• Korean Journal of Radiology
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• v.23 no.12
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• pp.1241-1250
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• 2022

Objective: To conduct a simulation study to determine whether artificial intelligence (AI)-aided mammography reading can reduce unnecessary recalls while maintaining cancer detection ability in women recalled after mammography screening. Materials and Methods: A retrospective reader study was performed by screening mammographies of 793 women (mean age ± standard deviation, 50 ± 9 years) recalled to obtain supplemental mammographic views regarding screening mammography-detected abnormalities between January 2016 and December 2019 at two screening centers. Initial screening mammography examinations were interpreted by three dedicated breast radiologists sequentially, case by case, with and without AI aid, in a single session. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and recall rate for breast cancer diagnosis were obtained and compared between the two reading modes. Results: Fifty-four mammograms with cancer (35 invasive cancers and 19 ductal carcinomas in situ) and 739 mammograms with benign or negative findings were included. The reader-averaged AUC improved after AI aid, from 0.79 (95% confidence interval [CI], 0.74-0.85) to 0.89 (95% CI, 0.85-0.94) (p < 0.001). The reader-averaged specificities before and after AI aid were 41.9% (95% CI, 39.3%-44.5%) and 53.9% (95% CI, 50.9%-56.9%), respectively (p < 0.001). The reader-averaged sensitivity was not statistically different between AI-unaided and AI-aided readings: 89.5% (95% CI, 83.1%-95.9%) vs. 92.6% (95% CI, 86.2%-99.0%) (p = 0.053), although the sensitivities of the least experienced radiologists before and after AI aid were 79.6% (43 of 54 [95% CI, 66.5%-89.4%]) and 90.7% (49 of 54 [95% CI, 79.7%-96.9%]), respectively (p = 0.031). With AI aid, the reader-averaged recall rate decreased by from 60.4% (95% CI, 57.8%-62.9%) to 49.5% (95% CI, 46.5%-52.4%) (p < 0.001). Conclusion: AI-aided reading reduced the number of recalls and improved the diagnostic performance in our simulation using women initially recalled for supplemental mammographic views after mammography screening.

• Investigative Magnetic Resonance Imaging
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• v.16 no.1
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• pp.1-5
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• 2012

Breast MRI is the most accurate adjunctive to the mammography for the screening of breast cancer. Despite lack of randomized controlled trials on the effectiveness of MRI screening, it is now recommended for the women at high risk for breast cancer by the American Cancer Society and the National Comprehensive Cancer Network based on several prospective observational studies. In Korea, a retrospective study reported that preoperative MRI screening of the contralateral breast in women with unilateral breast cancer was associated with reduced metachronous cancer incidence. To introduce breast MRI as a supplemental modality to screening mammography in Korea, standardization and education of interpretation, establishment of MR-guided biopsy and adequate indication, and evaluation of cost-effectiveness and should be preceded.

• Korean Journal of Radiology
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• v.22 no.2
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• pp.159-167
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• 2021

Objective: The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone. Materials and Methods: This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS. Results: Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001-0.705) compared to the mammography group. Conclusion: Our study found that Korean females aged 40-49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

• Korean Journal of Radiology
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• v.22 no.1
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• pp.9-22
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• 2021

Diffusion-weighted (DW) magnetic resonance imaging (MRI) is a rapid, unenhanced imaging technique that measures the motion of water molecules within tissues and provides information regarding the cell density and tissue microstructure. DW MRI has demonstrated the potential to improve the specificity of breast MRI, facilitate the evaluation of tumor response to neoadjuvant chemotherapy and can be employed in unenhanced MRI screening. However, standardization of the acquisition and interpretation of DW MRI is challenging. Recently, the European Society of Breast Radiology issued a consensus statement, which described the acquisition parameters and interpretation of DW MRI. The current article describes the basic principles, standardized acquisition protocols and interpretation guidelines, and the clinical applications of DW MRI in breast imaging.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.274-283
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• 2023

Objective: To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods: A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results: A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40-78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8-19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7-15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%-34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%-24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%-28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%-18.9%; P < 0.001). Conclusion: DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

• 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.

• Transactions of the Korean Society for Noise and Vibration Engineering
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• v.12 no.3
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• pp.236-242
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• 2002

This paper presents some advanced and supplemental methods to enhance the accuracy In case of calculating geometric divergence attenuation, attenuation by multiple screening structures, ground attenuation at unflat surfaces of sound during propagation outdoors by the methods specified in ISO 9613-2. Moreover, a calculation method for considering short-term wind effect, specified in ASJ Model-1998, is also introduced. To verity the accuracy of adopted methods, we have carried out highway traffic noise prediction and measurement at tile twelve locations appearing representative road shapes and structures, such as flat, retained cut, elevated, barrier-constructed roads. From the results, we have confirmed the predicted results show good correspondence with the measured at direct, diffracted and reflected sound fields within 30 m from the center of near side lane.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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• 2001.11b
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• pp.1280-1286
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• 2001

This paper presents some advanced and supplemental methods to enhance the accuracy in case of calculating geometric divergence attenuation, attenuation by multiple screening structures, ground attenuation at unflat surfaces of sound during propagation outdoors by the methods specified in ISO 9613-2. Moreover, a calculation method for considering short-term wind effect, specified in ASJ Model-1998, is also introduced. To verify the accuracy of adopted methods, we have carried out highway traffic noise prediction and measurement at the twelve locations appearing representative road shapes and structures, such as flat, retained cut, elevated, barrier-constructed roads. From the results, we have confirmed the predicted results show good correspondence with the measured at direct, diffracted and reflected sound fields within 30m from the center of near side lane.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.4
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• pp.175-202
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• 2017

Objectives: This study was conducted towards developing a screening tool for syndrome differentiation in the diagnosis of menopause in menopausal and perimenopausal women. Methods: We conducted a literature review of studies on menopausal diagnosis based on syndrome differentiation, and examined well-founded differentiated syndromes and their respective clinical symptoms. Based on the findings, we created a questionnaire through consultations with Oriental medicine experts in physiology, pathology, and diagnostics. Finally, the research team conducted an expert Delphi study on differentiated syndromes and the associated clinical symptoms. Results: Seven differentiated syndromes were selected, including Liver Depression (肝鬱), Kidney Yin Deficiency (腎陰虛), Kidney Yang Deficiency (腎陽虛), Liver and Kidney Yin Deficiency (肝腎陰虛), Kidney Yin and Yang Deficiency (腎陰陽兩虛), Heart-Kidney Noninteraction (心腎不交), and Dual Deficiency of Heart and Spleen (心脾兩虛); 4 disease locations, including liver (肝), heart (心), spleen (脾), and kidney (腎); and 3 disease natures, including Yin Deficiency (陰虛), Qi Stagnation (氣滯), and Blood Deficiency (血虛). In addition, we added 3 supplemental disease natures, including Yang Deficiency (陽虛), Qi Deficiency (氣虛), and Heat (火熱), in consideration of syndrome differentiation categories that may possibly be added in a follow-up clinical questionnaire. Conclusions: This resulted in a total of 7 differentiated syndromes, 4 disease locations, and 6 disease natures. We translated the clinical symptoms of these 17 categories into Korean Hangeul. After consulting with 5 Oriental medicine experts and a psychology expert, we produced a questionnaire for use in diagnosing menopause based on syndrome differentiation. The calculation of scores for the syndrome differentiation screening tool will be confirmed through clinical research based on the results of a review of existing literature.

• Journal of Microbiology and Biotechnology
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• v.20 no.11
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• pp.1592-1596
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• 2010

To verify the dominance of microorganisms in wastewater biological treatment, PCR-DGGE (denaturing gradient gel electrophoresis) was performed as a supplementary support method for screening of the dominant microorganisms from activated sludge. Results suggest that the dominant microorganisms in activated sludge are primarily responsible for strengthening its effectiveness as a biological treatment system, followed by the non-main dominant microorganisms, whereas the non-dominant microorganisms showed no effects. The degree of microbial abundance present on the profile of PCR-DGGE was in line with the treatment efficiency of augmented activated sludge with isolated cultures, suggesting that PCR-DGGE can be used as an effective supplementary method for verifying culturable dominant microorganisms in activated sludge of coking wastewater.