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8 "Computed tomography"
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Original article
Preliminary data on computed tomography-based radiomics for predicting programmed death ligand 1 expression in urothelial carcinoma
Chang Mu Lee, Seung Baek Hong, Nam Kyung Lee, Hong Koo Ha, Kyung Hwan Kim, Byeong Jin Kang, Suk Kim, Ja Yoon Ku
Kosin Med J. 2024;39(3):186-194.   Published online July 18, 2024
DOI: https://doi.org/10.7180/kmj.24.103
  • 2,764 View
  • 26 Download
Abstract PDFSupplementary MaterialPubReader   ePub   
Background
Programmed death ligand 1 (PD-L1) expression cannot currently be predicted through radiological findings. This study aimed to develop a prediction model capable of differentiating between positive and negative PD-L1 expression through a radiomics-based investigation of computed tomography (CT) images in patients with urothelial carcinoma.
Methods
Sixty-four patients with urothelial carcinoma who underwent immunohistochemical testing for PD-L1 were retrospectively reviewed. The number of patients in the positive and negative PD-L1 groups (PD-L1 expression >5%) was 14 and 50, respectively. CT images obtained 90 seconds after contrast medium administration were selected for radiomic extraction. For all tumors, 1,691 radiomic features were extracted from CT using a manually segmented three-dimensional volume of interest. Univariate and multivariate logistic regression analyses were performed to identify radiomic features that were significant predictors of PD-L1 expression. For the radiomics-based model, a receiver operating characteristic (ROC) analysis was performed.
Results
Among 64 patients, 14 were included in the PD-L1 positive group. Logistic regression analysis found that the following radiomic features significantly predicted PD-L1 expression: wavelet-low-pass, low-pass, and high-pass filters (LLH)_gray-level size-zone matrix (GLSZM)_SmallAreaEmphasis, wavelet-LLH_firstorder_Energy, log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis, original_shape_Maximum2DDiameterColumn, wavelet-low-pass, low-pass, and low-pass filters (LLL)_gray-level run-length matrix (GLRLM)_ShortRunEmphasis, and exponential_firstorder_Kurtosis. The radiomics signature was –4.0934+21.6224 (wavelet-LLH_GLSZM_SmallAreaEmphasis)+0.0044 (wavelet-LLH_firstorder_Energy)–4.7389 (log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis)+0.0573 (original_shape_Maximum2DDiameterColumn)–29.5892 (wavelet-LLL_GLRLM_ShortRunEmphasis)–0.4324 (exponential_firstorder_Kurtosis). The area under the ROC curve model representing the radiomics signature for differentiating cases that were deemed PD-L1 positive based on immunohistochemistry was 0.96.
Conclusions
This preliminary radiomics model derived from contrast-enhanced CT predicted PD-L1 positivity in patients with urothelial cancer.
Case reports
Primary gastric leiomyosarcoma: a case report and literature review
Yedaun Lee
Kosin Med J. 2024;39(1):60-65.   Published online August 18, 2023
DOI: https://doi.org/10.7180/kmj.23.118
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  • 59 Download
Abstract PDFPubReader   ePub   
After separating gastrointestinal (GI) stromal tumors from true smooth muscle tumors of the GI tract, leiomyosarcoma (LMS) of the GI tract has become a rare tumor. Gastric LMS is extremely rare and accounts for 0.1% of all cases of LMS in the GI tract. There are few English-language reports of gastric LMS describing radiologic findings. Here, we report a case of gastric LMS and review the recent literature focusing on radiologic findings. An 80-year-old female patient was referred for evaluation of a gastric mass accompanied by severe anemia. The physical examination revealed no specific findings except for an anemic conjunctiva. Laboratory data showed a low hemoglobin level of 5.1 g/dL. Endoscopy revealed a huge subepithelial mass in the posterior wall of the gastric body. Contrast-enhanced computed tomographic images showed an intraluminal protruding enhancing mass with an internal stalk appearance in the gastric body. There was no internal necrosis or calcification. The patient underwent subtotal gastrectomy and was diagnosed with primary gastric LMS. The diagnosis of gastric LMS is challenging due to its rarity. Our case report suggests that the presence of an internal stalk or spouting appearance can help prompt the radiologist to consider gastric LMS in the differential diagnosis.
Squamous cell carcinoma of the pancreas with a pancreatic intraductal papillary mucinous neoplasm: a case report
Nam Kyung Lee
Kosin Med J. 2024;39(1):71-74.   Published online August 17, 2023
DOI: https://doi.org/10.7180/kmj.23.123
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  • 36 Download
  • 1 Citations
Abstract PDFPubReader   ePub   
Squamous cell carcinoma (SCC) of the pancreas is very rare. No reports have described SCC accompanied by intraductal papillary mucinous neoplasm (IPMN) of the pancreas. This report presents the first known case of SCC with IPMN of the pancreas in a 71-year-old man, with a focus on radiologic findings. Here, the imaging features of SCC with IPMN of the pancreas were similar to those of IPMN of the pancreas with high-risk stigmata features.

Citations

Citations to this article as recorded by  
  • Invasive squamous cell carcinoma arising from an intraductal oncocytic papillary neoplasm demonstrating shared ATP1B1::PRKACA gene fusion
    Wai Szeto, Safa Alshaikh, Javier A. Arias-Stella, Yuman Fong, Rifat Mannan
    Human Pathology Reports.2024; 37: 300745.     CrossRef
Original articles
Comparison of the radiation dose between dual-acquisition coronary computed tomography angiography and coronary angiography for coronary spasm
Soo-Jin Kim, Moo Hyun Kim, Eun-Ju Kang
Kosin Med J. 2022;37(1):46-51.   Published online March 16, 2022
DOI: https://doi.org/10.7180/kmj.21.035
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Abstract PDFPubReader   ePub   
Background
Coronary computed tomography angiography (CCTA) is an imaging technique that can be used to evaluate and diagnose coronary artery stenosis. Dual-acquisition CCTA (DA-CCTA) with additional nitrate infusion is a promising alternative noninvasive diagnostic tool, as conventional CCTA has limitations in the diagnosis of variant angina compared to conventional angiographic coronary spasm tests. However, DA-CCTA may pose a potential risk due to radiation exposure. We compared the radiation dose between DA-CCTA and the coronary angiographic spasm provocation test.
Methods
Patients with clinically suspected variant angina at a single hospital between March 2013 and October 2018 were screened and underwent DA-CCTA or a coronary angiographic spasm provocation test. The effective radiation dose required for each approach was compared.
Results
In total, 211 suspected variant angina patients underwent DA-CCTA or the coronary angiographic spasm provocation test. Of these, 49 patients (mean age, 59.8 years; 67.3% men) received DA-CCTA and 162 patients (mean age, 60.5 years; 66.2% men) received a coronary angiographic spasm provocation test. There was a significant difference in the effective radiation dose, with a median dose of 5.1 mSv (interquartile range [IQR], 4.1–9.2 mSv) required for DA-CCTA and a median dose of 10.9 mSv (IQR, 8.4–15.2 mSv) for the coronary angiographic spasm provocation test (p<0.001).
Conclusion
DA-CCTA showed a significantly lower effective radiation dose than the coronary angiographic spasm provocation test required to diagnose variant angina.
Clinical Usefulness of Contrast-Enhanced Computed Tomography in Patients with Non-Obstructive Acute Pyleonephritis
In O Sun, Ji Hye Lim, Ju Hwan Oh, A Young Cho, Beum Jin Kim, Kwang Young Lee, Mi Sook Lee
Kosin Med J. 2020;35(1):38-46.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.38
  • 3,601 View
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Abstract PDFPubReader   ePub   
Objectives

The aim of this study is to investigate the clinical utility of contrast-enhanced computed tomography (CE-CT) in patient with non-obstrcutive acute pyelonephritis (APN).

Methods

From 2007 to 2013, 537 APN patients who underwent a CE-CT scan within 24 hours after hospital admission were enrolled. We divided these patients into greater (50% or greater involvment, n = 143) and lesser (less than 50% involvement, n = 394) groups based on renal parenchymal involvement in CE-CT examination. We compared clinical characteristics between two groups and analyzed the clinical value of CE-CT scan as a reliable marker for predicting clinical severity and disease course in patient with non-obstructive APN.

Results

The mean estimated glomerular filtration rate was 70.6 ± 25.5 mL/min/1.73m2. Compared with patients in lesser group, the patients in greater group had lower serum albumin levels (3.5 ± 0.5 vs 3.8 ± 0.6, P < 0.01) and longer hosptal stay (10.1 ± 4.7 vs 8.8 ± 4.5, P < 0.05). In addition, acute kidney injury (AKI) (23.1% vs 11.4%, P < 0.005) and bacteremia (36.4% vs 26.8%, P = 0.02) were frequently developed in greater group, respectively. The overall incidence of AKI was 14.8% based on RIFLE criteria. In a multivariate logistic regression analysis for predciting AKI, age, presence of diabetes mellitus and the presence of renal parenchymal involvement of greater than 50% in CE-CT were significant predictors of AKI.

Conclusions

The CE-CT scan could be useful to predict the clinical severity and course in non-obstructive APN patients with preserved renal function.

Correlation between nasal mucosal thickness around the lacrimal sac fossa and surgical outcomes in endonasal dacryocystorhinostomy
Jae Ho Yoo, Chang Zoo Kim, Ki Yup Nam, Seung Uk Lee, Jae Ho Lee, Sang Joon Lee
Kosin Med J. 2018;33(3):358-368.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.3.358
  • 3,785 View
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  • 3 Citations
Abstract PDFPubReader   
Objectives

To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography.

Methods

We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group.

Results

Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so.

Conclusions

Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

Citations

Citations to this article as recorded by  
  • Heat and mass transfer investigation concerning drug droplet phase change in nasal drug delivery
    Kartika Chandra Tripathy, Ajay Bhandari
    International Journal of Thermal Sciences.2026; 223: 110589.     CrossRef
  • From Growth Factors to Structure: PDGF and TGF‐β in Granulation Tissue Formation. A Literature Review
    Josiah Irma, Arief S. Kartasasmita, Angga Kartiwa, Irawati Irfani, Saraswati Anindita Rizki, Serena Onasis
    Journal of Cellular and Molecular Medicine.2025;[Epub]     CrossRef
  • Post-operative Clinical Evaluation of Endoscopic Dacryocystorhinostomy: Insights from a Three-Month Follow-Up Study
    Josiah Irma, Michael Lekatompessy, Arief S. Kartasasmita, Angga Kartiwa, Irawati Irfani, Saraswati Anindita Rizki, Giovanni Adrian Santoso, Jonathan Salim, Veli Sungono, Serena Onasis
    Indian Journal of Otolaryngology and Head & Neck Surgery.2024; 76(5): 4208.     CrossRef
Clinical Manifestations of 6 Cases of Septic Pulmonary Embolism at Increased Risk Recently
Su-Min Park, Kyung-Han Kim, Neul-Bom Yoon, Il-Hwan Jeong, Hye-won Lee, Soo-Keol Lee, Ki-Nam Lee, Choonhee Son, Soo-Jung Um
Kosin Med J. 2012;27(2):99-103.   Published online December 27, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.2.99
  • 2,918 View
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  • 1 Citations
Abstract PDFPubReader   ePub   
Objectives

The aim of this study was to investigate the clinico-radiologic features and microbiologic data of patients with SPE in a tertiary care hospital in Busan.

Methods

We retrospectively analyzed clinical and radiologic features of 6 cases with septic pulmonary embolism that occurred from March 2009 to March 2011 in Dong-A university medical center.

Results

The mean age of the study population was 58 years, and two men and four women were included. Clinical symptoms included general weakness (5 patients), febrile sensation (4 patients) and pleuritic chest pain (2 patients). Underlying conditions were chemoport infection (4 patients), dental abscess (1 patients), and cellulitis of hip (1 patient). Chest computed tomography revealed bilateral multiple nodular opacities in most patients, and cavitation, central necrosis, feeding vessels were identified. All patients received parenteral antimicrobial therapy with or without central catheter removal, drainage of the extrapulmonary infection. Causative organisms were Pseudomonas aeruginosa (2 patients), Candida albicans (1 patient), Bacillus species (1 patient), and Klebsiella pneumonia (1 patient).

Conclusions

Clinical and radiologic features of septic pulmonary embolism were various and nonspecific. The diagnosis was usually suggested by the presence of a predisposing factor of septic pulmonary embolism and CT findings of bilateral multiple nodular opacities in patients with infectious signs and symptoms. Most important underlying condition was intravascular device infection.

Citations

Citations to this article as recorded by  
  • Fat embolism syndrome: a review in cosmetic surgery
    Hongil Kim, Bommie Florence Seo, Gregory Randolph Dean Evans
    Kosin Medical Journal.2024; 39(3): 169.     CrossRef
In Vitro Correlation With Quantitative MR, Single Energy Quantitative CT, and Dual X-ray Absorptiometry
Ji Ho Ko, Jin Do Huh, Gyoo Sik Jung, Kyeng Seung Oh, Seung Ryong Lee, Young Duk Cho
Kosin Med J. 2004;19(1):209-216.
  • 622 View
  • 1 Download
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