Korean Journal of Radiology最新文献

{"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":"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":"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":"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":"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}

{"title":"Erratum: 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 Hahn, Jung Hee Shin, Ji-Hoon Kim, So Lyung Jung, Sae Rom Chung, Jung Hwan Baek, Dong Gyu Na","doi":"10.3348/kjr.2024.1136","DOIUrl":"10.3348/kjr.2024.1136","url":null,"abstract":"<p><p>This corrects the article on p. 942 in vol. 25, PMID: 39473087.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 12","pages":"1104"},"PeriodicalIF":4.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750962","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":"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":"25 11","pages":"1022-1028"},"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":"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":"25 11","pages":"1029-1031"},"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":"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":"25 11","pages":"1011-1021"},"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":"25 11","pages":"992-1002"},"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}