Computer-Aided Nodule Detection and Volumetry to Reduce Variability Between Radiologists in the Interpretation of Lung Nodules at Low-Dose Screening Computed Tomography

Jeon, Kyung Nyeo,Goo, Jin Mo,Lee, Chang Hyun,Lee, Youkyung,Choo, Ji Yung,Lee, Nyoung Keun,Shim, Mi-Suk,Lee, In Sun,Kim, Kwang Gi,Gierada, David S.,Bae, Kyongtae T. Lippincott Williams Wilkins, Inc. 2012 Vol. No.

OBJECTIVE: The aim of this study was to evaluate whether a computer-aided diagnosis (CAD) system improves interobserver agreement in the interpretation of lung nodules at low-dose computed tomography (CT) screening for lung cancer. MATERIALS AND METHODS: Baseline low-dose screening CT examinations from 134 participants enrolled in the National Lung Screening Trial were reviewed by 7 chest radiologists. All participants consented to the use of their deidentified images for research purposes. Screening results were classified as positive when noncalcified nodules larger than 4 mm in diameter were present. Follow-up evaluation was recommended according to the nodule diameter: 4 mm or smaller, more than 4 to 8 mm, and larger than 8 mm. When multiple nodules were present, recommendations were based on the largest nodule. Readers initially assessed the nodule presence visually and measured the average nodule diameter manually. Revision of their decisions after reviewing the CAD marks and size measurement was allowed. Interobserver agreement evaluated using multirater &kgr; statistics was compared between initial assessment and that with CAD. RESULTS: Multirater &kgr; values for the positivity of the screening results and follow-up recommendations were improved from moderate (&kgr; = 0.53–0.54) at initial assessment to good (&kgr; = 0.66–0.67) after reviewing CAD results. The average percentage of agreement between reader pairs on the positivity of screening results and follow-up recommendations per case was also increased from 77% and 72% at initial assessment to 84% and 80% with CAD, respectively. CONCLUSION: Computer-aided diagnosis may improve the reader agreement on the positivity of screening results and follow-up recommendations in the assessment of low-dose screening CT.

Pulmonary strongyloidiasis presenting micronodules on chest computed tomography

Bae, Kyungsoo,Jeon , Kyung Nyeo,Ha , Ji Young,Lee , Jong Sil,Na , Byoung-Kuk AME Publishing Company 2018 Journal of thoracic disease Vol.10 No.8

Prognostic value of computed tomographic coro­nary angiography and exercise electrocardiogra­phy for cardiovascular events

( Kye-hwan Kim ),( Kyung Nyeo Jeon ),( Min Gyu Kang ),( Jong Hwa Ahn ),( Jin-sin Koh ),( Yongwhi Park ),( Seok-jae Hwang ),( Young-hoon Jeong ),( Choong Hwan Kwak ),( Jin-yong Hwang ),( Jeong Rang Par 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.5

Background/Aims: This study is a head-to-head comparison of predictive values for long-term cardiovascular outcomes between exercise electrocardiography (ex-ECG) and computed tomography coronary angiography (CTCA) in patients with chest pain. Methods: Four hundred and forty-two patients (mean age, 56.1 years; men, 61.3%) who underwent both ex-ECG and CTCA for evaluation of chest pain were includ­ed. For ex-ECG parameters, the patients were classified according to negative or positive results, and Duke treadmill score (DTS). Coronary artery calcium score (CACS), presence of plaque, and coronary artery stenosis were evaluated as CTCA parameters. Cardiovascular events for prognostic evaluation were defined as un­stable angina, acute myocardial infarction, revascularization, heart failure, and cardiac death. Results: The mean follow-up duration was 2.8 ± 1.1 years. Fifteen patients experi­enced cardiovascular events. Based on pretest probability, the low- and intermedi­ate-risks of coronary artery disease were 94.6%. Odds ratio of CACS > 40, presence of plaque, coronary stenosis ≥ 50% and DTS ≤ 4 were significant (3.79, p = 0.012; 9.54, p = 0.030; 6.99, p < 0.001; and 4.58, p = 0.008, respectively). In the Cox regression model, coronary stenosis ≥ 50% (hazard ratio, 7.426; 95% confidence interval, 2.685 to 20.525) was only significant. After adding DTS ≤ 4 to coronary stenosis ≥ 50%, the integrated discrimination improvement and net reclassification improvement analyses did not show significant. Conclusions: CTCA was better than ex-ECG in terms of predicting long-term outcomes in low- to intermediate-risk populations. The predictive value of the combination of CTCA and ex-ECG was not superior to that of CTCA alone.

Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes

Kim, Young Joo,Jeon, Hee Jung,Kim, Chang Ho,Park, Jae Yong,Jung, Tae Hoon,Lee, Eung Bae,Park, Tae In,Jeon, Kyung Nyeo,Jung, Chi Young,Cha, Seung Ick The Korean Academy of Tuberculosis and Respiratory 2009 Tuberculosis and Respiratory Diseases Vol.67 No.4

Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5${\pm}$3.98 months with a follow-up period of 28.2${\pm}$26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes

( Young Joo Kim ),( Hee Jung Jeon ),( Chang Ho Kim ),( Jae Yong Park ),( Tae Hoon Jung ),( Eung Bae Lee ),( Tae In Park ),( Kyung Nyeo Jeon ),( Chi Young Jung ),( Seung Ick Cha ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.4

Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5±3.98 months with a follow-up period of 28.2±26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

Obesity Is a Related Factor With Severe COVID-19 Pneumonia in Children: A Case Series

Kim, Dong Joon,Song, EunHyang,Jeon, Kyung Nyeo,Park, Su Eun,Seo, Ji-Hyun The Korean Society of Pediatric Infectious Disease 2022 Pediatric Infection and Vaccine Vol.29 No.2

A small proportion of children with coronavirus disease 2019 (COVID-19) develop severe pneumonia. We reported the severe COVID-19 pneumonia in children aged <18 years with COVID-19 treated with remdesivir and dexamethasone from August 2021 to November 2021 by a retrospective review of their medical records. Eight children were included (5 males and 3 females). Their median age was 16 years (range: 9 to 17 years) and their median body mass index was 30.5 kg/m² (range: 22.8-38.5 kg/m²). All patients had fever and dyspnea with hypoxia. Chest radiographic findings were variable and included diffuse or multifocal consolidation, nodules, and ground-glass opacities in the lungs. After receiving intravenous remdesivir and dexamethasone, 7 of the 8 children experienced an improvement in their symptoms within 2 days. In our case series, obesity was present in 6 out of 8 children with severe COVID-19 pneumonia.

Clinical Characteristics of Coexisting Pulmonary Thromboembolism in Patients With Respiratory Tuberculosis

Park, Hyeyoung,Cha, Seung-Ick,Lim, Jae-Kwang,Nyeo Jeon, Kyung,Yoo, Seung-Soo,Lee, Jaehee,Lee, Shin-Yup,Kim, Chang-Ho,Park, Jae-Yong Elsevier 2017 The American journal of the medical sciences Vol.353 No.2

<P>Conclusions: The coexistence of PTE and respiratory tuberculosis rarely occurred in clinical practice. Compared with unprovoked PTE, PTE with respiratory tuberculosisis characterized by lower body mass index, higher levels of blood inflammatory markers, higher PESI and less frequent central PTE, but it is not associated with any differences in outcomes caused by PTE.</P>

Bone Suppression on Chest Radiographs for Pulmonary Nodule Detection: Comparison between a Generative Adversarial Network and Dual-Energy Subtraction

Bae Kyungsoo,Oh Dong Yul,Yun Il Dong,Jeon Kyung Nyeo 대한영상의학회 2022 Korean Journal of Radiology Vol.23 No.1

Objective: To compare the effects of bone suppression imaging using deep learning (BSp-DL) based on a generative adversarial network (GAN) and bone subtraction imaging using a dual energy technique (BSt-DE) on radiologists’ performance for pulmonary nodule detection on chest radiographs (CXRs). Materials and Methods: A total of 111 adults, including 49 patients with 83 pulmonary nodules, who underwent both CXR using the dual energy technique and chest CT, were enrolled. Using CT as a reference, two independent radiologists evaluated CXR images for the presence or absence of pulmonary nodules in three reading sessions (standard CXR, BSt-DE CXR, and BSp-DL CXR). Person-wise and nodule-wise performances were assessed using receiver-operating characteristic (ROC) and alternative free-response ROC (AFROC) curve analyses, respectively. Subgroup analyses based on nodule size, location, and the presence of overlapping bones were performed. Results: BSt-DE with an area under the AFROC curve (AUAFROC) of 0.996 and 0.976 for readers 1 and 2, respectively, and BSp-DL with AUAFROC of 0.981 and 0.958, respectively, showed better nodule-wise performance than standard CXR (AUAFROC of 0.907 and 0.808, respectively; p ≤ 0.005). In the person-wise analysis, BSp-DL with an area under the ROC curve (AUROC) of 0.984 and 0.931 for readers 1 and 2, respectively, showed better performance than standard CXR (AUROC of 0.915 and 0.798, respectively; p ≤ 0.011) and comparable performance to BSt-DE (AUROC of 0.988 and 0.974; p ≥ 0.064). BSt-DE and BSp-DL were superior to standard CXR for detecting nodules overlapping with bones (p < 0.017) or in the upper/middle lung zone (p < 0.017). BSt-DE was superior (p < 0.017) to BSp-DL in detecting peripheral and sub-centimeter nodules. Conclusion: BSp-DL (GAN-based bone suppression) showed comparable performance to BSt-DE and can improve radiologists’ performance in detecting pulmonary nodules on CXRs. Nevertheless, for better delineation of small and peripheral nodules, further technical improvements are required.

Serological Survey of Major Avian Viral Diseases Related with Egg Productionin Commercial Chicken Flocks in Korea

hae sun jang,Hae-Rim Lee,구본상,Eun-Ok Jeon,Moo-Sung Han,Kyung-Cheol Min,Seung-Baek Lee,Yeonji-Bae,Sun-Hyung Cho,Jong-Suk Mo,Jong-Nyeo Kim,모인필 한국가금학회 2014 韓國家禽學會誌 Vol.41 No.3

While use of mass rearing systems improved poultry production, chances of exposing to contagious diseases have been increased, making flocks more vulnerable to diseases. Diseases of interest which affects egg production adversely include Low pathogenic avian influenza (LPAI), Infectious bronchitis (IB), Avian meta-pneumoviral infection (aMPV) and Egg drop syndrome’76 (EDS’76). This report collected and analyzed 5,385 serum samples, which were collected from 1,330 different chicken flock, provided by Chungbuk National University, Avian Disease Laboratory at 2009. Serums were analyzed based on rearing stages; 0∼1.3weeks (wks) (maternal antibody period), >1.3∼3 wks (starting period), >3∼10 wks (growing period), >10∼22 wks (developing period), >22∼40 wks (peak laying period), >40∼60 wks (late laying period) and over 60 wks (post-molting period). Results showed the 99.7% of the tested flocks were immunized against ND and73.8%, 97.1%, 78,2% and 78% of the flocks were immunized against other 4 agents (LPAI, IB, EDS’76, aMPV). Maternal antibody was transferred to enough quantity for NDV. Generally, antibody titers which were developed at 22 weeks were stabilized permanently for life. In case of IB and aMPV, infection titer emerged as early as 10 weeks and the titer was increased from 99.4% to 100% for life. EDS76 showed increase in titers, reflecting decreased frequency of vaccination programs. Overall, this study displayed general trends of major viral disease in layers, but considering the trend of development of preventive measures and evolution of pathogens, conducting serological surveys on a regular basis is important.

Case Report : Thalidomide Induced Nonspecific Interstitial Pneumonia in Patient with Relapsed Multiple Myeloma

( Myung Hee Kang ),( Ji Hyun Ju ),( Hoon Gu Kim ),( Jung Hun Kang ),( Kyung Nyeo Jeon ),( Ho Cheol Kim ),( Gyeong Won Lee ) 대한내과학회 2010 The Korean Journal of Internal Medicine Vol.25 No.4

A 63-year-old female diagnosed with relapsed multiple myeloma visited our hospital complaining of a persistent cough. Since July 2006, she had been taking 100 mg thalidomide daily and gradually developed shortness of breath and a persistent dry cough. A chest X-ray and computed tomography showed ground glass opacities in both lungs. An open lung biopsy of the right middle lobe under general anesthesia revealed chronic peribronchial inflammation, mild interstitial fibrosis, and intra-alveolar macrophage infiltration, with some hemosiderin features, compatible with non-specific interstitial pneumonia (NSIP). After discontinuing the thalidomide, the patient`s symptoms did not deteriorate, although the radiographs did not improve. The patient is alive and well with regular outpatient follow-up without progression of the NSIP. (Korean J Intern Med 2010;25:447-449)