This retrospective multicenter study evaluated whether deep learning-based super-resolution (SR) reconstruction can enhance structural conspicuity in thick-section chest computed tomography (CT) and improve the detection performance of an artificial intelligence (AI)-based computer-aided detection (CAD) system for lung nodules in 96 patients with colorectal cancer (CRC) undergoing chest CT for metastatic surveillance. Pulmonary nodules <10 mm and ≤3 per patient were analyzed. Three image sets were evaluated using a commercial AI-CAD system: original thin-section images (reference), original 5-mm thick-section images, and SR-converted thin-section images. Nodule- and patient-level detection performances were compared using the Cochran-Mantel-Haenszel test and aligned rank transform analysis of variance (ART-ANOVA). Quantitative nodule metrics, image noise, and morphologic consistency were assessed between original and SR-converted thin-section images. Among 105 reference nodules, AI sensitivity increased from 31.4% with thick-section images to 61.0% with SR-converted images, and positive predictive value (PPV) increased from 42.9% to 80.0%. Patient-level sensitivity improved from 41.5% to 67.1%. SR reconstruction reduced image noise (P<0.001) and preserved nodule morphology, with 95.3% anatomic concordance and 80% solid-feature consistency. Nodule size remained comparable; however, density was lower in converted images. SR reconstruction generated 20% hallucinated nodules (16/80), predominantly benign or artifactual structures. In conclusion, SR reconstruction enhances AI-based pulmonary nodule detection by compensating for structural detail lost in thick-section CT. Despite hallucinated nodules, SR reconstruction may provide a feasible harmonization strategy for retrospective multicenter AI research using heterogeneous CT datasets, although further validation in larger populations is required.

Traumatic thoracic aortic injury and hemopericardium are among the most life-threatening conditions encountered in acute thoracic trauma care. CT angiography (CTA) is the cornerstone of evaluation in such cases, providing essential information for diagnosis, triage, and treatment planning. In traumatic aortic injury, key CTA findings, including the presence of an intimal flap, intramural hematoma, pseudoaneurysm, and contrast extravasation, form the basis of the Society for Vascular Surgery grading system and guide management. In patients with traumatic hemopericardium, CT attenuation characteristics, imaging features of cardiac tamponade, and associated cardiac injuries help determine the urgency and approach to intervention. Familiarity with common pitfalls and mimickers, including ductus diverticulum, mediastinal hematoma without aortic injury, and motion-related artifacts, is essential to avoid diagnostic errors. Structured reporting can facilitate communication of managementrelevant findings and support timely decision-making. This review summarizes the imaging findings, grading systems, management implications, pitfalls, and structured reporting considerations for traumatic aortic injury and hemopericardium.

The detection of progressive massive fibrosis (PMF) in regions where silicosis is endemic presents diagnostic challenges due to its resemblance to other conditions, such as lung cancer and tuberculosis on radiographs. Therefore, there is an increasing reliance on chest CT due to its higher sensitivity and specificity compared to conventional chest radiography. In this pictorial essay, we aim to illustrate the diverse manifestations of PMF on chest CT, offering valuable insights for an accurate differential diagnosis. Recognizing these manifestations is essential for improving diagnostic precision and minimizing unnecessary procedures.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT. Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Primary pulmonary malignant melanoma is an extremely rare type of melanoma. The radiologic features of primary pulmonary malignant melanoma are nonspecific; however, it almost always presents as a well-demarcated round or lobulated solitary solid nodule or mass. Herein, we report the case of a 78-year-old male with primary pulmonary malignant melanoma that was mistaken for primary pulmonary adenocarcinoma with lepidic growth and was seen as bilateral multiple subsolid nodules on CT.

Myxofibrosarcoma is one of the most common soft tissue sarcomas in elderly patients. It often occurs in the extremities, trunk, and retroperitoneum. However, it is rarely observed in the mediastinum, and only a few cases have been reported in the literature. Herein, we present the imaging findings, with an emphasis on the MRI results, of a surgically confirmed anterior mediastinal myxofibrosarcoma in a 66-year-old male.

Progressive massive fibrosis (PMF) with atypical findings is often misdiagnosed as lung cancer. Atypical features of PMF have been described in some reports; however, these reports only introduced their cases with a short literature review. We report two cases of solitary PMFs with no underlying simple pneumoconiosis or rapid growth at atypical location that were mistaken for lung cancer. We also suggest the useful CT findings to aid in the differential diagnosis.

Neurofibromatosis type 1 (NF1) is a relatively common inherited disorder characterized by the formation of neurofibromas, pigmentary abnormalities of the skin, Lisch nodules of the iris, and skeletal abnormalities. Multiple cutaneous neurofibromas are benign nerve sheath tumors and the main manifestation of NF1. Cardiac neurofibroma associated with NF1 is very rare, and few cases have been reported in the literature. Herein, we present the CT and MRI findings of a surgically confirmed left ventricular neurofibroma in a 32-year-old female with NF1.

The coronavirus disease (COVID-19) outbreak has reached global pandemic status as announced by the World Health Organization, which currently recommends reverse transcription polymerase chain reaction (RT-PCR) as the standard diagnostic tool. However, although the RT-PCR test results may be found negative, there are cases that are found positive for COVID-19 pneumonia on computed tomography (CT) scan. CT is also useful in assessing the severity of COVID-19 pneumonia. When clinicians desire a CT scan of a patient with COVID-19 to monitor treatment response, a safe method for patient transport is necessary. To address the engagement of medical resources necessary to transport a patient with COVID-19, our institution has implemented the use of mobile CT. Therefore, we report two cases of COVID-19 pneumonia evaluated by using mobile cone-beam CT. Although mobile cone-beam CT had some limitations regarding its image quality such as scatter noise, motion and streak artifacts, and limited field of view compared with conventional multi-detector CT, both cases had acceptable image quality to establish the diagnosis of COVID-19 pneumonia. We report the usefulness of mobile cone-beam CT in patients with COVID-19 pneumonia.

Objectives To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis. Methods We searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed. Results The pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048–0.128%; I 2 = 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029–34.279; p = 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103–91.469; p = 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725–14.925; p = 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149–9.492; p = 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309–20.447; p = 0.019). Conclusion The pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB. Key Points • The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died. • The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism. • Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism.

Human Aichivirus A (AiV-A) is classified as a Kobuvirus , group IV positive sense single strand RNA viruses. The first outbreak of AiV-A was reported from Aichi Prefecture, Japan in 1989. AiV-A exists not only among clinical patients, such as diarrhea, but also in a variety of water environments, as its occurrence is reported across a wide geographical range, from developing to advanced countries. For diagnose of AiV-A from water samples, mostly polymerase chain reaction (PCR) system have been developed. However, loop-mediated isothermal amplification (LAMP) assay has not been applied. In this study, developed a LAMP method to achieve a rapid, specific and highly sensitive detection of AiV-A. The method developed in this study is aimed specifically at AiV-A. Through a specific and non-specific selection and sensitivity test process for the five prepared LAMP primer sets, one primer set and optimum reaction temperature were selected. A newly developed method was more rapid (approximately 2–8 h), specific and equivalent detection of AiV-A than with the conventional PCRs. In addition, confirm system of positive LAMP reaction was developed by using the restriction enzyme Aci I and Hae III. For evaluation and verification of developing LAMP assay, a was applied to twenty cDNA from groundwater samples. This study proved rapid and specific diagnosis of AiV-A from water samples, and it is also demanded to be applicable to other environmental, clinical and food samples.

Purpose: We presented details and incidence of systemic arterial embolism (SAE) following a CT-guided per cutaneous transthoracic needle biopsy (PTNB) and evaluated risk factors for SAEs. Methods: We retrospectively evaluated 1014 PTNBs performed in our hospital from 2005 to 2017. SAE was identified in the pulmonary vein, left heart, coronary artery, and aorta by reviewing post-biopsy CT images. Limited post-biopsy CT scans only covering the region biopsied were available until the first case of SAE was identified (n = 503). Then, the entire thorax was scanned for further examination of SAE (n = 511). Eighteen gauge automatic cutting needles were used in all procedures. When SAE was evident on post-biopsy CT, subsequent brain CT was performed in order to confirm the cerebral SAE. Results: Nine patients (0.89%) developed SAEs. In the univariate analyses, the location of the needle tip relative to the lesion (outside or inside of the lesion) as well as accompanying pulmonary hemorrhage were significant risk factors for SAEs (P = 0.021 and 0.036, respectively). Two patients developed neurological symptoms with cerebral SAEs, and one of these had sequelae. In seven asymptomatic SAEs with no cerebral SAE, four patients were retrospectively-diagnosed cases and three patients were detected on post-biopsy CT images. All seven of these patients had no sequelae. Conclusion: The incidence of SAE was higher than expected, due to radiologically detected asymptomatic SAEs. The location of the needle tip relative to the lesion and accompanying pulmonary hemorrhage were significant risk factors for the occurrence of SAEs. We proposed a guideline for treating asymptomatic SAEs.

Rationale:In the thorax, Hodgkin lymphoma (HL) most frequently involves the anterior mediastinal and paratracheal regions and tends to spread to contiguous nodal groups. Enlarged lymph nodes typically have homogeneous soft tissue attenuation similar to that of muscle tissue on computed tomography (CT).Patient concerns:A contrast-enhanced CT examination of a 19-year-old man with right-sided chest pain showed an intense, heterogeneously enhancing mass with organization of serpentine and dilated blood vessels in the right anterior mediastinum that had invaded the upper lobe of the right lung.Diagnoses:Following a wedge resection, histopathological examination showed Reed-Sternberg cells that were positive for CD-15 and CD-30, which is typical of HL.Interventions:The patient was started treatment with 6 cycles of doxorubicin, bleomycin, vincristine, and dacarbazine (ABVD) regimen.Outcomes:After chemotherapy, the patient had shown a partial response to the treatment.Lessons:This presentation of HL as an extremely hypervascular anterior mediastinal mass on CT imaging has not been previously reported in the literature. This case suggests that HL should be included in the differential diagnosis of a hypervascular anterior mediastinal mass, especially if the patient is a young adult.

Abstract To identify a predictive value for the exacerbation status of chronic obstructive pulmonary disease (COPD) subjects, we evaluated the relationship between pulmonary vascular measurements on chest CT and severe COPD exacerbation. Six hundred three subjects enrolled in the COPDGene population were included and divided into nonexacerbator (n = 313) and severe exacerbator (n = 290) groups, based on whether they had an emergency room visit and/or hospitalization for COPD exacerbation. We measured the diameter of the main pulmonary artery (MPA) and ascending aorta (AA) at 2 different sites of the MPA (the tubular midportion and bifurcation) on both axial images and multiplanar reconstructions. Using multiple logistic regression analyses, we evaluated the relationship between each CT-measured pulmonary vasculature and exacerbation status. Axial and multiplanar MPA to AA diameter ratios (PA:AA ratios) at the tubular midportion and the axial PA:AA ratios at the bifurcation indicated significant association with severe exacerbation. The strongest association was found with the axial PA:mean AA ratio at the bifurcation (adjusted odds ratio [OR] = 12.53, 95% confidence interval [CI] = 2.35–66.74, P = .003) and the axial PA:major AA ratio at the tubular midportion (adjusted OR = 10.72, 95% CI = 1.99–57.86, P = .006). No differences were observed in the MPA diameter. Receiver operating characteristic analysis of these variables indicates that they may serve as a good predictive value for severe exacerbation (area under the curve, 0.77–0.78). The range of cut-off value for PA:AA ratio was 0.8 to 0.87. CT-measured PA:AA ratios at either the bifurcation or the tubular site, measured either on axial or multiplanar images, are useful for identification of the risk of severe exacerbation, and consequently can be helpful in guiding the management of COPD. Although CT measurement was used at the level of pulmonary bifurcation in previous studies, we suggest that future studies should monitor the tubular site of the MPA for maximum diagnostic value of CT in pulmonary hypertension or severe COPD exacerbation, as the tubular site of the MPA remains relatively constant on CT images.

Calcifying aponeurotic fibroma is a rare, benign fibroblastic tumor that typically occurs in the palms of the hands and soles of the feet in children and adolescents. We report an unusual case of a calcifying aponeurotic fibroma with diffuse intra-articular involvement of the carpal joints in a 59-year-old female. Radiographs and computed tomography scans revealed a large lobulated soft tissue mass with multiple stippled calcifications around the carpal joints and numerous erosions of the second to fifth carpometacarpal and intercarpal joints. Magnetic resonance imaging showed diffuse multinodular synovial proliferation with inhomogeneous hypo- to isointense signal intensity on T1-weighted images, inhomogeneous hypointense to hyperintense signal intensity on T2-weighted images, and inhomogeneous intense enhancement on fat-suppressed contrast-enhanced T1-weighted images. Radiologic diagnosis included gout, calcium pyrophosphate dihydrate deposition disease, and tenosynovial giant cell tumor. Surgical excision was performed, and the mass was diagnosed on pathologic examination as a calcifying aponeurotic fibroma. There has been no reported case of a calcifying aponeurotic fibroma with diffuse intra-articular involvement of the carpal joints in the literature.

Intrapulmonary solitary fibrous tumor is extremely rare. A few reports have presented typical CT findings such as well-defined, variable—sized, heterogeneously or homogenously well-enhanced intrapulmonary nodules. We report herein a rare case of intrapulmonary solitary fibrous tumor that showed typical clinical and CT features, and we also provide an ancillary CT finding that shows a distinguishable tubular vascular structure within the nodule. The tubular vascular structure was conjoined to the proximal pulmonary vein. In this study, we highlight an ancillary CT finding reported for the first time for the diagnosis of a patient with intrapulmonary solitary fibrous tumor.

Potato mop-top virus (PMTV) is classified as a plant quarantine virus in Korea. It is tested at import inspection sites. In this study, two sets of reverse transcription-hemi-nested polymerase chain reaction primers were developed to diagnose PMTV. In addition, modified- positive control plasmid was developed for the identification of false positive results in plant quarantine. The assay is expected to be useful for improving the detection and diagnosis of PMTV.

Purpose: The aim of the study was to correlate computed tomographic (CT) scoring systems for pulmonary sarcoidosis with cardiopulmonary exercise testing and evaluate which scoring system provides the most reliable information for assessing disease severity and predicting impairment of gas exchange during exercise. Materials and Methods: The institutional review board approved this retrospective study. All 62 patients underwent thin-section CT, pulmonary function tests, and cardiopulmonary exercise test. Two observers scored CT images according to scoring systems published by Remy-Jardin and colleagues. Spearman rank correlation coefficients were calculated between CT patterns and pulmonary functional impairment parameters, and multiple regression analyses were performed to evaluate which CT abnormalities were significantly associated with pulmonary functional impairment parameters. Results: Regardless of scoring system, PaO2max was significantly associated with the subscores of ground-glass opacity, linear opacity, and total CT scores. Multiple regression analyses showed that subscores of ground-glass and linear opacity in the Leung scoring system appeared to explain a significant amount of variance in functional parameters at rest and at maximal exercise. Conclusions: CT findings, particularly ground-glass opacity and linear abnormalities, can explain a significant amount of variance in cardiopulmonary exercise parameters. This suggests that CT-based scoring systems are valid measures of disease severity in sarcoidosis.

Turnip yellow mosaic virus (TYMV) is a plant pathogenic virus transmitted mainly through its host Brassica spp. TYMV is originated from Europe. Its infection cases have been reported in Australia, Brazil, Turkey, and Japan. Symptoms similar to those of TYMV infections were also reported in Korea in 2012. In this study, we developed RT-PCR primer pairs that were highly sensitive for detecting TYMV. The developed RT-PCR primer pairs offered about 10-100 times stronger detection sensitivity compared to primer pairs previously used in Korea. As a result, a 491 bp TYMV-specific band was identified. The specific band was confirmed to be TYMV based on sequencing results and phylogenetic analysis. The RT-PCR primer pairs developed in this study can be used to rapidly and precisely diagnose TYMV in agricultural products such as Chinese cabbage and other crops infected by TYMV.