• Archives of Plastic Surgery
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• v.44 no.3
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• pp.243-247
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• 2017

Reconstruction of the lower limb presents a complex problem after skin cancer surgery, as proximity of skin and bone present vascular and technical challenges. Studies on vascular anatomy have confirmed that the vascular plane on the lower limb lies deep to the deep fascia. Yet, many flaps are routinely raised superficial to this plane and therefore flap failure rates in the lower limb are high. Fascio-cutaneous flaps based on perforators offer a better cosmetic alternative to skin grafts. In this paper, we detail use of a thermal imaging camera to identify perforator 'compartments' that can help in designing such flaps.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.92-101
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• 2009

Purpose: Scintimammography is one of the screening tests for the early diagnosis of breast cancer. It has been widely accepted as very useful in assessing masses that have not been detected in breast scanning. This method is highly sensitive and specific with respect to the diagnosis of primary and relapsing breast cancer. It has some difficulties, however, in detecting tumors sized 1 cm and below due to the radioactivity around the breast and the geometrical structure of the equipment. The recent introduction of high-resolution Breast-specific Gamma Imaging (BSGI) has made it possible to more accurately discriminate between malignant and benign tumors than with any other test method. Thus, the possibility of an unnecessary biopsy being performed has decreased. The purpose of this study was to examine the diagnostic capacity of mammography, breast sonography, and scintimammography, which are used for the early diagnosis of known breast cancer, and of BSGI, and to evaluate the skillfulness of radiologists. Materials and Methods: The 53 volunteers participants who had no clinical manifestation of breast cancer underwent the BSGI in February 2009. In the BSGI procedure, scanning images were obtained from the craniocaudal projection (CC) and the mediolateral Oblique projection (MLO), as well as from the additional $80{\times}80$-matrix-sized views at various angles in the Present Time method, 10 minutes after the 25 mCi $^{99m}Tc$-MIBI was injected. Results: The results of the BSGI showed that two participants had masses in their breast tissue. As the results of the diagnosis of four participants were not clear, they were retested and the results of the second test were negative. The results of the clinical screening test for breast cancer showed that the sensitivity of BSGI, scintimammography, mammography, and breast sonography was 86.5%, 77.8%, 85~90%, and 66.7%, respectively, and that their specificity was 92.4%, 84.2%, 20~42%, and 68%, respectively. Conclusion: The autodiagnosis and breast cancer screening test are needed for the early diagnosis of breast cancer. It was not easy, however, to accurately determine the presence of a mass in the breast using the existing breast cancer screening test. The patients with unclear test findings were made to undergo a histologic biopsy for a more accurate diagnosis. It is expected that the BSGI can provide useful information for the early diagnosis of breast cancer and of primary breast cancer, and will reduce the performance of unnecessary biopsies because of its higher sensitivity and specificity than existing breast cancer screening tests.

• Proceedings of the KSMRM Conference
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• 2005.09a
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• pp.77-78
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• 2005

A specific FUS-MRI platform was designed for breast cancer treatment. phased array technologies, sideways FUS transmission, and spatio-temporal temperature control in the complete region of interest, were combined for a novel therapy approach with enhanced safety and afficacy. A phase I clinical trial will start soon.

• Korean Journal of Radiology
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• v.25 no.6
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• pp.559-564
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• 2024

Incidental pancreatic cystic lesions are a common challenge encountered by diagnostic radiologists. Specifically, given the prevalence of benign pancreatic cystic lesions, determining when to recommend aggressive actions such as surgical resection or endoscopic ultrasound with sampling is difficult. In this article, we review the common types of cystic pancreatic lesions including serous cystadenoma, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm with imaging examples of each. We also discuss high-risk or worrisome imaging features that warrant a referral to a surgeon or endoscopist and provid several examples of these features. These imaging features adhere to the latest guidelines from the International Consensus Guidelines, American Gastroenterological Association (2015), American College of Gastroenterology (2018), American College of Radiology (2010, 2017), and European Guidelines (2013, 2018). Our focused article addresses the imaging dilemma of managing incidental cystic pancreatic lesions, weighing the options between imaging follow-up and aggressive interventions.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.465-475
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• 2023

Objective : Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. Methods : We retrospectively reviewed data from 376 World Health Organization (WHO) grade II-IV adult glioma patients who were treated in the National Cancer Center from 2001 to 2020. Patients who underwent surgery at other institutions, those without initial images or those with pathologically unconfirmed cases were excluded. LM was diagnosed based on magnetic resonance imaging (MRI) findings or cerebrospinal fluid (CSF) cytology. The metastasis pattern was categorized as nodular or linear according to the enhancement pattern. Tumor proximity to the CSF space was classified as involved or separated, whereas location of the tumor was dichotomized as midline, for tumors residing in the thalamus, basal ganglia and brainstem, or lateral, for tumors residing in the cerebral and cerebellar hemispheres. Results : A total of 138 patients were enrolled in the study. A total of 44 patients (38%) were diagnosed with LM during a median follow-up of 9 months (range, 0-60). Among the clinical variables, tumor proximity to CSF space, the location of the tumor and the WHO grade were significant factors for LM development in univariate analysis. In multivariate analysis, the midline location of the tumor and WHO grade IV gliomas were the most significant factor for LM development. The hazard ratio was 2.624 for midline located gliomas (95% confidence interval [CI], 1.384-4.974; p=0.003) and 3.008 for WHO grade IV gliomas (95% CI, 1.379-6.561; p=0.006). Conclusion : Midline location and histological grading are an important factor for LM in glioma patients. The proximity to the CSF circulation pathway is also an important factor for WHO grade IV glioma LM. Patients carrying high risks should be followed up more thoroughly.

• Journal of Biomedical Engineering Research
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• v.27 no.2
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• pp.53-58
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• 2006

In this study, transverse relaxation time (T2) measurement and the evaluation of the characteristics of the spectral peak related to stomach tissue metabolites were performed using ex vivo proton magnetic resonance spectroscopic imaging (MRSI) at 1.5-T MRI/S instruments. Thirty-two gastric tissues resected from 12 patients during gastric cancer surgery, of which 19 were normal tissue and 13 were cancerous tissue, were used to measure the $T_2$ of the magnetic resonance spectroscopy (MRS) peaks. The volume of interest data results from the MRSI measurements were extracted from the proper muscle (MUS) layer and the composite mucosa/submucosa (MC/SMC) layer and were statistically analyzed. MR spectra were acquired using the chemical shift imaging (CSI) point resolved spectroscopy (CSI-PRESS) technique with the parameters of pulse repetition time (TR) and echo times (TE) TR/(TE1,TE2)=1500 msec/(35 msec, 144 msec), matrix $size=24{\times}24$, NA=1, and voxel $size=2.2{\times}2.2{\times}4mm^3$. In conclusion, the measured $T_2$ of the metabolite peaks, such as choline (3.21ppm) and lipid (1.33ppm), were significantly decreased (p<0.01 and p<0.05, respectively) in the cancerous stomach tissue.

• Tuberculosis and Respiratory Diseases
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• v.68 no.1
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• pp.16-21
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• 2010

Background: Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy. Methods: This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light. Results: Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44~81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ. Conclusion: NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1327-1331
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• 2014

Background: Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast; allows conducting quantitative assessment of the images besides the visual interpretation. The aim of this study was to correlate the quantitative assessment and visual interpretation of breast electrical impedance tomographs and associated factors. Materials and Methods: One hundred and fifty mammography patients above 40 years and undergoing EIT were chosen using convenient sampling. Visual interpretation of the images was carried out by a radiologist with minimum of three years experience using the breast imaging - electrical impedance (BI-EIM) classification for detection of abnormalities. A set of thirty blinded EIT images were reinterpreted to determine the intra-rater reliability using kappa. Quantitative assessment was by comparison of the breast average electric conductivity with the norm and correlations with visual interpretation of the images were determined using Chi-square. One-way ANOVA was used to compare the mean electrical conductivity between groups and t-test was used for comparisons with pre-existing Caucasians statistics. Independent t-tests were applied to compare the mean electrical conductivity of women with factors like exogenous hormone use and family history of breast cancer. Results: The mean electrical conductivity of Malaysian women was significantly lower than that of Caucasians (p<0.05). Quantitative assessment of electrical impedance tomography was significantly related with visual interpretation of images of the breast (p<0.05). Conclusions: Quantitative assessment of electrical impedance tomography images was significantly related with visual interpretation.

• Journal of Gastric Cancer
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• v.16 no.3
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• pp.152-160
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• 2016

Purpose: Endoscopic diagnosis of gastric cancer (GC) that emerges after eradication of Helicobacter pylori may be affected by unique morphological changes. Using comprehensive endoscopic imaging, which can reveal biological alterations in gastric mucosa after eradication, previous studies demonstrated that Congo red chromoendoscopy (CRE) might clearly show an acid non-secretory area (ANA) with malignant potential, while autofluorescence imaging (AFI) without drug injection or dyeing may achieve early detection or prediction of GC. We aimed to determine whether AFI might be an alternative to CRE for identification of high-risk areas of gastric carcinogenesis after eradication. Materials and Methods: We included 27 sequential patients with metachronous GC detected during endoscopic surveillance for a mean of 82.8 months after curative endoscopic resection for primary GC and eradication. After their H. pylori infection status was evaluated by clinical interviews and $^{13}C$-urea breath tests, the consistency in the extension of corpus atrophy (e.g., open-type or closed-type atrophy) between AFI and CRE was investigated as a primary endpoint. Results: Inconsistencies in atrophic extension between AFI and CRE were observed in 6 of 27 patients, although CRE revealed all GC cases in the ANA. Interobserver and intraobserver agreements in the evaluation of atrophic extension by AFI were significantly less than those for CRE. Conclusions: We demonstrated that AFI findings might be less reliable for the evaluation of gastric mucosa with malignant potential after eradication than CRE findings. Therefore, special attention should be paid when we clinically evaluate AFI findings of background gastric mucosa after eradication (University Hospital Medical Information Network Center registration number: UMIN000020849).

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.29-48
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• 2021

Diffusion-weighted magnetic resonance imaging (DW MRI) is a fast unenhanced technique that shows promise as a stand-alone modality for cancer screening and characterization. Currently, DW MRI may have lower sensitivity than that of dynamic contrast-enhanced MRI as a standalone modality for breast cancer detection but superior to that of mammography, which may provide a useful alternative for supplemental screening. Standardized acquisition and interpretation of DW MRI can improve the image quality and reduce the variability of the results. Furthermore, high-resolution DW MRI, with advanced techniques and postprocessing, will facilitate better detection and characterization of subcentimeter cancers and reduce false-negatives and false-positives. Future results from ongoing prospective multicenter clinical trials using standardized and optimized protocols will facilitate the use of DW MRI as a stand-alone modality.