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  • 1
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    Online Resource
    Comparison of peritumoral stromal tissue stiffness obtained by shear wave elastography between benign and malignant breast lesions
    SAGE Publications ; 2018
    In:  Acta Radiologica Vol. 59, No. 10 ( 2018-10), p. 1168-1175
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 59, No. 10 ( 2018-10), p. 1168-1175
    Abstract: Aggressive breast cancers produce abnormal peritumoral stiff areas, which can differ between benign and malignant lesions and between different subtypes of breast cancer. Purpose To compare the tissue stiffness of the inner tumor, tumor border, and peritumoral stroma (PS) between benign and malignant breast masses by shear wave elastography (SWE). Material and Methods We enrolled 133 consecutive patients who underwent preoperative SWE. Using OsiriX commercial software, we generated multiple 2-mm regions of interest (ROIs) in a linear arrangement on the inner tumor, tumor border, and PS. We obtained the mean elasticity value (E mean ) of each ROI, and compared the E mean between benign and malignant tumors. Odds ratios (ORs) for prediction of malignancy were calculated. Subgroup analyses were performed among tumor subtypes. Results There were 85 malignant and 48 benign masses. The E mean of the tumor border and PS were significantly different between benign and malignant masses ( P  〈  0.05 for all). ORs for malignancy were 1.06, 1.08, 1.05, and 1.04 for stiffness of the tumor border, proximal PS, middle PS, and distal PS, respectively ( P  〈  0.05 for all). Malignant masses with a stiff rim were significantly larger than malignant masses without a stiff rim, and were more commonly associated with the luminal B and triple negative subtypes. Conclusion Stiffness of the tumor border and PS obtained by SWE were significantly different between benign and malignant masses. Malignant masses with a stiff rim were larger in size and associated with more aggressive pathologic subtypes.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185117753728
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 2
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    Association of mammography and ultrasound features with MammaPrint in patients with estrogen receptor-positive, HER2-negative, node-positive invasive breast cancer
    SAGE Publications ; 2021
    In:  Acta Radiologica Vol. 62, No. 12 ( 2021-12), p. 1592-1600
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 62, No. 12 ( 2021-12), p. 1592-1600
    Abstract: MammaPrint is a 70-gene signature microarray assay that predicts the likelihood of recurrence of breast cancer and chemotherapeutic benefits. Purpose To investigate the association between mammography and ultrasound (US) features and MammaPrint results in patients with estrogen receptor (ER)-positive, HER2-negative, node-positive invasive breast cancer, and to identify the predictive factors for high risk of recurrence. Material and Methods This retrospective study included 251 patients with ER-positive, HER2-negative, 1–3 node-positive invasive breast cancer. Mammography and US findings were reviewed according to the BI-RADS criteria. The association between MammaPrint results and the clinicopathological and imaging features was evaluated. Logistic regression analysis was performed to identify independent predictors for high risk of recurrence. Results Of the patients, 143 (57.0%) and 108 (43.0%) had low and high risks for recurrence on MammaPrint, respectively. Young age (odds ratio [OR] 1.08; 95% confidence interval (CI) 1.04–1.12; P 〈 0.001), posterior enhancement on US (OR 2.45; 95% CI 1.16–5.20; P = 0.019), absence of posterior shadowing on US (OR 3.19; 95% CI 1.17–8.62; P = 0.023), high histologic grade (OR 113.36; 95% CI 6.79–1893.53; P = 0.001), and high Ki-67 level (OR 4.90; 95% CI 2.62–9.17; P 〈 0.001) were independently associated with high risk of recurrence on multivariate logistic regression analysis. Conclusion Posterior features in US may predict a high risk of recurrence in patients with ER-positive, HER2-negative, node-positive invasive breast cancer, which may be useful in enhancing the diagnostic value of MammaPrint and aid in the decision-making process regarding treatment.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185120980003
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 3
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    Comparison of mammography, ultrasound, and MRI in size assessment of ductal carcinoma in situ with histopathologic correlation
    SAGE Publications ; 2017
    In:  Acta Radiologica Vol. 58, No. 12 ( 2017-12), p. 1434-1441
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 58, No. 12 ( 2017-12), p. 1434-1441
    Abstract: The ability to accurately assess tumor size in ductal carcinoma in situ (DCIS) is an important clinical issue when selecting the appropriate treatment plan. Purpose To compare the accuracy of using mammography, ultrasound (US), and magnetic resonance imaging (MRI) to assess DCIS tumor size based on imaging and histopathological findings. Material and Methods Fifty-six patients with DCIS were included. Mammography, US, and MRI were reviewed, and the accuracy of the measured tumor sizes were compared with the imaging and histopathological parameters. Results If visible, tumor measurements demonstrated high reliability with the pathologically determined size, with the best results obtained using US ( k = 0.851) followed by mammography ( k = 0.815) and MRI ( k = 0.738). Tumor size assessment was significantly more accurate when the lesion was shown as a mass on US ( P = 0.003) or MRI ( P  〈  0.001) with minimal and mild background parenchymal enhancement ( P = 0.016) on MRI. When mammography was used to assess tumor size, the tumors with positive estrogen receptor status and luminal A subtype demonstrated a significantly more accurate tumor size. Conclusion The combination of US and MRI, in addition to mammography, has an important role in assessing the exact tumor extent of DCIS.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185117698860
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 4
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    Diagnostic performance of breast ultrasonography and MRI in the prediction of lymph node status after neoadjuvant chemotherapy for breast cancer
    SAGE Publications ; 2017
    In:  Acta Radiologica Vol. 58, No. 10 ( 2017-10), p. 1198-1205
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 58, No. 10 ( 2017-10), p. 1198-1205
    Abstract: Neoadjuvant chemotherapy (NAC) is widely used to treat breast cancer. Sentinel lymph node biopsy has replaced axillary lymph node dissection in patients who convert to node-negative status after NAC. However, few studies have evaluated the diagnostic performance of ultrasonography and magnetic resonance imaging (MRI) in determining axillary lymph node status after NAC. Purpose To evaluate the diagnostic performance of breast ultrasonography and MRI in determining residual metastatic axillary lymph node status after NAC for breast cancer and to identify histopathological factors affecting radiological performance. Material and Methods This study included 157 patients who underwent initial and follow-up preoperative breast ultrasonography and MRI before NAC between January and December 2010. The sensitivity, specificity, negative and positive predictive values, and accuracy of ultrasonography, MRI, and their combinations were evaluated. Results The sensitivity of ultrasonography, MRI, and their combination in post-NAC axillary imaging was 60.00%, 57.33%, and 65.33%, respectively; the specificity was 60.47%, 72.09%, and 60.47%, respectively. The positive predictive value was highest with MRI (78.18%). On univariate analysis, positive estrogen receptor status was associated with misdiagnosis by ultrasonography ( P = 0.002), MRI ( P = 0.002), and their combination ( P = 0.001). When residual metastatic lymph nodes were present, lymph nodes with macrometastasis ( 〉 2.0 mm) were associated with correct ultrasonography-based diagnosis ( P = 0.0027). Conclusion Imaging assists in predicting axillary lymph node status in patients undergoing NAC; however, is imprudent to omit sentinel lymph node biopsy or axillary lymph node dissection for staging in women determined to be node-positive.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185117690421
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 5
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    Comparison of invasive micropapillary and invasive ductal carcinoma of the breast: a matched cohort study
    SAGE Publications ; 2019
    In:  Acta Radiologica Vol. 60, No. 11 ( 2019-11), p. 1405-1413
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 60, No. 11 ( 2019-11), p. 1405-1413
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185119834689
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 6
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    Analysis of false-negative findings of breast cancer on previous magnetic resonance imaging
    SAGE Publications ; 2021
    In:  Acta Radiologica Vol. 62, No. 6 ( 2021-06), p. 722-734
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 62, No. 6 ( 2021-06), p. 722-734
    Abstract: Despite the excellent contribution of contrast-enhanced breast magnetic resonance imaging (MRI), there are variable false-negative cases on MRI. Purpose To evaluate the false-negative findings of breast cancer on previous MRI. Material and Methods Between 2012 and 2016, we collected 132 patients who underwent surgery for a second primary cancer and had both current and previous MRI at an interval of 〈 3 years. We included 45 patients; we excluded 38 patients who could not find a second cancer in the previous MRI and 49 patients who had a second cancer near to the original cancer and within within the same quadrant. Compared with current MRI, we retrospectively assessed the second primary cancer on previous MRI according to BI-RADS and analyzed the reasons of misinterpretation. Results Analysis of previous MRI revealed 26 (57.8%) masses (mean size 7.7 ± 2.25 mm), 12 (26.7%) non-mass enhancements (mean size 14.7 ± 4.76 mm), and 7 (15.5%) foci. At first reading, 24 (53.3%) were missed, 17 (37.8%) were assessed as BI-RADS category 2 or 3, and 4 (8.9%) were assessed as category 4. On current MRI, 39 (86.7%) lesions showed an increase in size and 22 (48.9%) showed a change in kinetics to wash-out pattern. Conclusion On previous MRI, missed or misinterpreted cancers show variable findings of mass and non-mass enhancements with any types of kinetics. Careful application of BI-RADS is necessary as well as an appropriate biopsy. Any lesion that increases in size and changes in kinetics should not be underestimated.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185120941830
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 7
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    Correlation between magnetic resonance imaging and the level of tumor-infiltrating lymphocytes in patients with estrogen receptor-negative HER2-positive breast cancer
    SAGE Publications ; 2020
    In:  Acta Radiologica Vol. 61, No. 1 ( 2020-01), p. 3-10
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 61, No. 1 ( 2020-01), p. 3-10
    Abstract: High levels of tumor-infiltrating lymphocytes (TILs) are associated with improved prognosis and response to therapy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Purpose This study investigated the associations between TIL levels and magnetic resonance imaging (MRI) findings in patients with estrogen receptor (ER)-negative HER-2 positive breast cancer. Material and Methods This study included 110 consecutive patients with surgically confirmed ER-negative HER2-positive breast cancers who underwent preoperative MRI from January to December 2015. Images of all lesions were reviewed in accordance with the BI-RADS lexicon by radiologists blinded to clinicopathologic findings. Tumor kinetic features were acquired by computer-aided diagnosis (CAD). Patients were divided into three TIL groups: low ( 〈 10%); intermediate (10–50%); and high ( 〉 50%). Associations between TIL levels and clinicopathologic and imaging features were evaluated; independent predictors of high and low TIL were identified by multiple logistic regression analysis. Results The 110 patients included 29 (26.4%) with low, 45 (40.9%) with intermediate, and 36 (32.7%) with high TIL levels. Multiple logistic regression analysis showed that older age (odds ratio [OR] = 1.08; P = 0.017), high peak enhancement (OR = 1.01; P = 0.019), positive CK5/6 (OR = 4.36; P = 0.024), and low Ki-67 (OR = 14.29; P = 0.037) were significantly associated with low TILs; low peak enhancement (OR = 1.01; P = 0.020) was significantly associated with high TILs. Conclusion MRI features may predict TIL levels in patients with ER-negative HER-2 positive breast cancer, enhancing the ability to diagnose and treat these patients.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185119851235
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 8
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    Digital breast tomosynthesis versus full-field digital mammography: comparison of the accuracy of lesion measurement and characterization using specimens
    SAGE Publications ; 2014
    In:  Acta Radiologica Vol. 55, No. 6 ( 2014-07), p. 661-667
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 55, No. 6 ( 2014-07), p. 661-667
    Abstract: Digital breast tomosynthesis (DBT) is one of the new techniques being developed to overcome the inherent limitations of mammography caused by superimposed structures in a 2D projection. Purpose To compare the diagnostic performances of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) for lesion characterization and size measurement using breast specimens. Material and Methods Out of 156 women scheduled for surgery, we included in our study 114 women, each of whom had a single, breast lesion. Three breast radiologists independently evaluated the DBT and FFDM performance regarding the breast specimens obtained during surgery. Each reader measured the lesion size, and then categorized the probability of malignancy using the American College of Radiology Breast Imaging Reporting and Data system (BI-RADS). After both reading sessions, the readers selected the preferred modality of either FFDM or DBT in lesion characterization. We also analyzed the radiologists’ evaluation performance in patients with dense versus fatty breasts when using DBT and FFDM. Results The imaging findings of 84 cancers and 30 benign lesions, all of which had been pathologically proven, were reviewed. The size evaluation determined by DBT was more accurately correlated with that found by pathology ( P = 0.001 for fatty breasts and 〈 0.001 for dense breasts) than that determined by FFDM. The correlation coefficients of DBT and FFDM to the pathologically determined lesion size were 0.90 and 0.89, respectively ( P  〈  0.001). Compared with the pathologically determined lesion size, the size determined by both imaging modalities was overestimated. Overall, assessment of the probability of malignancy by DBT and FFDM did not differ significantly ( P = 0.07); however, in dense breast, DBT was more strongly correlated with the pathology determination than FFDM ( P = 0.03). Conclusion DBT may be superior to FFDM for determining the preoperative size measurement of breast lesions irregardless of their parenchymal density. Particularly in dense breasts, DBT was more useful for differentiating the lesion malignancy rate.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185113503636
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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  • 9
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    Online Resource
    Analysis of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT: clinical significance and differential diagnosis
    SAGE Publications ; 2012
    In:  Acta Radiologica Vol. 53, No. 5 ( 2012-06), p. 530-535
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 53, No. 5 ( 2012-06), p. 530-535
    Abstract: With the widespread use of PET/CT, incidental hypermetabolic foci unrelated to the known malignancy have been described with increasing frequency. Purpose To determine the frequency and clinical significance of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT, and to explore factors differentiating benign and malignant breast uptake. Material and Methods From January 2005 to June 2010, a total of 51,971 whole-body FDG PET/CT examinations were performed in our clinic. After excluding 7254 sets of PET/CT data from patients known to have breast cancer, we retrospectively identified patients showing incidental focal hypermetabolic activity in the breast. Of 44,717 PET/CT examinations conducted on 32,988 patients, we identified 131 patients with no previous known or suspected benign and malignant breast disease. The etiology, mean SUV max , and diameter of breast lesions were assessed. We also compared the presentation of the lesions on CT, mammography, and ultrasonography. Results Of the 131 patients, 60 were histologically diagnosed with breast lesions, including 32 with malignant and 28 with benign lesions. An additional 11 patients were followed-up for more than 2 years and were clinically considered to have benign lesions. The remaining 60 patients who had neither histologic confirmation nor followed-up for more than 2 years were excluded. Therefore, 71 patients were finally included. The mean SUV max of 39 benign lesions and 32 malignant lesions were 2.02 ± 1.52 and 3.71 ± 3.83, respectively ( P = 0.0001). At a cut-off value of 2.3, the rate of malignancy and specificity of the mean SUVmax for differentiating benign and malignant breast lesions were 61.3%, 76.3, respectively. The CT data from PET/CT revealed that the mean diameters of benign and malignant lesions were 1.19 ± 0.97 cm and 2.26 ± 1.96 cm, respectively ( P = 0.0009). Conclusion Incidental focal 18F-FDG uptake in the breast as detected by PET/CT was indicative of malignancy in 45% of patients. Both mean SUV max and diameter were greater for malignant than benign lesions.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1258/ar.2012.120015
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
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  • 10
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    Hospital-Based Surveillance of Infection-Related Mortality in South Korea
    SAGE Publications ; 2009
    In:  Public Health Reports Vol. 124, No. 6 ( 2009-11), p. 883-888
    Details
    In: Public Health Reports, SAGE Publications, Vol. 124, No. 6 ( 2009-11), p. 883-888
    Type of Medium: Online Resource
    ISSN: 0033-3549 , 1468-2877
    URL: Article
    DOI: 10.1177/003335490912400617
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2017700-8
    SSG: 20,1
    SSG: 27
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