Concordant or Discordant? Imaging-Pathology Correlation in a Sonography-Guided Core Needle Biopsy of a Breast Lesion

육지현,김은경,김민정,고경희,곽진영,손은주,최준정,강혜윤 대한영상의학회 2011 Korean Journal of Radiology Vol.12 No.2

An imaging-guided core needle biopsy has been proven to be reliable and accurate for the diagnosis of both benign and malignant diseases of the breast, and has replaced surgical biopsy. However, the possibility of a false-negative biopsy still remains. Imaging-pathology correlation is of critical importance in imaging-guided breast biopsies to detect such a possible sampling error and avoid a delay in diagnosis. We will review fi ve possible categories and corresponding management after performing an imaging-pathology correlation in a sonography-guided core needle biopsy of a breast lesion, as well as illustrate the selected images for each category in conjunction with the pathologic fi nding. Radiologists should be familiar with the imaging features of various breast pathologies and be able to appropriately correlate imaging fi ndings with pathologic results after a core needle biopsy.

Shear-wave elastography in breast ultrasonography: the state of the art

육지현,권혜미,손은주 대한초음파의학회 2017 ULTRASONOGRAPHY Vol.36 No.4

Shear-wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. In breast ultrasonography, SWE has been shown to be useful for differentiating benign breast lesions from malignant breast lesions, and it has been suggested that SWE enhances the diagnostic performance of ultrasonography, potentially improving the specificity of conventional ultrasonography using the Breast Imaging Reporting and Data System criteria. More recently, not only has SWE been proven useful for the diagnosis of breast cancer, but has also been shown to provide valuable information that can be used as a preoperative predictor of the prognosis or response to chemotherapy.

Supplementary Screening Sonography in Mammographically Dense Breast: Pros and Cons

육지현,김은경 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.6

Sonography is an attractive supplement to mammography in breast cancer screening because it is relatively inexpensive, requires no contrast-medium injection, is well tolerated by patients, and is widely available for equipment as compared with MRI. Sonography has been especially valuable for women with mammographically dense breast because it has consistently been able to detect a substantial number of cancers at an early stage. Despite these findings, breast sonography has known limitations as a screening tool; operator-dependence, the shortage of skilled operators, the inability to detect microcalcifications, and substantially higher false-positive rates than mammography. Further study of screening sonography is still ongoing and is expected to help establish the role of screening sonography.

유방초음파의 최근 동향

육지현,김은경 대한초음파의학회 2012 ULTRASONOGRAPHY Vol.31 No.1

2차원 회색조 영상에 추가로 적용할 수 있는 다양한 새로운초음파 영상 기법들이 개발, 연구 되고 있다. 이 종설에서는 유방 병변의 발견 및 진단 목적으로 개발되어 실제 임상에서 2차원 회색조 영상에 추가로 적용할 수 있는 여러 유방 초음파 영상 기법의 최근 동향에 대해 소개하였다. 각각의 기법들의 원리, 적용 및 제한점에 대한 기본 지식을 바탕으로 초음파 검사를시행함으로써보다효과적이고정확한진단을내릴수있다. In the last 30 years, technical improvements have directly contributed to expanding sonographic breast imaging applications into the most important adjunctive imaging modality for breast evaluation. Most of these advances have related to improvements in sonographic gray-scale image resolution and contrast, but some applications such as color Doppler imaging, elastography, optical imaging, or three-dimensional ultra-sounds have resulted in sonographic information that is uniquely different from gray-scale imaging. The current spectrum of new breast sonographic techniques not only offers information uniquely different from gray-scale imaging but also involves hard-ware advances that affect the method of image production. In this article, we discuss the current trends in breast ultrasonography focusing on the advances to further improve accuracy for breast lesion diagnosis.

Factors Influencing the Background Parenchymal Enhancement in Follow-Up Breast MRI after Adjuvant Endocrine Therapy

육지현,손은주,김정아 대한자기공명의과학회 2015 Investigative Magnetic Resonance Imaging Vol.19 No.2

Purpose: To investigate factors influencing the evaluation of backgroundparenchymal enhancement (BPE) at follow-up breast magnetic resonance imaging(MRI) after adjuvant endocrine therapy. Materials and Methods: One hundred twelve women with breast cancer and MRIof the contralateral unaffected breast before and after endocrine therapy wereidentified. Two readers in consensus performed blinded side-by-side comparison ofBPE (minimal, mild, moderate, and marked) before and after therapy with categoricalscales. Age, body mass index, menopausal status, treatment regimen (selectiveestrogen receptor modulator or aromatase inhibitor), chemotherapy, follow-upduration, BPE at baseline MRI, MRI field strength before and after therapy, andrecurrence were analyzed for their influences on decreased BPE. Results: Younger age, premenopausal status, treatment with selective estrogenreceptor modulator, MRI field strength, and moderate or marked baseline BPE weresignificantly associated with decreased BPE. In multivariate analysis, MRI fieldstrength and baseline BPE showed a significant association. Conclusion: MRI field strength and baseline BPE before and after therapy .wereassociated with decreased BPE at post-therapy, follow-up MRI.

Shear-wave elastography for breast masses: local shear wave speed (m/sec) versus Young modulus (kPa)

육지현,손은주,박아영,김정아 대한초음파의학회 2014 ULTRASONOGRAPHY Vol.33 No.1

Purpose: To evaluate and compare the performance of shear-wave elastography (SWE) for breast masses using the local shear wave speed (m/sec) vs. Young modulus (kPa). Methods: A total of 130 breast lesions in 123 women who underwent SWE before ultrasound-guided core needle biopsy or surgical excision were included. With the region-of-interest placed over the stiffest areas of the lesion on SWE, the quantitative mean, maximum, and standard deviation (SD) of the elasticity values were measured in kPa and m/sec for each lesion. The SD was also measured with the region-of-interest including the whole breast lesion (wSD). The area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of each elasticity value measured in kPa and m/sec were compared. Results: Of the 130 lesions, 49 (37.7%) were malignant and 81 (62.3%) were benign. The AUCs for the mean, maximum, and SD of the elasticity values using kPa and m/sec did not differ significantly: mean, 0.974 vs. 0.974; maximum, 0.960 vs. 0.976; SD, 0.916 vs. 0.916. However, the AUC for wSD showed a significant difference: 0.964 (kPa) vs. 0.960 (m/sec) (P=0.036). There was no significant difference in the sensitivity and specificity of the mean, maximum, and wSD of the elasticity values. However, the specificity of the SD was significantly different between the two different measurements: 95.1% (kPa) vs. 87.7% (m/sec) (P=0.031). Conclusion: The quantitative elasticity values measured in kPa and m/sec on SWE showed good diagnostic performance. The specificity of the SD and AUC of the wSD measured in kPa were significantly higher than those measured in m/sec.

분비성 유방암: 증례 보고

육지현,고경희,김광일 대한영상의학회 2008 대한영상의학회지 Vol.59 No.1

분비성 유방암은 매우 드물게 발생하는 원발성 유방암으로, 특징적인 임상양상 및 조직소견을 보이는 관상피암의 한 아형으로 알려졌다. 다른 악성종양에 비해 천천히 자라고 예후가 비교적 좋은 것으로 알려졌으나 영상소견에 대해서는 거의 보고된 바 없다. 저자들은 유방 촬영술 및 초음파 검사상 양성 종양과 유사한 소견을 보인 48세 여자 환자의 분비성 유방암 1예를 보고하고자 한다.

Mn-DPDP 조영증강 자기공명영상: 국소 간 종양 발견에 적합한 영상 기법에 대한 연구

육지현,이정민,김인환,정경호,이승옥,김대곤,유희철,조백환,김종수 대한영상의학회 2002 대한영상의학회지 Vol.46 No.3

LED 램프 패키지 설계를 위한 기본 지침

육지현,홍대운,이성재,Youk, Ji-Hyun,Hong, Dae-Woon,Lee, Song-Jae 한국광학회 2011 한국광학회지 Vol.22 No.3

현재까지 더 좋은 성능의 LED 램프 패키지 구조의 개발을 위해 많은 연구가 진행되어 왔음에도 불구하고 아직 LED 램프 패키지 설계에 관한 표준화된 이론이나 지침 같은 것들이 마련되지 못한 것으로 판단된다. 이에 본 논문에서는 먼저 Monte Carlo photon simulation 기법을 이용하여 InGaN/Sapphire LED의 칩 구조 및 Epi-up 혹은 Epi-down 칩 부착 방식을 광추출효율 관점에서 분석하였다. 그리고 분석결과를 바탕으로 LED 램프 패키지 설계에 관한 기본 지침을 마련하였다. 이와 같이 마련된 설계지침은 관련 기업이나 연구기관에서, LED 램프의 구체적 응용분야에 따라 최적화된 패키지 구조를 설계하는 데에 중요하게 활용될 수 있을 것으로 기대된다. Although significant amount of research has been done to develop LED lamp packages for improved performance, no standard theories or guidelines have been established yet for designing LED lamp packages. In this paper, the photon extraction efficiency depending on both the InGaN/Sapphire LED chip structure and its attachment schemes for chip mounting has been analyzed by using the Monte Carlo photon simulation method. Based on the results of the analysis, we have derived guidelines for LED lamp package design, which can be utilized in industries or research institutes for designing new LED lamp packages optimized for particular applications.

Scoring System to Stratify Malignancy Risks for Mammographic Microcalcifications Based on Breast Imaging Reporting and Data System 5th Edition Descriptors

육지현,Hye Mi Gweon,손은주,Na Lae Eun,Eun Jung Choi,김정아 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.12

Objective: To develop a scoring system stratifying the malignancy risk of mammographic microcalcifications using the 5th edition of the Breast Imaging Reporting and Data System (BI-RADS). Materials and Methods: One hundred ninety-four lesions with microcalcifications for which surgical excision was performed were independently reviewed by two radiologists according to the 5th edition of BI-RADS. Each category’s positive predictive value (PPV) was calculated and a scoring system was developed using multivariate logistic regression. The scores for benign and malignant lesions or BI-RADS categories were compared using an independent t test or by ANOVA. The area under the receiver operating characteristic curve (AUROC) was assessed to determine the discriminatory ability of the scoring system. Our scoring system was validated using an external dataset. Results: After excision, 69 lesions were malignant (36%). The PPV of BI-RADS descriptors and categories for calcification showed significant differences. Using the developed scoring system, mean scores for benign and malignant lesions or BI-RADS categories were significantly different (p < 0.001). The AUROC of our scoring system was 0.874 (95% confidence interval, 0.840–0.909) and the PPV of each BI-RADS category determined by the scoring system was as follows: category 3 (0%), 4A (6.8%), 4B (19.0%), 4C (68.2%), and 5 (100%). The validation set showed an AUROC of 0.905 and PPVs of 0%, 8.3%, 11.9%, 68.3%, and 94.7% for categories 3, 4A, 4B, 4C, and 5, respectively. Conclusion: A scoring system based on BI-RADS morphology and distribution descriptors could be used to stratify the malignancy risk of mammographic microcalcifications.