• Journal of Breast Cancer
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• v.21 no.4
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• pp.447-452
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• 2018

Purpose: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis. Methods: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis. Results: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ${\geq}55$ years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p<0.05). Conclusion: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.130-134
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• 1997

Purpose: To analyze contrast-enhancement pattern of stomach cancer on dynamic MRI and to verify the efficacy of intravenous contrast agent in the evaluation of stomach cancer. Materials and Methods: Twelve patients with proven stomach cancer underwent dynamic MRI. By using l.OT scanner, we obtained precontrast FLASH images, and 30, 60, 90 second delay FLASH images after intravenous contrast injection. All patients ingested one liter of water and had intramuscular injection of Buscopan just before MR study. For quantitative analysis we measured signal to noise ratio (SiN) of stomach cancer on each image, and signal difference to noise ratio (SD/N) between cancer and intraluminal fluid, cancer and the pancreas. For qualitative analysis two radiologists evaluated lesion conspicuity on each image by grading system(grade 0, 1, 2, 3: poor, fair, good, excellent). Results: SiN of stomach cancer increased gradually by time(precontrast, 30, 60, 90 second delay: 38.7, 42.5, 57.4, 65.7). SD/N between cancer and intraluminal fluid significantly increased after contrast enhancement(l.24, 25.01, 39.30, 45.89). SD/Ns between cancer and the pancreas were 10.5, 9.33, 9.99, 10.66, respectively. In qualitative analysis, precontrast images were better than postcontrast images for delineation of stomach cancer. Postcontrast images showed clear endo-Iuminal side of stomach cancer, but outer margin of stomach cancer was more distinct on precontrast images. Conclusion: Precontrast MR images are better than postcontrast MR images in the depiction of stomach cancer. Intravenous contrast agent is not imperative in the evaluation of stomach cancer.

• Journal of Gastric Cancer
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• v.20 no.1
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• pp.60-71
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• 2020

Purpose: The utility of 18-fluordesoxyglucose positron emission tomography ([¹⁸F]-FDG-PET) combined with computer tomography or magnetic resonance imaging (MRI) in gastric cancer remains controversial and a rationale for patient selection is desired. This study aims to establish a preclinical patient-derived xenograft (PDX) based [¹⁸F]-FDG-PET/MRI protocol for gastric cancer and compare different PDX models regarding tumor growth and FDG uptake. Materials and Methods: Female BALB/c nu/nu mice were implanted orthotopically and subcutaneously with gastric cancer PDX. [¹⁸F]-FDG-PET/MRI scanning protocol evaluation included different tumor sizes, FDG doses, scanning intervals, and organ-specific uptake. FDG avidity of similar PDX cases were compared between ortho- and heterotopic tumor implantation methods. Microscopic and immunohistochemical investigations were performed to confirm tumor growth and correlate the glycolysis markers glucose transporter 1 (GLUT1) and hexokinase 2 (HK2) with FDG uptake. Results: Organ-specific uptake analysis showed specific FDG avidity of the tumor tissue. Standard scanning protocol was determined to include 150 μCi FDG injection dose and scanning after one hour. Comparison of heterotopic and orthotopic implanted mice revealed a long growth interval for orthotopic models with a high uptake in similar PDX tissues. The H-score of GLUT1 and HK2 expression in tumor cells correlated with the measured maximal standardized uptake value values (GLUT1: Pearson r=0.743, P=0.009; HK2: Pearson r=0.605, P=0.049). Conclusions: This preclinical gastric cancer PDX based [¹⁸F]-FDG-PET/MRI protocol reveals tumor specific FDG uptake and shows correlation to glucose metabolic proteins. Our findings provide a PET/MRI PDX model that can be applicable for translational gastric cancer research.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.209-217
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• 2008

Purpose: To date, anatomical imaging modalities of the pelvis and tumor markers have been the mainstay of surveillance for recurrent ovary cancer. This study aimed to assess the role of $^{18}F$-FDG PET/CT in evaluation of ovary cancer recurrences, especially in comparison with enhanced a and tumor marker CA 125. Materials and methods: 73 patients who had PET/CT scan for restaging of confirmed ovary cancer, and additional imaging with enhanced a of the pelvis within one month were included. CA 125 level was available in all patients. From the PET/CT images, maximum standard uptake values (SUVmax) of suspected recurrence sites were recorded. Confirmation was available through re-operation or biopsy in 26 cases, and clinical assessment with series of follow-up images in 47. Results: PET/CT had 93% sensitivity and 88% specificity for detecting recurrent ovary cancer. Enhanced a of pelvis had sensitivity and specificity of 83% and 88%, and CA 125 50% and 95%. Conclusion: PET/CT has higher sensitivity for detecting recurrent ovary cancer compared to enhanced a though the differences were not significant. PET/CT has significantly higher sensitivity than CA 125. However, the three tests all agreed in only 43% of the recurrence cases, and recurrence should be suspected when any of the tests, especially PET/CT, show positive findings.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.29-31
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• 2008

This review focuses on the clinical use of $^{18}F-FDG$ PET in small cell lung cancer. For initial staging of small cell lung cancer, $^{18}F-FDG$ PET appears to be better than conventional staging methods. $^{18}F-FDG$ PET seems to be potentially useful for detecting recurrence, restaging and therapy response assessment in small cell lung cancer. However, due to small number of literatures, the role of $^{18}F-FDG$ PET in small cell lung cancer requires further investigations.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.6-13
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• 2008

Head and neck cancer is the sixth most common type of human cancer worldwide. Squamous cell carcinoma is the most common cancer of the head and neck. Since $^{18}F-FDG$ PET is very sensitive to detecting squamous cell carcinoma, it has been widely used in patients with head and neck cancers for initial staging, management of recurrent cancers, and therapeutic monitoring. According to clinical research data, $^{18}F-FDG$ PET is expected to be a very helpful diagnostic tool in the management of head and neck cancer.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.2
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• pp.132-140
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• 2006

Well-differentiated thyroid cancer is the most common endocrine malignancy with an increasing incidence. Most patients with well-differentiated thyroid caner have a favorable prognosis with high survival rate. While surgery and radioiodine therapy is sufficient treatment for the majority of patients with differentiated thyroid cancer, a minority of these patients experiences progressive, life-threatening growth and metastatic spread of the disease. Because there is no prospective controlled study to evaluate the differences of management of thyroid cancer, it is hard to choose the best treatment option. And there are still lots of controversies about the management of this disease, such as surgical extent, proper use of radioiodine for remnant ablation and therapy, use of rhTSH instead of withdrawal of thyroid hormone, long-term follow-up strategy, thyroglobulin as a tumor marker, etc. In this review, recent data related to these conflicting issues and recent advances in diagnosis, radioiodine therapy and long-term monitoring of well-differentiated thyroid cancer are summarized.

• Korean Journal of Radiology
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• v.25 no.8
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• pp.698-705
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• 2024

Ductal carcinoma in situ (DCIS) accounts for approximately 30% of new breast cancer diagnoses. However, our understanding of how normal breast tissue evolves into DCIS and invasive cancers remains insufficient. Further, conclusions regarding the mechanisms of disease progression in terms of histopathology, genetics, and radiology are often conflicting and have implications for treatment planning. Moreover, the increase in DCIS diagnoses since the adoption of organized breast cancer screening programs has raised concerns about overdiagnosis and subsequent overtreatment. Active monitoring, a nonsurgical management strategy for DCIS, avoids surgery in favor of close imaging follow-up to de-escalate therapy and provides more treatment options. However, the two major challenges in active monitoring are identifying occult invasive cancer and patients at risk of invasive cancer progression. Subsequently, four prospective active monitoring trials are ongoing to determine the feasibility of active monitoring and refine the patient eligibility criteria and follow-up intervals. Radiologists play a major role in determining eligibility for active monitoring and reviewing surveillance images for disease progression. Trial results published over the next few years would support a new era of multidisciplinary DCIS care.

• Korean Journal of Radiology
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• v.23 no.7
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• pp.697-719
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• 2022

Gadoxetate magnetic resonance imaging (MRI) is widely used in clinical practice for liver imaging. For optimal use, we must understand both its advantages and limitations. This article is the outcome of an online advisory board meeting and subsequent discussions by a multidisciplinary group of experts on liver diseases across the Asia-Pacific region, first held on September 28, 2020. Here, we review the technical considerations for the use of gadoxetate, its current role in the management of patients with hepatocellular carcinoma (HCC), and its relevance in consensus guidelines for HCC imaging diagnosis. In the latter part of this review, we examine recent evidence evaluating the impact of gadoxetate on clinical outcomes on a continuum from diagnosis to treatment decision-making and follow-up. In conclusion, we outline the potential future roles of gadoxetate MRI based on an evolving understanding of the clinical utility of this contrast agent in the management of patients at risk of, or with, HCC.

• Journal of Korea Multimedia Society
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• v.8 no.4
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• pp.482-491
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• 2005

In this paper, we proposed the microcalcification detection algorithm which is based on wavelet transform and automatic thresholding method in the X-ray mammographic images. Digital X-ray imaging system is essential equipment in the field diagnosis and is widely used in the various fields such as chest, fracture of a bone, and dental correction. Especially, digital X-ray mammographic imaging is known as the most important method to diagnose the breast cancer, many researches to develop the imaging system are processing in country. In this paper, we proposed a microcalcifications detection algorithm necessary in the early phase of breast cancer diagnosis and showed that a algorithm could effectively detect microcalfication and could aid diagnosis-radiologist.