1.The Value of the Illness-Death Model for Predicting Outcomes in Patients with Non–Small Cell Lung Cancer
Kum Ju CHAE ; Hyemi CHOI ; Won Gi JEONG ; Jinheum KIM
Cancer Research and Treatment 2022;54(4):996-1004
Purpose:
The illness-death model (IDM) is a comprehensive approach to evaluate the relationship between relapse and death. This study aimed to illustrate the value of the IDM for identifying risk factors and evaluating predictive probabilities for relapse and death in patients with non–small cell lung cancer (NSCLC) in comparison with the disease-free survival (DFS) model.
Materials and Methods:
We retrospectively analyzed 612 NSCLC patients who underwent a curative operation. Using the IDM, the risk factors and predictive probabilities for relapse, death without relapse, and death after relapse were simultaneously evaluated and compared to those obtained from a DFS model.
Results:
The IDM provided more detailed risk factors according to the patient’s disease course, including relapse, death without relapse, and death after relapse, in patients with resected lung cancer. In the IDM, history of malignancy (other than lung cancer) was related to relapse and smoking history was associated with death without relapse; both were indistinguishable in the DFS model. In addition, the IDM was able to evaluate the predictive probability and risk factors for death after relapse; this information could not be obtained from the DFS model.
Conclusion
Compared to the DFS model, we found that the IDM provides more comprehensive information on transitions between states and disease stages and provides deeper insights with respect to understanding the disease process among lung cancer patients.
2.Relationship between Incidental Abnormalities on Screening Thoracic Computed Tomography and Mortality: A Long-Term Follow-Up Analysis
Jong Eun LEE ; Won Gi JEONG ; Hyo-Jae LEE ; Yun-Hyeon KIM ; Kum Ju CHAE ; Yeon Joo JEONG
Korean Journal of Radiology 2022;23(10):998-1008
Objective:
The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis.
Materials and Methods:
We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan–Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors.
Results:
Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02–6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths.
Conclusion
Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.
4.Erratum: Application of Deconvolution Algorithm of Point Spread Function in Improving Image Quality: An Observer Preference Study on Chest Radiography.
Kum Ju CHAE ; Jin Mo GOO ; Su Yeon AHN ; Jin Young YOO ; Soon Ho YOON
Korean Journal of Radiology 2018;19(2):368-368
On page 148, the Institutional Review Board number was incorrectly numbered as D-1609-071-719. The correct number is D-1608-091-785.
5.The Potential Role of Grid-Like Software in Bedside Chest Radiography in Improving Image Quality and Dose Reduction: An Observer Preference Study.
Su Yeon AHN ; Kum Ju CHAE ; Jin Mo GOO
Korean Journal of Radiology 2018;19(3):526-533
OBJECTIVE: To compare the observer preference of image quality and radiation dose between non-grid, grid-like, and grid images. MATERIALS AND METHODS: Each of the 38 patients underwent bedside chest radiography with and without a grid. A grid-like image was generated from a non-grid image using SimGrid software (Samsung Electronics Co. Ltd.) employing deep-learning-based scatter correction technology. Two readers recorded the preference for 10 anatomic landmarks and the overall appearance on a five-point scale for a pair of non-grid and grid-like images, and a pair of grid-like and grid images, respectively, which were randomly presented. The dose area product (DAP) was also recorded. Wilcoxon's rank sum test was used to assess the significance of preference. RESULTS: Both readers preferred grid-like images to non-grid images significantly (p < 0.001); with a significant difference in terms of the preference for grid images to grid-like images (p = 0.317, 0.034, respectively). In terms of anatomic landmarks, both readers preferred grid-like images to non-grid images (p < 0.05). No significant differences existed between grid-like and grid images except for the preference for grid images in proximal airways by two readers, and in retrocardiac lung and thoracic spine by one reader. The median DAP were 1.48 (range, 1.37–2.17) dGy*cm2 in grid images and 1.22 (range, 1.11–1.78) dGy*cm2 in grid-like images with a significant difference (p < 0.001). CONCLUSION: The SimGrid software significantly improved the image quality of non-grid images to a level comparable to that of grid images with a relatively lower level of radiation exposure.
Anatomic Landmarks
;
Humans
;
Lung
;
Radiation Exposure
;
Radiography*
;
Spine
;
Thorax*
6.Percutaneous Transabdominal Metallic Stent Placement for Palliation of Afferent Loop Syndrome: A Case Report
Kun Yung KIM ; Young Min HAN ; Eun Ha JUNG ; Gong Yong JIN ; Kum Ju CHAE ; Kang Ji LEE
Journal of the Korean Radiological Society 2019;80(2):333-338
The authors report a successful outcome after percutaneous transabdominal placement of a self-expandable metallic stent in a patient who had afferent loop syndrome caused by recurrent common bile duct adenocarcinoma. Enhanced abdominal CT showed marked dilation of the afferent loop adjacent to the anterior peritoneum, multiple hepatic metastases and lymph node metastasis around the choledochojejunal anastomosis site without marked dilation of intrahepatic bile ducts. Percutaneous drainage catheter was successfully placed to the dilated afferent loop just below the abdominal wall. Subsequent successful palliation of the afferent loop obstruction was achieved by placing a self-expandable metallic stent via the transabdominal route with the aid of cone-beam CT.
7.Application of Deconvolution Algorithm of Point Spread Function in Improving Image Quality: An Observer Preference Study on Chest Radiography
Kum Ju CHAE ; Jin Mo GOO ; Su Yeon AHN ; Jin Young YOO ; Soon Ho YOON
Korean Journal of Radiology 2018;19(1):147-152
OBJECTIVE: To evaluate the preference of observers for image quality of chest radiography using the deconvolution algorithm of point spread function (PSF) (TRUVIEW ART algorithm, DRTECH Corp.) compared with that of original chest radiography for visualization of anatomic regions of the chest. MATERIALS AND METHODS: Prospectively enrolled 50 pairs of posteroanterior chest radiographs collected with standard protocol and with additional TRUVIEW ART algorithm were compared by four chest radiologists. This algorithm corrects scattered signals generated by a scintillator. Readers independently evaluated the visibility of 10 anatomical regions and overall image quality with a 5-point scale of preference. The significance of the differences in reader's preference was tested with a Wilcoxon's signed rank test. RESULTS: All four readers preferred the images applied with the algorithm to those without algorithm for all 10 anatomical regions (mean, 3.6; range, 3.2–4.0; p < 0.001) and for the overall image quality (mean, 3.8; range, 3.3–4.0; p < 0.001). The most preferred anatomical regions were the azygoesophageal recess, thoracic spine, and unobscured lung. CONCLUSION: The visibility of chest anatomical structures applied with the deconvolution algorithm of PSF was superior to the original chest radiography.
Lung
;
Prospective Studies
;
Radiography
;
Radiography, Thoracic
;
Spine
;
Thorax
8.Interstitial Lung Abnormalities: What Radiologists Should Know
Kum Ju CHAE ; Gong Yong JIN ; Jin Mo GOO ; Myoung Ja CHUNG
Korean Journal of Radiology 2021;22(3):454-463
Interstitial lung abnormalities (ILAs) are radiologic abnormalities found incidentally on chest CT that are potentially related to interstitial lung diseases. Several articles have reported that ILAs are associated with increased mortality, and they can show radiologic progression. With the increased recognition of ILAs on CT, the role of radiologists in reporting them is critical. This review aims to discuss the clinical significance and radiologic characteristics of ILAs to facilitate and enhance their management.
9.2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology
Soon Ho YOON ; Sang Min LEE ; Chul Hwan PARK ; Jong Hyuk LEE ; Hyungjin KIM ; Kum Ju CHAE ; Kwang Nam JIN ; Kyung Hee LEE ; Jung Im KIM ; Jung Hee HONG ; Eui Jin HWANG ; Heekyung KIM ; Young Joo SUH ; Samina PARK ; Young Sik PARK ; Dong-Wan KIM ; Miyoung CHOI ; Chang Min PARK
Korean Journal of Radiology 2021;22(2):263-280
Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.
10.Structural and Functional Features on Quantitative Chest Computed Tomography in the Korean Asian versus the White American Healthy Non-Smokers
Hyun Bin CHO ; Kum Ju CHAE ; Gong Yong JIN ; Jiwoong CHOI ; Ching Long LIN ; Eric A HOFFMAN ; Sally E WENZEL ; Mario CASTRO ; Sean B FAIN ; Nizar N JARJOUR ; Mark L SCHIEBLER ; R Graham BARR ; Nadia HANSEL ; Christopher B COOPER ; Eric C KLEERUP ; MeiLan K HAN ; Prescott G WOODRUFF ; Richard E KANNER ; Eugene R BLEECKER ; Stephen P PETERS ; Wendy C MOORE ; Chang Hyun LEE ; Sanghun CHOI ;
Korean Journal of Radiology 2019;20(7):1236-1245
OBJECTIVE: Considering the different prevalence rates of diseases such as asthma and chronic obstructive pulmonary disease in Asians relative to other races, Koreans may have unique airway structure and lung function. This study aimed to investigate unique features of airway structure and lung function based on quantitative computed tomography (QCT)-imaging metrics in the Korean Asian population (Koreans) as compared with the White American population (Whites). MATERIALS AND METHODS: QCT data of healthy non-smokers (223 Koreans vs. 70 Whites) were collected, including QCT structural variables of wall thickness (WT) and hydraulic diameter (Dh) and functional variables of air volume, total air volume change in the lung (ΔVair), percent emphysema-like lung (Emph%), and percent functional small airway disease-like lung (fSAD%). Mann-Whitney U tests were performed to compare the two groups. RESULTS: As compared with Whites, Koreans had smaller volume at inspiration, ΔVair between inspiration and expiration (p < 0.001), and Emph% at inspiration (p < 0.001). Especially, Korean females had a decrease of ΔVair in the lower lobes (p < 0.001), associated with fSAD% at the lower lobes (p < 0.05). In addition, Koreans had smaller Dh and WT of the trachea (both, p < 0.05), correlated with the forced expiratory volume in 1 second (R = 0.49, 0.39; all p < 0.001) and forced vital capacity (R = 0.55, 0.45; all p < 0.001). CONCLUSION: Koreans had unique features of airway structure and lung function as compared with Whites, and the difference was clearer in female individuals. Discriminating structural and functional features between Koreans and Whites enables exploration of inter-racial differences of pulmonary disease in terms of severity, distribution, and phenotype.
Asian Continental Ancestry Group
;
Asthma
;
Continental Population Groups
;
Female
;
Forced Expiratory Volume
;
Humans
;
Lung
;
Lung Diseases
;
Phenotype
;
Prevalence
;
Pulmonary Disease, Chronic Obstructive
;
Thorax
;
Trachea
;
Vital Capacity