43 results on '"Kim, Seung-Seob"'
Search Results
2. Association between sclerostin levels and vascular outcomes in kidney transplantation patients
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Koh, Hee Byung, Ryu, Jung Hwa, Kim, Seung-seob, Kim, Myung-Gyu, Park, Jae Berm, Kim, Chan Duk, Kang, Kyung Pyo, Ro, Han, Han, Seung-Yeup, Huh, Kyu Ha, and Yang, Jaeseok
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- 2023
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3. ASO Visual Abstract: Preoperative Fistula Risk Prediction Using Computed Tomography Image Before Pancreatoduodenectomy
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Kim, Sung Hyun, Kim, Seung-seob, Hwang, Ho Kyoung, Kang, Chang Moo, Choi, Jin-Young, Kim, Kyung Sik, and Kim, Hyoung-Il
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- 2023
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4. ASO Author Reflections: Hounsfield Unit on Preoperative Computed Tomography as a Predictive Factor of Postoperative Pancreatic Fistula
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Kim, Sung Hyun, Kim, Seung-seob, Hwang, Ho Kyoung, Kang, Chang Moo, Choi, Jin-Young, Kim, Kyung Sik, and Kim, Hyoung-Il
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- 2023
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5. Optimal imaging criteria and modality to determine Milan criteria for the prediction of post-transplant HCC recurrence after locoregional treatment
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Seo, Nieun, Joo, Dong Jin, Park, Mi-Suk, Kim, Seung-seob, Shin, Hye Jung, Chung, Yong Eun, Choi, Jin-Young, Kim, Myoung Soo, and Kim, Myeong-Jin
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- 2023
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6. Magnetic resonance imaging improves stratification of fibrosis and steatosis in patients with chronic liver disease
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Lee, Han Ah, Kim, Seung-seob, Choi, Jin-Young, Seo, Yeon Seok, Park, Beom Jin, Sim, Ki Choon, and Kim, Seung Up
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- 2022
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7. Association of neutrophil-to-lymphocyte ratio, radiotherapy fractionation/technique, and risk of development of distant metastasis among patients with locally advanced rectal cancer
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Yang, Gowoon, Chang, Jee Suk, Choi, Jeong Eun, Baek, Eun Sil, Kim, Seung-Seob, Byun, Hwa Kyung, Cho, Yeona, Koom, Woong Sub, Yang, Seung Yoon, Min, Byung Soh, and Shin, Sang Joon
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- 2022
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8. Regional lymph node metastasis detected on preoperative CT and/or FDG-PET may predict early recurrence of pancreatic adenocarcinoma after curative resection
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Yoon, Ja Kyung, Park, Mi-Suk, Kim, Seung-Seob, Han, Kyunghwa, Lee, Hee Seung, Bang, Seungmin, Hwang, Ho Kyoung, Hwang, Sang Hyun, Yun, Mijin, and Kim, Myeong-Jin
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- 2022
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9. Deep-Transfer-Learning–Based Natural Language Processing of Serial Free-Text Computed Tomography Reports for Predicting Survival of Patients With Pancreatic Cancer.
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Kim, Sunkyu, Kim, Seung-seob, Kim, Eejung, Cecchini, Michael, Park, Mi-Suk, Choi, Ji A, Kim, Sung Hyun, Hwang, Ho Kyoung, Kang, Chang Moo, Choi, Hye Jin, Shin, Sang Joon, Kang, Jaewoo, and Lee, Choong-kun
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LANGUAGE models , *RECEIVER operating characteristic curves , *PANCREATIC cancer , *OVERALL survival , *COMPUTED tomography - Abstract
PURPOSE: To explore the predictive potential of serial computed tomography (CT) radiology reports for pancreatic cancer survival using natural language processing (NLP). METHODS: Deep-transfer-learning–based NLP models were retrospectively trained and tested with serial, free-text CT reports, and survival information of consecutive patients diagnosed with pancreatic cancer in a Korean tertiary hospital was extracted. Randomly selected patients with pancreatic cancer and their serial CT reports from an independent tertiary hospital in the United States were included in the external testing data set. The concordance index (c-index) of predicted survival and actual survival, and area under the receiver operating characteristic curve (AUROC) for predicting 1-year survival were calculated. RESULTS: Between January 2004 and June 2021, 2,677 patients with 12,255 CT reports and 670 patients with 3,058 CT reports were allocated to training and internal testing data sets, respectively. ClinicalBERT (Bidirectional Encoder Representations from Transformers) model trained on the single, first CT reports showed a c-index of 0.653 and AUROC of 0.722 in predicting the overall survival of patients with pancreatic cancer. ClinicalBERT trained on up to 15 consecutive reports from the initial report showed an improved c-index of 0.811 and AUROC of 0.911. On the external testing set with 273 patients with 1,947 CT reports, the AUROC was 0.888, indicating the generalizability of our model. Further analyses showed our model's contextual interpretation beyond specific phrases. CONCLUSION: Deep-transfer-learning–based NLP model of serial CT reports can predict the survival of patients with pancreatic cancer. Clinical decisions can be supported by the developed model, with survival information extracted solely from serial radiology reports. Survival of patients with pancreatic cancer can be predicted solely by leveraging an NLP model on serial CT reports. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Prognostic factors of gadoxetic acid–enhanced MRI for postsurgical outcomes in multicentric hepatocellular carcinoma
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Kim, Seung-seob, Lee, Sunyoung, and Kim, Myeong-Jin
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- 2021
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11. Extended application of subtraction arterial phase imaging in LI-RADS version 2018: a strategy to improve the diagnostic performance for hepatocellular carcinoma on gadoxetate disodium–enhanced MRI
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Kim, Seung-seob, Lee, Sunyoung, Bae, Heejin, Chung, Yong Eun, Choi, Jin-Young, Park, Mi-Suk, and Kim, Myeong-Jin
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- 2021
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12. Application of Liver Imaging Reporting and Data System version 2018 ancillary features to upgrade from LR-4 to LR-5 on gadoxetic acid–enhanced MRI
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Lee, Sunyoung, Kim, Seung-seob, Bae, Heejin, Shin, Jaeseung, Yoon, Ja Kyung, and Kim, Myeong-Jin
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- 2021
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13. Prognostic factors in patients with locally advanced or borderline resectable pancreatic ductal adenocarcinoma: chemotherapy vs. chemoradiotherapy
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Kim, Seung-seob, Lee, Sunyoung, Lee, Hee Seung, Bang, Seungmin, and Park, Mi-Suk
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- 2021
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14. Radiographic portal or superior mesenteric vein invasion is an independent prognostic factor in non-metastatic pancreatic ductal adenocarcinoma: A missing block of clinical T staging?
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Kang, Huapyong, Kim, Seung-seob, Sung, Min Je, Jo, Jung Hyun, Lee, Hee Seung, Chung, Moon Jae, Park, Jeong Youp, Park, Seung Woo, Song, Si Young, Park, Mi-Suk, and Bang, Seungmin
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- 2020
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15. Diagnostic performance of the LR-M criteria and spectrum of LI-RADS imaging features among primary hepatic carcinomas
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Kim, Seung-seob, Lee, Sunyoung, Choi, Jin-Young, Lim, Joon Seok, Park, Mi-Suk, and Kim, Myeong-Jin
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- 2020
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16. Retrospective comparison of EASL 2018 and LI-RADS 2018 for the noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging
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Lee, Sunyoung, Kim, Myeong-Jin, Kim, Seung-seob, Shin, Hyejung, Kim, Do Young, Choi, Jin-Young, Park, Mi-Suk, and Mitchell, Donald G.
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- 2020
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17. Combined pulmonary fibrosis and emphysema and idiopathic pulmonary fibrosis in non-small cell lung cancer: impact on survival and acute exacerbation
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Moon, Sung Woo, Park, Moo Suk, Kim, Young Sam, Jang, Joon, Lee, Jae Ho, Lee, Choon-Taek, Chung, Jin-Haeng, Shim, Hyo Sup, Lee, Kyung Won, Kim, Seung-Seob, Lee, Sang Hoon, and Yoon, Ho Il
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- 2019
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18. Active involvement of patients, radiation oncologists, and surgeons in a multidisciplinary team approach: Guiding local therapy in recurrent, metastatic rectal cancer.
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Choi, Seo Hee, Yang, Gowoon, Koom, Woong Sub, Yang, Seung Yoon, Kim, Seung‐Seob, Lim, Joon Seok, Kim, Han Sang, Shin, Sang Joon, and Chang, Jee Suk
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RECTAL cancer ,PATIENT participation ,METASTASIS ,ONCOLOGISTS ,SURGEONS ,TELEPHONE calls - Abstract
Background: Despite the extensive implementation of an organized multidisciplinary team (MDT) approach in cancer treatment, there is little evidence regarding the optimal format of MDT. We aimed to investigate the impact of patient participation in MDT care on the actual application rate of metastasis‐directed local therapy. Methods: We identified all 1211 patients with locally advanced rectal cancer treated with neoadjuvant radiochemotherapy at a single institution from 2006 to 2018. Practice patterns, tumor burden and OMD state were analyzed in recurrent, metastatic cases. Results: With a median follow‐up of 60.7 months, 281 patients developed metastases, and 96 (34.2%), 92 (32.7%), and 93 (33.1%) patients had 1, 2–5, and >5 lesions, respectively. In our study, 27.1% were managed in the MDT clinic that mandated the participation of at least four to five board‐certified multidisciplinary experts and patients in decision‐making processes, while the rest were managed through diverse MDT approaches such as conferences, tumor board meetings, and discussions conducted via phone calls or email. Management in MDT clinic was significantly associated with more use of radiotherapy (p = 0.003) and more sessions of local therapy (p < 0.001). At the time of MDT clinic, the number of lesions was 1, 2–5, and >5 in 9 (13.6%), 35 (53.1%), and 19 (28.8%) patients, respectively. The most common states were repeat OMD (28.8%) and de novo OMD (27.3%), followed by oligoprogression (15%) and induced OMD (10.6%). Conclusion: Our findings suggest that active involvement of patients and radiation oncologists, and surgeons in MDT care has boosted the probability of using local therapies for various types of OMD throughout the course of the disease. [ABSTRACT FROM AUTHOR]
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- 2023
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19. A Prediction Model of Tumor Progression and Survival in HER2-Positive Metastatic Gastric Cancer Patients Treated with Trastuzumab and Chemotherapy
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Chae, Dongwoo, Nam, Chung Mo, Kim, Joo Hoon, Lee, Choong-Kun, Kim, Seung-Seob, Kim, Hyo Song, Jung, Minkyu, Cheong, Jae Ho, Chung, Hyun Cheol, Rha, Sun Young, and Park, Kyungsoo
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- 2018
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20. Dual-energy CT for differentiating acute and chronic pulmonary thromboembolism: an initial experience
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Kim, Seung-seob, Hur, Jin, Kim, Young Jin, Lee, Hye-Jeong, Hong, Yoo Jin, and Choi, Byoung Wook
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- 2014
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21. Should the Splenic Vein Be Preserved—Fate of Sinistral Portal Hypertension after Pancreatoduodenectomy with Vascular Re-Section for Pancreatic Cancer.
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Kim, Sung Hyun, Kim, Seung-Seob, Hwang, Ho Kyoung, Lee, Woo Jung, and Kang, Chang Moo
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SPLENIC vein surgery , *PANCREATIC tumors , *SURGERY , *PATIENTS , *RETROSPECTIVE studies , *ACQUISITION of data , *ESOPHAGEAL varices , *RISK assessment , *CANCER patients , *COMPARATIVE studies , *SPLEEN diseases , *MEDICAL records , *DESCRIPTIVE statistics , *SURVIVAL analysis (Biometry) , *PORTAL hypertension , *COMPUTED tomography , *PANCREATICODUODENECTOMY , *LIGATURE (Surgery) , *DISEASE risk factors ,SURGICAL complication risk factors - Abstract
Simple Summary: This study aims to evaluate sinistral portal hypertension (SPH) development and its clinical impact on the long-term outcomes of patients with pancreatic cancer who underwent surgical resection with splenic vein (SV) ligation. Data from 94 consecutive patients who underwent pancreatoduodenectomy (PD) with vascular resection for pancreatic cancer were divided into two groups according to SV ligation, and the groups were compared. Variceal score in the SV ligation group was significantly higher than that in the SV saving group at the same postoperative periods, and clinically relevant variceal bleeding was noted in one patient from the SV ligation group. In survival analysis, there was no significant difference between the two groups. These results showed that although SV ligation induced SPH during PD for pancreatic cancer, it did not lead to clinically significant long-term complications. In addition, it did not impact the long-term survival of patients with resected pancreatic head cancer. Background: This study aims to evaluate sinistral portal hypertension (SPH) development and its clinical impact on the long-term outcomes of patients with pancreatic cancer who underwent surgical resection with splenic vein (SV) ligation. Methods: Data from 94 consecutive patients who underwent pancreatoduodenectomy (PD) with vascular resection for pancreatic cancer from 2008 to 2019 were retrospectively collected. The patients were divided into two groups according to whether the SV was preserved or ligated during the surgery. Their computed tomography images were serially reviewed (preoperative, 6-, 12-, and 24-months postoperative) with clinical parameters. The degree of variceal formation (variceal score) and splenomegaly were assessed, and the oncologic outcomes were compared between the two groups. Variceal score in the SV ligation group was significantly higher than that in the SV saving group at the same postoperative periods (SV saving vs. ligation: 12 months, 0.9 ± 1.3 vs. 3.5 ± 2.2, p < 0.001; 24 months, 1.4 ± 1.8 vs. 4.0 ± 3.4, p = 0.009). Clinically relevant variceal bleeding was noted in one patient from the SV ligation group (SV saving vs. ligation: 0.0% vs. 3.1%, p = 0.953). In survival analysis, there was no significant difference between the two groups (DFS; SV saving vs. ligation: 13.0 (11.1–14.9) months vs. 13.0 (10.4–15.6) months, p = 0.969, OS; SV saving vs. ligation: 35.0 (19.9–50.1) months vs. 27.0 (11.6–42.4) months, p = 0.417). Although SV ligation induced SPH during PD for pancreatic cancer, it did not lead to clinically significant long-term complications. In addition, it did not impact the long-term survival of patients with resected pancreatic head cancer. [ABSTRACT FROM AUTHOR]
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- 2022
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22. Evaluation of the 8th Edition AJCC Staging System for the Clinical Staging of Pancreatic Cancer.
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Kang, Huapyong, Kim, Seung-seob, Sung, Min Je, Jo, Jung Hyun, Lee, Hee Seung, Chung, Moon Jae, Park, Jeong Youp, Park, Seung Woo, Song, Si Young, Park, Mi-Suk, and Bang, Seungmin
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PANCREATIC tumors , *ADENOCARCINOMA , *CONFIDENCE intervals , *PAIRED comparisons (Mathematics) , *LYMPH nodes , *TUMOR classification , *COMPARATIVE studies , *KAPLAN-Meier estimator , *SURVIVAL analysis (Biometry) , *DESCRIPTIVE statistics , *DATA analysis software - Abstract
Simple Summary: The 8th edition of the AJCC staging system for pancreatic cancer has been validated for pathological staging; however, its suitability for clinical staging is still uncertain. Clinical staging is important for pancreatic cancer because surgical resection is not suitable for most patients. We validated the prognostic performance and suitability of the current staging system for clinical staging. In our analysis using a prospectively collected pancreatic cancer cohort database, survival difference was not shown between stage IB and IIA, which were divided by the new size-based T3 criterion. Among the patients who received surgery, the pathological stage was more advanced than the clinical stage in 57.3%, mostly due to a false-negative lymph node in clinical staging. These findings suggest that the 8th edition AJCC staging system is not validated for clinical staging and separate criteria more suitable for clinical staging should be established. The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for pancreatic cancer (PC) has been validated for pathological staging; however, its significance for clinical staging remains uncertain. We validated the prognostic performance and suitability of the current staging system for the clinical staging of PC. We identified 1043 patients from our PC registry who were staged by imaging according to the 8th edition staging system and conducted analysis, including overall survival (OS) comparison. Gradual prognostic stratification according to stage hierarchy yielded significant OS differences between stage groups, except between stage I and II (p = 0.193). A substage comparison revealed no survival differences between IB (T2N0) and IIA (T3N0), which were divided by the T3 criterion only (p = 0.278). A higher N stage had significantly shorter OS than a lower N stage (all pairwise p < 0.05). However, among the 150 patients who received upfront surgery, the pathological stage was more advanced than the clinical stage in 86 (57.3%), mostly due to a false-negative cN0 (70.9%). Our results suggest that the new definition of T3 and the number-based N criteria in the 8th edition AJCC staging system may be not adequate for clinical staging. Establishing separate criteria more suitable for clinical staging should be considered. [ABSTRACT FROM AUTHOR]
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- 2022
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23. Characteristics and Early Recurrence of Hepatocellular Carcinomas Categorized as LR-M: Comparison with Those Categorized as LR-4 or 5.
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Shin, Jaeseung, Lee, Sunyoung, Kim, Seung‐seob, Chung, Yong Eun, Choi, Jin‐Young, Park, Mi‐Suk, Kim, Myeong‐Jin, Kim, Seung-Seob, Choi, Jin-Young, Park, Mi-Suk, and Kim, Myeong-Jin
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LIVER tumors ,CANCER relapse ,RETROSPECTIVE studies ,MAGNETIC resonance imaging ,PSYCHOLOGICAL tests ,HEPATOCELLULAR carcinoma - Abstract
Background: According to the Liver Imaging Reporting and Data System (LI-RADS), the LI-RADS category M (LR-M), which are probably or definitely malignant but are not specific for hepatocellular carcinomas (HCCs), does not exclude HCCs. A gap in knowledge remains, including their characteristics and recurrence of HCCs categorized as LR-M.Purpose: To compare the characteristics of HCCs categorized as LR-M with HCCs categorized as LR-4 or LR-5 (LR-4/5) using the LI-RADS version 2018 and evaluate the relationship of these categories with the risk of early recurrence after curative resections of single HCCs.Study Type: Retrospective.Subjects: Two hundred and eighty-one patients (mean age, 57 years; 191 men and 90 women) who underwent curative resections for single HCCs and preoperative contrast-enhanced MRI between 2015 and 2017.Field Strength/sequence: 3T Dual gradient-echo T1 WI with in- and opposed-phase, turbo spin-echo T2 WI, diffusion-weighted echo-planar images, and three-dimensional gradient-echo T1 WI before and after administration of contrast agent.Assessment: MRI features according to the LI-RADS version 2018 were evaluated and LI-RADS category were assigned for each observation. Clinical, imaging, and histopathological features were compared based on LI-RADS categorization. Early recurrence rates (<2 years) and associated factors were also evaluated.Statistical Tests: Fisher's exact test, two-sample t test after satisfying assumption of normality through Shapiro-Wilk test, Fleiss κ coefficient, Cox proportional hazards regression analysis, Kaplan-Meier method, and log-rank test.Results: Forty-one HCCs (14.6%) were categorized as LR-M and 240 HCCs (85.4%) were categorized as LR-4/5. LR-M HCCs showed poorer differentiation than LR-4/5 HCCs. In the multivariate analysis, the LR-M category was an independent predictor for early recurrence (hazard ratio, 1.904; 95% confidence interval, 1.024-3.542; P < 0.05). Early recurrence rates were significantly higher in patients with LR-M HCCs than in patients with LR-4/5 HCCs (32.0% vs. 18.4%, respectively, P < 0 05).Data Conclusion: Compared to LR-4/5 HCCs, LR-M HCCs were associated with poorer tumor differentiation and higher early recurrence rates after curative resections of single HCCs.Level Of Evidence: 3 Technical Efficacy Stage: 2. [ABSTRACT FROM AUTHOR]- Published
- 2021
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24. Clinical features and treatment of endolymphatic sac tumor.
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Bae, Seong Hoon, Kim, Seung-seob, Kwak, Sang Hyun, Jung, Jin Sei, Choi, Jae Young, and Moon, In Seok
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ANGIOGRAPHY , *CANCER relapse , *CEREBELLUM , *COMPUTED tomography , *EAR tumors , *FACIAL paralysis , *HEARING disorders , *MAGNETIC resonance imaging , *MEDICAL protocols , *MEDICAL records , *RADIOSURGERY , *SYMPTOMS , *RETROSPECTIVE studies , *ENDOLYMPHATIC sac , *ACQUISITION of data methodology - Abstract
Background: Endolymphatic sac tumor (ELST) is an extremely rare disease that does not have established clinical guidelines. Objective: To provide guidance for the diagnosis and management of ELSTs. Methods: We retrospectively reviewed the medical records of patients who were suspected to have a lesion in the location of endolymphatic sac. Seven patients were included. Histopathologic diagnosis confirmed five ELSTs and two other diseases. Results: All of the enrolled patients had hearing impairment. Facial palsy was found in four out of five patients with ELST, whereas none of the patients in other disease group showed facial palsy. CT and MRI findings were consistent with those in previous literatures; however, angiographic findings were not consistent with those previously reported. All patients underwent surgery. Recurrence occurred in two patients with ELST, although there was no visible remnant tumor after the operation. These patients were treated with stereotactic radiosurgery. Conclusion: Hearing impairment and facial palsy were representative symptoms of ELST. All ELSTs showed 'salt and pepper' signal in MRI T1-weighted images, and smaller tumors could have blood supply from AICA in the radiologic study. Complete surgical resection with optional stereotactic radiosurgery should be considered in ELST. Hearing impairment and facial weakness are remarkable symptoms of ELST compared to other diseases that invade the endolymphatic sac. All ELSTs showed 'salt and pepper' signal in MRI T1-weighted images. ELST less than 3 cm in diameter could have blood supply from AICA. A complete surgical excision with optional stereotactic radiosurgery is required. [ABSTRACT FROM AUTHOR]
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- 2020
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25. Diagnostic Performance of CT/MRI Liver Imaging Reporting and Data System v2017 for Hepatocellular Carcinoma: A Systematic Review and Meta‐Analysis.
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Lee, Sunyoung, Kim, Seung‐Seob, Roh, Yun Ho, Choi, Jin‐Young, Park, Mi‐Suk, and Kim, Myeong‐Jin
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HEPATOCELLULAR carcinoma , *META-analysis , *LIVER , *LIVER cancer , *LONGITUDINAL method - Abstract
Background & Aims: The liver Imaging Reporting and Data System (LI‐RADS) is a comprehensive system for standardizing liver imaging in patients at high risk for hepatocellular carcinoma (HCC). We performed a meta‐analysis to determine the diagnostic performance of the LR‐5 category for HCC and the pooled proportions of HCCs in each LI‐RADS category using CT/MRI LI‐RADS v2017. Methods: We searched multiple databases for original studies reporting on the diagnostic accuracy of CT/MRI LI‐RADS v2017. Random‐effects models were used to determine the summary estimates of the diagnostic performance of the LR‐5 category and the pooled proportions of HCCs for each LI‐RADS category. Risk of bias and concerns regarding applicability were evaluated with the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. Results: Fourteen studies (3 prospective studies and 11 retrospective studies) were included in the final analysis, consisting of 2056 patients, 2589 observations, and 1693 HCCs. The pooled per‐observation sensitivity was 67% (95% confidence interval [CI], 62%‐72%) with specificity of 92% (95% CI, 88%‐95%) in the LR‐5 category of CT/MRI LI‐RADS v2017 for diagnosing HCC. The pooled proportions of HCCs were 0% (95% CI, 0%‐0%) for LR‐1, 4% (95% CI, 0%‐8%) for LR‐2, 34% (95% CI, 23%‐44%) for LR‐3, 67% (95% CI, 53%‐81%) for LR‐4, and 92% (95% CI, 87%‐96%) for LR‐5. The proportions of HCCs were significantly different among LI‐RADS categories 1‐5 (P =.034). Conclusions: The LR‐5 category of CT/MRI LI‐RADS v2017 shows moderate sensitivity and high specificity for diagnosing HCC. Higher LI‐RADS categories contained higher proportions of HCCs. [ABSTRACT FROM AUTHOR]
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- 2020
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26. KASL Clinical Practice Guidelines for Noninvasive Tests to Assess Liver Fibrosis in Chronic Liver Disease.
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Kim MN, Han JW, An J, Kim BK, Jin YJ, Kim SS, Lee M, Lee HA, Cho Y, Kim HY, Shin YR, Yu JH, Kim MY, Choi Y, Chon YE, Cho EJ, Lee EJ, Kim SG, Kim W, Jun DW, and Kim SU
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- 2024
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27. CT Evaluation of Long-Term Changes in Common Bile Duct Diameter after Cholecystectomy.
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Ahn SH, An C, Kim SS, and Park S
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Purpose: The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation., Materials and Methods: This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy., Results: The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy ( p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with longterm (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD., Conclusion: Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction., Competing Interests: Conflicts of Interest: The authors have no potential conflicts of interest to disclose., (Copyrights © 2024 The Korean Society of Radiology.)
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- 2024
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28. Comparison of Four Diagnostic Guidelines for Hepatocellular Carcinoma Using Gadoxetic Acid-enhanced Liver MRI.
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Yoon JH, Kim YK, Kim JW, Chang W, Choi JI, Park BJ, Choi JY, Kim SS, Park HS, Lee ES, Yu JS, Park SJ, You MW, Lee CH, and Lee JM
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- Humans, Male, Middle Aged, Retrospective Studies, Magnetic Resonance Imaging, Carcinoma, Hepatocellular diagnostic imaging, Liver Neoplasms diagnostic imaging, Gadolinium DTPA
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Background Noninvasive diagnostic guidelines for hepatocellular carcinoma (HCC) vary across different global geographic areas, especially regarding criteria about gadoxetic acid-enhanced MRI. Purpose To compare the diagnostic performance of four different international HCC diagnosis guidelines and readers' judgment in diagnosing HCC using gadoxetic acid-enhanced MRI in patients at high risk for HCC. Materials and Methods This retrospective study included patients who had not undergone treatment, were at risk for HCC, and who underwent gadoxetic acid-enhanced MRI from January 2015 to June 2018 from 11 tertiary hospitals in South Korea. Four radiologists independently reviewed focal liver lesions (FLLs) according to four guidelines: American Association for the Study of Liver Diseases (AASLD)/Liver Imaging Reporting and Data System (LI-RADS), Korean Liver Cancer Association-National Cancer Center (KLCA-NCC), European Association for the Study of the Liver (EASL), and Asian Pacific Association for the Study of the Liver (APASL). Reader judgment (HCC or not HCC) was also recorded. Malignant FLLs were confirmed at pathology, and histologic and clinical follow-up data were used for benign FLLs. The guidelines' diagnostic performance was compared using generalized estimating equations. Additionally, the diagnostic odds ratio was assessed. Results A total of 2445 FLLs (median size, 27.4 mm) were analyzed in 2237 patients (mean age, 59 years ± 11 [SD]; 1666 male patients); 69.3% (1694 of 2445) were HCCs. KLCA-NCC showed the highest accuracy (80.0%; 95% CI: 78.7, 81.2; P = .001), with high sensitivity in Eastern guidelines (APASL, 89.1% [95% CI: 87.8, 90.3]; KLCA-NCC, 78.2% [95% CI: 76.6, 79.7]) and high specificity in Western guidelines (AASLD/LI-RADS, 89.6% [95% CI: 87.8, 91.2]; EASL, 88.1% [95% CI: 86.2, 89.9]) ( P = .001). The diagnostic odds ratios were 20.7 (95% CI: 17.0, 25.3) for AASLD/LI-RADS, 18.9 (95% CI: 15.8, 22.6) for KLCA-NCC, 16.8 (95% CI: 13.8, 20.4) for EASL, and 8.9 (95% CI: 7.4, 10.7) for APASL. The readers' judgment demonstrated higher accuracy than that of the guidelines (accuracy, 86.0%; 95% CI: 84.9, 86.9; P = .001). Conclusion Among four different international HCC diagnosis guidelines, Eastern guidelines demonstrated higher sensitivity, whereas Western guidelines displayed higher specificity. KLCA-NCC achieved the highest accuracy, and AASLD/LI-RADS exhibited the highest diagnostic odds ratio. © RSNA, 2024 Supplemental material is available for this article.
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- 2024
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29. Large Language Models: A Guide for Radiologists.
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Kim S, Lee CK, and Kim SS
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- Humans, Radiologists, Radiology
- Abstract
Large language models (LLMs) have revolutionized the global landscape of technology beyond natural language processing. Owing to their extensive pre-training on vast datasets, contemporary LLMs can handle tasks ranging from general functionalities to domain-specific areas, such as radiology, without additional fine-tuning. General-purpose chatbots based on LLMs can optimize the efficiency of radiologists in terms of their professional work and research endeavors. Importantly, these LLMs are on a trajectory of rapid evolution, wherein challenges such as "hallucination," high training cost, and efficiency issues are addressed, along with the inclusion of multimodal inputs. In this review, we aim to offer conceptual knowledge and actionable guidance to radiologists interested in utilizing LLMs through a succinct overview of the topic and a summary of radiology-specific aspects, from the beginning to potential future directions., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2024 The Korean Society of Radiology.)
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- 2024
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30. Diagnostic performance of the 2022 KLCA-NCC criteria for hepatocellular carcinoma on magnetic resonance imaging with extracellular contrast and hepatobiliary agents: comparison with the 2018 KLCA-NCC criteria.
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Yoon JK, Lee S, Hwang JA, Lee JE, Kim SS, and Kim MJ
- Abstract
Background/aim: This study aimed to determine the diagnostic performance of 2022 Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) imaging criteria compared with the 2018 KLCA-NCC for hepatocellular carcinoma (HCC) in high-risk patients using magnetic resonance imaging (MRI)., Methods: This retrospective study included 415 treatment-naïve patients (152 patients who underwent extracellular contrast agent [ECA]-MRI and 263 who underwent hepatobiliary agent [HBA]-MRI; 535 lesions, including 412 HCCs) with a high risk of HCC who underwent contrast-enhanced MRI. Two readers evaluated all lesions according to the 2018 and 2022 KLCA-NCC imaging diagnostic criteria, and the per-lesion diagnostic performances were compared., Results: In "definite" HCC category of both 2018 and 2022 KLCA-NCC, HBA-MRI showed a significantly higher sensitivity for the diagnosis of HCC than ECA-MRI (77.0% vs. 64.3%, P =0.006) without a significant difference in specificity (94.7% vs. 95.7%, P =0.801). On ECAMRI, "definite" or "probable" HCC categories of the 2022 KLCA-NCC had significantly higher sensitivity than those of the 2018 KLCA-NCC (85.3% vs. 78.3%, P =0.002) with identical specificity (93.6%). On HBA-MRI, the sensitivity and specificity of "definite" or "probable" HCC categories of both 2018 and 2022 KLCA-NCC were not significantly different (83.3% vs. 83.6%, P >0.999 and 92.1% vs. 90.8%, P >0.999, respectively)., Conclusions: In "definite" HCC category of both 2018 and 2022 KLCA-NCC, HBA-MRI provides better sensitivity than ECA-MRI without compromising specificity. On ECA-MRI, "definite" or "probable" HCC categories of the 2022 KLCA-NCC may improve sensitivity in the diagnosis of HCC compared with the 2018 KLCA-NCC., Competing Interests: Conflict of Interest The authors have no conflicts to disclose., (© 2023 The Korean Liver Cancer Association.)
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- 2023
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31. Laparoscopic distal pancreatosplenectomy for left-sided pancreatic cancer in patients with radical subtotal gastrectomy for gastric cancer.
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Lee KH, Hong SS, Kim SS, Hwang HK, Lee WJ, and Kang CM
- Abstract
After radical subtotal gastrectomy (RSTG) for stomach cancer, the remnant stomach is supposed to be perfused through the short gastric vessels. What if a patient who received previous RSTG is diagnosed with resectable distal pancreatic cancer? Can radical distal pancreatosplenectomy (DPS) be performed safely without ischemic damage to the remnant stomach? Unfortunately, there are limited studies on this specific clinical issue. Notably, in spite of rare clinical presentation, it is expected to increase due to prolonged survival of patients with resected gastric cancer. Therefore, we aimed to demonstrate the safety and feasibility of the radical DPS in patients with previous RSTG. In this study, we investigated perioperative and long-term survival outcomes of DPS for left-sided pancreatic cancer in patients with previous RSTG.
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- 2022
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32. LI-RADS Version 2018 Targetoid Appearances on Gadoxetic Acid-Enhanced MRI: Interobserver Agreement and Diagnostic Performance for the Differentiation of HCC and Non-HCC Malignancy.
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Min JH, Lee MW, Park HS, Lee DH, Park HJ, Lee JE, Park SJ, Kim SS, Park SH, Ha SY, Hwang JA, Cha DI, and Park B
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- Aged, Bile Ducts, Intrahepatic pathology, Contrast Media, Female, Gadolinium DTPA, Humans, Magnetic Resonance Imaging methods, Male, Middle Aged, Observer Variation, Retrospective Studies, Sensitivity and Specificity, Bile Duct Neoplasms, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular pathology, Cholangiocarcinoma diagnostic imaging, Liver Neoplasms diagnostic imaging, Liver Neoplasms pathology
- Abstract
BACKGROUND. In LI-RADS version 2018, observations showing at least one of five targetoid appearances in different sequences or postcontrast phases are categorized LR-M, indicating likely non-hepatocellular carcinoma (HCC) malignancy. OBJECTIVE. The purpose of this study was to evaluate interobserver agreement for LI-RADS targetoid appearances among a large number of radiologists of varying experience and the diagnostic performance of targetoid appearances for differentiating HCC from non-HCC malignancy. METHODS. This retrospective study included 100 patients (76 men, 24 women; mean age, 58 ± 9 [SD] years) at high risk of HCC who underwent gadoxetic acid-enhanced MRI within 30 days before hepatic tumor resection (25 randomly included patients with non-HCC malignancy [13, intrahepatic cholangiocarcinoma; 12, combined HCC-cholangiocarcinoma]; 75 matched patients with HCC). Eight radiologists (four more experienced [8-15 years]; four less experienced [1-5 years]) from seven institutions independently assessed observations for the five targetoid appearances and LI-RADS categorization. Interobserver agreement and diagnostic performance for non-HCC malignancy were evaluated. RESULTS. Interobserver agreement was poor for peripheral washout (κ = 0.20); moderate for targetoid transitional phase or hepatobiliary phase appearance (κ = 0.33), delayed central enhancement (κ = 0.37), and targetoid restriction (κ = 0.43); and substantial for rim arterial phase hyperenhancement (κ = 0.61). Agreement was fair for at least one targetoid appearance (κ = 0.36) and moderate for at least two, three, or four targetoid appearances (κ = 0.43-0.51). Agreement for individual targetoid appearances was not significantly different between more experienced and less experienced readers other than for targetoid restriction (κ = 0.63 vs 0.43; p = .001). Agreement for at least one targetoid appearance was fair among more experienced (κ = 0.29) and less experienced (κ = 0.37) reviewers. Agreement for at least two, three, or four targetoid appearances was moderate to substantial among more experienced reviewers (κ = 0.45-0.63) and moderate among less experienced reviewers (κ = 0.42-0.56). Existing LR-M criteria of at least one targetoid appearance had median accuracy for non-HCC malignancy of 62%, sensitivity of 84%, and specificity of 54%. For all reviewers, accuracy was highest when at least three (median accuracy, 79%; sensitivity, 68%; specificity, 82%) or four (median accuracy, 80%; sensitivity, 54%; specificity, 88%) targetoid appearances were required. CONCLUSION. Targetoid appearances and LR-M categorization exhibited considerable interobserver variation among both more and less experienced reviewers. CLINICAL IMPACT. Requiring multiple targetoid appearances for LR-M categorization improved interobserver agreement and diagnostic accuracy for non-HCC malignancy.
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- 2022
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33. A Bounding-Box Regression Model for Colorectal Tumor Detection in CT Images Via Two Contrary Networks.
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Kim Y, Park S, Kim H, Kim SS, Lim JS, Kim S, Choi K, and Seo H
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- Electric Power Supplies, Humans, Mental Recall, Tomography, X-Ray Computed, Colorectal Neoplasms diagnostic imaging, Radiopharmaceuticals
- Abstract
The field of medical image analysis has been attracted to deep learning. Various deep learning-based techniques have been introduced to aid diagnosis in the CT image of the patient. The auxiliary model for diagnosis that we proposed is to detect colorectal tumors in the CT image. The model is combined with two contrary networks of 'Detection Transformer" and 'Hourglass". Furthermore., to improve the performance of the model., we propose an efficient connection method for two contrary models by using intermediate prediction information. A total of 3.,509 patients (193.,567 CT images) were applied to the experiment and our model outperforms the conventional models in colorectal tumor detection. Clinical Relevance - The proposed model in this paper automatically detects colorectal tumors and provides the bounding box in the CT images. Colorectal tumor is one of the common diseases. In addition, the mortality rate is so high that in-time treatment is required. The model we present here has a sensitivity (or recall) of 84.73 % for tumor detection and a precision of 88.25 % in the patient CT data. The in-slice performance of the tumor detection shows an IoU of 0.56, a sensitivity of 0.67, and a precision of 0.68.
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- 2022
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34. Retrospective Evaluation of Treatment Response in Patients with Nonmetastatic Pancreatic Cancer Using CT and CA 19-9.
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Kim SS, Lee S, Lee HS, Bang S, Han K, and Park MS
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- Carbohydrates therapeutic use, Humans, Male, Retrospective Studies, Tomography, X-Ray Computed methods, Treatment Outcome, Pancreatic Neoplasms, CA-19-9 Antigen analysis, Carcinoma, Pancreatic Ductal diagnostic imaging, Carcinoma, Pancreatic Ductal drug therapy, Pancreatic Neoplasms diagnostic imaging, Pancreatic Neoplasms drug therapy
- Abstract
Background Imaging studies have limitations in evaluating pancreatic ductal adenocarcinoma (PDAC) treatment response. Purpose To investigate the effectiveness of combined CT and carbohydrate antigen 19-9 (CA 19-9) evaluation at 8 weeks after first-line treatment to predict overall survival (OS) of patients with nonmetastatic PDAC. Materials and Methods Patients with nonmetastatic PDAC who received first-line treatment with either chemotherapy or concurrent chemoradiation in a single-center PDAC cohort registry were retrospectively enrolled in the study between January 2013 and December 2016. Follow-up CT images obtained 8 weeks after treatment were evaluated according to Response Evaluation Criteria in Solid Tumors. Patients with partial response (PR) or stable disease (SD) were defined as CT responders, and those with progressive disease (PD) were defined as CT nonresponders. Patients with a normalized CA 19-9 level at 8-week follow-up were defined as CA 19-9 responders, and those with a nonnormalized or nonelevated CA 19-9 level were defined as CA 19-9 nonresponders. OS was compared using the Kaplan-Meier method with Breslow analysis. Results A total of 197 patients (mean age ± standard deviation, 65 years ± 10; 107 men) were evaluated. Patients with PD ( n = 17) showed shorter OS than those with SD ( n = 147; P < .001) or PR ( n = 33; P = .003). OS did not differ between the patients with PR and those with SD ( P = .60). When the CT and CA 19-9 responses were integrated, OS was longest in CT and CA 19-9 responders (group 1, n = 27; median OS, 26.6 months [95% CI: 9.0, 44.1]), followed by CT responders but CA 19-9 nonresponders (group 2, n = 153; median OS, 15.9 months [95% CI: 13.3, 18.5]; P = .007 vs group 1) and CT and CA 19-9 nonresponders (group 3, n = 17; median OS, 6.5 months [95% CI: 0.8, 12.2]; P < .001 vs group 2). Conclusion Integrated evaluation with CT and carbohydrate antigen 19-9 response allowed more accurate stratification of survival in patients with pancreatic ductal adenocarcinoma in the early treatment period than did evaluation according to Response Evaluation Criteria in Solid Tumors. © RSNA, 2022 Online supplemental material is available for this article.
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- 2022
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35. Response to Neoadjuvant Therapy and Prognosis in Patients with Resectable Pancreatic Cancer: A Propensity Score Matching Analysis.
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Yoon MS, Lee HS, Kang CM, Lee WJ, Keum J, Sung MJ, Kim SS, Park MS, Jo JH, Chung MJ, Park JY, Park SW, Song SY, Hwang HK, and Bang S
- Subjects
- Antineoplastic Combined Chemotherapy Protocols adverse effects, Humans, Neoadjuvant Therapy, Pancreatectomy, Prognosis, Propensity Score, Carcinoma, Pancreatic Ductal drug therapy, Carcinoma, Pancreatic Ductal surgery, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms surgery
- Abstract
Background/aims: : Controversy regarding the effectiveness of neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma (PDAC) still exists. Here, we aimed to identify the potential benefits of neoadjuvant therapy followed by surgery for resectable PDAC., Methods: We reviewed radiologically resectable PDAC patients who received resection with curative intent at a tertiary hospital in South Korea between January 2012 and August 2019. A total of 202 patients underwent curative resection for resectable PDAC: 167 underwent surgical resection first during this period, and 35 received neoadjuvant chemotherapy/chemoradiation therapy followed by surgery. Resectable PDAC patients were subdivided, and 1:3 propensity score matching (PSM) was performed to reduce selection bias., Results: Compared with the group that received surgery first, the group that received neoadjuvant treatment followed by surgery had significantly smaller tumors (22.0 mm vs 27.0 mm, p=0.004), a smaller proportion of patients with postoperative pathologic T stage (p=0.026), a smaller proportion of patients with lymphovascular invasion (20.0% vs 40.7%, p=0.022), and a larger proportion of patients with negative resection margins (74.3% vs 51.5%, p=0.049). After PSM, the group that received neoadjuvant therapy had a significantly longer progression-free survival than those in the group that underwent surgery first (29.6 months vs 15.1 months, p=0.002). Overall survival was not significantly different between the two groups after PSM analysis., Conclusions: We observed significantly better surgical outcomes and progression-free survival with the addition of neoadjuvant therapy to the management of resectable PDAC. However, despite PSM, there was still selection bias due to the use of different regimens between the groups receiving surgery first and neoadjuvant therapy. Large homogeneous samples are needed in the future prospective studies.
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- 2022
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36. Increased Radiosensitivity of Solid Tumors Harboring ATM and BRCA1/2 Mutations.
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Kim KH, Kim HS, Kim SS, Shim HS, Yang AJ, Lee JJB, Yoon HI, Ahn JB, and Chang JS
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- Adult, Aged, Ataxia Telangiectasia Mutated Proteins radiation effects, Female, Genes, BRCA1 radiation effects, Genes, BRCA2 radiation effects, High-Throughput Nucleotide Sequencing methods, Humans, Male, Middle Aged, Retrospective Studies, DNA Repair radiation effects, Mutation radiation effects, Neoplasms radiotherapy, Radiation Tolerance
- Abstract
Purpose: Preclinical data indicate that response to radiotherapy (RT) depends on DNA damage repair. In this study, we investigated the role of mutations in genes related to DNA damage repair in treatment outcome after RT., Materials and Methods: Patients with solid tumor who participated in next generation sequencing panel screening using biopsied tumor tissue between October 2013 and February 2019 were reviewed and 97 patients that received RT were included in this study. Best response to RT and the cumulative local recurrence rate (LRR) were compared according to absence or presence of missense, nonsense, and frameshift mutations in ATM and/or BRCA1/2., Results: Of the 97 patients, five patients harbored mutation only in ATM, 22 in only BRCA1/2, and six in both ATM and BRCA1/2 (ATMmtBRCAmt). Propensity score matching was performed to select the control group without mutations (ATMwtBRCAwt, n=33). In total, 90 RT-treated target lesions were evaluated in 66 patients. Highest objective response rate of 80% was observed in ATMmtBRCAmt lesions (p=0.007), which was mostly durable. Furthermore, the cumulative 1-year LRR was the lowest in ATMmtBRCAmt lesions and the highest in ATMwtBRCAwt lesions (0% vs. 47.9%, p=0.008). RT-associated toxicities were observed in 10 treatments with no significant difference among the subgroups (p=0.680)., Conclusion: Tumors with ATM and BRCA1/2 mutations exhibited superior tumor response and local control after RT compared to tumors without these mutations. The results are hypothesis generating and suggest the need for integrating the tumor mutation profile of DNA repair genes during treatment planning.
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- 2022
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37. [Construction of a Standard Dataset for Liver Tumors for Testing the Performance and Safety of Artificial Intelligence-Based Clinical Decision Support Systems].
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Kim SS, Lee DH, Lee MW, Kim SY, Shin J, Choi JY, and Choi BW
- Abstract
Purpose: To construct a standard dataset of contrast-enhanced CT images of liver tumors to test the performance and safety of artificial intelligence (AI)-based algorithms for clinical decision support systems (CDSSs)., Materials and Methods: A consensus group of medical experts in gastrointestinal radiology from four national tertiary institutions discussed the conditions to be included in a standard dataset. Seventy-five cases of hepatocellular carcinoma, 75 cases of metastasis, and 30-50 cases of benign lesions were retrieved from each institution, and the final dataset consisted of 300 cases of hepatocellular carcinoma, 300 cases of metastasis, and 183 cases of benign lesions. Only pathologically confirmed cases of hepatocellular carcinomas and metastases were enrolled. The medical experts retrieved the medical records of the patients and manually labeled the CT images. The CT images were saved as Digital Imaging and Communications in Medicine (DICOM) files., Results: The medical experts in gastrointestinal radiology constructed the standard dataset of contrast-enhanced CT images for 783 cases of liver tumors. The performance and safety of the AI algorithm can be evaluated by calculating the sensitivity and specificity for detecting and characterizing the lesions., Conclusion: The constructed standard dataset can be utilized for evaluating the machine-learningbased AI algorithm for CDSS., Competing Interests: Conflicts of Interest: The authors have no potential conflicts of interest to disclose., (Copyrights © 2021 The Korean Society of Radiology.)
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- 2021
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38. LI-RADS Version 2018 Treatment Response Algorithm: Diagnostic Performance after Transarterial Radioembolization for Hepatocellular Carcinoma.
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Yoon J, Lee S, Shin J, Kim SS, Kim GM, and Won JY
- Subjects
- Aged, Algorithms, Contrast Media, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Sensitivity and Specificity, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular radiotherapy, Liver Neoplasms diagnostic imaging, Liver Neoplasms radiotherapy
- Abstract
Objective: To assess the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 treatment response algorithm (TRA) for the evaluation of hepatocellular carcinoma (HCC) treated with transarterial radioembolization., Materials and Methods: This retrospective study included patients who underwent transarterial radioembolization for HCC followed by hepatic surgery between January 2011 and December 2019. The resected lesions were determined to have either complete (100%) or incomplete (< 100%) necrosis based on histopathology. Three radiologists independently reviewed the CT or MR images of pre- and post-treatment lesions and assigned categories based on the LI-RADS version 2018 and the TRA, respectively. Diagnostic performances of LI-RADS treatment response (LR-TR) viable and nonviable categories were assessed for each reader, using histopathology from hepatic surgeries as a reference standard. Inter-reader agreements were evaluated using Fleiss κ., Results: A total of 27 patients (mean age ± standard deviation, 55.9 ± 9.1 years; 24 male) with 34 lesions (15 with complete necrosis and 19 with incomplete necrosis on histopathology) were included. To predict complete necrosis, the LR-TR nonviable category had a sensitivity of 73.3-80.0% and a specificity of 78.9-89.5%. For predicting incomplete necrosis, the LR-TR viable category had a sensitivity of 73.7-79.0% and a specificity of 93.3-100%. Five (14.7%) of 34 treated lesions were categorized as LR-TR equivocal by consensus, with two of the five lesions demonstrating incomplete necrosis. Inter-reader agreement for the LR-TR category was 0.81 (95% confidence interval: 0.66-0.96)., Conclusion: The LI-RADS version 2018 TRA can be used to predict the histopathologic viability of HCCs treated with transarterial radioembolization., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2021 The Korean Society of Radiology.)
- Published
- 2021
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39. Comparison of LI-RADS 2018 and KLCA-NCC 2018 for noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging.
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Lee S, Kim SS, Chang DR, Kim H, and Kim MJ
- Subjects
- Aged, Carcinoma, Hepatocellular diagnostic imaging, Diagnostic Errors, Female, Humans, Image Processing, Computer-Assisted, Liver Neoplasms diagnostic imaging, Magnetic Resonance Imaging standards, Male, Middle Aged, Reference Standards, Retrospective Studies, Sensitivity and Specificity, Carcinoma, Hepatocellular diagnosis, Contrast Media chemistry, Liver Neoplasms diagnosis, Magnetic Resonance Imaging methods
- Abstract
Background/aims: This study aimed to compare the diagnostic performances of Liver Imaging Reporting and Data System (LI-RADS) 2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 criteria on magnetic resonance imaging (MRI) for the noninvasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients., Methods: This retrospective study included 273 treatment-naïve patients (71 patients with extracellular contrast agent [ECA]-MRI and 202 patients with hepatobiliary agent [HBA]-MRI; 352 lesions including 263 HCCs) with high risk of HCC who underwent contrast-enhanced MRI between 2016 and 2017. Two readers evaluated all lesions according to the criteria of LI-RADS 2018 and KLCA-NCC 2018. The per-lesion diagnostic performances were compared using the generalized estimating equation method., Results: On ECA-MRI, the sensitivity and specificity of LI-RADS 2018 and KLCA-NCC 2018 were not significantly different (LR-5 vs. definite HCC: 75.8% vs. 69.4%, P=0.095 and 95.8% vs. 95.8%, P>0.999; LR-5/4 vs. definite/probable HCC: 87.1% vs.83.9%, P=0.313 and 87.5% vs. 91.7%, P=0.307). On HBA-MRI, definite HCC of KLCA-NCC 2018 showed significantly higher sensitivity (79.1% vs. 68.2%, P<0.001) than LR-5 of LI-RADS 2018 without a significant difference in specificity (93.9% vs. 95.4%, P=0.314). Definite/probable HCC of KLCA-NCC 2018 had higher specificity (92.3% vs. 80.0%, P=0.003) than LR-5/4 of LI-RADS 2018. The sensitivity was lower for definite/probable HCC than for LR-5/4 without statistical significance (85.6% vs. 88.1%, P=0.057)., Conclusion: On ECA-MRI, LI-RADS 2018 and KLCA-NCC 2018 showed comparable diagnostic performances. On HBA-MRI, definite HCC of KLCA-NCC 2018 provided better sensitivity than LR-5 category of LI-RADS 2018 without compromising the specificity, while definite/probable HCC of KLCA-NCC 2018 revealed higher specificity than LR-5/4 of LI-RADS 2018 for diagnosing HCC.
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- 2020
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40. Development of a multi-channel NIRS-USG hybrid imaging system for detecting prostate cancer and improving the accuracy of imaging-based diagnosis: a phantom study.
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Bae H, Kim SS, Lee S, Song H, Lee S, Koh D, Kim JG, and Jung DC
- Abstract
Purpose: This study aimed to develop a multi-channel near-infrared spectroscopy (NIRS) and ultrasonography (USG) fusion imaging system for imaging prostate cancer and to verify its diagnostic capability by applying the hybrid imaging system to a prostate cancer phantom., Methods: A multi-channel NIRS system using the near-infrared 785-nm wavelength with 12 channels and four detectors was developed. After arranging the optical fibers around a USG transducer, we performed NIRS imaging and grayscale USG imaging simultaneously. Fusion imaging was obtained by processing incoming signals and the spatial reconstruction of NIRS, which corresponded with grayscale USG acquired at the same time. The NIRS-USG hybrid system was applied to a silicone-based optical phantom of the prostate gland containing prostate cancer to verify its diagnostic capability qualitatively., Results: The NIRS-USG hybrid imaging system for prostate cancer imaging simultaneously provided anatomical and optical information with 2-dimensional registration. The hybrid imaging system showed more NIR attenuation over the prostate cancer model than over the model of normal prostate tissue. Its diagnostic capability to discriminate a focal area mimicking the optical properties of prostate cancer from the surrounding background mimicking the optical properties of normal prostate tissue was verified by applying the hybrid system to a silicone-based optical phantom of prostate cancer., Conclusion: This study successfully demonstrated that the NIRS-USG hybrid system may serve as a new imaging method for improving the diagnostic accuracy of prostate cancer, with potential utility for future clinical applications.
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- 2019
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41. Curative Resection of Single Primary Hepatic Malignancy: Liver Imaging Reporting and Data System Category LR-M Portends a Worse Prognosis.
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An C, Park S, Chung YE, Kim DY, Kim SS, Kim MJ, and Choi JY
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- Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular pathology, Cholangiocarcinoma pathology, Contrast Media, Female, Gadolinium DTPA, Humans, Image Interpretation, Computer-Assisted, Liver Neoplasms pathology, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Retrospective Studies, Survival Rate, Treatment Outcome, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular surgery, Cholangiocarcinoma diagnostic imaging, Cholangiocarcinoma surgery, Liver Neoplasms diagnostic imaging, Liver Neoplasms surgery, Magnetic Resonance Imaging methods
- Abstract
Objective: The purpose of this study was to examine the associations between preoperative Liver Imaging Reporting and Data System (LI-RADS) categories and prognosis after curative resection of single hepatic malignancies in patients with chronic liver disease., Materials and Methods: Between January 2008 and December 2010, 225 patients with chronic liver disease underwent resection of single hepatic malignant tumors (218 hepatocellular carcinomas, three cholangiocarcinomas, four biphenotypic carcinomas) after undergoing gadoxetic acid-enhanced MRI. Two radiologists retrospectively categorized the tumors into LI-RADS categories. Differences in disease-free survival duration between categories were analyzed by the Kaplan-Meier method with the log-rank test., Results: Reviewer 1 categorized two (0.9%) patients as having LR-3, 53 (23.6%) LR-4, 159 (70.7%) LR-5, and 11 (4.9%) LR-M lesions. The corresponding numbers for reviewer 2 were six (2.7%) LR-3, 30 (13.3%) LR-4, 178 (79.1%) LR-5, and 11 (4.9%) LR-M. The 2-year cumulative recurrence or death rates were 15.1% for lesions categorized LR-3 or LR-4 by reviewer 1, 31.7% for LR-5, and 60% for LR-M. For lesions categorized by reviewer 2 the corresponding rates were 20.6% for LR-3 or LR-4, 29% for LR-5, and 54.5% for LR-M. Disease-free survival was significantly worse among patients with lesions categorized as LR-M than for lesions categorized as LR-3 or LR-4 or as LR-5 (p < 0.01 for both reviewers). Disease-free survival did not significantly differ between patients with LR-3 or LR-4 and those with LR-5 lesions (reviewer 1, p = 0.301; reviewer 2, p = 0.291)., Conclusion: Patients with tumors preoperatively categorized as LR-M may have a worse prognosis than those with tumors categorized LR-3, LR-4, or LR-5 after curative resection of single hepatic malignancy.
- Published
- 2017
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42. Depth of response is a significant predictor for long-term outcome in advanced gastric cancer patients treated with trastuzumab.
- Author
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Lee CK, Kim SS, Park S, Kim C, Heo SJ, Lim JS, Kim H, Kim HS, Rha SY, Chung HC, Park S, and Jung M
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Immunological administration & dosage, Antineoplastic Agents, Immunological adverse effects, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biomarkers, Tumor, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Prognosis, ROC Curve, Stomach Neoplasms mortality, Trastuzumab administration & dosage, Trastuzumab adverse effects, Treatment Outcome, Antineoplastic Agents, Immunological therapeutic use, Stomach Neoplasms diagnosis, Stomach Neoplasms drug therapy, Trastuzumab therapeutic use
- Abstract
Purpose: We aimed to determine and compare the predictive values of depth of response (DpR) and early tumor shrinkage (ETS) on long-term outcomes in gastric cancer patients treated with trastuzumab., Results: From a total of 368 computed tomography examinations, DpR and ETS were evaluated. DpR was a significant tumor-size metric in predicting PFS and OS, and showed better discriminatory ability (higher Cτ indices, 0.6957 for PFS; 0.7191 for OS) than ETS. DpR ≥ 45% (vs. < 45%) was the optimal cutoff value, as it was best able to identify patients with longer PFS (median 9.0 vs. 6.3 months, hazard ratio [HR] = 0.608; 95% confidence interval [CI]: 0.335 to 1.104; P = 0.102) and OS (median 23.5 vs. 13.1 months, HR = 0.441; 95% CI: 0.203 to 0.955; P = 0.038)., Materials and Methods: Sixty-one gastric cancer patients who received first-line trastuzumab-based chemotherapy were assessed for DpR and ETS. We employed Kaplan-Meier estimates, log-rank tests, Cox proportional hazards regression models, time-dependent receiver operating characteristics, and Youden's J index to evaluate and determine cutoff values of DpR and ETS as predictors of progression-free survival (PFS) and overall survival (OS)., Conclusions: DpR and ETS were significant predictors of long-term outcomes in gastric cancer patients treated with first-line trastuzumab. Validation in prospective trials with larger patient populations is needed.
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- 2017
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43. Ultrasonographic findings of type IIIa biliary atresia.
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Kim SS, Kim MJ, Lee MJ, Yoon CS, Han SJ, and Koh H
- Abstract
Purpose: To describe the ultrasonographic (US) findings of type IIIa biliary atresia., Methods: We retrospectively reviewed a medical database of patients pathologically confirmed to have biliary atresia, Kasai type IIIa, between January 2002 and May 2013 (n=18). We evaluated US findings including the visible common bile duct (CBD), triangular cord thickness, gallbladder size and shape, and subcapsular flow on color Doppler US; laboratory data; and pathological hepatic fibrosis grades. We divided them into two groups-those with visible (group A) and invisible (group B) CBD on US-and compared all parameters between the two groups., Results: CBD was visible on US in five cases (27.8%; group A) and invisible in 13 cases (72.2%; group B). US was performed at an earlier age in group A than in group B (median, 27 days vs. 60 days; P=0.027) with the maximal age of 51 days. A comparison of the US findings revealed that the triangular cord thickness was smaller (4.1 mm vs. 4.9 mm; P=0.004) and the gallbladder length was larger (20.0 mm vs. 11.7 mm; P=0.021) in group A. The gallbladder shape did not differ between the two groups, and the subcapsular flow was positive in all cases of both groups. There was no significant difference in the laboratory data between the two groups. Upon pathological analysis, group A showed low-grade and group B showed low- to high-grade hepatic fibrosis., Conclusion: When CBD is visible on US in patients diagnosed with type IIIa biliary atresia, other US features could have a false negative status. A subcapsular flow on the color Doppler US would be noted in the type IIIa biliary atresia patients.
- Published
- 2014
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