Unnecessary prolonged treatment with biologic agents for Crohn’s disease (CD) patients with endoscopic complete remission (CR) might increase the opportunistic infections. To evaluate computed tomography enterography (CTE) findings obtained on CD patients achieving endoscopic CR after anti-tumor necrosis factor (TNF)-α therapy. Thirty-six consecutive patients with CD who had received anti-TNF- α therapy and undergone pre-and post-therapy CTE and ileocolonoscopy were initially enrolled. CTE was performed with a standard-dose enteric-phase scan. Eleven patients were excluded due to a mismatch of follow-up intervals or a long interval (>2 weeks) between CTE and ileocolonoscopy; additionally, five patients were excluded due to surgical intervention during the follow-up period. Therefore, 20 patients finally were analyzed. Two blinded readers evaluated the pre-and post-therapy CTE images by consensus for active inflammation, i.e. mural hyperenhancement, mural thickening (thickness > 3 mm), mural stratification, and increased peri-enteric fat attenuation in the rectum, colon, and terminal ileum. Endoscopic CR indicated mucosal healing identified by ileocolonoscopy and served as the reference standard. Nine patients with 16 bowel segments showed endoscopic CR. Ten of those segments showed residual abnormalities including mild mural hyperenhancement (9/16, P = 0.03), mild mural thickening (6/16, P < 0.001), and both findings (5/16, P < 0.001) on post-therapy CTE. The non-CR group (11 patients; 17 bowel segments) showed a higher concordance rate with post-therapy CTE (88%, 15/17) than did the CR group (38%, 6/16) (P = 0.004). Residual mild mural hyperenhancement and mild mural thickening were seen on post-therapy CTE in over half of the bowel segments showing endoscopic CR.

Objectives: This study aimed to compare ultrasound (US) findings between automated and handheld breast ultrasound (ABUS and HHUS, respectively) in small breast cancers, based on the breast imaging reporting and data system (BI-RADS) category. Methods: We included 51 women (mean age: 52 years; range: 39–66 years) with breast cancer (invasive or DCIS), all of whom underwent both ABUS and HHUS. Patients with tumors measuring ≤1 cm on either modality were enrolled. Two breast radiologists retrospectively evaluated multiple imaging features, including shape, orientation, margin, echo pattern, and posterior characteristics and assigned BI-RADS categories. Lesion sizes were compared between US and pathological findings. Statistical analyses were performed using Bowker’s test of symmetry, a paired t-test, and a cumulative link mixed model. Results: ABUS assigned lower BI-RADS categories than HHUS while still maintaining malignancy suspicion in categories 4A or higher (54.8% consistent with HHUS; 37.3% downcategorized in ABUS, p = 0.005). While ABUS demonstrated less aggressive margins in some cases (61.3% consistent with HHUS; 25.8% showing fewer suspicious margins in ABUS), this difference was not statistically significant (p = 0.221). Similarly, ABUS exhibited slightly greater height–width ratios compared to HHUS (median, interquartile range: 0.98, 0.7–1.12 vs. 0.86, 0.74–1.10, p = 0.166). No significant differences were observed in other US findings or tumor sizes between the two modalities (all p > 0.05). Conclusions: Small breast cancers exhibited suspicious US features on both ABUS and HHUS, yet they were assigned lower BI-RADS assessment categories on ABUS compared to HHUS. Therefore, when conducting breast cancer screening with ABUS, it is important to remain attentive to even subtle suspicious findings, and active consideration for biopsy may be warranted.

김지은, et al. J Korean Soc Radiol. 2021 Oct;82:e146. https://doi.org/10.3348/jksr.2021.0040

Angiosarcoma of the breast is a rare malignant sarcoma of endovascular origin that presents with various radiological findings. We encountered a case of angiosarcoma of the breast presenting as an irregular indistinct hyperechoic mass on ultrasonography, with a large single angiosarcoma of the spleen in a previously healthy 36-year-old female. Herein, we report the imaging and pathologic findings and review the literature.