• Korean Journal of Radiology
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• v.23 no.12
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• pp.1126-1240
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• 2022

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.269-272
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• 2020

• Korean Journal of Radiology
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• v.23 no.9
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• pp.847-852
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• 2022

• Korean Journal of Radiology
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• v.24 no.9
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• pp.890-902
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• 2023

Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

• Journal of radiological science and technology
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• v.45 no.2
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• pp.159-164
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• 2022

The study developed a radiation dose measurement program in the radiology laboratory to measure how much exposure the students are exposed to during the radiology class, to request for the improvement and the revision of the current Nuclear Safety Act. The experimental program is shown in the following figure, and experiments were conducted to determine the degree of radiation exposure in the control room with a lead gown at a distance of 1 m, 2 m, and 1 m, and in a control room with a radiographic lead glass wall. The duration of the experiment was 3 months from April to June, when radiation imaging practice classes were conducted, and 128 hours of imaging practice per month were conducted. In order to find out the dose of radiation dose during radiology imaging practice class, the experiment was carried out from April to June for 3 months, and according to the program, the results of exposure dose were 0.34 mSv at 1 m distance, 0.01 mSv at shielding of lead gown at 1 m distance, 0.16 mSv at 2 m distance, and 0.01 mSv at control room with radiation lead glass wall. The exposure dose from the test results was much below the annual general public limit dose of 1 mSv. The restriction on the operation of the radiation equipment in the practice of the students is a regulation that infringes the right of students to learn, and amendments or exemptions of Nuclear Safety Act should be enacted to ensure that it does not violate the fundamental right to learn for students in radiology.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.817-825
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• 2021

Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.985-993
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• 2022

This study was conducted to compare and evaluate the expectations and satisfaction of clinical practice for students who conducted practice at clinical practice institutions of various sizes before and after COVID-19, and to suggest future clinical practice guidance methods and operation directions. There was a significant difference in the evaluation of satisfaction with practice before and after COVID-19, especially after the evaluation of satisfaction with practice guidance, practice environment, and practice time. As a result of analyzing the decisive influencing factors related to practice satisfaction, students who conducted practice at university hospitals highly evaluated the institutional environmental factors, and students who conducted practice at small and medium-sized hospitals showed high satisfaction in participation-oriented practice. Therefore, it is thought that practice that utilizes the strengths and weaknesses of university hospitals and small and medium-sized hospitals will be more effective than clinical practice that relies only on university hospitals. However, in order to diversify the training institution to small and medium-sized hospitals, it is necessary to create a manual on standardized training courses, training methods, and evaluation methods suitable for the training goals and curriculum, and provide them to the institution. In addition, if it is operated through sufficient exchange of opinions and consultation with institutions, schools will be able to obtain opportunities to cultivate practical talents, and small and medium-sized hospitals with difficulties in expanding manpower will be able to secure excellent human resources first.

• Korean Journal of Radiology
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• v.24 no.3
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• pp.204-223
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• 2023

Currently, various types of transarterial treatments are performed for hepatocellular carcinoma from the early to advanced stages. Its indications and efficacy have been widely investigated. However, procedure-related complications have not been updated in the literature, although new types of transarterial treatments, such as drug-eluting bead transarterial chemoembolization and transarterial radioembolization, are common in daily practice. Herein, a comprehensive literature review was carried out, and complications were organized according to the organs affected and treatment modalities.

• Korean Journal of Radiology
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• v.20 no.6
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• pp.863-879
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• 2019

Hepatocellular carcinoma (HCC) can be noninvasively diagnosed on the basis of its characteristic imaging findings of arterial phase enhancement and portal/delayed "washout" on computed tomography (CT) and magnetic resonance imaging (MRI) in cirrhotic patients. However, different specific diagnostic criteria have been proposed by several countries and major academic societies. In 2018, major guideline updates were proposed by the Association for the Study of Liver Diseases, European Association for the Study of the Liver (EASL), Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) of Korea. In addition to dynamic CT and MRI using extracellular contrast media, these new guidelines now include magnetic resonance imaging (MRI) using hepatobiliary contrast media as the first-line diagnostic test, while the KLCA-NCC and EASL guidelines also include contrast-enhanced ultrasound (CEUS) as the second-line diagnostic test. Therefore, hepatobiliary MR contrast media and CEUS will be increasingly used for the noninvasive diagnosis and staging of HCC. In this review, we discuss the emerging role of hepatobiliary phase MRI and CEUS for the diagnosis of HCC and also review the changes in the HCC diagnostic criteria in major guidelines, including the KLCA-NCC practice guidelines version 2018. In addition, we aimed to pay particular attention to some remaining issues in the noninvasive diagnosis of HCC.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.181-186
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• 2022

Purpose: This study aimed to investigate inter-observer reliability among observers with different levels of proficiency and the diagnostic imaging reliability of cone-beam computed tomography (CBCT) images of the retromolar canal. Materials and Methods: CBCT images of 307 patients were assessed for the presence of retromolar canals(RMCs) by 3 observers independently. Diagnoses were made twice by each observer at intervals of more than 3 weeks. Interobserver reliability was assessed using the kappa coefficient. One observer had no experience in diagnosis using CBCT images. Therefore, a specialist in diagnostic imaging explained the CBCT images for interpretation and practiced diagnostic imaging together with this observer, while the other observer interpreted the images independently. Thereafter, the observers re-evaluated the images. Results: The interobserver kappa coefficients (including bilateral RMCs) calculated at the first reading were low, ranging from 0.21 to 0.61. Their values ranged from 0.95 (right side) to 1.00 (left side) after one-on-one practice with a diagnostic imaging specialist, while the values ranged from 0.65 (right side) to 0.66 (left side) without one-on-one practice. Conclusion: Diagnostic accuracy was improved through diagnostic imaging practice. To improve the anatomical interpretation of images, it is important to practice diagnostic imaging with a specialist in diagnostic imaging. One-on-one instruction about diagnostic imaging was an effective method of training.