Unusual relapse of acute myeloid leukemia: granulocytic sarcoma presenting as an acute paraplegia.
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Humans↗
Biomedical subjects
Bo Kyoung Seo
Publications and source records attributed to Bo Kyoung Seo.
Correlation of HER-2/neu overexpression with mammography and age distribution in primary breast carcinomas.
RATIONALE AND OBJECTIVES: HER-2/neu is a valuable prognostic and therapeutic marker in primary breast carcinoma. The objective of this study was to determine the mammographic and patient characteristics (age) that correlate with HER-2/neu overexpression in primary breast carcinoma. MATERIALS AND METHODS: HER-2/neu characteristics and preoperative mammograms were available in 498 patients with 543 primary breast carcinomas (526 invasive carcinomas and 17 ductal carcinoma in situ). HER-2/neu status was determined by immunohistochemistry and fluorescence in situ hybridization. For evaluation of patient age distribution, age was divided into 5 groups. For mammography, breast composition and abnormal findings were categorized. Abnormal findings were divided into mass, calcification, architectural distortion, asymmetric density, or none. RESULTS: For age distribution, women under than 50 years had more frequent HER-2/neu overexpression than women aged 60-69 years (P < .05). On mammography, there was no significant correlation between breast composition and HER-2/neu status (P > .05). Calcifications were more significantly frequent in carcinomas with HER-2/neu overexpression (56%) than in those without HER-2/neu overexpression (40%) (P = .001). Of the 242 carcinomas with calcifications on mammography, fine linear morphology was more significantly frequent in carcinomas with HER-2/neu overexpression (20%) when compared with those without HER-2/neu overexpression (10%) (P = .023). Diffuse distribution of calcifications was more common in carcinomas with HER-2/neu overexpression (11%) compared with carcinomas without HER-2/neu overexpression (5%) (P = .051). CONCLUSION: HER-2/neu overexpression in primary breast carcinoma is correlated with patients' age (under age 50) and calcifications at mammography.
Adult↗
The positive predictive value for diagnosis of breast cancer full-field digital mammography versus film-screen mammography in the diagnostic mammographic population.
RATIONALE AND OBJECTIVES: Diagnostic mammography is performed on women with clinical symptoms that suggest breast cancer or women for whom further mammographic evaluation has been requested because of an abnormal screening mammography. We assessed whether the use of full-field digital mammography would improve the positive predictive value (PPV) for the diagnosis of breast cancer in a diagnostic population compared with film-screen mammography. MATERIALS AND METHODS: From January 2002 to December 2003, 11,621 patients underwent diagnostic mammography at the University of North Carolina Hospital, Chapel Hill. Among these 11,621 patients, 1400 lesions in 1121 patients underwent biopsy. We included the biopsy-performed lesions, so PPV3 was used for comparison of PPVs between film-screen mammography and full-field digital mammography. Six breast radiologists interpreted the images using the Breast Imaging Reporting and Data System of the American College of Radiology. PPV3s were compared between film-screen and full-field digital mammography in the entire study cohort and in specified subgroups according to different radiologists, breast density, and lesion type on mammography. The chi(2) and Fisher's exact tests were used for comparison of PPV3s between two modalities of mammography with the Bonferroni procedure for subgroup analysis. RESULTS: In the entire study cohort, PPV3s of full-field digital mammography and film-screen mammography were similar (difference in PPV3,-0.007; 95% confidence interval, -0.081 to 0.068; P = .8602). In predefined subgroups, there was no difference in PPV3 by the radiologist, breast density, or lesion type between two modalities of mammography (P > .005). CONCLUSION: There is no improvement in PPV for the diagnosis of breast cancer with full-field digital mammography compared with film-screen mammography in a large diagnostic population.
Adult↗
A comparative study of mobile electronic data entry systems for clinical trials data collection.
PURPOSE: To determine the speed, accuracy, ease of use, and user satisfaction of various electronic data entry platforms for use in the collection of mammography clinical trials data. METHOD AND MATERIALS: Four electronic data entry platforms were tested: standalone personal digital assistant (PDA), Tablet PC, digitizer Tablet/PDA Hybrid (DTP Hybrid), and digital pen (d-pen). Standard paper data entry was used as control. Each of five radiologist readers was assigned to enter interpretations for 20 screening mammograms using three out of the five data entry methods. Assistants recorded both start and stop data entry times of the radiologists and the number of help requests made. Data were checked for handwriting recognition accuracy for the d-pen platform using handwriting verification software. A user satisfaction survey was administered at the end of each platform reading session. RESULTS: Tablet PC and d-pen were statistically equivalent to conventional pen and paper in initial data entry speed. Average verification time for d-pen was significantly less than secondary electronic data entry of paper forms (p-value <0.001). The number of errors in handwriting recognition for d-pen was less than secondary electronic data entry of the paper forms data. Users were most satisfied with Tablet PC, d-pen, and conventional pen and paper for data entry. CONCLUSIONS: Tablet PC and d-pen are equally fast and easy-to-use data entry methods that are well tolerated by radiologist users. Handwriting recognition review and correction for the d-pen is significantly faster and more accurate than secondary manual keyboard and mouse data entry.
Clinical Trials as Topic↗
A comparative study of 2D and 3D ultrasonography for evaluation of solid breast masses.
OBJECTIVE: To compare image quality and diagnostic accuracy of 2D with 3D ultrasonography in solid breast masses. METHODS AND MATERIAL: To rate image quality, two radiologists compared lesion contrast and characterization of 507 solid breast masses in 2D and 3D ultrasonography and then graded the 3D imaging in 3-point scale. To characterize the masses, the same radiologists rated the examination for clarity of margin, posterior acoustic feature, and clustered microcalcifications within a mass. In addition, the masses were assigned BI-RADS categories as proposed by the American College of Radiology, criteria using just ultrasonographic features. In the 202 pathologically confirmed cases, sensitivity, specificity, positive predictive value, negative predictive value, and false negative rate for diagnosis of breast cancer in 2D and 3D ultrasonography were assessed. Image quality and diagnostic accuracy were further evaluated according to the size of the masses. RESULTS: Two observers rated 3D imaging superior to 2D imaging in terms of lesion contrast and characterization of the masses. Especially, superiority of 3D ultrasonography in terms of image quality was increasing in more than 10 mm sized masses. However, diagnostic accuracy including sensitivity, specificity, positive predictive value, negative predictive value, and false negative rate for diagnosis of breast cancer of 3D imaging was not different from 2D imaging. CONCLUSION: In spite of superior image quality on 3D ultrasonography, it does not provide additional benefits to diagnostic accuracy for diagnosis of breast cancer.
Adult↗
Comparison of full-field digital mammography to screen-film mammography with respect to contrast and spatial resolution in tissue equivalent breast phantoms.
To determine if the improved contrast resolution of full-field digital mammography (FFDM) with reduced spatial resolution allows for superior or equal phantom object detection compared with screen-film mammography (SFM). Tissue equivalent breast phantoms simulating an adipose to glandular ratio of 50/50,30/70, and 20/80 were imaged according to each manufacturers' recommendation with four full-field digital mammography units (Fuji, Sectra, Fischer, and General Electric) and a screen-film mammography unit (MammoMatII 2000, Siemens, Munich, Germany). A total of 20 images were obtained in both hard- and soft-copy formats. For the purpose of soft-copy display, the screen-film hard-copy images were digitized with a 50 microm micron scanner. Six radiologists, experts in breast imaging, and three physicists, experts in scoring mammography phantoms, participated in a reader study where each reader scored each phantom for visibility of line-pairs and for 24 objects (fibers, clusters of specks, and masses). The data were recorded, entered into a database, and analyzed by a mixed-effect model. The limiting spatial resolution in line-pairs per millimeter visible with the digital units was less, regardless of display modality used, than that provided by the screen-film unit. The difference was statistically significant for the General Electric (p < 0.01) and Fuji digital mammography units (p = 0.03). With respect to the number of visible objects, a statistically significant higher number could be detected with the screen-film unit as compared to the Fischer (p < 0.01) and Sectra (p < 0.01) digital mammography units, but there was no significant difference between the other digital units and screen film. Overall, there was significantly better performance on the 50/50 phantom than with the 30/70 and 20/80 phantoms (p = 0.01, p < 0.01) for object visibility. For the digital mammography units, soft-copy display performed better than hard-copy display for the Fischer and Sectra images, but worse for Fuji and General Electric. In addition, soft-copy display of digitized screen-film images was significantly better than hard-copy display (p =0.02) of the original screen films for object visibility, but worse for spatial resolution. The higher contrast resolution of the FFDM units tested did not result in improved detection of line-pair resolution or objects in the phantoms tested versus screen-film mammography. The phantom performance of a digital mammography unit seems to be influenced by the type of detection task (line-pair resolution versus object visibility), the display modality (soft-copy versus hard-copy) chosen to score the phantoms, and the parenchymal pattern composition of the phantom.
Breast Neoplasms↗
Using MRI to evaluate anatomic significance of aortic bifurcation, right renal artery, and conus medullaris when locating lumbar vertebral segments.
OBJECTIVE: This study evaluated the anatomic significance and sites of aortic bifurcation, right renal artery, and conus medullaris when locating lumbar vertebral segments on MRI. SUBJECTS AND METHODS. The study group was composed of 210 patients who underwent MRI of the lumbosacral spine. The position of aortic bifurcation was evaluated using MRI. Midline and sagittal MRI were also assessed to identify the proximal portion of the right renal artery and the tip of the conus medullaris. These locations were recorded in relation to the upper or lower half of the adjacent vertebral body or the adjacent intervertebral disk space. RESULTS: The most common site of aortic bifurcation was at the L4 vertebra (83%). In most patients two separated iliac arteries were apparent at the level of the L4-L5 disk space (93%), and the right renal artery was located between the lower half of the L1 vertebra and the upper half of the L2 vertebra (92%). The position of the conus medullaris was variably located, and the most frequent site was at the L1 vertebra (56%). CONCLUSION: The aortic bifurcation, the right renal artery, and the combination of these structures can be reliable landmarks for determining the lumbar vertebral segments on MRI or CT. However, conus medullaris cannot be considered a good landmark because of its variable locations.
Adolescent↗
Segmental misty mesentery: analysis of CT features and primary causes.
PURPOSE: To review the computed tomographic (CT) features of segmental misty mesentery (SMM) in 29 patients and assess the primary causes of this CT finding. MATERIALS AND METHODS: The authors analyzed the medical records and CT features of SMM in 29 patients. CT images were evaluated for the site, thickness, and vascular changes of the involved mesentery; bowel wall changes; lymphadenopathy; and the fat ring sign. The primary cause of SMM in five patients was determined at histopathologic examination, that in three patients was determined at surgical observation of the mesentery, and that in nine patients was determined on the basis of follow-up CT and clinical data. The primary cause of SMM in 12 patients was unknown. RESULTS: Twenty-five of the 29 patients had various underlying diseases. Fourteen (48%) patients had a malignancy: 11 had intraabdominal cancer and three had extraabdominal cancer. Jejunal mesentery was more commonly involved than was ileal mesentery (P <.05). The mean thickness of the SMM was 4.0 cm. Mesenteric vessels were dilated in 27 patients (93%): 19 with venous dilatation and eight with either arterial dilatation only or both arterial and venous dilatation. At CT, seven (24%) patients had a thickened bowel wall; nine (31%) patients, lymphadenopathy; and two (7%) patients, the fat ring sign. The primary cause of SMM was edema in eight, malignant neoplasm in four, inflammation and/or fibrosis in five, and idiopathic in 12 patients. CONCLUSION: At CT, SMM appears as a result of malignant neoplasms, inflammation, or vascular disorders.
Adolescent↗
Unusual presentation of thymic carcinoma: hypertrophic osteoarthropathy.
Hypertrophic osteoarthropathy is characterized by clubbing and periosteal new bone formation along the shaft of the long bones of the extremities. Although various intrathoracic malignancies have been associated with the development of HOA, it has been extremely rare for HOA to occur in a patient with a thymic carcinoma. Recently, we experienced a 63-year-old woman diagnosed as a thymic carcinoma with hypertrophic osteoarthropathy. She had both digital clubbing and cortical thickening in her lower extremities identified radiologically. We herein describe this case with a review of the literature.
Carcinoma↗
A case of non-Hodgkin's lymphoma in a patient with neurofibromatosis type 1.
Neurofibromatosis type 1 is characterized by cutaneous neurofibromas and pigmented lesions of the skin called café au lait spots. Although neurofibromatosis type 1 represents a major risk factor for the development of malignancy, especially of nervous system tumors, malignant lymphoma rarely occurs in a patients with neurofibromatosis type 1. Recently, a 77-year-old woman with neurofibromatosis type 1 was diagnosed as non-Hodgkin's Lymphoma (diffuse large B cell). She had multiple café au lait spots, neurofibromas and right axillary lymph node enlargement. An abdominal CT scan demonstrated a left pelvic mass and para-aortic lymphadenopathy. Because non-Hodgkin's Lymphoma in a neurofibromatosis patient has never been reported in Korea, herein, we describe this case and include a review of the literature.
Aged↗
Utility of polymerase chain reaction for detecting Mycobacterium tuberculosis in specimens from percutaneous transthoracic needle aspiration.
PURPOSE: To determine the clinical utility of polymerase chain reaction (PCR) for detecting Mycobacterium tuberculosis in specimens from percutaneous transthoracic needle aspiration (PTNA). MATERIALS AND METHODS: PCR for M tuberculosis detection in specimens from PTNA was performed prospectively in addition to cytologic and histologic analyses in 45 patients. On computed tomographic (CT) scans, tuberculosis (TB) versus malignant neoplasm or other infection was diagnosed in 28 patients; possible malignancy was diagnosed in 11, but TB was considered clinically because of young patient age or presence of tuberculous lesions in other areas of the lungs. In six of these patients, TB was diagnosed, but bacteriologic results were negative. PTNA was performed with a 21-gauge needle by one chest radiologist by using CT (n = 25), ultrasonographic (n = 5), or fluoroscopic guidance (n = 15). Final diagnoses were malignant neoplasm (n = 19), hamartoma (n = 1), TB (n = 17), and pneumonia (including actinomycosis and aspergillosis) (n = 8). Sensitivity, specificity, and positive predictive values of PCR in PTNA specimens for diagnosis of TB were calculated. RESULTS: In 17 patients with TB, PCR results were positive in 11 and negative in six. PCR results were negative in all cases of malignant neoplasm, hamartoma, and pneumonia. Cytologic and histologic analysis of PTNA specimens resulted in a specific diagnosis of TB in two (12%) of 17 patients. By adding the PCR results, diagnosis of TB was established in 12 (71%) of 17 patients. Sensitivity, specificity, and positive and negative predictive values of PCR for diagnosis of TB in PTNA specimens were 65% (11 of 17), 100% (28 of 28), 100% (11 of 11), and 82% (28 of 34), respectively. CONCLUSION: PCR for detection of M tuberculosis in PTNA specimens is a useful adjuvant to cytologic and histologic analysis for diagnosis of TB.
Adult↗
Low-dose multidetector dynamic CT in the breast: preliminary study.
This study investigated the feasibility of using low-dose multidetector dynamic computed tomography (CT) scan for imaging breast. We measured the radiation dose using a phantom at low- and standard-dose CT. To compare the image quality at low- and standard-dose CT, we evaluated normal breasts in 57 cases. In 44 cases with breast cancer, we assessed the staging and time-enhancement curves of breast cancer. In conclusion, the low-dose multidetector dynamic CT scan is feasible for the evaluation of the breast, with reduced radiation dose and with similar image quality when compared with standard-dose CT scan. In breast cancers, low-dose dynamic CT could be used for the staging of breast cancer before surgery.
Adult↗
Sonographic evaluation of breast nodules: comparison of conventional, real-time compound, and pulse-inversion harmonic images.
OBJECTIVE: To compare the use of conventional, real-time compound, and pulse-inversion harmonic imaging in the evaluation of breast nodules. MATERIALS AND METHODS: Fifty-two breast nodules were included in this study, conducted between May and December 2000, in which conventional, real-time compound, and pulse-inversion harmonic images were obtained in the same plane. Three radiologists, each blinded to the interpretations of the other two, evaluated the findings, characterizing the lesions and ranking the three techniques from grade 1, the worst, to grade 3, the best. Lesion conspicuity was assessed, and lesions were also characterized in terms of their margin, clarity of internal echotexture, and clarity of posterior echo pattern. The three techniques were compared using Friedman's test, and interobserver agreement in image interpretation was assessed by means of the intraclass correlation coefficient. RESULTS: With regard to lesion conspicuity, margin, and internal echotexture of the nodules, real-time compound imaging was the best technique (p < 0.05); in terms of posterior echo pattern, the best was pulse-inversion harmonic imaging (p < 0.05). Real-time compound and pulse inversion harmonic imaging were better than conventional sonography in all evaluative aspects. Interobserver agreement was greater than moderate. CONCLUSION: Real-time compound and pulse-inversion harmonic imaging procedures are superior to conventional sonography in terms of both lesion conspicuity and the further characterization of breast nodules. Real-time compound imaging is the best technique for evaluation of the margin and internal echotexture of nodules, while pulse-inversion harmonic imaging is very effective for the evaluation of the posterior echo patterns.
Breast Neoplasms↗
Imaging findings of Castleman's disease localized in the axilla: a case report.
Castleman's disease is a rare benign lymphoproliferative disorder of uncertain origin which most commonly involves the mediastinum but rarely affects the axilla. We report a case of localized Castleman's disease involving the axillary lymph node. Mammography revealed a well-defined, homogeneously dense ovoid mass, 3 cm in size, in the left axilla, while gray-scale ultrasonography (US) demonstrated a well-defined, uniformly hypoechoic ovoid mass with good through transmission. Peripheral hypervascularity was observed at power Dopper US, and early rapid homogeneous enhancement at contrast-enhanced dynamic CT.
Axilla↗