• Investigative Magnetic Resonance Imaging
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• v.19 no.1
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• pp.56-61
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• 2015

Adenosarcoma of the uterus is a rare biphasic tumor containing benign glandular epithelial and malignant mesenchymal components. The tumor has been reported to be associated with antiestrogen therapy, particularly tamoxifen, but there have been a few case reports with MRI. We present two cases of MRI findings of uterine adenosarcoma after antiestrogen therapy, tamoxifen and toremifene in breast cancer patients. The tumor presents as a large polypoid mass occupying the endometrial cavity, and may protrude into the vagina. On MRI, the tumor typically shows solid components with scattered small cysts and heterogeneous enhancement. These findings are not significantly different from conventional adenosarcoma.

• Investigative Magnetic Resonance Imaging
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• v.19 no.2
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• pp.99-106
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• 2015

Purpose: To investigate factors influencing the evaluation of background parenchymal enhancement (BPE) at follow-up breast magnetic resonance imaging (MRI) after adjuvant endocrine therapy. Materials and Methods: One hundred twelve women with breast cancer and MRI of the contralateral unaffected breast before and after endocrine therapy were identified. Two readers in consensus performed blinded side-by-side comparison of BPE (minimal, mild, moderate, and marked) before and after therapy with categorical scales. Age, body mass index, menopausal status, treatment regimen (selective estrogen receptor modulator or aromatase inhibitor), chemotherapy, follow-up duration, BPE at baseline MRI, MRI field strength before and after therapy, and recurrence were analyzed for their influences on decreased BPE. Results: Younger age, premenopausal status, treatment with selective estrogen receptor modulator, MRI field strength, and moderate or marked baseline BPE were significantly associated with decreased BPE. In multivariate analysis, MRI field strength and baseline BPE showed a significant association. Conclusion: MRI field strength and baseline BPE before and after therapy .were associated with decreased BPE at post-therapy, follow-up MRI.

• Investigative Magnetic Resonance Imaging
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• v.23 no.3
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• pp.220-227
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• 2019

Purpose: To evaluate the usefulness of wash-in color map in detecting early enhancement of prostate focal lesion compared to whole dynamic contrast-enhanced MRI (DEC MRI) images. Materials and Methods: This study engaged 50 prostate cancer patients who underwent multiparametric MRI and radical prostatectomy as subjects. An expert [R1] and a trainee [R2] independently evaluated early enhancement and recorded the time needed to review 1) a wash-in color map and 2) whole DCE MRI images. Results: The review of whole DCE images by R1 showed fair agreement with color map by R1, whole images by R2, and color map by R2 (weighted kappa values = 0.59, 0.44, and 0.58, respectively). Both readers took a significantly shorter time to review the color maps as compared to whole images (P < 0.001). Conclusion: A trainee could achieve better agreement with an expert when using wash-in color maps than when using whole DCE MRI images. Also, color maps took a significantly shorter evaluation time than whole images.

• Nuclear Engineering and Technology
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• v.54 no.6
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• pp.2213-2220
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• 2022

The maximum dose delivery at the end of the beam range provides the main advantage of using proton therapy. The range of the proton beam, however, is subject to uncertainties, which limit the clinical benefits of proton therapy and, therefore, accurate in vivo verification of the beam range is desirable. For the beam range verification in spot scanning proton therapy, a prompt gamma detection system, called as gamma electron vertex imaging (GEVI) system, is under development and, in the present study, the performance of the GEVI system in spot scanning proton therapy was predicted with Geant4 Monte Carlo simulations in terms of shift detection sensitivity, accuracy and precision. The simulation results indicated that the GEVI system can detect the interfractional range shifts down to 1 mm shift for the cases considered in the present study. The results also showed that both the evaluated accuracy and precision were less than 1-2 mm, except for the scenarios where we consider all spots in the energy layer for a local shifting. It was very encouraging results that the accuracy and precision satisfied the smallest distal safety margin of the investigated beam energy (i.e., 4.88 mm for 134.9 MeV).

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.239-245
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• 2022

Contralateral axillary lymph node metastasis is a rare entity in breast cancer and is currently classified as a distant metastasis; however, recent studies have proposed aggressive curative treatment since this entity may manifest as a locoregional disease. Herein, we report a rare case of contralateral axillary lymph node metastasis that presented with imaging findings 22 months after the initial breast cancer diagnosis in a 67-year-old female. The patient underwent lymph node dissection of the axilla with adjuvant chemotherapy and radiotherapy. A follow-up examination 6 months after surgery showed no evidence of tumor recurrence or metastasis.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1650-1657
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• 2021

Metastatic mature teratoma is a common radiologic and histopathologic finding after chemotherapy for metastatic non-seminomatous germ cell tumors. The leading theory for these residual tumors is the selective chemotherapy resistance of teratomas versus the high chemotherapy sensitivity of the embryonal components. Growing teratoma syndrome is a relatively rare phenomenon defined as an enlarging residual mass histologically proven to be a mature teratoma in the setting of normal serum tumor markers. Metastatic mature teratomas should be resected because of their malignant potential and occasional progression to growing teratoma syndrome with the invasion of the surrounding structures. CT is the preferred imaging modality for post-chemotherapy surveillance and should cover all sites of potential metastatic disease. This article reviews the clinical, pathologic, and multimodality imaging features of metastatic mature teratomas in patients with primary testicular non-seminomatous germ cell tumors.

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.574-576
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• 2009

An intramedullary spinal cord metastasis (ISCM) rarely develops in systemic cancer but is indicative of a poor prognosis. A 56-year-old man was admitted due to weakness of the lower extremities. He had received radiotherapy 3 months prior for a brain metastasis that had developed 1 year after achieving a complete response from chemotherapy for extended stage small cell lung cancer. Although the brain lesion had improved partially, ISCM from the cervical to lumbar-sacral spinal cords, which was accompanied by a leptomeningeal dissemination, was diagnosed based on magnetic resonance imaging of the spine and cerebrospinal fluid cytology. Finally, he died of sudden cardiac arrest during treatment. This is the first case of ISCM involving the whole spinal segments. Physicians should be aware of the subsequent development of ISCM in lung cancer patients with a previously known brain metastasis who present with new neurological symptoms.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3407-3412
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• 2015

Background: The aim of this study was to evaluate and compare the accuracy of diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) value, and time-intensity curve (TIC) type analysis derived from dynamic contrast-enhanced MR imaging (DCE-MRI) in differentiating benign from malignant adnexal masses. Materials and Methods: 47 patients with 56 adnexal masses (27 malignant and 29 benign) underwent DWI and DCE-MRI examinations, prior to surgery. DWI signal intensity, mean ADC value, and TIC type were determined for all the masses. Results: High signal intensity on DWI and type 3 TIC were helpful in differentiating benign from malignant adnexal masses (p<0.001). The mean ADC value was significantly lower in malignant adnexal masses (p<0.001). An ADC value< $1.20{\times}10^{-3}mm^2/s$ may be the optimal cutoff for differentiating between benign and malignant tumors. The negative predictive value for low signal intensity on DWI, and type 1 TIC were 100%. The pairwise comparison among the receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) of TIC was significantly larger than the AUCs of DWI and ADC (p<0.001 for comparison of TIC and DWI, p<0.02 for comparison of TIC and ADC value). Conclusions: DWI, ADC value and TIC type derived from DCE-MRI are all sensitive and relatively specific methods for differentiating benign from malignant adnexal masses. By comparing these functional MR techniques, TIC was found to be more accurate than DWI and ADC.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.185-191
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• 2008

While indirect targeting strategies using reporter-genes are taking center stage in current molecular imaging research, another vital strategy has long involved direct imaging of specific receptors using radiolabeled ligands. Recently, there is renewal of immense interest in this area with particular attention to the epidermal growth factor receptor (EGFR), a transmembrane glycoprotein critically involved in the regulation of many cellular functions and malignancies. Recently, two novel classes of EGFR-targeting anticancer drugs have entered clinical trials with great expectations. These are monoclonal antibodies such as cetuximab that target the extracellular domain, and small molecule tyrosine kinase inhibitors such as gefitinib (lressa) and erlotinib (Tarceva) that target the catalytic domain of the receptor. However, early results have showed disappointing survival benefits, disclosing a major challenge for this therapeutic strategy; namely, the need to identify tumors that are most likely to respond to the agents. To address this important clinical issue, several noninvasive imaging techniques are under investigation including radiolabeled probes based on small molecule tyrosine kinase inhibitors, anti-EGFR antibodies, and EGF peptides. This review describes the current status, limitations, and future prospects in the development of radiotracer methods for EGFR imaging.

• Journal of the Korean Society of Radiology
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• v.8 no.3
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• pp.123-136
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• 2014

In this paper, we study to classify molecular imaging and applications to predict future. Molecular imaging in vivo at the cellular level and the molecular level changes taking place to be imaged, that is molecular cell biology and imaging technology combined with the development of the new field. Molecular imaging is used fluorescence, bioluminescence, SPECT, PET, MRI, Ultrasound and other imaging technologies. That is applied to monitoring of gene therapy, cell tracking and monitoring of cell therapy, antibody imaging, drug development, molecular interaction picture, the near-infrared fluorescence imaging of cancer using fluorescence, bacteria using tumor-targeting imaging, therapeutic early assessment, prediction and therapy. The future of molecular imaging would be developed through fused interdisciplinary research and mutual cooperation, which molecular cell biology, genetics, chemistry, physics, computer science, biomedical engineering, nuclear medicine, radiology, clinical medicine, etc. The advent of molecular imaging will be possible to early diagnosis and personalized treatment of disease in the future.