1.Prognostic Significance of a Complete Response on Breast MRI in Patients Who Received Neoadjuvant Chemotherapy According to the Molecular Subtype.
Eun Sook KO ; Heon HAN ; Boo Kyung HAN ; Sun Mi KIM ; Rock Bum KIM ; Gyeong Won LEE ; Yeon Hee PARK ; Seok Jin NAM
Korean Journal of Radiology 2015;16(5):986-995
OBJECTIVE: To evaluate the relationship between response categories assessed by magnetic resonance imaging (MRI) or pathology and survival outcomes, and to determine whether there are prognostic differences among molecular subtypes. MATERIALS AND METHODS: We evaluated 174 patients with biopsy-confirmed invasive breast cancer who had undergone MRI before and after neoadjuvant chemotherapy, but before surgery. Pathology findings were classified as a pathologic complete response (pCR) or a non-pCR, and MRI findings were designated as a radiologic CR (rCR) or a non-rCR. We evaluated overall and subtype-specific associations between clinicopathological factors including the assessment categories and recurrence, using the Cox proportional hazards model. RESULTS: There were 41 recurrences (9 locoregional and 32 distant recurrences). There were statistically significant differences in recurrence outcomes between patients who achieved a radiologic or a pCR and patients who did not achieve a radiologic or a pCR (recurrence hazard ratio, 11.02; p = 0.018 and recurrence hazard ratio, 3.93; p = 0.022, respectively). Kaplan-Meier curves for recurrence-free survival showed that triple-negative breast cancer was the only subtype that showed significantly better outcomes in patients who achieved a CR compared to patients who did not achieve a CR by both radiologic and pathologic assessments (p = 0.004 and 0.001, respectively). A multivariate analysis found that patients who achieved a rCR and a pCR did not display significantly different recurrence outcomes (recurrence hazard ratio, 2.02; p = 0.505 and recurrence hazard ratio, 1.12; p = 0.869, respectively). CONCLUSION: Outcomes of patients who achieved a rCR were similar to those of patients who achieved a pCR. To evaluate survival difference according to molecular subtypes, a larger study is needed.
Adult
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Aged
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Antineoplastic Agents/therapeutic use
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Breast Neoplasms/drug therapy/mortality/*pathology
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Female
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Humans
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Kaplan-Meier Estimate
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*Magnetic Resonance Imaging
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Middle Aged
;
Neoadjuvant Therapy
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Neoplasm Recurrence, Local
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Prognosis
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Proportional Hazards Models
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Receptor, ErbB-2/genetics/metabolism
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Receptors, Estrogen/genetics/metabolism
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Receptors, Progesterone/genetics/metabolism
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Remission Induction
2.Whole-Body MRI in Children: Current Imaging Techniques and Clinical Applications.
Korean Journal of Radiology 2015;16(5):973-985
Whole-body magnetic resonance imaging (MRI) is increasingly used in children to evaluate the extent and distribution of various neoplastic and non-neoplastic diseases. Not using ionizing radiation is a major advantage of pediatric whole-body MRI. Coronal and sagittal short tau inversion recovery imaging is most commonly used as the fundamental whole-body MRI protocol. Diffusion-weighted imaging and Dixon-based imaging, which has been recently incorporated into whole-body MRI, are promising pulse sequences, particularly for pediatric oncology. Other pulse sequences may be added to increase diagnostic capability of whole-body MRI. Of importance, the overall whole-body MRI examination time should be less than 30-60 minutes in children, regardless of the imaging protocol. Established and potentially useful clinical applications of pediatric whole-body MRI are described.
Child
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Humans
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Leukemia/radiography
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*Magnetic Resonance Imaging
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Neoplasms/radiography
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Radiation, Ionizing
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*Whole Body Imaging
3.Differences in Regional Glucose Metabolism of the Brain Measured with F-18-FDG-PET in Patients with Essential Tremor According to Their Response to Beta-Blockers.
In Uk SONG ; Sang Won HA ; Young Soon YANG ; Yong An CHUNG
Korean Journal of Radiology 2015;16(5):967-972
OBJECTIVE: In this study, there was an investigation as to whether there is a functional difference in essential tremor (ET), according to responses to beta-blockers, by evaluating regional changes in cerebral glucose metabolism. MATERIALS AND METHODS: Seventeen male patients with ET were recruited and categorized into two groups: 8 that responded to medical therapy (group A); and 9 that did not respond to medical therapy (group B). Eleven age-sex matched healthy control male subjects were also included in this study. All subjects underwent F-18 fluorodeoxyglucose (FDG)-PET, and evaluated for their severity of tremor symptoms, which were measured as a score on the Fahn-Tolosa-Marin tremor rating scale (FTM). The FDG-PET images were analyzed using a statistical parametric mapping program. RESULTS: The mean FTM score 6 months after the initiation of propranolol therapy was significantly lower in group A (18.13 > 8.13), compared with group B (14.67 = 14.67). The glucose metabolism in group A in the left basal ganglia was seen to be decreased, compared with group B. The ET showed a more significantly decreased glucose metabolism in both the fronto-temporo-occipital lobes, precuneus of right parietal lobe, and both cerebellums compared with the healthy controls. CONCLUSION: Essential tremor is caused by electrophysiological disturbances within the cortical-cerebellar networks and degenerative process of the cerebellum. Furthermore, ET may have different pathophysiologies in terms of the origin of disease according to the response to first-line therapy.
Adrenergic beta-Antagonists/*pharmacology/therapeutic use
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Aged
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Brain/*drug effects/metabolism/radiography
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Brain Mapping
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Essential Tremor/*diagnosis/drug therapy/radiography
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Fluorodeoxyglucose F18/*chemistry
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Glucose/*metabolism
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Humans
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Male
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Middle Aged
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*Positron-Emission Tomography
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Propranolol/pharmacology/therapeutic use
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Radiopharmaceuticals/*chemistry
4.Nuclear Molecular Imaging for Vulnerable Atherosclerotic Plaques.
Korean Journal of Radiology 2015;16(5):955-966
Atherosclerosis is an inflammatory disease as well as a lipid disorder. Atherosclerotic plaque formed in vessel walls may cause ischemia, and the rupture of vulnerable plaque may result in fatal events, like myocardial infarction or stroke. Because morphological imaging has limitations in diagnosing vulnerable plaque, molecular imaging has been developed, in particular, the use of nuclear imaging probes. Molecular imaging targets various aspects of vulnerable plaque, such as inflammatory cell accumulation, endothelial activation, proteolysis, neoangiogenesis, hypoxia, apoptosis, and calcification. Many preclinical and clinical studies have been conducted with various imaging probes and some of them have exhibited promising results. Despite some limitations in imaging technology, molecular imaging is expected to be used both in the research and clinical fields as imaging instruments become more advanced.
Atherosclerosis/*diagnosis/pathology/radiography
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Endothelial Cells/metabolism
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Humans
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Inflammation/pathology
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Lipoproteins, LDL/metabolism
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Macrophages/immunology/metabolism
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Plaque, Atherosclerotic
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Positron-Emission Tomography
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Tomography, Emission-Computed, Single-Photon
5.Inflammatory Pseudotumor of the Breast: a Case Report with Imaging Findings.
Seung Ja KIM ; Woo Kyung MOON ; Ji Hun KIM ; Nariya CHO ; Chung Min CHANG
Korean Journal of Radiology 2009;10(5):515-518
Inflammatory pseudotumor, also known as inflammatory myofibroblastic tumor and plasma cell granuloma, is an uncommon low-grade lesion composed of spindle cells admixed with mature plasma cells and other inflammatory cells, such as histiocytes, lymphocytes, and eosinophils. Here, we describe the mammographic and ultrasonographic findings of a case of an inflammatory pseudotumor of the breast in a 60-year-old woman. With the suspicion of malignancy, core needle biopsy and surgical excision confirmed the mass as being an inflammatory pseudotumor of the breast.
Biopsy
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Breast Diseases/pathology/*radiography/*ultrasonography
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Diagnosis, Differential
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Female
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Granuloma, Plasma Cell/pathology/*radiography/*ultrasonography
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Humans
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Mammography
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Middle Aged
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Ultrasonography, Mammary
6.Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage.
Eun Ju LEE ; Young Jun LEE ; Seung Ro LEE ; Dong Woo PARK ; Hyun Young KIM
Korean Journal of Radiology 2009;10(5):511-514
We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/microLiter and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia.
Cerebral Hemorrhage/diagnosis/*etiology
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Cerebral Infarction/diagnosis/*etiology
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Diagnosis, Differential
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Eosinophilia/*complications/drug therapy
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Humans
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Magnetic Resonance Imaging
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Male
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Middle Aged
7.Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses.
Ilkay Koray BAYRAK ; Turkay YALIN ; Zafer OZMEN ; Tolga AKSOZ ; Roula DOUGHANJI
Korean Journal of Radiology 2009;10(5):508-510
Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient's mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance.
Adult
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Breast Neoplasms/drug therapy/radiography/*secondary/ultrasonography
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Diagnosis, Differential
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Female
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Humans
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Mammography
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Precursor Cell Lymphoblastic Leukemia-Lymphoma/*pathology
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Ultrasonography, Mammary
8.Erratum.
Ai Jun REN ; Yong GUO ; Shu Ping TIAN ; Li Jing SHI ; Min Hua HUANG
Korean Journal of Radiology 2012;13(2):256-256
No abstract available.
9.RE: Few Comments on: "Musculoskeletal Applications of Elastography: A Pictorial Essay of Our Initial Experience".
Luca Maria SCONFIENZA ; Davide ORLANDI ; Stefano LONGO ; Enzo SILVESTRI
Korean Journal of Radiology 2012;13(2):254-255
No abstract available.
Elasticity Imaging Techniques/*methods
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Humans
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Musculoskeletal Diseases/*ultrasonography
10.Micropapillary Lung Cancer with Breast Metastasis Simulating Primary Breast Cancer due to Architectural Distortion on Images.
Kyungran KO ; Jae Yoon RO ; Eun Kyung HONG ; Seeyeon LEE
Korean Journal of Radiology 2012;13(2):249-253
A 47-year-old Korean woman with right middle lobe lung adenocarcinoma, malignant pleural effusion, and multiple lymph node and bone metastases, after three months of lung cancer diagnosis, presented with a palpable right breast mass. Images of the right breast demonstrated architectural distortion that strongly suggested primary breast cancer. Breast biopsy revealed metastatic lung cancer with a negative result for estrogen receptor (ER), progesterone receptor (PR) and mammaglobin, and a positive result for thyroid transcription factor-1 (TTF-1). We present a case of breast metastasis from a case of lung cancer with an extensive micropapillary component, which was initially misinterpreted as a primary breast cancer due to unusual image findings with architectural distortion.
Adenocarcinoma/drug therapy/*secondary
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Antineoplastic Combined Chemotherapy Protocols/therapeutic use
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Biopsy, Needle
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Bone Neoplasms/secondary
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Breast Neoplasms/drug therapy/*secondary
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Diagnosis, Differential
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Female
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Humans
;
Lung Neoplasms/*pathology
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Lymphatic Metastasis
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Mammography
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Middle Aged
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Neoplasm Staging
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Tomography, X-Ray Computed
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Ultrasonography, Mammary