Hee Jung Moon

Wonju Severance Christian Hospital, Genshū, Gangwon-do, South Korea

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Publications (147)397.32 Total impact

  • Hee Jung Moon, Eun-Kyung Kim
    05/2015; DOI:10.14366/usg.15029
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    ABSTRACT: Purpose To investigate whether ultrasonographic (US) features of thyroid nodules are associated with tumor recurrence in classic papillary thyroid carcinoma (PTC). Materials and Methods This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. A total of 515 patients (mean age, 45.8 years ± 13.2 [standard deviation]; range, 17-80 years) who underwent total thyroidectomy and central lymph node dissection for classic PTC greater than 10 mm from January 2003 to February 2006 and who were followed up for 12 months or longer were included. Malignant-appearing PTCs were defined as those showing at least one suspicious US feature among marked hypoechogenicity, irregular or microlobulated margin, microcalcifications, and taller-than-wide shape. Benign-appearing PTCs were defined as those without any suspicious US features. Kaplan-Meier cumulative-event curves for recurrence were compared by using the log-rank test. The multivariate Cox proportional hazard regression analysis was used to estimate hazard ratios (HRs) of the malignant-appearing US features for recurrence in the preoperative, postoperative, and combined models. Results Fifty-six (10.9%) of 515 patients had recurrence. Malignant-appearing PTCs had lower 5- and 10-year disease-free survival rates compared with benign-appearing PTCs (P = .01). In the preoperative model, malignant-appearing US features (HR, 3.523; 95% confidence interval [CI]: 1.263, 9.830) and larger nodule size (HR, 1.074; 95% CI: 1.051, 1.098) were independently associated with recurrence. In the combined model, male sex (HR, 1.990; 95% CI: 1.098, 3.610), malignant-appearing US features (HR, 2.828; 95% CI: 1.016. 7.870), larger nodule size (HR, 1.067; 95% CI: 1.043, 1.092), extrathyroidal extension (HR, 2.590; 95% CI: 1.160, 5.780), and lymph node metastasis (HR, 2.511; 95% CI: 1.163, 5.421) were independently associated with recurrence. Conclusion The presence of malignant-appearing US features was independently associated with recurrence in patients with classic PTC. (©) RSNA, 2015.
    Radiology 05/2015; DOI:10.1148/radiol.2015142470 · 6.21 Impact Factor
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    ABSTRACT: Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) scans. Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on (18)F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on (18)F-FDG-PET/CT were calculated and compared. Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P < .05). The area under the receiver operating characteristics curve value of TIRADS was the greatest, comparable with the combined TIRADS and SUV (0.737 to 0.724, P = .788). TIRADS may be applied in the risk stratification of thyroid incidentalomas detected on (18)F-FDG-PET/CT. Considering the high malignancy rate of thyroid incidentalomas showing increased (18)F-FDG uptake, ultrasonography-guided fine needle aspiration is mandatory even if there are no suspicious features present on US. Copyright © 2015 Elsevier Inc. All rights reserved.
    Surgery 05/2015; DOI:10.1016/j.surg.2015.03.017 · 3.11 Impact Factor
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    ABSTRACT: The aim of this study was to assess the malignancy yield of ultrasound Breast Imaging Reporting and Data System (BI-RADS) classification and the diagnostic value of adding ultrasound to diagnosis of breast cancer in patients with pathologic nipple discharge. Of 267 patients with pathologic nipple discharge seen from February 2003 to March 2011, 198 with histopathologic confirmation and follow-up data were included. Ultrasound images and mammograms were analyzed according to BI-RADS. The malignancy rate for each BI-RADS category and the difference in diagnostic performance resulting from the addition of ultrasound to mammography were calculated. Of the 198 enrolled patients, 34 were diagnosed with a malignancy. The malignancy rates obtained with the addition of ultrasound to mammography were 0.0% (0 of 27) for category 1, 5.9% (1/17) for category 2, 9.4% (5/53) for category 3, 21.5% (20/93) for category 4 and 100% (8/8) for category 5. The malignancy rates for mammography alone were 7.7%-9.0% for categories 1-3, 68.5% (13/19) for category 4 and 100.0% (5/5) for category 5. Adding US to mammography did not significantly increase sensitivity compared with mammography alone. Other diagnostic performance markers such as specificity and positive predictive value were not improved. Among patients for whom mammograms were available, ultrasound detected 5 breast cancers (26.3%) in addition to the 19 breast cancers found by positive mammography. Although it did not increase overall diagnostic performance in patients with pathologic nipple discharge, addition of ultrasound to mammography did detect an additional 26.3% of malignant lesions. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
    Ultrasound in medicine & biology 05/2015; 41(8). DOI:10.1016/j.ultrasmedbio.2015.03.029 · 2.10 Impact Factor
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    ABSTRACT: To compare the value of cytokeratin fragment 21-1 (CYFRA 21-1) concentration in the fine-needle biopsy aspirates (fine needle aspirate [FNA] CYFRA 21-1) with cytopathology of fine-needle aspiration biopsy (FNA cytology) and to assess whether CYFRA 21-1 concentrations from ultrasound-guided fine-needle aspiration biopsy (US-FNAB) specimens (FNA CYFRA 21-1) is not inferior to FNA cytology in the diagnosis of axillary lymph node (ALN) metastasis of breast cancer patients.This study received institutional review board approval, and written informed consent was obtained from all patients. US-FNAB was performed in 373 ALNs from 358 patients with invasive breast cancer. Concentrations of CYFRA 21-1 were measured from washouts of the syringe used during US-FNAB (FNA CYFRA 21-1), and ALN metastasis was determined using a cutoff value of 1.93 ng/mL. FNA cytology, intraoperative sentinel lymph node biopsy, and surgical pathology results were reviewed and analyzed. The noninferiority margin for the difference in accuracies between FNA cytology and FNA CYFRA 21-1 was set as 5%.Among 373 ALNs, 136 (36.5%) were benign, and 237 (63.5%) were metastatic. The mean FNA CYFRA 21-1 was significantly higher in metastatic ALNs compared to that in benign ALNs (P = 0.001). For the diagnosis of ALN metastasis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA CYFRA 21-1 (cutoff value 1.93 ng/mL) were not significantly different from those of FNA cytology (P > 0.05). FNA CYFRA 21-1 reached statistical noninferiority to FNA cytology in terms of diagnostic accuracy for ALN metastasis. Of the 20 ALNs (8 metastasis, 12 benign) that showed insufficient results on FNA cytology, FNA CYFRA 21-1 accurately diagnosed 15 ALNs (4 metastasis, 11 benign).The diagnostic performance of FNA CYFRA 21-1 is comparable with that of FNA cytology for breast cancer ALN metastasis. Our results indicate that FNA CYFRA 21-1, using an US-FNAB specimen, can be a useful method equal to FNA cytology in terms of diagnostic accuracy.
    Journal of pediatric gastroenterology and nutrition 05/2015; 94(19):1-6. DOI:10.1097/MD.0000000000000811 · 2.87 Impact Factor
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    ABSTRACT: Fine needle aspiration (FNA) is currently accepted as an easy, safe, and reliable tool for the diagnosis of thyroid nodules. Nonetheless, a proportion of FNA samples are categorized into non-diagnostic or indeterminate cytology, which frustrates both the clinician and patient. To overcome this limitation of FNA, core needle biopsy (CNB) of the thyroid has been proposed as an additional diagnostic method for more accurate and decisive diagnosis for thyroid nodules of concern. In this review, we focus on the effectiveness and limitations of CNB, and what factors should be considered when CNB is utilized in the diagnosis of thyroid nodules.
    05/2015; 49(3):230-5. DOI:10.4132/jptm.2015.03.21
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    ABSTRACT: Purpose To compare the malignancy rates and the effectiveness of the Thyroid Imaging Reporting and Data System (TIRADS) for risk stratification of nodules with nondiagnostic results classified before and after application of the Bethesda System for Reporting Thyroid Cytopathology. Materials and Methods This retrospective study was approved by an institutional review board, with waiver of informed consent. A total of 763 patients with 790 thyroid nodules and nondiagnostic cytologic results were included (mean age ± standard deviation, 52.3 years ± 11.5), 485 nodules from the pre-Bethesda period (from March 2007 to December 2008) and 305 nodules from the post-Bethesda period (from May 2011 to May 2012). A TIRADS category was assigned to each thyroid nodule on the basis of the number of features that appeared suspicious for cancer at ultrasonography (US). Malignancy rates and TIRADS categories during the two periods were compared. Correlation between TIRADS category and malignancy risk between the two periods was evaluated and compared. Results The malignancy rates of nodules with nondiagnostic cytologic results were not significantly different between the two periods (P = .148). Malignancy risk of TIRADS category 3, 4a, 4b, 4c, and 5 was 1.8%, 5.7%, 4.1%, 29.8%, and 16.7%, for the pre-Bethesda period, and 1.6%, 3.0%, 7.1%, 16.3%, and 25.0% for the post-Bethesda period, respectively. Near-perfect correlation was seen between the TIRADS category and malignancy risk in the post-Bethesda period (r = 0.961, P = .009), while no significant correlation was found in the pre-Bethesda period (r = 0.731, P = .161). Conclusion Malignancy risk stratification with TIRADS was more effective for nodules with nondiagnostic cytologic results classified according to the Bethesda System. When these Bethesda-classified nodules with nondiagnostic results are evaluated as TIRADS category 3 or 4a, they may be treated conservatively with follow-up US, but when other cytologic classifications are applied, follow-up US and fine- needle aspiration must be considered for nodules showing one or more features suspicious for cancer at US. (©) RSNA, 2015.
    Radiology 04/2015; DOI:10.1148/radiol.15142308 · 6.21 Impact Factor
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    ABSTRACT: To evaluate the malignancy risk and characteristics of thyroid nodules with two "Atypia of Undetermined Significance" or "Follicular Lesion of Undetermined Significance" (AUS/FLUS) results, and compare characteristics of malignancies with two AUS/FLUS results to those with one AUS/FLUS result. Of 441 thyroid nodules with initial AUS/FLUS results, 236 underwent repeat fine-needle-aspiration (FNA), with 58 obtaining repeated AUS/FLUS results. Thyroid Imaging Reporting and Data System (TIRADS) categories were assigned, and clinico-pathological characteristics were compared between benign and malignant nodules and between malignancies with two consecutive AUS/FLUS results and those with one AUS/FLUS result. Thirty-one percent (18/58) of nodules with two AUS/FLUS results and 58.1 % (18/31) of confirmed nodules were malignant. Age, gender, nodule size, ultrasound features and TIRADS categories did not differ between benign and malignant nodules or between malignancies with one and two AUS/FLUS results. Malignancies with two AUS/FLUS results had a higher proportion of a follicular variant of papillary thyroid carcinoma (PTC) (46.7 % vs. 13.6 %, P = 0.009). Thyroid nodules with two AUS/FLUS results had a high malignancy risk of at least 31.0 % and a higher proportion of a follicular variant of PTC. Surgery should be considered regardless of ultrasound features. • Thyroid nodules with two consecutive AUS/FLUS results had a high malignancy risk. • Ultrasound features are less useful in nodules with two AUS/FLUS results. • The follicular variant of PTC is more frequent in malignancies with two AUS/FLUS results.
    European Radiology 03/2015; DOI:10.1007/s00330-015-3668-5 · 4.34 Impact Factor
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    ABSTRACT: Women who have been treated for breast cancer are at risk for second breast cancers, such as ipsilateral recurrence or contralateral metachronous breast cancer. As the number of breast cancer survivors increases, interest in patient management and surveillance after treatment has also increased. However, post-treatment surveillance programs for patients with breast cancer have not been firmly established. In this review, we focus on the imaging modalities that have been used in post-treatment surveillance for patients with breast cancer, such as mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography, the effectiveness of each modality for detecting recurrence, and how they can be applied to manage patients.
    Korean journal of radiology: official journal of the Korean Radiological Society 03/2015; 16(2):219-228. DOI:10.3348/kjr.2015.16.2.219 · 1.81 Impact Factor
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    ABSTRACT: OBJECTIVE. The purpose of this article is to evaluate the clinical significance of subcentimeter enhancing lesions incidentally detected on preoperative breast MRI in patients with breast cancer and the role of second-look ultrasound in lesion detection and characterization. MATERIALS AND METHODS. From January 2010 through December 2010, 180 lesions measuring less than 10 mm incidentally detected on MRI in 108 women with second-look ultrasound examinations were included (mean patient age, 47.9 years; mean [± SD] lesion size, 5.56 ± 1.64 mm). Seventy-two (40.0%) lesions were smaller than 5 mm, and 108 (60.0%) were 5 mm or larger. Of the 180 lesions, 103 (57.2%) had been biopsied or excised by localization, and 77 (42.8%) with benign ultrasound features had been followed with ultrasound for at least 2 years. Clinical and imaging features were recorded for analysis. RESULTS. Of the 180 enhancing lesions detected on MRI, 14 (7.8%) were malignant and 166 (92.2%) were benign. The malignancy rate of lesions 5 mm or larger was higher than that for lesions smaller than 5 mm (10.2% vs 4.2%), without statistical significance (p = 0.344). The washout enhancement pattern was statistically significantly associated with malignancy (p = 0.032). Although malignant ultrasound features such as nonparallel orientation were more common in malignant lesions, most malignancies had benign features, including oval shape, parallel orientation, and circumscribed margins, with BI-RADS category 4a (n = 12; 85.8%) as the final assessment. CONCLUSION. Second-look ultrasound is a feasible method for evaluating MRI-detected subcentimeter sized lesions in preoperative assessment of patients with breast cancer. A lower threshold should be applied with consideration of MRI features in deciding whether to biopsy or excise these lesions.
    American Journal of Roentgenology 03/2015; 204(3):W357-62. DOI:10.2214/AJR.14.12948 · 2.74 Impact Factor
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    ABSTRACT: BRAF(V600E) mutation analysis has been used as a complementary diagnostic tool to ultrasonography-guided, fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodule with high specificity reported up to 100%. When highly sensitive analytic methods are used, however, false-positive results of BRAF(V600E) mutation analysis have been reported. In this study, we investigated the clinical, US features, and outcome of patients with thyroid nodules with benign cytology but positive BRAF(V600E) mutation using highly sensitive analytic methods from US-FNA. This study included 22 nodules in 22 patients (3 men, 19 women; mean age, 53 years) with benign cytology but positive BRAF(V600E) mutation from US-FNA. US features were categorized according to the internal components, echogenicity, margin, calcifications, and shape. Suspicious US features included markedly hypoechogenicity, noncircumscribed margins, micro or mixed calcifications, and nonparallel shape. Nodules were considered to have either concordant or discordant US features to benign cytology. Medical records and imaging studies were reviewed for final cytopathology results and outcomes during follow-up. Among the 22 nodules, 17 nodules were reviewed. Fifteen of 17 nodules were malignant, and 2 were benign. The benign nodules were confirmed as adenomatous hyperplasia with underlying lymphocytic thyroiditis and a fibrotic nodule with dense calcification. Thirteen of the 15 malignant nodules had 2 or more suspicious US features, and all 15 nodules were considered to have discordant cytology considering suspicious US features. Five nodules had been followed with US or US-FNA without resection, and did not show change in size or US features on follow-up US examinations. BRAF(V600E) mutation analysis is a highly sensitive diagnostic tool in the diagnosis of papillary thyroid carcinomas. In the management of thyroid nodules with benign cytology but positive BRAF(V600E) mutation, thyroidectomy should be considered in nodules which have 2 or more suspicious US features and are considered discordant on image-cytology correlation. Copyright © 2015 Elsevier Inc. All rights reserved.
    Surgery 02/2015; 157(2):354-61. DOI:10.1016/j.surg.2014.09.003 · 3.11 Impact Factor
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    ABSTRACT: The 5th edition of Breast Imaging Reporting and Data System subdivides suspicious calcifications into two categories: 4B-amorphous, coarse heterogeneous, and fine pleomorphic calcifications; 4C-fine linear or fine linear branching calcifications. We investigated whether these revised categories are appropriate for malignancy risk stratification. We studied 246 patients (mean age 48.2 years) with suspicious microcalcifications detected on mammography who underwent stereotactic biopsy (n = 154) or surgical excisional biopsy with preoperative mammogram-guided needle localization (n = 92). Pre-biopsy mammograms were reviewed retrospectively, and imaging features were analyzed according to the revised morphology and distribution descriptors. Pathological results of stereotactic biopsy and surgical excision were considered, with the surgical results being the reference standard. Positive predictive values (PPVs) were calculated and compared using the χ (2) test or Fisher's exact test. Overall PPV of suspicious microcalcifications was 22.4 %. PPVs of morphology descriptors were as follows: amorphous 7.9 %, coarse heterogeneous 17.8 %, fine pleomorphic 63.2 %, fine linear/fine linear branching 100 % (p < 0.001). PPVs of distribution descriptors were as follows: regional 8.8 %, grouped 14.3 %, linear 87.5 %, segmental 63.6 % (p < 0.001). For morphology and distribution descriptors combinations, PPVs for amorphous/regional and amorphous/grouped microcalcifications were 4.2 and 7.6 %, resepectively. The PPV for fine pleomorphic/linear or segmental was 93.8 %. Subcategorization of morphology descriptors for suspicious microcalcifications is needed because of the different PPVs for amorphous, coarse heterogeneous, and fine pleomorphic microcalcifications. Combining morphology and distribution descriptors for suspicious microcalcifications provides accurate risk stratification.
    Annals of Surgical Oncology 01/2015; DOI:10.1245/s10434-014-4362-6 · 3.94 Impact Factor
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    ABSTRACT: The incidence of small thyroid malignancy has increased. However, there is no evidence-based guideline for managing thyroid nodules ≤5 mm on ultrasonography (US). We evaluated how to manage thyroid nodules ≤5 mm. Thyroid nodules ≤5 mm in size on US that had undergone surgery and US-guided fine-needle aspiration were eligible. A total of 3,117 thyroid nodules in 3,012 patients were included. The size changes of malignant and benign nodules during follow-up were evaluated. Thyroid malignancies were classified according to follow-up and surgery time within and after 12 months. Clinico-pathological characteristics were compared. Of 3,117 nodules, 1,639 nodules in 1,619 patients were benign and 1,478 in 1,427 were malignant. Only 5.8 and 1.2 % of malignant nodules and 6.8 and 4.2 % of benign nodules increased in size when a 2-mm and 3-mm change on US were referenced. Of 1,079 patients with an index malignancy ≤5 mm, extrathyroidal extension, lymph node metastasis, recurrence, and mortality were not significantly different between patients with and without follow-up and between patients with surgery within 12 months and after 12 months. None of the patients who underwent surgery had distant metastasis and none died of thyroid malignancy. In thyroid nodules ≤5 mm found on US, US-FNA could be recommended in cases of increased size during US follow-up if lateral LNM was not found because a delay in surgery did not impact cancer recurrence and mortality.
    Endocrine 01/2015; DOI:10.1007/s12020-015-0526-9 · 3.53 Impact Factor
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    ABSTRACT: The aim of this study was to compare the mammography, ultrasound (US) and histologic features of triple-negative (TN) invasive carcinoma of no special type (NST) to non-TN invasive carcinoma of NST. The second aim was to assess whether the distinct imaging characteristics of TN breast cancer would persist after controlling for the histologic features. A total of 344 invasive carcinomas of NST in 337 patients from January 2007 to February 2008 were included in this study. Two radiologists retrospectively reviewed the mammography and US findings using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) lexicon and our institution's criteria. On mammography, TN invasive carcinoma of NST most commonly presented as a mass with round shape and non-spiculated margin. On US, it was more likely to have internal hypoechogenicity, an abrupt boundary and posterior acoustic enhancement. TNBC lacked major suspicious imaging findings such as an irregular shape, spiculated margin and calcification.
    Ultrasound in Medicine & Biology 12/2014; 41(2). DOI:10.1016/j.ultrasmedbio.2014.09.006 · 2.10 Impact Factor
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    ABSTRACT: We investigated the additional diagnostic yield of the mutation test and evaluated the frequency of the BRAF mutation in conventional PTC (cPTC) according to ultrasound (US) features and the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on the BRAF(V600E) mutation status. During the study period, 279 patients who underwent FNA with an additional BRAF(V600E) mutation test were diagnosed as cPTC after surgery. We analyzed the association between the mutation and several clinical factors. Of the 279 cPTCs, 250 (89.6%) had the BRAF(V600E) mutation. The BRAF mutation test was helpful in diagnosing an additional 19% (53/279) of cPTCs. The frequency of the BRAF mutation in cPTCs with suspicious US features was higher than that of cPTCs with negative US features regardless of the BSRTC. Suspicious US features may be helpful in deciding whether an additional BRAF(V600E) mutation test should be done in thyroid nodules with indeterminate cytology. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology 11/2014; 124(5). DOI:10.1177/0003489414560433 · 1.05 Impact Factor
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    ABSTRACT: The purpose of this study was to assess the usefulness of HER2 levels in ultrasonographically guided fine-needle aspiration biopsy (US-FNA) aspirates of axillary lymph nodes (ALNs) in the determination of lymph node metastasis or the characterization of primary breast cancer, and to correlate the HER2 levels in US-FNA aspirates (FNA-HER2s) of metastatic ALNs with the HER2 statuses of corresponding primary breast cancers. An institutional review board approved the study. Between January and October 2010, 164 patients with 167 ALNs examined by US-FNA were included. FNA-HER2s of ALNs were measured by chemiluminescence immunoassay, and they were correlated with cytologic/final diagnoses. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the diagnostic ability to differentiate benign and metastatic ALNs. Additionally, FNA-HER2s of metastatic ALNs were correlated with HER2 status and other clinicopathologic variables of the primary breast cancers. Among the 167 ALNs, 138 were metastatic and 29 were benign. The mean FNA-HER2 (6.3 ng/ml) of metastatic ALNs was higher than that of benign ALNs. All 29 benign ALNs showed no measurable value of FNA-HER2 (0.0 ng/ml). The area under the ROC curves of FNA-HER2 of ALNs was 0.679 for the diagnosis of ALN metastasis. The FNA-HER2 statuses of 108 metastatic ALNs (79.4%) were concordant with the HER2 statuses of the corresponding primary breast cancers. In a subgroup analysis of HER2-positive cancers with ALN metastasis, distant metastasis was significantly associated with FNA-HER2-negativity of metastatic ALNs (P = 0.04). Although FNA-HER2 of ALNs did not improve the diagnostic performance of FNA cytology in preoperative diagnosis of ALN metastasis of overall patients, FNA-HER2-positive metastatic ALNs were significantly associated with HER2-positivity of primary breast cancers. Additionally, FNA-HER2 analysis of ALN may help to develop more personalized treatment protocol for breast cancer patients by determining the concordance or discordance of HER2 status between primary cancers and metastatic ALNs.
    PLoS ONE 11/2014; 9(11):e113065. DOI:10.1371/journal.pone.0113065 · 3.53 Impact Factor
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    ABSTRACT: To evaluate the upgrade rate and delayed false-negative results of percutaneous vacuum-assisted removal (VAR) and surgical excision in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy (CNB) of the breast and to validate the role of VAR as a rebiopsy method for these discordant lesions. Percutaneous US-guided 14-gauge CNB was performed on 7470 patients between August 2005 and December 2010. Our study population included 161 lesions in 152 patients who underwent subsequent rebiopsy due to imaging-histologic discordance. Rebiopsy was performed using VAR (n = 88) or surgical excision (n = 73). We investigated the upgrade rate immediately after rebiopsy and delayed false-negative results during at least 24 months of follow-up after rebiopsy. We also evaluated the clinicoradiological differences between VAR and surgical excision. Total upgrade to malignancy occurred in 13.7% (22/161) of lesions at rebiopsy including both VAR and surgical excision: 4.6% (4/88) of VAR cases (4/88) and 24.7% (18/73) of surgical excision cases (p < 0.001). Surgical excision was performed significantly more frequently in older patients and for larger-sized lesions than that of VAR, and a significant difference was detected between VAR and surgical excision in the Breast Imaging and Reporting and Data System category (p < 0.007). No delayed false-negative results were observed after VAR or surgical excision during the follow-up period. Long-term follow-up data showed no delayed cancer diagnoses after US-guided VAR in imaging-histologic discordant lesions of the breast, suggesting that VAR might be a rebiopsy method for these lesions.
    Korean journal of radiology: official journal of the Korean Radiological Society 11/2014; 15(6):697-703. DOI:10.3348/kjr.2014.15.6.697 · 1.81 Impact Factor
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    ABSTRACT: Objective The aim of this study was to investigate the diagnostic performance of preoperative staging ultrasound (US) according to body mass index (BMI) in patients with papillary thyroid carcinoma (PTC)Patients and Methods This retrospective study included 625 PTC patients who underwent preoperative staging US and surgical excision at a referral center between December 2012 and April 2013. Four experienced radiologists prospectively evaluated the extent of primary tumors, multifocality, and the presence of lymph node metastasis. Patients were grouped according to BMI (normal < 25; overweight 25 ≤ and < 30; obese ≥ 30,/non-obese < 30; obese ≥ 30 kg/m2). Diagnostic performances of preoperative staging US (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) were compared according to BMI based on pathologic findings of surgical specimens.ResultsPreoperative staging US in the obese group (BMI ≥ 30 kg/m2) showed a significantly lower negative predictive value and accuracy in the detection of central lymph node metastasis (P=0.010 and P=0.025, respectively) than in the non-obese (BMI < 30 kg/m2) group. However, there were no significant differences in the diagnostic performance of preoperative staging US for extrathyroidal extension, bilateral multifocality, and lateral lymph node metastasis in analyses using the two (non-obese vs. obese) and three BMI (normal vs. overweight vs. obese) groups, respectively.Conclusion Obesity (BMI ≥ 30 kg/m2) may affect the preoperative US staging of central lymph node metastasis in PTC patients.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 10/2014; DOI:10.1111/cen.12638 · 3.35 Impact Factor
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    ABSTRACT: Triple-negative breast cancer (TNBC) which expresses neither hormonal receptors nor HER-2 is associated with poor prognosis and shorter survival. Several studies have suggested that TNBC patients attaining pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) show a longer survival than those without pCR.
    Acta Radiologica 09/2014; DOI:10.1177/0284185114548507 · 1.35 Impact Factor
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    ABSTRACT: Purpose The purpose of our study was to evaluate the underestimation rate of atypical ductal hyperplasia (ADH) on vacuum-assisted breast biopsy (VABB), and to examine the correlation between residual microcalcifications and the underestimation rate of ADH. Methods A retrospective study was performed on 27 women (mean age, 49.2±9.2 years) who underwent additional excision for ADH via VABB for microcalcifications observed by using mammography. The mammographic findings, histopathologic diagnosis of all VABB and surgical specimens, and association of malignancy with residual microcalcifications were evaluated. The underestimation rate of ADH was also calculated. Results Of the 27 women with microcalcifications, nine were upgraded to ductal carcinoma in situ (DCIS); thus, the underestimation rate was 33.3% (9/27). There was no difference in age (p=0.40) and extent of microcalcifications (p=0.10) when comparing benign and malignant cases. Six of 17 patients (35.3%) with remaining calcifications after VABB were upgraded to DCIS, and three of 10 patients (30%) with no residual calcifications after VABB were upgraded (p=1.00). Conclusion The underestimation rate of ADH on VABB was 33.3%. Furthermore, 30% of patients with no remaining calcifications were upgraded to DCIS. Therefore, we conclude that all ADH cases diagnosed via VABB should be excised regardless of the presence of residual microcalcifications.
    Journal of Breast Cancer 09/2014; 17(3):265-9. DOI:10.4048/jbc.2014.17.3.265 · 1.32 Impact Factor

Publication Stats

991 Citations
397.32 Total Impact Points


  • 2014–2015
    • Wonju Severance Christian Hospital
      Genshū, Gangwon-do, South Korea
  • 2009–2015
    • Yonsei University
      • • Department of Radiology
      • • Natural Science Research Institute
      Sŏul, Seoul, South Korea
    • Yonsei University Hospital
      • Surgery
      Sŏul, Seoul, South Korea
  • 2011
    • Korea Institute of Radiological & Medical Sciences
      Sŏul, Seoul, South Korea
    • Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
      San Paulo, São Paulo, Brazil
  • 2010
    • Catholic University of Daegu
      • Department of Internal Medicine
      Kayō, North Gyeongsang, South Korea
  • 2008–2009
    • Kosin University
      • College of Medicine
      Tsau-liang-hai, Busan, South Korea
    • Yeungnam University
      • Division of Internal Medicine
      Onyang, South Chungcheong, South Korea
  • 2007
    • CHA University
      • College of Medicine
      Sŏul, Seoul, South Korea