• Korean Journal of Radiology
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• v.21 no.10
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• pp.1150-1160
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• 2020

Objective: To describe the experience of implementing a deep learning-based computer-aided detection (CAD) system for the interpretation of chest X-ray radiographs (CXR) of suspected coronavirus disease (COVID-19) patients and investigate the diagnostic performance of CXR interpretation with CAD assistance. Materials and Methods: In this single-center retrospective study, initial CXR of patients with suspected or confirmed COVID-19 were investigated. A commercialized deep learning-based CAD system that can identify various abnormalities on CXR was implemented for the interpretation of CXR in daily practice. The diagnostic performance of radiologists with CAD assistance were evaluated based on two different reference standards: 1) real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) results for COVID-19 and 2) pulmonary abnormality suggesting pneumonia on chest CT. The turnaround times (TATs) of radiology reports for CXR and rRT-PCR results were also evaluated. Results: Among 332 patients (male:female, 173:159; mean age, 57 years) with available rRT-PCR results, 16 patients (4.8%) were diagnosed with COVID-19. Using CXR, radiologists with CAD assistance identified rRT-PCR positive COVID-19 patients with sensitivity and specificity of 68.8% and 66.7%, respectively. Among 119 patients (male:female, 75:44; mean age, 69 years) with available chest CTs, radiologists assisted by CAD reported pneumonia on CXR with a sensitivity of 81.5% and a specificity of 72.3%. The TATs of CXR reports were significantly shorter than those of rRT-PCR results (median 51 vs. 507 minutes; p < 0.001). Conclusion: Radiologists with CAD assistance could identify patients with rRT-PCR-positive COVID-19 or pneumonia on CXR with a reasonably acceptable performance. In patients suspected with COVID-19, CXR had much faster TATs than rRT-PCRs.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.749-755
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• 2021

Congenital defects of the pericardium, which are generally asymptomatic, are rare disorders characterized by complete or partial absence of the pericardium. Here, we report a rare case of a 19-year-old male who was incidentally diagnosed with congenital absence of the left pericardium during examination for symptoms of pneumothorax. Chest radiography and CT revealed a collapsed left lung without any evidence of trauma, no unusual findings of free air spaces along the right side of the ascending aorta, heart shifted toward the left side of the thorax, and a shallow chest. Subsequent thoracoscopy confirmed the absence of the left pericardium and displacement of the heart toward the left thoracic cavity. We further discuss the correlation between radiologic images and surgical findings of a congenital pericardial defect associated with spontaneous pneumothorax.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.982-987
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• 2021

The coronary sinus (CS) is the venous drainage system of the heart. CS ostium atresia is a rarely seen cardiac malformation. Congenital atresia of the CS is usually found together with persistent left superior vena cava (LSVC) and other cardiac malformations. However, isolated congenital atresia of the CS is very rare. We present a rare case of isolated congenital atresia of the CS connecting the left atrium and coronary veins without persistent LSVC in a 58-year-old female.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.851-861
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• 2021

Liver injury is a common consequence of blunt abdominopelvic trauma. Contrast-enhanced CT allows for the rapid detection and evaluation of liver injury. The treatment strategy for blunt liver injury has shifted from surgical to nonoperative management, which has been widely complemented by interventional management to treat both liver injury and its complications. In this article, we review the major imaging features of liver injury and the role of interventional management for the treatment of liver injury.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.808-829
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• 2022

Hepatocellular carcinoma (HCC) can be diagnosed noninvasively on multiphasic CT and MRI based on its distinctive imaging findings. These features include arterial phase hyperenhancement and washout on portal or delayed phase images. However, radiologists face significant diagnostic challenges because some HCCs exhibit atypical imaging characteristics. In addition to many HCC-mimicking lesions, such as arterioportal shunts, combined HCC-cholangiocarcinoma, intrahepatic cholangiocarcinoma, and hemangioma present a challenge for radiologists in actual clinical practice. The ability to distinguish HCCs from mimickers on initial imaging examinations is crucial for appropriate management and treatment decisions. Therefore, this pictorial review presents the imaging findings of atypical HCCs and HCCs mimicking malignant and benign lesions and discusses important clues that may help narrow down the differential diagnosis.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.846-860
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• 2022

Persistent left superior vena cava (PLSVC) is a rare congenital, thoracic, and vascular anomaly. Although PLSVCs generally do not have a hemodynamic effect, several types of PLSVC and some cardiac anomalies may manifest with clinical symptoms. The presence of PLSVC can render catheterization via left subclavian access difficult when placing a pacemaker or central venous catheter. As such, recognizing a PLSVC that is typically incidentally discovered can prevent complications such as vascular injury. Differentiating vessels found in a similar location as PLSVC is necessary when performing thoracic vascular procedures. This pictorial essay explains the multi-detector CT findings of a PLSVC, and provides a summary of other blood vessels that require differentiation during thoracic vascular procedures.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1204-1209
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• 2020

Cases of undifferentiated pleomorphic sarcoma of the thoracic aorta are rare, and usually present with embolic events, renovascular hypertension, or back pain. Mural-based undifferentiated pleomorphic sarcomas that present as ruptured saccular aneurysms are extremely rare and are difficult to differentiate from mycotic aneurysms or penetrating atherosclerotic ulcers. Herein, we report a case of histopathologically proven undifferentiated pleomorphic sarcoma arising from the wall of the descending thoracic aorta that manifested as a mass after thoracic endovascular aortic repair for the treatment of a ruptured saccular aneurysm. We present findings obtained by CT and PET to provide helpful information for the accurate diagnosis and appropriate treatment of future cases.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1373-1377
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• 2023

Immunoglobulin G4 (IgG4)-related lung disease can have various clinical courses. To our knowledge, reports of IgG4-related lung disease with waxing and waning pulmonary infiltrates only are very rare. A few lung nodules and ground glass opacities were incidentally found in a pre-operative evaluation in a 36-year-old female. The lung lesions showed waxing and waning in the follow-up chest CT. She underwent a surgical biopsy, and IgG4-related lung disease was confirmed.

• Korean Journal of Heritage: History & Science
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• v.55 no.1
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• pp.305-321
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• 2022

The stone chamber tomb in Eungpyeong-ri, Buyeo, is a joint tomb that contains the bodies of two individuals. This paper investigates the relationship between the buried persons and the characteristics of the stone chamber tomb. Based on the geographical location, relics, and the excavated human bones, it was determined that the tomb was built during the Sabi Period of the Baekje Dynasty and that the buried individuals were most probably residents of high stature or government officials. To study the excavated bones, the remains were carefully collected and conservation was carried out. Before collecting samples from the human bones for the analytical research, the results of near-infrared analysis were used to collect the samples for the isotope analysis and DNA analysis. The most important issue when handling the excavation site was the reinforcing agent and the concentration of the agent used. In situations like this, Paraloid B-72 is the most suitable agent. When the shape of human bones was difficult to distinguish from the soil, conservation was performed using X-ray and CT imaging data. The same chemical used for the reinforcement of the site was used to complete a minimum level of conservation to the surface areas where the conservation treatment of removing foreign substances, the reinforcement areas, and bonded areas were carried out. The collagen yield from the sample obtained at selected position was 3.8% to 6.1%. The results of analyzing the stable isotopes of carbon and nitrogen found in the extracted collagen showed that the stable isotope ratios came out to δ¹³C -18.3‰±0.1‰, -19.0‰±0.1‰ for EBW and δ¹⁵N 10.7‰±0.5‰, 10.6‰±0.1‰ for EBE. It is believed the two individuals consumed small amounts of minor cereals, mainly from C₃ plants, and protein was obtained from eating terrestrial animals. What's more, the deviations in data obtained from the two individuals were so small that it could be inferred that the individuals ate similar foods. Considering the preservation state of the sample, amplifying DNA for the DNA analysis would have been very difficult since the amount of surviving DNA was so deficient. For DNA analysis, it is anticipated that the results could be derived by applying improved extraction methods that will be developed in the future. In this research, any association between scientific analysis(DNA and stable isotope ratio) and near-infrared spectroscopy was difficult to establish. Further research is needed on the utilization of near-infrared analysis for gathering samples from human bones.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.881-887
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• 2023

This study aims to analyze the development and current trends of AI-based medical imaging devices commercialized in South Korea. As of September 30, 2023, there were a total of 186 AI-based medical devices licensed, certified, and reported to the Korean Ministry of Food and Drug Safety, of which 138 were related to imaging. The study comprehensively examined the yearly approval trends, equipment types, application areas, and key functions from 2018 to 2023. The study found that the number of AI medical devices started from four products in 2018 and grew steadily until 2023, with a sharp increase after 2020. This can be attributed to the interaction between the advancement of AI technology and the increasing demand in the medical field. By equipment, AI medical devices were developed in the order of CT, X-ray, and MR, which reflects the characteristics and clinical importance of the images of each equipment. This study found that the development of AI medical devices for specific areas such as the thorax, cranial nerves, and musculoskeletal system is active, and the main functions are medical image analysis, detection and diagnosis assistance, and image transmission. These results suggest that AI's pattern recognition and data analysis capabilities are playing an important role in the medical imaging field. In addition, this study examined the number of Korean products that have received international certifications, particularly the US FDA and European CE. The results show that many products have been certified by both organizations, indicating that Korean AI medical devices are in line with international standards and are competitive in the global market. By analyzing the impact of AI technology on medical imaging and its potential for development, this study provides important implications for future research and development directions. However, challenges such as regulatory aspects, data quality and accessibility, and clinical validity are also pointed out, requiring continued research and improvement on these issues.