Program & Abstract Book - ACAR 2017

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Apr 21, 2017 - Fellow and Trustee of the International Cancer Imaging Society (ICIS), ..... for Reducing Radiation Dose ..... Acoustic Radiation Force Impulse.
Program & Abstract Book

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Welcome Message Congratulatory Message ASAR Gold Medalist ASAR Honorary Fellow Honorary Lecturers Organizing Committee Invited Guests Program at a Glance Awards Scientific Program in Detail Official & Social Programs Congress Information Transportation Useful Tips in Korea Technical Exhibition Sponsors Floor Plan Invited Lectures Scientific Sessions Informal Sessions Scientific Exhibition Authors Index Advertisement

Welcome Message

Seung Hyup Kim, MD, PhD President, Organizing Committee ACAR 2017

Dear colleagues, On behalf of the Organizing Committee of the 6th Congress of Abdominal Radiology (ACAR 2017), I would like to express my warmest gratitude to you all for participating in the ACAR 2017 to be held in Busan, Korea on April 21 to 22, 2017. Under the theme of "Toward Systematic and Standardized Abdominal Imaging," the Organizing Committee will provide a dynamic scientific program to advance the study of Abdominal Radiology and its associated diseases by encouraging teaching, research and further education in the specialty. The scientific program consists of Plenary Lecture, Honorary Lectures, Debate Sessions, Refresher Courses, Special Focuses, Interactive Case Review Session, Hands-on Session, Asian Chapter Sessions, Luncheon Symposia, Scientific Sessions, Informal Sessions and Scientific Exhibition (E-posters). Sixteen exhibitors with 34 booths have participated in the technical exhibition where participants will get a glimpse of radiology innovation through direct contacts with the radiology industry. The Organizing Committee is devoting its utmost efforts to prepare a most meaningful and enjoyable congress. I trust that you will benefit greatly from our program and make the most of your time in Busan, Korea's largest port city with abundance of coastal tourist attractions, historical and cultural sites, and of course, trendy shopping areas. I am confident that you will enjoy your stay in Busan, and extend a hearty welcome to you to ACAR 2017.

Sincerely yours,

Seung Hyup Kim, MD, PhD President, Organizing Committee

ACAR 2017

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Congratulatory Message

Hiromu Mori, MD, PhD President Asian Society of Abdominal Radiology

On behalf of the Asian Society of Abdominal Radiology (ASAR), I would like to congratulate Professor Seung Hyup Kim and Organizing Committee of the 6th Asian Congress of Radiology (ACAR) which will be held in Busan, Korea, from April 21st to April 22nd, 2017. As President of ASAR, I would like to welcome all participants to this biennial congress of ASAR. I am also thankful to Professor Seung Hyup Kim and his team for their extensive effort to organize this 6th ACAR in Busan. All of participants will have every opportunity to learn and feel directly the updated development of Abdominal Radiology. In 2015 just after the 5th ACAR held in Hamamatsu, Japan, ASAR had decided to have biennial ACAR as a platform exchanging knowledge and opinion of cutting-edge research and annual ASAR Educational Lecture Course as an educational seminar for young abdominal radiologists of whole Asia. This 6th ACAR in Busan is the first ACAR after this decision. I am sure this monumental ACAR will gain enormous success as all of previous ACAR meetings did. As the President of ASAR, I take an opportunity to introduce the recent development of ASAR as follows: - ASAR decided and established contract with Abdominal Radiology as the official society journal. - ASAR welcomed Singapore Society of Abdominal Radiology (February, 2016) and Indonesian Society of Abdominal Radiology (October, 2016) as new Group Member of ASAR. - ASAR had successful the 1st ASAR Educational Lecture Course in Jakarta (October, 2016) as the result of cooperation of ASAR Board of Executive Council Members and local organizing committee of Indonesia. - ASAR established the direction of annual ASAR Educational Lecture Course of 2016-2019, and annual ACAR since 2020. As 5th ACAR in Hamamatsu, this 6th ACAR in Busan is truly international meeting. We will have distinguished international guest speakers from Society of Abdominal Radiology (SAR, North America), European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Urogenital Radiology (ESUR). In the same way, ASAR has been sending excellent qualified researchers from ASAR to the annual meetings of SAR, ESGAR, and ESUR since 2013. We, this worldwide allied societies, have an identical goal to educate essential knowledge to younger generation and to exchange cutting-edge research knowledge. I am so sure this ACAR in Busan will provide an opportunity for all participants to just be in a worldwide atmosphere and this will become a breakthrough in any aspect for participants.

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I sincerely hope every participants will enjoy Busan and get something good from ACAR. Looking forward to seeing you in Busan soon.

Hiromu Mori, MD, PhD President Asian Society of Abdominal Radiology

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ASAR Gold Medalist

Byung Ihn Choi, MD, PhD Professor Chung-Ang University Hospital, Korea

Dr. Choi is a Clinical Chair Professor of Radiology at Chung-Ang University Medical Center and a Professor Emeritus of Seoul National University, College of Medicine, Seoul, Korea. He was Chair of the Department of Radiology at the Seoul National University Hospital and President for eight national and international societies including the Korean Society of Radiology (KSR), Asian Oceanian Society of Radiology (AOSR), Asian Society of Abdominal Radiology (ASAR) and Asian Federation of Societies of Ultrasound in Medicine and Biology (AFSUMB). He also served as a member of the executive committee of seven international radiology organizations including the International Society of Radiology (ISR) and the World Federation of Ultrasound in Medicine and Biology (WFUMB). He is currently Honorary Member of twelve international and regional societies including the Radiological Society of North America (RSNA) and the European Society of Radiology (ESR). He is Honorary Fellow of five prestigious colleges of radiology including the American College of Radiology (ACR). Dr. Choi is a world-renowned abdominal radiologist, particularly in the field of hepatobiliary imaging. He is a tireless and prolific clinical and scientific researcher, devoted teacher, and an outstanding clinician. Throughout his career, he has delivered 421 invited lectures and published more than 500 scientific papers. In recognition of his passion for abdominal radiology and enthusiasm for Asian abdominal radiologists, we are proud to present the Gold Medal to Dr. Choi.

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Yi-Hong Chou, MD, PhD Professor Taipei Veternas General University Hospital, Taiwan

Dr. Yi-Hong Chou is Chief of the Ultrasound Section at Taipei Veterans General Hospital and Professor of Radiology at National Yang Ming University School of Medicine, Taipei, Taiwan. Dr. Chou currently serves as President of the Asian Oceanian Society of Radiology (AOSR); Administrative Councilor of the World Federation for Ultrasound in Medicine and Biology (WFUMB); Editor-in-Chief of the Journal of Medical Ultrasound, the official journal of the Asian Federation of Societies for Ultrasound in Medicine and Biology (AFSUMB); and Associate Editor of Ultrasound in Medicine and Biology, the official journal of WFUMB. Dr. Chou is the former president of several national and international societies including the AFSUMB, Asian Society of Abdominal Radiology (ASAR), Asian Breast Diseases Association (ABDA), and Radiological Society of Republic of China (CTSR). He has published more than 350 articles and book chapters and has co-edited five books on breast, chest and acute abdomen. In recognition of his passion for abdominal radiology and enthusiasm for Asian Society of Abdominal Radiology, we are proud to present the Gold Medal to Dr. Chou.

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ASAR Honorary Fellow

Harriet C. Thoeny, MD Professor of Radiology Past President of European Society of Urogenital Radiology Senior Staff Member of Inselspital, Bern University Hospital, Switzerland

Dr. Thoeny is a Senior Staff Member of the Institute of Diagnostic, Pediatric and Interventional Radiology, University Hospital, Bern, Switzerland. She is the Past-President of the European Society of Urogenital Radiology (ESUR), an Executive Board Member, Fellow and Trustee of the International Cancer Imaging Society (ICIS), and a fellow of the European Society of Head and Neck Radiology (ESHNR), the European Society of Urogenital Radiology (ESUR). She is currently a member of the Program Planning Committee of the European School of Radiology (ESOR) and a member the Programme Planning Committee (PPC) of the European Congress of Radiology (ECR). She is an associate editor of Radiology and a reviewer of several international journals including Investigative Radiology, European Radiology, Nature, Journal of Urology, British Journal of Radiology and European Journal of Radiology among others. Dr. Thoeny has published many articles in highly ranked international journals such as Radiology, European Urology, European Radiology, etc and she is the principle investigator of various grants. She has given more than 100 invited lectures at the annual meetings of various international societies such as European Society of Radiology (ESR), ESUR, ICIS, International Society of Magnetic Resonance in Medicine (ISMRM), European Society of Gastrointestinal Radiology (ESGAR), Korean Society of Radiology (KSR), ESOR, Society of Abdominal Radiology (SAR), ESHNR and many more. In recognition of her outstanding contribution to the field of abdominal radiology, we are proud to present the Honorary Fellowship to Dr. Thoeny.

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Honorary Lecturers Society of Abdominal Radiology (SAR)

Judy Yee, MD Past President of Society of Abdominal Radiology Professor of University of California, San Francisco USA

William W. Mayo-Smith, MD, FACR President of Society of Abdominal Radiology Professor at Brigham and Women's Hospital USA

SAR Honorary Lecture State-of-the-art CT colonography Revisiting CT radiation in 2017, updates from the US

Judy Yee William W. Mayo-Smith

European Society of Gastrointestinal and Abdominal Radiology (ESGAR)

Panagiotis Prassopoulos, MD Meeting President of ESGAR 2017 Professor at University Hospital of Alexandroupolis Greece

Steve Halligan, MD President-Elect of European Society of Gastrointestinal and Abdominal Radiology Professor at University College London UK

ESGAR Honorary Lecture The clinical role of imaging in peritoneal carcinomatosis Imaging anal fistula

Panagiotis Prassopoulos Steve Halligan

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European Society of Radiology (ESUR)

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Harriet C. Thoeny, MD Professor of Radiology Past President of European Society of Urogenital Radiology Senior Staff Member of Inselspital, Bern University Hospital Switzerland

Raymond Oyen, MD, FACR President of European Society of Urogenital Radiology Professor of University Hospital Leuven, Catholic University Leuven Belgium

ESUR Honorary Lecture Imaging of the prostate based on PIRADS version 2 Prostate MRI: DWI for cancer detection and assessment of aggressiveness

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ACAR 2017 Busan

Harriet C. Thoeny Raymond Oyen

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Organizing Committee ASAR Executive Council Officers Asian Society of Abdominal Radiology

President Immediate Past President President-elect Vice President Secretary Treasurer Chairman of the Education Committee Chairman of the Membership Committee Chairman of the By-Law Committee Chairman of the Communication Committee Councilor at large

Hiromu Mori, Japan Yi-Hong Chou, Taiwan Seung Hyup Kim, Korea Cheng Zhou, China Manabu Minami, Japan Myeong-Jin Kim, Korea Takamichi Murakami, Japan Jeong Min Lee, Korea Bin Song, China Jeong Yeon Cho, Korea Takehiko Gokan, Japan Chang Hong Liang, China Cher Heng Tan, Singapore Yi-You Chiou, Taiwan

ACAR 2017 Organizing Committee

The 6th Asian Congress of Abdominal Radiology

President Vice President Chair, Organizing Committee Secretary General Secretary Treasurer Financial Auditor Chairs, Scientific Program Committee Chairs, Scientific Exhibition Committee Chair, Planning Committee Chair, Promotion/Communication Committee Chairs, Publication Committee Chair, Technical Exhibition Committee Chair, International Affair Committee Chairs, Social Program Committee Chairs, Registration/Accommodation Committee Interactive Case Review Session Moderator

Advisory Board

Seung Hyup Kim Byung Chul Kang, Won Jae Lee Myeong-Jin Kim Jeong Yeon Cho Dalmo Yang, Young Taik Oh Jeong Min Lee Jae-Joon Chung, Byung Kwan Park Mi-Suk Park, Chan Kyo Kim Se Hyung Kim, Sung Il Jung Seong Ho Park Min Ju Kim Jung Hoon Kim, Min Hoan Moon Chang Hee Lee Jin-Young Choi Yong Moon Shin, Hyuck jae Choi Dongil Choi, Deuk Jae Sung Joon-Il Choi, Hak Jong Lee Byung Ihn Choi, Jae Hoon Lim Chang hae Suh, Cheol Min Park Jae Young Byun, Hae Jeong Jeon Yong yeon Jeong, Kyoung-Sik Cho Kyung seung Oh, Seong Kuk Yoon

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Invited Guests Seung Yon Baek, Korea Erdenebulgan Batmunkh, Mongolia Joyce Bomers, The Netherlands Jae Ho Byun, Korea Jae Young Byun, Korea Jae Hee Cheon, Korea Yi-You Chiou, Taiwan Bum Sang Cho, Korea Hyeon Je Cho, Korea Jeong Yeon Cho, Korea Kyoung-Sik Cho, Korea Byung Ihn Choi, Korea Chul Soon Choi, Korea Jin Young Choi, Korea Yi-Hong Chou, Taiwan Jae-Joon Chung, Korea Undrakh-Erdene Erdenebold, Mongolia Shinya Fujii, Japan Jurgen Futterer, The Netherlands Takehiko Gokan, Japan Satoshi Goshima, Japan Steve Halligan, UK Joon Koo Han, Korea Jay Heiken, USA Sukhee Heo, Korea Hye-Suk Hong, Korea Keum Nahn Jee, Korea Hae Jeong Jeon, Korea Yong Yeon Jeong, Korea Shenghong Ju, China Sung Il Jung, Korea Byung Chul Kang, Korea Musturay Karcaaltincaba, Turkey Ah Young Kim, Korea Chan Kyo Kim, Korea Hye Jin Kim, Korea Jae woon Kim, Korea Jin Woong Kim, Korea Kie Hwan Kim, Korea Kyeong Ah Kim, Korea

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ACAR 2017 Busan

Myeong-Jin Kim, Korea Se Hyung Kim, Korea See Hyung Kim, Korea Seong Hyun Kim, Korea So Yeon Kim, Korea Sun Ho Kim, Korea You Me Kim, Korea Young Kon Kim, Korea Yoshio Kitazume, Japan Yu-Ting Kuo, Taiwan Ryohei Kuwatsuru, Japan Chang Hee Lee, Korea Chau Hung Lee, Singapore Eun Ju Lee, Korea Hak Jong Lee, Korea Hyun Lee, Korea Jeong Min Lee, Korea Jong Seok Lee, Korea Ju Hee Lee, Korea Kyoung Ho Lee, Korea Seung Soo Lee, Korea Won Jae Lee, Korea Yedaun Lee, Korea Young Hwan Lee, Korea Changhong Liang, China Joonseok Lim, Korea Gigin Lin, Taiwan Zaiyi Liu, China Shunro Matsumoto, Japan William W. Mayo-Smith, USA Ji Hye Min, Korea Manabu Minami, Japan Min Hoan Moon, Korea Hiromu Mori, Japan Takamichi Murakami, Japan Gankhuyag Ochirbat, Mongolia Young Taik Oh, Korea Raymond Oyen, Belgium Byungkwan Park, Korea Ga Eun Park, Korea

Ji Hoon Park, Korea Jung Jae Park, Korea Seong Ho Park, Korea Sumi Park, Korea Sung Yoon Park, Korea Panagiotis Prassopoulos, Greece Sung Eun Rha, Korea Hyunchul Rhim, Korea Hunkyu Ryeom, Korea ENKHBOLD Sereejav, Mongolia Sang Soo Shin, Korea Prijo Sidipratomo, Indonesia Bin Song, China Deuk Jae Sung, Korea Cher Heng Tan, Singapore Wey Chyi Teoh, Singapore Yeeliang Thian, Singapore Harriet C. Thoeny, Switzerland Erdembileg Tsevegmid, Mongolia Takahiro Tsuboyama, Japan Kazuhiko Ueda, Japan Hebert Alberto Vargas, USA Tan Duc VO, Vietnam Li-Jen Wang, Taiwan Takeyuki Watadani, Japan Dal Mo Yang, Korea Judy Yee, USA Kwon-Ha Yoon, Korea Seong Kuk Yoon, Korea Kengo Yoshimitsu, Japan Mengsu Zeng, China Huimao Zhang, China Cheng Zhou, China

Program Book

Program at a Glance Day 1 : April 21 (Fri) Time

2F GBR A

7:00 7:30

Studio G

22F GBR B&C

Studio 2

Private Hall

Registration & Break (Coffee & Bread)

7:00

Debate Session 1 (GI)

Scientific Session 1 (GU)

Refresher Course 1 (GI)

Refresher Course 2 (GU)

7:30

8:00 8:30 9:00

8:00

Interactive

8:30

Interactive

9:00

Break

9:30 10:00

9:30

Special Focus 1 (GI)

Special Focus 2 (GU)

11:30

Break Opening Ceremony Plenary Lecture

12:00 12:30

Luncheon Symposium 1

13:00

Break & Visit Scientific & Technical Exhibition 13:30 14:00

China Chapter Session

Scientific Session 2 (GU)

14:30 15:00

10:00

Scientific & Technical Exhibition Informal Presentation

10:30 11:00

10:30 11:00 11:30 12:00

ASAR EC Meeting

13:30 14:00

Scientific Session 3 (GI) 14:30 15:00

Coffee Break

15:30

ESGAR Honorary Lecture

ESUR Honorary Lecture

16:00

16:30 17:00

16:30

Special Focus 3 (GI)

17:00

Special Focus 4 (GU)

17:30 18:00

17:30

Break

18:30 19:00 19:30

12:30 13:00

15:30 16:00

Time

ASAR-ESGAR, ESUR & SAR Council Meeting

18:00 18:30 19:00

Congress Reception (Convention Hall)

19:30

20:00

20:00

20:30

20:30

21:00

21:00

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Day 2 : April 22 (Sat) Time

2F GBR A

7:00 7:30

Studio G

GBR B&C

22F

1F

Private Hall

The Grand Table

Registration & Break (Coffee & Bread) Scientific Session 4 (GI)

Debate Session 2 (GU)

Refresher Course 3 (GI)

Refresher Course 4 (GU)

7:00 7:30

8:00 8:30

8:00

Break

9:30

Mongolia Chapter Session

Special Focus 5 (GI & GU)

Mongolian Language

10:30

Break

11:00 11:30

SAR Honorary Lecture

12:00 12:30

Luncheon Symposium 2

8:30

Scientific & Technical Exhibition Informal Presentation

Interactive

9:00

10:00

Time

9:00 9:30 10:00

Hands-on Session (GU)

10:30 11:00 11:30

ASAR General Assembly ASAR New EC Meeting

13:00

12:00 12:30 13:00

Break & Visit Scientific & Technical Exhibition 13:30

13:30

14:00

Japan Chapter Session

Scientific Session 5 (GI)

14:30 15:00

17:00

Interactive Case Review Session

18:00 18:30

Interactive

Closing Ceremony

15:30 16:00 16:30 17:00 17:30 18:00 18:30

19:00

19:00

19:30

19:30

20:00

20:00

20:30 21:00

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14:30 15:00

Scientific & Technical Exhibition Informal Presentation

Special Focus 6 (GI & GU)

16:30

17:30

14:00

Scientific Session 6 (GU)

Coffee Break

15:30 16:00

Poster Presentation (E-poster)

20:30

*All the programs are in English, except the Mongolian Chapter Session on the day 2.

ACAR 2017 Busan

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Awards ACAR 2017 Awards The ACAR 2017 organizing committee is preparing various awards and prizes for those who submit abstracts to encourage scientific activity.

Young Investigator Award (YIA) - USD 500 & Certificate * Awarded to young foreign presenters who were born on or after January 1, 1971 and whose abstracts have been accepted for presentation at the scientific session or exhibition. * The award is given only once to the presenting author regardless of the number of accepted abstracts or coauthors.

Best Scientific Paper Award (BPA) - KRW 500,000 & Certificate * Awarded to primary authors of selected scientific oral presentations.

Best Scientific Exhibition Award (BEA) - Grand Prix: KRW 500,000 & Certificate Gold: KRW 300,000 & Certificate * Awarded to primary authors of selected scientific and educational exhibitions.

**Among the countries with a bilateral Tax Convention agreement with Korea, a 22% tax has to be deducted from the final amount before payment for the following countries: Afghanistan, Argentina, Belgium, Brazil, Cameron, Colombia, Costa Rica, Denmark, Georgia, Guatemala, Hong Kong, Kenya, Lebanon, Mozambique, Paraguay, Peru, Puerto Rico, Serbia, Singapore, Sudan, Suriname, Switzerland, Taiwan, Turkey, and Uruguay.

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Scientific Program in Detail Apr. 21 (Fri) Debate Session 1 (GI) Liver MR Contrast Agents: Extracellular Agents (ECA) vs Hepatobiliary Agents (HBA) 07:00-08:00

Grand Ballroom A

Chairperson: Chang Hee Lee (Korea), Kengo Yoshimitsu (Japan)

07:00-07:10 Keynote Lecture Chang Hee Lee (Korea)

Refresher Course 1 *Interactive (GI) Diagnostic Challenges-Interactive Session 08:00-09:00

Grand Ballroom A

Chairperson: Joon Koo Han (Korea), Yu-Ting Kuo (Taiwan)

07:10-07:25 ECA better than HBA Jin Young Choi (Korea)

08:00-08:20 Focal Liver Lesions in Cirrhotic/Noncirrhotic Patients Ju Hee Lee (Korea)

07:25-07:40 HBA better than ECA Musturay Karcaaltincaba (Turkey)

08:20-08:40 Solid and Cystic Lesions in Pancreas Kazuhiko Ueda (Japan)

07:40-08:00 Discussion

08:40-09:00 Diseases in the Gut Wey Chyi Teoh (Singapore)

Scienific Session 1 (GU) Genitourinary (Imaging of Female, Male and Adrenal Gland) 07:00-08:00

Studio G

Chairperson: Sung Il Jung (Korea), Young Taik Oh (Korea)

Refresher Course 2 *Interactive (GU) Case-based Reviews-Interactive Session 08:00-09:00

Studio G

Chairperson: Eun Ju Lee (Korea), Cheng Zhou (China)

07:00-07:10 A follow-up Study of Pelvic Organ Prolapse Primiparas after Vaginal Delivery Using Dynamic MRI Yujiao Zhao (China)

08:00-08:20

Adrenal Lesions Sung Il Jung (Korea)

08:20-08:40

07:10-07:20 Can MRI Diagnose the Outcome of the Hormone Therapy for Endometrial Cancer? Yumiko Oishi Tanaka (Japan)

Renal Lesions Young Taik Oh (Korea)

08:40-09:00

Solid and Cystic Lesions in Ovary Sung Eun Rha (Korea)

07:20-07:30 The MR Imaging Findings for Detecting Malignant/Borderline Tumors Associated with Endometriotic Cysts: Evaluation of Longitudinal Follow up Cases Naoko Nishio (Japan) 07:30-07:40 Pa t i e n t D o s e M o n i t o r i n g d u r i n g Hysterosalpingography with DAP Meter: Focused on the Value of Last Image Hold for Reducing Radiation Dose Myoung Seok Lee (Korea) 07:40-07:50 What MRI Features Suspect Malignant Pure Mesenchymal Uterine Tumors rather than Uterine Leiomyoma with Cystic Degeneration? Tae-Hyung Kim (Korea)

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07:50-08:00 Magnetic Resonance (MR) Imaging Characterization between Malignant and Benign Pheochromocytoma Hyoung in Choi (Korea)

ACAR 2017 Busan

Special Focus 1 (GI) Inflammatory Bowel Disease Update 09:20-10:40

Grand Ballroom A

Chairperson: Ah Young Kim (Korea), Prijo Sidipratomo (Indonesia)

09:20-09:40

Standardized Nomenclature for CTE/MRE Interpretation and Guide for Usage Seong Ho Park (Korea)

09:40-10:00

Evaluation and Monitoring of Bowel Inflammatory Severity Using CTE/MRE Se Hyung Kim (Korea)

10:00-10:20

China Chapter Session

Recent and Emerging Imaging Techniques to Evaluate IBD Yoshio Kitazume (Japan)

Chairperson: Changhong Liang (China), Cheng Zhou (China)

China Chapter Session 13:40-15:00

Grand Ballroom A

13:40-14:00 Beyond Image: Application of Radiomics in Abdominal Tumors Zaiyi Liu (China) 14:00-14:20 Renal Functional MR Imaging of Nephropathy and Beyond Shenghong Ju (China)

Special Focus 2 (GU) Prostate Imaging-challenge & Opportunity 09:20-10:40

Studio G

Chairperson: Sung Eun Rha (Korea), Harriet Thoeny (Switzerland)

14:20-14:40 Investigation of HCC with Micro Vessel Invasion via Imaging Mengsu Zeng (China)

09:20-09:40

Transrectal Ultrasound: the Present and the Future Hak Jong Lee (Korea)

09:40-10:00

mpMRI: Detection and Beyond Hebert Alberto Vargas (USA)

10:00-10:20

Advances in DWI Hebert Alberto Vargas (USA)

Scientific Session 2 (GU)

10:20-10:40

Strategy for Active Surveillance Deuk Jae Sung (Korea)

Genitourinary (Kidney: Functional Evaluation and Lesion Characterization)

Plenary Lecture 11:20-12:00

Grand Ballroom A Asian Society of Abdominal Radiology: Past, Present and Future Byung Ihn Choi (Korea)

Luncheon Symposium 1 12:00-13:00

14:40-15:00 A Comparative Study of CT Colonography using Low Dose Protocol in Patients with Colorectal Cancer: Assessment of Image Quality, Radiation Dose and CTC Findings Huimao Zhang (China)

13:30-15:00

Chairperson: Myeong-Jin Kim (Korea), Bin Song (China)

11:20-12:00

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10:20-10:40

Evaluation and Monitoring of Bowel Inflammation Using Clinical, Laboratory, and Endoscopic Parameters Jae Hee Cheon (Korea)

Grand Ballroom A

Chairperson: Jeong Yeon Cho (Korea) 12:00-13:00 CI-AKI (Contrast-induced Acute Kidney Injury) Young Taik Oh (Korea)

Studio G

Chairperson: Byung Chul Kang (Korea), Hebert Alberto Vargas (USA)

13:30-13:40 Investigation of Protective Effects of Hydration and Atorvastatin against Contrast- Induced Kidney Injury in DN Rabbits Using BOLD MRI Xin Zhang (China) 13:40-13:50 Use of Iterative Reconstruction and a Small Contrast Volume in Rabbit Kidney CT: Comparison with Conven-tional Protocol Rihyeon Kim (Korea) 13:50-14:00 Assessment of Transplanted Kidney in the Early Phase by Functional MRI and its Correlation to Renal Function Wei Zhang (China) 14:00-14:10 Renal Fat Quantification in Patients with Diabetic Nephropathy Using Multi-echo VIBE Dixon MRI Lei Chu (China)

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14:10-14:20 Diagnostic Accuracy of Combined ThreeDimensional Contrast-Enhanced MR Pulmonary Angiography and Renal Venography At 3.0-T for Embolism Detection in Patients with Nephrotic Syndrome Yan E Zhao (China) 14:20-14:30 IVIM-derived Parameters for Differentiating Fat Poor Angiomyolipomas from Clear Cell Renal Cell Carcinomas: Comparison between Single-Section and WholeLesion Histogram Analysis Yuqin Ding (China) 14:30-14:40 Differentiation of Renal Cell Carcinoma Subtypes with Different Iodine Quantification Methods on Dual-Energy CT: Areal Versus Volumetric Analysis Chenchen Dai (China) 14:40-14:50 Vascular Occlusion Effects of Endovascular Radiofrequency Wire Electrode on Rabbit Renal Artery: Comparison with PVA Embolization Daehyun Hwang (Korea)

Private Hall

Chairperson: Hyunchul Rhim (Korea), Seung Yon Baek (Korea)

13:30-13:40 Comparison of Convolutional Neural Networks and Sparsitiy Based Learned Dictionaries for Automatic Detection of Liver Metastases in CT Examinations Eyal Klang (Israel) 13:40-13:50 Evaluation of Diagnostic Performance of CT with Stomach Protocol Compared with Endoscopic Ultrasonography in Diagnosing Gastric Subepithelial Tumors Joon Chul Ra (Korea) 13:50-14:00 The Comparative Study on the Intravoxel Incoherent Motion Imaging and Real-Time Shear Wave Elastrography for Evaluating Severity of Hepatic Fibrosis Qinghong Duan (China) 14:00-14:10 Virtual Monoenergetic Dual-Energy CT Enterography: Optimization of keV Settings and the Added Value for Small Bowel Diseases Sang Min Lee (Korea)

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14:20-14:30 MR Fistulography- Structured Report-ing A Novel Method to Reduce Miscommunication and Misinterpretation of Perianal Fistulae Kishan Ashok Bhagwat (India) 14:30-14:40 Gd-BOPTA Liver-Renal Excretion Shift in MRI Assessment of Liver Function in Patients Maksim Shorikov (Russia) 14:40-14:50 Benefit of Low Kev and Adaptive Statistical Iterative Reconstruction (ASIR) Technique for Small BMI Patients Zheng Zhu (China)

ESGAR Honorary Lecture 15:20-16:20

Grand Ballroom A

Chairperson: Dal Mo Yang (Korea), Takamichi Murakami (Japan)

Scientific Session 3 (GI) 13:30-15:00

14:10-14:20 Evaluation of Liver Iron Content in NonAlcoholic Fatty Liver Disease Using Mdixon-Quant Magnetic Resonance Imaging Youe Ree Kim (Korea)

15:20-15:50 The Clinical Role of Imaging in Peritoneal Carcinomatosis Panagiotis Prassopoulos (Greece) 15:50-16:20 Imaging anal Fistula Steve Halligan (UK)

ESUR Honorary Lecture 15:20-16:20

Studio G

Chairperson: Jeong Yeon Cho (Korea), Yi-Hong Chou (Taiwan)

15:20-15:50 Imaging of the Prostate based on PIRADS Version 2 Harriet Thoeny (Switzerland) 15:50-16:20 Prostate MRI: DWI for Cancer Detection and Assessment of Aggressiveness Raymond Oyen (Belgium)

Diagnosis of HCC: Regional Differences and Similarities 16:20-17:50

Grand Ballroom A

Chairperson: Won Jae Lee (Korea), Hiromu Mori (Japan)

16:20-16:35 USA Perspectives Jay Heiken (USA)

16:50-17:05 Taiwan Perspectives Yi-You Chiou (Taiwan)

Special Focus 4 (GU) Guidelines on Contrast Media Studio G

Chairperson: Jae Young Byun (Korea), Manabu Minami (Japan)

16:50-17:05 Singapore Perspectives Cher Heng Tan (Singapore) 17:05-17:20 Korea Perspectives Min Hoan Moon (Korea) 17:20-17:50 Panel Discussion by Delegates

Grand Ballroom A

07:20-07:30 Evaluation of Hepatic Steatosis Using Acoustic Structure Quantification Ultrasound in a Rat Model: Comparison with Pathology and MR Spectroscopy Jae Seok Bae (Korea)

17:20-17:50 Panel Discussion by Delegates

16:35-16:50 Japan Perspectives Ryohei Kuwatsuru (Japan)

07:00-08:00

Chairperson: Chul Soon Choi (Korea), Kyoung Ho Lee (Korea)

07:10-07:20 Staging Liver Fibrosis using Diffusional Kurtosis Imaging Li Yang (China)

17:05-17:20 Korea Perspectives Myeong-Jin Kim (Korea)

16:20-16:35 Taiwan Perspectives Yi-Hong Chou (Taiwan)

Scienific Session 4 (GU)

07:00-07:10 Pe r f o r m a n c e o f N o r m a l A p p e n d i x Detection: Comparison of Low-Dose and Regular-Dose Unenhanced Computed Tomography Hwi Ryong Park (Korea)

16:35-16:50 Japan Perspectives Takamichi Murakami (Japan)

16:20-17:50

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Apr. 22 (Sat)

Special Focus 3 (GI)

07:30-07:40 Sensitivity and Specificity of Gadoxetic Acid-Enhanced MRI in Diagnosing Hepatocellular Carcinoma: Optimal Dynamic Phase for Evaluation of Washout Appearance Chansik An (Korea) 07:40-07:50 Degree of Hepatic Steatosis in Chronic Hepatitis C Patients: Comparison with Healthy and Chronic Hepatitis B Patients Chul Soon Choi (Korea) 07:50-08:00 Evaluation of Metastases to Pancreas using Computed Tomography - Single Centre Experience with Review of Literature Prashant Sarda (India)

Debate Session 2 (GU) GU-CT Urography: Nephrographic Phase (NP) vs Excretory Phase (EP) 07:00-08:00

Studio G

Chairperson: Sun Ho Kim (Korea), Takehiko Gokan (Japan)

07:00-07:10 Keynote Lecture Takehiko Gokan (Japan) 07:10-07:25 NP better than EP Li-Jen Wang (Taiwan) 07:25-07:40 EP better than NP Chau Hung Lee (Singapore) 07:40-08:00 Discussion

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Refresher Course 3 *Interactive (GI)

Mongolia Chapter Session

Diagnostic Challenges-Interactive Session

Mongolia Chapter Session

08:00-09:00

Grand Ballroom A

Chairperson: Jae-Joon Chung (Korea), Mengsu Zeng (China)

08:00-08:20 Imaging Presentation of Abdominal Autoimmune Disease Manabu Minami (Japan) 08:20-08:40 Imaging Spectrum of Nonepithelial GI Tract Tumor Yedaun Lee (Korea) 08:40-09:00 IPMN: Malignant Risk Stratification with Imaging Ji Hye Min (Korea)

09:20-10:40

Studio G

Chairperson: Enkhbold Sereejav (Mongolia), Erdembileg Tsevegmid (Mongolia)

09:20-09:40 Primovist Liver MRI Experience in Mongolia Undrakh-Erdene Erdenebold (Mongolia) 09:40-10:00 Differential Diagnosis of Liver Cancer Gankhuyag Ochirbat (Mongolia) 10:00-10:20 CT Findings of Adrenal Gland Diseases Erdembileg Tsevegmid (Mongolia) 10:20-10:40 Differential Diagnosis of Pancreatic Lesions Erdenebulgan Batmunkh (Mongolia)

Refresher Course 4 (GU) Hands-on Session (GU)

Urologic Imaging 08:00-09:00

Studio G

Chairperson: You Me Kim (Korea), Yi-You Chiou (Taiwan)

09:00-12:00

Private Hall

08:00-08:20 Testicular and Scrotal Diseases Seong Kuk Yoon (Korea)

Moderator: Chan Kyo Kim (Korea), Jurgen Futterer (Netherlands)

08:20-08:40 Retroperitoneal Diseases Kyeong Ah Kim (Korea)

09:00-09:10

Anatomy & Biology Deuk Jae Sung (Korea)

08:40-09:00 Urothelial Tumors Bum Sang Cho (Korea)

09:10-09:30

Cases

09:30-09:40

Recommended MRI Protocols Sung Il Jung (Korea)

Special Focus 5 (GI & GU)

09:40-10:00

Cases

CT Technique Update

10:00-10:15

PI-RADS v2: Critical Points Jurgen Futterer (Netherlands)

10:15-10:35

Cases

10:35-10:45

Break

Double Reduction in Radiation Dose and Contrast Amount Ji Hoon Park (Korea)

10:45-11:00

Pitfalls in MRI Interpretation Jurgen Futterer (Netherlands)

11:00-11:20

Cases

09:40-10:00

CT Urography: How Can We Apply to Evaluate Urolithiasis and Urothelial Cancer? Takehiko Gokan (Japan)

11:20-11:30

Pre-biopsy MRI: When and How Chan Kyo Kim (Korea)

10:00-10:20

Dual Energy CT in Abdominal Imaging Satoshi Goshima (Japan)

11:30-11:50

Cases

11:50-12:00

Q&A

10:20-10:40

Dual Energy CT in Renal Diseases Jung Jae Park (Korea)

09:20-10:40

Grand Ballroom A

Chairperson: Yong Yeon Jeong (Korea), Cher Heng Tan (Singapore)

09:20-09:40

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Urologic Imaging

ACAR 2017 Busan

11:00-12:00

Scientific Session 5 (GI) Grand Ballroom A

Chairperson: Jeong Min Lee (Korea), Changhong Liang (China)

11:00-11:30

State-of-the-art CT Colonography Judy Yee (USA)

11:30-12:00

Revisiting CT Radiation in 2017, Updates from the US William W. Mayo-Smith (USA)

13:30-15:00

12:00-13:00

13:30-13:40

Quantitative Study of Liver Iron Deposition with Dual-Energy CT on A Rabbit Model Tao Li (China)

13:40-13:50

Comprehensive Analysis of the Predictors of Microvascular Invasion in Hepatocellular Carcinoma: Diffusion Kurtosis Imaging (DKI), Together with Other Potential Risk Factors WenTao Wang (China)

13:50-14:00

Histopathologic Characteristics of Morphologically Aggressive Hepatocellular Carcinoma with Irregular Rim-Like Arterial Phase Enhancement Hyungjin Rhee (Korea)

14:00-14:10

A c o u s t i c R a d i a t i o n Fo r c e I m p u l s e Elastography for Assessment of Sinusoidal Obstructive Syndrome (Hepatic VenoOcclusive Disease) in Rat Chemotherapy Models So Hyun Park (Korea)

14:10-14:20

LOCAT (Low-dOse CT for acute Appendicitis Trial): Pragmatic Non-inferiority Trial Comparing Clinical Outcomes Following L o w - v s. S t a n d a r d - d o s e A b d o m e n Computed Tomography as the First-line Imaging Test in Adolescents and Young Adults with Suspected Append Hyuk Jung Kim (Korea)

14:20-14:30

Measurement Reproducibility of Parameters Derived by Introvoxel Incoherent Motion Diffusion-Weighted MRI Imaging in Rectal Cancer Meng Yankai (China)

14:30-14:40

The Role of Diffusion Weighted Imaging (DWI) in the Assessment of Jejunal Crohn’s Disease, MR-Enterography Compared to Video Capsule Endoscopy Michal Marianne Amitai (Israel)

14:40-14:50

Mannose-Coated Gadolinium Nanoliposomes for Improved MR Imaging in Acute Pancreatitis Bing Tian (China)

Grand Ballroom A

Chairperson: Joon Koo Han (Korea)

12:00-12:30 A long Short Story of GBCAs, From wellknown NSF to New Hypersignals Harriet Thoeny (Switzerland) 12:30-13:00 Is the Incidence of Allergic Reaction by Different Iodide Contrast Media are Equal? Jungwon Park (Korea)

Japan Chapter Session Japan Chapter Session 13:30-15:00

Grand Ballroom A

Chairperson: Hiromu Mori (Japan), Manabu Minami (Japan)

13:30-14:00 Hepato-Biliary, Pancreatic, and Perirenal Lymphatic System: 3T MRI Imaging Shunro Matsumoto (Japan) 14:00-14:30 D i f f e r e n t i a l D i a g n o s i s o f B e n i g n , Borderline, and Malignant Ovarian Tumors with MRI And PET/CT Takahiro Tsuboyama (Japan) 14:30-15:00 Peritumoral Enhancement for Assessing Endometrial Cancer on Dynamic Contrast Enhanced MR Imaging: its Pathological Findings and Clinical Significance Shinya Fujii (Japan)

Studio G

Chairperson: Hae Jeong Jeon (Korea), Hunkyu Ryeom (Korea)

Luncheon Symposium 2 Contrast Media: The Safety Update

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SAR Honorary Lecture

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Scientific Session 6 (GU)

Special Focus 6 (GI & GU)

Gentourinary (Evaluation of Prostate, Kidney, Bladder and Other Tumors)

Oncologic Imaging: Challenges in Response Evaluation

13:30-15:00

Chairperson: Kwon-Ha Yoon (Korea), Tan Duc VO (Vietnam)

Private Hall

Chairperson: Hak Jong Lee (Korea), Chan Kyo Kim (Korea)

13:30-13:40 Prediction of Insignificant Prostate Cancer in Potential Candidates of Active Surveillance: Utility of PI-RADS Version 2 Jae Hyun Yim (Korea) 13:40-13:50 Developing a New PI-RADS v2-based Nomogram for Forecasting High-grade Prostate Cancer Xiangke Niu (China) 13:50-14:00 The Optimal Virtual Non-contrast (VNC) Image Induced Post-Enhance CT Image for Evaluation of Kidney Neoplasm: In Comparison to True Non-contrast (TNC) Image Pinggui Lei (China)

Grand Ballroom A

15:20-15:40 Rectal Cancer: Radiologic-Pathologic Correlation of Down-Staging after Neoadjuvant Treatment Yeeliang Thian (Singapore) 15:40-16:00 Prostate Cancer: How Should We Evaluate Response after Radiotherapy or Androgen Deprivation Therapy? Sung Yoon Park (Korea) 16:00-16:20 Pancreatic Cancer: How Should We Evaluate Response after Neoadjuvant Treatment? Hye Jin Kim (Korea) 16:20-16:40 HCC: What Criteria Should We use in the Condition of Diverse Treatment? Seung Soo Lee (Korea)

14:00-14:10 Assessment of Cold Sink Effect in Renal Cryoablation by Analyzing Radiographic Ice Ball on Computed Tomography Sung Yoon Park (Korea)

Interactive Case Review Session

14:10-14:20 Prediction of High Grade Ureteral Urothelial Carcinoma : CT and Histologic Correlation Sungtae Hwang (Korea)

Panalists: Gigin Lin (Taiwan)

14:20-14:30 mpMRI for Cervical Cancer Histological Type and Grade Evaluation Maksim Shorikov (Russia) 14:30-14:40 mpMRI for Detection of Cervical Cancer Recurrence after Chempradiotherapy Maksim Shorikov (Russia) 14:40-14:50 Diagnosis of Retroperitoneal Tumors Analysis of MRI features Zheng Zhu (China) 14:50-15:00 Clinical Characteristics and MSCT Diagnostic Value of Testicular Non-Tumorous Lesions Qiang Gao (China)

Poster Presentation 13:30-15:00

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15:20-16:50

ACAR 2017 Busan

Grand Ballroom B & C

16:50-18:10

Grand Ballroom A

Moderator: Joon-Il Choi (Korea), Hak Jong Lee (Korea) Takeyuki Watadani (Japan) Jong Seok Lee (Korea) Byungkwan Park (Korea)

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Official & Social Programs Official Programs Opening Ceremony April 21(Fri), 2017, 11:00-11:20 Opening President’s Address Welcome Address Congratulatory Address Closing & Introduction of Plenary Lecture

Grand Ballroom A, 2F, Haeundae Grand Hotel Jeong Yeon Cho (Secretary General, ACAR 2017) Seung Hyup Kim (President, ACAR 2017) Myeong-Jin Kim (Chair, Organizing Committee, ACAR 2017) Hiromu Mori (President, ASAR) Jeong Yeon Cho (Secretary General, ACAR 2017)

Closing Ceremony April 22(Sat), 2017, 18:10-18:40 Opening ACAR 2017 Closing Report Interactive Case Review Session & Best Scientific Paper Award Ceremony Farewell Address Introduction of ACAR 2019 Closing

Grand Ballroom A, 2F, Haeundae Grand Hotel Jeong Yeon Cho (Secretary General, ACAR 2017) Myeong-Jin Kim (Chair, Organizing Committee, ACAR 2017)

Seung Hyup Kim (President, ACAR 2017) Representative of ACAR 2019 Jeong Yeon Cho (Secretary General, ACAR 2017)

Social Programs Congress Reception Registered participants and their accompanying persons who have ticketed for the Congress Reception in advance can attend this social event. April 21(Fri), 2017, 18:30-20:40 Welcome Address ASAR Gold Medalist Award Ceremony Introduction of Honorary Lecturers Honorary Fellowship Ceremony Best Scientific Exhibition Award Ceremony Introduction of Major Sponsors Toast Dinner & Performance Lucky Draw

Convention Hall, 2F, Haeundae Grand Hotel Seung Hyup Kim (President, ACAR 2017) Byung Ihn Choi (Korea) Yi-Hong Chou (Taiwan) Harriet Thoeny (Switzerland) Myeong-Jin Kim (Chair, Organizing Committee, ACAR 2017) Jeong Yeon Cho (Secretary General, ACAR 2017) Jae Hoon Lim (Advisory Board, ACAR 2017)

Join Lucky Draw to win a prize! Participants of the Congress Reception may have a chance to win a Lucky Draw prize. Please tear out Congress Reception coupon and put it in the Lucky Draw box at the entrance.

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Congress Information Congress Overview Congress Name Date Place Theme

The 6th Asian Congress of Abdominal Radiology April 21(Fri) - 22(Sat), 2017 Haeundae Grand Hotel, Busan, Korea Toward Systematic and Standardized Abdominal Imaging Asian Society of Abdominal Radiology, ASAR Korean Society of Abdominal Radiology, KSAR Korean Society of Urogenital Radiology, KSUR English www.acar2017.org

Hosted by Official Language Website

Registration All Participants must visit the registration desk prior to attending the session. Date Operating Hours Place

April 21(Fri) - 22(Sat), 2017 06:30-18:30 Grand Ballroom Lobby, 2F

On-Site Registration Category Physician Trainee Non-physician Accompanying Person

Onsite Registration Fee USD 200 USD 120 USD 160 USD 50

※ One day registration is available at onsite (USD 100) ※ Accompanying person will also have full access to all session rooms and exhibition hall

Nametag A nametag will be provided upon your arrival at the registration desk. It is compulsory to wear the nametag at all times throughout the congress. Please be noted that admission to session rooms, exhibition halls, lounges, and social events is restricted without a nametag.

Badge Color Identification PARTICIPANT INVITED GUEST

24

ACAR 2017 Busan

: Regular Participants (Physician, Trainee, Non-Physician) : Invited Speakers, Chairperson and Panelists.

Scan your Nametag at Barcode System!

Program Book

Please make sure to scan your nametag before entering the session room. The data will be used to figure out the attendance rate. *내국인 참가자의 경우, 학술장 출입과 퇴장 시 반드시 네임택 스캔을 하셔야 대한의사협회 연수평점이 인정됩니다. (일일 최대 6평점 이수 가능)

Barcode Attendance System location

출석확인 평점 인정 기준 구분 2시간 초과 3시간 초과 4시간 초과 5시간 초과

인정평점 3평점 4평점 5평점 6평점

Facilities Preview Room Date Operating Hours Place

April 21(Fri) - 22(Sat), 2017 06:30-18:30 Studio 1, 2F

Business Meeting Room Date Operating Hours Place

April 21(Fri) - 22(Sat), 2017 06:30-18:30 Studio 2, 2F

Rest Lounge Rest lounge will be open for all participants to have a rest throughout the congress. Date Operating Hours Place

April 21(Fri) - 22(Sat), 2017 06:30-18:30 Studio 3, 2F

※ Please note that the rest Lounge will be temporarily closed at 12:30 until 14:00 on April 21 (Fri), 2017.

Exhibition Hall Date Operating Hours Place

April 21(Fri) - 22(Sat), 2017 08:00-18:30 Grand Ballroom B&C, 2F

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Other Information

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Information (Lost & Found) Registration desk staffs will be in service during congress period and provide the relevant information on the congress. Any missing or unintended belongings will be taken to the registration desk as well.

Wi-Fi Free Wi-Fi will be provided for all participants of ACAR 2017. Network Name: grandhotel (No password is required)

Parking Any participants with their own vehicles are permitted to park on hotel parking area with free of charges.

Food & Beverages Coffee Station Coffee Station will provide fresh coffee and cookies with free of charges throughout the congress. Date Operating Hours Place

April 21(Fri) - 22(Sat), 2017 08:00-18:30 Grand Ballroom B&C, 2F

Coffee Break Fresh coffee and cookie will be served in the Grand Ballroom Lobby between sessions. Date Serving Time Place

26

ACAR 2017 Busan

April 21(Fri) - 22(Sat), 2017 15:00-15:20 Grand Ballroom Lobby, 2F

Program Book

Luncheon Symposia Lunch will be provided during industry sponsored luncheon symposia. Luncheon Symposium 1 April 21(Fri), 2017 12:00-13:00 Grand Ballroom A, 2F

Date Time Place

Date Time Place

Luncheon Symposium 2 April 22(Sat), 2017 12:00-13:00 Grand Ballroom A, 2F

Sponsored by

Sponsored by

Hotel Information Class ★★★★★ ★★ ★★ ★★★★

Hotel Name Haeundae Grand Hotel IBIS Budget Ambassador Haeundae Toyoko Inn Busan Haeundae No.2 SHILLA STAY HAEUNDAE

Phone No. +82-51-740-0114 +82-51-901-1100 +82-51-741-1045 +82-2-2230-0700

Distance to venue Main Venue 2 minutes on Foot (127m) 4 minutes on Foot (238m) 5 minutes on Foot (357m)

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Transportation From Venue to three International Airports (Gimhae, Gimpo and Incheon)

*KTX - Korea Train Express *AREX - Airport Railroad Express

Taxi Taxis are a popular means of public transportation in Korea. There are basically two types of taxis: regular and deluxe. The fare system is based on both distance and time. Regular taxi fares are 2,800 Korean won (USD 2.5) for the first 2km and 100 won will be added for each additional 144m. If you want to take a taxi, please ask the hotel concierge desk as they will order a taxi for you upon request.

28

ACAR 2017 Busan

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Useful Tips in Korea Currency Major foreign currencies that can be exchanged at banks, hotels and the airport include the US dollar, Japanese Yen, Euro, and UK sterling. Most hotels, restaurants, and shops accept major international credit cards including Visa, American Express, Diners Club, Master Card, and JCB. Foreign-issued ATM cards may have limited use. USD 1 = Approximately KRW 1,170 ATM (Automated Teller Machines) Travelers who carry internationally recognized credit cards can get a cash advance in Korea Won from Automated Teller Machines (ATMs) installed at airports, major hotels, department stores, subway stations and tourist attractions. ATMs are in operation 24 hours a day. Most large stores, hotels and restaurants in Korea accept major international credit cards. However it is advisable to carry some cash, since many smaller establishments and stores are unlikely to accept credit cards. Time The Korean local time is 9 hours ahead of GMT with no daylight savings time. Weather (Busan) The climate in Busan in April ranges approximately between 12-20℃ International Call International dialing code in Busan, Korea is +82-51(Area code). Please omit (0) when dialing from overseas. Value-Added Tax (VAT) Value-Added Tax (VAT) is levied on most goods and services at a standard rate of 10% and is included in the retail price. In tourist hotels, this 10% tax applies to rooms, meals and other services and is included in the bill. Tipping Tipping is not a regular practice in Korea. Service charges are included in your bill for rooms, meals and other services at hotels and upscale restaurants. Koreans occasionally do tip when they are especially pleased with the service they receive. Business hours Government office hours are usually from 09:00 am to 06:00 pm on weekdays and closed on weekends. Banks are open from 09:00 am to 04:00 pm on weekdays and closed on Saturday and Sunday. Major stores are open every day from 10:30 am to 08:00 pm including Sundays. Emergency Numbers (without an area code) * 1339: Medical Emergency (provides interpretation services for English, Japanese and Chinese) * 119: Emergencies for Fire, Rescue & Hospital Services * 112: Police * 129: First Aid Services Liability and Insurance The Organizing Committee will take no liability for personal injuries sustained by, or for loss or damage to property belonging to congress participants, either during of as a result of the congress, It is, therefore, advised that participants arrange their own personal health, accident and travel insurance.

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Technical Exhibition Exhibition Overview The ACAR 2017 Exhibition will be held in conjunction with the congress from April 21 (Fri) - 22 (Sat), 2017. Participants will have the opportunity to learn about the latest innovations in the field of abdominal radiology. Place Operating Hours Scale

Grand Ballroom B, C and lobby, 2F April 21(Fri) - 22(Sat), 2017, 08:00-18:30 16 Exhibitors with 34 Booths

Exhibition Layout (Grand Ballroom, 2F)

Informal Session

Session Room (GI) Grand Ballroom A

Exhibition Hall Grand Ballroom B&C

Exhibition Hall Grand Ballroom Lobby

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ACAR 2017 Busan

Exhibitors

Gold Sponsor

Silver Sponsor

Bronze Sponsor

Exhibitor

Booth No. G-01 G-02 G-03 G-04 G-05 G-06 G-07 S-01 S-02 S-03 S-04 B-01 B-02 E-01 E-02 E-03

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Category

Company Name Dongkook Pharmaceutical Co., Ltd. Guerbet Korea Ltd. Siemens Healthineers Korea GE Healthcare Korea Co., Ltd. Bracco Imaging Korea, Ltd. Bayer Korea Ltd. Central Medical Service Corea Co., Ltd. Imaging Solutions Korea Ltd. Shinki Commercial Co., Ltd. SAMSUNG Philips Korea Ltd. Toshiba Medical Systems Korea Co., Ltd. Accuzen Co., Ltd. DongSeo MediCare Co., Ltd. Withhealthcare Dasol Life Science Inc.

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Directory G-01

Dongkook Pharmaceutical

Siemens Healthcare Ltd.

Product or Service of Company

Product or Service of Company

Radiology Related Product (Contrast Media- Pamiray, Ashexol, Tomoray, Uniray)

Radiology Related Product (CT, MRI, US etc.)

President Correspondence Tel Fax E-mail Website

Mr. Ki-Ho Cheong Ms. So-Hyun Sun +82-2-3452-0965 +82-2-3453-7542 [email protected] www.dkpharm.co.kr



-The mostly widely used Iopamidol product(Pamiray®) in Korea. -Optimum safety of products line-up for contrast-induced nephropathy and N.S.F. -Exporting contrast media to EU and Japan about 20 million US dollar in 2015. -Our company motto is creation, harmony and trust. Creation means the origination of higher value added by development of the individual’s abilities. Harmony means the harmonious teamwork of these abilities. Based on the principal above, the things gain from the fulfillment of customer expectation is the trust. In addition, our final goal - respect for life and healthy life of the nation - settled the policy of the company, Human & Life.

Guerbet Korea Ltd.

G-02

Product or Service of Company

32

G-03

President Correspondence Tel Fax E-mail Website

Mr. HyeonGu Park Ms. Naejung Hwang +82-2-3450-7685 +82-2-3450-7882 [email protected] www.healthcare.siemens.co.kr

Siemens Healthineers is the separately managed healthcare business of Siemens AG enabling healthcare providers worldwide to meet their current challenges and to excel in their respective environments. A leader in medical technology, Siemens Healthineers is constantly innovating its portfolio of products and services in its core areas of diagnostic and therapeutic imaging and in laboratory diagnostics and molecular medicine. Siemens Healthineers is also actively developing its digital health services and enterprise services. To help customers succeed in today’s dynamic healthcare marketplace, Siemens Healthineers is championing new business models that maximize opportunity and minimize risk for healthcare providers. In fiscal 2016, which ended on September 30, 2016, Siemens Healthineers generated revenue of €13.5 billion and net income of over €2.3 billion and has about 46,000 employees worldwide.

G-04

GE Healthcare Korea

Contrast media & Medical device (Xenetix, ScanBag, Dotarem, Lipiodol, FlowSens)

Product or Service of Company

President Correspondence Tel Fax E-mail Website

President Correspondence Tel Fax E-mail Website

Mr. Mathieu Elie Ms. Soo Yeun Lee +82-2-3453-1212 +82-2-3453-2634 [email protected] www.guerbet.co.kr

Contrast media, CT, MRI, U/S, X-ray

Mr. Sia Moussavi Ms. Soojin Jung +82-2-6201-3799 +82-2-6201-3801 [email protected] www.gehealthcare.co.kr





Guerbet is a pharmaceutical group specialized in medical imaging providing contrast media for diagnostic purposes. The company’s origin in linked to Marcel Guerbet’s discovery of the first organic iodinated contrast medium in 1901, Lipiodol® The Guerbet company was created in 1926 by Andre Guerbet. Since then, the company’s significant growth has been driven by regular innovations in medical imaging technologies accompanied by the introduction of new contrast media. Over the last 46 years, Guerbet’s own research and development resulted in the launching of four major products: Telebrix®, Dotarem® and Xenetix®. And Guerbet successfully launch CT injector, Flowsens®

GE Healthcare provides transformational medical technologies and services to meet the demand for increased access, enhanced quality and more affordable healthcare around the world. GE works on things that matter - great people and technologies taking on tough challenges. From medical imaging, software & IT, patient monitoring and diagnostics to drug discovery, biopharmaceutical manufacturing technologies and performance improvement solutions, GE Healthcare helps medical professionals deliver great healthcare to their patients.

ACAR 2017 Busan

Bracco Imaging Korea

G-07

Central Medical Service Co., Ltd

Product or Service of Company

Product or Service of Company

Radiology Related Product (Contrast Media, Injector, etc.)

BONOREX (Radiology Related Product (CT, MRI, etc.)

President Correspondence Tel Fax E-mail Website

President Correspondence Tel Fax E-mail Website

Mr. Taesook Yoo Ms. Hyunjin Lee +82-2-2222-3500 +82-2-2222-3551 [email protected] www.braccoimaging.com

Mr. Kim Boogeun Ms. Kim Yejin +82-2-3394-5161 +82-2-3394-5165 [email protected] www.cmscorea.co.kr





Headquartered in Milan, Italy, Bracco Imaging S.p.A. is one of the World's leading companies in the diagnostic imaging business. Bracco Imaging provides a large portfolio of imaging agents and it operates in over 90 markets worldwide, either directly or indirectly through subsidiaries, joint ventures, license and distribution partnership agreements. Bracco Imaging Korea, the fully owned subsidiary of Bracco Imaging, markets Iomeron® and Iopamiro® (2 non-ionic monomeric iodinated agents for CT and cardiology) MultiHance® (a high relaxivity agent for MRA and MRI of the CNS, the liver and the breast), ProHance® (a Macrocyclic MRI agent) and SonoVue® (a contrast agent for ultrasound exams). Also, Bracco Imaging Korea provides EmpowerCTA ® (CT injector), EmpowerMR® (MR injector) and CT Exprès™ though a local distributor.

Central Medical Service Co., LTD. (CMS) was established in 2006. CMS is in steady growth in contrast media market for 10 years. CMS is providing BONOREX (Iohexol) for CT and BONO-I (Gd-DTPA) for MRI. CMS is expanding business area to CT injection device which is called “CT motion”. It permits injection directly from the media containers, reduces cost for disposables and allows rapid patient changeovers in the case of high examination volume. CT motion is technologically innovative product which gives a brilliant combination of hygienic safety, efficiency, and flexibility.

S-01

Program Book

G-05

Imaging Solutions Korea Ltd.

(Business Partners: Reyon Pharmaceutical Co., D&D Hunex)

Bayer Korea Ltd.

G-06

Product or Service of Company CT

Product or Service of Company Radiology Related Products (CT, MRI, US, etc.) Contrast Agents, Drugs and Pharmaceuticals Other (Medical devices, Software)

President Correspondence Tel Fax E-mail Website

Mr. Dimitrios Kamitsos Mr. Jae Hwan Lee +82-2-829-6600 +82-2-831-3791 [email protected] https://radiology.bayer.com/

Bayer Radiology as the worldwide market leader in diagnostic imaging, we continue to drive forward innovation in CT & MRI. We are providing Ultravist ®, an well-balanced contrast medium for CT and X-ray, Gadovist® 1.0, only existing 1.0M MR contrast medium and Primovist®, a liver-specific MR contrast medium. From 2012, Bayer Radiology continuously evolves portfolio: including contrast media, we expand our business with Radiation Dose Management System, RadimetricsTM Enterprise Platform and medical devices, Medrad® for your daily clinical work, but also for your research. Through this combination, Bayer Radiology hopes to offer you innovative solutions in radiology to improve medical procedures and patient care.

President Correspondence Tel Fax E-mail Website

Mr. Mathieu Elie Ms. So-Hee Lee (Rosa) +82-2-3404-2000 (Main) +82-70-8644-9090 +82-2-3453-2634 [email protected] www.reyonpharm.co.kr

Imaging Solutions Korea's CMDS business manufactures and markets a comprehensive array of diagnostic imaging products engineered to work across the radiology suite - computed tomography, magnetic resonance imaging, X-ray and cardiac catheterization - as well as the company's urological imaging system and related components. The company's prefilled contrast media syringe was the first of its kind and, along with its contrast delivery systems, helps simplify contrast media injections and improve technologists' efficiency, while also helping to reduce or prevent certain patient risks.

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S-02

Shinki Commercial Co., Ltd

Philips Korea

S-04

Product or Service of Company

Product or Service of Company

Radiology Related Product (Ultrasound, CR, DR, Digital Mammography) Medical IT (3D Software for Diagnosis & Surgery Planning)

Radiology Related Product (CT, MRI, US etc.)

President Correspondence Tel Fax E-mail Website

Mr. Sang Kyu Lee Mr. Hong Sik Kim +82-10-9060-1106 +82-2-521-8683 [email protected] www.shinkisa.com

Since 1974, SHINKI is a leading provider of the top notch medical imaging, industrial and veterinary product with utmost service & consulting to our client. With headquarters in Seoul and four regional branches, SHINKI serves over 3,400 medical and more than 1,500 industrial customers nationwide.

SAMSUNG

S-03

President Correspondence Tel Fax E-mail Website

Mr. Dominique Oh Ms. Jungmi Ehim +82-2-709-1434 +82-2-709-1445 [email protected] www.philips.co.kr

Royal Philips is a diversified health and well-being company, focused on improving people’s lives through meaningful innovation in the areas of Healthcare, Consumer Lifestyle and Lighting. At Philips, we understand that providing quality healthcare means balancing many needs. You need high quality images for fast, confident decision-making. Seamless collaboration is critical so that information gets to the right person quickly. And patients demand quality, more personalized care that addresses their needs for comfort and dose management. It’s a complicated formula. Through our ongoing collaboration with you, we are committed to solving your challenges by delivering meaningful innovations in CT, MR, Interventional X-ray, Ultrasound, Patient monitoring, critical care & emergency solution and Informatics solutions. Together, we create the future of healthcare.

Product or Service of Company Radiology Related Product (Ultrasound, Digital Radiography, etc.)

President Website

Mr. Dong-Soo Jun http://www.samsungmedicalsolution.com

B-01

Toshiba Medical Systems Korea Co., Ltd.

Samsung Healthcare : Combining leading technology to improve the quality of people’s lives Samsung is committed to create a new future for medical professionals and patients with a mission to bring health and well-being to people’s lives. Integrating its leading expertise in display, IT, mobile and electronics, our vision is to bring confident diagnosis, cost-effective solutions and improved workflow to customers. Specializing in diagnostic imaging devices and in-vitro diagnostics, Samsung’s innovation in healthcare is led by Samsung Electronics’ Health & Medical Equipment Business and Samsung Medison, with more than 1,600 employees over 100 countries.

Product or Service of Company Radiology Related Product (CT, MRI, US etc.)

President Correspondence Tel Fax E-mail Website

Mr. Charles Ju Ms. Soyoung Park +82-2-860-8028 +82-2-855-8052 [email protected] www.toshiba-medical.co.kr

Toshiba Medical Systems Corporation is a leading worldwide provider of medical diagnostic imaging systems and comprehensive medical solutions, such as CT, X-ray and vascular, ultrasound, and MRI systems, as well as information systems for medical institutions. Toshiba Medical Systems Corporation has been providing medical products for about 100 years. We have responded to customers’ need by providing a wide range of high-value solutions in over 135 countries around the globe. As a subsidiary of Toshiba Medical Systems Corporation, Toshiba Medical Systems Korea markets, sells, distributes and services radiology and cardiovascular systems, including CT, MR, ultrasound, X-ray and cardiovascular equipment, and coordinates clinical diagnostic imaging research for all modalities in Korea.

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ACAR 2017 Busan

E-02

WITH HEALTHCARE Co., LTD.

Product or Service of Company

Product or Service of Company

Contrast Agents

Contrast Agents, Drugs and Pharmaceuticals Other (Medical devices)

President Correspondence Tel Fax E-mail Website

Mr. Tae Young Lee Ms. Soo Yeon Park +82-2-799-0201 +82-2-798-6613 [email protected] www.accuzen.com

ACCUZEN founded in 2005, has grown to become an expert pharmaceutical company with advanced technology in contrast media. ACCUZEN is a frontier company in the field of contrast media, manufacturing a line of first-class contrast media products for X-rays, CT, MRI. Through constant efforts in research, we will not stop developing to provide a reliable health service. We pursue to maintain our innovative and creative entrepreneurship by constantly challenging ourselves. We strive to do our best to fulfill our mission to meet the customers’ needs.

E-01

DongSeo MediCare Co., Ltd.

Product or Service of Company Radiology Related Product (US)

President Correspondence Tel Fax E-mail Website

Mr. Sang-Han Kim Mr. Jin-Kook Kim +82-31-423-3845 +82-31-8018-2181 [email protected] www.dsmed.kr

DongSeo Medicare is the Best Healthcare Company since 1995 establishment. We've been selling Ultrasound Imaging system-Aixplorer Model of Supersonic Imagine Ltd. Ultrasound system of Supersonic Imagine is best selling system in the domestic market. Sales of DongSeo Medicare is developed with a goal of establishing the best quality and service.

President Correspondence Tel Fax E-mail Website

Program Book

ACCUZEN

B-02

Mr. Myunghwan Son Ms. DaBin Seok +82-2-2253-7718 +82-2-2253-7715 [email protected] www.withhealthcare.com

Withhealthcare was founded in 2007 and since then we has been made our greater effort for being a specializing company in Korean contrast media sales. Needless to say, our best value is the trust on the customer. Our main product, “Omnihexol” (lohexol) a low-osmolality, nonionic contrast media for CT and angiograpy is made by Korea United Pharmacy which had improved the manufacturing patent using ultrasonic process line to minimize the amounts of impurities. So that it could reduce the side effect that is possible to happen. For its stability, safety, and high purity, both patients and physicians can be satisfied by enabling accurate imaging. The safety of “Omnihexol” is proved by two big hospitals in Korea Seoul National University and Yonsei Severance in 2010. Better Safety, Trust, and Confidence for patients and clients, we will always do our best.

E-03

Dasol Life Science Inc. Dasol Life Science

Product or Service of Company Contrast Agents, Drugs and Pharmaceuticals

President Correspondence Tel Fax E-mail Website

Mr. Booick Jung Ms. Sera Lim +82-2-3437-9220 +82-2-3437-9330 [email protected] www.dasol-ls.com

Dasol Life Science is a start-up company as a Korean partner of SANOCHEMIA Pharmazeutika AG for X-ray contrast media and imaging agents. SANOCHEMIA, based on Austria, is a specialty pharmaceuticals company covering diagnostics, neurodegeneration, pain and oncology from development, manufacturing to sales & marketing. Its expertise lies in rapidly and efficiently tapping previously unexploited potential in known substances by means of new administration forms and application technologies. Thanks to this expertise and others, SANOCHEMIA has business internationally from EU to US, China & India and also have distribution contracts for Spain, Portugal and America with radiological products. SCANLUX®, the 1st X-ray contrast media with Dasol, has over 10 year clinical experiences in many countries and also got FDA approval in 2010.

The 6th Asian Congress of Abdominal Radiology

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Program Book

Sponsors The ACAR 2017 organizing committee would like to express our sincere appreciation for your great support as one of our distinguished sponsors.

Gold

Silver

Bronze

Supporting Organizations

Special Thanks to Luncheon Symposium 2, Congress Reception Welcome Dinner, Farewell Dinner Congress Bag, Lanyard Luncheon Symposium 1

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ACAR 2017 Busan

Floor Plan (Grand Ballroom, 2F) E-poster Informal Session

Grand Ballroom B&C

Registration

1

Take the elevator to go to 1F - The Grand Table (Restaurant) 22F - Private Hall (Session Room)

Session Room (GI) Grand Ballroom A

Exhibition Hall Grand Ballroom Lobby Stairs

1 Elevator Preview Room Studio 1

Hotel Lobby, 1F Business Meeting Room Studio 2

Congress Reception Convention Hall

Rest Lounge Studio 3

Main Entrance

Session Room Studio G

ID: grandhotel (no password required)

Free parking @ hotel parking area

All speakers must visit preview room (4 hours before your presentation)

- Coffee Station @ Grand Ballroom B&C - Coffee Break at 15:00-15:20 everyday

For any inquiries, Visit Registration desk

GI = Gastrointestinal Radiology GU = Genitourinary Radiology

Abstract

April 21 (Fri) Debate Session 1

DS 01: Liver MR Contrast Agents: Extracellular Agents (ECA) vs Hepatobiliary Agents (HBA) Grand Ballroom A Chairperson: Chang Hee Lee (Korea), Kengo Yoshimitsu (Japan)

Keynote Lecture Chang Hee Lee, Korea

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DS 01_GI_02

ECA better than HBA Jin-Young Choi, Korea

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DS 01_GI_03

HBA better than ECA Musturay Karcaaltincaba, Turkey

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07:00-07:10 07:10-07:25 07:25-07:40

Refresher Course 1 *Interactive

RC 01: Diagnostic Challenges-Interactive Session

Chairperson: Joon Koo Han (Korea), Yu-Ting Kuo (Taiwan)

Grand Ballroom A

Focal Liver Lesions in Cirrhotic / Noncirrhotic Patients Ju Hee Lee, Korea

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RC 01_GI_02

Solid and Cystic Lesions in Pancreas Kazuhiko Ueda, Japan

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RC 01_GI_03

Diseases in the Gut Wey Chyi Teoh, Singapore

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RC 01_GI_01

08:00-08:20

08:20-08:40 08:40-09:00

Refresher Course 2 *Interactive

RC 02: Case-based Reviews-Interactive Session Chairperson: Eun Ju Lee (Korea), Cheng Zhou (China)

Studio G

RC 02_GU_01

Adrenal Lesions Sung Il Jung, Korea

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RC 02_GU_02

Renal Lesions Young Taik Oh, Korea

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RC 02_GU_03

Solid and Cystic Lesions in Ovary Sung Eun Rha, Korea

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08:00-08:20 08:20-08:40 08:40-09:00

Special Focus 1

SF 01: Inflammatory Bowel Disease Update

Chairperson: Ah Young Kim (Korea), Prijo Sidipratomo (Indonesia) SF 01_GI_01

09:20-09:40 SF 01_GI_02

09:40-10:00

Invited Lectures (21, Fri)

DS 01_GI_01

Grand Ballroom A

Standardized Nomenclature for CTE / MRE Interpretation and Guide for Usage Seong Ho Park, Korea Evaluation and Monitoring of Bowel Inflammatory Severity Using CTE / MRE Se Hyung Kim, Korea

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SF 01_GI_03

10:00-10:20 SF 01_GI_04

10:20-10:40

Evaluation and Monitoring of Bowel Inflammation Using Clinical, Laboratory, and Endoscopic Parameters Jae Hee Cheon, Korea Recent and Emerging Imaging Techniques to Evaluate IBD Yoshio Kitazume, Japan

Special Focus 2

SF 02: Prostate Imaging-challenge & Opportunity

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Studio G

Chairperson: Sung Eun Rha (Korea), Harriet C. Thoeny (Switzerland)

Invited Lectures (21, Fri)

SF 02_GU_01

Transrectal Ultrasound: The Present and the Future Hak Jong Lee, Korea

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SF 02_GU_02

mpMRI: Detection and Beyond Hebert Alberto Vargas, USA

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SF 02_GU_03

Advances in DWI Hebert Alberto Vargas, USA

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SF 02_GU_04

Strategy for Active Surveillance Deuk Jae Sung, Korea

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09:20-09:40 09:40-10:00 10:00-10:20 10:20-10:40

Plenary Lecture

PL 01: Plenary Lecture

Chairperson: Myeong-Jin Kim (Korea), Bin Song (China) PL 01

11:20-12:00

Grand Ballroom A

Asian Society of Abdominal Radiology: Past, Present and Future Byung Ihn Choi, Korea

China Chapter Session

CS 01: China Chapter Session

Chairperson: Changhong Liang (China), Cheng Zhou (China)

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Grand Ballroom A

CS 01_01

Beyond Image: Application of Radiomics in Abdominal Tumors Zaiyi Liu, China

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CS 01_02

Renal Functional MR Imaging of Nephropathy and Beyond Shenghong Ju, China

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CS 01_03

Investigation of HCC with Micro Vessel Invasion via Imaging Mengsu Zeng, China

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CS 01_04

A Comparative Study of CT Colonography with 256-MDCT Using Low Dose Protocol in Patients with Colorectal Cancer: Assessment of Radiation Dose, Image Quality, and CTC Findings Huimao Zhang, China

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13:40-14:00 14:00-14:20 14:20-14:40 14:40-15:00

ESGAR Honorary Lecture

HL 01: ESGAR Honorary Lecture

Chairperson: Dal Mo Yang (Korea), Takamichi Murakami (Japan) HL 01_01

15:20-15:50

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The Clinical Role of Imaging in Peritoneal Carcinomatosis Panagiotis Prassopoulos, Greece

ACAR 2017 Busan

Grand Ballroom A 70

HL 01_02

15:50-16:20

Imaging Anal Fistula Steve Halligan, United Kingdom

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ESUR Honorary Lecture

HL 02: ESUR Honorary Lecture

Chairperson: Jeong Yeon Cho (Korea), Yi-Hong Chou (Taiwan) HL 02_01

15:20-15:50

Studio G

Imaging of the Prostate Based on PIRADS Version 2 Harriet C. Thoeny, Switzerland

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Prostate MRI: DWI for Cancer Detection and Assessment of Aggressiveness 15:50-16:20 Raymond Oyen, Belgium

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HL 02_02

SF 03: Diagnosis of HCC: Regional Differences and Similarities Chairperson: Won Jae Lee (Korea), Hiromu Mori (Japan)

Grand Ballroom A

SF 03_GI_01 USA Perspectives

74

SF 03_GI_02 Japan Perspectives

75

SF 03_GI_03 Taiwan Perspective

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SF 03_GI_04 Korea Perspectives

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16:20-16:35 16:35-16:50 16:50-17:05 17:05-17:20

Jay Heiken, USA

Takmichi Murakami, Japan Yi-You Chiou, Taiwan Myeong-Jin Kim, Korea

Special Focus 4

SF 04: Guidelines on Contrast Media

Chairperson: Jae Young Byun (Korea), Manabu Minami (Japan)

Studio G

SF 04_GU_01 Taiwan Perspectives

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SF 04_GU_02 Japan Perspectives

80

SF 04_GU_03 Singapore Perspectives

81

SF 04_GU_04 Korea Perspectives

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16:20-16:35 16:35-16:50 16:50-17:05 17:05-17:20

Invited Lectures (21, Fri)

Special Focus 3

Yi-Hong Chou, Taiwan

Ryohei Kuwatsuru, Japan Cher Heng Tan, Singapore Min Hoan Moon, Korea

April 22 (Sat) Debate Session 2

DS 02: GU-CT Urography: Nephrographic Phase (NP) vs Excretory Phase (EP) Studio G Chairperson: Sun Ho Kim (Korea), Takehiko Gokan (Japan) DS 02_GU_01 Keynote Lecture

07:00-07:10

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Takehiko Gokan, Japan

The 6th Asian Congress of Abdominal Radiology

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DS 02_GU_02 NP Better than EP

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DS 02_GU_03 EP Better than NP

85

07:10-07:25 07:25-07:40

Li-Jen Wang, Taiwan Chau Hung Lee, Singapore

Refresher Course 3 *Interactive

RC 03: Diagnostic Challenges-Interactive Session

Chairperson: Jae-Joon Chung (Korea), Mengsu Zeng (China)

Grand Ballroom A

Invited Lectures (22, Sat)

RC 03_GI_01 Imaging Presentation of Abdominal Autoimmune Disease

86

RC 03_GI_02 Imaging Spectrum of Nonepithelial GI Tract Tumor

87

RC 03_GI_03 IPMN: Malignant Risk Stratification with Imaging

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08:00-08:20 08:20-08:40 08:40-09:00

Manabu Minami, Japan Yedaun Lee, Korea

Ji Hye Min, Korea

Refresher Course 4

RC 04: Urologic Imaging

Studio G

Chairperson: You Me Kim (Korea), Yi-You Chiou (Taiwan) RC 04_GU_01 Testicular and Scrotal Diseases

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RC 04_GU_02 Retroperitoneal Diseases

90

RC 04_GU_03 Urothelial Tumors

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08:00-08:20 08:20-08:40 08:40-09:00

Seong Kuk Yoon, Korea Kyeong Ah Kim, Korea Bum Sang Cho, Korea

Special Focus 5

SF 05: CT Technique Update

Chairperson: Yong Yeon Jeong (Korea), Cher Heng Tan (Singapore)

Grand Ballroom A

SF 05_GI_GU_01 Double Reduction in Radiation Dose and Contrast Amount

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SF 05_GI_GU_02 CT Urography: How Can We Apply to Evaluate Urolithiasis and

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09:20-09:40

Ji Hoon Park, Korea

Urothelial Cancer? 09:40-10:00 Takehiko Gokan, Japan SF 05_GI_GU_03 Dual Energy CT in Abdominal Imaging Satoshi Goshima, Japan 10:00-10:20 SF 05_GI_GU_04 Dual Energy CT in Renal Diseases Jung Jae Park, Korea 10:20-10:40

Mongolia Chapter Session

CS 02: Mongolia Chapter Session

Chairperson: Enkhbold Sereejav (Mongolia), Erdembileg Tsevegmid (Mongolia)

Primovist Liver MRI Experience in Mongolia 09:20-09:40 Undrakh-Erdene Erdenebold, Mongolia

CS 02_01

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95 96

Studio G 97

CS 02_02

Differential Diagnosis of Liver Cancer Gankhuyag Ochirbat, Mongolia

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CS 02_03

CT Findings of Adrenal Gland Diseases Erdembileg Tsevegmid, Mongolia

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CS 02_04

Differential Diagnosis of Pancreatic Lesions Erdenebulgan Batmunkh, Mongolia

09:40-10:00 10:00-10:20 10:20-10:40

SAR Honorary Lecture

HL 03: SAR Honorary Lecture

Grand Ballroom A

State-of-the-Art CT Colonography 11:00-11:30 Judy Yee, USA HL 03_02 Revisiting CT Radiation in 2017: Updates from the US William W. Mayo-Smith, USA 11:30-12:00

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HL 03_01

Japan Chapter Session

CS 03: Japan Chapter Session

Chairperson: Hiromu Mori (Japan), Manabu Minami (Japan)

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Grand Ballroom A

Hepato-biliary, Pancreatic, and Perirenal Lymphatic System: 13:30-14:00 3T MRI Imaging Shunro Matsumoto, Japan Differential Diagnosis of Benign, Borderline, and Malignant Ovarian CS 03_02 Tumors with MRI and PET/CT 14:00-14:30 Takahiro Tsuboyama, Japan CS 03_03 Peritumoral Enhancement for Assessing Endometrial Cancer on Dynamic Contrast Enhanced MR imaging: Its Pathological Findings and Clinical 14:30-15:00 Significance Shinya Fujii, Japan CS 03_01

Special Focus 6

SF 06: Oncologic Imaging: Challenges in Response Evaluation Chairperson: Kwon-Ha Yoon (Korea), Tan Duc VO (Vietnam) SF 06_GI_GU_01

15:20-15:40

SF 06_GI_GU_02

15:40-16:00

SF 06_GI_GU_03

16:00-16:20

SF 06_GI_GU_04

16:20-16:40

Invited Lectures (22, Sat)

Chairperson: Jeong Min Lee (Korea), Changhong Liang (China)

100

104 105 106

Grand Ballroom A

Rectal Cancer: Radiologic-Patholgic Correlation of Down-Staging after Neoadjuvant Treatment Yeeliang Thian, Singapore Prostate Cancer: How Should We Evaluate Response after Radiotherapy or Androgen Deprivation Therapy? Sung Yoon Park, Korea Pancreatic Cancer: How Should We Evaluate Response after Neoadjuvant Treatment? Hye Jin Kim, Korea HCC: What Criteria Should We Use in the Condition of Diverse Treatment? Seung Soo Lee, Korea

107 108 109 110

The 6th Asian Congress of Abdominal Radiology

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Debate Session 1

07:00-08:00, April 21 (Fri), Grand Ballroom A

Liver MR Contrast Agents: Extracellular Agents (ECA) vs Hepatobiliary Agents (HBA) DS 01_GI_01 07:00-07:10

Keynote Lecture Chang Hee Lee

Korea University Guro Hospital, Korea

Invited Lectures (21, Fri)

Extracellular agents are distributed within the extracellular interstitial space. Gadolinium chelates, which are formed by the chelation of gadolinium to organic ligands such as diethylenetriaminepentaacetic acid, constitute a class of extra-cellular agents. Although several formulations are available with different ligands, their pharmacologic characteristics and imaging considerations are essentially identical. There are multiple indications for the use of extracellular contrast agents in MR imaging of the liver. These include lesion detection, lesion characterization, and liver vasculature assessment. Gadolinium also may be helpful for the MR imaging evaluation of patients with known or suspected cholangitis. Hepatocytespecific MR contrast agents initially distribute in the extracellular fluid (ECF) compartment, similar to ECF contrast agents, and are subsequently taken up by functioning hepatocytes and excreted in the bile. Consequently, these agents provide dual benefits of dynamic imaging as well as delayed hepatobiliary phase

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ACAR 2017 Busan

(HBP) imaging. Among the commercially available hepatocytespecific agents, Gadoxetic acid (Primovist outside the United States or Eovist in the United States, Bayer Healthcare, Berlin, Germany; formerly known as Gd-EOB-DTPA) is currently used widely because of the rapid acquisition of HBP images (10~20 min after contrast injection) and more intense HBP enhancement. It’s strength include strong washout, higher diagnostic performance, detection of early HCC, easy diagnosis of FNH, and potential imaging biomarker. However, HBA enhanced MRI has several weakness, such as weak arterial enhancement, spoiled arterial phase, difficult diagnosis of high flow hemangioma, and expensive prices. In this lecture, I will talk about “representative pearls and pitfalls” of the GD-EOB-DTPA Liver MRI, comparing ECA enhanced liver MRI. After finishing two debates, participants will be have a firm knowledge about ECA and HBA enhanced liver MRI.

Debate Session 1

07:00-08:00, April 21 (Fri), Grand Ballroom A

Liver MR Contrast Agents: Extracellular Agents (ECA) vs Hepatobiliary Agents (HBA) DS 01_GI_02 07:10-07:25

ECA better than HBA Jin-Young Choi

Yonsei University College of Medicine, Korea can show hypointensity on the transitional phase and/or hepatobiliary phase images, which is referred to “pseudowashout”. One should carefully consider other features of hemangiomas to prevent misdiagnosis of HCC in these cases. If necessary, further evaluation with multiphasic MRI using ECA, multiphasic CT, or a contrast-enhanced ultrasound can be performed. In the background of cirrhosis of chronic hepatitis, hypervascular intrahepatic cholangiocarcinomas (ICC) can mimic HCC based on gadoxetic acid enhanced MRI enhancement pattern. On ECA-enhanced imaging, ICC typically show peripheral or weak enhancement on the hepatic arterial phase and centripetal or persistent enhancement on the portal venous and delayed phase. However, ICC, particularly small ones, develop on the background of liver cirrhosis or chronic hepatitis showing arterial enhancement and/ or a venous washout pattern more frequently than those in the normal liver. ECA-enhanced dynamic MRI had a great success for the diagnosis of typical or hypervascular HCC with extremely high specificity. However, it is challenging to distinguish early or hypovascular HCC from premalignant dysplastic nodules using conventional approach. Signal intensity on the hepatobiliary phase images of gadoxetic acid enhanced-MRI can be useful in the differentiation between HCCs and DNs and/or benign cirrhotic nodules, although there are substantial overlaps in the imaging features. It is also possible to distinguish hypovascular early HCC because early HCC are well visualized as hypointense lesions on hepatobiliary phase. Another advantage of gadoxetic acid MRI is the ability to distinguish arterioportal shunts from hypervascular HCC. Other applications of gadoxetic acid-enhanced MRI include prediction of microvascular invasion and increased sensitivity for residual HCC after locoregional therapy.

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Invited Lectures (21, Fri)

MR contrast agents shorten T1 and T2 by increasing the corresponding proton relaxation rates due to dipole-dipole interactions between contrast agents and protons. MR contrast agents can be classified on the basis of their biodistribution: extracellular contrast agent (ECA) and hepatobiliary contrast agent (HCA). ECA is lower molecular weight extracellular complex that equilibrates rapidly between the intravascular and interstitial space. HCA is distributed not only to the extracellular space, but is also selectively taken up by functioning hepatocytes and excreted into bile and kidneys. Extensive studies have shown the benefit of HCA in the diagnosis of focal hepatic lesions. However, there are some technical issues regarding the use of HCA. The relatively short bolus transit time of gadoxetic acid resulting from the reduced dose requires particular attention to the arterial phase acquisition. Modified injection strategies have been proposed to lengthen the arterial bolus transit time. Two injection strategies that have shown favorable results for arterial phase imaging include reducing the injection flow rate and diluting the contrast agent. Lower recommended dose for gadoxetic acid (0.025 mmol/kg) may lead to weaker arterial enhancement. In addition, insufficient liver enhancement on hepatobiliary phase images with gadoxetic acid can be seen in patients with moderate liver dysfunction. In patients with severe liver disease, the hepatobiliary phase may be of limited utility. For differential diagnosis of focal hepatic lesions, HCA-enhanced MRI should be interpreted with caution. Hyperintensity on hepatobiliary phase in hepatic tumors usually suggests benign hepatocellular lesions such as focal nodular hyperplasia (FNH) or FNH-like nodules and some hepatocellular adenomas. However, some HCCs may show hyperintensity on hepatobiliary phase. Some hemangiomas, especially high flow types,

Debate Session 1

07:00-08:00, April 21 (Fri), Grand Ballroom A

Liver MR Contrast Agents: Extracellular Agents (ECA) vs Hepatobiliary Agents (HBA) DS 01_GI_03 07:25-07:40

HBA better than ECA Musturay Karcaaltincaba

Hacettepe University School of Medicine, Turkey

Invited Lectures (21, Fri)

Gadoxetic acid is increasingly used for liver MRI indications. Recent advances and new concepts regarding Gd-EOB-DTPA will be reviewed by cases. The role of gadoxetic acid in diagnosis of unseen or uncharacterizable liver pathologies will be emphasized. The lecture will be two parts including focal lesions and diffuse pathologies. In cases with focal lesions focal nodular hyperplasia (FNH), hepatic adenoma with beta catenin activation,

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focal hyperfunction, HCC, FNH-like lesions, serum amyloid A containing hepatic nodules. Diffuse pathologies will include cases with total, lobar, segmental, focal liver dysfunction due to various etiologies. Gadoxetic acid opened new horizons in liver imaging in terms of biopsyless diagnosis of focal and diffuse pathologies and assessment of liver function.

Refresher Course 1 *Interactive

08:00-09:00, April 21 (Fri), Grand Ballroom A

Diagnostic Challenges-Interactive Session RC 01_GI_01 08:00-08:20

Focal Liver Lesions in Cirrhotic / Noncirrhotic Patients Ju Hee Lee

National Cancer Center, Korea include focal nodular hyperplasia, hepatocellular adenoma, and regenerative nodules from various etiologies. Hepatic cysts, biliary hamartomas, and biliary cystadenomas are benign lesions of cholangiocellular origin. Benign mesenchymal tumors include hemangioma, angiomyolipoma, and other rarely encountered tumors such as schwannoma. Primary malignant neoplasms of the liver are classi-fied by the cell of origin. HCC is the most common primary liver cancer and intrahepatic cholangiocarcinoma is the second. Biliary cystadenocarcinoma, epithelioid hemangioendothelioma, and sarcomas are rare malignant tumors of the liver. Overall, metastases are the most frequent malignant tumors of the liver, except in patients with preexisting cirrhosis, in whom primary malignant neoplasms are more frequent. Hepatic metastases have various imaging features and resemble the imaging findings of the primary tumors. Liver is one of the most commonly involved organs of lymphomas, and majority of the cases are secondary lymphoma. The evaluation of focal liver masses should be systematic and include both radiologic appearance and clinical information to help narrow the differential diagnosis. References 1. Choi Ed. Radiology illustrated hepatobiliary and pancreatic radiology. Heidelberg: Springer. 2. Gore RM, Levine MS. Textbook of Gastrointestinal radiology, 4th ed. Philadelphia, PA: ELSEVIER Saunders.

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Invited Lectures (21, Fri)

Liver cirrhosis is characterized by irreversible remodeling of the hepatic architecture with bridging fibrosis and formation of a spectrum of hepatocellular nodules, including regenerative nodules (RNs), dysplastic nodules (DNs), and hepatocellular carcinomas (HCCs). These cirrhosis- associated hepatocellular nodules result from the localized proliferation of hepatocytes and their supporting stroma in response to liver injury. The strongest predisposing factor for developing HCC is liver cirrhosis, and approximately 80 % of cases of HCC have been developed in a cirrhotic liver. Therefore, it is important to diagnose HCC within a cirrhotic liver. Intrahepatic cholangiocarcinoma (IHCC) is the second most common primary liver cancer following HCC. Its predisposing factors also include chronic hepatitis and liver cirrhosis. And enhancement pattern of IHCC shows thin rim enhancement like atypical pattern of HCC. In case of small IHCC, arterial enhancement can be seen. Combined hepatocellular-cholangiocarcinomas can show enhancement pattern of HCC or IHCC. Focal confluent hepatic fibrosis observed in endstage liver disease can be mass-like in appearance and therefore may be mistaken for HCC. Although incidence of metastases is relatively low in cirrhotic liver, hypervascular metastases can mimic HCC when they developed in cirrhotic liver. Each of the cellular components of the liver can give rise to both benign and malignant tumors. Whether the liver is cirrhosis or not, various tumors can occur and the differential diagnosis is necessary. Benign liver masses of hepatocellular origin

Refresher Course 1 *Interactive

08:00-09:00, April 21 (Fri), Grand Ballroom A

Diagnostic Challenges-Interactive Session RC 01_GI_02 08:20-08:40

Solid and Cystic Lesions in Pancreas Kazuhiko Ueda

The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan

Invited Lectures (21, Fri)

Learning objectives: 1) Discuss findings of cases with solid and cystic lesions in pancreas which will be presented in this course.

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ACAR 2017 Busan

2) Discuss keys to diagnosis of the lesions. 3) Describe and review the imaging features of solid and cystic lesions in pancreas.

Refresher Course 1 *Interactive

08:00-09:00, April 21 (Fri), Grand Ballroom A

Diagnostic Challenges-Interactive Session RC 01_GI_03 08:40-09:00

Diseases in the Gut Wey Chyi Teoh

Changi General Hospital, Singapore and timing for any surgical management is very much dependent on identifying the underlying cause and/or potential complications, it is important that the radiologist is well versed in evaluating the imaging findings of bowel obstruction. Through a series of interesting and challenging cases, the following are the intended learning objectives of this lecture: - Differentiating the common aetiologies of mechanical bowel obstruction, and further dividing them into intrinsic or extrinsic causes. - Knowing and describing essential information that the surgeons will need to know. - Identify urgent findings that will require the imminent surgical attention.

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Invited Lectures (21, Fri)

Bowel loop dilatation is one of the most commonly encountered findings in screening abdominal radiographs of patients who present to the emergency department with abdominal pain. Causes of bowel loop dilatation can be divided broadly as functional in nature or secondary to mechanical obstruction. The former can usually be managed conservatively while the later may require close observation or definitive surgical management. Early advance modality imaging of such patients is now considered crucial and essential for patient’s management. Computed tomography is the most commonly used modality for adult patients in the emergency setting as it is highly accurate when interpreted by an experienced reader. As the need

Refresher Course 2 *Interactive

08:00-09:00, April 21 (Fri), Studio G

Case-based Reviews-Interactive Session RC 02_GU_01 08:00-08:20

Adrenal Lesions Sung Il Jung

Konkuk University Medical Center, Korea

Invited Lectures (21, Fri)

The widespread use of imaging has led to increase the detection of incidental adrenal lesions and has highlighted the importance of accurate characterization of adrenal lesions. Indeed, incidental adrenal masses in patients with no history of malignancy or endocrine abnormality are present in approximately 5% of all abdominal CT examinations. However, the majority of such masses are adrenal adenoma which has benign nature. Adrenal adenoma usually has abundant intracytoplasmic lipid and vascular network. These characteristics of cell compositions and vascularity in adrenal adenoma can be important background for performing the dedicated CT protocol including precontrast, early enhanced and delayed enhanced scan and chemical shift MR technique in order to diagnose it. In addition to adrenal adenoma, rare benign and malignant tumors and tumors-like lesions can also occur in adrenal gland. Benign adrenal tumors include myelolipoma, schwannoma, ganglioneuroma, hemangioma, lymphangioma, oncocytoma or pheochromocytoma. Myelolipoma can be easily detected on precontrast CT scan because of its macroscopic fat. Neurogenic tumors such as schwannoma or ganglioneuroma appear to be relatively well-circumscribed homogeneous solid mass. Hemangioma or lymphangioma is very rare and we can occasionally see plebolith or nodular delayed enhancement in hemangioma and multiple thin-walled septum in lymphangioma.

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Oncocytoma is also rare tumor and has nonspecific imaging features. Because pheochromocytoma arises from chromaffin cells in the adrenal medulla, it can cause adrenergic excess related symptoms. Classically, pheochromocytoma tends to have heterogeneous strong enhancement and cystic change or calcification is not uncommon. However, no imaging features can reliably distinguish the more common benign pheochromocytoma from the rare malignant one besides direct local invasion into adjacent organs or distant metastasis. Malignant adrenal tumors include cortical carcinoma, sarcoma, lymphoma, or metastasis. The imaging features of cortical carcinoma or sarcoma are nonspecific, and they are likely to be seen as bulky heterogeneously enhanced mass with necrosis or hemorrhage. Lymphoma can occur in focal or diffuse patterns with homogeneous enhancement and bilateral involvement is common. Imaging appearances of adrenal metastasis are nonspecific, so metastasis should be considered unless evident clues of benign adrenal lesions can be detected. Tumors-like adrenal lesions include hemorrhage, cyst, or adrenal cortical hyperplasia. Adrenal hemorrhage or cyst can contain various patterns of hematoma or fluid. Adrenal cortical hyperplasia can manifest as either a diffuse or nodular forms. In conclusion, sophisticated radiologic imaging can provide useful informations for the detection, diagnosis and treatment of adrenal mass.

Refresher Course 2 *Interactive

08:00-09:00, April 21 (Fri), Studio G

Case-based Reviews-Interactive Session RC 02_GU_02 08:20-08:40

Renal Lesions Young Taik Oh

Severance Hospital, Korea we need sometimes additional investigation for more confident diagnosis due to size (too small to evaluate completely), artifacts (pseudoenhanceent), inadequite imaging protocol and/or suboptimal imaging quality. In this session, some helpful tips of CT image features and additional role of US and MR imaging of renal lesion will be introduced. Additionally, the percutaneous biopsy of small renal masses will be briefly discussed.

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In this session, several interesting cases of the kidney will be presented. The main foci of this session are to be familiar with representative renal lesions and learn the helpful tips for differentiating them. Nowadays CT is the choice of imaging modality for the evaluation of renal lesion. To differentiate benign from the malignant renal lesion is crucial for planning patients’ treatment. Although imaging diagnosis can be done with typical imaging features.

Refresher Course 2 *Interactive

08:00-09:00, April 21 (Fri), Studio G

Case-based Reviews-Interactive Session RC 02_GU_03 08:40-09:00

Solid and Cystic Lesions in Ovary Sung Eun Rha

The Catholic University of Korea, Seoul St. Mary's Hospital, Korea

Invited Lectures (21, Fri)

On the basis of the morphologic characteristics, ovarian masses can be classified into one of four categories; (1) unilocular cystic mass, (2) multilocular cystic mass, (3) cystic and solid mass, and (4) predominantly solid mass. In general, a complex cystic and solid ovarian mass strongly suggests the possibility of malignancy. However, many benign lesions including mature cystic teratoma, struma ovarii, sclerosing stromal tumor, fibothecoma, and tuboovarian abscess, etc also appear as a complex cystic and solid mass.

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Therefore, imaging findings should be evaluated in correlation with patient’s age, menopausal status, history, clinical finding and tumor markers to make an accurate differential diagnosis. On the basis of signal intensity characteristics, several specific pathologic types of ovarian masses can be accurately diagnosed with MR imaging findings. This talk will present several representative complex solid and cystic ovarian lesions to review differential diagnosis and to learn about imaging strategies for avoiding pitfalls.

Special Focus 1

09:20-10:40, April 21 (Fri), Grand Ballroom A

Inflammatory Bowel Disease Update SF 01_GI_01 09:20-09:40

Standardized Nomenclature for CTE / MRE Interpretation and Guide for Usage Seong Ho Park

Asan Medical Center, Korea

1. Standardized nomenclature for interpreting and reporting CT/MR enterography Although CT/MR enterography are widely used in the management of Crohn’s disease, it is also true that there is a relatively substantial heterogeneity and inconsistency in the way that the examinations are interpreted and reported, both within an institution and across different centers. Consistency in the interpretation and reporting of the imaging studies would be especially crucial for accurate, consistent patient management and follow-up. Standardized definitions and nomenclature for the findings and disease phenotypes noted on CT/ MR enterography have been drafted through an international multidisciplinary effort. 2. Assessment of bowel inflammatory severity using CT/MR enterography Despite numerous CT/MR enterography-based scoring systems to (semi-)quantitatively measure

bowel inflammatory severity of Crohn’s disease reported in the literature, there are still not any robust widely accepted CT/MR enterography parameters to measure bowel inflammatory severity of Crohn’s disease. MaRIA score (2, 4) and London score (5) are arguably the two most popular scoring systems thus far. However, they are not well accepted in daily clinical practice. A more robust imaging parameter or interpretation system should be made. 3. Evaluation of bowel damage and fibrosis In contrast with the high diagnostic performance of CT/MR enterography for diagnosing bowel inflammation of Crohn’s disease, neither CT enterography nor MR enterography can accurately diagnose and measure bowel damage and fibrosis. More research studies are needed in this area. Conclusions CT/MR enterography provide accurate diagnostic information regarding bowel inflammation and complications of Crohn’s disease. However, there is currently a lack of robust imaging parameters to be used in daily practice to (semi-)quantitatively measure bowel inflammatory severity. CT/MR enterography also has a limited role in evaluating bowel damage and fibrosis. Therefore, more work is needed in these areas in the future. Standardized nomenclature for CT/MR enterography findings will enhance the clinical impact and utility of CT/ MR enterography in the management of Crohn’s disease.

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Invited Lectures (21, Fri)

Introduction CT enterography and MR enterography are currently the primary imaging methods to evaluate the small bowel. Of them, the importance of MR enterography is increasingly recognized related to the concerns about radiation exposure from CT enterography. The purpose of this lecture is to summarize the current status and role of the two examinations and to discuss CT/MR enterography-related issues to be resolved, hopefully, in the near future. Given the time limitation, this lecture will focus on the imaging evaluation of Crohn’s disease and will skip other diseases.

Special Focus 1

09:20-10:40, April 21 (Fri), Grand Ballroom A

Inflammatory Bowel Disease Update SF 01_GI_02 09:40-10:00

Evaluation and Monitoring of Bowel Inflammatory Severity Using CTE / MRE Se Hyung Kim

Seoul National University Hospital, Korea

Invited Lectures (21, Fri)

Assessment of inflammatory activity in Crohn’s disease (CD) has become crucial to drive therapeutic choices and monitor their effect [1]. In the past, this evaluation was based on clinical indexes, mainly the Crohn’s Disease Activity Index (CDAI), integrated by laboratory parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and orosomucoids, and endoscopic findings [2, 3]. However, endoscopy can assess only mucosal inflammation which might not be enough in a transmural disease like CD [4]. Recently, many papers have suggested the role of radiologic techniques such as computed tomography enteroclysis or enterography (CTE) and magnetic resonance enteroclysis or enterography (MRE) not only in detecting extramural complications but also in the evaluation of disease activity. According to a recent meta-analysis investigating the accuracy for grading CD activity using CT, MR, and US [5], CT and MRI showed similar accuracy in grading CD activity (86% and 84% on a per-patient basis, respectively) and no significant differences in accuracy were seen between these two modalities. Data on over- and under-grading also showed similar results for CT and MRI. Furthermore, US showed significantly lower accuracy (44%) in the per-patient data than both CT and MRI. In many previous articles, MR features used for the determination of disease activity include bowel wall thickness, T1 enhancement and pattern, T2 mural signal intensity, mucosal abnormalities, presence of inflammatory mass, stenosis (with pre-stenotic dilatation), lymph nodes, abscesses, and fistulas [68]. CT features used for disease activity evaluation are as follows: mucosal irregularity, mucosal or mural enhancement, wall thickening, double halo sign, ulceration, edema of the mesenteric fat, engorged vasa recta, lymphadenopathy, fistula, and abscess [9-11]. In this lecture, I would like to discuss CTE/MRE

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technique, imaging criteria and grading for CD activity, and reported diagnostic performance of CTE/MRE for determining disease activity. And finally I will touch on challenges and future directions of CTE/MRE. References 1. Biancone L, De Nigris F, Del Vecchio Blanco G, et al. Monitoring the activity of Crohn’s disease. Aliment Pharmacol Ther 2002;16:29-33. 2. Sandborn WJ, Feagan BG, Hanauer S, et al. A review of activity indices and efficacy endpoints for clinical trials of medical therapy in adults with Crohn’s disease. Gastroenterology 2002;122:512-530. 3. Sostegni R, Daperno M, Scaglione N, et al. Review article: Crohn’s disease: monitoring disease activity. Aliment Pharmacol Ther 2003;17:11-17. 4. Colombel JF, Solem CA, Sandborn WJ, et al. Quantitative measurement and visual assessment of ileal Crohn’s disease activity by computed tomography enterography: correlation with endoscopic severity and C reactive protein. Gut 2006;55:1561-1567. 5. Puylaert CA, Tielbeek JA, Bipat S, Stoker J. Grading of Crohn's disease activity using CT, MRI, US and scintigraphy: a meta-analysis. Eur Radiol 2015;25:3295-3313. 6. Girometti R, Zuiani C, Toso F, et al. MRI scoring system including dynamic motility evaluation in assessing the activity of Crohn’s disease of the terminal ileum. Acad Radiol 2008;15:153-164. 7. Koilakou S, Sailer J, Peloschek P, et al. Endoscopy and MR enteroclysis: equivalent tools in predicting clinical recurrence in patients with Crohn’s disease after ileocolic resection. Inflamm Bowel Dis 2010;16:198-203. 8. Schill G, Iesalnieks I, Haimerl M, et al. Assessment of disease behavior in patients with

Crohn’s disease by MR enterography. Inflamm Bowel Dis 2013;19:983-990. 9. Mohamed AM, Amin SK, El-Shinnawy MA, Elfouly A, Baki AH. Role of CT enterography in assessment of Crohn’s disease activity: correlation with histopathologic diagnosis. Egypt J Radiol Nucl Med 2012;43:353-359. 10. Mao R, Gao X, Zhu ZH, et al. CT enterography in evaluating postoperative recurrence of

Crohn’s disease after ileocolic resection: complementary role to endoscopy. Inflamm Bowel Dis 2013;19:977-982. 11. Kolkman JJ, Falke TH, Roos JC, et al. Computed tomography and granulocyte scintigraphy in active inflammatory bowel disease. Comparison with endoscopy and operative findings. Dig Dis Sci 1996;41:641650.

Invited Lectures (21, Fri)

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Special Focus 1

09:20-10:40, April 21 (Fri), Grand Ballroom A

Inflammatory Bowel Disease Update SF 01_GI_03 10:00-10:20

Evaluation and Monitoring of Bowel Inflammation Using Clinical, Laboratory, and Endoscopic Parameters Jae Hee Cheon

Yonsei University College of Medicine, Korea

Invited Lectures (21, Fri)

Endoscopic assessment for the disease extension, severity, and neoplasia surveillance has a crucial role in the management of inflammatory bowel disease (IBD). Recent advances in endoscopic imaging techniques have revolutionized from conventional white light endoscopy to up-to-date technologies during the past decades. These novel endoscopic techniques using molecular probes or electronic filter technologies provide an opportunity to visualize mucosal details and inflammation/dysplasia even at the cellular or subcellular level. High definition endoscopy and dye-based chromoendoscopy can improve the detection rate of dysplasia and evaluate the inflammatory changes with a better visualization. Dye-less chromoendoscopy including narrow band imaging (NBI), iScan, autofluorescence imaging (AFI) can also facilitate surveillance in comparison to white light endoscopy with optical or electronic filter technologies. Moreover, confocal laser endomicroscopy (CLE) or endocytoscopy have an opportunity to achieve real-time histology with in vivo evaluation and tend to have a high accuracy in comparison with histology. These new technologies in IBD would be more appropriate to be combined with standard endoscopy or further histologic

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confirmation. While accurate, endoscopy is also an expensive and invasive procedure and can often be a burden to patients. Accordingly, a number of potential biological markers have been used to objectively measure relative degrees of inflammation and to monitor disease activity. Noninvasive serum biomarkers such as C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), albumin level, and hemoglobin level are commonly checked during routine follow up of patients with IBD to detect early active status and institute appropriate therapies. Other serum markers such as triggering receptor expressed on myeloid cells-1 (TREM-1) and several fecal markers (calprotectin, lactoferrin) have also been under investigation and are now used in clinical practice. Among established serum biomarkers, CRP has been the most commonly used due to previous findings that Crohn’s disease (CD) patients with elevated CRP respond better to biological therapy than those without elevated CRP. Recently published studies support the idea that optimal therapies should be targeted not only to clinical remission, but also to mucosal healing in order to fundamentally alter the natural course of disease in IBD patients.

Special Focus 1

09:20-10:40, April 21 (Fri), Grand Ballroom A

Inflammatory Bowel Disease Update SF 01_GI_04 10:20-10:40

Recent and Emerging Imaging Techniques to Evaluate IBD Yoshio Kitazume

Tokyo Medical and Dental University, Japan Therefore, the diagnosis of fibrosis using crosssectional imaging remains a challenge. The clinical manifestations of CD are characterized by the combination of inflammation and accumulated intestinal damage that cannot be assessed by the current imaging findings alone. The Lémann score, or the Crohn’s Disease Digestive Damage Score, is the first attempt to create a global CD bowel damage scoring system. It is calculated by combining imaging, clinical, and endoscopic findings. The goal of this lecture is to provide an overview of recent and emerging imaging techniques and procedures to evaluate CD activity and the intestinal fibrosis and damage in patients with IBD. The lecture will focus on the following these techniques: for MR imaging, diffusion-weighted imaging, perfusion, bowel motility map assessment using cine MR, and magnetization transfer; for US imaging, contrast-enhanced US, Doppler and elastography; for nuclear medicine, fluorodeoxyglucose (FDG) positron emission tomography (PET) /MR and FDG PET/CT.

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Invited Lectures (21, Fri)

Traditionally, cross-sectional imaging modalities, such as computed tomography (CT), magnetic resonance (MR) imaging, and ultrasound (US), have been employed in the diagnosis, staging, and follow up of patients with inflammatory bowel disease (IBD). It has been reported that crosssectional imaging has a high diagnostic accuracy in the assessment of Crohn's disease (CD) by comparing it with histopathological, surgical, and endoscopic examination. These previous studies have established the role of conventional crosssectional imaging in the assessment of CD activity. Recent studies have focused on the detection and quantification of intestinal fibrosis associated with CD using cross-sectional imaging. Quantification of intestinal fibrosis is crucial; if fibrosis is predominant, then endoscopic dilatation of the stricture or surgery is necessary whereas if inflammation is predominant, then medical therapy is selected. Fibrosis and inflammation often coexist in CD and it is difficult to differentiate fibrosis from inflammation because there are overlraps between these two conditions in conventional imaging findings.

Special Focus 2

09:20-10:40, April 21 (Fri), Studio G

Prostate Imaging-challenge & Opportunity SF 02_GU_01 09:20-09:40

Transrectal Ultrasound: The Present and the Future Hak Jong Lee

Seoul National University Bundang Hospital, Korea

Invited Lectures (21, Fri)

Transrectal US(TRUS) is commonly used for the estimation of prostate volume and guiding biopsy. The pathologic findings of focal lesion seen on TRUS are variable. The cancer positive rates of focal lesion are relatively low ranging from 25% to 50%. There are several new trends for the further detection of prostate cancer: Contrast enhanced US (CEUS), elastography, and MR-TRUS fusion. The increased microvessel density due to neovascularization in cancer shows increased enhancement in CEUS. From the results of metaanalysis, the pooled sensitivity of CEUS in detection prostate cancer was 0.70, and the pooled specificity was 0.74. However, still CEUS has limitations It cannot completely replace systematic biopsy, operator dependent, and lacks standardization in imaging technique and diagnostic criteria. Elastography reflects the elasticity of tissue.

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Elastography starts from the assumption that the increased cell density in cancer tissue changes tissue elasticity. However, the lack in standardization of the techniques and the variable reference standard limit the use of elastography. MR-TRUS fusion image has potentials in detecting the “highest grade” or “representative” lesion for deciding the treatment plan for prostate cancer (for example, active surveillance vs. prostatectomy). MR, especially ADC image can guide the proper site for prostate biopsy. In conclusion, the routine TRUS has limited role in the detection of prostate cancer, it is the easiest modality for evaluating prostate volume. The CEUS or elastography have still limited role due to several reasons. MR TRUS fusion has potentials in detecting representative prostate cancer.

Special Focus 2

09:20-10:40, April 21 (Fri), Studio G

Prostate Imaging-challenge & Opportunity SF 02_GU_02 09:40-10:00

mpMRI: Detection and Beyond Hebert Alberto Vargas

Memorial Sloan Kettering Cancer Center, USA individual patient management in multiple clinical scenarios. In this session, we will discuss the most common clinical needs that can be met through information derived from multiparametric MRI, together with tips for optimizing sequence selection, acquisition and imaging interpretation in each context.

Special Focus 2

09:20-10:40, April 21 (Fri), Studio G

Prostate Imaging-challenge & Opportunity SF 02_GU_03 10:00-10:20

Advances in DWI Hebert Alberto Vargas

Memorial Sloan Kettering Cancer Center, USA The added value of diffusion-weighted magnetic resonance imaging (DW-MRI) for the detection, localization, and staging of primary prostate cancer has been extensively documented in original studies and meta-analyses. More recently, DW-MRI and related techniques have been used to noninvasively

assess prostate cancer aggressiveness and estimate its biological behavior. In this session we will summarize the potential applications of DW-MRI for noninvasive optimization of pre-therapeutic risk assessment, patient management decisions, and evaluation of treatment response.

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Prostate MRI has now been around for several decades, and while certainly its use and acceptance has skyrocketed in recent years, its primary roles have also evolved. The initial focus of prostate MRI was on zonal anatomy delineation and staging, but there are now opportunities to take full advantage of current multiparametric MRI sequences to guide

Special Focus 2

09:20-10:40, April 21 (Fri), Studio G

Prostate Imaging-challenge & Opportunity SF 02_GU_04 10:20-10:40

Strategy for Active Surveillance Deuk Jae Sung

Korea University Anam Hospital, Korea

Invited Lectures (21, Fri)

Multiparametric MRI Multiparametric(MP)-MRI of the prostate typically consists of T2-weighted imaging. diffusion weighted imaging and dynamic contrast-enhanced MRI. MPMRI offers the most accurate imaging assessment of prostate cancer and regional metastatic spread and aids in many aspects of prostate cancer management, including initial detection, biopsy guidance, treatment planning and follow-up and has further potential emerging roles to replace TRUS biopsy for patients undergoing active surveillance and to initially evaluate patients with suspected prostate cancer before TRUS biopsy. In patients with clinically low-risk prostate cancer, cancer detection at MP-MRI is significantly dependent on cancer volume and Gleason grade; the detection rates for cancers with a volume of 1 cm3 or more and a Gleason grade of 7 or more are significantly higher than those with a lower volume or Gleason grade. Risk stratification and active surveillance Screening with serum PSA levels has led to an increased incidence of prostate cancer, but these “screening” cancers are generally smaller and of lower grade and stage than clinically detected cancers, leading to fears of overtreatment. Active surveillance has become an acceptable mode of treatment, but concern remains that the patient’s tumor may actually be more aggressive than originally thought on the basis of increasing PSA levels, inconsistencies between different scoring systems, and concerns about undersampling during random prostate biopsies. Determining biological aggressiveness and risk stratification has implications for treatment. The decision to undergo active surveillance or radical treatment is based on several factors, including

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serum PSA, PSA density, Gleason score at biopsy, and percentage of the involvement in the core. MRI currently does not exist in standard-of care decisionmaking algorithms or in nomograms. But, the blind prostate biopsy misses many tumors outside of the normal prostate biopsy template, while also underestimating the grade of the cancer. So, a few groups are conducting research in implementing MRI into such algorithms and nomograms. MPMRI has been reported to predict more aggressive disease. Some investigators reported a positive correlation of MP-MRI findings with D‘Amico risk scores. The information from MP-MRI can provide data about the risk of aggressiveness of prostate cancer and also help clinicians to counsel their patients about their disease prognosis and potential need for active surveillance. In a more recent study, MP-MRI could improve the detection of clinically significant prostate cancer, and reduce safely unnecessary biopsies in a quarter of patients. But, there are still major issues surrounding MRI and active surveillance; the definition of significant disease, the heterogeneity of inclusion criteria, and agreement about what constitutes radiologic progression during active surveillance. Summary MP-MRI can add valuable information to traditional metrics for identifying patients who might be appropriate candidates for active surveillance or active treatment. Even though one of the most important challenges in using MRI for risk stratification in patients with prostate cancer is to identify ways in which the positive and negative predictive values of the test may be considerably improved, it is now important to establish an organized strategy for developing an MRI based program in the management of prostate cancer.

Plenary Lecture

11:20-12:00, April 21 (Fri), Grand Ballroom A

Plenary Lecture PL 01

11:20-12:00

Asian Society of Abdominal Radiology: Past, Present and Future Byung Ihn Choi

Chung-Ang University Hospital, Korea and KSUR. 3rd ACAR was held in Beijing, China, hosted by CSAR in 2011. 4th congress was held in Kaohsiung, Taiwan, by CTSR in 2013. 5th ACAR was held in Hamamatsu, Japan, in 2015. In 2017, Korea will host ACAR 2017 in Busan. ASAR has education program initiated by Professor Mori and Minami from 2016. Education is the most important activity of ASAR for radiologists in Asian and Oceanic region. ESGAR, ESUR and SAR have well-organized and extensive education program. ASAR has to develop and establish an efficient and sustainable education programs and system. Official journal of ASAR is Abdominal Radiology in conjunction with Society of Abdominal Radiology (SAR) which is a unified society of SGR and SUR in 2012. Collaboration with other regional abdominal societies such as ESGAR, SAR, and ESUR is also important activity of ASAR. There are three regional collaboration projects of ASAR with SAR, ESGAR, and ESUR. 1st collaboration contract of ASAR with SAR was made in 2012. 2nd collaboration contract with ESGAR was made in 2013, and 3rd collaboration contract was made with ESUR in 2015. In addition, collaboration of ASAR and Asian Oceanian Society of Radiology (AOSR), particularly Asian Oceanian School of Radiology (AOSOR), is very important to activate and improve the education program in Asian countries. In summary, education should be done using high quality subspecialized experts by structured training system. Future strategies for education are more standardization of training system & institution, intensification of basic knowledge (physics, pathology, biochemistry, molecular imaging etc.), new training paradigm for tomorrow’s radiologists, and overview of illness integrating traditional pathophysiology-based models with emerging molecular mechanisms for integrated analysis of both imaging and genetic data. The 6th Asian Congress of Abdominal Radiology

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Invited Lectures (21, Fri)

Asian Society of Abdominal Radiology (ASAR) is a federation of affiliated organizations, consisting of five reginal societies including Japanese Society of Abdominal Radiology (JSAR), Korean Society of Abdominal Radiology (KSAR), Korean Society of Urogenital Radiology (KSUR), Chinese Society of Abdominal Radiology (CSAR), Chinese Taipei Society of Radiology (CTSR) and Singapore Radiological Society (SRS). ASAR was founded in 2007 under cooperation of JSAR, KSAR and KSUR. The aims of ASAR are to advance the study of abdominal imaging and intervention, in Asia, by encouraging radiological and clinical excellence, teaching, research and further education in the subspecialty, and ultimately to strengthen the Asian radiology and to reinforce competitiveness compared to American or European radiology. The society’s mission is to serve the health care needs of the general public through the support of science, teaching and research and the quality of service in the field of Asian radiology. Formation of ASAR was triggered by the formation of Society of Gastrointestinal Radiologists (SGR) in 1971, Society of Uroradiology (SUR) in 1974, European Society of Gastrointestinal and Abdominal Radiology (ESGAR) in 1989, and European Society of Uroradiology (ESUR) in 1990. Professors Yuji Itai, Byung Ihn Choi and Osamu Matsui had a closed meeting for discussion of formation of ASAR in Kobe in 2000. In addition, in 2006, prof. Matsui, prof. Choi and Prof. Mori had a discussion session for ASAR with strong support of professor Uchida during JSAR Executive Council meeting in 2006. Finally, 1st congress of ASAR (ACAR) was held in Miyazaki, Japan, in 2007 in conjunction with annual meeting of JSAR. Asian Congress of Abdominal Radiology (ACAR) has taken place biennially since the 1st meeting in Miyazaki. The 2nd meeting was held in Seoul, Korea in June in 2009, in conjunction with KSAR

For pursuing our mission of ASAR in the future, ASAR should be a harmonious, stable and competent organization. Strong collaboration with AOSR, SAR, ESGAR and ESUR is also important.

Invited Lectures (21, Fri)

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Therefore, devotion and great effort by national delegates and administrate council members of ASAR are needed with support of all members of affiliated societies.

China Chapter Session

13:30-15:00, April 21 (Fri), Grand Ballroom A

China Chapter Session CS 01_01

13:40-14:00

Beyond Image: Application of Radiomics in Abdominal Tumors Zaiyi Liu

The People's Hospital of Guangdong, China reflects underlying pathophysiology and that these relationships can be revealed via quantitative image analyses. Radiomics can extract of advanced quantitative imaging features to objectively and quantitatively describe tumor phenotypes. These features, termed radiomics features, are extracted from medical images using advanced mathematical algorithms to uncover tumor characteristics that may fail to be appreciated by the naked eye Radiomics may thus provide great potential to capture important phenotypic information, such as intra-tumor heterogeneity, subsequently providing valuable information for personalized therapy. In this topic, the presenter will briefly introduce the application of radiomics in abdominal tumors, including gene analysis, tumor tissue characterization, clinical tumor staging, treatment evaluation, and outcome evaluation, etc. The aim of this lecture is to: (1) introduce the definition of the radiomics; (2) application of radiomics in abdominal tumors, and (3) the limitations of the radiomics.

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Invited Lectures (21, Fri)

Non-invasive medical imaging modalities including computed tomography (CT), magnetic resonance (MR), Ultrasound, and positron emission tomography (PET) are routinely used for tumor evaluation in clinical practice, such as tumor detection, tissue characterization, and cancer staging, etc. In addition, imaging can potentially provide valuable information for personalized medicine that aims to tailor treatment strategy based on the characteristics of individual patients and their tumors. However, traditional tumor imaging evaluation was based on some subjective imaging features, such as tumor size, number, attenuation, enhancement pattern, etc., which cannot meet the need for individualized evaluation of the patients. With the development of high-throughput computing sciences, it is now feasible to rapidly extract innumerable imaging quantitative features from CT, MR, and PET. The digital medical images can be converted into mineable high-dimensional data, and the extraction process is termed as radiomics. The notion of radiomics is motivated by the concept that biomedical images contain information that

China Chapter Session

13:30-15:00, April 21 (Fri), Grand Ballroom A

China Chapter Session CS 01_02

14:00-14:20

Renal Functional MR Imaging of Nephropathy and Beyond Shenghong Ju

Zhongda Hospital of Southeast University, China

Invited Lectures (21, Fri)

This lecture course will provide you an introduction to the recent progression of renal functional MRI techniques. Renal function is interpreted as a wider definition than just glomerular filtration rate (GFR) in the setting of MR imaging. It is characterized by various physiologic aspects including perfusion, water molecular diffusion, and tissue oxygenation, etc. MRI shows great promise in evaluating these renal tissue characteristics noninvasively. In the past a few decades, renal MRI techniques have undergone dramatic progress by taking the advantage of new MRI hardware. This lecture briefly reviews the applications of state-of-the-art functional MRI techniques for the evaluation of various renal pathologies, and lists unresolved issues that will require future work. In this lecture, the following MRI applications will be introduced. 1. Diffusion based MRI techniques includes traditional diffusion weighted imaging (DWI), diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) imaging and diffusion kurtosis imaging (DKI). IVIM is able to separately

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estimate tissue perfusion and diffusivity of hydrogen protons. DKI estimates the kurtosis of the water diffusion probability distribution function. These diffusion based techniques have been applied in clinical diagnosis of malignant tumors and estimation for other conditions such as renal artery stenosis, renal graft, contrast induced nephropathy, diabetic nephropathy; 2.Blood oxygen level dependent (BOLD) imaging allows estimating tissue oxygenation in vivo, and can be combined with gaschallenging, furosemide or water loading techniques. 3. Dynamic contrast enhanced MR urography (DCEMRU) allows calculating GFR using different tracer kinetic models. 4. Fat quantification techniques includes chemical shift imaging and Dixon imaging, which is able to quantify small amount of fat deposition or stenosis. It is thought to be especially useful in evaluating diabetic nephropathy. 5. Other MRI techniques. After completion of this lecture course, participants will be better able to know the application of renal functional MRI techniques for diagnosis as well as scientific research.

China Chapter Session

13:30-15:00, April 21 (Fri), Grand Ballroom A

China Chapter Session CS 01_03

14:20-14:40

Investigation of HCC with Micro Vessel Invasion via Imaging Mengsu Zeng

Zhongshan Hospital of Fudan University, China therapy method in order to get an optimized survival rate if radiologists could give a accuracy diagnosis of HCC with MVI. This lecture mainly focus on introducing the present study and clinical research results of Zhongshan Hospital about MVI with CT and MRI , and we hope that MRI diagnosis of MVI would be as a complementary element for the HCC strategy of diagnosis and treatment in the near future via the wide scope of clinical investigation around the world.

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Invited Lectures (21, Fri)

Currently, clinical physicians (such as general surgeons and hepatologists etc.) are interesting in the micro-vessel invasion (MVI) of HCC, which is independent factor related to the recurrence and distant metastasis, even survival rate for the patients with suffering from HCC after curative treatment, so radiologists are in front of a challenge and should investigate the features of CT and MRI of HCC with MVI before treatment (including surgery, RFA and transplantation). Patients of HCC with MVI could been obtained a comprehensive and effective

China Chapter Session

13:30-15:00, April 21 (Fri), Grand Ballroom A

China Chapter Session CS 01_04

14:40-15:00

A Comparative Study of CT Colonography with 256-MDCT Using Low Dose Protocol in Patients with Colorectal Cancer: Assessment of Radiation Dose, Image Quality, and CTC Findings Invited Lectures (21, Fri)

Huimao Zhang

The First Hospital of Jilin University, China

CT colonography (CTC) is a widely accepted tool for colorectal disease, because CTC provide noninvasive images to detect colorectal lesions. The lecture is to introduce when and how to perform CT colonography (CTC), and what we did about the low dose CTC in China. 1. When to perform CTC? 1.1 CTC indications:Screening; Failed colonoscopy; Evaluation of colon proximal to an obstructing lesion; Patients with contraindications to colonoscopy or who refuse other screening options; Preoperative with contrast-enhanced CTC; Detection of anastomotic and metachronous recurrence. 1.2 CTC contraindications: patients with active colonic inflammation and in those who have recently undergone colorectal surgery 1.3 CTC and colonoscopy: A. CTC after colonscopy: a. When endoscopic biopsy has been done, CTC can be performed on the same day as the endoscopic procedure. An ultralow/low dose preCTC scan of the abdomen and pelvis before insertion of the rectal tube may rule out the presence of extraluminal gas that would indicate a colonoscopic perforation. b. Endoscopic resection (i.e. polypectomy/ mucosectomy), it is prudent to consider an approximately 2- week delay before performing CTC. B. Colonscopy following the CTC Suggest same-day polypectomy as a possible option after CT colonography (CTC) performed with full bowel preparation.

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2. How to perform CTC 2.1 Patient Preparation There are several techniques that may be used for bowel preparation, and con- troversy remains as to how to optimize patient preparation. The goal is to have a well-prepared, well-distended colon that will facilitate polyp detection and minimize false-positive findings. a. cathartics such as magnesium citrate b.phosphosoda c.colonic lavage solutions such as polyethylene glycol 2.2 Fecal and Fluid Tagging Fecal tagging is achieved by having the patient ingest small amounts of barium or iodine with their meals prior to imaging. With the computer electronic-cleansing techniques, the highattenuation tagged fecal material can be segmented from the data. 2.3 Colonic Distention a. Room air: easy, clean, and inexpensive b. Carbon dioxide (CO2): Absorbed from the colon it causes less cramping after the procedure. c. Volumn: No strict number of insufflations, since the length of an individual colon is variable. General, 2L. 3. Radiation Dose The current situation in china: most patients with colorectal cancer were diagnosed in the advanced stage. 3.1 Study of phantom and find of low dose protocol Standard Human Body phantom scanned with different tube voltages and currents,and find the best low dose protocol 3.2 Low radiation dose in patients with colorectal

cancer 3.2.1 Noise, SNR, CNR and subjective images quality: The image quality of low-dose CTC with iDose was non-significant different than that using standard-dose protocol. 3.2.2 CTC findings: The low dose acquisitions would provide useful information of colorectal and extracolonic structures.

4. Where are we going? a. Bowel preparation b. Fecal and fluid tagging c. Colonic distention d. Low radiation dose e. Computer-assisted Detection ……. f. Radiomics and radiogenomics

Invited Lectures (21, Fri)

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ESGAR Honorary Lecture

15:20-16:20, April 21 (Fri), Grand Ballroom A

ESGAR Honorary Lecture HL 01_01

15:20-15:50

The Clinical Role of Imaging in Peritoneal Carcinomatosis Panagiotis Prassopoulos

Invited Lectures (21, Fri)

University Hospital of Alexandroupoli, Medical School, Democritus University of Thrace, Greece Cytoreductive surgery and perioperative intraperitoneal chemotherapy have revolutionized the treatment options of peritoneal carcinomatosis and significantly upgraded the role of imaging. The location of implants in the intraperitoneal distribution of malignancies- mostly from primaries in the ovaries, colon, stomach or pancreas - is primarily governed by peritoneal fluid circulation and by anatomic pathways formed by peritoneal reflections, namely ligaments, mesenteries and omenta. The most common sites where the peritoneal fluid may temporarily arrested - facilitating implantation of cancer cells - include cul-de-sac, distal small bowel mesentery, right paracolic gutter, posterior sub-hepatic space, greater omentum and subphrenic spaces. The role of imaging is to disclose the presence and extent of the disease that is fundamental in candidates for cytoreductive surgery - to monitor response to treatment and to reveal recurrences. Imaging should describe the intraabdominal tumour burden on a site by site basis and provide detailed information regarding involvement of specific anatomic areas, like the hapatoduodenal ligament, the falciform ligament, the small bowel mesentery, coexisting retroperitoneal lymphadenopathy etc. State of the art preoperative imaging is fundamental in the selection process of those patients that may benefit from cytoreductive surgery and perioperative intraperitoneal chemotherapy and it is also important for the surgical planning in those patients. MDCT with thin

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collimation and i.v contrast material supplemented by multiplanar reconstructions is the primary imaging modality for the investigation of peritoneal carcinomatosis. Techniques like CT Enteroclysis are of useful in the disclosure of limited infiltration of the small bowel and the small bowel mesentery. Ascitis, contrast enhanced smooth, nodular, or plaquelike peritoneal thickening, peritoneal nodules, plaques or masses, rounded, ill-defined soft-tissue or cystic mesenteric masses, mesenteric fixation with increased attenuation values and thickening, irregular soft-tissue permeation of omental fat or confluent solid omental masses are the most frequent CT findings of peritoneal carcinomatosis. CT has a sensitivity and specificity between 8595%, depending on the size, location and applied examination protocol. MR imaging using a postgadolinium enhanced 3dFLASH sequence with fat saturation may alternatively be used and it is advantageous especially in cases of diffused layered type of peritoneal/mesenteric involvement. Diffusion MRI has high sensitivity in diagnosing small peritoneal implants and should incorporated in a comprehensive MR imaging protocol. PET/CT is indicated in the post-treatment imaging evaluation. Multidisciplinary collaboration gathering dedicated surgeons, abdominal radiologists, oncologists, gastroenterologists and pathologists has major impact in the survival and quality of life of patients with peritoneal carcinomatosis.

ESGAR Honorary Lecture

15:20-16:20, April 21 (Fri), Grand Ballroom A

ESGAR Honorary Lecture HL 01_02

15:50-16:20

Imaging Anal Fistula Steve Halligan

University College London, United Kingdom I will explain how to classify fistulas by MR imaging and how to detect features that will influence subsequent surgery. In particular, I will show how precise preoperative characterisation of the anatomical course of the fistula and all associated infection is critical if surgery is to be effective. I will show how preoperative imaging is able to influence subsequent surgery, increasing the chance of cure and reducing postoperative relapse.

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Invited Lectures (21, Fri)

This lecture will explain the pathogenesis of fistulain-ano and then go on to describe the different types of fistula encountered, the Parks Classification of fistula-in-ano, and will detail the principles of surgical treatment. I will explain exactly what it is that the surgeon needs to know from pre-operative radiology. I will detail how fistula-in-ano is imaged, with a strong emphasis on MRI.

ESUR Honorary Lecture

15:20-16:20, April 21 (Fri), Studio G

ESUR Honorary Lecture HL 02_01

15:20-15:50

Imaging of the Prostate Based on PIRADS Version 2 Harriet C. Thoeny

Inselspital, University Hospital Bern, Switzerland

Invited Lectures (21, Fri)

Prostate imaging is based on the so-called PIRADS(Prostate Imaging and Reporting Data System) system that provides clinical guidelines for performing and interpreting multiparametric MRI (mpMRI) of the prostate. In order to perform correct mpMRI all sequences should be acquired with the same angle, slice thickness and location. PI-RADS is an objective tool based on a 5-point scoring system to define the probability of the presence of a significant prostate cancer and to exclude significant prostate cancer with a high likelihood. Furthermore, interreader variability should be decreased. PIRADS allows to improve and standardize communication between radiologists and urologists. In PIRADS vs 2 an overall score based on all mpMR

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techniques (High-resolution T2, DW-MRI and DCEMRI) is provided for each detected lesion. PIRADS 1 and 2 mean that clinical significant cancer is unlikely to be present, PIRADS 3 means indeterminate lesion and PIRADS 4 and 5 suggest that clinically significant cancer is highly likely to be present, in PIRADS 4 the size of the lesion is smaller than 1.5 cm, whereas PIRADS 5 means that the tumor is larger than 1.5 cm. Most of the prostate cancers are located in the peripheral zone and DW-MRI is the dominant sequence to detect a significant cancer in this location, whereas T2 is the dominant sequence to detect significant prostate cancer in the transition zone. If a sequence is technically inadequate, this should be assigned assessment category “X”.

ESUR Honorary Lecture

15:20-16:20, April 21 (Fri), Studio G

ESUR Honorary Lecture HL 02_02

15:50-16:20

Prostate MRI: DWI for Cancer Detection and Assessment of Aggressiveness Raymond Oyen

University Hospitals Leuven, Belgium GS). This is contradictory to other studies where significant differences in ADC values were reported according to GS. An extension of an earlier study is ongoing in our institution, correlating in vivo mpMRI with high resolution ex vivo MRI at 9.4 T (anatomical and DWI), and matched with radical prostatectomy specimens. Distinction between organ-confined disease (T2) and early extraprostatic disease (T3) is crucial for treatment decisions and prognosis because less than 5% of patients demonstrate nodal metastases with T2 stage, opposed to 15%-30% with T3 stage. Data on MRI staging performance are conflicting, and influencing factors include variation in acquisition protocols, magnetic field strength, use of an endorectal coil and reader experience. An important limitation of MRI is the poor performance to detect limited ECE (20 mm. The combination of direct and indirect signs of ECE improved sensitivity (85.2%) at the expense of moderate decrease of specificity (83.9%). Challenges for prostate cancer imaging will be the in depth integration of morphological, functional and biomarker data for improved diagnosis/detection, tissue characterization, staging, surveillance, and follow-up (therapy response, recurrence). This will require a multidisciplinary approach with a single, integrated and structured report. In addition, such integrated data set can be used for planning and targeted imaging guided biopsy and focal therapy.

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Multiparametric MRI (mpMRI) of the prostate is the key imaging modality for detection and staging of prostate cancer. With limited access to MRI due to governmental constraints and the awareness that MRI is increasingly important for prostate imaging, the question raised if with a ‘limited’ acquisition protocol, acceptable accuracy in cancer detection and staging could be achieved. An acquisition protocol was optimized at 1.5-T (no endorectal coil), with T2-weighted sequences (3 spatial planes) and with a single functional MRI technique, i.e. DWIMRI (6 b-values) (no contrast enhancement). Such protocol obviously has disadvantages including limited spatial resolution, functional information and probably decreased detection and staging performance. Advantages include short acquisition time (16 minutes), cost reduction (no contrast agent or endorectal coil), patient comfort, and increased access for mpMRI-studies. This simplified mpMRI was correlated with whole mount radical prostatectomy specimens. For prostate cancer detection, sensitivity was 92% for all tumors, 91.6% for primary peripheral zone (PZ) cancers and 93.5% for central gland (CG) tumors. In line with published data, the sensitivity largely depended on tumor volume, Gleason score (GS) and T stage (i.e., extracapsular extension - ECE). The sensitivity increased with tumor volume ≥0.5 cc and ECE (stage T3/T4). Visible tumors at mpMRI were significantly larger (mean 4.8 cc) than invisible tumors (mean 1.6 cc). Tumor detection (PZ and CG) also increased with GS, however with considerable overlap of ADC values of cancers with different GS. There was at least a tendency to inverse correlation of ADC values with GS (i.e., lower ADC-values with higher

Special Focus 3

16:20-17:50, April 21 (Fri), Grand Ballroom A

Diagnosis of HCC: Regional Differences and Similarities SF 03_GI_01 16:20-16:35

USA Perspectives Jay Heiken

Mallinckrodt Institute of Radiology, USA

Invited Lectures (21, Fri)

Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related mortality worldwide. When recognized at early stages, HCC can be cured with appropriate therapy, which may involve resection, percutaneous ablation or orthotopic liver transplantation (OLT), depending on a patient’s liver function. Since 2001, multiple expert panels in different parts of the world have accepted the noninvasive diagnosis of HCC if certain imaging criteria are met. Asian consensus guidelines (Asian Pacific Association for the Study of the Liver, Japanese Society of Hepatology, Korean Liver Cancer Study Group) differ from Western consensus guidelines (American Association for the Study of Liver Diseases and European Association for the Study of the Liver) in that they allow for the use of either MRI with a hepatobiliary contrast agent or contrast enhanced ultrasound (CEUS) to confirm the noninvasive diagnosis of HCC when CT or MRI with an extracellular agent fails to demonstrate strict imaging criteria for the diagnosis of HCC. This difference in diagnostic approach has largely to do with differences in treatment priorities for HCC in Western countries compared with Asia. In the United States OLT is considered the treatment of choice for patients with cirrhosis and HCC. Currently, approximately 25% of liver transplants performed in the United States are on patients with HCC, because patients with cirrhosis who develop HCC are given additional priority on the liver transplant waiting list independent of their liver function. In Asia prioritization of liver transplantation for patients

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with HCC is not feasible due to the large mismatch between the high incidence of HCC and the limited availability of donor livers. Since 2013 the Organ Procurement and Transplant Network (OPTN) in the United States has mandated that in order for a patient with a diagnosis of HCC that is based on imaging alone to get priority on the liver transplant waiting list, specific CT or MRI criteria must be met. The criteria include size (10-19 mm vs. ≥20 mm), arterial phase hyperenhancement, washout, pseudocapsule and/or threshold growth. The MRI imaging criteria must be based on the use of extracellular contrast agents only, and CEUS cannot be used to confirm a noninvasive diagnosis of HCC for the purpose of conferring transplant waiting list priority to a patient with likely HCC. Thus, the approach to the noninvasive diagnosis of HCC in the United States is more conservative than it is in Asia, favoring specificity over sensitivity. The rationale is that if a patient with an imaging diagnosis of HCC can potentially receive higher priority on the transplant waiting list than a patient with poorer liver function but no HCC, then we need to be as certain as possible that the diagnosis is accurate. In contradistinction, the approach in Asia is to prioritize sensitivity over specificity so that patients can receive appropriate treatment, liver resection or directed therapy, as soon as possible. Therefore, in Asia hepatobiliary phase hypointensity at MRI and postvascular phase hypoenhancement at CEUS can be used to confirm a noninvasive diagnosis of HCC.

Special Focus 3

16:20-17:50, April 21 (Fri), Grand Ballroom A

Diagnosis of HCC: Regional Differences and Similarities SF 03_GI_02 16:35-16:50

Japan Perspectives Takmichi Murakami

Kindai University Faculty of Medicine, Japan CE-US are recommended to be performed. To detect hypovascular HCC, which is usually well differentiated HCC and may be early HCC, EOBMRI is recommended to be performed. Hepatocyte phase of EOB-MRI is superior to dynamic MDCT, SPIO-MRI and CE-US to detect hypovascular HCC, and shows almost the same diagnostic accuracy as CTAP and CTHA. EOB-MRI is the best way to detect early HCC. As mentioned before, EOB-MRI shows high sensitivity even to detect hypovascular lesion, small hypovascular nodules are sometimes detected only on the hepatocyte phase of EOB-MRI. When the nodules are more than 10-15 mm, biopsy should be considered for differential diagnosis of HCC. When the nodule are less than 10-15 mm, follow-up every 3-6 months by dynamic CT, CE-US, or EOBMRI should be considered. Biopsy or treatment may be considered if they are found to have grown or hypervascularization appears during follow-up. High intensity on T2-weighted or diffusion weighted image and high growth rate of 1.8×10-3 /day are predictive factors for arterial hypervascularization from hypovascular nodules. So, biopsy should be performed for these nodule even if these are less than 10-15 mm. Gd-EOB-DTPA enhanced MR imaging is superior to dynamic CT and SPIO MR imaging and the same as CTAP and CTHA in diagnosis of HCC. It has a great impact on the diagnostic algorithm of HCC

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There are two guidelines for diagnosis of hepatocellular carcinoma (HCC) in Japan. One was Japanese Imaging Guideline by Japan Radiological Society & Japanese College of Radiology, and another is Surveillance and Diagnostic Algorithm in Clinical Practice Guideline for HCC by Japanese Society of Hepatology. Both guidelines for HCC have almost same clinical questions (CQ) and answers. There is no discrepancy between the two guideline. Typical HCC, so called hypervascular HCC, shows hyper enhancement in the arterial phase and washout of contrast medium in the portal and equilibrium phases. Contrast (Sonazoid) enhanced (CE)-US, dynamic MDCT and Gd-EOBDTPA enhanced (EOB)-MRI are recommended to be performed to detect these hypervascular HCC. For detection of hyper vascular HCC, there is no significant difference among dynamic MDCT, dynamic MRI with Gd-DTPA. These are complementary examinations. EOB-MRI is superior to these dynamic study, and shows almost the same diagnostic accuracy as SPIO MRI and as CTAP and CTHA which is high sensitivity but invasive examination. CE-US is complicated and costs time. EOB-MRI is the best diagnostic imaging method, however, it may not be useful for severe liver damage case and obstructive jaundice case. Moreover, EOB-MRI requires high-end MR system and costs high. So, when HCC is suspected by screening US, any of dynamic CT, EOB-MRI, and

Special Focus 3

16:20-17:50, April 21 (Fri), Grand Ballroom A

Diagnosis of HCC: Regional Differences and Similarities SF 03_GI_03 16:50-17:05

Taiwan Perspective Yi-You Chiou

Taipei Veterans General Hospital, Taiwan

Invited Lectures (21, Fri)

The HCC management consensus guideline in Taiwan will be introduced in this speech, including epidemiology, surveillance, diagnosis, staging, and treatment. The common risk factors for HCC are HBV or HCV infection and alcoholic liver disease. Less common causes include fatty liver, hereditary hemochromatosis, autoimmune hepatitis, alpha-1 antitrypsin deficiency and Wilson disease, porphyria and schistosomiasis. These risk factors can lead to remodeling of texture with the fibrotic progression of hepatic parenchyma. The growing knowledge on biological behaviors of HCC as well as continuous improvement in imaging techniques and experienced interpretation of

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imaging features of the nodules in cirrhotic liver, the detection and characterization of HCC has improved in the past decade. The fact that the classic imaging features could yield a definite diagnosis and the probability of needle tract seeding are limiting the necessity of liver biopsy. Therefore, HCC is the unique malignancy to be diagnosed by diagnostic imaging, exempting the necessity of a needle biopsy. Since imaging plays a decisive role in the diagnosis of HCC, it is critical that imaging examination might be performed according to generalized protocols and the imaging findings might be interpreted and reported following a standardized terminology and categorization.

Special Focus 3

16:20-17:50, April 21 (Fri), Grand Ballroom A

Diagnosis of HCC: Regional Differences and Similarities SF 03_GI_04 17:05-17:20

Korea Perspectives Myeong-Jin Kim

Yonsei University College of Medicine, Korea strategy of surveillance has been advocated by some authors [6, 7]. One of the important differences from those of other organizations is that, in Korean guideline, a lesion less than 1 cm can be diagnosed as HCC in high-risk patients when typical features of HCC in two or more of the imaging modalities (dynamic contrast-enhanced CT/MRI or liver-specific contrastenhanced MRI) and continuously rising serum α-fetoprotein at two or more examination with hepatitis activity under control [1]. Typical features or radiological hallmarks are described as arterial phase enhancement (hypervascularity in the arterial phase) with washout in portal or delayed phase. However, there are some debates how to define the arterial phase enhancement and washout. During a recent consensus conference held during a meeting of Korean Society of Abdominal Radiology showed that there was considerable variability on the radiologists’ understanding the definition of imaging criteria. This talk will discuss the current controversy and discrepancy in imaging diagnosis of HCC between Korea and other countries. References 1. Korean Liver Cancer Study, G. and K. National Cancer Center, 2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma. Korean J Radiol, 2015. 16(3): p. 465-522. 2. Kim, K.A., et al., Development of hepatocellular carcinomas in patients with absence of tumors on a prior ultrasound examination. Eur J Radiol, 2012. 81(7): p. 1450-4. 3. Chung, Y.E., et al., The impact of CT follow-up interval on stages of hepatocellular carcinomas detected during the surveillance of patients with The 6th Asian Congress of Abdominal Radiology

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Invited Lectures (21, Fri)

Hepatocellular carcinoma (HCC) is the fourth and sixth most common cancer in men and women, and the top-ranked cause of death in people in their forties and fifties in Korea [1]. As in other countries, radiologic imaging plays pivotal roles in the diagnosis and management of HCC. Imaging evaluation of HCC in Korea may be characterized by active use of new technologies, primary use of hepatocyte-directed contrast agent as the first choice for magnetic resonance imaging (MRI), and crowding of patients in major hospitals. Recently, a Korean practice guideline for the management of HCC was first developed in 2003 and revised in 2009 and 2015. However, this guideline mainly focuses on the initial diagnosis and treatment of patients with newly detected HCC. And also, for imaging diagnosis, various guidelines including those of Asian, European, and American are also considered for the establishment of the diagnosis. Recently developed LI-RADS system has been actively discussed and investigated for research, however, is not widely adapted in clinical practice, although its clinical utility has been appreciated by some attending physicians who are exposed to the radiologists using this system in their reports. One of the main differences in clinical practice between Korean and western countries would be active use of serum tumor markers in surveillance of risk patients. Although the utility of alpha-fetoprotein in surveillance of HCC has been severely rebutted by some authors, it is still plays an important role in clinical practice in Korea, considering the limitation of ultrasonography (US) surveillance alone [2]. Regular or intermittent use of computed tomography (CT), non-contrast or contrast-enhanced MRI is also commonly adapted by some clinicians [35]. Considering that HBV is still a major causes of HCC in Korea and the differences in growth rate, clinical, and radiologic findings of HCC between HCC developed in HBV and HBC patients, different

liver cirrhosis. AJR Am J Roentgenol, 2012. 199(4): p. 816-21. 4. Kim, Y.K., et al., Noncontrast MRI with diffusionweighted imaging as the sole imaging modality for detecting liver malignancy in patients with high risk for hepatocellular carcinoma. Magn Reson Imaging, 2014. 32(6): p. 610-8. 5. Kim, S.Y., et al., MRI With Liver-Specific Contrast for Surveillance of Patients With Cirrhosis at High Risk of Hepatocellular

Invited Lectures (21, Fri)

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Carcinoma. JAMA Oncol, 2016. 6. An, C., et al., Growth rate of early-stage hepatocellular carcinoma in patients with chronic liver disease. Clin Mol Hepatol, 2015. 21(3): p. 279-86. 7. Kim, K.E., et al., Hepatocellular carcinoma: clinical and radiological findings in patients with chronic B viral hepatitis and chronic C viral hepatitis. Abdom Imaging, 2011.

Special Focus 4

16:20-17:50, April 21 (Fri), Studio G

Guidelines on Contrast Media SF 04_GU_01 16:20-16:35

Taiwan Perspectives Yi-Hong Chou

Taipei Veterans General Hospital, Taiwan of Tumor Ablation (TATA) to create a guideline most suitable for Taiwan physicians to follow. This can be after Q3 of 2017. Of course, we know that Japan has long-term experience on Sonazoid, China has long-term experience on SonoVue, Korea has both, and Taiwan has some (limited) experience on Sonazoid and Definity. We do hope through this session we may have a consensus on this important issue. A proposed guideline from any of the experienced regional or national society may be also helpful for Asian Countries.

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Although the Taiwan ultrasound community (Society of Ultrasound in Medicine, ROC, SUMROC; or Chinese Taipei Society of Ultrasound in Medicine, CTSUM) has been discussing on the guideline of USCA for at least 4 years, we still have not yet started to set up the Guidelines. We are now adopting the guideline from EFSUMB and WFUMB as references. The Advanced Ultrasound Technology Committee of SUMROC and US Contrast Agent Subcommittee (Chaired by Prof. YiHong Chou) would like to invite the Taiwan Liver Cancer Association (TLCA) and Taiwan Academy

Special Focus 4

16:20-17:50, April 21 (Fri), Studio G

Guidelines on Contrast Media SF 04_GU_02 16:35-16:50

Japan Perspectives Ryohei Kuwatsuru

Juntendo University Postgraduate School of Medicine, Japan

Invited Lectures (21, Fri)

There is no comprehensive guideline on contrast media in Japan even though several guidances or guidelines on contrast media have been made. Summary of “Guidelines on the use of iodinated contrast media in patients with kidney disease 2012” will be introduced in this lecture. The guidelines were made by Japanese Society of Nephrology, Japan Radiological Society, and Japanese Circulation Society joint working group. Topics of the guidelines will be explained as follows.

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1. Definition of contrast induced nephropathy. 2. Risk factors and patient assessment. 3. Type and volume of contrast media. 4. Invasive diagnostic imaging including cardiac angiography or percutaneous catheter intervention. 5. Intravenous contrast media imaging including contrast-enhanced CT. 6. Prevention of contrast-enhanced nephropathy: fluid therapy.

Special Focus 4

16:20-17:50, April 21 (Fri), Studio G

Guidelines on Contrast Media SF 04_GU_03 16:50-17:05

Singapore Perspectives Cher Heng Tan

Tan Tock Seng Hospital, Singapore contrast induced nephropathy and concurrent use of metformin. Proposed guidelines on prophylactic measures such as steroid preparation will also be discussed.

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Invited Lectures (21, Fri)

In this lecture, the Singaporean perspectives on the use of iodinated contrast media for imaging, particularly in the setting of computed tomography will be shared. These include, but are not limited to, general adverse reactions (asthma and allergy),

Special Focus 4

16:20-17:50, April 21 (Fri), Studio G

Guidelines on Contrast Media SF 04_GU_04 17:05-17:20

Korea Perspectives Min Hoan Moon

SMG-SNU Boramae Medical Center, Korea

Invited Lectures (21, Fri)

Guidelines on contrast media from a Korean perspective will be divided into four parts: 1) special patient population, 2) guidelines before contrast injection, 3) guidelines during contrast injection, and 4) guidelines after contrast injection. Special patient population includes patients with previous adverse reaction, renal impairment, metformin administration, pheochomocytoma, paraganglioma, hyperthyroidism, thyroid nodules, being pregnant and being lactating. In patients with previous adverse reaction, an alternative test not requiring a contrast agent should be considered first. If a contrast agent should be used, premedication and a different type of contrast agent will be tried. In patients with renal impairment, efforts should be made to prevent contrast induced nephropathy and nephrogenic systemic fibrosis. The best way is to look for alternative test not requiring contrast agent. The second way is to apply hydration therapy for prevention of contrast induced nephropathy and to use low or intermediate risk agent for prevention of nephrogenic systemic fibrosis. Of notable, correlation of time of the contrast media injection with the hemodialysis is unnecessary in the case of iodine based contrast media, whereas correlation of time of the contrast media injection with the hemodialysis session is recommended in the case of gadolinium based contrast media. Special precautions are necessary when diabetic patients on metformin are given iodine-based contrast medium

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in that 90% of the metformin is excreted through the kidneys as unchanged and a failure of renal function can lead to fatal lactic acidosis. Iodine based contrast media are likely to induce thyrotoxicosis in iodine-deficient areas such as Europe. However, iodine based contrast media is unlikely to induce thyrotoxicosis in Korea, iodine excess area and thus the risk factors for contrast-induced thyrotoxicosis are not evaluated in advance. Guidelines to be aware of before use of contrast media will include guidelines for the use of central venous catheters and those for fasting time. Central venous catheter is used when the peripheral IV line cannot be secured. It is advisable to use a power injector compatible catheter as much as possible because a dynamic study can be performed using rate limit and pressure limit provided by power injector compatible catheters. There are no general guidelines about fasting time before contrast media injection. Authors use 4 hour fasting time for contrast-enhanced CT and 6 hour fasting time for abdomen/pelvis MR. Guidelines to be aware of during/after use of contrast media will include guidelines for a record of contrast use, extravasation, patient monitoring, and records of adverse drug reactions. In the case of extravasation, following protocol is applied; 1) limb elevation, 2) ice or warm packing, 3) careful monitoring for compartment syndrome, and 4) referral to ER, if needed.

Debate Session 2

07:00-08:00, April 22 (Sat), Studio G

GU-CT Urography: Nephrographic Phase (NP) vs Excretory Phase (EP) DS 02_GU_01 07:00-07:10

Keynote Lecture Takehiko Gokan

The purpose is to give keynote lecture of CT Urography (CTU): Nephrographic Phase (NP) vs. Excretory Phase (EP) to the audiences in this session. CTU is the most wildly used imaging method for evaluating patients with hematuria. However, there is no absolute consensus about the optimal imaging technique for CTU including to detect urothelial carcinoma. Conventional three-phase CTU protocol includes noncontrast CT, NP, and EP. The split bolus technique is a CT imaging investigation used in patients with hematuria aiming to put together, in a single image acquisition, both the NP and renal EP and thus reducing the radiation dose of the study. And furthermore single-phase dual energy CTU has

a potential to replace three-phase conventional CTU for detecting tumors with a lower radiation dose. The excretory phase was considered to be the most important phase of CT especially for detecting urothelial carcinomas. However, a recent study showed EP phase of CTU had a higher performance than the EP in detecting upper tract urothelial carcinoma. Another study showed that the NP and EP are complimentary for the detection of upper tract urothelial carcinoma. In this keynote lecture, basic CTU technique as well as usefulness of NP and EP are discussed. Several questions are given to the audiences before and after the lecture.

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Showa University, Japan

Debate Session 2

07:00-08:00, April 22 (Sat), Studio G

GU-CT Urography: Nephrographic Phase (NP) vs Excretory Phase (EP) DS 02_GU_02 07:10-07:25

NP Better than EP Li-Jen Wang

Invited Lectures (22, Sat)

Linkou Chang Gung Memorial Hospital, Taiwan Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan There are several advantages of nephrogenic phase (NP) than excretory phase (EP). CTU with NP alone needs shorter examination time than CTU with EP [1]. Solid organs of the abdomen are better evaluated on NP than EP [1]. Urinary stones are potentially detected on NP rather than EP, even in the absence of unenhanced CT [1]. Normal nephrogram could be confirmed on NP [2]; however, abnormal nephrogram on NP may become unrecognizable on EP. Renal parenchymal tumors have more conspicuous enhancement on NP than EP. On diuretic CTU, both urothelial carcinoma of the upper urinary tract and the urinary bladder are better detected on NP than EP [3]. NP on CTU does not rely on detection of filling defect within opacified of urotract for tumor detection [3]. Furthermore,

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the opacification of the whole urotract could be not achievable even in kidneys with normal function [3]. References 1. W o l i n E A , H a r t m a n D S , O l s o n J R . Nephrographic and pyelographic analysis of CT urography: principles, patterns, and pathophysiology. AJR American journal of roentgenology 2013; 200:1210-1214. 2. Yuh BI, Cohan RH. Different phases of renal enhancement: role in detecting and characterizing renal masses during helical CT. AJR American journal of roentgenology 1999; 173:747-755. 3. Metser U, Goldstein MA, Chawla TP, Fleshner NE, Jacks LM, O'Malley ME. Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography--a prospective study. Radiology 2012; 264:110118.

Debate Session 2

07:00-08:00, April 22 (Sat), Studio G

GU-CT Urography: Nephrographic Phase (NP) vs Excretory Phase (EP) DS 02_GU_03 07:25-07:40

EP Better than NP Chau Hung Lee

Introduction: CT is modality of choice in evaluation of the urinary tract. It supersedes excretory urography (EU) / intravenous urography (IVU) and is preferred over MR urography due to better spatial resolution, faster and cheaper, unless there are specific contraindications. There are various established protocols: -Combined CT and EU/IVU -Three-phase: plain, nephrographic phase (NP), excretory phase (EP) -Split bolus: plain, combined NP and EP (essentially an EP study) -Dose reduction Why EP better than NP? -With optimal distension, mural irregularity may be easier to detect in EP -No significant difference between NP and EP for upper tract evaluation

-When incorporated in the split-bolus technique, allows both NP and EP to be acquired in one scan acquisition - reduce radiation dose -Distension usually better in EP compared to NP important for upper tract evaluation -Intraluminal filling defects are better with surrounding contrast in EP -Extrinsic compression / transition points easier seen on EP -Easier to differentiate renal cysts from renal pelvis in polycystic kidneys Conclusion: -EP remains fundamental for CT urography -Literature appears to suggest NP better than EP, but for detection of bladder cancer / recurrence -EP is better than NP for: - distension (for evaluation of upper tracts) - detecting intraluminal lesions - assessing extrinsic compression

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Tan Tock Seng Hospital, Singapore

Refresher Course 3 *Interactive

08:00-09:00, April 22 (Sat), Grand Ballroom A

Diagnostic Challenges-Interactive Session RC 03_GI_01 08:00-08:20

Imaging Presentation of Abdominal Autoimmune Disease Manabu Minami

Invited Lectures (22, Sat)

University of Tsukuba Hospital, Japan Autoimmune diseases systemically involve several organs as well as mesenchymal tissues. In the abdomen, gastrointestinal tracts, hepatopancreaticobiliary system and urogenital systems are frequent targets of the involvement. Moreover, the serosal membrane and skins are also affected. The disease presentation is also influenced by the rapidness of onset, stage of the disease, and its time course. The imaging manifestations in the abdomen can be categorized as follows: 1) inflammation, edema, swelling of the organ or thickening of the tract wall (especially in acute phase) 2) increased permeability of the membrane and/or vessels, causing fluid leakage, protein loosing, or ascites

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3) vasculitis causing hemorrhage, ischemia or infarct 4) fibrosis causing deformity and compensatory hypertrophy of solid organs, stenosis and obstruction of the tracts (especially in chronic phase) 5) collagen defects resulting in dilatation or perforation of the tract Each autoimmune disease can present these findings in various combinations. Radiologists should be familiar with them and summarize them comprehensively with the clinical information to reach the correct diagnosis and judge the spectrum of the diseases. Through the lecture the key points will be discussed in Q & A format.

Refresher Course 3 *Interactive

08:00-09:00, April 22 (Sat), Grand Ballroom A

Diagnostic Challenges-Interactive Session RC 03_GI_02 08:20-08:40

Imaging Spectrum of Nonepithelial GI Tract Tumor Yedaun Lee

Nonepithelial tumors arise from the submucosa, muscularis propria, or serosa. These tumors are previously referred to as submucosal tumors. However, the term submucosal is not adequate because these tumors do not necessarily arise in the submucosa. Nonepithelial tumors consist of mesenchymal tumors and lymphomas. Mesenchymal tumors include gastrointestinal stromal tumors (GISTs), myogenic tumors such as leiomyoma and leiomyosarcoma, neurogenic tumors such as schwannoma, lipoma, vascular tumors such as glomus tumor and hemangioma, inflammatory fibriod tumor, and so on. Adequate bowel luminal distension with air or neutral oral contrast agent and contrast enhancement are important because the identification of intact overlying mucosal layer on enhanced CT/MR images can be helpful in distinguishing between epithelial and nonepithelial tumors. GISTs are the most common mesenchymal tumors of GI tract. The most common site of GIST is the stomach. GISTs have a variable imaging appearance in regards to enhancement pattern, location within the bowel, relation to the bowel and

additional features such as necrosis or cavity. Small tumors appear as a well-defined and homogenous enhancement pattern and large tumors may be lobulated and heterogeneously enhanced and have irregular margin, necrosis and cavity. Leiomyoma is rare tumor in GI tract. Esophagus is the most common site. In stomach, leiomyoma is almost always seen in the gastric cardia and shows homogeneous enhancement pattern. Schwannoma arise most often in the stomach. It shows homogeneous enhancement. Hemorrhage, necrosis or cavity are rare. Lipoma is seen most commonly in the colon. The cecum is the most common site. On CT images, a homogeneous mass with attenuation values of -70 to -120 HU is diagnostic of a lipoma. Accurate differentiation of GISTs from other nonepithelial tumors is important for planning adequate management and predicting prognosis. Combination of tumor location, growth pattern, enhancement degree, tumor margin, and other additional features such as necrosis, lymphadenopathy and calcification may help radiologists suggest a proper diagnosis.

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Invited Lectures (22, Sat)

Inje University Haeundae Paik Hospital, Korea

Refresher Course 3 *Interactive

08:00-09:00, April 22 (Sat), Grand Ballroom A

Diagnostic Challenges-Interactive Session RC 03_GI_03 08:40-09:00

IPMN: Malignant Risk Stratification with Imaging Ji Hye Min

Invited Lectures (22, Sat)

Chungnam National University Hospital, Korea Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is one of the mucin-producing tumors of the pancreas that develops from the epithelial lining of the main pancreatic duct (MPD) or its side branch. The incidence of IPMN is increasing and currently accounts for 20% to 50% of all cystic neoplasms of the pancreas. As IPMN has variable risks of malignancy and the management of this entity is closely related to its malignant potential, it is important to predict the risk of IPMN malignancy. IPMN can be classified into three types, i.e., main duct IPMN (MD-IPMN), branch duct IPMN (BDIPMN), and mixed type, based on imaging studies and/or the histology. MD-IPMN is characterized by segmental or diffuse dilation of the main pancreatic duct (MPD) of >5 mm without other causes of obstruction. Pancreatic cysts of >5 mm in diameter that communicate with the MPD should be considered as BD-IPMN. Mixed type patients meet the criteria for both MD-IPMN and BD-IPMN. There are considerable differences in the proportions of each type and the risks of malignancy. The mean frequency of malignancy in MD-IPMN is 61.6% (range, 36- 100%) and the mean frequency of invasive IPMN is 43.1% (range, 11-81%). The mean frequency of malignancy in resected BD-

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IPMN is 25.5% (range, 6.3-46.5%) and the mean frequency of invasive cancer is 17.7% (range, 1.436.7%). To help determine the proper management plan for IPMN, the recently revised international consensus guidelines were proposed in 2012. They suggested more conservative and sophisticated surgical indications. For pancreatic cyst ≥1 cm, pancreatic protocol CT or gadolinium-enhanced MRI with magnetic resonance cholangiopancreatography (MRCP) is recommended for better characterization of the lesion. “High-risk stigmata” on CT or MRI include obstructive jaundice in a patient with a cystic lesion of the pancreatic head, enhanced solid component and MPD size of ≥10 mm. “Worrisome features” include cyst of ≥3 cm, thickened enhanced cyst walls, non-enhanced mural nodules, MPD size of 5-9 mm, abrupt change in the MPD caliber with distal pancreatic atrophy, and lymphadenopathy. All cysts with “worrisome features” and cysts of >3 cm without “worrisome features” should undergo EUS to further risk-stratify the lesion, and all cysts with “high-risk stigmata” should be resected. If no “worrisome features” are present, no further initial work-up is recommended, although surveillance is still required according the size stratification.

Refresher Course 4

08:00-09:00, April 22 (Sat), Studio G

Urologic Imaging RC 04_GU_01 08:00-08:20

Testicular and Scrotal Diseases Seong Kuk Yoon

Clinical evaluation alone may be insufficient for accurate diagnosis in some cases, as a variety of testicular and scrotal processes may have similar clinical manifestations and accurate physical examination may be limited by pain or the presence of a large hydrocele. Therefore, differentiation of these conditions and disorders is important for the determination of appropriate treatment. Ultrasound (US) is the best imaging modality to evaluate for testicular and scrotal disease as it is portable, easy to perform, lacks ionizing radiation, and is less expensive than other imaging modalities. US can directly visualize the pathologic conditions suspected during a clinical examination and can provide additional information. Color and power Doppler US can demonstrate testicular perfusion. Color Doppler and pulsed Doppler parameters are optimized to display low-flow velocities so

as to demonstrate blood flow in the testes and surrounding scrotal structures. Power Doppler US may also be used to demonstrate intratesticular flow in patients with an acute scrotum. MRI as well as US is useful for detection of small testicular rupture and the differentiation of extratesticular lesions from intratesticular lesions and MRI is helpful to distinguish solid lesions from cystic lesions. An important limitation of MRI is the not inconsiderable time constraints imposed. In this review, normal anatomy of the scrotum, acute scrotum, and scrotal masses are briefly summarized. In conclusion, it is essential to be familiar with the clinical features of testicular and scrotal pathologic states and to correlate the sonographic findings with the patient’s history and symptoms to make an accurate differential diagnosis.

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Invited Lectures (22, Sat)

Dong-A University, College of Medicine, Korea

Refresher Course 4

08:00-09:00, April 22 (Sat), Studio G

Urologic Imaging RC 04_GU_02 08:20-08:40

Retroperitoneal Diseases Kyeong Ah Kim

Invited Lectures (22, Sat)

Korea University Guro Hospital, Korea The retroperitoneum is the compartmentalized space bounded anteriorly by the posterior parietal peritoneum and posteriorly by the transversalis fascia. It extends from the diaphragm superiorly to the pelvic brim inferiorly. This lecture discusses clinically relevant anatomy of the abdominal retroperitoneal spaces, their cross-sectional imaging evaluation with CT and MRI, and the imaging features of common retroperitoneal pathologic processes.

Xanthogranulomatosis/Erdheim-Chester Disease, Extramedullary Hematopoiesis

I. Imaging anatomy of the abdominal retroperitoneum

The retroperitoneum has been described as a “hinterland of straggling mesenchyme, with vascular and nervous plexuses, weird embryonic rests and shadowy fascial boundaries.” The prospective diagnosis of a retroperitoneal disease poses a profound clinical challenge because of the nonspecific nature of its consequent symptoms. On the other hand, cross-sectional imaging techniques have significantly contributed to our understanding of retroperitoneal anatomy and the broad spectrum of diseases that occur. Although a precise imaging diagnosis may not be possible in every patient, the identification and accurate interpretation of the imaging characteristics of a lesion can guide a reasonable line of subsequent management.

The abdominal retroperitoneum is divided by fascial planes into the anterior and posterior pararenal spaces and the perirenal (or perinephric) space. CT and MR Imaging of the Retroperitoneum: In general, CT is the workhorse for evaluating retroperitoneal disease, whereas MR imaging is more often used as a problem-solving tool. II. Pathologic conditions The retroperitoneum can be involved by a wide spectrum of diseases. They are divided into neoplastic and nonneoplastic processes. 1. Neoplastic Processes The neoplasms in the retroperitoneum can be further categorized into 4 important groups: (1) mesodermal neoplasms, (2) neurogenic tumors, (3) germ cell, sex cord, and stromal tumors, and (4) lymphoid neoplasms. 2. Nonneoplastic Processes Retroperitoneal fibrosis, Retroperitoneal fluid collections, Pneumoretroperitoneum 3. Miscellaneous Retroperitoneal Conditions

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4. Retroperitoneal Nonparenchymal Cysts and Cystic Lesions Lymphangioma, Cystadenoma and Cystadenocarcinoma, Bronchogenic Cyst, Nonpancreatic Pseudocyst III. Summary

References 1. Korobkin M., Silverman P.M., Quint L.E., et al: CT of the extraperitoneal space: normal anatomy and fluid collections. AJR Am J Roentgenol 1992; 159: 933-942 2. Rajiah P., Sinha R., Cuevas C., et al: Imaging of uncommon retroperitoneal masses. Radiographics 2011; 31: 949-976 3. Dinauer P.A., Brixey C.J., Moncur J.T., et al: Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics 2007; 27: 173-187 4. Ya n g D . M . , J u n g D . H . , K i m H . , e t a l :

Retroperitoneal cystic masses: CT, clinical, and pathologic findings and literature review. Radiographics 2004; 24: 1353-1365 5. R h a S . E . , B y u n J . Y. , J u n g S . E . , e t a l : Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 2003; 23: 29-43

6. Va g l i o A . , S a l v a r a n i C . , a n d B u z i o C . : Retroperitoneal fibrosis. Lancet 2006; 367: 241251 7. Goenka AH, Shah SN, Remer EM: Imaging of the Retroperitoneum. Radiologic Clinics 2012; 50; 333-355

Invited Lectures (22, Sat)

The 6th Asian Congress of Abdominal Radiology

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Refresher Course 4

08:00-09:00, April 22 (Sat), Studio G

Urologic Imaging RC 04_GU_03 08:40-09:00

Urothelial Tumors Bum Sang Cho

Invited Lectures (22, Sat)

Chungbuk National University College of Medicine, Korea Urothelial cancers encompass carcinomas of the bladder, ureters, and renal pelvis, which occur at a ratio of 50:3:1, respectively. Cancer of the urothelium is a multifocal process. Patients with cancer of the upper urinary tract have a 30% to 50% chance of developing cancer of the bladder at some point in their lives. On the other hand, patients with bladder cancer have a 2% to 3% chance of developing cancer of the upper urinary tract. The major cause of urothelial cancer is cigarette smoking. The minor cause are analgesic abuse, chronic inflammation, occupation, and family history. Blood in the urine is the most common symptom in patients presenting with urothelial tract cancer. It is most often painless, unless there is obstruction due to a clot or tumor and/or deeper levels of tumor invasion have already occurred. In algorithm for asymptomatic microscopic hematuria by AUA, CT urography (CTU) is used as the best imaging modality. The relative frequency of transitional cell carcinomas along the renal tract varies greatly, largely as a function of the surface area of each section : renal pelvis: uncommon ~2-3% ureter: least common ~1% bladder: by far the most common ~97% Transitional cell carcinoma of the bladder staging uses the TNM system Ta - non invasive papillary tumour Tis - in situ (non invasive flat) T1 - through lamina propria into sub-epithelial connective tissues T2 - into muscularis propria T2a - only invades inner half of the muscle T2b - invades into outer half of the muscle T3 - invasion into perivesical tissues T3a - microscopic extravesical invasion

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T3b - macroscopic extravesical invasion T4 - direct invasion into adjacent structures T4a - prostate, uterus, vaginal vault T4b - pelvic side wall and / or abdominal wall N0 - no nodal involvement N1 - single node involved < 2 cm N2 - single node 2-5 cm or multiple nodes all < 5 cm 2-3 N3 - one or more nodes > 5 cm M0 - no metastases M1 - metastases identified Transitional cell carcinoma of the renal pelvis and ureter staging uses the TNM system Ta: noninvasive papillary tumour Tis: in situ (noninvasive flat) T1: through lamina propria into sub-epithelial connective tissues T2: into muscularis propria T3: invasion into peripelvic fat or renal parenchyma T4: direct invasion into adjacent structures or beyond renal capsule N0: no nodal involvement N1: single node involved 0.75). T2 values in PRM injury group, non-injury group and control group were (62.78±1.23)ms, (49.75±3.17)ms, (49.96±4.37)ms respectively. There were significant

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difference between PRM injury group and noninjury group, control group respectively(P=0.000, P=0.000). T2 values of ICM in PRM injury group, non-injury group and control group were (70.80±6.50)ms, (62.41±7.32)ms, (62.78±6.91)ms, and there were significant difference between PRM injury group and non-injury group, control group respectively(P=0.000, P=0.000). The color gradation of PRM in PRM injury group were mixed with blue, green and yellow, and tone were lightened on artificial color images; color gradation of ICM were uneven with green and yellow, and tone were higher than those of control group and non-injury group. CONCLUSION: T2-mapping can quantitatively assess birth-related LAM injury and T2 map artificial color images show the range and degree of LAM injury visually. moreover, it is hopeful to find micro injury that T2WI images is difficult to find. IS 03_GU_02

Asymptomatic Bartholin Cyst: Evaluation with Multidetector Row CT

Christopher Silman, Shunro Matsumoto, Ryo Takaji, Akira Matsumoto, Ayumi Otsuka, Hiromu Mori, Yoshihiro Nishida, Hisashi Narahara Oita University, Japan

P U R P O S E : To d e t e r m i n e t h e m o r p h o l o g i c characteristics of Bartholin cysts on multidetector computed tomography (MDCT) and their frequency in asymptomatic women. MATERIALS AND METHODS: A total of 3280 consecutive examinations including the pelvis of female patients who had undergone both unenhanced and contrast-enhanced MDCTs from January 2013 to September 2016, were assessed for Bartholin cyst. Positive diagnosis was made by shape, contrast enhancement and anatomical location. Age, laterality, size, and attenuation patterns were recorded. All clinical histories were checked to exclude any paravaginal-related symptoms. Any available follow-up MDCT scans or MRI were also evaluated. RESULTS: Asymptomatic Bartholin cysts were seen in 17 (0.52%) out of 3280 patients with a mean age of 56 years. Cysts occurred on the left side in 65% and the mean maximum diameter was 21.8 mm. Attenuation values were low (mean +16 HU) in 47%, isointense to the surrounding soft tissues in 6% and high (mean +63 HU) in 47%, respectively.

All the hyperattenuating cysts were found in older (≥ 50 years) cases. Ten patients with follow-up MDCT scans showed minimal changes in size and density over time. CONCLUSION: Asymptomatic Bartholin cysts may be incidentally detected on MDCT with reasonable frequency even in postmenopausal age. Hyperattenuating Bartholin cysts are more common than previously thought and are usually seen in older women. The size and attenuation of Bartholin cysts may slightly change over time.

Informal Session 4 IS 04_GI

IS 04_GI_01

CT and MRI Imaging Characteristics of Unexpected Splenic Autotransplantation after Splenectomy

Jian-hua Wang1, Qian-Jiang Ding2, Can Tu1, Yu-Tao Wang1, Ting Liu1, Zhi-Hao Ren2, Si-Qi Wang2 1 The Affiliated Hospital of Ningbo University, China 2 Ningbo University, China

IS 04_GI_02

Low Profile Detachable Coil Embolization via Selective Single Marker Microcatheters

Yuki Yoshino, Yoshihisa Kodama, Yasuo Sakurai Teine Keijinkai Hospital, Japan

PURPOSE: The use of specially designated 2-marker microcatheters for detachable coil embolization is recommended; nevertheless, it is sometimes preferable to use selective singlemarker microcatheters because of their improved a c c e s s i b i l i t y. N e w l y d e v e l o p e d l o w p r o f i l e detachable microcoils were considered to be able to pass into and be placed via these undesignated single-marker microcatheters; however, this has not been confirmed. This study aimed to evaluate the feasibility of transcatheter arterial embolization (TAE) with low profile detachable coils via selective singlemarker microcatheters. MATERIALS AND METHODS: Thirty-one TAE procedures performed between November 2014 and October 2016 were included in this retrospective study. They were divided into two groups: a singlemarker microcatheter group (Group 1, n = 16) and a 2-marker microcatheter group (Group 2, n = 15). The clinical success rate and the complication rate of each group were evaluated with concern about the details of the detachable microcoils. RESULTS: The clinical success was achieved in all procedures. The placement of 101 and 100 microcoils was attempted for Groups 1 and 2, respectively. The details of the microcoils (0.010inch diameters/ 0.014-inch diameters/ 0.018-inch diameters or more) were 31/70/0 in Group 1 and 13/12/75 in Group 2. Four microcoils in Group 1 had not been placed due to stacking, whereas no complications were observed in Group 2. All complications were observed during the 0.010-inch microcoil placement in Group 1; thus, 0.010-inch coil placement was considered to be a significant risk The 6th Asian Congress of Abdominal Radiology

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Informal Session (21, Fri)

PURPOSE: To discuss the imaging characteristics of splenosis for improving its diagnostic accuracy. MATERIALS AND METHODS: Twelve patients with splenic autotransplantation were diagnosed by surgical pathology and needle biopsy. Patients underwent CT and plain and enhanced MRI scan, and the imaging data were collected. RESULTS: Multiple nodules were found in 8 cases and single nodules were found in 4 cases. The nodules were detected in splenic recess in 10 cases, in tail of the pancreas in 5 cases, in right liver in 3 cases, and in other parts of abdominal cavity in 3 cases. The size of nodules was different, and the maximum diameter of 94.57% of the nodules was less than 3 cm. The nodules were all homogeneous and soft without cystic change, calcification or necrosis. Slightly short T1 and short T2 signal were shown in tail of the pancreas in 1 case. Long T1 and long T2 signal were shown in the rest cases. In CT arterial phase, blood supply from abdominal aorta was shown in nodules of right liver in 1 case. The nodules were surrounded by thin layer of low density ring, which showed long T1 and long T2 signal. Homogeneous or inhomogeneous enhancement was shown in the arterial phase,

continuous homogeneous enhancement was shown in portal venous phase, and the decline degree of enhancement was significant in delayed phase. CONCLUSION: Multiple nodules were found in abdominal cavity with homogeneous density or signal and clear boundary. The enhanced features were consistent with spleen. The possibility of splenosis should be considered by the history of splenic trauma or splenectomy.

factor for complications (4/31 vs. 0/70, p=0.008). CONCLUSION: TAE with detachable microcoils via single-marker microcatheter appeared to be feasible, although special attention should be paid to 0.010-inch microcoil placement. IS 04_GI_03

Endobiliary Photodynamic Therapy in Klatskin Tumor Patients

Olga Sergeeva, Maksim Shorikov, Dmitry Frantsev, Andrey Kukushkin, Eduard Virshke, Vadim Panov, Boris Dolgushin N.N. Blokhin Russian Cancer Research Center, Russia

Informal Session (21, Fri)

PURPOSE: Management of non-surgical Klatskin tumor patients is metamorphosing from an accustomed biliary drainage palliation to varying survival prolonging therapies nowadays (Lu Y. et al., 2015). Demonstration of the personal endobiliary photodynamic therapy (PDT) results in these patients is a point of the paper. MATERIALS AND METHODS: One hundred thirty five endobiliary PDT procedures (median 2, range 1-10 per patient) have been performed in 47 biopsy confirmed Klatskin tumor patients (21 female, 26 male, age range 19-75 years) with previous percutaneous biliary drainage in N. N. Blokhin Cancer Research Center since February 2008. The patients had Bismuth IV type tumors or local recurrence after previous surgery and were not eligible for liver and bile duct resections. The second generation chlorin sensitizers, 0.6-2.0 mg/ kg, were administrated intravenously two to four hours prior the procedure with consecutive wireguided insertion of optical fiber and endobiliary laser irradiation (662 nm laser LAHTA-MILON) at low fluence rate pulse mode regimens (12-50 mW/cm2, up to 1000 J per liver). The progressive proximal tumor extension, cholangitis aggravation or tumor marker increase were regarded as indications for additional PDT procedures. The follow-up included clinical examination, lab tests and abdomen MRI every three months. RESULTS: There was no post-procedural mortality. The only patient developed post-procedural liver abscess required percutaneous biliary drainage. The endobiliary PDT resulted in bile duct recanalization, cholangitis abatement and improvement of liver function tests. Several MRI findings (post-PDT peritumoral inflammatory infiltration, lymph node

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reaction, abscopal effects, etc.) assumed possible immune system activation. The median survival, one and two-year survival rates were 15.6 months (minmax 2-49 months) 70.0%, 26.0% and 30.6 months (min-max 5-69 months), 84.3%, 56.9% from the first PDT procedure and from the diagnosis, respectively. CONCLUSION: The endobiliary PDT is a safe and an effective strategy in non-surgical Klatskin tumor patient management, increasing both survival rate and quality of life. IS 04_GI_04

Transluminal Biliary Stricture Biopsy Negative for Malignancy: What Then?

Olga Sergeeva, Maksim Shorikov, Eduard Virshke, Ekaterina Moroz, Olga Chistyakova, Boris Dolgushin N.N. Blokhin Russian Cancer Research Center, Russia

PURPOSE: The majority of biliary strictures are attributed to bile duct malignancy, but there is a group of neoplastic-mimicking lesions constituent 3-31% of surgical findings. Though transluminal biliary biopsy (TBB) was initially applied in the late 1980s it has not been widely accepted until recently. So, the proportion of biliary carcinoma-resembling lesions has remained unexplored in non-surgical patients and, which is more, their management put in a fog the physicians. Pictorial essay of TBB confirmed benign strictures including follow-up is the point of the paper. MATERIALS AND METHODS: 224 patients underwent percutaneous transhepatic biliary drainage for obstructive jaundice. TBB was performed in 162 out of 224 patients. Biopsy brush and forceps were delivered to biliary stricture through thin-walled tube inserted in the drainage channel. 129 histologic and 184 cytological studies were carried out. The TBB was repeated at least three times in negative for malignancy cases to improve diagnostic accuracy. All patients with nonneoplastic TBB findings underwent imaging followup in a period 8-94 months. RESULTS: The majority of patients demonstrated neoplastic biliary strictures (152/162, 93.8%). Pathologist findings consistent with malignancy were obtained in 86% of cytological and 67% of histological samples. Two biopsy attempts had significantly better diagnostic accuracy (p0.1). In 10 patients (6.2%) non-neoplastic biliary strictures were

revealed. The additional work-up relegated them to IgG4-related cholangiopathy in 4, dominant stricture in primary sclerosing cholangitis in 2, penetrating duodenal ulcer causing biliary stricture in 1, biliary papillomatosis in 1, cryptogenic cicatrical strictures in 2 patients. Nobody required surgery. Patient's status improved after specific treatment in 8 cases. Biliary drainages were removed in 3 patients. CONCLUSION: Biliary neoplastic-mimicking lesions still remain diagnostic dilemma. Multiple TBBs along with careful follow-up may be effective in stricture differentiation without surgical exploration.

Informal Session 5 IS 05_GI

IS 05_GI_01

Ischemic Biliary Injury Developed after Transcatheter Arterial Chemoembolization for Hepatic Malignancy

Houyun Xu , Hongjie Hu , Wenbo Xiao The Fourth Affiliated Hospital of Zhejiang University, China 2 Sir Run Run Shaw Hospital of Zhejiang University, China 1

2

1

1

IS 05_GI_02

Endovascular Management for Ruptured Pseudoaneurysm in Seven Hepatic Arteries, Two Gastroduodenal Arteries and One Superior Mesenteric Artery

Daehyun Hwang Hallym University Dongtan Sacred Heart Hospital, Korea

PURPOSE: Pseudoaneurysm is serious complication of acute or chronic surgical injury to the hepatic artery, GDA and SMA. Transcatheter embolization has been considered as the treatment of choice. The purpose of this study is to assess the efficacy of coil embolization for hepatic artery, GDA and SMA pseudoaneurysm and one stenting and coiling for ruptured hepatic artery pseudoaneurysm. MATERIALS AND METHODS: Ten cases in eight patients (seven men and one woman; mean age, 52; range, 28-76) were treated with transcatheter arterial coil embolization and one glue embolization between January 2007 and December 2016. They were analyzed with regard to the clinical presentation, radiological finding, procedure, and outcome. All patients presented with epigastric pain and gastrointestinal bleeding. The aneurysms ranged from 0.4 to 4.4 cm in size. The aneurysms were located in hepatic artery (n=7), GDA (n=2) and the superior mesenteric artery (n=1). Embolization was performed with microcoils in all aneurysms (n=9). Glue (n =1) was also used. RESULTS: Complete occlusions were achieved in The 6th Asian Congress of Abdominal Radiology

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Informal Session (21, Fri)

PURPOSE: The aim of this study was to evaluate the predisposing factors and the clinical course of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatic malignancy. M AT E R I A L S A N D M E T H O D S : A l l i m a g i n g materials, laboratory datas and clinical information obtained in 21 patients with TACE-induced bile duct injuries were reviewed retrospectively to evaluate the predisposing factors and the clinical course. Meanwhile all patients’ basic principals, biochemical tests, TACE-protocols and the management of complications also were analyzed. RESULTS: 21 patients received TACE at our single institution were identified to have bile duct injury the average onset of bile duct injury following TACE is 3.9±2.7 months (9 cases of intrahepatic bile ducts dilation, 1 case of biloma, 3 cases of hepatic bile duct stricture combined with intrahepatic bile ducts dilation, 5 cases of biloma combined with intrahepatic bile ducts dilation, 3 cases showed intrahepatic bile ducts dilation, biloma and intrahepatic bile ducts dilation). Postoperative follow-up has indicated that alanine aminotransferase (ALT), aspertate aminotransferase

(AST), alkaline phosphatase (ALP)and gamma glutamyl transpeptidase (GGT) increased significantly compared with pre-TACE (t= -2.721, P=0.014; t= -2.674, P=0.015; t= -3.079, P=0.006; t= -3.377, P=0.003, respectively). Particularly, 16 of 21 patients had surgical tumor resection prior to TACE, the other 5 patients who have no hepatectomy history (х2=4.732, P = 0.039). CONCLUSION: Bile duct injury complicated with TACE has a close relationship with the blood vessels injury that supply the bile duct and longterm biliary infection. Iodine oil, PVA, gelatin sponge particles and hepatectomy history were risk factors of bile duct injury. The rapid rise of ALP, GGT and total bilirubin in a week after TACE can be predicted the bile duct injury. The probability of bile duct injury caused by preventive TACE-procedure increased significantly.

6 patients. Two patients had re-embolization of rebleeding. One hepatic artery origin and one GDA origin. Their causes are incomplete embolization by fibered coils. Mild biliary ischemic injury was noted in one patient. And there was no recurrence of the symptoms and bleeding during follow-up (mean, 13 months; range, 5-24 months). Two patients presented hepatic infarction. In one patient who was treated with stent insertion with coiling, however, rebleeding occurred at aneurysmal neck portion five days later. In emergency surgery, coiled aneurysmal sac was removed. One month after, another ruptured aneurysm was detected in angiography and we performed coil packing twice. He expired one month later due to septic shock. Another patient had a good prognosis without any complications. CONCLUSION: Transcatheter arterial fiber coils embolization for ruptured hepatic artery and GDA aneurysm are effective treatment. Two cases showed re-bleeding by incomplete coil embolization. Transcatheter arterial glue embolization is also effective material for ruptured SMA pseudoaneurysm and no recurrence was found. IS 05_GI_03

Malignant Bile Duct Obstruction Jaundice Post Treatment of PTBD Complications in Current Situation NCC

Informal Session (21, Fri)

Gantulga Vanchinsuren1, Erdenebulgan Batmunkh1, Yumchinserchin Narangerel2 1 National Cancer Center of Mongolia, Mongolia 2 NCC, Mongolia

PURPOSE: This study presents our experience in biliary drainage with the malignant /HCC, CCC, Pancreatic tumor and others/ bile duct obstruction of percutaneous transhepatic method and simultaneous assessment of method effectiveness and safety. The aim was to assess outcomes and complications of PTBD in a large group of patients. MATERIALS AND METHODS: In time period 20142016, to extract 60 patients hospitalized in Hepato Pancreatic Biliary Department of National Cancer Center, Mongolia were investigated retrospectively. PTBD procedure was applied to patients with biliary tract obstruction with malignant. In total 60 procedures of percutaneous drainage were applied. Average age of patients was 63.6 years. Successful and complication were noted after procedure. All complications data were analyzed statistically.

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RESULTS: In examined group percutaneous drainage was successful in 76.7% interventions. In 23.3% procedures drainage application was ineffective. The most common complication during procedure was hemobilia (13.3%) and the long term complication was drain dislocation (9.9%). CONCLUSION: PTBD is an effective method of biliary tract decompression and it is an important alternative to endoscopic drainage. IS 05_GI_04

Endovascular Treatment for Acute Thromboembolic of Superior Mesenteric Artery: Cases Report

Luan Nguyen, Dung Anh Nguyen, Hien M Tran, Huy A Le Gia Dinh Hospital, Vietnam

PURPOSE: Acute thromboembolic mesenteric ischemia (AMI) is a life-threatening situation and, without adequate treatment, can be fatal with the mortality rate remains high, between 60% and 90%. Over the last years, revascularization was increasingly performed by endovascular techniques. We report five cases which underwent catheter-directed thrombolysis (CDT) and aspirated thrombectomy (AT) in patients suffered AMI with regard to technical success, intervention-related complication rate, and clinical outcome. MATERIALS AND METHODS: We report five patients (3 men, 3 women) which underwent emergent endovascular revascularization of superior mesenteric artery (SMA). All imaging reports; laboratory analysis and follow-up data were collected and reviewed. RESULTS: Four patients underwent CDT and AT, and two patients had CDT alone. Technical success with near complete and complete restoration of SMA perfusion was achieved in four patients. One death was thrombotic in the both of SMA and superior mesenteric vein, the rest was severe co-morbidity. CONCLUSION: Endovascular revascularization with CDT in combination with AT is feasible. This combination can shorten reperfusion time; however, it should monitor blood lost during procedure.

Informal Session 6

resultant ischemia of ovaries respectively.

IS 06_GU

IS 06_GU_01

Ovarian and Fallopian Tube Torsion-to Optimize MR Imaging Plane and Sequence for Diagnosis

Kishan Ashok Bhagwat1, Aisha Althaaf2, Vinay Kumar Dev2, Gouri Naganur2 1 SS Institute of Medical Science and Research Centre, India 2 SS Hospital Ssimsrc Rguhs, India

Pelvic Floor Structural Alterations of Primipara with Stress Urinary Incontinence after Vaginal Delivery: A MRI Study

Yujiao Zhao1, Wen Shen2 Tianjin First Center Hospital, Tianjin, China 2 Tianjin First Center Hospital, China 1

P U R P O S E : To i n v e s t i g a t e t h e p e l v i c f l o o r structure changes in primiparas with stress urinary incontinence after vaginal delivery. MATERIALS AND METHODS: Nineteen primiparous women complaining involuntary urine leakage after vaginal delivery as the stress urinary incontinent group(SUI), twenty-five normal primiparous women as the normal delivery group(DN) and seventeen nulliparous as the control group(NC) were prospectively collected in our study. All the subjects underwent static and dynamic MRI. Two radiologists measured the pelvic structures changes including levator ani hiatus area(LHA), H line, M line, bladder neck to PCL(B-PCL), cervix to PCL(UPCL), retrovesical angle(RVA), anterior urethra angle(AUA), levator plate angle(LPA), urethral length(D), bladder neck to the long axis of pubis(S) and if there was bladder funnel. The consistency between two observers were calculated by intraclass correlation coefficient (ICC), one-way ANOVA was used to compare the measurements difference among three groups and the proportion of bladder funnel in three groups were compared by chi-square test. RESULTS: The consistency between two observers were good(ICC>0.75). The measurements including LHA, H line, M line, B-PCL,U-PCL, RVA, AUA, LPA, D, S were different among three groups(P 0.3) CONCLUSION: Radiological severity indexes of both MCTSI and CTSI in acute pancreatitis are significantly correlated with clinical severity indexes including MGSS, RACG, and clinical findings of ICU care, hospitalization period and mortality.

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Isolated Main Pancreatic Duct Dilatation: CT Differentiation between Benign and Malignant Causes

Sewoo Kim, Sehyung Kim, Dongho Lee, Sangmin Lee, Yeonsoo Kim, Jin Young Jang, Joon Koo Han Seoul National University Hospital, Korea

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Differential Diagnosis of Periampullary Solid Tumor: Focusing on Specific Image Findings of Adenocarcinoma and Other Solid Tumor

Hyo Won Eun Samsung Medical Center, Korea

PURPOSE: 1.To learn the basic anatomy and diseases spectrum of the periampullary solid tumor. 2.To learn the key differential diagnostic points adenocarcinoma from other periampullary solid tumor. MATERIALS AND METHODS: The definition of periampullary tumor is the mass arising within 2 cm of the major duodenal papilla and comprises caner of the ampulla, distal CBD, pancreas, and duodenum. Solid tumors of the periampullary portion can have a broad spectrum of diseases. A multimodality imaging approach is often helpful. Knowledge of relevant clinical information and key radiologic features is essential for confident lesion characterization and differentiation. RESULTS: The results were derived from pathologically proven periampullary solid tumor including ductal adenocarcinoma, ductal adenocarcinoma variants such as adenosquamous carcinoma, colloid carcinoma, and undifferentiated carcinoma, acinar cell carcinoma, and mixed carcinoma, SPN, neuroendocrine tumor, GIST, mass forming CBD cancer, and metastasis. Emphasis will be made in specific imaging features of ductal adenocarcinoma and other solid tumor on CT, MRI, ERCP and EUS. CONCLUSION: We review solid tumors of the periampullary portion in terms of relevant clinical information and key radiologic features that allow confident lesion characterization and differentiation from other disease entities.

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PURPOSE: To retrospectively evaluate differential CT features between isolated benign and malignant main pancreatic duct (MPD) dilatation and to investigate if radiologists’ diagnostic performance can be improved with knowledge of differential CT features. MATERIALS AND METHODS: Forty-one patients who had MPD dilatation without visible mass on CT were retrospectively enrolled in this study from January 2000 to October 2016. Two radiologists reviewed CT images in consensus for the location, shape, and length of transition, dilated PD diameter, the presence of patent PD sign, parenchymal atrophy, attenuation difference, associated pancreatitis, calcification, PD/common bile duct (CBD) enhancement, and perilesional cyst. Chisquare test, Fisher’s exact test, and Student's t-test were used to find the differential CT features between benign and malignant MPD dilatation. Two successive review sessions for the differentiation between the two disease entities were then independently performed by three other reviewers on a 5-point confidence scale. The reviewers were made aware of the results of univariate analyses in the second session. Radiologists’ performance was evaluated using a pairwise comparison of ROC curves. RESULTS: There were 19 benign and 22 malignant MPD dilatations. In patients with benign MPD dilatation, transition areas are frequently located in the head (57.9%[11/19] vs. 13.6%[3/22], P=0.003) and showed significantly shorter ( 0.05), treatment failure (p = 0.31), complications (p = 0.29), or initial (p = 0.73) or total (p = 0.72) hospitalization

between patients with and without high-grade obstruction. CONCLUSIONS: For patients who were managed by non-operative treatment for appendiceal inflammatory masses, the presence of high-grade obstruction identified on initial CT scan did not significantly affect outcomes of treatment failure, complications, and initial and total hospitalization. SE_GI_56

Research on Signs and Symptoms of Gastrointestinal Perforation and Acute Appendicitis

Saindelger Batbaatar The Third National Central Clinical Hospital, Mongolia

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Radiology Pattern of Gastrointestinal Tuberculosis

Aida Abdul Aziz, Ch'ng Li Shyan Hospital Sungai Buloh, Malaysia

PURPOSE: Gastrointestinal involvement of abdominal tuberculosis is rare; when present, however, in the previous study it almost always involves the ileocecal region (90%). These case series study is to evaluate the involvement of specific part of gastrointensitinal tract (proximal ileum, ileum, terminal ileum, ileocaecal valve, colon) as well as associated abdominal involvement (ascites and lymphadadenitis). MATERIALS AND METHODS: CT findings were retrospectively analysed in immunocompetent and immunocompromised patients with proved abdominal TB from the year 2008. Data collected from patients history, culture, other imaging like radiographs and ultrasounds. RESULTS: From this case series study, only 6% of the confirmed abdominal TB cases involves the gastrointestinal tract. Out of these number, only 10% involves the ileocaecal valve while others majority will involve the colon and/or other parts of small bowel. All of these cases are associated with abdominal lymphadenopathy. More than 90% of these cases has concurrent peritoneal involvement, either, wet (most common), dry or fibrotic type. Few cases involvement of the GI tract of fistulous commnication from the adjacent extensive psoas/ iliopsoas abscess are also illustrated here. More extensive and rare involvement are seen in those with associated AIDS/HIV disease (detailed result will be listed in the original poster). CONCLUSION: Recent pattern of gastrointestinal involvement of Abdominal TB has changed the traditionally known most common involvement of the ileocaecal junction. The recent pattern, predominantly in the emergence of HIV/AIDS related disease, more extensive involvement of the rest of GI tract is seen. CT reliably demonstrates the entire range of findings which need interpretation in the light of clinical and laboratory data.

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PURPOSE: The purpose of the research is to research signs and symptoms of gastrointestinal perforation and acute appendicitis. MATERIALS AND METHODS: We involved 21 patients with diagnosis of gastrointestinal perforation and 94 patients with diagnosis of acute appendicitis who were diagnosed Department of Radiology of State Third Central Hospital, Mongolia named after P.N. Shastin and “Achtan” Clinical Hospital in years from 2014 to 2016. RESULTS: The following signs and symptoms were diagnosed. Herein: for patients with gastrointestinal perforation, intra-abdominal gas in 71.4%, intraabdominal liquid in 52.3%, certain level of gas and liquid in 85.7%, gas and Arka sign in bowels of small intestine in upper part of abdominal cavity in 9.5%. For patients with acute appendicitis, intra-abdominal free gas in 3.2%, intra-abdominal free liquid in 20.2%, gas and arka sign in bowels of small intestine in inferior part of abdominal cavity in 27.7%, gas and small Arka sign in bowels of small intestine of pelvic cavity in 78.7%, transverse margin and clear liquid level of bowels of small intestine in 86.2%, transverse margin and unclear liquid level in bowels of small intestine in 51.1%, appearance of gas and liquid level in appendix in 87.2% and lateral tilt of lumbar vertebrae line in 54.3%. CONCLUSION: 1. The following signs and symptoms were diagnosed in patients with gastrointestinal perforation. Gas and liquid level of stomach in 85.7% and intra-abdominal gas in 71.4% and free liquid of abdominal cavity in 52.3%. 2. For patients with acute appendicitis, gas and liquid level of appendix in 87.2%, transverse margin and clear

liquid level of .. of small intestine in 86.2%, gas and Arka sign in bowels of small intestine in inferior part of abdominal cavity in 78.7%.

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The Result of the Study of Determinating The Hiatal Hernia and Gastro-Esophageal Reflux Disease (Gerd) by Endoscopy and Roentgenography

Oyuntogos Batdelger1, Badamsed Tserendorj2 1 Resident of Radiology, Mongolian National University Medical Science, Mongolia 2 Department of Radiology, State Third Central Hospital, Mongolia

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PURPOSE: To determine the association of endoscopic degree with GERD and to identify type of findings with roentgenography of hiatal hernia. MATERIALS AND METHODS: We evaluated the 30 patients, who are diagnosed with hiatal hernia at Department of Radiology of Third Central Hospital, Ulaanbaatar, Mongolia between years of 2015 to 2016. R E S U LT S : O u r s t u d y i n c l u d e d 1 7 f e m a l e (57,7%±9.1) and 13 (43,3%±9.1) male overall 30 patients with hiatal hernia between age of 39-82. Paraesophageal hernia was nodetected among patients under 54 years old whereas 1 (25%) out of 4 (13,3%) patientswith paraesophageal hernia were 55-64 years old. Seven (26,9%) of 26 (86,7%) patients with axial type hiatal hernia were between age of 45-54. In 7 (23,3%) patients with GERD М who are diagnosed by endoscopic examination had 14.4% mild, 28,6% moderate and 57,1% severe types of hiatal hernia. The 66.7% of 3 (10,0%) GERD Adegree patients had mild, 33.3% patients had moderate hiatal hernia. The 62.5% of 8 (26,7%) GERD B degree patients had mild, 37.6% patients had severe hiatal hernia. The 25,0% of 8(26,7%) patients who are diagnosed GERD C degree had mild, 62,5% patients had moderate hiatal hernia and 12.5% had severe type of hiatal hernia. The 25,0% of 4 (13,3%) patients who are diagnosed GERD D degree had moderate, 75.0% patients had severe hiatal hernia and there was no mild type of hiatal hernia detected (p 0.05). CONCLUSION: The association of esophageal tumor movement in different directions with the tumor location can be evaluated by cine MRI noninvasively.

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Primary Burkitt's Lymphoma of The Appendix: A Case Report and Literature Review

Wei-Ti Chang, Chang-Ming Yang, Wai-Sang Kuan Min-Sheng General Hospital, Taiwan

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The New Way of the View of Dynamic Film Defecography in Diagnosis of Functional Outlet Obstructive Constipation

Jing Liu The Affiliated Hospital of Guizhou Medical University, China

PURPOSE: To discuss the new way of the view of dynamic film defecography (DFG) in diagnosis of functional outlet obstructive constipation (OOC). MATERIALS AND METHODS: To collect 100 cases by dynamic film defecography (DFG) using phase photography and dynamic movie. Comparison with the two imaging methods in the diagnosis of functional OOC, to analyze the cause of diagnostic differences, to record using the dynamic film way and to find the cases of new anatomical structure disorder. RESULTS: Comparison with phase photograph method, the dynamic film in the diagnosis can significantly increase the diagnosis rate of perineum descending (PD), pelvic floor hernia (PFH), internal intussusceptions (IRI) and anal sphincter. Comparison with phase photograph method, the dynamic film can significantly increase the accuracy of perineum descending (PD), pelvic floor hernia (PFH), internal intussusceptions (IRI) and anal sphincter (p < 0.05). CONCLUSION: To diagnosis of functional OOC by the film dynamic DFG, which can be made the accurate of diagnosis and discover the new anatomical structure disorder.

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PURPOSE: Burkitt’s lymphoma is a highly aggressive non-Hodgkin’s lymphoma. Gastrointestinal tract is the most common site for extranodal involvement by non-Hodgkin’s lymphoma. However, primary appendiceal non-Hodgkin’s lymphoma is unusual, and Burkitt’s lymphoma of the appendix is exceedingly rare after reviewing the literature. MATERIALS AND METHODS: This 65-year-old female had suffered from right abdominal pain since October 2016. Poor intake, easily fatigue and body weight loss 16 kg in 4 months were also complained. Thus, he went to our hospital for help. Physical examination revealed right lower abdominal tenderness. Lab data showed leukocytosis with left shift. Initially, acute appendicitis was suspected. Abdominal CT was then performed and showed markedly dilated appendix about 3.5 cm with wall thickening and heterogeneous contrast medium enhancement involves most of the dilated appendix. Besides, multiple necrotic and markedly enlarged lymph nodes are also noted within right lower abdomen. Initial impression was appendiceal adenocarcinoma or carcinoid with regional lymphadenopathy. After well explaining the condition to patient and her family, she underwent exploratory laparotomy and right hemicolectomy on 2016/11/17. RESULTS: Intraoperative finding showed a large hard mass was noted over the junction of appendix and cecum with multiple enlarged lymph nodes around superior mesenteric vein, and appendiceal malignancy was suspected. Pathology revealed dense and diffuse tumor cell infiltrate is noted involving the appendix, whole wall of adjacent colon, small intestine, and mesentery. Immunohistochemically, these cells are positive for CD20, negative for CD10, CD43, cyclinD1, CD3, CD30 and cytokeratin. Based on the morphology and the result of immunostains, a picture of high grade B cell lymphoma is considered, and Burkitt’s lymphoma is favored. CONCLUSION: Our case is unusual in that the primary appendiceal Burkitt’s lymphoma in an adult patient to our knowledge is exceedingly rare. If the diameter of appendix measures 3 cm or larger, accompanying prominent abdominal

lymphadenopathy, non-Hodgkin’s lymphoma should be the lead differential diagnosis.

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Protocol Optimization of Magnetic Resonance Colonography for Polyp Detection Using Pig Colonic Phantom: Influence of Magnetic Field Strength, Colonic Distension Technique, and MRI Sequence

Eun-Suk Cho, Jeong-Sik Yu, Joo Hee Kim, Jae-Joon Chung Gangnam Severance Hospital, Korea

Scientific Exhibition (GI)

PURPOSE: To compare the diagnostic performance and image quality of MR Colonography (MRC) using pig colon phantoms and to evaluate the influence of magnetic field strength (1.5-T or 3.0-T), colonic distension technique (bright- or dark-lumen), and MRI sequences. MATERIALS AND METHODS: Six pig colon segments (60-92 cm) with 56 artificial colon polyps (0.4-1.6 cm) were placed in plastic container containing soybean oil. The colon was distended using room air for dark-lumen MRC and with tap water or a gadolinium-chelate based enema fluid for bright-lumen MRC. Each colon phantom was scanned on both 1.5-T and 3.0-T scanners using the following sequences: 2D fast-imaging with steadystate precession, T2-weighted 2D single-shot fast-spin-echo (SSFSE), and/or T1-weighted 3D gradient-echo (GRE) sequences. Two radiologists evaluated the presence of polyps and analyzed the image quality. RESULTS: For polyp detection sensitivity and image quality, MRC obtained at 1.5-T was better than that obtained at 3.0-T, and a bright-lumen technique was superior to a dark-lumen technique. Bright-lumen MRC at 1.5-T was most sensitive for polyp detection (p < 0.001) and gave the highest image quality (p < 0.05) regardless of polyp size and shape (flat or sessile). SSFSE and 3D GRE sequences at brightlumen MRC at 1.5-T had highest sensitivity for polyp detection (83.9% and 83.0%, respectively) and highest image quality. CONCLUSION: The most effective sequences of MRC for polyp detection were SSFSE- or 3D GREbased bright-lumen MRC obtained with a 1.5-T scanner. These sequences had the highest polyp detection rate and the best image quality.

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Cystic Lesions of Upper Gastrointestinal Tract

Young Seo Cho, Yongsoo Kim, Sanghyeok Lim Hanyang University Guri Hospital, Korea

PURPOSE: To review radiologic findings of various cystic lesion involving stomach and duodenum. MATERIALS AND METHODS: Cystic lesion in the stomach and duodenum are rare disease entity. Most of cystic lesions are benign lesions and their imaging features look very similar. Patients have various chief complains such as nonspecific abdominal pain, bowel obstruction, bleeding, and associated malignancy. We will show the CT and endoscopic ultrasonographic findings of cystic lesion in the upper GI and correlate these features with pathologic findings. R E S U LT S : We d e m o n s t r a t e d i v e r s e c y s t i c lesions in stomach and duodenum classified as follows. Congenital lesions (bronchogenic cyst, duplication cyst and ectopic pancreas) Inflammatory lesions (gastritis cystica profunda, Tuberculosis, pancreatic pseudocyst and anisakiasis) Neoplasms (lymphangioma, cystic degeneration of GIST and mucinous adenocarcinoma) Miscellaneous lesions (Brunner’s gland cyst, trauma related submucosal hematoma and gossypiboma). CONCLUSION: Diagnosis of cystic lesions of the stomach and duodenum is difficult because of non-specific clinical manifestations and radiologic features. Despite the overlap of the radiologic appearance of various cystic lesions, the anatomic location and certain radiologic details of the lesion can help narrow the differential diagnosis. SE_GI_64

Imaging Findings of Diverticular Disease of Gastrointestinal Tract

Yoon Young Jung Eulji General Hospital, Korea

PURPOSE: Diverticular disease of the gastrointestinal tract is not uncommon and frequently detected on imaging modalities. Diverticulitis can lead to complications such as perforation, abscess, peritonitis, bowel obstruction, bleeding, or fistula. Diverticulitis is usually self-limiting and responds well to conservative therapy, but there are some complications that require surgery. Moreover,

there is a need to differentiation from other surgical diseases such as appendicitis. Therefore, understanding the imaging findings of diverticular disease of the gastrointestinal tract is important in clinical practice. MATERIALS AND METHODS: I provide imaging findings of diverticular disease of the gastrointestinal tract and a brief review of diseases. RESULTS: Diverticular disease of the gastrointestinal tract is not rare in clinical practice. Therefore, understanding the imaging findings of diverticular disease of the gastrointestinal tract is important. CONCLUSION: Understanding the imaging features of diverticular disease of the gastrointestinal tract helps to accurate diagnosis and proper treatment. SE_GI_65

deposits and the origin could not be established. Most tumors were well defined with central necrosis and heterogeneous rim of soft tissue. Metastases were seen in 28 of 53 (52%) patients at presentation or during follow-up. Mesentery, omentum and liver were the most frequent sites of metastasis. CONCLUSION: CT is considered to be the imaging modality of choice for the detection, staging, surgical planning and follow-up of patient with GIST. They usually present as large, exophytic, wellcircumscribed, heterogeneous, centrally necrotic tumors that arise in the wall of stomach, small or large bowel. Liver, mesentery and omentum are most common site of metastasis. SE_GI_66

Sonographic Features of Malignant Appendiceal Tumors in 7 Cases

Hyun Jin Kim, Hyuk Jung Kim, Suk Ki Jang Bundang Jesaeng General Hospital, Korea

PURPOSE: GISTs are the commonest mesenchymal neoplasms of the GIT originating anywhere from esophagus to rectum and also from mesentery, omentum or retroperitoneum. GISTs are defined as spindle cell or pleomorphic mesenchymal tumors of the gastrointestinal tract, which express the KIT protein. They arise within the gut muscularis layer with origin being distinct from smooth muscle and neural tissue. Purpose of this study is : 1) To study and describe the anatomical distribution, imaging features, patterns of spread of GIST. 2) To study appearance of post-operative and recurrent GIST. MATERIALS AND METHODS: Retrospective study of CT images of histopathologically proven GIST patients (n=53) was done for a duration of 36 months. CT images were evaluated for morphological appearance, local extension and metastatic spread if any. Follow up analysis of post treatment images was done to study recurrent lesions. RESULTS: This study included 53 pathologically proved GIST cases. The primary tumor was localized to the stomach (n = 22), small bowel (n = 20), colon (n = 3), rectum (n = 3) and mesentery (n =4). There was one case with extensive peritoneal

PURPOSE: Review and documentation of the sonographic features of seven malignant appendiceal tumors MATERIALS AND METHODS: Seven patients with confirmed malignant appendiceal neoplasms, who underwent preoperative ultrasonography, were identified from a patient registry from January 2000 to December 2015. The histologic diagnoses of these patients’ tumors included two mucinous cystadenocarcinomas, four colonic type adenocarcinomas, and one signet-ring cell carcinoma. Sonographic images were analyzed by the consensus review of two radiologists, focusing on the following characteristics: outer and inner luminal diameters of the appendix, presence of a mass-like lesion, appendiceal wall characteristics, and other findings. RESULTS: The two mucinous cystadenocarcinomas had markedly enlarged inner luminal diameters (mean, 23 mm; range, 15- 31 mm) and thick irregular walls (mean wall thickness 5.5 mm; range, 5-6 mm). In contrast, the five non-mucinous carcinomas (four adenocarcinomas and one signetring cell carcinoma) had relatively small inner luminal diameters (mean ± SD, 6.6 ± 4.5 mm; range, 2-15 mm) and prominent wall thickening (mean wall thickness ± SD, 6.2 ± 2.3 mm; range, 3-10 mm) or a mass. Of five non-mucinous tumors, only one had a discernible mass, three had thick irregular walls, and four had submucosal hypoechogenicity.

Meenu Gupta1, Prashant Sarda1, Saugata Sen1, Sumit Mukherjee1, Dayanand Lingegowda1, Ruchi Gupta2 1 Tata Medical Center, Kolkata, India 2 AIIMS, Patna, India

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Gastrointestinal Stromal Tumors: Distribution, Imaging features and Pattern of Spread

Regardless of histologic type, five of seven malignant appendiceal tumors showed severe periappendiceal fat infiltration or periappendiceal abscessation, suggestive of perforation. CONCLUSION: Although the sonographic findings of the malignant appendiceal tumors are nonspecific, some sonographic findings seen in these seven cases may help radiologists consider the possibility of underlying malignant appendiceal tumors. SE_GI_67

Leiomyomas in the Stomach: CT Findings and Differentiation from Gastrointestinal Stroma Tumors

Heon-Ju Kwon1, Hae Jung Kim1, Bohyun Kim2, Jin-Hee Jung3, Ji Yeon Park4, Mi Ran Jeon1, Mi Sung Kim1 1 Kangbuk Samsung Hospital, Korea 2 Ajou University Hospital, Korea 3 Dongguk University Ilsan Hospital, Korea 4 Myongji Hospital, Korea

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PURPOSE: To identify CT findings for differentiation of leiomyomas from gastrointestinal stromal tumors (GISTs) in the stomach. MATERIALS AND METHODS: CT images of patients with pathologically proven leiomyomas (n=64) and GISTs (n=40) in stomach were retrospectively reviewed. The qualitative findings including longitudinal and axial location, growth pattern, contour, surface, margin, enhancement pattern and degree of tumor, presences of intralesional low attenuation, calcification, surface dimples or ulcers, and prominent enhancement of underlying mucosa, mesenteric fat infiltration, lymphadenopathy, direct invasion to adjacent organ, and distant metastasis and quantitative values such as long (LD) and short diameters (SD), LD/SD ratio, and mean attenuation value of each lesion in portal phase were assessed. To assess the improvement of radiologists’ performance improvement with knowledge of significant CT findings, two successive review sessions (without and with knowledge of significant CT findings) were performed by one reviewer (nonexpert resident). The data were analyzed using t-test, chi-square test, and ROC curve analysis. RESULTS: Cardial location, endoluminal growth pattern, homogeneous enhancement, low degree enhancement, absence of low attenuation lesion, LD ≤ 19.9 mm, SD ≤ 16.9 mm, LD/SD ratio > 1.29, and

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attenuation value in portal phase ≤ 74.1 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05). Given information of the significant CT findings for the differentiation, accuracy for the diagnosis of leiomyomas and GISTs increased from 65.4% (68/104) to 86.5% (90/104) (P < 0.001). CONCLUSION: CT features including longitudinal location, growth pattern, enhancement pattern and degree, presence of low attenuation lesion, LD, SD, LD/SD ratio, and attenuation value in portal phase could help differentiating leiomyomas from GISTs in the stomach. SE_GI_68

Gallstone Ileus: A Case Report

Zaya Duisyenbi, Undrakh-Erdene Erdenebold, Ononchimeg Buriad, Sarnaitsetseg Munkhbat, Bolortuya Byambadorj United Family Intermed Hospital, Mongolia

PURPOSE: Introduction: Gallstone ileus is characterized by occlusion of the intestinal lumen as a result of gallstones. Patients who have subacute or chronic cholecystitis that leads to gallstone erosion into the bowel. Gallstone is a rare disease and accounts for 1%-4% of all cases of mechanical bowel obstruction. It usually occurs in the elderly with a female predominance and may result in a high mortality rate. Its diagnosis is difficult and diagnostic imaging plays a great role in the management of patients with suspected gallstone ileus. MATERIALS AND METHODS: Case presentation: We report a case of a 69-year-old female patient who had history of previous stroke and new acute ischemic stroke came to our hospital complaining of vomiting in last two days. RESULTS: Imaging findings: Ultrasound presented diffuse dilatation of fluid filled small bowel loops. Plain abdominal radiograph shown markedly distended small bowel loops and suggested small bowel obstruction. After then on abdominal computed tomography, gallstone ileus was diagnosed based on the presence of pneumobilia, chronic cholecystitis, bowel obstruction, an ectopic stone within the ileum and suspecting cholecystoduodenal fistula. Patient underwent emergent enterolithotomy alone. Cholecystectomy was not done due to patient’s health condition. CONCLUSION: In conclusion, computed tomography

and magnetic resonance imaging have made it easier to diagnose gallstone ileus. CT examinations in patients with diagnosis of gallstone ileus, providing important information regarding the exact number, size, and location of ectopic stones and the site of intestinal obstruction or direct visualization of a biliary-enteric fistula, to help clinicians in the therapeutic management of patients. Enterotomy with stone extraction alone remains the most common surgical method because of its low incidence of complications. SE_GI_69

Resurrection of Dead Gastrocolic Fistula by Computed Tomography Colonography

Yuen Chi Ho, Kam Ho Lee, Andrew Kai Chun Cheng, Wendy WM Lam Queen Mary Hospital, Hong Kong, China

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Recent Update of CT Enterography: Comprehensive Review of Techniques and Clinical Applications

Jimi Huh1, Seong Ho Park2, Ah young Kim2, Jong Hwa Lee1, Yoong Ki Jeong1 1 Ulsan University Hospital, Korea 2 Asan Medical Center, Korea

PURPOSE: Computed tomographic enterography (CTE) is a dedicated CT technique for detailed evaluation of small bowel. In the past decades, there have been great advances in CT techniques, oral contrast agents, and clinical applications. We aim to comprehensively review recent updates of CTE. MATERIALS AND METHODS: We systematically searched the PubMed with search terms of ‘computed tomography’ and ‘enterography’ and selected relevant literatures. RESULTS: Key concepts of CTE techniques include high spatial and temporal resolution combined with good luminal distention provided by neutral oral contrast agents. In the past decade, great advancement has achieved in terms of CTE acquisition, reconstruction, and dose reduction techniques. There have been continuous efforts to find optimal oral contrasts which enable good luminal distension of small bowel in a short time as well as good patient compliance. Nowadays, several kinds of oral contrasts such as lowconcentration BaSO4 suspensions or sorbitol, flavored beverage, and PEG solutions compete in the market. Good bowel wall visualization broadens the clinical applications of CTE from tumor detection to active/occult bleeding detection and comprehensive evaluation of inflammatory bowel disease. Especially, CTE is very useful in diagnosis, evaluation of disease extent and activity, and presence of complications of Crohn’s disease, which enable selection of the most appropriate treatment and accurate treatment response assessment. Combined with development of anti-TNF inhibitors, the use of CTE has emphasized from clinician’s side. Regarding the drawback of CTE, radiation exposure is the most important disadvantage. However, recent advances in dose reduction and reconstruction techniques such as model-base The 6th Asian Congress of Abdominal Radiology

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PURPOSE: Computed tomography colonography (CTC) is getting widely used to investigate patients with incomplete or contraindication for conventional optical colonoscopy. The potential relative contraindications of CTC, however, remain underestimated. We report a case to illustrate that past history of healed colonic fistulation can be a potential relative contraindication for CTC. MATERIALS AND METHODS: A 71-year-old gentleman had previous peptic ulcer disease and subtotal gastrectomy and adhesiolysis done in 1996. He was complicated with enterocolic fistula, and remained asymptomatic on conservative treatment. Previous barium follow through study did not revealed any residual fistula. An upper endoscopy performed 2 years ago revealed normal gastric remnant. An optical colonoscopy done 2 years ago was suboptimal due to poor bowel preparation and grossly normal mucosa was reported. CTC was requested due to elevated CEA level. Standard bowel preparation was prescribed according to departmental protocol. CTC was performed with CO2 insufflator, with pressure of 20 mmHg according to departmental guideline. RESULTS: Communication of the gastric remnant with the splenic flexure was clearly depicted, measuring ~1 cm. Findings are suggestive of gastro-colic fistula tract. No free peritoneal gas was detected. The colonic assessment was suboptimal due to poor bowel preparation. CONCLUSION: Radiologists and clinicians and should be aware of the possibility of occult colonic

fistulation and consider it as potential risk and relative contraindication for CTC.

iterative reconstruction, automatic exposure control or automatic kVP selection can greatly reduce radiation dose. CONCLUSION: The quality of CTE has greatly advanced in the past decades due to advances in CTE techniques and oral contrast agent. Therefore, CTE has been increasingly utilized in clinical practice and gained emphasis from clinicians. SE_GI_71

Inflammatory and Infectious Diseases of Duodenum

Yongsoo Kim, Sanghyeok Lim, Young Seo Cho Hanyang University Guri Hospital, Korea

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PURPOSE: 1. To review its anatomic location and relationship among various adjacent organs. 2. To review inflammatory and infectious diseases entities involving duodenum. 3. To correlated with endoscopic findings of the inflammatory and infectious diseases. MATERIALS AND METHODS: Duodenum is the shortest segment of intestinal tract, so it is often overlooked by radiologists. Most inflammatory and infectious duodenal diseases are combined affected with stomach or jejunum and ileum. So we overlooked duodenal imaging findings when inflammatory or infectious diseases involve duodenum. RESULTS: This presentation displays anatomic location and relationship of duodenum with other organs such as stomach, pancreas, gallbladder, and other segments of gastrointestinal tract. Furthermore, it also demonstrates diverse inflammatory and infectious diseases entities of duodenum classified as peptic ulcer related diseases, granulomatous inflammatory bowel diseases, caustic infection, and pancreatitis related duodenal manifestation with endoscopic finding correlated. CONCLUSION: It is possible to understand the anatomy and diverse inflammatory and infectious diseases category of the duodenum.

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Small Bowel Neoplasms: A Pattern-Based Imaging Approach on CT

Sang Won Kim, Hyun Cheol Kim, Ji Su Kim, Dal Mo Yang Kyung Hee University Hospital at Gangdong, Korea

PURPOSE: To illustrate small bowel tumors based on imaging patterns and to facilitate their differential diagnosis. MATERIALS AND METHODS: Since a broad spectrum of tumors can occur in the small bowels, it is not easy to make a correct diagnosis of these tumors on CT. Therefore, once a mass is detected on CT, the radiologist needs to analyse the mass based on presenting patterns such as location, multiplicity, morphology, and enhancement patterns. RESULTS: 1) General features of small bowel tumors : Benign tumors vs. Malignant tumors 2) Propensity to location (1) Jejunum > ileum: adenocarcinoma, T-cell lymphoma, hemangioma, GIST (2) Ileum > jejunum: adenocarcinoma in Crohn's disease, B-cell lymphoma, neuroendocrine tumor, lipoma, inflammatory fibroid polyp 3) Tumors presenting as multiple polypoid masses (1) Metastasis (2) Polyposis syndrome (Peutz-Jegher's syndrome) (3) Mantle cell lymphoma (4) Neuroendocrine tumor (5) GIST in neurofibromatosis type I 4) Well-enhancing tumors of small bowel (1) Adenoma (2) Hemangioma (3) Small GIST (4) Neuroendocrine tumor (5) Malignant gastrointestinal neuroectodermal tumor (clear cell sarcoma) 5 ) Wa l l t h i c k e n i n g p a t t e r n ( m i m i c k e r s o f adenocarcinoma) (1) Lymphoma (2) GIST (3) Malignant gastrointestinal neuroectodermal tumor (4) Metastasis (5) Hemangioma CONCLUSION: We illustrate various small bowel neoplasms according to their specific presenting patterns on CT. If the radiologist pays attention to various presenting patterns of small bowel

neoplasms on CT, a diagnosis will be made more accurately.

Scientific Exhibition (GI) GI_Mesentery and Peritoneum

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Mesenteric Pleomorphic Liposarcoma Imaging Findings in Abdominal Msct Scan

Ferawati Dakio1, Bachtiar Murtala2 Radiology Resident of Medical Faculty of Hasanuddin University, Wahidin Sudirohusodo Hospital, Indonesia 2 Radiology Consultant of Medical Faculty of Hasanuddin University, Wahidin Sudirohusodo Hospital, Indonesia 1

The Anatomy, Physiology and Pathologic Condition of the Greater Omentum: Comprehensive Imaging Review

Akitoshi Inoue1, Shinichi Ohta2, Shohei Chatani2, Kenji Furuichi3, Hisayasu Matsuo4, Michio Yamasaki5, Akira Furukawa6, Kiyoshi Murata2 1 Higashi-Ohmi General Medical Center, Japan 2 Shiga University of Medical Science, Japan 3 Saiseikai Noe Hospital, Japan 4 Omihachiman Community Medical Center, Japan 5 Kohka Public Hospital, Japan 6 Tokyo Metropolitan University, Japan

PURPOSE: The aim of this exhibition is as follow: 1, To review anatomy, embryology and histology of the greater omentum, 2, To learn about protective mechanism of the greater omentum and omental implantation, and 3, To demonstrate various disease of the greater omentum. MATERIALS AND METHODS: Embryology and the normal gross and imaging anatomy about the greater omentum will be shown. Its physiology will be explained by literature. Various disease including neoplasm, imflammation, and vascular lesion are observed in the greater omentum. Primary and secondary neoplasm may occur same as the other peritoneum. Peritonitis frequently involves the greater omentum. Interestingly, the greater omentum may cause small bowel obstruction by adhesion and internal hernia. These cases will be presented in this exhibition. RESULTS: The greater omentum is composed of a double layer of peritoneum and a free-hanging large peritoneal fold which connects the visceral peritoneum of the greater curvature of the stomach to the transverse colon. The greater omentum is characteristic structure with mobility and also has unique functions. To cover gastrointestinal perforation and intraperitoneal inflammation results in preventing from panperitonitis. The greater omentum has been known for its protective mechanism to intraperitoneal infection, and gastrointestinal perforation for a long time and it is called as “Policeman of the abdomen”. Therefore, the greater omentum is surgically used for septic complications, anastomotic leak, perforation and fistula, which is called omental implantation. CONCLUSION: Radiologist should be familiar with anatomical and physiological knowledge as well as pathological condition of the greater omentum. The 6th Asian Congress of Abdominal Radiology

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PURPOSE: To present a case of mesenteric pleomorphic liposarcoma using abdominal MSCT Scan. MATERIALS AND METHODS: It was reported. 65-year-old man, presented with chief complain of abdominal mass since 2 months ago, that enlarged gradually. It was associated with significant weight loss without anorexia, no fever, no urinary and defecation complaint. Work up diagnosis were clinical evaluation, laboratory findings, abdominal MSCT imaging and histopathological examination. Abdominal NECT Scan, showed complex mass with cystic dominant (-5 HU), thin wall, inner septation, without calcification, 23,5 x13x22 cm in size at right side abdomen suggestive mass origin from mesenteric tissue. CECT Scan showed wall and septal enhancement. Histopathological examination of cyst wall specimen showed sitoplasm, nucleus atypical, pleomorphic with mitosis and a little necrotic area and fatty tissue. It was performed surgery and chemotherapy. RESULTS: At the beginning the patient was referred as non specific intraabdominal tumor based on physical examination. Abdominal MSCT scan showed mesenteric tumor predominant of fat, consistent with liposarcoma. Laboratoy finding are still in normal range. The definite diagnosis based on histopathological examination is mesenteric pleomorphic liposarcoma. CONCLUSION: Mesenteric pleomorphic liposarcoma is rare intra-abdominal pathology. Abdominal MSCT Scan, has important role for diagnosis in this case.

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Scientific Exhibition (GI) GI_Intervention

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Unusual Postoperative Shunt or Instrumentations in the Abdomen

Cheol Min Park, Kyeong Ah Kim, Chang Hee Lee, Jongmee Lee, Jae Woong Choi, Yang Shin Park Korea University Guro Hospital, Korea

PURPOSE: Simple Abdomen is usually the initial radiological study in the patients after abdomen surgery or interventional procedures. MATERIALS AND METHODS: In the daily practice, we can see many catheters or instrumentations such as Levin tube, Foley catheter, stent or postoperative drainage catheters. RESULTS: However. lumboperitoneal shunt and extracorporeal membrane oxygenation (ECMO) placement are not frequent procedures and not familiar to abdominal radiologists. CONCLUSION: We will describe these techniques and radiologic findings on plain film and CT. SE_GI_76

Transcatheter Arterial Embolization for Postoperative Bleeding Following Gastrointestinal Surgery

Shohei Chatani, Akitoshi Inoue, Shinichi Ohta, Satoshi Shimizu, Ryo Uemura, Yoshihide Tanoue, Yuka Itsuno, Shigetaka Sato Shiga University of Medical Science, Japan

Scientific Exhibition (GI)

PURPOSE: The aims of this retrospective study are to clarify technical and clinical success rates and to evaluate the factors relating to the prognosis after transcatheter arterial embolization (TAE) for intraabdominal hemorrhage following gastrointestinal surgery. MATERIALS AND METHODS: This study included 18 patients (16 males and 2 females; average age: 59.9; age range: 25-77) and 23 TAE procedures that were performed for postoperative bleeding after gastrointestinal surgery between January 2006 and May 2016. First, the technical and clinical success rates were calculated. Second, primary diseases, surgical procedures, postoperative duration, symptoms, shock index, with or without pancreatic

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fistula, sentinel bleeding, TAE procedures and embolic agents were investigated. The patients were classified into a pancreatic fistula group and a non-pancreatic fistula group and statistical analysis between the 2 groups was performed. RESULTS: The technical success rate was 91.3% (21/23). 2 cases of TAE were not successful because active bleeding such as extravasation and pseudoaneurysms was not depicted on the angiogram in one case, and the pseudoaneurysm was related to a lot of small vessels in another case. The clinical success rate was 88.9% (16/18) because one patient with portal thrombosis and the other patient whom TAE was not successful died. All technical and clinical unsuccessful cases were in the pancreatic fistula group. In the pancreatic fistula group, multiple pseudoaneurysms were observed in 4 of 11 cases (36.4 %) (p=0.12), and more than one TAE procedures were performed in 3 of 11 cases (27.3%) (p=0.25). There were no significant differences between two groups regarding all evaluated items. CONCLUSION: TAE was an effective and safe method for the management of postoperative bleeding after gastrointestinal surgery. In the patients with pancreatic fistula several pseudoaneurysms tended to form and more than one TAE procedure tended to be required. SE_GI_77

No-touch Radiofrequency Ablation using Multiple Electrodes: An In Vivo Comparison Study of Switching Monopolar versus Switching Bipolar Modes in Porcine Livers

Won Chang, Jeong Min Lee, Jeong Hee Yoon, Dong Ho Lee, Sang Min Lee, Kyoung Bun Lee, Bo Ram Kim, Tae-Hyung Kim Seoul National University Hospital, Korea

PURPOSE: To evaluate the in vivo technical feasibility, efficiency, and safety of switching bipolar (SB) and switching monopolar (SM) radiofrequency ablation (RFA) as a no-touch ablation technique in the porcine liver MATERIALS AND METHODS: The animal care and use committee approved this animal study and 16 pigs were used in two independent experiments. In the first experiment, RFA was performed on 2-cm tumor mimickers in the liver using a notouch technique in the SM mode (2 groups, SM1: 10 minutes, n = 10; SM2: 15 minutes, n = 10) and

SB-mode (1 group, SB: 10 minutes, n = 10). The technical success with sufficient safety margins, creation of confluent necrosis, ablation size, and distance between the electrode and ablation zone margin (DEM), were compared between groups. In the second experiment, thermal injury to the adjacent anatomic organs was compared between SM-RFA (15 minutes, n = 13) and SB-RFA modes (10 minutes, n = 13). RESULTS: The rates of the technical success and the creation of confluent necrosis were higher in the SB group than in the SM1 groups (100% vs. 60% and 90% vs. 40%, both p < 0.05). The ablation volume in the SM2 group was significantly larger than that in the SB group (59.2±18.7 cm3 vs. 39.8±9.7 cm3, p < 0.05), and the DEM in the SM2 group was also larger than that in the SB group( 1.39±0.21 cm vs. 1.07±0.10 cm, p < 0.05). In the second experiment, the incidence of thermal injury to the adjacent organs and tissues in the SB group (23.1%, 3/13) was significantly lower than that in the SM group (69.2%, 8/13) (p = 0.021). CONCLUSION: SB-RFA was more advantageous for a no-touch technique for liver tumors, showing a better safety profile than SM-RFA.

Scientific Exhibition (GI) GI_Emergency

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Application of Dual Energy CT for Abdominal Emergency

Hanako Kuroda, Ryosuke Abe, Ayumi Yamada, Yoshimitsu Ohgiya, Takehiko Gokan Showa University Hospital, Japan

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Usual vs Unusual: Differentiation of Gastric Epithelial Tumor from Non-Epithelial Tumor in Emergency CT

Jung Hee Yoon, Seung Ho Kim, Yedaun Lee Inje University Haeundae Paik Hospital, Korea

PURPOSE: In emergency practice, we infrequently meet various solid lesions in the stomach. As they resemble each other, radiologists often make misdiagnosis. The purpose of this exhibition was to differentiate gastric epithelial tumor from non-epithelial tumor in emergency routine CT encountered in our institution and discuss the importance of their correlation to findings in CT and endoscopy when diagnosing solid mass in stomach. MATERIALS AND METHODS: The institutional review board approved this study and waived the requirement for informed consent. Out of 36 patients who initially present with solid tumor in the stomach on routine abdominopelvic CT (APCT) at emergency department of our institution between December 2013 and March 2016, pathologically diagnosed 15 patients were included. The CT images of 15 patients (mean 61.3 years; range 4181 years) were reviewed retrospectively. Endoscopic gastroduodenography or endoscopic ultrasound was performed for gastric assessment, and some of patients subsequently underwent biopsy and surgery for final diagnosis and treatment. RESULTS: Of the 15 patients, twelve patients were proved to have non-epithelial tumor (1 leiomyoma; 1 leiomyosarcoma; 2 lymphoma; 2 schwannoma; 6 GIST). Among them, gastric masses in five patients (42%) were misdiagnosed as epithelial tumor in APCT. The other three patients were proved to have epithelial tumor but one of them (33%) was The 6th Asian Congress of Abdominal Radiology

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PURPOSE: To assess the advantages of DECT for the emergency abdominal radiology. To learn how to use the advantages of DECT for the emergency abdominal radiology. MATERIALS AND METHODS: A retrospective review was performed of patients from October 1st, 2015 to November 1st, 2016 who underwent DECT in abdominal emergency setting. All cases were performed with 3rd generation dual source CT (SOMATOM Force, Siemens Healthcare, Germany). Variety of DECT technologies including iodine map image, monoenergy image, virtual noncontrast image, virtual noncalcium image were used for evaluation of the cases.

RESULTS: Iodine map image showed ischemic status due to torsion of intestine, ovarian mass etc. Monoenergy low KeV image salvaged suboptimal studies in patients with poor enhancement. Metallic artifact reduction was possible with monoenergy high KeV image. Virtual noncontrast image suggested the possibility of abbreviation of precontrast CT. Virtual noncalcium image was able to show bone marrow edema due to acute vertebral compression fracture. CONCLUSION: A variety of image reconstruction and postprocessing techniques of DECT will be useful for the CT diagnosis of abdominal emergency.

misdiagnosed as non-epithelial tumor in APCT. CONCLUSION: Routine APCT provides opportunities for evaluation of gastric intraluminal and extragastric morphology. But, it has limitation when evaluating detailed mucosa of stomach and it is even harder to make a diagnosis when the lesion is combined with acute complication. When we make a diagnosis for stomach tumor in emergency department, it is necessary to correlate CT radiologic findings with endoscopic features. SE_GI_80

Abdominal-Pelvic MDCT in Motor Vehicle Accident Injuries: What Dose a Radiologist Need to Know?

Daejung Kim Bundang CHA General Hospital, Korea

Scientific Exhibition (GI)

PURPOSE: To know injury mechanism and pattern, appropriate CT protocol and important CT findings and intraabdominal/extaabdominal injuries. MATERIALS AND METHODS: To review mechanism and pattern of injuries, CT protocol, improtant CT findings and pitfalls and each organ injuries. RESULTS: (1) Mechanism and pattern of injuries Collisions and Acceleration/Deceleration injury (seat belt syndrome) (2) CT protocol a. Oral contrast material b. Single phase versus Dynamic phase (3) Important CT findings and pitfalls. Hemoperitoneum, Extravasated contrast material (Active bleeding), Hematoma (sentinel colt sign), Penumoperitoneum, Retropneumoperitoneum, fluid collection, mesentery haziness, bowel wall thickening/enhancement (4) Injuries a. Intraperitoneal organ injuries (spleen, liver) - hematoma, laceration, infarction, active bleeding, etc. b. R etroperitoneal organ injuries (pancreas, adrenal gland, kidney) - hematoma, laceration, infarction, active bleeding, etc. c. Vascular injury (abdominal aorta and branches) - pseudoaneurysm, dissection d. Hollow viscus and mesentery injuries. e. bladder injury. f. diaphragmatic injury. g. extraabdominal injuries - heart, lung, extrathoracic aorta and musculoskeletal injuries. CONCLUSION: There is characteristic injury

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patterns associated with injuries from motor vehicle accident and these injuries are usually multisystem. Radiologists should know important CT findings and pitfalls and also characteristic injury patterns in Abdominal-Pelvic MDCT. SE_GI_81

The Imaging Evaluation of the Abdominal Trauma

Young Mi Ku, Su Lim Lee The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Korea

PURPOSE: The purpose of this poster presentation is to explain the basic information of the abdominal trauma and related MDCT findings and to update the current trends. MATERIALS AND METHODS: The agenda of this presentation composed with the injury mechanism, the common causes, determining factors for specific organ injuries, steps for radiologic evaluation, and major image findings mainly on the MDCT depend on specific organ base. RESULTS: 1. Review the traumatic injury mechanism. 2. Step approach of imaging procedure. 3. Various image findings of MDCT feature depend on specific organ base. CONCLUSION: To know the role of imaging in the trauma setting with under standing the trauma mechanism and cause is important. SE_GI_82

Overview of Practical Imaging Modalities in the Diagnosis of Acute Appendicitis

Sheeba Zaheer1, Boon Keat Lim2 Ministry of Health Holdings, Singapore 2 AHPL, Singapore 1

PURPOSE: This poster aims to demonstrate the different types of imaging techniques that can be practically employed to aid in early and accurate diagnosis of acute appendicitis in an emergency setting. MATERIALS AND METHODS: - Literature review of the various imaging modalities that can be used to diagnose acute appendicitis was performed. - Those which were employed and which aided in

surgically proven cases of acute appendicitis in Khoo Teck Puat Hospital, Singapore, were reviewed retrospectively and discussed in this presentation. - These include plain radiographs, ultrasound, computed tomography and magnetic resonance imaging. RESULTS: Retrospective review on the various imaging modalities that can be employed to aid in the diagnosis of acute appendicitis through poster presentation. CONCLUSION: According to ACR guidelines, imaging is now indicated in almost all the cases, with very few exceptions. If a patient presents with atypical symptoms along with inconclusive lab findings, radiologic investigations further play a crucial role, the choice of modality depending on the resource and support available in a given institution at that point of time. Although cross-sectional imaging is currently the gold-standard for diagnosing acute appendicitis, other modalities can also help in raising suspicion for the same, specially in centres where advanced imaging is not available. An early and accurate diagnosis of acute appendicitis not only helps in decreasing associated morbidity and mortality but also helps in lowering the overall cost of healthcare. SE_GI_83

Results of the Research on Chest Ultrasound Findings for the Diagnosis of Pneumonia

Zolboo Baatarjav Mongolian National University of Medical Sciences, Mongolia

Scientific Exhibition (GI) GI_Other

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Rare Splenic Lesions and Neoplasms: Imaging Findings with Pathologic Correlation

Kai-Wei Yu, Yi-You Chiou , Yi-Chen Yeh Taipei Veterans General Hospital, Taiwan

PURPOSE: Knowledge of the pathologic, and radiologic spectrum of splenic neoplasms has been reviewed in many studies, but due to wide spectrum of clinical and radiologic splenic manifestations, the accuracy of differential diagnosis of splenic neoplasms remained uncertain. In this presentation, we summarized our experience in imaging features with splenic neoplasms at our hospital, emphasized on those characteristics that may aid in specific diagnosis. MATERIALS AND METHODS: We retrospectively searched from data base of pathological report system in our hospital from December 2002 to December 2015 and collected both benign and malignant splenic neoplasms, including: hemangioma, lymphangioma, harmatoma, The 6th Asian Congress of Abdominal Radiology

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Scientific Exhibition (GI)

PURPOSE: The purpose of this research is to study and identify the findings of pneumonia observed on chest ultrasound. MATERIALS AND METHODS: We selected 71 patients who had been hospitalized for pneumonia at Pulmonary Department at Shastin Memorial State Third Central Hospital during 2013-2015. We used Japanese portable ultrasound machines Aloka SSD 500 and Toshiba 310A with convex array 3.5 MHz probe for chest ultrasound diagnosis. By using the results from the treatments and diagnosis, performing an analysis on chest ultrasound was possible. Moreover, we developed a specific card with findings seen on ultrasound examination performed for patients with pneumonia and with the help of those cards we had been able to evaluate our survey. The diagnosis of pneumonia

was confirmed by clinical laboratory, Chest PA and computed tomography. RESULTS: The symptoms of pneumonia observed during chest ultrasound are as follow: - air bronchogram in 63 (88.7%±3.8) - fluid bronchogram in 9 (12.7%±3.9) - fluid accumulation in inflammation in 33 (46.5%±5.9)/ pleural effusion in inflammation/pneumonia affected area of the lung - oncogenic obstructive pneumoniain 5 (7.0%±3.0) - necrotizing pneumonia with multiple small abscesses in 12 (16.9%±4.5) - multiple accumulations in pleural space in 14 (19.7%±4.7)/multiple accumulations beneath pulmonary pleura CONCLUSION: Following findings were found with chest ultra sonography in patients: air bronchogram, fluid bronchogram, fluid accumulation in inflammation, oncogenic obstructive pneumonia, necrotizing pneumonia with multiple small abscesses, and multiple accumulations in pleural space. The domination of air bronchogram symptom is statistically true for patients with pneumonia (P