Journal of the Korean Society of Radiology最新文献

The board certification examination in radiology comprehensively assesses candidates' interpretive skills in clinical situations and their ability to support therapeutic decision-making. It is essential that the examination consistently upholds validity and reliability, with the overarching goal of producing an appropriate number of well-qualified specialists. The Examination Committee plays a pivotal role in the administration and management of the certification process. Recently, the testing format has shifted from paper-based methods to smart device-based test (SBT). Question banks have been organized and computerized. Test items have transitioned from simple memory-based questions to case-based problem-solving formats. Additionally, imaging presentation has evolved from still images to stacked or video formats that closely simulate real-world reading environments. Test item development should progress beyond conventional arrow-marked questions, allowing candidates to independently identify lesions and provide differential diagnoses in realistic interpretation settings. In an era increasingly shaped by artificial intelligence, examination formats must adapt to incorporate and reflect these technological advances. The Examination Committee must remain committed to continuous reflection, innovation, and adaptation to address these challenges.

[This corrects the article on p. 624 in vol. 86, PMID: 41113373.].

Contrast-enhanced mammography (CEM) is an advanced imaging technique that combines morphological and functional information to enhance breast cancer detection, similar to MRI. Using dual-energy X-rays and iodinated contrast agents, CEM highlights enhancing abnormalities and is highly sensitive in detecting malignancies, particularly in dense breasts. Its advantages include rapid image acquisition and cost-effectiveness, making it useful in screening, diagnosis, staging, and monitoring of chemotherapy response. Emerging applications of radiomics and artificial intelligence are poised to improve lesion characterization and predict molecular subtypes. While promising, CEM also has limitations, including increased radiation exposure, risks associated with contrast, potential for false results, and difficulty in widespread integration because of the limited availability of CEM-guided biopsy. Overall, CEM is a valuable and cost-effective tool with increased clinical relevance. This review provides a comprehensive summary of CEM for clinical and future considerations.

The use of interlaminar spacers in double-door laminoplasty for treating cervical spinal stenosis is a relatively new technique; however, reports of complications associated with this procedure are rare. Here, we present the case of a 42-year-old male who presented with a posterior neck mass 2 years after undergoing double-door laminoplasty with interlaminar spacers. Imaging studies, including ultrasonography, plain radiography, and MRI, revealed the wear, fragmentation, and migration of multiple interlaminar spacers, thereby forming a foreign body granuloma. This case highlights a rare complication that emphasizes the need for awareness and careful postoperative follow-up to detect such adverse outcomes.

Purpose: To compare the diagnostic performance between biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) using split dynamic MRI for detecting clinically significant prostate cancer (csPCa) with Prostate Imaging and Reporting Data System (PI-RADS) v2.1, using prostatectomy as the reference standard of pathologic analysis.

Materials and methods: We retrospectively analyzed 77 PCa cases in 60 patients who underwent radical prostatectomy for biopsy-proven prostate cancer. The MR Images of the prostate were interpreted in consensus by two experienced radiologists (aged 3 and 35 years). We retrospectively reviewed the MRI images according to PI-RADS v2.1 and recorded the scores from T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) imaging, and peak relaxation rate (R2^*) for each lesion at three different time points: 1) bpMRI (T2WI, DWI, and ADC), 2) mpMRI1 (T2WI, DWI, ADC, and DCE), and 3) mpMRI2 (T2WI, DWI, ADC, DCE, and peak R2^*). The diagnostic performances of bpMRI, mpMRI1, and mpMRI2 in detecting csPCa using PI-RADS V2.1 were evaluated. Additionally, we evaluated the diagnostic performance of DCE-MRI and peak R2^* for csPCa detection.

Results: The area under the curve, sensitivity, specificity, and accuracy for diagnosing csPCa with PI-RADS v2.1 in all lesions and peripheral zone (PZ) lesions were not significantly different between the bpMRI, mpMRI1, and mpMRI2 protocols (p > 0.05). DCE-MRI was better than the peak R2^* for diagnosing csPCa in PZ lesions (p < 0.001).

Conclusion: mpMRI using split dynamic MRI has diagnostic performance similar to that of bpMRI for detecting csPCa using PI-RADS v2.1.

The forefoot and midfoot consist of various musculoskeletal structures that predispose patients to a wide range of disorders. However, small and complex anatomical features pose challenges for radiological diagnosis and increase the risk of misdiagnosis. This can significantly influence the selection of appropriate treatments and overall prognosis. In this pictorial essay, we review the imaging findings of significant disorders affecting the forefoot and midfoot, along with their relevant anatomical foundations, to provide essential insights for differential diagnosis and support accurate clinical assessment.

Infectious spinal disease is suspected in patients presenting with acute spinal pain, limited range of motion, and elevated inflammatory serum markers. However, these clinical indicators are not exclusive to infectious conditions and are observed across a spectrum of non-infectious spinal diseases, including inflammatory and degenerative spinal disorders. Owing to the overlapping clinical features, avoiding unnecessary invasive procedures and antibiotic treatments can be challenging. Recognizing the radiographic characteristics of these diseases and raising awareness about them are crucial for accurate diagnosis and treatment, resulting in a better prognosis for patients. We present various cases of non-infectious spinal diseases that mimic infections to enhance awareness and facilitate accurate diagnostic approaches.

Lymphoma is characterized by the neoplastic proliferation of lymphoid cells within the lymphatic system. When it infiltrates organs beyond the lymph nodes, it is called extranodal lymphoma. Extranodal lymphoma can affect various thoracic organs, including the lungs, pleura, chest wall, bony thorax, and breasts. This disease often presents with diverse imaging manifestations such as consolidation, nodules, masses, pleural or pericardial effusion, pleural thickening, pleural masses, large sternal masses, and breast masses. These findings may overlap with those of other thoracic conditions, posing challenges in the differential diagnosis. Given the critical importance of timely diagnosis and treatment in patients with lymphoma, distinguishing extranodal lymphoma from other diseases and evaluating the exact extent and distribution of lymphoma are crucial. This pictorial essay reviews the diverse thoracic involvement of extranodal lymphoma to facilitate diagnosis and appropriate treatment planning.

Vascular Ehlers-Danlos syndrome (EDS) is a rare genetic connective tissue disorder caused by abnormalities in extracellular matrix components, such as collagen. Among the six subtypes of EDS, type IV is known to have the worst prognosis. However, owing to its low prevalence (approximately 4%), diagnosis is often delayed, leading to fatal complications such as bleeding. We report a case of an 18-year-old male who presented with hemoptysis. CT revealed cavitary nodules and signs of bleeding. A biopsy was attempted, during which the bleeding tendency of the patient was noted, and a rapidly progressing pneumothorax developed in both lungs. This led us to suspect a diagnosis of type IV EDS. This case highlights the importance of considering type IV EDS as a differential diagnosis in patients with cavitary nodules and ground-glass opacities on imaging, especially in the presence of increasing pneumothorax and a tendency to bleed.

A 74-year-old woman was diagnosed with locally advanced invasive ductal carcinoma of the right breast, which was confirmed as triple-negative breast cancer (TNBC) by immunohisto-chemical analysis. Multiple ipsilateral axillary lymph node metastases were identified, but no distant metastases were detected. The patient underwent neoadjuvant chemotherapy, which was ineffective, and subsequently developed tumor-related wound bleeding. To control the bleeding and reduce tumor vascularity, transcatheter arterial embolization (TAE) was performed. Permanent embolization using Embosphere microspheres and glue induced in complete ischemia, leading to a significant reduction in tumor and lymph node size, thereby enabling surgical resection. A follow-up examination one year later revealed no evidence of recurrence or metastasis. This case report highlights the potential therapeutic efficacy of TAE in the management of locally advanced TNBC resistant to neoadjuvant chemotherapy.