Purpose To evaluate the accuracy and time-efficiency of newly developed software in automatically creating curved planar reconstruction (CPR) images along the main pancreatic duct (MPD), which was developed based on a 3-dimensional convolutional neural network, and compare them with those of conventional manually generated CPR ones. Materials and methods A total of 100 consecutive patients with MPD dilatation (≥ 3 mm) who underwent contrast-enhanced computed tomography between February 2021 and July 2021 were included in the study. Two radiologists independently performed blinded qualitative analysis of automated and manually created CPR images. They rated overall image quality based on a four-point scale and weighted κ analysis was employed to compare between manually created and automated CPR images. A quantitative analysis of the time required to create CPR images and the total length of the MPD measured from CPR images was performed. Results The κ value was 0.796, and a good correlation was found between the manually created and automated CPR images. The average time to create automated and manually created CPR images was 61.7 s and 174.6 s, respectively (P < 0.001). The total MPD length of the automated and manually created CPR images was 110.5 and 115.6 mm, respectively (P = 0.059). Conclusion The automated CPR software significantly reduced reconstruction time without compromising image quality.

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Purpose To evaluate the feasibility and safety of the craniocaudal approach for superior sulcus lesions of the thorax. Material and Methods Between October 2010 and December 2020, the data from 22 consecutive patients who underwent drainage or biopsy using a craniocaudal trajectory were retrospectively reviewed. The craniocaudal approach was applied for patients in which the fluid collection or tumor was limited to the superior thoracic sulcus lesion or otherwise inaccessible owing to intervening structures such as pleural dissemination. The indications for this procedure were drainage in 20 patients and biopsy in 2 patients. Technical success, procedure time, complications, and clinical success were evaluated. Results Technical and clinical success were achieved in all patients, and no major complications were found. The median procedure time was 25 min (range 15–40 min). This procedure was performed with fluoroscopic guidance in 11 patients and ultrasound guidance in 11 patients. The routes of needle passage were the first intercostal space (n = 16), the second intercostal space (n = 5), and between the clavicle and the first rib (n = 1). Conclusion The craniocaudal approach for superior sulcus lesions might be a safe and feasible option for patients in which the conventional intercostal approach is difficult. Level of Evidence Retrospective cohort study. Level 4.

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Educational Poster Background: Computed tomographyguided needle biopsy (CTNB) has been widely applied for obtaining a specimen before resection, especially in small lung nodules. However, an increased risk of tumor seeding has been reported, which does not correspond to our experience. At our single institute, 418 p-stage I lung cancers underwent CTNB before resection between October 2003 and December 2012. Procedures were performed following the same steps; briefly, an 18-gauge core biopsy needle was inserted into a lesion under CT-fluoroscopy; multiple penetrations of the pleura were avoided whenever possible (average 1.1 times/lesion); the insertion route was intentionally chosen to include some distance in the normal lung parenchyma. Forty-eight tumor recurrences were observed during the clinical follow-up (range 1-168 months, median 62 months). Among them, five cases developed either pleural-or chest wall-dominant recurrence. In contrast to some literature that reported high occurrence rates of the seeding, a lower rate of approximately 1% was observed in our case series. Tumor seeding caused by CTNB does not occur as frequently as it has been emphasized. Fewer times of pleural penetration and inclusion of the normal lung parenchyma in the insertion route are considered to contribute to a lower pleural seeding rate.