Jeong Nam Heo

Dual-energy CT to detect recurrent HCC after TACE: Initial experience of color-coded iodine CT imaging

OBJECTIVES To evaluate the feasibility of diagnosing recurrence of HCC after TACE color-coded iodine CT (CICT) based on arterial phase scans obtained by a dual-energy CT (DECT) scanner. METHODS A CICT scan was acquired from an iodine map after applying material decomposition of the liver tissue and setting a threshold attenuation level for viable tumors. Two radiologists reviewed both conventional and CICT sets in 31 patients who had a history of TACE for HCC. The performances in detecting local tumor progression (LTP) were evaluated by alternative free-response receiver operating characteristics. The rate of uncertain diagnosis and interobserver agreement of the diagnosis were explored. Additionally, the reading time and radiation dose were also investigated. RESULTS The mean figures of merit of the conventional and CICT sets for LTP were 0.818 and 0.847, respectively (p=0.459). The rate of uncertain diagnosis was significantly decreased in CICT sets (34.5% vs. 0%), and interobserver agreement was improved (k=0.527 vs. 0.718). On the CICT set, mean reading time was reduced by 49s and mean radiation dose was also decreased by 18.3% when replacing the non-contrast CT with CICT. CONCLUSIONS CICT is comparable to conventional liver CT protocol in demonstrating viable HCCs, while it allows a reduction in radiation dose.

Changing Waveform During Respiration on Hepatic Vein Doppler Sonography of Severe Portal Hypertension Comparison With the Damping Index

The purposes of this study were to assess retrospectively whether the waveform change during respiration on hepatic vein Doppler sonography is a parameter of severe portal hypertension as estimated by the hepatic venous pressure gradient (HVPG) and to compare with a hepatic vein damping index (DI) at expiration.

Rib xanthoma resected by video-assisted thoracoscopic surgery using a bone punch.

Xanthomas of the rib are extremely rare benign neoplasms, most commonly reported in soft tissue, but rarely in bone. We report a case of a 4-cm xanthoma of the rib resected by video-assisted thoracoscopic surgery and pulled through a 2-cm port incision around the patients areola. To the best of our knowledge, there are only 8 other such cases, and none of which were removed by thoracoscopic surgery.