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Automated Versus Handheld Breast Ultrasound for Evaluating Axillary Lymph Nodes in Patients With Breast Cancer

  • Sun Mi Kim;Mijung Jang;Bo La Yun;Sung Ui Shin;Jiwon Rim;Eunyoung Kang;Eun-Kyu Kim;Hee-Chul Shin;So Yeon Park;Bohyoung Kim
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.146-156
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    • 2024
  • Objective: Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. Materials and Methods: We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017-May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. Results: The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS-HHUS agreement was 95.9% (236/246; Cohen's kappa = 0.883). Conclusion: Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS.

Effects of Instructional Material Using ICT at High School Earth Science (고등학교 지구과학 수업에서 ICT 활용 수업자료의 효과)

  • Lee, Yong-Seob;Kim, Jong-Hee;Kim, Sang-Dal
    • Journal of the Korean earth science society
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    • v.25 no.5
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    • pp.336-347
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    • 2004
  • This study investigated the effects of the application of a variety of ICTs cause the effects on self-directed learning capability, creativity and problem-solving ability. In order to achieve the above aim, Web-Based Instructions(WBI) and instructions using CD-ROM Titles for the unit of 'the solar system and the galaxy' were applicated and analyzed which belongs to the area of 'the earth' in the subject 'science' for high school students. Instructions using WBI materials and CD-ROM titles were found to be effective on 'self-conception', 'creativity', 'future inclination', 'self-assessment ability', 'openness' and' initiative' improvement all of which belong to self-directed learning characteristics. They did not, however, show meaningful effect on improving 'learning eagemess' and 'responsibility' improvement. On looking into self-directed learning characteristics according to prerequisite learning levels, both groups and these for instruction using CD-ROM learning materials were found to have no effect on interaction. With respect to problem-solving ability improvement which is characteristic of the instruction using ICTs, WBI proved more fruitful than instruction using CD-ROM titles on improving scholastic achievement level. WBI was effective on 'fluency', 'originality' and 'resistance to premature closure'. It on the other hand, was of no use on 'abstraction of titles' and 'elaborateness' These results came from the following characteristics: WBI came into effect on 'fluency' and 'originality' in the areas of variety and vitality, which are characteristic of WBI. In the area of resistance to premature closure WBI was effective on organizing learning contents owing to the animation of picture materials which are variously presented in the web site. As a result of WBI questionnaire about WBI, an excellent effect on the structure of display, quantity of information, indication and instruction, supplementary study and further study were discussed.

Implementation of Radiotherapy Educational Contents Using Virtual Reality (가상현실 기술을 활용한 방사선치료 교육 콘텐츠 제작 구현)

  • Kwon, Soon-Mu;Shim, Jae-Goo;Chon, Kwon-Su
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.409-415
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    • 2018
  • The development of smart devices has brought about significant changes in daily life and one of the most significant changes is the virtual reality zone. Virtual reality is a technology that creates the illusion that a 3D high-resolution image has already been created using a display device just like it does in itself. Unrealized subjects are forced to rely on audiovisual materials, resulting in a decline in the concentration of practices and the quality of classes. It used virtual reality to develop effective teaching materials for radiology students. In order to produce a video clip bridge using virtual reality, a radiology clinic was selected to conduct two exposures from July to September 2017. The video was produced taking into account the radiology and work flow chart and filming was carried out in two separate locations : in the computerized tomography unit and in the LINAC room. Prior to filming the scenario and the filming route were checked in advance to facilitate editing of the video. Modeling and mapping was performed in a PC environment using the Window XP operating system. Using two leading virtual reality camera Gopro Hero, CC pixels were produced using a 4K UHD, Adobe, followed by an 8 megapixel resolution of $3,840{\times}2,160/4,096{\times}2,160$. Total regeneration time was performed in about 5 minutes during the production of using virtual reality to prevent vomiting and dizziness. Currently developed virtual reality radiation and educational contents are being used to secure the market and extend the promotion process to be used by various institutions. The researchers will investigate the satisfaction level of radiation and educational contents using virtual reality and carry out supplementary tasks depending on the results.

The Usefulness of $^{18}F-FDG $ PET as a Cancer Screening Test ($^{18}F-FDG $ PET의 암 선별검사로서의 유용성)

  • Ko, Doo-Heun;Choi, Joon-Young;Song, Yun-Mi;Lee, Su-Jin;Kim, Young-Hwan;Lee, Kyung-Han;Kim, Byung-Tae;Lee, Moon-Kyu
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.444-450
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    • 2008
  • Purpose: The aim of this study was to evaluate the usefulness of whole body positron emission tomography (PET) using $^{18}F-fluorodeoxyglucose$ ($^{18}F-FDG$) for cancer screening in asymptomatic subjects. Materials and Methods: The subjects were 1,762 men and 259 women who voluntarily underwent $^{18}F-FDG$ PET for cancer screening as a part of a routine health examination. Final diagnosis was decided by other diagnostic studies, pathological results or clinical follow-up for 1 year. Results: Of 2,021 subjects, 40 (2.0%) were finally proved to have cancer. Abnormal focal $^{18}F-FDG$ uptake suggesting malignancy was found in 102 subjects (5.0%). Among them, 21 subjects (1.0%) were proved to have cancer. Other tests in the routine health examination could not find 9 of 21 cancers (42.9%) detected by PET. The sensitivity, specificity, positive predictive value, and negative predictive value of PET for cancer screening were 52.5%, 95.9%, 20.6%, and 99.0%, respectively. Pathologies of cancers missed on PET were adenocarcinoma (n = 9; 3 colon cancers, 3 prostate cancers, 2 stomach cancers, and 1 rectal cancer), differentiated thyroid carcinoma (n = 6), bronchioalveolar cell carcinoma (n = 2), urinary bladder cancer (n = 1), and melanoma (n = 1). More than half of cancers which were not detected by PET were smaller than 1 cm in diameter. Conclusion: $^{18}F-FDG$ PET might be useful for cancer screening in asymptomatic subjects due to its high specificity and negative predictive value and playa supplementary role to the conventional health check-up, but it could not replace due to limited sensitivity for urological cancers, small-sized tumors and some hypometaboic cancers.

Analysis and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Compost (음식물쓰레기 퇴비화시설의 설치 및 운영 현황분석 및 개선방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.95-111
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    • 2004
  • This research sought to determine the status of the installation and operation of composting facilities of domestic public resource-making facilities and come up with corresponding improvement measures. The composting facilities were the most extensively installed of related facilities with over a 0.5 ton treated volume per day. The monthly and yearly carry-in volume of food waste were found to stand at 1,101.7 tons per day and 930.9 tons per day, thus falling short of the average planned volume of 1,270.9 tons. Many composting facilities, which were installed in areas for which factory registration were not approved, did not get approvals. Composting facilities underwent operation stoppage mainly due to faulty fermentation and crushing equipment. Mainly metals contained in food waste caused faults to the crushing equipment, thus requiring a facility designing against faults and corrosion. The initial water content was found to stand at 50-60%, thus complying with the requirement. However, since the composting food waste had an appropriate mixture of sawdust, food waste, and returned compost, it should meet the initial conditions. For fermentation facilities, the duration time for fermentation was 15 days, and post-fermentation tanks required 21 days of duration time, thus establishing the minimum criteria. However, some facilities did not meet the requirements, taking more time in decomposition, thus suggesting a need to determine the duration time according to facilities. In composting food waste, microorganism-based thermal oxidizer-operated fermentation tanks should be used to ensure an economic operation. On the contrary, 14 out of 25 survey targets heated fermentation tanks in any form. These thermal facilities contain the growth of bacteria, lowering chemical reaction in composting; thus composting facilities should be basically designed to use microorganism-based thermal oxidizers in drying water. An average daily volume of food waste and supplementary materials that was injected in producing compost was 22.8 tons. This volume produced 7.3 tons of compost per day, decreasing 68%. Properties of produced compost were analyzed by its color, absence or presence of remaining decomposition heat, and smell, to assess the quality. As a result, the composting process was not properly installed nor operated in about 50% of composting facilities. Compost should be produced to be soil-friendly.

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Effect of LED mixed light conditions on the glucosinolate pathway in brassica rapa (배추 유묘의 글루코시놀레이트 합성 기작에 미치는 LED 혼합광의 효과)

  • Moon, Junghyun;Jeong, Mi Jeong;Lee, Soo In;Lee, Jun Gu;Hwang, Hyunseung;Yu, Jaewoong;Kim, Yong-Rok;Park, Se Won;Kim, Jin A
    • Journal of Plant Biotechnology
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    • v.42 no.3
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    • pp.245-256
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    • 2015
  • In the agricultural industries, LEDs are used as supplementary, as well as main lighting sources in closed cultivation systems. In cultivation using artificial light sources, various light qualities have been tried to supplement fluorescent lamps to promote plant growth and metabolism. Microarray analysis of Brassica rapa seedlings under blue and fluorescent mixed with blue light conditions identified changes in three genes of the glucosinolate pathway. This attracted attention as functional materials highly expressed 3.6-4.6 fold under latter condition. We selected four more genes of the glucosinolate pathway from the Brassica database and tested their expression changes under fluorescent light mixed with red, green, and blue, respectively. Some genes increased expression under red and blue mixed conditions. The Bra026058, Bra015379, and Bra021429; the orthologous genes of CYP79F1, ST5a, and FMOGS-OX1 in Arabidopsis, are highly expressed in Brassica rapa under fluorescent mixed with blue light conditions. Further, Bra029355, Bra034180, Bra024634, and Bra022448; the orthologous genes of MAM1, AOP3, UGT74B1, and BCAT4 in Arabidopsis, are highly expressed in Brassica rapa under fluorescent mixed with red light conditions. The various light conditions had unique effects on the varieties of Brassica, resulting in differences in glucosinolate synthesis. However, in some varieties, glucosinolate synthesis increased under mixed blue light conditions. These results will help to construct artificial light facilities, which increase functional crops production.

The Application of Dynamic Acquisition with Motion Correction for Static Image (동적 영상 획득 방식을 이용한 정적 영상의 움직임 보정)

  • Yoon, Seok-Hwan;Seung, Jong-Min;Kim, Kye-Hwan;Kim, Jae-Il;Lee, Hyung-Jin;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.46-53
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    • 2010
  • Purpose: The static image of nuclear medicine study should be acquired without a motion, however, it is difficult to acquire static image without movement for the serious patients, advanced aged patients. These movements cause decreases in reliability for quantitative and qualitative analysis, therefore re-examination was inevitable in the some cases. Consequently, in order to improve the problem of motion artifacts, the authors substituted the dynamic acquisition technique for the static acquisition, using motion correction. Materials and Methods: A capillary tube and IEC body phantom were used. First, the static image was acquired for 60 seconds while the dynamic images were acquired with a protocol, 2 sec/frame${\times}$30 frames, under the same parameter and the frames were summed up into one image afterwards. Also, minimal motion and excessive motion were applied during the another dynamic acquisition and the coordinate correction was applied towards X and Y axis on the frames where the motion artifact occurred. But the severe blurred images were deleted. Finally, the resolution and counts were compared between the static image and the summed dynamic images which before and after applying motion correction, and the signal of frequency was analysed after frequency spatial domain was transformed into 2D FFT. Supplementary examination, the blind test was performed by the nuclear medicine department staff. Results: First, the resolution in the static image and summed dynamic image without motion were 8.32 mm, 8.37 mm on X-axis and 8.30 mm, 8.42 mm on Y-axis, respectively. The counts were 484 kcounts, 485 kcounts each, so there was nearly no difference. Secondly, the resolution in the image with minimal motion applying motion correction was 8.66 mm on X-axis, 8.85 mm on Y-axis and had 469 kcounts while the image without motion correction was 21.81 mm, 24.02 mm and 469 kcounts in order. So, this shows the image with minimal motion applying motion correction has similar resolution with the static image. Lastly, the resolution in the images with excessive motion applying motion correction were 9.09 mm on X-axis, 8.83 mm on Y-axis and had 469 kcounts while the image without motion correction was 47.35 mm, 40.46 mm and 255 kcounts in order. Although there was difference in counts because of deletion of blurred frames, we could get similar resolution. And when the image was transformed into frequency, the high frequency was decreased by the movement. However, the frequency was improved again after motion correction. In the blind test, there was no difference between the image applying motion correction and the static image without motion. Conclusion: There was no significant difference between the static image and the summed dynamic image. This technique can be applied to patients who may have difficulty remaining still during the imaging process, so that the quality of image can be improved as well as the reliance for analysis of quantity. Moreover, the re-examination rate will be considerably decreased. However, there is a limit of motion correction, more time will be required to successfully image the patients applying motion correction. Also, the decrease of total counts due to deletion of the severe blurred images should be calculated and the proper number of frames should be acquired.

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A Study on the Restoration of the Wangheungsa Temple's Wooden Pagoda (왕흥사 목탑의 복원 연구)

  • Kim, Kyeong-Pyo;Sung, Sang-Mo
    • Journal of architectural history
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    • v.19 no.3
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    • pp.7-29
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    • 2010
  • The form of the Wangheungsa Temple's wooden pagoda site is that of the traditional form of the wooden pagodas constructed during the Baekjae Period. Likewise, it is an important ruin for conducting research on the form and type of the wooden pagodas constructed during the Baekjae Period. In particular, the method used for the installation of the central pillar's cornerstone is a new technique. The purpose of this research is to restore the ruin of the Wangheungsa Temple's wooden pagoda of the Baekjae Period that remains at the Wangheungsa Temple's wooden pagoda site. Until now, research conducted on the wooden pagoda took place mostly centered on the Hwangryongsa Temple's wooden pagoda. Meanwhile, the reality concerning Baekjae's wooden pagoda is one in which there were not many parallel cases pertain to the design for restoration. This research paper wants to conduct academic examination of the Wangheungsa Temple's wooden pagoda to organize the intention of design and design process in a simple manner. This research included review of the Baekjae Period's wooden pagoda related ruins and the review of the existing wooden pagoda ruin to analyze the wooden pagoda construction technique of the era. Then, current status of the Wangheungsa Temple's wooden pagoda site is identified to define the characteristics of the wooden pagoda, and to set up the layout format and the measure to estimate the size of the wooden pagoda in order to design each part. Ultimately, techniques and formats used for the restoration of the wooden pagoda were aligned with the wooden pagoda of the Baekjae Period. Basically, conditions that can be traced from the current status of the Wangheungsa Temple site excavation using the primary standards as the standard. Wangheungsa Temple's wooden pagoda was designed into the wooden pagoda of the Baekjae's prosperity phase. The plane was formed into $3{\times}3$ compartments to design into three tier pagoda. The height was decided by factoring in the distance between the East-West corridors, size of the compartment in the middle, and the view that is visible from above the terrace when entering into the waterway. Basically, the origin of the wooden structure format is based on the Goguryeo style, but also the linkage with China's southern regional styles and Japan's ancient wooden pagoda methods was factored in. As for the format of the central pillar, it looks as if the column that was erected after digging the ground was used when setting up the columns in the beginning. During the actual construction work of the wooden pagoda, central pillar looks as if it was erected by setting up the cornerstone on the ground. The reason that the reclaimed part of pillar that use the underground central cornerstone as the support was not utilized, was because the Eccentric Load of the central pillar's cornerstone was factored in the state of the layers of soil piled up one layer at a time that is repeated with the yellow clay and sandy clay and the yellow clay that were formed separately with the $80cm{\times}80cm$ angle at the upper part of the central pillar's cornerstone was factored in as well. Thus, it was presumed that the central pillar was erected in the actual design using the ground style format. It is possible to presume the cases in which the reclaimed part of pillar were used when constructed for the first time, but in which central pillar was installed later on, after the supplementary materials of the underground column is corroded. In this case, however, technique in which soil is piled up one layer at a time to lay down the foundation of a building structure cannot be the method used in that period, and the reclamation cannot fill up using the $80cm{\times}80cm$ angle. Thus, it was presumed that the layers of soil for building structure's foundation was solidified properly on top of the central pillar's cornerstone when the first wooden pagoda construction work was taking place, and that the ground style central pillar was erected on its upper part by placing the cornerstone once again. Wangheungsa Temple's wooden pagoda is significant from the structure development aspect of the Korean wooden pagodas along with the Hwangryongsa Temple's wooden pagoda. Wangheungsa Temple's wooden pagoda construction technique which was developed during the prosperity phase of the Baekjae Period is presumed to have served as a role model for the construction of the Iksan Mireuksa Temple's wooden pagoda and Hwangryongsa Temple's wooden pagoda. With the plan to complement the work further by excavating more, the basic wooden pagoda model was set up for this research. Wangheungsa Temple's wooden pagoda was constructed as at the Baekjae Kingdom wide initiative, and it was the starting point for the construction of superb pagoda using state of the art construction techniques of the era during the Baekjae's prosperous years, amidst the utmost interest of all the Baekjae populace. Starting out from its inherent nature of enshrining Sakyamuni's ashes, it served as the model that represented the unity of all the Baekjae populace and the spirit of the Baekjae people. It interpreted these in the most mature manner on the Korean peninsula at the time.

A Functional MRI Study on the Brain Activation Associated with Mental Calculation (기능적 자기공명영상을 이용한 수리연산의 대뇌 활성화에 관한 연구)

  • Choi Dae Seob;Na Dong Gyu;Kim Sam Soo;Cho Jae Min;Park Eui Dong;Chung Sung Hoon;Ryoo Jae Wook
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.16-23
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    • 2005
  • Purpose : In order to investigate the functional brain anatomy associated with mental calculation, functional magnetic resonance imaging was performed. Materials and Methods : In six normal right handed subjects, functional MR images were obtained using a 1.57 MR scanner and the EPI BOLD technique. The study included experiment I and experiment II. Each experiment consisted of five resting and four activation periods with each period of 30 seconds. During the activation period of both experiment I and II, calculation equations[an example: $(4+5)\times8=72$] were presented and the subjects were instructed to decide true or false of them. During the resting period of experiment I, the subjects were instructed to visually fixate on a crosshair. During the resting period of experiment II, two diagrams (an example: $(\bullet,\;\blacksquare)$)were presented and the subjects were instructed to decide they are same or not. For the post-processing of images, the SPM program was used, with the threshold of significance set at p<0.00001. The activated areas during the tasks were assessed. Results : In experiment 1, the inferior frontal gyrus, prefrontal cortex, promoter area, supplementary motor area, and intraparietal sulcus including superior parietal cortex were activated bilaterally. Although these areas were also activated in experiment II, the activated signals in the right frontal and parietal lobes were lessened. Conclusion : The left inferior frontal gyrus and prefrontal cortex and bilateral intraparietal sulci were activated during mental calculation. The right frontal and parietal lobes might be related to attention and decision making.

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Functional Brain Mapping Using $H_2^{15}O$ Positron Emission Tomography ( II ): Mapping of Human Working Memory ($H_2^{15}O$ 양전자단층촬영술을 이용한 뇌기능 지도 작성(II): 작업 기억의 지도 작성)

  • Lee, Jae-Sung;Lee, Dong-Soo;Lee, Sang-Kun;Nam, Hyun-Woo;Kim, Seok-Ki;Park, Kwang-Suk;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.238-249
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    • 1998
  • Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.

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