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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。
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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。
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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。
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引用次数: 0
Reporting Guidelines for Artificial Intelligence Studies in Healthcare (for Both Conventional and Large Language Models): What's New in 2024. 医疗保健领域人工智能研究报告指南(传统模型和大型语言模型):2024 年的新动向。
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.2024.0598
Seong Ho Park, Chong Hyun Suh
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引用次数: 0
Comparative Evaluation of the Accuracies of Large Language Models in Answering VI-RADS-Related Questions. 大型语言模型在回答 VI-RADS 相关问题时准确性的比较评估。
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.2024.0438
Eren Çamur, Turay Cesur, Yasin Celal Güneş
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引用次数: 0
Radiation Safety and Radiologist Working Hours in Uzbekistan. 乌兹别克斯坦的辐射安全和放射科医生的工作时间。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.3348/kjr.2024.0460
Yulduz Khodjibekova, Lalita Yunusova
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引用次数: 0
Loading and Coverage Hours of Radiologists in Taiwan: Findings of a Small Survey in 2024. 台湾放射科医师的工作量和工作时间:2024 年小型调查的结果。
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.2024.0487
Min-Ru Shen, Shu-Huei Shen, Li-Jen Wang, Hong-Jen Chiou
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引用次数: 0
Ultrasound Imaging in Active Surveillance of Small, Low-Risk Papillary Thyroid Cancer. 低风险小型甲状腺乳头状癌主动监测中的超声波成像。
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.2024.0148
Sangeet Ghai, David P Goldstein, Anna M Sawka

The recent surge in the incidence of small papillary thyroid cancers (PTCs) has been linked to the widespread use of ultrasonography, thereby prompting concerns regarding overdiagnosis. Active surveillance (AS) has emerged as a less invasive alternative management strategy for low-risk PTCs, especially for PTCs measuring ≤1 cm in maximal diameter. Recent studies report low disease progression rates of low-risk PTCs ≤1 cm under AS. Ongoing research is currently exploring the feasibility of AS for larger PTCs (<20 mm). AS protocols include meticulous ultrasound assessment, emphasis on standardized techniques, and a multidisciplinary approach; they involve monitoring the nodules for size, growth, potential extrathyroidal extension, proximity to the trachea and recurrent laryngeal nerve, and potential cervical nodal metastases. The criteria for progression, often defined as an increase in the maximum diameter of the PTC, warrant a review of precision and ongoing examinations. Challenges exist regarding the reliability of volume measurements for defining PTC disease progression. Although ultrasonography plays a pivotal role, challenges in assessing progression and minor extrathyroidal extension underscore the importance of a multidisciplinary approach in disease management. This comprehensive overview highlights the evolving landscape of AS for PTCs, emphasizing the need for standardized protocols, meticulous assessments, and ongoing research to inform decision-making.

近年来,小型甲状腺乳头状癌(PTC)的发病率激增,这与超声波检查的广泛应用有关,从而引发了对过度诊断的担忧。主动监测(AS)已成为低风险PTC,尤其是最大直径≤1厘米的PTC的一种微创替代治疗策略。最近的研究报告显示,低风险 PTC(最大直径≤1 厘米)在 AS 下的疾病进展率较低。目前正在进行的研究正在探索对较大的 PTC 进行 AS 治疗的可行性 (
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引用次数: 0
Photon-Counting Computed Tomography: Experience in Musculoskeletal Imaging. 光子计数计算机断层扫描:肌肉骨骼成像经验。
IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-07-01 DOI: 10.3348/kjr.2024.0096
Jan-Peter Grunz, Henner Huflage

Since the emergence of the first photon-counting computed tomography (PCCT) system in late 2021, its advantages and a wide range of applications in all fields of radiology have been demonstrated. Compared to standard energy-integrating detector-CT, PCCT allows for superior geometric dose efficiency in every examination. While this aspect by itself is groundbreaking, the advantages do not stop there. PCCT facilitates an unprecedented combination of ultra-high-resolution imaging without dose penalty or field-of-view restrictions, detector-based elimination of electronic noise, and ubiquitous multi-energy spectral information. Considering the high demands of orthopedic imaging for the visualization of minuscule details while simultaneously covering large portions of skeletal and soft tissue anatomy, no subspecialty may benefit more from this novel detector technology than musculoskeletal radiology. Deeply rooted in experimental and clinical research, this review article aims to provide an introduction to the cosmos of PCCT, explain its technical basics, and highlight the most promising applications for patient care, while also mentioning current limitations that need to be overcome.

自 2021 年底第一台光子计数计算机断层扫描(PCCT)系统问世以来,它在放射学各个领域的优势和广泛应用已得到证实。与标准能量积分探测器计算机断层扫描相比,PCCT 可在每次检查中实现更高的几何剂量效率。虽然这一点本身就具有突破性,但其优势还不止于此。PCCT 实现了超高分辨率成像的空前结合,没有剂量损失或视场限制,通过探测器消除了电子噪声,并提供了无处不在的多能谱信息。考虑到骨科成像对微小细节的可视化要求很高,同时又要覆盖骨骼和软组织解剖的大部分,没有哪个亚专科能比肌肉骨骼放射学更受益于这种新型探测器技术了。这篇综述文章深深扎根于实验和临床研究,旨在介绍 PCCT 的全貌,解释其技术基础,并重点介绍在患者护理方面最有前景的应用,同时也提及目前需要克服的局限性。
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引用次数: 0
期刊
Korean Journal of Radiology
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