Background: and Purpose: Brain atrophy, characterized by sulcal widening and ventricular enlargement, is a hallmark of neurodegenerative diseases such as Alzheimer’s disease. Visual assessments are subjective and variable, while automated methods struggle with subtle intensity differences and standardization, highlighting limitations in both approaches. This study aimed to develop and evaluate a novel method focusing on cerebrospinal fluid (CSF) regions by assessing segmentation accuracy, detecting stage-specific atrophy patterns, and testing generalizability to unstandardized datasets. Methods: We utilized T1-weighted magnetic resonance imaging data from 3,315 participants from Samsung Medical Center and 1,439 participants from other hospitals. Segmentation accuracy was evaluated using the Dice similarity coefficient (DSC), and W-scores were calculated for each region of interest (ROI) to assess stage-specific atrophy patterns. Results: The segmentation demonstrated high accuracy, with average DSC values exceeding 0.9 for ventricular and hippocampal regions and above 0.8 for cortical regions. Significant differences in W-scores were observed across cognitive stages (cognitively unimpaired, mild cognitive impairment, dementia of Alzheimer’s type) for all ROIs (all, p<0.05). Similar trends were observed in the images from other hospitals, confirming the algorithm’s generalizability to datasets without prior standardization. Conclusions This study demonstrates the robustness and clinical applicability of a novel CSF-focused segmentation method for assessing brain atrophy. The method provides a scalable and objective framework for evaluating structural changes across cognitive stages and holds potential for broader application in neurodegenerative disease research and clinical practice.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Purpose: This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT). Materials and Methods: A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated. Results: After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT. Conclusion Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.

Background: and Purpose: Brain atrophy, characterized by sulcal widening and ventricular enlargement, is a hallmark of neurodegenerative diseases such as Alzheimer’s disease. Visual assessments are subjective and variable, while automated methods struggle with subtle intensity differences and standardization, highlighting limitations in both approaches. This study aimed to develop and evaluate a novel method focusing on cerebrospinal fluid (CSF) regions by assessing segmentation accuracy, detecting stage-specific atrophy patterns, and testing generalizability to unstandardized datasets. Methods: We utilized T1-weighted magnetic resonance imaging data from 3,315 participants from Samsung Medical Center and 1,439 participants from other hospitals. Segmentation accuracy was evaluated using the Dice similarity coefficient (DSC), and W-scores were calculated for each region of interest (ROI) to assess stage-specific atrophy patterns. Results: The segmentation demonstrated high accuracy, with average DSC values exceeding 0.9 for ventricular and hippocampal regions and above 0.8 for cortical regions. Significant differences in W-scores were observed across cognitive stages (cognitively unimpaired, mild cognitive impairment, dementia of Alzheimer’s type) for all ROIs (all, p<0.05). Similar trends were observed in the images from other hospitals, confirming the algorithm’s generalizability to datasets without prior standardization. Conclusions This study demonstrates the robustness and clinical applicability of a novel CSF-focused segmentation method for assessing brain atrophy. The method provides a scalable and objective framework for evaluating structural changes across cognitive stages and holds potential for broader application in neurodegenerative disease research and clinical practice.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Purpose: This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT). Materials and Methods: A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated. Results: After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT. Conclusion Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.

Background: and Purpose: Brain atrophy, characterized by sulcal widening and ventricular enlargement, is a hallmark of neurodegenerative diseases such as Alzheimer’s disease. Visual assessments are subjective and variable, while automated methods struggle with subtle intensity differences and standardization, highlighting limitations in both approaches. This study aimed to develop and evaluate a novel method focusing on cerebrospinal fluid (CSF) regions by assessing segmentation accuracy, detecting stage-specific atrophy patterns, and testing generalizability to unstandardized datasets. Methods: We utilized T1-weighted magnetic resonance imaging data from 3,315 participants from Samsung Medical Center and 1,439 participants from other hospitals. Segmentation accuracy was evaluated using the Dice similarity coefficient (DSC), and W-scores were calculated for each region of interest (ROI) to assess stage-specific atrophy patterns. Results: The segmentation demonstrated high accuracy, with average DSC values exceeding 0.9 for ventricular and hippocampal regions and above 0.8 for cortical regions. Significant differences in W-scores were observed across cognitive stages (cognitively unimpaired, mild cognitive impairment, dementia of Alzheimer’s type) for all ROIs (all, p<0.05). Similar trends were observed in the images from other hospitals, confirming the algorithm’s generalizability to datasets without prior standardization. Conclusions This study demonstrates the robustness and clinical applicability of a novel CSF-focused segmentation method for assessing brain atrophy. The method provides a scalable and objective framework for evaluating structural changes across cognitive stages and holds potential for broader application in neurodegenerative disease research and clinical practice.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Purpose: This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT). Materials and Methods: A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated. Results: After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT. Conclusion Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.

Background: and Purpose: Brain atrophy, characterized by sulcal widening and ventricular enlargement, is a hallmark of neurodegenerative diseases such as Alzheimer’s disease. Visual assessments are subjective and variable, while automated methods struggle with subtle intensity differences and standardization, highlighting limitations in both approaches. This study aimed to develop and evaluate a novel method focusing on cerebrospinal fluid (CSF) regions by assessing segmentation accuracy, detecting stage-specific atrophy patterns, and testing generalizability to unstandardized datasets. Methods: We utilized T1-weighted magnetic resonance imaging data from 3,315 participants from Samsung Medical Center and 1,439 participants from other hospitals. Segmentation accuracy was evaluated using the Dice similarity coefficient (DSC), and W-scores were calculated for each region of interest (ROI) to assess stage-specific atrophy patterns. Results: The segmentation demonstrated high accuracy, with average DSC values exceeding 0.9 for ventricular and hippocampal regions and above 0.8 for cortical regions. Significant differences in W-scores were observed across cognitive stages (cognitively unimpaired, mild cognitive impairment, dementia of Alzheimer’s type) for all ROIs (all, p<0.05). Similar trends were observed in the images from other hospitals, confirming the algorithm’s generalizability to datasets without prior standardization. Conclusions This study demonstrates the robustness and clinical applicability of a novel CSF-focused segmentation method for assessing brain atrophy. The method provides a scalable and objective framework for evaluating structural changes across cognitive stages and holds potential for broader application in neurodegenerative disease research and clinical practice.