• Title/Summary/Keyword: Lung, CT

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Quantitative Analysis of Lung Contusion (폐좌상의 정량분석)

  • 오중환
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.833-837
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    • 1994
  • Lung contusion due to blunt chest trauma is the most common lung injury and correlated with the clinical course and prognosis. Its diagnosis by CT[Computerized Tomogram] gives a more clear and understandable three dimensional view, by which we are able to measure the volume of the contused and entire lung. Other variables are arterial blood gas, number of rib fracture, presence of hemopneumothorax, sternal fracture and clavicle fracture, number of associated non-thoracic injuries, ventilator time and presence of pulmonary complication. Percentage[%] of lung contusion are expressed as mean $\pm$ standard deviation and data analysis was performed by means of multivariate repeated measures analysis of variance to detect significant differences in variables between positive thoracic injury group and negative group. The paired t-test was used. Differences of percentage of lung contusion between groups were assessed by one-way analysis of variance. Simple linear regression was used to perform correlation analysis in the number of rib fracture and ventilator time. A p value less than 0.05 was considered statistically significant. Pneumothorax and the number of associated other injuries affect the amount of lung contusion and pulmonary complication group has more contused lung volume. Arterial blood gas study shows no correlation with the amount of lung contusion statistically. The number of rib fracture correlated with the amount of lung contusion, which also correlated with ventilator time[r=0.56, p<0.05]. In conclusion, quantitative anlysis of lung contusion by CT predicts the clinical course and treatment such as ventilator care.

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Correlation between Expiratory Increase of Lung Attenuation and Age and Smoking in the Subjects with Normal Inspiratory Low Dose CT and Pulmonary Function Test (저선량 흉부전산화단층촬영의 흡기 영상과 폐기능이 정상인 성인에서 호기 말 폐 감쇄도 증가 정도와 연령 및 흡연과의 연관성)

  • Kwon, Sung-Youn;Hwang, Yong-Il;Yoon, Ho-Il;Lee, Jae-Ho;Lee, Choon-Taek;Lee, Kyung Won
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.457-463
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    • 2008
  • Background: The attenuation of the lung parenchyma increases on expiration as a consequence of decreased air in the lung. Expiratory CT scans have been used to show air trapping in patients with chronic airway disease and diffuse parenchymal disease and also in asymptomatic smokers. Although there have been several reports investigating the regional air trapping on a expiratory CT scan, there have been only a few reports evaluating the changes of whole lung attenuation with considering its clinical significance, and especially in healthy subjects. The purpose of this study was to evaluate the correlation of an expiratory increase of lung attenuation with age and smoking in healthy subjects. Methods: Asymptomatic subjects who underwent a low dose chest CT scan as part of a routine check-up and who showed normal spirometry and a normal inspiratory CT scan were recruited for this study. We excluded the subjects with significant regional air trapping seen on their expiratory CT scan. Lung attenuation was measured at 24 points of both the inspiratory and expiratory CT scans, respectively, for 100 subjects. The correlations between an expiratory increase of the lung attenuation and the amount of smoking, the patient's age and the results of spirometric test were assessed. Results: There were 87 men and 13 women included in this study. Their median age was 49.0 years old (range:25~71). Sixty current smokers, 24 ex-smokers and 16 non-smokers were included. As age increased, the expiratory increase of lung attenuation was reduced at every measuring points (r=-0.297~-0.487, Pearson correlation). The statistical significance was maintained after controlling for the effect of smoking. Smoking was associated with a reduction of the expiratory increase of lung attenuation. But the significance was reduced after controlling for the patient's age. The $FEV_1$, FVC, $FEV_1/FVC$ and $FEF_{25{\sim}75%}$ were not associated with an expiratory increase of lung attenuation. Conclusion: The expiratory increase of lung attenuation in subjects with a normal inspiratory CT scan was negatively correlated with age. It was also reduced in heavy smokers. It may reflect aging and the smoking related changes.

Diagnostic Performance of Whole-Body Diffusion-Weighted Imaging Compared to PET-CT Plus Brain MRI in Staging Clinically Resectable Lung Cancer

  • Usuda, Katsuo;Sagawa, Motoyasu;Maeda, Sumiko;Motono, Nozomu;Tanaka, Makoto;Machida, Yuichiro;Matoba, Takuma Matsui Munetaka;Watanabe, Naoto;Tonami, Hisao;Ueda, Yoshimichi;Uramoto, Hidetaka
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2775-2780
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    • 2016
  • Background: Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI. Materials and Methods: PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas. Results: PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies. Conclusions: Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.

Assessment of Allograft Function in Dog Single Lung Transplantation on CT (한국산 잡견에서 컴퓨터단층촬영을 이용한 이식폐의 기능평가)

  • 박기성;박창권
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1055-1061
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    • 1997
  • In the field of the experimental lung transplantation, we analyzed the CT findings of acute rejection, infection in the left single allotransplanted lung of adult mongrel dogs, and the CT findings were compared with the histological findings obtained by the lung biopsy Twenty two adult mongrel dogs were divided into two groups(Donor and recipient group). Donor lungs were flushed with LPDG(low pota,ilium dextral glucose) solution(n=4) or modified Euro-collins solution(n=7) and preserved over 20 hours with $10^{\circ}C(1$ case preservation for 4hours). After left single lung transplantation, the chest X-ray and sequential computed tomogram were performed with concomitant hemodynamic study and arterial blood gas analysis on immediate postoperative period, postoperative 3rd day and postoperative 7th day. Two of eleven transplanted lungs had acute rejection which was represented as moderate infiltration at immediate or 1st postoperative d y but became extensive infiltration at postoperative 3rd day on CT. There were showed one case of bronchopleural fistula, six cases of pneumonia and two cases of pulmonary infarction. In one rejection cases, the opacity of transplanted lung was improved by injection of methylprednisolone 500mg daily during 3 days. We concluded that CT was a useful noninvasive evaluation parameter after lung transplantation and the serial CT scan enabled early detection of acute rejection.

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The evaluate the usefulness of various CT kernel applications by PET/CT attenuation correction (PET/CT 감쇠보정시 다양한 CT Kernel 적용에 따른 유용성 평가)

  • Lee, Jae-Young;Seong, Yong-Jun;Yoon, Seok-Hwan;Park, Chan-Rok;Lee, Hong-Jae;Noh, Kyung-Wun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.2
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    • pp.37-43
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    • 2017
  • Purpose Recently PET/CT image's attenuation correction is used CTAC(Computed Tomgraphy Attenuation Correction). it can quantitative evaluation by SUV(Standard Uptake Value). This study's purpose is to evaluate SUV and to find proper CT kernel using CTAC with applied various CT kernel to PET/CT construction. Materials and Methods Biograph mCT 64 was used for the equipment. We were performed on 20 patients who had examed at our hospital from february through March 2017. Using NEMA IEC Body Phantom, The data was reconstructed PET/CT images with CTAC appiled various CT kernel. ANOVA was used to evaluated the significant difference in the result. Results The result of measuring the radioactivity concentration of Phantom was B45F 96% and B80F 6.58% against B08F CT kernel, each respectively. the SUVmax increased to B45F 0.86% and B80F 6.54% against B08F CT kernel, In case of patient's parts data, the Lung SUVmax increased to B45F 1.6% and B80F 6.6%, Liver SUVmax increased to B45F 0.7% and B80F 4.7%, and Bone SUVmax increased to B45F 1.3% and B80F 6.2%, respectively. As for parts of patient's about Standard Deviation(SD), the Lung SD increased to B45F 4.2% and B80F 15.4%, Liver SD increased to B45F 2.1% and B80F 11%, and Bone SD increased to B45F 2.3% and B80F 14.7%, respectively. There was no significant difference discovered in three CT kernel (P >.05). Conclusion When using increased noise CT kernel for PET/CT reconstruction, It tends to change both SUVmax and SD in ROI(region of interest), Due to the increase the CT kernel number, Sharp noise increased in ROI. so SUVmax and SD were highly measured, but there was no statistically significant difference. Therefore Using CT kernel of low variation of SD occur less variation of SUV.

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Thoracoscopic Right Middle Lung Lobectomy in a Maltese Dog with Primary Pulmonary Bronchoalveolar Carcinoma

  • Park, Jiyoung;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.166-169
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    • 2018
  • A 14-year-old, 3.9 kg, castrated male Maltese presented with an intermittent cough. A solitary mass ($1.6{\times}2{\times}1.8cm$) was located in right middle lung lobe on CT examination and thoracoscopic right middle lung lobectomy was performed without lung separation. The patient recovered uneventfully and was discharged at POD3. With a histopathologic diagnosis of pulmonary bronchoalveolar carcinoma, Re-evaluation via CT scanning with contrast on POD 50 and 255 revealed no evidence of residual, metastatic or recurrent lesions. The patient has been doing well since surgery during a 9-month follow-up period.

Lung cancer and insurance medicine (폐암과 보험의학)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.31 no.1
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    • pp.34-36
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    • 2012
  • Lung cancer such as small cell lung cancer(SCLC) and non small cell lung cancer(NSCLC) have high mortality rate, so, we insurance doctors have little interest in their risk. But nowadays there's a lot of development in targeted therapy of NSCLC. Screening by CT scanning and early resection strategy also shows better prognosis. It is helpful for underwriters and insurance doctors to review the current development of targeted therapy of NSCLC and estimation of extra-risk of early lung cancer. The preferred treatment option for patients whose tumors contain EGFR-activating mutations are one of the EGFR-directed tyrosine kinase inhibitors, such as gefitinib or erlotinib. In patients with NSCLC whose tumors harboured an ALK rearrangement, there was 61% objective response rate to crizotinib in the phase 1 study. The median survival progression-free survival was 10 months. Mortality analysis of early lung cancer who were detected by CT screening, MR of 105% and EDR of 1‰ were calculated.

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Correlation of Temporary Lateral Recumbency and Lung Opacity on Ventrodorsal Radiograph (일시적인 횡와 자세와 흉와위 영상에서 폐 불투과도의 상관관계)

  • Lee, Hyunjik;Jeong, Jiyoon;Choi, Wooshin;Lee, Donghoon;Lee, Youngjae;Chang, Jinhwa;Chang, Dongwoo
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.313-318
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    • 2015
  • The lung opacity on radiography is influenced by various factors. The physical density of the lung and the attenuation ensured on computed tomography (CT) scans is determined by three components : lung tissue, blood, and air. Temporary right lateral recumbency may responsible for the increase of opacity on ventrodorsal projection view. Thus, our aim is to demonstrate that the effect of right lateral recumbency posture on right lung opacity using radiograph and CT scan. In this study, 62 dogs without clinical or radiologic signs of cardiopulmonary disease are selected. Thorax radiographs per 30 seconds for 2 minutes (30s, 60s, 90s, 120s) were performed for 62 dogs. After discussion of the radiographic findings of lung field by two radiologists and a student at Chungbuk national university veterinary medical center a consensus opinion was recorded. Computed tomography per a minute (1 min, 2 min) for 2 minutes were performed for 2 dogs. Mean x-ray attenuation of lung was measured quantitatively using software at two levels (aortic arch and basal level). Among 62 dogs with radiograph comparison, 9.3% of dogs showed influence by postural effect. However, all 2 dogs with computed tomography comparison, showed influence by postural effect. In conclusion, position dependent changes of lung density in CT exam are not consistent with thoracic radiograph.

A Pulmonary Paragonimiasis Case Mimicking Metastatic Pulmonary Tumor

  • Kim, Ki-Uk;Lee, Kwang-Ha;Park, Hye-Kyung;Jeong, Yeon-Joo;Yu, Hak-Sun;Lee, Min-Ki
    • Parasites, Hosts and Diseases
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    • v.49 no.1
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    • pp.69-72
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    • 2011
  • Pulmonary paragonimiasis is a relatively rare cause of lung disease revealing a wide variety of radiologic findings, such as air-space consolidation, nodules, and cysts. We describe here a case of pulmonary paragonimiasis in a 27-year-old woman who presented with a 2-month history of cough and sputum. Based on chest computed tomography (CT) scans and fluorodeoxyglucose positron emission tomography (FDG-PET) findings, the patient was suspected to have a metastatic lung tumor. However, she was diagnosed as having Paragonimus westermani infection by an immunoserological examination using ELISA. Follow-up chest X-ray and CT scans after chemotherapy with praziquantel showed an obvious improvement. There have been several reported cases of pulmonary paragonimiasis mimicking lung tumors on FDG-PET. However, all of them were suspected as primary lung tumors. To our knowledge, this patient represents the first case of paragonimiasis mimicking metastatic lung disease on FDG-PET CT imaging.

Feasibility of Shrinking Field Radiation Therapy through 18F-FDG PET/CT after 40 Gy for Stage III Non-Small Cell Lung Cancers

  • Ding, Xiu-Ping;Zhang, Jian;Li, Bao-Sheng;Li, Hong-Sheng;Wang, Zhong-Tang;Yi, Yan;Sun, Hong-Fu;Wang, Dong-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.319-323
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    • 2012
  • Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/CT during treatment for patients with stage III non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.