• Korean Journal of Radiology
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• 제23권12호
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• pp.1126-1240
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• 2022

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

• Imaging Science in Dentistry
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• 제50권3호
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• pp.269-272
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• 2020

• Korean Journal of Radiology
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• 제23권9호
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• pp.847-852
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• 2022

• Korean Journal of Radiology
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• 제24권9호
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• pp.890-902
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• 2023

Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

• 대한방사선기술학회지:방사선기술과학
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• 제45권2호
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• pp.159-164
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• 2022

The study developed a radiation dose measurement program in the radiology laboratory to measure how much exposure the students are exposed to during the radiology class, to request for the improvement and the revision of the current Nuclear Safety Act. The experimental program is shown in the following figure, and experiments were conducted to determine the degree of radiation exposure in the control room with a lead gown at a distance of 1 m, 2 m, and 1 m, and in a control room with a radiographic lead glass wall. The duration of the experiment was 3 months from April to June, when radiation imaging practice classes were conducted, and 128 hours of imaging practice per month were conducted. In order to find out the dose of radiation dose during radiology imaging practice class, the experiment was carried out from April to June for 3 months, and according to the program, the results of exposure dose were 0.34 mSv at 1 m distance, 0.01 mSv at shielding of lead gown at 1 m distance, 0.16 mSv at 2 m distance, and 0.01 mSv at control room with radiation lead glass wall. The exposure dose from the test results was much below the annual general public limit dose of 1 mSv. The restriction on the operation of the radiation equipment in the practice of the students is a regulation that infringes the right of students to learn, and amendments or exemptions of Nuclear Safety Act should be enacted to ensure that it does not violate the fundamental right to learn for students in radiology.

• 대한영상의학회지
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• 제82권4호
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• pp.817-825
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• 2021

과민성폐렴(hypersensitivity pneumonitis)은 기도를 통해 흡입된 항원물질이 세기관지와 폐포에 면역매개 염증병변을 일으켜 발생하는 간질성폐질환(interstitial lung disease)이다. 다양한 유기물질이 발생원인으로 작용할 수 있기에 환자의 흉부영상검사와 임상증상을 통해 과민성폐렴을 의심하고 직업 또는 주변 환경을 통해 노출되는 항원을 파악하는 것이 과민성폐렴 진단의 핵심이다. 하지만 다양한 임상증상과 진행 형태로 인해 간질성폐질환 환자의 진단에서 과민성폐렴을 정확히 감별할 수 있느냐는 풀기 쉽지 않은 주제이다. 이에 2020년 미국흉부학회, 일본호흡기학회 그리고 라틴아메리카흉부학회는 과민성폐렴 진단에 대한 새로운 임상진료지침을 발표하였다. 이번 임상진료지침은 과민성폐렴 진단에 있어서 흉부 고해상도 전산화단층촬영(high-resolution CT; 이하 HRCT)의 역할을 강조하며 과민성폐렴에 대한 새로운 분류 기준도 제시하고 있다. 본 종설은 흉부 HRCT 내용을 포함해 새롭게 소개된 과민성폐렴 진단에 대한 전반을 살펴보고자 한다.

• 한국방사선학회논문지
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• 제16권7호
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• pp.985-993
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• 2022

본 연구는 COVID-19 전·후 다양한 규모의 기관에서 임상 실습을 진행한 학생을 대상으로 임상 실습에 대한 기대도 및 만족도 등을 비교 평가하고 이를 통해 앞으로의 임상 실습 지도방법 및 운영 방향성에 대한 제언을 목적으로 시행하였다. 실습에 대한 만족도의 평가는 COVID-19 전·후에서 유의한 차이가 나타났는데 특히 실습 지도, 실습환경, 실습시간에 대한 만족도 평가에서 COVID-19 이후의 만족도가 낮아짐을 확인할 수 있다. 실습만족도와 관련된 결정적인 영향 인자를 분석한 결과 대학병원에서 실습을 시행한 학생들은 기관의 환경적인 요인을 높게 평가하였고, 중소병원에서 실습을 시행한 학생들은 참여 중심의 실습에서 만족감을 높게 나타내었다. 따라서 대학병원에만 의존하는 임상 실습보다는 대학병원과 중소병원의 장단점을 활용하는 실습이 효과성이 높을 것으로 생각된다. 그러나 중소병원으로 실습 기관을 다각화하기 위해서는 실습목표와 교육과정에 맞는 표준화된 실습 과정 및 실습 지도 방법, 평가방법에 관한 매뉴얼을 만들어 기관에 제공하고 교육하는 것이 선행되어야 할 것이다. 그리고 기관과의 충분한 의견교환과 협의를 통해 운영된다면 학교에서는 실무형 인재양성의 기회를 얻고 인력확충에 있어 어려움이 있는 중소병원도 훌륭한 인적자원을 우선적으로 확보할 수 있을 것으로 사료된다.

• Korean Journal of Radiology
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• 제24권3호
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• pp.204-223
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• 2023

Currently, various types of transarterial treatments are performed for hepatocellular carcinoma from the early to advanced stages. Its indications and efficacy have been widely investigated. However, procedure-related complications have not been updated in the literature, although new types of transarterial treatments, such as drug-eluting bead transarterial chemoembolization and transarterial radioembolization, are common in daily practice. Herein, a comprehensive literature review was carried out, and complications were organized according to the organs affected and treatment modalities.

• Korean Journal of Radiology
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• 제20권6호
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• pp.863-879
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• 2019

Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.181-186
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• 2022

Purpose: This study aimed to investigate inter-observer reliability among observers with different levels of proficiency and the diagnostic imaging reliability of cone-beam computed tomography (CBCT) images of the retromolar canal. Materials and Methods: CBCT images of 307 patients were assessed for the presence of retromolar canals(RMCs) by 3 observers independently. Diagnoses were made twice by each observer at intervals of more than 3 weeks. Interobserver reliability was assessed using the kappa coefficient. One observer had no experience in diagnosis using CBCT images. Therefore, a specialist in diagnostic imaging explained the CBCT images for interpretation and practiced diagnostic imaging together with this observer, while the other observer interpreted the images independently. Thereafter, the observers re-evaluated the images. Results: The interobserver kappa coefficients (including bilateral RMCs) calculated at the first reading were low, ranging from 0.21 to 0.61. Their values ranged from 0.95 (right side) to 1.00 (left side) after one-on-one practice with a diagnostic imaging specialist, while the values ranged from 0.65 (right side) to 0.66 (left side) without one-on-one practice. Conclusion: Diagnostic accuracy was improved through diagnostic imaging practice. To improve the anatomical interpretation of images, it is important to practice diagnostic imaging with a specialist in diagnostic imaging. One-on-one instruction about diagnostic imaging was an effective method of training.