection, the LN stations of interest were examined under the NIR mode to locate any extra ICG-stained (E) tissues, which were excised and sent for pathologic confirmation. This technique was tested in 2 steps: infra-pyloric LN dissection (step 1) and review of all stations after proper radical node dissection (step 2). Results: In step 1, 15 patients who underwent laparoscopic pylorus-preserving gastrectomy (LPPG) and 15 patients who underwent laparoscopic distal gastrectomy (LDG) were examined. Seven and 2 E-tissues were obtained during LPPG and LDG, respectively. From the retrieved E-tissues, 1 and 0 tissue obtained during LPPG and LDG, respectively, was confirmed as LN. In step 2, 20 patients were enrolled (13 D1+ dissection and 7 D2 dissection). Six E-tissues were retrieved from 5 patients, and 1 tissue was confirmed as LN in the pathologic review. Overall, 15 E-tissues were detected and removed, and 2 tissues were confirmed as LNs in the pathologic review. Both nodes were from LN station #6, with 1 case each in the LDG and LPPG groups. Conclusions: NIR imaging may provide additional node detection during laparoscopic LN dissection for gastric cancer, especially in the infra-pyloric area.

• Journal of the Korean Society of Radiology
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• v.6 no.1
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• pp.63-71
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• 2012

This study aimed to evaluate the accuracy of breast cancer diagnosis of digital mammography which is in the highest interest of breast imaging test, and to investigate the characteristics of breast cancer patients. For this purpose, 57 breast cancer patients who underwent breast imaging test were examined between May 2010 and June 2011. The average age of the breast cancer patients was 50.8 years old, and the most frequently occurring location was the upper outer quadrant (UOQ), accounting for 33.3%. By age, the highest occurrence rate of breast cancer was the age group of 40~49, accounting for 42.1%. As for the breast composition of the breast cancer patients, fatty breast accounted for 31.6% (18/57) and dense breast for 68.4% (39/57), indicating that nearly 70% of the breast cancer patients have dense breast. It was found that the detection rate of breast cancer was the highest (45.3%) when both microcalcification and mass are simultaneously present in the radiographic lesion of the breast imaging. In dense breast, the mass without microcalcification was lower in detection rate than fatty breast. Accordingly, the mass is the cause of raising the false negative rate in dense breast. The findings show that the false negative rate of digital mammography was 7.0% and the sensitivity 93.0%. Also, the false negative rate of dense breast was 12.8%, and the sensitivity 87.2%, indicating that the sensitivity to breast cancer in this study was higher than the dense breast of previously reported screen film mammography.

• Investigative Magnetic Resonance Imaging
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• v.14 no.2
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• pp.121-125
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• 2010

Purpose : The purpose of this study was to evaluate the diagnostic accuracy of 3.0-T breast MRI for detecting additional breast cancer soon after the initial diagnosis of breast cancer. Materials and Methods : From March to June 2009, 101 patients recently diagnosed breast cancer underwent breast MRI and surgery. Parameters analyzed on MRI were total extent of tumor, suspicious findings of multifocal, multicentric, or contralateral cancer. The diagnosis of MRI-detected cancer was confirmed by means of biopsy or surgical specimen evaluation after the localization. Results : MRI showed 37 additional suspicious findings in 34 patients. Twenty nine findings were true-positive (29/37, 78.4%), including 16 cases of multifocality, 11 cases of multicentricity and 2 cases of contralateral cancer. Among these cancers, 13 (44.8%) were ductal carcinoma in situ (DCIS) and 16 (55.1%) were infiltrating cancer. Eight findings were false-positive (8/37, 21.6%) including 6 cases of benign disease and 2 cases of high-risk lesions. Conclusion : In women with recently diagnosed breast cancer, 3.0-T MR imaging showed additional suspicious findings in 33.7%. The sensitivity and specificity for detecting additional breast cancer was 100% and 89.3%, respectively.