9075Background: Hyperprogressive disease (HPD) emerges as a new subset of patients treated with immune-oncology (IO) agent. The definition of HPD is not yet clearly established, and it is unclear which patient is rapidly progressing after IO treatment. We investigated clinical features and potential genomic markers associated with HPD after IO therapy. Methods: We performed a retrospective clinical and radiological analysis of advanced NSCLC patients treated with single IO at Samsung Medical Center(July 2014 to December 2017). CT scans were quantitatively analyzed in terms of tumor volume and tumor growth rate (TGR) by comparing prior vs upon IO. We extracted tumor volume for each metastatic organ, classifying into HPD and non-HPD by volume-based growth kinetics. We also performed deep targeted sequencing of 375 of genes. Results: Of 220 evaluable patients37 patients (17%) were classified as HPD. 26 (70%) were male, 24 (65%) smoker, 25(68%) ≧ 65 years, 10 (27%) ECOG PS ≧ 2, 31(84%) adenocarcinoma. Compare...

Lung cancer is the leading cause of cancer-related deaths worldwide, and imaging techniques such as chest radiography, computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) play an important role in its diagnosis, staging, treatment planning, post-operative surveillance, and treatment response evaluation. Pulmonary MRI can non-invasively visualize structural and functional abnormalities in the lungs without using ionizing radiation, although it has been suggested that it has less clinical utility than chest radiography, CT, and PET/CT for thoracic diseases, especially lung diseases. With recent advances related to MRI pulse sequences, pulmonary MRI has become practicable in an expanding number of clinical situations. This review article focuses on recent advances in MRI and discusses its clinical applications in the detection, diagnosis, staging, pre-operative evaluation, post-operative surveillance, and treatment response evaluation of lung cancer.

To evaluate the effect of the deep learning model reconstruction (DLM) method in terms of image quality and diagnostic agreement in low-dose computed tomography (LDCT) for interstitial lung disease (ILD), 193 patients who underwent LDCT for suspected ILD were retrospectively reviewed. Datasets were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction Veo (ASiR-V), and DLM. For image quality analysis, the signal, noise, signal-to-noise ratio (SNR), blind/referenceless image spatial quality evaluator (BRISQUE), and visual scoring were evaluated. Also, CT patterns of usual interstitial pneumonia (UIP) were classified according to the 2022 idiopathic pulmonary fibrosis (IPF) diagnostic criteria. The differences between CT images subjected to FBP, ASiR-V 30%, and DLM were evaluated. The image noise and BRISQUE scores of DLM images was lower and SNR was higher than that of the ASiR-V and FBP images (ASiR-V vs. DLM, p < 0.001 and FBP vs. DLR-M, p < 0.001, respectively). The agreement of the diagnostic categorization of IPF between the three reconstruction methods was almost perfect (κ = 0.992, CI 0.990–0.994). Image quality was improved with DLM compared to ASiR-V and FBP.

Basaloid squamous cell carcinoma (SCC) is very rare subtype of SCC of the lung and it is important to distinguish basaloid to other subtypes of SCCs, since the prognosis of basaloid subtype is considered poorer than that of other non-basaloid subtypes of SCCs. Aim of this study was to assess computed tomography (CT) findings of basaloid SCC of the lung in 12 patients. From January 2016 to April 2021, 12 patients with surgically proven basaloid SCC of the lung were identified. CT findings were analyzed, and the imaging features were compared with histopathologic reports. Clinical and demographic features were also analyzed. Axial location of the tumor was central in 5 patients, while 7 was in peripheral. Of the 7 patients whose tumors were located in the peripheral, margin of the tumor were smooth (n = 2), lobulated (n = 2), or spiculated (n = 3). After contrast injection, net enhancement value ranged from 15.8 to 71.8 HU (median, 36.4 HU). Endobronchial growth were seen in 5 patients and these patients accompanied obstructive pneumonia or atelectasis. Internal profuse necrosis, cavitation, or calcifications were not seen. On CT, basaloid squamous cell presents as solitary nodule or mass with moderate enhancement. Tumor was located either peripheral or central compartment of the lung and cavitation was absent.

Purpose: To report on infiltrative invasion of the diaphragm, an uncommon manifestation ofrecurrent hepatocellular carcinoma (HCC), and evaluate its clinical significance.Methods: Using the term “diaphragm” or “diaphragmatic” and “invasion” or “involvement,” we searched for patients in the database of radiologic reports of liver computed tomography or magnetic resonance imaging performed between 2012 and 2016 at our institution. Nine patients with infiltrative invasion of the diaphragm due to recurrent HCC were included. Their clinical and imaging findings were evaluated.Results: The median age of patients at the time of diagnosis was 68 years (range, 40 to 73). There were eight men and one woman. Imaging findings of infiltrative invasion of the diaphragm revealed diffuse thickening with enhancementinvolving a part ofthe diaphragm. The median interval between initial manifestation on imaging and radiologic diagnosis of infiltrative invasion ofthe diaphragm was 6.8 months (range, 3.4 to 18.6). In two of three patients who underwent surgicalresection, tumors of the diaphragm were controlled without recurrence. In six patients except for one patient who was not followed up, tumors recurred at the resection site or diaphragm tumors showed a partial response or disease progression.Conclusion: Infiltrative invasion of the diaphragm by recurrent HCC manifested with diffuse thickening and diaphragm enhancement on radiologic imaging. A good prognosis can be expected only in patients who are diagnosed early and undergo surgical resection.