59 results on '"Sungmin Woo"'
Search Results
2. Reply to 'Hepatic Adenomas With Hepatobiliary Phase Iso- or Hyperintensity: Standardized Definitions Are Required'
- Author
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Tae-Hyung, Kim, Sungmin, Woo, Sanam, Ebrahimzadeh, Matthew D F, Mclnnes, Scott R, Gerst, and Richard K, Do
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Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2023
3. Multiparametric Prostate MRI for Biochemical Failure in the Era of Targeted PET Radiotracers: Point—MRI May No Longer Be Needed in Patient Workup
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Jeeban P, Das and Sungmin, Woo
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Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2023
4. Programmatic Implementation of a Custom Subspecialized Oncologic Imaging Workflow Manager at a Tertiary Cancer Center
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Anton S. Becker, Jeeban P. Das, Sungmin Woo, Pierre Elnajjar, Joshua Chaim, Joseph P. Erinjeri, Hedvig Hricak, and Hebert Alberto Vargas
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Research Report ,Neoplasms ,Humans ,General Medicine ,Medical Oncology ,Tomography, X-Ray Computed ,Magnetic Resonance Imaging ,Workflow - Abstract
PURPOSE To evaluate whether a custom programmatic workflow manager reduces reporting turnaround times (TATs) from a body oncologic imaging workflow at a tertiary cancer center. METHODS A custom software program was developed and implemented in the programming language R. Other aspects of the workflow were left unchanged. TATs were measured over a 12-month period (June-May). The same prior 12-month period served as a historical control. Median TATs of magnetic resonance imaging (MRI) and computed tomography (CT) examinations were compared with a Wilcoxon test. A chi-square test was used to compare the numbers of examinations reported within 24 hours and after 72 hours as well as the proportions of examinations assigned according to individual radiologist preferences. RESULTS For all MRI and CT examinations (124,507 in 2019/2020 and 138,601 in 2020/2021), the median TAT decreased from 4 (interquartile range: 1-22 hours) to 3 hours (1-17 hours). Reports completed within 24 hours increased from 78% (124,127) to 89% (138,601). For MRI, TAT decreased from 22 (5-49 hours) to 8 hours (2-21 hours), and reports completed within 24 hours increased from 55% (14,211) to 80% (23,744). For CT, TAT decreased from 3 (1-19 hours) to 2 hours (1-13 hours), and reports completed within 24 hours increased from 84% (82,342) to 92% (99,922). Delayed reports (with a TAT > 72 hours) decreased from 17.0% (4,176) to 2.2% (649) for MRI and from 2.5% (2,500) to 0.7% (745) for CT. All differences were statistically significant ( P < .001). CONCLUSION The custom workflow management software program significantly decreased MRI and CT report TATs.
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- 2022
5. Hepatic Adenoma Subtypes on Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI: Systematic Review and Meta-Analysis
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Tae-Hyung Kim, Sungmin Woo, Sanam Ebrahimzadeh, Matthew D. F. McInnes, Scott R. Gerst, and Richard K. Do
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Gadolinium DTPA ,Diagnosis, Differential ,Focal Nodular Hyperplasia ,Liver Neoplasms ,Humans ,Contrast Media ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Amines ,Sensitivity and Specificity ,Magnetic Resonance Imaging ,Adenoma, Liver Cell ,Retrospective Studies - Published
- 2022
6. Decision curve analysis in the evaluation of radiology research
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Andrew J. Vickers and Sungmin Woo
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Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2022
7. Prognostic and predictive values of interim 18F-FDG PET during neoadjuvant chemoradiotherapy for esophageal cancer: a systematic review and meta-analysis
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Tae Hyung Kim, Sungmin Woo, Sangwon Han, Yong Il Kim, and Jin-Sook Ryu
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Oncology ,medicine.medical_specialty ,Receiver operating characteristic ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Standardized uptake value ,General Medicine ,Esophageal cancer ,medicine.disease ,Confidence interval ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Meta-analysis ,Internal medicine ,Interim ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Neoadjuvant therapy - Abstract
To determine the prognostic and predictive value of early metabolic response assessed by a change in standardized uptake value (SUV) on interim 18F-FDG PET in patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy. PubMed and Embase were searched up until 10 September, 2020, for studies evaluating a change in SUV on interim 18F-FDG PET for predicting a pathologic response, progression-free survival (PFS), or overall survival (OS) in patients with esophageal cancer. The sensitivity and specificity for predicting a pathologic response were pooled using bivariate and hierarchical summary receiver operating characteristic (HSROC) models. Meta-analytic pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) were derived using a random-effects model. A total of 11 studies (695 patients) were included in the meta-analysis. For nine studies assessing predictive accuracy, the pooled sensitivity and specificity of an early metabolic response for predicting a pathologic response were 0.80 (95% CI 0.61–0.91) and 0.54 (95% CI 0.45–0.63), respectively. The area under the HSROC curve was 0.64 (95% CI 0.60–0.68). Across the nine studies assessing prognostic value, an early metabolic response determined by interim PET showed pooled HRs for predicting PFS and OS of 0.44 (95% CI, 0.30–0.63) and 0.42 (95% CI, 0.31–0.56), respectively. Change in SUV on interim 18F-FDG PET had significant prognostic value and moderate predictive value for a pathologic response in esophageal cancer treated with neoadjuvant chemoradiotherapy. Interim 18F-FDG PET may help prognostic stratification and guide treatment planning in oncologic practice.
- Published
- 2021
8. Diagnostic Accuracy of MRI in Local Staging (T Category) of Penile Cancer and the Value of Artificial Erection: A Systematic Review and Meta-Analysis
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Satheesh Krishna, Nicola Schieda, Girish S. Kulkarni, Krishna Shanbhogue, Ronaldo H. Baroni, and Sungmin Woo
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Male ,Preoperative Care ,Humans ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Magnetic Resonance Imaging ,Penile Neoplasms ,Sensitivity and Specificity ,Neoplasm Staging - Published
- 2022
9. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in newly diagnosed multiple myeloma: a systematic review and meta-analysis
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Yong Il Kim, Jin-Sook Ryu, Sungmin Woo, Dok Hyun Yoon, and Sangwon Han
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,Interventional radiology ,General Medicine ,Newly diagnosed ,medicine.disease ,Confidence interval ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Positron emission tomography ,030220 oncology & carcinogenesis ,Meta-analysis ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Multiple myeloma ,Neuroradiology - Abstract
We performed a systematic review and meta-analysis on the prognostic values of 18F-FDG PET/CT in patients with newly diagnosed multiple myeloma (MM). PubMed and Embase were searched until July 10, 2019, for studies that reported the prognostic significance of 18F-FDG PET in patients with newly diagnosed MM, with overall (OS) and progression-free survival (PFS) included as outcomes. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were meta-analytically pooled using a random-effects model. Fifteen studies (1670 patients) were included for qualitative synthesis. Among multiple PET parameters, the presence of extramedullary disease (EMD), more than three focal lesions (FLs), and high FDG uptake were widely evaluated and significantly associated with shorter OS and PFS in most of the included studies. Among 11 studies included in quantitative synthesis, the overall HRs of EMD, more than three FLs, and high FDG uptake on PFS were 2.12 (95% CI, 1.52–2.96), 2.38 (95% CI, 1.84–3.07), and 2.02 (95% CI, 1.51–2.68), respectively. The pooled HRs of those three parameters on OS were 2.37 (95% CI, 1.77–3.16), 3.29 (95% CI, 2.38–4.56), and 2.28 (95% CI, 1.67–3.13). No statistical differences were found across parameters for either PFS (p = 0.6822) or OS (p = 0.2147). Pretreatment 18F-FDG PET/CT is a significant predictor for disease progression and survival in patients with MM. It may be a useful prognostic biomarker capable of accurate risk stratification and application in clinical decision-making for newly diagnosed MM. • There remain unmet clinical needs for reliable prognostic biomarkers in patients with newly diagnosed multiple myeloma. • This meta-analysis shows that the presence of extramedullary disease, more than three focal lesions, and high FDG uptake from baseline 18 F-FDG PET are significant prognostic factors. • These imaging biomarkers might help the accurate stratification of patient prognosis which is required for choosing an appropriate therapeutic strategy in clinical practice.
- Published
- 2020
10. CT Characteristics of Non–Small Cell Lung Cancer With Anaplastic Lymphoma Kinase Rearrangement: A Systematic Review and Meta-Analysis
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Sungmin Woo, Darragh Halpenny, Tae Hyung Kim, Chong Hyun Suh, Sangwon Han, and Soon Ho Yoon
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Oncology ,medicine.medical_specialty ,Funnel plot ,Lung Neoplasms ,Pleural effusion ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,hemic and lymphatic diseases ,Internal medicine ,Humans ,Anaplastic lymphoma kinase ,Medicine ,Anaplastic Lymphoma Kinase ,Radiology, Nuclear Medicine and imaging ,Lung cancer ,Gene Rearrangement ,business.industry ,General Medicine ,Publication bias ,Odds ratio ,medicine.disease ,Lymphangitic Carcinomatosis ,030220 oncology & carcinogenesis ,Meta-analysis ,Tomography, X-Ray Computed ,business - Abstract
OBJECTIVE. The purpose of this study was to perform a systematic review and meta-analysis regarding CT features of non–small cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK) rearrangement. MATERIALS AND METHODS. The PubMed and Embase databases were searched up to February 20, 2019. Studies that evaluated CT features of NSCLC with and without ALK rearrangement was included. Methodologic quality was assessed using Quality Assessment of Diagnostic Accuracy Studies–2. The association between CT features and ALK rearrangement was pooled in the form of the odds ratio (OR) or the mean difference (MD) using the random-effects model. Heterogeneity was examined using the inconsistency index (I(2)). Publication bias was examined using funnel plots and Egger tests. RESULTS. Sixteen studies were included, consisting of 3113 patients with NSCLC. The overall prevalence of patients with ALK rearrangement was 17% (528/3113). Compared with NSCLC without ALK rearrangement, on CT images those with ALK rearrangement were more frequently solid (OR = 2.86), central in location (OR = 2.72), and 3 cm or smaller (OR = 0.57); had lower contrast-enhanced CT attenuation (MD = −4.79 HU); more frequently had N2 or N3 disease (OR = 5.63), lymphangitic carcinomatosis (OR = 3.46), pleural effusion (OR = 1.91), or pleural metastasis (OR = 1.81); and less frequently had lung metastasis (OR = 0.66). Heterogeneity varied among CT features (I(2) = 0–80%). No significant publication bias was seen (p = 0.15). CONCLUSION. NSCLC with ALK rearrangement had several distinctive CT features compared with that without ALK rearrangement. These CT biomarkers may help identify patients likely to have ALK rearrangement.
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- 2019
11. Editorial Comment: Time to Ditch Bone Scans for Prostate Cancer Workup in the Era of PSMA PET/CT?
- Author
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Sungmin, Woo
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Male ,Positron Emission Tomography Computed Tomography ,Humans ,Prostatic Neoplasms ,Bone Neoplasms ,Gallium Radioisotopes ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Gallium Isotopes - Published
- 2022
12. Prognostic Value of 18F-FDG PET in Neuroendocrine Neoplasm
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Sungmin Woo, Changhoon Yoo, Tae Hyung Kim, Baek-Yeol Ryoo, Jin-Sook Ryu, Sangwon Han, and Hyo Sang Lee
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Oncology ,medicine.medical_specialty ,business.industry ,Fdg uptake ,Neuroendocrine neoplasm ,General Medicine ,Publication bias ,Prognosis ,Confidence interval ,18f fdg pet ,Neuroendocrine Tumors ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,Internal medicine ,Meta-analysis ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prognostic biomarker ,In patient ,Radiopharmaceuticals ,business - Abstract
Objectives Accurate assessment of the prognosis is critical for the rational treatment of neuroendocrine neoplasms (NENs). We performed a systematic review and meta-analysis of the prognostic value of 18F-FDG PET for NENs. Patients and methods PubMed and Embase databases were searched up to September 2020 for studies that evaluated 18F-FDG PET as prognostic factors in patients with NENs with overall survival (OS) and event-free survival (EFS) as outcomes. Hazards ratios (HRs) comparing high and low FDG uptakes were pooled using the DerSimonian-Laird method. Publication bias was assessed and adjusted for using the trim-and-fill method. Metaregression and subgroup analyses were performed to explore the cause of heterogeneity. Results Twenty-three studies (1799 patients) were included. The overall pooled HRs of high FDG uptake on EFS and OS were 2.84 (95% confidence interval [CI], 2.21-3.64) and 3.50 (95% CI, 2.42-4.12), respectively. Publication biases were present regarding both EFS and OS (P = 0.0342 and 0.0009, respectively). After adjustment, effect sizes remained significant for EFS and OS (adjusted HR, 2.26 [95% CI, 1.76-2.89]; 3.16 [95% CI, 2.42-4.12]). In metaregression analyses, the proportion of grade 3 tumors positively correlated with the HR of OS (adjusted P = 0.0422). Conclusions 18F-FDG PET is a significant prognostic factor in patients with NENs. 18F-FDG PET might be a useful prognostic biomarker in conjunction with the histologic grade and can help select the optimal treatment.
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- 2021
13. The role of imaging in pelvic exenteration for gynecological cancers
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Yukio Sonoda, Soleen Ghafoor, Eric Rios-Doria, Pamela Ines Causa Andrieu, and Sungmin Woo
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medicine.medical_specialty ,Pelvic exenteration ,business.industry ,Genital Neoplasms, Female ,medicine.medical_treatment ,General surgery ,En bloc resection ,General Medicine ,Genitalia, Female ,Magnetic Resonance Imaging ,Multimodal Imaging ,030218 nuclear medicine & medical imaging ,Pelvic Exenteration ,03 medical and health sciences ,0302 clinical medicine ,Female genitourinary oncology special feature: Review Article ,030220 oncology & carcinogenesis ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,business ,Tomography, X-Ray Computed - Abstract
Pelvic exenteration (PE) is one of the most challenging gynecologic oncologic surgeries and is an overriding term for different procedures that entail radical en bloc resection of the female reproductive organs and removal of additional adjacent affected pelvic organs (bladder, rectum, anus, etc.) with concomitant surgical reconstruction to restore bodily functions. Multimodality cross-sectional imaging with MRI, PET/CT, and CT plays an integral part in treatment decision-making, not only for the appropriate patient selection but also for surveillance after surgery. The purpose of this review is to provide a brief background on pelvic exenteration in gynecologic cancers and to familiarize the reader with the critical radiological aspects in the evaluation of patients for this complex procedure. The focus of this review will be on how imaging can aid in treatment planning and guide management.
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- 2021
14. The Diagnostic Performance of MRI for Detection of Extramural Venous Invasion in Colorectal Cancer: A Systematic Review and Meta-Analysis of the Literature
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Chong Hyun Suh, Sangwon Han, Sungmin Woo, Hebert Alberto Vargas, and Tae Hyung Kim
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medicine.medical_specialty ,Colorectal cancer ,Article ,Veins ,030218 nuclear medicine & medical imaging ,Cochran's Q test ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Venous Invasion ,Extramural ,business.industry ,General Medicine ,Publication bias ,medicine.disease ,Magnetic Resonance Imaging ,Primary tumor ,Vascular Neoplasms ,Antispasmodic drugs ,030220 oncology & carcinogenesis ,Meta-analysis ,Radiology ,Colorectal Neoplasms ,business - Abstract
OBJECTIVE: The purpose of this article is to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of MRI for detecting extramural venous invasion (EMVI) in patients with colorectal cancer. MATERIALS AND METHODS: PubMed and EMBASE were searched up to November 9, 2018. We included diagnostic accuracy studies that used MRI for EMVI detection in patients with colorectal cancer, using pathologic analysis as the reference standard. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies–2 tool. Sensitivity and specificity were pooled and plotted in a hierarchic summary ROC plot. Metaregression analysis using several clinically relevant covariates was performed. RESULTS: Fourteen studies (n = 1751 patients) were included. Study quality was moderate in general. Pooled sensitivity was 0.61 (95% CI, 0.49–0.71), and pooled specificity was 0.87 (95% CI, 0.79–0.92). There was substantial heterogeneity according to the Cochran Q test (p < 0.01) and Higgins I(2) heterogeneity index (98% and 95% for sensitivity and specificity, respectively). Publication bias was present (p = 0.01). Higher rates of advanced T category, use of high-resolution MRI, and use of antispasmodic drugs were shown to significantly affect heterogeneity (p < 0.01). Location of primary tumor, preoperative treatment status, study design, definition of reference standard, magnetic field strength, and use of functional MRI were not statistically significant (p = 0.17–0.92). CONCLUSION: MRI shows moderate sensitivity and good specificity for the detection of EMVI in colorectal cancer. The use of high-resolution MRI may improve diagnostic performance.
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- 2019
15. Head-to-Head Comparison Between Biparametric and Multiparametric MRI for the Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis
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Min Hoan Moon, Sungmin Woo, Seung Hyup Kim, Chong Hyun Suh, Jeong Yeon Cho, and Sang Youn Kim
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Male ,medicine.medical_specialty ,Head to head ,business.industry ,MEDLINE ,Contrast Media ,Prostatic Neoplasms ,Multiparametric MRI ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Meta-analysis ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Abstract
The purpose of this study was to perform a systematic review and meta-analysis of a head-to-head comparison between the performance of biparametric MRI (bpMRI; only T2-weighted imaging and DWI) and that of multiparametric MRI (mpMRI; T2-weighted imaging, DWI, dynamic contrast-enhanced MRI) for the diagnosis of prostate cancer.The PubMed and Embase databases were searched up to November 11, 2017. The search included diagnostic test accuracy studies that compared bpMRI and mpMRI for prostate cancer diagnosis with histopathologic findings from biopsy or radical prostatectomy as the reference standard. Methodologic quality was evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies tool. Sensitivity and specificity were pooled by means of bivariate and hierarchic summary ROC (HSROC) modeling and graphically presented with HSROC plots. Meta-regression analysis and multiple subgroup analyses were used to compare the diagnostic performances of bpMRI and mpMRI.Twenty studies (2142 patients) were included. Pooled sensitivity and specificity were 0.74 (95% CI, 0.66-0.81) and 0.90 (95% CI, 0.86-0.93) for bpMRI and 0.76 (95% CI, 0.69-0.82) and 0.89 (95% CI, 0.85-0.93) for mpMRI. MRI protocol (bpMRI vs mpMRI) was not a significant factor in heterogeneity (p = 0.83). In 26 subgroups evaluated on the basis of stratification to clinicopathologic, study, and MRI characteristics, MRI protocol (bpMRI vs mpMRI) was not a significant factor in heterogeneity in any subgroup (p = 0.25-0.97).A head-to-head comparison showed that the performance of bpMRI was similar to that of mpMRI in the diagnosis of prostate cancer. Consistent results were found in multiple subgroup analyses.
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- 2018
16. Prognostic Value of Volume-Based Metabolic Parameters of 18F-FDG PET/CT in Uterine Cervical Cancer: A Systematic Review and Meta-Analysis
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Hye Sung Kim, Chong Hyun Suh, Sungmin Woo, Yeon Joo Kim, and Sangwon Han
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medicine.medical_specialty ,Uterine cervical cancer ,business.industry ,General Medicine ,Metabolic tumor volume ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Total lesion glycolysis ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Meta-analysis ,parasitic diseases ,medicine ,Radiology, Nuclear Medicine and imaging ,Fdg pet ct ,Radiology ,business ,Value (mathematics) ,Volume (compression) - Abstract
OBJECTIVE. The purpose of this study is to perform a systematic review and meta-analysis of volume-based 18F-FDG PET/CT parameters regarding the prognostic value of metabolic tumor volume (MTV) and...
- Published
- 2018
17. Emergency room imaging in pediatric patients with cancer: analysis of the spectrum and frequency of imaging modalities and findings in a tertiary cancer center and their relationship with survival
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Elizabeth Acquafredda, Abdallah Araji, Anita P. Price, Sungmin Woo, Gerald Behr, Natalie Gangai, Hebert Alberto Vargas, Tanya M. Trippett, Mohammad Ali El Amine, and Hedvig Hricak
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Diagnostic Imaging ,Male ,medicine.medical_specialty ,Adolescent ,Pediatric cancer ,Survival ,R895-920 ,Admission ,Imaging modalities ,Imaging ,Medical physics. Medical radiology. Nuclear medicine ,Interquartile range ,Internal medicine ,Neoplasms ,medicine ,Overall survival ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,RC254-282 ,Proportional Hazards Models ,Retrospective Studies ,Radiological and Ultrasound Technology ,business.industry ,Proportional hazards model ,Hazard ratio ,Cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Emergency room ,General Medicine ,medicine.disease ,Pneumonia ,Oncology ,Child, Preschool ,Female ,business ,Emergency Service, Hospital ,Research Article - Abstract
Background To assess the spectrum and frequency of modalities used for emergency room (ER) imaging and their findings in pediatric cancer patients and assess their relationship with survival. Methods Consecutive pediatric cancer patients that underwent imaging during an ER visit at our tertiary cancer center over a 5-year period were retrospectively analyzed. Imaging findings were considered positive when they were relevant to the ER presenting complaint. Imaging positivity was correlated with inpatient admission. Overall survival (OS) was assessed with Kaplan-Meier curves and uni- and multi-variate Cox proportional hazards model was used to identify significant factors associated with OS. Results Two hundred sixty-one patients (135 males and 126 females; median age 11 years [interquartile range 5–16 years] with 348 visits and a total of 406 imaging studies were included. Common chief complaints were related to the chest (100 [28.7 %]) and fever (99 [28.4 %]). ER imaging was positive in 207 visits (59.5 %), commonly revealing increased metastases (50 [14.4 %]), pneumonia (47 [13.5 %]), and other lung problems (12 [2.9 %]). Positive ER imaging was associated with inpatient admission (69.3 % [133/192] vs. 40.4 % [63/156], p p p p Conclusions Imaging was able to delineate the cause for ER visits in children with cancer in over half of the cases. Positive ER imaging was associated with admission and worse survival.
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- 2021
18. Extramedullary Myeloma of the Uterus on 18F-FDG PET/CT: A Rare Manifestation of Multiple Myeloma
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Pamela Ines Causa Andrieu, Reddy Ryan, Jeeban Paul Das, Oguz Akin, Sungmin Woo, and Gary A. Ulaner
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medicine.medical_specialty ,Poor prognosis ,Uterus ,Newly diagnosed ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Multiple myeloma ,Pelvic MRI ,business.industry ,General Medicine ,Tissue sampling ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Plasma cell infiltration ,030220 oncology & carcinogenesis ,Fdg pet ct ,Female ,Radiology ,business ,Multiple Myeloma - Abstract
Involvement of the uterus by myeloma is an extremely rare manifestation of extramedullary multiple myeloma (MM), denoting a poor prognosis. Extramedullary MM occurs in 7% to 18% of newly diagnosed patients with MM, and 6% to 20% of patients can develop it later. We present a case of extramedullary MM of the uterus suspected on F-FDG PET/CT as a site of disease recurrence in a 47-year-old woman previously in remission. Further evaluation with pelvic MRI identified an infiltrative process involving the uterus, and subsequent tissue sampling confirmed malignant plasma cell infiltration of the uterus. This case highlights a rare site of myeloma recurrence, which can be detected by F-FDG PET/CT.
- Published
- 2020
19. Can High-Risk CT Features Suggest Local Recurrence After Stereotactic Body Radiation Therapy for Lung Cancer? A Systematic Review and Meta-analysis
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Darragh Halpenny, Tae Hyung Kim, Yeon Joo Kim, Chong Hyun Suh, Sungmin Woo, and Soon Ho Yoon
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Male ,medicine.medical_specialty ,Lung Neoplasms ,Pleural effusion ,Stereotactic body radiation therapy ,medicine.medical_treatment ,Salvage treatment ,Stereotactic radiation therapy ,Radiosurgery ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lung cancer ,Methodological quality ,Lung ,Aged ,Aged, 80 and over ,business.industry ,Reproducibility of Results ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Treatment Outcome ,030220 oncology & carcinogenesis ,Meta-analysis ,Female ,Radiology ,Neoplasm Recurrence, Local ,business ,Tomography, X-Ray Computed - Abstract
Purpose To perform a systematic review and meta-analysis evaluating usefulness of high-risk CT features (HRFs) on follow-up CT in detecting local recurrence after stereotactic body radiation therapy (SBRT) in lung cancer patients. Methods Pubmed and EMBASE were searched up to January 11th, 2019. We included studies that differentiated local recurrence from post-SBRT changes after SBRT on follow-up CT in lung cancer patients. Methodological quality was assessed using QUADAS-2. The association between HRFs and local recurrence were pooled in the form of odds ratio (OR) using the random effects model. Heterogeneity was examined by the Inconsistency index (I2). Results Eight studies were included, consisting of 356 lung cancer patients. The overall prevalence of patients with local recurrence was 18.8 % (67/356). Compared with post-SBRT changes, local recurrence after SBRT more frequently demonstrated air-bronchogram disappearance (OR = 7.15), bulging margin (OR = 24.12), craniocaudal growth (OR = 26.07), enlargement after 12 months (OR = 28.11), enlarging opacity (OR = 7.92), linear margin disappearance (OR = 29.24), and sequential enlargement (OR = 83.23) (p ≤ 0.02). Pleural effusion appearance was not related with local recurrence (p = 0.82). Heterogeneity varied among HRFs (I2 = 0–91 %). The quality of the studies was considered moderate. Conclusions Several HRFs on follow-up CT after SBRT were useful in suggesting local recurrence. These HRFs may help raise clinical suspicion of local recurrence, initiate prompt additional test for confirmation and perform subsequent proper personalized salvage treatment.
- Published
- 2020
20. Diagnostic performance of conventional and advanced imaging modalities for assessing newly diagnosed cervical cancer: systematic review and meta-analysis
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Sungmin Woo, Zachary J. Ward, Hedvig Hricak, Rifat Atun, Andrew M. Scott, and Hebert Alberto Vargas
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medicine.medical_specialty ,Uterine Cervical Neoplasms ,Sensitivity and Specificity ,Article ,Fluorodeoxyglucose F18 ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Invasiveness ,Lymph node ,Neuroradiology ,Ultrasonography ,Cervical cancer ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Magnetic resonance imaging ,Interventional radiology ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Positron emission tomography ,Meta-analysis ,Lymphatic Metastasis ,Positron-Emission Tomography ,Female ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
To review the diagnostic performance of contemporary imaging modalities for determining local disease extent and nodal metastasis in patients with newly diagnosed cervical cancer. Pubmed and Embase databases were searched for studies published from 2000 to 2019 that used ultrasound (US), CT, MRI, and/or PET for evaluating various aspects of local extent and nodal metastasis in patients with newly diagnosed cervical cancer. Sensitivities and specificities from the studies were meta-analytically pooled using bivariate and hierarchical modeling. Of 1311 studies identified in the search, 115 studies with 13,999 patients were included. MRI was the most extensively studied modality (MRI, CT, US, and PET were evaluated in 78, 12, 9, and 43 studies, respectively). Pooled sensitivities and specificities of MRI for assessing all aspects of local extent ranged between 0.71–0.88 and 0.86–0.95, respectively. In assessing parametrial invasion (PMI), US demonstrated pooled sensitivity and specificity of 0.67 and 0.94, respectively—performance levels comparable with those found for MRI. MRI, CT, and PET performed comparably for assessing nodal metastasis, with low sensitivity (0.29–0.69) but high specificity (0.88–0.98), even when stratified to anatomical location (pelvic or paraaortic) and level of analysis (per patient vs. per site). MRI is the method of choice for assessing any aspect of local extent, but where not available, US could be of value, particularly for assessing PMI. CT, MRI, and PET all have high specificity but poor sensitivity for the detection of lymph node metastases. • Magnetic resonance imaging is the method of choice for assessing local extent. • Ultrasound may be helpful in determining parametrial invasion, especially in lower-resourced countries. • Computed tomography, magnetic resonance imaging, and positron emission tomography perform similarly for assessing lymph node metastasis, with high specificity but low sensitivity.
- Published
- 2020
21. Prognostic Value of Pretreatment MRI in Patients With Prostate Cancer Treated With Radiation Therapy: A Systematic Review and Meta-Analysis
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Michael J. Zelefsky, Tae Hyung Kim, Sangwon Han, Hebert Alberto Vargas, Chong Hyun Suh, Hedvig Hricak, Sungmin Woo, and Antonio C. Westphalen
- Subjects
Oncology ,Biochemical recurrence ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Article ,030218 nuclear medicine & medical imaging ,Metastasis ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,business.industry ,Hazard ratio ,Prostatic Neoplasms ,General Medicine ,medicine.disease ,Prognosis ,Magnetic Resonance Imaging ,Radiation therapy ,030220 oncology & carcinogenesis ,Meta-analysis ,business - Abstract
OBJECTIVE. Despite a substantial increase in the use of MRI for pretreatment evaluation of prostate cancer, its prognostic value in patients undergoing radiation therapy (RT) is not well known. Therefore, the purpose of this study was to systematically review the literature and perform a meta-analysis on the prognostic value of pretreatment MRI in patients with prostate cancer who underwent external beam radiation therapy (EBRT) or brachytherapy. MATERIALS AND METHODS. PubMed and Embase databases were searched for studies published on or before March 13, 2019. We included studies that evaluated pretreatment MRI as a prognostic factor in prostate cancer regarding biochemical recurrence (BCR), metastatic failure, and overall or cancer-specific mortality. Effect sizes were measured in terms of the hazard ratio (HR) and were meta-analytically pooled using the random-effects model. The quality of the studies was independently evaluated using the Quality in Prognostic Studies tool. RESULTS. Twelve studies (2205 patients) were included. All studies assessed BCR; metastasis was evaluated in three studies, and mortality was evaluated in one study. Extraprostatic extension (EPE), seminal vesicle invasion (SVI), large tumor size or volume, number of sextants involved, and tumor involvement of prostatic apex were significant prognostic factors of BCR (pooled HRs = 1.50-4.47). EPE, larger tumor size, greater tumor volume, presence of metastatic pelvic lymph nodes (LNs), and presence of SVI were significant risk factors for metastasis (pooled HRs = 1.12-11.96). Pelvic LN metastasis was significantly predictive of cancer-specific mortality (HR = 4.45 [95% CI, 1.30-15.23]). CONCLUSION. Several pretreatment MRI findings were significant prognostic factors in patients with prostate cancer who underwent RT.
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- 2019
22. Prognostic value of volume-based metabolic parameters of 18F-FDG PET/CT in ovarian cancer: a systematic review and meta-analysis
- Author
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Chong Hyun Suh, Sungmin Woo, Sangwon Han, Yeon Joo Kim, and Hye Sung Kim
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Hazard ratio ,Disease progression ,General Medicine ,Metabolic tumor volume ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Total lesion glycolysis ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Meta-analysis ,parasitic diseases ,Medicine ,Radiology, Nuclear Medicine and imaging ,Fdg pet ct ,In patient ,business ,Ovarian cancer - Abstract
To perform a systematic review and meta-analysis on the prognostic value of 18F-FDG PET-derived volume-based parameters regarding metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with ovarian cancer. Pubmed and EMBASE databases were searched up to February 12, 2018 for studies which evaluated MTV or TLG as a prognostic factor in ovarian cancer with progression-free (PFS) and overall survival (OS) as the endpoints. Hazard ratios (HRs) were meta-analytically pooled using the random-effects model. Multiple subgroup analyses based on clinicopathological and PET variables were performed. Eight studies with 473 patients were included. The pooled HRs of MTV and TLG for PFS were 2.50 (95% CI 1.79–3.48; p
- Published
- 2018
23. A systematic review of the prognostic value of texture analysis in 18F-FDG PET in lung cancer
- Author
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Yeon Joo Kim, Chong Hyun Suh, Sangwon Han, Jong Jin Lee, Sungmin Woo, and Jungsu S. Oh
- Subjects
Oncology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,General Medicine ,medicine.disease ,Texture (geology) ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Positron emission tomography ,030220 oncology & carcinogenesis ,Internal medicine ,Image acquisition ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Lung cancer ,Value (mathematics) ,Statistical evidence ,Survival analysis - Abstract
The aim of this study was to perform a systematic review of the prognostic value of texture parameters derived by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with lung cancer. PubMed and EMBASE databases were searched up to March 12, 2018, for original articles involving texture analysis for the prediction of prognosis in patients with lung cancer. Risk of bias in the studies was critically assessed using the QUIPS tool. The results of survival analysis in the included studies were compared. Of the 446 articles retrieved, 17 studies were eligible for inclusion. Our review suggests that the prognostic value of texture parameters in lung cancer remains unproven. Most studies had a moderate to high risk of bias. Texture parameters that described prognosis were not replicated across studies. Conflicting results on hazard ratios were found among the studies. This discrepancy is partly explained by false-positive findings originating from statistical error and variability caused by different methodologies used for image acquisition and processing in the included studies. Based on currently available evidence, there is insufficient evidence to support the prognostic value of texture analysis in 18F-FDG PET in lung cancer. Further studies implementing well-established methodologies and statistical evidence are warranted for proper validation of these promising imaging biomarkers.
- Published
- 2018
24. Head-To-Head Comparison Between High- and Standard-b-Value DWI for Detecting Prostate Cancer: A Systematic Review and Meta-Analysis
- Author
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Seung Hyup Kim, Sungmin Woo, Chong Hyun Suh, Jeong Yeon Cho, and Sang Youn Kim
- Subjects
Adult ,Male ,Head to head ,MEDLINE ,Diagnostic accuracy ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Reference standards ,Aged ,Aged, 80 and over ,business.industry ,Quality assessment ,Prostatic Neoplasms ,General Medicine ,Middle Aged ,High B-Value ,medicine.disease ,Diffusion Magnetic Resonance Imaging ,030220 oncology & carcinogenesis ,Meta-analysis ,business ,Nuclear medicine - Abstract
The purpose of this study was to perform a head-to-head comparison between high-b-value (1000 s/mmThe MEDLINE and EMBASE databases were searched up to April 1, 2017. The analysis included diagnostic accuracy studies in which high- and standard-b-value DWI were used for prostate cancer detection with histopathologic examination as the reference standard. Methodologic quality was assessed with the revised Quality Assessment of Diagnostic Accuracy Studies tool. Sensitivity and specificity of all studies were calculated and were pooled and plotted in a hierarchic summary ROC plot. Meta-regression and multiple-subgroup analyses were performed to compare the diagnostic performances of high- and standard-b-value DWI.Eleven studies (789 patients) were included. High-b-value DWI had greater pooled sensitivity (0.80 [95% CI, 0.70-0.87]) (p = 0.03) and specificity (0.92 [95% CI, 0.87-0.95]) (p = 0.01) than standard-b-value DWI (sensitivity, 0.78 [95% CI, 0.66-0.86]); specificity, 0.87 [95% CI, 0.77-0.93] (p0.01). Multiple-subgroup analyses showed that specificity was consistently higher for high- than for standard-b-value DWI (p ≤ 0.05). Sensitivity was significantly higher for high- than for standard-b-value DWI only in the following subgroups: peripheral zone only, transition zone only, multiparametric protocol (DWI and T2-weighted imaging), visual assessment of DW images, and per-lesion analysis (p ≤ 0.04).In a head-to-head comparison, high-b-value DWI had significantly better sensitivity and specificity for detection of prostate cancer than did standard-b-value DWI. Multiple-subgroup analyses showed that specificity was consistently superior for high-b-value DWI.
- Published
- 2018
25. Pheochromocytoma as a frequent false-positive in adrenal washout CT: A systematic review and meta-analysis
- Author
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Seung Hyup Kim, Sungmin Woo, Sang Youn Kim, Chong Hyun Suh, and Jeong Yeon Cho
- Subjects
Adenoma ,endocrine system ,medicine.medical_specialty ,endocrine system diseases ,Adrenal Gland Neoplasm ,Adrenal Gland Neoplasms ,Pheochromocytoma ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Adrenal adenoma ,False Positive Reactions ,Radiology, Nuclear Medicine and imaging ,Neuroradiology ,business.industry ,Washout ,General Medicine ,medicine.disease ,ROC Curve ,030220 oncology & carcinogenesis ,Meta-analysis ,Radiology ,Differential diagnosis ,Tomography, X-Ray Computed ,business - Abstract
To evaluate the proportion of pheochromocytomas meeting the criteria for adenoma on adrenal washout CT and the diagnostic performance of adrenal washout CT for differentiating adenoma from pheochromocytoma. MEDLINE and EMBASE were searched to 28 March 2017. We included studies that used adrenal washout CT for characterisation of pheochromocytomas. Two independent reviewers assessed the methodological quality using Quality Assessment of Diagnostic Accuracy Studies-2. Proportions were pooled using an inverse variance method for calculating weights (random-effects). Sensitivity and specificity were pooled using hierarchical logistic regression modelling and plotted in a hierarchical summary receiver-operating-characteristics (HSROC) plot. Ten studies (114 pheochromocytomas) were included. The pooled proportion of pheochromocytomas meeting the criteria for adenomas was 35 % (95 % CI 20–51). For eight studies providing information on diagnostic performance, the pooled sensitivity and specificity for differentiating adenoma from pheochromocytoma were 0.97 (95 % CI 0.93–0.99) and 0.67 (95 % CI 0.44–0.84), respectively. The area under the HSROC curve was 0.97 (95 % CI 0.95–0.98). There was a non-negligible proportion of pheochromocytomas meeting the criteria for adenoma on adrenal washout CT. Although overall diagnostic performance was excellent for differentiating adenoma from pheochromocytoma, specificity was relatively low. • Non-negligible proportion of pheochromocytomas can be mistaken for adenoma. • Adrenal washout CT showed good sensitivity (97%) but relatively low specificity (67%). • Findings other than washout percentage should be used when diagnosing pheochromocytomas
- Published
- 2017
26. Shear-Wave Elastography for Detection of Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis
- Author
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Jeong Yeon Cho, Chong Hyun Suh, Sungmin Woo, Sang Youn Kim, and Seung Hyup Kim
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Shear wave elastography ,genetic structures ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Prostatic Neoplasms ,General Medicine ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Meta-analysis ,Elasticity Imaging Techniques ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Elastography ,Radiology ,business - Abstract
The objective of this study is to review the diagnostic performance of shear-wave elastography (SWE) in the detection of prostate cancer (PCa).The MEDLINE, EMBASE, and Cochrane library databases were searched up to December 23, 2016. We included diagnostic accuracy studies that used SWE for PCa detection with prostatectomy or biopsy used as the reference standard. The methodologic quality of the studies was evaluated by two independent reviewers using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary ROC plot with further exploration done using meta-regression analysis and subgroup analysis.Eight studies (a total of 1028 patients) were evaluated. The pooled sensitivity was 0.83 (95% CI, 0.66-0.92) with a specificity of 0.85 (95% CI, 0.78-0.90) for the detection of PCa. Study design (prospective vs retrospective) was the only significant factor affecting heterogeneity (p0.01). At subgroup analysis, the pooled sensitivity and specificity were 0.84 (95% CI, 0.64-0.94) and 0.84 (95% CI, 0.76-0.90), respectively, in studies using shear-wave speed imaging and 0.84 (95% CI, 0.64-0.94) and 0.86 (95% CI, 0.78-0.91), respectively, in studies based on per-lesion analysis.SWE shows good performance for the detection of PCa. However, specific recommendations regarding cutoff value cannot be made because of study heterogeneity.
- Published
- 2017
27. Diagnostic performance of MRI for prediction of muscle-invasiveness of bladder cancer: A systematic review and meta-analysis
- Author
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Seung Hyup Kim, Sang Youn Kim, Sungmin Woo, Jeong Yeon Cho, and Chong Hyun Suh
- Subjects
Adult ,Oncology ,medicine.medical_specialty ,030232 urology & nephrology ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Neoplasm Invasiveness ,Radiology, Nuclear Medicine and imaging ,In patient ,Methodological quality ,Sensitivity analyses ,Aged ,Aged, 80 and over ,Muscle Neoplasms ,Bladder cancer ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Quality assessment ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Urinary Bladder Neoplasms ,Meta-analysis ,Radiology ,business - Abstract
Purpose To review the diagnostic performance of ≥1.5-T MRI for local staging of bladder cancer. Methods MEDLINE and EMBASE were searched up to February 21, 2017. We included diagnostic accuracy studies published since 2000 that used ≥1.5-T MRI for local staging (≥T2 [muscle-invasive]) in patients with bladder cancer, using pathology as the reference standard. The methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity were pooled and plotted in a hierarchical summary receiver operating characteristics plot. Sensitivity analyses using several clinically relevant covariates were performed. Results 24 studies (1774 patients) were included. Pooled sensitivity was 0.92 (95% CI 0.88–0.95) with specificity of 0.87 (95% CI 0.78–0.93). Sensitivity analyses showed that sensitivity estimates were comparable and consistently high across all subgroups, but specificity estimates were variable. Studies using 3-T scanners had higher specificity (0.93 [95% CI 0.86–0.98]) than those using 1.5-T scanners (0.83 [95% CI 0.74–0.98]). Studies using multiparametric MRI (conventional + ≥2 functional sequences) showed the highest accuracy with sensitivity and specificity of 0.94 (95% CI 0.89–1.00) and 0.95 (95% CI 0.89–0.98), respectively. Conclusions MRI shows good diagnostic performance for predicting muscle-invasiveness of bladder cancer. Multiparametric 3-T MRI seems to improve both sensitivity and specificity.
- Published
- 2017
28. Differentiation between papillary renal cell carcinoma and fat-poor angiomyolipoma: a preliminary study assessing detection of intratumoral hemorrhage with chemical shift MRI and T2*-weighted gradient echo
- Author
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Sungmin Woo, Jeong Yeon Cho, Sang Youn Kim, and Seung Hyup Kim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Angiomyolipoma ,Hemorrhage ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,Aged, 80 and over ,Radiological and Ultrasound Technology ,Papillary renal cell carcinomas ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Kidney Neoplasms ,030220 oncology & carcinogenesis ,Hemosiderin ,Female ,Radiology ,Differential diagnosis ,business ,T2 weighted ,Gradient echo - Abstract
Background Recent literature suggests that intratumoral hemorrhage detection may be helpful in differentiating papillary renal cell carcinoma (pRCC) from fat-poor angiomyolipoma (fpAML). Purpose To determine whether intratumoral hemorrhage detected using chemical shift magnetic resonance imaging (MRI) and T2*-weighted (T2*W) gradient echo (GRE) can be used to differentiate pRCC from fpAML. Material and Methods This retrospective study included 42 patients with pRCC (n = 28) and fpAML (n = 14) who underwent MRI followed by surgery. Two blinded radiologists independently assessed the presence of intratumoral hemorrhage using chemical shift MRI (decrease in signal intensity from opposed- to in-phase) and T2*W GRE (“blooming”). Consensus reading was determined for discrepant cases. MRI findings were compared using Chi-square test. Inter-observer agreement was assessed using kappa statistics. Results Inter-observer agreement was substantial for both sequences ( k = 0.622 and 0.793, P Conclusion The prevalence of intratumoral hemorrhage identified from chemical shift MRI or T2*W GRE was significantly different between pRCC and fpAML. These hemorrhage-sensitive MRI sequences may be used as an adjunctive tool for discriminating between the two entities.
- Published
- 2017
29. Magnetic resonance imaging for detection of parametrial invasion in cervical cancer: An updated systematic review and meta-analysis of the literature between 2012 and 2016
- Author
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Chong Hyun Suh, Seung Hyup Kim, Jeong Yeon Cho, Sang Youn Kim, and Sungmin Woo
- Subjects
medicine.medical_specialty ,Uterine Cervical Neoplasms ,Subgroup analysis ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Neoplasm Invasiveness ,Radiology, Nuclear Medicine and imaging ,Peritoneal Neoplasms ,Neuroradiology ,Cervical cancer ,medicine.diagnostic_test ,Receiver operating characteristic ,Parametrial ,business.industry ,Magnetic resonance imaging ,Interventional radiology ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,030220 oncology & carcinogenesis ,Meta-analysis ,Female ,Radiology ,Peritoneum ,business - Abstract
To review the diagnostic performance of MRI for detection of parametrial invasion (PMI) in cervical cancer patients. MEDLINE and EMBASE databases were searched for studies providing diagnostic performance of MRI for detecting PMI in patients with cervical cancer. Studies published between 2012 and 2016 using surgico-pathological results as reference standard were included. Study quality was evaluated using QUADAS-2. Sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary receiver operating characteristic plot. Meta-regression and subgroup analyses were performed. Fourteen studies (1,028 patients) were included. Study quality was generally moderate. Pooled sensitivity was 0.76 (95% CI 0.67–0.84) and specificity was 0.94 (95% CI 0.91–0.95). The possibility of heterogeneity was considered low: Cochran’s Q-test (p = 0.471), Tau2 (0.240), Higgins I2 (0%). With meta-regression analysis, magnet strength, use of DWI, and antispasmodic drugs were significant factors affecting heterogeneity (p
- Published
- 2017
30. Diagnostic performance of computed tomography for bowel endometriosis: A systematic review and meta-analysis
- Author
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Chong Hyun Suh, Hye Sung Kim, and Sungmin Woo
- Subjects
Adult ,medicine.medical_specialty ,Tomography Scanners, X-Ray Computed ,Adolescent ,Endometriosis ,Computed tomography ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Intestinal Neoplasms ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Laparoscopy ,Methodological quality ,Prior Surgery ,medicine.diagnostic_test ,business.industry ,General Medicine ,Publication bias ,Equipment Design ,Middle Aged ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Meta-analysis ,Female ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
Purpose To perform a systematic review and meta-analysis regarding the performance of CT for diagnosis of bowel endometriosis. Materials and methods Pubmed and EMBASE were systematically searched up to March 28, 2019. Diagnostic accuracy studies using CT for diagnosis of bowel endometriosis using laparoscopy followed by histopathology as the reference standard were included. Methodological quality of the included studies was evaluated using Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity were pooled using hierarchical summary receiver operating modelling. Meta-regression analysis was done to explore heterogeneity. Results Twelve studies (1091 patients) were included. Pooled sensitivity and specificity were 0.92 (95% confidence interval [CI], 0.83-0.97) and 0.95 (95% CI, 0.88-0.98), respectively. Substantial heterogeneity was present: I2 = 92.38% for sensitivity and 89.09% for specificity. Deeks’ asymmetry test suggested publication bias (p = 0.04). At meta-regression analysis, history of prior surgery for endometriosis was the only significant factor affecting heterogeneity (p Conclusions CT shows excellent performance in the diagnosis of bowel endometriosis. Due to small number of included studies and publication bias, further studies may be needed to validate these results.
- Published
- 2019
31. Prognostic Value of Volumetric Parameters of Pretreatment 18F-FDG PET/CT in Esophageal Cancer: A Systematic Review and Meta-analysis
- Author
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Chong Hyun Suh, Sungmin Woo, Sangwon Han, Jong Jin Lee, and Yeon Joo Kim
- Subjects
Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Predictive Value of Tests ,Internal medicine ,Positron Emission Tomography Computed Tomography ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Progression-free survival ,Stage (cooking) ,business.industry ,Hazard ratio ,General Medicine ,Esophageal cancer ,medicine.disease ,Confidence interval ,Progression-Free Survival ,030220 oncology & carcinogenesis ,Meta-analysis ,Predictive value of tests ,Fdg pet ct ,Radiopharmaceuticals ,business ,Glycolysis - Abstract
Purpose We performed a systematic review and meta-analysis on the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) derived from pretreatment F-FDG PET/CT in patients with esophageal cancer. Methods PubMed and EMBASE databases were searched until April 12, 2018, for studies that evaluated MTV or TLG as prognostic factors in esophageal cancer, with overall survival (OS) and event-free survival serving as the end points. Hazard ratios (HRs) were meta-analytically pooled using a random-effects model. Subgroup analyses based on the clinicopathological and PET variables were performed. Results In total, 16 studies with 1294 patients were included. The pooled HRs of MTV and TLG for OS were 2.26 (95% confidence interval [CI], 1.73-2.96) and 2.23 (95% CI, 1.73-2.87), respectively. Regarding event-free survival, the pooled HRs of MTV and TLG were 2.03 (95% CI, 1.66-2.49) and 2.57 (95% CI, 1.82-3.62), respectively. Metabolic tumor volume was found to be a significant prognostic factor for OS consistently across multiple subgroups classified based on stage, histological subtype, treatment, delineation of volume of interest, and the determination method of cutoff value, with pooled HRs ranging from 1.96 to 2.54. Conclusions In patients with esophageal cancer, MTV and TLG derived from pretreatment F-FDG PET are significant prognostic factors. As prognostic biomarkers, volumetric metabolic parameters may bolster the role of F-FDG PET in the management of esophageal cancer.
- Published
- 2018
32. Commentary on 'Prostate-Specific Membrane Antigen PET-CT in Patients With High-Risk Prostate Cancer Before Curative-Intent Surgery or Radiotherapy (proPSMA): a Prospective, Randomised, Multicentre Study'
- Author
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Hebert Alberto Vargas and Sungmin Woo
- Subjects
Curative intent ,Oncology ,PET-CT ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,MEDLINE ,General Medicine ,medicine.disease ,Radiation therapy ,Prostate cancer ,Text mining ,Internal medicine ,Glutamate carboxypeptidase II ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,business - Published
- 2021
33. Preoperative Evaluation of Prostate Cancer Aggressiveness: Using ADC and ADC Ratio in Determining Gleason Score
- Author
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Sungmin Woo, Seung Hyup Kim, Jeong Yeon Cho, and Sang Youn Kim
- Subjects
Male ,Prostate Cancer Aggressiveness ,Biopsy ,medicine.medical_treatment ,Spearman's rank correlation coefficient ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Unpaired t-Test ,medicine ,Humans ,Effective diffusion coefficient ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Prostatectomy ,Urinary bladder ,Receiver operating characteristic ,business.industry ,Prostatic Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,body regions ,Diffusion Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Neoplasm Grading ,Nuclear medicine ,business - Abstract
The objective of our study was to evaluate apparent diffusion coefficient (ADC) and various ADC ratios in determining aggressiveness of prostate cancer.One hundred sixty-five patients with biopsy-proven prostate cancer underwent 3-T MRI followed by radical prostatectomy. ADC and ADC ratios were calculated using the peripheral zone, transition zone, same zone as the tumor, and urinary bladder as references. ADC and ADC ratios were correlated with Gleason score using the Spearman correlation coefficient (ρ) and were compared between low-grade (Gleason score = 6) and high-grade (Gleason score ≥ 7) prostate cancer using the unpaired t test. ROC curves were used to compare diagnostic accuracies of ADC and ADC ratios in determining high-grade prostate cancer.Fifty-six (33.9%) and 109 (66.1%) patients had low- and high-grade prostate cancer, respectively. ADC (ρ = -0.476) and all ADC ratios (ρ = -0.397, -0.412, -0.381, and -0.474, respectively) correlated significantly with Gleason score (p0.001) and were significantly lower in patients with high-grade prostate cancer (p0.001). For predicting high-grade prostate cancer, tumor ADC and tumor-to-urinary bladder ADC ratio showed the highest AUC (0.794 and 0.790, respectively) but without statistically significant difference (p = 0.803). AUC of tumor ADC (0.794) was statistically significantly higher than those of the tumor-to-peripheral zone and tumor-to-transition zone ADC ratios (0.746, p = 0.039; 0.751, p = 0.027; respectively). AUC of tumor ADC was not statistically significantly higher than that of the tumor-to-tumor zone ADC ratio (0.763, p = 0.193). AUC calculated using the tumor-to-urinary bladder ADC ratio was statistically significantly higher than that using the tumor-to-transition zone ADC ratio (p = 0.028) and marginally higher than that from tumor-to-peripheral zone ADC ratio (p = 0.080). Otherwise, no significant differences were seen in the AUCs (p = 0.193-0.828).Both ADC and various ADC ratios correlated significantly with Gleason score and were significant predictors of high-grade prostate cancer. However, no benefit was found in using ADC ratio over ADC.
- Published
- 2016
34. JOURNAL CLUB: Identification of Bone Metastasis With Routine Prostate MRI: A Study of Patients With Newly Diagnosed Prostate Cancer
- Author
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Seung Hyup Kim, Sang Youn Kim, Sungmin Woo, and Jeong Yeon Cho
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Bone Neoplasms ,030218 nuclear medicine & medical imaging ,Metastasis ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Predictive Value of Tests ,Prostate ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Bone metastasis ,Magnetic resonance imaging ,Retrospective cohort study ,General Medicine ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Magnetic Resonance Imaging ,Prostate-specific antigen ,medicine.anatomical_structure ,ROC Curve ,030220 oncology & carcinogenesis ,Predictive value of tests ,Radiology ,Neoplasm Grading ,business - Abstract
The purpose of this study was to evaluate whether routine prostate MRI is adequate for detection of bone metastasis in patients with newly diagnosed prostate cancer.The study included 308 patients with newly diagnosed prostate cancer who underwent prostate MRI. Two radiologists categorized MRI findings as normal, metastasis, or equivocal. Histologic analysis or best valuable comparator based on comprehensive review of images and clinical follow-up studies were used as reference standards. Clinicopathologic variables and MRI findings were compared between patients with and those without bone metastasis by use of chi-square and t tests. The diagnostic performance of prostate MRI for detecting bone metastasis was assessed by ROC analysis. Subgroup analysis was performed for patients at high risk of bone metastasis.Twenty-one (6.8%) patients had bone metastasis. They had significantly higher prostate-specific antigen levels (p = 0.015) and Gleason scores (p0.001) than those without bone metastasis. The diagnostic performance of MRI was as follows: sensitivity, 95.2%; specificity, 99-100%; positive predictive value, 86.9-100%; negative predictive value, 99.7%. For 119 patients at high risk of bone metastasis, these values were 95%, 100%, 100%, and 99%. Only 1 of the 21 (4.8%) patients had bone metastasis only in an area not explored with prostate MRI, that is, the thoracic spine.The diagnostic performance of routine prostate MRI for identifying bone metastasis in patients with newly diagnosed prostate cancer was excellent.
- Published
- 2016
35. Prostate cancer-specific mortality after radical prostatectomy: value of preoperative MRI
- Author
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Sang Youn Kim, Sungmin Woo, Seung Hyup Kim, Ja Hyeon Ku, and Jeong Yeon Cho
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Predictive Value of Tests ,Prostate ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Prostatectomy ,Univariate analysis ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Cancer ,Magnetic resonance imaging ,General Medicine ,Specific mortality ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Predictive value of tests ,Preoperative Period ,Radiology ,Neoplasm Grading ,business ,Nuclear medicine ,Follow-Up Studies - Abstract
Background Although magnetic resonance imaging (MRI) is currently indispensable in the preoperative setting of biopsy-proven prostate cancer, the value of preoperative MRI for predicting prostate cancer-specific mortality (PCSM) is not well known. Purpose To evaluate the value of MRI for predicting PCSM in patients who underwent radical prostatectomy (RP) for localized prostate cancer. Material and Methods A total of 318 patients underwent MRI followed by RP. MRI was assessed for the presence of clinically significant cancer using a five-point Likert scale, where ≥4 was considered positive. Cox proportional hazards regression analyses was used to determine the relationship of preoperative factors with PCSM. PCSM was calculated using the Kaplan-Meier method and compared between factors using the log-rank test. Results After a median follow-up of 104 months, 11 (3.5%) patients died of prostate cancer. One hundred and four (32.7%) patients had clinically significant prostate cancer on MRI. Univariate analysis revealed that Gleason grade, greatest percentage of involved core length (GPCL), and clinically significant cancer on MRI were significantly related to PCSM ( P = 0.001–0.003). Multivariate analysis showed that GPCL (hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.000–1.057; P = 0.048) and clinically significant cancer on MRI (HR, 10.903; 95% CI, 1.287–92.374; P = 0.028) were independent predictors of PCSM. The 5 - and 10-year PCSM rates were 0.6% and 1.3% in patients with GPCL Conclusion Preoperative MRI and GPCL may be used to predict PCSM after RP.
- Published
- 2015
36. The Diagnostic Performance of MRI for Detection of Lymph Node Metastasis in Bladder and Prostate Cancer: An Updated Systematic Review and Diagnostic Meta-Analysis
- Author
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Jeong Yeon Cho, Chong Hyun Suh, Sungmin Woo, Seung Hyup Kim, and Sang Youn Kim
- Subjects
Male ,medicine.medical_specialty ,MEDLINE ,Contrast Media ,Lymph node metastasis ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Metastasis ,Diagnosis, Differential ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Lymph node ,Bladder cancer ,business.industry ,Prostatic Neoplasms ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Meta-analysis ,Lymphatic Metastasis ,Female ,Radiology ,business - Abstract
The purpose of this article is to review the diagnostic performance of MRI for the detection of pelvic lymph node (LN) metastasis in patients with bladder and prostate cancer.MEDLINE and EMBASE were searched up to January 13, 2017. We included diagnostic accuracy studies that used MRI for pelvic LN detection in patients with bladder or prostate cancer, using histopathologic analyses published since 2000 as the reference standard. Two independent reviewers assessed the methodologic quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity of all studies were calculated. Per-patient and per-LN results were pooled and plotted in a hierarchic summary ROC plot. Metaregression, sensitivity, and subgroup analyses were performed.Twenty-four studies (2928 patients) were included. Pooled per-patient sensitivity (n = 21) was 0.56 (95% CI, 0.42-0.69) with a specificity of 0.94 (95% CI, 0.90-0.96). Per-LN pooled estimates (n = 9) showed consistent results: sensitivity of 0.57 (95% CI, 0.29-0.82) and specificity of 0.97 (95% CI, 0.94-0.98). At metaregression analysis, type of cancer, magnet field strength, and use of ultrasmall superparamagnetic particles of iron oxide (USPIO) were significant factors affecting heterogeneity (p ≤ 0.01). Sensitivity analyses showed that specificity estimates were comparable (range, 0.87-0.95), but sensitivity estimates showed significant differences. Studies that used USPIO (n = 4) had higher sensitivity (0.86; 95% CI, 0.62-0.96) than did those not using USPIO (n = 17; 0.46; 95% CI, 0.35-0.58).MRI shows high specificity but poor and heterogeneous sensitivity for detecting pelvic LN metastasis in patients with bladder and prostate cancer. Using USPIO can improve sensitivity.
- Published
- 2018
37. Performance of pre-treatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography for detecting metastasis in ovarian cancer: a systematic review and meta-analysis
- Author
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Sangwon Han, Jong Jin Lee, Chong Hyun Suh, and Sungmin Woo
- Subjects
Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Confidence interval ,030218 nuclear medicine & medical imaging ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Obstetrics and gynaecology ,Positron emission tomography ,030220 oncology & carcinogenesis ,Laparotomy ,Meta-analysis ,medicine ,business ,Ovarian cancer ,Nuclear medicine - Abstract
Objective We describe a systematic review and meta-analysis of the performance of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting metastasis in ovarian cancer. Methods MEDLINE and Embase were searched for diagnostic accuracy studies that used ¹⁸F-FDG PET or PET/CT for pre-treatment staging, using surgical findings as the reference standard. Sensitivities and specificities were pooled and plotted in a hierarchic summary receiver operating characteristic plot. Potential causes of heterogeneity were explored through sensitivity analyses. Results Eight studies with 594 patients were included. The overall pooled sensitivity and specificity for metastasis were 0.72 (95% confidence interval [CI]=0.61-0.81) and 0.93 (95% CI=0.85-0.97), respectively. There was considerable heterogeneity in sensitivity (I²=97.57%) and specificity (I²=96.74%). In sensitivity analyses, studies that used laparotomy as the reference standard showed significantly higher sensitivity and specificity (0.77; 95% CI=0.67-0.87 and 0.96; 95% CI=0.92-0.99, respectively) than those including diagnostic laparoscopy (0.62; 95% CI=0.46-0.77 and 0.84; 95% CI=0.69-0.99, respectively). Higher specificity was shown in studies that confirmed surgical findings by pathologic evaluation (0.95; 95% CI=0.90-0.99) than in a study without pathologic confirmation (0.69; 95% CI=0.24-1.00). Studies with a lower prevalence of the FDG-avid subtype showed higher specificity (0.97; 95% CI=0.94-1.00) than those with a greater prevalence (0.89; 95% CI=0.80-0.97). Conclusion Pre-treatment ¹⁸F-FDG PET/CT shows moderate sensitivity and high specificity for detecting metastasis in ovarian cancer. With its low false-positive rate, it can help select surgical approaches or alternative treatment options.
- Published
- 2018
38. Extracapsular Extension in Prostate Cancer: Added Value of Diffusion-Weighted MRI in Patients With Equivocal Findings on T2-Weighted Imaging
- Author
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Jeong Y.eon Cho, Seung Hoon Kim, Sungmin Woo, and Sang Y.oun Kim
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Prostate cancer ,Prostate ,Humans ,Medicine ,Effective diffusion coefficient ,Neoplasm Invasiveness ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Aged ,Retrospective Studies ,Aged, 80 and over ,Receiver operating characteristic ,business.industry ,Prostatectomy ,Prostatic Neoplasms ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,Diffusion Magnetic Resonance Imaging ,medicine.anatomical_structure ,Radiology ,business ,Nuclear medicine ,Student's t-test ,Diffusion MRI - Abstract
OBJECTIVE. The objective of our study was to evaluate diffusion-weighted imaging (DWI) and T2-weighted imaging for predicting extracapsular extension (ECE) in patients with prostate cancer. MATERIALS AND METHODS. One hundred seventeen patients underwent preoperative 3-T MRI and radical prostatectomy. Two radiologists evaluated ECE with T2-weighted imaging based on the Prostate Imaging Reporting and Data System (PI-RADS). Then, the apparent diffusion coefficient (ADC) of the tumor calculated from two b values (0, 1000 s/mm(2)) was measured. Interreader agreement of T2-weighted imaging scores was assessed with weighted kappa statistics. We compared T2-weighted imaging scores and ADC values between patients with ECE and those without ECE using the unpaired Student t test and evaluated their association with ECE using logistic regression analyses and ROC curves incorporating prostate-specific antigen value, Gleason score, clinical stage, and greatest percentage involved core length. The ADC values were also tested for differences between patients with ECE and those without ECE in subgroups stratified by the T2-weighted imaging criteria shown to have a high specificity for ECE. RESULTS. Fifty (42.7%) patients had ECE. There was substantial agreement for T2-weighted imaging scores (κ = 0.613). T2-weighted imaging scores and ADCs were significantly different in patients with ECE and those without ECE (p < 0.001). Multivariate analysis showed that the greatest percentage involved core length, T2-weighted imaging score, and ADC (p < 0.05) were independently predictive of ECE. The AUCs for these variables (range, 0.733-0.770) were not significantly different except for the AUC for clinical stage (0.552). The use of a high specificity (92.5%) setting for ECE divided the patients into the following groups: patients with a T2-weighted imaging score of ≥ 4 (n = 20) and patients with a T2-weighted imaging score of < 4 (n = 97). In patients with a T2-weighted imaging score of ≥ 4, the ADC was not significantly different between patients with ECE and those without ECE (p = 0.555). However, among patients with a T2-weighted imaging score of ≤ 3, the ADC value was significantly lower in patients with ECE (mean ± SD, 0.794 ± 0.116) than in those without ECE (1.027 ± 0.339) (p < 0.001). CONCLUSION. T2-weighted imaging scores and ADCs were independently associated with ECE, and the ADC had incremental value in patients without a high suspicion of ECE on T2-weighted imaging.
- Published
- 2015
39. Histogram analysis of apparent diffusion coefficient map of diffusion-weighted MRI in endometrial cancer: a preliminary correlation study with histological grade
- Author
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Jeong Yeon Cho, Sang Youn Kim, Sungmin Woo, and Seung Hyup Kim
- Subjects
Adult ,Gadolinium DTPA ,medicine.medical_specialty ,Percentile ,Contrast Media ,Sensitivity and Specificity ,Endometrium ,Histogram ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Effective diffusion coefficient ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Analysis of Variance ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Endometrial cancer ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Image Enhancement ,medicine.disease ,Endometrial Neoplasms ,Tumor Burden ,Diffusion Magnetic Resonance Imaging ,ROC Curve ,Skewness ,Area Under Curve ,Kurtosis ,Female ,Radiology ,Neoplasm Grading ,business ,Nuclear medicine ,Diffusion MRI - Abstract
Background Until now, several investigators have explored the value of diffusion-weighted magnetic resonance imaging (DWI) for the preoperative tumor grading of endometrial cancer. However, the diagnostic value of DWI with quantitative analysis of apparent diffusion coefficient (ADC) has been controversial. Purpose To explore the role of histogram analysis of ADC maps based on entire tumor volume in determining the grade of endometrial cancer. Material and Methods This study was IRB-approved with waiver of informed consent. Thirty-three patients with endometrial cancer underwent DWI (b = 0, 600, 1000 s/mm2), and corresponding ADC maps were acquired. Regions of interest (ROIs) were drawn on all slices of the ADC map in which the tumor was visualized including areas of necrosis to derive volume-based histographic ADC data. Histogram parameters (5th–95th percentiles, mean, standard deviation, skewness, kurtosis) were correlated with histological grade using one-way ANOVA with Tukey-Kramer test for post hoc comparisons, and were compared between high (grade 3) and low (grades 1/2) grade using Student t-test. ROC curve analysis was performed to determine the optimum threshold value for each parameter, and their corresponding sensitivity and specificity. Results The standard deviation, quartile, 75th, 90th, and 95th percentiles of ADC showed significant differences between grades ( P ≤ 0.03 for all) and between high and low grades ( P ≤ 0.024 for all). There were no significant correlations between tumor grade and other parameters. ROC curve analysis yielded sensitivities and specificities of 75% and 96%, 62.5% and 92%, 100% and 52%, 100% and 72%, and 100% and 88%, using standard deviation, quartile, 75th, 90th, and 95th percentiles for determining high grade with corresponding areas under the curve (AUCs) of 0.787, 0.792, 0.765, 0.880, and 0.925, respectively. Conclusion Histogram analysis of ADC maps based on entire tumor volume can be useful for predicting the histological grade of endometrial cancer. The 90th and 95th percentiles of ADC were the most promising parameters for differentiating high from low grade.
- Published
- 2014
40. Adrenal adenoma and metastasis from clear cell renal cell carcinoma: can they be differentiated using standard MR techniques?
- Author
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Jeong Yeon Cho, Seung Hyup Kim, Sang Youn Kim, and Sungmin Woo
- Subjects
Adenoma ,Adult ,Gadolinium DTPA ,Male ,Oncology ,medicine.medical_specialty ,Necrosis ,Adrenal Gland Neoplasms ,Contrast Media ,Sensitivity and Specificity ,Metastasis ,Diagnosis, Differential ,symbols.namesake ,Internal medicine ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Adrenal adenoma ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Renal Cell ,Fisher's exact test ,Aged ,Retrospective Studies ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Kidney Neoplasms ,Clear cell renal cell carcinoma ,symbols ,Female ,Radiology ,medicine.symptom ,business ,Clear cell - Abstract
Background Chemical-shift magnetic resonance imaging (MRI) has been known to successfully differentiate adenomas from metastases. However, there has been concern that metastasis from extra-adrenal primary malignancies which contain high lipid content such as clear cell renal cell carcinoma (RCC) could mimic adrenal adenomas. Purpose To evaluate the ability of MR to differentiate adrenal adenoma from metastasis using chemical-shift imaging and MR feature analysis in patients with clear cell RCC. Material and Methods This study was institutional review board-approved; informed consent was waived. Eleven patients with 13 metastases and 13 patients with 15 adrenal adenomas in patients with clear cell RCC for evaluation of an adrenal mass underwent MR. Signal intensity on in- and opposed-phases, signal intensity index (SII), size, T2 SI, cystic change, necrosis, and hemorrhage were evaluated. Statistical analyses included Student t-test and Fisher exact test. If available, precontrast CT attenuation of the adrenal adenomas was measured. SII was correlated with attenuation using Pearson correlation coefficient. Results Mean size of adenomas was smaller than that of metastases ( P Conclusion In patients with clear cell RCC who underwent MR for adrenal masses, SII and MR features such as cystic change, necrosis, and hemorrhage were helpful in differentiating adenomas from metastases.
- Published
- 2014
41. Diagnostic Performance of CT for Diagnosis of Fat-Poor Angiomyolipoma in Patients With Renal Masses: A Systematic Review and Meta-Analysis
- Author
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Sungmin Woo, Seung Hyup Kim, Sang Youn Kim, Chong Hyun Suh, and Jeong Yeon Cho
- Subjects
medicine.medical_specialty ,Angiomyolipoma ,business.industry ,General Medicine ,medicine.disease ,Sensitivity and Specificity ,Kidney Neoplasms ,030218 nuclear medicine & medical imaging ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Tomography x ray computed ,030220 oncology & carcinogenesis ,Meta-analysis ,medicine ,Renal mass ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
The purpose of this article is to systematically review and perform a meta-analysis of the diagnostic performance of CT for diagnosis of fat-poor angiomyolipoma (AML) in patients with renal masses.MEDLINE and EMBASE were systematically searched up to February 2, 2017. We included diagnostic accuracy studies that used CT for diagnosis of fat-poor AML in patients with renal masses, using pathologic examination as the reference standard. Two independent reviewers assessed the methodologic quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity of included studies were calculated and were pooled and plotted in a hierarchic summary ROC plot. Sensitivity analyses using several clinically relevant covariates were performed to explore heterogeneity.Fifteen studies (2258 patients) were included. Pooled sensitivity and specificity were 0.67 (95% CI, 0.48-0.81) and 0.97 (95% CI, 0.89-0.99), respectively. Substantial and considerable heterogeneity was present with regard to sensitivity and specificity (ICT shows moderate sensitivity and excellent specificity for diagnosis of fat-poor AML in patients with renal masses. When methods other than pixel distribution analysis are used, better sensitivity can be achieved.
- Published
- 2017
42. Apparent diffusion coefficient for prediction of parametrial invasion in cervical cancer: a critical evaluation based on stratification to a Likert scale using T2-weighted imaging
- Author
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Seung Hyup Kim, Sungmin Woo, Sang Youn Kim, and Jeong Yeon Cho
- Subjects
Adult ,medicine.medical_specialty ,Uterine Cervical Neoplasms ,Hysterectomy ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Likert scale ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Preoperative Care ,Republic of Korea ,medicine ,Prevalence ,Effective diffusion coefficient ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Neoplasm Staging ,Retrospective Studies ,Cervical cancer ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Parametrial ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Diffusion Magnetic Resonance Imaging ,Treatment Outcome ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Radiology ,business ,Nuclear medicine ,T2 weighted ,Diffusion MRI - Abstract
To evaluate the value of apparent diffusion coefficient (ADC) for determining parametrial invasion (PMI) in cervical cancer, by stratifying them into subgroups based on a Likert scale using T2-weighted imaging (T2WI).This retrospective study included 87 patients with FIGO stage IA2-IIB cervical cancer who underwent preoperative MRI followed by radical hysterectomy. Radiological PMI was assessed on T2WI using a six-point Likert scale and ADC values of the tumors were measured. MRI findings were compared between patients with and without PMI. Differences in ADC according to the Likert scale were also assessed.19 (21.8%) patients had pathological PMI. The prevalence of PMI was significantly associated with Likert scale (P 0.001). ADC values significantly differed according to Likert scale (P 0.001). However, only tumors with a Likert score of 0 (MRI-invisible) had significantly greater ADC than others (P 0.001) while no significant difference was observed among tumors with Likert scores of 1-5 (P = 0.070-0.889). Patients with PMI had significantly lower ADC values than those without PMI (P = 0.034). However, no significant difference was seen between patients with and without PMI within each Likert score group (P = 0.180-0.857).T2WI-based Likert score for radiological PMI and ADC values of the tumor were significantly associated with pathological PMI. However, the apparent association seen between ADC values and PMI may be due to contribution of high ADC values of MRI-invisible tumors rather than reflecting their relationship.
- Published
- 2017
43. Radiologic findings for prediction of rehabilitation outcomes in patients with chronic symptomatic os subfibulare
- Author
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Sungmin Woo, Chankue Park, Jaeyoung Kim, and Beom Suk Kim
- Subjects
Adult ,Joint Instability ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Radiography ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Fibula ,Neuroradiology ,Retrospective Studies ,030222 orthopedics ,Rehabilitation ,medicine.diagnostic_test ,business.industry ,Anterior talofibular ligament ,Interventional radiology ,Magnetic resonance imaging ,030229 sport sciences ,General Medicine ,Tarsal Bones ,Middle Aged ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Chronic Disease ,Physical therapy ,Female ,business ,Lateral Ligament, Ankle ,Ankle Joint - Abstract
To retrospectively evaluate the radiologic findings for predicting rehabilitation outcomes in patients with chronic symptomatic os subfibulare. 38 patients with chronic lateral ankle pain and os subfibulare underwent a standardized rehabilitation program. Rehabilitation outcome was evaluated after ≥3 months of intervention as the following: good response group (n = 20) without the need for further treatment and poor response group (n = 18) who underwent surgery after rehabilitation. Size, shape and location of os subfibulare, anterior talofibular ligament abnormality and attachment to the os subfibulare, interposition of fluid signal intensity between the os subfibulare and the fibula, and bone marrow edema in the os subfibulare on radiographs and MRI were evaluated by two radiologists blinded to rehabilitation outcomes and were compared between the two groups. The mean size of os subfibulare was significantly different between good and poor response groups: 7 versus 12 mm (p
- Published
- 2017
44. Differentiation of lipid poor angiomyolipoma from hepatocellular carcinoma on gadoxetic acid-enhanced liver MR imaging
- Author
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Joon Koo Han, Ijin Joo, Jeong Min Lee, Byung Ihn Choi, Sungmin Woo, Rihyeon Kim, and Dong Ho Lee
- Subjects
Adult ,Gadolinium DTPA ,Male ,medicine.medical_specialty ,Gadoxetic acid ,Angiomyolipoma ,Urology ,Contrast Media ,Diagnosis, Differential ,symbols.namesake ,Internal medicine ,Image Processing, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,neoplasms ,Fisher's exact test ,Aged ,Retrospective Studies ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Gastroenterology ,Magnetic resonance imaging ,Retrospective cohort study ,General Medicine ,Middle Aged ,Hepatology ,HCCS ,Image Enhancement ,medicine.disease ,Magnetic Resonance Imaging ,digestive system diseases ,Hepatocellular carcinoma ,symbols ,Female ,Radiology ,business ,medicine.drug - Abstract
To investigate magnetic resonance (MR) findings of angiomyolipoma (AML) on gadoxetic acid-enhanced MR imaging, and to identify features that differentiate AML from hepatocellular carcinoma (HCC) in patients with a low risk of HCC development. This retrospective study was institutional review board approved, and the requirement for informed consent was waived. Twelve patients with hepatic AML who underwent gadoxetic acid-enhanced MRI with no risk factors for HCC development were recruited. Twenty-seven patients with HCC under the same inclusion criteria were recruited as control. Two radiologists analyzed the images in consensus for morphologic features, enhancement patterns, and hepatobiliary phase (HBP) findings. All results were analyzed using the Mann–Whitney test, two-tailed Fisher exact test, and chi-square test. Patients with AML were younger than those with HCC (48.8 ± 15 years for AML vs. 62.7 ± 14.2 years for HCC, p = 0.008) with female predominance, while most HCC patients were male (75% (9/12) vs. 15% (4/27), p
- Published
- 2014
45. Length of capsular contact on prostate MRI as a predictor of extracapsular extension: which is the most optimal sequence?
- Author
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Seung Hyup Kim, Jeong Yeon Cho, Sungmin Woo, and Sang Youn Kim
- Subjects
Male ,Contrast Media ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Predictive Value of Tests ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Invasiveness ,Sequence (medicine) ,Aged ,Retrospective Studies ,Prostatectomy ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Image Enhancement ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,business ,Nuclear medicine - Abstract
Background Length of capsular contact (LCC) is a promising biomarker for predicting extracapsular extension (ECE), but the most optimal magnetic resonance imaging (MRI) sequence for measuring LCC is yet to be determined. Purpose To evaluate LCC using different MRI sequences for determining ECE in prostate cancer. Material and Methods A total of 185 patients underwent prostate MRI followed by radical prostatectomy. LCC was measured separately on T2-weighted (T2W) images, apparent diffusion coefficient (ADC) maps, and dynamic contrast-enhanced (DCE) MRI. LCCs (LCCT2, LCCADC, LCCDCE, and LCCmax [greatest value of 3 LCCs]) were compared between sequences using Wilcoxon signed rank test and was tested for determining ECE using the Mann–Whitney U test, ROC curve analysis, and logistic regression analysis. Results There were no significant differences among LCCs ( P = 0.333–0.837). All LCCs were significantly greater in patients with ECE ( P 14, >13, >12, and >14 mm for LCCT2, LCCADC, LCCDCE, and LCCmax, respectively. LCCmax yielded the highest area under the curve (0.895) which was significantly greater than that by LCCADC (0.858, P = 0.030). Otherwise, there were no significant difference between LCCs ( P = 0.052–0.985). At univariate analysis, age, clinical stage, PSA, Gleason score, and all LCCs were significantly associated with ECE ( P Conclusion LCC measured on any sequence was significantly different in patients with and without ECE and was independently associated with the presence of ECE. Although LCCmax showed the greatest ability to predict ECE, there was relatively equivalent performance among different MRI sequences.
- Published
- 2016
46. Added Value of Integrated Whole-Body PET/MRI for Evaluation of Colorectal Cancer: Comparison With Contrast-Enhanced MDCT
- Author
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Bo Yun Hur, Yong Sub Song, Sungmin Woo, Jeong Min Lee, Jin Chul Paeng, Ju Hyeon Jeon, and Beomsik Kang
- Subjects
Adult ,medicine.medical_specialty ,Colorectal cancer ,Whole body imaging ,Contrast Media ,Malignancy ,Multimodal Imaging ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Image Interpretation, Computer-Assisted ,Multidetector Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Whole Body Imaging ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Positron emission tomography ,030220 oncology & carcinogenesis ,Positron-Emission Tomography ,Whole body pet ,Radiology ,medicine.symptom ,Radiopharmaceuticals ,business ,Nuclear medicine ,Colorectal Neoplasms - Abstract
The purpose of this study was to evaluate the added clinical value of PET/MRI compared with conventional contrast-enhanced MDCT (CECT) alone in the evaluation of patients with colorectal cancer.The study population comprised 51 patients with colorectal cancer who underwent (18)F-FDG PET/MRI and CECT within a 90-day interval between October 2012 and August 2013. Two reviewers in consensus evaluated whether PET/MRI added value to CECT for lesion detection and characterization and assessed whether changes in treatment strategies were made. The malignancy probability of each lesion was assessed on a 5-point scale. ROC analyses were performed with histopathologic findings, imaging, and clinical follow-up as the reference standards. Two reviewers evaluated the presence or absence of pulmonary metastatic nodules on PET/MR images that had been detected on chest CT scans.PET/MRI added value to CECT for 14 of 51 patients (27.5%) in terms of better characterization (12/51 [23.5%]) and additional detection (2/51 [3.9%]) of extracolonic lesions. The additional information from PET/MRI led to a change in treatment strategy for 11 of 51 (21.6%) patients. ROC analyses showed that PET/MRI was significantly superior to CT in depicting colorectal cancer (p0.05). The rate of detection of pulmonary metastatic nodules with PET/MRI was 52.9% (9/17).Integrated whole-body PET/MRI added value to CECT in the detection of metastatic lesions and characterization of indeterminate lesions, albeit with limited performance for small pulmonary metastatic nodules. The results suggest that PET/MRI may aid in the selection of more appropriate treatment strategies for patients with colorectal cancer.
- Published
- 2015
47. Early stage cervical cancer: role of magnetic resonance imaging after conization in determining residual tumor
- Author
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Sungmin Woo, Sang Youn Kim, Seung Hyup Kim, Hye Sung Kim, Jeong Yeon Cho, and Hyun Hoon Chung
- Subjects
Adult ,Gadolinium DTPA ,medicine.medical_specialty ,Multivariate analysis ,Neoplasm, Residual ,Conization ,Contrast Media ,Uterine Cervical Neoplasms ,Logistic regression ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Aged ,Neoplasm Staging ,Retrospective Studies ,Cervical cancer ,Aged, 80 and over ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Magnetic resonance imaging ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,030220 oncology & carcinogenesis ,Female ,Radiology ,business - Abstract
Background Although magnetic resonance imaging (MRI) is currently indispensable in the management of cervical cancer, its role in determining residual tumor in patients with cervical cancer after conization is not well known. Purpose To evaluate the value of MRI after conization in determining residual tumor in patients with FIGO stage IA-IB1 cervical cancer. Material and Methods In this retrospective study, 55 patients underwent conization followed by preoperative MRI and definitive surgery. Two radiologists evaluated the presence of residual tumor on MRI. MRI and preoperative clinical variables were compared between patients with and without residual tumor at final pathology using Student’s t-test or Chi-square test. Association between variables and the presence of residual tumor was assessed using logistic regression analyses and receiver operating characteristic (ROC) curves. Results Residual tumor at final pathology was found in 30 (54.5%) patients. Patients with residual tumor were older, had greater SCC antigen, and more frequently had positive conization margins and identifiable tumor on MRI ( P Conclusion Identifiable tumor on MRI after conization in patients with early stage cervical cancer was an independent predictor of residual tumor at final pathology.
- Published
- 2015
48. Updated prostate imaging reporting and data system (PIRADS v2) recommendations for the detection of clinically significant prostate cancer using multiparametric MRI: critical evaluation using whole-mount pathology as standard of reference
- Author
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Kazuhiro Matsumoto, Debra A. Goldman, Evis Sala, Hedvig Hricak, Sungmin Woo, Behfar Ehdaie, Chaya S. Moskowitz, Victor E. Reuter, Tatsuo Gondo, H. A. Vargas, Andreas M. Hötker, and Samson W. Fine
- Subjects
Male ,medicine.medical_specialty ,Pathology ,medicine.medical_treatment ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neuroradiology ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Prostatectomy ,Prostatic Neoplasms ,Magnetic resonance imaging ,Retrospective cohort study ,Interventional radiology ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,PI-RADS ,medicine.anatomical_structure ,Radiology Information Systems ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Radiology ,business - Abstract
To evaluate the recommendations for multiparametric prostate MRI (mp-MRI) interpretation introduced in the recently updated Prostate Imaging Reporting and Data System version 2 (PI-RADSv2), and investigate the impact of pathologic tumour volume on prostate cancer (PCa) detectability on mpMRI. This was an institutional review board (IRB)-approved, retrospective study of 150 PCa patients who underwent mp-MRI before prostatectomy; 169 tumours ≥0.5-mL (any Gleason Score [GS]) and 37 tumours
- Published
- 2015
49. Angiomyolipoma with minimal fat: differentiation of morphological and enhancement features from renal cell carcinoma at CT imaging
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Sungmin Woo, Jeong Yeon Cho, Min Hoan Moon, Seung Hyup Kim, See Hyung Kim, Sang Youn Kim, and Chang Kyu Sung
- Subjects
Adult ,Male ,medicine.medical_specialty ,Angiomyolipoma ,Contrast Media ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Predictive Value of Tests ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Renal Cell ,Retrospective Studies ,Radiological and Ultrasound Technology ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Tomography x ray computed ,030220 oncology & carcinogenesis ,Predictive value of tests ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Radiology ,Ct imaging ,business ,Tomography, X-Ray Computed - Abstract
Background Angiomyolipoma (AML) with minimal fat may mimic renal cell carcinoma (RCC) and is difficult to distinguish from RCC with imaging studies alone. Precise diagnostic strategies have been explored to discern AML with minimal fat from RCC. Purpose To compare the morphological and enhancement features of AML with minimal fat with those of size-matched RCC on computed tomography (CT). Material and Methods Our study included 143 pathologically proved renal tumors (29 AML with minimal fat: mean diameter, 2.5 cm; range, 1.2–4 cm; 114 RCC: mean diameter, 2.8 cm; range, 1.3–4 cm). All patients underwent biphasic helical CTs. Two radiologists retrospectively evaluated the morphological (i.e. non-round and round appearances, with or without capsule) and enhancement features (i.e., wash-out, gradual, or prolonged). For the parameters that had statistically significance between the two groups, we calculated the positive and negative predictive values by using the univariate χ2 test. P Results AML with minimal fat showed a non-round appearance without a capsule ( n = 24, 83%) and prolonged enhancement ( n = 20, 69%). The positive and negative predictive values of the non-round appearance without capsule for differentiating AML with minimal fat from RCC were 82.8% and 95.6%, respectively. The positive and negative predictive values of prolonged enhancement were 62.5% and 90.8%, respectively. These features were valuable predictors for AML with minimal fat from RCC. Conclusion CT images with non-round shape without capsule and prolonged enhancements may be used to differentiate AML with minimal fat from RCC.
- Published
- 2015
50. Switching bipolar hepatic radiofrequency ablation using internally cooled wet electrodes: comparison with consecutive monopolar and switching monopolar modes
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Jeong Min Lee, Won Seok Choi, Eui Jin Hwang, Byung Ihn Choi, In Pyung Hwang, Jung Hwan Yoon, Sungmin Woo, and Joon Koo Han
- Subjects
Liver surgery ,medicine.medical_specialty ,Materials science ,Full Paper ,Radiofrequency ablation ,Radio Waves ,Swine ,medicine.medical_treatment ,General Medicine ,Equipment Design ,Ablation ,law.invention ,Surgery ,Liver ,law ,Electrode ,Models, Animal ,medicine ,Catheter Ablation ,Animals ,Radiology, Nuclear Medicine and imaging ,Bipolar radiofrequency ,Electrodes ,Biomedical engineering - Abstract
To evaluate whether switching bipolar radiofrequency ablation (SB-RFA) using three internally cooled wet (ICW) electrodes can induce coagulations5 cm in porcine livers with better efficiency than consecutive monopolar (CM) or switching monopolar (SM) modes.A total of 60 coagulations were made in 15 in vivo porcine livers using three 17-gauge ICW electrodes and a multichannel radiofrequency (RF) generator. RF energy (approximately 200 W) was applied in CM mode (Group A, n = 20) for 24 min, SM mode for 12 min (Group B, n = 20) or switching bipolar (SB) mode for 12 min (Group C, n = 20) in in vivo porcine livers. Thereafter, the delivered RFA energy, as well as the shape and dimension of coagulations were compared among the groups.Spherical- or oval-shaped ablations were created in 30% (6/20), 85% (17/20) and 90% (18/20) of coagulations in the CM, SM and SB groups, respectively (p = 0.003). SB-RFA created ablations5 cm in minimum diameter (Dmin) in 65% (13/20) of porcine livers, whereas SM- or CM-RFA created ablations5 cm in only 25% (5/20) and 20% (4/20) of porcine livers, respectively (p = 0.03). The mean Dmin of coagulations was significantly larger in Group C than in Groups A and B (5.1 ± 0.9, 3.9 ± 1.2 and 4.4 ± 1.0 cm, respectively, p = 0.002) at a lower delivered RF energy level (76.8 ± 14.3, 120.9 ± 24.5 and 114.2 ± 18.3 kJ, respectively, p 0.001).SB-RFA using three ICW electrodes can create coagulations5 cm in diameter with better efficiency than do SM- or CM-RFA.SB-RFA can create large, regular ablation zones with better time-energy efficiency than do CM- or SM-RFA.
- Published
- 2015
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