• Korean Journal of Radiology
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• v.20 no.6
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• pp.863-879
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• 2019

Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.

• Clinical Endoscopy
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• v.55 no.2
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• pp.279-286
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• 2022

Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a standard procedure for obtaining tissue from lesions near the gastrointestinal lumen. However, there is a scarcity of information on the diagnostic performance of EUS-FNA for abdominal lymphadenopathy of unknown causes. To assess the accuracy of EUS-FNA in diagnosing abdominal lymphadenopathy of unknown etiology. Methods: The EUS records of patients with undiagnosed abdominal lymphadenopathy between 2010 and 2015 were reviewed. Results: A total of 42 patients were included in this study. Adequate specimens were obtained from 40 patients (95%). The final diagnoses were metastatic cancer (n=16), lymphoma (n=9), tuberculosis (n=8), inflammatory changes (n=6), and amyloidosis (n=1). For diagnosing malignancy, EUS-FNA had a sensitivity of 84.6%, specificity of 95.7%, positive predictive value of 91.7%, negative predictive value of 91.7%, and area under the receiver operating characteristic curve (AUROC) of 0.901. For the diagnosis of lymphoma, EUS-FNA was 100% accurate when combined with cytologic evaluation and immunohistochemical staining. The diagnostic sensitivity decreased to 75%, whereas the specificity remained 100%, for tuberculosis. The overall AUROC was 0.850. No procedure-related complications occurred. Conclusions: EUS-FNA showed high diagnostic performance for abdominal lymphadenopathy of unknown causes, especially malignancy, lymphoma, and tuberculosis. Therefore, it is a crucial diagnostic tool for this patient population.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.98-104
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• 1997

We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

• The Journal of the Korean dental association
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• v.55 no.11
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• pp.778-788
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• 2017

Ultrasound sonography(US) is used to evaluate various diseases of oral and maxillofacial region including salivary glands, soft tissue and jaw lesions because of easy accessibility and no hazard of ionizing radiation. Also, US can offer dynamic study showing real-time images during diagnostic or surgical procedure. US images provide accurate information about the internal features of lesions on the jaw prior to surgical treatment. Doppler images are used to visualize the vascular distribution of the lesions and to provide additional information to enhance diagnostic value. It is necessary to evaluate the diagnostic value of US and evaluate its usefulness by looking at clinical cases using US images. Therefore, US imaging may be recommended as an assistant image in evaluating jaw lesions. US images provided accurate information about the internal structure of lesions on the jaw prior to surgical treatment, and diagnostic value was enhanced by visualizing the vascular distribution of the lesion using doppler imaging. We report the protocol and suggest the effectiveness of US for various lesions and US-guided sialography.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.442-449
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• 2020

Objective: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) versus ultrasonography (US) in symptomatic patients with dense breasts, while using histology as the gold standard. Materials and Methods: After obtaining approval from the local ethics board, this prospective study collected data from patients with symptomatic breasts who underwent CESM and US examinations from May 1, 2017 to September 30, 2017. We then selected those with dense breasts and pathological results as our sample population. Both CESM and US results were classified by a radiologist through the Breast Imaging Reporting and Data System, and the results were compared with their corresponding histological results. The chi-square test was conducted to compare the diagnostic performance of CESM and US, and the receiver operating characteristic curves for the two imaging modalities were obtained. Results: A total of 131 lesions from 115 patients with dense breasts were included in this study. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 93.8%, 88.1%, 88.2%, 93.7%, and 90.8% for CESM, and 90.6%, 82.1%, 82.9%, 90.2%, and 86.3% for US, respectively. The p values for sensitivity, specificity, PPV, NPV, and accuracy were 0.687, 0.388, 0.370, 0.702, and 0.238, respectively. The area under the curve of CESM (0.917) was comparable with that of US (0.884); however, the differences between CESM and US were not statistically significant (p = 0.225). Eight false-positive cases and 4 false-negative cases for breast cancer were found in CESM, while 12 false-positive cases and 6 false-negative cases were found in US. Conclusion: The diagnostic performances of CESM and US are comparable in symptomatic women with dense breasts; however, the routine use of additional US imaging is questionable for lesions that can be detected by CESM.

• Clinical Endoscopy
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• v.57 no.2
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• pp.237-245
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• 2024

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions. Methods: Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S). Results: A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles (p=0.03). Conclusions: Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.

• The Journal of the Acoustical Society of Korea
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• v.42 no.5
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• pp.429-440
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• 2023

This study explores recent research trends and potential applications of ultrasound optical imaging-based multimodal technology. Ultrasound imaging has been widely utilized in medical diagnostics due to its real-time capability and relative safety. However, the drawback of low resolution in ultrasound imaging has prompted active research on multimodal imaging techniques that combine ultrasound with other imaging modalities to enhance diagnostic accuracy. In particular, ultrasound optical imaging-based multimodal technology enables the utilization of each modality's advantages while compensating for their limitations, offering a means to improve the accuracy of the diagnosis. Various forms of multimodal imaging techniques have been proposed, including the fusion of optical coherence tomography, photoacoustic, fluorescence, fluorescence lifetime, and spectral technology with ultrasound. This study investigates recent research trends in ultrasound optical imaging-based multimodal technology, and its potential applications are demonstrated in the biomedical field. The ultrasound optical imaging-based multimodal technology provides insights into the progress of integrating ultrasound and optical technologies, laying the foundation for novel approaches to enhance diagnostic accuracy in the biomedical domain.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.41-61
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• 2001

The purpose of this study was to assess pregnant women's knowledge of, attitude to, and satisfaction with prenatal ultrasound and to determine the factors that influence their perception. A self-administered questionnaire survey was completed by two hundred eighty five pregnant women who visited the obstetric departments of three hospitals located in Seoul from October 17, 2000 to October 28, 2000. The major results are as follows. 1. Overall, the respondents did not fully understand the purpose of prenatal ultrasound. 92.2% of respondents stated that the main purpose of prenatal ultrasound was to check the fetus' age, growth and development but only 44.5% of respondents were aware of the fact that chromosomal abnormalities cannot be diagnosed only by prenatal ultrasound. The majority of respondents were aware of the diagnostic limitations of ultrasound. 2. While the majority of respondents were aware of the importance of pre-examination information, only 31.8% of respondents received such information from their health care providers. 3. Regarding the examination quality, 80.3% of respondents were satisfied with the competency of the examination. But more than 50% of respondents stated the cost and waiting time were not acceptable. 4. The knowledge of, attitude to, and satisfaction with prenatal ultrasound showed statistically significant differences according to the characteristics of each hospital. 5. From multiple regression analysis, the major components for knowledge of prenatal ultrasound were characteristics of hospitals, religion, income and gestational age. The major components for attitude toward prenatal ultrasound were characteristics of hospitals, religion and gestational age. The major components for satisfaction with prenatal ultrasound were characteristics of hospitals, income and drinking during the pregnancy. In conclusion, the respondents' perception of prenatal ultrasound is considerably low. More effective educational material or programs with prenatal ultrasound information should be provided to pregnant women prior to prenatal ultrasound examination. New strategies such as process reengineering are recommendable to increase the satisfaction with prenatal ultrasound.

• The Journal of the Acoustical Society of Korea
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• v.24 no.2
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• pp.78-86
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• 2005

This study considers the magnitude of the harmonic components radiated from the ultrasonic contrast agents (UCA) activated by a typical diagnostic ultrasound. The nonlinear dynamic response of UCA to a 2 MHz diagnostic ultrasound pulse was predicted using Gilmore Model. The elastic property of the shell membrane of the UCA was ignored in the numerical model. Simulation was carried out for the UCA varying from 1 - 9 $\mu$m in its initial radius and the driving diagnostic ultrasound whose mechanical index (MI) ranges from 0.125 to 8. The powers of the sub. ultra and second harmonics of the acoustic signal from the UCA activated were compared with that of the fundamental component. The results show that. if the UCA is bigger than its resonant size (2 $\mu$m in radius for the present case) the sub harmonic power was much bigger than the fundamental. In particular, the 2nd harmonic component currently used as an imaging parameter for the harmonic imaging, was predicted to be lower in power than both the sub and the ultra harmonic component. This study indicates that, for obtaining harmonic imaging with UCA, the sub or ultra harmonics could be taken as imaging parameters better than the 2nd harmonic component.

• Journal of Embryo Transfer
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• v.11 no.3
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• pp.291-300
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• 1996

Real time B-mode ultrasound was used to detect the early conceptus in 187 Korean native cattles between days 10 and 60 after last insemination. The ultrasound diagnostic findings were systemically confirmed by palpation per rectum after the 60th day of last insemination. The embryonic vesicle and the embryo proper within the veside were first visible on mean day fl and 23, respectively. The heartbeat of the embryo proper could be detected on day 26, and the limb buds, placentomes, amnion, fetal movement, umbilical cord, optic area and split hooves were first visible on day 33, 34, 34, 44.5, 45, 32 and 48, respectively. The mean length of embryo proper was 3.8mm on day 23 which later increased to 56. 6rnrn on day 60. When ultrasound was used to detect the conceptus between days 20 and 30 after insemination and palpation per rectum after the 60th day of insemination, the accuracy rates of pregnancy detection by ultrasound scanning at days 20, 22, 24, 26, 28, 30 were 44.4, 69.2, 78.6, 87.5, 90.0, 93.3%. In summary, the early pregnancy diagnosis of Korean native cattle with ultrasound appears high accuracy rates. It is considered that ultrasound can be used in veterinary practice well.