PURPOSE: To investigate the efficacy and the risk factors for failure and complications of mitomycin C (MMC)-augmented needle revision (NR) of failed filtering blebs. METHODS: Thirty eyes whose intraocular pressure (IOP) did not decrease after the cutting of scleral flap sutures were recruited. NR was performed with a 26-gauge needle under a slit-lamp. Immediately following NR, all eyes received a subconjunctival injection of 0.1 ml of 0.02 mg/ml (group A) or 0.1 mg/ml (group B) MMC at the adjacent conjunctiva. The mean follow-up period after the last needle revision was 13.2+/-4.2 months. RESULTS: The mean IOP decreased from 25.7+/-10.6 mmHg before surgery to 13.7+/-2.5 mmHg at the last follow-up in group A and from 24.1+/-6.8 mmHg to 17.7+/-8.6 mmHg in group B (group A: p=0.001, group B: p=0.065). Subconjunctival hemorrhage, hyphema, and a shallow anterior chamber appeared in most cases. However, choridal detachment and avascular changes of the conjunctiva were observed in group B. CONCLUSIONS: IOP decreased in both groups A and B, but severe complications appeared only in group B. NR followed by a subconjunctival injection of 0.02 rather than 0.1 mg/ml is a safe and effective method.
Anterior Chamber ; Blister ; Conjunctiva ; Eye ; Follow-Up Studies ; Hemorrhage ; Hyphema ; Intraocular Pressure ; Mitomycin ; Needles ; Risk Factors ; Sutures

The prevalence of small renal masses (SRM) has risen, paralleling the increased usage of cross-sectional imaging. A large proportion of these SRMs are not malignant, and do not require invasive treatment such as nephrectomy. Therefore, differentation between early renal cell carcinoma (RCC) and benign SRM is critical to achieve proper management. This article reviews the radiological features of benign SRMs, with focus on two of the most common benign entities, angiomyolipoma and oncocytoma, in terms of their common imaging findings and differential features from RCC. Furthermore, the role of percutaneous biopsy is discussed as imaging is yet imperfect, therefore necessitating biopsy in certain circumstances to confirm the benignity of SRMs.
Abdominal Fat/pathology ; Adenoma, Oxyphilic/diagnosis/radiography/ultrasonography ; Angiomyolipoma/diagnosis/radiography/ultrasonography ; Carcinoma, Renal Cell/*diagnosis/radiography/ultrasonography ; Diagnosis, Differential ; Humans ; Kidney Neoplasms/*diagnosis/*radiography/ultrasonography ; Leiomyoma/diagnosis/radiography/ultrasonography

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.
Electrons* ; Fluorodeoxyglucose F18 ; Humans ; Laparoscopy ; Laparotomy ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Population Characteristics ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Prevalence ; ROC Curve ; Sensitivity and Specificity

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A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT scan to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT scan was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules.1,2 Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity.3 The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT scan provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.
B-Lymphocytes ; Biopsy, Needle ; Body Image ; Fatigue ; Female ; Follow-Up Studies ; Hepatomegaly ; Humans ; Liver ; Lymphoma ; Lymphoma, B-Cell ; Middle Aged ; Spleen ; Weight Loss

OBJECTIVE: To assess the diagnostic value of shear wave elastography (SWE) for prostate cancer detection. MATERIALS AND METHODS: In this retrospective study, 87 patients with the suspicion of prostate cancer (prostate-specific antigen > 4 ng/mL and abnormal digital rectal examination) underwent a protocol-based systematic 12-core biopsy followed by targeted biopsy at hypoechoic areas on grey-scale ultrasound. Prior to biopsy, SWE was performed by placing two circular 5 mm-sized regions of interest (ROIs) along the estimated biopsy tract in each sector and one ROI for hypoechoic lesions. SWE parameters, S (mean stiffness) and R (mean stiffness ratio), were calculated and compared regarding different histopathologic tissues and their accuracy for diagnosing prostate cancer was analyzed. SWE parameters were correlated with Gleason score and were compared between indolent (< 8) and aggressive (> or = 8) tissues in prostate cancer patients. RESULTS: Prostate cancer was detected in 7.5% of 1058 cores in 29.9% of 87 patients. Seven (43.8%) of 16 hypoechoic lesions were confirmed as prostate cancer. SWE parameters were significantly different among the histopathologic entities (p < 0.001). Prostate cancer was stiffer than benign tissues (p < or = 0.003). Sensitivity, specificity and receiver operating characteristic curve area for diagnosing cancer were 43%, 80.8%, and 0.599, respectively, for a cutoff of S > 43.9 kPa and 60.8%, 66.4%, and 0.653, respectively, for R > 3. Both, S and R showed a significant correlation with Gleason score (r > or = 0.296, p < or = 0.008) and were significantly different between indolent and aggressive prostate cancer (p < or = 0.006). CONCLUSION: Shear wave elastographic parameters are significantly different between prostate cancer and benign prostate tissue and correlate with Gleason score.
Adult ; Aged ; Aged, 80 and over ; Biopsy ; Elasticity Imaging Techniques/*methods ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Prostate/pathology/*ultrasonography ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/pathology/*ultrasonography ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Interventional/methods

A rubber tip disconnection of Arrow-Trerotola percutaneous thrombolytic device (PTD) may occur occasionally. We experienced 5 cases of a rubber tip disconnection among 453 mechanical thrombectomy sessions with the use of PTD. We present a report about these five cases and suggest possible causes for the occurrences.
Aged ; Catheter Obstruction/*etiology ; Equipment Failure Analysis/*methods ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis/*instrumentation ; Rubber ; Thrombectomy/*instrumentation ; Treatment Outcome

Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73–0.83) and 0.67 (95% CI 0.60–0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77–0.84). Substantial heterogeneity was present among the included studies according to Cochran’s Q-test (p < 0.01) and Higgins I2 (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers’ experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14–0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.

Typhoid fever, showed a dramatic decrease in its incidence from 56 per 100,000 population just after Korea's independence to <1 per 100,000 population in 2000s. The clinical features of patients with typhoid fever in Korea were not too different from those reported in textbooks. Beyond cultures and Widal test, other diagnostic techniques such as string capsule culture and polymerase chain reaction have been tried in Korea. As chloramphenicol is not used anymore in Korea, ampicillin, cotrimoxazole, fluoroquinolones, and third-generation cephalosporins have been administered for therapy of typhoid fever. Especially, ciprofloxacin and ceftriaxone were successfully tried with shorter duration of treatment (1 week). However, cases of treatment failure and resistance in ciprofloxacin were reported in Korea, which requires a great caution. As preventive vaccines, parenteral Vi polysaccharide vaccine and oral live attenuated vaccine are mainly used in Korea. The decline in the number of chronic carriers of typhoid fever in Korea by the roles of doctors and patient management from the health care authorities such as Korea Centers for Diseases Control and Prevention, prescription of effective antimicrobial agents, and increased piped water supply ratio are considered to be the major contributing factors to the reduction in the outbreak of typhoid fever in Korea.

Objective: To evaluate the completeness of the reporting of systematic reviews and meta-analyses published in a general radiology journal using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Materials and Methods: Twenty-four articles (systematic review and meta-analysis, n = 18; systematic review only, n = 6) published between August 2009 and September 2021 in the Korean Journal of Radiology were analyzed. Completeness of the reporting of main texts and abstracts were evaluated using the PRISMA 2020 statement. For each item in the statement, the proportion of studies that met the guidelines’ recommendation was calculated and items that were satisfied by fewer than 80% of the studies were identified. The review process was conducted by two independent reviewers. Results: Of the 42 items (including sub-items) in the PRISMA 2020 statement for main text, 24 were satisfied by fewer than 80% of the included articles. The 24 items were grouped into eight domains: 1) assessment of the eligibility of potential articles, 2) assessment of the risk of bias, 3) synthesis of results, 4) additional analysis of study heterogeneity, 5) assessment of non-reporting bias, 6) assessment of the certainty of evidence, 7) provision of limitations of the study, and 8) additional information, such as protocol registration. Of the 12 items in the abstract checklists, eight were incorporated in fewer than 80% of the included publications. Conclusion Several items included in the PRISMA 2020 checklist were overlooked in systematic review and meta-analysis articles published in the Korean Journal of Radiology. Based on these results, we suggest a double-check list for improving the quality of systematic reviews and meta-analyses. Authors and reviewers should familiarize themselves with the PRISMA 2020 statement and check whether the recommended items are fully satisfied prior to publication.