Hee Jung Moon

Yonsei University Hospital, Sŏul, Seoul, South Korea

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Publications (127)327.73 Total impact

  • [Show abstract] [Hide abstract]
    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; · 3.40 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 (Stockholm, Sweden : 1987). 09/2014;
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    ABSTRACT: 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.
    Journal of breast cancer. 09/2014; 17(3):265-9.
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    ABSTRACT: The purpose of this study was to evaluate the diagnostic performance of quantitative histogram parameters using real-time tissue elastography (RTE) in the diagnosis of patients with diffuse thyroid disease. One hundred and sixteen patients (mean age, 43.7 ± 10.97 y) who had undergone pre-operative staging ultrasonography and RTE were included. For each patient, 11 parameters were obtained from RTE images, from which the “elastic index” was calculated. Diagnostic performance of the elastic index and that of the 11 parameters on RTE were calculated and compared. Of the 116 patients, 31 had diffuse thyroid disease and 85 had normal thyroid parenchyma. Area under the receiver operating characteristic curve (Az) of MEAN (average relative value) elasticity was high (0.737), without significant differences from other elasticity values. Diagnostic performance of the elastic index was higher than the MEAN, Az = 0.753, without significance (p = 0.802). In conclusion, RTE using the elastic index was found to have good diagnostic performance and may be useful in the diagnosis and management of patients with diffuse thyroid disease.
    Ultrasound in Medicine & Biology. 09/2014; 40(9):2012–2019.
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    ABSTRACT: Purpose To evaluate the malignancy risks of thyroid nodules with nondiagnostic results at ultrasonography (US)-guided fine-needle aspiration biopsy (FNAB) and the criteria for selecting those for repeat US-guided FNAB according to the thyroid imaging reporting and data system (TIRADS). Materials and Methods This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Five hundred forty-eight nondiagnostic nodules were included. US features of internal composition, echogenicity, margin, calcifications, shape, and vascularity were evaluated, and thyroid nodules were classified according to TIRADS. TIRADS category 3 included nodules without any suspicious features of solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. Categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features. The malignancy risk was calculated. Results Of the 548 nodules, 40 (7.3%) were malignant and 508 (92.7%) were benign. The malignancy risks of categories 3 and 4a nodules were 0.8% and 1.8%, respectively, whereas the malignancy risks of categories 4b, 4c, and 5 nodules were 6.1%, 14.4%, and 31%. In the 294 nodules larger than 10 mm, the malignancy risks of categories 3, 4a, 4b, 4c, and 5 nodules were 0.9%, 1.3%, 0%, 15%, and 33%, respectively. In the 254 nodules measuring 10 mm or smaller, the malignancy risks of categories 3, 4a 4b, 4c, and 5 nodules were 0%, 2.7%, 14%, 14.3%, and 31%. Conclusion Nondiagnostic thyroid nodules without suspicious US features and those with one suspicious feature can be followed up with US, but nondiagnostic nodules with two or more suspicious features should undergo repeat US-guided FNAB. © RSNA, 2014.
    Radiology 08/2014; · 6.34 Impact Factor
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    ABSTRACT: The incidence of asymptomatic papilloma has increased with the rising popularity of core needle biopsy for breast lesions. In this study, the risk of benign papilloma without atypia for subsequent breast carcinoma during follow-up was evaluated. From January 2000 to December 2010, among 39,461 women with breast ultrasonography, 37,847 women with benign papilloma on biopsy or excision, with benign diseases on biopsy, and with only ultrasonography performed were recruited. Women with concurrent or prior high-risk lesions (atypia, phyllodes tumor, or lobular neoplasm) or malignancies, or with a follow-up period of less than 12 months were excluded. The eligible 12,302 women were classified into three groups; papilloma (n = 265, patients with benign papilloma without atypia at excision), benign (n = 3,066, patients with benign results other than high risk results on core needle biopsy), and ultrasonography (n = 8,971, patients who underwent ultrasonography only without biopsy or surgery). The relative risks (RRs) of the papilloma and benign groups were calculated with intervals of 2 years using the Poisson regression analysis with age, family history, follow-up period, and breast parenchymal density being adjusted, and the ultrasonography group was used as a reference. The RR of the papilloma group was 4.8 (95% confidence interval [CI], 2.5–9.0), significantly higher than 1.5 (95% CI, 1.0–2.1) of the benign group. In the first 2 years, the RR of the papilloma group was 5.2 (95% CI, 2.2–12.6) but it dropped to 2.2 (95% CI, 0.5–9.2) during the next 2 years. Afterward, the RR increased over time although statistical significance was not achieved. Benign papilloma without atypia increased breast cancer risk fivefold when the ultrasonography group was used as a reference, higher than other benign lesions.
    The Breast Journal 07/2014; · 1.83 Impact Factor
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    ABSTRACT: To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up.
    Ultrasonography (Seoul, Korea). 07/2014; 33(3):200-205.
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    ABSTRACT: To evaluate the positive predictive value (PPV) of bilateral whole-breast ultrasonography (BWBU) for detection of synchronous breast lesions on initial diagnosis of breast cancer and evaluate factors affecting the PPV of BWBU according to varying clinicoimaging factors.
    Ultrasonography (Seoul, Korea). 07/2014; 33(3):170-177.
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    ABSTRACT: The purpose of this study was to evaluate the diagnostic performance of quantitative histogram parameters using real-time tissue elastography (RTE) in the diagnosis of patients with diffuse thyroid disease. One hundred and sixteen patients (mean age, 43.7 ± 10.97 y) who had undergone pre-operative staging ultrasonography and RTE were included. For each patient, 11 parameters were obtained from RTE images, from which the "elastic index" was calculated. Diagnostic performance of the elastic index and that of the 11 parameters on RTE were calculated and compared. Of the 116 patients, 31 had diffuse thyroid disease and 85 had normal thyroid parenchyma. Area under the receiver operating characteristic curve (Az) of MEAN (average relative value) elasticity was high (0.737), without significant differences from other elasticity values. Diagnostic performance of the elastic index was higher than the MEAN, Az = 0.753, without significance (p = 0.802). In conclusion, RTE using the elastic index was found to have good diagnostic performance and may be useful in the diagnosis and management of patients with diffuse thyroid disease.
    Ultrasound in medicine & biology. 06/2014;
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    ABSTRACT: Recently, higher body mass index (BMI) has been associated with aggressive pathologic features of papillary thyroid carcinoma. The aim of this study was to clarify the relationship between BMI and aggressive pathologic features of papillary thyroid microcarcinoma (PTMC) and to evaluate whether the BMI can be a prognostic factor of PTMC. This retrospective study included 612 PTMC patients who underwent surgical excision at a referral center between April 2006 and December 2007. Patients were grouped according to BMI (<25 or ≥25 kg/m(2)). Multivariable logistic regression analysis was performed to determine independent predictors of aggressive pathologic features (advanced stage, extrathyroidal extension, and lymph node metastasis), with adjustment for age, gender, tumor size, multifocality, thyroid stimulating hormone (TSH) level, and BMI (value/group). PTMC patients with a BMI ≥ 25 kg/m(2) showed significantly higher prevalences of extrathyroidal extension, advanced pathologic TNM stage, and male gender, compared to those of patients with a BMI < 25 kg/m(2). Lymph node metastasis and mean TSH level were not significantly different between the two BMI subgroups. In multivariable analysis, the BMI ≥ 25 kg/m(2) group was positively associated with the presence of extrathyroidal extension (adjusted odds ratio 1.49, P = 0.05). Higher BMI was associated with extrathyroidal extension in PTMC patients. This study suggests that the BMI could be considered as a prognostic factor for predicting the presence of extrathyroidal extension and it may help decide the appropriate surgical extent for PTMC patients.
    Endocrine 05/2014; · 1.42 Impact Factor
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    ABSTRACT: To determine the indications and the diagnostic accuracy of vacuum-assisted breast biopsy (VABB) under ultrasonographic (US) guidance based on a 10-year period of clinical use. Material and.
    Ultrasonography (Seoul, Korea). 05/2014;
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    ABSTRACT: Background. The association between the BRAF mutation and persistence/recurrence was investigated in patients with classical papillary thyroid carcinoma (PTC) at a BRAF mutation prevalent area.Methods. A total of 282 patients with total thyroidectomy and prophylactic central neck dissection were included. The BRAF mutation was evaluated with cytology specimen using dual priming oligonucleotide (DPO)-based multiplex PCR and direct sequencing preoperatively.Results. Thirty four patients (12%) had persistence/recurrence. In all PTC, the BRAF mutation on both methods was not associated with persistence/recurrence. In PTC > 10 mm, the BRAF mutation on DPO-based multiplex PCR was significantly associated with persistence/recurrence and a potential predictor for persistence/recurrence. In PTC ≤ 10 mm, none of the covariates were significantly different between patients with and without persistence/recurrence.Conclusions. The BRAF mutation was significantly associated with persistence/recurrence and a potential predictor in patients with classical PTC > 10 mm at a BRAF mutation prevalent area. Head Neck, 2014
    Head & Neck 05/2014; · 2.83 Impact Factor
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    ABSTRACT: To compare automated volumetric breast density measurement (VBDM) with radiologists' evaluations based on the Breast Imaging Reporting and Data System (BI-RADS), and to identify the factors associated with technical failure of VBDM.
    Korean journal of radiology: official journal of the Korean Radiological Society 05/2014; 15(3):313-21. · 1.32 Impact Factor
  • Hee Jung Moon, Eun-Kyung Kim, Jin Young Kwak
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    ABSTRACT: The indications of repeat fine-needle aspiration (FNA) for thyroid nodules with benign results of the Bethesda system were investigated. A total of 1,398 nodules were classified according to the Thyroid Imaging Reporting and Data System (TIRADS). TIRADS category 3 included nodules without solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape on ultrasonography (US). Categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features, respectively. The malignancy risks, and odds ratio (OR) with 95 % confidence interval (CI) were calculated. Analyses were performed for all nodules, nodules >10 mm, and nodules ≤10 mm. Of 1.398 nodules, 43 (3.1 %) were malignanct. The malignancy risks of benign nodules with categories 3, 4a, and 4b were 0.7, 1.2, and 0.7 %, respectively, whereas those for nodules with categories 4c and 5 were 9.8 and 22.2 %, respectively. The ORs of nodules with categories 4c and 5 were 19.4 (95 % CI 5.0-76.2) and 50.6 (95 % CI 10.4-245.0), respectively. In nodules >10 mm, the malignancy risks of categories 4c and 5 were 2.7 and 20 %, respectively, and the ORs were 10.7 (95 % CI 1.2-93.7) and 236.1 (95 % CI 12.6-4426.4), respectively. In nodules ≤ 10 mm, the malignancy risks of categories 4c and 5 were 12.6 and 22.6 %, respectively, and the ORs were 10.1 (95 % CI 1.3-78.0) and 18.9 (95 % CI 2.1-168.9), respectively. Repeat US-guided FNA should be considered in benign thyroid nodules with three or more suspicious US features regardless of size.
    Annals of Surgical Oncology 02/2014; · 4.12 Impact Factor
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    ABSTRACT: Heterogeneous echogenicity and micro-nodulations of diffuse thyroid disease on ultrasonography (US) might influence the diagnostic performance of pre-operative US staging, especially the detection of multi-focality. This study was designed to determine whether heterogeneous echogenicity of the thyroid parenchyma influences the diagnostic performance of US in the detection of multi-focality in papillary thyroid carcinoma. Between December 2010 and April 2011, 811 patients underwent pre-operative staging US for papillary thyroid carcinoma and surgery. Twelve radiologists performed the pre-operative US for T and N staging. Underlying parenchymal echogenicity and unilateral and bilateral multi-focality of the thyroid nodules were also evaluated. Patients were divided into two groups on the basis of the underlying echogenicity of the thyroid gland. To evaluate the diagnostic accuracy of US with respect to underlying echogenicity, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated and compared between the two groups. Among the 811 patients included, US revealed underlying heterogeneous echogenicity of the thyroid parenchyma in 204 (25.2%) and underlying homogeneous echogenicity of the thyroid parenchyma in 607 (74.8%). There were no significant differences between the two groups in the diagnostic performance of pre-operative staging US in predicting unilateral multi-focality and bilaterality. Underlying heterogeneous echogenicity in a thyroid gland with Hashimoto's thyroiditis does not significantly influence the detection of multi-focality in papillary thyroid cancer on pre-operative US staging.
    Ultrasound in medicine & biology 01/2014; · 2.46 Impact Factor
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    ABSTRACT: Background: Recently, it has been reported that the risk of thyroid malignancy increases with increasing concentrations of serum TSH. The aim of study was to determine whether or not serum TSH can be a predictor for thyroid malignancy, when considering the relevant US features and clinical risk factors. Methods: This retrospective study included 1200 euthyroid patients with 1269 thyroid nodules who underwent ultrasound-guided fine-needle aspiration biopsy between January and June 2009. Serum TSH, US feature, and clinical parameters were compared according to final diagnosis. Subgroup analyses were performed according to nodule size. Results: Serum TSH did not show a positive association with malignancy for all nodules and micronodule subgroup in multivariate analysis, although they showed significant association with thyroid malignancy for macronodule subgroup. For all nodules and the two subgroups, suspicious US features and younger age were significantly associated with malignancy in univariate and multivariate analyses. Conclusions: Our study suggests that TSH alone is not as useful as US features in deciding whether or not to perform FNA in patients with micronodules. Head Neck, 2014.
    Head & Neck 01/2014; · 2.83 Impact Factor
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    ABSTRACT: Purpose To investigate the natural history of thyroid nodules found to be benign at initial fine-needle aspiration biopsy (FNAB) to determine the percentage of nodules that increased in volume by more than 50% as being an indicator of malignancy. Materials and Methods This retrospective observational cohort study was approved by the institutional review board, and the need to obtain informed consent was waived. The study included 854 FNAB-confirmed benign thyroid nodules. Suspicious ultrasonographic (US) features included marked hypoechogenicity, irregular or microlobulated margin, microcalcification, and taller-than-wide shape. Univariate and multivariate generalized linear mixed models were used to assess the association with nodule growth greater than 50% in volume. Results For the 854 nodules, the initial mean diameter was 19.92 mm (range, 3.10-60.00 mm), and the initial mean volume was 3.19 cm(3) (range, 0.01-4.64 cm(3)). The majority (682 [79.9%] of 854) of thyroid nodules with benign cytologic results at initial FNAB did not grow more than 50% in volume during 4 years of mean follow-up (range, 7-101 months). More than 4 years of follow-up time versus less than 2 years, younger age, a cystic component of less than 25%, and nodule size 1 cm or larger versus less than 1 cm were independently associated with growth. There was only one malignant nodule (0.6%) among 172 thyroid nodules with a volume increase of 50% or greater during the entire follow-up time. Ten malignant nodules (overall malignancy rate: 1.2%) were detected among the 854 total nodules, and eight of these 10 nodules showed suspicious features at US. Conclusion Repeat FNAB for nodules showing more than 50% growth in volume is unlikely to result in a diagnosis of malignancy. A positive FNAB result for malignancy is significantly more likely in the presence of suspicious US features. © RSNA, 2014.
    Radiology 01/2014; · 6.34 Impact Factor
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    ABSTRACT: We presented the photoacoustic imaging (PAI) tool and to evaluate whether microcalcifications in breast tissue can be detected on photoacoustic (PA) images.
    PLoS ONE 01/2014; 9(8):e105878. · 3.53 Impact Factor
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    ABSTRACT: Objective. To determine the role of imaging-cytology correlation in reducing false negative results of fine-needle aspiration (FNA) at thyroid nodules. Methods. This retrospective study included 667 nodules 1 cm or larger in 649 patients diagnosed as benign at initial cytologic evaluation and that underwent follow-up ultrasound (US) or FNA following a radiologist's opinion on concordance between imaging and cytologic results. We compared the risk of malignancy of nodules classified into subgroups according to the initial US features and imaging-cytology correlation. Results. Among included nodules, 11 nodules were proven to be malignant (1.6%) in follow-up FNA or surgery. The malignancy rate was higher in nodules with suspicious US features (11.4%) than in nodules without suspicious US features (0.5%, P < 0.001). When a thyroid nodule had discordant US findings on image review after having benign FNA results, malignancy rate increased to 23.3%, significantly higher than that of nodules with suspicious US features (P < 0.001). However, no significant difference was found in the risk of malignancy between the nodules without suspicious US features (0.5%) and imaging-cytology concordant nodules (0.6%, P = 0.438). Conclusions. Repeat FNA can be effectively limited to patients with cytologically benign thyroid nodules showing discordance in imaging-cytology correlation after initial biopsy, which reduces unnecessary repeat aspirations.
    International journal of endocrinology. 01/2014; 2014:491508.
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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 01/2014; 9(11):e113065. · 3.53 Impact Factor

Publication Stats

684 Citations
327.73 Total Impact Points

Institutions

  • 2009–2014
    • Yonsei University Hospital
      • Surgery
      Sŏul, Seoul, South Korea
  • 2013
    • Jeju National University
      Tse-tsiu, Jeju, South Korea
    • CHA University
      • College of Medicine
      Seoul, Seoul, South Korea
    • Ewha Womans University
      • Department of Radiology
      Sŏul, Seoul, South Korea
  • 2010–2013
    • Yonsei University
      • Department of Radiology
      Seoul, Seoul, South Korea
    • Catholic University of Daegu
      • Department of Internal Medicine
      Kayō, North Gyeongsang, South Korea
  • 2012
    • Kyung Hee University
      • College of Medicine
      Seoul, Seoul, South Korea
  • 2011
    • Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
      San Paulo, São Paulo, Brazil
  • 2009–2011
    • Korea Institute of Radiological & Medical Sciences
      Sŏul, Seoul, South Korea
  • 2008–2009
    • Kosin University
      • College of Medicine
      Pusan, Busan, South Korea
    • Yeungnam University
      • Division of Internal Medicine
      Onyang, South Chungcheong, South Korea