OBJECTIVE. This study was designed to validate the usefulness of a CT finding of abnormal pericardial thickening and to investigate the value of associated thoracic changes in predicting the presence of malignant pericardial effusion.MATERIALS AND METHODS. Seventy-four consecutively registered patients with pericardial effusion detected with transthoracic echocardiography were included in the study. The patients fulfilled the following criteria: undergoing pericardial fluid cytologic examination or pericardial tissue biopsy and undergoing chest CT examination less than 30 days after pericardial fluid or tissue examination. CT images were reviewed for the presence of pericardial thickening, the pattern of pericardial thickening, and the presence of pleural effusion and mediastinal lymph node enlargement.RESULTS. Twenty-eight cases of malignant and 46 cases of benign pericardial effusion were identified. Mean pericardial thickening was greater in association with malignant disease (7.25 ± 2.91 mm) than with...

The aim of this study is to investigate the clinical utility of staging chest CT in breast cancer by evaluating diagnostic yield (DY) of chest CT in detection of metastasis, according to the molecular subtype and clinical stage. This retrospective study included 840 patients with 855 breast cancers from January 2017 to December 2018. The number of patients in clinical stage 0/I, II, III and IV were 457 (53.5%), 298 (34.9%), 92 (10.8%) and 8 (0.9%), respectively. Molecular subtype was identified in 841 cancers and there were 709 (84.3%) luminal type, 55 (6.5%) human epidermal growth factor receptor 2 (HER2)-enriched type and 77 (9.2%) triple-negative (TN) type. The DYs in clinical stage 0/I, cII, cIII and cIV were 0.2% (1/457), 1.7% (5/298), 4.3% (4/92) and 100.0% (8/8), respectively. The DYs in luminal type, HER2-enriched type and TN type were 1.7% (12/709), 3.6% (2/55) and 2.6% (2/77), respectively. Clinical stage was associated with the DY (p = 0.000). However, molecular subtype was not related to the DY (p = 0.343). Molecular subtype could not provide useful information to determine whether staging chest CT should be performed in early-stage breast cancer. However, chest CT should be considered in advanced breast cancer.

Background/Objectives: Lung-RADS was introduced to standardize the management of nodules detected during lung cancer screening. However, significant interobserver variability has been reported, and its consistency across different hospital settings remains insufficiently investigated. This study aimed to compare Lung-RADS categorization and diagnostic performance between tertiary and non-tertiary hospitals, and to evaluate interobserver variability and associated differences in recommended management. Methods: This single-tertiary-center, referral-based retrospective study included patients referred to a tertiary hospital after lung cancer screening at 29 non-tertiary hospitals between September 2019 and December 2023. CT images were reinterpreted at a tertiary hospital using Lung-RADS. A blinded review was performed by an independent thoracic radiologist, and interobserver variability was assessed using Cohen’s kappa. Discordance rate and major discordance (≥9-month follow-up difference) were determined. Sensitivity, specificity, and diagnostic accuracy were calculated and compared. Results: Sixty patients (median age, 63 years [interquartile range, 58–68]; 59 men and one woman) with 43 confirmed final diagnoses (18 of lung cancer and 25 of benign lesions) were included. Interobserver variability was fair between tertiary and non-tertiary hospitals (κ = 0.30), and between non-tertiary hospitals and thoracic radiologist (κ = 0.28), but almost perfect between tertiary hospital and thoracic radiologist (κ = 0.82). Lung-RADS discordance occurred in 50.0% of the cases (30/60), with 70.0% (21/30) classified as major discordance. Among the 43 patients with confirmed final diagnoses, specificity was significantly higher in tertiary hospital reports (68.0%, 95% CI 46.5–85.1) compared to non-tertiary hospital reports (20.0%, 95% CI 6.8–40.7; p = 0.001), while sensitivity was comparable (100.0%, 95% CI 81.5–100 vs. 88.9%, 95% CI 65.3–98.6; p = 0.480). Conclusions: Frequent discordances in Lung-RADS categorization were observed between tertiary and non-tertiary hospitals. Higher specificity was observed for tertiary hospital interpretations within this referral cohort. These discrepancies may affect patient management, highlighting the need for strategies to improve consistency.