• Title/Summary/Keyword: 병기설정

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Uterine Cervical Cancer: Emphasis on Revised FIGO Staging 2018 and MRI (자궁경부암: 개정된 2018 FIGO 병기와 자기공명영상을 중심으로)

  • Weon Jang;Ji Soo Song
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1083-1102
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    • 2021
  • Uterine cervical cancer is a common gynecological cancer prevalent in Korea. Early detection, precise diagnosis, and appropriate treatment can affect its prognosis. Imaging approaches play an important role in staging, treatment planning, and follow-up. MRI specifically provides the advantage of assessing tumor size and disease severity with high soft tissue contrast. The revised version of the International Federation of Gynecology and Obstetrics (FIGO) staging system has been introduced in 2018, which incorporates subdivided primary tumor size and lymph node metastasis. In this review, the staging of uterine cervical cancer based on previous studies, the recently revised FIGO staging, and various post-treatment images are primarily described using MRI.

Preoperative Staging of Endometrial Carcinoma by MRI (자기공명영상을 통한 자궁내막암의 수술전 병기 결정)

  • Kim, See-Hyung;Cho, Jae-Ho;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.116-125
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    • 2002
  • Background: In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. Material and method: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. Results: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. Conclusion: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.

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Effectiveness of Esophageal Ultrasonography Surgical Therapy of Esophageal Cancer (식도암 수술에서 식도내시경초음파(EUS) 진단의 효용성)

  • Jung, Jae-Seung;Lee, Sung-Ho;Cho, Seong-Joon;Son, Ho-Sung;Sun, Kyung;Kim, Kwang-Taik;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.91-97
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    • 2003
  • With the advent of stage-adapted multimodal regiments for esophageal malignancy, accurate staging has become of utmost importance. Endoscopic ultrasono graphy(EUS) i.: a diagnostic method for the local staging of esophageal cancer, in particular for T and N evaluation. The aim of this study was to examine the diagnostic efficacy of the EUS and to evaluate the relation between prognosis and EUS findings. Material and Method : We reexamined the cases of 88 consecuitive patients who underwent transthroacic esophagectomy and cervical esophagogastrostomy for esophageal cancer from January 1991 to July 2001 We compared EUS findings, histological results and outcomes. Result : There were 83 male(94.3%) and 5 female. Median age was 61.3 years old. Overall staging accuracy were 59.0% for T staging and 76.0% for N staging, In early T staging group, the accuracy was 74.9% except 74 stage. However significant differences were not found in the ability of EUS-determined T-stage and N-Stage to predict survival. Multivariate analysis showed EUS-stage to predict survival. Conclusion : EUS provides a high degree of accuracy in assessing both T and N parameters in staging esophagal cancer. EUS should be performed in all patients with esophageal cancer, not only for staging before therapy, but also as a valuable method of determining prognosis.

Quantitative Evaluation of Liver Fibrosis on T1 Relaxometry in Comparison with Fibroscan (Fibroscan과 비교를 통한 T1 MR Relaxometry를 이용한 간섬유화의 정량적 평가)

  • Byeong Hak Sim;Suk Hee Heo;Sang Soo Shin;Seong Beom Cho;Yong Yeon Jeong
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.365-378
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    • 2020
  • Purpose This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

Accessing the Clustering of TNM Stages on Survival Analysis of Lung Cancer Patient (폐암환자 생존분석에 대한 TNM 병기 군집분석 평가)

  • Choi, Chulwoong;Kim, Kyungbaek
    • Smart Media Journal
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    • v.9 no.4
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    • pp.126-133
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    • 2020
  • The treatment policy and prognosis are determined based on the final stage of lung cancer patients. The final stage of lung cancer patients is determined based on the T, N, and M stage classification table provided by the American Cancer Society (AJCC). However, the final stage of AJCC has limitations in its use for various fields such as patient treatment, prognosis and survival days prediction. In this paper, clustering algorithm which is one of non-supervised learning algorithms was assessed in order to check whether using only T, N, M stages with a data science method is effective for classifying the group of patients in the aspect of survival days. The final stage groups and T, N, M stage clustering groups of lung cancer patients were compared by using the cox proportional hazard model. It is confirmed that the accuracy of prediction of survival days with only T, N, M stages becomes higher than the accuracy with the final stages of patients. Especially, the accuracy of prediction of survival days with clustering of T, N, M stages improves when more or less clusters are analyzed than the seven clusters which is same to the number of final stage of AJCC.

Analysis of Diagnostic Performance of CT and EUS for Clinical TN Staging of Gastric Cancer (위암의 임상적 병기 설정을 위한 전산화단층촬영 및 초음파 내시경의 진단력 평가)

  • Shin, Ru-Mi;Lee, Ju-Hee;Lee, Moon-Soo;Park, Do-Joong;Kim, Hyung-Ho;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.177-185
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    • 2009
  • Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.

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Update of Head and Neck Cancer Staging in the 8th Edition Cancer Staging Manual of the American Joint Committee on Cancer (두경부암 병기 설정의 최신 변화: AJCC 암 병기설정 매뉴얼8판)

  • Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.9-15
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    • 2017
  • The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

Connection Rerouting for Mobile Host in Multicast Network (멀티캐스트 네트워크에서 이동호스트를 위한 연결 재설정)

  • 김용수;장경성;김병기
    • Proceedings of the Korean Information Science Society Conference
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    • 1998.10a
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    • pp.264-266
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    • 1998
  • IP 유니테스트 이동성을 지원하는 연결 재설정 방법에 대한 연구들은 네트워크가 멀티 캐스르 기능지원하지 않는 경우에 이동 호스트에 데이터그램을 송수신 할 수 없는 전송문제를 내포하고 있다. 본 논문은 멀티캐스트 기능을 지원하지 않는 네트워크에서도 이동호스트에게 멀티캐스트 응용 서비스를 제공할 수 있는 MCI-Based rerouting 방법을 제안한다. 이 연구는 종단 이동호스트와 최적 경로를 이루는 네트워크의 최하단 멀티캐스트 라우터를 단순한 비교 연산만으로 찾아 연결을 재설정한다. 근원지에서 최하단 멀티캐스트라우터까지는 멀티캐스트로 전달되고, 멀티캐스트 라우터에서 이동 호스트까지는 터널링을 이용함으로써 이동호스트에 멀티캐스트 데이터그램을 송수신 할 수 있게 한다. 또한 광대역의 인터넷에서도 멀티캐스트 데이터 그램을 송수신할 수 있게 함으로써 확장성을 고혀한다.

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A Clinical Use of CT Scan in Rectal Cancer (직장암 단층촬영(CT)의 임상적 이용)

  • Suh, Bo-Yang;Chung, Yong-Sik;Lee, Su-Jeung;Shim, Min-Chul;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.67-72
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    • 1986
  • Authors evaluated the accuracy of preoperative pelvic CT scan staging and its effects on management in 12 biopsy proved rectal cancer patients. Authors also studied postoperative CT in 5 patients to detect disease recurrence and metastasis. Preoperative CT staging was identical to surgical and/or pathological staging in 9 patients(75%), but it was underestimated in two cases and overstimated in one instance than in surgical stagings. In 7 cases, CT scan didnot alter original choice of procedures. However, preoperative CT staging gave definitive informations to change management plans in 5 cases otherwise the treatment would be difficult and inadequate. Postoperative CT showed local recurrence in one and liver metastases in 2 cases. One of them was not detected at exploratory laparotomy.

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