• 제목/요약/키워드: 종양의 크기

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Analysis of Relativity Between Invasiveness on Chest of Tomographic Finding and Histopathologic Invasiveness (종격동 종양의 전산화 단층촬영(CT)소견, 수술소견 및 병리조직학적 침윤도 사이의 상관성 분석)

  • 김용희;이현우
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.780-785
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    • 1997
  • Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

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Anterolateral Thigh Free Flap for Reconstruction after Wide Resection of Soft Tissue Sarcoma (악성 연부조직 종양의 광범위 절제 후 전외측 대퇴부 유리 피판을 이용한 재건술)

  • Park, Jong-Hyuk;Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.119-124
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    • 2008
  • Purpose: To present our experience with soft tissue reconstruction using anterolateral thigh free flap after resection of soft tissue sarcoma. Materials and Methods: Between January of 2003 and June of 2007, we treated 7 patients with soft tissue reconstruction using anterolateral thigh free flap after wide resection for soft tissue sarcoma. We retrospectively analyzed type and size of tumors, resection margin, size of defect after resection, time of operation, flap survival and complication. Results: The type of sarcoma was 3 synovial sarcoma, 2 malignant fibrous histiocytoma, 1 leimyosarcoma and 1 fibrosarcoma. The size of tumor varied from $3{\times}5\;cm$ to $7{\times}8\;cm$. The resection margins of tumors were negative in all cases. The size of soft tissue defect after resection varied from $6{\times}8\;cm$ to $15{\times}10\;cm$. The mean time of operation was 3.6 hours. All flaps were survived. Conclusion: Anterolateral thigh free flap appear to be ideal for reconstruction after wide resection of soft tissue sarcoma.

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Positional Change of the Uterus during Definitive Radiotherapy for Cervix Cancer (자궁경부암의 방사선치료 시 자궁의 크기와 위치 변화)

  • Park, Won;Huh, Seung-Jae;Lee, Jeung-Eun
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.135-142
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    • 2003
  • Purpose: The purpose of this study was to investigate the positional change of the uterus during radiotherapy. Materials and Methods: Between 1997 and 2001, 47 patients received definitive radiotherapy for cervical cancer at the Samsung Medical Center. For each patient, two MRI scans were taken; one before and the other 3$\~$4 weeks after the radiotherapy treatment. In T2 weighted MRI images, the positional change of the uterine was quantified by measuring six quantities; the distance from the cervix os to the isthmus of the uterus (Dcx), the maximum length from the isthmus of the uterus to the uterine fundus (Dco), the maximum vertical distance of the uterine body (Dco-per), the angle between the vertical line and the cervical canal in the sagittal images (Acx), the angle of the uterine corpus from the vertical line in the sagittal plan (Aco-ap), and the relative angle of the uterine corpus from a fixed anatomical landmark in the axial images (Aco-axi). Results: The mean Dcx values, before and during the treatment, were 36.7 and 27.8 mm, respectively. The Dco deviated by more than 10 mm in 14 cases (29.8$\%$). The change in the Acx ranged from 0.1 to 67.8$^{\circ}$ (mean 13.2$^{\circ}$). The Aco-ap changed by a maximum of 84.8$^{\circ}$ (mean 16.9$^{\circ}$). The differences in the Dcx plus the Dco in the smaller (<4 cm) and larger ($geq$4 cm) tumors were 5.3 and 19.4 mm, respectively. With patients less than 60 years old, or with a tumor size larger than 4 cm, the difference in the Acx was statistically significant. Conclusion: The positional changes of the uterus, during radiation treatment, should be considered in the 3DCRT or IMRT treatment planning, particularly in patients under 60 years of age or in those with a tumor size greater than 4 cm in maximum diameter.

Kidney Tumor Segmentation through Semi-supervised Learning Based on Mean Teacher Using Kidney Local Guided Map in Abdominal CT Images (복부 CT 영상에서 신장 로컬 가이드 맵을 활용한 평균-교사 모델 기반의 준지도학습을 통한 신장 종양 분할)

  • Heeyoung Jeong;Hyeonjin Kim;Helen Hong
    • Journal of the Korea Computer Graphics Society
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    • v.29 no.5
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    • pp.21-30
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    • 2023
  • Accurate segmentation of the kidney tumor is necessary to identify shape, location and safety margin of tumor in abdominal CT images for surgical planning before renal partial nephrectomy. However, kidney tumor segmentation is challenging task due to the various sizes and locations of the tumor for each patient and signal intensity similarity to surrounding organs such as intestine and spleen. In this paper, we propose a semi-supervised learning-based mean teacher network that utilizes both labeled and unlabeled data using a kidney local guided map including kidney local information to segment small-sized kidney tumors occurring at various locations in the kidney, and analyze the performance according to the kidney tumor size. As a result of the study, the proposed method showed an F1-score of 75.24% by considering local information of the kidney using a kidney local guide map to locate the tumor existing around the kidney. In particular, under-segmentation of small-sized tumors which are difficult to segment was improved, and showed a 13.9%p higher F1-score even though it used a smaller amount of labeled data than nnU-Net.

Depth Dose Distribution of Proton Beams by Variation of Tumor Density using Geant4 (Geant4 전산모사를 이용한 종양의 밀도 변화에 따른 양성자의 선량 분포)

  • Kim, You-Me;Chon, Kwon-Su
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.771-779
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    • 2021
  • It is necessary to overlap several peaks to form spread out Bragg peak (SOBP) in order to cover the tumor volume because a mono-energetic proton beam forms a narrow Bragg peak. The tumor density has been considered as a brain tissue and then the absorbed dose of the tumor is calculated using Monte Carlo simulations. However, densities of tumors were not a constant. In this study, the SOBP of proton beams was calculated according to changing density of tumors by using Geant4. Tumors were selected as 10 mm and 20 mm width which were the treatment range in the brain phantom. The energies and relative weights of the proton beams were calculated using mathematical formula to form the SOBP suitable for the location and size of the tumor. As the density of the tumor was increased, the 95% modulation range and the practical range were decreased, and average absorbed dose in the 95% modulation range was increased. The change of the tumor density affects the dose distribution of the proton beams, which results in short SOBP within the tumor volume. The consideration of the tumor density affects the determination of the range, so that the margin of the treatment volume can be minimized, and the advantages of proton therapy can be maximized.

Mouse Tumor Necrosis Using Photodynamic Therapy (광역학적 치료법을 이용한 쥐의 악성종양 괴사)

  • 임현수;변상현
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.49-55
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    • 2004
  • In this paper, we investigated the effects of the photodynamic therapy(PDT) for the tumor mass in mice. In the experimental method, we divided the mice into two control and test group which HepG2 and HeLa cell line induced cancer mass in mice. Photofrin was administered to the tumor-bearing mouse, followed 30 hours later by 630nm and 650nm laser light exposure. After photodynamic therapy we analyzed the two mice group for the tumor mass size, tumor growth, tumor cell necrosis, pathological anatomy change. According to the results, tumor cell necrosis was shown in the tissues which the reduce size of tumor and tumor cell necrotic change according to the irradiation time and light dose amount. The considerable difference, however, between the 630nm and 650nm wavelength was not found for the tumor cell necrotic change and other damage of normal tissue was not found.

Evaluation of MR Based Respiratory Motion Correction Technique in Liver PET/MRI Study (Liver PET/MRI 검사 시 MR 기반 호흡 움직임 보정 방법의 유용성 평가)

  • Do, Yong Ho;Lee, Hong Jae;Kim, Jin Eui;Noh, Gyeong Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.15-22
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    • 2018
  • Purpose Respiratory motion during PET/MRI acquisition may result in image blurring and error in measurement for volume and quantification of lesion. The aim of this study was to evaluate changes of quantitative accuracy, tumor size and image quality by applying MR based respiratory motion correction technique (MBRMCT) using integrated PET/MR scanner. Materials and Methods Data of 30 patients (aged $62.5{\pm}10.2y$) underwent $^{18}F-FDG$ liver PET/MR (Biograph mMR 3.0T, Siemens) study were collected. PET listmode data for 7 minutes was simultaneously acquired with maximum average gate (MAG), minimum time gate (MTG) and non gate (NG) T1 weighted MR images. Gated PET reconstruction was performed using mu-maps generated from MAG and MTG by setting 35% of efficiency window. Maximum SUV ($SUV_{max}$), peak SUV ($SUV_{peak}$), tumor size and full width at half maximum (FWHM) in the z-axis direction of MAG, MTG and NG PET images were evaluated. Results Compared to NG, mean $SUV_{max}$ and $SUV_{peak}$ were increased in MAG 13.15%(p<0.0001), 8.66%(p<0.0001), MTG 13.27%(p<0.0001), 8.80%(p<0.0001) and mean tumor size and FWHM were decreased in MAG 14.47%(p<0.0001), 15.49%(p=0.0004), MTG 14.89%(p<0.0001), 15.79%(p=0.0003) respectively. Mean $SUV_{max}$ and $SUV_{peak}$ of MTG were increased by 0.07%(p=0.8802), 0.13%(p=0.7766). Mean tumor size and FWHM of MTG were decreased by 0.49%(p=0.2786), 0.36%(p=0.2488) compared to MAG. There was no statistically significant difference between MAG and MTG which increase total scan time for about 7 and 2 minutes. Conclusion SUV, accuracy of tumor size and spatial resolution were improved in both of MAG and MTG by applying MBRMCT without installing additional hardware in liver PET/MR study. More accurate information can be provided with the increase of 2 minutes scan time if applying MTG of MBRMCT to various abdominal PET/MR studies affected by respiratory motion.

Adenoid Cystic Carcinoma of the Parotid and Submandibular Glands: A Comparative Study (이하선과 악하선에 생긴 선양낭암의 비교)

  • Lee S.S.;Park J.S.;Luna Mario A.;El-Naggar Adel;Batsakis John G.
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.2
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    • pp.104-113
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    • 1991
  • 선양낭암은 타액선종양중 비교적 드문 악성종양으로 병리조직학적 및 임상적으로 독특한 양상을 보인다. 병리조직학상 종양세포가 신경주변으로 침범하여 수술당시 적절한 수술연을 얻기 어렵고 이에 따른 국소재발이 거듭되고 임파선전이 및 예측치 않는 원격전이가 생기기도 한다. 지금까지 선양낭암환자의 예후에 영향을 미치는 여러 요인들에 대한 연구들이 이루워지고 있는데 그중 조직학적 분화도, 원발부위, 종양의 크기, 수술연의 상태와 임상적 병기들이 중요시되고 있다. 이에 저자들은 1960년부터 1980년 까지 텍사스대학 M.D. Anderson 암센터에서 치료받은 이하선 및 악하선 선양낭암 각각 13례와 26례를 대상으로 원발부위가 환자의 생존 및 치료에 미치는 영향을 알고자 다른 예후인자로 알려진 조직병리학적 소견들과 함께 통계학적 분석을 실시하였다. 이하선과 악하선에 생긴 선양낭암을 비교한 결과 이하선에 생긴 경우 조직학적 분화도가 더 낮았고 악하선 종양에서 수술연에 종양침범율이 더 적었다. 경부 임파절 전이는 악하선 종양에서 많았으나 반면 원격전이는 이하선 종양에서 더 많이 발생하였다. 그러나 종양의 크기, 선경주위침범 유무, 국소재발과 환자의 생존율사이에는 의의있는 상관 관계는 없었다. 이하선과 악하선에 생긴 선양낭암의 여러 특성들과 생존률간의 univariate 분석결과 악하선에 생긴 선양낭암 환자에서 종양이 크거나 조직학상 분화가 나쁘거나(solid pattern), 경부임파절 전이와 원격전이가 생기면 예후에 나쁜 영향을 끼침이 밝혀졌다. 그러나 이하선에 생긴 경우 분석례가 너무 적어 결론을 내리기에 불충분하였다. 원발부위에 따른 선양낭암 환자들의 특성을 chi-square 검정법을 이용하여 통계학적으로 분석한 결과 이 두군간에는 의의있는 통계학적 차이는 발견할 수 없었다.

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Role of Endoscopic Ultrasonography in the Diagnosis of Gastrointestinal Stromal Tumors in the Stomach (위의 위장관 간질성 종양에 대한 내시경 초음파의 진단적 역할)

  • Yoon, Ji-Hoon;Kim, Hyun-Chul;Choi, Chang-Soo;Oh, Sang-Hoon;Choi, Young-Kil
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.120-126
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    • 2005
  • Purpose: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors(GISTs) and assessed differences between the two groups. Materials and Methods: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echoheterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. Results: Tumor sizes over 40 mm were observed in $85.7\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.000). Intralesional cystic spaces were noted in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.003). The outer margin was irregular in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.014). $85.7\%$ of the malignant and $13.0\%$ of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. Conclusion: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.

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Solitary Hepatic VX2 Tumor Model and Its CT Findings in Rabbits (가토에서 VX2 단일간암모델과 CT 소견)

  • Lee, Hae-Beom;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.388-392
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    • 2006
  • To verify the solitary nodular hepatocellular tumor model induced by intraparenchymal VX2 tumor cell injection and assess the diagnostic imaging character by computed tomography in rabbits. The tumor cell fragment ($1{\sim}2mm^3$) was loaded in Seldinger needle and directly implanted into the livers of 80 New Zealand white rabbits. The tumor size and patterns of tumor growth were evaluated using spiral computed tomography (CT) at 1, 2, and 3 weeks after tumor implantation. A solitary nodular tumor was successfully created in 82.5% (66/80). The mortality rate was 5% (4/80). The tumor sizes measured were 7.46.3, 14.210.8, 16.212.6 cm at 1, 2, and 3 weeks after tumor implantation on arterial phase CT images. The tumors were round to oval shape with peripheral enhancement and central hypoattenuation on arterial phase, and hypoatteuated wash-out pattern on portal phase. It is considered that inoculation of tumor fragment loaded in Seldinger needle is useful and practical method for creating a solitary hepatic tumor. And CT scanning are valuable to investigate the hepatic tumor and compatible to the observations on macro-and microscopic findings.