Korean Journal of Radiology最新文献

{"title":"Optimizing Yttrium-90 Radioembolization Dosimetry for Hepatocellular Carcinoma: A Korean Perspective.","authors":"In Joon Lee, Hyo-Cheol Kim","doi":"10.3348/kjr.2025.0308","DOIUrl":"10.3348/kjr.2025.0308","url":null,"abstract":"<p><p>Yttrium-90 transarterial radioembolization (TARE) has emerged as a valuable treatment option for hepatocellular carcinoma (HCC) and is being increasingly incorporated into clinical guidelines. Recent advancements in dosimetry, including personalized dosimetry and multi-compartment modeling, have significantly improved tumor response and clinical outcomes. Although high tumor-absorbed doses are associated with better oncologic control, careful dose adjustment is essential for minimizing toxicity to normal liver tissue and lungs. This review explores the key aspects of TARE dosimetry, including single- and multi-compartment modeling, differences between resin and glass microspheres, dose-response relationships, and strategies to mitigate hepatotoxicity and radiation pneumonitis. Various clinical applications of TARE have been discussed, ranging from curative-intent radiation segmentectomy and lobectomy to palliative treatment of diffuse and macrovascular invasion-associated HCCs. In South Korea, where cadaveric liver transplantation is limited, a multidisciplinary approach is particularly important for optimizing treatment strategies and preserving liver function for potential future interventions. As dosimetry continues to evolve, further research is required to refine dose optimization protocols and validate their clinical impact in different patient populations, including those in South Korea.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"688-703"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317321","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":"Impact of Aortic Stenosis Severity on Left Heart Function Analyzed Using CT-Derived Strain Parameters.","authors":"Sohee Park, Seung-Ah Lee, Jong Eun Lee, Joon-Won Kang, Dong Hyun Yang, Hyun Jung Koo","doi":"10.3348/kjr.2024.1261","DOIUrl":"10.3348/kjr.2024.1261","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate changes in left ventricular and left atrial mechanics in relation to the severity of aortic stenosis (AS) by comparing computed tomography (CT)-derived strain values in patients with mild-to-severe AS.</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 120 patients (median age, 76 years; 45.0% male), comprising 30, 30, and 60 patients with mild, moderate, and severe AS, respectively, all of whom underwent multiphase cardiac CT between 2015 and 2021. Patients were selected from 177 individuals who met the initial eligibility criteria, with matching for age, sex, and hypertension in a 1:1:2 ratio across the mild, moderate, and severe AS groups. Electrocardiography-gated cardiac CT images were analyzed to obtain various quantitative left ventricle (LV) and left atrium (LA) strain parameters. Statistical differences in cardiac CT-derived LV and LA strain parameters among mild, moderate, and severe AS were evaluated using the Kruskal-Wallis test, followed by post-hoc tests.</p><p><strong>Results: </strong>The median LV global longitudinal strain differed significantly across AS severity (GLS: -19.4%, -18.2%, and -16.2% for mild, moderate, and severe AS, respectively; <i>P</i> < 0.001), with the absolute value decreasing as AS severity increased. Additionally, the median values of LV global circumferential strain (GCS: -29.8%, -30.8%, and -27.4%, respectively; <i>P</i> = 0.045), LV global radial strain (GRS: 50.1%, 50.3%, and 39.3%, respectively; <i>P</i> = 0.004), and LA conduit strain (11.5%, 11.2%, and 9.0%, respectively; <i>P</i> = 0.031) differed significantly according to AS severity, with lower absolute values observed in patients with severe AS.</p><p><strong>Conclusion: </strong>In patients with AS, CT-derived LV and LA strains revealed changes in myocardial deformation according to AS severity. Specifically, there was a gradual decrease in the absolute value of LV GLS with increasing AS severity and initial preservation until moderate AS, followed by an eventual decrease in the absolute values of LV GCS, LV GRS, and LA conduit strain in severe AS.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 7","pages":"626-637"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528572","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":"Contrast-Enhanced Abdominopelvic CT After Peripheral Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Eun Sun Choi, Jong Keon Jang","doi":"10.3348/kjr.2025.0256","DOIUrl":"10.3348/kjr.2025.0256","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"734-737"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317316","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":"Impact of Deep Learning-Based Image Conversion on Fully Automated Coronary Artery Calcium Scoring Using Thin-Slice, Sharp-Kernel, Non-Gated, Low-Dose Chest CT Scans: A Multi-Center Study.","authors":"Cherry Kim, Sehyun Hong, Hangseok Choi, Won-Seok Yoo, Jin Young Kim, Suyon Chang, Chan Ho Park, Su Jin Hong, Dong Hyun Yang, Hwan Seok Yong, Marly van Assen, Carlo N De Cecco, Young Joo Suh","doi":"10.3348/kjr.2025.0177","DOIUrl":"https://doi.org/10.3348/kjr.2025.0177","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of deep learning-based image conversion on the accuracy of automated coronary artery calcium quantification using thin-slice, sharp-kernel, non-gated, low-dose chest computed tomography (LDCT) images collected from multiple institutions.</p><p><strong>Materials and methods: </strong>A total of 225 pairs of LDCT and calcium scoring CT (CSCT) images scanned at 120 kVp and acquired from the same patient within a 6-month interval were retrospectively collected from four institutions. Image conversion was performed for LDCT images using proprietary software programs to simulate conventional CSCT. This process included 1) deep learning-based kernel conversion of low-dose, high-frequency, sharp kernels to simulate standard-dose, low-frequency kernels, and 2) thickness conversion using the raysum method to convert 1-mm or 1.25-mm thickness images to 3-mm thickness. Automated Agaston scoring was conducted on the LDCT scans before (LDCT-Org_auto) and after the image conversion (LDCT-CONV_auto). Manual scoring was performed on the CSCT images (CSCT_manual) and used as a reference standard. The accuracy of automated Agaston scores and risk severity categorization based on the automated scoring on LDCT scans was analyzed compared to the reference standard, using the Bland-Altman analysis, concordance correlation coefficient (CCC), and weighted kappa (κ) statistic.</p><p><strong>Results: </strong>LDCT-CONV_auto demonstrated a reduced bias for Agaston score, compared with CSCT_manual, than LDCT-Org_auto did (-3.45 vs. 206.7). LDCT-CONV_auto showed a higher CCC than LDCT-Org_auto did (0.881 [95% confidence interval {CI}, 0.750-0.960] vs. 0.269 [95% CI, 0.129-0.430]). In terms of risk category assignment, LDCT-Org_auto exhibited poor agreement with CSCT_manual (weighted κ = 0.115 [95% CI, 0.082-0.154]), whereas LDCT-CONV_auto achieved good agreement (weighted κ = 0.792 [95% CI, 0.731-0.847]).</p><p><strong>Conclusion: </strong>Deep learning-based conversion of LDCT images originally obtained with thin slices and a sharp kernel can enhance the accuracy of automated coronary artery calcium score measurement using the images.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of GPT-4 Turbo and GPT-4o in Korean Society of Radiology In-Training Examinations.","authors":"Arum Choi, Hyun Gi Kim, Moon Hyung Choi, Shakthi Kumaran Ramasamy, Youme Kim, Seung Eun Jung","doi":"10.3348/kjr.2024.1096","DOIUrl":"10.3348/kjr.2024.1096","url":null,"abstract":"<p><strong>Objective: </strong>Despite the potential of large language models for radiology training, their ability to handle image-based radiological questions remains poorly understood. This study aimed to evaluate the performance of the GPT-4 Turbo and GPT-4o in radiology resident examinations, to analyze differences across question types, and to compare their results with those of residents at different levels.</p><p><strong>Materials and methods: </strong>A total of 776 multiple-choice questions from the Korean Society of Radiology In-Training Examinations were used, forming two question sets: one originally written in Korean and the other translated into English. We evaluated the performance of GPT-4 Turbo (gpt-4-turbo-2024-04-09) and GPT-4o (gpt-4o-2024-11-20) on these questions with the temperature set to zero, determining the accuracy based on the majority vote from five independent trials. We analyzed their results using the question type (text-only vs. image-based) and benchmarked them against nationwide radiology residents' performance. The impact of the input language (Korean or English) on model performance was examined.</p><p><strong>Results: </strong>GPT-4o outperformed GPT-4 Turbo for both image-based (48.2% vs. 41.8%, <i>P</i> = 0.002) and text-only questions (77.9% vs. 69.0%, <i>P</i> = 0.031). On image-based questions, GPT-4 Turbo and GPT-4o showed comparable performance to that of 1st-year residents (41.8% and 48.2%, respectively, vs. 43.3%, <i>P</i> = 0.608 and 0.079, respectively) but lower performance than that of 2nd- to 4th-year residents (vs. 56.0%-63.9%, all <i>P</i> ≤ 0.005). For text-only questions, GPT-4 Turbo and GPT-4o performed better than residents across all years (69.0% and 77.9%, respectively, vs. 44.7%-57.5%, all <i>P</i> ≤ 0.039). Performance on the English- and Korean-version questions showed no significant differences for either model (all <i>P</i> ≥ 0.275).</p><p><strong>Conclusion: </strong>GPT-4o outperformed the GPT-4 Turbo in all question types. On image-based questions, both models' performance matched that of 1st-year residents but was lower than that of higher-year residents. Both models demonstrated superior performance compared to residents for text-only questions. The models showed consistent performances across English and Korean inputs.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"524-531"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024638","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 of C-X-C-Chemokine-Receptor-Type-4-Directed PET/CT Using [¹⁸F]AlF-NOTA-QHY-04 in Identifying Molecular Subtypes of Small Cell Lung Cancer.","authors":"Yuxi Luo, Kai Cheng, Jingru Liu, Jinli Pei, Shengnan Xu, Xinzhi Zhao, Shijie Wang, Kunlong Zhao, Wanhu Li, Jie Liu, Jinming Yu","doi":"10.3348/kjr.2024.1266","DOIUrl":"10.3348/kjr.2024.1266","url":null,"abstract":"<p><strong>Objective: </strong>Molecular subtyping of small-cell lung cancer (SCLC) has major implications for prognostic relevance and treatment guidance. This study aimed to explore the feasibility of a novel tracer targeting C-X-C-chemokine-receptor-type-4 (CXCR4) for distinguishing different SCLC subtypes.</p><p><strong>Materials and methods: </strong>Thirty-five patients with pathologically confirmed SCLC were enrolled in this prospective study. Immunohistochemical staining was performed to classify the molecular subtypes into SCLC-A, SCLC-N, SCLC-P, and SCLC-I. [¹⁸F]AlF-NOTA-QHY-04 PET/CT parameters were obtained, including the maximum, mean, and peak standard uptake values (SUV_max, SUV_mean, and SUV_peak, respectively) and the ratios of tumors (T) and normal tissues (NT) based on the SUV_max (T/NT). These parameters were compared among the molecular subtypes. A receiver operating characteristic (ROC) curve was used to analyze the performance of the parameters for distinguishing SCLC-N from other subtypes and neuroendocrine (NE) subtypes (SCLC-A and SCLC-N) from non-NE subtypes (SCLC-P and SCLC-I).</p><p><strong>Results: </strong>The molecular subtypes were SCLC-A (n = 17), SCLC-N (n = 6), SCLC-P (n = 7), and SCLC-I (n = 5). The SCLC-N subtype exhibited significantly higher uptake in both primary tumors and lymph node metastases than the other three subtypes (<i>P</i> < 0.05). When SCLC-N was compared with the other three subtypes combined (referred to as \"other SCLCs\"), all parameters were significantly higher in the SCLC-N group (<i>P</i> < 0.05). ROC analysis showed that these parameters had high accuracy in distinguishing SCLC-N from other SCLCs (area under ROC curve: 0.868-0.948 for primary tumors and 0.783-0.888 for lymph node metastases). Compared with the non-NE group, the SUV_max, SUV_mean, and T/NT_lung were significantly higher in the NE group for primary tumors. ROC analysis showed moderate accuracy in distinguishing between the NE and non-NE groups (ROC area: 0.692-0.786 for primary tumors and 0.692-0.815 for lymph node metastases).</p><p><strong>Conclusion: </strong>Our preliminary findings indicate that CXCR4-directed PET/CT imaging using [¹⁸F]AlF-NOTA-QHY-04 may differentiate between SCLC-N and other molecular subtypes and between NE and non-NE subtypes of SCLC.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 6","pages":"593-603"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159816","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":"Overview of South Korean Guidelines for Approval of Large Language or Multimodal Models as Medical Devices: Key Features and Areas for Improvement.","authors":"Seong Ho Park, Geraldine Dean, Ernest Montañà Ortiz, Joon-Il Choi","doi":"10.3348/kjr.2025.0257","DOIUrl":"10.3348/kjr.2025.0257","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"519-523"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032417","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":"Uncover This Tech Term: Variational Autoencoders.","authors":"Advait Teli","doi":"10.3348/kjr.2025.0073","DOIUrl":"10.3348/kjr.2025.0073","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"616-619"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007574","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":"Superior Diagnostic Yield of Core Needle Biopsy Over Fine Needle Aspiration in Diagnosing Follicular-Patterned Neoplasms: A Multicenter Study Focusing on Bethesda IV Results.","authors":"Leehi Joo, Jung Hwan Baek, Jungbok Lee, Dong Eun Song, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee","doi":"10.3348/kjr.2024.1022","DOIUrl":"10.3348/kjr.2024.1022","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic outcomes of core needle biopsy (CNB) and fine-needle aspiration (FNA) using Bethesda IV as a test-positive criterion for diagnosing follicular-patterned neoplasms in a large multicenter cohort.</p><p><strong>Materials and methods: </strong>This retrospective study included 5463 thyroid nodules ≥1 cm from 4883 patients (4019 females, 864 males; mean age 53.8 years) that underwent FNA or CNB across 26 hospitals in Korea between June and September 2015. The final diagnosis in cases diagnosed as Bethesda IV (follicular neoplasm) in biopsies were confirmed by surgical pathology. The primary study outcome was the diagnostic yield, defined as the proportion of nodules with follicular-patterned neoplasms confirmed at surgery after receiving Bethesda IV results on biopsy (FNA or CNB), among all that underwent biopsy. Secondary outcomes included false referral rate (FRR) and positive predictive value (PPV). All nodules were analyzed before matching (823 and 4640 nodules for CNB and FNA, respectively) and after nodule matching in a 1:2 ratio (799 and 1571 nodules, respectively) according to age, sex, nodule size, and Korean Thyroid Imaging Reporting and Data System (K-TIRADS) category. Additionally, the diagnostic yields of various histological subtypes of follicular-patterned neoplasms and nodule subgroups were analyzed.</p><p><strong>Results: </strong>CNB demonstrated a significantly higher diagnostic yield than FNA both before (9.0% vs. 0.5%; <i>P</i> < 0.001) and after matching (9.0% vs. 0.6%; <i>P</i> < 0.001). CNB consistently had higher diagnostic yields than FNA for most histological subtypes and all subgroups. FRR was not significantly different between the CNB and FNA groups after matching (0.4% vs. 0.1%; <i>P</i> = 0.337). The PPV was consistently greater than 90% for both methods, with no significant difference.</p><p><strong>Conclusion: </strong>CNB had a higher diagnostic yield than FNA for follicular-patterned neoplasms, with no significant difference in FRR using Bethesda IV as the test-positive criterion.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"604-615"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033586","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":"Response to \"MRI Morphometry of the Spinal Cord Depends on Several Factors That Must Be Taken Into Account When Selecting Healthy Volunteers\".","authors":"Bio Joo, Hyung Jun Park, Mina Park, Sang Hyun Suh, Sung Jun Ahn","doi":"10.3348/kjr.2025.0190","DOIUrl":"10.3348/kjr.2025.0190","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"622-623"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764247","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}