• 한국방사선학회논문지
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• 제15권2호
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• pp.147-152
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• 2021

본 연구에서는 선별적 유방촬영술 방법의 하나인 디지털 유방촬영술을 시행한 5320명의 유방암검진 결과를 후향적으로 분석하여 디지털 유방촬영술을 통한 유방암검진의 효용성을 살펴보았다. 유방암 검진을 시행한 환자들의 평균 나이는 57.7세(범위 30~87세)이며 암 발견율은 26건으로 1000명당 4.6건에서 유방암이 발견 되었다. 유방암 검진을 실시한 환자들의 위험인자별 암 발견율을 살펴보면 대부분 아무런 기저질환이나 기왕력이 없는 환자에서 유방암이 발견되는 비율이 높았다. 추가적인 초음파 검사등을 통해 확인된 위음성율은 3.6 %로 Film-Screen system의 위음성율에 비해 상대적으로 매우 낮은 것을 확인할 수 있다.

• Investigative Magnetic Resonance Imaging
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• 제21권4호
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• pp.233-241
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• 2017

Purpose: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. Materials and Methods: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. Results: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. Conclusion: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8335-8338
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• 2016

Purpose: To make a comparison of single voxel magnetic resonance spectroscopy (SV-MRS) and dynamic contrast enhancement (DCE) MRI for differentiation of benign and malignant breast lesions in a sample of Iranian women. Materials and Methods: A total of 30 women with abnormal breast lesions detected in mammography, ultrasound, or clinical breast exam were examined with DCE and SV-MRS. tCho (total choline) resonance in MRS spectra was qualitatively evaluated and detection of a visible tCho peak at 3.2 ppm was defined as a positive finding for malignancy. Different types of DCE curves were persistent (type 1), plateau (type 2), and washout (type 3). At first, lesions were classified according to choline findings and types of DCE curve, finally being compared to pathological results as the standard reference. Results: this study included 19 patients with malignant lesions and 11 patients with benign ones. While 63.6 % of benign lesions (7 of 11) showed type 1 DCE curves and 36.4% (4 of 11) showed type 2, 57.9% (11of 19) of malignant lesions were type 3 and 42.1% (8 of 19) type 2. Choline peaks were detected in 18 of 19 malignant lesions and in 3 of 11 benign counterparts. 1 malignant and 8 benign cases did not show any visible resonance at 3.2 ppm so SV-MRS featured 94.7% sensitivity, 72.7 % specificity and 86.7% accuracy.Conclusions: The present findings indicate that a combined approach using MRS and DCE MRI can improve the specificity of MRI for differentiation of benign and malignant breast lesions.

• Asian Pacific Journal of Cancer Prevention
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• 제15권7호
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• pp.3179-3183
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• 2014

Background: The purpose of study was to evaluate radiologic or clinical features of breast cancer undergoing ultrasound (US)-guided 14G core needle biopsy (CNB) and analyze the differences between underestimated and accurately diagnosed groups. Materials and Methods: Of 1,898 cases of US-guided 14G CNB in our institute, 233 cases were proven to be cancer by surgical pathology. The pathologic results from CNB were invasive ductal carcinoma (IDC) (n=157), ductal carcinoma in situ (DCIS) (n=40), high-risk lesions in 22 cases, and benign in 14 cases. Among high-risk lesions, 7 cases of atypical ductal hyperplasia (ADH) were reported as cancer and 11 cases of DCIS were proven IDC in surgical pathology. Some 29 DCIS cases and 157 cases of IDC were correctly diagnosed with CNB. The clinical and imaging features between underestimated and accurately diagnosed breast cancers were compared. Results: Of 233 cancer cases, underestimation occurred in 18 lesions (7.7%). Among underestimated cancers, CNB proven ADH (n=2) and DCIS (n=11) were diagnosed as IDC and CNB proven ADH (n=5) were diagnosed at DCIS finally. Among the 186 accurately diagnosed group, the CNB results were IDC (n=157) and DCIS (n=29). Comparison of underestimated and accurately diagnosed groups for BI-RADS category, margin of mass on mammography and US and orientation of lesion on US revealed statistically significant differences. Conclusions: Underestimation of US-guided 14G CNB occurred in 7.7% of breast cancers. Between underestimated and correctly diagnosed groups, BI-RADS category, margin of the mass on mammography and margin and orientation of the lesions on US were different.

• 대한영상의학회지
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• 제84권1호
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• pp.275-279
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• 2023

과립 세포 종양은 신체의 모든 부위에서 발생할 수 있으나, 특히 두경부에서 주로 발생하는 드문 양성 연부 종양이며, 이 중 5%-8%가 유방에서 발생한다. 저자들은 드문 부위인 액와부 부유방에 발생한 과립 세포 종양 1예를 보고하고자 한다. 50세 여자에게 2개월 전부터 좌측 액와부에 만져지는 종괴가 있었다. 이학적 검사, 유방 촬영술 및 초음파 소견에서 유방의 악성 종양을 먼저 생각하였다. 조직 검사에서 양성 과립 세포 종양으로 진단되었으며 이후 광범위 국소 절제술을 시행하였다. 환자는 수술 후 2년의 추적 관찰 기간 동안 재발하지 않았다. 대부분의 과립 세포 종양은 양성이지만, 재발의 가능성 때문에 종양의 광범위한 완전 절제와 추적 관찰이 필요하다. 영상의학과 의사는 불필요한 치료를 막기 위해 유방 및 액와부 병변의 감별 진단으로 과립 세포 종양의 특징에 대해 알고 있어야 한다.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.15-27
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• 2003

Therapeutic ultrasound is commonly applied for deep heating in physical therapy setting. However, it is difficult to determine the exact application dosage and to confirm the immediate heating effect. Microwave Radio-Thermometer (MRT) can measure the temperature by the electromagnetic energy in the microwave region of the object that emits above absolute zero temperature. MRT was used for early diagnosis of breast cancer since it was not harmful, non-invasive, and non-ionizing to the human body. The purposes of this study were to investigate how accurately 1.1 GHz RTM (RES Ltd. Russia) measures the change of average temperature in the tissue, and to determine the depth of temperature change measurement. Therapeutic ultrasound was applied (continuous wave for 5 minutes, 1 MHz, intensity of 1.5 $W/cm^2$ [in vitro] and 1.0 $W/cm^2$ [in vivo]) in four different conditions: (1) 30 cases of in vitro specimen of pork, (2) 30 cases of in vitro specimen of pork ankle joint, (3) 10 cases of in vivo canine thigh, and (4) 30 cases of in vivo human body. Intraclass Correlation Coeffients (ICC[3,1]) between average needle probe thermometer below surface and MRT temperature was revealed as followed: (1) Before ultrasound application ICCs ranges above .8 in specimen of pork (15 mm underneath the skin) and above .82 in specimen of pork ankle joint (10~30 mm underneath the skin). (2) After ultrasound application ICCs ranges above .7 in both specimens of pork and pork ankle joint. (3) Before ultrasound application ICCs ranges above .8 in canine thigh (20 mm underneath the skin). (4) After ultrasound application ICCs ranges above .82 in canine thigh. The temperature of the human body increased significantly with the mean of $15^{\circ}C$ in muscle tissue and with the mean of $3.5^{\circ}C$ in joint (p<.00). It was revealed that the average depth of temperature measurement of the tissue by MRT was in between 10 and 35 mm, and determined that the proper temperature measurement band was $36.5{\sim}37.0^{\circ}C$.

• 한국방사선학회논문지
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• 제13권1호
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• pp.9-14
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• 2019

본 연구는 유방 초음파 검사 시 S-detect 성능에 관한 내용을 알아보고 이에 따라 조직 검사와 비교하여 불필요한 조직 검사를 줄일 수 있는 방안을 알아보고자 하였다. 2018년 8월에서 10월까지 유방초음파 검사를 시행한 환자 중 유방결절이 발견되어 조직 검사가 계획된 30명의 환자를 대상으로 후향적으로 분석하였다. S-detect 방법에서의 악성 감별과 Biopsy에서의 악성감별에 유의한 차이가 있는지 알아보기 위해 Mc Nemar test 분석을 실시하였다. S-detector 방법의 분석 결과 민감도는 90.9 %, 특이도 84.21 %, 정확도 86.66%, 양성예측도 76.92%, 음성예측도 94.11 %로 나타났다. S-detect 방법과 Biopsy 방법 간에 일치도 분석 결과 kappa 값이 0.724(p<0.05)로 높게 나타났으며, 두 방법 간에 좋은 일치도를 보였다. 유방초음파 검사 시 S-detect를 활용한 검사 방법에 있어서 유방 종괴에 악성과 양성 감별 진단에 있어서 진단적으로 가치가 있었으며, 유방조직 검사 실시 전 적절히 활용한다면 불필요한 조직 검사를 줄일 수 있는데 도음을 줄 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3185-3190
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• 2016

Background: This study was designed to compare radioguided versus routine wire localization of nonpalpable non-malignant breast lesions in terms of efficacy for complete excision, ease of use, time saving, and cosmetic outcome. Materials and Methods: Patients with non-palpable breast masses and non-malignant core biopsy results who were candidates for complete surgical lumpectomy were enrolled and randomly assigned to radioguided or wire localization groups. Radiologic, surgical, and pathologic data were collected and analyzed to determine the difficulty and duration of each procedure, ease of use, accuracy, and cosmetic outcomes. Results: This prospective randomized study included 60 patients, randomly divided into wire guided localization (WGL) or radioguided occult lesion localization (ROLL) groups. The mean duration of localization under ultrasound guidance was shorter in the ROLL group (14.4 min) than in the WGL group (16.5 min) (p<0.001). The ROLL method was significantly easier for radiologists (p=0.0001). The mean duration of the surgical procedure was 22.6 min (${\pm}10.3min$) for ROLL and 23.6 min (${\pm}9.6min$) for WGL (p=0.6), a non-significant difference. Radiography of the surgical specimens showed 100% lesion excision with clear margins, as proved by pathologic examination, with both techniques. The surgical specimens were slightly heavier in the ROLL group, but the difference was not significant (p=0.06). Conclusions: The ROLL technique provides effective, fast, and simple localization and excision of non-palpable non-malignant breast lesions.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.20-25
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• 2020

Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

• 대한영상의학회지
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• 제84권2호
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• pp.345-360
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• 2023

국내에 자기공명영상의 보급의 증가와 함께 유방 자기공명영상의 건수도 지속적으로 증가하고 있다. 하지만 이에 비해 자기공명영상 유도하 조직생검술 및 침위치결정술과 같은 유방의 중재적 시술은 초음파 유도하 시술이나 입체정위생검술에 비해 많이 이루어지지 않는다. 유방 자기공명영상은 다른 유방 영상 검사들에 비해 높은 민감도를 보이는 검사법이지만 그 특이도는 제한되는 검사법이기 때문에, 자기공명영상에서만 발견된 병변들은 자기공명영상 유도하 조직생검술이나 자기공명영상 유도하 침위치결정술을 통한 수술적 절제를 통하여 병리적 진단이 이루어져야 한다. 이러한 배경을 바탕으로, 본 종설에서는 자기공명영상 유도하 유방의 중재적 시술들의 적응증, 시술 방법, 시술 과정에서의 여러 고려 사항 및 제한점들에 대해 다루고자 한다.