Korean Journal of Radiology最新文献

{"title":"OK-432 (Picibanil) Sclerotherapy for the Treatment of Chyle Leakage After Thyroid Surgery.","authors":"Hunjong Lim, Sang Il Choi","doi":"10.3348/kjr.2025.0230","DOIUrl":"10.3348/kjr.2025.0230","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the safety and efficacy of OK-432 (Picibanil) sclerotherapy for the management of chyle leakage following thyroid surgery.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the medical records of 12 consecutive patients with chyle leakage who underwent Picibanil sclerotherapy after thyroid surgery between January 2019 and December 2024. The collected data included patient demographics, clinical presentation, prior treatments, sclerotherapy details, treatment outcomes, and adverse effects. Clinical success was defined as fulfillment of all three criteria: 1) Improvement in clinical signs and symptoms, 2) Volume reduction of the chyloma without compressive effects on surrounding tissues on ultrasonography, and 3) Drainage amount of <10 mL/day (if applicable). Recurrence was defined as the reappearance of chyle leakage symptoms or re-accumulation of fluid at the previous chyloma site on follow-up imaging after initial clinical success.</p><p><strong>Results: </strong>Among the 12 patients (median age: 45.5 years), 11 (91.7%) achieved clinical success. One patient (8.3%) did not respond to treatment and subsequently required thoracic duct embolization. The median number of sclerotherapy sessions was two (range, 1-4). Minor adverse effects, such as fever (10/12) and localized pain (4/12), were observed but resolved without long-term complications. No recurrence was noted during the median post-sclerotherapy follow-up period of 35 months (range: 10-57 months).</p><p><strong>Conclusion: </strong>Picibanil sclerotherapy may be a safe and effective treatment for chyle leakage after thyroid surgery. It may offer a minimally invasive alternative with a high clinical success rate and minor, manageable adverse effects.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"727-733"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Obstacles and Strategic Interventions for Addressing Gaps in the Understanding of Human-Artificial Intelligence Interactions in Medical Practice.","authors":"Hongnan Ye","doi":"10.3348/kjr.2025.0361","DOIUrl":"10.3348/kjr.2025.0361","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"738-739"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging in Acute Obstetric Conditions: A Pictorial Essay.","authors":"Hyungwoo Ahn","doi":"10.3348/kjr.2025.0037","DOIUrl":"10.3348/kjr.2025.0037","url":null,"abstract":"<p><p>Acute abdominopelvic pain during pregnancy and the postpartum period is a diagnostic challenge owing to the overlapping symptoms of obstetric, gastrointestinal, and urinary conditions coupled with pregnancy-induced physiological changes. This pictorial essay reviews critical obstetric emergencies and categorizes cases into two phases: the first covers the preconception-to-pregnancy period, while the second focuses on the postpartum period. This essay covers key obstetric emergencies, such as ovarian hyperstimulation syndrome, hyperreactio luteinalis, ectopic pregnancy, red degeneration of fibroids, placenta accreta spectrum disorders, placental abruption, uterine rupture, retained products of conception, and uterine arteriovenous malformations, with an emphasis on their clinical and imaging characteristics. While ultrasound remains the first-line modality, MRI offers superior soft tissue contrast for more complex cases, and CT is reserved for critical scenarios in which the radiation risk is outweighed by diagnostic necessity. Timely and accurate imaging is essential for differentiating these conditions, guiding interventions, such as uterine arterial embolization and surgery, and minimizing maternal and fetal morbidity. This work aims to enhance the diagnostic precision and multidisciplinary management of obstetric emergencies, ensuring optimal clinical outcomes.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"660-677"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Regarding \"Overview of South Korean Guidelines for Approval of Large Language or Multimodal Models as Medical Devices: Key Features and Areas for Improvement\".","authors":"Hye Jin Baek","doi":"10.3348/kjr.2025.0529","DOIUrl":"10.3348/kjr.2025.0529","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"740-742"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Announcement of New Gastrointestinal Section Editor.","authors":"Seong Ho Park","doi":"10.3348/kjr.2025.0744","DOIUrl":"10.3348/kjr.2025.0744","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 7","pages":"625"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric MRI for Diagnosing Dysthyroid Optic Neuropathy: Added Value of Magnetization Transfer Imaging.","authors":"Jiang Zhou, Quan Yuan, Xiong-Ying Pu, Jin-Ling Lu, Hu Liu, Huan-Huan Chen, Xiao-Quan Xu, Hao Hu, Fei-Yun Wu","doi":"10.3348/kjr.2024.1188","DOIUrl":"10.3348/kjr.2024.1188","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the ability of magnetization transfer imaging (MTI) to diagnose dysthyroid optic neuropathy (DON) and to establish the added value of MTI to conventional T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI).</p><p><strong>Materials and methods: </strong>One hundred and forty-nine patients with thyroid-associated ophthalmopathy were included and divided into training (46 eyes with DON and 148 eyes without DON) and validation (20 eyes with DON and 64 eyes without DON) cohorts. The orbital magnetic resonance imaging (MRI) protocols included coronal MTI, fat-suppressed T2WI, and DWI. The minimum, mean, and maximum values of the magnetization transfer ratio (MTR), signal intensity ratio (SIR), apparent diffusion coefficient (ADC) of each optic nerve (ON), and modified muscle index (mMI) of each orbit were calculated and compared between the groups. Multi-variable logistic regression analysis was performed to identify the independent imaging predictors of DON. The performance of each imaging predictor and their combinations using a binary logistic regression model for diagnosing DON was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Eyes with DON exhibited significantly lower MTRs and ADCs of the ON, increased SIRs of the ON, and increased mMI. The MTR_mean of the ON, ADC_mean of the ON, and mMI were independent predictors of DON. The multi-variable model incorporating these three variables yielded an area under the ROC curve (AUC) of 0.946 and showed significantly higher diagnostic performance than MTR_mean (AUC = 0.831), ADC_mean (AUC = 0.738), or mMI (AUC = 0.862) alone in the training cohort (all <i>P</i> < 0.001). In the validation cohort, the multi-variable model achieved satisfactory diagnostic performance (AUC = 0.926).</p><p><strong>Conclusion: </strong>MTI may be a useful non-invasive technique for diagnosing DON. MTR can provide additional value to conventional DWI in distinguishing patients with DON from those without DON.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"704-715"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Analysis With Time-Dependent Diffusion MRI for Assessing WHO/ISUP Tumor Grade in Clear Cell Renal Cell Carcinoma.","authors":"Chunlei He, Enyu Yuan, Lei Ye, Hui Xu, Xiaoyong Zhang, Hao Zeng, Yuntian Chen, Jin Yao, Bin Song","doi":"10.3348/kjr.2024.1202","DOIUrl":"10.3348/kjr.2024.1202","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility of time-dependent diffusion-weighted imaging (<i>t_d</i>-<i>dMRI</i>) in assessing the pathological World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade of clear cell renal cell carcinoma (ccRCC).</p><p><strong>Materials and methods: </strong>A total of 138 patients (median age, 58 years [interquartile range, 51-64 years]; 89 males) with surgically confirmed ccRCC, comprising 48 high-grade (WHO/ISUP grade III/IV) and 90 low-grade (WHO/ISUP grade I/II) tumors, were included in the study among patients who underwent preoperative <i>t_d</i>-<i>dMRI</i> for suspected RCC between May 2022 and May 2024. The <i>t_d</i>-<i>dMRI</i> microstructural parameters, including cell <i>diameter</i> (<i>d</i>), intracellular volume fraction (<i>f_in</i>), <i>cellularity</i>, and extracellular diffusivities (<i>D_ex</i>), were quantified using a two-compartment model. The solid tumor area was manually annotated to extract the mean values from each parameter map. We analyzed the differences in <i>t_d</i>-<i>dMRI</i> parameters between the high- and low-grade tumors and evaluated the ability of these parameters to distinguish between the two tumor groups. High-definition hematoxylin-and-eosin-stained slides were obtained from 92 patients. We assessed the correlation between <i>t_d</i>-<i>dMRI</i> parameters and pathologic nuclear fraction, which was quantified using an automated nucleus segmentation model (Hover-Net).</p><p><strong>Results: </strong>Compared to high-grade tumors, low-grade tumors exhibited lower <i>cellularity</i> and <i>f_in</i> and higher <i>diameter</i> and <i>D_ex</i>. For differentiation between low- and high-grade ccRCC, the <i>f_in</i> exhibited the highest diagnostic performance (areas under the receiver operating characteristic curve [AUC] = 0.943; 95% confidence interval, 0.906-0.980), followed by <i>cellularity</i> (AUC = 0.931; 0.887-0.976), <i>D_ex</i> (AUC = 0.863; 0.800-0.926), and <i>diameter</i> (AUC = 0.690; 0.596-0.784). The nuclei on pathology slides were automatically segmented, and the nuclear fraction exhibited a moderate correlation with <i>f_in</i> (<i>r</i> = 0.65, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong><i>t_d</i>-<i>dMRI</i> parameters show potential for assessing pathological WHO/ISUP grades and may serve as promising noninvasive biomarkers for characterizing RCC.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"678-687"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreign Body Ingestion: Radiologic Evaluation, Findings, and Management.","authors":"Sang Min Lee, Song-Ee Baek, Choong Wook Lee, Young Chul Kim, Min-Jeong Kim","doi":"10.3348/kjr.2025.0118","DOIUrl":"10.3348/kjr.2025.0118","url":null,"abstract":"<p><p>Foreign body ingestion and sensation are common clinical conditions encountered in emergency and outpatient settings. True foreign body ingestion typically involves a history of swallowing a foreign object and is often confirmed by radiographic findings. The management of foreign body ingestion depends on the type, size, and location of the object, as well as the patient's symptoms. High-risk objects, such as button/disk batteries, multiple magnets, and sharp objects, often require urgent or emergent endoscopic removal to prevent severe complications such as perforation, obstruction, and fistula formation. Imaging is crucial for diagnosis and management, with radiographs being the first-line modality and CT offering superior sensitivity for detecting radiolucent objects and complications. Mimickers of foreign body ingestion and sensations, even without the presence of an actual foreign body, arise from motility disorders (e.g., achalasia), structural or mucosal abnormalities (e.g., Zenker's diverticulum, reflux esophagitis, and esophageal strictures), and extrinsic compression. Although these mimickers produce similar symptoms, they require different diagnostic approaches. This review highlights the radiological findings, management strategies for various foreign bodies, and the distinguishing features of their mimickers, emphasizing the importance of timely and accurate differentiation to guide appropriate interventions and improve patient outcomes.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 7","pages":"638-649"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave Ablation Versus Surgical Resection for Small (≤3 cm) Hepatocellular Carcinoma in Older Patients: A Propensity Score Matching Analysis.","authors":"Kaige Chen, Yimin Ji, Gongzheng Wang, Wen Chen, Qiang Zhu, Ximing Wang, Cuihong Liu, Xinya Zhao","doi":"10.3348/kjr.2025.0049","DOIUrl":"10.3348/kjr.2025.0049","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of microwave ablation (MWA) and surgical resection (SR) for small (≤3 cm) hepatocellular carcinoma (HCC) in older patients.</p><p><strong>Materials and methods: </strong>This retrospective study initially enrolled 319 patients who were aged ≥65 years, had a single HCC ≤3 cm, and had Child-Pugh class A or B. Of these, 108 received MWA and 211 received SR. Overall survival (OS), disease-free survival (DFS), local tumor progression (LTP), complications, and postoperative hospital stay were compared between the groups. Hazard ratios (HRs) were estimated using the SR group as reference. Propensity score matching (PSM) was used to minimize confounding biases.</p><p><strong>Results: </strong>After PSM, 80 patients each were included in the MWA and SR groups. There were no statistically significant differences in the 1-, 3-, and 5-year OS rates (MWA: 96.2%, 80.3%, and 55.4%, respectively; SR: 91.3%, 81.4%, and 64.8%, respectively; HR = 1.06; 95% confidence interval [CI], 0.61-1.85; <i>P</i> = 0.839) and DFS rates (MWA: 72.4%, 43.2%, and 26.4%, respectively; SR: 78.8%, 51.2%, and 38.0%, respectively; HR = 1.27; 95% CI, 0.84-1.90; <i>P</i> = 0.247) between the MWA and SR groups. MWA was associated with a higher LTP rate (HR = 2.96; 95% CI, 1.21-7.28; <i>P</i> = 0.028). Additionally, older patients in the MWA group had fewer complications (52.5% vs. 97.5%, <i>P</i> < 0.001) and shorter postoperative hospital stay (3 days vs. 6 days, <i>P</i> < 0.001) than those in the SR group.</p><p><strong>Conclusion: </strong>In older patients with a single HCC ≤3 cm, MWA was superior to SR in terms of complications and postoperative hospital stay, and there was no significant difference in the 5-year OS and DFS outcomes. Therefore, MWA may be an alternative curative treatment for such patients.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 7","pages":"650-659"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FloWise Flow Diverter for Treatment of Unruptured Wide-Neck Intracranial Aneurysms: A Prospective, Multicenter, Single-Arm, Open-Label, Pivotal Study.","authors":"Hyun Jin Han, Keun Young Park, Byung Moon Kim, Yong Bae Kim, Hong-Jun Jeon, Sang Hyun Suh, Sangil Suh, Jung-Jae Kim, Jun-Hwee Kim, Chang Ki Jang, Dong Joon Kim, Jung Keun Lee, Sunghan Kim, Kyu Seon Chung, Solbi Kim, Sun Yoon, Min Jeoung Kim","doi":"10.3348/kjr.2024.1212","DOIUrl":"10.3348/kjr.2024.1212","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the safety and efficacy of a new flow diverter in the treatment of unruptured wide-neck aneurysms.</p><p><strong>Materials and methods: </strong>Patients who had unruptured intracranial aneurysms with a neck diameter ≥4 mm or dome-to-neck ratio <2 and who met other eligibility criteria were enrolled from seven institutions. The patients were treated with a new flow diverter (FloWise; Taewoong Medical, Seoul, Korea) and followed at 1, 3, 6, and 12 months after treatment. The primary efficacy endpoint was the complete occlusion of the target aneurysm at 12 months. Safety endpoints included ipsilateral stroke (National Institutes of Health Stroke Scale score ≥5), newly developed neurological deficit (modified Rankin Scale score ≥3), death at 30 days, and ≥50% parent artery stenosis or occlusion at the 12-month follow-up. The superiority of FloWise over the predefined reference value (56.7%) was investigated using a one-sided binomial test with a statistical significance of <i>P</i> < 0.025.</p><p><strong>Results: </strong>Seventy patients (59.0 ± 9.9 years; male:female = 16:54) with 93 aneurysms (median diameter, 5.2 mm [range, 1.6-26.1 mm]; median neck diameter, 4.1 mm [range, 1.2-22.4 mm]) were included. Of these, 69 patients who completed the follow-up as planned constituted the efficacy analysis set. Complete aneurysm occlusion was achieved in 56 target aneurysms (81.2%; 95% confidence interval [CI], 69.9-89.6; <i>P</i> < 0.001). Procedural success and ≥50% aneurysm volume reduction were observed in 69 (100%) and 66 (95.7%; 95% CI, 87.8-99.1) target aneurysms, respectively. No ipsilateral strokes occurred in any of the 70 patients. Serious adverse events occurred in 6 patients; these events were causally related to the treatment in 4 (5.7%) cases and possibly related to the device in 2 (2.9%) cases.</p><p><strong>Conclusion: </strong>FloWise flow diverter is safe and effective for the treatment of unruptured wide-neck aneurysms.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"716-726"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}