48 results on '"Jae Seok Bae"'
Search Results
2. Accelerated Pancreatobiliary <scp>MRI</scp> for Pancreatic Cancer Surveillance in Patients With Pancreatic Cystic Neoplasms
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Jeong Hee Yoon, Jae Seok Bae, Sunkyung Jeon, Won Chang, Sang Min Lee, Jin Young Park, Jeong Sub Lee, Eun Sun Lee, In Rae Cho, Sang‐Hyub Lee, and Jeong Min Lee
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Pancreatic Neoplasms ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Magnetic Resonance Imaging ,Carcinoma, Pancreatic Ductal ,Retrospective Studies - Abstract
Pancreatobiliary MRI is often recommended for patients at risk of developing pancreas cancer. But the surveillance MRI protocol has not yet been widely accepted.To establish an accelerated MRI protocol targeting the table time of 15 minutes for pancreatic cancer surveillance and test its performance in lesion characterization.Prospective.A total of 30 participants were enrolled, who were undergoing follow-up care for intraductal papillary mucinous neoplasms or newly diagnosed pancreatic cysts (≥10 mm) and were scheduled for or had recently undergone contrast-enhanced CT (CECT).A 3 T; heavily T2WI, 3D MRCP, DWI, dynamic T1WI, two-point Dixon.In-room time and table time were measured. Seven radiologists independently reviewed image quality of MRI and then the presence of high-risk stigmata and worrisome features in addition to diagnostic confidence for accelerated MRI, CECT, and the noncontrast part of accelerated MRI (NC-MRI).Fisher's exact test was used for categorical variables and either the Student's t-test or Mann-Whitney test was performed for continuous variables. The generalized estimated equation was used to compare the diagnostic performance of examinations on a per-patient basis. Interobserver agreement was evaluated via Fleiss kappa. A P value of0.05 was considered to be statistically significant.The in-room time was 18.5 ± 2.6 minutes (range: 13.7-24.9) and the table time was 13.9 ± 1.9 minutes (range: 10.7-17.5). There was no significant difference between the diagnostic performances of the three examinations (pooled sensitivity: 75% for accelerated MRI and CECT, 68% for NC-MRI, P = 0.95), with the highest significant diagnostic confidence for accelerated MRI (4.2 ± 0.1). With accelerated MRI, the interobserver agreement was fair to excellent for high-risk stigmata (κ = 0.34-0.98).Accelerated MRI protocol affords a table time of 15 minutes, making it potentially suitable for cancer surveillance in patients at risk of developing pancreatic cancer.2 TECHNICAL EFFICACY STAGE: 2.
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- 2022
3. LI-RADS Tumor in Vein at CT and Hepatobiliary MRI
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Sae-Jin Park, Jeong Min Lee, Jeong Hee Yoon, Haeryoung Kim, Jeongin Yoo, Ijin Joo, Jae Seok Bae, Sun Kyung Jeon, and Kyoung Bun Lee
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Male ,Hepatic resection ,Contrast Media ,Sensitivity and Specificity ,McNemar's test ,Interquartile range ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Vein ,Reference standards ,Aged ,Retrospective Studies ,Liver imaging ,business.industry ,Liver Neoplasms ,Reproducibility of Results ,Soft tissue ,Middle Aged ,Image Enhancement ,Magnetic Resonance Imaging ,Vascular Neoplasms ,Radiology Information Systems ,medicine.anatomical_structure ,Liver ,Female ,Tomography, X-Ray Computed ,business ,Nuclear medicine - Abstract
Background Diagnostic performance of the Liver Imaging Reporting and Data System tumor in vein (LR-TIV) category at CT and/or MRI has not yet been evaluated, to the knowledge of the authors. Purpose To assess the diagnostic performance of the LR-TIV category in detecting macroscopic tumors in veins (TIVs) at CT and hepatobiliary contrast agent-enhanced (HBA) MRI, with pathologic results used as the reference standard. Materials and Methods Between January 2010 and December 2019, consecutive patients with or without macroscopic TIV who underwent both CT and HBA MRI before hepatic resection or liver transplant were retrospectively included. Three radiologists independently assessed the LR-TIV features of enhancing soft tissue in vein and features suggestive of TIV (FSTIV) and reached a consensus. Macroscopic TIV at pathologic examination was the reference standard. Sensitivities and specificities of the LR-TIV category without and with FSTIV were calculated, and the added value of FSTIV was evaluated by using the McNemar test. Results In the 1322 patients with (n = 101) or without (n = 1221) macroscopic TIV (median age, 64 years [interquartile range, 58-70 years]; 1053 men), without consideration of FSTIV, the sensitivity and specificity of enhancing soft tissue in vein for detecting macroscopic TIV at pathologic examination were 64.4% (65 of 101) and 99.8% (1218 of 1221) with CT and 62.4% (63 of 101) and 99.8% (1218 of 1221) with HBA MRI, respectively. With consideration of FSTIV, the sensitivity and specificity of the LR-TIV category became 67.3% (68 of 101 patients) and 99.7% (1217 of 1221 patients) at both CT and HBA MRI. No difference was found between measurements without and with FSTIV (sensitivity, 62% vs 67% for CT [P = .45] and 64% vs 67% for HBA MRI [P = .18]; specificity, 99% for both CT and HBA MRI [P > .99 for both]). Conclusion The Liver Imaging Reporting and Data System tumor in vein category showed moderate sensitivity and high specificity in the detection of macroscopic tumors in veins at both CT and hepatobiliary contrast agent-enhanced MRI, with pathologic examination used as the reference standard. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Morrell in this issue.
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- 2022
4. Evaluation of LI-RADS Version 2018 Treatment Response Algorithm for Hepatocellular Carcinoma in Liver Transplant Candidates: Intraindividual Comparison between CT and Hepatobiliary Agent–enhanced MRI
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Haeryoung Kim, Jeong Hee Yoon, Kyoung Bun Lee, Jeong Min Lee, Ijin Joo, Sun Kyung Jeon, Jae Seok Bae, and Hyo Jin Kang
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Male ,Treatment response ,Carcinoma, Hepatocellular ,Contrast Media ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Intraindividual comparison ,In patient ,Retrospective Studies ,Liver imaging ,business.industry ,Liver Neoplasms ,Significant difference ,Mean age ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Liver Transplantation ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,Tomography, X-Ray Computed ,business ,Algorithm ,Algorithms - Abstract
Background The Liver Imaging Reporting and Data System (LI-RADS), version 2018, treatment response algorithm (TRA) is used to assess hepatocellular carcinoma (HCC) after local-regional therapy (LRT). However, its diagnostic performance has not yet been fully compared between CT and hepatobiliary agent (HBA)-enhanced MRI in patients who have undergone liver transplant (LT). Purpose To compare the diagnostic performance of LI-RADS TRA when using CT versus using HBA-enhanced MRI in an intraindividual manner according to pathologic results. Materials and Methods Between January 2011 and September 2019, 165 patients with 237 clinically suspected HCCs underwent LRT followed by LT and were retrospectively included. All patients underwent both CT and HBA-enhanced MRI after LRT and before LT. Three radiologists independently assessed tumor viability with both modalities by using LI-RADS TRA and reached a consensus. Pathologic tumor viability categorized as either completely (100%) or incompletely (
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- 2021
5. Association between spleen volume and the post-hepatectomy liver failure and overall survival of patients with hepatocellular carcinoma after resection
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Jeongin Yoo, Haeryoung Kim, Kyung Bun Lee, Kyung-Suk Suh, Kwang-Woong Lee, Jae Seok Bae, Dong Ho Lee, and Nam-Joon Yi
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medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Hepatectomy ,Humans ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Retrospective Studies ,Body surface area ,Receiver operating characteristic ,Proportional hazards model ,business.industry ,Liver Neoplasms ,Hazard ratio ,General Medicine ,Odds ratio ,medicine.disease ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Radiology ,business ,Liver Failure ,Spleen - Abstract
Post-hepatectomy liver failure (PHLF) can occur as a major complication after hepatic resection (HR) in patients with hepatocellular carcinoma (HCC) and negatively affects the prognosis. We aimed to retrospectively assess whether the spleen volume (SV) measured from preoperative CT images would be associated with the development of PHLF and overall survival (OS) after HR in patients with HCC. We enrolled 317 consecutive patients with very early/early stage HCC who underwent a preoperative CT and HR between January 2010 and December 2016. The SV was obtained from preoperative CT images using semi-automated volumetric software and was divided by body surface area to yield SVBSA. Receiver operating characteristic (ROC) curves and logistic regression analyses were performed to identify factors affecting the development of PHLF. The Cox proportional hazard model was used to identify prognostic factors for OS. PHLF was observed in 72 patients (22.7% [72/317]). SVBSA was associated with the development of PHLF (odds ratio, 2.321; 95% CI, 1.347–4.001; p = 0.002) with the area under the ROC curve of 0.663 using the cutoff value of 107.5 cm3 (p 146 cm3 (95.0% vs. 78.7%, p < 0.001). In patients with HCC, a larger SVBSA was associated with a higher rate of PHLF and worse OS after HR. The SVBSA may be useful in selecting good surgical candidates. • A significantly higher spleen volume divided by body surface area was observed in patients who experienced post-hepatectomy liver failure than in patients who did not (148 cm 3 vs. 112 cm 3 , p < 0.001). • The area under the receiver operating characteristic curve of spleen volume divided by body surface area to predict the development of post-hepatectomy liver failure was 0.663 (p < 0.001). • Spleen volume divided by body surface area was a significant influencing factor for overall survival (hazard ratio, 3.935; 95% CI, 1.520–10.184; p < 0.001), with the optimal cutoff of 146 cm 3 .
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- 2020
6. Prognostic Value of Tumor Regression Grade on MR in Rectal Cancer: A Large-Scale, Single-Center Experience
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Jung Ho Kim, Bo Yun Hur, Se Hyung Kim, Heera Yoen, Jae Seok Bae, Jeong Hee Yoon, Hyeon Jeong Oh, Joon Koo Han, and Hye Eun Park
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Adult ,Male ,medicine.medical_specialty ,Colorectal cancer ,Kaplan-Meier Estimate ,Single Center ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Magnetic resonance imaging ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lymph node ,Survival analysis ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Tumor Regression Grade ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Rectal Neoplasms ,Hazard ratio ,Chemoradiotherapy ,Middle Aged ,medicine.disease ,Prognosis ,Regression ,medicine.anatomical_structure ,Diffusion Magnetic Resonance Imaging ,030220 oncology & carcinogenesis ,Gastrointestinal Imaging ,Original Article ,Female ,Radiology ,Neoplasm Grading ,business ,Kappa ,Rectal neoplasm - Abstract
Objective To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared with pathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserver agreement for evaluating mrTRG. Materials and methods Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; mean age, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologists independently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologists graded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models were used for survival analysis. Cohen's kappa analysis was used to determine interobserver agreement. Results According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5. By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantly different according to the 5-point grading mrTRG (p = 0.024) and pTRG (p = 0.038). The 5-year disease-free survival (DFS) was significantly different among the five mrTRG groups (p = 0.039), but not among the five pTRG groups (p = 0.072). OS and DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio = 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, k value between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weighted MRI may improve interobserver agreement on mrTRG.
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- 2020
7. LI-RADS M (LR-M) criteria and reporting algorithm of v2018: diagnostic values in the assessment of primary liver cancers on gadoxetic acid-enhanced MRI
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Jeong Min Lee, Jae Seok Bae, Sun Kyung Jeon, Ijin Joo, Hyo Jin Kang, and Min Young Kim
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Gadolinium DTPA ,medicine.medical_specialty ,Gadoxetic acid ,Carcinoma, Hepatocellular ,Urology ,Contrast Media ,Malignancy ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,neoplasms ,Intrahepatic Cholangiocarcinoma ,Retrospective Studies ,Radiological and Ultrasound Technology ,business.industry ,Liver Neoplasms ,Gastroenterology ,Retrospective cohort study ,Hepatology ,medicine.disease ,Magnetic Resonance Imaging ,digestive system diseases ,Bile Duct Neoplasms ,Liver ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Etiology ,Liver cancer ,business ,Algorithm ,Algorithms ,medicine.drug - Abstract
To evaluate diagnostic values of the liver imaging reporting and data system (LI-RADS) M (LR-M) category based on novel explicit criteria that accept both targetoid and nontargetoid LR-M features and the suggested reporting algorithm of LI-RADS v2018 to assess primary liver cancers (PLCs) on gadoxetic acid-enhanced MRI (Gd-EOB-MRI). This retrospective study included 165 patients at high risk for hepatocellular carcinoma (HCC) with pathologically confirmed PLCs (HCC, n = 113; intrahepatic cholangiocarcinoma [iCCA], n = 23; and combined hepatocellular cholangiocarcinoma [cHCC-CCA], n = 29). Two radiologists independently analyzed Gd-EOB-MRI features and determined LI-RADS category for each tumor and categorized the likely etiology either as HCC or non-HCC malignancy if LR-M was assigned. Diagnostic performances for HCC or those for malignancy were compared according to imaging criteria. LR-M was assigned in 95.7%/91.3% of iCCAs; 55.2%/58.6% of cHCC-CCAs; and 21.2%/17.7% of HCCs in reviewers 1/2. Combination of LR-5 plus LR-M resulted in sensitivity of 95.2%/97.6% to diagnose PLCs as malignant, which were significantly higher than that of LR-5 plus “LR-M with ≥ 1 targetoid appearances” (84.8%/91.5%, Ps
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- 2020
8. Differential and prognostic MRI features of gallbladder neuroendocrine tumors and adenocarcinomas
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Jeongin Yoo, Haeryoung Kim, Jae Seok Bae, Se Hyung Kim, and Joon Koo Han
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Adult ,Male ,medicine.medical_specialty ,Adenocarcinoma ,Neuroendocrine tumors ,030218 nuclear medicine & medical imaging ,Metastasis ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Effective diffusion coefficient ,Radiology, Nuclear Medicine and imaging ,Lymph node ,Survival analysis ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Gallbladder ,Reproducibility of Results ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,body regions ,Neuroendocrine Tumors ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Gallbladder Neoplasms ,Radiology ,business - Abstract
To identify MRI features that are helpful for the differentiation of gallbladder neuroendocrine tumors (GB-NETs) from gallbladder adenocarcinomas (GB-ADCs) and to evaluate their prognostic values. Between January 2008 and December 2018, we retrospectively enrolled patients who underwent MRI for GB malignancy. Two radiologists independently assessed the MRI findings and reached a consensus. Significant MRI features, which distinguish GB-NETs from GB-ADCs, were identified. Cox regression analyses were performed to find MRI features that were prognostic for overall survival. There were 63 patients with GB-NETs (n = 21) and GB-ADCs (n = 42). Compared with GB-ADCs, GB-NETs more frequently demonstrated the following MRI features: well-defined margins, intact overlying mucosa, and thick rim contrast enhancement and/or diffusion restriction (ps
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- 2020
9. Contrast-Enhanced CT and Ultrasonography Features of Intracholecystic Papillary Neoplasm with or without associated Invasive Carcinoma
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Jae Hyun Kim, Jung Hoon Kim, Hyo-Jin Kang, and Jae Seok Bae
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Male ,Carcinoma ,Humans ,Female ,Gallbladder Neoplasms ,Radiology, Nuclear Medicine and imaging ,Tomography, X-Ray Computed ,Retrospective Studies ,Ultrasonography - Abstract
To assess the contrast-enhanced CT and ultrasonography (US) findings of intracholecystic papillary neoplasm (ICPN) and determine the imaging features predicting ICPN associated with invasive carcinoma (ICPN-IC).In this retrospective study, we enrolled 119 consecutive patients, including 60 male and 59 female, with a mean age ± standard deviation of 63.3 ± 12.1 years, who had pathologically confirmed ICPN (low-grade dysplasia [DP] = 34, high-grade DP = 35, IC = 50) and underwent preoperative CT or US. Two radiologists independently assessed the CT and US findings, focusing on wall and polypoid lesion characteristics. The likelihood of ICPN-IC was graded on a 5-point scale. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of ICPN-IC separately for wall and polypoid lesion findings. The performances of CT and US in distinguishing ICPN-IC from ICPN with DP (ICPN-DP) was evaluated using the area under the receiver operating characteristic curve (AUC).For wall characteristics, the maximum wall thickness (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.1-1.9) and mucosal discontinuity (aOR = 5.6; 95% CI: 1.3-23.4) on CT were independently associated with ICPN-IC. Among 119 ICPNs, 110 (92.4%) showed polypoid lesions. Regarding polypoid lesion findings, multiplicity (aOR = 4.0; 95% CI: 1.6-10.4), lesion base wall thickening (aOR = 6.0; 95% CI: 2.3-15.8) on CT, and polyp size (aOR = 1.1; 95% CI: 1.0-1.2) on US were independently associated with ICPN-IC. CT showed a higher diagnostic performance than US in predicting ICPN-IC (AUC = 0.793 vs. 0.676;ICPN showed polypoid lesions and/or wall thickening on CT or US. A thick wall, multiplicity, presence of wall thickening in the polypoid lesion base, and large polyp size are imaging findings independently associated with invasive cancer and may be useful for differentiating ICPN-IC from ICPN-DP.
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- 2023
10. Deep learning-based image reconstruction of 40-keV virtual monoenergetic images of dual-energy CT for the assessment of hypoenhancing hepatic metastasis
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Taehee Lee, Jeong Min Lee, Jeong Hee Yoon, Ijin Joo, Jae Seok Bae, Jeongin Yoo, Jae Hyun Kim, Chulkyun Ahn, and Jong Hyo Kim
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Radiography, Dual-Energy Scanned Projection ,Deep Learning ,Liver Neoplasms ,Image Processing, Computer-Assisted ,Humans ,Radiographic Image Interpretation, Computer-Assisted ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Signal-To-Noise Ratio ,Tomography, X-Ray Computed ,Retrospective Studies - Abstract
To evaluate the diagnostic value of deep learning model (DLM) reconstructed dual-energy CT (DECT) low-keV virtual monoenergetic imaging (VMI) for assessing hypoenhancing hepatic metastases.This retrospective study included 131 patients who underwent contrast-enhanced DECT (80-kVp and 150-kVp with a tin filter) in the portal venous phase for hepatic metastasis surveillance. Linearly blended images simulating 100-kVp images (100-kVp), standard 40-keV VMI images (40-keV VMI), and post-processed 40-keV VMI using a vendor-agnostic DLM (i.e., DLM 40-keV VMI) were reconstructed. Lesion conspicuity and diagnostic acceptability were assessed by three independent reviewers and compared using the Wilcoxon signed-rank test. The contrast-to-noise ratios (CNRs) were also measured placing ROIs in metastatic lesions and liver parenchyma. The detection performance of hepatic metastases was assessed by using a jackknife alternative free-response ROC method. The consensus by two independent radiologists was used as the reference standard.DLM 40-keV VMI, compared to 40-keV VMI and 100-kVp, showed a higher lesion-to-liver CNR (8.25 ± 3.23 vs. 6.05 ± 2.38 vs. 5.99 ± 2.00), better lesion conspicuity (4.3 (4.0-4.7) vs. 3.7 (3.7-4.0) vs. 3.7 (3.3-4.0)), and better diagnostic acceptability (4.3 (4.0-4.3) vs. 3.0 (2.7-3.3) vs. 4.0 (4.0-4.3)) (p0.001 for all). For lesion detection (246 hepatic metastases in 68 patients), the figure of merit was significantly higher with DLM 40-keV VMI than with 40-keV VMI (0.852 vs. 0.822, p = 0.012), whereas no significant difference existed between DLM 40-keV VMI and 100-kVp (0.852 vs. 0.842, p = 0.31).DLM 40-keV VMI provided better image quality and comparable diagnostic performance for detecting hypoenhancing hepatic metastases compared to linearly blended images.• DLM 40-keV VMI provides a superior image quality compared with 40-keV or 100-kVp for assessing hypoenhancing hepatic metastasis. • DLM 40-keV VMI has the highest CNR and lesion conspicuity score for hypoenhancing hepatic metastasis due to noise reduction and structural preservation. • DLM 40-keV VMI provides higher lesion detectability than standard 40-keV VMI (p = 0.012).
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- 2021
11. Utilization of virtual non-contrast images derived from dual-energy CT in evaluation of biliary stone disease: Virtual non-contrast image can replace true non-contrast image regarding biliary stone detection
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Dong Ho Lee, Jae Seok Bae, Sun Kyung Jeon, Joon Koo Han, and Ijin Joo
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Adult ,Male ,Adolescent ,media_common.quotation_subject ,Gallstones ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Radiography, Dual-Energy Scanned Projection ,Biliary disease ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Contrast (vision) ,Radiology, Nuclear Medicine and imaging ,Biliary Tract ,Aged ,Retrospective Studies ,media_common ,Aged, 80 and over ,Common bile duct ,business.industry ,Significant difference ,Reproducibility of Results ,General Medicine ,Middle Aged ,musculoskeletal system ,medicine.disease ,medicine.anatomical_structure ,Biliary stone ,030220 oncology & carcinogenesis ,Female ,Dose reduction ,Dual energy ct ,Tomography, X-Ray Computed ,Nuclear medicine ,business - Abstract
Objectives To compare the virtual non-contrast (VNC) images acquired through dual-energy computed tomography (DECT) with the true non-contrast (TNC) images in the detection of biliary stones and to calculate dose reduction by replacing TNC images with VNC images. Methods Between March 2017 and April 2018, we retrospectively enrolled 75 patients with suspicious biliary disease who underwent dual-source DECT and surgery and/or endoscopic intervention within 2 months from the CT. Biliary stones were present in 45 patients. The sensitivity and specificity for detecting gallstone and common bile duct (CBD) stone were compared between the VNC and TNC using McNemar test. In addition, the possible reduction in radiation dose was calculated. Results In our study, 37 patients had gallstones, 2 had CBD stones, and 6 had both gallstone and CBD stones. For detection of gallstones, the sensitivity and specificity were 90.7% (39/43) and 87.5% (28/32), respectively, for the TNC images, and 88.4% (38/43) and 90.6% (29/32), respectively, for the VNC images. With respect to CBD stones, the sensitivity and specificity were 87.5% (7/8) and 98.5% (66/67), respectively, for the TNC images, and 75.0% (6/8) and 100% (67/67), respectively, for the VNC images. There was no significant difference in the sensitivity and specificity between each image set (P > 0.05). The radiation dose reduction of 22.4 ± 1.3% is expected by omitting TNC images. Conclusions The VNC images derived from DECT were comparable to the TNC images for the detection of biliary stones and may replace the TNC images to reduce radiation dose.
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- 2019
12. Assessment of hepatic steatosis by using attenuation imaging: a quantitative, easy-to-perform ultrasound technique
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Haeryoung Kim, Jeong Hoon Lee, Dong Ho Lee, Joon Koo Han, Jae Young Lee, Yun Bin Lee, Su Jong Yu, Byung Ihn Choi, Eun Ju Cho, and Jae Seok Bae
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Adult ,Male ,medicine.medical_specialty ,Biopsy ,Sensitivity and Specificity ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Stage (cooking) ,Ultrasonography ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Biopsy, Needle ,Ultrasound ,Reproducibility of Results ,General Medicine ,Gold standard (test) ,Middle Aged ,medicine.disease ,Fatty Liver ,Liver ,ROC Curve ,Evaluation Studies as Topic ,030220 oncology & carcinogenesis ,Female ,Histopathology ,Radiology ,Steatosis ,business - Abstract
To evaluate the diagnostic performance of attenuation imaging (ATI) in the detection of hepatic steatosis compared with a histopathology gold standard. We prospectively enrolled 108 consecutive patients (35 males; median age, 54.0 years) who underwent percutaneous liver biopsy for evaluation of diffuse liver disease between January 2018 and November 2018 in a tertiary academic center. Grayscale ultrasound examination with ATI was performed just before biopsy, and an attenuation coefficient (AC) was obtained from each patient. The degree of hepatic steatosis, fibrosis stage, and necroinflammatory activity were assessed on histopathologic examination. The significant factor associated with the AC was found by a linear regression analysis, and the diagnostic performance of the AC for the classification into each hepatic steatosis stage was evaluated by receiver operating characteristic (ROC) analysis. The distribution of hepatic steatosis grade on histopathology was 53/11/22/16/6 for none/mild (
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- 2019
13. Quantitative contrast-enhanced US helps differentiating neoplastic vs non-neoplastic gallbladder polyps
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Sang Hyub Lee, Woo Hyun Paik, Haeryoung Kim, Hyo Jin Kang, Wooil Kwon, Jae Young Lee, Se Hyung Kim, Jae Seok Bae, Ji Kon Ryu, Jin-Young Jang, and Joon Koo Han
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Adult ,Male ,medicine.medical_specialty ,Intraclass correlation ,medicine.medical_treatment ,Contrast Media ,Gallbladder Diseases ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,Polyps ,0302 clinical medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Cholecystectomy ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Pathological ,Aged ,Ultrasonography ,Neuroradiology ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Gallbladder ,Ultrasound ,Area under the curve ,Interventional radiology ,General Medicine ,Middle Aged ,digestive system diseases ,surgical procedures, operative ,medicine.anatomical_structure ,ROC Curve ,030220 oncology & carcinogenesis ,Female ,Gallbladder Neoplasms ,Radiology ,business ,Precancerous Conditions - Abstract
To differentiate between large (≥ 1 cm in diameter) gallbladder (GB) non-neoplastic and neoplastic polyps using quantitative analysis of contrast-enhanced ultrasound (CEUS) findings. From September 2017 to May 2018, 29 patients (10 males; median age, 63 years) with GB polyps of ≥ 1 cm in diameter who were undergoing cholecystectomy were consecutively enrolled. All patients underwent preoperative conventional US and CEUS examinations. Quantitative analysis of CEUS findings using time-intensity curves between the two groups was independently performed by two radiologists. The interobserver agreement for the quantitative analysis of the CEUS results was measured using the intraclass correlation coefficient. Receiver operating characteristic analysis was performed to evaluate the diagnostic performance of CEUS examination. After the cholecystectomy, the patients were classified into the non-neoplastic polyp group (n = 12) and the neoplastic polyp group (n = 17) according to the pathological results. The interobserver agreement for quantitative assessment between the two radiologists was near perfect to substantial. Quantitative assessment of the CEUS findings revealed that the rise time, mean transit time, time to peak, and fall time of non-neoplastic GB polyps were significantly shorter than those of neoplastic polyps (p
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- 2019
14. MDCT findings predicting post-operative residual tumor and survival in patients with pancreatic cancer
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Jung Hoon Kim, Won Chang, Jae Seok Bae, Joon Koo Han, and Ijin Joo
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Male ,medicine.medical_specialty ,Neoplasm, Residual ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pancreatectomy ,0302 clinical medicine ,Pancreatic cancer ,medicine.artery ,Multidetector Computed Tomography ,Republic of Korea ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Postoperative Period ,Stage (cooking) ,Pancreas ,Survival analysis ,Neoplasm Staging ,Retrospective Studies ,Common hepatic artery ,business.industry ,Proportional hazards model ,Hazard ratio ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Pancreatic Neoplasms ,Survival Rate ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Adenocarcinoma ,Female ,Radiology ,business ,Carcinoma, Pancreatic Ductal - Abstract
To predict residual tumor (R) classification and overall survival (OS) on preoperative MDCT in patients who underwent first-line surgery for pancreatic ductal adenocarcinoma (PDA). Three hundred sixteen patients with PDA who underwent MDCT and first-line surgery were included. Patients were divided into a test (n = 216) and a validation group (n = 100). The R classification was categorized into R0 (no residual tumor) and R1/R2 (microscopic/macroscopic residual tumor). We assessed the correlation between the MDCT findings and the R classification. For survival analysis, we used the Kaplan–Meier estimation and Cox proportional hazard model to determine the prognostic factors for OS. Validation of the prediction models for the R classification and OS was performed using C statistics and calibration plot. Peritumoral fat stranding (odds ratio (OR) 3.826), suspicious distant metastasis (OR 2.916), portal vein involvement (OR 2.795), and tumor size (OR 1.045) were independent predictors for residual tumor (p
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- 2019
15. Influence of Amlodipine on Haemostatic Measurements during Clopidogrel Treatment in Patients with Coronary Artery Disease
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Jeong Rang Park, Jin-Yong Hwang, Hyun Woong Park, Seok-Jae Hwang, Jeong Yoon Jang, Jong-Hwa Ahn, Jin-Sin Koh, Paul A. Gurbel, Min Gyu Kang, Yongwhi Park, Udaya S. Tantry, Young-Hoon Jeong, Kyehwan Kim, Choong Hwan Kwak, and Jae Seok Bae
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Male ,0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Republic of Korea ,medicine ,Cytochrome P-450 CYP3A ,Humans ,Rosuvastatin ,Prospective Studies ,Amlodipine ,Rosuvastatin Calcium ,Antihypertensive Agents ,Aged ,Hemostasis ,Aspirin ,Cross-Over Studies ,medicine.diagnostic_test ,business.industry ,Percutaneous coronary intervention ,Hematology ,Middle Aged ,Clopidogrel ,Crossover study ,Thromboelastography ,Thrombelastography ,Discontinuation ,Treatment Outcome ,030104 developmental biology ,Cardiology ,Female ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Amlodipine has a potential to reduce clopidogrel bioactivation through the cytochrome P450 3A4 enzyme in vivo, but the clinical impact of this interaction remains controversial. This randomized, open-label, two-period, crossover study was performed to evaluate the influence of amlodipine on the haemostatic profiles of high-risk patients during clopidogrel treatment. We recruited 40 Asian patients (Male/Female: n = 36/4) receiving clopidogrel (75 mg/day), aspirin (100 mg/day) and rosuvastatin for at least 6 months following percutaneous coronary intervention. Patients were randomly assigned to receive either 5 mg daily amlodipine or not for 2 weeks, and then were crossed over to the other treatment for 2 weeks. Haemostatic measurements were conducted with the VerifyNow assay and thromboelastography (TEG). Primary endpoint was P2Y12 Reaction Units (PRU) during on- versus off-amlodipine treatment. The on-amlodipine strategy showed higher level of PRU compared with the off-amlodipine strategy (176.8 ± 75.4 vs. 150.7 ± 65.5 PRU; ∆mean: 26.1 PRU; ∆95% confidence interval [CI]: 4.5–47.7 PRU; p = 0.019). Platelet-fibrin clot strength measured by TEG was lower during on- versus off-amlodipine treatment (7,712 ± 1,889 vs. 8,559 ± 2,174 dyne/cm2; ∆mean: –847 dyne/cm2; ∆95% CI: –1,632 to –62 dyne/cm2; p = 0.035). After amlodipine discontinuation, 27 patients (67.5%) showed a decrease in PRU, which was associated with ‘PRU ≥ 160 on-amlodipine’ in multivariate analysis (odds ratio: 62.014; 95% CI: 2.302–1670.328; p = 0.014). In conclusion, amlodipine increases platelet reactivity and decreases platelet-fibrin clot strength during clopidogrel treatment. In addition, the effect of amlodipine discontinuation on clopidogrel responsiveness is associated with on-amlodipine platelet reactivity.
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- 2019
16. Development of a predictive model for extragastric recurrence after curative resection for early gastric cancer
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Jae Seok, Bae, Won, Chang, Se Hyung, Kim, Yunhee, Choi, Seong-Ho, Kong, Hyuk-Joon, Lee, Han-Kwang, Yang, Yoonjin, Kwak, Hyung-Ho, Kim, and Joon Koo, Han
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Gastrectomy ,Risk Factors ,Stomach Neoplasms ,Humans ,Neoplasm Recurrence, Local ,Early Detection of Cancer ,Retrospective Studies - Abstract
Stratification of patients who undergo curative resection for early gastric cancer (EGC) is warranted due to the heterogeneity in the risk of developing extragastric recurrence (EGR). Therefore, we aimed to stratify the need for postoperative surveillance for EGR detection in patients with EGC by developing a model for predicting EGR-free survival.This retrospective cohort study included patients who underwent postoperative surveillance after curative resection of EGC (n = 4149). Cox proportional hazard models were used to identify predictors to build a model for predicting EGR-free survival. Bootstrap-corrected c-index and calibration plots were used for internal and external (n = 2148) validations.A risk-scoring system was constructed using variables significantly associated with EGR-free survival: pathologic T stage (pT1b[sm1], hazard ratio [HR] 4.928; pT1b[sm2], HR 5.235; pT1b[sm3], HR 7.748) and N stage (pN1, HR 4.056; pN2, HR 9.075; pN3, HR 30.659). Patients were dichotomized into a very-low-risk group or a low-or-greater-risk group. The 5-year EGR-free survival rates differed between the two groups (99.9 vs. 97.3%). The discriminative performance of the model was 0.851 (Uno's c-index) and 0.751 in the internal and external cohorts, respectively. The calibration slope was 0.916 and 1.131 in the internal and external cohorts, respectively.Our model for predicting EGR-free survival based on the pathologic T and N stages may be useful for stratifying patients who have undergone curative surgery for EGC. The results suggest that patients in the very-low-risk group may be spared from postoperative surveillance considering their extremely high EGR-free survival rate.
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- 2021
17. Prediction of prognosis and resectability using MR imaging, clinical, and histopathological findings in patients with perihilar cholangiocarcinoma
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Jeongin, Yoo, Jung Hoon, Kim, Jae Seok, Bae, and Hyo-Jin, Kang
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Cholangiocarcinoma ,Bile Duct Neoplasms ,Humans ,Prognosis ,Magnetic Resonance Imaging ,Klatskin Tumor ,Retrospective Studies - Abstract
To predict poor overall survival (OS) and risk of residual tumor after surgery using MR imaging, clinical, and histopathological findings in perihilar cholangiocarcinoma.196 patients with perihilar cholangiocarcinoma who underwent preoperative MRI and curative-intent surgery were retrospectively included. MRI findings were assessed by two radiologists. Clinical characteristics and histopathological results such as serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), T and N stage, and resection status, were also investigated. Cox regression analysis and the Kaplan-Meier method were used to identify prognostic factors for OS. We further analyzed the correlation between MRI features and residual tumors using logistic regression analysis.The median OS was 25.0 ± 26.6 months. T stage (hazard ratio [HR] 6.26, p = 0.014), N stage (HR 1.86, p = 0.002), CA-19-937 U/mL (HR 2.06, p0.001), enlarged LN on MRI (HR 1.69, p = 0.006), and residual tumor (HR 1.52, p = 0.034) were important predictors of poor survival. The 5-year OS of the complete resection group (n = 107) was significantly better than that of the residual tumor group (n = 89) (35.5% vs. 18.8%, p = 0.002). Additionally, peritumoral fat stranding (odds ratio[OR] 2.09, p = 0.027), Bismuth type III/IV (OR 1.95, p = 0.022), and common bile duct (CBD) involvement (OR 2.3, p = 0.008) on MRI were important predictors of residual tumors in univariate analyses. However, absence of peritumoral fat stranding was a significant independent predictor for complete resection (OR 1.99, p = 0.048) and showed the highest sensitivity, at 79.8%.MR imaging, clinical and histopathological results are useful for predicting poor survival after surgery for perihilar cholangiocarcinoma. Furthermore, MRI findings, including peritumoral fat stranding, CBD involvement, and Bismuth type, are important for the prediction of residual tumors.
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- 2021
18. Prediction of residual tumor and overall survival after first-line surgery in patients with pancreatic ductal adenocarcinoma using preoperative magnetic resonance imaging findings
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Jung Hoon Kim, Joon Koo Han, Jae Seok Bae, and Hyo Jin Kang
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Male ,medicine.medical_specialty ,Pancreatic ductal adenocarcinoma ,Neoplasm, Residual ,First line ,Adenocarcinoma ,030218 nuclear medicine & medical imaging ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Preoperative Care ,medicine ,Overall survival ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Pancreas ,Retrospective Studies ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Survival Analysis ,Pancreatic Neoplasms ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Radiology ,business ,Carcinoma, Pancreatic Ductal - Abstract
Background Complete resection is the only potentially curative treatment in patients with pancreatic ductal adenocarcinoma (PDA) and is associated with a longer overall survival (OS) than incomplete resection of tumor. Hence, prediction of the resection status after surgery would help predict the prognosis of patients with PDA. Purpose To predict residual tumor (R) classification and OS in patients who underwent first-line surgery for PDA using preoperative magnetic resonance imaging (MRI). Material and Methods In this study, 210 patients with PDA who underwent MRI and first-line surgery were randomly categorized into a test group (n=150) and a validation group (n=60). The R classification was divided into R0 (no residual tumor) and R1/R2 (microscopic/macroscopic residual tumor). Preoperative MRI findings associated with R classification and OS were assessed by using logistic regression and Cox proportional hazard models. In addition, the prediction models for the R classification and OS were validated using calibration plots and C statistics. Results On preoperative MRI, portal vein encasement (odds ratio 4.755) was an independent predictor for R1/R2 resection ( P=0.040). Tumor size measured on MRI (hazard ratio [HR] per centimeter 1.539) was a predictor of OS, along with pathologic N1 and N2 stage (HR 1.944 and 3.243, respectively), R1/R2 resection (HR 3.273), and adjuvant chemoradiation therapy (HR 0.250) ( PConclusion Preoperative MRI was valuable for predicting R1/R2 resection using portal vein encasement. Tumor size measured on MRI was useful for the prediction of OS after first-line surgery for PDA.
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- 2021
19. Volumetric CT Texture Analysis of Intrahepatic Mass-Forming Cholangiocarcinoma for the Prediction of Postoperative Outcomes: Fully Automatic Tumor Segmentation Versus Semi-Automatic Segmentation
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Sungeun Park, Junghoan Park, Jae Hyun Kim, Jae Seok Bae, Jeong Min Lee, Jihyuk Lee, and Ijin Joo
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Adult ,Male ,Intraclass correlation ,CT-quantitative ,Adults (Human) ,Cholangiocarcinoma ,Volumetric CT ,Medicine ,Humans ,Computer applications-texture analysis ,Radiology, Nuclear Medicine and imaging ,Segmentation ,Aged ,Retrospective Studies ,Reproducibility ,business.industry ,Hazard ratio ,Liver Neoplasms ,Reproducibility of Results ,Cone-Beam Computed Tomography ,Middle Aged ,Semi automatic segmentation ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Liver ,Fully automatic ,Gastrointestinal Imaging ,Female ,Original Article ,Tumor response ,business ,Nuclear medicine ,Tumor segmentation - Abstract
OBJECTIVE To determine whether volumetric CT texture analysis (CTTA) using fully automatic tumor segmentation can help predict recurrence-free survival (RFS) in patients with intrahepatic mass-forming cholangiocarcinomas (IMCCs) after surgical resection. MATERIALS AND METHODS This retrospective study analyzed the preoperative CT scans of 89 patients with IMCCs (64 male; 25 female; mean age, 62.1 years; range, 38-78 years) who underwent surgical resection between January 2005 and December 2016. Volumetric CTTA of IMCCs was performed in late arterial phase images using both fully automatic and semi-automatic liver tumor segmentation techniques. The time spent on segmentation and texture analysis was compared, and the first-order and second-order texture parameters and shape features were extracted. The reliability of CTTA parameters between the techniques was evaluated using intraclass correlation coefficients (ICCs). Intra- and interobserver reproducibility of volumetric CTTAs were also obtained using ICCs. Cox proportional hazard regression were used to predict RFS using CTTA parameters and clinicopathological parameters. RESULTS The time spent on fully automatic tumor segmentation and CTTA was significantly shorter than that for semi-automatic segmentation: mean ± standard deviation of 1 minutes 37 seconds ± 50 seconds vs. 10 minutes 48 seconds ± 13 minutes 44 seconds (p < 0.001). ICCs of the texture features between the two techniques ranged from 0.215 to 0.980. ICCs for the intraobserver and interobserver reproducibility using fully automatic segmentation were 0.601-0.997 and 0.177-0.984, respectively. Multivariable analysis identified lower first-order mean (hazard ratio [HR], 0.982; p = 0.010), larger pathologic tumor size (HR, 1.171; p < 0.001), and positive lymph node involvement (HR, 2.193; p = 0.014) as significant parameters for shorter RFS using fully automatic segmentation. CONCLUSION Volumetric CTTA parameters obtained using fully automatic segmentation could be utilized as prognostic markers in patients with IMCC, with comparable reproducibility in significantly less time compared with semi-automatic segmentation.
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- 2021
20. Comparisons between image quality and diagnostic performance of 2D- and breath-hold 3D magnetic resonance cholangiopancreatography at 3T
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Heera, Yoen, Jeong Min, Lee, Sang Min, Lee, Hyo-Jin, Kang, Jae Seok, Bae, Eunju, Kim, Johannes M, Peeters, and Jeong Hee, Yoon
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Breath Holding ,Male ,Imaging, Three-Dimensional ,Cholangiopancreatography, Magnetic Resonance ,Humans ,Pancreatic Diseases ,Artifacts ,Magnetic Resonance Imaging - Abstract
To compare the image quality and diagnostic performance of 2D MRCP to those of breath-hold 3D MRCP using compressed sensing (CS-MRCP) and gradient and spin-echo (GRASE-MRCP) at 3T.From January to November 2018, patients who underwent pancreatobiliary MRI including 2D MRCP and two breath-hold 3D MRCP using CS and GRASE at 3T were included. Three radiologists independently evaluated image quality, motion artifact, and pancreatic cyst conspicuity. Diagnostic performance was assessed for bile duct anatomic variation, bile duct, and pancreatic diseases using a composite algorithm as reference standards. Pancreatic lesion detectability and conspicuity were evaluated using JAFROC and generalized estimating equation analysis.One hundred patients (male = 50) were included. Bile duct anatomic variation, bile duct and pancreatic diseases were present in respectively 31, 15, and 79 patients. Breath-hold 3D MRCP provided better image quality than 2D MRCP (3.5 ± 0.6 in 2D MRCP; 4.0 ± 0.7 in GRASE-MRCP and 3.9 ± 0.8 in CS-MRCP, p0.001 for both). There was no difference in motion artifact between 2D and breath-hold 3D MRCP (p = 0.1). Breath-hold 3D CS-MRCP provided better pancreatic cyst conspicuity than 2D MRCP (2.7 [95% CI: 2.5-3.0] vs. 2.3 [95% CI: 2.1-2.5], p = 0.001). There were no significant differences between the diagnostic performance of the three sequences in the detection of bile duct anatomic variation or pancreatic lesions (p0.05).Breath-hold 3D MRCP with GRASE or CS can provide better image quality than 2D MRCP in a comparable scan time.• Breath-hold 3D MRCP using compressed sensing (CS) or gradient and spin-echo (GRASE) provided a better image quality with less image blurring than 2D MRCP. • There were no significant differences between 2D MRCP and breath-hold 3D MRCP in either motion artifact or the number of non-diagnostic exams. • There were no significant differences between 2D MRCP and either type of breath-hold 3D MRCP in the diagnosis of bile duct anatomic variation or detection of pancreatic lesions.
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- 2020
21. Added value of [
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Ieun, Yoon, Jae Seok, Bae, Jeongin, Yoo, Dong Ho, Lee, and Se Hyung, Kim
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Gallium Radioisotopes ,Octreotide ,Magnetic Resonance Imaging ,Kidney Neoplasms ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,Fluorodeoxyglucose F18 ,Stomach Neoplasms ,Positron Emission Tomography Computed Tomography ,Positron-Emission Tomography ,Multidetector Computed Tomography ,Organometallic Compounds ,Humans ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,Carcinoma, Renal Cell ,Neoplasm Staging ,Retrospective Studies - Abstract
To investigate an additional value of [This retrospective study included 167 patients who underwent [All 167 patients were pathologically diagnosed with NENs (n = 131) or non-NENs (n = 36) by surgery (n = 93) or biopsy (n = 74). The non-NEN group included focal pancreatitis (n = 7), gastrointestinal stromal tumor (n = 6), serous cystadenoma (n = 5), metastatic renal cell carcinoma (n = 4), intrapancreatic accessory spleen (n = 4), ductal adenocarcinoma (n = 3), solid pseudopapillary neoplasm (n = 2), intraductal papillary mucinous carcinoma (n = 1), adenosquamous carcinoma (n = 1), schwannoma (n = 1), paraganglioma (n = 1), and solitary fibrous tumor (n = 1). Radiologists' diagnostic performance significantly improved after the addition of [[• [
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- 2020
22. Magnetic Resonance Elastography Versus Transient Elastography in the Prediction of Complications After Resection for Hepatocellular Carcinoma
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Haeryoung Kim, Kyung-Suk Suh, Yunhee Choi, Kwang-Woong Lee, Nam-Joon Yi, Dong Ho Lee, Jae Seok Bae, and Kyung Bun Lee
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Liver Cirrhosis ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,business.industry ,Liver Neoplasms ,Odds ratio ,medicine.disease ,Gastroenterology ,Confidence interval ,Resection ,Magnetic resonance elastography ,Postoperative Complications ,Liver ,ROC Curve ,Liver stiffness ,Hepatocellular carcinoma ,Internal medicine ,medicine ,Elasticity Imaging Techniques ,Humans ,Surgery ,Transient elastography ,business ,Complication ,Retrospective Studies - Abstract
OBJECTIVE To compare the performances of magnetic resonance elastography (MRE) and transient elastography (TE) for predicting severe complications after hepatic resection (HR) in patients with hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA Liver stiffness measurement (LSM) may have the potential to predict outcomes after HR in HCC patients. METHODS Consecutive patients who underwent HR for HCC between 2017 and 2019 were retrospectively enrolled. Before HR, LSM was performed in all patients using both MRE and TE. All postoperative complications were assessed using the comprehensive complication index (CCI). Severe postoperative complications were defined as a CCI≥26.2. The performances of MRE and TE for predicting high CCI and diagnosing liver fibrosis were compared using the area under the receiver-operating-characteristic curve (AUROC). Uni-/multivariable logistic regression analyses were used to identify factors associated with high CCI. RESULTS Among the 208 enrolled patients, 28 patients (13.5%) had high CCI. For detecting high CCI, MRE had an AUROC of 0.874 (95% confidence interval [CI], 0.821-0.916), which was significantly higher than the AUROC of TE (0.756; 95% CI, 0.692-0.813)(P = 0.020). MRE outperformed TE in detecting fibrosis of ≥F2 (AUROC: 0.935 vs. 0.767; P = 0.008), ≥F3 (AUROC: 0.902 vs. 0.774; P = 0.001) and F4 (AUROC: 0.916 vs. 0.767; P
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- 2020
23. Hepatobiliary phase of gadoxetic acid-enhanced MRI in patients with HCC: prognostic features before resection, ablation, or TACE
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Jae Seok, Bae, Jung Hoon, Kim, Dong Ho, Lee, Jae Hyun, Kim, and Joon Koo, Han
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Gadolinium DTPA ,Carcinoma, Hepatocellular ,Liver Neoplasms ,Humans ,Chemoembolization, Therapeutic ,Prognosis ,Magnetic Resonance Imaging ,Retrospective Studies - Abstract
Patients with hepatocellular carcinoma (HCC) receiving different treatments might have specific prognostic factors that can be captured in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI). We aimed to identify the clinical findings and HBP features with prognostic value in patients with HCC.In this retrospective, single-institution study, we included patients with Barcelona Clinic Liver Cancer very early/early stage HCC who underwent GA-MRI before treatment. After performing propensity score matching, 183 patients received the following treatments: resection, radiofrequency ablation (RFA), and transarterial chemoembolization (TACE) (n = 61 for each). Cox regression models were used to identify clinical factors and HBP features associated with disease-free survival (DFS) and overall survival (OS).In the resection group, large tumor size was associated with poor DFS (hazard ratio [HR] 4.159 per centimeter; 95% confidence interval [CI], 1.669-10.365) and poor OS (HR 8.498 per centimeter; 95% CI, 1.072-67.338). In the RFA group, satellite nodules on HBP images were associated with poor DFS (HR 5.037; 95% CI, 1.061-23.903) and poor OS (HR 9.398; 95% CI, 1.480-59.668). Peritumoral hypointensity on HBP images was also associated with poor OS (HR 13.062; 95% CI, 1.627-104.840). In addition, serum albumin levels and the prothrombin time-international normalized ratio were associated with DFS and/or OS. Finally, in the TACE group, no variables were associated with DFS/OS.Different HBP features and clinical factors were associated with DFS/OS among patients with HCC receiving different treatments.• In patients who underwent resection for HCC, a large tumor size on HBP images was associated with poor disease-free survival and overall survival. • In the RFA group, satellite nodules and peritumoral hypointensity on HBP images, along with decreased serum albumin levels and PT-INR, were associated with poor disease-free survival and/or overall survival. • In the TACE group, no clinical or HBP imaging features were associated with disease-free survival or overall survival.
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- 2020
24. 2D shear wave elastography is better than transient elastography in predicting post-hepatectomy complication after resection
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Dong Ho, Lee, Eun Sun, Lee, Jae Seok, Bae, Jae Young, Lee, Joon Koo, Han, Nam-Joon, Yi, Kwang-Woong, Lee, Kyung-Suk, Suh, Haeryoung, Kim, Kyung Bun, Lee, and Byung Ihn, Choi
- Subjects
Liver Cirrhosis ,Liver ,Elasticity Imaging Techniques ,Hepatectomy ,Humans ,Prospective Studies - Abstract
Both transient elastography (TE) and 2D shear wave elastography (SWE) are accurate methods to evaluate liver fibrosis. We aimed to evaluate the diagnostic performance of 2D-SWE in predicting post-hepatectomy complication and to compare it with TE.We prospectively enrolled 125 patients with liver tumors. Liver stiffness (LS) (kilopascal [kPa]) was measured using both TE and 2D-SWE before surgery. All post-operative complication was evaluated using the comprehensive complication index (CCI), and CCI ≥ 26.2 was defined as severe complication. Logistic regression analysis was performed to identify predictive factors for severe complication. Receiver operating characteristic analysis was used to evaluate the diagnostic performance of TE/2D-SWE in detecting liver fibrosis and severe complication.Severe complication developed in 18 patients. The median LS in patients with severe complication was significantly higher for both 2D-SWE (11.4 kPa vs. 7.0 kPa, p 0.001) and TE (8.9 kPa vs. 6.2 kPa, p = 0.009). LS obtained from 2D-SWE was a significant factor correlated with severe complication (odds ratio: 1.27 per kPa [1.10-1.46], p = 0.001). The diagnostic performance of 2D-SWE was significantly higher than that of TE in detecting both ≥F3 (p = 0.024) and F4 (p = 0.048). The area under the curve of 2D-SWE to predict severe complication was 0.854, significantly higher than 0.692 of TE (p = 0.004). The optimal cut-off LS from 2D-SWE to predict severe complication was 8.6 kPa, with sensitivity of 88.9% (16/18) and specificity of 73.8% (79/107).LS obtained from 2D-SWE was a significant predictive factor for severe complication, and 2D-SWE showed significantly a better diagnostic performance than TE in detecting liver fibrosis and severe complication.• The diagnostic performance of 2D-SWE was significantly higher than that of TE in detecting both ≥ F3 (AUC: 0.853 vs. 0.779, p = 0.024) and F4 (AUC: 0.929 vs. 0.872, p = 0.048). • Liver stiffness value obtained from 2D-SWE was a significant factor correlated with the development of severe complication defined as CCI ≥ 26.2 after hepatic resection for liver tumors (odds ratio: 1.27 per kPa [1.10-1.46], p = 0.001). • 2D-SWE provided significantly a better diagnostic performance in predicting severe complication after hepatic resection than TE (AUC for 2D-SWE: 0.853 vs. AUC for TE: 0.692, p = 0.004).
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- 2020
25. Deep learning-based decision support system for the diagnosis of neoplastic gallbladder polyps on ultrasonography: Preliminary results
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Hee Dong Chae, Sae Jin Park, Jae Seok Bae, Younbeom Jeong, Joon Koo Han, Ijin Joo, and Jung Hoon Kim
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Male ,Decision support system ,medicine.medical_specialty ,Intraclass correlation ,lcsh:Medicine ,Gall bladder cancer ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Deep Learning ,Polyps ,0302 clinical medicine ,Gall bladder ,medicine ,Humans ,lcsh:Science ,Retrospective Studies ,Ultrasonography ,Multidisciplinary ,business.industry ,Deep learning ,Gallbladder ,lcsh:R ,Middle Aged ,digestive system diseases ,medicine.anatomical_structure ,Binary classification ,030220 oncology & carcinogenesis ,lcsh:Q ,Female ,Gallbladder Neoplasms ,False positive rate ,Artificial intelligence ,Radiology ,Differential diagnosis ,business ,Precancerous Conditions - Abstract
Ultrasonography (US) has been considered image of choice for gallbladder (GB) polyp, however, it had limitations in differentiating between nonneoplastic polyps and neoplastic polyps. We developed and investigated the usefulness of a deep learning-based decision support system (DL-DSS) for the differential diagnosis of GB polyps on US. We retrospectively collected 535 patients, and they were divided into the development dataset (n = 437) and test dataset (n = 98). The binary classification convolutional neural network model was developed by transfer learning. Using the test dataset, three radiologists with different experience levels retrospectively graded the possibility of a neoplastic polyp using a 5-point confidence scale. The reviewers were requested to re-evaluate their grades using the DL-DSS assistant. The areas under the curve (AUCs) of three reviewers were 0.94, 0.78, and 0.87. The DL-DSS alone showed an AUC of 0.92. With the DL-DSS assistant, the AUCs of the reviewer’s improved to 0.95, 0.91, and 0.91. Also, the specificity of the reviewers was improved (65.1–85.7 to 71.4–93.7). The intraclass correlation coefficient (ICC) improved from 0.87 to 0.93. In conclusion, DL-DSS could be used as an assistant tool to decrease the gap between reviewers and to reduce the false positive rate.
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- 2020
26. Quantitative Assessment of Fatty Liver using Ultrasound with Normalized Local Variance Technique
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Dong Ho Lee, Jae Young Lee, Jeong Hoon Lee, Joon Koo Han, Jae Seok Bae, Byung Ihn Choi, Su Jong Yu, Yun Bin Lee, Haeryoung Kim, and Eun Ju Cho
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Liver Cirrhosis ,medicine.medical_specialty ,medicine.medical_treatment ,Biopsy ,Liver transplantation ,Gastroenterology ,Liver disease ,Fibrosis ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Receiver operating characteristic ,business.industry ,Fatty liver ,medicine.disease ,Fatty Liver ,Liver ,ROC Curve ,Area Under Curve ,Elasticity Imaging Techniques ,Histopathology ,Steatosis ,Hepatic fibrosis ,business - Abstract
To assess the diagnostic performance of the normalized local variance (NLV) ultrasound technique in the detection of the fatty liver using histopathology as a reference standard. We prospectively enrolled 194 consecutive patients with clinical suspicion of diffuse liver disease or history of liver transplantation. Conventional grayscale ultrasound and NLV examinations were performed and immediately followed by liver biopsies. The degrees of fatty liver, necroinflammatory activity, and fibrosis stage were evaluated by histopathological assessment. The diagnostic performance of the NLV values in detecting each grade of fatty liver was determined using receiver operating characteristics analyses, and multivariate linear regression analyses were performed to identify variables significantly associated with the NLV values. The number of patients in each degree of fatty liver and hepatic fibrosis was 118/37/26/13 and 81/68/24/6/14 for none/mild/moderate/severe steatosis and F0 / F1/F2 / F3/F4 fibrosis on histopathological examinations, respectively. The area under the receiver operating characteristics curve and optimal cut-off NLV value for detecting fatty liver of varying degrees were 0.911 and 1.095 for ≥ S1, 0.974 and 1.055 for ≥ S2, and 0.954 and 1.025 for ≥ S3, respectively. Multivariate analyses revealed that not fibrosis or inflammation but rather the degree of steatosis was associated with the NLV value. The NLV value demonstrated excellent diagnostic performance for detecting varying degrees of fatty liver, and the degree of steatosis on histopathological examinations was the only significant factor affecting the NLV value.ZIEL: Beurteilung der diagnostischen Leistung der Ultraschalltechnik der normalisierten lokalen Varianz („Normalized Local Variance“, NLV) bei der Diagnose der Fettleber mit der Histopathologie als Referenzstandard. Prospektiv nahmen wir 194 konsekutive Patienten mit klinischem Verdacht auf eine diffuse Lebererkrankung oder mit Lebertransplantation als Anamnese auf. Konventionelle Graustufen-Ultraschall- und NLV-Untersuchungen wurden durchgeführt und unmittelbar im Anschluss daran erfolgten Leberbiopsien. Der Grad der Fettleber, die nekroinflammatorische Aktivität und das Fibrosestadium wurden durch die Histopathologie beurteilt. Die diagnostische Leistung der NLV-Werte bei der Diagnose des jeweiligen Verfettungsgrades der Leber wurde mittels ROC-Analysen bestimmt; multivariate lineare Regressionsanalysen wurden durchgeführt, um die Variablen zu identifizieren, die signifikant mit den NLV-Werten assoziiert sind. Die Anzahl der Patienten bei jedem Grad der Fettleber und Leberfibrose betrug 118/37/26/13 für fehlende/milde/moderate/schwere Steatose und 81/68/24/6/14 für F0-/F1-/F2-/F3-/F4-Fibrose in den histopathologischen Untersuchungen. Die Fläche unter der ROC-Kurve betrug 0,911 für ≥ S1, 0,974 für ≥ S2 und 0,954 für ≥ S3 und der optimale Cut-off des NLV-Werts betrug 1,095 für ≥ S1, 1,055 für ≥ S2 und 1,025 für ≥ S3 für die Diagnose des unterschiedlichen Grades der Fettleber. Multivariate Analysen zeigten, dass nicht eine Fibrose oder Entzündung, sondern vielmehr der Grad der Steatose mit dem NLV-Wert assoziiert war. Der NLV-Wert zeigte eine ausgezeichnete diagnostische Leistung zum Nachweis der unterschiedlichen Grade der Fettleber. Der Steatosegrad in der Histopathologie war der einzige signifikante Faktor, der den NLV-Wert beeinflusste.
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- 2020
27. The Impact of platelet-fibrin clot strength on occurrence and clinical outcomes of peripheral artery disease in patients with significant coronary artery disease
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Seok-Jae Hwang, Jeong Yoon Jang, Jong-Hwa Ahn, Min Gyu Kang, Sang Young Cho, Jin-Sin Koh, Udaya S. Tantry, Paul A. Gurbel, Young-Hoon Jeong, Yongwhi Park, Kyehwan Kim, Jae Seok Bae, Jin-Yong Hwang, Choong Hwan Kwak, and Hyun Woong Park
- Subjects
Blood Platelets ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,Severity of Illness Index ,Coronary artery disease ,03 medical and health sciences ,Peripheral Arterial Disease ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Postoperative Complications ,Internal medicine ,Antithrombotic ,Republic of Korea ,medicine ,Prevalence ,Humans ,Ankle Brachial Index ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,Fibrin ,medicine.diagnostic_test ,business.industry ,Percutaneous coronary intervention ,Thrombosis ,Hematology ,Odds ratio ,Middle Aged ,medicine.disease ,Thromboelastography ,Thrombelastography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
Patients with peripheral artery disease (PAD) have shown the increased risk of cardiovascular (CV) morbidity and mortality. This study sought to evaluate the impact of clot strength on prevalence and major adverse CV events (MACE) of PAD in high-risk patients. We enrolled patients undergoing percutaneous coronary intervention (PCI) (n = 1667) with available platelet–fibrin clot strength [thrombin-induced maximal amplitude (MAthrombin) measured by thromboelastography] and inflammation [high sensitivity C-reactive protein (hs-CRP)]. PAD was defined with abnormal ankle-brachial index (≤ 0.9 or > 1.4). MACE was defined as a composite of CV death, myocardial infarction or stroke. PAD was observed in 201 patients (12.1%). In the multivariate analysis, high clot strength [MAthrombin ≥ 68 mm: odds ratio (OR) 1.70, 95% confidence interval (CI) 1.20 to 2.41, p = 0.003] and enhanced inflammation (hs-CRP ≥ 3.0 mg/L: OR 2.30, 95% CI 1.56 to 3.41, p
- Published
- 2020
28. Accuracy of Two-Dimensional Shear Wave Elastography and Attenuation Imaging for Evaluation of Patients With Nonalcoholic Steatohepatitis
- Author
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Haeryoung Kim, Byung Ihn Choi, Jae Seok Bae, Dong Ho Lee, Jae Young Lee, Su Jong Yu, Joon Koo Han, Kyung Bun Lee, and Eun Ju Cho
- Subjects
Liver Cirrhosis ,Biopsy ,03 medical and health sciences ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Nonalcoholic fatty liver disease ,medicine ,Humans ,Hepatology ,Receiver operating characteristic ,business.industry ,Attenuation ,Ultrasound ,Gastroenterology ,medicine.disease ,Liver ,030220 oncology & carcinogenesis ,Attenuation coefficient ,Area Under Curve ,Elasticity Imaging Techniques ,030211 gastroenterology & hepatology ,Steatohepatitis ,Steatosis ,business ,Nuclear medicine ,Transient elastography - Abstract
We evaluated the accuracy of a multiparametric approach using attenuation imaging and 2-dimensional shear wave elastography (2D-SWE) for the detection of steatosis and fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).We studied 102 patients with increased levels of liver enzymes or suspicion of NAFLD, examined by attenuation imaging and 2D-SWE, immediately before biopsy collection and analysis (reference standard), from January 2018 to July 2019. We collected data on the attenuation coefficient (dB/cm/MHz) from attenuation imaging, liver stiffness measurements, and shear wave dispersion slope (SWDS, [m/s]/kHz) from 2D-SWE. Multivariate linear regression analysis was performed to identify factors associated with each parameter. Diagnostic performance was determined from area under the receiver operating curve (AUROC) values.The attenuation coefficient was associated with steatosis grade (P.01) and identified patients with steatosis grades S1 or higher, S2 or higher, and S3 or higher, with AUROC values of 0.93, 0.88, and 0.83, respectively. Liver stiffness associated with fibrosis stage (P.01) and lobular inflammatory activity was the only factor associated with SWDS (P.01). SWDS detected inflammation grades I1 or higher, I2 or higher, and I3 or higher with AUROC values of 0.89, 0.85, and 0.78, respectively. We developed a risk scoring system to detect steatohepatitis based on the attenuation coefficient (score of 1 for 0.64attenuation coefficient ≤ 0.70; score of 2 for 0.70attenuation coefficient ≤ 0.73; and score of 3 for attenuation coefficient0.73) and SWDS (score of 2 for 10.5 [m/s]/kHzSWDS ≤ 11.7 [m/s]/kHz; and score of 3 for SWDS11.7 [m/s]/kHz), using an unweighted sum of each score. Based on histopathology analysis, 55 patients had steatohepatitis. Risk scores correlated with NAFLD activity score (rho = 0.73; P.01). Our scoring system identified patients with steatohepatitis with an AUROC of 0.93-this value was significantly higher than that of other parameters (P.05), except SWDS (AUROC, 0.89; P = .18).In the evaluation of patients with suspected NAFLD, the attenuation coefficient can identify patients with steatosis and liver stiffness can detect fibrosis accurately. SWDS was associated significantly with lobular inflammation. We developed a risk scoring system based on the attenuation coefficient and SWDS that might be used to detect steatohepatitis.
- Published
- 2020
29. Evaluation of lymphedema in upper extremities by MR lymphangiography: Comparison with lymphoscintigraphy
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Roh Eul Yoo, Gi Jeong Cheon, Hak Chang, Seung Hong Choi, Jae Seok Bae, Minseok Suh, and Seong Oh Park
- Subjects
Male ,medicine.medical_specialty ,Axillary lymph nodes ,Biomedical Engineering ,Biophysics ,Contrast Media ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Gadobutrol ,Lymphatic System ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,Healthy volunteers ,Organometallic Compounds ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lymphedema ,Prospective Studies ,Prospective cohort study ,Aged ,medicine.diagnostic_test ,business.industry ,Lymphography ,Reproducibility of Results ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Lymphatic system ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Axilla ,Female ,Lymph Nodes ,Radiology ,Lymph ,business ,Lymphoscintigraphy ,medicine.drug - Abstract
Purpose To validate usefulness of magnetic resonance (MR) lymphangiography for evaluation of peripheral lymphedema in upper extremities by comparison with lymphoscintigraphy. Materials and methods This prospective study had institutional review board approval and written informed consent was obtained from all patients. Initially, protocol of MR lymphangiography for upper extremity was established in seven healthy volunteers with 3.0T fat-saturated three-dimensional gradient-echo MR after gadobutrol injection. Then six patients with unilateral lymphedema of the upper extremities were examined with MR lymphangiography and lymphoscintigraphy, and the results were correlated with each other. Four categories were defined to scale the quality of drainage. Results of both techniques were separately evaluated by two radiologists and a nuclear physician. We evaluated sensitivity, specificity and correlation of both techniques. Results MR lymphangiography showed sensitivities of 100% for all four categories, while lymphoscintigraphy yielded a sensitivity of 83.3% for delineation of lymph vessels and 100% for the other three categories. Specificity of MR lymphangiography was 85.7% for delay of drainage and 100% for other three categories, while lymphoscintigraphy showed specificity of 66.7% for pattern of lymphatic drainage and 100% for other three categories. Delay and pattern of drainage was same in 83.3% and non-visualization of axillary LNs was indistinguishably noted in all patients on both techniques. Anatomic level of enhanced lymph vessel was identical in 66.7% of the patients. Conclusion MR lymphangiography showed better performance for depiction of lymph vessels. MR lymphangiography and lymphoscintigraphy yielded same results in all or most patients for evaluation of axillary lymph nodes enhancement and lymphatic drainage in upper extremity.
- Published
- 2018
30. Can quantitative iodine parameters on DECT replace perfusion CT parameters in colorectal cancers?
- Author
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Joon Koo Han, Se Hyung Kim, Hyo Jin Kang, Jae Seok Bae, and Sun Kyung Jeon
- Subjects
Male ,medicine.medical_specialty ,Intraclass correlation ,chemistry.chemical_element ,Blood volume ,Radiation Dosage ,Iodine ,030218 nuclear medicine & medical imaging ,Radiography, Dual-Energy Scanned Projection ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Reproducibility ,business.industry ,Ultrasound ,Reproducibility of Results ,Digital Enhanced Cordless Telecommunications ,General Medicine ,Blood flow ,Middle Aged ,chemistry ,030220 oncology & carcinogenesis ,Female ,Radiology ,Colorectal Neoplasms ,Tomography, X-Ray Computed ,business ,Perfusion - Abstract
To determine the correlation between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT (PCT) parameters in patients with pathologically proven colorectal cancers (CRC) and to evaluate their reproducibility and respective radiation exposures. Institutional review board approval and written informed consents were obtained for this study. Forty-one patients with CRCs who underwent same-day DECT and PCT were prospectively enrolled. Three radiologists independently analyzed the iodine concentration of the tumors and iodine ratios [ratio of lesion to aorta (IRa) or to infrarenal IVC (IRv)] from DECT as well as blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) from PCT. Pearson R and linear correlation, paired t-test, and intraclass correlation coefficients (ICCs) were used. Significant correlations were found between iodine parameters from DECT and PCT parameters: iodine concentration of tumors and BV (r = 0.32, p = 0.04), PMB (r = 0.34, p = 0.03), and MTT (r = -0.38, p = 0.02); iodine ratio (IRa) and MTT (r = -0.32, p = 0.04); iodine ratio (IRv) and BF (r = 0.32, p = 0.04) and PMB (r = 0.44, p =
- Published
- 2018
31. Performance of a Simplified Dichotomous Phenotypic Classification of Bicuspid Aortic Valve to Predict Type of Valvulopathy and Combined Aortopathy
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Jae Seok Bae, Sahmin Lee, Ji Hye Lee, Byung Joo Sun, Cheol Hyun Chung, Sung-Ho Jung, Osung Kwon, Jeong Yoon Jang, Jong-Min Song, Jae-Kwan Song, Dae-Hee Kim, and Duk-Hyun Kang
- Subjects
Male ,Aortic valve ,medicine.medical_specialty ,Aortic Diseases ,Heart Valve Diseases ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Aortography ,03 medical and health sciences ,0302 clinical medicine ,Bicuspid aortic valve ,Bicuspid Aortic Valve Disease ,Predictive Value of Tests ,Internal medicine ,Multidetector Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Left coronary cusp ,030212 general & internal medicine ,Retrospective Studies ,business.industry ,Mean age ,Middle Aged ,medicine.disease ,Stenosis ,Phenotype ,medicine.anatomical_structure ,Echocardiography ,Aortic Valve ,Concomitant ,Aortic valve surgery ,Cardiology ,Classification methods ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
A simplified classification of bicuspid aortic valve (BAV) morphology using only the orientation of fused cusps was recently proposed. The aim of this study was to test whether it is useful for showing an association with the type of valvulopathy or aortopathy.BAV phenotype was retrospectively classified in 681 patients (mean age, 59 ± 12 years; 424 men) who underwent aortic valve surgery. Each BAV was classified using both dichotomous (right and left coronary cusp fusion [CCF] vs mixed cusp fusion [MCF]) and conventional methods, and its association with the dominant valvulopathy (aortic stenosis [AS] vs regurgitation) and concomitant aortic surgery was analyzed. Four cardiologists individually reviewed transthoracic echocardiographic images of 100 randomly selected patients to compare the feasibility and accuracy of the two classification methods.The frequencies of BAV CCF and MCF were 53% (n = 361) and 47% (n = 320), respectively. AS was the predominant cause of surgery (n = 546 [80%]), and concomitant aortic surgery was done in 31% (n = 214). Patients with BAV MCF showed a higher frequency of AS (89% vs 73%, P .001) and aortic surgery (38% vs 26%, P .001) than those with BAV CCF. There were independent associations between BAV MCF and AS (odds ratio, 3.32; 95% CI, 1.99-5.54; P .001) as well as aortic surgery (odds ratio, 1.76; 95% CI, 1.26-2.45; P = .001). The feasibility of the classification methods did not differ, but dichotomous classification revealed higher accuracy than conventional (87% [95% CI, 84.1%-90.7%] vs 70% [95% CI, 65.0%-74.3%]) for all four examiners, with higher κ coefficients representing interrater agreement (κ = 0.73 ± 0.06 to 0.83 ± 0.06 [dichotomous method] vs 0.51 ± 0.06 to 0.73 ± 0.06 [conventional method]).The dichotomous classification method is useful for showing the association with the type of valvulopathy or aortopathy, with better diagnostic performance than the conventional method.
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- 2017
32. Comparative analysis of three nutrition scores in predicting mortality after acute myocardial infarction
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Choong Hwan Kwak, Jong Hwa Ahn, Yongwhi Park, Jeong Rang Park, Jae Seok Bae, Kyehwan Kim, Hye-Ree Kim, Jin-Sin Koh, Jin-Yong Hwang, Min Gyu Kang, Seok-Jae Hwang, Young-Hoon Jeong, and Hyunwoong Park
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Myocardial Infarction ,Nutritional Status ,030209 endocrinology & metabolism ,Body weight ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Total cholesterol ,Nutritional risk index ,medicine ,Humans ,Cumulative incidence ,In patient ,Myocardial infarction ,Geriatric Assessment ,Aged ,Retrospective Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Body Weight ,Mean age ,Prognosis ,medicine.disease ,Nutrition Assessment ,Female ,business ,Mace - Abstract
We investigated the utility of nutrition scores in predicting mortality and prognostic importance of nutrition status using three different scoring systems in patients with acute myocardial infarction (AMI).In total, 1147 patients with AMI were enrolled in this study (72.5 % men; mean age 65.6 years). Patients were divided into three groups according to the geriatric nutritional risk index (GNRI); prognostic nutritional index (PNI); and triglycerides, total cholesterol, and body weight index(TCBI) scores as tertile: low (GNRI ≤ 103.8, n = 382), intermediate (103.8GNRI ≤ 112.3, n = 383), and high (GNRI112.3, n = 382) GNRI groups; low (PNI ≤ 50.0, n = 382), intermediate (50.0PNI ≤ 56.1, n = 383), and high (PNI56.1, n = 382) PNI groups; and low (TCBI ≤ 1086.4, n = 382), intermediate (1086.3GNRI ≤ 2139.1, n = 383), and high (TCBI2139.1, n = 382) TCBI groups.In the GNRI, TCBI, and PNI groups, the cumulative incidence of all-cause death and major adverse cardiovascular events (MACEs) was significantly higher in the low score group, followed by the intermediate and high score groups. Moreover, both intermediate and low PNI groups had a similar cumulative incidence of all-cause death and MACE. The GNRI score (AUC 0.753, 95% CI 0.608~0.745, P = 0.009) had significantly higher areas under the curve (AUCs) than the TCBI (AUC 0.659, 95% CI 0.600~0.719, reference) and PNI (AUC 0.676, 95% CI 0.608~0.745, P = 0.669) scores.Patients with low nutrition scores were at a higher risk of MACE and all-cause death than patients with high nutrition scores. Additionally, the GNRI had the greatest incremental value in predicting risks among the three different scoring systems used in this study.
- Published
- 2021
33. Shear-Wave Dispersion Slope from US Shear-Wave Elastography: Detection of Allograft Damage after Liver Transplantation
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Haeryoung Kim, Kwang-Woong Lee, Jae Seok Bae, Jae Young Lee, Joon Koo Han, Dong Ho Lee, Nam-Joon Yi, Kyung-Suk Suh, and Kyung Bun Lee
- Subjects
Male ,medicine.medical_treatment ,Biopsy ,Liver transplantation ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Interquartile range ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Liver Diseases ,Middle Aged ,Allografts ,Confidence interval ,Liver Transplantation ,030220 oncology & carcinogenesis ,Liver biopsy ,Elasticity Imaging Techniques ,Female ,Elastography ,Nuclear medicine ,business - Abstract
Background Allograft damage (hepatic parenchymal damage) after liver transplant is associated with the degree of necroinflammation in graft liver. According to a recent animal study, shear-wave dispersion slope obtained at US shear-wave elastography (SWE) is associated with necroinflammatory activity in the liver. Purpose To evaluate the role of shear-wave dispersion slope in detecting allograft damage after liver transplant. Materials and Methods In this prospective study, 104 liver transplant recipients underwent percutaneous liver biopsy for allograft evaluation from December 2017 to November 2018. All participants underwent allograft SWE examination just before liver biopsy, and liver stiffness and shear-wave dispersion slope were obtained. Allograft damage was diagnosed by histopathologic analysis. Clinical and imaging factors related to liver stiffness and shear-wave dispersion slope were determined by multivariable linear regression analysis. Diagnostic performance of each variable in detecting allograft damage was evaluated by comparing area under the receiver operating curve (AUC) values. Results There were 104 study participants (35 women); median age was 56 years (interquartile range, 50-62 years). Allograft damage was found in 46 of 104 (44.2%) of participants. The median liver stiffness (8.2 kPa vs 6.3 kPa; P < .01) and shear-wave dispersion slope (14.4 [m/sec]/kHz vs 10.4 [m/sec]/kHz; P < .01) were higher in participants with allograft damage than in those without damage, respectively. Fibrosis stage was the only determinant factor for liver stiffness (coefficient, 1.8 kPa per fibrosis stage; 95% confidence interval: 0.1, 3.5; P = .03), whereas both fibrosis stage (coefficient, 1.4 [m/sec]/kHz per fibrosis stage; 95% confidence interval: 0.3, 2.6; P = .02) and necroinflammatory activity (coefficient, 1.6 [m/sec]/kHz per necroinflammatory activity grade; 95% confidence interval: 0.5, 2.7; P < .01) affected shear-wave dispersion slope. The AUC for shear-wave dispersion slope in detecting allograft damage was 0.86, which was higher than that of liver stiffness (AUC, 0.75; P < .01). Conclusion Shear-wave dispersion slope determined at US shear-wave elastography may help in detecting allograft damage after liver transplant. © RSNA, 2019 Online supplemental material is available for this article.
- Published
- 2019
34. Safety of Ligation of Aberrant Left Hepatic Artery Originating from Left Gastric Artery in Laparoscopic Gastrectomy for Gastric Cancer
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Yun Suhk Suh, Hyuk Joon Lee, Se Hyung Kim, Felix Berlth, Chun Chao Zhu, Shin Hoo Park, Jae Seok Bae, Rene Ronson G. Ang, Seong Ho Kong, Han-Kwang Yang, and Tae Han Kim
- Subjects
Male ,medicine.medical_specialty ,Left gastric artery ,Left hepatic artery ,lcsh:Medicine ,Article ,03 medical and health sciences ,0302 clinical medicine ,Hepatic Artery ,Blood loss ,Gastrectomy ,Stomach Neoplasms ,medicine.artery ,Medicine ,Humans ,lcsh:Science ,Ligation ,Retrospective Studies ,Multidisciplinary ,business.industry ,lcsh:R ,Laparoscopic gastrectomy ,Cancer ,Middle Aged ,University hospital ,medicine.disease ,Surgery ,Liver ,030220 oncology & carcinogenesis ,Surgical oncology ,030211 gastroenterology & hepatology ,lcsh:Q ,Female ,Laparoscopy ,Lymph ,business ,Gastric cancer - Abstract
There are still lot of controversies whether aberrant left hepatic artery (ALHA) originating from left gastric artery should be ligated or preserved during gastric cancer (GC) surgery. We aimed to investigate this issue. We reviewed ALHA cases who had laparoscopic gastrectomy for gastric cancer at Seoul National University Hospital (SNUH) from 2012 to 2016. Type of ALHA variants using Michel’s classification of hepatic arterial anatomy and diameter of each vessel were evaluated by 2 radiologists. Postoperative hepatic function and surgical outcome were collected until 6 months after surgery. Results showed that if the diameter of ALHA was larger than 1.5 mm, a transient elevation of SGOT and SGPT on postoperative day 2 was observed in the ligated cases. No differences were observed in operation time, amount of blood loss, overall complication rate, hospital stay, and number of lymph nodes retrieved between the ligated and preserved replaced left hepatic artery (RLHA) and accessory left hepatic artery (acLHA) group. In this study, we conclude that ligation of ALHA seems to be safe as none of the patients suffered adverse outcome. A transient rise in postoperative SGOT and SGPT levels were seen after ligating ALHA >1.5 mm in diameter regardless of subtype.
- Published
- 2019
35. Influence of rabeprazole and famotidine on pharmacodynamic profile of dual antiplatelet therapy in clopidogrel-sensitive patients: The randomized, prospective, PROTECT trial
- Author
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Yongwhi Park, Jin-Sin Koh, Young-Hoon Jeong, Seok-Jae Hwang, Jeong Yoon Jang, Jin-Yong Hwang, Jae Seok Bae, Jong-Hwa Ahn, Jeong Rang Park, Choong Hwan Kwak, Min Gyu Kang, and Kyehwan Kim
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Platelet Function Tests ,medicine.drug_class ,medicine.medical_treatment ,Rabeprazole ,Proton-pump inhibitor ,030204 cardiovascular system & hematology ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Drug Interactions ,cardiovascular diseases ,Aged ,Randomized Controlled Trials as Topic ,Aspirin ,business.industry ,Percutaneous coronary intervention ,Proton Pump Inhibitors ,Hematology ,General Medicine ,Middle Aged ,Clopidogrel ,Famotidine ,030104 developmental biology ,Pharmacodynamics ,Conventional PCI ,Female ,business ,Gastrointestinal Hemorrhage ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Although acid suppressants are needed to attenuate gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI), pharmacodynamic interaction between clopidogrel and proton pump inhibitor (PPI) can increase the risk of high platelet reactivity (HPR). We sought to evaluate serial changes of platelet measures and influence of rabeprazole on platelet measures. After 600-mg clopidogrel loading for elective PCI, clopidogrel-sensitive patients were recruited and randomly assigned to add rabeprazole of daily 20 mg (n = 40) or famotidine of daily 40 mg (n = 40). Platelet measures were performed with light transmittance aggregometry and VASP-P assay. Primary endpoint was 5 μM ADP-induced platelet aggregation (PA) at 30-day follow-up. HPR was defined as 5 μM ADP-induced PA > 46%. Baseline platelet measures did not differ significantly between the groups. The 30-day level of 5 μM ADP-induced PA was similar between the famotidine vs. rabeprazole group (30.0 ± 16.4% vs. 30.2 ± 13.9%, P= .956). In addition, other platelet measures were comparable between the groups. At 30-day follow-up, the incidence of HPR was similar between the famotidine and rabeprazole groups (20.5% vs. 15.4%; P= .555). In conclusion, adjunctive use of rabeprazole showed the similar antiplatelet effect even in clopidogrel-sensitive patients compared with adjunctive famotidine, which may support the similar effect of rabeprazole and famotidine on the antiplatelet effect of dual antiplatelet therapy with clopidogrel plus aspirin.
- Published
- 2019
36. Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard
- Author
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Jeong Hoon Lee, Eun Sun Lee, Byung Ihn Choi, Eun Ju Cho, Haeryoung Kim, Young Youn Cho, Kyung Bun Lee, Jae Seok Bae, Dong Ho Lee, Jae Young Lee, Su Jong Yu, and Joon Koo Han
- Subjects
Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,Liver fibrosis ,Youden's J statistic ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,Tertiary Care Centers ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Bayesian multivariate linear regression ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Stage (cooking) ,Ultrasonography ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Middle Aged ,Reference Standards ,medicine.disease ,Liver ,ROC Curve ,Area Under Curve ,030220 oncology & carcinogenesis ,Gastrointestinal Imaging ,Elasticity Imaging Techniques ,Original Article ,Female ,Histopathology ,Elastography ,Nuclear medicine ,business - Abstract
Objective The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. Materials and Methods We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0–F4) and necroinflammatory activity grade (A0–A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. Results Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. Conclusion The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology.
- Published
- 2020
37. Clinical Feasibility of Gadoxetic Acid-Enhanced Isotropic High-Resolution 3-Dimensional Magnetic Resonance Cholangiography Using an Iterative Denoising Algorithm for Evaluation of the Biliary Anatomy of Living Liver Donors
- Author
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Berthold Kiefer, Jae Seok Bae, Jeong Min Lee, Kyung-Suk Suh, Su Joa Ahn, Hyo-Jin Kang, and Stephan Kannengiesser
- Subjects
Adult ,Gadolinium DTPA ,Male ,Gadoxetic acid ,Materials science ,Adolescent ,Denoising algorithm ,High resolution ,Contrast Media ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Cholangiography ,Nuclear magnetic resonance ,Imaging, Three-Dimensional ,medicine ,Image Processing, Computer-Assisted ,Living Donors ,Humans ,Radiology, Nuclear Medicine and imaging ,Biliary Tract ,Retrospective Studies ,medicine.diagnostic_test ,Isotropy ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Image Enhancement ,Magnetic Resonance Imaging ,Liver Transplantation ,Biliary anatomy ,Liver donors ,Feasibility Studies ,Female ,030217 neurology & neurosurgery ,Algorithms ,medicine.drug - Abstract
The aim of this study was to evaluate the clinical feasibility of gadoxetic acid-enhanced isotropic high-resolution (IHR) 3-dimensional (3D) T1-weighted (T1W) magnetic resonance cholangiography (MRC) using an iterative denoising (ID) algorithm for evaluation of the biliary anatomy of living liver donors in comparison with conventional 3D multislice T2-weighted (T2W) MRC.In this institutional review board-approved retrospective study, a total of 75 living liver donors who underwent conventional 3D multislice T2W-MRC and IHR-3D-T1W-MRC on a 3 T scanner and subsequent right hepatectomy for liver donation were included. Isotropic high-resolution T1W-MRCs were obtained in both axial and coronal planes using the 3D VIBE Dixon sequence and an ID algorithm implemented with wavelet thresholding of 3D complex-valued data of the noise level, g-factor, and k-space filtering. Thereafter, 3 board-certified radiologists independently reviewed the examinations for visibility and sharpness of the bile ducts (BDs), as well as overall image quality on a 5-point scale. For diagnostic performance, anatomic variations of the BD, length of right hepatic duct, and the expected number of BD openings at right hepatectomy were also recorded. As the reference standard, BD variation was determined by surgeons in consensus using intraoperative real-time fluorescent cholangiography.Mean acquisition times of 3D-T2W-MRC and IHR-T1W-MRC were 367 seconds and 17 seconds (P0.001), respectively. Compared with 3D-T2W-MRCs, IHR-T1W-MRCs yielded significantly improved visibility and sharpness of all evaluated intrahepatic bile ducts (all Ps0.05), and higher overall image quality (P0.01). The IHR-T1W-MRCs also demonstrated significantly higher agreement in BD variation (87.6% vs 81.3%, P = 0.03) and expected BD openings (76.9% vs 70.2%, P = 0.006) than 3D-T2W-MRC compared with the reference standard. Interobserver agreement in estimating the length of right hepatic duct, IHR-T1W-MRC showed excellent interobserver agreement (intraclass correlation coefficient, 0.94), whereas 3D-T2W-MRC showed good interobserver agreement (intraclass correlation coefficient, 0.78).Isotropic high-resolution T1W-MRCs with ID provided significantly improved BD image quality and more accurate depiction of the BD anatomy and BD openings at right donor hemihepatetomy than 3D-T2W-MRC.
- Published
- 2018
38. Prognostic value of MRI in assessing extramural venous invasion in rectal cancer: multi-readers' diagnostic performance
- Author
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Hye Eun Park, Bo Yun Hur, Won Chang, Joon Koo Han, Jung Ho Kim, Jae Seok Bae, Se Hyung Kim, Mi Hye Yu, Hyo Jin Kang, and Juil Park
- Subjects
Adult ,Male ,medicine.medical_specialty ,Colorectal cancer ,Intraclass correlation ,Kaplan-Meier Estimate ,Adenocarcinoma ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Invasiveness ,Survival analysis ,Neuroradiology ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,Observer Variation ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Rectal Neoplasms ,Interventional radiology ,Magnetic resonance imaging ,General Medicine ,Chemoradiotherapy, Adjuvant ,Middle Aged ,medicine.disease ,Prognosis ,Magnetic Resonance Imaging ,ROC Curve ,030220 oncology & carcinogenesis ,Area Under Curve ,Blood Vessels ,Female ,Radiology ,Clinical Competence ,business ,Chemoradiotherapy - Abstract
This study was conducted in order to determine the prognostic value of MRI for extramural venous invasion (EMVI) in rectal cancer compared to pathology and to assess the diagnostic performance of multireaders. We retrospectively enrolled 222 patients (M:F = 148:74; mean age ± standard deviation, 61.5 ± 12 years) with histopathologically proven rectal cancers who underwent preoperative MRI between 2007 and 2016. Among them, 74 patients had positive EMVI on pathology (pEMVI) and 148 patients had negative pEMVI. Three radiologists with 7 (reviewer 1), 3 (reviewer 2), and 1 (reviewer 3) year of experience in rectal MR imaging determined the presence of EMVI on MRI (mrEMVI) using a 5-point grading system. Using histopathologic results as the reference standard, radiologists’ performances were analyzed and compared with receiver operating characteristic (ROC) analysis. For assessment of interobserver variation, intraclass correlation coefficients (ICC) were used. Lastly, Kaplan–Meier estimation and Cox proportional hazard models were used for survival analysis. The area under the ROC curve (AUC) was highest in reviewer 1 (0.829), followed by reviewer 2 (0.798) and reviewer 3 (0.658). Differences in AUCs between reviewer 1 or 2 and reviewer 3 were statistically significant (p
- Published
- 2018
39. Coronary artery calcium score in predicting periprocedural myocardial infarction in patients undergoing an elective percutaneous coronary intervention
- Author
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Jin-Sin Koh, Hyun Woong Park, Jeong Yoon Jang, Hyun Gyung Jang, Jae Seok Bae, Seok-Jae Hwang, Yongwhi Park, Choong Hwan Kwak, Jeong Rang Park, Young-Hoon Jeong, Jin-Yong Hwang, Jong-Hwa Ahn, Yoomee Kang, Min Gyu Kang, and Kyehwan Kim
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Computed Tomography Angiography ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Risk Assessment ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Interquartile range ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Republic of Korea ,medicine ,Prevalence ,Humans ,Cumulative incidence ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Vascular Calcification ,Aged ,Retrospective Studies ,business.industry ,Incidence ,Troponin I ,Percutaneous coronary intervention ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Up-Regulation ,Treatment Outcome ,Conventional PCI ,Cardiology ,Female ,Myocardial infarction diagnosis ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
BACKGROUND This study aimed to evaluate whether the coronary artery calcium score (CACS) measured with computed tomography coronary angiography (CTCA) predicts periprocedural myocardial infarction (PMI) in patients undergoing an elective percutaneous coronary intervention (PCI). PATIENTS AND METHODS A total of 197 patients with stable angina underwent elective PCI after CTCA. We evaluated CACS using CTCA and assessed the clinical risk factors for PMI. PMI was defined as an elevation of troponin I levels exceeding five times the upper limit of normal within 24 h after PCI. Patients were followed up for major adverse cardiovascular events for a median of 4.6 years. RESULTS The prevalence of PMI was 18.7% (37 patients) and patients with PMI showed a trend toward a higher CACS (721±779 vs. 498±842, P=0.142). The prevalence of PMI showed a positive correlation with the CACS distribution [8.0%, first interquartile range (IQR); 14.3%, second IQR; 22.4%, third IQR; 30.6%, fourth IQR; P=0.002]. The CACS cut-off value for PMI was greater than 113 (area under the curve: 0.670; 95% confidence interval: 0.600-0.736; P
- Published
- 2018
40. Generalizability of EXCEL and NOBLE results to a large registry population with unprotected left main coronary artery disease
- Author
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Seung-Jung Park, Jae Seok Bae, Seungbong Han, Seung-Whan Lee, Seong-Wook Park, Jung-Min Ahn, Cheol Hyun Lee, Young-Hak Kim, Soo-Jin Kang, Duk-Woo Park, Cheol Whan Lee, Pil Hyung Lee, and Se Hun Kang
- Subjects
Male ,medicine.medical_specialty ,Asia ,Time Factors ,Databases, Factual ,medicine.medical_treatment ,Population ,MEDLINE ,Myocardial Infarction ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Revascularization ,Coronary Angiography ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Risk Factors ,medicine ,Humans ,Generalizability theory ,030212 general & internal medicine ,Registries ,Left main coronary artery disease ,Coronary Artery Bypass ,Intensive care medicine ,education ,Propensity Score ,Aged ,Proportional Hazards Models ,Randomized Controlled Trials as Topic ,education.field_of_study ,Proportional hazards model ,business.industry ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,Stroke ,Logistic Models ,Treatment Outcome ,Emergency medicine ,Propensity score matching ,Observational study ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry.We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481). The primary outcome for between-study comparison was a composite of death, myocardial infarction (MI), or stroke.There were between-study differences in patient risk profiles (age, BMI, diabetes, and clinical presentation), lesion complexities, and procedural characteristics (stent type, the use of off-pump surgery, and radial artery); the proportion of diabetes and acute coronary syndrome was particularly lower in NOBLE than in other studies. Although there was interstudy heterogeneity for the protocol definition of MI, the risks for serious composite outcome of death, MI, or stroke were similar between PCI and CABG in EXCEL [hazard ratio (HR): 1.00; 95% confidence interval (CI): 0.79-1.26; P=0.98] and in the matched cohort of IRIS-MAIN (HR: 1.08; 95%CI: 0.85-1.38; P=0.53), whereas it was significantly higher after PCI than after CABG in NOBLE (HR: 1.47; 95%CI: 1.06-2.05; P=0.02), which was driven by more common MI and stroke after PCI.In the comparison of a large-sized, all-comer registry, the EXCEL trial might represent better generalizability with respect to baseline characteristics and observed clinical outcomes compared with the NOBLE trial.
- Published
- 2017
41. Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians?
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Paul A. Gurbel, Jae Seok Bae, Jong-Hwa Ahn, Young-Hoon Jeong, and Udaya S. Tantry
- Subjects
medicine.medical_specialty ,Gastrointestinal bleeding ,medicine.medical_treatment ,Population ,Clinical Decision-Making ,Hemorrhage ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Lower risk ,White People ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Asian People ,Fibrinolytic Agents ,Risk Factors ,Internal medicine ,Antithrombotic ,medicine ,Humans ,030212 general & internal medicine ,education ,Stroke ,Pharmacology ,education.field_of_study ,business.industry ,Patient Selection ,Percutaneous coronary intervention ,Anticoagulants ,medicine.disease ,Clopidogrel ,Treatment Outcome ,Drug Therapy, Combination ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, Coronary Artery Disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials including mostly Caucasians. Despite a low response to clopidogrel, East Asian patients with CAD show a similar or even a lower rate of ischemic event occurrence and higher bleeding risk compared with Caucasian patients. The latter is referred to as the "East Asian Paradox", suggesting a dissimilar therapeutic window for antiplatelet therapy than Caucasians. In addition, different net clinical benefits have been observed between the races with potent P2Y12 inhibitors that may be related to racial differences in pharmacokinetic and pharmacodynamic profiles. Furthermore, there is emerging concern regarding differences between East Asian vs. Western patients in pharmacodynamic and clinical efficacies of anticoagulant agents. We now summarize experimental and clinical evidence of the efficacy and safety of antithrombotic agents in the East Asian population. We suggest the concept of "race-tailored antithrombotic treatment" in CAD patients and/or in patients undergoing percutaneous coronary intervention.
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- 2017
42. Full Metal Jacket With Drug-Eluting Stents for Coronary Chronic Total Occlusion
- Author
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Seong-Wook Park, Duk-Woo Park, Jae-Seok Bae, Seung-Whan Lee, Jung-Min Ahn, Sung-Cheol Yun, Seung-Jung Park, Pil Hyung Lee, Young-Hak Kim, Cheol Whan Lee, and Soo-Jin Kang
- Subjects
Target lesion ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Coronary Angiography ,Prosthesis Design ,Coronary Restenosis ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Risk Factors ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Registries ,Adverse effect ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Coronary Thrombosis ,Hazard ratio ,Stent ,Drug-Eluting Stents ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Treatment Outcome ,Coronary Occlusion ,Metals ,Conventional PCI ,Chronic Disease ,Multivariate Analysis ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives The aim of this study was to evaluate the long-term outcomes and predictors of adverse events following successful “full metal jacket” (FMJ) (stent length ≥60 mm without gap) procedures using drug-eluting stents to treat coronary chronic total occlusions (CTOs). Background The FMJ stenting procedure is often required to treat CTOs, but its clinical efficacy and safety remain unknown. Methods In total, 1,126 successful CTO procedures (1,107 consecutive patients) performed between May 2003 and March 2015 were studied. The primary endpoint was target lesion failure, a composite of cardiac death, target vessel–related myocardial infarction, or target lesion revascularization or reocclusion. Results Overall, 406 patients (36.7%) underwent the FMJ procedure, increasing in frequency over time (28.5% from 2003 to 2006 and 41.7% after 2011). The mean stent length was 76.8 ± 14.6 mm (range 60 to 122 mm), and the average number of stent overlaps was 2.5 ± 0.6 (range 2 to 4). A total of 127 patients (31.3%) had persistent luminal narrowing at the distal reference segment after stenting. During the median follow-up period of 5.1 years, target lesion failure occurred in 16.0% of patients. There were 17 cases of total reocclusion and 5 cases of stent thrombosis. Multivariate analysis confirmed that the number of implanted stents (hazard ratio: 1.72; 95% confidence interval: 1.16 to 2.54; p = 0.006) and persistent distal luminal narrowing (hazard ratio: 2.73; 95% confidence interval: 1.66 to 4.47; p Conclusions The FMJ procedure using drug-eluting stents for CTOs provides acceptable long-term clinical results. Persistent distal luminal narrowing increases the future likelihood of adverse events despite procedural success.
- Published
- 2017
43. Diagnostic accuracy of gadoxetic acid-enhanced MR for small hypervascular hepatocellular carcinoma and the concordance rate of Liver Imaging Reporting and Data System (LI-RADS)
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Jin Wook Chung, Joon Koo Han, Hyo Cheol Kim, Mi Hye Yu, Jung Hoon Kim, Dong Ho Lee, and Jae Seok Bae
- Subjects
Gadolinium DTPA ,Male ,lcsh:Medicine ,Diagnostic accuracy ,Pathology and Laboratory Medicine ,030218 nuclear medicine & medical imaging ,Diagnostic Radiology ,0302 clinical medicine ,Medicine and Health Sciences ,lcsh:Science ,Tomography ,Liver imaging ,Aged, 80 and over ,Brain Mapping ,Multidisciplinary ,medicine.diagnostic_test ,Radiology and Imaging ,Liver Diseases ,Liver Neoplasms ,Arteries ,Middle Aged ,Magnetic Resonance Imaging ,Mesenteric Arteries ,Professions ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,Radiology ,Anatomy ,medicine.drug ,Research Article ,Adult ,medicine.medical_specialty ,Gadoxetic acid ,Carcinoma, Hepatocellular ,Imaging Techniques ,Concordance ,Brain Morphometry ,Neuroimaging ,Gastroenterology and Hepatology ,Research and Analysis Methods ,Sensitivity and Specificity ,Carcinomas ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Gastrointestinal Tumors ,Radiologists ,medicine ,Carcinoma ,Humans ,Aged ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Diffusion Weighted Imaging ,lcsh:R ,Cancers and Neoplasms ,Biology and Life Sciences ,Magnetic resonance imaging ,Hepatocellular Carcinoma ,medicine.disease ,Computed Axial Tomography ,People and Places ,Gastrointestinal Imaging ,Lesions ,Cardiovascular Anatomy ,Blood Vessels ,lcsh:Q ,Population Groupings ,business ,Nuclear medicine ,Liver and Spleen Scan ,Neuroscience - Abstract
Background & aims To assess diagnostic accuracy of gadoxetic acid–enhanced MR for small hypervascular hepatocellular carcinoma (HCC) detected by C-arm CT and concordance rate of Liver Imaging Reporting and Data System (LI-RADS). Methods In this retrospective study, we recruited 4,544 patients suspected of having HCC underwent C-arm CT from November 2008 to May 2013. Among these patients, gadoxetic acid–enhanced MR was performed in 167 patients with HCC (n = 379; 257 > 1 cm, 122 ≤ 1 cm). HCC was confirmed by MR, CT, or follow-up images. Two radiologists graded likelihood of HCC and assessed MR features. Jackknife alternative free-response receiver operating characteristic (JAFROC) analysis was performed. All HCCs were evaluated concordance rate of LI-RADS. Results Mean JAFROC figure of merit for large (>1-cm) HCC was 0.948, while that for small HCC was 0.787 with fair agreement (κ = 0.409). Mean sensitivity and positive predictive value (PPV) were 91% and 90% for large HCC versus 63.0% and 79% for small HCC, respectively. Seventeen of 122 small HCCs (13.9%) were not visible on MR. Among 379 HCCs, 99 met LR-5, and 259 met LR-4. Common features for small HCC included arterial enhancement (81.9%), hepatobiliary phase hypointensity (80.3%), and delayed washout (72.9%). Conclusion Diagnostic accuracy of gadoxetic acid–enhanced MR imaging for small, hypervascular HCCs (Mean figure of merit = 0.787) was still low compared with large HCC (Mean figure of merit = 0.948). LR-5 and LR-4 covered 94% (358/379) of the HCCs.
- Published
- 2017
44. Measurement Variability of Persistent Pulmonary Subsolid Nodules on Same-Day Repeat CT: What Is the Threshold to Determine True Nodule Growth during Follow-Up?
- Author
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Ye Ra Choi, Jung Im Kim, Yong Sub Song, Jae Seok Bae, Hyungjin Kim, Leonard Sunwoo, Jin Mo Goo, Jong Hyuk Lee, Chang Min Park, and Jae Hyun Kim
- Subjects
Male ,Lung Neoplasms ,lcsh:Medicine ,Computed tomography ,Lung pathology ,Lung and Intrathoracic Tumors ,030218 nuclear medicine & medical imaging ,Diagnostic Radiology ,0302 clinical medicine ,Adenocarcinomas ,Medicine and Health Sciences ,lcsh:Science ,Tomography ,Lung ,Observer Variation ,Multiple Pulmonary Nodules ,Multidisciplinary ,medicine.diagnostic_test ,Adenocarcinoma of the Lung ,Radiology and Imaging ,Middle Aged ,Professions ,Oncology ,030220 oncology & carcinogenesis ,Female ,Radiology ,medicine.symptom ,Anatomy ,Observer variation ,Research Article ,medicine.medical_specialty ,Histology ,Imaging Techniques ,Neuroimaging ,Surgical and Invasive Medical Procedures ,Image Analysis ,Research and Analysis Methods ,Carcinomas ,03 medical and health sciences ,Diagnostic Medicine ,Radiologists ,medicine ,Cancer Detection and Diagnosis ,Humans ,Measurement variability ,business.industry ,lcsh:R ,Biology and Life Sciences ,Cancers and Neoplasms ,Nodule (medicine) ,Computed Axial Tomography ,Tomography x ray computed ,People and Places ,lcsh:Q ,Population Groupings ,business ,Tomography, X-Ray Computed ,Neuroscience - Abstract
PURPOSE:To assess the measurement variability of subsolid nodules (SSNs) in follow-up situations and to compare the degree of variability between measurement metrics. METHODS:Two same-day repeat-CT scans of 69 patients (24 men and 45 women) with 69 SSNs were randomly assigned as initial or follow-up scans and were read by the same (situation 1) or different readers (situation 2). SSN size and solid portion size were measured in both situations. Measurement variability was calculated and coefficients of variation were used for comparisons. RESULTS:Measurement variability for the longest and average diameter of SSNs was ±1.3 mm (±13.0%) and ±1.3 mm (±14.4%) in situation 1, and ±2.2 mm (±21.0%) and ±2.1 mm (±21.3%) in situation 2, respectively. For solid portion, measurement variability on lung and mediastinal windows was ±1.2 mm (±27.1%) and ±0.8 mm (±24.0%) in situation 1, and ±3.7 mm (±61.0%) and ±1.5 mm (±47.3%) in situation 2, respectively. There were no significant differences in the degree of variability between the longest and average diameters and between the lung and mediastinal window settings (p>0.05). However, measurement variability significantly increased when the follow-up and initial CT readers were different (p
- Published
- 2016
45. Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ
- Author
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Woo Kyung Moon, Jae Seok Bae, Jung Min Chang, Su Hyun Lee, and Sung Ui Shin
- Subjects
Image-Guided Biopsy ,medicine.medical_specialty ,Breast Neoplasms ,Logistic regression ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Predictive Value of Tests ,Biopsy ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Carcinoma, Ductal, Breast ,General Medicine ,Ductal carcinoma ,Middle Aged ,medicine.disease ,Carcinoma, Intraductal, Noninfiltrating ,030220 oncology & carcinogenesis ,Predictive value of tests ,Elasticity Imaging Techniques ,Female ,Radiology ,Elastography ,Ultrasonography, Mammary ,business - Abstract
To investigate whether mass stiffness measured by shear-wave elastography (SWE) can predict the histological upgrade of ductal carcinoma in situ (DCIS) confirmed through ultrasound (US)-guided core needle biopsy (CNB). The institutional review board approved this study and informed consent was waived. A database search revealed 120 biopsy-confirmed DCIS in patients who underwent B-mode US and SWE prior to surgery. Clinicopathologic results, B-mode findings, size on US, and mean and maximum elasticity values on SWE were recorded. Associations between upgrade to invasive cancer and B-mode US findings, SWE information, and clinical variables were assessed using univariate, multivariate logistic regression, and multiple linear regression analysis. The overall upgrade rate was 41.7 % (50/120). Mean stiffness value (P = .014) and mass size (P = .001) were significantly correlated with histological upgrade. The optimal cut-off value of mean stiffness value, yielding the maximal sum of sensitivity and specificity, was 70.7 kPa showing sensitivity of 72 % and specificity of 65.7 % for detecting invasiveness. Qualitative elasticity colour scores were significantly correlated with the histological upgrade, mammographic density, and B-mode category (P
- Published
- 2015
46. Cone-Beam CT Virtual Navigation-Guided Percutaneous Needle Biopsy of Suspicious Pleural Metastasis: A Pilot Study
- Author
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Soon Ho Yoon, Chang Min Park, Jin Mo Goo, Hyun Ju Lim, and Jae Seok Bae
- Subjects
Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Cone beam computed tomography ,Pleural Neoplasms ,Biopsy ,Pilot Projects ,Malignancy ,Sensitivity and Specificity ,Metastasis ,030218 nuclear medicine & medical imaging ,Thoracic Imaging ,03 medical and health sciences ,Pleural disease ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Cone-beam computed tomography ,Middle Aged ,Pleural Diseases ,Virtual navigation guidance ,medicine.disease ,Pneumothorax ,Dose area product ,030220 oncology & carcinogenesis ,Pleura ,Female ,Original Article ,Radiology ,Complication ,business - Abstract
Objective To evaluate the diagnostic performance of cone-beam computed tomography (CBCT) virtual navigation-guided percutaneous pleural biopsy for suspected malignant pleural disease. Materials and methods This study enrolled 59 patients (31 males and 28 females; mean age, 63.4 years) with suspected malignant pleural disease diagnosed with CBCT from December 2010 to December 2016. Sixty-three CBCT-guided biopsies were performed using a coaxial system with 18- or 20-gauge cutting needles. Procedural details, diagnostic performance, radiation exposure, and complication rates were investigated. Results The mean diameter perpendicular to the pleura of 51 focal and 12 diffuse pleural lesions was 1.53 ± 0.76 cm. The mean distance from the skin to the target was 3.40 ± 1.51 cm. Mean numbers of CT acquisitions and biopsies were 3.21 ± 0.57 and 3.05 ± 1.54. Total procedure time and coaxial introducer indwelling time were 11.87 ± 5.59 min and 8.78 ± 4.95 min, respectively. The mean dose area product was 12013.61 ± 7969.59 mGym2. There were 48 malignant, 10 benign, and 5 indeterminate lesions. Sensitivity, specificity, and diagnostic accuracy were 93.8% (45/48), 100% (10/10), and 94.8% (55/58), respectively. Positive and negative predictive values for malignancy were 100% (45/45) and 76.9% (10/13), respectively. Four patients (6.8%) with benign pathology during initial biopsy but still showing a high suspicion of malignancy underwent repeat biopsy and three of them were finally diagnosed with malignant pleural disease. There were three cases of minimal pneumothorax and no grave procedure-related complications. Conclusion Cone-beam computed tomography-guided biopsy is an accurate and safe diagnostic technique for suspected malignant pleural lesion with reasonable radiation exposure and procedure time.
- Published
- 2018
47. Efficacy of Gastric Balloon Dilatation and/or Retrievable Stent Insertion for Pyloric Spasms after Pylorus-Preserving Gastrectomy: Retrospective Analysis
- Author
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Byung Ihn Choi, Cheong Il Shin, Se Hyung Kim, Joon Koo Han, Ijin Joo, Tae Han Kim, Jee Hyun Baek, Han-Kwang Yang, Hyuk-Joon Lee, Jeong Hee Yoon, and Jae Seok Bae
- Subjects
Adult ,Male ,Spasm ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Medicine ,Balloon ,Postoperative Complications ,Gastrectomy ,medicine ,Humans ,lcsh:Science ,Pylorus ,Aged ,Gastric Balloon ,Retrospective Studies ,Aged, 80 and over ,Chi-Square Distribution ,Multidisciplinary ,Gastric emptying ,business.industry ,Stomach ,lcsh:R ,Stent ,Middle Aged ,Dilatation ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Balloon dilations ,Balloon dilation ,Feasibility Studies ,Female ,Stents ,lcsh:Q ,Radiology ,business ,Research Article - Abstract
Purpose We retrospectively investigated the feasibility and clinical efficacy of balloon dilatation and subsequent retrievable stent insertion, when necessitated, for pyloric spasms after pylorus-preserving gastrectomy (PPG). Materials and Methods Forty-five patients experiencing pyloric spasms after PPG underwent fluoroscopic balloon dilations to alleviate obstructive symptoms due to delayed gastric emptying. Patients showing poor response to balloon dilation underwent subsequent retrievable stent insertion. Safety of the procedures was analyzed, and subjective symptoms and objective signs of pyloric spasms were analyzed and compared before and after treatment. Results Thirty-three patients (73.3%, 33/45) showed good response to balloon dilatation requiring no further treatment (balloon group). Conversely, 12 patients (26.7%, 12/45) showed poor or no response after balloon dilation requiring subsequent stent insertion (stent group). Balloon dilations and/or stent insertions were safely performed in all patients except one patient who suffered a transmural tear after balloon dilatation. In both groups, mean subjective symptom score was significantly improved and mean pyloric canal-to-height of the adjacent vertebral body ratio was significantly increased after the procedures (P
- Published
- 2015
48. Value of Computerized 3D Shape Analysis in Differentiating Encapsulated from Invasive Thymomas
- Author
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Jong Hyuk Lee, Chang Min Park, Sang Min Lee, Jae Seok Bae, Jin Mo Goo, and Sang Joon Park
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Thymoma ,Chest ct ,lcsh:Medicine ,Logistic regression ,Sphericity ,hemic and lymphatic diseases ,medicine ,Humans ,Binary logistic regression analysis ,lcsh:Science ,Retrospective Studies ,Multidisciplinary ,business.industry ,lcsh:R ,Mean age ,Odds ratio ,Middle Aged ,medicine.disease ,lcsh:Q ,Female ,Tomography, X-Ray Computed ,Nuclear medicine ,business ,Research Article ,Shape analysis (digital geometry) - Abstract
Objectives To retrospectively investigate the added value of quantitative 3D shape analysis in differentiating encapsulated from invasive thymomas. Materials and Methods From February 2002 to October 2013, 53 patients (25 men and 28 women; mean age, 53.94 ± 13.13 years) with 53 pathologically-confirmed thymomas underwent preoperative chest CT scans (slice thicknesses ≤ 2.5 mm). Twenty-three tumors were encapsulated thymomas and 30 were invasive thymomas. Their clinical and CT characteristics were evaluated. In addition, each thymoma was manually-segmented from surrounding structures, and their 3D shape features were assessed using an in-house developed software program. To evaluate the added value of 3D shape features in differentiating encapsulated from invasive thymomas, logistic regression analysis and receiver-operating characteristics curve (ROC) analysis were performed. Results Significant differences were observed between encapsulated and invasive thymomas, in terms of cystic changes (p=0.004), sphericity (p=0.016), and discrete compactness (p=0.001). Subsequent binary logistic regression analysis revealed that absence of cystic change (adjusted odds ratio (OR) = 6.636; p=0.015) and higher discrete compactness (OR = 77.775; p=0.012) were significant differentiators of encapsulated from invasive thymomas. ROC analyses revealed that the addition of 3D shape analysis to clinical and CT features (AUC, 0.955; 95% CI, 0.935–0.975) provided significantly higher performance in differentiating encapsulated from invasive thymomas than clinical and CT features (AUC, 0.666; 95% CI, 0.626–0.707) (p
- Published
- 2015
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