• Investigative Magnetic Resonance Imaging
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• 제16권1호
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• pp.1-5
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• 2012

유방 MRI는 유방암의 유방촬영 스크리닝법에 대한 가장 정확한 보완 검사법이다. 아직까지 MRI 스크리닝의 효과에 대한 무작위 대조군연구가 없음에도 불구하고, 현재 미국암학회와 국립 종합암네트워크 (NCCN)에서는 MRI 스크리닝을 유방암 고위험여성에서 권고하고 있다. 국내에서는, 한 후향적 연구에서 유방암 환자의 반대쪽 유방암에 대한 MRI 스크리닝법이 유방촬영술과 초음파에서 발견하지 못한 암을 발견하고 이는 이후 유방암 발병을 감소시킴을 보고하고 있다. 국내에 유방촬영 스크리닝법의 보완법으로 MRI를 도입하기 위해서는 판독의 표준화와 교육, MR 유도하 조직검사법과 적절한 적응증의 확립, 비용-효용성에 대한 평가가 선결되어야 한다.

• Korean Journal of Radiology
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• 제20권4호
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• pp.533-541
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• 2019

Breast magnetic resonance imaging (MRI) has been increasingly utilized, especially in screening for high-risk cases, because of its high sensitivity and superior ability to detect cancers as compared with mammography and ultrasound. Several limitations such as higher cost, longer examination time, longer interpretation time, and low availability have hindered the wider application of MRI, especially for screening of average-risk women. To overcome some of these limitations and increase access to MRI screening, an abbreviated breast MRI protocol has been introduced. Abbreviated breast MRI is becoming popular and challenges the status quo. This review aims to present an overview of abbreviated MRI, discuss the current findings, and introduce ongoing prospective trials.

• Korean Journal of Radiology
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• 제22권1호
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• pp.9-22
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• 2021

Diffusion-weighted (DW) magnetic resonance imaging (MRI) is a rapid, unenhanced imaging technique that measures the motion of water molecules within tissues and provides information regarding the cell density and tissue microstructure. DW MRI has demonstrated the potential to improve the specificity of breast MRI, facilitate the evaluation of tumor response to neoadjuvant chemotherapy and can be employed in unenhanced MRI screening. However, standardization of the acquisition and interpretation of DW MRI is challenging. Recently, the European Society of Breast Radiology issued a consensus statement, which described the acquisition parameters and interpretation of DW MRI. The current article describes the basic principles, standardized acquisition protocols and interpretation guidelines, and the clinical applications of DW MRI in breast imaging.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6177-6186
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• 2015

Sensitivity and specificity are the two most important indicators in selection of medical imaging devices for cancer screening. Breast images taken by conventional or digital mammography, ultrasound, MRI and optical mammography were collected from 2,143,852 patients. They were then studied and compared for sensitivity and specificity results. Optical mammography had the highest sensitivity (p<0.001 and p<0.006) except with MRI. Digital mammography had the highest specificity for breast cancer imaging. A comparison of specificity between digital mammography and optical mammography was significant (p<0.021). If two or more breast diagnostic imaging tests are requested the overall sensitivity and specificity will increase. In this literature review study patients at high-risk of breast cancer were studied beside normal or sensitive women. The image modality performance of each breast test was compared for each.

• Investigative Magnetic Resonance Imaging
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• 제13권1호
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• pp.1-8
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• 2009

유방 MRI는 유방 질환의 진단과 치료 분야에 최첨단 기법으로서 지난 10년 동안 유방 MRI는 연구 분야에서 임상 분야로 진화해 왔다. 따라서, 유방 MRI의 적응증과 적절한 영상을 얻는 방법, 소견을 해석하고 보고하는 법에 대한 이해가 필요하다. 유방 MRI는 양성과 악성 종괴의 감별, 유방암 환자의 수술 전 병기 결정, 수술전 항암요법에 대한 종양의 반응 평가, 유방 성형 여성의 평가 등에 사용되고 있다. 또한 유방암 고위험군 여성에서 선별 보조 검사로서 사용될 수 있다. 이러한 목적을 성공적으로 이루기 위해서는 적절한 MRI기법과 다른 유방 영상 소견과 연관 지어 해석할 수 있는 영상의학과 의사가 중요하다. 본 소고에서는 유방 MRI의 적응증, 표준화된 용어와 카테고리의 사용에 중점을 두어 기술하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5023-5029
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• 2013

Background: To evaluate knowledge about screening tests and tests without proven screening value in a Greek Breast Unit population undergoing benign vacuum-assisted breast biopsy (VABB). Materials and Methods: This study included 81 patients. Three knowledge-oriented items (recommended or not, screening frequency, age of onset) were assessed. Regarding screening tests two levels of knowledge were evaluated: i). crude knowledge (CK), i.e. knowledge that the test is recommended and ii). advanced knowledge (AK), i.e. correct response to all three knowledge-oriented items. Solely CK was evaluated for tests without proven screening value. Risk factors for lack of knowledge were assessed with multivariate logistic regression. A second questionnaire was administered 18 months after VABB to assess its impact on the performance of tests. Results: Concerning screening tests considerable lack of AK was noted (mammogram, 60.5%; Pap smear, 59.3%; fecal occult blood testing, 93.8%; sigmoidoscopy, 95.1%). Similarly lack of CK was documented regarding tests without proven screening value (breast self-examination, 92.6%; breast MRI, 60.5%; abdominal ultrasound, 71.6%; barium meal, 48.1%; urine analysis, 90.1%; chest X-Ray, 69.1%; electrocardiogram, 74.1%; cardiac ultrasound, 75.3%). Risk factors for lack of AK were: place of residence (mammogram), age (Pap smear), personal income (sigmoidoscopy); risk factors for lack of CK included number of offspring (breast MRI, chest X-Ray), BMI (abdominal ultrasound), marital status (urine analysis), current smoking status (electrocardiogram). VABB's only effect was improvement in mammogram rates. Conclusions: A considerable lack of knowledge concerning screening tests and misperceptions regarding those without proven value was documented.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5089-5095
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• 2014

Background: As a common and essential contrast medium at present, gadobenate dimeglumine has shown better performance than some other agents when applied to Breast Magnetic Resonance Imaging Screening (Breast MRI Screening). Nevertheless, reports on the diagnostic performance of these two mediums (gadobenate dimeglumine and gadopentetate dimeglumine) are not completely consistent. Objective: To assess the diagnostic value of gadobenate dimeglumine and gadopentetate dimeglumine for Breast MRI Screening in patients suffering from breast cancer and to provide more convinced evidence to guide clinical practice in terms of appropriate contrast agents. Data Sources and Review Methods: Original articles in English and Chinese published before January 2013 were selected from available databases (The Cochrane Library, PUBMED, EMBASE, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, Chinese Journal Full-text). The criteria for inclusion and exclusion were based on the standard for diagnosis tests. Meta-Disc software (Version 1.4) was used for data analysis. Then, the area under curve (AUC) of SROC and the spearman rank correlation of sensitivity against (1-specificity) were calculated. Results: Total of 17 researches involving 1934 patients were included. The pooled sensitivity of gadobenate dimeglumine and gadopentetate dimeglumine were 0.99 (0.97, 1.00) and 0.93 (0.88, 1.00) respectively. The pooled specificity for these two contrast agents were 0.924 (0.902, 0.943) and 0.838 (0.817, 0.858) respectively, and the AUC of SROC curve were 0.9781 and 0.9215 respectively. Conclusions: Gadobenate dimeglumine can be regarded as a more effective and feasible contrast medium for Breast MRI Screening. At least 5% differences in diagnostic performance are usually considered as clinically relevant.

• Korean Journal of Radiology
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• 제22권6호
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• pp.867-879
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• 2021

Objective: To compare the screening performance of diffusion-weighted (DW) MRI and combined mammography and ultrasound (US) in detecting clinically occult contralateral breast cancer in women with newly diagnosed breast cancer. Materials and Methods: Between January 2017 and July 2018, 1148 women (mean age ± standard deviation, 53.2 ± 10.8 years) with unilateral breast cancer and no clinical abnormalities in the contralateral breast underwent 3T MRI, digital mammography, and radiologist-performed whole-breast US. In this retrospective study, three radiologists independently and blindly reviewed all DW MR images (b = 1000 s/mm² and apparent diffusion coefficient map) of the contralateral breast and assigned a Breast Imaging Reporting and Data System category. For combined mammography and US evaluation, prospectively assessed results were used. Using histopathology or 1-year follow-up as the reference standard, cancer detection rate and the patient percentage with cancers detected among all women recommended for tissue diagnosis (positive predictive value; PPV2) were compared. Results: Of the 30 cases of clinically occult contralateral cancers (13 invasive and 17 ductal carcinoma in situ [DCIS]), DW MRI detected 23 (76.7%) cases (11 invasive and 12 DCIS), whereas combined mammography and US detected 12 (40.0%, five invasive and seven DCIS) cases. All cancers detected by combined mammography and US, except two DCIS cases, were detected by DW MRI. The cancer detection rate of DW MRI (2.0%; 95% confidence interval [CI]: 1.3%, 3.0%) was higher than that of combined mammography and US (1.0%; 95% CI: 0.5%, 1.8%; p = 0.009). DW MRI showed higher PPV2 (42.1%; 95% CI: 26.3%, 59.2%) than combined mammography and US (18.5%; 95% CI: 9.9%, 30.0%; p = 0.001). Conclusion: In women with newly diagnosed breast cancer, DW MRI detected significantly more contralateral breast cancers with fewer biopsy recommendations than combined mammography and US.

• 대한영상의학회지
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• 제82권1호
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• pp.29-48
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• 2021

확산강조영상은 유방암의 진단과 스크리닝에 있어 독립적 검사 방법으로서의 기대되는 결과를 보여주는 빠른 비조영증강 검사 방법이다. 현재까지의 연구 결과 유방암 진단에 있어 독립적 검사 방법으로서 확산강조영상의 민감도는 역동적 조영증강 검사보다는 낮으나 유방촬영술보다는 높으며, 이로써 유방암 스크리닝에 대한 유용한 대안이 될 수 있을 것으로 보인다. 확산강조영상의 표준화된 영상 획득과 판독을 통해 영상 화질이 개선될 수 있고, 판독 결과의 다양성도 감소할 것으로 기대된다. 또한, 최신 기법과 후처리 기법을 사용한 고해상도 확산강조영상을 시행함으로써 1 cm 미만의 작은 암의 발견율을 증가시킬 수 있고, 가음성 및 가양성 결과를 감소시킬 것으로 보인다. 현재 한국에서 진행 중인 고위험군 여성에서의 확산강조영상 스크리닝에 대한 다기관 연구 결과가 나온다면 독립적 검사로서의 확산강조영상의 사용을 촉진시킬 수 있을 것으로 기대된다.

• 한국건강관리협회지
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• 제2권1호
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• pp.9-25
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• 2004

Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items of major health screening program in Korea. Most, of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis), cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infections diseases(hepatitis, tuberculosis, sexually-transmitted diseases, parasites), chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress and earlypsychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests( CBC, urinalysis, liver function tests, lipid tests, glucose, HbA1c, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT) endoscopy(gastroscopy, colonoscopy), sonography (abdomen, thyroid, pelvis, breast), cytology(cervix), bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA125, PSA and eye tests. Advanced technologies, like CT, PET, MRI, MRI/Angio, molecular testing were widly used in hospital based health screening programmes. In summary, a variety of tests were untilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few programs used tests excessvely disregarding health screening subjects.