• Journal of the Korea Computer Graphics Society
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• v.30 no.1
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• pp.11-17
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• 2024

Lung cancer segmentation in chest CT images is challenging due to the varying sizes of tumors and the presence of surrounding structures with similar intensity values. To address these issues, we propose a lung cancer segmentation network that incorporates deep supervision and utilizes UNet3+ as the backbone. Additionally, we propose a hybrid lesion focal loss function comprising three components: pixel-based, region-based, and shape-based, which allows us to focus on the smaller tumor regions relative to the background and consider shape information for handling ambiguous boundaries. We validate our proposed method through comparative experiments with UNet and UNet3+ and demonstrate that our proposed method achieves superior performance in terms of Dice Similarity Coefficient (DSC) for tumors of all sizes.

• Proceedings of the Korea Multimedia Society Conference
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• 2000.04a
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• pp.133-136
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• 2000

본 논문에서는 폐암의 변이 형태 분석을 위한 정량적 분석 방법을 연구하였다. 보다 객관적인 분석의 필수적 요인인 정확한 분할을 이해 질감 특징과 통계학적 분류방법을 이용하였으며, 변이 형태 분석을 위해서 분할된 ROI 로부터 여러 가지 형태학적 특성값과 질감 특성값을 추출하여 변이 형태에 따라 비교분석하였다. 이러한 폐암의 변이 형태 분석을 위한 방법은 다른 기관으로의 원격전이가 쉬운 종양의 특성평가에 대한 객관적 병리진단의 보조도구로 사용될 수 있을 것이다.

• Proceedings of the Korea Information Processing Society Conference
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• 2004.05a
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• pp.749-752
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• 2004

CT 영상에서 폐암 추출을 위한 컴퓨터지원진단시스템(CAD)에서 전처리 시스템은 매우 중요한 역할을 담당한다. 본 논문에서는 CT 영상에서 폐암 추출을 위한 전처리 기법을 소개한다. CT 영상에서 폐 영역 추출 과정에서 가장 먼저 수행되는 이진화를 위해 k-means 클러스터링 알고리즘을 이용하고, 비관심 영역 제거 방법으로 연결요소를 분석하고, 이진화 과정에서 발생한 폐 외곽 분실을 재구성하기 위해 Rolling Ball 알고리즘을 수행한다. 또한 분할된 폐 영역에서 폐암 후보자를 선출하기 위해 분할과정에서 수행하였던 이진화 방법을 폐 영역에 다시 한번 적용하고 잡음제거를 위해 모폴러지 기법을 사용한 전처리 기법을 제안한다.

• Progress in Medical Physics
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• v.26 no.4
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• pp.229-233
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• 2015

We retrospectively reviewed lung cancer patients who were treated with stereotactic ablative radiotherapy (SABR). We investigated the value of response evaluation after treatment by measuring the volume change of tumors on serial chest computed tomography (CT) examinations. The study included 11 consecutive patients with early-stage (T1-T2aN0M0) non-small cell lung cancer (NSCLC) who were treated with SABR. The median dose of SABR was 6,000 cGy (range 5,000~6,400) in five fractions. Sequential follow-up was performed with chest CT scans. Median follow-up time was 28 months. Radiologic measurement was performed on 51 CT scans with a median of 3 CT scans per patient. The median time to partial response ($T_{PR}$) was 3 months and median time to complete remission ($T_{CR}$) was 5 months. Overall response rate was 90.9% (10/11). Five patients had complete remission, five had partial response, and one patient developed progressive disease without response. On follow-up, three patients (27.2%) developed progressive disease after treatment. We evaluated the the response after SABR. Our data also showed the timing of response after SABR.

• RED RIBBON
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• s.70
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• pp.16-18
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• 2006

사람이 죽는 방법이 몇 가지나 될까? 각종 질병사, 사고사, 자살…등등 일일이 열거하기 어려울 것이다. 그중에서도, 한국 사람을 많이 죽이는 나쁜 병 상위 4가지는 암/ 중풍/ 심장병/ 당뇨이다. 이 4가지 병으로 사망하는 사람이 전체 사망자의 50%를 넘는다. 그런데 이러한 흔한 사망원인들을 일으키는 위험요소 중 최고로 해로운 놈이 바로 담배다. 금연을 권하면, 담배피고도 오래 사는 옆집 할아버지를 들먹거리는 사람들이 꼭 있다. 물론 담배를 많이 피워도 폐암에 잘 안 걸 리는 사람도 있다. 이런 분들은 유전적으로 폐암에 대한 면역력이 강한 분들이다. 하지만, 당신도 그럴까? 개개인의 면역력에 따라서 흡연의 해독은 더 크게도 좀 약하게도 나타날 수 있다. 안그래도 면역력이 약한 HIV 환우들에게 흡연은 반드시 물리쳐야 하는 적중의 적인 것이다.

• Radiation Oncology Journal
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• v.24 no.2
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• pp.96-102
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• 2006

Purpose: A retrospective study was performed to evaluate the efficiency and feasibility of twice daily radiation therapy plus concurrent chemotherapy for limited-stage small cell lung cancer in terms of treatment response, survival, patterns of failure, and acute toxicities. Materials and Methods: Between February 1993 and October 2002, 76 patients of histologically proven limited-stage small cell lung cancer (LS-SCLC) were treated with twice daily radiation therapy and concurrent chemotherapy. Male was in 84% (64/76), and median age was 57 years (range, 32-75 years). Thoracic radiation therapy consisted of 120 or 150 cGy per fraction, twice a day at least 6 hours apart, 5 days a week. Median total dose was 50.4 Gy (range, 45-51 Gy). Concurrent chemotherapy consisted of CAV ($cytoxan\;1000mg/m^2,\;adriamycin\;40mg/m^2,\;vincristine\;1mg/m^2$) alternating with PE ($cisplatin\;60mg/m^2,\;etoposide\;100mg/m^2$) or PE alone, every 3 weeks. The median cycle of chemotherapy was six (range, 1-9 cycle). Prophylactic cranial irradiation (PCI) was recommended to the patients who achieved a complete response (CR). PCI scheme was 25 Gy/10 fractions. Median follow up was 18 months (range, 1-136 months). Results: Overall response rate was 86%; complete response in 39 (52%) and partial response in 26 (34%) patients. The median overall survival was 23 months. One, two, and three year overall survival rate was 72%, 50% and 30%, respectively. In univariate analysis, the treatment response was revealed as a significant favorable prognostic factor for survival (p<0.001). Grade 3 or worse acute toxicities were leukopenia in 46 (61%), anemia in 5 (6%), thrombocytopenia in 10 (13%), esophagitis in 5 (6%), and pulmonary toxicity in 2 (2%) patients. Of 73 evaluable patients, 40 (55%) patients subsequently had disease progression. The most frequent first site of distant metastasis was brain. Conclusion: Twice daily radiation therapy plus concurrent chemotherapy produced favorable response and survival for LS-SCLC patients with tolerable toxicities. To improve the treatment response, which proved as a significant prognostic factor for survival, there should be further investigations about fractionation scheme, chemotherapy regimens and compatible chemoradiotherapy schedule.

• Tuberculosis and Respiratory Diseases
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• v.63 no.2
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• pp.154-164
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• 2007

Background: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. Irinotecan also can act as a potential radiation sensitizer along with cisplatin. To evaluate efficacy and toxicity of irinotecan plus cisplatin (IP) with concurrent thoracic radiotherapy, we conducted a phase II study of IP followed by concurrent IP plus hyperfractionated thoracic radiotherapy in patients with previously untreated limited-stage small-cell lung cancer. Methods: Twenty-four patients with previously untreated small-cell lung cancer were enrolled onto the study since November 2004. Irinotecan $60mg/m^2$ was administered intravenously on days 1 and 8 in combination with cisplatin $60mg/m^2$ on day1 every 21 days. From the first day of third cycle, twice-daily thoracic irradiation (total 45 Gy) was given. Prophylactic cranial irradiation was given to the patients who showed complete remission after concurrent chemoradiotherapy. Restaging was done after second and sixth cycle with chest CT and/or bronchosocpy. Results: Up to November 2004, 19 patients were assessable. The median follow-up time was 12.5 months. A total of 99 cycles (median 5.2 cycles per patient) were administered. The actual dose intensity values were cisplatin $19.6mg/m^2$/week and irinotecan $38.2mg/m^2$/week. Among the 19 patients, the objective response rate was 95% (19 patients), with 9 patients (47%) having a complete response (CR). The major grade 3/4 hematological toxicities were neutropenia (35% of cycles), anemia (7% of cycles), thrombocytopenia (7% of cycles). Febrile neutropenia was 4% of cycles. The predominant grade 3/4 non-hematological toxicities was diarrhea (5% of cycles). Toxicities was not significantly different with concurrent administration of irinotecan and cisplatin with radiotherapy, except grade 3/4 radiation esophagitis (10% of patients). No treatment-related deaths were observed. The 1-year and 2-year survival rate of eligible patients was 89% (16/18) and 47% (9/18), respectively. Conclusion: Three-week schedule of irinotecan plus cisplatin followed by concurrent IP plus hyperfractionated thoracic radiotherapy is an effective treatment for limited disease small-cell lung cancer, with acceptable toxicity.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1200-1205
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• 1998

Background: Lung cancer formation is a multistage process involving activation of protooncogene and inactivation of tumor suppressor genes. We evaluate the significance of cyclin D1, p53, bcl-2 gene mutations in patients with curatively resected stage IIIA non-small cell lung cancer(NSCLC). Material and Method: One hundred consecutive cases of stage IIIA lung cancers from patients operated on curatvely between 1990 and 1995 for which adequate paraffin blocks and clinical history were available. Immunohistochemical studies were performed on the representative tissue sections from each case by the labelled streptovidin- biotin method. Sections for cyclin D1, p53, Bcl-2 immunostaining were pretreated in a microwave oven for 10 to 20 minutes in citrate buffer before immunostaining. The overnight incubation with NCL-cyclin D1-GM for cyclin D1, with clone DO-7 for p53, with clone 124 for bcl-2 was done. Mean follow-up was 24.1 months (range 2-84 months) after operation. Result: One hundred cases of lung cancers were composed of 56 cases of squamous cell carcinoma, 37 cases of adenocarcinoma, 5 cases of adenosquamous cell carcinoma, and 2 cases of large cell carcinoma. The 5-year survival was 32.1%. The positive expression rate of cyclin D1 was 35%, p53 was 56%, and bcl-2 was 17%. But there were no correlation between cyclin D1, p53, Bcl-2 protein expression and survival. Conclusion: These observation indicate that cyclin D1, p53, bcl-2 protein overexpression might be implicated in the oncogenesis of non-small cell lung carcinomas but they have no usefulness as a prognostic marker.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.73-77
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• 1990

From January 1981 to December 1989, total 42 patients with atelectasis from lung cancer were treated with radiation therapy at the Department of Therapeutic Radiology in Kyung Hee University Hospital. The reexpansion of atelectasis after radiotherapy of the lung was evaluated retrospectively, utillzing treatment records and follow-up chest radiographs. Of the patients with non-small cell carcinoma of the lung, the response rate was $62\%$ (21/34). Patient with small cell carcinoma showed a $75\%$ (6/8) response rate. There appears to be some evidence of a relationship of total tumor dose versus response of atelectasis; radiation dose over 40 Gy (1337 ret), had a favorable effect on the rate of response compared with that below 40 Gy (1297 ret), $70\%$(21/30) and $50\%$ (6/12), respectively (p<0.01). Total response rate (partial and complete responses) of all patients was $64\%$ (27/42). Franction size was not contributed to the difference of response rates between small fraction ($180\~200$ cGy) and large fraction (300 cGy), $53\%$ (14/22) and $65\%$ (13/20), respectively. The results of this study suggest that radiation therapy has a definite positive role in management of atelectasis caused by lung cancer, especially in inoperable non-small cell carcinoma.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.470-474
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• 2006

Background: Mediastinal lymph node metastasis is an important factor for staging and prognosis of non-small cell lung cancer (NSCLC), so accurate diagnosis is essential for treatment. Mediastinoscopy provides histopathological diagnosis of mediastinal lymphnode metastasis in NSCLC. The efficacy of mediastinoscopy was investigated. Material and Method: From Jun, 1999 to Aug, 2005, mediastinoscopic lymph node biopsy was performed to 348 patients with NSCLC. Patients characteristics, radiologic findings, mediastinoscopic results and pathologic stages were evaluated for investigation of safety and efficacy of modiastinoscopy in NSCLC. Result: There was 263 male and 85 female patients and the mean age was $62.1{\pm}8.5$ years. By radiologic study for mediastinal lymph node metastasis, 203 patients were negative and 145 patients were positive. Mean procedure time was $55.5{\pm}16.5$ minutes and biopsy was peformed at $2.2{\pm}1.0$ lymph node stations. There were only transient complications (1.7%) during the procedure, without other complication and mortality. There was 7.8% of false negative result in mediastinoscopy. Sensitivity (77.5% vs 71.9%, p=0.012), specificity (100% vs 74.4%, p=0.00), and accuracy (92.2% vs 73.6%, p=0.00) of mediastinoscopy were more superior than that of radiologic study for the diagnosis of mediastinal lymph node metastasis in NSCLC. Conclusion: Mediastinoscopy is a safe and effective modality for diagnosis of mediastinal lymph node metastasis in NSCLC.