Jin Woong Kim

Objectives: To investigate whether hepatic capsular thickness (HCT) measured on ultrasonography (US) is associated with HCT measured on arterial-phase computed tomography (CT), and to evaluate the potential discriminative performance of US-measured HCT in women with Fitz–Hugh–Curtis syndrome (FHCS). Methods: In this retrospective dual-center case–control study, 17 women with clinically diagnosed FHCS who underwent both arterial-phase CT and abdominal US within a 3-day interval were included. Thirty-five healthy women served as controls. HCT was measured on CT and US by two abdominal radiologists blinded to clinical information. HCT values were compared between groups, the association between CT and US measurements was assessed, interobserver agreement was evaluated using the intraclass correlation coefficient (ICC), and receiver operating characteristic analysis was performed to explore candidate cutoff values for discriminating FHCS from controls. Results: Median HCT on CT was significantly greater in the FHCS group than in the control group [1.80 mm (IQR, 1.60–2.00) vs. 0.60 mm (IQR, 0.40–0.70); U = 595.0, p < 0.001]. Median HCT on US was also significantly greater in the FHCS group than in the control group [1.50 mm (IQR, 1.30–2.00) vs. 0.70 mm (IQR, 0.60–0.80); U = 589.0, p < 0.001]. CT- and US-based HCT measurements showed a significant positive correlation (rho = 0.66, p < 0.001). Interobserver agreement for HCT measurement was good in the overall cohort (ICC, 0.804; 95% confidence interval [CI], 0.66–0.89). In exploratory receiver operating characteristic (ROC) analysis, the candidate cutoff values were 1.1 mm for CT and 0.85 mm for US. These ROC-derived metrics should be interpreted as exploratory estimates from an idealized case–control setting rather than as real-world diagnostic performance. Conclusions: US-measured HCT was significantly increased in women with clinically diagnosed FHCS and showed a significant positive correlation of moderate strength with CT-measured HCT. These findings suggest that US-based HCT assessment may provide supportive imaging information in patients with suspected FHCS. Further validation in larger cohorts, particularly in clinically relevant control populations, is warranted.

Predictors of tumor conspicuity on Kupffer-phase Sonazoid-enhanced ultrasonography in liver tumors: implications for fusion-guided ablation

Bae JS, et al. Korean J Radiol. 2026 ;27:e76. https://doi.org/10.3348/kjr.2026.0885

Abnormal brain metabolite levels are indicators of physiological and pathological tissue conditions. Noninvasive imaging of these metabolites enables funct

Rare pancreatic tumors and non-neoplastic tumor-like lesions present a diagnostic challenge due to their uncommon occurrence and overlapping imaging characteristics with more prevalent pancreatic neoplasms. Advances in imaging technologies and diagnostic criteria have contributed to increased detection of these rare entities in clinical practice. This pictorial review focuses on the radiologic–pathologic correlation of rare pancreatic tumors, including colloid carcinoma, acinar cell carcinoma, pancreatoblastoma, primary pancreatic lymphoma, and non-neoplastic tumor-like lesions such as hamartomas and inflammatory pseudotumors. Detailed imaging features, such as signal intensities on MRI and enhancement patterns on CT, are correlated with pathological findings to assist in the differential diagnosis. Familiarity with these characteristics is crucial for radiologists to ensure accurate diagnosis and guide appropriate treatment strategies, as management and prognosis significantly differ from common pancreatic neoplasms.

Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.

Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi, Research Committee of the Korean Liver Cancer Association. Gut and Liver 2024;18:789-802. https://doi.org/10.5009/gnl240350

The aim of this study was to evaluate the findings of CT scans in patients with pathologically confirmed primary colorectal squamous-cell carcinoma (SCC). The clinical presentation and CT findings in eight patients with pathologically confirmed primary colorectal squamous-cell carcinoma were retrospectively reviewed by two gastrointestinal radiologists. Hematochezia was the most common symptom (n = 5). The tumors were located in the rectum (n = 7) and sigmoid colon (n = 1). The tumors showed circumferential wall thickening (n = 4), bulky mass (n = 3), or eccentric wall thickening (n = 1). The mean maximal wall thickness of the involved segment was 29.1 mm ± 13.4 mm. The degree of tumoral enhancement observed via CT was well enhanced (n = 4) or moderately enhanced (n = 4). Necrosis within the tumor was found in five patients. The mean total number of metastatic lymph nodes was 3.1 ± 3.3, and the mean short diameter of the largest metastatic lymph node was 16.6 ± 5.7 mm. Necrosis within the metastatic node was observed in six patients. Invasions to adjacent organs were identified in five patients (62.5%). Distant metastasis was detected in only one patient. In summary, primary SCCs that arise from the colorectum commonly present as marked invasive wall thickening or a bulky mass with heterogeneous well-defined enhancement, internal necrosis, and large metastatic lymphadenopathies.

Han S, et al. Korean J Radiol. 2024 Sep;25(9):773-787. https://doi.org/10.3348/kjr.2024.0550

We present the first documented case of a fistula between the treated zone and the appendix after RFA in a patient with HCC. Contrast-enhanced CT and MRI revealed a subcapsular hepatic nodule with image findings of HCC located adjacent to the ascending colon and cecum. An ultrasound-guided core needle biopsy was subsequently performed to distinguish between hepatic metastasis and HCC. Post-RFA imaging identified a low-attenuating ablated area adjacent to an air-filled appendix. The patient later experienced complications, including increased liver enzymes and an abscess at the ablation site. Imaging revealed a fistulous tract between the RFA zone and the appendix. Over the following months, the patient underwent conservative treatment involving intravenous antibiotics and repeated percutaneous drainage, exhibiting eventual symptom relief and an absence of the fistulous tract upon subsequent imaging. This case highlights the rare complications that can arise during RFA due to peculiar anatomical variations, such as a subhepatic appendix, resulting from midgut malrotation and previous surgery. It is imperative for operators to be cognizant of potential anatomical variations when considering RFA treatment, ensuring comprehensive pre-procedural imaging and post-procedure monitoring. This case also emphasizes the potential viability of nonoperative management in complex scenarios in which surgical interventions pose significant risks.