Korean Journal of Radiology最新文献

Objective: To assess percutaneous radiofrequency ablation (RFA) techniques, radiation doses, and treatment outcomes for recurrent tumors of a single pediatric kidney.

Materials and methods: Between August 2019 and January 2025, computed tomography (CT)-guided RFA was performed to treat six recurrent tumors in three children (one boy and two girls; median age at RFA, 12 years and 9 months) who had previously undergone unilateral nephrectomy for sarcoma or Wilm's tumor. All renal tumors (range, 1.6-3.3 cm; median, 2.3 cm) were endophytic and included five Bosniak III cysts and one solid tumor. An internally cooled electrode was used for treatment under general anesthesia. The RFA duration, ablation cycles, electrode repositioning, renal function change, dose-length product (DLP), and oncological outcomes were assessed. A paired t-test was used for statistical analysis.

Results: All tumors were successfully treated in a single session. The median RFA duration was 16 minutes and 40 seconds (range, 7-36 minutes). The median number of RFA cycles and electrode repositions was 4.5 (range, 2-19) and 1 (range, 0-2), respectively. The median estimated glomerular filtration rate before and after RFA were 152.1 mL/min/1.73 m² (range, 107.2-183.4 mL/min/1.73 m²) and 110.7 mL/min/1.73 m² (range, 81.7-162.3 mL/min/1.73 m²), respectively (P = 0.040). The median DLP was 267.1 mGycm (range, 156.7-411.8 mGycm). The technical success and primary effectiveness rates were 100% (6/6). No local tumor progression was detected in any tumors for 1-66 months (median, 34.5 months).

Conclusion: Low-dose CT-guided RFA has the potential to treat recurrent endophytic renal tumors and may result in good treatment outcomes.

Recent systematic reviews have raised concerns about the quality of reporting in studies evaluating the accuracy of large language models (LLMs) in medical applications. Incomplete and inconsistent reporting hampers the ability of reviewers and readers to assess study methodology, interpret results, and evaluate reproducibility. To address this issue, the MInimum reporting items for CLear Evaluation of Accuracy Reports of Large Language Models in healthcare (MI-CLEAR-LLM) checklist was developed. This article presents an extensively updated version. While the original version focused on proprietary LLMs accessed via web-based chatbot interfaces, the updated checklist incorporates considerations relevant to application programming interfaces and self-managed models, typically based on open-source LLMs. As before, the revised MI-CLEAR-LLM focuses on reporting practices specific to LLM accuracy evaluations: specifically, the reporting of how LLMs are specified, accessed, adapted, and applied in testing, with special attention to methodological factors that influence outputs. The checklist includes essential items across categories such as model identification, access mode, input data type, adaptation strategy, prompt optimization, prompt execution, stochasticity management, and test data independence. This article also presents reporting examples from the literature. Adoption of the updated MI-CLEAR-LLM can help ensure transparency in reporting and enable more accurate and meaningful evaluation of studies.

Objective: To evaluate the current status of cardiac magnetic resonance imaging (CMR) practice across Asian regions, guiding future clinical advancements and academic collaboration in CMR.

Materials and methods: This descriptive, cross-sectional study is based on presentations from the "Current Status of CMR in Asia" session at the 2025 Asian Society of Cardiovascular Imaging congress held on June 14. Data from nine Asian regions-including China (Mainland), Chinese Taipei, Hong Kong (China), India, Indonesia, Japan, South Korea, Thailand, and Vietnam (listed in alphabetical order)-were collected via structured surveys or general overviews, addressing institutional characteristics, technical infrastructure, clinical applications, and research activity. Descriptive statistics were used for analysis.

Results: CMR scan volumes varied widely across Asia, with high-volume centers reporting from fewer than 100 scans per month to over 20,000 scans per year. Cardiomyopathy and ischemic heart disease were the most common clinical indications, while congenital heart disease or heart failure were also important in some regions. CMR supervision differed by region, with procedures overseen by either radiologists or cardiologists. Key barriers to clinical utilization included high costs, limited scanner availability, and a shortage of trained personnel. Common research obstacles included low scan volumes, inadequate funding, and the absence of multicenter networks.

Conclusion: This study highlights the need for coordinated efforts to improve scanner access, enhance workforce training, and foster multiregional collaboration to ensure the sustainable growth of CMR practice and research across Asia.

Breast lesions that do not meet the criteria for a mass on ultrasound (US), analogous to asymmetry on mammography or nonmass enhancement on MRI, are frequently encountered during diagnostic or screening US. These lesions, referred to as nonmass lesions (NMLs), are discrete areas of altered echotexture compared to surrounding breast tissue, lacking the threedimensionality or conspicuity of a mass. Their subtle nature makes it difficult-particularly for less experienced US operators-to distinguish between benign and malignant NMLs. With increasing clinical recognition, the upcoming sixth edition of the American College of Radiology Breast Imaging Reporting and Data System may include NMLs as a distinct diagnostic category. This article illustrates the sonographic features of NMLs and their pathologic correlations, providing extensive representative examples across benign NMLs, benign NMLs with upgrade potential, and malignant NMLs. In addition, it offers a practical and structured guide for a diagnostic approach to aid clinical management.

Objective: The trends in chest computed tomography (CT) utilization among patients with pneumonia and its association with pneumonia incidence and mortality remain unclear. This study aimed to investigate these trends and their associations in older adults.

Materials and methods: We conducted a retrospective analysis of a Korean population aged 61-81 years at each calendar year between 2009 and 2018, using data from the government-provided National Health Insurance claims database (annual cohort size: 511,931-725,843 individuals). For each calendar year, we evaluated population-level, age- and sex-standardized pneumonia incidence and mortality rates; age- and sex-standardized frequency of chest CT acquisition, and 30-day mortality among patients with pneumonia. Pneumonia severity was categorized based on hospitalization and use of supplemental oxygen therapy. Incidence and mortality rates of pneumonia with and without chest CT were also evaluated for each severity subtype.

Results: The age- and sex-standardized incidence rate of pneumonia increased from 27.7 to 29.4 per 1,000 person-years between 2009 and 2018. Incidence rate of pneumonia with chest CT increased from 3.7 to 5.9 per 1,000 person-years, whereas incidence rate of pneumonia without chest CT remained stable (24.1 to 23.4 per 1,000 person-years). The frequency of chest CT acquisition among patients with pneumonia rose from 13.4% to 20.4%, regardless of severity. Over the same period, the age- and sex-standardized pneumonia mortality rate decreased from 51.9 to 44.2 per 100,000 person-years, and 30-day mortality among patients with pneumonia declined from 2.1% to 1.7%, regardless of severity.

Conclusion: Chest CT acquisition among older Korean patients with pneumonia increased steadily between 2009 and 2018. The population-level pneumonia incidence also increased, mainly in pneumonia diagnosed with chest CT acquisition. Further research is needed to assess the potential impact of increased chest CT utilization on mortality and the risk of overdiagnosis.