1.A Comparative Study of Clinical Outcomes of Arthroscopic Meniscal Surgery in Relation to Anxiety and Patient Satisfaction
Orgil Z ; ; Baatarjav S ; Gonchigsuren D ; Naranbat L
Mongolian Journal of Health Sciences 2026;91(1):108-111
Background:
A prospective cohort study was conducted on 103 patients who underwent arthroscopic knee surgery at the National Trauma and Orthopedic Research Center and Grandmed Hospital between 2020 and 2023. This study examined the short-term clinical outcomes of the surgery in terms of anxiety and satisfaction. Arthroscopic knee surgery is an effective treatment, providing short-term pain relief and improved function. Arthroscopic meniscal surgery is a minimally invasive procedure aimed at reducing pain, restoring functional activity, and preventing irreversible degenerative changes of the knee joint. In recent years, the incidence of meniscal injuries, associated knee pain, functional impairment, and progressive joint degeneration changes has steadily increased.
Aim:
This study aimed to evaluate short-term clinical outcomes of arthroscopic meniscal surgery for meniscal tears and to compare these outcomes in relation to anxiety and patient satisfaction.
Materials and Methods:
A prospective cohort study was conducted between 2020 and 2023, including 103 patients who underwent arthroscopic meniscal surgery at the National Trauma and Orthopedic Research Center and Grandmed Hospital. Among them, 69 patients underwent partial meniscectomy, and 34 patients underwent meniscal repair. Clinical outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) before and after surgery.
Result:
Significant improvements were observed in all KOOS subscale scores postoperatively compared with preoperative values. Mean scores for pain improved from 57.93±12.58 to 80.93±5.70, symptoms from 54.13±12.73 to 80.27±6.22, activities of daily living from 61.28±13.19 to 79.61±4.91, sport and recreation from 42.28±13.21 to 72.04±6.88, and knee-related quality of life from 45.08±12.46 to 77.85±7.96, all demonstrating statistically significant improvement.
Conclusion
Arthroscopic meniscal surgery demonstrates favorable short-term clinical outcomes, effectively reducing pain and improving knee function and quality of life. These findings support the effectiveness of arthroscopic intervention and highlight the importance of considering psychological factors such as anxiety and patient satisfaction in postoperative evaluation.
2.Assessment of Response to Chemoradiotherapy in Cervical Cancer in Relation to MRI and FDG-PET/CT Parameters
Erdenetuya Ya ; ; Gonchigsuren D ; Manduul E ; Adiyadelgerekh B ; Sarnai G ; Li Zhen ; Tsakhim-Erdene Ts ; Munkhbaatar D
Mongolian Journal of Health Sciences 2026;96(6):156-162
Background:
In Mongolia, cervical cancer accounted for 11.9% of all cancers diagnosed in women and 7.3% of cancer-related deaths in 2017, ranking as the third most common cancer among women. The American Society for Radiation Oncology (ASTRO) guidelines recommend concurrent chemo-radiotherapy (CCRT) as a standard and effective treatment for patients with FIGO stage IB3–IVA cervical cancer. Accurate assessment of tumor response following CCRT is essential for evaluating treatment efficacy, identifying residual disease, and estimating the risk of recurrence. Magnetic resonance imaging (MRI) is widely used to assess tumor size, local extent, parametric involvement, and post-treatment morphological changes. In contrast, 18F-FDG PET/CT provides both anatomical and functional information and enables quantitative assessment of tumor metabolic activity using the standardized uptake value (SUV).
Aim:
To estimate the relationship between treatment response to concurrent chemo-radiotherapy and radiological parameters obtained from MRI and 18F-FDG PET/CT in patients with cervical cancer.
Materials and Methods:
This retrospective study included 35 patients with histo-pathologically confirmed cervical carcinoma who received concurrent chemo-radiotherapy at the Department of Radiation Oncology, National Cancer Center, between 2024 and 2025. Pelvic MRI examinations were performed using a 1.5-T Siemens MRI system to evaluate tumor dimensions and local tumor characteristics before and after treatment. 18F-FDG PET/CT was performed to assess the metabolic activity of the primary tumor, and the maximum SUV was measured. Tumor response following CCRT was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The relationships between tumor response, changes in tumor size, and pre-treatment SUV were statistically analyzed.
Result:
A total of 35 patients aged 32–73 years were included in the study, with a mean age of 51.2±12.6 years. The mean baseline longitudinal tumor diameter measured by MRI was 54.3±15.8 mm. Twenty-eight patients (80.0%) had tumors larger than 4 cm, whereas 7 (20.0%) had tumors smaller than 4 cm. According to the FIGO staging system, 22 patients (62.9%) had stage IIIC1 disease, 7 (20.0%) had stage IIIC2, 3 (8.6%) had stage IIIB, 2 (5.7%) had stage IIB, and 1 (2.9%) had stage IVA disease. Histopathologically, 31 patients (88.6%) had squamous cell carcinoma, 3 (8.6%) had adenocarcinoma, and 1 (2.9%) had clear cell carcinoma. Of the 35 patients, 23 (65.7%) had reached the scheduled post-treatment follow-up time and were evaluable for treatment response according to RECIST 1.1, whereas 12 patients (34.3%) had not yet reached the scheduled time for post-treatment assessment. Among the 23 evaluable patients, 15 (65.2%) achieved a complete response (CR), while 8 (34.8%) achieved a partial response (PR). Following CCRT, the longest tumor diameter measured by MRI decreased by a mean of 94.8% in the CR group and 65.3% in the PR group. The reduction in tumor diameter was significantly greater in the CR group than in the PR group (p=0.0016). The mean baseline primary tumor SUVmax on 18F-FDG PET/CT was 16.0±9.8 in the CR group and 24.3±14.5 in the PR group. Although the baseline SUVmax tended to be lower in the CR group, the difference did not reach statistical significance (Mann–Whitney U test, p=0.059). A higher baseline SUVmax tended to be associated with a smaller reduction in tumor diameter following CCRT.
Conclusion
CCRT resulted in a significant reduction in primary tumor size in patients with cervical cancer. The reduction in tumor size was significantly greater among patients who achieved a complete response than among those who achieved a partial response. Although pre-treatment 18F-FDG PET/CT findings suggest that MRI-based tumor size assessment combined with metabolic information from 18F-FDG PET/CT may provide complementary information for evaluating treatment response following CCRT.
3.CT-based radiomics for preoperative differentiation of renal cell carcinoma subtypes: internal and external validation
Enkhbold S ; Purevdorj O ; Telmen K ; Sodgerel B ; Shiirevnyamba A ; Gonchigsuren D ; Oyunbold L
Mongolian Journal of Health Sciences 2026;95(5):37-43
Background:
Renal cell carcinoma (RCC) accounts for 85–90% of all primary renal malignancies in adults and 1–3% of all cancers worldwide, with incidence rising steadily year by year. Clear cell (ccRCC), papillary (pRCC), and chromophobe (chRCC) subtypes differ significantly in genetic alterations, biological behavior, and treatment response, making preoperative subtype identification clinically important. Conventional qualitative CT assessment is limited, and contrast-enhanced CT-based radiomics may represent a novel diagnostic approach.
Aim:
To develop a model for preoperative differentiation of ccRCC from non-ccRCC subtypes using contrast-enhanced CT-based radiomics, and to evaluate its diagnostic performance through internal and external validation.
Materials and Methods:
A retrospective study was conducted on 121 patients with histopathologically confirmed RCC treated at the Urology–Andrology Center of the First Central Hospital of Mongolia between 2021 and 2024. Patients were categorized into ccRCC (n=84) and non-ccRCC (n=37) groups. Tumor segmentation was performed on corticomedullary phase CT images using 3D Slicer software, and a total of 122 radiomic features were extracted, including first-order uniformity, gray-level co-occurrence matrix (GLCM), gray-level run-length matrix (GLRLM), shape flatness, and GLCM maximum probability. Diagnostic performance was assessed by ROC analysis, and model generalizability was evaluated through external validation (n=73).
Results:
GLRLM demonstrated a statistically significant difference between the ccRCC (mean 0.1230) and non-ccRCC (mean 0.0170) groups (p<0.001). ROC analysis yielded an optimal cut-off value of 0.1493 for GLRLM, with an internal validation AUC of 0.9103, sensitivity of 83.3%, and specificity of 92.3% (p<0.01). External validation (n=73) achieved an AUC of 0.860 and an accuracy of 86.0%, confirming the model’s generalizability. First-order uniformity (AUC=0.880) and variance (AUC=0.862) showed comparable discriminative performance to GLRLM, whereas flatness (AUC=0.584) and GLCM Imc2 (AUC=0.621) demonstrated relatively poor discriminative ability. Confusion matrix analysis yielded an accuracy of 86.0% in both internal and external validation cohorts.
Conclusion
Non-invasive CT-based radiomics demonstrates the ability to accurately differentiate RCC subtypes preoperatively with high precision (AUC=0.92), as confirmed by both internal and external validation.
4.Diagnostic yield and safety of CT-guided transthoracic core needle biopsy for mediastinal lesions (A 10-year single-center cohort study)
Tuvshinbayar J ; ; Enkhsaruul L ; Gonchigsuren D ; Baasanjav N ; Ichinnorov D ;
Mongolian Journal of Health Sciences 2026;97(7):76-82
Background:
Mediastinal lesions encompass a broad spectrum of malignant and benign conditions, and histopathological confirmation is often required to guide appropriate management. Computed tomography (CT)-guided transthoracic core needle biopsy (CNB) is a less invasive alternative to surgical biopsy; however, data on its diagnostic performance and safety in Mongolia remain limited.
Aim:
To evaluate the diagnostic yield and safety of CT-guided transthoracic CNB for mediastinal lesions and to identify factors associated with diagnostic outcomes and procedure-related complications.
Materials and Methods:
This retrospective–prospective observational cohort study included 58 CT-guided transthoracic CNB procedures performed in 55 patients with mediastinal lesions. CT characteristics, histopathological diagnoses, procedural variables, and complications were analyzed. Fisher’s exact test, Pearson’s χ² test with Monte Carlo simulation, and the Mann–Whitney U test were applied, with Holm adjustment for multiple comparisons.
Results:
The median age was 57 years [IQR, 46–67], and 63.6% of patients were male. Malignancy was confirmed in 76.4%, while 21.8% had non-malignant disease. A specific diagnosis was established in 54 of 58 procedures, yielding a diagnostic yield of 93.1% (95% CI, 83.6–97.3%). CT lesion composition, internal characteristics, and mediastinal location were not significantly associated with diagnostic category (all p>0.05). The overall complication rate was 6.9%, with CIRSE grade ≥3 complications occurring in 1.7%. All complications occurred when the needle-path depth exceeded 7 cm, an association that remained significant after Holm adjustment (adjusted p=0.007).
Conclusion
CT-guided transthoracic core needle biopsy is a highly effective diagnostic procedure with a favorable safety profile for mediastinal lesions. A needle-path depth >7 cm may indicate increased procedural risk and warrants validation in larger studies.
5. Preoperative local staging of colorectal carcinoma in Mongolian patients using computed tomography
Orkhon G ; Nergui B ; Narantsatsralt J ; Gonchigsuren D ; Tuvshinjargal D
Innovation 2015;9(4):34-37
In Europe, colorectal cancer (CRC) is the second most frequent malignancy and the second commonest cause of death from cancer. -The prognosis of CRC patients is dependent on the stage of disease at the time of diagnosis. Contrast-enhanced computed tomography (CT) examinations allows simultaneous assessment of tumor’s local staging, estimation of its possible invasion into neighboring organs, and detection of nodal and distant metastases; which is essential for appropriate treatment planning and estimation of its outcomes. The lack of reports on CT findings in CRC in Mongolia, increase in CRCmorbidity, and significant potential benefits of early detection served as background for this study.We investigated subjects with histologically proven adenocarcinoma who underwent CRC-related operative treatment either at National Cancer Center, First State Central Hospital, or Ulaanbaatar Songdo Hospital (UBSH) in 2009-2012. We retrospectively reviewed and analyzed from the UBSH’ database their preoperative CT, colonoscopy, surgical and pathohistologic reports using PACSPLUS,OCS operation systems. CECT examinations were performed at Siemens Somatom 64 multidetector scanner.Countrywide, 111 patients underwent surgery for colorectal cancer in 2009-2012. Totally, we involved86 subjects, whose age ranged from 25 to 87 years (mean 61.3years ±13.7SD). The F: M= 48 (55.8%) :38 (44.2%).The CECT determined T2 staging in 10/86 (11.6%),T3 in 61/86 (70.9%); T4 in 15/86 (17.4%);a significant difference in T-staging between CECT and histopathological examination (х2=41.28, p=0.00 (p<0.05)) was found. The CECT detected no peritumoral lymphadenopathy (N0) in 39/86 (45.3%), N1 in 18/86 (20.9%) and N2 in 29/86 (33.7%) patients; there was a significant difference in N-staging between CT and histopathological evaluation (х2=17.74, p=0.007(p<0.05)). For T-staging, CECT evaluation yielded sensitivity of 50% in T2 , 83.6% in T3, 71.4% in T4 staging; Diagnostic accuracy of CT for T2 staging was 89.7%, for T3- 78.2%, for T4- 88.7%. For N-staging, CECT had sensitivity of 88.2%, specificity of 64% and accuracy of 73.8%.Preoperative colorectal cancer patients in Mongolia receive initial MDCT in late stage. The similarsensitivity in staging of T-parameter to that of the international comparable studies. Nodal heterogeneity on CECT was more sensitive for nodal metastases than the size.
6.Preoperativelocalization of colorectal cancer tumor in Mongolian patients using colonoscopy and computed tomography
Orkhon G ; Nergui B ; Gantuya G ; Gonchigsuren D ; Tuvshinjargal D
Mongolian Medical Sciences 2014;170(4):39-41
Purpose: To evaluate colorectal cancer localization in preoperative patients in Mongolia using CECTand endoscopyMaterials and Methods: Totally 10575 optic colonoscopy examinations were performed at UlaanbaatarSongdo Hospital between January 2009 and December 2012. From these examinations, colorectal cancerwas detected in 218 cases; from them 175 had CT examinations. From patients with CT examinations,111 underwent surgery at UBSH, National Cancer Center, State Central Hospital. (64MDCT SiemensSomatom). Only 86 patients with colorectal carcinoma proved by endoscopic or operative pathologywere included into this study. We retrospectively reviewed from the UBSH’ database their preoperativeCT, colonoscopy, surgical and pathohistologic reports using PACSPLUS, OCS operation systems. Toclassify colorectal tumor localization, we divided colon into 8 anatomic parts. The size of tumor wasmeasured as longest dimension visible on CT examination.Results: Study population’s age range was 25-87 age (mean 61.3years ±13.7SD). F: M= 48 (55.8%):38 (44.2%). Urban residents composed 58 (67.4%), rural- 27 (31.4%), foreigner- 1 (1.2%). Tumor sizerange on CT was 0-13 ñì (mean 6.5±2.2 ñì) . Colonoscopy and CT detected colorectal cancer in rectumin 30(34.9%) and 31 (36.1%), in sigmoid colon in 21(24.4%)’’’ and 19(22.1%), in hepatic flexure- 9(10.5%) and 9(10.5%), retrospectively. Double (synchronous) colorectal cancer was detected in 1(1.1%)at colonoscopy and in 2 (2.2%) at CT.Conclusions: The 60-69 age group composed the largest group (38.4%) in colorectal cancer patients,with slight predominance of urban residents over rural and higher female predilection. Sigmoid andrectum are shown to have highest incidence in colorectal cancer. To our best knowledge, it is firstpublication on detection of synchronous colorectal cancer in Mongoliaby both CT and colonoscopy.CT examination is less risky and reliable method to evaluate the entire colonic length in patients withcolorectal cancer suspicion, if observers are skilled in detection of CT signs of colorectal cancer.
7.Current situation of health information system of Mongolia
Enkhbold S ; Jargalsaikhan D ; Gonchigsuren D ; Khurelbaatar N ; Chimedsuren O
Mongolian Medical Sciences 2012;160(2):41-45
Goal: The purpose of this study is to identify issues of current situation of the health information system in the health care facilities of Mongolia.Materials and Methods: A total 362 users as hospital directors, physicians, nurses, statisticians and IT workers of 105 health care facilities at primary, secondary and tertiary level participated in this study. Data collection methods were generated using a combination of questionnaires and in-depth interview of the users. The statistical analysis was carried out using the SPSS. Outcome measures were calculated with 95% confidence intervals (CI).Results: The survey results were shown that a vertical health information flow regulates in the health sector, internal networks set up and H-info 2.0 software as routine data processing and insurance claims are used in the hospitals of Mongolia. Regarding of e-health software as Computerized Physician Order Entry (CPOE), Drug Information System (DIS), Laboratory Information System (LIS) and Radiology Information System (RIS), 82.6% of the health care facilities used only CPOE. There 50% of the existed e-health software is not integrated in the health care facilities. In the data management, 27.0% of the health care facilities that used e-health applications had no backup solution. 45.5% of total users said that the information technology human resource is insufficient. 70.0% of users responded as there did not any continues training program in health information technology. The study was determined lack of functions and difficulty of using the existed software and inadequate software operation and not user-friendliness are the causes of the most of dissatisfactions. Conclusions: A vertical health information flow, internal networks, routine statistic processing set up and mainly CPOE used in the health care facilities. However there is no integration of e-health software and lack of its capacity. It is required modern integrated health information system in the health sector of Mongolia.
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