• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8271-8277
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• 2014

Aims: Apparent diffusion coefficient (ADC) values of nodes in diffusion-weighted imaging (DWI) are widely used in differentiating metastatic from non-metastatic lymph nodes. The purpose of this meta-analysis was to demonstrate whether DWI could contribute to the precise diagnosis of breast cancer (BC) with and without lymph node metastasis (LNM). Materials and Methods: English and Chinese electronic databases were searched for relevant studies followed by a comprehensive literature search. Two reviewers independently assessed the methodological quality of the included trials based on the quality assessment of diagnostic accuracy studies (QUADAS). Summary odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were calculated. Results: Final analysis of 624 BC subjects (patients with LNM = 254, patients without LNM = 370) were incorporated into the current meta-analysis from 9 eligible cohort studies. Combined ORs of ADCs suggested that ADC values in BC patients without LNM were higher than in patients with LNM (OR=0.56, 95%CI: 0.11-1.01, p=0.015). Subgroup analysis stratified by country indicated a low ADC value in BC patients with LNM rather than those without LNM among Chinese (OR=1.27, 95%CI: 0.89-1.66, p<0.001), Italians (OR=0.75, 95%CI: 0.13-1.38, p=0.018), and Egyptians (OR=1.27, 95%CI: 0.71-1.84, p<0.001). The findings of subgroup analysis by MRI machine type revealed that ADC values from diffusion MRI may be potential diagnostic indicators for BC using Non-Philips 1.5T (OR=1.10, 95%CI: 0.84-1.36, p<0.001). Conclusions: The main findings of our meta-analysis demonstrated that increased signal intensity on DWI and decreased signals on ADC are helpful in diagnosis of BC patients with or without LNM. DWI could therefore be an important imaging investigation in patients suspected of BC.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2259-2263
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• 2016

Background: Mammographic density determined according paranchymal patterns is a risk factor for breast cancer and its relationships with body and other breast characteristics of women is important. The purpose of the present study was to correlate breast parenchymal patterns and mammography abnormality findings with women's BMI, compressed breast thickness (CBT) and age in Tabriz city, Iran. Materials and Methods: From 1,100 mammograms interpreted by radiologists, breast parenchymal was classified into four categories from Types 1 (mostly fatty) through 4 (mostly fibroglandular tissue). Age, BMI, and CBT were recorded and their relation with risk for the development of breast abnormalities in mammograms was analyzed. Results: In women with a mean age of $45.8{\pm}8.63years$ 17.7% were in the high density group (Type 3 and 4). A comparison of four types of breast paranchymal with BMI, CBT and age showed inverse relations to breast density. Abnormal mammographic findings were 25.8% of all reported mammograms with a circular mass (12.7%) as the most common abnormality. About 21% abnormal cases were in less than 40 years. Increasing of BMI had significant relation with breast abnormality but in CBT was not observed. Conclusions: Measurement of women's body characteristics is useful for assistance in mammography diagnosis as well as selection of imaging instrument by high sensitivity for following patient in future. The effects of age, CBT and BMI groups on the breast paranchymal were significant.

• 한국전자파학회논문지
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• 제20권8호
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• pp.797-805
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• 2009

본 논문에서는 전자파를 이용하여 인체 내 암 조직을 찾아내기 위해 역산란 방법인 BIM(Born Iterative Method)에 적용되는 순방향 해석 알고리즘을 MoM(Method of Moment)으로 구현하였다. 특히 유방암의 전자파 산란 해석을 위해 2차원 유방 단면 구조를 이용하였다. 이 단면 구조를 적분방정식과 2차원 그린함수를 이용하여 정식화한 후 MoM을 적용하여 해석하고 산란 전장을 구하였다. 또한, 유방암 측정 실험 장치를 통해 얻은 모사구조에 대한 측정값과 MoM을 이용한 수치해석 계산 값을 비교하여 결과를 분석하였다.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.193-199
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• 2012

Objective : The objective of study is to evaluate the incidence of leptomeningeal carcinomatosis (LMC) in breast cancer patients with parenchymal brain metastases (PBM) and clinical risk factors for the development of LMC. Methods : We retrospectively analyzed 27 patients who had undergone surgical resection (SR) and 156 patients with whole brain radiation therapy (WBRT) as an initial treatment for their PBM from breast cancer in our institution and compared the difference of incidence of LMC according to clinical factors. The diagnosis of LMC was made by cerebrospinal fluid cytology and/or magnetic resonance imaging. Results : A total of 27 patients (14%) in the study population developed LMC at a median of 6.0 months (range, 1.0-50). Ten of 27 patients (37%) developed LMC after SR, whereas 17 of 156 (11%) patients who received WBRT were diagnosed with LMC after the index procedure. The incidence of LMC was significantly higher in the SR group compared with the WBRT group and the hazard ratio was 2.95 (95% confidence interval; 1.33-6.54, p<0.01). Three additional factors were identified in the multivariable analysis : the younger age group (<40 years old), the progressing systemic disease showed significantly increased incidence of LMC, whereas the adjuvant chemotherapy reduce the incidence. Conclusion : There is an increased risk of LMC after SR for PBM from breast cancer compared with WBRT. The young age (<40) and systemic burden of cancer in terms of progressing systemic disease without adjuvant chemotherapy could be additional risk factors for the development of LMC.

• Investigative Magnetic Resonance Imaging
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• 제19권1호
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• pp.37-46
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• 2015

Purpose: This report compared the diagnostic effectiveness between ultrasmall superparamagnetic iron oxide (USPIO) and gadolinium (Gd) based magnetic resonance imaging (MRI) for differentiation of axillary status in breast cancer patients. Materials and Methods: The present authors performed a meta-analysis of previous studies that compared USPIO or Gd based MRI with histological diagnosis after surgery or biopsy. We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, Ovid databases and references of articles to identify studies reporting data until December 2013. Pooled sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analysis was done. Analyses of study quality and heterogeneity were also assessed. Results: There were 14 publications that met the criteria for inclusion in our meta-analysis. USPIO based MRI showed 0.83 (95% CI: 0.75-0.89) and 0.97 (95% CI: 0.94-0.98) for pooled sensitivity and specificity, respectively. Gd based MRI represented pooled sensitivity and specificity of 0.61 (95% CI: 0.55-0.67) and 0.90 (95% CI: 0.87-0.92) for each. Overall weighted area under the curve for USPIO and Gd based MRI were 0.9563 and 0.9051, respectively. Conclusion: USPIO based MRI had a tendency toward high pooled sensitivity and specificity in detection of axillary metastases for breast cancer. This result may mean that USPIO based MRI could be used as complementary modality to differentiate axillary status more precisely, and assist in the decision-making process regarding possible invasive procedures, such as sentinel node biopsy.

• 대한영상의학회지
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• 제84권1호
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• pp.3-14
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• 2023

유방영상 판독과 자료 체계(Breast Imaging Reporting and Data System; 이하 BI-RADS)는 유방영상 판독의 표준화 및 판독 질 관리를 위해 유방 병변의 특성을 기술하는 용어 사전(lexicon), 평가 범주(assessment category) 및 처치(management)를 위한 권고들을 제시한 시스템이다. 판독의는 BI-RADS에서 권장하는 표준화된 용어를 이용하여 검사 결과를 임상의에게 간결하고 재현 가능하게 전달할 수 있고, 평가 범주 판정을 통하여 검사에서 발견된 병변이 악성일 가능성을 추정된 확률로 제공하고 이에 따른 처치를 권고할 수 있다. 현재 사용 중인 BI-RADS 5판이 가지는 한계는 표준화된 용어 사전이 정립되지 않은 일부 영역들이 존재한다는 것과 MRI 판정 범주 3-4의 평가 기준이 유방촬영술이나 초음파의 기준에 비해 모호하다는 점이다. BI-RADS의 다음 개정판에는 이러한 한계들을 극복하기 위한 개선안이 포함될 것으로 예상한다.

• 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

• 대한영상의학회지
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• 제82권1호
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• pp.12-28
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• 2021

유방촬영술은 유방암 검진 및 진단을 위한 기본적인 영상 검사이지만, 판독이 어려우며 높은 숙련도를 필요로 한다고 잘 알려져 있다. 이러한 어려움을 극복하기 위해 최근 몇 년 사이에 인공지능을 이용한 유방암 검출 알고리즘들이 활발히 연구되고 있다. 본 종설에서 저자는 고전적인 computer-aided detection 소프트웨어 대비 최근 많이 사용되는 딥러닝의 특징을 알아보고, 딥러닝 알고리즘의 개발 방법과 임상적 검증 방법에 대해서 기술하였다. 또한 딥러닝 기반의 검진 유방촬영술의 판독 방법 분류, 유방 치밀도 평가, 그리고 유방암 위험도 예측 모델 등을 위한 딥러닝 연구들도 소개하였다. 마지막으로 유방촬영술 관련 인공지능 기술들에 대한 영상의학과 전문의의 관심과 의견의 필요성을 기술하였다.

• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.94-97
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• 2012

Tumors that metastasize to the pituitary gland are unusual, and are typically seen in elderly patients with diffuse malignant disease. The most common metastases to the pituitary are from primary breast and lung cancers. We report a 65-year-old woman with pituitary metastasis from breast cancer who presented with recent-onset left progressive deterioration of visual acuity and visual field. The clinical diagnosis was made after brain and sellar magnetic resonance imaging showed a large sellar mass compressing the optic chiasm and invading the pituitary stalk. An otorhinolaryngology and neurosurgery team removed the tumor via a transsphenoidal approach, and this procedure obtained symptomatic relief. Postoperatively, metastasis from breast invasive ductal adenocarcinoma was confirmed histologically. We report this unusual case with a review of the relevant literature.

• 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.