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Purpose The purpose of this study was to evaluate the diagnostic performance and cost of screening thyroid ultrasonography (US) in an asymptomatic population and determine the US features of screening-detected thyroid cancer. Materials and Methods This study included 1,845 asymptomatic participants who underwent screening thyroid US between March and August 2012 at the screening center in our hospital. We evaluated the diagnostic performance of screening thyroid US for thyroid cancer and the average cost of diagnosis for each patient. We also determined the characteristic US features of screeningdetected thyroid cancer. Results Of the 1,845 subjects, 661 showed no abnormalities, 1,155 exhibited benign thyroid nodules, and 29 exhibited thyroid cancer. Imaging features such as solid composition, hypoechogenicity, taller-than-wide axis, and ill-defined or spiculated margins of nodules were suggestive of malignancy. The rate of detection of cancer was 1.6% (29/1,845), and the sensitivity, specificity, and positive and negative predictive values were 100% (18/18), 98.7% (1,051/1,065), 56.3% (18/32), and 100% (1,051/1,051), respectively. Of 18 patients who underwent thyroidectomy, three (16.7%) had a pathological tumor staging of T3, and four (22.2%) had a pathological nodal staging of N1a. The average cost of diagnosis for each patient with cancer was $7,319. Conclusion Screening thyroid US exhibited a good diagnostic performance, with a feasible social cost of use. This modality demonstrated significant differences in sonographic features between screening-detected cancer and benign nodules. [ABSTRACT FROM AUTHOR]

Background Although digital breast tomosynthesis (DBT) is an emerging technique yielding higher sensitivity and specificity compared to digital mammography (DM) alone, relative contribution of prior mammograms on the interpretation of DBT combined with DM has not been investigated. Purpose To retrospectively compare the diagnostic performances of DM, DM + DBT, and DM + DBT with prior mammograms. Material and Methods Three breast radiologists independently reviewed images of 116 patients with 24 cancers in the sequential order of DM, DM + DBT, and DM + DBT with prior mammograms using Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Results The average areas under the receiver operating characteristic curve (AUC) of DM, DM + DBT, and DM + DBT with prior mammograms were 0.712, 0.777, and 0.816, respectively. Adding prior mammograms did not significantly affect the AUC of DM + DBT ( P = 0.108), whereas adding DBT significantly increased the AUC of DM ( P = 0.009). Sensitivity for DM, DM + DBT, and DM + DBT with prior mammograms was 58.3%, 69.4%, and 69.4%, and specificities were 84.1%, 85.9%, and 93.8%, respectively. Addition of DBT significantly increased the sensitivity ( P = 0.0090) of DM. Prior mammograms significantly improved the specificity of DM + DBT ( P = 0.0004), whereas adding prior mammogram did not affect sensitivity of DM + DBT ( P = 1.000). Conclusion DBT significantly increases the overall sensitivity and diagnostic performance of DM. Prior mammograms significantly increase the specificity of DM + DBT but have no significant effect on sensitivity and overall diagnostic performance. [ABSTRACT FROM AUTHOR]

Background: The relationship between biomarkers and imaging features is important because imaging findings can predict molecular features. Objectives: To investigate the relationship between clinicopathologic and radiologic factors and the immunohistochemical (IHC) profiles associated with breast cancer. Patients and Methods: From December 2004 to September 2013, 200 patients (mean age, 56 years; range, 29 - 82 years) were diagnosed with breast cancer and underwent surgery at our institution. Their medical records were reviewed to determine age, symptom presence, mammographic findings (including mass, asymmetry, microcalcifications, or negativity), sonographic Breast Imaging-Reporting and Data System (BI-RADS) category, pathologic type of cancer (invasive ductal, mucinous, medullary, or papillary carcinoma), histologic grade, T-stage, and IHC subtypes. Based on the IHC profiles, tumor subtypes were classified as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, or triple-negative (TN) cancers. Using univariate and multivariate logistic regression analyses, we looked for correlations between four IHC subtypes and two IHC subtypes (TN and non-triple negative [non-TN]) and clinicopathologic and radiologic factors, respectively. Results: Based on our univariate analyses with the four subtypes, the TN subtype showed a higher incidence of masses on mammography compared to the other subtypes (P = 0.037), and the TN subtype also tended to have the highest histologic grade among the subtypes (P < 0.001). With regard to the two IHC subtypes, the TN subtype had a significant association with medullary cancer (P = 0.021), higher histologic grade (grade 3; P < 0.001), and higher T stage (T2; P = 0.027) compared to the non-TN subtypes. In a multivariate logistic regression analysis of the clinicoradiologic factors compared to luminal A, the HER2 subtype had a significant association with BI-RADS category 4b (odds ratio [OR], 9.005; 95% confidence interval [CI], 1.414 - 57.348; P = 0.020) and borderline significance with category 4c (OR, 4.669; 95% CI, 0.970 - 22.468; P = 0.055). In a multivariate logistic regression analysis of the clinicoradiologic factors associated with the non-TN subtypes, the TN subtype was significantly correlated with medullary carcinoma (OR, 7.092; 95% CI, 1.149 - 43.772; P = 0.035). Conclusion: These results suggest that patients with the TN subtypes are more likely to have higher-histologic-grade tumors and medullary cancer. The HER2 subtype was typically associated with a higher BI-RADS category. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the efficacy of radiofrequency (RF) ablation for benign thyroid nodules and assess the usefulness of internal factors (ultrasonographic findings) and external factors (treatment-related findings) in prediction of treatment efficacy. Methods: We evaluated 22 benign thyroid nodules from 19 patients treated with RF ablation between March 2010 and January 2013. The internal and external factors of these nodules were retrospectively reviewed and correlated with the therapeutic success and the volume reduction ratio (VRR). The volume and size of the nodules were determined before treatment, and the VRR was calculated at 6-month and 1-year follow-up examinations after RF ablation. Therapeutic success was defined as a >50% volume reduction. Results: The mean VRRs were 66.1±18.7% at 6 months and 74.3±16.7% at 1 year. The therapeutic success rate after 6 months and 1 year was 81.8% and 90.9%, respectively. At the 1-year follow-up, the margin of the nodule correlated with therapeutic success. Most of the successfully ablated nodules showed well-defined margins on initial ultrasonography (18/20, 90%) (P=0.026). In addition, nodules with ill-defined margins showed a tendency toward having a low VRR at the 6-month and 1-year follow-up examinations. Conclusion: RF ablation was effective in decreasing the volume of benign thyroid nodules. Thyroid nodules with well-defined margins tended to show successful outcomes at the 1-year follow-up examination after RF ablation. [ABSTRACT FROM AUTHOR]