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Biomedical subjects

Jae Mun Lee

Publications and source records attributed to Jae Mun Lee.

15 recordsLinked to original sources

18F-fluorodeoxyglucose positron emission tomography in patients with recurrent ovarian cancer: in comparison with vascularity, Ki-67, p53, and histologic grade.

The aim of this study was to assess the correlation between 18F-fluorodeoxyglucose positron emission tomography (FDG PET) positivity of tumor recurrence and vascularity, Ki-67, p53, and histologic grade in patients with ovarian cancer. Nineteen patients with recurrent ovarian cancer underwent FDG PET before second-look surgery. Archival paraffin-embedded tissue materials were used to assess histologic grade including architectural pattern, mitotic activity, and nuclear pleomorphism; intratumor microvessel density (MVD); Ki-67; and p53. Univariate analysis was used to evaluate the correlation between FDG PET positivity and each biomarker. Stepwise logistic regression analysis was used to determine the best parameter to explain FDG PET positivity. MVD revealed significant positive correlation with FDG PET positivity (p=0.0341). There was no significant correlation between FDG PET positivity and Ki-67 or p53 (p=0.4040, p=0.6027). Mitotic activity yielded statistically significant positive correlations with FDG PET positivity (p=0.0448) although histologic grade revealed no positive correlation (p=1). Stepwise logistic regression analysis revealed MVD to be the strongest parameter for FDG PET positivity (OR=0.696, 95% CI 0.487-0.993, p=0.0458). In conclusion, FDG PET positivity revealed positive correlation with MVD and mitotic activity. MVD was the strongest parameter in predicting positive tumor recurrence on FDG PET.

Adult↗

The sternalis muscles: incidence and imaging findings on MDCT.

OBJECTIVE: We studied the incidence and appearance of the sternalis muscles on multidetector computed tomography (MDCT) to permit the differentiation of the sternalis from significant pathologic condition. METHODS: We retrospectively evaluated consecutive contrast-enhanced 16 row MDCT scans of the chest obtained in 1387 Korean patients (790 males and 597 females) between September 2003 and January 2005. All computed tomography scans were obtained in the supine position. Age ranges were 16 to 87 years and average was 59.2 years. Imaging analysis was based upon distribution (unilateral or bilateral, size, shape, and location). Statistical differences were evaluated by chi tests and Independent Samples t tests. RESULTS: The sternalis muscle was present in 86 (6.2%) of 1387 patients. This muscle was more common in female (44 of 597, 7.3%) than in male (42 of 790, 5.3%) patients, but statistical significance was not noted (P=0.058). Twenty-three patients showed bilateral sternalis muscles. Among 63 patients with unilateral sternalis muscles, 28 patients showed left sternalis muscles and 35 patients showed right sternalis muscles. Unilateral distribution was more common. The height, AP diameter, and width of the sternalis muscle were not significantly different between unilateral and bilateral muscles (P=0.182, 0.911, and 0.114, respectively). The height and AP diameter showed no significant difference between male and female (P=0.470, 0.329, respectively) patients, but the width was wider in male (P<0.001) patients. All sternalis muscles showed flat appearance, except for 1 case. The sternalis muscles were located longitudinally in parasternal position in all cases. CONCLUSIONS: The sternalis muscle is an unusual normal variant of the chest wall musculature running parallel to the sternum with various sizes and most sternalis muscles are flat on MDCT. Unilateral distribution is more common, and the size of muscle is larger in males. Its incidence is 6.2% in Korean population. Radiologists should be familiar with the image findings of the sternalis muscle to avoid any confusing pathologic lesions and facilitate its clinical use such as flap.

Adult↗

Evaluation of joint effusion in rabbits by color Doppler, power Doppler, and contrast-enhanced power Doppler ultrasonography.

PURPOSE: The aim of this prospective study was to evaluate the diagnostic value of power Doppler ultrasonography (PDUS) and contrast-enhanced PDUS (CEPDUS) in the depiction and characterization of experimentally induced arthritis in the rabbit. MATERIALS AND METHODS: Thirty rabbits were divided into three groups consisting of one control group (saline injection group) and two experimental groups: a suppurative arthritis group and a chemically induced synovitis group. The same amount (1 ml) of each agent was directly injected into the right hip joint. Serial color Doppler ultrasound (CDUS), PDUS, and CEPDUS images were obtained before and after injection. RESULTS: We observed that all of the infected knees in the suppurative arthritis group with Staphylococcus aureus demonstrated an increased signal on PDUS after inoculation. A minimal power Doppler signal was presented in the chemically induced synovitis group with talc injection, but none of the control knees demonstrated any increased signals. CEPDUS was the most sensitive imaging modality for evaluating the increase of blood flows in suppurative arthritis and was subsequently followed by PDUS and CDUS. CONCLUSION: The increased signals obtained with PDUS represent increased local blood flows; therefore, this technique can be used for evaluating the degree of inflammation. Furthermore, using the contrast agent enhances the sensitivity of PDUS, and it can even be useful for differentiating borderline cases.

Animals↗

Breast MRI findings after modified radical mastectomy and transverse rectus abdominis myocutaneous flap in patients with breast cancer.

PURPOSE: To evaluate the MRI findings in breast cancer patients who had undergone a modified radical mastectomy (MRM) and a transverse rectus abdominis myocutaneous (TRAM) flap. MATERIALS AND METHODS: MRI was performed on 20 patients who had been diagnosed with breast cancer and had undergone an MRM and TRAM flap. The results were examined in terms of MRI's ability to detect the flap and assess possible postoperative changes and recurrence. In addition, MRI images of the opposite breast were analyzed. Follow-up examinations were carried out on 11 patients, and all changes were assessed. RESULTS: The flap was clearly visualized by MRI in all of the patients. The signal intensity of the flap was equivalent to that of fat. The contact zone between the TRAM flap and the mastectomy site was enhanced after contrast infusion. Postoperative changes, such as skin thickening (n=20), edema (n=2), fluid collection (n=3), hematoma (n=1), and fat necrosis (n=3), were detected. In two patients, artificially inserted fat tissue was identified. On the MRI of the opposite breast, enhancing lesions were detected in seven patients. In one patient with this finding, ductal carcinoma in situ was diagnosed. On the follow-up MRI, a decrease in skin thickening, fat necrosis, and hematoma was detected. CONCLUSION: MRI is an effective method for lesion detection and evaluation of postoperative changes after MRM and TRAM flap, as well as for evaluation of the opposite breast.

Adult↗

CT and MRI findings of sex cord-stromal tumor of the ovary.

OBJECTIVE: The purpose of this article was to research the clinical and imaging features of sex cord-stromal tumors of the ovary to help in specific diagnosis of ovarian tumors. Sex cord-stromal tumors of the ovary are rare ovarian neoplasms, which arise from stromal cells and primitive sex cords in the ovary. The common types are granulosa cell tumors, fibrothecomas, sclerosing stromal tumors, and Sertoli-Leydig cell tumors. They account for most of the hormonally active ovarian tumors. They have characteristic imaging features in each type of the tumor. CONCLUSION: Clinical and radiologic clues are helpful in differential diagnosis from the more common epithelial tumors; sex cord-stromal tumors primarily are treated surgically and have generally good prognosis.

Adult↗

Sonographic findings in a patient with cystic hypersecretory duct carcinoma of the breast.

In this report, we describe a case of a rare form of intraductal carcinoma of the breast known as cystic hypersecretory duct carcinoma in a 49-year-old woman with a palpable mass and no history of breast disease. Mammography showed heterogeneous dense breast tissue with no definite abnormally increased density or microcalcifications. Gray-scale sonography detected multiple small aggregated, anechoic cysts with good through-transmission in the upper outer quadrant of the left breast, corresponding to the location of the palpable mass. The patient underwent an excision biopsy, and histopathologic examination of the surgical specimen revealed multiple cysts of different size containing an eosinophilic material resembling thyroid colloid. The locations of the cysts corresponded to those of the anechoic cysts detected on sonography. The epithelium lining the cysts showed micropapillary growth consistent with a diagnosis of cystic hypersecretory duct carcinoma. The mammographic and sonographic findings in this case differed somewhat from those reported previously for this rare form of breast carcinoma. Because the imaging findings and low-power microscopic appearance of the mass in our patient's case closely resembled those of some benign breast lesions, we recommend careful differentiation of this type of lesion using high-power microscopy during histopathologic evaluation.

Breast Neoplasms↗

The renal sinus: pathologic spectrum and multimodality imaging approach.

Various pathologic conditions can occur in the renal sinus, primarily originating in the constituents of the renal sinus, and the renal sinus can be secondarily involved by surrounding renal parenchymal and adjacent retroperitoneal lesions. Lipomatosis and cysts are common renal sinus lesions with little clinical significance, but differentiation from other pathologic conditions is important. Renal vascular lesions such as renal artery aneurysm or arteriovenous fistula can mimic other parapelvic or peripelvic lesions at excretory urography, but their vascular nature is evident at color Doppler ultrasonography, contrast material-enhanced computed tomography (CT), and magnetic resonance (MR) imaging. Although most tumors originating in the renal pelvis are transitional cell carcinoma or squamous cell carcinoma, renal parenchymal tumors such as renal cell carcinoma or benign multilocular cystic nephroma have a tendency to grow into the renal sinus. Rare tumors of mesenchymal origin can develop in the renal sinus, but their imaging findings are nonspecific. The observation of renal sinus fat is important for detecting a small tumor located in that area and determining the exact tumor stage. Multiplanar CT or MR images can allow exact evaluation of the extent of complex renal sinus disease.

Adolescent↗

CT and MRI findings of cystadenofibromas of the ovary.

The aim of this study was to assess imaging findings on CT or MR images of histologically proven ovarian cystadenofibromas. In the period 1995-2001, 32 histologically proven ovarian cystadenofibromas were identified in 28 women. Of the 32 ovarian cystadenofibromas, 16 tumors were purely cystic and the remaining 16 were complex cystic on CT or MR images. Solid components of 16 complex cystic tumors were seen as nodular ( n=8) or trabecular ( n=9) solid areas. One tumor had both nodular and trabecular solid components. Among 16 complex cystic tumors, 14 had thick or irregular septa; thus, half of ovarian cystadenofibromas had morphological imaging features of malignancy on CT or MR images. On histology, solid components in the cystic tumors were correlated with fibrous stromas that occasionally made a false-positive result for malignancy on imaging.

Adolescent↗

Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer.

OBJECTIVE: The purpose of our study was to evaluate the diagnostic accuracy of FDG positron emission tomography (PET) in comparison with CT in detecting recurrent ovarian carcinoma and its ability to reveal small tumor recurrence. MATERIALS AND METHODS: We reviewed the records of 31 consecutive patients with pathologically proven epithelial carcinoma who underwent FDG PET 1 month before second-look surgery to assess recurrent tumor. Of these 31 patients, 21 patients also underwent CT 1 month before second-look surgery. The diagnostic accuracies of FDG PET (n = 31), CT (n = 21), and combined FDG PET and CT (n = 21) in detecting recurrent tumor were calculated and compared with each other using the Bennett's test in 21 patients who underwent both imaging studies. Detection rates of individual tumors relative to their sizes were compared between FDG PET and CT using the McNemar test. RESULTS: The sensitivity, specificity, and accuracy of FDG PET, CT, and combined FDG PET and CT for revealing recurrent ovarian cancer were 45.3%, 99.7%, 91.0%; 54.5%, 99.6%, 91.7%; 58.2%, 99.6%, 92.4%, respectively. We found no statistically significant difference in the diagnostic accuracy of FDG PET, CT, and combined FDG PET and CT (chi(2) < 5.991). Detection rates of tumor nodules found on CT were significantly greater than those on FDG PET when nodule size was 0.3-0.7 cm (p < 0.05). CONCLUSION: FDG PET did not improve the overall diagnostic accuracy in detecting recurrent ovarian carcinoma compared with CT. Rather, FDG PET was inferior to CT in its ability to reveal small-tumor recurrence.

Adolescent↗

CT and MR imaging of ovarian tumors with emphasis on differential diagnosis.

Ovarian tumors are classified on the basis of tumor origin as epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, embryonal carcinoma), sex cord-stromal tumors (fibrothecoma; granulosa cell, sclerosing stromal, and Sertoli-Leydig cell tumors), and metastatic tumors. Epithelial tumors are primarily cystic and, when malignant, are associated with varying proportions of a solid component. Papillary projections are a distinctive feature of epithelial tumors. Profuse papillary projections are highly suggestive of borderline (low-malignant-potential) or malignant tumor. Ovarian teratomas demonstrate lipid material at computed tomography and magnetic resonance (MR) imaging. Malignant germ cell tumors manifest as a large, complex abdominal mass that contains both solid and cystic components. Tumor markers are helpful in diagnosis. The radiologic appearance of sex cord-stromal tumors varies from small solid masses to large multicystic masses. Granulosa cell tumors are usually large multicystic masses with solid components. Fibrothecoma, sclerosing stromal tumor, and Sertoli-Leydig cell tumors are usually solid masses. Fibromas have very low signal intensity on T2-weighted MR images. Certain radiologic findings predominate for each type of tumor. Knowledge of these key features of ovarian tumors provides the criteria for making a specific diagnosis or substantially narrowing the differential diagnosis.

Diagnosis, Differential↗

Neurogenic tumors in the abdomen: tumor types and imaging characteristics.

There is a broad spectrum of neurogenic tumors that involve the abdomen. These tumors can be classified as those of (a) ganglion cell origin (ganglioneuromas, ganglioneuroblastomas, neuroblastomas), (b) paraganglionic system origin (pheochromocytomas, paragangliomas), and (c) nerve sheath origin (neurilemmomas, neurofibromas, neurofibromatosis, malignant nerve sheath tumors). Abdominal neurogenic tumors are most commonly located in the retroperitoneum, especially in the paraspinal areas and adrenal glands. All of these tumors except neuroblastomas and ganglioneuroblastomas are seen in adult patients. Abdominal neurogenic tumor commonly manifests radiologically as a well-defined, smooth or lobulated mass. Calcification may be seen in all types of neurogenic tumors. The diagnosis of abdominal neurogenic tumor is suggested by the imaging appearance of the lesion, including its location, shape, and internal architecture. Benign and malignant neurogenic tumors are difficult to differentiate unless distant metastatic foci are seen. For malignant tumors, imaging modalities other than computed tomography (CT) and magnetic resonance (MR) imaging may be necessary for staging. However, because most neurogenic tumors in adults are benign, CT and MR imaging can be used to develop a differential diagnosis and help determine the immediate local extent of tumor.

Abdominal Neoplasms↗