Korean Journal of Radiology最新文献

{"title":"Growth and Clinical Impact of Subsolid Lung Nodules ≥6 mm During Long-Term Follow-Up After Five Years of Stability.","authors":"Jong Hyuk Lee, Woo Hyeon Lim, Chang Min Park","doi":"10.3348/kjr.2024.0564","DOIUrl":"10.3348/kjr.2024.0564","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence and timing of late growth of subsolid nodules (SSNs) ≥6 mm after initial 5-year stability, its clinical implications, and the appropriate follow-up strategy.</p><p><strong>Materials and methods: </strong>This retrospective study included SSNs ≥6 mm that remained stable for the initial five years after detection. The incidence and timing of subsequent growth after five years of stability were analyzed using the Kaplan-Meier method. Descriptive analyses were conducted to evaluate the clinical stage shift in the SSNs, showing growth and the presence of metastasis during the follow-up period. Finally, an effective follow-up CT scan strategy for managing SSNs after a 5-year period of stability was investigated.</p><p><strong>Results: </strong>Two hundred thirty-five eligible SSNs (211 pure ground-glass and 24 part-solid nodules) in 235 patients (median age, 63 years; 132 female) were followed for additional <1 to 181 months (median, 87.0 months; interquartile range [IQR], 47.0-119.0 months) after 5-year stability. Fourteen SSNs (6.0%) showed growth at two to 145 months (median, 96 months; IQR: 43.0-122.25 months) from the CT scan confirming 5-year stability, with the estimated cumulative incidence of growth of 0.4%, 2.1%, and 6.5% at 1, 5, and 10 years, respectively. Nine SSNs (3.8%) exhibited clinical stage shifts. No lung cancer metastases were observed. Hypothetical follow-up CT scans performed at 5, 10, and 15 years after 5-years of stability, would have detected 5 (36%), 11 (79%), and 14 (100%) of the 14 growing SSNs, along with 4 (44%), 8 (89%), and 9 (100%) of the nine stage shifts, respectively.</p><p><strong>Conclusion: </strong>During a long-term follow-up of pulmonary SSNs ≥6 mm after 5-years of stability, a low incidence of growth without occurrence of metastasis was noted. CT scans every five years after the initial 5-year stability period may be reasonable.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"1093-1099"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621848","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":"The Value of Non-Clinical Applications of Artificial Intelligence in Radiology Should Be Noted.","authors":"Hongnan Ye","doi":"10.3348/kjr.2024.1021","DOIUrl":"10.3348/kjr.2024.1021","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 12","pages":"1100-1101"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751066","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":"Endovascular Treatment With Targeted Embolization of Cavernous Sinus Dural Arteriovenous Fistulas: A Single-Center Study.","authors":"Sangil Park, Kyubong Lee, Eunji Moon, Jung Cheol Park, Boseong Kwon, Deok Hee Lee, Dae Chul Suh, Yunsun Song","doi":"10.3348/kjr.2024.0351","DOIUrl":"10.3348/kjr.2024.0351","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility, efficacy, and safety of targeted embolization for cavernous sinus dural arteriovenous fistulas (CSDAVF).</p><p><strong>Materials and methods: </strong>This retrospective study investigated patients with CSDAVF who underwent endovascular treatment at a tertiary hospital between October 1991 and March 2023. Treatment strategies were determined based on clinical symptoms and shunt characteristics. Targeted or non-targeted curative embolization was performed to achieve complete shunt occlusion. Initially, targeted embolization, selective occlusion of the shunted pouch while preserving the normal cavernous sinus lumen, was conducted, should that fail, non-targeted embolization was performed. In contrast, palliative embolization solely reduced shunt flow. Clinical signs, imaging characteristics, and outcomes were evaluated according to the agreed treatment strategy.</p><p><strong>Results: </strong>In total, 198 patients with CSDAVF (mean age 59.0 ± 12.1 years, 23.2% male) participated in this study. Of which, 94 patients (47.5%) were treated with targeted embolization, 75 (37.9%) with non-targeted embolization, and 29 (14.6%) with palliative treatment. For patients undergoing curative embolization, 55.7% (94/169) successfully achieved targeted embolization; this procedure was usually used to treat focal fistulas (restrictive or late-restrictive types), whereas diffuse fistulas (proliferative type) often underwent non-targeted or palliative embolization. For patients that underwent targeted embolization, the rate of complete or near-complete occlusion on immediate post-treatment digital subtraction angiography was 93.6% (88/94), with a complication rate of 2.1% (2/94), symptom improvement rate of 96.8% (91/94), and retreatment rate of 5.3% (5/94). No serious complications were reported during follow-up.</p><p><strong>Conclusion: </strong>When successful, targeted embolization of CSDAVF causes low rates of cranial nerve palsy, retreatment, and good clinical outcomes.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"1083-1092"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621844","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":"LI-RADS: Current Status and Future Directions.","authors":"Sang Hyun Choi, Kathryn J Fowler, Victoria Chernyak, Claude B Sirlin","doi":"10.3348/kjr.2024.0161","DOIUrl":"10.3348/kjr.2024.0161","url":null,"abstract":"<p><p>The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system that uses standardized terminology, technique, interpretation, and reporting of imaging studies for hepatocellular carcinoma surveillance, diagnosis, and locoregional treatment response assessment. Since its initial release in 2011, LI-RADS has evolved and expanded in scope. In this article, we discuss recent updates intended to address clinical needs and mitigate current challenges.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 12","pages":"1039-1046"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750966","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 \"The Value of Non-Clinical Applications of Artificial Intelligence in Radiology Should Be Noted\".","authors":"Nicole Kessa Wee, Kim-Ann Git, Wen-Jeng Lee, Gaurang Raval, Aziz Pattokhov, Evelyn Lai Ming Ho, Chamaree Chuapetcharasopon, Noriyuki Tomiyama, Kwan Hoong Ng, Cher Heng Tan","doi":"10.3348/kjr.2024.1073","DOIUrl":"10.3348/kjr.2024.1073","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 12","pages":"1102-1103"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750968","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":"Determining Disease Activity and Glucocorticoid Response in Thyroid-Associated Ophthalmopathy: Preliminary Study Using Dynamic Contrast-Enhanced MRI.","authors":"Hao Hu, Xiong-Ying Pu, Jiang Zhou, Wen-Hao Jiang, Qian Wu, Jin-Ling Lu, Fei-Yun Wu, Huan-Huan Chen, Xiao-Quan Xu","doi":"10.3348/kjr.2024.0335","DOIUrl":"10.3348/kjr.2024.0335","url":null,"abstract":"<p><strong>Objective: </strong>To assess the role of dynamic contrast-enhanced (DCE)-MRI of the extraocular muscles (EOMs) for determining the activity of thyroid-associated ophthalmopathy (TAO) and treatment response to glucocorticoids (GCs).</p><p><strong>Materials and methods: </strong>We prospectively enrolled 65 patients with TAO (41 active, 82 eyes; 24 inactive, 48 eyes). Twenty-two active patients completed the GC treatment and follow-up assessment, including 15 patients (30 eyes) and 7 patients (14 eyes), defined as responsive and unresponsive, respectively. Model-free (time to peak [TTP], area under the curve [AUC], and Slope_max) and model-based (K^trans, K_ep, and V_e) parameters of EOMs in embedded simplified histogram analyses were calculated and compared between groups. Multivariable logistic regression analysis was used to identify the independent predictors. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the diagnostic performance.</p><p><strong>Results: </strong>Active patients exhibited significantly higher TTP at the 10th percentile (-10th), TTP-mean, and TTP at the 90th percentile (-90th); AUC-10th, AUC-mean, AUC-90th, and AUC-max; K^trans-10th and K^trans-mean; and V_e-10th, V_e-mean, V_e-90th, and V_e-max than inactive patients (<i>P</i> < 0.05). Responsive patients exhibited significantly lower TTP-min; higher K^trans-mean and K^trans-max; and higher K_ep-10th, K_ep-mean, and K_ep-max than unresponsive patients (<i>P</i> < 0.05). TTP-mean and V_e-mean were independent variables for determining disease activity (<i>P</i> = 0.017 and 0.022, respectively). A combination of the two parameters could determine active TAO with moderate performance (AUROC = 0.687). TTP-min and K^trans-mean were independent predictors of the response to GCs (<i>P</i> = 0.023 and 0.004, respectively), uniting which could determine the response to GCs with decent performance (AUROC = 0.821).</p><p><strong>Conclusion: </strong>DCE-MRI-derived model-free and model-based parameters of EOMs can assist in the evaluation of TAO. In particular, TTP-mean and V_e-mean could be useful for determining the activity of TAO, whereas TTP-min and K^trans-mean could be promising biomarkers for determining the response to GCs.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"1070-1082"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621719","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":"Survey of Experts' Opinions on the Diagnosis and Management of Pancreatic Cystic Neoplasms.","authors":"Jeong Hee Yoon, In Rae Cho, Won Chang, Bohyun Kim, Siwon Jang, Yeun-Yoon Kim, Jeong Woo Kim, Sang Hyub Lee, Jeong Min Lee","doi":"10.3348/kjr.2024.0626","DOIUrl":"10.3348/kjr.2024.0626","url":null,"abstract":"<p><strong>Objective: </strong>To survey experts' opinions in abdominal radiology (radiologists) and pancreas-specialized gastroenterology (pancreatologists) in South Korea regarding diagnosing and managing pancreatic cystic neoplasms (PCNs).</p><p><strong>Materials and methods: </strong>Between August 25, 2023, and October 5, 2023, an online survey was conducted among members of the Korean Society of Abdominal Radiology and the Korean Pancreatobiliary Association via email invitation.</p><p><strong>Results: </strong>The responses from 100 radiologists and 41 pancreatologists were analyzed. Of the respondents, 55.3% (78/141) reported seeing more than 50 patients or reading more than 50 exams related to PCN each month. The most common and preferred diagnostic modality for PCN was contrast-enhanced computed tomography (CECT), favored by 87.8% (36/41) of pancreatologists. When discrepancies arose between CECT or magnetic resonance imaging (MRI) and endoscopic ultrasound, 31.2% (44/141) of the respondents opted for multidisciplinary team discussion, whereas 29.1% (41/141) chose short-term follow-up using CECT or MRI. A total of 88.7% (125/141) of the respondents adhered to the 2017 International Association of Pancreatology (IAP) guidelines in their practice. Among the radiologists, 51.0% (51/100) endorsed a cut-off value of 5 mm for enhancing mural nodules, and 22.0% (22/100) supported a 5 mm/2 yr growth rate in the IAP guidelines v.2017. Additionally, 73.0% (73/100) of radiologists favored discontinuing surveillance, whereas 41.5% (17/41) of pancreatologists disagreed with stopping surveillance.</p><p><strong>Conclusion: </strong>The survey underscores the clinical burden PCN poses and identifies CECT as the foremost diagnostic tool. Variability was noted in the terminology, differential diagnosis, approaches for resolving discrepancies between imaging examinations, and opinions on surveillance discontinuation among the respondents as a whole, as well as between radiologists and pancreatologists. Although the 2017 IAP guidelines are primarily followed, there remains a level of dissatisfaction with risk stratification among radiologists. This highlights the need for more standardized diagnostic algorithms and improved consensus among specialists to address these challenges.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"1047-1060"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622423","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":"Comparing Oncologic Outcomes of Heat-Based Thermal Ablation and Cryoablation in Patients With T1a Renal Cell Carcinoma: A Population-Based Cohort Study From the SEER Database.","authors":"Run-Qi Guo, Jin-Zhao Peng, Jie Sun, Yuan-Ming Li","doi":"10.3348/kjr.2024.0462","DOIUrl":"10.3348/kjr.2024.0462","url":null,"abstract":"<p><strong>Objective: </strong>There is controversy among different guidelines regarding the use of thermal ablation to treat clinical T1a renal cell carcinomas with tumor sizes ranging from 3.1-4 cm. Therefore, we compared oncological outcomes between heat-based thermal ablation (hTA) and cryoablation (CA) in patients with solid T1a renal cell carcinomas, including those with a tumor size ≤3 cm and a tumor size of 3.1-4 cm.</p><p><strong>Materials and methods: </strong>Within the Surveillance, Epidemiology, and End Results database (2000-2019), we identified patients with clinical T1a renal cell carcinomas that were histologically confirmed and treated with hTA or CA. After propensity score matching using a 1:1 ratio, the overall survival (OS) and cancer-specific survival (CSS) were estimated and compared between the two methods. Cancer-specific mortality (CSM) was also analyzed, considering other-cause mortality as a competing risk.</p><p><strong>Results: </strong>Of the 3513 assessable patients, 1426 (40.6%) and 2087 (59.4%) were treated with hTA and CA, respectively. After propensity score matching, the hTA and CA groups included 1393 and 1393 patients, respectively. hTA was associated with shorter OS than CA with a hazard ratio of 1.17 (95% confidence interval, 1.04-1.32; <i>P</i> = 0.010). The hTA and CA groups did not reveal statistically significant differences in CSS with a hazard ratio of 1.07 (95% confidence interval, 0.76-1.50; <i>P</i> = 0.706). The hTA and CA groups did not show statistically significant differences in CSM (<i>P</i> = 0.849). However, the hTA group showed a significantly higher other-cause mortality (<i>P</i> = 0.011).</p><p><strong>Conclusion: </strong>In patients with clinical stage T1a renal cell carcinomas, hTA was comparable to CA in terms of CSS and CSM. However, hTA resulted in a slightly shorter OS than CA. Large-scale randomized clinical trials are required to obtain more robust evidence.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"1061-1069"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621701","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":"Prostate Cancer Screening With MRI: Lessons Learned From Repeat Rounds of the GÖTEBORG-2 and STHLM3-MRI Trials.","authors":"Sungmin Woo, Hebert Alberto Vargas, Anwar R Padhani","doi":"10.3348/kjr.2024.1024","DOIUrl":"10.3348/kjr.2024.1024","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"1033-1035"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621901","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":"Training of Radiology Residents in Singapore.","authors":"Francis Cho Hao Ho, Cher Heng Tan, Tze Chwan Lim, Chow Wei Too, Hsien Min Low, Charles Xian Yang Goh","doi":"10.3348/kjr.2024.1055","DOIUrl":"10.3348/kjr.2024.1055","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 12","pages":"1036-1038"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751021","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}