Purpose To determine the diagnostic performance of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance (MR) imaging in the preoperative assessment of pancreatic cancer in comparison with that of FDG PET/computed tomography (CT) plus contrast material–enhanced multidetector CT. Materials and Methods This prospective study was approved by the institutional review board; written informed consent was obtained. Thirty-seven patients with 39 pancreatic tumors underwent preoperative FDG PET/MR imaging, PET/CT, and contrast-enhanced multidetector CT. The authors measured maximal and mean standardized uptake values (SUVmax and SUVmean, respectively) of pancreatic cancer at PET/MR imaging and PET/CT. Two radiologists independently reviewed the two imaging sets (set 1, PET/MR imaging; set 2, PET/CT plus multidetector CT) to determine tumor resectability according to a five-point scale, N stage (N0 or N positive), and M stage (M0 or M1). With use of clinical-surgical-pathologic findings as the standard of reference (n = 20), diagnostic performances of the two imaging sets were compared by using the McNemar test. Results Both SUVmax and SUVmean of pancreatic tumors showed strong correlations between PET/MR imaging and PET/CT (r = 0.897 and 0.890, respectively; P < .001). The diagnostic performance of PET/MR imaging was not significantly different from that of PET/CT plus multidetector CT in the assessment of tumor resectability (area under the receiver operating characteristic curve: 0.891 vs 0.776, respectively, for reviewer 1 [P = .109] and 0.859 vs 0.797 for reviewer 2 [P = .561]), N stage (accuracy: 54% [seven of 13 patients] vs 31% [four of 13 patients]; P = .250 for both reviewers), and M stage (accuracy: 94% [16 of 17 patients] vs 88% [15 of 17 patients] for reviewer 1 [P > .999] and 94% [16 of 17 patients] vs 82% [14 of 17 patients] for reviewer 2 [P = .500]). Conclusion FDG PET/MR imaging showed a diagnostic performance similar to that of PET/CT plus contrast-enhanced multidetector CT in the preoperative evaluation of the resectability and staging of pancreatic tumors. © RSNA, 2016 Online supplemental material is available for this article.

McNemar's test

PET-CT

Multidetector computed tomography

10.1148/radiol.2016152798

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Citations (74)

Visceral Obesity Predicts Significant Fibrosis in Patients With Nonalcoholic Fatty Liver Disease

Medicine (2015)

Su Jong Yu Won Kim Donghee Kim Jung‐Hwan Yoon Kyoung Bun Lee

Nonalcoholic fatty liver disease (NAFLD) is associated with visceral obesity. However, the association between visceral adipose tissue (VAT) area and fibrosis in NAFLD patients has not been completely established. This study was aimed to determine the relationship between the computed tomography-measured VAT area and significant fibrosis in NAFLD patients. A total of 324 NAFLD patients and 132 controls were evaluated by liver biopsy. NAFLD was diagnosed based on histological examinations and alcohol consumption <20 g/day. The NAFLD patients showed a higher age and gender-adjusted VAT area than the control group (86.1 ± 2.3 vs 56.7 ± 3.7, P < 0.001). The VAT area increased across the control, NAFLD without significant fibrosis, and NAFLD with significant fibrosis groups (54.9 ± 3.5, 80.6 ± 2.4, and 123.4 ± 6.4, P < 0.001). This association persisted after adjusting for multiple confounders (P for trend = 0.028). A multivariate regression analysis demonstrated the VAT area was independently associated with NAFLD with significant fibrosis (F2-F4) (odds ratio [OR] 1.21 95% confidence interval [CI] 1.07-1.37 per 10 cm(2) increase of VAT area; OR 2.62 [per 1 - standard deviation (SD)] 95% CI 1.41-4.86). Moreover, a multivariate logistic regression analysis revealed the VAT area was independently associated with nonalcoholic steatohepatitis (NASH) in NAFLD (OR 1.17 95% CI 1.05-1.32 per 10 cm increase of VAT area; OR 2.21 [per 1 - SD] 95% CI 1.25-3.89). Increased VAT area is independently associated with NASH or significant fibrosis and VAT might be a central target for lifestyle modifications in NAFLD patients.

10.1097/md.0000000000002159

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Citations (105)

Antibacterial infection and immune-evasive coating for orthopedic implants

Science Advances (2020)

Kyomin Chae Woo Young Jang Kijun Park Jinhyeok Lee Hyunchul Kim

Antibacterial and immune-evasive coating for orthopedic implants reduce infection and infection-induced immune response.

10.1126/sciadv.abb0025

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Citations (89)

Liver fibrosis staging with a new 2D-shear wave elastography using comb-push technique: Applicability, reproducibility, and diagnostic performance

PLoS ONE (2017)

Sang Min Lee Jeong Min Lee Hyo Jin Kang Hyung Kung Yang Jeong Hee Yoon

To evaluate the applicability, reproducibility, and diagnostic performance of a new 2D-shear wave elastography (SWE) using the comb-push technique (2D CP-SWE) for detection of hepatic fibrosis, using histopathology as the reference standard.This prospective study was approved by the institutional review board, and informed consent was obtained from all patients. The liver stiffness (LS) measurements were obtained from 140 patients, using the new 2D-SWE, which uses comb-push excitation to produce shear waves and a time-aligned sequential tracking method to detect shear wave signals. The applicability rate of 2D CP-SWE was estimated, and factors associated with its applicability were identified. Intraobserver reproducibility was evaluated in the 105 patients with histopathologic diagnosis, and interobserver reproducibility was assessed in 20 patients. Diagnostic performance of the 2D CP-SWE for hepatic fibrosis was evaluated by receiver operating characteristic (ROC) curve analysis.The applicability rate of 2D CP-SWE was 90.8% (109 of 120). There was a significant difference in age, presence or absence of ascites, and the distance from the transducer to the Glisson capsule between the patients with applicable LS measurements and patients with unreliable measurement or technical failure. The intraclass correlation of interobserver agreement was 0.87, and the value for the intraobserver agreement was 0.95. The area under the ROC curve of LS values for stage F2 fibrosis or greater, stage F3 or greater, and stage F4 fibrosis was 0.874 (95% confidence interval [CI]: 0.794-0.930), 0.905 (95% CI: 0.832-0.954), and 0.894 (95% CI: 0.819-0.946), respectively.2D CP-SWE can be employed as a reliable method for assessing hepatic fibrosis with a reasonably good diagnostic performance, and its applicability might be influenced by age, ascites, and the distance between the transducer and Glisson capsule.

Transient elastography

10.1371/journal.pone.0177264

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Citations (43)

Quantification of hepatic macrosteatosis in living, related liver donors using T1‐independent, T2*‐corrected chemical shift MRI

Journal of Magnetic Resonance Imaging (2012)

Eugene Joe Jeong Min Lee Kyung Won Kim Kyoung Bun Lee Soo‐Jin Kim

Abstract Purpose: To evaluate the diagnostic implications of the iterative decomposition of water and fat using echo‐asymmetry and the least‐squares estimation (IDEAL) technique to detect hepatic steatosis (HS) in potential liver donors using histopathology as the reference standard. Materials and Methods: Forty‐nine potential liver donors (32 male, 17 female; mean age, 31.7 years) were included. All patients were imaged using the in‐ and out‐of‐phase (IOP) gradient‐echo (GRE) and IDEAL techniques on a 1.5 T MR scanner. To estimate the hepatic fat fraction (FF), two reviewers performed regions‐of‐interest measurement in 15 areas of the liver seen on the IOP images and on the IDEAL‐FF images. The magnetic resonance imaging (MRI) and pathology values of macrosteatosis were correlated using the Pearson correlation coefficient. We analyzed the diagnostic performance of IOP imaging and IDEAL for detecting HS. Results: The results of the hepatic‐FF estimated on IDEAL were well correlated with the histologic degree of macrosteatosis (γ = 0.902, P < 0.001). IDEAL showed 100% sensitivity and 91% specificity for detecting HS, and IOP imaging showed 87.5% sensitivity and 97% specificity, respectively. Conclusion: IDEAL is a useful tool for the preoperative diagnosis of HS in potential living liver donors; it can also help to avoid unnecessary biopsies in these patients. J. Magn. Reson. Imaging 2012;36:1124–1130. © 2012 Wiley Periodicals, Inc.

Steatosis

Histopathology

10.1002/jmri.23738

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Citations (27)

Reconstructive challenges in the management of a rare case of sphenoid osteosarcoma--a case report.

PubMed (2001)

Kyoung Bun Lee E S Ang K C Tan

Primary osteosarcoma of the sphenoid bone is an extremely rare condition. This paper presents a case of a lady with recurrent oesteosarcoma of the sphenoid bone who had resection of the tumour via a combined neurosurgical and craniofacial procedure and reconstruction with a free flap and bone graft. It details the diagnosis, treatment and follow-up of this unusual condition.

Sphenoid bone

Source

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Citations (5)

Impact of Macroscopic Morphology, Multifocality, and Mucin Secretion on Survival Outcome of Intraductal Papillary Neoplasm of the Bile Duct

Journal of Gastrointestinal Surgery (2013)

Mee Joo Kang Jin‐Young Jang Kyoung Bun Lee In Woong Han Sun‐Whe Kim

10.1007/s11605-013-2151-3

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Citations (41)

Impact of Type of Surgery on Survival Outcome in Patients With Early Gallbladder Cancer in the Era of Minimally Invasive Surgery

Medicine (2016)

Jin‐Young Jang Jin Seok Heo Youngmin Han Jihoon Chang Jae Ri Kim

Laparoscopic surgery has been widely accepted as a feasible and safe treatment modality in many cancers of the gastrointestinal tract. However, most guidelines on gallbladder cancer (GBC) regard laparoscopic surgery as a contraindication, even for early GBC. This study aims to evaluate and compare recent surgical outcomes of laparoscopic and open surgery for T1(a,b) GBC and to determine the optimal surgical strategy for T1 GBC. The study enrolled 197 patients with histopathologically proven T1 GBC and no history of other cancers who underwent surgery from 2000 to 2014 at 3 major tertiary referral hospitals with specialized biliary-pancreas pathologists and optimal pathologic handling protocols. Median follow-up was 56 months. The effects of depth of invasion and type of surgery on disease-specific survival and recurrence patterns were investigated. Of the 197 patients, 116 (58.9%) underwent simple cholecystectomy, including 31 (15.7%) who underwent open cholecystectomy and 85 (43.1%) laparoscopic cholecystectomy. The remaining 81 (41.1%) patients underwent extended cholecystectomy. Five-year disease-specific survival rates were similar in patients who underwent simple and extended cholecystectomy (96.7% vs 100%, P = 0.483), as well as being similar in patients in the simple cholecystectomy group who underwent open and laparoscopic cholecystectomy (100% vs 97.6%, P = 0.543). Type of surgery had no effect on recurrence patterns. Laparoscopic cholecystectomy for T1 gallbladder cancer can provide similar survival outcomes compared to open surgery. Considering less blood loss and shorter hospital stay with better cosmetic outcome, laparoscopic cholecystectomy can be justified as a standard treatment for T1b as well as T1a gallbladder cancer when done by well-experienced surgeons based on exact pathologic diagnosis.

Contraindication

Gallbladder Cancer

Gallbladder disease

10.1097/md.0000000000003675

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Citations (53)

COQ6 Mutations in Children With Steroid-Resistant Focal Segmental Glomerulosclerosis and Sensorineural Hearing Loss

American Journal of Kidney Diseases (2017)

Eujin Park Yo Han Ahn Hee Gyung Kang Kee Hwan Yoo Nam Hee Won

Glomerulosclerosis

10.1053/j.ajkd.2016.10.040

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Citations (49)