• Korean Journal of Radiology
• /
• v.22 no.7
• /
• pp.1185-1193
• /
• 2021

Objective: Clear cell sarcoma of the kidney (CCSK) is the second-most common but extremely rare primary renal malignancy in children after Wilms' tumor. The aims of this study were to evaluate the imaging features that could distinguish between CCSK and Wilms' tumor and to assess the features with diagnostic value for identifying CCSK. Materials and Methods: We reviewed the initial contrast-enhanced abdominal-pelvic CT scans of children with CCSK and Wilms' tumor between 2010 to 2019. Fifty-eight children (32 males and 26 females; age, 0.3-10 years), 7 with CCSK, and 51 with Wilms' tumor, were included. The maximum tumor diameter, presence of engorged perinephric vessels, maximum density of the tumor (Tmax) of the enhancing solid portion, paraspinal muscle, contralateral renal vein density, and density ratios (Tmax/muscle and Tmax/vein) were analyzed on the renal parenchymal phase of contrast-enhanced CT. Fisher's exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables, respectively. Logistic regression and receiver operating characteristic curve analyses were also performed. Results: The age, sex, and tumor diameter did not differ between the two groups. Engorged perinephric vessels were more common in patients in the CCSK group (71% [5/7] vs. 16% [8/51], p = 0.005). Tmax (median, 148.0 vs. 111.0 Hounsfield unit, p = 0.004), Tmax/muscle (median, 2.64 vs. 1.67, p = 0.002), and Tmax/vein (median, 0.94 vs. 0.59, p = 0.002) were higher in the CCSK compared to the Wilms' group. Multiple logistic regression revealed that engorged vessels (odds ratio 13.615; 95% confidence interval [CI], 1.770-104.730) and Tmax/muscle (odds ratio 5.881; 95% CI, 1.337-25.871) were significant predictors of CCSK. The cutoff values of Tmax/muscle (86% sensitivity, 77% specificity) and Tmax/vein (71% sensitivity, 86% specificity) for the diagnosis of CCSK were 1.97 and 0.76, respectively. Conclusion: Perinephric vessel engorgement and greater tumor enhancement (Tmax/muscle > 1.97 or Tmax/vein > 0.76) are helpful for differentiating between CCSK and Wilms' tumor in children aged below 10 years.

• Korean Journal of Radiology
• /
• v.22 no.3
• /
• pp.344-353
• /
• 2021

Objective: The mitotic count of gastrointestinal stromal tumors (GIST) is closely associated with the risk of planting and metastasis. The purpose of this study was to develop a predictive model for the mitotic index of local primary GIST, based on deep learning algorithm. Materials and Methods: Abdominal contrast-enhanced CT images of 148 pathologically confirmed GIST cases were retrospectively collected for the development of a deep learning classification algorithm. The areas of GIST masses on the CT images were retrospectively labelled by an experienced radiologist. The postoperative pathological mitotic count was considered as the gold standard (high mitotic count, > 5/50 high-power fields [HPFs]; low mitotic count, ≤ 5/50 HPFs). A binary classification model was trained on the basis of the VGG16 convolutional neural network, using the CT images with the training set (n = 108), validation set (n = 20), and the test set (n = 20). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated at both, the image level and the patient level. The receiver operating characteristic curves were generated on the basis of the model prediction results and the area under curves (AUCs) were calculated. The risk categories of the tumors were predicted according to the Armed Forces Institute of Pathology criteria. Results: At the image level, the classification prediction results of the mitotic counts in the test cohort were as follows: sensitivity 85.7% (95% confidence interval [CI]: 0.834-0.877), specificity 67.5% (95% CI: 0.636-0.712), PPV 82.1% (95% CI: 0.797-0.843), NPV 73.0% (95% CI: 0.691-0.766), and AUC 0.771 (95% CI: 0.750-0.791). At the patient level, the classification prediction results in the test cohort were as follows: sensitivity 90.0% (95% CI: 0.541-0.995), specificity 70.0% (95% CI: 0.354-0.919), PPV 75.0% (95% CI: 0.428-0.933), NPV 87.5% (95% CI: 0.467-0.993), and AUC 0.800 (95% CI: 0.563-0.943). Conclusion: We developed and preliminarily verified the GIST mitotic count binary prediction model, based on the VGG convolutional neural network. The model displayed a good predictive performance.

• Journal of radiological science and technology
• /
• v.47 no.3
• /
• pp.205-211
• /
• 2024

Currently, with the development of technologies, X-ray examinations for medical examinations at hospital is increasing. This study was conducted to help reduce radiation exposure by measuring the exposure dose received by pediatric patients and the spatial dose of the X-ray room. Dosimeters were installed in the eyeball, thyroid gland, breast, gonads and 4 directions at a distance of 30 cm, 40 cm, 50 cm from the phantom. The dose was measured ten times each, before, and after the application of the bismuth shield under the examination conditions of the head, chest, and abdomen of pediatric patients. Under the condition of head examination, when a shielding was applied, the dose reduction rate was 68.58% for the eyeball, 72.88% for the thyroid, 84.2% for the breast, and 72.36% for the gonad. The chest examination showed reductions of 19.56% eyeball, 56.98% thyroid, 1.21% breast, and 0.68% gonad. The abdominal examination showed reduction rates of 2.6% eyeball, 10.67% thyroid, 19.85% breast, and 82.02% gonad. Spatial dose decreased by 62.25% at 30 cm, 61.16% at 40 cm, and 68.68% at 50 cm. When the bismuth shield was applied, there was a decrease in dose across all examinations, as well as a reduction in spatial dose. Continued research on the use of bismuth shields will help radiological technologists achieve their goal of dose reduction.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.37 no.1
• /
• pp.75-88
• /
• 2024

Objectives: This study aimed to identify the current use of Korean medicine for obesity and its effect for women in climacteric period. Methods: We studied women aged 45-55 who visited Daejeon Korean medicine Hospital of Daejeon University to lose body weight from January 1, 2021 to December 31, 2022 via an analysis of the medical records. The treatment duration was continuous for more than 2 weeks, and a body composition was measured by Inbody 770 at 2 to 4 weeks after the first visit. Results: 28 patients were finally selected and their average age was 49.32±3.38 years. Based on the body mass index (BMI) classification, 19 were in the 1st obesity group, 5 in the 2nd obesity group, 3 in the overweight group and 1 in the normal group. Patients usually complained comcomitant symptoms, and the symptoms of menopausal disorder was the most frequent. The average treatment duration was 3.68±0.67 weeks and the average treatment frequency was 3.93±0.98 times. All patients took herbal medicines Gambi-tang and 23 took modified fasting therapy including Gamro-su. 14 were treated by whole body far-infrared therapy and 6 were gotten partial obesity treatment. Among patients treated for accompanying symptoms, menopausal disorders were the most common (35.71%), and herbal medicine such as Gamisoyou-san, Hominis Placenta Pharmacopuncture, moxibustion, and cupping were used. After treatment, on average, body composition changed significantly; body weight 3.28±1.82 kg, BMI 1.36±1.04 kg/m², body fat 1.70±1.67 kg, skeletal muscle mass 0.81±0.91 kg, abdominal circumference 2.04±2.6 cm, and visceral fat area 8.91±12.83 cm². Conclusions: We analyzed general characteristics, BMI distribution, types of Korean medicine treatment and change of body composition. This study could be used as reference to provide practical data of treatment for obese women in climacteric period.

• Korean Journal of Radiology
• /
• v.25 no.2
• /
• pp.179-188
• /
• 2024

Objective: ¹⁷⁷Lutetium [Lu] Ludotadipep is a novel prostate-specific membrane antigen targeting therapeutic agent with an albumin motif added to increase uptake in the tumors. We assessed the biodistribution and dosimetry of [¹⁷⁷Lu]Ludotadipep in patients with metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: Data from 25 patients (median age, 73 years; range, 60-90) with mCRPC from a phase I study with activity escalation design of single administration of [¹⁷⁷Lu]Ludotadipep (1.85, 2.78, 3.70, 4.63, and 5.55 GBq) were assessed. Activity in the salivary glands, lungs, liver, kidneys, and spleen was estimated from whole-body scan and abdominal SPECT/CT images acquired at 2, 24, 48, 72, and 168 h after administration of [¹⁷⁷Lu]Ludotadipep. Red marrow activity was calculated from blood samples obtained at 3, 10, 30, 60, and 180 min, and at 24, 48, and 72 h after administration. Organand tumor-based absorbed dose calculations were performed using IDAC-Dose 2.1. Results: Absorbed dose coefficient (mean ± standard deviation) of normal organs was 1.17 ± 0.81 Gy/GBq for salivary glands, 0.05 ± 0.02 Gy/GBq for lungs, 0.14 ± 0.06 Gy/GBq for liver, 0.77 ± 0.28 Gy/GBq for kidneys, 0.12 ± 0.06 Gy/GBq for spleen, and 0.07 ± 0.02 Gy/GBq for red marrow. The absorbed dose coefficient of the tumors was 10.43 ± 7.77 Gy/GBq. Conclusion: [¹⁷⁷Lu]Ludotadipep is expected to be safe at the dose of 3.7 GBq times 6 cycles planned for a phase II clinical trial with kidneys and bone marrow being the critical organs, and shows a high tumor absorbed dose.

• Journal of the Korean Society of Radiology
• /
• v.81 no.5
• /
• pp.1260-1265
• /
• 2020

Kaposi's sarcoma (KS) is a multicentric human immunodeficiency virus-associated neoplasm characterized by multiple vascular nodules in the skin, mucous membranes, and viscera. Gastrointestinal acquired immunodeficiency syndrome (AIDS)-related KS is the most common visceral involvement reported in disseminated disease. Here, we present the findings of a rare case of KS involving multiple organs with abdominal pain and active bleeding in the colon. Multiple intraluminal lesions were found in the terminal ileum, sigmoid colon, and rectum by ileocolonoscopy, and in the jejunum and ileum by fluoroscopy. Abdominopelvic CT revealed multiple enhanced flat lesions in the ileum and enlarged lymph nodes. The diagnosis was confirmed by histopathology, and antiretroviral therapy was initiated as the treatment of choice for KS. Owing to the increasing number of AIDS patients, it is essential for radiologists and clinicians to be aware of the imaging characteristics of KS to protect physicians from indiscriminate exposure to AIDS.

• Journal of the Korean Society of Radiology
• /
• v.81 no.6
• /
• pp.1348-1363
• /
• 2020

The newly revised 2018 Organ Injury Scale (OIS) has a similar format to the previous American Association for Surgery and Trauma (AAST) Emergency General Surgery Grading System, dividing the criteria for grading solid organ damage into three groups; imaging, operation, and pathology. The most significant alteration in the OIS system 2018 revision is the incorporation of multidetector CT (MDCT) findings of vascular injury including pseudoaneurysm and arteriovenous fistula. Similar to the previous OIS, the highest of the three criteria is assigned the final grade. In addition, if multiple grade I or II injuries are present, one grade is advanced for multiple injuries up to grade III. This pictorial essay demonstrates the MDCT findings of solid organ injury grades based on the 2018 OIS system.

• Korean Journal of Radiology
• /
• v.23 no.2
• /
• pp.159-171
• /
• 2022

Objective: This study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients. Materials and Methods: This study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I-III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival. Results: Among 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm²/m² and 72.0 ± 46.0 cm², respectively. The mean value of the delta SMI was -0.9 cm²/m² and the delta VAT was 0.5 cm². The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937-1.031; p = 0.475 and adjusted HR, 1.001; 95% CI, 0.995-1.006; p = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766-1.043; p = 0.155 and adjusted HR, 1.001; 95% CI, 0.989-1.014; p = 0.848, respectively). Conclusion: Our study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.3
• /
• pp.258-263
• /
• 2023

Backgrounds/Aims: Hemangiomas are the most common benign liver lesions; however, they are usually asymptomatic and seldom require surgery. Enucleation and resection are the most commonly performed surgical procedures for symptomatic lesions. This study aims to compare the outcomes of these two surgical techniques. Methods: A retrospective analysis of symptomatic hepatic hemangiomas (HH) operated upon between 2000 and 2021. Patients were categorized into the enucleation and resection groups. Demographic profile, intraoperative bleeding, and morbidity (Clavien-Dindo Grade) were compared. Independent t-test and chi-square tests were used for continuous and categorical variables respectively. p-value of < 0.05 was considered significant. Results: Sixteen symptomatic HH patients aged 30 to 66 years underwent surgery (enucleation = 8, resection = 8) and majority were females (n = 10 [62.5%]). Fifteen patients presented with abdominal pain, and one patient had an interval increase in the size of the lesion from 9 to 12 cm. The size of hemangiomas varied from 6 to 23 cm. The median blood loss (enucleation: 350 vs. resection: 600 mL), operative time (enucleation: 5.8 vs. resection: 7.5 hours), and postoperative hospital stay (enucleation: 6.5 vs. resection: 11 days) were greater in the resection group (statistically insignificant). In the resection group, morbidity was significantly higher (62.6% vs. 12.5%, p = 0.05), including one mortality. All patients remained asymptomatic during the follow-up. Conclusions: Enucleation was simpler with less morbidity as compared to resection in our series. However, considering the small number of patients, further studies are needed with comparable groups to confirm the superiority of enucleation over resection.

• Animal Bioscience
• /
• v.37 no.2
• /
• pp.193-202
• /
• 2024

Objective: Oxidative stress (OS) is a pathological process arising from the excessive production of free radicals in the body. It has the potential to alter animal gene expression and cause damage to the jejunum. However, there have been few reports of changes in the expression of long noncoding RNAs (lncRNAs) in the jejunum in piglets under OS. The purpose of this research was to examine how lncRNAs in piglet jejunum change under OS. Methods: The abdominal cavities of piglets were injected with diquat (DQ) to produce OS. Raw reads were downloaded from the SRA database. RNA-seq was utilized to study the expression of lncRNAs in piglets under OS. Additionally, six randomly selected lncRNAs were verified using quantitative real-time polymerase chain reaction (qRT-PCR) to examine the mechanism of oxidative damage. Results: A total of 79 lncRNAs were differentially expressed (DE) in the treatment group compared to the negative control group. The target genes of DE lncRNAs were enriched in gene ontology (GO) terms and Kyoto encyclopedia of genes and genomes (KEGG) signaling pathways. Chemical carcinogenesis-reactive oxygen species, the Foxo signaling pathway, colorectal cancer, and the AMPK signaling pathway were all linked to OS. Conclusion: Our results demonstrated that DQ-induced OS causes differential expression of lncRNAs, laying the groundwork for future research into the processes involved in the jejunum's response to OS.