Seong Jong Yun

Benefit of adding digital breast tomosynthesis to digital mammography for breast cancer screening focused on cancer characteristics: a meta-analysis

PurposeWe evaluated the benefit of adding digital breast tomosynthesis (DBT) to full-field digital mammography (FFDM) compared to FFDM alone for breast cancer detection, focusing on cancer characteristics.MethodsWe searched electronic databases and relevant references for published studies comparing DBT plus FFDM to FFDM alone for breast cancer screening. Pooled risk ratios (RRs) for various pathologic findings were determined using random effects models.ResultsEleven eligible studies were included. Pooled RRs showed a greater cancer detection for DBT plus FFDM than for FFDM alone for invasive cancer (1.327; 95% CI, 1.168–1.508), stage T1 (1.388; 95% CI, 1.137–1.695), nodal-negative (1.451; 95% CI, 1.209–1.742), all histologic grades (grade I, 1.812; grade II/III, 1.403), and histologic types of invasive cancer (ductal, 1.437; lobular, 1.901). However, adding DBT did not increase for detection of carcinoma in situ (1.198; 95% CI, 0.942–1.524), stage ≥T2 (1.391; 95% CI, 0.895–2.163), or nodal-positive cancer (1.336; 95% CI, 0.921–1.938). Heterogeneity among studies was not significant in any subset analysis.ConclusionsAdding DBT to FFDM enabled detection of early invasive breast cancer that might have been missed with FFDM alone. Knowing which cancer characteristic DBT detects may allow it to play a complementary role in predicting long-term patient outcomes and facilitate treatment planning.

The roles of the liver and pancreas in renal nutcracker syndrome

INTRODUCTION To assess the frequency and significance of presence of the liver and pancreas at the left renal vein (LRV) level in patients with suspected renal nutcracker syndrome (NCS). MATERIALS AND METHODS We included 101 patients with hematuria who underwent urography three-dimensional CT between April 2009 and November 2013. These patients were divided into NCS (n=25) and non-NCS (n=76) patients according to the following CT criteria: (1) the presence of beak sign and (2) hilar-aortomesenteric left renal vein diameter ratio >4. Patients were grouped according to the presence of the liver and pancreas at the LRV: group LP (both liver and pancreas), group L (only liver), group P (only pancreas), and group O (neither liver nor pancreas). The difference in the frequencies of groups was analyzed between NCS and non-NCS patients. Multivariate analysis was used to determine the independent factors between NCS and non-NCS patients. RESULTS The frequencies of group LP, group L, group P, and group O in NCS vs. non-NCS were 88% vs. 5.3% (p<0.001), 4.0% vs. 2.6% (p=0.75), 4.0% vs. 11.8% (p=0.45), 4.0% vs. 80.3% (p<0.001), respectively. Multivariate analysis demonstrated that group was a predictor for differential diagnosis between NCS and non-NCS (p=0.022), and group LP was an independent factor for the presence of NCS (odds ratio, 43.8; 95% confidence interval, 3.8-500.3; p<0.002; reference, group O). CONCLUSION The presence of the liver and pancreas at the level of the LRV was frequently found in NCS and was the independent factor for NCS.

Comparison of Low- and Standard-Dose CT for the Diagnosis of Acute Appendicitis: A Meta-Analysis

OBJECTIVE A meta-analysis was performed to compare low-dose CT and standard-dose CT in the diagnosis of acute appendicitis with an emphasis on diagnostic value. MATERIALS AND METHODS A systematic literature search for articles published through June 2016 was performed to identify studies that compared low-dose CT with standard-dose CT for the evaluation of patients suspected of having acute appendicitis. Summary estimates of sensitivity and specificity with 95% CIs were calculated using a bivariate random-effects model. Meta-regression was used to perform statistical comparisons of low-dose CT and standard-dose CT. RESULTS Of 154 studies, nine studies investigating a total of 2957 patients were included in this meta-analysis. The pooled sensitivity and specificity of low-dose CT were 96.25% (95% CI, 91.88-98.31%) and 93.22% (95% CI, 88.75-96.00%), respectively. The pooled sensitivity and specificity of standard-dose CT were 96.40% (95% CI, 93.55-98.02%) and 92.17% (95% CI, 88.24-94.86%), respectively. In a joint model estimation of meta-regression, lowand standard-dose CT did not show a statistically significant difference (p = 0.71). Both lowand standard-dose CT seem to be characterized by high positive and negative predictive values across a broad spectrum of pretest probabilities for acute appendicitis. CONCLUSION Low-dose CT is highly effective for the diagnosis of suspected appendicitis and can be considered a valid alternative first-line imaging test that reduces the potential risk of exposure to ionizing radiation.

The radiologic diagnosis of idiopathic myointimal hyperplasia of mesenteric veins with a novel presentation: case report and literature review.

Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare condition of the rectosigmoid colon that primarily affects middle-aged men. IMHMV typically presents as proctosigmoiditis and often requires surgical resection due to complications throughout the protracted clinical course. It can be differentiated from idiopathic chronic inflammatory bowel disease by histopathologic examination of surgically resected colon specimens. This report describes a rare case of IMHMV presenting as left hemicolitis in a 64-year-old male. We also describe potentially distinguishing computed tomographic and angiographic findings that may aid in the diagnosis of IMHMV.

Intramuscular diffuse-type tenosynovial giant cell tumor of the deltoid muscle in a child

Tenosynovial giant cell tumors (GCTs) typically form in the joints or extra-articular soft tissues such as the tendon sheath, and are benign tumors that commonly occur in the hands or wrists in the third to fifth decades of life. However, the diffuse type of extra-articular GCT arising within muscle is a rare soft tissue tumor, especially in a pediatric patient. In this report, we describe the magnetic resonance imaging and sonographic findings of a rare case of intramuscular diffuse-type GCT in the deltoid muscle of a 9-year-old boy.

Efficacy of double inversion recovery magnetic resonance imaging for the evaluation of the synovium in the femoro-patellar joint without contrast enhancement

ObjectiveTo investigate the efficacy of double inversion recovery (DIR) sequence for evaluating the synovium of the femoro-patellar joint without contrast enhancement (CE).MethodsTwo radiologists independently evaluated the axial DIR and CE T1-weighted fat-saturated (CET1FS) images of 33 knees for agreement; the visualisation and distribution of the synovium were evaluated using a four-point visual scaling system at each of the five levels of the femoro-patellar joint and the location of the thickest synovium. The maximal synovial thickness at each sequence was measured by consensus.ResultsThe interobserver agreement was good (κ = 0.736) for the four-point scale, and was excellent for the location of the thickest synovium on DIR and CET1FS (κ = 0.955 and 0.954). The intersequential agreement for the area with the thickest synovium was also excellent (κ = 0.845 and κ = 0.828). The synovial thickness on each sequence showed excellent correlation (r = 0.872).ConclusionThe DIR showed as good a correlation as CET1FS for the evaluation of the synovium at the femoro-patellar joint. DIR may be a useful MR technique for evaluating the synovium without CE.Key Points• DIR can be useful for evaluating the synovium of the femoro-patellar joint.• Interobserver and intersequential agreements between DIR and CET1FS were good.• Mean thickness of the synovium was significantly different between two sequences.

Severity of nonalcoholic fatty liver disease on sonography and risk of coronary heart disease

To evaluate the relationship between nonalcoholic fatty liver disease (NAFLD) on sonography (US) and the risk of coronary heart disease (CHD) as well as the predictive value of US‐diagnosed NAFLD to determine intermediate/high CHD risk compared with as well as in combination on with NAFLD fibrosis score (NFS).

Simultaneously detected parosteal osteoma and osteochondroma in the distal femur of a single patient

Parosteal osteoma arising from long tubular bone is an extremely rare bone tumor and should be distinguished from parosteal osteosarcoma, whereas osteochondroma is a common benign bone tumor showing an outgrowth of medullary and cortical bone with a cartilaginous cap. This report describes simultaneously detected parosteal osteoma and osteochondroma arising from the distal femur in a single patient.

Comparison between 3D isotropic and 2D conventional MR arthrography for diagnosing rotator cuff tear and labral lesions: A meta-analysis: Meta-Analysis of 3D vs. 2D Shoulder MRA

Although 3D‐isotropic MR arthrography has been characterized as a substitute imaging tool for rotator cuff tear (RCT) and labral lesions, it has not been commonly used in clinical practice because of controversy related to image blurring and indistinctness of structural edges.

ADC as a useful diagnostic tool for differentiating benign and malignant vertebral bone marrow lesions and compression fractures: a systematic review and meta-analysis

ObjectivesTo assess the sensitivity and specificity of quantitative assessment of the apparent diffusion coefficient (ADC) for differentiating benign and malignant vertebral bone marrow lesions (BMLs) and compression fractures (CFs)MethodsAn electronic literature search of MEDLINE and EMBASE was conducted. Bivariate modelling and hierarchical summary receiver operating characteristic modelling were performed to evaluate the diagnostic performance of ADC for differentiating vertebral BMLs. Subgroup analysis was performed for differentiating benign and malignant vertebral CFs. Meta-regression analyses according to subject, study and diffusion-weighted imaging (DWI) characteristics were performed.ResultsTwelve eligible studies (748 lesions, 661 patients) were included. The ADC exhibited a pooled sensitivity of 0.89 (95% confidence interval [CI] 0.80–0.94) and a pooled specificity of 0.87 (95% CI 0.78–0.93) for differentiating benign and malignant vertebral BMLs. In addition, the pooled sensitivity and specificity for differentiating benign and malignant CFs were 0.92 (95% CI 0.82–0.97) and 0.91 (95% CI 0.87–0.94), respectively. In the meta-regression analysis, the DWI slice thickness was a significant factor affecting heterogeneity (p < 0.01); thinner slice thickness (< 5 mm) showed higher specificity (95%) than thicker slice thickness (81%).ConclusionsQuantitative assessment of ADC is a useful diagnostic tool for differentiating benign and malignant vertebral BMLs and CFs.Key Points• Quantitative assessment of ADC is useful in differentiating vertebral BMLs.• Quantitative ADC assessment for BMLs had sensitivity of 89%, specificity of 87%.• Quantitative ADC assessment for CFs had sensitivity of 92%, specificity of 91%.• The specificity is highest (95%) with thinner (< 5 mm) DWI slice thickness.