Eun Young Chae

University of Ulsan, Urusan, Ulsan, South Korea

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Publications (25)29.19 Total impact

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    ABSTRACT: Purpose: The purpose of this study is to evaluate usefulness of MR CAD in patients undergoing neoadjuvant chemotherapy for prediction of tumor's pathologic complete response. Objective: 148 breast cancer patients (mean age: 47.3, range: 29-72 years) who underwent neoadjuvant chemotherapy included our study. They had taken MRI before and after neoadjuvant chemotherapy, and pathologic result reviewed as gold standard. Methods: Computer-generated kinetic features for each lesion were recorded, and features analyzed included "threshold enhancement" at 50% and 100% minimum thresholds; degree of initial peak enhancement; and enhancement profiles composed of lesion percentages of washout, plateau, and persistent enhancement. Final pathologic size and character of tumor was correlated with post-chemotherapy mammography, ultrasonography and MR CAD findings. Kruskal-Wallis test and intraclass correlation coefficient (ICC) were used to analysis. Results: We divided 148 patients as complete pathologic response group and non-complete pathologic response group. Complete pathologic response was defined as no histopathologic evidence of any residual invasive cancer cells in the breast or axillary lymph nodes. 39 patients showed complete pathologic response, 109 patients showed non-complete pathologic response. Between enhancement profiles of MR CAD, plateau proportion of tumor was significantly correlated with tumor's pathologic response (mean proportion of plateau on complete pathologic response group was 27%, p-value=0.007). Conclusion: When plateau proportion of tumor is high on MR CAD, we can predict non-complete pathologic response of neoadjuvant chemotherapy. Advances in knowledge: MR CAD can be a useful tool for the assessment of response to neoadjuvant chemotherapy and prediction of pathologic result.
    The British journal of radiology. 08/2014;
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    ABSTRACT: To evaluate the diagnostic performance of an apparent diffusion coefficient (ADC) and quantitative kinetic parameters in patients with newly diagnosed breast cancer.
    Magnetic resonance imaging. 04/2014;
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    ABSTRACT: The purpose of this study was to compare the accuracy and effectiveness of automated breast volume scanning (ABVS) and hand-held ultrasound (HHUS) in the detection of breast cancer in a large population group with a long-term follow-up, and to investigate whether different ultrasound systems may influence the estimation of cancer detection. Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From September 2010 to August 2011, a total of 1,866 ABVS and 3,700 HHUS participants, who underwent these procedures at our institute, were included in this study. Cancers occurring during the study and subsequent follow-up were evaluated. The reference standard was a combination of histology and follow-up imaging (≥12 months). The recall rate, cancer detection yield, diagnostic accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated with exact 95% confidence intervals. The recall rate was 2.57 per 1,000 (48/1,866) for ABVS and 3.57 per 1,000 (132/3,700) for HHUS, with ? significant difference (p=0.048). The cancer detection yield was 3.8 per 1,000 for ABVS and 2.7 per 1,000 for HHUS. The diagnostic accuracy was 97.7% for ABVS and 96.5% for HHUS with statistical significance (p=0.018). The specificity of ABVS and HHUS were 97.8%, 96.7%, respectively (p=0.022). ABVS shows a comparable diagnostic performance to HHUS. ABVS is an effective supplemental tool for mammography in breast cancer detection in a large population.
    Asian Pacific journal of cancer prevention: APJCP 01/2014; 15(21):9101-5. · 1.50 Impact Factor
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    ABSTRACT: PURPOSE To compare the performance of coronal view of automated breast ultrasound (ABUS) with that of transverse view in the lesion detection METHOD AND MATERIALS Three breast radiologists independently interpreted the ABUS images from 113 women, 14 with negative findings and 99 with known breast lesions (99 benign and 53 malignant findings). The readers were asked to detect the presence or absence of the abnormalities using transverse and coronal view in the different reading session. If a lesion was detected, we evaluated the location, characteristics of lesions. Intraclass correlation coefficients and kappa statistics were used for statistical analysis. Time to review and interpret an examination was also evaluated. RESULTS The detection rate of malignant lesions was 95.6% and 87.4% for transverse and coronal view (p=0.0089). The detection rate of benign lesions was 72.4% and 56.6% for transverse and coronal view (p=0.0001). Larger lesions are more consistently detected by coronal view: detection rates were 7.4% at 5 mm or smaller; 48.4% at 6-10 mm; 80.1% at 11-15 mm; 89.1% for lesions larger than 15 mm (p<0.0001). The times of coronal view to review and rate an examination was shorter than that of transverse view (p<0.0001). ICC values for clockface, distance from nipple, and lesion diameter by coronal view all exceeded 0.7, indicating high reliability. Moderate agreement was found for mass shape, margin, echogenicity, and BIRADS final assessment. CONCLUSION The detection rate of coronal view was significantly lower than that of transverse view for both benign and malignant lesions. CLINICAL RELEVANCE/APPLICATION Coronal view can be used as an additional method to transverse view. However, the role of coronal view by ABUS is not yet established, which needs to undergo further studies.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: PURPOSE To retrospectively compare the accuracy and effectiveness of automated breast volume scanning (ABVS) and hand-held ultrasound (HHUS) in the detection of breast cancer in a large population group with a long-term follow-up, and to investigate whether different ultrasound systems may influence the estimation of cancer detection. METHOD AND MATERIALS A total of 1870 ABVS and 3706 HHUS participants, who underwent these procedures at our institute between September 2010 and August 2011, were included in this study. Cancers occurring during the study and subsequent follow-up were evaluated. The reference standard was a combination of histology and follow-up imaging (≥12 months). The diagnostic accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated with exact 95% confidence intervals. RESULTS The recall rate was 2.89 (54/1870) for ABVS and 3.86 (143/3706) for HHUS. The diagnostic accuracy was 97.75% (95% CI, 96.9893.38) for ABVS and 96.68% (95% CI, 96.0597.23) for HHUS and this difference was statistically significant (P = 0.026). The sensitivity and specificity of ABVS and HHUS were 100% (95% CI, 73.54100), 97.74% (95% CI, 96.9698.37) and 95.45% (95% CI, 77.1699.88), 96.69% (95% CI, 96.0697.24), respectively, and the specificity showed statistical significance (P = 0.029). CONCLUSION ABVS shows a comparable diagnostic performance to HHUS. We thus find that ABVS as an effective supplemental tool for mammography in breast cancer detection in a large population. CLINICAL RELEVANCE/APPLICATION In this study, ABVS shows comparable diagnostic performance when compared with HHUS in the detection of breast cancer in a large population group with a long-term follow-up.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: PURPOSE To determine the frequency and the malignancy rate of BI-RADS category 3 lesions detected on screening breast ultrasound and reassess whether they satisfied the ACRIN 6666 protocol. METHOD AND MATERIALS During two years, 28,796 asymptomatic women underwent screening mammography. Among them, 8359 women underwent additional breast ultrasound as part of a screening examination. Radiologists analyzed US lesion features and provided a final BI-RADS assessment. We retrospectively reviewed the initial US images with BI-RADS category 3 lesions and their mammography as well. We also investigated the outcome of these lesions. The reference standard was a combination of pathology and clinical follow-up for at least 24 months. RESULTS The frequency of category 3 lesions detected on breast US was 16.8% (1403/8359). Of 941 patients with follow up for at least 24 months or biopsy, six eventually proved to be malignant (0.6%). The malignancy rate was 1.5% (4/805) for patients with abnormal mammogram and 0.5% (2/136) for those with negative mammogram. When the ACRIN (American College of Radiology Imaging Network) 6666 protocol were strictly applied, 147 (15.6%) were retrospectively recategorized as BI-RADS 4 (n=7) or BI-RADS 2 (n=140). CONCLUSION The malignancy rate of BI-RADS category 3 lesions is very low, especially with negative mammogram. CLINICAL RELEVANCE/APPLICATION With BI-RADS category 3, careful assessment is needed to avoid unnecessary biopsy or short-interval follow-up.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: The purpose of the study described here was to investigate the correlation between histologic factors, including immunohistochemical factors, related to the prognosis of breast cancer and shear wave elastography (SWE) measurements. One hundred twenty-two breast cancers from 116 women were subjected to sonoelastography. Of the SWE features, mean and maximum elasticity and SWE ratio were extracted. The SWE ratio was calculated as the ratio of the stiffness of a portion of the lesion to that of a similar region of interest in fatty tissue. High ratios indicate stiffer lesions. The Mann-Whitney U-test, Kruskal-Wallis test and receiver operating characteristic (ROC) curve were used for statistical analysis. Estrogen receptor negativity, progesterone receptor negativity, p53 positivity, Ki-67 positivity, high nuclear grade, high histologic grade and large tumor (invasive) size were associated with a significantly high SWE ratio (p < 0.05). ROC curve analysis yielded SWE ratio cutoff values of 2.74-3.69 for significant immunohistochemical factors and 4.21 for the basal-like subtype by maximizing specificity while ensuring more than 80% sensitivity. Breast cancers with aggressive histologic features had high SWE ratios. Shear wave elastography may provide useful information for determining prognosis.
    Ultrasound in medicine & biology 11/2013; · 2.46 Impact Factor
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    ABSTRACT: To evaluate the diagnostic performance of automated breast ultrasound (ABUS) after breast magnetic resonance imaging (MRI) as a replacement for hand-held second-look ultrasound (HH-SLUS), we evaluated 58 consecutive patients with breast cancer who had additional suspicious lesions on breast MRI. All patients underwent HH-SLUS and ABUS. Three breast radiologists evaluated the detectability, location, characteristics and conspicuity of lesions on ABUS. We also evaluated inter-observer variability and compared the results with HH-SLUS results. Eighty additional suspicious lesions were identified on breast MRI. Fifteen of the 80 lesions (19%) were not detected on HH-SLUS. Eight of the 15 lesions (53%) were detected on ABUS, whereas the remaining 7 were not detected on ABUS. Among the 65 lesions detected on HH-SLUS, only 3 lesions were not detected on ABUS. The intra-class correlation coefficients for lesion location and size all exceeded 0.70, indicating high reliability. Moderate to fair agreement was found for mass shape, orientation, margin and Breast Imaging Reporting and Data System (BI-RADS) final assessment. Therefore, ABUS can reliably detect additional suspicious lesions identified on breast MRI and may help in the decision on biopsy guidance method (US vs. MRI) as a replacement tool for HH-SLUS.
    Ultrasound in medicine & biology 09/2013; · 2.46 Impact Factor
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    ABSTRACT: Objectives- The purpose of this study was to evaluate the use and performance of supplemental screening whole-breast sonography in conjunction with mammography in asymptomatic women with dense breast tissue. Methods- A total of 28,796 asymptomatic women underwent screening mammography. Among 20,864 women with dense breasts (72%), 8359 underwent additional sonography as part of their screening examinations. We classified women with mammographically dense breasts into mammography-only and mammography-plus-sonography groups. The reference standard was a combination of pathologic results and clinical follow-up at 2 years. We compared the recall rate, cancer detection yield, sensitivity, specificity, and positive predictive value in each group. Results- Among the 20,864 women with dense breasts, 35 cancers were diagnosed, with a mean size of 13 mm. The cancer detection yield was 0.480 per 1000 women in the mammography-only group and increased to 2.871 in the mammography-plus-sonography group. Of 24 cancers detected in the mammography-plus-sonography group, the mean size was 11 mm, and the axillary lymph nodes were negative in 19 of 20. The sensitivity was significantly higher in the mammography-plus-sonography group than the mammography-only group (100% versus 54.55%; P = .002). The positive predictive values of sonographically prompted biopsy were 11.1% for the mammography-plus-sonography group and 50% for the mammography-only group. Conclusions- Supplemental screening whole-breast sonography increases the cancer detection yield by 2.391 cancers per 1000 women with dense breast tissue over that of mammography alone. It is beneficial for increased detection of breast cancers that are predominantly small and node negative; however, it also raises the number of false-positive results.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 09/2013; 32(9):1573-8. · 1.40 Impact Factor
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    ABSTRACT: To compare the accuracy of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) in preoperative assessment of local extent of breast cancer. Lesion sizes of breast cancers on DBT and FFDM images were independently evaluated by breast radiologists. Each lesion was flagged as either mis-sized or not depending on whether the assessment of size at imaging was within 1 cm of the lesion size at surgery. Additional analyses were made by mammographic parenchymal density and by lesion size, using 2 cm as the boundary to separate the two subgroups. Statistical comparisons were performed using a repeated measures linear model on the percent mis-sized. P-values < 0.05 were considered statistically significant. The dataset included 173 malignant breast lesions (mean size 23.8 mm, 43% of lesions were ≤2 cm in size) in 169 patients, two-thirds of which had heterogeneously or extremely dense breasts. Overall, the percentage of lesions mis-sized at DBT was significantly lower than at FFDM (19% versus 29%, p = 0.003). There was significantly less mis-sizing at DBT in both heterogeneously dense breasts (11.1% difference between DBT and FFDM, p = 0.016) and extremely dense breasts (15.8% difference, p = 0.024). DBT also had significantly less mis-sizing than FFDM in the subgroup of lesions that were ≤2 cm in size (14.7% difference, p = 0.005). DBT was significantly superior to FFDM for the evaluation of lesion size overall, and specifically for small lesions and for lesions in dense breasts. The superiority of DBT versus FFDM increased with parenchymal density.
    Clinical Radiology 08/2013; · 1.66 Impact Factor
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    ABSTRACT: OBJECTIVE. The purpose of our study was to assess the diagnostic performance of breast MRI in evaluating residual disease in patients after excisional biopsy for breast cancer on the basis of both morphologic and kinetic features. MATERIALS AND METHODS. Of 5304 breast MRI examinations performed between January 2007 and December 2011, 308 evaluated postoperative sites after excisional biopsy of breast cancer. Among these, 203 patients who were not treated with chemotherapy or radiotherapy before MRI and underwent definitive surgery within 30 days after MRI were enrolled. MRI findings were analyzed on the basis of contrast-enhanced subtraction images. The enhancement patterns were classified into four categories: no enhancement (P1), thin regular rim enhancement (P2), thick or irregular rim enhancement (P3), and nodular or nonmasslike enhancement (P4) around the postoperative sites. The enhancement kinetics were assessed as follows: persistent, plateau, and washout pattern. RESULTS. From 207 breast MRI examinations in 203 patients, 144 breasts had residual breast cancer at histopathologic examination after definitive surgery. When P1 and P2 were considered negative for residual cancer and P3 and P4 were considered positive, the sensitivity, specificity, positive and negative predictive values, and accuracy were 79.9%, 73.0%, 87.1%, 61.3%, and 77.8%, respectively. The specificity and positive predictive value improved to 90.5% and 91.7%, when analyzed with washout enhancement kinetics as another positive finding for residual cancer. A statistically significant trend of decreasing specificity and positive predictive value (p < 0.05) was found with the passage of a time interval between excision and breast MRI. CONCLUSION. Although the overlapping features of the postsurgical changes and malignant lesions remain as the limitations, dynamic contrast-enhanced breast MRI is a useful tool for residual disease prediction after excisional biopsy for breast cancer. Combined use of morphologic and kinetic evaluation parameters improved the diagnostic performance. We do not recommend that MRI be unreasonably delayed after excisional biopsy considering the risk of prolonging definitive surgery.
    American Journal of Roentgenology 05/2013; 200(5):1167-73. · 2.90 Impact Factor
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    ABSTRACT: PURPOSE To evaluate the diagnostic performance of automated US of the breast as a replacement tool of second-look US performed after breast MRI. METHOD AND MATERIALS During five months, we evaluated 58 consecutive patients (mean age, 45 years; range, 30~ 62 years) with breast cancer, who had additional suspicious lesions detected on breast MRI. All patients underwent hand-held second-look US (HH-SLUS) and automated breast US (ABUS). Three breast radiologists reviewed the detectability, location, characteristics, and conspicuity of these lesions on ABUS. We also evaluated the interobserver variability and compared with the results of HH-SLUS. Kappa statistics and intraclass correlation coefficient (ICC) were used for statistical analysis. RESULTS There were 80 additional suspicious lesions identified by breast MRI. Among them, 14 lesions (14/80,17.5%) were not detected on HH-SLUS. Eight lesions (8/14, 57%) were detected on ABUS by at least 2 readers whereas the remaining 6 (43%) were not detected on ABUS. Among 66 lesions detected on HH-SLUS, only three lesions (3/80, 4%) were not detected on ABUS. ICCs for lesion location and size all exceeded 0.75, indicating high reliability. Substantial agreement was found for mass shape, orientation, margin, and BIRADS final assessments (k = 0.71, 0.72, 0.61, and 0.63, respectively). CONCLUSION ABUS could reliably detect the additional suspicious lesions identified by breast MRI. Therefore, ABUS could reduce the cost and time of HH-SLUS and it might be helpful to decide the biopsy guidance method (US-guided vs. MR-guided). CLINICAL RELEVANCE/APPLICATION ABUS could play a role as a replacement tool of hand-held second-look US for evaluating the additional suspicious lesions identified by breast MRI.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting; 11/2012
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    ABSTRACT: PURPOSE To evaluate the correlation of parameters in optical imaging with maximum standardized uptake value (mSUV) in breast cancer patients METHOD AND MATERIALS We performed optical diffusion breast imaging after conventional ultrasound in 252 patients. In these patients, 240 patients who underwent whole body PET CT before treatment included in our study. One of the five radiologists performed optical diffusion imaging of the targeted lesions using a handheld probe (Optimus, XinAoMDT). All patients underwent ultrasound-guided core needle biopsy or surgery. Five radiologists reviewed conventional ultrasound features, assessed the BI-RADS category and reviewed optical diffusion imaging results for each lesion. Surgery and biopsy results were used as reference standards. We compared the parameters in optical diffusion imaging with mSUV of preoperative known malignant lesion on PET-CT. RESULTS Pearson’s correlation cofficient was used for evaluation. Mean values of each parameters was 0.24 in synthesis diagnosis index (SDI), 0.23 in total hemoglobin (HBT), 0.96 in oxygen saturation (SO2). Mean value of mSUV was 8.30. Only SO2 was significantly correlated with mSUV (p-value=0.001, confidence interval <0.01). Tumor oxygenation is known factor of tumor metabolism and mSUV is frequently used as predictor of pathologic response after neoadjuvant chemotherapy. CONCLUSION SO2 level of optical diffusion breast imaging is well correlated with mSUV of PET-CT. If there are high SO2 level in optical imaging, we can predict high mSUV level on PET-CT and higher pathologic complete response rate after neoadjuvant chemotherapy in breast cancer patients. CLINICAL RELEVANCE/APPLICATION If there are high SO2 level in optical imaging, we can predict high mSUV level on PET-CT and higher pathologic complete response rate after neoadjuvant chemotherapy in breast cancer patients.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting; 11/2012
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    ABSTRACT: PURPOSE: To compare the performance of radiologists in the use of conventional ultrasound (US) and automated breast volume ultrasound (ABVU) for the characterization of benign and malignant solid breast masses based on breast imaging and reporting data system (BI-RADS) criteria. MATERIALS AND METHODS: Conventional US and ABVU images were obtained in 87 patients with 106 solid breast masses (52 cancers, 54 benign lesions). Three experienced radiologists who were blinded to all examination results independently characterized the lesions and reported a BI-RADS assessment category and a level of suspicion of malignancy. The results were analyzed by calculation of Cohen's κ coefficient and by receiver operating characteristic (ROC) analysis. RESULTS: Assessment of the agreement of conventional US and ABVU indicated that the posterior echo feature was the most discordant feature of seven features (κ = 0.371 ± 0.225) and that orientation had the greatest agreement (κ = 0.608 ± 0.210). The final assessment showed substantial agreement (κ = 0.773 ± 0.104). The areas under the ROC curves (Az) for conventional US and ABVU were not statistically significant for each reader, but the mean Az values of conventional US and ABVU by multi-reader multi-case analysis were significantly different (conventional US 0.991, ABVU 0.963; 95 % CI -0.0471 to -0.0097). The means for sensitivity, specificity, positive predictive value, and negative predictive value of conventional US and ABVU did not differ significantly. CONCLUSION: There was substantial inter-observer agreement in the final assessment of solid breast masses by conventional US and ABVU. ROC analysis comparing the performance of conventional US and ABVU indicated a marginally significant difference in mean Az, but not in mean sensitivity, specificity, positive predictive value, or negative predictive value.
    Breast Cancer 10/2012; · 1.33 Impact Factor
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    ABSTRACT: With the widespread use of PET/CT, incidental hypermetabolic foci unrelated to the known malignancy have been described with increasing frequency. To determine the frequency and clinical significance of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT, and to explore factors differentiating benign and malignant breast uptake. From January 2005 to June 2010, a total of 51,971 whole-body FDG PET/CT examinations were performed in our clinic. After excluding 7254 sets of PET/CT data from patients known to have breast cancer, we retrospectively identified patients showing incidental focal hypermetabolic activity in the breast. Of 44,717 PET/CT examinations conducted on 32,988 patients, we identified 131 patients with no previous known or suspected benign and malignant breast disease. The etiology, mean SUV(max), and diameter of breast lesions were assessed. We also compared the presentation of the lesions on CT, mammography, and ultrasonography. Of the 131 patients, 60 were histologically diagnosed with breast lesions, including 32 with malignant and 28 with benign lesions. An additional 11 patients were followed-up for more than 2 years and were clinically considered to have benign lesions. The remaining 60 patients who had neither histologic confirmation nor followed-up for more than 2 years were excluded. Therefore, 71 patients were finally included. The mean SUV(max) of 39 benign lesions and 32 malignant lesions were 2.02 ± 1.52 and 3.71 ± 3.83, respectively (P = 0.0001). At a cut-off value of 2.3, the rate of malignancy and specificity of the mean SUVmax for differentiating benign and malignant breast lesions were 61.3%, 76.3, respectively. The CT data from PET/CT revealed that the mean diameters of benign and malignant lesions were 1.19 ± 0.97 cm and 2.26 ± 1.96 cm, respectively (P = 0.0009). Incidental focal 18F-FDG uptake in the breast as detected by PET/CT was indicative of malignancy in 45% of patients. Both mean SUV(max) and diameter were greater for malignant than benign lesions.
    Acta Radiologica 05/2012; 53(5):530-5. · 1.33 Impact Factor
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    ABSTRACT: Cerebral arterial dissections are recognized as a common cause of stroke. However, few studies have reported on the distribution of cerebral arterial dissection and angiographic pattern related to the presenting clinical symptom pattern. We analyzed the distribution of cerebral artery dissection along with angiographic and clinical presenting a pattern as depicted on angiograms. From January 2000 to January 2007, 133 arterial dissection patients admitted to our institutes were retrospectively reviewed. The characteristic angiographic findings of all cerebral arteries were carefully evaluated on 4-vessel angiograms. The male-female ratio was 77: 56 and the mean age was 51 years. According to the angiographic finding depicting the location of the dissection plane in the arterial wall, we categorized to steno-occlusive, aneurysmal, combined and unclassifiable pattern. In each dissection pattern, we evaluated presenting symptoms and presence of infarction or hemorrhage. The most common symptom on presentation was headache (47%), followed by motor weakness of arm or leg (31%), dysarthria/aphasia (19%) and vertigo (16%). The most common angiographic pattern was steno-occlusive (46%), followed by combined (steno-occlusive and aneurismal) (27%) and aneurysmal (22%) patterns. Steno-occlusive pattern was most commonly related to infarction (33/61, 54%) in contrast that aneurysmal pattern was most frequently related to subarachnoid hemorrhage (SAH) (7/29, 24%). The most frequent abnormality in patients with dissection of the intradural vertebral arteries including posterior cerebral artery (PCA) was SAH (23/70, 33%), followed by infarction. Infarction was the most common abnormality in patients with the extradural and intradural carotid arteries, and the extradural vertebral artery. In contrast that the extradural arterial dissections tended to result in ischemia with steno-occlusive pattern, the intradural arterial dissections tended to result in SAH with aneurysmal type, especially in the vertebral artery. Dissection requires combined analysis of angiographic pattern and type of stroke depending on the location.
    Neurointervention. 08/2011; 6(2):78-83.
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    ABSTRACT: To describe the clinical and radiologic features of cytomegalovirus (CMV) enterocolitis in apparently immunocompetent hosts. Our institutional review board approved this retrospective study, and informed consent was waived. Twelve apparently immunocompetent patients (7 women and 5 men; mean age, 58 years) with pathologically proven CMV enterocolitis were included. Computed tomographic (CT) scans were retrospectively reviewed to determine the extent and the location of mural thickening, maximal mural thickness, enhancement pattern, that is, single-halo, double-halo, and homogeneous patterns, and ascites. Eight patients had comorbidities potentially affecting the host immune status, whereas 4 patients were apparently healthy before presentation. On CT, all patients showed mural thickening (range, 4-11 mm) involving the colon (n = 8), the small bowel (n = 1), or both (n = 3). Segmental involvement was most common (n = 9 for colon and n = 2 for small bowel), whereas focal involvement of the rectum (n = 1) and diffuse involvement of the entire ileum (n = 1) or the entire small bowel and colon (n = 1) were also noted. Colonic lesions showed variable enhancement patterns, including the single-halo (n = 6), homogeneous (n = 3), and double-halo patterns (n = 2), whereas all small-bowel lesions in 4 patients exhibited a single-ring pattern. Ascites was present in 7 patients. Complications requiring surgery occurred in 3 patients and included refractory bleeding (n = 2) and bowel perforation (n = 1). Cytomegalovirus enterocolitis in immunocompetent hosts typically develops in elderly subjects with comorbidities, although it may also affect relatively young and healthy subjects. On CT, it is characterized by mild mural thickening of the small bowel and the colon and frequently shows segmental involvement and a single-halo enhancement pattern.
    Journal of computer assisted tomography 10/2010; 34(6):892-8. · 1.38 Impact Factor
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    ABSTRACT: To evaluate the feasibility of MR imaging to depict the in vivo recruitment of superparamagnetic iron oxide (SPIO)-labeled macrophages and to aid diagnosis of graft rejection in kidney transplantation. This study was approved by the institution's committee on animal research. Eighteen male Lewis rats received a kidney transplant; 12 had an F344 rat donor and six had a Lewis rat donor. Peritoneal macrophages were harvested from thioglycollate-treated Lewis rats, cultured, and labeled with SPIO. After resuspension of macrophages in a concentration of 1 x 10(7) cells per milliliter of Hanks balanced salt solution, 5 x 10(6) of SPIO-labeled macrophages was administered through the tail vein 2 or 5 days after transplantation in each group. The transplanted kidneys were imaged on a 4.7-T MR imager 24 hours after macrophage administration. The Wilcoxon signed rank test was performed for evaluating the differences between the relative signal intensity (SI) before and after SPIO-labeled macrophage administration. A low-SI zone was predominantly noted in the medulla of the transplanted kidneys, and the relative SI decreased significantly from 1.40 to 0.53 (P < .001) in the allogeneic transplants following SPIO-labeled macrophage administration 5 days after the allogeneic transplantation. In the syngeneic group, the lower-SI zone was not noted in the grafts. At histopathologic examination, the lower-SI zone corresponded to the distribution of the SPIO-labeled macrophages. This study demonstrates that the homing of intravenously administered SPIO-labeled macrophages can be monitored in the allograft rejection model on in vivo MR images.
    Radiology 09/2010; 256(3):847-54. · 6.34 Impact Factor
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    ABSTRACT: To evaluate liver volume alterations and liver function after right portal vein embolization (PVE) during mid-term follow-up based on embolization score. Computed tomography (CT) images and liver function profiles were obtained before PVE, and at short-term (7-45 days), and mid-term follow-up (106-380 days) after PVE in all 30 patients. The patients were divided into group A (PVE score >or=3, n=20) and group B (PVE score <3, n=10). High score indicates more complete embolization. Left liver volume (LLV) and percentage future liver remnant (%FLR) increased significantly between pre-PVE and short-term follow-up and between short-term and mid-term follow-up in group A. Increase in FLR volume was significantly higher at the mid-term follow-up than at the short-term follow-up in group A. The ratio of embolized to total liver volume (RETLV) on short-term follow-up was significantly higher in group A than in group B. Aspartate transaminase (AST) and alanine transaminase (ALT) were elevated on short-term follow-up, whereas at mid-term follow-up in group A, they had significantly returned to the baselines. PVE resulted in continued compensatory hypertrophy of the unembolized liver during the 6-month follow-up. Compensatory hypertrophy in the unembolized liver was proportional to the ratio of embolization and to the embolized liver volume.
    Clinical Radiology 04/2010; 65(4):288-96. · 1.66 Impact Factor
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    ABSTRACT: Bronchopleural fistula (BPF), one of the potentially fatal complications after pulmonary resection, remains a therapeutic challenge. We present a case of postpneumonectomy BPF successfully managed with a silicone-covered bronchial occlusion stent. The BPF was successfully occluded without complications, and there was no stent migration or any other problem seen at the 1-year follow-up. This novel technique can be an effective option for the treatment of postoperative BPF.
    The Annals of thoracic surgery 01/2010; 89(1):293-6. · 3.45 Impact Factor

Publication Stats

24 Citations
29.19 Total Impact Points

Institutions

  • 2012–2014
    • University of Ulsan
      • College of Medicine
      Urusan, Ulsan, South Korea
  • 2010–2013
    • Asan Medical Center
      • • Department of Radiology
      • • Department of Oncology
      Sŏul, Seoul, South Korea
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea