Journal of the Korean Society of Radiology最新文献

Primary mucosa-associated lymphoid tissue (MALT) lymphoma of the lung, also known as pulmonary extranodal marginal zone B-cell lymphoma, is a rare type of non-Hodgkin lymphoma and signifies an uncommon pulmonary malignancy. Given its infrequency, there is limited documentation on its radiological characteristics. In this study, we present the case of a 64-year-old male patient with a pathologically confirmed diagnosis of primary MALT lymphoma of the lungs, which manifested as persistent bilateral lung consolidation without respiratory symptoms. These findings persisted despite six weeks of pneumonia treatment. The patient underwent sequential diagnostic assessments, including chest radiography, chest CT, endoscopy, colonoscopy, and fluorodeoxyglucose PET/CT. A CT-guided percutaneous core biopsy at the right lung consolidation site confirmed the diagnosis of pulmonary MALT lymphoma. Pulmonary MALT lymphoma, while uncommon and slow-growing, should be considered in patients presenting with persistent lung consolidation after ruling out common causes like infection or inflammation.

The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer (OPC) has been consistently increasing, now surpassing that of HPV-negative OPC. HPV-positive OPC exhibits distinct clinical characteristics and prognostic implications compared to HPV-negative OPC; occurs more frequently in younger, sexually active individuals; and generally demonstrates more favorable outcomes. Radiologic evaluation is crucial for tumor staging, predicting HPV status, and assessing or forecasting treatment response and patient outcomes. Recently, radiomics has enhanced tumor characterization. This review summarizes the key clinical features of HPV-positive OPC that radiologists should be familiar with and provides an overview of its radiologic characteristics, emphasizing the role of imaging in diagnosis, staging, treatment response assessment, and outcome prediction.

Sarcomatoid carcinomas are rare malignant tumors comprising a mixture of malignant epithelial and mesenchymal cells. Sarcomatoid carcinomas are found at various sites of the body, including the lungs and the hepatobiliary, urinary, and digestive tracts. However, sarcomatoid carcinoma of the ampulla of Vater (AoV) is rare with only a few reported cases. Here, we present the case of a 60-year-old woman with sarcomatoid carcinoma of the AoV, diagnosed using CT and MRI.

Purpose: This study aims to evaluate the effects of different mixing techniques on the characteristics of n-butyl-2-cyanoacrylate (NBCA) and ethiodized oil mixtures.

Materials and methods: Two mixing techniques were compared: the hand-stirring method (manual mixing of NBCA and ethiodized oil in a medicine cup) and the syringe-pumping method (emulsification of NBCA and ethiodized oil using a 10-mL syringe with a 3-way stopcock). The flow and polymerization times were measured, and variance analysis (F-test) was performed to assess the differences in the variability of the results between the two methods. Mixture homogeneity and particle distribution were examined.

Results: The syringe-pumping method yielded significantly a faster flow time (19.9 ± 1.33 s vs. 28.1 ± 5.77 s, p < 0.001) and polymerization time (102.4 ± 4.9 s vs. 123.3 ± 28.9 s, p < 0.001) than the hand-stirring method. Variance analysis revealed differences in both flow time (F = 104.37, p < 0.001) and polymerization time (F = 63.53, p < 0.001) between the two groups. The syringe-pumping method produced a more homogeneous mixture with a greater number of particles.

Conclusion: Syringe-pumping produces more consistent and homogenous NBCA and ethiodized oil emulsion with faster flow and polymerization characteristics than hand-stirring. These findings suggest that syringe-pumping enhances the efficacy and reliability of embolization procedures.

Accurate staging is essential for establishing treatment strategies and predicting the prognosis of patients with head and neck cancer. Radiologic imaging plays a pivotal role in evaluating deep tissue invasion and regional nodal metastasis that extend beyond the limits of endoscopic evaluation. This review examines the revised staging system for oral cavity cancer in the American Joint Committee on Cancer 8th edition, focusing on radiologically relevant parameters, particularly the tumor depth of invasion, and on key considerations in image interpretation. This article serves as a practical guide for radiologists to ensure accurate staging and facilitate effective communication with clinicians.

Extranodal extension (ENE) is an important adverse prognostic factor in head and neck cancer and has significant implications for treatment planning. Traditionally, pathologic ENE has guided nodal staging and postoperative management; however, its assessment is limited to surgically treated patients. In contrast, imaging-detected ENE (iENE) can be evaluated before treatment in all patients, regardless of treatment modality, underscoring its growing clinical relevance. Despite this advantage, variability in imaging interpretation has persisted due to the lack of standardized definitions and diagnostic criteria. Recent international consensus efforts have addressed this gap by proposing standardized terminology and a tiered classification system for iENE to enhance reproducibility and clinical communication. This review summarizes the concept and clinical significance of iENE from a radiologist's perspective, examines the limitations of previously proposed imaging criteria, and provides a stepwise explanation of the standardized classification system. Practical considerations for applying this system in routine radiologic interpretation and reporting are also discussed.

The recently revised American Joint Committee on Cancer Version 9 staging system for nasopharyngeal cancer reflects advances in high-resolution imaging techniques and aims for more detailed risk stratification. Key revisions include the requirement of unequivocal cortical bone destruction or marrow infiltration for T3 category and the introduction of imaging criteria for extranodal extension in the N3 category. Additionally, the M category was subdivided based on the number of distant metastatic lesions. These changes highlight the importance of accurate evaluations using CT, MRI, and PET. This review details the updated criteria and radiological considerations that support accurate imaging interpretation and staging.

Musculoskeletal (MSK) tumors are neoplasms that arise in the bones, cartilage, muscles, tendons, nerves, and synovium. These lesions are highly diverse, comprising various tissue components such as mature fat, fluid, hematoma, and fibrous tissue. MRI is a crucial modality for diagnosing MSK tumors, providing both qualitative and quantitative assessments of tissue composition. The key tissue components of MSK tumors that are identifiable on MRI include mature fat and fluid. However, hyperintense mimickers-such as subacute hematomas on T1-weighted image (T1WI) and pseudocystic lesions on T2-weighted image (T2WI)-can complicate MRI interpretation. Masses with non-specific MRI features-such as intermediate signal intensity (SI) on T1WI and high SI on T2WI-require differential diagnosis. Special attention should be paid to the tumor's specific location, imaging signs, patterns of low-SI foci on both sequences, and features suggestive of malignancy, with biopsy indicated in uncertain cases. Advanced MRI techniques enhance diagnostic precision. DIXON quantifies fat content, diffusion-weighted imaging assesses cellularity with tumor heterogeneity, and dynamic contrast-enhanced MRI quantifies perfusion. Ultimately, integrating conventional and functional MRI analyses is essential to accurately characterize the diverse and complex nature of MSK tumors.

The detection of progressive massive fibrosis (PMF) in regions where silicosis is endemic presents diagnostic challenges due to its resemblance to other conditions, such as lung cancer and tuberculosis on radiographs. Therefore, there is an increasing reliance on chest CT due to its higher sensitivity and specificity compared to conventional chest radiography. In this pictorial essay, we aim to illustrate the diverse manifestations of PMF on chest CT, offering valuable insights for an accurate differential diagnosis. Recognizing these manifestations is essential for improving diagnostic precision and minimizing unnecessary procedures.

Biochemical recurrence, marked by rising prostate specific antigen levels, is a common and challenging clinical scenario following curative treatments for localized prostate cancer (PCa), such as radical prostatectomy (RP) or radiation therapy (RT). An accurate assessment is critical for detecting local recurrence and distinguishing it from distant metastatic disease, thereby guiding salvage therapies. While multiparametric MRI has demonstrated strong performance in detecting local recurrence, the lack of standardized reporting has historically limited its clinical utility and reproducibility. To address this variability, an international consensus-based Prostate Imaging for Recurrence Reporting (PI-RR) system was introduced in 2021. PI-RR adopts a 5-point Likert scale, similar to Prostate Imaging Reporting and Data System, but places greater emphasis on dynamic contrast-enhanced MRI and incorporates knowledge of the prior primary tumor location to grade the likelihood of recurrence. This review article provides a comprehensive overview of the PI-RR system, detailing its imaging acquisition recommendations, specific scoring criteria after RT and RP, clinical implications, and future directions within the evolving landscape of PCa imaging.