The ASEAN Journal of Radiology 2022-12-31T15:09:37+07:00 Wiwatana Tanomkiat Open Journal Systems <p>The ASEAN Journal of Radiology (ASEAN-JR) is the official journal of ASEAN association of Radiology (AAR), Royal College of Radiologists of Thailand (RCRT), Radiological Society of Thailand (RST), and Foundation of Orphan and Rare Lung Disease (FORLD). <br /><br />ISSN: 0859-144X (Print)<br />ISSN: 2672-9393 (Online)</p> Associated ultrasound findings improve the accuracy of twinkling artifacts in kidney stone diagnosis 2022-12-05T13:32:32+07:00 Rujiluck Rojthamrong Kewalee Sasiwimonphan <p><strong>Background:</strong> Twinkling artifact (TA) in color Doppler ultrasound is commonly used as a sign of kidney tract stone detection but the accuracy is limited as compared with unenhanced computed tomography (CT).</p> <p><strong>Objective:</strong> Define the associated ultrasound findings that may improve the accuracy of TA compared with CT for diagnosing kidney stones.</p> <p><strong>Materials and Methods:</strong> Prospective study was conducted on 128 TAs in patients sent for unenhanced CT KUB and performed color Doppler ultrasound on the same day. TA sizes and associated sonographic signs were recorded and analyzed with receiver operating characteristic curves (ROCs). The diagnostic reference was the CT scan.</p> <p><strong>Results:</strong> There was a total of 128 TAs with the size of 3.95 mm (2.7-6 mm). Only 30 TAs showed as kidney stones in CT. The sizes of kidney stones in CT were 5.4 mm (3.4-6.4 mm) which represented a significant difference in TA size (<em>P </em>= 0.002). ROC curve analysis showed that 5 mm would be the optimal size of TA for kidney stone predictions. Other significant signs for improved diagnosis include echoic foci (<em>P </em>= 0.039), posterior shadows (<em>P </em>= 0.001), long TA tails (<em>P </em>= 0.001) and 2<sup>nd</sup> approach TA (<em>P </em>= 0.001). Then a predictive AT model was created to predict kidney stones, which moderately improved diagnosis accuracy for kidney stones with good agreement.</p> <p><strong>Conclusion:</strong> The combination of TA and other sonographic signs are moderately associated with kidney stone diagnosis including TA size (<u>&gt;</u> 5 mm), posterior acoustic shadow, long TA tail, junctional line location and focal Caliectasis.</p> 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology Randomised trial on pain reduction in hysterosalpingography - a modified technique without vulsellum forceps 2022-12-03T20:49:10+07:00 Olubukola Omidiji Omodele Olowoyeye Richard Efidi Omololu Adegbola Oluyemisi Toyobo Ogonna Okeke Thaddaeus Opara Abidemi Shabi <p>ABSTRACT</p> <p>Background: Pain is the most common side effect of hysterosalpingography (HSG) and partly arises from vulsellum placement on the cervix and cervical traction.</p> <p>Objective: To study the effect of conducting HSG without grasping the cervix with vulsellum forceps on the time taken to complete the procedure, pain experienced by the participants and diagnostic quality of HSG images produced.<br />Materials and Methods: A randomized controlled trial of 64 consenting adult women referred to the Radiodiagnostic department for HSG from July to December 2020 was carried out. The women were consecutively selected and randomly distributed into two groups: Group 1 - no cervical grasp and Group 2 – with cervical grasp with vulsellum forceps. HSG was done using a fluoroscopy machine, following the standard hospital protocol with speculum, Leech Wilkinson cannula and Urografin 76%. Procedure time, procedure pain using the visual analog scale and diagnostic quality of images were assessed. Data analysis was done using Microsoft Excel and SPSS software version 22.<br />Results: The overall mean duration of the procedure was 12.59 minutes. There was no significant difference in the procedure duration between both groups. The overall mean pain scores immediately and 15 minutes after the procedure were 4.83 and 2.23 respectively. Significant differences in pain scores were seen in the immediate post procedure 3.94 (group 1) versus 5.72 (group 2) and 15 minutes post procedure 1.75 (group 1) versus 2.72 (group 2). After adjusting for confounders, the pain score was noted to be significantly related to the HSG technique with vulsellum use associated with the higher immediate post HSG pain score. No significant difference was seen in the diagnostic image quality between group I and II<br />Conclusion: The elimination of vulsellum forceps during hysterosalpingography was associated with reduced pain in the immediate and 15 minutes after the procedure, without significantly increasing the procedure duration. It had no deleterious effect on the image quality.</p> 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology Correlation of ultrasound attenuation imaging versus MRI proton density fat fraction in non-alcoholic fatty liver 2022-11-25T13:38:01+07:00 Pantajaree Hiranrat Surachate Siripongsakun Kamonwan Soonklang <p><strong>Background:</strong> Attenuation Imaging (ATI) is a novel method for assessment of hepatic steatosis, based on ultrasound attenuation by calculating attenuation coefficient which increases in the fatty liver condition. The previous published data comparing ATI and Magnetic Resonance Proton Density Fat Fraction (MR-PDFF) has moderate to high correlation coefficient (r=0.66-0.81). However, fatty liver is commonly associated with obesity which may be an influencing factor of the ATI measurement.</p> <p> </p> <p><strong>Objective:</strong> The purpose of this study was to evaluate diagnostic accuracy of ATI in non-alcoholic fatty liver disease (NAFLD) compared to MRI-PDFF</p> <p> </p> <p><strong>Materials and Methods:</strong> The 62 non-alcoholic fatty liver disease (NAFLD) patients with available ATI, MRI-PDFF, and MRE examination, excluding cirrhosis, history of significant alcohol drinking, and chronic liver condition were retrospectively evaluated.</p> <p> </p> <p><strong>Results:</strong> The correlation coefficient (r) of ATI vs MRI-PDFF were in good correlation (r = 0.63-0.69, p&lt;0.001). The inter-observer reliability of two observers was 100% with the Cohen kappa coefficient of 1.00 (p &lt; 0.001).Area under the receiver operating characteristics of ATI for diagnosis of steatosis grade &gt; 0 was 0.96 and for diagnosis of steatosis grade &gt; 1 was 0.83.</p> <p> </p> <p><strong>Conclusions:</strong> ATI is a novel ultrasound method to quantify the degree of fat deposition with a good correlation to MRI-PDFF with high interobserver’ reliability. Obesity commonly associated with fatty liver may be an interfering factor of ATI measurement.</p> 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology Dual-energy spectral CT in assessment of pleural effusion 2022-12-15T21:16:25+07:00 Wilailak Muang-im Juntima Euathrongchit Apichat Tantraworasin Yutthaphan Wannasopha <p><strong>Background</strong><strong>: </strong>Pleural effusion is a common clinical problem. The ability to differentiate between benign and malignant pleural effusions has many clinical benefits. However, few studies have investigated the diagnostic value of dual-energy spectral computed tomography (DECT) in pleural effusion.</p> <p><strong>Objective</strong><strong>: </strong>To evaluate the diagnostic values of DECT for assessment of pleural effusion<strong>.</strong></p> <p><strong>Materials and Methods</strong><strong>: </strong>We retrospectively analyzed data from 87 patients presenting with pleural effusion who underwent chest DECT from October 2019 to November 2020. Two reviewers blindly reviewed the CT images of pleural effusion in consensus. The pleural fluid attenuation in standard conventional CT images and monoenergetic images, at 40 keV, 100 keV and 140 keV, were recorded. Data pertaining to the effective atomic number, the iodine concentration (IC)and associated CT findings including pleural thickening, pleural nodules and extrapleural fat clouding was analyzed.</p> <p><strong>Results</strong><strong>: </strong>Of 87 patients, 44 were presented with benign effusions and the remaining 43 were presented with malignancy.There were no statistically significant differences in differentiating between benign and malignant pleural effusions by using the attenuation values, the effective atomic number or the IC. Irregular pleural thickening and pleural nodules were detected statistically significant in the patients with malignant pleural effusions with moderate accuracy, (48.83%; p &lt; 0.01; AuROC 0.7103 and 34.88%; p &lt; 0.01; AuROC 0.654 respectively).</p> <p><strong>Conclusion</strong><strong>:</strong> DECT attenuation values did not show any reliable clinical value in the differentiation between benign and malignant pleural effusions. The presence of pleural nodules or irregular pleural thickening would suggest malignant pleural effusion with moderate accuracy.</p> 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology Asian Radiology Education Program (AREP): A new step of radiology education in Asia 2022-09-21T02:13:54+07:00 Silanath Terpenning Janardhana Ponnatapura <p>Asian radiology Education Program was created by a group of radiologists from Asia (Bhutan, Cambodia, Indonesia, Laos, nepal, Myanmar, Mongolia, Thailand and Vietnam) and USA to share experiences, expertise and knowledge from the West to radiology colleagues in Asia, to collaborate radiology education, research projects and exchange visitor programs in the near future. Our altimate goal is to enhance radiology care and access across the globe.&nbsp;&nbsp;Our program is a non-profit program and therefore there is no cost to join.</p> <p>We broadcast live radiology education webinars three weekends each month with multiple subspeciality lecture series: Cardiothoracic Imaging, Body Imaging, Neuroradiology, MSK Radiology and Hot and cutting-edge topics in Radiology.&nbsp; This year’s program runs from January to October 2022. Our moderators are academic radiologists from member countries and our guest speakers are from leading academic institutes in the US from coast to coast.&nbsp;</p> <p>Thank you for the opportunity to share a few thoughts about our program.</p> <p>Asian Radiology Educaiton Program</p> 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology MFU Wellness Center and FUJIFILM bring medical innovation to provide people in remote areas of Chiang Rai tuberculosis screening with the aim of reducing limitations to access basic healthcare services 2022-12-22T17:33:30+07:00 FUJIFILM Thailand Ltd. 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology The first face-to-face Malaysian Congress of Radiology after the COVID-19 outbreak 2022-12-28T08:50:13+07:00 SOCHEAT CHUM 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology The first examination for professional license in medical physics in Thailand 2022-12-22T21:13:47+07:00 Wiwatana Wiwatana <p>The Ministry of Health had announced on November 2<sup>nd</sup>, 2020 that profession license was required for practicing medical physics in Thailand. The first license examination was taken place on July 26<sup>th</sup>, 2022 under supervision of the Royal College of Radiologists of Thailand. The first seventeen medical physicists has been licenced by the Department of Health Service Support on August 10<sup>th</sup>, 2022 [3]. It is strongly believed that this important step will lead to safer and better qualified practice and patients’ care in Radiology.</p> 2022-12-31T00:00:00+07:00 Copyright (c) 2022 The ASEAN Journal of Radiology