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Cho, Nariya,Moon, Woo Kyung American Roentgen Ray Society, etc.] 2009 American Journal of Roentgenology Vol.192 No.3
<P>The purpose of this study was to describe the application of digital mammography-guided skin marking as a localization technique for suspicious microcalcifications for sonographically guided biopsy.</P>
Cho, Nariya,Moon, Woo Kyung,Kim, Ha Young,Chang, Jung Min,Park, Sang Hee,Lyou, Chae Yeon W.B. Saunders 2010 Journal of ultrasound in medicine Vol.29 No.1
<P>OBJECTIVE: The purpose of this study was to evaluate the diagnostic potential of the sonoelastographic strain index for differentiation of nonpalpable breast masses. METHODS: Ninety-nine nonpalpable breast masses (79 benign and 20 malignant) in 94 women (mean age, 45 years; range, 21-68 years) who had been scheduled for a sonographically guided core biopsy were examined with B-mode sonography and sonoelastography. Radiologists who had performed the biopsies analyzed the B-mode sonograms and provided American College of Radiology Breast Imaging Reporting and Data System categories. The strain index (fat to lesion strain ratio) was calculated by dividing the strain value of the subcutaneous fat by that of the mass. The histologic result from the sonographically guided core biopsy was used as a reference standard. The diagnostic performance of the strain index and that of B-mode sonography were compared by receiver operating characteristic (ROC) curve analysis. RESULTS: The mean strain index values +/- SD were 6.57 +/- 6.62 (range, 1.29-28.69) in malignant masses and 2.63 +/- 4.57 (range, 0.54-38.76) in benign masses (P = .019). The area under the ROC curve values were 0.835 (95% confidence interval [CI], 0.747-0.902) for B-mode sonography and 0.879 (95% CI, 0.798-0.936) for the strain index (P = .490). The sensitivity, specificity, positive predictive value, and negative predictive value were 95% (19 of 20), 75% (59 of 79), 48% (19 of 39), and 98% (59 of 60), respectively, when a best cutoff point of 2.24 was used. CONCLUSIONS: The strain index based on the fat to lesion strain ratio has diagnostic performance comparable with that of B-mode sonography for differentiation of benign and malignant breast masses.</P>
Nonpalpable Breast Masses: Evaluation by US Elastography
Cho, Nariya,Moon, Woo Kyung,Park, Jeong Seon,Cha, Joo Hee,Jang, Mijung,Seong, Min Hyun The Korean Radiological Society 2008 KOREAN JOURNAL OF RADIOLOGY Vol.9 No.2
<P><B>Objective</B></P><P>To compare the diagnostic performances of conventional ultrasound (US) and US elastography for the differentiation of nonpalpable breast masses, and to evaluate whether elastography is helpful at reducing the number of benign biopsies, using histological analysis as a reference standard.</P><P><B>Materials and Methods</B></P><P>Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant). Two experienced radiologists unaware of the biopsy and clinical findings analyzed conventional US and elastographic images by consensus, and classified lesions based on degree of suspicion regarding the probability of malignancy. Results were evaluated by receiver operating characteristic curve analysis. In addition, the authors investigated whether a subset of lesions was categorized as suspicious by conventional US, but as benign by elastography.</P><P><B>Results</B></P><P>Areas under the ROC curves (Az values) were 0.901 for conventional US and 0.916 for elastography (<I>p</I> = 0.808). For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign.</P><P><B>Conclusion</B></P><P>Elastography was found to have a diagnostic performance comparable to that of conventional US for the differentiation of nonpalpable breast masses. The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.</P>
Cho, Nariya,Lim, Jihe,Moon, Woo Kyung 대한초음파의학회 2014 ULTRASONOGRAPHY Vol.33 No.2
<P><B>Purpose:</B></P><P>To evaluate the negative predictive value (NPV) of ultrasound (US) elastography for non-palpable Breast Imaging Reporting and Data System (BI-RADS) category 3 lesions on ultrasonography and to determine whether US elastography is helpful in reducing the number of BI-RADS category 3 lesions on ultrasonography.</P><P><B>Methods:</B></P><P>Two hundred seventy-six consecutive, non-palpable BI-RADS category 3 lesions in 256 women who underwent US elastography and US-guided core biopsy, and who had at least 12 months of follow-up data, comprised our study group. The BI-RADS final assessment category and elasticity score were prospectively and independently classified. The rate of malignancy and NPV according to the elasticity score were analysed. We also investigated whether there was a subset of BI-RADS category 3 lesions that were of benign histology but negative on elastography.</P><P><B>Results:</B></P><P>Of the 276 non-palpable BI-RADS category 3 lesions, three lesions (1.0%) were finally confirmed as ductal carcinomas in situ. No cancers were found in the remaining 273 lesions with benign biopsy histology at a mean follow-up of 39.4 months (range, 12 to 72 months). The NPV of a negative elasticity score (elasticity score of 1) was 99.3% (165 of 166). If BI-RADS category 3 lesions showing a negative elasticity score were downgraded to BI-RADS category 2, 60.4% (165 of 273) of them with benign histology could have been safely followed without biopsy with an increased malignancy rate from 1% (3 of 276) to 1.8% (2 of 110), which is not significantly higher (P=0.626).</P><P><B>Conclusion:</B></P><P>US elastography has the potential to reduce the number of BI-RADS category 3 lesions on ultrasonography.</P>
Cho, Nariya,Moon, Woo Kyung,Cha, Joo Hee,Kim, Sun Mi,Han, Boo-Kyung,Kim, Eun-Kyung,Kim, Mi Hye,Chung, Soo Young,Choi, Hye-Young,Im, Jung-Gi Radiological Society of North America 2006 Radiology Vol.240 No.1
<P>PURPOSE: To compare prospectively obtained static two-dimensional (2D) and three-dimensional (3D) ultrasonographic (US) images in the diagnostic performance of radiologists with respect to the differentiation of benign from malignant solid breast masses with histopathologic examination as the reference standard. MATERIALS AND METHODS: This study had institutional review board approval, and patient informed consent was obtained. Conventional 2D and 3D US images were obtained from 141 patients (age range, 25-71 years; mean age, 46 years) with 150 solid breast masses (60 cancers and 90 benign lesions) before excisonal or needle biopsy. Four radiologists who had not performed the examinations independently reviewed 2D US images and stored 3D US data and provided a level of suspicion concerning probability of malignancy. The sensitivity, specificity, and negative predictive values of 2D images were compared with those of 3D US images. RESULTS: For all readers, 3D US images were the same as or better than 2D US images in terms of sensitivity (100% vs 100% for reader 1; 100% vs 98% for reader 2; 98% vs 93% for reader 3; 93% vs 92% for reader 4), specificity (58% vs 56% for reader 1; 51% vs 46% for reader 2; 83% vs 72% for reader 3; 86% vs 84% for reader 4), and negative predictive values (100% vs 100% for reader 1; 100% vs 98% for reader 2; 99% vs 94% for reader 3; 95% vs 94% for reader 4). These differences, however, were not statistically significant (P > .05). CONCLUSION: The performance of the radiologists with respect to the characterization of solid breast masses with static 2D US images was similar to that with 3D US data.</P>
Cho, Nariya,Jang, Mijung,Lyou, Chae Yeon,Park, Jeong Seon,Choi, Hye Young,Moon, Woo Kyung Radiological Society of North America 2012 Radiology Vol.262 No.1
<P>To investigate the effect of the combined use of ultrasonographic (US) elastography and color Doppler US on the accuracy of radiologists in distinguishing benign from malignant nonpalpable breast masses and in making the decision for biopsy recommendations at B-mode US.</P>
Cho, Nariya,Im, Seock-Ah,Kang, Keon Wook,Park, In-Ae,Song, In Chan,Lee, Kyung-Hun,Kim, Tae-Yong,Lee, Hyunjong,Chun, In Kook,Yoon, Hai-Jeon,Moon, Woo Kyung Springer-Verlag 2016 EUROPEAN RADIOLOGY Vol.26 No.7
<P>To prospectively compare performances of single-voxel proton magnetic resonance spectroscopy (H-1-MRS) and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting pathologic response to neoadjuvant chemotherapy (NAC) in breast cancer patients. Thirty-five breast cancer patients who received NAC and subsequent surgery were prospectively enrolled. MRS and FDG-PET were performed before and after the 1st NAC cycle. Percentage changes of total choline-containing compounds (tCho) via MRS, and maximum and peak standardized uptake values (SUVmax, SUVpeak) and total lesion glycolysis (TLG) via FDG-PET were measured, and their performances in predicting pathologic complete response (pCR) were compared. Of the 35 patients, 6 showed pCR and 29 showed non-pCR. Mean % reductions of tCho, SUVmax, SUVpeak, and TLG of the pCR group were larger than those of the non-pCR group (-80.3 +/- 13.9 % vs. -32.1 +/- 49.4 %, P = 0.025; -54.7 +/- 22.1 % vs. -26.3 +/- 33.7 %, P = 0.058; -60.7 +/- 18.3 % vs. -32.3 +/- 23.3 %, P = 0.009; -89.5 +/- 8.5 % vs. -52.6 +/- 36.2 %, P = 0.020). Diagnostic accuracy (area under ROC curve; Az, 0.911) of the % reduction of tCho was comparable to those of %SUVmax (0.822), SUVpeak (0.862), and TLG (0.879) in distinguishing pCR from non-pCR (all P > 0.05). MRS showed comparable performance to FDG-PET in early prediction of pCR in breast cancer patients. aEuro cent MRS can predict response to NAC in breast cancer post-1 (st) cycle. aEuro cent Changes in tCho and SUV after NAC reflect tumour cellularity changes. aEuro cent MRS can be an alternative to FDG-PET in predicting response to NAC.</P>
Sonoelastography for 1,786 non-palpable breast masses: diagnostic value in the decision to biopsy.
Yi, Ann,Cho, Nariya,Chang, Jung Min,Koo, Hye Ryoung,La Yun, Bo,Moon, Woo Kyung Springer International 2012 EUROPEAN RADIOLOGY Vol.22 No.5
<P>To evaluate the diagnostic value of sonoelastography by correlation with histopathology compared with conventional ultrasound on the decision to biopsy.</P>