• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.101-110
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• 2011

To describe the background, mechanism, clinical results and complications of prolotheapy based on the literature review. Prolotherapy is a minimally invasive injection-based treatment of chronic musculoskeletal pain, including ligament and joint laxity. The mechanism of this injection-based technique is to initiate a local inflammatory response with resultant tissue healing. The used proliferants are classified by bio-mechanism to act in three different ways as osmotic, irritants, and chemotatics. The most commonly used proliferant is hyperosmolar (10~25%) dextrose to act by osmotic rupture of cells. High resolution ultrasound imaging of musculoskeletal structure provide a more accurate diagnosis. Also ultrasound-guided intervention provides a more high efficacy and low rate of complications. The most common complication is local pain at the injected site, that is self-limited and good responsive to anti-inflammatory agents. Other complications are rare. It is reported that prolotherapy appears safe when performed by an experienced clinician. Prolotherapy has grown in popularity and has received significant recent attention. However there are limited evidence-based data supporting the indication and efficacy of prolotherapy in the treatment of chronic musculoskeletal pain or soft tissue injuries. Future studies are necessary to determine whether prolotherapy can play an independent and definitive role in a treatment for chronic musculoskeletal pain.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.959-969
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• 2021

Objective: This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. Materials and Methods: This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. Results: The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. Conclusion: 2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.

• Korean Journal of Radiology
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• v.25 no.2
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• pp.146-156
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• 2024

Objective: Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. Materials and Methods: We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017-May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. Results: The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS-HHUS agreement was 95.9% (236/246; Cohen's kappa = 0.883). Conclusion: Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS.

• Clinical Endoscopy
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• v.57 no.3
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• pp.393-401
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• 2024

Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a highly accurate method for diagnosing pancreatic neuroendocrine tumors (PNETs); however, some PNETs are difficult to diagnose. Recently, the efficacy of needle-based confocal laser endomicroscopy (nCLE) in diagnosing solid pancreatic masses has been reported. However, the efficacy of nCLE in the diagnosis of PNETs remains unknown and only a small number of cases have been reported. Hence, this study aimed to evaluate the efficacy of nCLE in the diagnosis of PNETs. Methods: This single-center retrospective study evaluated 30 consecutive patients with suspected PNETs on contrast-enhanced computed tomography, who consented to nCLE combined with EUS-FNA and were diagnosed using EUS-FNA or surgical resection. The diagnostic criteria for PNETs using nCLE were based on the nesting and trabecular and glandular arrangement of tumor cell clusters surrounded by capillary vessels and fibrosis, as reported in previous studies. Results: The diagnosis using nCLE was classified into three categories: misdiagnosis in three cases (10%), non-diagnostic in six cases (20%), and diagnostic in 21 cases (70%). nCLE was able to diagnose PNET in one of the two cases with inconclusive EUS-FNA. Conclusions: Although further development of the resolution and optimization of the diagnostic criteria are required, nCLE may constitute a useful diagnostic option in cases of inconclusive EUS-FNA for PNETs.

• The Journal of the Korea Contents Association
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• v.12 no.10
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• pp.349-356
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• 2012

In the diagnosis of coronary artery atheromatous plaque, Cardiac computed tomography (Cardiac Computed Tomographic Angiography: CCTA) compared with IVUS(Intravascular Ultrasound: IVUS) investigate the diagnostic accuracy, Interested in CCTA atheromatous plaque in computed tomography values (Hounsfield Unit: HU) try to find out. From April 2006 to August 2008 among coronary artery disease(Coronary Artery Disease: CAD) patients with confirmed or suspicious of CAD by CCTA performed atherosclerotic plaques and found 200 patients who underwent IVUS were enrolled. 200 patients who underwent CCTA and IVUS results from the 476 plaque was found, IVUS results of the soft plaque(n; 84), fibrous plaque(n; 63), mixed plaque (n; 97), calcific plaque(n; 232). The results are classified according to the IVUS plaque in HU in the soft plaque : $53.8{\pm}10.5$, fibrous plaque : $108.1{\pm}20.0$, mixed plaque : $371.2{\pm}113.1$, and calcific plaque : $731.0{\pm}160.4$. CCTA had sensitivity of 97% and confidence interval of 95.0-98.3. This study that is the diagnosis of coronary atheromatous plaque for using CCTA, we confirm the high sensitivity and the confidence interval Based on IVUS results CCTA atheromatous plaque with HU in the analysis could be classified to characterize in the treatment of patients with CAD is expected to help.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.1
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• pp.1-6
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• 2011

Purpose: To evaluate the usefulness of ultrasonography in diagnosis of the medial meniscus tear as a screening tool before performing magnetic resonance imaging. Materials and Methods: From April 2009 to September 2010, magnetic resonance imaging (MRI) was taken in 147 knees out of 341 knees examined with ultrasonography (US) under the suspicion of medial meniscus tear. The sonographic findings were 16 without abnormality, 12 inhomogeneity, 4 cluster, 60 cleavage and 55 more than 5mm medial extrusion of medial meniscus. In Statistical analysis, sensitivity and specificity, positive predictive value and negative predictive values were calculated. Results: The MRI showed abnormality in 104 knees. Sensitivity and specificity of ultrasonography for MRI was 94.2% and 23.3%, respectively. Positive predictive value was 74.8%, negative predictive value was 62.5%. The positive predictive value of ultrasonography were 58.3% in heterogeneity, 100% in showing cluster, 75% in visible cleft and 80% in medial extrusion. Conclusion: The US is a useful tool in prediction of medial meniscus tear before confirming it in high-cost MRI.

• Journal of the Korean Society of Radiology
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• v.10 no.4
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• pp.247-253
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• 2016

Ultrasound devices diagnose many disease, which is widely used, can not be standardized quantitative evaluated in order to evaluate sonography image of quality. Therefore, in this papers, aims to get correct image in order to accurate diagnosis by figuring out the appropriate parameter based on each target by measuring distortion which results in the analyzation of the sensitivity of SNR and the histogram of signal by manipulating parameter of 8 mm target in ATS-539 multipurpose phantom. Equipment using Acuson sequoia 512, convex probe and utilizes multi-objective phantom. experiment method is that first you put the phantom on the flat and acquire 85 sheets of image, changing frequency(2,3,4 MHz, harmonic 3, 4, 4.5 MHz), Focus(2, 4, 6 unit), and Dynamic Range(58, 68, 78, 88, 98) for a 8 mm structure. through the Image J program. The sensitivity angle of 8mm target through Image J program is gauged by each separate target SNR and the distorted angle subtract and measure Histogram of background from Histogram of signal and take top 40% from the given result value above. According to parameter variation we found out proper parameter by acquiring SNR of sensitivity and distortion data for aspect of transition. The more this findings have Focus, the lower distortion value and at 4 MHz frequency this result have high SNR and low distortion value. Dynamic Range got an appropriate image on 88 and 98. It is considered on the basis of the experimental data, the probability of disease diagnosis will get higher.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2016.05a
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• pp.490-492
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• 2016

Pancreatic ultrasound imaging is used to diagnose pancreatic hyperplasia, pancreatic steatosis, pancreatic cancer and the like. If the diagnosis of pancreatic steatosis is pancreatic parenchyma echo shades splashes spleen than in the pancreas ultrasound it determines that the fat is deposited. And research on ultrasound imaging of pancreatic cancer but is actively conducted research studies on pancreatic steatosis is insufficient In addition, pancreatic steatosis is often an error in accordance with the diagnostic criteria are vague and subjective diagnosis of the artisan. This study was a quantitative analysis using the feature value extracting a feature of an image extracted by applying a parameter to the algorithm GLCM image of the normal and pancreatic fat. Setting a region of interest ($5{\times}5pixel$) in the mild 89 case, moderate 89 case, severe 89 case, total image 267 case using GLCM algorithm, and using the Autocorrelation, Sum average, Sum of squares, Sum varience 4 kinds parameter in each image It was analyzed.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.182-193
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• 2021

Purpose To identify the features that can be used for differentiating appendicitis from non-appendicitis in pediatric patients with equivocal ultrasound (US) results. Materials and Methods A total of 53 pediatric patients (≤ 18 years old) with equivocal results on US examination for suspected appendicitis between November 2012 and October 2017 were included. US evaluation was conducted based on information retrieved from a predefined structured report form. Then, the likelihood of appendicitis was prospectively classified into five categories. The equivocal results were considered as grade 3 (indeterminate) and grade 4 (probably appendicitis). Results Of the 53 patients, 25 (47.2%) and 28 (52.8%) were classified into grade 3 and 4 groups, respectively. Among the individual US findings, increased vascularity of the appendiceal wall and peri-appendiceal fat infiltration were independent findings associated with the diagnosis of appendicitis (p = 0.005, p = 0.045, respectively) in the multivariate logistic regression analysis and showed the highest diagnostic accuracy (69.8% and 62.3%, respectively). Conclusion Increased vascularity within the appendiceal wall and peri-appendiceal fat infiltration were significant predictors of appendicitis in patients with equivocal US findings.

• Journal of the Korea Convergence Society
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• v.8 no.12
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• pp.49-53
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• 2017

Breast cancer is the sccond most female cancer patient in the entire female cancer patient, and has emerged as the highest contributor to female cancer deaths. If breast cancer id detected early, the cure rate is 92 percent. However, if early detection fails, breast cancer has a very high rate of metastasis. The transition from cancer to cancer has become more successful as cancer progresses. Early diagnosis of cancer is an important factor in improving quality of life. Examples of breast cancer include Mammograph, ultrasound, and Momotome. Mommography is not only painful for the examiner, but also for easy access to breast cancer exam inations. In this paper, breast cancer diagnosis data mammograph data was used. In addition, the Neural Network were classified for early diagnosis of breast cancer early using NEWFM. After learning of data using NEWFM, the accuracy of the breast cancer data classification was 84.4391%.