Min Hyun Seong

Kangbuk Samsung Hospital, Sŏul, Seoul, South Korea

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Publications (5)5.78 Total impact

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    ABSTRACT: There are relatively few studies reporting the frequency of false-positive computer-aided detection (CAD) marks and their reproducibility in normal cases. To evaluate retrospectively the false-positive mark rate of a CAD system and the reproducibility of false-positive marks in two sets of negative digital mammograms. Two sets of negative digital mammograms were obtained in 360 women (mean age 57 years, range 30-76 years) with an approximate interval of 1 year (mean time 343.7 days), and a CAD system was applied. False-positive CAD marks and the reproducibility were determined. Of the 360 patients, 252 (70.0%) and 240 (66.7%) patients had 1-7 CAD marks on the initial and second mammograms, respectively. The false-positive CAD mark rate was 1.5 (1.1 for masses and 0.4 for calcifications) and 1.4 (1.0 for masses and 0.4 for calcifications) per examination in the initial and second mammograms, respectively. The reproducibility of the false-positive CAD marks was 12.0% for both mass (81/680) and microcalcification (33/278) marks. False-positive CAD marks were seen in approximately 70% of normal cases. However, the reproducibility was very low. Radiologists must be familiar with the findings of false-positive CAD marks, since they are very common and can increase the recall rate in screening.
    Acta Radiologica 11/2009; 50(9):999-1004. · 1.33 Impact Factor
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    ABSTRACT: The purpose of this study was to determine the rate of underestimation of atypical ductal hyperplasia (ADH) at sonographically guided core biopsy of the breast and to identify the factors involved. We retrospectively reviewed 3,563 lesions con secutively evaluated with sonographically guided core biopsy between January 2002 and June 2006. Histologic analysis yielded ADH in 60 of the 3,563 lesions (1.7%). The rate of underestimation of ADH was determined by dividing the number of lesions that proved to be carcinoma at surgical excision by 44, the total number of lesions evaluated with excisional biopsy. Clinical, sonographic, and core biopsy features were analyzed to identify factors that affect the rate of underestimation of ADH. The rate of underestimation of ADH was found to be 48% (21 of 44 lesions). Underestimation of ADH was significantly less frequent for lesions evaluated with 11-gauge vacuum-assisted biopsy than for lesions evaluated with 14-gauge automated gun biopsy (22% [four of 18 lesions] vs 65% [17 of 26 lesions], p = 0.012). The other clinical, sonographic, and biopsy features examined did not affect the rate of underestimation of ADH. For sonographically guided core biopsy of the breast, the rate of underestimation of ADH was 48%. This rate was lower for lesions evaluated with 11-gauge vacuum-assisted biopsy (22%) than for those evaluated with 14-gauge automated gun biopsy (65%). This finding was particularly true of smaller lesions (< or = 2.0 cm) and for lesions of the mass-only type.
    American Journal of Roentgenology 11/2008; 191(5):1347-51. · 2.90 Impact Factor
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    ABSTRACT: To compare the diagnostic performances of conventional ultrasound (US) and US elastography for the differentiation of nonpalpable breast masses, and to evaluate whether elastography is helpful at reducing the number of benign biopsies, using histological analysis as a reference standard. Conventional US and real-time elastographic images were obtained for 100 women who had been scheduled for a US-guided core biopsy of 100 nonpalpable breast masses (83 benign, 17 malignant). Two experienced radiologists unaware of the biopsy and clinical findings analyzed conventional US and elastographic images by consensus, and classified lesions based on degree of suspicion regarding the probability of malignancy. Results were evaluated by receiver operating characteristic curve analysis. In addition, the authors investigated whether a subset of lesions was categorized as suspicious by conventional US, but as benign by elastography. Areas under the ROC curves (Az values) were 0.901 for conventional US and 0.916 for elastography (p = 0.808). For BI-RADS category 4a lesions, 44% (22 of 50) had an elasticity score of 1 and all were found to be benign. Elastography was found to have a diagnostic performance comparable to that of conventional US for the differentiation of nonpalpable breast masses. The authors conclude that BI-RADS category 4a lesions with an elasticity score of 1 probably do not require biopsy.
    Korean Journal of Radiology 01/2008; 9(2):111-8. · 1.56 Impact Factor
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    ABSTRACT: PURPOSE To evaluate inter- and intraobserver agreement of breast radiologists for the visual assessments of strain images obtained with real-time free-hand US elastography METHOD AND MATERIALS During the last 5 months, 130 consecutive women (mean, 55 years; range, 27-78 years) who had been scheduled to undergo US-guided core biopsy were examined with a commercialized US elastography. BIRADS category based on gray-scale US was 3 in 15% (20/130), 4 in 62% (80/130), and 5 in 23% (30/130). Representative real-time gray-scale and elasticity image files were saved as video clips for a total of 130 lesions (80 benign, 50 malignant, mean size 1.2cm, range 0.4-3.7cm). Three experienced radiologists independently analyzed the video clips without knowledge of the histology and provided the elasticity score by 5-point scale according to the degree and distribution of strain induced by light compression. The analysis was done two times with 1 month interval. Results were evaluated by using weighted κ statistics and receiver operating characteristic (ROC) curve analysis. RESULTS Three readers showed moderate to substantial interobserver agreement (mean κ (mκ), 0.644; range, 0.580-0.687) and substantial to almost perfect intraobserver agreement (mk, 0.821; range, 0.742-0.918). Interobserver agreement of malignant lesions (mκ, 0.520; range, 0.480-0.583) was lower than that of benign lesions (mκ, 0.606; range, 0.520-0.668). There was no significant difference in inter- and intraobserver agreements according to lesion size. Mean area under the ROC curve was 0.817 (0.770-0.845, 95% confidence interval). The sensitivity, specificity, positive predictive value and negative predictive values at cutoff score between 3 and 4 were 50.3%, 92.3%, 80.0%, and 75.0%, and those at 2 and 3 were 81.0%, 62.9%, 58.4%, and 85.8%, respectively. CONCLUSION Interobserver agreement of breast radiologists was moderate to substantial and intraobserver agreement was substantial to perfect for the visual assessments of strain images obtained with real-time free-hand US elastography. CLINICAL RELEVANCE/APPLICATION Relatively low interobserver agreement of visual assessments for US-elastography enhances need for more standardized assessment method.
    Radiological Society of North America 2007 Scientific Assembly and Annual Meeting; 11/2007
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    ABSTRACT: PURPOSE To retrospectively compare the outcomes of ultrasound (US)-guided 14G automated gun and 11G vacuum-assisted device (VAD) biopsies of breast papillary lesions. Outcome was defined in terms of missed tumors, the need (both immediate and delayed) for a second biopsy, and histologic underestimation METHOD AND MATERIALS Among 139 papillary lesions diagnosed by US-guided percutaneous biopsy during 3-year period (2003-2005), 30 cases with follow-up less than 6 months were excluded. Total 109 papillary lesions of 106 patients (age range, 13-87 years; mean 47.1 years) underwent surgical excision (n=51) or sonographic follow-up (n=58; range, 6-32 months; median, 12 months). The US-guided biopsies were performed with 14G gun (n=69) or 11G VAD (n=40). RESULTS The histology of percutaneous biopsies was classified as benign (n=72), atypical hyperplasia (ADH) (n=24), DCIS (n=8), invasive cancer (n=1) and indeterminate papillary lesion (n=3). There were no significant differences between two groups for lesion size, BI-RADS categories, and histologic results. Only one DCIS was reported as benign with 14G gun. There was no missed cancer with VAD. A second biopsy was recommended immediately after the first in 44.9%(31/69) with 14G gun versus with 17.5%(7/40) with 11G VAD (p= 0.004). The ADH underestimation was 62.5%(10/16) with 14G gun versus 0%(0/4) with 11G VAD (p =0.043). There was no DCIS underestimation in both groups. US follow-up in the remaining 58 lesions revealed stable in 42 (25 in 14G gun and 17 in 11G VAD) and no residual lesion in 16 (2 in 14G gun and 14 in 11G VAD). CONCLUSION For papillary lesions, the need for a second biopsy and histologic underestimation as well as missed cancer rate were lower when US-guided biopsy was performed with 11G VAD than those with 14G gun. CLINICAL RELEVANCE/APPLICATION For papillary lesion of breast, the outcome of US-guided biopsy with 11G vacuum-assisted device is better than with 14G gun biopsy, in terms of histologic underestimation.
    Radiological Society of North America 2006 Scientific Assembly and Annual Meeting; 11/2006