• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8917-8921
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• 2014

Objective: To observe and compare the effects of multi-patch biopsy under conventional white light imaging endoscopy (C-WLI) and precise targeted biopsy under magnifying narrow-band imaging endoscopy (M-NBI) on the endoscopic submucosal dissection (ESD) of early gastric cancers and intraepithelial neoplasias. Methods: According to the way of selecting biopsy specimens, patients were divided into C-WLI and M-NBI groups, 20 cases. The ESD operations of the 2 groups were compared quantitively. Results: The mean frequency of biopsy in M-NBI group was ($1.00{\pm}0.00$), obviously lower than in the C-WLI group ($4.78{\pm}1.02$) (P<0.01).The average total number of selected biopsy specimens was also fewer ($1.45{\pm}0.12$ and $7.82{\pm}2.22$, respectively, P<0.01). There was no significant difference in the time of determining excision extension, marking time and the time of specimen excision of 2 groups during the ESD (P>0.05), whereas submucosal injection time, mucosal dissection time, stopping bleeding time, wound processing time in the M-NBI group were significantly shorter than in the C-WLI group (P<0.01). Conclusion: Precise targeted biopsy under M-NBI can obviously shorten the time of ESD operation, with small quantity of tissues but high pathological positive rate.

• Korean Journal of Radiology
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• 제24권8호
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• pp.739-751
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• 2023

Objective: This systematic review and meta-analysis evaluated the accuracy of preoperative breast magnetic resonance imaging (MRI) features and tumor-to-nipple distance (TND) for diagnosing occult nipple-areolar complex (NAC) involvement in breast cancer. Materials and Methods: The MEDLINE, Embase, and Cochrane databases were searched for articles published until March 20, 2022, excluding studies of patients with clinically evident NAC involvement or those treated with neoadjuvant chemotherapy. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Two reviewers independently evaluated studies that reported the diagnostic performance of MRI imaging features such as continuity to the NAC, unilateral NAC enhancement, non-mass enhancement (NME) type, mass size (> 20 mm), and TND. Summary estimates of the sensitivity and specificity curves and the summary receiver operating characteristic (SROC) curve of the MRI features for NAC involvement were calculated using random-effects models. We also calculated the TND cutoffs required to achieve predetermined specificity values. Results: Fifteen studies (n = 4002 breast lesions) were analyzed. The pooled sensitivity and specificity (with 95% confidence intervals) for NAC involvement diagnosis were 71% (58-81) and 94% (91-96), respectively, for continuity to the NAC; 58% (45-70) and 97% (95-99), respectively, for unilateral NAC enhancement; 55% (46-64) and 83% (75-88), respectively, for NME type; and 88% (68-96) and 58% (40-75), respectively, for mass size (> 20 mm). TND had an area under the SROC curve of 0.799 for NAC involvement. A TND of 11.5 mm achieved a predetermined specificity of 85% with a sensitivity of 64%, and a TND of 12.3 mm yielded a predetermined specificity of 83% with a sensitivity of 65%. Conclusion: Continuity to the NAC and unilateral NAC enhancement may help predict occult NAC involvement in breast cancer. To achieve the desired diagnostic performance with TND, a suitable cutoff value should be considered.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1715-1718
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• 2015

Background: Magnetic resonance imaging of breast, reported to be a high sensitivity of 94% to 100%, is the most sensitive method for detection of breast cancer. The purpose of this study was to investigate our clinical experience in MRI-guided breast lesion wire localization in Chinese women. Materials and Methods: A total of 44 patients with 46 lesions undergoing MRI-guided breast lesion localization were prospectively entered into this study between November 2013 and September 2014. Samples were collected using a 1.5-T magnet with a special MR biopsy positioning frame device. We evaluated clinical lesion characteristics on pre-biopsy MRI, pathologic results, and dynamic curve type baseline analysis. Results: Of the total of 46 wire localization excision biopsied lesions carried out in 44 female patients, pathology revealed fourteen malignancies (14/46, 30.4%) and thirty-two benign lesions (32/46, 69.6%). All lesions were successfully localized followed by excision biopsy and assessed for morphologic features highly suggestive of malignancy according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category of MRI (C4a=18, C4b=17, C4c=8,C5=3). Of 46 lesions, 37 were masses and 9 were non-mass enhancement lesions. Thirty-two lesions showed a continuous kinetics curve, 11 were plateau and 3 were washout. Conclusions: Our study showed success in MRI-guided breast lesion wire localization with a satisfactory cancer diagnosis rate of 30.4%. MRI-guided wire localization breast lesion open biopsy is a safe and effective tool for the workup of suspicious lesions seen on breast MRI alone without major complications. This may contribute to increasing the diagnosis rate of early breast cancer and improve the prognosis in Chinese women.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2425-2430
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• 2015

Clinical resistance to chemotherapeutic agents is one of the major hindrances in the treatment of human cancers. EHZ2 is involved in drug resistance and is overexpressed in drug-resistant cancer cell lines. In this study, we investigated the effects of EHZ2 on cisplatin -resistance in A549/DDP and AGS/DDP cells. EHZ2 mRNA and protein were found to be significantly overexpressed in A549/DDP and AGS/DDP cells, compared to parental cells. EHZ2 siRNA successfully silenced EHZ2 mRNA and protein expression. Proliferation was inhibited and drug resistance to cisplatin was improved. Flow cytometry showed that silencing of EHZ2 arrested A549/DDP and AGS/DDP cells in the G0/G1 phase, increasing apoptosis, rh-123 fluorescence intensity and caspase-3/8 activities. Silencing of EHZ2 also significantly reduced the mRNA and protein expression levels of cyclin D1 and MDR1,while up-regulating p15, p21, p27 and miR-218 in A549/DPP cells. Furthermore, silencing of EHZ2 also significantly increased the expression level of tumor suppressor factor miR-218. We also found down-regulating EHZ2 expression increased methylation in A549/DDP and AGS/DDP cells. This study demonstrates that drug resistance can be effectively reversed in human cisplatin-resistant lung and gastric cancer cells through delivery of siRNAs targeting EHZ2.

• Korean Journal of Radiology
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• 제22권5호
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• pp.840-860
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• 2021

Imaging plays a key role in the diagnosis and characterization of thyroid diseases, and the information provided by imaging studies is essential for management planning. A referral guideline for imaging studies may help physicians make reasonable decisions and minimize the number of unnecessary examinations. The Korean Society of Thyroid Radiology (KSThR) developed imaging guidelines for thyroid nodules and differentiated thyroid cancer using an adaptation process through a collaboration between the National Evidence-based Healthcare Collaborating Agency and the working group of KSThR, which is composed of radiologists specializing in thyroid imaging. When evidence is either insufficient or equivocal, expert opinion may supplement the available evidence for recommending imaging. Therefore, we suggest rating the appropriateness of imaging for specific clinical situations in this guideline.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3945-3949
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• 2015

Background: For brachytherapy of cervical cancer, applicator shifts can not be avoided. The present investigation concerned Utrecht interstitial applicator shifts and their effects on organ movement and DVH parameters during 3D CT-based HDR brachytherapy of cervical cancer. Materials and Methods: After the applicator being implanted, CT imaging was achieved for oncologist contouring CTVhr, CTVir, and OAR, including bladder, rectum, sigmoid colon and small intestines. After the treatment, CT imaging was repeated to determine applicator shifts and OARs movements. Two CT images were matched by pelvic structures. In both imaging results, we defined the tandem by the tip and the base as the marker point, and evaluated applicator shift, including X, Y and Z. Based on the repeated CT imaging, oncologist contoured the target volume and OARs again. We combined the treatment plan with the repeated CT imaging and evaluated the change range for the doses of CTVhr D90, D2cc of OARs. Results: The average applicator shift was -0.16 mm to 0.10 mm for X, 1.49 mm to 2.14 mm for Y, and 1.9 mm to 2.3 mm for Z. The change of average physical doses and EQD2 values in Gy${\alpha}/{\beta}$ range for CTVhr D90 decreased by 2.55 % and 3.5 %, bladder D2cc decreased by 5.94 % and 8.77 %, rectum D2cc decreased by 2.94 % and 4 %, sigmoid colon D2cc decreased by 3.38 % and 3.72 %, and small intestines D2cc increased by 3.72 % and 10.94 %. Conclusions: Applicator shifts and DVH parameter changes induced the total dose inaccurately and could not be ignored. The doses of target volume and OARs varied inevitably.

• 대한영상의학회지
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• 제81권3호
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• pp.610-619
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• 2020

목적 본 연구는 방광암 환자에서 전립선 Prostate Imaging Reporting and Data System version 2 (이하 PI-RADS v2)가, 우연히 발견된 전립선암 또는 요로상피세포암종의 전립선침범을 예측하는데 도움이 되는지 분석하였다. 대상과 방법 3 Tesla 다중 매개 자기공명영상에서 수술 전 영상을 촬영한 후, 근치적 방광전립 선절제술을 시행한 72명의 방광암 환자가 연구에 포함되었다. 수술 전 영상 소견은 두 명의 영상의학과 의사가 분석하였고, 수술 검체는 한 명의 병리과 의사가 평가하였다. 그 후, 전립선 PI-RADS v2의 결과와 병리 소견을 비교 분석하였다. 결과 72명의 방광암 환자 중 29명이 전립선암(40.3%)이 있었고, 20명이 요로상피세포암종(27.8%)이 있었다. 스코어 4를 기준값으로 설정하였을 때, 전립선암을 예측하는 진단 정확도는 65.3%, 특이도는 90.7%, 양성 예측도는 66.7%였다. 또한 전립선암 또는 요로상피세포암종을 예측하는 진단 정확도는 47.2%, 특이도는 92.3%, 양성 예측도는 83.3%였다. 결론 정확도는 낮은 편이었지만, 양성 예측도와 특이도는 높은 편이었다. 따라서 전립선 PI-RADS v2에서 스코어 1, 2 또는 3에 해당되면 우연히 발견된 전립선암과 요로상피세포암종의 침범을 배제하는데 도움이 될 수 있다.

• 대한영상의학회지
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• 제81권4호
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• pp.886-898
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• 2020

목적 본 연구는 부인암을 가진 여성에서 유방암의 선별검사로서의 디지털 유방단층 촬영술을 평가하였다. 대상과 방법 부인암을 가진 환자들 중 검진 목적으로 디지털 유방단층 촬영술을 촬영한 환자들을 대상으로 후향적 연구를 시행하였으며 유방암 발견율, 소환율, 민감도, 특이도, 양성예측도를 계산하였다. 양성예측도 1은 모든 양성 선별검사 중 1년 이내에 조직 검사에서 유방암을 진단받은 환자의 백분율로 정의되었다. 양성예측도 2는 진단 검사에서 조직검사의 필요 판정을 받은 후(그리고 선별 검사에서 Breast Imaging Reporting and Data System 카테고리 4, 5를 받은 후) 1년 이내에 조직검사에서 유방암을 진단받은 환자의 백분율로 정의되었다. 양성예측도 3은 실제로 조직검사를 시행 받은 환자 중 1년 이내에 조직검사에서 유방암을 진단받은 환자의 백분율로 정의되었다. 검진으로 발견된 암의 각 경우에 대해 환자의 나이, 부인암의 종류, 유방 밀도, 영상의 특징, 최종 Breast Imaging Reporting and Data System 평가, 조직학적 유형, T 및 N 병기, 분자아형 및 Ki-67 지수를 분석했다. 결과 전체 508명 중 7개의 유방암이 발견되었으며 유방암 발견율은 1000건 당 암 13.8이었다. 민감도는 100%, 특이도는 83.2%였으며 위음성률은 1000건 당 0이었다. 양성예측도 1, 양성예측도 2, 양성예측도 3은 각각 7.7, 31.8, 31.8이었으며 소환율은 17.9%였다. 결론 본 연구에서 디지털 유방단층 촬영술은 높은 유방암 발견율, 높은 민감도, 높은 양성예측도를 보이며 T, N 병기가 낮은 초기 암에 대해 높은 발견율을 보였다. 따라서 부인암 환자와 같은 고위험군에서 유방암의 선별검사로서 디지털 유방단층 촬영술이 유용할 수 있다.

• 대한핵의학회지
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• 제36권1호
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• pp.28-33
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• 2002

Lung cancer has become a loading cause of cancer death in Korea. Positron emission tomography was introduced in clinical nuclear medicine in the early 1990s and many studios using this functional imaging technology were performed for evaluation of its clinical utility. I review the current role of positron emission tomography in the diagnosis, staging, and therapy monitoring of lung cancer.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.71-75
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• 2008

The prevalence of pancreas cancer is increasing. Due to difficulty in detecting early stage disease, the prognosis of pancreas cancer is known to be poor. Clinical use of FDG PET in pancreas has been reported. FDG PET showed good performance in diagnosing pancreas cancer, and is expected to be useful in staging and detecting recurrence.