• 대한디지털의료영상학회논문지
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• 제16권2호
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• pp.25-29
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• 2014

The full-field digital mammography (FFDM), which has been known as a digital breast imaging system, carries out more outstanding performance than the screen-film mammography in overall image quality, skin & nipple, description of pectoral muscle and expression of micro-calcification. Thus, in this thesis, I perform experiments for both the enhancement of image quality and accurate estimation of the result in question, when detecting the very tiny-sized lesions in mammography. The image of digital breast X-rays is the important diagnostic tool for detecting early breast cancer and micro calcification lesion. The experiment of how much compression rate has an effect on the result of diagnosis in the case of microcalcification lesion, with JPEG2000 40:1 compression and over 50% enlargement led to obscure or definitely unacceptable diagnostic results is performed. And in another study of assessment of PSNR degree. I recognized the importance of standardized management system in mammography, where not to mention the accurate reading of the image has the most crucial role in diagnosis

• 한국방사선학회논문지
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• 제8권4호
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• pp.147-153
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• 2014

디지털 Mammography영상에서 압축률에 따른 화질의 특성에 대해 정량적 평가와 정성적평가를 실시하였다. ACR Accreditation phantom을 대상으로 JPEG2000, JPEG 압축알고리즘을 적용하여 압축한 후 Detection Score를 측정하여 압축률에 상관없이 10점 인정기준을 충족하였다. 또한 실제미세병소 영상을 선정하여 압축을 실시하여 확대율에 따른 진단능의 변화를 측정하여 20:1 이상 압축 후 50% 이상 확대 시 진단능에 영향을 미칠 수 있음을 알 수 있었다. 또한, 정량적 평가방법인 PSNR, RMSE, MAE, SSIM등을 측정하여 압축률에 따른 원본영상과의 차이점은 비교적 허용 가능한 오차범위 내의 값이 측정되었다. 또한 MTF 측정을 통해 Full Field Digital Mammography 영상의 화질이 진단에 적합한 영상임을 알 수 있었다.

• 한국산학기술학회논문지
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• 제12권10호
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• pp.4578-4589
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• 2011

최근 디지털 유방촬영술 분야에서 영상의 획득장치, 표시장치, 저장장치는 각각 별도의 분야로 발전하고 있다. 영상획득장치는 유방을 통과한 X-선을 흡수 포착하여 영상으로 저장하는 장치인데, 이를 이용하여 촬영된 영상은 여러 가지의 영상처리기술을 이용하여 진단이 가능하기 때문에 조기에 병변을 발견할 수 있다. 본 논문에서는 지금까지의 디지털 유방촬영술의 기술에 대하여 알아보고 구현된 디지털 유방X-선촬영기의 성능을 분석한다.

• 한국융합학회논문지
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• 제10권2호
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• pp.29-34
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• 2019

본 연구는 디지털 유방촬영장치의 DBT(Digital Breast Tomosynthesis)와 FFDM(Full Field DigitalMammography)의 비교를 위해 유방조직등가팬텀을 이용하여 두께와 밀도를 변화시켜 선량 및 화질을 평가하여 DBT의 유용성을 평가하였다. 측정 결과 평균유선선량은 팬텀 두께 6 cm이상 밀도 70% 이상일 때, 두께 7 cm이상 밀도 50% 이상일 때 FFDM 보다 DBT가 낮은 것을 알 수 있었다. 영상 측정 결과, 섬유소는 DBT에서 우수하다고 측정 되었고, 작은 석회화 그룹과 종양에서는 FFDM 이 우수하였다. 유방의 복잡한 조직과 유사한 BR3D 팬텀에서는 모든 두께와 섬유소, 석회화 및 종양 그룹 모두 DBT 가 우수하다고 측정 되었다. DBT는 FFDM보다밀도가 높고 두께가 두꺼운 두께가 두껍고 밀도가 높은 유방에서 영상 품질 우수하고 낮은 선량을 제공함으로서, 한국 여성의 많은 분포를 차지하는 치밀유방에 더 유용할 수 있을 것이라 사료된다.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1031-1043
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• 2022

Objective: To compare digital breast tomosynthesis (DBT) and MRI as an adjunct to full-field digital mammography (FFDM) for the preoperative evaluation of women with breast cancer based on mammographic density. Materials and Methods: This retrospective study enrolled 280 patients with breast cancer who had undergone FFDM, DBT, and MRI for preoperative local tumor staging. Three radiologists independently sought the index cancer and additional ipsilateral and contralateral breast cancers using either FFDM alone, DBT plus FFDM, or MRI plus FFDM. Diagnostic performances across the three radiologists were compared among the reading modes in all patients and subgroups with dense (n = 186) and non-dense breasts (n = 94) according to mammographic density. Results: Of 280 patients, 46 (16.4%) had 48 additional (39 ipsilateral and nine contralateral) cancers in addition to the index cancer. For index cancers, both DBT plus FFDM and MRI plus FFDM showed sensitivities of 100% in the non-dense group. In the dense group, DBT plus FFDM showed lower sensitivity than that of MRI plus FFDM (94.6% vs. 99.6%, p < 0.001). For additional ipsilateral cancers, DBT plus FFDM showed specificity and positive predictive value (PPV) of 100% in the non-dense group, but sensitivity and negative predictive value (NPV) were not statistically different from those of MRI plus FFDM (p > 0.05). In the dense group, DBT plus FFDM showed higher specificity (98.2% vs. 94.1%, p = 0.005) and PPV (83.1% vs. 65.4%; p = 0.036) than those of MRI plus FFDM, but lower sensitivity (59.9% vs. 75.3%; p = 0.049). For contralateral cancers, DBT plus FFDM showed higher specificity than that of MRI plus FFDM (99.0% vs. 96.7%, p = 0.014), however, the other values did not differ (all p > 0.05) in the dense group. Conclusion: DBT plus FFDM showed an overall higher specificity than that of MRI plus FFDM regardless of breast density, perhaps without substantial loss in sensitivity and NPV in the diagnosis of additional cancers. Thus, DBT may have the potential to be used as a preoperative breast cancer staging tool.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4109-4114
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• 2015

Background: Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer. Materials and Methods: In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods. Results: The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (P<0.05). The area under FFDM ROC curve is 0.805, while that is 0.941 in COMBO pattern. COMBO shows relation of mass with the surrounding tissues, the calcification in the mass, and multiple foci clearly in breast cancer tissues. The optimal sensitivity of cut-off value in COMBO pattern is 82.9%, which is higher than that in FFDM (60%). They share the same specificity which is both 93.2%. Conclusions: Digital Breast Tomosynthesis (DBT) could be used for the BI-RADS classification in breast cancer in clinical.

• 대한영상의학회지
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• 제83권5호
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• pp.1090-1103
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• 2022

목적 본 연구는 미세석회화가 의심되는 유방에서 정위적 조직검사에 앞서서 시행하는 디지털 유방단층영상합성법(digital breast tomosynthesis with the two-dimensional synthesized mammogram; 이하 DBT with 2DSM)과 전면디지털유방촬영술(full-field digital mammography; 이하 FFDM)의 진단능을 비교 평가하고 영상의 진단적 명확도를 평가하기 위해서 시행하였다 대상과 방법 2015년 1월에서 2020년 1월까지 후향적 연구로서 189명의 환자 중 정위적 조직검사를 통한 조직병리검사상 미세석회화 병변이 확인된 환자를 중 DBT with 2DSM나 FFDM을 시행한 환자군에서 시행되었다. 두 명의 영상의학과 의사가 눈가림 상태로, Breast Imaging Reporting and Data System (BI-RADS) 분류에 따른 미세석회화의 평가 및 본 연구에서 별도로 1-5점 척도를 통해 정의한 진단적 명확도에 대한 평가를 시행하였다. 결과 전반적인 검사자간 일치도는 우수한 것으로 확인되었다. 맥네머 검정에서 악성가능성이 높은 미세석회화(4B, 4C, or 5)의 검출에 있어서는 두 진단방법 간에 통계적 유의성은 보이지 않았으나, 양성가능성이 높은 미세석회화(4A)의 진단에 있어서는 통계적 유의성을 보였다. DBT with 2DSM는 FFDM보다 더 높은 가시성을 보임이 확인되었고, 치밀유방에서도 FFDM보다 진단에 있어서 더 우수하였다. 결론 DBT with 2DSM는 FFDM과 비교하여 미세석회화 병변에 대해서 더 높은 전반적 진단적 정확도와 진단적 명확성을 제공하였다. DBT with 2DSM는 FFDM보다 양성 미세석회화 병변에서와 치밀유방에서 우수성을 보였다. 본 연구에서는 치밀 유방에서 미세석회화 병변에 대해서 정위적 생검을 시행할 때 유용한 진단 기구로서의 DBT with 2DSM의 역할을 확인할 수 있었다.

• 대한의용생체공학회:의공학회지
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• 제28권1호
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• pp.162-168
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• 2007

For the past decade, the full-field digital mammography has been widely used for early diagnosis of breast cancer, and computer aided diagnosis has been developed to assist physicians as a second opinion. In this study, we try to predict the breast cancer using both mediolateral oblique(MLO) view and craniocaudal(CC) view together. A skilled radiologist selected 35 pairs of ROIs from both MLO view and CC view of digital mammogram. We extracted textural features using Spatial Grey Level Dependence matrix from each mammogram and evaluated the generalization performance of the classifier using Support Vector Machine. We compared the multi-view based classifier to single-view based classifier that is built from each mammogram view. The results represent that the multi-view based computer aided diagnosis in digital mammogram could improve the diagnostic performance and have good possibility for clinical use to assist physicians as a second opinion.

• 한국방사선학회논문지
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• 제10권3호
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• pp.215-222
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• 2016

엑스선유방촬영술은 다양한 유방질환 중 석회화 병변을 진단하는데 가장 효과적인 방법이다. 환자의 의료피폭 저감과 진단에 필요한 최적의 영상을 얻기 위해서는 성능유지를 지속적으로 관리해야 한다. 엑스선유방촬영술에서 엑스선을 발생시키는 양극의 경사각도는 중심선을 기준으로 하기 때문에 조사야 내의 위치에 따라 엑스선관의 유효초점이 미세하게 달라질 수 있어 공간분해능의 차이가 발생할 수 있다. 본 연구에서는 디지털 엑스선유방촬영장치에서 검출기 위치에 따른 LSF를 측정하여 MTF를 계산함으로써 공간분해능 변화에 대해서 연구하였다. 와이어 직경에 대한 변화에서 $50{\mu}m$ 직경의 와이어의 경우 가장 높은 공간주파수 값을 나타냈으며 검출기의 픽셀보다 작은 직경을 갖는 와이어를 사용해야 검출기의 공간주파수에 따른 응답을 바르게 구할 수 있다는 것을 알 수 있었다. 조사야 내의 검출기의 위치에 따라서 공간주파수는 중심부분의 와이어가 나머지 와이어보다 우수한 MTF 특성을 보였으나, 그 차이는 미소하게 나타났다. 또한 중앙부분에서 반치폭 또는 유효초첨이 가장 작게 나타났으며 중앙에서 벗어날수록 반치폭이 증가하여 공간분해능이 낮아진 것으로 나타났다.

• Korean Journal of Radiology
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• 제20권1호
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• pp.58-68
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• 2019

Objective: To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast tissue, and to determine the influencing factors in the detection of breast cancers using the two techniques. Materials and Methods: Three blinded radiologists independently graded cancer detectability of 300 breast cancers (288 women with dense breasts) on DBT and conventional FFDM images, retrospectively. Hormone status, histologic grade, T stage, and breast cancer subtype were recorded to identify factors affecting cancer detectability. The Wilcoxon signed-rank test was used to compare cancer detectability by DBT and conventional FFDM. Fisher's exact tests were used to determine differences in cancer characteristics between detectability groups. Kruskal-Wallis tests were used to determine whether the detectability score differed according to cancer characteristics. Results: Forty breast cancers (13.3%) were detectable only with DBT; 191 (63.7%) breast cancers were detected with both FFDM and DBT, and 69 (23%) were not detected with either. Cancer detectability scores were significantly higher for DBT than for conventional FFDM (median score, 6; range, 0-6; p < 0.001). The DBT-only cancer group had more invasive lobular-type breast cancers (22.5%) than the other two groups (i.e., cancer detected on both types of image [both-detected group], 5.2%; cancer not detected on either type of image [both-non-detected group], 7.3%), and less detectability of ductal carcinoma in situ (5% vs. 16.8% [both-detected group] vs. 27.5% [both-non-detected group]). Low-grade cancers were more often detected in the DBT-only group than in the both-detected group (22.5% vs. 10%, p = 0.026). Human epidermal growth factor receptor-2 (HER-2)-negative cancers were more often detected in the DBT-only group than in the both-detected group (92.3% vs. 70.5%, p = 0.004). Cancers surrounded by mostly glandular tissue were detected less often in the DBT only group than in the both-non-detected group (10% vs. 31.9%, p = 0.016). DBT cancer detectability scores were significantly associated with cancer type (p = 0.012), histologic grade (p = 0.013), T and N stage (p = 0.001, p = 0.024), proportion of glandular tissue surrounding lesions (p = 0.013), and lesion type (p < 0.001). Conclusion: Invasive lobular, low-grade, or HER-2-negative cancer is more detectable with DBT than with conventional FFDM in patients with dense breasts, but cancers surrounded by mostly glandular tissue might be missed with both techniques.