Korean Journal of Radiology最新文献

{"title":"Conversion of Mixed-Language Free-Text CT Reports of Pancreatic Cancer to National Comprehensive Cancer Network Structured Reporting Templates by Using GPT-4.","authors":"Hokun Kim, Bohyun Kim, Moon Hyung Choi, Joon-Il Choi, Soon Nam Oh, Sung Eun Rha","doi":"10.3348/kjr.2024.1228","DOIUrl":"10.3348/kjr.2024.1228","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility of generative pre-trained transformer-4 (GPT-4) in generating structured reports (SRs) from mixed-language (English and Korean) narrative-style CT reports for pancreatic ductal adenocarcinoma (PDAC) and to assess its accuracy in categorizing PDCA resectability.</p><p><strong>Materials and methods: </strong>This retrospective study included consecutive free-text reports of pancreas-protocol CT for staging PDAC, from two institutions, written in English or Korean from January 2021 to December 2023. Both the GPT-4 Turbo and GPT-4o models were provided prompts along with the free-text reports via an application programming interface and tasked with generating SRs and categorizing tumor resectability according to the National Comprehensive Cancer Network guidelines version 2.2024. Prompts were optimized using the GPT-4 Turbo model and 50 reports from Institution B. The performances of the GPT-4 Turbo and GPT-4o models in the two tasks were evaluated using 115 reports from Institution A. Results were compared with a reference standard that was manually derived by an abdominal radiologist. Each report was consecutively processed three times, with the most frequent response selected as the final output. Error analysis was guided by the decision rationale provided by the models.</p><p><strong>Results: </strong>Of the 115 narrative reports tested, 96 (83.5%) contained both English and Korean. For SR generation, GPT-4 Turbo and GPT-4o demonstrated comparable accuracies (92.3% [1592/1725] and 92.2% [1590/1725], respectively; <i>P</i> = 0.923). In the resectability categorization, GPT-4 Turbo showed higher accuracy than GPT-4o (81.7% [94/115] vs. 67.0% [77/115], respectively; <i>P</i> = 0.002). In the error analysis of GPT-4 Turbo, the SR generation error rate was 7.7% (133/1725 items), which was primarily attributed to inaccurate data extraction (54.1% [72/133]). The resectability categorization error rate was 18.3% (21/115), with the main cause being violation of the resectability criteria (61.9% [13/21]).</p><p><strong>Conclusion: </strong>Both GPT-4 Turbo and GPT-4o demonstrated acceptable accuracy in generating NCCN-based SRs on PDACs from mixed-language narrative reports. However, oversight by human radiologists is essential for determining resectability based on CT findings.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"557-568"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007794","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":"Association Between Extracellular Volume Assessed by Cardiac MRI and New-Onset Atrial Fibrillation in Patients With ST-Segment Elevation Myocardial Infarction.","authors":"Lei Chen, Bowen Qiu, Xinjia Du, Jiahua Liu, Zhongxiao Liu, Wensu Chen, Wenliang Che, Yuan Lu","doi":"10.3348/kjr.2025.0070","DOIUrl":"10.3348/kjr.2025.0070","url":null,"abstract":"<p><strong>Objective: </strong>Although left ventricular (LV) fibrosis has been strongly linked to atrial fibrillation (AF), its relationship with new-onset AF (NOAF) following ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to investigate the association between different extracellular volume (ECV) measurements in the LV and NOAF during acute-phase STEMI.</p><p><strong>Materials and methods: </strong>This retrospective study included 517 patients diagnosed with acute STEMI (440 males, 77 females; mean age, 57.2 ± 12.4 years). All patients underwent cardiac magnetic resonance (CMR) imaging with T1 mapping sequences during hospitalization. Blood samples were collected within 24 hours of the CMR examination. ECV was assessed in three regions of the left ventricle: the non-myocardial infarction region (NMI-ECV), the myocardial infarction region (MI-ECV), and the entire myocardium (integral ECV). Multi-variable logistic regression was used to evaluate the associations between these ECV parameters and NOAF. Receiver operating characteristic (ROC) analysis was performed to assess the predictive value of ECV measurements, both alone and in combination with two conventional risk factors-N-terminal pro-B-type natriuretic peptide and infarct-related artery (right coronary artery).</p><p><strong>Results: </strong>During hospitalization, 40 (7.7%) patients developed NOAF. After adjusting for confounding factors, including left atrial strain, MI-ECV, NMI-ECV, and integral ECV were independently associated with NOAF. The area under the ROC curve for predicting NOAF was 0.702 (95% confidence interval: 0.615-0.789), 0.625 (0.531-0.719), and 0.712 (0.627-0.798) for MI-ECV, NMI-ECV, and integral ECV, respectively. The addition of integral ECV and MI-ECV to conventional factors significantly improved the predictive performance for NOAF.</p><p><strong>Conclusion: </strong>ECV measured using CMR was independently and significantly associated with NOAF occurrence in acute-phase STEMI. Incorporating ECV into risk assessment models could significantly improve NOAF prediction.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 6","pages":"546-556"},"PeriodicalIF":4.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159804","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 \"2025 Korean Society of Abdominal Radiology Recommendations on Gallbladder Polyps and Gallbladder Wall Thickening Warrant Further Investigation and Clarification\".","authors":"Jeong Hee Yoon","doi":"10.3348/kjr.2025.0216","DOIUrl":"10.3348/kjr.2025.0216","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"516-517"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764245","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 \"Comparison of Recommendations for Gallbladder Polyps and Gallbladder Wall Thickening Between KSAR and WFUMB Guidelines\".","authors":"Jeong Hee Yoon","doi":"10.3348/kjr.2025.0215","DOIUrl":"10.3348/kjr.2025.0215","url":null,"abstract":"","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"511-513"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764246","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":"Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI.","authors":"Xue-Han Wu, Yu-Tao Que, Xin-Yue Yang, Zi-Qiang Wen, Yu-Ru Ma, Zhi-Wen Zhang, Quan-Meng Liu, Wen-Jie Fan, Li Ding, Yue-Jiao Lang, Yun-Zhu Wu, Jian-Peng Yuan, Shen-Ping Yu, Yi-Yan Liu, Yan Chen","doi":"10.3348/kjr.2024.0767","DOIUrl":"10.3348/kjr.2024.0767","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (<i>K</i>^trans, <i>k</i>_ep, and <i>v</i>_e) and DWI (ADC_min, ADC_max, and ADC_mean), were analyzed and compared between the two groups. Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.</p><p><strong>Results: </strong>All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all <i>P</i> < 0.05). However, ADC values did not demonstrate significant differences (all <i>P</i> > 0.05). Among the single quantitative parameters, <i>v</i>_e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, <i>v</i>_e, and ADC_mean improved diagnostic performance, achieving an AUC of 0.833 (<i>P</i> = 0.027).</p><p><strong>Conclusion: </strong>The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"400-410"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764242","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 T2 Mapping Analysis With MRI of Talar Cartilage in Ankle Trauma: A Study Based on Lauge-Hansen Classification and Anatomical Locations.","authors":"Eun Kyung Khil, Jang Gyu Cha, Sung Jae Kim, Yu Sung Yoon","doi":"10.3348/kjr.2024.0773","DOIUrl":"https://doi.org/10.3348/kjr.2024.0773","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs. lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using <i>t</i>-tests. The T2 values were also compared between the medial and lateral sides within each group.</p><p><strong>Results: </strong>Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; <i>P</i> < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; <i>P</i> < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group (<i>P</i> ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides (<i>P</i> = 0.037 and 0.011, respectively).</p><p><strong>Conclusion: </strong>MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 5","pages":"435-445"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000311","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":"Frequently Asked Questions on Imaging in Chimeric Antigen Receptor T-Cell Therapy Clinical Trials.","authors":"Sang Eun Won, Eun Sung Lee, Chong Hyun Suh, Sinae Kim, Hyo Jung Park, Kyung Won Kim, Jeffrey P Guenette","doi":"10.3348/kjr.2024.1126","DOIUrl":"https://doi.org/10.3348/kjr.2024.1126","url":null,"abstract":"<p><p>Clinical trials for chimeric antigen receptor (CAR) T-cell therapy are in the early stages but are expected to progress alongside new treatment approaches. This suggests that imaging will play an important role in monitoring disease progression, treatment response, and treatment-related side effects. There are, however, challenges that remain unresolved, regarding imaging in CAR T-cell therapy. We herein discuss the role of imaging, focusing on how tumor response evaluation varies according to cancer type and target antigens in CAR T-cell therapy. CAR T-cell therapy often produces rapid and significant responses, and imaging is vital for identifying side effects such as cytokine release syndrome and neurotoxicity. Radiologists should be aware of drug mechanisms, response assessments, and associated toxicities to effectively support these therapies. Additionally, this article highlights the importance of the Lugano criteria, which is essential for standardized assessment of treatment response, particularly in lymphoma therapies, and also explores other factors influencing imaging-based evaluation, including emerging methodologies and their potential to improve the accuracy and consistency of response assessments.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 5","pages":"471-484"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007796","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":"Effects of Deep Learning-Based Reconstruction on the Quality of Accelerated Contrast-Enhanced Neck MRI.","authors":"Minkook Seo, Kook-Jin Ahn, Hyun-Soo Lee, Marcel Dominik Nickel, Jinhee Jang, Yeon Jong Huh, Ilah Shin, Ji Young Lee, Bum-Soo Kim","doi":"10.3348/kjr.2024.1059","DOIUrl":"https://doi.org/10.3348/kjr.2024.1059","url":null,"abstract":"<p><strong>Objective: </strong>To compare the quality of deep learning-reconstructed turbo spin-echo (DL-TSE) and conventionally interpolated turbo spin-echo (Conv-TSE) techniques in contrast-enhanced MRI of the neck.</p><p><strong>Materials and methods: </strong>Contrast-enhanced T1-weighted DL-TSE and Conv-TSE images were acquired using 3T scanners from 106 patients. DL-TSE employed a closed-source, 'work-in-progress' (WIP No. 1062, iTSE, version 10; Siemens Healthineers) algorithm for interpolation and denoising to achieve the same in-plane resolution (axial: 0.26 × 0.26 mm²; coronal: 0.29 × 0.29 mm²) while reducing scan times by 15.9% and 52.6% for axial and coronal scans, respectively. The full width at half maximum (FWHM) and percent signal ghosting were measured using stationary and flow phantom scans, respectively. In patient images, non-uniformity (NU), contrast-to-noise ratio (CNR), and regional mucosal FWHM were evaluated. Two neuroradiologists visually rated the patient images for overall quality, sharpness, regional mucosal conspicuity, artifacts, and lesions using a 5-point Likert scale.</p><p><strong>Results: </strong>FWHM in the stationary phantom scan was consistently sharper in DL-TSE. The percent signal ghosting outside the flow phantom was lower in DL-TSE (0.06% vs. 0.14%) but higher within the phantom (8.92% vs. 1.75%) compared to Conv-TSE. In patient scans, DL-TSE showed non-inferior NU and higher CNR. Regional mucosal FWHM was significantly better in DL-TSE, particularly in the oropharynx (coronal: 1.08 ± 0.31 vs. 1.52 ± 0.46 mm) and hypopharynx (coronal: 1.26 ± 0.35 vs. 1.91 ± 0.56 mm) (both <i>P</i> < 0.001). DL-TSE demonstrated higher overall image quality (axial: 4.61 ± 0.49 vs. 3.32 ± 0.54) and sharpness (axial: 4.40 ± 0.56 vs. 3.11 ± 0.53) (both <i>P</i> < 0.001). In addition, mucosal conspicuity was improved, especially in the oropharynx (axial: 4.41 ± 0.67 vs. 3.40 ± 0.69) and hypopharynx (axial: 4.45 ± 0.58 vs. 3.58 ± 0.63) (both <i>P</i> < 0.001). Extracorporeal ghost artifacts were reduced in DL-TSE (axial: 4.32 ± 0.60 vs. 3.90 ± 0.71, <i>P</i> < 0.001) but artifacts overlapping anatomical structures were slightly more pronounced (axial: 3.78 ± 0.74 vs. 3.95 ± 0.72, <i>P</i> < 0.001). Lesions were detected with higher confidence in DL-TSE.</p><p><strong>Conclusion: </strong>DL-based reconstruction applied to accelerated neck MRI improves overall image quality, sharpness, mucosal conspicuity in motion-prone regions, and lesion detection confidence. Despite more pronounced ghost artifacts overlapping anatomical structures, DL-TSE enables substantial scan time reduction while enhancing diagnostic performance.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 5","pages":"446-445"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016031","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":"Increased CT Attenuation of Pericolic Adipose Tissue as a Noninvasive Marker of Disease Severity in Ulcerative Colitis.","authors":"Jun Lu, Hui Xu, Jing Zheng, Tianxin Cheng, Xinjun Han, Yuxin Wang, Xuxu Meng, Xiaoyang Li, Jiahui Jiang, Xue Dong, Xijie Zhang, Zhenchang Wang, Zhenghan Yang, Lixue Xu","doi":"10.3348/kjr.2024.0857","DOIUrl":"https://doi.org/10.3348/kjr.2024.0857","url":null,"abstract":"<p><strong>Objective: </strong>Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown. This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity.</p><p><strong>Materials and methods: </strong>This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI_MS, FAI_OMS, and FAI_RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman's correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The FAI_MS and FAI_OMS scores were significantly higher than FAI_RS in three phases (all <i>P</i> < 0.001). The FAI_MS and FAI_OMS scores moderately correlated with the UCEIS score (<i>r</i> = 0.474-0.649 among the three phases). Additionally, FAI_MS and FAI_OMS identified severe UC, with AUC varying from 0.77 to 0.85.</p><p><strong>Conclusion: </strong>Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI_MS and FAI_OMS of three phases showed similar prediction accuracies for severe UC identification.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"26 5","pages":"411-421"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989481","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 to Predict Gleason Score Upgrading and Downgrading at Radical Prostatectomy Compared to Presurgical Biopsy.","authors":"Jiahui Zhang, Lili Xu, Gumuyang Zhang, Daming Zhang, Xiaoxiao Zhang, Xin Bai, Li Chen, Qianyu Peng, Zhengyu Jin, Hao Sun","doi":"10.3348/kjr.2024.1008","DOIUrl":"10.3348/kjr.2024.1008","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the value of multiparametric MRI (mpMRI) in predicting Gleason score (GS) upgrading and downgrading in radical prostatectomy (RP) compared with presurgical biopsy.</p><p><strong>Materials and methods: </strong>Clinical and mpMRI data were retrospectively collected from 219 patients with prostate disease between January 2015 and December 2021. All patients underwent systematic prostate biopsy followed by RP. MpMRI included conventional diffusion-weighted and dynamic contrast-enhanced imaging. Multivariable logistic regression analysis was performed to analyze the factors associated with GS upgrading and downgrading after RP. Receiver operating characteristic curve analysis was used to estimate the area under the curve (AUC) to indicate the performance of the multivariable logistic regression models in predicting GS upgrade and downgrade after RP.</p><p><strong>Results: </strong>The GS after RP was upgraded, downgraded, and unchanged in 92, 43, and 84 patients, respectively. The AUCs of the clinical (percentage of positive biopsy cores [PBCs], time from biopsy to RP) and mpMRI models (prostate cancer [PCa] location, Prostate Imaging Reporting and Data System [PI-RADS] v2.1 score) for predicting GS upgrading after RP were 0.714 and 0.749, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, tPSA, PCa location, and PI-RADS v2.1 score) was 0.816, which was larger than that of the clinical factors alone (<i>P</i> < 0.001). The AUCs of the clinical (age, percentage of PBCs, ratio of free/total PSA [F/T]) and mpMRI models (PCa diameter, PCa location, and PI-RADS v2.1 score) for predicting GS downgrading after RP were 0.749 and 0.835, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, F/T, PCa diameter, PCa location, and PI-RADS v2.1 score) was 0.883, which was larger than that of the clinical factors alone (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Combining clinical factors and mpMRI findings can predict GS upgrade and downgrade after RP more accurately than using clinical factors alone.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"422-434"},"PeriodicalIF":4.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764244","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}