Conclusions: The addition of FDG PET/CT scanning to chest CT imaging provides better performance for predicting conversion to thoracotomy during VATS lobectomy in lung cancer patients. Therefore, in lung cancer patients undergoing surgical resection, FDG PET/CT can provide additional reliable information in selecting the appropriate surgical approach for a lobectomy.

Objectives To compare the differences in radiologic and pathologic features of surgically resected chronic obstructive pulmonary disease (COPD)‐related adenocarcinomas according to the presence of emphysema. Methods A total of 216 smokers with surgically resected lung adenocarcinoma were included in this retrospective study, and 102 patients were diagnosed with COPD. We classified COPD patients as emphysematous or non‐emphysematous group based on the emphysema severity on computed tomography (CT) and evaluated the differences in the CT and pathologic features between the two groups. The relationship between emphysema and disease‐free survival was assessed using a Kaplan–Meier curve. Results Lung adenocarcinomas in emphysema group presented a more aggressive pathologic grade and higher prevalence of solid lesions (vs subsolid lesions) on CT than those in non‐emphysematous group (P = 0.006 and <0.001, respectively). After adjustment for age, sex, smoking pack‐years and tumor size, emphysema group had a greater risk for higher histologic grade and higher prevalence of solid lesions than non‐emphysema group (odds ratio, 3.445; 95% confidence interval, 1.124‐10.564; P = 0.030, odds ratio, 6.192; 95% confidence interval, 1.804‐21.254; P = 0.004, respectively). Kaplan‐Meier survival curves showed that patients with emphysema had significantly impaired disease‐free survival compared with those without emphysema (median disease‐free survival = 37.0 vs 57.5 months, P = 0.038). Conclusion Adenocarcinomas in emphysema‐present COPD had more aggressive features of pathology and CT findings, and worse disease‐free survival than those without emphysema. These findings might provide an insight into the different pathobiology and prognostic implications of lung adenocarcinomas according to the presence of emphysema in patients with COPD.

Patient: Female, 29-year-old Final Diagnosis: Vanishing white matter disease Symptoms: Weakness of upper and lower limb Clinical Procedure: — Specialty: Neurology Objective: Congenital defects/diseases Background: Vanishing white matter disease (VWMD) – also known as childhood ataxia with central nervous system hypomyelination – is one of the most commonly inherited white matter diseases in children. Notably, a course of chronic progressive disease with episodes of rapid and major stress-induced neurological deterioration, such as fever and minor head trauma, is a typical clinical feature of VWMD. The combination of clinical features with specific magnetic resonance imaging findings, including diffuse and extensive white matter lesions with rarefaction or cystic destruction, could recommend a genetic diagnosis. However, VWMD is phenotypically diverse and can affect individuals of all ages. Case Report: A 29-year-old female patient presented with recent aggravation in gait disturbance. She had progressive movement disorder, with symptoms ranging from hand tremors to upper- and lower-extremity weakness, for 5 years. Whole-exome sequencing was performed to confirm the diagnosis of VWMD, and it revealed a mutation in homozygous eIF2B2 gene. The temporal evolution of VWMD observed in the patient for 17 years (from the age of 12 to 29 years) indicated an increased extent of T2 white matter hyperintensity in the cerebrum into the cerebellum and an increased amount of dark signal intensities in the globus pallidus and dentate nucleus. Moreover, a T2*-weighted imaging (WI) scan revealed diffuse, linear, and symmetrical hypointensity along the juxtacortical white matter on the magnification view. Conclusions: This is the case report about rare and unusual finding of diffuse linear juxtacortical white matter hypointensity on T2*-WI scan as a potential radiographic marker for adult-onset VWMD.

Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as "acute-on-chronic liver failure (ACLF)," a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

Results Questionnaires were completed by 25 participants (n=16 professionals, n=5 parents, n=4 young people). Data that were perceived to be most beneficial (by all groups) were appointment scheduling, medication lists and transition information. Young people and their parents also perceived that viewing clinical correspondence, blood tests and radiology reports would be highly beneficial. A comparison between stakeholder groups identified that young people and parents were significantly more likely to perceive benefits associated with being able to view laboratory and radiology data than professionals (p<0.05).Clinicians perceived that there was a higher degree of risk associated with the inclusion of nearly all data items. These differences were statistically significant (p<0.05) in relation to next of kin and contact details, laboratory, radiology and appointment scheduling data.Analysis of qualitative feedback provided by health professionals identified that there may be specific risks associated with displaying next of kin and contact details, relating to concerns around safeguarding. Conclusions Professionals involved in providing paediatric care perceive that there are more significant risks and fewer, less significant benefits associated with paediatric patient portals than young people and their carers. Discrepancies in perceived risk and benefit should be explored to ensure that future implementations of paediatric patient portals are acceptable to key stakeholders.