• 대한핵의학회지
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• 제15권2호
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• pp.1-9
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• 1981

Bone scans with $^{99m}Tc-MDP$ (methylene diphosphonate) were obtained and analysed in 574 patients with biopsy-proven malignancy, who visited Seoul National University Hospital from April, 1979 to June, 1931. Clinical staging was done in all patients without bone scan information and compared with bone scan to determine the predictive value of bone scanning. 1. Primary site of the maligancies were lung in 152, breast in 97, stomach in 43, colon in 15, esophagus in 9, liver and pancreas in 11, kidney in 14, bladder in 27, prostate in 22, thyroid in 20, skin in 11, bone in 9, head and neck in 36, ovary and uterus in 17, hematopoietic and lymphoretic ular system in 33, nervous system in 10, and others in 9 cases. Primary site was not defined in 39 cases. 2. Bone scans were positive in 186 cases (32.4%), which, included 48 cases (31.6%) of lung cancer, 27 cases (27.8%) of breast cancer, 12 cases(28%) of stomach cancer, 6 cases(40%) of colon cancer, 6 cases(43%) of kidney tumor, 4 cases(15%) of bladder cancer, 14 cases(64%) of prostate cancer, 3 cases(15%) of thyroid cancer and 66 other cases. 3. Bone scans were suspicious in 64 cases (11.2%) which included 29 cases (19.1%) of lung cancer, 10 cases (10.3%) of breast cancer, 4 cases (9.3%) of stomach cancer, one case (7%) of colon cancer, 3 cases(11%) of bladder cancer, 2 cases(10%) of thyroid cancer and 15 other cases. 4. Out of 121 cases with early stage of malignancy (which included 20 cases of lung cancer in stage I, II, 38 cases of breast cancer, 13 cases of stomach cancer, 8 cases of kidney tumor, 14 cases of thyroid cancer in stage $I{\sim}III$, and 6 cases of colon cancer, 14 cases of bladder cancer, 8 cases of prostate cancer in stage $A{\sim}C$, bone scans were positive in 5 cases (4.1%) which included 3 cases of lung cancer one case of breast cancer and one case of prostate cancer, and considered as further advanced stage. Out of 121 cases with early stage of malgnancy, bone scans were suspicious in 21 cases (17.4%) which inlcuded 9 cases of lung cancer, 4 cases of breast cancer, 2 cases of stomach cancer, one case of colon cancer, 3 cases of bladder cancer, and 2 cases of thyroid cancer. From these results, we concluded bone scan was useful in detecting bone metastasis in patients of early stage of malignancy, determining prognosis and establishing therapentic plan.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.695-698
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• 2010

Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

• Nuclear Medicine and Molecular Imaging
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• 제43권1호
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• pp.48-54
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• 2009

목적: 기존의 Tc-99m MIBI 유방스캔은 유방암 진단에 어느 정도 유용하다고 알려져 있으나 작은 병변을 발견하는데 민감도가 낮은 것이 문제점이었다. 고해상도 유방 전용 스캔 또한 작은 병변에 대한 예민도에 한계가 있다. 본 연구에서는 1 cm이상의 촉지되는 병변에 대해서 고해상도 유방 전용 스캔의 유용성을 알아보고자 하였다. 대상 및 방법: 19명의 만져지는 병변이 있은 환자를 대상으로 Tc-99m MIBI 유방스캔을 시행하였다 약 925-1110 MBq을 투여한 10분 후에 조기 영상을 촬영하고, 30분 후에 지연 영상을 시행하였다. 결과: 19명중 23개의 병변이 조직학적으로 진단되었고, 그 중 18개는 악성으로, 5개 병변은 양성으로 진단되었다. 고해상 유방스캔이 악성 병변을 찾는데 있어 민감도 100%로 매우 유용하였다. 다섯 개의 양성 중 2개는 초기 영상에서 섭취 증가를 보였으나 지연 영상에서 섭취감소를 보여 양성으로 판단하였고 병변 진단에 지연 영상이 도움이 되었다. 유방 촬영술이 13개의 병변들에서 모호한 결과를 보였고 1개의 악성 병변을 양성으로 진단한 것에 비해 유방 전용 스캔은 악성 선별에 훨씬 우수한 결과를 보였다. 결론: 본 연구에 의하면 고해상 유방 전용 스캔은 1 cm 이상의 만져지는 병변에서 악성 병변을 선별하는데 큰 도움이 될 것으로 기대된다. 이러한 결과는 좀 더 많은 환자를 대상으로 한 연구에 의해 검증되어야 하며 특히 지연영상을 촬영하는 최적의 시간에 대해서도 비교 연구가 필요할 것으로 사료된다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 춘계학술대회
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• pp.399-401
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• 2022

유방 악성 상태를 분류하기 위한 최종 진단은 침습적 생검을 이용한 현미경 분석을 통해 확인이 가능하나, 분석을 위해 일정 시간과 비용이 부과되며, 병리학적 지식을 보유한 전문가가 필요하다. 이러한 문제를 극복하기 위해, 딥 러닝을 활용한 진단 기법은 조직병리학적 이미지에서 유방암을 양성 및 악성으로 분류에 효율적인 방법으로 고려된다. 본 연구는 유방암 조직병리학적 이미지를 40배 확대한 BreaKHIS 데이터 세트를 사용하여 양성 및 악성으로 분류하였으며, 100% 미세 조정 체계와 Adagrad를 이용한 최적화로 사전 훈련된 컨볼루션 신경망 모델 아키텍처를 사용하였다. 사전 훈련된 아키텍처는 InceptionResNetV2 모델을 사용하여 마지막 계층을 고밀도 계층과 드롭아웃 계층으로 대체하여 수정된 InceptionResNetV2를 생성하도록 구성되었다. 훈련 손실 0.25%, 훈련 정확도 99.96%, 검증 손실 3.10%, 검증 정확도 99.41%, 테스트 손실 8.46%와 테스트 정확도 98.75%를 입증한 결과는 수정된 InceptionResNetV2 모델이 조직병리학적 이미지에서 유방 악성 유형을 예측하는 데 신뢰할 수 있음을 보여주었다. 향후 연구는 k-폴드 교차 검증, 최적화, 모델, 초 매개 변수 최적화 및 100×, 200× 및 400× 배율에 대한 분류에 초점을 맞추어 추가실험이 필요하다.

• 한국방사선학회논문지
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• 제17권5호
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• pp.743-749
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• 2023

유방의 관상피내암(DCIS; ductal carcinoma in situ)은 유방의 상피세포가 악성화되었지만, 아직 정상적인 유관에 한정되어 있는 경우를 지칭하며, 최근 빠르게 증가하고 있다. 본 증례에서 추적관찰 2년 동안은 유방 촬영술 및 초음파 검사상 병변은 BI-RADS Category 3으로 분류되는 작은 mass가 관찰되었지만 낭성 mass 소견을 보여, 전형적인 악성 종양의 소견과는 거리가 있었으나 추적관찰 2년째에 유방초음파상 우측 유방 6시 방향에 불분명한 경계(Lobulated margin)를 보이는 저에코(hypoechoic) 종괴가 약 2.1 × 1.3 cm 크기로 보였으며 조직 검사상 관상피내암으로 진단되었다. 관상피내암은 특징적인 임상소견이 없고 초기에 양성의 임상, 영상 소견을 보일 수 있으므로 정기적인 추적관찰을 시행하는 것이 조기 진단에 중요할 것으로 사료되며, 유방촬영술과 초음파 검사로 관상피내암을 발견하는 것은 유방암 환자 전체의 예후를 좋게 하는 데에 중요하다고 할 수 있겠다. 4년 전 처음 검사 시 증상이 없으며 유방촬영상 정상이고 유방초음파상 악성 징후 없는 낭성병변이 추적관찰 중에 관상피내암의 소견인 비대칭 음영과 미세석회화, 분엽상의 mass가 관찰된 관상피내암의 증례를 보고한다.

• 대한세포병리학회지
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• 제14권2호
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• pp.53-59
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• 2003

Fine needle aspiration cytology (FNAC) has been known as a very sensitive and effective method for preoperative diagnosis. We studied cases preoperatively diagnosed by FNAC and confirmed by the histopathologic examination to define the effectiveness of FNAC. A total of 567 cases including breast, thyroid gland, lymph node, and soft tissue confirmed histologically after FNAC were enrolled, among 2,844 FNAC cases from January 1996 to March 2000. Overall sensitivity and specificity of FNAC were 93% and 100%, respectively. Sensitivity and specificity of FNAC by sites or organs were 91% and 100% in breast, 100% and 100% in thyroid, 97% and 100% in lymph node, and 71% and 100% in soft tissue, respectively. Nine cases showed diagnostic discrepancy; eight cases of sampling error and one case of interpretation error. Five cases, diagnosed as fibrocystic change at FNAC but invasive ductal carcinoma after the histopathologic examination, were categorized as sampling error due to the presence of diffuse fibrosis or deep seated location. One case of breast, diagnosed descriptively as atypical ductal and stromal cells suggesting invasive ductal carcinoma at FNAC but malignant phyllodes tumor histologically, was categorized as interpretation error. Other cases of sampling errors were two cases of soft tissue, a case of lymph node, and a case of salivary gland.

• 대한두경부종양학회지
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• 제15권2호
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• pp.177-181
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• 1999

Objective: The clinical significance of mass screening for thyroid carcinoma remains unclear. This study was carried out to clarify the value of mass screening for thyroid carcinoma. Materials and Methods: From December 1997 through July 1998, a total of 1,401 subjects who were enrolled to receive breast screening or follow-up examination for breast cancer were included in this study. Thyroid glands were examined by 10 MHz ultrasonography by one experienced radiologist. The patients with thyroid nodules were classified into 2 groups according to their potential risk of malignancy by ultrasonographic findings(high-risk : hypoechogenicity, microcalcification, irregular margin, taller than wider shape). High-risk patients were advised to undergo fine-needle aspiration biopsy and thyroidectomy. The characteristics of the thyroid cancers detected by ultrasonographic mass screening were compared by those of clinical thyroid cancer excluding male patients during the same period. Results: Thyroid nodules were detected in 353(25.2%) of the subjects and 259(73.4%) were listed in the low-risk group and 94(26.6%) in high-risk group. Among 94 patients in the high-risk group, 43 underwent thyroidectomy and 37 turned out to have thyroid carcinomas. Thus, the detection rates for carcinoma were 2.6% of all subject, 10.5% of the detected nodules, 36.4% of the high risk women and 86.0% of the operated cases. The tumor size was significantly smaller in the mass-screening group than in the clinical cancer group(p<0.05). However, there was no statistical differences between two groups in the prevalences of neck node involvement and extracapsular invasion and the patients distributions by AMES score, MACIS score and TNM stage. Conclusion: Ultrasonogrpahic mass screening may be useful for the early detection of thyroid carcinoma in women who are scheduled to have breast examination.

• Korean Journal of Radiology
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• 제25권4호
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• pp.343-350
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• 2024

Objective: Artificial intelligence-based computer-aided diagnosis (AI-CAD) is increasingly used in mammography. While the continuous scores of AI-CAD have been related to malignancy risk, the understanding of how to interpret and apply these scores remains limited. We investigated the positive predictive values (PPVs) of the abnormality scores generated by a deep learning-based commercial AI-CAD system and analyzed them in relation to clinical and radiological findings. Materials and Methods: From March 2020 to May 2022, 656 breasts from 599 women (mean age 52.6 ± 11.5 years, including 0.6% [4/599] high-risk women) who underwent mammography and received positive AI-CAD results (Lunit Insight MMG, abnormality score ≥ 10) were retrospectively included in this study. Univariable and multivariable analyses were performed to evaluate the associations between the AI-CAD abnormality scores and clinical and radiological factors. The breasts were subdivided according to the abnormality scores into groups 1 (10-49), 2 (50-69), 3 (70-89), and 4 (90-100) using the optimal binning method. The PPVs were calculated for all breasts and subgroups. Results: Diagnostic indications and positive imaging findings by radiologists were associated with higher abnormality scores in the multivariable regression analysis. The overall PPV of AI-CAD was 32.5% (213/656) for all breasts, including 213 breast cancers, 129 breasts with benign biopsy results, and 314 breasts with benign outcomes in the follow-up or diagnostic studies. In the screening mammography subgroup, the PPVs were 18.6% (58/312) overall and 5.1% (12/235), 29.0% (9/31), 57.9% (11/19), and 96.3% (26/27) for score groups 1, 2, 3, and 4, respectively. The PPVs were significantly higher in women with diagnostic indications (45.1% [155/344]), palpability (51.9% [149/287]), fatty breasts (61.2% [60/98]), and certain imaging findings (masses with or without calcifications and distortion). Conclusion: PPV increased with increasing AI-CAD abnormality scores. The PPVs of AI-CAD satisfied the acceptable PPV range according to Breast Imaging-Reporting and Data System for screening mammography and were higher for diagnostic mammography.

• Journal of Chest Surgery
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• 제18권1호
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• pp.86-91
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• 1985

A clinical analysis was performed on 11 cases of metastatic lung cancer experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during the 15 year period from 1970 to 1984. Of the 1lpatients of metastatic lung cancer, 4 patients were male and 7 patients were female and the age ranged from 27 years to 60 years old with the average of 38.8 years old. The sites of primary tumor were uterus and ovary in 5 patients, breast in 2, sarcoma in 2, rectum in 1 and testis in l.\ulcorner Tumor free intervals in each patients were as followed; unrecognition of primary site in 2 patients, simultaneous discovery of primary tumor and metastasis in 3, 14 months in 1, 4 years in 4 and 5 years in Twelve thoracotomies were performed in 11 patients and performed procedures were as followed; pneumonectomy in 1 patient, lobectomy in 7, wedge resection in 2, decortication and wedge resection in 1 and biopsy only in 1. Of the 11 patients, 4 patients died within one year after operation, 2 patients died within 2 years and 2 patients are alive over 5 years after operations. Other 3 patients are alive 2 months, 4 months and 9 months after operation at present.

• 대한기관식도과학회지
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• 제7권2호
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• pp.168-173
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• 2001

Background and Objectives： The introduction of highly sensitive imaging techniques has made it possible to detect many non-palpable nodules, or“incidentaloma”in the thyroid. Discovery of these lesions raises concerns about their malignancy, but the optimal strategy for managing these lesions has not been clearly established. This study was designed to evaluate the usefulness of ultrasonographic exam with new diagnostic criteria and presume the value of mass screening for thyroid cancer. Materials and Methods : Mass screening for thyroid cancer were carried out in conjunction with mass screening for breast cancer. The subjects were 630 women aged 30 years or over. Thyroid glands were examined with 10 MHz transducer ultrasonography by one radiologist. Needle aspiration biopsy were performed when suspicious of malignancy under the new diagnostic criteria. Results and Conclusion : The new ultrasonographic criteria to diagnose thyroid cancer provided useful information and ensured more accurate evaluation. 7 cases of thyroid cancer were discovered and successfully managed. It should be further demonstrated that there is sufficient value of mass screening for thyroid cancer to perform it independently despite early cancer detection.