Korean Journal of Radiology最新文献

{"title":"Description of FDG and Prostate-Specific Membrane Antigen PET/CT Findings in Korean Patients With Advanced Metastatic Castration-Resistant Prostate Cancer.","authors":"Sae Jung Na, Seunggyun Ha, In-Ho Kim, Ji Youl Lee, Joo Hyun O","doi":"10.3348/kjr.2024.0439","DOIUrl":"10.3348/kjr.2024.0439","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to describe the [¹⁸F]fluorodeoxyglucose (FDG) and prostate-specific membrane antigen (PSMA) PET/CT findings in Korean men with advanced metastatic castration-resistant prostate cancer (mCRPC).</p><p><strong>Materials and methods: </strong>The results of paired FDG and PSMA PET/CT examinations performed in 42 consecutive men with prostate cancer for treatment planning after failure of anti-androgen therapy and chemotherapy were studied. Tumor lesions with FDG or PSMA uptake intensity higher than that of the liver on visual review were considered positive and noted per patient and tumor site (prostate bed, lymph node, bone, and visceral organ). The presence of unequivocally discordant FDG and PSMA uptake patterns in tumor lesions was assessed. Patients were grouped according to the total tumor volume as seen on each PET/CT scan, and the clinical findings between the patient groups were compared using the Mann-Whitney U test.</p><p><strong>Results: </strong>On patient-based analysis, the image findings were PSMA+/FDG- in 2 patients, PSMA-/FDG+ in one, and PSMA+/FDG+ in 39 patients. On site-based analysis, the discordance (PSMA+/FDG- or PSMA-/FDG+) rate was 9.5% (4/42) for prostate/bed, 11.9% (5/42) for lymph nodes, 9.5% (4/42) for bones, and 11.9% (5/42) for visceral organs. FDG uptake was higher than PSMA uptake in at least one tumor site in 54.8% (23/42) of patients. Patients with greater total tumor volume on FDG PET/CT than that on PSMA PET/CT (\"FDG-dominant pattern\") accounted for 28.6% (12/42), and they had significantly shorter time from diagnosis (median 25 months vs. 62 months, <i>P</i> = 0.049), and higher aspartate aminotransferase (median 28.5 vs. 22.5, <i>P</i> = 0.027) and lactate dehydrogenase (median 341.5 vs. 224.5, <i>P</i> = 0.010) levels.</p><p><strong>Conclusion: </strong>Most patients with advanced mCRPC had tumors with positive findings on both FDG and PSMA PET/CT. However, the uptake patterns varied; 54.8% of the patients had tumor(s) with FDG uptake greater than PSMA uptake, and FDG-dominant pattern was noted in 28.6% of the patients.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546166","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":"Angiographic Anatomy of the Prostatic Artery in the Korean Population: A Bicentric Retrospective Study.","authors":"Seunghyun Lee, Dong Jae Shim, Doyoung Kim, Soo Buem Cho, Seung Hwan Baek, Edward Wolfgang Lee, Jung Whee Lee","doi":"10.3348/kjr.2024.0451","DOIUrl":"10.3348/kjr.2024.0451","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to analyze the origins of prostatic arteries (PAs) in the Korean population and compare them with those reported in the literature.</p><p><strong>Materials and methods: </strong>From April 2018 to February 2024, 108 male (mean age ± standard deviation: 71.6 ± 9.7 years) with lower urinary tract symptoms (n = 102) or refractory hematuria (n = 6) underwent prostatic artery embolization (PAE). Computed tomography and angiography images were retrospectively reviewed. The branching pattern of the internal iliac artery (IIA) was classified according to the Yamaki system. The origin of the PA was categorized using the de Assis definition, and the incidence of each type was recorded. A systematic literature review was conducted and the most common types of PA were investigated.</p><p><strong>Results: </strong>PAE was successfully implemented on 211 of the 216 pelvic sidewalls. PA cannulation failed in five sidewalls due to a steno-occlusive state. The most common IIA type was type A, in which the IIA was divided into the superior gluteal artery and gluteal-pudendal trunk (77%). Of 226 PAs analyzed, including 15 in 211 sidewalls exhibiting dual PAs, the most common PA origin was the internal pudendal artery (type IV, 35%), followed by the superior vesical (type I, 25%) and obturator (type III, 21%) arteries. Anterior division of IIA (type II) was less common (10%). Type V (uncommon origins) occurred in 8% of cases, including five distal internal pudendal arteries, four quadfurcations, three inferior gluteal arteries, three trifurcations, two medial femoral circumflex arteries, and two rectal arteries. Two of the five patients with surgically or endovascularly altered anatomy were successfully treated via PAs originating from the medial femoral circumflex arteries. Globally, type I is the most common PA type.</p><p><strong>Conclusion: </strong>In the Korean population, the most common IIA pattern and PA origin were types A and IV, respectively.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546151","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 Surveillance After Breast-Conserving Surgery for Cancer With Acellular Dermal Matrix Reconstruction.","authors":"Da Won Jung, Jin Chung, Ji Min Kim, Eun Suk Cha, Jeoung Hyun Kim","doi":"10.3348/kjr.2023.1073","DOIUrl":"10.3348/kjr.2023.1073","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate postoperative imaging findings of patients who underwent breast-conserving surgery for cancer and reconstruction with MegaDerm^® (sheet-type and pellet-type), analyzing false positives and recurrences, using multi-modality images.</p><p><strong>Materials and methods: </strong>This study included 201 women (age range: 28-81 years, mean age ± standard deviation: 53.2 ± 8.6 years) who underwent breast-conserving surgery and immediate reconstruction with MegaDerm^®. Post-surgery, each patient underwent at least one mammography (MG), ultrasonography (US), and MRI, totaling 713 MG, 1063 US, and 607 MRI examinations. Postoperative images were reviewed separately for the two types of MegaDerm^®, and suspicious imaging findings (false positives and recurrences) were analyzed, with a particular focus on the findings in direct contact with MegaDerm^®.</p><p><strong>Results: </strong>MegaDerm^® appeared as a circumscribed mass with homogeneous iso- or high density on MG, posterior shadowing on US, and no enhancement on MRI. Calcification was more common and increased in size in sheet-type MegaDerm^®, while pellet-type often exhibited irregular margins. Nine out of 17 false positives had suspicious findings in direct contact with MegaDerm^®, and six out of nine recurrences showed similar findings. Common suspicious findings included calcifications, asymmetries, and MegaDerm^® irregularities on MG; masses and MegaDerm^® irregularities on US; and enhancing masses and MegaDerm^® irregularities with enhancement on MRI. Notably, MegaDerm^® irregularity with calcification was observed on MG and US in only one recurrence case. In 44.4% (4/9) of false-positives in direct contact with MegaDerm^®, suspicious findings showed no change or resolution on follow-up.</p><p><strong>Conclusion: </strong>Suspicious imaging findings in direct contact with MegaDerm^® may be associated with false positives or recurrences. Therefore, it is essential to recognize these characteristic findings and review the patient's history of MegaDerm^® insertion when in doubt.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546170","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":"Insufficient Transparency in Stochasticity Reporting in Large Language Model Studies for Medical Applications in Leading Medical Journals.","authors":"Chong Hyun Suh, Jeho Yi, Woo Hyun Shim, Hwon Heo","doi":"10.3348/kjr.2024.0788","DOIUrl":"10.3348/kjr.2024.0788","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546171","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":"Effect of Microwave Ablation Power and Antenna Approach on Tumor Seeding: An Ex Vivo Subcapsular Tumor Model Study.","authors":"Hyo Jeong Lee, Chang Hoon Oh, Jin Sil Kim, Jeong Kyong Lee","doi":"10.3348/kjr.2024.0602","DOIUrl":"10.3348/kjr.2024.0602","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model.</p><p><strong>Materials and methods: </strong>Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups.</p><p><strong>Results: </strong>Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, <i>P</i> < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], <i>P</i> = 0.009 for parallel access; 30.0% [3/10] vs. 90.0% [9/10], <i>P</i> = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, <i>P</i> < 0.001). The size of the ablation zone did not differ significantly between the two power groups (<i>P</i> = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablation-zone size (<i>P</i> = 0.536, 0.463, and 0.271, respectively).</p><p><strong>Conclusion: </strong>Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546168","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":"Standardized Ultrasound Evaluation for Active Surveillance of Low-Risk Thyroid Microcarcinoma in Adults: 2024 Korean Society of Thyroid Radiology Consensus Statement.","authors":"Ji Ye Lee, Min Kyoung Lee, Hyun Kyung Lim, Chang Yoon Lee, Jin Yong Sung, Jung Hyun Yoon, Soo Yeon Han, Jung Hee Shin, Ji-Hoon Kim, So Lyung Jung, Sae Rom Chung, Jung Hwan Baek, Dong Gyu Na","doi":"10.3348/kjr.2024.0871","DOIUrl":"10.3348/kjr.2024.0871","url":null,"abstract":"<p><p>Active surveillance (AS) has been widely adopted as an alternative to immediate surgery owing to the indolent nature and favorable outcomes of papillary thyroid microcarcinoma (PTMC). AS is generally recommended for tumors measuring ≤1 cm without aggressive cytological subtypes, risk of gross extrathyroidal extension (ETE), lymph node metastasis (LNM), or distant metastasis. AS requires careful patient selection based on various patient and tumor characteristics, and ultrasound (US) findings. Moreover, during AS, regular US is performed to monitor any signs of tumor progression, including tumor growth, new US features of potential gross ETE, and LNM. Therefore, appropriate imaging-based assessment plays a crucial role in determining whether AS or surgery should be pursued. However, detailed recommendations concerning US evaluation are currently insufficient, necessitating the formulation of this guideline. The Korean Society of Thyroid Radiology has developed a consensus statement for low-risk PTMC, covering US assessment methods when considering AS as a management option and conducting follow-up imaging tests during AS. This guideline aims to provide optimal scientific evidence and expert opinion consensus regarding a standardized US-based assessment protocol for low-risk PTMC.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546172","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":"Ultrasound Findings After Breast Cancer Radiation Therapy: Cutaneous, Pleural, Pulmonary, and Cardiac Changes.","authors":"Orlando Catalano, Roberta Fusco, Serena Carriero, Stefania Tamburrini, Vincenza Granata","doi":"10.3348/kjr.2024.0672","DOIUrl":"10.3348/kjr.2024.0672","url":null,"abstract":"<p><p>External beam radiation therapy (RT) can induce toxicity in patients surgically treated for breast cancer. Modern irradiation techniques have lowered the incidence and severity of radiation-induced injuries; however, their side effects on normal tissues remain challenging. This review illustrates early and late changes observed using ultrasound (US) imaging, including echocardiography, at the skin, muscle, pleura, lungs, and heart levels. The US findings and the potential role of this technique in detecting and grading early and late complications of RT are highlighted in this article. US has proven useful in the differential diagnosis of post-RT complications, including but not limited to cancer recurrence and toxicity from other sources, such as anticancer drugs. Additionally, considering the progressive nature of RT-induced injury, early detection of toxicity may be helpful in the individual stratification of damage risk and serve as a tool for patient screening and management. In these cases, US can be used as a radiation-free biomarker of RT side effects at the subclinical stage.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546173","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":"Duration of Response as Clinical Endpoint: A Quick Guide for Clinical Researchers.","authors":"Seonok Kim, Min-Ju Kim, Jooae Choe","doi":"10.3348/kjr.2024.0589","DOIUrl":"10.3348/kjr.2024.0589","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546167","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":"Image-Based Generative Artificial Intelligence in Radiology: Comprehensive Updates.","authors":"Ha Kyung Jung, Kiduk Kim, Ji Eun Park, Namkug Kim","doi":"10.3348/kjr.2024.0392","DOIUrl":"10.3348/kjr.2024.0392","url":null,"abstract":"<p><p>Generative artificial intelligence (AI) has been applied to images for image quality enhancement, domain transfer, and augmentation of training data for AI modeling in various medical fields. Image-generative AI can produce large amounts of unannotated imaging data, which facilitates multiple downstream deep-learning tasks. However, their evaluation methods and clinical utility have not been thoroughly reviewed. This article summarizes commonly used generative adversarial networks and diffusion models. In addition, it summarizes their utility in clinical tasks in the field of radiology, such as direct image utilization, lesion detection, segmentation, and diagnosis. This article aims to guide readers regarding radiology practice and research using image-generative AI by 1) reviewing basic theories of image-generative AI, 2) discussing the methods used to evaluate the generated images, 3) outlining the clinical and research utility of generated images, and 4) discussing the issue of hallucinations.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546169","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":"A Nomogram Using Imaging Features to Predict Ipsilateral Breast Tumor Recurrence After Breast-Conserving Surgery for Ductal Carcinoma In Situ.","authors":"Bo Hwa Choi, Soohee Kang, Nariya Cho, Soo-Yeon Kim","doi":"10.3348/kjr.2024.0268","DOIUrl":"10.3348/kjr.2024.0268","url":null,"abstract":"<p><strong>Objective: </strong>To develop a nomogram that integrates clinical-pathologic and imaging variables to predict ipsilateral breast tumor recurrence (IBTR) in women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS).</p><p><strong>Materials and methods: </strong>This retrospective study included consecutive women with DCIS who underwent BCS at two hospitals. Patients who underwent BCS between 2003 and 2016 in one hospital and between 2005 and 2013 in another were classified into development and validation cohorts, respectively. Twelve clinical-pathologic variables (age, family history, initial presentation, nuclear grade, necrosis, margin width, number of excisions, DCIS size, estrogen receptor, progesterone receptor, radiation therapy, and endocrine therapy) and six mammography and ultrasound variables (breast density, detection modality, mammography and ultrasound patterns, morphology and distribution of calcifications) were analyzed. A nomogram for predicting 10-year IBTR probabilities was constructed using the variables associated with IBTR identified from the Cox proportional hazard regression analysis in the development cohort. The performance of the developed nomogram was evaluated in the external validation cohort using a calibration plot and 10-year area under the receiver operating characteristic curve (AUROC) and compared with the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram.</p><p><strong>Results: </strong>The development cohort included 702 women (median age [interquartile range], 50 [44-56] years), of whom 30 (4%) women experienced IBTR. The validation cohort included 182 women (48 [43-54] years), 18 (10%) of whom developed IBTR. A nomogram was constructed using three clinical-pathologic variables (age, margin, and use of adjuvant radiation therapy) and two mammographic variables (breast density and calcification morphology). The nomogram was appropriately calibrated and demonstrated a comparable 10-year AUROC to the MSKCC nomogram (0.73 vs. 0.66, <i>P</i> = 0.534) in the validation cohort.</p><p><strong>Conclusion: </strong>Our nomogram provided individualized risk estimates for women with DCIS treated with BCS, demonstrating a discriminative ability comparable to that of the MSKCC nomogram.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349327","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}