Korean Journal of Radiology最新文献

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, is the fastest-growing cause of chronic liver disease worldwide, affecting approximately 30% of the global population. Imaging is vital for detecting, quantifying, and monitoring hepatic steatosis-the defining abnormality of MASLD-and subsequent fibrosis-the key determinant of liver-related outcomes. This review summarizes the principles, clinical usage, efficacy, and advancements in various imaging modalities for the noninvasive assessment of hepatic steatosis and fibrosis, with an emphasis on ultrasound, CT, and MRI. Additionally, this review explores the evolving landscape of MASLD diagnostic approaches, including machine-learning techniques, opportunistic screening, standardized imaging guidelines, and therapies, emphasizing the pivotal role that radiologists can play in shaping these developments.

Objective: This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO).

Materials and methods: A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTR_asym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTR_asym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman's correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO.

Results: Patients with active TAO showed lower MTR values (P < 0.001) and higher MTR_{asym (1 ppm)}, MTR_{asym (2 ppm)}, and MTR_{asym (3.5 ppm)} (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTR_{asym (1 ppm)}, MTR_{asym (2 ppm)}, and MTR_{asym (3.5 ppm)} were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively; all P < 0.001). MTR and MTR_{asym (1 ppm)} were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTR_{asym (1 ppm)} in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTR_{asym (1 ppm)} significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001).

Conclusion: MTR and MTR_{asym (1 ppm)} were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.

Objective: This study aimed to evaluate the feasibility, safety, and oncologic outcomes of irreversible electroporation (IRE) using a clustered electrode in patients with locally advanced pancreatic cancer (LAPC).

Materials and methods: In this single-center prospective cohort study, 13 patients with LAPC (median age, 60 years; range, 48-78 years) underwent clustered electrode IRE between September 2022 and September 2024. Patient characteristics, procedural details, and clinical outcomes were recorded. Endpoints included technical success, procedure-related complications, overall survival (OS), and progression-free survival (PFS).

Results: Tumors were located in the pancreatic head in four patients (30.8%) and in the body/tail in nine (69.2%). The median tumor size was 2.4 cm (1.5-4.0 cm), and vascular invasion was present in all patients. Technical success was achieved in all patients. Intraoperative IRE was performed in 11 (84.6%) patients, and 2 (15.4%) patients underwent percutaneous IRE. Gastrointestinal bleeding events as major complications occurred in two patients (15.4%) and, both were successfully controlled by embolization. No 60-day mortality was observed. At a median follow-up of 24.5 months (range, 9.9-33.4 months) after IRE, median OS and PFS from IRE were 20.1 and 14.5 months, respectively.

Conclusion: IRE using clustered electrodes for LAPC appears to be a feasible therapeutic approach, offering reliable technical success and acceptable safety. Survival outcomes are encouraging; however, larger, controlled studies are required.