Abstract Background To evaluate the real-world effectiveness, treatment patterns, and safety of ranibizumab in Korean patients with neovascular age-related macular degeneration (nAMD). Methods LUMINOUS™ is a 5-year, global, prospective, observational, open-label study. Adults aged ≥18 years who were either treatment-naïve or prior-treated were enrolled and treated with ranibizumab 0.5 mg per the local label. Outcome measures included mean (±standard deviation) changes from baseline in visual acuity (VA) and central retinal thickness (CRT), and rate of ocular and non-ocular adverse events (AEs). Results Overall, 367 Korean patients with nAMD (152 treatment-naïve and 215 prior-treated) were enrolled. The mean VA changes from baseline at 1-year were +10.1 (±21.77; P = 0.0005) and +1.4 (±15.17; P = 0.2142) Early Treatment Diabetic Retinopathy Study letters, with mean number of injections of 5.2 and 3.4 in the treatment-naïve and prior-treated groups, respectively. VA gains were greater in patients with worse baseline VA, who received a loading dose, and with polypoidal choroidal vasculopathy (PCV). Multivariate logistic regression analyses demonstrated younger age, worse baseline VA, and those who received loading dose being associated with higher odds of any gain in VA at 1 year ( P < 0.05). Mean CRT changes from baseline were –126.7 (±174.90) µm ( P < 0.0001) and +10.8 (±89.52) µm ( P = 0.5833) in the treatment-naïve and prior-treated groups, respectively, with greater reductions observed in patients with PCV. Ocular and non-ocular AEs were reported in 8.4% (n=31) and 10.1% (n=37) of patients, respectively. Conclusion The LUMINOUS study confirms real-world effectiveness and safety of ranibizumab in Korean patients with nAMD; factors including age, baseline VA, and loading-dose were associated with VA gain at one-year post-treatment.
Abstract To evaluate the real-world treatment outcomes in patients with neovascular age-related macular degeneration (nAMD) in Korea, focusing on retinal fluid resolution. This multi-institutional retrospective chart review study, analyzed medical records of patients with nAMD (age ≥ 50 years) who received their first anti-vascular endothelial growth factor (VEGF) treatment in ophthalmology clinics across South Korea between January 2017 and March 2019. The primary endpoint was the proportion of patients with retinal fluid after 12 months of anti-VEGF treatment. The association between fluid-free period and VA gains was also evaluated. A total of 600 patients were enrolled. At baseline, 97.16% of patients had retinal fluid; after 12 months of anti-VEGF treatment, 58.10% of patients had persistent retinal fluid. VA improvements were relatively better in patients with absence of retinal fluid compared with presence of retinal fluid (+ 12.29 letters vs. + 6.45 letters at month 12; P < .0001). Longer duration of absence of retinal fluid over first 12 months correlated with better VA gains at month 12 ( P < .01). More than half of the study patients with nAMD had retinal fluid even after 12 months of treatment with their current anti-VEGF. Presence of retinal fluid was associated with relatively worse VA outcomes.
The aim of this study is to evaluate CT, FDG PET, and clinicopathologic features of the adenosquamous carcinoma of the lung (ASC).Twenty-six patients (M/F = 20:6; mean age, 65.0 years) who underwent surgical resection of ASC were included. The tumors were assessed in terms of size, location, morphologic characteristics, and maximum standardized uptake value (SUVmax) on CT and FDG PET. Proportion of adenocarcinoma was determined. The central and peripheral groups were compared. The differences in disease-free survival among the groups according to the observations were analyzed by Kaplan-Meier test for patients who underwent curative resection (n = 21).Diameter was 3.8 ± 1.9 cm. Five tumors were located centrally (19.2%) and 21 tumors peripherally (80.8%). Internal low and heterogeneous attenuation was found in all patients. Margins were lobulated in 20 (80%) patients, spiculated in 23 (92%), and ill-defined in 23 (92%). SUVmax was 8.3 ± 3.9. Adenocarcinoma proportion was 33 ± 28%. Central ASC were larger than peripheral ASC (5.7 cm vs. 3.4 cm, P = 0.007). Only SUVmax >6.3 was a poor prognostic factor.ASC was more commonly peripheral than central, and showed internal low and heterogeneous attenuation and possessed lobulated, spiculated, or ill-defined margin on CT. Mean SUVmax of ASC was 8.3 ± 3.9. Central ASC was larger than peripheral ASC. Except for tumor size, central ASC and peripheral ASC showed no significant differences in pathology, FDG PET, and survival. Higher SUVmax was a poor prognostic factor.
EKG-gated cardiac CT revealed a variant vein in a 44-year-old man that was misinterpreted as a mass on echocardiography. The variant vein was an extension of the confluence of the left internal jugular vein and left subclavian vein and coursed anterior to the right ventricle. It connected to the right atrium directly at the inferior surface of the heart. The variant vein was likely a persistent left superior vena cava, a variant that has never been reported.
Abstract Objectives To determine the risk factors for mortality in Korean patients with rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) in comparison to patients with RA but without ILD (RA-nonILD). Methods Data were extracted from a single-centre prospective cohort of RA patients with a chest computed tomography scan at an academic referral hospital in Korea. Patients with RA-ILD enroled between May 2017 and August 2022 were selected, and those without ILD were selected as comparators. The mortality rate was calculated, and the causes of each death were investigated. We used Cox proportional hazard regression with Firth’s penalised likelihood method to identify the risk factors for mortality in patients with RA-ILD. Results A total of 615 RA patients were included: 200 with ILD and 415 without ILD. In the RA-ILD group, there were 15 deaths over 540.1 person-years (PYs), resulting in mortality rate of 2.78/100 PYs. No deaths were reported in the RA-nonILD group during the 1669.9 PYs. The primary causes of death were infection (nine cases) and lung cancer (five cases), with only one death attributed to ILD aggravation. High RA activity (adjusted HR 1.87, CI 1.16–3.10), baseline diffusing capacity for carbon monoxide (DLCO) < 60% (adjusted HR 4.88, 95% CI 1.11–45.94), and usual interstitial pneumonia (UIP) pattern (adjusted HR 5.13, 95% CI 1.00–57.36) were identified as risk factors for mortality in RA-ILD patients. Conclusion Patients with RA-ILD have an elevated risk of mortality compared with those without ILD. Infection-related deaths are the main causes of mortality in this population. High RA activity, low DLCO, and the UIP pattern are significantly associated with the mortality in patients with RA-ILD.
variant rs35705950 is the common and most significant risk variant for rheumatoid arthritis-interstitial lung disease (RA-ILD) in Western populations. However, little is known about its significant association with RA-ILD in Asian populations. We here investigate the association of rs35705950 with Korean patients with RA-ILD.
Objective The purpose of this study was to compare image quality of iterative reconstruction (IR) to filtered back projection (FBP) in low-dose computed tomography of the chest. Methods Forty-three consecutive patients were retrospectively enrolled. Eight series of images were reconstructed using FBP and 7 levels of IR in each subject. Image noise, signal-to-noise ratio (SNR), and SNR improvement were measured. Two radiologists evaluated subjective artifact, image artificiality, and subjective overall image quality with 4- or 5-point scales. Results Iterative reconstruction showed significantly lower image noise (135.5 ± 36.6 vs 219.9 ± 40.9) and higher SNR (0.36 ± 0.12 vs 0.21 ± 0.05) than FBP (P < 0.001). Signal-to-noise ratio improvement was 72.4% ± 44.9%. Subjective artifact of FBP was significantly higher than IR images (P < 0.001). Image artificiality of IR was significantly higher than that of FBP (P < 0.001). Overall, subjective image quality was poor in FBP and acceptable or good in IR. Conclusions With the use of IR, low-dose computed tomography of the chest would achieve less image noise and better image quality compared to the FBP.
Objective The aim of this study was to evaluate whether a computer-aided diagnosis (CAD) system improves interobserver agreement in the interpretation of lung nodules at low-dose computed tomography (CT) screening for lung cancer. Materials and Methods Baseline low-dose screening CT examinations from 134 participants enrolled in the National Lung Screening Trial were reviewed by 7 chest radiologists. All participants consented to the use of their deidentified images for research purposes. Screening results were classified as positive when noncalcified nodules larger than 4 mm in diameter were present. Follow-up evaluation was recommended according to the nodule diameter: 4 mm or smaller, more than 4 to 8 mm, and larger than 8 mm. When multiple nodules were present, recommendations were based on the largest nodule. Readers initially assessed the nodule presence visually and measured the average nodule diameter manually. Revision of their decisions after reviewing the CAD marks and size measurement was allowed. Interobserver agreement evaluated using multirater κ statistics was compared between initial assessment and that with CAD. Results Multirater κ values for the positivity of the screening results and follow-up recommendations were improved from moderate (κ = 0.53–0.54) at initial assessment to good (κ = 0.66–0.67) after reviewing CAD results. The average percentage of agreement between reader pairs on the positivity of screening results and follow-up recommendations per case was also increased from 77% and 72% at initial assessment to 84% and 80% with CAD, respectively. Conclusion Computer-aided diagnosis may improve the reader agreement on the positivity of screening results and follow-up recommendations in the assessment of low-dose screening CT.
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