Although the characteristics of solitary metastasis and glioblastoma multiforme may be similar on conventional MRI, DWI can offer diagnostic information to distinguish between the tumors.

BACKGROUND AND PURPOSE:Histopathologic grade of glial tumors is inversely correlated with the minimum apparent diffusion coefficient (ADC). We assessed the diagnostic values of minimum ADC for preoperative grading of supratentorial astrocytomas that were diagnosed as low-grade astrocytomas on conventional MR imaging.

Purpose:The first Korean national population-based cancer registry using nationwide hospital-based recording system and the regional cancer registries provided the source to obtain national cancer incidences for the period 1999～2001.M aterials and Methods: The incidence of cancer in Korea was calculated based on the Korea Central Cancer Registry database, data from additional medical record review survey, the Regional Cancer Registry databases, site-specific cancer registry databases, and cancer mortality data from the Korea National Statistical Office. Crude and age-standardized rates were calculated by sex for 18 age groups.Results: The overall crude incidence rates (CR) were 247.3 and 188.3 per 100,000 for men and women and the overall age-standardized incidence rates (ASR) were 281.2 and 160.3 per 100,000, respectively. Among men, five leading primary cancer sites were stomach (CR 58.6, ASR 65.6), lung (CR 42.1, ASR 50.9), liver (CR 41.9, ASR 44.9), colon and rectum (CR 24.2, ASR 27.3) and bladder (CR 7.7, ASR 9.2). Among women, the most common cancers were stomach (CR 30.8, ASR 25.8), breast (CR 25.7, ASR 21.7), colon and rectum (CR 19.6, ASR 16.7), uterine cervix (CR 18.4, ASR 15.5), and lung cancer (CR 15.1, ASR 12.4). In 0～14 age group, leukemia was most common for both sexes. For men, stomach cancer was most common in 15～64 age group, but lung cancer was more frequent for over 65 age group. For women, thyroid cancer in 15～34 age group, breast cancer in 35～64 age group, and stomach cancer in over 65 age group were most common for each age group. The proportions of death certificate only were 7.5% for men and 7.4% for women.Conclusion: This is the first attempt to determine the national cancer incidence and this data will be useful to plan for research and national cancer control in Korea.

Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research.

R esults: O f the total of 99,025 malignancies, 55,398 (55.9% ) cases were males and 43,627 (44.1% ) were fem ales. M ore than one third of cases were from the elderly (65 years old and more). The six leading primary cancer sites in the order of their relative frequency, were stomach (24.0% ), followed by the lung (16.0% ), the liver (15.4% ), the colorectum (11.6% ), the bladder (3.2% ), and the prostate (3.0% ) among males. In females, the breast (16.8% ) was the common cancer site, followed by the stomach (15.3% ), the colorectum (10.7% ), the thyroid gland (9.5% ), the cervix uteri (9.1% ), and the lung (6.6% ).C onclusion: W ith the continued increase in cancer cases especially prostate cancer among males and thyroid cancer among females, the total number of registered cancer cases in Korea continues to rapidly increase.