• Korean Journal of Radiology
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• 제23권12호
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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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• 제16권1호
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• pp.1-5
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• 2012

유방 MRI는 유방암의 유방촬영 스크리닝법에 대한 가장 정확한 보완 검사법이다. 아직까지 MRI 스크리닝의 효과에 대한 무작위 대조군연구가 없음에도 불구하고, 현재 미국암학회와 국립 종합암네트워크 (NCCN)에서는 MRI 스크리닝을 유방암 고위험여성에서 권고하고 있다. 국내에서는, 한 후향적 연구에서 유방암 환자의 반대쪽 유방암에 대한 MRI 스크리닝법이 유방촬영술과 초음파에서 발견하지 못한 암을 발견하고 이는 이후 유방암 발병을 감소시킴을 보고하고 있다. 국내에 유방촬영 스크리닝법의 보완법으로 MRI를 도입하기 위해서는 판독의 표준화와 교육, MR 유도하 조직검사법과 적절한 적응증의 확립, 비용-효용성에 대한 평가가 선결되어야 한다.

• Korean Journal of Radiology
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• 제22권2호
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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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• 제22권1호
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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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• 제24권4호
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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.

• 대한영상의학회지
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• 제82권1호
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• pp.29-48
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• 2021

확산강조영상은 유방암의 진단과 스크리닝에 있어 독립적 검사 방법으로서의 기대되는 결과를 보여주는 빠른 비조영증강 검사 방법이다. 현재까지의 연구 결과 유방암 진단에 있어 독립적 검사 방법으로서 확산강조영상의 민감도는 역동적 조영증강 검사보다는 낮으나 유방촬영술보다는 높으며, 이로써 유방암 스크리닝에 대한 유용한 대안이 될 수 있을 것으로 보인다. 확산강조영상의 표준화된 영상 획득과 판독을 통해 영상 화질이 개선될 수 있고, 판독 결과의 다양성도 감소할 것으로 기대된다. 또한, 최신 기법과 후처리 기법을 사용한 고해상도 확산강조영상을 시행함으로써 1 cm 미만의 작은 암의 발견율을 증가시킬 수 있고, 가음성 및 가양성 결과를 감소시킬 것으로 보인다. 현재 한국에서 진행 중인 고위험군 여성에서의 확산강조영상 스크리닝에 대한 다기관 연구 결과가 나온다면 독립적 검사로서의 확산강조영상의 사용을 촉진시킬 수 있을 것으로 기대된다.

• 한국소음진동공학회논문집
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• 제12권3호
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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.

• 한국소음진동공학회:학술대회논문집
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• 한국소음진동공학회 2001년도 추계학술대회논문집 II
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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.

• 대한한방부인과학회지
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• 제30권4호
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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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• 제20권11호
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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.