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Prospective Comparison of FOCUS MUSE and Single-Shot Echo-Planar Imaging for Diffusion-Weighted Imaging in Evaluating Thyroid-Associated Ophthalmopathy. 前瞻性比较 FOCUS MUSE 和单次回声-平面成像在评估甲状腺相关性眼病中的弥散加权成像。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0177
YunMeng Wang, YuanYuan Cui, JianKun Dai, ShuangShuang Ni, TianRan Zhang, Xin Chen, QinLing Jiang, YuXin Cheng, YiChuan Ma, Tuo Li, Yi Xiao

Objective: To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO).

Materials and methods: SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation.

Results: Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores (P < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) (P < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs (P < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC: 0.925 vs. 0.779; P = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI (r = 0.391, P < 0.001) and FOCUS MUSE DWI (r = 0.645, P < 0.001).

Conclusion: FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.

目的前瞻性地比较单次(SS)回声平面成像(EPI)和视场优化与约束不失真单次多路灵敏度编码(FOCUS MUSE)扩散加权成像(DWI)在评估甲状腺相关性眼病(TAO)中的应用:从 39 名 TAO 患者(18 名男性;平均 ± 标准偏差:48.3 ± 13.3 岁)和 26 名健康对照者(9 名男性;平均 ± 标准偏差:43.0 ± 18.5 岁)身上获取 SS EPI 和 FOCUS MUSE DWI。两名放射科医生使用 4 点李克特量表对视觉图像质量进行评分。比较了两种 DWI 的图像质量评分、信噪比(SNR)、对比度与噪声比(CNR)以及眼外肌(EOMs)的表观弥散系数(ADC)。还评估了眼外肌 ADC 的差异。使用接收器操作特征曲线评估了区分活动性和非活动性TAO的性能。利用斯皮尔曼相关性分析了ADC与临床活动评分(CAS)之间的相关性:与 SS EPI DWI 相比,FOCUS MUSE DWI 的图像质量评分明显更高(P < 0.001),外侧直肌(LRM)和内侧直肌(MRM)的 SNR 和 CNR 更高(P < 0.05),而 LRM 和 MRM 的 ADC 差异不大。在 SS EPI 和 FOCUS MUSE DWIs 中,活动性 TAO 的 ADC 均高于非活动性 TAO 和健康对照组(P < 0.001)。非活动性TAO和健康对照组在两种DWI中的ADC差异不明显。与 SS EPI DWI 相比,FOCUS MUSE DWI 能更好地区分活跃与非活跃 TAO(AUC:0.925 对 0.779;P = 0.007)。在SS EPI DWI(r = 0.391,P < 0.001)和FOCUS MUSE DWI(r = 0.645,P < 0.001)中,ADC与CAS明显相关:结论:与SS EPI DWI相比,FOCUS MUSE DWI为评估EOM提供了更好的图像,在诊断活动性TAO方面表现更好。FOCUS MUSE的应用将有助于对TAO进行DWI评估。
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引用次数: 0
Risk Stratification of Thyroid Nodules Diagnosed as Bethesda Category III by Ultrasound, Size, and Cytology. 通过超声波、大小和细胞学诊断为 Bethesda III 类甲状腺结节的风险分层。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0292
Hye Shin Ahn, Dong Gyu Na, Ji-Hoon Kim

Objective: This study aimed to evaluate the performance of an integrated risk stratification system (RSS) based on ultrasound (US) RSSs, nodule size, and cytology subcategory for diagnosing malignancy in thyroid nodules initially identified as Bethesda category III on fine-needle aspiration.

Materials and methods: This retrospective study was conducted at two institutions and included consecutive patients with Bethesda category III nodules, and final diagnoses confirmed by repeat biopsy or surgery. A total of 320 Bethesda category III nodules (≥1 cm) from 309 patients (223 female and 86 male; mean age, 50.9 ± 12.0 years) were included. The malignancy risk of Bethesda category III nodules and predictors of malignancy were assessed according to US RSSs, nodule size, and cytology subcategory. The diagnostic performances of US-size cytology (USC) RSS and US RSS alone for malignancy were compared.

Results: The intermediate or high suspicion US category independently increased the malignancy risk in all US RSSs (P ≤ 0.001). Large nodule size (≥3 cm) independently increased the malignancy risk of low- or intermediate suspicion US category nodules. Additionally, the atypia of undetermined significance cytology subcategory independently increased the malignancy risk of low suspicion US category nodules in most US RSSs. The area under the receiver operating characteristic curve of the USC RSSs was greater than that of the US RSSs alone (P < 0.048). Malignancy was not found in the very low risk category of USC RSS.

Conclusion: The diagnostic performance of USC RSS for malignancy was superior to that of US RSS alone in Bethesda category III nodules. Malignancy can be ruled out in the very low-risk category of USC RSS.

研究目的本研究旨在评估基于超声(US)RSS、结节大小和细胞学亚类的综合风险分层系统(RSS)在诊断细针穿刺初步确定为Bethesda III类甲状腺结节的恶性肿瘤方面的性能:这项回顾性研究在两家医疗机构进行,包括贝塞斯达III类结节的连续患者,最终诊断结果由重复活检或手术证实。研究共纳入了 309 名患者(女性 223 人,男性 86 人;平均年龄(50.9±12.0)岁)的 320 个 Bethesda III 类结节(≥1 厘米)。根据 US RSS、结节大小和细胞学亚类评估了 Bethesda III 类结节的恶性风险和恶性预测因素。比较了US-size细胞学(USC)RSS和单独US RSS对恶性肿瘤的诊断效果:结果:在所有 US RSS 中,中度或高度怀疑 US 类别会独立增加恶性肿瘤风险(P ≤ 0.001)。大结节尺寸(≥3 厘米)可独立增加低度或中度可疑 US 类别结节的恶性风险。此外,在大多数 US RSS 中,意义未定的细胞学不典型性亚类会独立增加低度可疑 US 类别结节的恶性风险。USC RSS 的接收器操作特征曲线下面积大于单独 US RSS 的接收器操作特征曲线下面积(P < 0.048)。在 USC RSS 的极低风险类别中未发现恶性肿瘤:结论:在贝塞斯达 III 类结节中,USC RSS 对恶性肿瘤的诊断效果优于单纯 US RSS。在 USC RSS 的极低风险类别中可以排除恶性肿瘤。
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引用次数: 0
KJR Honors Distinguished Reviewers for 2024. KJR 荣获 2024 年度杰出评论员称号。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0802
Seong Ho Park
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引用次数: 0
Letter to the Editor "Survey on Value Elements Provided by Artificial Intelligence and Their Eligibility for Insurance Coverage With an Emphasis on Patient-Centered Outcomes". 致编辑的信 "关于人工智能提供的价值要素及其保险承保资格的调查,强调以患者为中心的结果"。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0727
Mukesh Kumar Dharmalingam Jothinathan
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引用次数: 0
Advances in Understanding Hepatocellular Carcinoma Vasculature: Implications for Diagnosis, Prognostication, and Treatment. 了解肝细胞癌血管的进展:对诊断、预后和治疗的影响》。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0307
Hyungjin Rhee, Young Nyun Park, Jin-Young Choi

Hepatocellular carcinoma (HCC) progresses through multiple stages of hepatocarcinogenesis, with each stage characterized by specific changes in vascular supply, drainage, and microvascular structure. These vascular changes significantly influence the imaging findings of HCC, enabling non-invasive diagnosis. Vascular changes in HCC are closely related to aggressive histological characteristics and treatment responses. Venous drainage from the tumor toward the portal vein in the surrounding liver facilitates vascular invasion, and the unique microvascular pattern of vessels that encapsulate the tumor cluster (known as a VETC pattern) promotes vascular invasion and metastasis. Systemic treatments for HCC, which are increasingly being used, primarily target angiogenesis and immune checkpoint pathways, which are closely intertwined. By understanding the complex relationship between histopathological vascular changes in hepatocarcinogenesis and their implications for imaging findings, radiologists can enhance the accuracy of imaging diagnosis and improve the prediction of prognosis and treatment response. This, in turn, will ultimately lead to better patient care.

肝细胞癌(HCC)会经历多个肝癌发生阶段,每个阶段都会出现血管供应、引流和微血管结构的特定变化。这些血管变化会对 HCC 的成像结果产生重大影响,从而实现无创诊断。HCC 的血管变化与侵袭性组织学特征和治疗反应密切相关。肿瘤向周围肝脏门静脉的静脉引流促进了血管入侵,而包裹肿瘤簇的独特微血管模式(称为 VETC 模式)促进了血管入侵和转移。目前越来越多的 HCC 系统治疗方法主要针对血管生成和免疫检查点通路,而这两种通路密切相关。通过了解肝癌发生过程中组织病理学血管变化之间的复杂关系及其对成像结果的影响,放射科医生可以提高成像诊断的准确性,改善对预后和治疗反应的预测。这反过来又将最终带来更好的患者护理。
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引用次数: 0
How to Optimize Prompting for Large Language Models in Clinical Research. 如何优化临床研究中大型语言模型的提示。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0695
Jeong Hyun Lee, Jaeseung Shin
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引用次数: 0
Minimum Reporting Items for Clear Evaluation of Accuracy Reports of Large Language Models in Healthcare (MI-CLEAR-LLM). 医疗保健大型语言模型准确性清晰评估报告的最低报告项目(MI-CLEAR-LLM)。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0843
Seong Ho Park, Chong Hyun Suh, Jeong Hyun Lee, Charles E Kahn, Linda Moy
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引用次数: 0
Ultrasound-Guided Percutaneous Biopsy With Needle Track Plugging in Patients With Focal Liver Lesions on an Outpatient Basis: A Randomized Controlled Trial. 门诊病灶性肝损伤患者在超声引导下进行针道堵塞经皮活检:随机对照试验
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.3348/kjr.2024.0536
Ja Kyung Yoon, Choong-Kun Lee, Hongjeong Yoon, Hye Jin Choi, Seung-Seob Kim

Objective: The increasing utilization of various molecular tests for diagnosing and selecting treatments for patients with malignancies has led to a rising trend in both the frequency of biopsies and the required tissue volume. We aimed to compare the safety of outpatient ultrasound (US)-guided percutaneous liver biopsy (PLB) between the coaxial method with needle track plugging (NTP) and the conventional method.

Materials and methods: This single-center, prospective, randomized controlled study was conducted from October 2022 to May 2023. Patients referred for US-guided PLB with target liver lesions measuring ≥1 cm and requiring ≥3 tissue cores were enrolled. Patients with severe coagulopathy or a substantial volume of ascites were excluded. Patients were randomly assigned to undergo PLB using either the coaxial method with NTP or the conventional method, in a 1:1 ratio, and were subsequently discharged after 2 hours. The primary endpoint was the presence of a patent track sign, defined as a linear color flow along the biopsy track on Doppler US, as an indication of bleeding. The secondary endpoints included clinically significant bleeding, delayed bleeding after discharge, and diagnostic yield. The incidences of these endpoints were compared between the two methods.

Results: A total of 107 patients completed the study protocol. Patent track signs were observed significantly less frequently in the coaxial method with NTP group than in the conventional method group: 16.7% (9/54) vs. 35.8% (19/53; P = 0.042). Clinically significant bleeding and delayed bleeding did not occur in either group, and both methods achieved a high diagnostic yield: 94.4% (51/54) vs. 98.1% (52/53; P = 0.624).

Conclusion: Compared with the conventional method, the coaxial method with NTP may potentially be safer, with a reduced risk of overall bleeding complications after PLB when retrieving ≥3 tissue cores. The coaxial method with NTP could be considered a viable option for acquiring multiple liver tissues on an outpatient basis.

目的:随着恶性肿瘤患者越来越多地使用各种分子检验来诊断和选择治疗方法,活检的频率和所需组织量都呈上升趋势。我们的目的是比较超声(US)引导的门诊经皮肝活检(PLB)与针道堵塞(NTP)同轴法和传统方法的安全性:这项单中心、前瞻性、随机对照研究于2022年10月至2023年5月进行。研究对象为在 US 引导下进行 PLB 的肝脏靶病变≥1 厘米且需要≥3 个组织核的患者。有严重凝血功能障碍或大量腹水的患者被排除在外。患者按照 1:1 的比例被随机分配到使用 NTP 同轴法或传统方法进行 PLB,然后在 2 小时后出院。主要终点是出现通畅径迹征象,即多普勒超声显示活检径迹出现线性彩色血流,作为出血迹象。次要终点包括有临床意义的出血、出院后延迟出血和诊断率。对两种方法的终点发生率进行了比较:共有 107 名患者完成了研究方案。在使用 NTP 的同轴法组中,观察到闭塞性径迹征的频率明显低于传统方法组:16.7%(9/54)对 35.8%(19/53;P = 0.042)。两组均未出现临床明显出血和延迟出血,两种方法的诊断率都很高:94.4%(51/54)vs 98.1%(52/53;P = 0.624):结论:与传统方法相比,带有 NTP 的同轴方法可能更安全,当取回≥3 个组织核时,PLB 后总体出血并发症的风险更低。带NTP的同轴法可被视为在门诊获取多个肝脏组织的可行方案。
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引用次数: 0
2023 Korean Multidisciplinary Guidelines for Colon Cancer Management: Summary of Radiological Points. 2023 年韩国结肠癌治疗多学科指南:放射学要点摘要。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-01 DOI: 10.3348/kjr.2024.0575
Nieun Seo, Hyo Seon Ryu, Myungsu Lee, Sun Kyung Jeon, Kum Ju Chae, Joon-Kee Yoon, Kyung Su Han, Ji Eun Lee, Jae Seon Eo, Young Chul Yoon, Sung Kyung Moon, Hyun Jung Kim, Jung-Myun Kwak
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引用次数: 0
Determining Progressive Disease Using RANO 2.0-Further Clarifications and Explanations. 使用 RANO 2.0 确定进展期疾病--进一步说明和解释。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-01 Epub Date: 2024-07-15 DOI: 10.3348/kjr.2024.0476
Ji Eun Park, Yae Won Park, Young-Hoon Kim, Sang Woo Song, Chang-Ki Hong, Jeong Hoon Kim, Ho Sung Kim
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引用次数: 0
期刊
Korean Journal of Radiology
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