OBJECTIVES:The kidney plays a vital role in eliminating gadolinium-based contrast agents (GBCAs), and renal function may contribute to various GBCA-associated adverse drug reactions (ADRs), particularly acute kidney injury (AKI). The objective of the study is to investigate whether GBCA administration elevates AKI risk and explore the correlation between renal function and the incidence of GBCA-associated acute ADRs. MATERIALS AND METHODS:Adult patients who underwent MRI examinations between January 2015 and June 2021 at the inpatient department of a single tertiary general hospital were retrospectively examined. Baseline estimated glomerular filtration rate (eGFR) before MRI examination, serum creatinine levels of the nearest timepoint before and after MRI examinations, and symptoms of GBCA-associated acute ADRs were retrospectively reviewed. AKI was diagnosed based on the Kidney Disease: Improving Global Outcomes guideline. Propensity score matching and inverse probability of treatment weighting were used to adjust for selection bias. The rates of GBCA-associated acute ADRs and AKI were compared using generalized estimating equation (GEE) for total data and randomly sampled one patient-one examination data. RESULTS:This study included 35,197 MRI examinations with available serum creatinine levels, and AKI was diagnosed in 569 cases (1.62%; 95% CI: 1.48%-1.75%). Logistic regression with GEE after propensity score matching revealed a significantly lower AKI incidence in examinations with GBCA enhancement (OR, 0.59; 95% CI: 0.46-0.77; P < 0.001); this finding was consistent across patient groups with both eGFR of >60 mL/min/1.73 m 2 (OR, 0.53; 95% CI: 0.34-0.84; P = 0.007) and eGFR between 30 and 60 mL/min/1.73 m 2 (OR, 0.49; 95% CI: 0.32-0.74; P < 0.001). The rates of GBCA-associated acute allergic-like reactions (adjusted OR, 1.01; 95% CI: 1.00-1.02; P = 0.125) and physiological reactions (adjusted OR, 1.00; 95% CI: 0.98-1.02; P = 0.997) showed no significant association with baseline eGFRs. CONCLUSIONS:In this large retrospective study, the administration of GBCAs was not associated with higher rates of AKI, which remained consistent across varying levels of baseline renal function. Furthermore, no significant increase in GBCA-associated acute ADRs was observed in patients with impaired renal function. These findings suggest that GBCA administration is generally well-tolerated across a wide spectrum of renal function, without increasing the risk of AKI or GBCA-associated acute ADRs.

Purpose: To evaluate the diagnostic performance of the American College of Radiology (ACR) Bone Reporting and Data System (Bone-RADS) in diagnosis of malignant tumors of the appendicular bone on conventional radiographs. Methods: Primary and secondary tumors of appendicular bone in patients who underwent radiographic and MRI examinations were classified into benign, intermediate, and malignant using a reference standard of histopathology, imaging follow-up, or clinical-radiologic consensus. Two radiologists assessed five radiographic features (margin, periosteal reaction, endosteal erosion, pathologic fracture, and extra-osseous mass), scored point total (points from radiographic features and a history of cancer), and assigned Bone-RADS categories. The diagnostic performance of Bone-RADS and interreader agreements were calculated. Results: A total of 778 patients (507 benign, 45 intermediate, and 226 malignant tumors) were included. BoneRADS showed high discrimination performance, with areas under the receiver-operating characteristics curve of 0.940-0.957 for point total and 0.895-0.900 for categorization. Bone-RADS had high sensitivity (95.2 %-99.1 %) and negative predictive value (NPV) (96.4 %-99.5 %), but relatively low specificity (65.0 %-68.6 %) and positive predictive value (PPV) (53.7 %-61.9 %). Interreader agreements were good to excellent for Bone-RADS point total (ICC = 0.850), categorization (k = 0.739), and most of the radiographic features (k = 0.621-0.822), except for endosteal erosion (k = 0.537) and extra-osseous mass (k = 0.234). Conclusion: In diagnosis of malignant bone tumors, ACR Bone-RADS showed high discrimination performance, with high sensitivity and NPV, but relatively low specificity and PPV. Nevertheless, relatively low interobserver agreement in some radiographic features and the consensus-based points system in Bone-RADS warrant further research and possible updates.

Background Limited data exist on the optimal postoperative surveillance protocol for high-grade soft tissue sarcoma, particularly regarding the optimal imaging modality and imaging interval for detecting local recurrence. This study aimed to assess the benefit of short-term postoperative ultrasonography (USG) for detecting local recurrence in patients with high-grade soft tissue sarcoma. Methods Patients with newly diagnosed high-grade soft tissue sarcoma who underwent surgical resection between January 2010 and June 2020 were included. Short-term USG was added to the follow-up protocol as a surveillance tool alongside routine magnetic resonance imaging (MRI). The primary outcome was the additional detection rate of short-term USG compared with routine MRI surveillance for early local recurrence detection. Subgroup analysis was performed to evaluate factors influencing USG detection rate. The additional detection rate of short-term USG for detection of metastatic lymph nodes was also evaluated. The secondary outcome was the false referral rate of short-term USG. Results In total, 198 patients (mean age ± standard deviation: 52.1 ± 15.8 years; 94 women) were included. Local recurrence occurred in 20 patients (10.1%; 20/198). Short-term USG detected local recurrence in advance of routine MRI visits in 7 out of 198 patients, resulting in an additional detection rate of 3.5% (95% CI: 1.7–7.1%). Subgroup analysis showed no significant difference in the short-term USG detection rate based on initial tumor characteristics, and receipt of radiotherapy or chemotherapy. Short-term USG additionally detected five of seven patients with metastatic lymph nodes [2.5% (95% CI, 1.1–5.8%, 5/198)]. The false referral rate of short-term USG was 3.5% (95% CI: 1.7–7.1%; 7/198). Conclusions Short-term USG as part of postoperative surveillance for high-grade soft tissue sarcoma can enhance early detection of local tumor recurrence and metastatic lymphadenopathy. Early detection of local tumor recurrence could lead to a prompt surgical resection and aid in local disease control.

Recent studies report excellent local control (LC) and favorable toxicities of stereotactic ablative radiotherapy (SABR) for pulmonary metastasis (PM) from sarcoma. This study compared the LC and survival of SABR and metastasectomy for sarcoma PM. We analyzed the LC rates of 54 PMs treated with SABR between 2008 and 2022. For survival analysis, we compared 14 patients who received SABR as first-line treatment with 61 patients who underwent metastatectomy. For SABR-treated PMs, a median total dose of 55 Gy (range, 48–60) was administered over 3–10 fractions. Median follow-up for LC in SABR-treated PMs was 19.2 months (range, 0.8–124.0), and the 2-year LC rate was 92.2

The real-world evidence about the efficacy of cytotoxic chemotherapy in desmoid tumors is still limited. We investigated the efficacy of chemotherapy in the treatment of recurrent or progressive desmoid tumors. The patients with desmoid tumors who had received cytotoxic chemotherapy between November 2007 and June 2020 in two tertiary hospitals in Korea were reviewed. A total of 25 patients were included in the analysis. The most common primary tumor site was the intra-abdominal or pelvic cavity (56

OBJECTIVE:This study aimed to determine the prevalence of vertebral venous congestion (VVC) in patients with chemoport insertion, evaluate the imaging characteristics of nodular VVC, and identify the factors associated with VVC. MATERIALS AND METHODS:This retrospective single-center study was based on follow-up contrast-enhanced chest computed tomography (CT) of 1412 adult patients who underwent chemoport insertion between January 2016 and December 2016. The prevalence of venous stenosis, reflux, and VVC were evaluated. The imaging features of nodular VVC, including specific locations within the vertebral body, were analyzed. To identify the factors associated with VVC, patients with VVC were compared with a subset of patients without VVC who had been followed up for > 3 years without developing VVC after chemoport insertion. Toward this, a multivariable logistic regression analysis was performed. RESULTS:After excluding 333 patients, 1079 were analyzed (mean age ± standard deviation, 62.3 ± 11.6 years; 540 females). The prevalence of VVC was 5.8% (63/1079), with all patients (63/63) demonstrating vertebral venous reflux and 67% (42/63) with innominate vein stenosis. The median interval between chemoport insertion and VVC was 515 days (interquartile range, 204-881 days). The prevalence of nodular VVC was 1.5% (16/1079), with a mean size of 5.9 ± 3.1 mm and attenuation of 784 ± 162 HU. Nodular VVC tended to be located subcortically. Forty-four patients with VVC underwent CT examinations with contrast injections in both arms; the VVC disappeared in 70% (31/44) when the contrast was injected in the arm contralateral to the chemoport site. Bevacizumab use was independently associated with VVC (odds ratio, 3.45; P < 0.001). CONCLUSION:The prevalence of VVC and nodular VVC was low in patients who underwent chemoport insertion. Nodular VVC was always accompanied by vertebral venous reflux and tended to be located subcortically. To avoid VVC, contrast injection in the arm contralateral to the chemoport site is preferred.

If a solitary spinal lesion is found in an older patient, bone metastasis can be primarily considered as the diagnosis. Bone metastasis can occur anywhere, but it mostly occurs in the vertebral body and may sometimes show typical imaging findings, presenting as a single lesion. Therefore, differentiating it from other lesions that mimic bone metastases can be challenging, potentially leading to delayed diagnosis and initiation of primary cancer treatment. This review provides an overview of imaging findings and clinical guidelines for bone metastases and discusses its differences from other diseases that can occur as solitary spinal lesions in older patients.

To evaluate whether DTI parameters of the ulnar nerve at the elbow are associated with clinical outcomes in patients receiving cubital tunnel decompression (CTD) surgery for ulnar neuropathy. This retrospective study included 21 patients with cubital tunnel syndrome who received CTD surgery between January 2019 and November 2020. All patients underwent pre-operative elbow MRI, including DTI. Region-of-interest analysis was performed on the ulnar nerve at three levels around the elbow: above (level 1), cubital tunnel (level 2), and below (level 3). Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated on three sections at each level. Clinical data on symptom improvement in respect to pain and tingling sensation after CTD were recorded. Logistic regression analysis was used to compare DTI parameters of the nerve at three levels and the entire nerve course between patients with and without symptom improvement after CTD. After CTD, 16 patients showed improvement in symptoms, but five did not. ROC analysis of DTI parameters showed that AUCs of FA, AD, and MD were higher at level 1 than at levels 2 and 3, with FA showing the highest AUC (level 1: FA, 0.7104 [95 • After CTD surgery for ulnar neuropathy at the elbow, persistent symptoms may be observed, depending on symptom severity. • DTI parameters of the ulnar nerve at the elbow showed differences in their capacity for discriminating between patients with and without symptom improvement following CTD surgery, with this capacity depending on the nerve level at the elbow. • FA, AD, and MD measured above the cubital tunnel on pre-operative DTI may be associated with surgical outcomes, with FA showing the strongest association (AUC at level 1, 0.7104 [95

OBJECTIVES:To evaluate diagnostic utility of additional DCE-MRI for detecting residual soft tissue sarcomas (STS) after unplanned excision (UPE). METHODS:We retrospectively evaluated 32 patients with UPE of STS, followed by conventional MRI with DCE-MRI and wide excision (WE), between November 2019 and January 2022. Residual tumors on conventional MRI were categorized into three groups: Lesion-type-0, no abnormal enhancement, Lesion-type-1, an indeterminate lesion, and Lesion-type-2, a definite enhancing nodule. On DCE-MRI, ROIs were manually placed on enhancing areas of suspected residual tumor. The mean and 95th percentile values of AUC of time-intensity curve were calculated at 60, 90, and 120 s of Enhancement-cycle-1 and -2. Optimal DCE parameters were identified by ROC analysis. Diagnostic performance of conventional MRI and DCE-MRI was compared using McNemar's test. RESULTS:On WE, residual tumor was present in 23 (71.9%) of 32 patients. On MRI, Lesion-type-1 was found in 16/32 (50%) patients and Lesion-type-2 in 16/32 (50%). The optimal DCE parameter was the 95th percentile value of AUC at 120s of Enhancement-cycle-2. The sensitivity, specificity, and AUC were as follows: 65.2% (95% CI, 45.8-85.7%), 88.9% (CI, 68.4-100%), and 0.77 (CI, 0.62-0.92) for conventional MRI, and 100%, 55.6% (CI, 23.1-88.0%), and 0.78 (CI, 0.61-0.95) for combined conventional and DCE-MRI. CONCLUSIONS:Additional DCE-MRI aided in detecting residual STS after UPE, particularly in cases without definite soft tissue nodular enhancement. ADVANCES IN KNOWLEDGE:Close follow up may be suggested for patients showing abnormality in DCE-MRI, with more suspicion of residual tumor.

Multiple myeloma (MM) is a malignant hematologic disease caused by the proliferation of clonal plasma cells in the bone marrow, and its incidence is increasing in Korea. With the development of treatments for MM, the need for early diagnosis and treatment has emerged. In recent years, the International Myeloma Working Group (IMWG) has been constantly revising the laboratory and radiological diagnostic criteria for MM. In addition, as whole-body MRI (WBMR) has been increasing used in the diagnosis and treatment response evaluation of patients with MM, the Myeloma Response Assessment and Diagnosis System (MY-RADS) was created to standardize WBMR image acquisition techniques, image interpretation, and response evaluation methods. Radiologists need to have a detailed knowledge of the features of MM for accurate diagnosis. Thus, in this review article, we describe the imaging method for MM according to the latest IMWG guidelines as well as the image acquisition and response evaluation technique for WBMR according to MY-RADS.

Background The latest International Myeloma Working Group (IMWG) guideline recommends low-dose whole-body (WB) computed tomography (CT) as the first-line imaging technique for the initial diagnosis of plasma cell disorders. Purpose To evaluate diagnostic performances of CT and diffusion-weighted imaging (DWI) as the first-line imaging modalities and assess misclassification rates obtained following the guideline. Material and Methods Two independent radiologists analyzed CT (acquired as PET/CT) and DWI (3-T; b-values = 50 and 900 s/mm(2)) of patients newly diagnosed with plasma cell disorder, categorizing the number of bone lesions. Diagnostic performance of CT and DWI was compared using the McNemar test, and misclassification rates were calculated with a consensus WB-MRI reading as the reference standard. Differences in lesion number categories were assessed using marginal homogeneity and kappa statistics. Results Of 56 patients (36 men; mean age = 63.5 years), 39 had myeloma lesions. DWI showed slightly higher sensitivity for detecting myeloma lesions (97.4%) than CT (84.6%-92.3%; P > 0.05). CT showed significantly higher specificity (88.2%) than DWI (52.9%-58.8%; P<0.05). CT had a higher additional study requirement rate than DWI (7.7%-15.4% vs. 2.6%), but a lower unnecessary treatment rate (11.8% vs. 41.2%-47.1%). Both readers showed significant differences in categorization of the number of lesions on CT compared with the reference standard (P < 0.001), and one reader showed a significant difference on DWI (P = 0.006 and 0.098). Conclusion CT interpreted according to the IMWG guideline is a diagnostically effective first-line modality with relatively high sensitivity and specificity. DWI alone may not be an acceptable first-line imaging modality because of low specificity.

Purpose For liposarcoma (LPS), clinical course and proper treatment strategies have not been well-established. Recently, immunecheckpoint inhibitors have shown potential efficacy in LPS. We aimed to describe the clinical course of LPS and evaluate the clinical impact of programmed death-ligand 1 (PD-L1). Materials and Methods We reviewed all consecutive patients (n=332) who underwent curative-intent surgery for localized LPS at Asan Medical Center between 1989 and 2017. PD-L1 testing was performed in well-differentiated and dedifferentiated LPS. Results The median age was 56 years with males comprising 60.8%. Abdomen-pelvis (47.6%) and well-differentiated (37.7%) were the most frequent primary site and histologic subtype, respectively. During a median follow-up of 81.2 months, recurrence was observed in 135 (40.7%), and 86.7% (117/135) were loco-regional. Well-differentiated subtype (hazard ratio [HR], 0.38), abdomenpelvis origin (HR, 2.43), tumor size larger than 5 cm (HR, 1.83), positive resection margin (HR, 2.58), and postoperative radiotherapy (HR, 0.36) were significantly related with recurrence-free survival as well as visceral involvement (HR, 1.84) and multifocality (HR, 3.79) in abdomen-pelvis LPS. PD-L1 was positive in 31.5% (23/73) and 51.3% (39/76) of well-differentiated and dedifferentiated LPS, respectively, but had no impact on survival outcomes. Conclusion Clinical course of LPS was heterogeneous according to histology and anatomic location. Clear resection margin was important to lower recurrence and postoperative radiotherapy might have additional benefit. A decent portion of well-differentiated and dedifferentiated LPS were positive for PD-L1, but its prognostic role was unclear. Further research is needed to determine clinical implications of PD-L1, especially for advanced-stage LPS with unmet needs for effective systemic treatment.

Purpose: To assess conventional MRI features associated with residual soft-tissue sarcomas following unplanned excision (UPE), and to compare the diagnostic performance of conventional MRI only with that of MRI including diffusion-weighted imaging (DWI) for residual tumors after UPE. Materials and Methods: We included 103 consecutive patients who had received UPE of a soft-tissue sarcoma with wide excision of the tumor bed between December 2013 and December 2019 and who also underwent conventional MRI and DWI in this retrospective study. The presence of focal enhancement, soft-tissue edema, fascial enhancement, fluid collections, and hematoma on MRI including DWI was reviewed by two musculoskeletal radiologists. We used classification and regression tree (CART) analysis to identify the most significant MRI features. We compared the diagnostic performances of conventional MRI and added DWI using the McNemar test. Results: Residual tumors were present in 69 (66.9%) of 103 patients, whereas no tumors were found in 34 (33.1%) patients. CART showed focal enhancement to be the most significant predictor of residual tumors and correctly predicted residual tumors in 81.6% (84/103) and 78.6% (81/103) of patients for Reader 1 and Reader 2, respectively. Compared with conventional MRI only, the addition of DWI for Reader 1 improved specificity (32.8% vs. 56%, 33.3% vs. 63.0%, P < 0.05), decreased sensitivity (96.8% vs. 84.1%, 98.7% vs. 76.7%, P < 0.05), without a difference in diagnostic accuracy (76.7% vs. 74.8%, 72.9% vs. 71.4%) in total and in subgroups. For Reader 2, diagnostic performance was not significantly different between the sets of MRI (P > 0.05). Conclusion: After UPE of a soft-tissue sarcoma, the presence or absence of a focal enhancement was the most significant MRI finding predicting residual tumors. MRI provided good diagnostic accuracy for detecting residual tumors, and the addition of DWI to conventional MRI may increase specificity.

Rationale and Objectives: To develop and validate prediction models to differentiate acute and chronic vertebral compression fractures based on radiologic and radiomic features on CT. Materials and Methods: This study included acute and chronic compression fractures in patients who underwent both spine CT and MRI examinations. For each fractured vertebra, three CT findings ([1] cortical disruption, [2] hypoattenuating cleft or sclerotic line, and [3] rela-tive bone marrow attenuation) were assessed by two radiologists. A radiomic score was built from 280 radiomic features extracted from non-contrast-enhanced CT images. Weighted multivariable logistic regression analysis was performed to build a radiologic model based on CT findings and an integrated model combining the radiomic score and CT findings. Model performance was evaluated and compared. Models were externally validated using an independent test cohort.Results: A total to 238 fractures (159 acute and 79 chronic) in 122 patients and 58 fractures (39 acute and 19 chronic) in 32 patients were included in the training and test cohorts, respectively. The AUC of the radiomic score was 0.95 in the training and 0.93 in the test cohorts. The AUC of the radiologic model was 0.89 in the training and 0.83 in the test cohorts. The discriminatory performance of the integrated model was significantly higher than the radiologic model in both the training (AUC, 0.97; p<0.01) and the test (AUC, 0.95; p=0.01) cohorts.Conclusion: Combining radiomics with radiologic findings significantly improved the performance of CT in determining the acuity of verte-bral compression fractures.(c) 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Objectives To develop and validate a combined radiomics-clinical model to predict malignancy of vertebral compression fractures on CT. Methods One hundred sixty-five patients with vertebral compression fractures were allocated to training ( n = 110 [62 acute benign and 48 malignant fractures]) and validation ( n = 55 [30 acute benign and 25 malignant fractures]) cohorts. Radiomics features ( n = 144) were extracted from non-contrast-enhanced CT images. Radiomics score was constructed by applying least absolute shrinkage and selection operator regression to reproducible features. A combined radiomics-clinical model was constructed by integrating significant clinical parameters with radiomics score using multivariate logistic regression analysis. Model performance was quantified in terms of discrimination and calibration. The model was internally validated on the independent data set. Results The combined radiomics-clinical model, composed of two significant clinical predictors (age and history of malignancy) and the radiomics score, showed good calibration (Hosmer-Lemeshow test, p > 0.05) and discrimination in both training (AUC, 0.970) and validation (AUC, 0.948) cohorts. Discrimination performance of the combined model was higher than that of either the radiomics score (AUC, 0.941 in training cohort and 0.852 in validation cohort) or the clinical predictor model (AUC, 0.924 in training cohort and 0.849 in validation cohort). The model stratified patients into groups with low and high risk of malignant fracture with an accuracy of 98.2% in the training cohort and 90.9% in the validation cohort. Conclusions The combined radiomics-clinical model integrating clinical parameters with radiomics score could predict malignancy in vertebral compression fractures on CT with high discriminatory ability. Key Points • A combined radiomics-clinical model was constructed to predict malignancy of vertebral compression fractures on CT by combining clinical parameters and radiomics features. • The model showed good calibration and discrimination in both training and validation cohorts. • The model showed high accuracy in the stratification of patients into groups with low and high risk of malignant vertebral compression fractures.

Purpose To evaluate the osseous anatomy of the proximal femur extracted from a 3D-MRI volumetric interpolated breath-hold (VIBE) sequence using either a Dixon or water excitation (WE) fat suppression method, and to measure the overall difference using CT as a reference standard. Material and methods This retrospective study reviewed imaging of adult patients with hip pain who underwent 3D hip MRI and CT. A semi-automatically segmented CT model served as the reference standard, and MRI segmentation was performed manually for each unilateral hip joint. The differences between Dixon-VIBE-3D-MRI vs. CT, and WE-VIBE-3D-MRI vs. CT, were measured. Equivalence tests between Dixon-VIBE and WE-VIBE models were performed with a threshold of 0.1 mm. Bland-Altman plots and Lin's concordance-correlation coefficient were used to analyze the agreement between WE and Dixon sequences. Subgroup analyses were performed for the femoral head/neck, intertrochanteric, and femoral shaft areas. Results The mean and maximum differences between Dixon-VIBE-3D-MRI vs. CT were 0.2917 and 3.4908 mm, respectively, whereas for WE-VIBE-3D-MRI vs. CT they were 0.3162 and 3.1599 mm. The mean differences of the WE and Dixon methods were equivalent (P = 0.0292). However, the maximum difference was not equivalent between the two methods and it was higher in WE method. Lin's concordance-correlation coefficient showed poor agreement between Dixon and WE methods. The mean differences between the CT and 3D-MRI models were significantly higher in the femoral shaft area (P = 0.0004 for WE and P = 0.0015 for Dixon) than in the other areas. The maximum difference was greatest in the intertrochanteric area for both techniques. Conclusion The difference between 3D-MR and CT models were acceptable with a maximal difference below 3.5mm. WE and Dixon fat suppression methods were equivalent. The mean difference was highest at the femoral shaft area, which was off-center from the magnetization field.

Purpose: Because of the heterogeneity of sarcomas, establishing a well-collected, sarcoma specific database is important for sarcoma research. We analyzed the first histology-based, sarcoma-specific institutional registry in Korea, which collected 28 years of patient data according to a predefined data format. Patients and Methods: Adult bone and soft tissue sarcoma patients who were treated from June 1989 to January 2017 were identified and analyzed, based on the ICD-O-3 codes. Results: Among the 3420 patients included, soft tissue and bone sarcomas comprised 77.8% (n = 2661) and 22.2% (n = 759), respectively. Median age at diagnosis was 50 (range, 16-98) in soft tissue sarcomas and 37 (range, 16-85) in bone sarcomas. Males and females comprised 45.5% and 54.5% of soft tissue sarcomas and 52.7% and 47.3% of bone sarcomas, respectively. Among the 3407 patients with treatment data available, 90.5% of the patients with soft tissue sarcomas and 80.8% of the patients with bone sarcomas received surgery first, of which 57.8% and 71.7% did not receive any subsequent treatment, respectively. Overall, the proportion of patients who received surgery alone decreased from 85.7% to 60.5% from the pre-2000 period to the 2010-2017 period. However, the use of adjuvant chemotherapy increased in patients with soft tissue sarcomas (from 8.0% to 17.2% in the same period), and the use of perioperative radiotherapy also increased in both groups (from 1.4% to 22.7% in soft tissue sarcomas, and 0% to 14.5% in bone sarcomas in the same period). In both soft tissue and bone sarcomas, old age (>= 65 years) and diagnosis in the early study period were associated with poorer survival. Conclusion: We presented a comprehensive summary of our sarcoma registry, including the demographics, changes in treatment patterns, and survival outcomes. This study will provide a framework for future studies.

Background/Aim: To compare absolute volume (AV) assessment according to Response Evaluation Criteria in Solid Tumors (RECIST) for the response evaluation of desmoid tumors (DTs) treated with radiotherapy. Patients and Methods: Eighteen patients with DTs ≥3 cm in size were included. Results: The median follow-up duration was 78.0 months. Five patients achieved a complete response according to RECIST, seven reached a partial response (PR), and one eventually exhibited progression. The overall response rate was 61%, the median time to PR was 8.0 months. Six patients achieved stable disease, although three developed progressions. Of the six patients with a PR, the median change in maximum diameter was −46%, and the median change in maximum volume was −84%. Three patients could have been diagnosed with progression at least 6 months earlier if the AV increment was considered. Conclusion: An AV assessment is essential for an accurate response assessment of DTs and radiotherapy seems feasible as a first-line treatment for DTs.

The diagnostic and treatment methods of multiple myeloma (MM) have been rapidly evolving owing to advances in imaging techniques and new therapeutic agents. Imaging has begun to play an important role in the management of MM, and international guidelines are frequently updated. Since the publication of 2015 International Myeloma Working Group (IMWG) criteria for the diagnosis of MM, whole-body magnetic resonance imaging (MRI) or low-dose whole-body computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/CT have entered the mainstream as diagnostic and treatment response assessment tools. The 2019 IMWG guidelines also provide imaging recommendations for various clinical settings. Accordingly, radiologists have become a key component of MM management. In this review, we provide an overview of updates in the MM field with an emphasis on imaging modalities.

1Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 2Division of Hematology and Oncology, Ulsan University Hospital, Ulsan, Republic of Korea; 3Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 4Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 5Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 6Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea