• Radiation Oncology Journal
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• 제18권4호
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• pp.221-225
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• 2000

목적 : 본 연구는 1997년에 개정된 비인강암에 대한 AJCC병기 분류법을 1992년의 분류법과 비교하여 새로운 병기 분류법의 신뢰성을 평가하고자 시행되었다. 재료 및 방법 : 1983년부터 1996년까지 서울대학교 병원 치료방사선과에 방사선 치료를 위해 내원한 185명의 조직학적으로 확진되고 원격전이의 증거가 없는 비인강암 환자들을 대상으로 하였다. 이들 환자들에 대하여 의무 기록과 전산화 단층촬영, 자기공명영상을 검토하여 1992년 병기 분류법과 1997년 병기 분류법에 따라 병기를 분류하였고 각 병기 분류법에 따라 생존율을 산출하였다. 결과 : 1992년 분류법과 1997년 분류법에 따른 5년 생존율은 병기 I에서 각각 100$\%$; 병기 II에서는 100$\%$ 와 68.8$\%$; 병기 III에서는 61.4$\%$ 와 63.8$\%$; 병기 IV에서는 61.1$\%$ 와 63.2$\%$ 였다. 각각의 분류법으로 산출한 5년 생존율은 각각의 병기분류법 내에서 병기에 따라 유의한 차이를 보였으나 양 분류법 간에는 병기 II를 제외하고는 통계학적인 차이는 없었다. 결론 : 새로운 비인강암의 AJCC 병기분류법은 이전의 1992년 분류법과 비교하여 신뢰할 수 있을 것으로 생각되나 더 많은 환자를 대상으로 임상적 연구가 진행되어야 할 것으로 생각된다.

• Investigative Magnetic Resonance Imaging
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• 제22권4호
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• pp.254-259
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• 2018

Application of magnetic resonance imaging (MRI) for assessment of pulmonary disease has been limited, due to susceptibility to cardiac pulsation, respiratory motion, and inhomogeneity of the magnetic field of the lung. With technical advances of MRI and unmet clinical needs for more accurate diagnosis and assessment of the disease, however, the use of MRI for evaluation of the lung has broadened. Herein, we present a case of pneumonic-type lung adenocarcinoma in a patient with history of anaphylactic shock to iodinated contrast medium, in which MRI played a critical role for targeted lung biopsy and cancer staging. Through this paper, we would like to report potential value of MRI in assessment of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9487-9494
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• 2014

Background: The size of a hepatic neoplasm is critical for staging, prognosis and selection of appropriate treatment. Our study aimed to compare the radiological size of solid hepatocellular carcinoma (HCC) masses on magnetic resonance imaging (MRI) with the pathological size in a Chinese population, and to elucidate discrepancies. Materials and Methods: A total of 178 consecutive patients diagnosed with HCC who underwent curative hepatic resection after enhanced MRI between July 2010 and October 2013 were retrospectively identified and analyzed. Pathological data of the whole removed tumors wereassessed and differences between radiological and pathological tumor size were identified. All patients were restaged using a modified Tumor-Node-Metastasis (TNM) staging system postoperatively according to the maximum diameter alteration. The lesions were classified as hypo-staged, iso-staged or hyper-staged for qualitative assessment. In the quantitative analysis, the relative pre and postoperative tumor size contrast ratio ($%{\Delta}size$) was also computed according to size intervals. In addition, the relationship between radiological and pathological tumor diameter variation and histologic grade was analyzed. Results: Pathological examination showed 85 (47.8%) patients were overestimated, 82 (46.1%) patients underestimated, while accurate measurement by MRI was found in 11 (6.2%) patients. Among the total subjects, 14 (7.9%) patients were hypo-staged and 15 (8.4%) were hyper-staged post-operatively. Accuracy of MRI for calculation and characterized staging was related to the lesion size, ranging from 83.1% to 87.4% (<2cm to ${\geq}5cm$, p=0.328) and from 62.5% to 89.1% (cT1 to cT4, p=0.006), respectively. Overall, MRI misjudged pathological size by 6.0 mm (p=0.588 ), and the greatest difference was observed in tumors <2cm (3.6 mm, $%{\Delta}size=16.9%$, p=0.028). No statistically significant difference was observed for moderately differentiated HCC (5.5mm, p=0.781). However, for well differentiated and poorly differentiated cases, radiographic tumor maximum diameter was significantly larger than the pathological maximum diameter by 3.15 mm and underestimated by 4.51 mm, respectively (p=0.034 and 0.020). Conclusions: A preoperative HCC tumor size measurement using MRI can provide relatively acceptable accuracy but may give rise to discrepancy in tumors in a certain size range or histologic grade. In pathological well differentiated subjects, the pathological tumor size was significantly overestimated, but underestimated in poorly differentiated HCC. The difference between radiological and pathological tumor size was greatest for tumors <2 cm. For some HCC patients, the size difference may have implications for the decision of resection, transplantation, ablation, or arterially directed therapy, and should be considered in staging or selecting the appropriate treatment tactics.

• Korean Journal of Radiology
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• 제23권8호
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• pp.785-793
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• 2022

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease involving apocrine-bearing sites. It is characterized by recurrent painful nodules and abscesses that potentially rupture, resulting in sinus tract formation, fistulas, and scarring. HS tends to be found in the intertriginous areas (i.e., the axillary, inguinal, and perianal areas of the body). HS may be uncommon for radiologists because its diagnosis is usually based on clinical assessment. However, diagnosis based solely on clinical manifestations can underestimate the severity of HS. Ultrasonography and MRI play a critical adjunct role in determining the severity and extent of the disease and greatly aid its management. Given that MRI is an effective imaging tool, its role in the analysis of severe and anogenital HS lesions merits considerable attention. Unfortunately, anoperineal HS imposes diagnostic dilemmas. It has multiple symptoms and presentations and often mimics other diseases in the intertriginous areas. Therefore, a thorough understanding of HS is essential to avoid delayed diagnoses. This review highlights the typical MRI imaging features and staging of HS, emphasizing on the anoperineal location. The review also differentiates the disease from mimics to facilitate the prompt delivery of appropriate treatment and improve patients' quality of life.

• Korean Journal of Radiology
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• 제20권6호
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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.

• 대한기관식도과학회지
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• 제6권1호
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• pp.7-15
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• 2000

Background and Objectives:Submucosal spread of hypopharyngeal canceris frequently incriminated for the high incidence of local recurrence after resection. Although mucosal spread is better detected by means of direct visualization, submucosal spread is better evaluated by using cross-sectional imaging rather than endoscopy. This study was designed to evaluate the efficacy of MRI in diagnosing involvement of inferior margin of hypopharyngeal cancer. Materials and Method : Eight patients with hypopharyngeal cancer underwent MRI prior to surgery. And postoperative histopathopogic involvement of tumor was compared with the preoperative MRI axial scan. Results : In preoperative MRI findings, involvement of pyriform sinus apex was 6 cases(definitive 5 cases, probable 1 cases), that of esophageal inlet was 1 case(probable), that of cervical esophagus was 1 case(probable). In postoperative histopathologic findings, the results were same. Conclusion : MRI evaluation for patient with hypopharyngeal cancer ensures accurate staging and provides essential information about the tumor involvement of inferior margin. And there is needed to be thin section thickness in evaluation of inferior margin of hypopharyngeal cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4705-4709
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• 2014

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies. Materials and Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department. Results: MRI was 100% sensitive and had a 100% positive predictive value to detect lymph node metastasis in lymph nodes with spiculated margins and 100% sensitive with a 75% positive predictive value to detect lymph node metastasis in a lymph node with lobulated margins. The sensitivity and positive predictive value of MRI to detect heterogeneous nodal enhancement were 100% and 75% respectively. Conclusions: Our study results reinforce that MRI should be used as a modality of choice in the pretreatment assessment of lymph nodes in proven gynaecological malignancies in order to determine the line of patientmanagement, distinguishing surgical from non-surgical cases.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.297-306
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• 2018

Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1713-1718
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• 2012

Advanced imaging approaches (computed tomography, CT; magnetic resonance imaging, MRI; $^{18}F$-fluorodeoxyglucose positron emission tomography, FDG PET) have increased roles in cervical cancer staging and management. The recent FIGO (International Federation of Gynecology and Obstetrics) recommendations encouraged applications to assess the clinical extension of tumors rather than relying on clinical examinations and traditional non-cross sectional investigations. MRI appears to be better than CT for primary tumors and adjacent soft tissue involvement in the pelvis. FDG-PET/CT has increased in usage with a particular benefit for whole body evaluation of tumor metabolic activity. The potential benefits of advanced imaging are assisting selection of treatment based upon actual disease extent, to adequately treat a tumor with minimal normal tissue complications, and to predict the treatment outcomes. Furthermore, sophisticated external radiation treatment and brachytherapy absolutely require advanced imaging for target localization and radiation dose calculation.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.110-116
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• 2005

Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.