White matter tract density index is associated with disability in multiple sclerosis.

BACKGROUND: The association between common neuroradiological markers of multiple sclerosis (MS) and clinical disability is weak. Given that the disability in patients with MS may depend on the underlying structural connectivity of the brain, our study aimed to examine the association between white matter tracts affected by MS and the patients' disability using a new tract density index (TDI). METHOD: This study included 53 patients diagnosed with MS, examined between 2019 and 2020. Manual lesion segmentation was performed on fluid-attenuated inversion recovery (FLAIR) images, and the density of white matter tracts encompassing the lesion (i.e., TDI) was calculated. Correlation analysis was employed to assess the association between TDI and disability. Additionally, the relationship between disability, TDI, and lesion-derived network metrics was examined by computing a partial correlation network. RESULTS: The TDI significantly correlated with the expanded disability status scale (EDSS) (r = 0.30, p = 0.03). Furthermore, the patient's disability is linked solely through TDI to lesion-derived network metrics -a key metric that 'bridges' the gap between the brain lesion and disability. CONCLUSIONS: In this study, MS lesions encompassing regions with high white matter tract density were associated and linked with severe physical disability. These findings indicate that TDI may be an outcome predictor that may connect radiologic findings to clinical practice.

Comparison of Small (70-150 µm) and Intermediate (100-300 µm) Size Drug-Eluting Embolics for Transarterial Chemoembolization of Small Hepatocellular Carcinomas (≤3 cm).

PURPOSE: To compare oncologic outcomes of transarterial chemoembolization (TACE) using 70-150 µm and 100-300 µm drug-eluting beads (DEBs) to treat small hepatocellular carcinoma (HCC). METHODS: This retrospective study included 93 patients with small HCC (≤3cm) who underwent first TACE with DEB: 43 with 70-150 µm DEBs and 50 with 100-300 µm DEBs. Initial tumor response was assessed using per-patient and per-lesion analysis. Progression-free survival (PFS) and target tumor PFS were analyzed for patients and lesions with initial complete response (CR). Overall survival (OS) and safety outcomes were also evaluated. RESULTS: At 1 month, initial CR rates were 72.1% in the 70-150 µm group and 70.0% in the 100-300 µm group. PFS was significantly longer in the 70-150 µm group (median, 26 months) compared with the 100-300 µm group (median, 11 months; log-rank p=0.049), with comparable OS results (p=0.096). Per-lesion analysis found that target tumor PFS was significantly longer in the 70-150 µm group (median, 30 months) compared with the 100-300 µm group (median, 13 months; p=0.009). Subgroup analysis revealed the 70-150 µm group had significantly longer target tumor PFS compared with the 100-300 µm group in the 1.0-2.0 cm subgroup (p=0.017), but not in the 2.1-3.0 cm subgroup (p=0.117). No significant differences in adverse events were observed between the two groups. CONCLUSION: The 70-150 µm and 100-300 µm DEB-TACE resulted in comparable tumor response and short-term safety in small HCCs (≤3cm). However, in cases where CR was achieved, treatment with smaller beads demonstrated longer PFS and target tumor PFS.

Aponeurotic expansion of the supraspinatus tendon and concomitant shoulder pathologies.

OBJECTIVES: We investigated the correlation of aponeurotic expansion of the supraspinatus tendon (AESST) with shoulder pathologies such as long head of biceps tendon (LHB), supraspinatus tendon (SST), and subscapularis tendon (SSc). METHODS: We retrospectively evaluated 47 healthy patients and 163 patients with shoulder symptoms from August 2014 to March 2021. First, the presence of AESST was evaluated based on Moser et al.'s classification. Second, the presence of abnormal findings of including LHB tendinitis, LHB subluxation, SST tendinitis, SST tear, SSc tendinitis, and SSc tendon tear was evaluated. We analyzed the prevalence and type of AESST between the two study groups and the relationship between abnormal findings and the presence of AESST. RESULTS: The prevalence of AESST for readers 1 and 2 was 26.1% and 30.4% in the asymptomatic group, respectively, and 22.8% and 31.3% in the symptomatic group. Type 1 was most common (17.3-23.9%) followed by types 2a and 2b. There were no significant differences in the distribution of aponeurosis type between the two groups. In the AESST-positive groups, 45.9% and 47.1% had SST tears on examination by readers 1 and 2, respectively, whereas only 26.4% and 27.9% had SST tears in the AESST-negative group suggesting AESST is associated with SST tear. The odds ratio for SST tear in the presence of AESST was 2.370 and 2.294 (readers 1 and 2). CONCLUSIONS: There is an association between SST tears and the presence of AESST. KEY POINTS: • We evaluated the prevalence of aponeurotic expansion of the supraspinatus tendon (AESST) on MR imaging by type in both symptomatic and asymptomatic groups. • We investigated the correlation of AESST with shoulder pathologies such as biceps tendon and supraspinatus tendon tears. • There is an association between SST tears and the presence of AESST. • Radiologists should be aware of the risk of rotator cuff pathology if AESST is detected.

Ultrasonographic and strain elastographic features of epidermal cyst according to body location.

BACKGROUND: There are not many studies on the differences of ultrasound (US) findings between epidermal cysts (ECs) located in the trunk and those in the extremities. PURPOSE: To compare the sonographic findings of ECs according to location in the body (trunk vs. extremity) and evaluated the feasibility of strain elastography (SE). MATERIAL AND METHODS: This is a retrospective study of 76 patients with surgically confirmed non-ruptured EC who underwent US including SE. The US analyses included size, shape, ratio of depth to length (DLR), involvement of more than half the dermis, "submarine sign," and SE characters of each lesion. SE findings were assigned into four grades based on elasticity. RESULTS: The submarine sign was more significantly observed in ECs located in the trunk versus extremities (P value = 0.004 and 0.035, respectively). Truncal lesions were significantly more likely to possess an ovoid shape (P < 0.05) and exhibited higher DLR (P < 0.05). There were more cases with low elasticity according to SE (grade 3 or 4) compared to high elasticity (grade 1 or 2). However, we did not observe significant differences between the two locations (P > 0.05). More-than-half signs also did not exhibit a significant difference (P > 0.05). CONCLUSION: The submarine sign, ovoid shape, and tall lesions (higher DLR) are common in the trunk. However, the degree of elasticity and number of more-than-half signs did not differ between the two groups.

Intra- and extra-capsular ganglia at the gastrocnemius origin and association with meniscal tears and severity of osteoarthritis of the knee joint.

BACKGROUND: The association between size of ganglia or type of ganglia (intra-articular or extra-articular) and meniscal tears or severity of the osteoarthritis (OA) is not evaluated. PURPOSE: To evaluate the prevalence, size, and location of intra- and extra-capsular ganglia at the gastrocnemius origin and to assess their associations with meniscal injury and grades of OA. MATERIAL AND METHODS: This study included 301 consecutive patients who had knee pain and had undergone magnetic resonance imaging (MRI) of the knee. We evaluated presence of ganglia at the gastrocnemius muscle origin site and diagnosed whether it was an intra-capsular located or mixed-capsular located (intra-capsular and extra-capsular) and then measured the diameter of each ganglion. After two weeks, we evaluated whether articular cartilage injury existed. The presence of a meniscal tear was also recorded. RESULTS: A total of 186 patients (93%) had intra- and extra-capsular ganglia. Intra-capsular ganglia were found in 183 cases (91%) and mixed-capsular ganglia were found in 16 cases (8%). In cases with intra- and extra-capsular ganglia, more meniscal tears were found (P = 0.029). Intra-capsular ganglia showed more meniscal tears (P = 0.021). Intra-capsular ganglia were more likely to have high-grade OA (P = 0.043). Patients who had a meniscal tear displayed larger-sized ganglia, especially of the intra-capsular type (P = 0.044). CONCLUSION: Patients with intra- and extra-capsular ganglia, especially of the intra-capsular type, are more likely to have meniscal injury and more severe OA. Patients with a meniscal tear or OA are more likely to have larger intra- and extra-capsular ganglia, especially of the intra-capsular type.

Cyclops lesions associated with both bundles and selective bundle repair of the anterior cruciate ligament.

BACKGROUND: The remnant of a ruptured anterior cruciate ligament (ACL) can increase the risk of impingement or a cyclops lesion, which can increase challenges to proper tunnel placement. PURPOSE: To evaluate the prevalence of cyclops lesions after ACL reconstruction and to assess the difference in the incidence of cyclops lesions between single-bundle repair and selective bundle repair of the ACL. MATERIAL AND METHODS: This retrospective study included 151 patients who were diagnosed with an ACL tear after knee joint magnetic resonance imaging (MRI) who underwent ACL reconstruction surgery. MRI diagnosis of cyclops lesion formation was made if a soft-tissue mass was seen anteriorly in the intercondylar notch near the tibial insertion of the reconstructed ACL, based on sagittal T2-weighted (T2W) imaging. The size of the cyclops lesions was recorded as the largest diameter on the sagittal T2W imaging. RESULTS: A cyclops lesion was detected in 74 (38.5%) cases. Cyclops lesions were detected more frequently in cases with single-bundle repair of the ACL, but the results were not statistically significant (P = 0.609). Compared with selective bundle repair, cyclops lesions had a significantly higher prevalence in the posterolateral (PL) bundle repair than in the anteromedial (AM) bundle repair (P = 0.027) based on MR images at 6-12 months after surgery. CONCLUSION: The incidence of cyclops lesions did not differ significantly in single-bundle repair and selective bundle repair of ACL. However, selective PL bundle repair of the ACL showed a significantly increased incidence of cyclops lesions compared with selective AM bundle repair.

Prevalence of anterolateral ligament injuries and lateral meniscus tear on MR imaging in patients with both-bundle tear vs. selective bundle incomplete tear of the anterior cruciate ligament.

OBJECTIVES: We investigated the prevalence of anterolateral ligament (ALL) injury and lateral meniscus (LM) tear in cases with both-bundle tear and selective bundle incomplete tear of the anterior cruciate ligament (ACL). METHODS: A total of 174 cases of magnetic resonance (MR) images that had an ACL tear and underwent arthroscopic ACL reconstruction were retrospectively reviewed. ACL injury was classified into both bundle, anteromedial bundle, and posterolateral bundle (PL) on arthroscopic finding. The ALL was divided into three portions: femoral, meniscal, and tibial. ALL injury was scored into three groups: grade 0 is intact; grade 1 is stranding and edema surrounds the expected location of the ALL; grade 2 is clear discontinuity of the ALL consistent with rupture. Traumatic LM tear was also assessed on MR images. RESULTS: The total prevalence of ALL injury was 36.2% (reader 1) and 42.0% (reader 2). ALL injury was statistically related to the selective bundle tear (p = 0.002 and 0.004, readers 1 and 2). PL bundle tear was significantly correlated with the ALL injury (p value < 0.001, readers 1 and 2, both). The location and grade of ALL injury were not significantly correlated with the type of ACL injury. LM tear was not significantly related to the types of ACL tear (p = 0.208 and 0.907, readers 1 and 2) and ALL injury (p value = 0.096 and 0.383, readers 1 and 2). CONCLUSIONS: ALL injury was significantly related to the PL bundle tear of the ACL. LM tear was not significantly correlated with the types of ACL injury and ALL injury. KEY POINTS: • Anterolateral ligament (ALL) injury was significantly related to the posterolateral bundle (PL) tear of the anterior cruciate ligament (ACL). • Lateral meniscus (LM) tear was not significantly correlated with the types of ACL injury and ALL injury. • Clinicians and radiologists should be aware of these relationships and scrutinize ALL injury in cases with PL bundle tears, even with an incomplete ACL injury.

Wedging of vertebral bodies at the thoracolumbar spine in healthy individuals on whole body MRI screening: correlation with disc degeneration and disc herniation.

BACKGROUND: There have been no reports on the relationship between wedging of vertebral bodies at the thoracolumbar spine and disc herniation in healthy individuals on magnetic resonance imaging (MRI). PURPOSE: To investigate the degree of wedging of vertebral bodies at the thoracolumbar spine in healthy individuals who underwent whole-body (WB) MRI. We also assessed the correlation between wedging and adjacent disc pathology. MATERIAL AND METHODS: This retrospective study comprised 200 healthy patients who underwent WB MRI as part of a regular health check from January 2019 to February 2019. We measured anterior and posterior vertical heights of each vertebral body between T10 and L2. The ratio of anterior height to posterior height (APR) was calculated, and we evaluated disc degeneration or disc herniation using WB MRI. RESULTS: The APR of T10 was significantly higher than at the other levels (P < 0.05), and the APR of L1 was significantly lower (P < 0.05). Men had a significantly smaller APR than women at T12 to L2 (P < 0.05). Regarding the relationship between APR and disc degeneration, the group without disc degeneration had a higher APR, with statistical significance at T12, L1, and L2. Regarding the relationship between APR and disc herniation, the group without disc herniation had a higher APR, with statistical significance at T11, T12, L1, and L2. CONCLUSION: Wedging of vertebral bodies is most prominent at L1. Although the values were statistically significant only at some levels, the patients with disc degeneration or herniation had more prominent wedge deformity of thoracolumbar spine.

Association between joint effusions and concomitant structural injuries (tendinitis and structural injury) on MRI in ankle trauma without fracture.

BACKGROUND: The evaluation of correlations among joint effusion, ligament injuries, tenosynovitis and osteochondral lesion of talus (OLT) in the ankle joint is important for developing a treatment plan and predicting prognosis. PURPOSE: To evaluate correlations among tibiotalar (anterior) and talocalcaneal (posterior) joint effusion, tenosynovitis of major flexor tendons, ligaments, and OLT in a group of patients with ankle trauma. MATERIAL AND METHODS: This retrospective study included 101 patients with ankle trauma who underwent magnetic resonance imaging. Two radiologists assessed the presence and amount of effusion in the tibiotalar and talocalcaneal joints from grade 0 to 2, according to the amount of capsular distension. Concomitant structural injuries were assessed in the tibialis posterior (TP), flexor digitorum longus, flexor hallucis longus, and peroneus tendons, and the anterior talofibular ligament, calcaneofibular ligament, anteroinferior tibiofibular ligament, posteroinferior tibiofibular ligament, and OLT. RESULTS: The proportion of anterior and posterior joint effusion according to grade was 67.3% for anterior joint effusion grade 0, 22.8% for grade 1, and 9.9% for grade 2; for posterior joint effusion, grade 0 was 74.2%, grade 1 was 22.8%, and grade 2 was 3.0%. We found statistically significant correlations between posterior joint effusion and tenosynovitis of TP (P < 0.05) and between posterior joint effusion and OLT (P < 0.05). CONCLUSION: Posterior joint effusion is correlated with TP injury and OLT; however, tendon injuries have no correlation with other structural injuries of the ankle joint in a general population with ankle trauma.

Attachment Type, Thickness, and Volume of the Posterior Meniscofemoral Ligament and Meniscal Pathology.

Several studies have investigated the relationship between the thickness of the posterior meniscofemoral ligament (pMFL) and the presence of a discoid meniscus. We investigated the correlation between meniscal pathology and anatomic features of pMFL such as attachment type, thickness, and volume. We retrospectively evaluated 191 patients who underwent knee MRI. MR images were reviewed to assess the attachment type of the pMFL on the medial femoral condyle (high vs. low), the thickness of the pMFL, and the presence of a meniscal tear or a discoid meniscus. The pMFL volume was quantified by using three-dimensional (3D) segmentation software. The relationship between the frequency of medial or lateral meniscal tear and anatomic features of pMFL were analyzed using Chi-square, Fisher's exact, or Mann-Whitney U test. High type pMFLs had significantly greater thickness and volume than low type pMFLs (p < 0.001). Patients with degenerative lateral meniscal tear had significantly higher thickness and volume of the pMFL than patients with intact lateral meniscus (p < 0.05). The pMFL thickness and volume were not significantly related to traumatic lateral meniscal tear, medial meniscal tear, and discoid meniscus. High type pMFLs tended to be thicker and larger than low type pMFLs and higher thickness and volume of the pMFL was significantly related to the degenerative lateral meniscal tear. However, the attachment type of the pMFL itself was not significantly related to the lateral meniscal tear as well as the medial meniscal tear.

Radiofrequency ablation of subcapsular lesions with internally cooled perfusion electrode: ex vivo study.

PURPOSE: To compare the ex vivo efficiency of an internally cooled perfusion (ICP) electrode and an internally cooled (IC) electrode for radiofrequency ablation (RFA) of subscapular lesions. MATERIAL AND METHODS: Using 200 W generator and ICP electrode (group A, n = 10) or 15 gauge or 17 gauge IC electrode (group B, n = 10 and group C, n = 10), RFA was applied to the bovine liver for 12 min. Each electrode was inserted at a 3 cm depth into the liver block, and the proximal end of the active exposure portion of each electrode was located at a capsule of the liver block. During RFA, normal saline was pumped through the side hole of the ICP electrode into the tissue at an injection rate of 0.5 mL/min. RESULTS: The ICP electrode achieved larger capsular ablative area and ablative volume than the IC electrode: 7.29 ± 1.59 cm2 and 44.56 ± 10.08 cm3 in group A; 4.36 ± 1.29cm2 and 30.15 ± 5.97 cm3 in group B; and 3.57 ± 0.99cm2 and 24.52 ± 4.21 cm3 in group C (p < .05), respectively. Mean impedance of ICP RFA was lower than IC RFA: 41.5 ± 3.75Ω in group A; 52.4 ± 5.64Ω in group B; and 58.1 ± 10.98Ω in group C (p < .05). CONCLUSION: RFA using the ICP electrode more efficiently created a larger capsular ablative area and ablative volume of ablation than IC RFA for subcapsular lesions. The results were obtained in an ex vivo liver model without tumor simulation inside.

Superselective vesical artery embolization for intractable bladder hemorrhage related to pelvic malignancy.

BACKGROUND: Intractable bladder hemorrhage from pelvic malignancy can be potentially life-threatening and its management can be a challenging clinical problem. PURPOSE: To evaluate safety, efficacy, and clinical outcome of superselective vesical artery embolization for the control of intractable bladder hemorrhage from pelvic malignancy. MATERIAL AND METHODS: Between January 2010 and September 2018, 20 patients underwent superselective vesical artery embolization for intractable hematuria secondary to pelvic malignancy arising from or invading the bladder. Treatment details and clinical outcomes were obtained. RESULTS: There were 12 men and 8 women (mean age = 77 years). Bilateral embolization was performed in 10 patients and unilateral approach in 10 patients. Two patients died within four days after embolization due to underlying heart failure and systemic metastasis, respectively. The remaining 18 patients had a follow-up of >30 days. Bleeding was controlled after the first embolization in 17/18 patients and after a repeat embolization in the remaining one patient. The mean follow-up period of 18 patients was 10.6 months (range = 1-77 months). Late recurrent hemorrhage (≥ 30 days after embolization) was reported in 6 (33.3%) patients. Five of these six patients underwent repeat embolization. There were no major complications related to embolization. CONCLUSION: Palliative superselective vesical artery embolization is a feasible, effective, and safe procedure to control intractable hematuria in patients with pelvic malignancy.

Complications after 100 sessions of cone-beam computed tomography-guided lung radiofrequency ablation: a single-center, retrospective experience.

Objective: To evaluate complications after consecutive 100 sessions of cone-beam computed tomography (CBCT)-guided radiofrequency ablation (RFA) of lung tumorsMaterials and methods: A retrospective study was conducted from January 2016 and October 2018. All procedures were performed using a CBCT virtual navigation guidance system, combining three-dimentional CBCT, needle planning software, and real-time fluoroscopy. Complications were evaluated for each RFA session in 63 consecutive patients (31 male, 32 female; mean age 58.0 years) with 121 lung tumors who underwent 100 sessions of CBCT-guided lung ablation with an internally cooled RFA system. Complications were recorded using the Common Terminology Criteria of Adverse Events (CTCAE) 5.0. A major complication was defined as a grade 3 or 4 adverse event.Results: There was no postprocedural mortality. The major and minor complication rates were 5% and 28%, respectively. The major complications were significant pulmonary hemorrhage (1%), large hemothorax requiring drainage (1%), pneumonia treated with antibiotics (2%), and delayed bronchopleural fistula (1%). The minor complications were pneumothorax (15%), hemoptysis (11%), and subcutaneous emphysema (2%). Of the 15 pneumothoraces, percutaneous catheter drainage was required in six sessions. Pneumothorax was more likely to occur if RFA was performed on two or more tumors at one session. Immediate, periprocedural and delayed complications were 23%, 9%, and 1%, respectively.Conclusion: CBCT-guided RFA of lung tumors is a relatively safe procedure with acceptable morbidity.

Anatomical Variations Encountered during Adrenal Venous Sampling: A Report of Three Case Series and Review of Literature.

Primary aldosteronism is a group of disorders in which the autonomous secretion of aldosterone is associated with hypertension and hypokalemia. It is crucial to determine the laterality of aldosterone hypersecretion because treatment options differ accordingly. Adrenal venous sampling (AVS) is considered the most reliable method for assessing the laterality of primary aldosteronism. This procedure is often technically challenging because of the small size and varied locations of the adrenal veins. A better understanding of anatomical variations and careful review of imaging studies would improve sampling success. This report presents three cases of anatomical variations encountered during AVS.

[Adrenal Vein Sampling in Primary Aldosteronism: A Pictorial Essay for Optimal Left-Side Sampling]. / ì¼ì°¨ì„±ê³ ì•Œë„ìŠ¤í Œë¡ í˜ˆì¦ì—ì„œì˜ ë¶€ì‹ ì •ë§¥ì±„í˜ˆìˆ : ìµœì ì˜ 좌측채혈을 위한 임상화보.

Primary aldosteronism (PA) is a curable cause of hypertension. Recent studies have revealed that the actual prevalence of PA is higher than previously recognized. Adrenal vein sampling (AVS) is an essential diagnostic procedure for revealing the cause of PA and determining the treatment plan. The success of AVS is confirmed by comparing cortisol levels between the samples from each adrenal vein and peripheral vein. The failure rate of the procedure is reported to be high in the right adrenal vein, which is directly connected to the inferior vena cava, while that in the left adrenal vein is relatively low; however, this has rarely been reported. In this review, we introduce and analyze cases of failure in left adrenal vein sampling.

Evaluation of Pretreatment Albumin-Bilirubin Grade as a Better Prognostic Factor Compared to Child-Pugh Classification in Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization Combined with Radiotherapy.

This study assessed the use of pretreatment albumin--bilirubin (ALBI) grade as a prognostic factor in patients with hepatocellular carcinoma (HCC) receiving combined transarterial chemoembolization (TACE) and radiotherapy (RT). Patients who underwent RT following TACE between January 2011 and December 2020 were analyzed retrospectively. The survival outcomes of patients in regard to the ALBI grade and Child-Pugh (C-P) classification were evaluated. A total of 73 patients with a median follow-up of 16.3 months were included. Thirty-three (45.2%) and forty patients (54.8%) were categorized into ALBI grades 1 and 2-3, respectively, while sixty-four (87.7%) and nine (12.3%) were C-P classes A and B, respectively (p = 0.003). The median progression-free survival (PFS) and overall survival (OS) for ALBI grade 1 vs. 2-3 were 8.6 months vs. 5.0 months (p = 0.016) and 27.0 months vs. 15.9 months (p = 0.006), respectively. The median PFS and OS for C-P class A vs. B were 6.3 months vs. 6.1 months (p = 0.265) and 24.8 months vs. 19.0 months (p = 0.630), respectively. A multivariate analysis showed that ALBI grades 2-3 were significantly associated with worse PFS (p = 0.035) and OS (p = 0.021). In conclusion, the ALBI grade could be a good prognosticator in HCC patients who were treated with combined TACE-RT.

Clinical outcomes and prognostic factors of cone-beam CT-guided radiofrequency ablation for pulmonary metastases in colorectal cancer patients.

AIM: Radiofrequency ablation (RFA) has been increasingly used for the treatment of pulmonary metastases in various malignancies. METHODS: A retrospective analysis was performed to establish the safety and efficacy of cone-beam computed tomography (CBCT)-guided RFA in patients with metastatic colorectal cancer between 2016 and 2019, and the prognostic factors of local tumor control were assessed. RESULTS: A total of 31 patients with colorectal cancer underwent 48 sessions of lung RFA. The mean diameter of metastases targeted for RFA was 11 mm (range: 4-32), and the RFA was technically successful in 43 sessions (90%). There were 14 complications (29%), the majority of which required no intervention, with no cases of mortality. The median follow-up duration from RFA in the surviving 29 patients was 18.0 months. Only two patients (6%) died of disease progression, and the 3-year overall survival rate was 91% (95% CI: 83-99). Local tumor progression (LTP) of the RFA site was observed in 27%, and the LTP-free survival rates at 1 and 2 years were 81% (95% CI: 70-82) and 64% (95% CI: 50-77), respectively. Multivariate analysis showed that the progression of extra-RFA sites and the presence of extrapulmonary metastasis were independent prognostic factors significantly associated with LTP at RFA site. CONCLUSION: Lung RFA using CBCT guidance is a comparatively safe and effective option for the treatment of lung metastases from colorectal cancer. However, the control of extrapulmonary metastases should be accompanied by combined or sequential systemic treatment and local treatment.

Comparison of Clinical Efficacy and Safety between 70-150 µm and 100-300 µm Doxorubicin Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma.

BACKGROUND: This study aimed to compare the efficacy and safety of 70-150 µm doxorubicin drug-eluting bead (DEB) transarterial chemoembolization (TACE) with those of 100-300 µm DEB-TACE as first-line treatment in patients with hepatocellular carcinoma (HCC). METHODS: We retrospectively investigated 72 patients who underwent TACE with 70-150 µm DEBs (n = 40) or 100-300 µm DEBs (n = 32) for HCC in a tertiary center between March 2013 and May 2019. Initial treatment response and adverse events were assessed using the modified Response Evaluation Criteria in Solid Tumors and the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0, respectively. RESULTS: At the 2-month post-treatment assessment, the complete and objective response rates were 47.5% and 85.0%, respectively, for the 70-150 µm group and 34.4% and 81.3%, respectively, for the 100-300 µm group; however, the difference was not statistically significant (p > 0.05). In total, 65% patients in the 70-150 µm group and 59.4 % patients in the 100-300 µm group experienced at least one symptom of post-embolization syndrome after TACE; all symptoms were classified as grade 1 or 2. There was no significant difference between the two groups in terms of post-procedural laboratory changes such as changes in liver enzymes and bilirubin levels (p > 0.05). Laboratory toxicity of grade 3 occurred in three patients, all of which were transient elevation of liver enzyme levels. Hepatobiliary adverse events, such as bile duct injury, biloma, liver abscess, and hepatic infarction, were not observed in either treatment group. CONCLUSION: This study found no significant difference in tumor response between 70-150 µm and 100-300 µm DEB-TACE. Both groups showed favorable safety profiles, and the difference was not significant.

Protruding anterior medial meniscus and posterior tibial translation as secondary signs of complete and partial posterior cruciate ligament tear.

OBJECTIVE: To evaluate whether measurement of protruding anterior meniscus in the medial compartment (PAMM) and posterior tibial translation (PTT) can be used as a secondary sign of posterior cruciate ligament (PCL) tear for differential diagnosis of partial or complete tear. METHODS: 21 cases with complete PCL tear, 35 cases with partial PCL tear, and 55 normal cases were reviewed in this retrospective study. PTT and PAMM were measured from the MR images associated with each case. Non-parametric data were evaluated using the Kruskal-Wallis test and the Mann-Whitney U-test with Bonferroni correction to compare differences among the three groups: complete tear, partial tear, and controls. RESULTS: There were significant differences in the median values of PAMM among the three groups, and with PAMM increasing as the grade of PCL injury increased. However, there were no significant differences in median PTT among the three groups. Median PAMM in the partial and complete tear groups was significantly higher than in subjects without PCL rupture (adjusted p-value <0.05). Although median PAMM in subjects in the complete tear group tended to be higher than in those with a partial tear, this difference was not statistically significant (adjusted p-values ≥0.418). CONCLUSION: PAMM is more useful finding than PTT and can predict PCL tear with or without posterior instability. However, PAMM cannot differentiate partial tear and complete tear of the PCL. ADVANCES IN KNOWLEDGE: PAMM is more useful finding than PTT and can predict PCL tear with or without posterior instability. However, PAMM cannot differentiate partial tear and complete tear of the PCL.