Automatic Lung Cancer Segmentation in 18 FFDG PET/CT Using a Two-Stage Deep Learning Approach / 대한핵의학회잡지

Purpose@#Since accurate lung cancer segmentation is required to determine the functional volume of a tumor in [ 18 F]FDG PET/CT, we propose a two-stage U-Net architecture to enhance the performance of lung cancer segmentation using [ 18 F]FDG PET/CT. @*Methods@#The whole-body [ 18 F]FDG PET/CT scan data of 887 patients with lung cancer were retrospectively used for network training and evaluation. The ground-truth tumor volume of interest was drawn using the LifeX software. The dataset was randomly partitioned into training, validation, and test sets. Among the 887 PET/CT and VOI datasets, 730 were used to train the proposed models, 81 were used as the validation set, and the remaining 76 were used to evaluate the model. In Stage 1, the global U-net receives 3D PET/CT volume as input and extracts the preliminary tumor area, generating a 3D binary volume as output. In Stage 2, the regional U-net receives eight consecutive PET/CT slices around the slice selected by the Global U-net in Stage 1 and generates a 2D binary image as the output. @*Results@#The proposed two-stage U-Net architecture outperformed the conventional one-stage 3D U-Net in primary lung cancer segmentation. The two-stage U-Net model successfully predicted the detailed margin of the tumors, which was determined by manually drawing spherical VOIs and applying an adaptive threshold. Quantitative analysis using the Dice similarity coefficient confirmed the advantages of the two-stage U-Net. @*Conclusion@#The proposed method will be useful for reducing the time and effort required for accurate lung cancer segmentation in [ 18 F]FDG PET/CT.

The Value of MicroRNAs as an Indicator of the Severity and the Acute Phase of Spinal Cord Injury

OBJECTIVE: To assess the role of miRNA-21 and miRNA-223 in a balloon-compression model of spinal cord injury (SCI). METHODS: A total of 50 male Wistar rats (n=50) were divided into the three groups: the group A (n=15, insertion of the unflated Fogarty balloon catheter), the group B (n=15, insertion of the Fogarty balloon catheter at a volume of 20 μL) and the group C (n=15, insertion of the Fogarty balloon catheter at a volume of 50 μL). After the behavioral test, RNA isolation, microRNA expression profiling using microarrays and quantitative polymerase chain reaction, measurements were compared between the three groups. RESULTS: Despite a lack of significant differences in time-dependent changes in miRNA-21 expression levels between the three groups at 4 hours, there were significant differences in them at 1, 3, and 7 days (p<0.05). Moreover, there were significant differences in time-dependent changes in miRNA-223 expression levels between the three groups at 4 hours and 1, 3, and 7 days (p<0.05). Furthermore, miRNA-223 expression levels reached the highest at 1 day but were decreased with time thereafter in all the three groups. CONCLUSION: Expression levels of miRNA-21 and miRNA-223 might be associated with the severity and acute phase of SCI, respectively. It is mandatory, however, to analyze changes in levels of inflammatory markers and the relevant biological pathways.

Rupture of the Deep Femoral Artery during Proximal Femoral Nailing Following an Intertrochanteric Fracture: A Case Report / 대한고관절학회지

Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling. Computed tomography angiography was performed 7 days after the procedure. We found a pseudoaneurysm of the perforating artery caused by injury to the deep femoral artery and an intramuscular hematoma in the anterior thigh muscle. We successfully treated the pseudoaneurysm using coil embolization. Throughout the management of intertrochanteric femoral fractures, it is important to be aware and monitor signs and symptoms related to the possibility of blood vessel damage. When a patient presents with swelling and pain on the middle thigh and/or unexplained anemia postoperatively, the possibility that these symptoms are caused by an injury to the femoral artery must be considered.

Bilateral Macula-involving Metastatic Infection Resulting from Septic Embolization

No abstract available.

A Validation Study of the Korean-version of Symmetry, Ordering and Arranging Questionnaire / 신경정신의학

OBJECTIVES: The Symmetry, Ordering and Arranging Questionnaire (SOAQ) has been reported as a valid tool for the assessment of symmetry, ordering and arranging compulsive behaviors of patients with obsessive compulsive disorder. It was introduced by Radomsky and Rachman in 2004. The aim of this study was to assess the reliability, validity and psychometric properties of the Korean-version of the SOAQ (K-SOAQ). METHODS: Two hundreds twenty eight under-graduate college students were enrolled in this study. They were assessed with K-SOAQ, Obsessive-Compulsive Inventory-Revised (OCI-R), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Statistical analysis was done using calculation of Cronbach's alpha, Spearman Correlation Coefficient and Principal Components Analysis. RESULTS: There were no significant differences in sex, education, and total scores of BDI and BAI. The Cronbach's alpha coefficient of K-SOAQ was high, Cronbach's alpha=0.96. There was strong evidence for a one-factor solution, accounting for 60.3% of the variance. Convergent validity was examined through correlations between the SOAQ and the OCI-R (r=0.61). Divergent validity was examined through correlations between the SOAQ and two self report measures; BDI (r=0.12) and BAI (r=0.19). CONCLUSION: The K-SOAQ showed good reliability and validity for the assessment of severity of compulsive characteristics regarding symmetry, ordering and arranging. The K-SOAQ is a useful instrument for assessing compulsive symptoms related with symmetry, ordering and arranging in Korea.