Objective: To compare the quality of deep learning-reconstructed turbo spin-echo (DL-TSE) and conventionally interpolated turbo spin-echo (Conv-TSE) techniques in contrast-enhanced MRI of the neck. Materials and Methods: Contrast-enhanced T1-weighted DL-TSE and Conv-TSE images were acquired using 3T scanners from 106 patients. DL-TSE employed a closed-source, ‘work-in-progress’ (WIP No. 1062, iTSE, version 10; Siemens Healthineers) algorithm for interpolation and denoising to achieve the same in-plane resolution (axial: 0.26 x 0.26 mm 2 ; coronal: 0.29 x 0.29 mm 2 ) while reducing scan times by 15.9% and 52.6% for axial and coronal scans, respectively. The full width at half maximum (FWHM) and percent signal ghosting were measured using stationary and flow phantom scans, respectively. In patient images, non-uniformity (NU), contrast-to-noise ratio (CNR), and regional mucosal FWHM were evaluated. Two neuroradiologists visually rated the patient images for overall quality, sharpness, regional mucosal conspicuity, artifacts, and lesions using a 5-point Likert scale. Results: FWHM in the stationary phantom scan was consistently sharper in DL-TSE. The percent signal ghosting outside the flow phantom was lower in DL-TSE (0.06% vs. 0.14%) but higher within the phantom (8.92% vs. 1.75%) compared to ConvTSE. In patient scans, DL-TSE showed non-inferior NU and higher CNR. Regional mucosal FWHM was significantly better in DL-TSE, particularly in the oropharynx (coronal: 1.08 ± 0.31 vs. 1.52 ± 0.46 mm) and hypopharynx (coronal: 1.26 ± 0.35 vs. 1.91 ± 0.56 mm) (both P < 0.001). DL-TSE demonstrated higher overall image quality (axial: 4.61 ± 0.49 vs. 3.32 ± 0.54) and sharpness (axial: 4.40 ± 0.56 vs. 3.11 ± 0.53) (both P < 0.001). In addition, mucosal conspicuity was improved, especially in the oropharynx (axial: 4.41 ± 0.67 vs. 3.40 ± 0.69) and hypopharynx (axial: 4.45 ± 0.58 vs. 3.58 ± 0.63) (both P < 0.001).Extracorporeal ghost artifacts were reduced in DL-TSE (axial: 4.32 ± 0.60 vs. 3.90 ± 0.71, P < 0.001) but artifacts overlapping anatomical structures were slightly more pronounced (axial: 3.78 ± 0.74 vs. 3.95 ± 0.72, P < 0.001). Lesions were detected with higher confidence in DL-TSE. Conclusion DL-based reconstruction applied to accelerated neck MRI improves overall image quality, sharpness, mucosal conspicuity in motion-prone regions, and lesion detection confidence. Despite more pronounced ghost artifacts overlapping anatomical structures, DL-TSE enables substantial scan time reduction while enhancing diagnostic performance.

Objective: To compare the quality of deep learning-reconstructed turbo spin-echo (DL-TSE) and conventionally interpolated turbo spin-echo (Conv-TSE) techniques in contrast-enhanced MRI of the neck. Materials and Methods: Contrast-enhanced T1-weighted DL-TSE and Conv-TSE images were acquired using 3T scanners from 106 patients. DL-TSE employed a closed-source, ‘work-in-progress’ (WIP No. 1062, iTSE, version 10; Siemens Healthineers) algorithm for interpolation and denoising to achieve the same in-plane resolution (axial: 0.26 x 0.26 mm 2 ; coronal: 0.29 x 0.29 mm 2 ) while reducing scan times by 15.9% and 52.6% for axial and coronal scans, respectively. The full width at half maximum (FWHM) and percent signal ghosting were measured using stationary and flow phantom scans, respectively. In patient images, non-uniformity (NU), contrast-to-noise ratio (CNR), and regional mucosal FWHM were evaluated. Two neuroradiologists visually rated the patient images for overall quality, sharpness, regional mucosal conspicuity, artifacts, and lesions using a 5-point Likert scale. Results: FWHM in the stationary phantom scan was consistently sharper in DL-TSE. The percent signal ghosting outside the flow phantom was lower in DL-TSE (0.06% vs. 0.14%) but higher within the phantom (8.92% vs. 1.75%) compared to ConvTSE. In patient scans, DL-TSE showed non-inferior NU and higher CNR. Regional mucosal FWHM was significantly better in DL-TSE, particularly in the oropharynx (coronal: 1.08 ± 0.31 vs. 1.52 ± 0.46 mm) and hypopharynx (coronal: 1.26 ± 0.35 vs. 1.91 ± 0.56 mm) (both P < 0.001). DL-TSE demonstrated higher overall image quality (axial: 4.61 ± 0.49 vs. 3.32 ± 0.54) and sharpness (axial: 4.40 ± 0.56 vs. 3.11 ± 0.53) (both P < 0.001). In addition, mucosal conspicuity was improved, especially in the oropharynx (axial: 4.41 ± 0.67 vs. 3.40 ± 0.69) and hypopharynx (axial: 4.45 ± 0.58 vs. 3.58 ± 0.63) (both P < 0.001).Extracorporeal ghost artifacts were reduced in DL-TSE (axial: 4.32 ± 0.60 vs. 3.90 ± 0.71, P < 0.001) but artifacts overlapping anatomical structures were slightly more pronounced (axial: 3.78 ± 0.74 vs. 3.95 ± 0.72, P < 0.001). Lesions were detected with higher confidence in DL-TSE. Conclusion DL-based reconstruction applied to accelerated neck MRI improves overall image quality, sharpness, mucosal conspicuity in motion-prone regions, and lesion detection confidence. Despite more pronounced ghost artifacts overlapping anatomical structures, DL-TSE enables substantial scan time reduction while enhancing diagnostic performance.

Background: This study evaluated adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Korean guidelines in the prescription patterns of respiratory specialists for stable chronic obstructive pulmonary disease (COPD) management. Methods: Data were collected on medications from 2011 to 2022 using the Korea COPD Subtype Study (KOCOSS) cohort. Patients were divided into two groups: those registered before and after 2019, and we analyzed the percentage of patients meeting the recommended treatment criteria established by each guideline. Results: Among 3,477 patients, 85.6% received pharmacological therapy, and 81.6% utilized inhaled medications. Compared to patients enrolled before 2019, there was an increase in inhaler prescriptions among those registered after 2019 (79.7% vs. 86.7%), with dual bronchodilators being the predominant therapy prescribed. Of the patients receiving treatment, 56.9% adhered to the Korean 2018 guideline. Compliance with the GOLD 2019 and GOLD 2023 guidelines was observed in 31.3% and 28.0% of cases, respectively. When analyzing inhaler prescription patterns according to both subgroups and considering the Korean 2018, GOLD 2019, and GOLD 2023 guidelines concurrently, the adherence rates were as follows: (56.6%, 37.8%, 24.0%) and (57.7%, 14.0%, 38.6%). Conclusion Adherence rates were higher for the Korean guideline compared to the GOLD recommendations. Furthermore, alignment with both the Korean 2018 and GOLD 2023 guidelines increased among patients enrolled after 2019, compared to those registered earlier. These findings suggest that physicians are modifying their therapeutic strategies to align with both domestic and recent international guidelines.

Purpose: This study evaluated the therapeutic efficacy of intravitreal methotrexate (MTX) injections in patients diagnosed with intraocular lymphoma via vitrectomy and immunocytochemical staining. Methods: In a retrospective analysis of medical records, we reviewed data from four patients (six eyes) diagnosed with intraocular lymphoma cytologically after undergoing vitrectomy at our hospital between December 2021 and December 2023. Each case was followed for a minimum of 6 months after treatment, with comparisons made between pre- and post-treatment observations Results: The mean age of the patients was 63.5 ± 9.8 years, with an average interval of 29.3 ± 32.0 months from initial symptom onset to intraocular lymphoma diagnosis. Diagnosis was confirmed through cytological and immunocytochemical analysis of vitreous specimens, identifying diffuse large B-cell lymphoma in four eyes and atypical lymphoid cells in two eyes. On average, 14.0 ± 1.7 intravitreal MTX injections were administered per eye. The mean best-corrected visual acuity improved from 1.18 ± 0.90 pre-treatment to 0.37 ± 0.70 post-treatment. Ophthalmic complications included toxic keratopathy in three eyes and retinal hemorrhage in one eye. Additionally, nasal cavity lymphoma was diagnosed in two patients. Conclusions Diagnostic vitrectomy combined with cytology and immunocytochemical staining is essential for the early diagnosis of intraocular lymphoma and differentiation from inflammatory diseases, such as uveitis. Intravitreal MTX injections can induce clinical remission in intraocular lymphoma cases.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Purpose: This study evaluated the therapeutic efficacy of intravitreal methotrexate (MTX) injections in patients diagnosed with intraocular lymphoma via vitrectomy and immunocytochemical staining. Methods: In a retrospective analysis of medical records, we reviewed data from four patients (six eyes) diagnosed with intraocular lymphoma cytologically after undergoing vitrectomy at our hospital between December 2021 and December 2023. Each case was followed for a minimum of 6 months after treatment, with comparisons made between pre- and post-treatment observations Results: The mean age of the patients was 63.5 ± 9.8 years, with an average interval of 29.3 ± 32.0 months from initial symptom onset to intraocular lymphoma diagnosis. Diagnosis was confirmed through cytological and immunocytochemical analysis of vitreous specimens, identifying diffuse large B-cell lymphoma in four eyes and atypical lymphoid cells in two eyes. On average, 14.0 ± 1.7 intravitreal MTX injections were administered per eye. The mean best-corrected visual acuity improved from 1.18 ± 0.90 pre-treatment to 0.37 ± 0.70 post-treatment. Ophthalmic complications included toxic keratopathy in three eyes and retinal hemorrhage in one eye. Additionally, nasal cavity lymphoma was diagnosed in two patients. Conclusions Diagnostic vitrectomy combined with cytology and immunocytochemical staining is essential for the early diagnosis of intraocular lymphoma and differentiation from inflammatory diseases, such as uveitis. Intravitreal MTX injections can induce clinical remission in intraocular lymphoma cases.

Background: This study evaluated adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Korean guidelines in the prescription patterns of respiratory specialists for stable chronic obstructive pulmonary disease (COPD) management. Methods: Data were collected on medications from 2011 to 2022 using the Korea COPD Subtype Study (KOCOSS) cohort. Patients were divided into two groups: those registered before and after 2019, and we analyzed the percentage of patients meeting the recommended treatment criteria established by each guideline. Results: Among 3,477 patients, 85.6% received pharmacological therapy, and 81.6% utilized inhaled medications. Compared to patients enrolled before 2019, there was an increase in inhaler prescriptions among those registered after 2019 (79.7% vs. 86.7%), with dual bronchodilators being the predominant therapy prescribed. Of the patients receiving treatment, 56.9% adhered to the Korean 2018 guideline. Compliance with the GOLD 2019 and GOLD 2023 guidelines was observed in 31.3% and 28.0% of cases, respectively. When analyzing inhaler prescription patterns according to both subgroups and considering the Korean 2018, GOLD 2019, and GOLD 2023 guidelines concurrently, the adherence rates were as follows: (56.6%, 37.8%, 24.0%) and (57.7%, 14.0%, 38.6%). Conclusion Adherence rates were higher for the Korean guideline compared to the GOLD recommendations. Furthermore, alignment with both the Korean 2018 and GOLD 2023 guidelines increased among patients enrolled after 2019, compared to those registered earlier. These findings suggest that physicians are modifying their therapeutic strategies to align with both domestic and recent international guidelines.