• Title/Summary/Keyword: CT, MRI

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Contralateral Internal Mammary Lymphadenopathy Mimicking Metastasis in a Patient with a History of Breast Cancer and Prior Interstitial Mammoplasty by Paraffin Injection: MRI, PET-CT, and Pathological Findings

  • Nam, Kyung Jin;Choo, Ki Seok;Kim, Jee Yeon
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.4
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    • pp.245-248
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    • 2018
  • Foreign body injections into breasts may produce foreign body reactions, fibrosis, and local swelling of involved lymph nodes, which can be misdiagnosed as metastasis or malignancy. Here, the authors report MR imaging, PET-CT imaging, and pathologic findings of contralateral internal mammary lymphadenopathy suspicious of breast cancer metastasis in a 58-year-old woman with history of left breast cancer, and previous interstitial mammoplasty by paraffin injection in both breasts.

Clinical Feasibility of Dual-Layer CT With Virtual Monochromatic Image for Preoperative Staging in Patients With Breast Cancer: A Comparison With Breast MRI

  • Bokdong Yeo;Kyung Min Shin;Byunggeon Park;Hye Jung Kim;Won Hwa Kim
    • Korean Journal of Radiology
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    • v.25 no.9
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    • pp.798-806
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    • 2024
  • Objective: Dual-layer CT (DLCT) can create virtual monochromatic images (VMIs) at various monochromatic X-ray energies, particularly at low keV levels, with high contrast-to-noise ratio. The purpose of this study was to assess the clinical feasibility of contrast-enhanced chest DLCT with a low keV VMI for preoperative breast cancer staging, in comparison to breast MRI. Materials and Methods: A total of 152 patients with 155 index breast cancers were enrolled in the study. VMIs were generated from contrast-enhanced chest DLCT at 40 keV and maximum intensity projection (MIP) with three-dimensional (3D) reconstruction was performed for both bilateral breast areas. Two radiologists reviewed in consensus the 3D MIP images of the chest DLCT with VMI and breast MRI in separate sessions with a 3-month wash-out period. The detection rate and mean tumor size of the index cancer were compared between the chest DLCT with VMI and breast MRI. Additionally, the agreement of tumor size measurement between the two imaging modalities were evaluated. Results: Of all index cancers, 84.5% (131/155) were detected in the chest DLCT with VMI, while 88.4% (137/155) were detected in the breast MRI (P = 0.210). The Bland-Altman agreement between the chest DLCT with VMI and breast MRI was a mean difference of -0.05 cm with 95% limits of agreement of -1.29 to 1.19 cm. The tumor size in the chest DLCT with VMI (2.3 ± 1.7 cm) was not significantly different from that in the breast MRI (2.4 ± 1.6 cm) (P = 0.106). Conclusion: The feasibility of chest DLCT with VMI was demonstrated for preoperative tumor staging in breast cancer patients, showing comparable cancer detectability and good agreement in tumor size measurement compared to breast MRI. This suggests that chest DLCT with VMI can serve as a potential alternative for patients who have contraindications to breast MRI.

Usefulness of $^{99m}Tc$-HMPAO SPECT in Patients with Subarachnoid Hemorrhage due to Ruptured Intracranial Aneurysm (뇌동맥류파열에 의한 지주막하출혈 환자에서 $^{99m}Tc$-HMPAO SPECT 검사의 유용성)

  • Choi, C.W.;Lee, K.H.;Kim, J.H.;Kwark, C.;Lee, D.S.;Chung, J.K.;Lee, M.C.;Han, D.H.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.175-182
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    • 1993
  • We evaluated the usefulness of $^{99m}Tc$-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients (48%), but CT/MRI showed the bilateral abnormalities in only 3 patients (14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that $^{99m}Tc$-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

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Survey of the Musculoskeletal Disorders of Riot Police and Conscripted Policeman in Radiologic Examination (전.의경의 방사선 검사를 통한 근골격계 질환 현황 조사)

  • Cho, Jae-Hwan;Kang, Maeng-Jin;Seok, Jong-Min;Jeun, Sung-Joon;Lim, Youn-Shik;Jeong, Jae-Kyo;Kim, Hyeon-Ju;Ju, Myeong-Shik;Dong, Kyung-Rae;Park, Cheol-Soo;Lee, Jin;Lee, Hae-Kag
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.315-324
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    • 2011
  • The purpose of this study was to use as basic data for the is systematic and efficient facility inventory of policeman and the riot police, conscripted policeman. First, the analysis was performed for the patient implementing the simple x-ray, CT, and MRI examination to the policeman and the riot police, conscripted policeman within the radiologic examination. As to the classification by disease, it classified into the partial body as the common disease and musculoskeletal system disease. As to the fixed quantity comparison of the policeman and the riot police, conscripted policeman the basic X-ray, CT, MRI examination by part average personnel was compared. As to the research result the riot police, conscripted policeman, the Lower extremity examination occupies the simple X-ray, CT, and MRI examination in comparison with the other part altogether much and particularly, the Knee examination ratio occupies much among the Lower extremity examination.

Clinical Usefulness of I-123 MIBG Scintigraphy with Early Planar and SPECT Image in The Diagnosis of Neuroendocrine Tumors (신경내분비종양 진단에 있어서 I-123 MIBG 조기 평면 영상과 SPECT 영상의 임상적 유용성)

  • Shin, Jung-Woo;Ryu, Jin-Sook;Won, Kyoung-Sook;Choi, Yun-Young;Kim, Hee-Jung;Yang, Seoung-Oh;Lee, Hee-Kyung;Suh, Yong-Sup
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.516-523
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    • 1996
  • The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(1 adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), 1 false positive(hepatocellular carcinoma) and 3 false negatives(1 recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.

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$^{99m}Tc$-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI/CT and EEG (경련성 질환에서 $^{99m}Tc$-HMPAO 뇌혈류 SPECT : SPECT, CT/MRI와 EEG의 비교)

  • Yang, Hyung-In;Im, Ju-Hyuk;Choi, Chang-Woon;Lee, Dong-Soo;Chung, June-Key;No, Jae-Kyu;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.17-21
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    • 1994
  • We studied 115 patients with seizure who had been performed brain SPECT, brain MRI or CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction, multiple sclerosis, AV-malformation, granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions, 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4, temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

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Platysma Infiltration on CT or MRI in Parotid Pathology (이하선 병변에서 활경근 침윤의 빈도와 조건)

  • Hie Bum Suh;Hak Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.152-161
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    • 2021
  • Purpose To evaluate the incidence and condition of platysma infiltration in benign tumors, malignant tumors, and inflammatory disease in the parotid gland using CT or MRI. Materials and Methods Patients with benign tumors (n = 314), malignant tumors (n = 52), and inflammatory disease (n = 22) in the parotid gland were included. The incidence of platysma infiltration and the relationship between platysma infiltration and the location, capsular involvement, and focality of the mass were retrospectively evaluated using CT or MRI. Results The incidence of platysma infiltration was 0% in benign tumors,19.2% in malignant tumors (10/52), and 50.0% in inflammation (11/22). Platysma infiltration was positive in 10 of 13 patients with inflammatory lesion with capsular involvement. Platysmal infiltrations in inflammatory lesion showed diffuse lesion in 10 patients and focal lesion in one patient. Malignant tumor with platysmal infiltration showed all capsular involvement, and diffuse lesion in seven and focal lesion in three. Conclusion Platysma infiltration was more common in patients with inflammatory disease than those with malignant tumors or benign tumors. In inflammatory disease, platysma infiltration was more common in patients with capsular involvement or diffuse lesion.

Utility of FDG PET-CT Scans on Nodal Staging of Squamous Cell Carcinoma in the Oral Cavity and Oropharynx (구강 및 구인두 편평상피암종의 림프절 전이에 대한 PET-CT 영상의 유용성)

  • Joo, Young-Hoon;Sun, Dong-Il;Park, Jun-Ook;Yoo, Ie-Ryung;Kim, Min-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.1
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    • pp.14-18
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    • 2010
  • Objectives : We evaluated the use of FDG PET/CT for the identification of cervical nodal metastases of SCC of the oral cavity and oropharynx with histological correlation. Material and Methods : We reviewed 46 medical records, from January 2004 to July 2007, of patients who underwent FDG PET/CT and CT/MRI for SCC of the oral cavity and oropharynx before surgery. We recorded the lymph node metastases according to the neck level affected and the system used for the imaging-based nodal classification. Results : The FDG PET/CT had a sensitivity of 75.6% and a specificity of 96.7% ; it had a higher sensitivity than the CT/MRI for identification of cervical metastases on the side of the neck(26/28 vs. 20/28, p=0.031) and at each of the cervical levels(34/45 vs. 26/45, p=0.008). There was a significant difference in the $SUV_{max}$ between the benign and malignant cervical lymph nodes($3.31{\pm}3.23$ vs. $4.22{\pm}2.57$, p=0.028). The receiver-operating-characteristic (ROC) curve analysis for differentiating the benign from the malignant cervical lymph nodes, showed that the area under the curve(AUC) of the FDG PET/CT was 0.775. The cut-off value for the $SUV_{max}$ was 2.23 based on the ROC curve. There was a significant correlation between the $SUV_{max}$ and the size of the cervical lymph nodes(Spearman r=0.353, p=0.048). Conclusion : FDG PET/CT images were more accurate than the CT/MRI images. In addition, the $SUV_{max}$ cut-off values were important for evaluating cervical the cervical nodes in the patients with SCC of the oral cavity and oropharynx.

Image Registration for PET/CT and CT Images with Particle Swarm Optimization (Particle Swarm Optimization을 이용한 PET/CT와 CT영상의 정합)

  • Lee, Hak-Jae;Kim, Yong-Kwon;Lee, Ki-Sung;Moon, Guk-Hyun;Joo, Sung-Kwan;Kim, Kyeong-Min;Cheon, Gi-Jeong;Choi, Jong-Hak;Kim, Chang-Kyun
    • Journal of radiological science and technology
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    • v.32 no.2
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    • pp.195-203
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    • 2009
  • Image registration is a fundamental task in image processing used to match two or more images. It gives new information to the radiologists by matching images from different modalities. The objective of this study is to develop 2D image registration algorithm for PET/CT and CT images acquired by different systems at different times. We matched two CT images first (one from standalone CT and the other from PET/CT) that contain affluent anatomical information. Then, we geometrically transformed PET image according to the results of transformation parameters calculated by the previous step. We have used Affine transform to match the target and reference images. For the similarity measure, mutual information was explored. Use of particle swarm algorithm optimized the performance by finding the best matched parameter set within a reasonable amount of time. The results show good agreements of the images between PET/CT and CT. We expect the proposed algorithm can be used not only for PET/CT and CT image registration but also for different multi-modality imaging systems such as SPECT/CT, MRI/PET and so on.

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Additional Value of Integrated 18F-FDG PET/MRI for Evaluating Biliary Tract Cancer: Comparison with Contrast-Enhanced CT

  • Jeongin Yoo;Jeong Min Lee;Jeong Hee Yoon;Ijin Joo;Dong Ho Lee
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.714-724
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    • 2021
  • Objective: To evaluate the value of 18F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer. Materials and Methods: This retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference. Results: The diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [Az]: 0.77 vs. 0.91 [p = 0.027] for reviewer 1; 0.76 vs. 0.92 [p = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [p = 0.004]; 0.81 vs. 0.92 [p = 0.023]), and overall resectability (0.79 vs. 0.92 [p = 0.007]; 0.82 vs. 0.94 [p = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [p = 0.029]; 0.82 vs. 0.94 [p = 0.045]). Conclusion: PET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.