Purpose: We performed this study to compare T1-201 and Tc-99m MIBI scans for the differentiation of malignant from benign breast mass. Materials and Methods: Thirty-eight female patients underwent T1-201 breast scan and thirty-two of them also underwent Tc-99m MIBI scan of the breast. After intravenous injection of 74-111 MBq of T1-201, early (10 minutes) and delayed (3 hours) images were obtained. Then, 555-740 MBq of Tc-99m MIBI was injected and images after 30 minutes were obtained. We compared T1-201 and Tc-99m MIBI scans with pathologic results. Results: Twenty-three patients were confirmed to have infiltrating duct carcinoma and fifteen patients to have benign breast mass by excisonal biopsy. The sensitivity of early and delayed T1-201 scan and Tc-99m MIBI scan in the detection of malignant breast lesion were 100% (23/23), 82% (18/22), and 90% (18120), respectively. The sensitivity of early T1-201 scan was significantly higher than that of delayed T1-201 scan (p<0.05). The specificity of early and delayed T1-201 scan and Tc-99m MIBI scan were 73% (l1/15), 73% (l1/15) and 83% (10/12), respectively (p: not significant). Three patients out of nine with fibroadenoma and one patient with atypical duct hyperplasia were false positive in both early and delayed T1-201 scans. The size of fibroadenoma with false positive in early and delayed T1-201 scan (4 cases) was larger than that of 11 fibroadenoma with true negative scan (p<0.01). Metastatic axillary lymph node involvement was present in fifteen patients. The sensitivity to detect metastatic nodes was 38% (5/13) for early T1-201 images, 15% (2/13) for delayed T1-201 images, 58% (7/12) for Tc-99m MIBI planar images and 67% (4/6) for Tc-99m MIBI SPECT. The sensitivity of Tc-99m MIBI planar or SPECT was significantly higher than that of delayed T1-201 images (p<0.05). Conclusion: Early T1-201 and Tc-99m MIBI scan are useful noninvasive methods to differentiate malignant from benign mass of breast Tc-99m MIBI scan was sensitive in detecting axillary lymph node metastasis in patients with breast cancer.
Recently as the ultrasonography became generalized, the annual change rate of the incidence of thyroid cancer extraordinarily grew to 24.5% in Korea. Therefore, the aim of this study was performed to identify the risk factors of thyroid cancer apart from conventional risk factors of dietary iodine and ionizing radiation. In this retrospective study, 411 patients underwent fine-needle aspiration biopsy were examined from January 2011 to March 2013. The subjects are divided into two groups which are 260 patients with benign nodule and 151 patients with malignancy nodule. We compared age, hematologic values, body mass index, waist circumference, menopausal status, breast nodules status, uterine myoma status, fatty liver status of targeted group of patients. According to the result, in thyroid cancer group with obesity, the number of case of breast nodules and myoma was higher, and their thyroid stimulating hormone values was higher than the benign nodule group. In order to establish factors influencing thyroid and thyroid cancer, there is a definite need for continuous study.
Purpose: In the breast cancer patient, lymphatic mapping and sentinel lymph node biopsy are the most important procedure for axillary lymph node staging. We aimed to compare the three radiocolloids [$^{99m}Tc$-antimony trisulfide colloid (ASC), $^{99m}Tc$-tin colloid (TC), and $^{99m}Tc$-human serum albumin (HSA)] for sentinel lymph node mapping. Subjects and Methods: Totally, 397 patients with clinically N0 stage were enrolled. $^{99m}Tc$-ASC was injected in 202 out of 397 patients, $^{99m}Tc$-TC was injected in 120 patients, and $^{99m}Tc$-HSA was injected in the remaining 75 patients. The sentinel lymph nodes were localized by lymphoscintigraphy and selected using intraoperative gamma probe. All sentinel lymph nodes were investigated by intraoperative pathologic consultation. The axillary lymph nodes which were harvested by the lymph node dissection were also investigated. Results: The patients of each group showed similar clinical characteristics. There were no significant differences (p>0.05) in the identification rate of sentinel lymph nodes (IR), false negative rate (FNR), and negative predictive value (NPV). The axillary lymphadenectomy revealed axillary lymph node metastases in those three groups (ASC-33.2%, TC-31.7%, HSA-22.7%). The IR, FNR, and NPV were not significantly different among those groups. Conclusion: Those three $^{99m}Tc$-labeled radiocolloids showed equivalent results in sentinel lymph node mapping of breast cancer.
So Yeon Won;Eun-Kyung Kim;Hee Jung Moon;Jung Hyun Yoon;Vivian Youngjean Park;Min Jung Kim
Journal of the Korean Society of Radiology
/
v.81
no.1
/
pp.147-156
/
2020
Purpose The objective of this study was to evaluate the diagnostic value and threshold levels of cytokeratin fragment 21-1 (CYFRA 21-1) in fine-needle aspiration (FNA) washouts for detection of lymph node (LN) recurrence in postoperative breast cancer patients. Materials and Methods FNA cytological assessments and CYFRA 21-1 measurement in FNA washouts were performed for 64 axillary LNs suspicious for recurrence in 64 post-operative breast cancer patients. Final diagnosis was made on the basis of FNA cytology and follow-up data over at least 2 years. The concentration of CYFRA 21-1 was compared between recurrent LNs and benign LNs. Diagnostic performance and cut-off value were evaluated using a receiver operating characteristic curve. Results Regardless of the non-diagnostic results, the median concentration of CYFRA 21-1 in recurrent LNs was significantly higher than that in benign LNs (p < 0.001). The optimal diagnostic cut-off value was 1.6 ng/mL. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CYFRA 21-1 for LN recurrence were 90.9%, 100%, 100%, 98.1%, and 98.4%, respectively. Conclusion Measurement of CYFRA 21-1 concentration from ultrasound-guided FNA biopsy aspirates showed excellent diagnostic performance with a cut-off value of 1.6 ng/mL. These results indicate that measurement of CYFRA 21-1 concentration in FNA washouts is useful for the diagnosis of axillary LN recurrence in post-operative breast cancer patients.
Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.
Kim Bo Kyoung;Shin Seong Soo;Kim Seong Deok;Ha Sung Whan;Noh Dong-Young
Radiation Oncology Journal
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v.19
no.1
/
pp.21-26
/
2001
Purpose : This study was peformed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. Materials and Methods : From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients $(90\%)$ and lumpectomy or excisional biopsy for 10 patients $(8.3\%)$. Forty six patients $(38\%)$ received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the sternal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Results : Cosmetic score was excellent or good in $76\%$ (91/120), fair in $19\%$ (23/120) and poor in $5\%$ (6/120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (N0 versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0.0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conclusion : Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary node metastasis and treated with less extensive surgery without chemotherapy.
In the past, most patient of breast cancer suffered side effects due to the useless removement of Axillary Lymph Node, but there is no need to remove it because of the result in this study. The purpose of this study is to save surgery time and side effects after surgical operation for patients with breast cancer by making decisions of operation range for metastasis in first Stenosis Lymph Node using the $^{99m}Tc-Tincolloid$ Scintigraphy and the Micro Probe for radioisotope. As a result of this study, 15 among 20 patients became objects of this study could reduced side effects for operation because there were no axillary lymph node operations. However there is no standard for method of this treatment. It should be standardize where inject point is, how much $^{99m}Tc-Tincolloid$ should be injected(radioactivity value), and the need of massage and Lymph Scintigraphy. Nevertheless I think that this result of study is useful to reduce suffering and side effects from breast cancer and also we should try to do that continuously. The objects for this study were 20 patients diagnosed as breast cancer by Ultrasonography, Mammography & Biopsy. The average of patient age was 45.4 years and its range was between 31 and 71 years. In case of clinical period there were 9 patients of Period I and II patients of Period III. The equipment for this study were $^{99m}Tc-Tincolloid$ describing the Stenosis Lymph Node as a tracer, Micro Probe : Neoprobe 2000(the rest is Gamma Probe) tracing the location, and MS-II Gamma Camera : SIEMENS(the rest is MS-II Gamma Camera) describing the images. There were 3 methods for this study, after selecting one of those methods all 20 patients were performed Stenosis Lymph Node diagnosis & Gamma Probe in operation room. The result was that I imaged all the 20 patients, and seek the Stenosis Lymph Node by using Gamma Probe. Metastasis in Stenosis Lymph Node was 5 and Metastasis in Axillary Lymph Node was 3 between Metastasis in Stenosis Lymph Node cases. Finally 15 patients were also proved that Axillary Lymph Node was Positive and that means there was no Metastasis in Axillary Lymph Node.
Fourteen cases of pericardia I tumor were clinically experienced from June 1966 to July 1981, for 15 years in St. Mary's Hospital, Department of Thoracic and Cardiovascular Surgery, Catholic Medical College. There were three primary tumors of the pericardium, liposarcoma, teratoma and malignant mesothelioma, and 11 metastatic pericardial tumors. In metastatic pericardial tumors, eight were originated from the lung, one was breast, and the other two cases were unknown origin. There were 6 adenocarcinoma, one small cell carcionoma ~nd one alveolar cell carcinoma in 8 cases from the lung, and 5 male and 3 female patients were composed the metastatic pericardial cancer from the lung. In clinical symptoms were dyspnea in all cases, and 9 cases had the generalized edema and enlarged liver size. Six patients had been operated, three of the primary pericardial tumor and three of metastatic pericardial tumor. Two of the primary tumors were cured satisfactorily by the mass removal, but one died due to cardiac arrest at postoperative one day. In metastatic tumors, operation were performed as two pericardial window formation and one left lower lobectomy with pericardial fenestration, but one was died in second operative day. Other nine metastatic tumors were diagnosed by needle biopsy in one case and by cell block of effusion in eight cases.
Park, So Yoon;Han, Boo-Kyung;Cho, Eun Yoon;Bang, Sa-Ik
Investigative Magnetic Resonance Imaging
/
v.19
no.3
/
pp.191-195
/
2015
We present a 53-year-old woman with a large chest wall mass in the interpectoral space, which was eventually confirmed as a lipogranuloma resulting from hydrogel implant rupture. Ultrasonography (US) showed reduced implant volume with surrounding peri-implant fluid collection, suggesting the possibility of implant rupture. A heterogeneously hypoechoic mass was found between the pectoralis major and minor muscles adjacent to the ruptured implant. On magnetic resonance imaging (MRI), there was a large mass in the left interpectoral space of the upper inner chest wall. The mass showed slightly high signal intensity (SI) on pre-contrast T1-weighted image (WI) with mixed iso and high SI on T2-WI. The signal of the mass was suppressed using the water suppression technique but not with the fat suppression technique on T2-WI. The mass showed diffuse enhancement upon contrast enhancement. The enhancing kinetics showed persistent enhancement pattern. US-guided core needle biopsy revealed a lipogranuloma and removal confirmed a ruptured PIP hydrogel implant.
Park, Sang Gyu;Kim, Yeseul;Woong, Jun Hyun;Song, Chang Myeon
Korean Journal of Head & Neck Oncology
/
v.35
no.2
/
pp.71-75
/
2019
Inflammatory myofibrolastic tumor (IMT) is a rare borderline neoplasm. It frequently occurs in the lung but occasionally occurs in extrapulmonary sites such as the genitourinary tract, gastrointestinal tract, breast, salivary glands, sinonasal tract, orbit, and the central nervous system. Laryngeal involvement of IMT is very rare. A 61-year-old woman who complained of hoarseness persisting for 3 months visited our hospital. Laryngoscopy showed an elevated lesion in the right true vocal cord. Incisional biopsy was confirmed as larygeal inflammatory myofibrolastic tumor. We performed a transoral excision with CO2 LASER under suspension examination. Regional recurrence or distant metastasis was not observed after 9 months of follow-up. Herein we report a case of larygeal inflammatory myofibrolastic tumor that was treated with surgery alone, with a literature review.
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