Min Woo Lee

Keimyung University, Sŏul, Seoul, South Korea

Are you Min Woo Lee?

Claim your profile

Publications (169)336.69 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective of this study was to compare the targeting and ablation performance between a newly developed radiofrequency (RF) electrode embedded with an electromagnetic position sensor (EMPS) at the electrode tip and a conventional RF electrode.
    Investigative radiology. 10/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Radiofrequency ablation (RFA) has gained a wide acceptance as a first-line therapeutic option for small hepatocellular carcinoma (HCC). For very early-stage HCC, despite a higher rate of local tumor progression, RFA is considered as a viable alternative to surgical resection owing to its comparable long-term survival, reduced morbidity, and greater preservation of hepatic parenchyma. For HCCs larger than 2cm, RFA can contribute to near-curative therapy when combined with chemoembolization. RFA can be used as part of a multimodal treatment strategy for more advanced or recurrent cases, and could be a useful bridging therapy for patients who are waiting for liver transplantation. However, the use of RFA is still limited in treating large tumors and some tumors in high-risk locations. To overcome its current limitations, other ablation techniques are being developed and it is important to validate the role of other techniques for enhancing performance of ablation therapy for HCC.
    Baillière&#x027 s Best Practice and Research in Clinical Gastroenterology 10/2014; · 3.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE. The objective of our study was to evaluate the added value of diffusion-weighted imaging (DWI) for distinguishing between malignant and benign focal splenic lesions. MATERIALS AND METHODS. This study included 53 patients with 11 malignant and 42 benign splenic lesions who underwent gadoxetic acid-enhanced MRI and DWI. Qualitative and quantitative analyses were conducted for splenic lesions. Two blinded observers evaluated the two image sets-that is, the conventional MR images alone versus the combined conventional MR and DW images-and scored their confidence for malignancy of splenic lesions. The Fisher exact test and Mann-Whitney U test were performed, and diagnostic performance values (ROC curve analysis) were evaluated. RESULTS. All malignant lesions showed a progressive hypovascular enhancement pattern, whereas the hypervascular enhancement patterns were shown in only benign lesions (n = 20, 47.6%) (p < 0.05). The mean apparent diffusion coefficient (ADC) of the malignant lesions (0.73 × 10(-3) mm(2)/s) was significantly lower than that of the benign lesions (1.21 × 10(-3) mm(2)/s) (p < 0.001). The addition of DW images to conventional MR images showed a significant improvement for predicting malignant splenic lesions (area under ROC curve [Az] without DW images vs with DW images: 0.774 vs 0.983 for observer 1 and 0.742 vs 0.986 for observer 2) (p < 0.001). In addition, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of combined conventional MR and DW images were higher than those of conventional MR images alone. CONCLUSION. The addition of DWI to conventional MRI improves differentiation of malignant from benign splenic lesions.
    AJR. American journal of roentgenology. 10/2014; 203(4):803-812.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Effective HPLC-DAD and HPLC-ESI-MS/MS methods have been developed for the analysis of eight benzo[c]phenanthridine alkaloids (sanguinarine, chelirubine, macarpine, chelerythrine, dihydrosanguinarine, dihydrochelirubine, dihydromacarpine and dihydrochelerythrine), which are important metabolites in Eschscholtzia californica cell culture. By adopting a ternary gradient pump system, the dihydro-form alkaloids hardly separable from each other could be successfully separated, and all the target alkaloids could be simultaneously quantified with the LOD values of 0.01-0.79 μg/mL and the LOQ values of 0.03-3.59 μg/mL. This HPLC-DAD method was further confirmed by HPLC-ESI-MS/MS system in multiple reaction monitoring mode. Each separated HPLC peak was identified as the target alkaloid, showing its relevant ionized molecule and selected fragment ion. By applying the established method, alkaloid production during the E. californica cell culture could be successfully monitored and some valuable information on its metabolism could be deduced.
    Bioscience Biotechnology and Biochemistry 07/2014; 78(7):1103-1111. · 1.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE. The purposes of this study were to assess the widths of the intercostal spaces of the right inferior human rib cage through which high-intensity focused ultrasound therapy would be applied for treating liver cancer and to elucidate the demographic factors associated with intercostal space width. SUBJECTS AND METHODS. From March 2013 to June 2013, the widths of the intercostal spaces and the ribs at six areas of the right inferior rib cage (area 1, lowest intercostal space on anterior axillary line and the adjacent upper rib; area 2, second-lowest intercostal space on anterior axillary line and the adjacent upper rib; areas 3 and 4, lowest and second-lowest spaces on midaxillary line; areas 5 and 6, lowest and second-lowest spaces on posterior axillary line) were sonographically measured in 466 patients (214 men, 252 women; mean age, 53.0 years) after an abdominal sonographic examination. Demographic factors and the presence or absence of chronic liver disease were evaluated by multivariate analysis to investigate which factors influence intercostal width. RESULTS. The width of the intercostal space was 19.7 ± 3.7 mm (range, 9-33 mm) at area 1, 18.3 ± 3.4 mm (range, 9-33 mm) at area 2, 17.4 ± 4.0 mm (range, 7-33 mm) at area 3, 15.4 ± 3.5 mm (range, 5-26 mm) at area 4, 17.2 ± 3.7 mm (range, 7-28 mm) at area 5, and 14.5 ± 3.6 mm (range, 4-26 mm) at area 6. The corresponding widths of the ribs were 15.2 ± 2.3 mm (range, 8-22 mm), 14.5 ± 2.3 mm (range, 9-22 mm), 13.2 ± 2.0 mm (range, 9-20), 14.3 ± 2.2 mm (range, 9-20 mm), 15.0 ± 2.2 mm (range, 10-22 mm), and 15.1 ± 2.3 mm (range, 8-21 mm). Only female sex was significantly associated with the narrower intercostal width at areas 1, 2, 3, and 5 (regression coefficient, 1.124-1.885; p = 0.01-0.04). CONCLUSION. There was substantial variation in the widths of the intercostal spaces of the right inferior rib cage such that the anterior and inferior aspects of the intercostal space were relatively wider. Women had significantly narrower intercostal spaces than men.
    AJR. American journal of roentgenology. 07/2014; 203(1):201-8.
  • Source
    Min Woo Lee
    [Show abstract] [Hide abstract]
    ABSTRACT: With the technical development of ultrasonography (US), electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR) images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA). Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce the false positive detection of focal hepatic lesions with poor sonographic conspicuity. Three-dimensional US can also be fused with realtime US for the percutaneous RFA of liver tumors requiring overlapping ablation. When fusion imaging is not sufficient for identifying small focal hepatic lesions, contrast-enhanced US can be added to fusion imaging.
    Ultrasonography (Seoul, Korea). 06/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A central mechanism of virulence of extracellular bacterial pathogens is the injection into host cells of effector proteins that modify host cellular functions. HopW1 is an effector injected by the type III secretion system that increases the growth of the plant pathogen Pseudomonas syringae on the Columbia accession of Arabidopsis. When delivered by P. syringae into plant cells, HopW1 causes a reduction in the filamentous actin (F-actin) network and the inhibition of endocytosis, a known actin-dependent process. When directly produced in plants, HopW1 forms complexes with actin, disrupts the actin cytoskeleton and inhibits endocytosis as well as the trafficking of certain proteins to vacuoles. The C-terminal region of HopW1 can reduce the length of actin filaments and therefore solubilize F-actin in vitro. Thus, HopW1 acts by disrupting the actin cytoskeleton and the cell biological processes that depend on actin, which in turn are needed for restricting P. syringae growth in Arabidopsis.
    PLoS Pathogens 06/2014; 10(6):e1004232. · 8.14 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine the value of fusion imaging with contrast-enhanced ultrasonography (CEUS) and computed tomography (CT)/magnetic resonance (MR) images for percutaneous radiofrequency ablation (RFA) of very-early-stage hepatocellular carcinomas (HCCs) that are inconspicuous on fusion imaging with B-mode ultrasound (US) and CT/MR images. This retrospective study was approved by our institutional review board and the requirement for informed consent was waived. Fusion imaging with CEUS using Sonazoid contrast agent and CT/MR imaging was performed on HCCs (<2 cm) that were inconspicuous on fusion imaging with B-mode US. We evaluated the number of cases that became conspicuous on fusion imaging with CEUS. Percutaneous RFA was performed under the guidance of fusion imaging with CEUS. Technical success and major complication rates were assessed. In total, 30 patients with 30 HCCs (mean, 1.2 cm; range, 0.6-1.7 cm) were included, among which 25 (83.3%) became conspicuous on fusion imaging with CEUS at the time of the planning US and/or RFA procedure. Of those 25 HCCs, RFA was considered feasible for 23 (92.0%), which were thus treated. The technical success and major complication rates were 91.3% (21/23) and 4.3% (1/23), respectively. Fusion imaging with CEUS and CT/MR imaging is highly effective for percutaneous RFA of very-early-stage HCCs inconspicuous on fusion imaging with B-mode US and CT/MR imaging.
    Clinical and molecular hepatology. 03/2014; 20(1):61-70.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ultrasound (US)-guided radiofrequency ablation (RFA) is frequently infeasible even for very early or early stage hepatocellular carcinoma (HCC) due to various reasons such as inconspicuous tumors or absence of a safe electrode path and the infeasibility rate is reportedly as high as 45%. In such cases, transarterial chemoembolization (TACE) is a commonly practiced alternative. To analyze long-term outcomes including tumor progression patterns and factors contributing to survival of patients who received TACE as the first line of therapy for very early or early stage HCC infeasible for US-guided RFA. From October 2006 through October 2009, 116 patients with very early or early stage HCCs underwent the first-line therapy TACE after their tumors were deemed infeasible for RFA. Long-term survival rates were calculated and prognostic factors were assessed by univariate and multivariate analyses. The patterns and rates of tumor progression or recurrence were also evaluated. The 1, 3, and 5-year survival rates of the whole cohort were 94.7%, 68.4%, and 47.2% with a mean overall survival of 53.1 months (95% CI: 48.2-58.0). Preserved liver function with Child-Pugh class A was the only independent factor associated with longer survival. The most common first tumor progression pattern was intrahepatic distant recurrence. The cumulative rates of local tumor progression and intrahepatic distant recurrence at 1, 3, and 5 years were 33% and 22%, 52% and 49%, and 73% and 75%, respectively. TACE is a viable first-line treatment of HCC infeasible for RFA, especially when liver function was preserved.
    Acta Radiologica 02/2014; · 1.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Oxidative stress is associated with the pathogenesis of pelvic organ prolapse (POP). Because glutathione S-transferases (GSTs) are the major detoxification enzymes which protect cells against oxidative stress, genetic variations in the GST gene may modulate the risk of POP. This study aimed to determine the association between advanced POP and the polymorphisms of GSTM1, GSTT1 and GSTP1 (rs1695). Study design This is a hospital-based case-control study. The POP group consisted of 189 women diagnosed with POP stage III or IV, and the control group consisted of 156 postmenopausal women with POP stage 0 or I. The GSTM1 and GSTT1 null mutations were detected by multiplex PCR, and the GSTP1 Ile105Val polymorphism was genotyped by real-time PCR analysis using a TaqMan assay. Results There was no significant association between the GSTM1 and GSTT1 null mutations and advanced POP (p > 0.05). The distribution of the GSTP1 Ile105Val genotypes, however, was significantly different between the POP and control groups (AA/AG/GG rates= 74.1%/25.9%/0% vs. 64.1%/32.1%/3.8%, p = 0.008), and the G allele frequency was significantly lower in the POP group than in the control group (13.0% vs. 19.9%, p = 0.014). Women with the non-AA genotype had a 0.63-fold lower risk of developing advanced POP than women with the AA genotype (95% CI, 0.39-0.99), and women with the G allele had a 0.60-fold lower risk of advanced POP than women with the A allele (95% CI, 0.40-0.90). Conclusions The GSTP1 Ile105Val polymorphism is a protective factor against advanced POP.
    European journal of obstetrics, gynecology, and reproductive biology 01/2014; · 1.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology. However, more work is still needed for the complete standardization of terminology.
    Korean journal of radiology: official journal of the Korean Radiological Society 01/2014; 15(1):95-107. · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Background. Radiofrequency ablation (RFA) as a curative therapy for hepatocellular carcinoma (HCC) is widely used. The aim of this study was to investigate predisposing factors for HCC recurrence in patients with hepatitis B virus (HBV)-related small HCC after RFA. Methods. A total of 170 patients underwent percutaneous RFA for HBV-related small HCC (≤3 cm in diameter) from January 2008 to December 2010 at Samsung Medical Center. We analyzed the risk factors for recurrence of HCC after RFA. Results. The median follow-up duration was 27.0 months. A total of 89 patients (52%) experienced recurrence after percutaneous RFA. Cumulative recurrence-free rates after RFA at 1-, 3-, and 5 years were 81.3%, 47.2% and 35.7%, respectively. Univariate analysis showed that predisposing factors for HCC recurrence were the multinodularity (hazard ratio (HR) 2.22, p = 0.005), pre-RFA HBV DNA levels ≥2000 IU/mL (HR 1.61, p = 0.025), and Barcelona Clinic Liver Cancer stage A (HR 1.54, p = 0.046). The independent risk factors for recurrence by multivariate analysis were the multinodularity (HR 1.94, p = 0.026) and pre-RFA HBV DNA levels ≥2000 IU/mL (HR 1.57, p = 0.039). Conclusion. Multinodularity and HBV DNA levels were associated with the recurrence of HBV-related small HCC after RFA.
    Scandinavian Journal of Gastroenterology 12/2013; · 2.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: CONCLUSION 3D US liver CADx using multiple slices in the vicinity of the lesion center and combination of their various views can enhance the diagnostic accuracy for liver cancer. BACKGROUND The objective of this study is to enhance the performance of 3D US Computer-Aided Diagnosis (CADx) for liver cancer. The proposed 3D US liver CADx uses multiple slices and various views from 3D volume for diagnosis of benign and malignant tumors. Our CADx system segments the lesion and extracts the features and then classifies lesions as benign for cyst and hemangioma and as malignants for hepatocellular carcinoma. EVALUATION 2D (1024x768) and 3D (512x510x256) US images of liver lesions were acquired for this research from 44 patients (22 benign and 22 malignant cases) respectively by using 2D and 3D US probes from Feb. 2012 to Mar. 2013. The accuracy of our CADx was 1) 80.8% by only a 2D slice containing a lesion; 2) 81.9%, 78.8%, 74.4% by using a center slice of the lesion with three orthogonal views, respectively; 3) 81.8% by combining three orthogonal views of the lesion (total 3 slices); 4) 85.5%, 79.0%, 75.5% by using seven slices of the lesion for three orthogonal views, respectively; 5) 84.0% by combining seven slices of the lesion with their three orthogonal views (total 21 slices). The seven slices include a center slice which bisects a lesion and additional slices in the vicinity of the lesion center in 3D volume. 2D lesion contour for ground truth was obtained by a radiologist and 3D lesion volume was obtained semi-automatically. Majority voting was used to classify lesions from the multiple slices and views. The 10-fold cross-validation and averaged accuracy of 100 iterations were used for performance evaluation. DISCUSSION The combination of three orthogonal views only at the center of the lesion was less effective to improve the 3D CADx accuracy. However because our 3D US liver CADx can use additional information of the 3D volume, the combination of multiple slices and their different views outperformed the case of combining multiple views only at the center of the lesion (p<0.0001) and 2D US liver CADx (p<0.0001) though the resolution of 3D US was lower than 2D US.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the incidence and causes of mistargeting after fusion imaging-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs). Between September 2011 and March 2013, 955 HCCs in 732 patients were treated with percutaneous RF ablation. Among them, ablation of 551 HCCs was accomplished under fusion imaging guidance, and seven mistargetings were noted in seven patients (male-to-female ratio = 6:1; mean age, 60.1 y; range, 47-73 y). The incidence of mistargeting and the cause of liver disease in the patients with mistargeting were evaluated. The causes of mistargeting were assessed according to the following classification: small size of HCC, subcapsular location, subphrenic location, confusion with pseudolesions, poor conspicuity of HCC, poor sonographic window, and poor electrode path. The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3% (7 of 551). All patients with mistargeting were hepatitis B virus carriers. The most common cause of mistargeting was the small size of HCC (100%; 7 of 7), followed by confusion with surrounding pseudolesions (85.7%; 6 of 7), subcapsular (71.4%; 5 of 7) and subphrenic locations (71.4%; 5 of 7), poor conspicuity of the HCC (71.4%; 6 of 7), poor sonographic window (28.6%; 2 of 7), and poor electrode path (28.6%; 2 of 7). The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3%. The most common cause of mistargeting was the small size of HCC, followed by confusion with surrounding pseudolesions, subcapsular and subphrenic locations, and poor conspicuity of the HCC.
    Journal of vascular and interventional radiology: JVIR 12/2013; · 1.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE/AIM The aim of the this exhibit is 1. To describe the imaging features and managements of various complications associated with radiofrequency ablation (RFA) 2. To review the risk factors potentially affecting RFA-induced complications 3. To determine the impact of RFA-induced complications on the long term outcomes of RFA. CONTENT ORGANIZATION Although RFA is considered to be a safe and effective technique for treating liver tumors, various complications can happen when inadequately performed. We have performed more than 6,000 RFA procedures for treating liver tumors during the recent 14 years period and encountered diverse procedure-related complications. We divided RFA-induced complications into five types: hemorrhage, hepatic vascular injuries, biliary injuries, extrahepatic organ injuries and tumor progression. SUMMARY The major teaching points of this exhibit are 1. Because an early and accurate diagnosis of complications is mandatory for proper management, radiologists should be familiar with the imaging features, as well as management strategies of RFA-induced complication. 2. Through understanding of risk factors for developing RFA-induced complications may be beneficial in preventing potential complications. 3. Physicians who perform RFA should be aware of the impact of RFA-induced complications on the long term therapeutic outcomes of RFA.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives- The purpose of this study was to assess the coverage of transverse subcostal sonography in the supine position by using computed tomography (CT) performed before a sonographic liver examination as a predictor of sonographic coverage. Methods- A total of 124 patients (87 men and 37 women; mean age, 55.55 years; range, 24-79 years) who underwent abdominal CT and subsequent liver sonography were enrolled. All patients were assessed for the coverage of transverse subcostal sonography in the supine position by consensus of 2 radiologists. We evaluated the correlation between the level of the posterior rib against the liver dome on axial CT and a sonographic coverage scoring system using Spearman partial correlation analysis. The optimal cutoff value of the liver position and other potential factors associated with sonographic coverage were analyzed. Results- Among age, sex, body mass index, interposition of bowel around the gallbladder fossa, atrophic changes from cirrhotic liver, and liver position, liver position was the only independent factor associated with sonographic coverage (P < .001). Liver position and the sonographic coverage score were moderately negatively correlated, with statistical significance (r = -0.44; P < .001). The optimal cutoff value for the level of the hepatic dome was at the 10th posterior rib on axial CT. Conclusions -Liver position is the only independent factor associated with the coverage of transverse subcostal sonography in the supine position. If it is above the 10th posterior rib level, we can predict difficulty in adequate sonographic coverage of the liver.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 12/2013; 32(12):2053-61. · 1.40 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose To compare the long-term therapeutic outcomes of radiofrequency (RF) ablation for small perivascular hepatocellular carcinoma (HCC) and nonperivascular HCC. Materials and Methods This retrospective study was approved by the institutional review board. Between December 2004 and April 2008, 241 patients (175 men and 66 women; age range, 32-82 years) with a single early-stage HCC that was 3 cm or smaller in the greatest dimension underwent ultrasonography-guided percutaneous RF ablation as a first-line treatment. The patients were divided into two groups according to the presence or absence of contacting hepatic vessels that were 3 mm or larger in axial diameter: a group with perivascular HCC (n = 58) and a group with nonperivascular HCC (n = 183). Cumulative local tumor progression, disease-free and long-term survival rates, and prognostic factors were assessed by using Cox proportional hazard models with Bonferroni correction. Results The overall median follow-up period was 58 months (range, 13-92 months). The cumulative local tumor progression rates were 10%, 16%, and 26% at 1, 3, and 5 years, respectively, in the perivascular group, and 6.7%, 15.5%, and 20.5% in the nonperivascular group; the differences were not significant (P = .323). The corresponding disease-free survival rates were 79%, 41%, and 29% in the perivascular group and 71.3%, 38.7%, and 26.0% in the nonperivascular group, with no significant difference (P = .689). The corresponding overall survival rates were 100%, 94%, and 82% in the perivascular group and 100%, 88.4%, and 73.9% in the nonperivascular group, also without significant difference (P = .267). There was no significant prognostic factor for local tumor progression, whereas extrahepatic and intrahepatic distant recurrences were significant prognostic factors for overall survival in multivariable analysis. Conclusion The long-term therapeutic outcomes of RF ablation as first-line treatment for small perivascular HCC were similar to those for nonperivascular HCC. © RSNA, 2013.
    Radiology 11/2013; · 6.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE. The objective of our study was to assess whether fusion imaging of conventional ultrasound and liver CT or MR images can improve the conspicuity of lesions and feasibility of percutaneous radiofrequency ablation (RFA) for the treatment of hepatocellular carcinomas (HCCs) not visible on ultrasound. Whether peritumoral anatomic landmarks can be used for the placement of an electrode in HCCs not visible on ultrasound even after image fusion was also evaluated. MATERIALS AND METHODS. Planning ultrasound for percutaneous RFA was performed using conventional ultrasound first and then using fusion imaging later during the same session. The visibility of HCCs and feasibility of RFA on conventional ultrasound and on fusion imaging were assessed. We evaluated how many HCCs initially not visible on conventional ultrasound could be visualized and ablated after applying the fusion imaging technique. One hundred twenty HCCs not visible on conventional ultrasound in 96 patients were included. RESULTS. When fusion imaging was applied, 38 of the 120 (31.7%) HCCs that were initially not visible could be seen and RFA was feasible. Among the remaining 82 HCCs still not visible after image fusion, 26 (31.7%) were ablated under the guidance of fusion imaging the technique based on peritumoral anatomic landmarks. Overall, 64 of 120 (53.3%) HCCs (59.4%, 57 of 96 patients) not visible on conventional ultrasound could be ablated under the guidance of the fusion imaging technique. CONCLUSION. Fusion imaging can improve the conspicuity of HCCs and the feasibility of percutaneous RFA of HCCs not visible on conventional ultrasound. Peritumoral anatomic landmarks can be used for electrode placement in HCCs that are still not visible even after image fusion.
    American Journal of Roentgenology 11/2013; 201(5):1141-7. · 2.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives- There is no standardized method for size measurement of hepatocellular carcinoma. The purpose of this study was to evaluate whether the size and stage of hepatocellular carcinoma differ according to the imaging modality. Methods- This retrospective study was approved by our Institutional Review Board, and written informed consent was waived. Patients with hepatocellular carcinoma who underwent either computed tomography (CT) or magnetic resonance imaging (MRI) along with planning sonography for radiofrequency ablation on the same day were included. A total of 113 patients with 127 hepatocellular carcinomas were included. The sizes of the tumors were measured and the tumor stages were assessed on CT/MRI and sonography. The results were compared by a t test, Bland-Altman limits of agreement, and a McNemar test. Results- There was a significant difference in the hepatocellular carcinoma size between CT/MRI and sonographic measurements (mean difference, 0.26 cm; P < .0001). The sizes of 102 tumors (80.3%) were larger on sonography than on CT/MRI. Twelve tumors (9.5%) were the same size and 13 (10.2%) were smaller on sonography than on CT/MRI. There was also difference in the tumor stage (very early or not) between CT/MRI and sonography (P= .006, McNemar test). The stage was discordant in 16 of 127 tumors (12.6%). Among 69 tumors at the very early stage on CT/MRI, 14 (20.3%) were beyond the very early stage on sonography. Conclusions- The size of hepatocellular carcinoma measured on sonography tends to be larger than on CT/MRI; therefore, the tumor stage can differ between sonography and CT/MRI.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 10/2013; 32(10):1703-9. · 1.40 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the added value of 3 Tesla liver MR in patients with hepatocellular carcinoma (HCC) within the liver computed tomography (CT) -based Milan criteria. Liver CT and MR images of 130 patients with HCC within the Milan criteria based on liver CT were retrospectively reviewed. The number of MR-diagnosed HCCs and that of high risk hypervascular nodules (HRHNs), the effect of obtaining MR on patient management and CT appearances of MR-diagnosed HCCs and those of HRHNs were evaluated. Independent predictor for diagnosing additional HCCs on liver MR was analyzed. A total of 18.5% (24/130) of patients had additional 39 HCCs on MR, with a 5.4% (7/130) dropout rate from the Milan criteria. 28.5% (37/130) of patients had additional 78 HRHNs. Overall, 39.2% (51/130) of patients required changes in management. The common CT appearances of MR-diagnosed HCCs were arterial enhancing lesions ≥ 0.5cm (38.4%, 15/39), low density nodules < 1.5 cm (30.8%, 12/39) and invisibility (28.2%, 11/39). For MR-diagnosed HRHNs, 55.1% (43/78) were invisible on CT. The presence of inconclusive lesions on CT was an independent predictor for diagnosing additional HCCs on MR. For patients with HCCs within the Milan criteria on liver CT, liver MR may be necessary to detect additional HCCs and HRHNs.J. Magn. Reson. Imaging 2013. © 2013 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 09/2013; · 2.57 Impact Factor

Publication Stats

972 Citations
336.69 Total Impact Points

Institutions

  • 2011–2014
    • Keimyung University
      • Department of Chemical Engineering
      Sŏul, Seoul, South Korea
    • Hanbat National University
      • Department of Chemical and Biological Engineering
      Daiden, Daejeon, South Korea
  • 2010–2014
    • Sungkyunkwan University
      • Samsung Medical Center
      Sŏul, Seoul, South Korea
    • Inha University
      • Department of Information and Communication Engineering
      Seoul, Seoul, South Korea
  • 2006–2014
    • University of Chicago
      • Department of Molecular Genetics & Cell Biology
      Chicago, Illinois, United States
  • 2013
    • Sejong University
      Sŏul, Seoul, South Korea
  • 2008–2013
    • Chungnam National University
      • Department of Bio Based Materials
      Daiden, Daejeon, South Korea
    • Korea Institute of Energy Research
      Sŏul, Seoul, South Korea
    • Konkuk University
      Sŏul, Seoul, South Korea
    • Chonbuk National University
      • Department of Environmental Engineering
      Seoul, Seoul, South Korea
    • Amkor Technology
      Chandler, Arizona, United States
  • 2012
    • Hallym University
      • College of Medicine
      Seoul, Seoul, South Korea
    • San Francisco VA Medical Center
      San Francisco, California, United States
    • University of Seoul
      Sŏul, Seoul, South Korea
    • University of California, San Francisco
      • Department of Neurology
      San Francisco, CA, United States
  • 1998–2012
    • Pohang University of Science and Technology
      • Department of Chemical Engineering
      Andong, North Gyeongsang, South Korea
  • 2004–2011
    • Seoul National University Hospital
      • • Department of Internal Medicine
      • • Department of Radiology
      Sŏul, Seoul, South Korea
  • 2009–2010
    • Konkuk University Medical Center
      • Department of Radiology
      Changnyeong, South Gyeongsang, South Korea
  • 2007–2008
    • Korea Institute of Science and Technology
      • Doping Control Center
      Sŏul, Seoul, South Korea
    • Seoul Medical Center
      Sŏul, Seoul, South Korea