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Preoperative MRI Features Associated With Axillary Nodal Burden and Disease-Free Survival in Patients With Early-Stage Breast Cancer. 与早期乳腺癌患者腋窝结节负担和无病生存率相关的术前磁共振成像特征
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-01 DOI: 10.3348/kjr.2024.0196
Junjie Zhang, Zhi Yin, Jianxin Zhang, Ruirui Song, Yanfen Cui, Xiaotang Yang

Objective: To investigate the potential association among preoperative breast MRI features, axillary nodal burden (ANB), and disease-free survival (DFS) in patients with early-stage breast cancer.

Materials and methods: We retrospectively reviewed 297 patients with early-stage breast cancer (cT1-2N0M0) who underwent preoperative MRI between December 2016 and December 2018. Based on the number of positive axillary lymph nodes (LNs) determined by postoperative pathology, the patients were divided into high nodal burden (HNB; ≥3 positive LNs) and non-HNB (<3 positive LNs) groups. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors associated with ANB. Predictive efficacy was evaluated using the receiver operating characteristic (ROC) curve and area under the curve (AUC). Univariable and multivariable Cox proportional hazards regression analyses were performed to determine preoperative features associated with DFS.

Results: We included 47 and 250 patients in the HNB and non-HNB groups, respectively. Multivariable logistic regression analysis revealed that multifocality/multicentricity (adjusted odds ratio [OR] = 3.905, 95% confidence interval [CI]: 1.685-9.051, P = 0.001) and peritumoral edema (adjusted OR = 3.734, 95% CI: 1.644-8.479, P = 0.002) were independent risk factors for HNB. Combined peritumoral edema and multifocality/multicentricity achieved an AUC of 0.760 (95% CI: 0.707-0.807) for predicting HNB, with a sensitivity and specificity of 83.0% and 63.2%, respectively. During the median follow-up period of 45 months (range, 5-61 months), 26 cases (8.75%) of breast cancer recurrence were observed. Multivariable Cox proportional hazards regression analysis indicated that younger age (adjusted hazard ratio [HR] = 3.166, 95% CI: 1.200-8.352, P = 0.021), larger tumor size (adjusted HR = 4.370, 95% CI: 1.671-11.428, P = 0.002), and multifocality/multicentricity (adjusted HR = 5.059, 95% CI: 2.166-11.818, P < 0.001) were independently associated with DFS.

Conclusion: Preoperative breast MRI features may be associated with ANB and DFS in patients with early-stage breast cancer.

摘要研究早期乳腺癌患者术前乳腺 MRI 特征、腋窝结节负担(ANB)和无病生存期(DFS)之间的潜在关联:我们回顾性研究了2016年12月至2018年12月期间接受术前MRI检查的297例早期乳腺癌(cT1-2N0M0)患者。根据术后病理确定的腋窝淋巴结(LNs)阳性数目,将患者分为高结节负担(HNB;≥3 个 LNs 阳性)和非 HNB(结果:高结节负荷组和非高结节负荷组分别有 47 名和 250 名患者。多变量逻辑回归分析显示,多病灶性/多中心性(调整后的几率比[OR] = 3.905,95% 置信区间[CI]:1.685-9.0511.685-9.051,P = 0.001)和瘤周水肿(调整后的比值比 [OR] = 3.734,95% 置信区间 [CI]:1.644-8.479,P = 0.002)是 HNB 的独立危险因素。合并瘤周水肿和多灶性/多中心性后,预测 HNB 的 AUC 为 0.760(95% CI:0.707-0.807),敏感性和特异性分别为 83.0% 和 63.2%。在中位 45 个月(5-61 个月)的随访期间,共观察到 26 例(8.75%)乳腺癌复发。多变量考克斯比例危险回归分析表明,年龄较小(调整后危险比[HR] = 3.166,95% CI:1.200-8.352,P = 0.021)、肿瘤体积较大(调整后HR = 4.370,95% CI:1.671-11.428,P = 0.002)和多灶性/多中心性(调整后HR = 5.059,95% CI:2.166-11.818,P < 0.001)与DFS独立相关:结论:术前乳腺磁共振成像特征可能与早期乳腺癌患者的ANB和DFS有关。
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引用次数: 0
Clinical Feasibility of Dual-Layer CT With Virtual Monochromatic Image for Preoperative Staging in Patients With Breast Cancer: A Comparison With Breast MRI. 双层 CT 虚拟单色图像用于乳腺癌患者术前分期的临床可行性:与乳腺磁共振成像的比较。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-01 DOI: 10.3348/kjr.2023.1312
Bokdong Yeo, Kyung Min Shin, Byunggeon Park, Hye Jung Kim, Won Hwa Kim

Objective: Dual-layer CT (DLCT) can create virtual monochromatic images (VMIs) at various monochromatic X-ray energies, particularly at low keV levels, with high contrast-to-noise ratio. The purpose of this study was to assess the clinical feasibility of contrast-enhanced chest DLCT with a low keV VMI for preoperative breast cancer staging, in comparison to breast MRI.

Materials and methods: A total of 152 patients with 155 index breast cancers were enrolled in the study. VMIs were generated from contrast-enhanced chest DLCT at 40 keV and maximum intensity projection (MIP) with three-dimensional (3D) reconstruction was performed for both bilateral breast areas. Two radiologists reviewed in consensus the 3D MIP images of the chest DLCT with VMI and breast MRI in separate sessions with a 3-month wash-out period. The detection rate and mean tumor size of the index cancer were compared between the chest DLCT with VMI and breast MRI. Additionally, the agreement of tumor size measurement between the two imaging modalities were evaluated.

Results: Of all index cancers, 84.5% (131/155) were detected in the chest DLCT with VMI, while 88.4% (137/155) were detected in the breast MRI (P = 0.210). The Bland-Altman agreement between the chest DLCT with VMI and breast MRI was a mean difference of -0.05 cm with 95% limits of agreement of -1.29 to 1.19 cm. The tumor size in the chest DLCT with VMI (2.3 ± 1.7 cm) was not significantly different from that in the breast MRI (2.4 ± 1.6 cm) (P = 0.106).

Conclusion: The feasibility of chest DLCT with VMI was demonstrated for preoperative tumor staging in breast cancer patients, showing comparable cancer detectability and good agreement in tumor size measurement compared to breast MRI. This suggests that chest DLCT with VMI can serve as a potential alternative for patients who have contraindications to breast MRI.

目的:双层 CT(DLCT)可以在各种单色 X 射线能量下生成虚拟单色图像(VMI),尤其是在低 keV 水平下,具有较高的对比度-噪声比。本研究的目的是评估对比增强胸部 DLCT 与低 keV VMI 在乳腺癌术前分期方面的临床可行性,并与乳腺 MRI 进行比较:该研究共纳入了 152 名患有 155 例指数乳腺癌的患者。对比增强胸部 DLCT 在 40 keV 下生成 VMI,并对双侧乳房区域进行最大强度投影(MIP)和三维(3D)重建。两名放射科医生分别对胸部 DLCT 的三维 MIP 图像、VMI 和乳腺 MRI 进行了一致审查,并有 3 个月的冲洗期。比较了胸部 DLCT 与 VMI 和乳腺 MRI 的检出率和指标癌的平均肿瘤大小。此外,还评估了两种成像方式对肿瘤大小测量的一致性:在所有指标癌中,84.5%(131/155)在胸部 DLCT 和 VMI 中检测到,88.4%(137/155)在乳腺 MRI 中检测到(P = 0.210)。胸部 DLCT 与 VMI 和乳腺 MRI 之间的 Bland-Altman 一致度平均相差-0.05 厘米,95% 的一致度范围为-1.29 至 1.19 厘米。胸部 DLCT 与 VMI 的肿瘤大小(2.3 ± 1.7 厘米)与乳腺 MRI 的肿瘤大小(2.4 ± 1.6 厘米)无显著差异(P = 0.106):结论:胸部 DLCT 和 VMI 用于乳腺癌患者术前肿瘤分期的可行性得到了证实,与乳腺 MRI 相比,胸部 DLCT 的癌症检测能力相当,肿瘤大小测量的一致性也很好。这表明,对于有乳腺磁共振成像禁忌症的患者来说,胸部 DLCT 与 VMI 可以作为一种潜在的替代方法。
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引用次数: 0
Radiation Recall Pneumonitis: Imaging Appearance and Differential Considerations. 放射性休克性肺炎:影像学表现和鉴别考虑。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-01 DOI: 10.3348/kjr.2024.0334
Nahyun Celina Jo, Girish S Shroff, Jitesh Ahuja, Rishi Agrawal, Melissa C Price, Carol C Wu

Radiation recall pneumonitis is an inflammatory reaction of previously radiated lung parenchyma triggered by systemic pharmacological agents (such as chemotherapy and immunotherapy) or vaccination. Patients present with non-specific symptoms such as cough, shortness of breath, or hypoxia soon after the initiation of medication or vaccination. Careful assessment of the patient's history, including the thoracic radiation treatment plan and timing of the initiation of the triggering agent, in conjunction with CT findings, contribute to the diagnosis. Once a diagnosis is established, treatment includes cessation of the causative medication and/or initiation of steroid therapy. Differentiating this relatively rare entity from other common post-therapeutic complications in oncology patients, such as recurrent malignancy, infection, or medication-induced pneumonitis, is essential for guiding downstream clinical management.

放射性回忆性肺炎是由全身性药物(如化疗和免疫疗法)或疫苗接种引发的先前接受过放射治疗的肺实质的炎症反应。患者在用药或接种疫苗后不久就会出现咳嗽、气短或缺氧等非特异性症状。仔细评估患者的病史,包括胸部放射治疗计划和开始使用诱发剂的时间,并结合 CT 结果,有助于诊断。一旦确诊,治疗包括停用致病药物和/或开始类固醇治疗。将这种相对罕见的疾病与肿瘤患者常见的其他治疗后并发症(如恶性肿瘤复发、感染或药物诱发的肺炎)区分开来,对于指导下游临床治疗至关重要。
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引用次数: 0
Autoimmune Encephalitis: Insights Into Immune-Mediated Central Nervous System Injury. 自身免疫性脑炎:洞察免疫介导的中枢神经系统损伤
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-01 DOI: 10.3348/kjr.2023.1307
Vivek Pai, Heejun Kang, Suradech Suthiphosuwan, Andrew Gao, Daniel Mandell, Manohar Shroff

Autoimmune encephalitis (AE) is a category of immune-mediated disorders of the central nervous system (CNS) affecting children and adults. It is characterized by the subacute onset of altered mentation, neurocognitive issues, refractory seizures/drug-resistant epilepsy, movement disorders, and/or autonomic dysfunction. AE is mediated by autoantibodies targeting specific surface components or intracytoplasmic antigens in the CNS, leading to functional or structural alterations. Multiple triggers that induce autoimmunity have been described, which are mainly parainfectious and paraneoplastic. The imaging features of AE often overlap with each other and with other common causes of encephalitis/encephalopathy (infections and toxic-metabolic etiologies). Limbic encephalitis is the most common imaging finding shared by most of these entities. Cortical, basal ganglia, diencephalon, and brainstem involvement may also be present. Cerebellar involvement is rare and is often a part of paraneoplastic degeneration. Owing to an improved understanding of AE, their incidence and detection have increased. Hence, in an appropriate setting, a high degree of suspicion is crucial when reporting clinical MRIs to ensure prompt treatment and better patient outcomes. In this review, we discuss the pathophysiology of AE and common etiologies encountered in clinical practice.

自身免疫性脑炎(AE)是一类由免疫介导的中枢神经系统(CNS)疾病,多发于儿童和成人。其特点是亚急性发病,表现为精神改变、神经认知问题、难治性癫痫发作/耐药性癫痫、运动障碍和/或自主神经功能障碍。自身免疫性疾病是由针对中枢神经系统特定表面成分或细胞质内抗原的自身抗体介导的,从而导致功能或结构改变。目前已描述了多种诱发自身免疫的因素,主要是副感染性和副肿瘤性因素。边缘性脑炎的影像学特征往往与其他常见的脑炎/脑病病因(感染和中毒性代谢病因)相互重叠。边缘性脑炎是大多数此类疾病最常见的影像学表现。皮质、基底节、间脑和脑干也可能受累。小脑受累很少见,通常是副肿瘤变性的一部分。由于对 AE 的认识有所提高,其发病率和检出率也有所上升。因此,在适当的情况下,报告临床磁共振成像时必须高度怀疑,以确保及时治疗和更好的患者预后。在这篇综述中,我们将讨论 AE 的病理生理学和临床实践中常见的病因。
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引用次数: 0
Fluoroscopy-Guided Percutaneous Transthoracic Pleural Forceps Biopsy in Patients With Exudative Pleural Effusion. 在透视引导下对渗出性胸腔积液患者进行经皮穿刺胸膜钳活检。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 Epub Date: 2024-07-15 DOI: 10.3348/kjr.2023.0960
Doo Ri Kim, In Chul Nam, Hye Jin Baek, Jeong Jae Kim, Im Kyung Hwang, Jeong Sub Lee, Duk Ju Kim, Chang Lim Hyun, Sung Eun Park, Sung Wook Song

Objective: This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion.

Materials and methods: Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology.

Results: Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study. The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively; 65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (P = 0.008 and 0.001, respectively).

Conclusion: Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.

研究目的本研究旨在评估渗出性胸腔积液患者在透视引导下经皮穿刺胸膜镊活检术(PTPFB)的诊断性能和手术特点:这项回顾性研究纳入了2014年5月1日至2023年2月28日期间接受PTPFB的渗出性胸腔积液患者。评估了经皮导管引流术(PCD)和 PTPFB 之间的间隔时间、活检次数、手术时间和手术相关并发症。计算了使用 PCD 引流术、PTPFB 以及联合 PTPFB 和胸膜细胞学检查进行胸膜细胞学检查诊断恶性肿瘤的敏感性、特异性和准确性:本研究共纳入 71 例患者,其中男性 50 例,女性 21 例(平均年龄为 69.5 ± 15.3 岁)。最终诊断为良性病变的患者有 48 人(67.6%),恶性病变的患者有 23 人(32.4%)。PCD 和活检之间的总体间隔时间为 2.4 ± 3.7 天。接受延迟 PTPFB 组的 PCD 和活检之间的间隔为 5.2 ± 3.9 天。活检的平均次数为(4.5 ± 1.3)次。平均手术时间为 4.4 ± 2.1 分钟。一名患者(1.4%)出现轻微出血并发症。胸膜细胞学、PTPFB、PTPFB 和胸膜细胞学联合检查的敏感性、特异性和准确性分别为 47.8%(11/23)、100%(48/48)和 83.1%(59/71);分别为 65.2%(15/23)、100%(48/48)和 88.7%(63/71);分别为 78.3%(18/23)、100%(48/48)和 93.0%(66/71)。细胞学联合 PTPFB 的敏感性和准确性明显高于单独的细胞学检测(P = 0.008 和 0.001):结论:透视引导下的 PTPFB 是针对渗出性胸腔积液患者的一种准确、安全的诊断技术,诊断效果可接受,并发症发生率低,手术时间合理。
{"title":"Fluoroscopy-Guided Percutaneous Transthoracic Pleural Forceps Biopsy in Patients With Exudative Pleural Effusion.","authors":"Doo Ri Kim, In Chul Nam, Hye Jin Baek, Jeong Jae Kim, Im Kyung Hwang, Jeong Sub Lee, Duk Ju Kim, Chang Lim Hyun, Sung Eun Park, Sung Wook Song","doi":"10.3348/kjr.2023.0960","DOIUrl":"10.3348/kjr.2023.0960","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion.</p><p><strong>Materials and methods: </strong>Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology.</p><p><strong>Results: </strong>Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study. The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively; 65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (<i>P</i> = 0.008 and 0.001, respectively).</p><p><strong>Conclusion: </strong>Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"706-714"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiology for Ductal Carcinoma In Situ of the Breast: Updates on Invasive Cancer Progression and Active Monitoring. 乳腺原位导管癌放射学:侵袭性癌症进展和主动监测的最新进展。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI: 10.3348/kjr.2024.0117
Lars J Grimm

Ductal carcinoma in situ (DCIS) accounts for approximately 30% of new breast cancer diagnoses. However, our understanding of how normal breast tissue evolves into DCIS and invasive cancers remains insufficient. Further, conclusions regarding the mechanisms of disease progression in terms of histopathology, genetics, and radiology are often conflicting and have implications for treatment planning. Moreover, the increase in DCIS diagnoses since the adoption of organized breast cancer screening programs has raised concerns about overdiagnosis and subsequent overtreatment. Active monitoring, a nonsurgical management strategy for DCIS, avoids surgery in favor of close imaging follow-up to de-escalate therapy and provides more treatment options. However, the two major challenges in active monitoring are identifying occult invasive cancer and patients at risk of invasive cancer progression. Subsequently, four prospective active monitoring trials are ongoing to determine the feasibility of active monitoring and refine the patient eligibility criteria and follow-up intervals. Radiologists play a major role in determining eligibility for active monitoring and reviewing surveillance images for disease progression. Trial results published over the next few years would support a new era of multidisciplinary DCIS care.

在新诊断出的乳腺癌中,乳腺导管原位癌(DCIS)约占 30%。然而,我们对正常乳腺组织如何演变为 DCIS 和浸润性癌症的了解仍然不足。此外,有关组织病理学、遗传学和放射学方面的疾病进展机制的结论往往相互矛盾,并对治疗计划产生影响。此外,自开展有组织的乳腺癌筛查项目以来,DCIS 诊断率的上升也引起了人们对过度诊断和随后过度治疗的担忧。主动监测是一种针对 DCIS 的非手术治疗策略,它避免了手术,而是通过密切的影像学随访来降低治疗难度,并提供了更多的治疗选择。然而,主动监测的两大挑战是识别隐匿性浸润癌和有浸润癌进展风险的患者。随后,四项前瞻性主动监测试验正在进行中,以确定主动监测的可行性,并完善患者资格标准和随访间隔。放射科医生在确定主动监测的资格和审查监测图像是否有疾病进展方面发挥着重要作用。未来几年公布的试验结果将支持多学科 DCIS 护理新时代的到来。
{"title":"Radiology for Ductal Carcinoma In Situ of the Breast: Updates on Invasive Cancer Progression and Active Monitoring.","authors":"Lars J Grimm","doi":"10.3348/kjr.2024.0117","DOIUrl":"10.3348/kjr.2024.0117","url":null,"abstract":"<p><p>Ductal carcinoma in situ (DCIS) accounts for approximately 30% of new breast cancer diagnoses. However, our understanding of how normal breast tissue evolves into DCIS and invasive cancers remains insufficient. Further, conclusions regarding the mechanisms of disease progression in terms of histopathology, genetics, and radiology are often conflicting and have implications for treatment planning. Moreover, the increase in DCIS diagnoses since the adoption of organized breast cancer screening programs has raised concerns about overdiagnosis and subsequent overtreatment. Active monitoring, a nonsurgical management strategy for DCIS, avoids surgery in favor of close imaging follow-up to de-escalate therapy and provides more treatment options. However, the two major challenges in active monitoring are identifying occult invasive cancer and patients at risk of invasive cancer progression. Subsequently, four prospective active monitoring trials are ongoing to determine the feasibility of active monitoring and refine the patient eligibility criteria and follow-up intervals. Radiologists play a major role in determining eligibility for active monitoring and reviewing surveillance images for disease progression. Trial results published over the next few years would support a new era of multidisciplinary DCIS care.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"698-705"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Chemoembolization Outcomes Using 70-150 µm and 100-300 µm Drug-Eluting Beads in Treating Small Hepatocellular Carcinoma: A Korean Multicenter Study. 使用 70-150 µm 和 100-300 µm 药物洗脱珠治疗小肝细胞癌的化疗栓塞效果比较:一项韩国多中心研究。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.3348/kjr.2024.0231
Byung Chan Lee, Gyoung Min Kim, Juil Park, Jin Wook Chung, Jin Woo Choi, Ho Jong Chun, Jung Suk Oh, Dong Ho Hyun, Jung Ho Yang

Objective: To evaluate the outcomes of drug-eluting bead transarterial chemoembolization (DEB-TACE) according to the size of the beads for the treatment of small hepatocellular carcinoma (HCC).

Materials and methods: This retrospective study included 212 patients with a single HCC ≤5 cm from five tertiary institutions. One hundred and nine patients were treated with 70-150-µm doxorubicin DEBs (group A), and 103 patients received 100-300-µm doxorubicin DEBs (group B). The initial tumor response (assessed between 3 weeks and 2 months after DEB-TACE), time to local tumor progression (TTLTP), restricted mean duration of complete response (RMDCR), rate of complications, incidence of post-embolization syndrome, and length of hospital stay were compared between the two groups. Logistic regression was used to analyze prognostic factors for initial tumor response.

Results: The initial objective response rates were 91.7% (100/109) and 84.5% (87/103) for groups A and B, respectively (P = 0.101). In the subgroup analysis of tumors ≤3 cm, the initial objective response rates were 94.6% (53/56) and 78.0% (39/50) for groups A and B, respectively (P = 0.012). There was no significant difference in the TTLTP (median, 23.7 months for group A vs. 19.0 months for group B; P = 0.278 [log-rank], 0.190 [multivariable Cox regression]) or RMDCR at 24 months (11.4 months vs. 8.5 months, respectively; P = 0.088). In the subgroup analysis of tumors >3-cm, the RMDCR at 24 months was significantly longer in group A than in group B (11.8 months vs. 5.7 months, P = 0.024). The incidence of mild bile duct dilatation after DEB-TACE was significantly higher in group B than in group A (5.5% [6/109] vs. 18.4% [19/103], P = 0.003).

Conclusion: DEB-TACE using 70-150-µm microspheres demonstrated a higher initial objective response rate in ≤3-cm HCCs and a longer RMDCR at 24 months in 3.1-5-cm HCCs compared to larger DEBs (100-300-µm).

目的根据药物洗脱珠的大小,评估经动脉化疗栓塞术(DEB-TACE)治疗小肝细胞癌(HCC)的疗效:这项回顾性研究纳入了来自五所三级医疗机构的212例单个HCC≤5厘米的患者。其中,109 名患者接受了 70-150 微米多柔比星 DEBs 治疗(A 组),103 名患者接受了 100-300 微米多柔比星 DEBs 治疗(B 组)。比较了两组患者的初始肿瘤反应(评估时间为 DEB-TACE 术后 3 周至 2 个月)、局部肿瘤进展时间(TTLTP)、限制性平均完全反应时间(RMDCR)、并发症发生率、栓塞后综合征发生率和住院时间。采用逻辑回归分析肿瘤初始反应的预后因素:A组和B组的初始客观反应率分别为91.7%(100/109)和84.5%(87/103)(P = 0.101)。在肿瘤≤3厘米的亚组分析中,A组和B组的初始客观反应率分别为94.6%(53/56)和78.0%(39/50)(P = 0.012)。24个月时的TTLTP(中位数为A组23.7个月对B组19.0个月;P = 0.278 [log-rank], 0.190 [multivariable Cox regression])或RMDCR(分别为11.4个月对8.5个月;P = 0.088)无明显差异。在肿瘤大于 3 厘米的亚组分析中,A 组 24 个月时的 RMDCR 明显长于 B 组(11.8 个月对 5.7 个月,P = 0.024)。DEB-TACE后轻度胆管扩张的发生率B组明显高于A组(5.5% [6/109] vs. 18.4% [19/103],P = 0.003):结论:与较大的DEB(100-300微米)相比,使用70-150微米微球的DEB-TACE在≤3厘米的HCC中显示出更高的初始客观反应率,在3.1-5厘米的HCC中显示出更长的24个月RMDCR。
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引用次数: 0
A Novel Melanin-Targeted 18F-PFPN Positron Emission Tomography Imaging for Diagnosing Ocular and Orbital Melanoma. 用于诊断眼部和眼眶黑色素瘤的新型黑色素靶向 18F-PFPN 正电子发射断层成像。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 Epub Date: 2024-07-10 DOI: 10.3348/kjr.2024.0243
Yiyan Wang, Xinghua Wang, Jie Zhang, Xiao Zhang, Yang Cheng, Fagang Jiang

Objective: 18F-N-(2-(Diethylamino)ethyl)-5-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy) picolinamide (18F-PFPN) is a novel positron emission tomography (PET) probe designed to specifically targets melanin. This study aimed to evaluate the diagnostic feasibility of 18F-PFPN in patients with ocular or orbital melanoma.

Materials and methods: Three patients with pathologically confirmed ocular or orbital melanoma (one male, two females; age 41-59 years) were retrospectively reviewed. Each patient underwent comprehensive 18F-PFPN and 18F-fluorodeoxyglucose (18F-FDG) PET scans. The maximum standardized uptake value (SUVmax) of the lesion and the interference caused by background tissue were compared between 18F-PFPN and 18F-FDG PET imaging. In addition, the effect of intrinsic pigments in the uvea and retina on the interpretation of the results was examined. The contralateral non-tumorous eye of each patient served as a control.

Results: All primary tumors (3/3) were detected using 18F-PFPN PET, while only two primary tumors were detected using 18F-FDG PET. Within each lesion, the SUVmax of 18F-PFPN was 2.6 to 8.3 times higher than that of 18F-FDG. Regarding the quality of PET imaging, the physiological uptake of 18F-FDG PET in the brain and periocular tissues limited the imaging of tumors. However, 18F-PFPN PET minimized this interference. Notably, intrinsic pigments in the uvea and retina did not cause abnormal concentrations of 18F-PFPN, as no anomalous uptake of 18F-PFPN was detected in the healthy contralateral eyes.

Conclusion: Compared to 18F-FDG, 18F-PFPN demonstrated higher detection rates for ocular and orbital melanomas with minimal interference from surrounding tissues. This suggests that 18F-PFPN could be a promising clinical diagnostic tool for distinguishing malignant melanoma from benign pigmentation in ocular and orbital melanomas.

目的:18F-N-(2-(二乙基氨基)乙基)-5-(2-(2-(2-氟乙氧基)乙氧基)乙氧基)吡啶酰胺(18F-PFPN)是一种新型正电子发射断层扫描(PET)探针,专为黑色素设计。本研究旨在评估 18F-PFPN 在眼部或眼眶黑色素瘤患者中的诊断可行性:回顾性研究了三名经病理确诊的眼部或眼眶黑色素瘤患者(一名男性,两名女性;年龄 41-59 岁)。每位患者都接受了18F-PFPN和18F-氟脱氧葡萄糖(18F-FDG)正电子发射计算机断层扫描。比较了18F-PFPN和18F-FDG PET成像的病灶最大标准化摄取值(SUVmax)和背景组织造成的干扰。此外,还研究了葡萄膜和视网膜固有色素对结果解读的影响。每位患者的对侧无瘤眼作为对照:所有原发性肿瘤(3/3)均通过 18F-PFPN PET 检测到,而只有两个原发性肿瘤通过 18F-FDG PET 检测到。在每个病灶中,18F-PFPN 的 SUVmax 是 18F-FDG 的 2.6 至 8.3 倍。关于 PET 成像的质量,18F-FDG PET 在大脑和眼周组织中的生理性摄取限制了肿瘤的成像。然而,18F-PFPN PET 将这种干扰降至最低。值得注意的是,葡萄膜和视网膜中的固有色素不会导致18F-PFPN的异常浓度,因为在健康的对侧眼没有检测到18F-PFPN的异常摄取:结论:与 18F-FDG 相比,18F-PFPN 对眼部和眼眶黑色素瘤的检出率更高,且受周围组织的干扰极小。结论:与 18F-FDG 相比,18F-PFPN 对眼部和眼眶黑色素瘤的检出率更高,且对周围组织的干扰极小,这表明 18F-PFPN 是一种很有前途的临床诊断工具,可用于区分眼部和眼眶黑色素瘤中的恶性黑色素瘤和良性色素沉着。
{"title":"A Novel Melanin-Targeted <sup>18</sup>F-PFPN Positron Emission Tomography Imaging for Diagnosing Ocular and Orbital Melanoma.","authors":"Yiyan Wang, Xinghua Wang, Jie Zhang, Xiao Zhang, Yang Cheng, Fagang Jiang","doi":"10.3348/kjr.2024.0243","DOIUrl":"10.3348/kjr.2024.0243","url":null,"abstract":"<p><strong>Objective: </strong><sup>18</sup>F-N-(2-(Diethylamino)ethyl)-5-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy) picolinamide (<sup>18</sup>F-PFPN) is a novel positron emission tomography (PET) probe designed to specifically targets melanin. This study aimed to evaluate the diagnostic feasibility of <sup>18</sup>F-PFPN in patients with ocular or orbital melanoma.</p><p><strong>Materials and methods: </strong>Three patients with pathologically confirmed ocular or orbital melanoma (one male, two females; age 41-59 years) were retrospectively reviewed. Each patient underwent comprehensive <sup>18</sup>F-PFPN and <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) PET scans. The maximum standardized uptake value (SUV<sub>max</sub>) of the lesion and the interference caused by background tissue were compared between <sup>18</sup>F-PFPN and <sup>18</sup>F-FDG PET imaging. In addition, the effect of intrinsic pigments in the uvea and retina on the interpretation of the results was examined. The contralateral non-tumorous eye of each patient served as a control.</p><p><strong>Results: </strong>All primary tumors (3/3) were detected using <sup>18</sup>F-PFPN PET, while only two primary tumors were detected using <sup>18</sup>F-FDG PET. Within each lesion, the SUV<sub>max</sub> of <sup>18</sup>F-PFPN was 2.6 to 8.3 times higher than that of <sup>18</sup>F-FDG. Regarding the quality of PET imaging, the physiological uptake of <sup>18</sup>F-FDG PET in the brain and periocular tissues limited the imaging of tumors. However, <sup>18</sup>F-PFPN PET minimized this interference. Notably, intrinsic pigments in the uvea and retina did not cause abnormal concentrations of <sup>18</sup>F-PFPN, as no anomalous uptake of <sup>18</sup>F-PFPN was detected in the healthy contralateral eyes.</p><p><strong>Conclusion: </strong>Compared to <sup>18</sup>F-FDG, <sup>18</sup>F-PFPN demonstrated higher detection rates for ocular and orbital melanomas with minimal interference from surrounding tissues. This suggests that <sup>18</sup>F-PFPN could be a promising clinical diagnostic tool for distinguishing malignant melanoma from benign pigmentation in ocular and orbital melanomas.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":" ","pages":"742-748"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amyloid-Related Imaging Abnormalities in the Era of Anti-Amyloid Beta Monoclonal Antibodies for Alzheimer's Disease: Recent Updates on Clinical and Imaging Features and MRI Monitoring. 抗淀粉样β单克隆抗体治疗阿尔茨海默病时代与淀粉样蛋白相关的影像异常:临床和成像特征及核磁共振成像监测的最新进展。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.3348/kjr.2024.0105
So Yeong Jeong, Chong Hyun Suh, Sang Joon Kim, Cynthia Ann Lemere, Jae-Sung Lim, Jae-Hong Lee

Recent advancements in Alzheimer's disease treatment have focused on the elimination of amyloid-beta (Aβ) plaque, a hallmark of the disease. Monoclonal antibodies such as lecanemab and donanemab can alter disease progression by binding to different forms of Aβ aggregates. However, these treatments raise concerns about adverse effects, particularly amyloid-related imaging abnormalities (ARIA). Careful assessment of safety, especially regarding ARIA, is crucial. ARIA results from treatment-related disruption of vascular integrity and increased vascular permeability, leading to the leakage of proteinaceous fluid (ARIA-E) and heme products (ARIA-H). ARIA-E indicates treatment-induced edema or sulcal effusion, while ARIA-H indicates treatment-induced microhemorrhage or superficial siderosis. The minimum recommended magnetic resonance imaging sequences for ARIA assessment are T2-FLAIR, T2* gradient echo (GRE), and diffusion-weighted imaging (DWI). T2-FLAIR and T2* GRE are necessary to detect ARIA-E and ARIA-H, respectively. DWI plays a role in differentiating ARIA-E from acute to subacute infarcts. Physicians, including radiologists, must be familiar with the imaging features of ARIA, the appropriate imaging protocol for the ARIA workup, and the reporting of findings in clinical practice. This review aims to describe the clinical and imaging features of ARIA and suggest points for the timely detection and monitoring of ARIA in clinical practice.

阿尔茨海默病治疗的最新进展主要集中在消除淀粉样蛋白-β(Aβ)斑块上,这是阿尔茨海默病的标志性特征。莱卡奈单抗(lecanemab)和多那奈单抗(donanemab)等单克隆抗体可以通过与不同形式的 Aβ 聚集体结合来改变疾病的进展。然而,这些治疗方法引发了对不良反应的担忧,尤其是淀粉样蛋白相关成像异常(ARIA)。仔细评估安全性,尤其是有关 ARIA 的安全性至关重要。ARIA是由于治疗相关的血管完整性破坏和血管通透性增加,导致蛋白液(ARIA-E)和血红素产物(ARIA-H)渗漏。ARIA-E表示治疗引起的水肿或脑沟渗出,而ARIA-H表示治疗引起的微出血或浅表巩膜沉着。用于 ARIA 评估的最低推荐磁共振成像序列是 T2-FLAIR、T2* 梯度回波(GRE)和弥散加权成像(DWI)。T2-FLAIR 和 T2* GRE 分别是检测 ARIA-E 和 ARIA-H 所必需的。DWI 在区分 ARIA-E 和急性至亚急性梗死方面发挥着作用。包括放射科医生在内的医生必须熟悉 ARIA 的影像学特征、ARIA 检查的适当影像学方案以及临床实践中对检查结果的报告。本综述旨在描述 ARIA 的临床和影像学特征,并提出在临床实践中及时发现和监测 ARIA 的要点。
{"title":"Amyloid-Related Imaging Abnormalities in the Era of Anti-Amyloid Beta Monoclonal Antibodies for Alzheimer's Disease: Recent Updates on Clinical and Imaging Features and MRI Monitoring.","authors":"So Yeong Jeong, Chong Hyun Suh, Sang Joon Kim, Cynthia Ann Lemere, Jae-Sung Lim, Jae-Hong Lee","doi":"10.3348/kjr.2024.0105","DOIUrl":"10.3348/kjr.2024.0105","url":null,"abstract":"<p><p>Recent advancements in Alzheimer's disease treatment have focused on the elimination of amyloid-beta (Aβ) plaque, a hallmark of the disease. Monoclonal antibodies such as lecanemab and donanemab can alter disease progression by binding to different forms of Aβ aggregates. However, these treatments raise concerns about adverse effects, particularly amyloid-related imaging abnormalities (ARIA). Careful assessment of safety, especially regarding ARIA, is crucial. ARIA results from treatment-related disruption of vascular integrity and increased vascular permeability, leading to the leakage of proteinaceous fluid (ARIA-E) and heme products (ARIA-H). ARIA-E indicates treatment-induced edema or sulcal effusion, while ARIA-H indicates treatment-induced microhemorrhage or superficial siderosis. The minimum recommended magnetic resonance imaging sequences for ARIA assessment are T2-FLAIR, T2* gradient echo (GRE), and diffusion-weighted imaging (DWI). T2-FLAIR and T2* GRE are necessary to detect ARIA-E and ARIA-H, respectively. DWI plays a role in differentiating ARIA-E from acute to subacute infarcts. Physicians, including radiologists, must be familiar with the imaging features of ARIA, the appropriate imaging protocol for the ARIA workup, and the reporting of findings in clinical practice. This review aims to describe the clinical and imaging features of ARIA and suggest points for the timely detection and monitoring of ARIA in clinical practice.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 8","pages":"726-741"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Thermal Ablation for Solitary Low-Risk T2N0M0 Papillary Thyroid Carcinoma. 热消融治疗单发低风险 T2N0M0 甲状腺乳头状癌的有效性和安全性
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.3348/kjr.2023.1279
Yu-Lin Fei, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Shi-Liang Cao, Jie Wu, Hui-Di Zhou, Ming-An Yu

Objective: To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA).

Materials and methods: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates.

Results: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355).

Conclusion: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.

目的评估热消融治疗单发低危T2N0M0甲状腺乳头状癌(PTC)的疗效和安全性,并比较微波消融(MWA)和射频消融(RFA)的疗效:这项回顾性单中心研究涉及34名患者(年龄:40.0±13.9岁;28名女性),他们都患有最大直径大于2厘米且小于4厘米的低风险T2N0M0 PTC,并在2016年11月至2023年4月期间接受了微波消融(MWA)(n = 15)或射频消融(RFA)(n = 19)。主要结果是疾病进展累积率和延迟手术率。而次要结果包括肿瘤大小变化、肿瘤完全消失累积率和并发症发生率:中位随访时间为 18.0 个月(四分位数间距 [IQR]:9.0-40.0 个月)。12 个月时,消融区体积缩小率的中位数为 74.2%(IQR:53.7%-86.0%)。有两名患者在 1 年内出现疾病进展,其中一名患者在 RFA 术后出现局部肿瘤进展,另一名患者在 MWA 术后出现新的肿瘤,因此在剩余的随访期内,累计疾病进展率为 8.8%(95% 置信区间 [CI]:0%-19.8%)。两名患者随后都接受了额外的消融治疗,无需手术。1年、3年和5年的肿瘤完全消失累积率分别为4.0%(95% CI:0%-11.4%)、26.8%(95% CI:2.7%-44.9%)和51.2%(95% CI:0%-79.1%)。MWA组和RFA组的疾病进展率(P = 0.829)和肿瘤完全消失率(P = 0.633)无明显差异。在出现一过性声音嘶哑的患者中,14.7%(5/34)出现了并发症。RFA 的并发症发生率高于 MWA(21.1% [4/19] vs. 6.7% [1/15];P = 0.355),但无统计学意义:结论:在治疗单发低风险 T2N0M0 PTC 时,MWA 和 RFA 在疗效和安全性方面均表现出良好的短期疗效,且无显著差异。
{"title":"Efficacy and Safety of Thermal Ablation for Solitary Low-Risk T2N0M0 Papillary Thyroid Carcinoma.","authors":"Yu-Lin Fei, Ying Wei, Zhen-Long Zhao, Li-Li Peng, Yan Li, Shi-Liang Cao, Jie Wu, Hui-Di Zhou, Ming-An Yu","doi":"10.3348/kjr.2023.1279","DOIUrl":"10.3348/kjr.2023.1279","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA).</p><p><strong>Materials and methods: </strong>This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates.</p><p><strong>Results: </strong>The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (<i>P</i> = 0.829) or complete tumor disappearance (<i>P</i> = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; <i>P</i> = 0.355).</p><p><strong>Conclusion: </strong>Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.</p>","PeriodicalId":17881,"journal":{"name":"Korean Journal of Radiology","volume":"25 8","pages":"756-766"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Korean Journal of Radiology
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