• Korean Journal of Radiology
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• 제21권1호
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• pp.15-24
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• 2020

Mammography is the primary screening method for breast cancers. However, the sensitivity of mammographic screening is lower for dense breasts, which are an independent risk factor for breast cancers. Automated breast ultrasound (ABUS) is used as an adjunct to mammography for screening breast cancers in asymptomatic women with dense breasts. It is an effective screening modality with diagnostic accuracy comparable to that of handheld ultrasound (HHUS). Radiologists should be familiar with the unique display mode, imaging features, and artifacts in ABUS, which differ from those in HHUS. The purpose of this study was to provide a comprehensive review of the clinical significance of dense breasts and ABUS screening, describe the unique features of ABUS, and introduce the method of use and interpretation of ABUS.

• Korean Journal of Radiology
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• 제23권6호
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• pp.574-580
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• 2022

• 대한전기학회:학술대회논문집
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• 대한전기학회 2006년 학술대회 논문집 정보 및 제어부문
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• pp.148-150
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• 2006

In this paper, we propose a new method for detection of mass-type breast cancer in dense mammogram. As the proposed method analyzes texture of the breast tissue using method by fusing Homogeneity and Ranklets, improve problem of traditional method. Homogeneity gives the measure of uniform density, and Ranklets determine orientation selective property at vertical, horizontal and diagonal in mass region. The proposed method is suitable to dense mammogram with tangled normal tissue and cancer tissue. SVM(Support Vector Machine) classifier is used for effective detection of mass-type breast cancer in dense mammogram.

• 대한방사선기술학회지:방사선기술과학
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• 제34권1호
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• pp.1-7
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• 2011

유방영상에서 유방암 진단의 정확도를 평가하고 유방암 환자들의 특성을 알아보고자 한, 본 논문은 screen-film 방식의 유방영상검사를 실시한 유방암 환자 85명을 대상으로 2010년 3월부터 2010년 10월까지 연구 조사되었다. 유방암 환자들의 평균 나이는 51.9세로 조사되었고, 유방암의 발생 부위는 상외측(UOQ)이 전체의 43.5%로 가장 많았다. 연령에 따른 유방암 발생은 40~49세에서 37.6%(32/85)로 모든 연령대에서 가장 높게 나타났다. 유방암 환자들의 breast composition(유방조직 밀도)은 fatty breast가 30.6%(26/85), dense breast가 69.4%(59/85)로 나타나, 70%에 가까운 유방암 환자들이 dense breast의 형태를 띠고 있었다. 또한 fatty breast를 가진 환자들의 평균 나이는 62.4세이었고, dense breast 환자들의 평균 나이는 46.5세로 유방실질의 양상에 따라 유의한 연령차가 있는 것으로 조사되었다(P = 0.000). 유방암 환자들의 유방영상 위음성률은 27.1%(23/85)로 조사되었고, 민감도는 72.9%(62/85)로 조사되었다. 또한, dense breast를 가진 유방암 환자들의 유방영상 위음성률은 32.2%(19/59)이고 민감도는 67.8%(40/59)로 나타났다.

• 한국방사선학회논문지
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• 제6권1호
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• pp.63-71
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• 2012

본 연구는 유방영상검사의 최고의 관심영역인 DR 방식의 유방영상에서 유방암 진단의 정확도를 평가하고, 유방암 환자들의 특성을 알아보고자 DR 방식으로 유방영상검사를 실시한 유방암 환자 57명을 대상으로 2010년 5월부터 2011년 6월까지 조사되었다. 유방암 환자들의 평균 나이는 50.8세이었고, 유방암의 발생 부위는 상외측(UOQ)이 전체의 33.3%로 가장 많은 것으로 조사되었다. 연령에 따른 유방암 발생은 40-49세에서 42.1%로 모든 연령대에서 가장 높게 나타났다. 유방암 환자들의 유방조직 밀도는 지방형 유방이 31.6%(18/57), 치밀유방이 68.4%(39/57)로 나타나, 70%에 가까운 유방암 환자들이 치밀유방의 형태를 띠고 있었다. 유방영상에서 방사선학적 병변 중 종괴와 미세석회화가 함께 동반된 경우 (45.3%)가 유방암 발견율이 가장 높은 것으로 조사되었고, 치밀유방에서 미세석회화를 동반하지 않는 종괴의 경우 지방형 유방에서보다 유방암의 발견율이 더 낮은 것으로 조사되었으며, 이러한 종괴는 치밀유방에서 위음성율을 높이는 원인이 되고 있다. Digital mammography의 위음성률은 7.0%이었고, 민감도는 93.0%인 것으로 조사되었다. 치밀유방의 위음성율은 12.8%, 민감도는 87.2%로 조사되었는데 이는 이전에 보고된 screen film mammography의 치밀유방에서 보다 유방암에 대한 민감도가 더 높은 것으로 조사되었다.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1031-1043
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• 2022

Objective: To compare digital breast tomosynthesis (DBT) and MRI as an adjunct to full-field digital mammography (FFDM) for the preoperative evaluation of women with breast cancer based on mammographic density. Materials and Methods: This retrospective study enrolled 280 patients with breast cancer who had undergone FFDM, DBT, and MRI for preoperative local tumor staging. Three radiologists independently sought the index cancer and additional ipsilateral and contralateral breast cancers using either FFDM alone, DBT plus FFDM, or MRI plus FFDM. Diagnostic performances across the three radiologists were compared among the reading modes in all patients and subgroups with dense (n = 186) and non-dense breasts (n = 94) according to mammographic density. Results: Of 280 patients, 46 (16.4%) had 48 additional (39 ipsilateral and nine contralateral) cancers in addition to the index cancer. For index cancers, both DBT plus FFDM and MRI plus FFDM showed sensitivities of 100% in the non-dense group. In the dense group, DBT plus FFDM showed lower sensitivity than that of MRI plus FFDM (94.6% vs. 99.6%, p < 0.001). For additional ipsilateral cancers, DBT plus FFDM showed specificity and positive predictive value (PPV) of 100% in the non-dense group, but sensitivity and negative predictive value (NPV) were not statistically different from those of MRI plus FFDM (p > 0.05). In the dense group, DBT plus FFDM showed higher specificity (98.2% vs. 94.1%, p = 0.005) and PPV (83.1% vs. 65.4%; p = 0.036) than those of MRI plus FFDM, but lower sensitivity (59.9% vs. 75.3%; p = 0.049). For contralateral cancers, DBT plus FFDM showed higher specificity than that of MRI plus FFDM (99.0% vs. 96.7%, p = 0.014), however, the other values did not differ (all p > 0.05) in the dense group. Conclusion: DBT plus FFDM showed an overall higher specificity than that of MRI plus FFDM regardless of breast density, perhaps without substantial loss in sensitivity and NPV in the diagnosis of additional cancers. Thus, DBT may have the potential to be used as a preoperative breast cancer staging tool.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2010년도 춘계 종합학술대회 논문집
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• pp.218-220
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• 2010

85명의 유방암 환자를 대상으로 이들의 유방영상을 검토하고 유방암 환자들의 특징을 살펴보고자 한 본 논문에서 유방암 환자들의 평균나이는 51.9세이었고, 유방암이 가장 많이 발생하는 부위는 상외측(43.5%)인 것으로 조사되었으며, 유방암이 가장 많이 발생하는 연령은 40대 인 것으로 조사되었다. 유방암 환자들의 유방조직밀도는 69.4%가 dense breast이었고, 30.6%가 fatty breast인 것으로 조사되었으며, 이 두 그룹의 평균연령은 dense breast를 가진 그룹이 유의하게 낮은 것으로 조사되었다. 유방영상의 위음성률은 27.1%, 민감도는 72.9%로 조사되었고, dense breast를 가진 환자들의 유방영상 위음성률은 32.2%, 민감도는 67.8%로 조사되었다.

• 핵의학기술
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• 제16권1호
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• pp.76-79
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• 2012

Purpose: This study was to evaluate usefulness of $^{99m}Tc$-MIBI scintimammography for dense breast by comparing concordance in test results between Tc-99m MIBI scintimammography and mammography whose effect was proved the most as an imaging tool depending on breast density and at the same time by examining limitation on evaluation depending on density of breast tissue. [Materials and Methods] In the period from December 2010 to July 2011, this study targeted 150 patients who took both of $^{99m}Tc$-MIBI scintimammography and mammography conducted by using breast gamma camera in this hospital. Breast density was classified to the four levels of pattern 1~4 based on the results of mammography. $^{99m}Tc$-MIBI scintimammography was conducted with the LCC, the RCC, the LMLO, and the RML one minute after intravenous injection of 99mTc-MIBI 7400 MBq (20 mCi) while analysis was made for concordance in test results of $^{99m}Tc$-MIBI scintimammography and mammography. [Results] Among the 150 patients, pattern 1 was found in 3 patients, pattern 2 in 44 patients, pattern 3 in 61 patients, and pattern 4 in 37 patients. There were 5 patients who showed the case where it was impossible to determine density of breast tissue due to foreign body inserted to breast. The concordance ratio of the results between $^{99m}Tc$-MIBI scintimammography and mammography was 95.5% for pattern 2, 95.1% for pattern 3 and 94.6% for pattern 4. This demonstrated that the concordance rate decreased according to the increase in breast density. [Conclusion] When there was limitation on evaluation of breast specific gamma imaging test results due to increased intake in breast tissue or surgical site, the concordance rate was 6.8% for pattern 2, 16.3% for pattern 3 and 18.9% for pattern 4. This demonstrated that the degree of limitation on evaluation of breast specific gamma imaging test results increased according to the increase in breast density.

• 핵의학기술
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• 제20권1호
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• pp.42-46
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• 2016

[목 적] 유방촬영술은 유방의 해부학적 구조를 관찰할 수 있어 유방암의 조기 진단 및 발견에 가장 널리 이용하는 검사법이지만 치밀형 유방을 가진 고위험군 환자에서는 민감도가 현저히 감소한다. Molecular Breast Imaging (MBI) 검사는 고해상도로 유방의 기능적 영상 획득이 가능하고, 치밀 조직에서 종양의 위치 확인이 유용하여 더욱 향상된 진단적 정보를 얻을 수 있는 새로운 영상 기법이다. 이에 본 연구는 치밀형 유방을 가진 환자에게서 종양 진단을 위한 MBI의 유용성을 평가하고자 한다. [대상 및 방법] 2015년 9월 1일부터 10월 10일까지 본원에 내원한 여성 유방암 환자 중 치밀형 유방 환자 10명을 대상으로 연구하였으며, 대상 환자는 MBI와 유방촬영술을 모두 시행하였다. MBI (Discovery 750B; General Electric Healthcare, USA) 검사는 $^{99m}Tc-MIBI$ 20 mCi를 병변이 있는 반대 측 팔에 주사한 후 20분 뒤 양측 유방의 상하 방향, 내외 사 방향 영상을 얻었고, 유방촬영술 또한 동일한 자세로 시행하였다. MBI와 유방촬영 영상을 각각의 영상과, 두 영상을 모두 활용한 경우의 민감도와 특이도를 블라인드 테스트로 비교 평가하였다. [결 과] 유방촬영술에서는 민감도 63%, 특이도 38.6%였으며, MBI 검사에서는 민감도 88.5%, 특이도 87%였다. 유방촬영술과 MBI 검사를 모두 활용한 경우 민감도 93%, 특이도 91.7%로 나타났다. [결 론] 본 연구에서는 유방촬영술에서 쉽게 판별할 수 없었던 치밀 조직의 종양이 MBI 검사상 육안적 평가가 용이해져 보다 정확한 진단이 가능하였다. 그러나 MBI 검사는 미세석회화를 영상화 하는 데에 어려움이 있으므로 유방촬영술과 함께 진행된다면 더욱 많은 진단적 정보를 제공해 줄 것으로 생각된다.

• 대한디지털의료영상학회논문지
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• 제12권1호
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• pp.33-41
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• 2010

National Cancer Screening Project and Korean Society of Breast Imaging recommend that breast cancer screening should be performed on those aged 40 and above. Nevertheless, this recommendation is usually ignored by a number of medical institutions. The purpose of this study is to emphasize the necessity of an age limitation in screening mammography. Ten institutions were randomly selected and telephone inquiries about patients' age limitation and internal guidelines were set up. The 3,214 women, who underwent screening mammography through 'GE Senography 2000D' in each hospital, were classified into five groups according to age(from 20s to 40s, at intervals of 5). And then, collected data was analyzed by a radiologist in accordance with ACR-BIRADS(American College of Radiology Breast Imaging Reporting and Data System), through which breast parenchymal density and the results of analysis were categorized in order to predict the sensitivity of mammography. Information about craniocaudal-view mammograms was automatically produced by use of GE Senography 2000D, and the average glandular dose was retrospectively analyzed through the program 'Excel 2007.' Two institutions did not set the age limitation. Other seven institutions internally allowed those who wanted to receive mammography regardless of age. Approximately 99% of those aged 20 to 29 were judged as having the dense breast. In those aged 35 to 39, breast parenchymal density tended to be lower, but the fatty breast to increase. In the case of 'category-zero' that does not need additional tests, the rate of 'heterogeneously dense' and 'extremely dense' reached to 83.1% and 15.1% respectively. Regarding dense breasts, there was no sufficient information for image reading. The glandular dose, applied to 3,214, was 1.47mGy on the average. In those aged 20 to 24 who are sensitive to radiation, the average glandular dose indicated 1.59mGy. Those aged 35 and above showed the lowest value, 1.43mGy. In those aged 35 to 39, the breast tended to change from denseness to fattiness. The average glandular dose was lowest in those aged 35 and above, which suggests that screening mammography should be periodically performed on those aged 35 and above in order that breast cancer may be early detected. On the other hand, in those aged less than 35, it is difficult to analyze mammograms due to the high density of breast parenchyma, and also retakes become frequent. In particular, subjects may be exposed to excessive doses. Accordingly, it should be substituted by breast self-examination or clinical breast examination. In case of need, it is advisable to perform ultrasonography.