• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.341-344
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• 2008

The authors present a case of 68-year-old woman who underwent resection of a metastatic adenocarcinoma in the left parietooccipital area. The intraoperative course was uneventful; however, after closure of the scalp incision, increased bleeding from the suture line was noted. A computerized tomography scan that was performed immediately after operation revealed acute epidural hemorrhage with mass effect under the bone flap. The patient developed disseminated intravascular coagulation and immediate re-exploration was performed. This patient was successfully treated owing to early recognition of the condition and immediate treatment with transfusion. Neurosurgeons should be alert that hypercoagulabe state is common in cancer patients and consumptive coagulopathy can occur after resection of metastatic brain tumor.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2019.05a
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• pp.432-435
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• 2019

Convolutional Neural Networks (CNNs) have recently been gaining popularity in the medical image analysis field because of their image segmentation capabilities. In this paper, we present a CNN that performs automated brain tumor segmentations of sparsely annotated 3D Magnetic Resonance Imaging (MRI) scans. Our CNN is based on 3D U-net architecture, and it includes separate Dilated and Depth-wise Convolutions. It is fully-trained on the BraTS 2018 data set, and it produces more accurate results even when compared to the winners of the BraTS 2017 competition despite having a significantly smaller amount of parameters.

• Proceedings of the Korea Information Processing Society Conference
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• 2023.05a
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• pp.574-575
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• 2023

뇌종양은 인체에 발생하는 여러 종양 중 세 번째로 많이 나타난다. 뇌종양 환자 수는 지속해서 증가하고 있으며, 별도의 예방법이 존재하지 않아 빠른 진단 및 종양 종류에 따른 치료가 매우 중요하다. 현재 뇌종양 진료는 전문의가 전용 소프트웨어로 뇌 Magnetic Resonance Imaging(MRI) 이미지를 확대, 축소하여 자세히 살펴보면서 종양의 크기, 위치, 양성/악성 여부 등을 판단한다. 이 방식은 의사의 숙련도에 따라 진료 시간과 판독의 차이가 크고 오진 가능성이 있다. 본 논문은 뇌종양 종류별 MRI 이미지가 학습된 CNN 모델을 사용한 의사의 뇌종양 진단 시간 단축, 진단 정확도 향상을 통해 환자 치료의 효율성을 높이는 방안으로 Brain Tumor X를 제안한다.

• The Korean Journal of Nuclear Medicine
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• v.8 no.1_2
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• pp.39-47
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• 1974

The purpose of this study is to evalute the diagnostic value of the brain scanning and compare the diagnostic accuracy between the scan and carotid angiography. 109 cases which are proved by specific method to each disease, are analized to evalute the diagnostic value of the brain scanning. The 70 cases among the proven 109 case are performed both the scanning and the arteriography and analized to compare the accuracy between the scanning and the arteriography. The results are as follows; 1. The diagnostic accuracy of the brain scanning in the diseases of the central nervous system is 64.2%. 2. The diagnostic accuracy of the brain scanning in the brain tumor is 88%, especially brain abscess. glioma, glioblastoma multiforme, menirgioma and metastic tumor show high positive rate. 3. The diagnostic accuracy in the disease of the brain vessels is 54 %. 4. The comparison of the diagnostic value between the scanning and the arteriography is as follows; 1) The diagnostic value in all diseases of the central nervous system is nearly equal. 2) The diagnostic accuracy in the intracranial tumor is slightly higher in the brain scanning (90.9%) than in the arteriography (81.8%). 3) The diagnostic accuracy in the disease of the brain vessel is higher in the arteriography (77.3%) than in the scanning (54.5%). 5) The diagnostic value when combining the scanning and the arteriography, is 83% in the all central nervous system-lesions, 97% in the cranial tumor and 81.8% in the disease of the central nervous system-vessel. The brain scanning is simple and safe procedure, and moreover has excellent diagnostic value in the diagnosis of the central nervous system lesion.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.151-154
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• 2005

A 43-year-old woman was admitted with the chief complaint of progressive visual disturbance and her brain radiological studies disclosed well demarcated tumor at tuberculum sellae area and bilateral mirror image paraclinoid internal carotid artery saccular aneurysms. A larger left side aneurysm was pointing medialy and almost encased by the tumor. Although a brain tumor and intracranial aneurysm can be simultaneously treated by surgery, the high risk of intra-operative aneurysm rupture should be considered. Therefore, the author secondly performed tumor resection after the endovascular embolization of the aneurysm which was embedding the tumor using a Guglielmi detachable coil. After successful treatment of the patient with tuberculum sellae meningioma associated with bilateral mirror image paraclinoid aneurysms using endovascular and surgical techniques, the authors present the case with a review of the related literatures.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.165-172
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• 2012

We investigated the vascular characteristics of tumors and normal tissue using perfusion CT in the rabbit brain tumor model. The VX2 carcinoma concentration of $1{\times}10^7$ cells/ml(0.1ml) was implanted in the brain of nine New Zealand white rabbits (weight: 2.4kg-3.0kg, mean: 2.6kg). The perfusion CT was scanned when the tumors were grown up to 5mm. The tumor volume and perfusion value were quantitatively analyzed by using commercial workstation (advantage windows workstation, AW, version 4.2, GE, USA). The mean volume of implanted tumors was $316{\pm}181mm^3$, and the biggest and smallest volumes of tumor were 497 $mm^3$ and 195 $mm^3$, respectively. All the implanted tumors in rabbits are single-nodular tumors, and intracranial metastasis was not observed. In the perfusion CT, cerebral blood volume (CBV) were $74.40{\pm}9.63$, $16.08{\pm}0.64$, $15.24{\pm}3.23$ ml/100g in the tumor core, ipsilateral normal brain, and contralateral normal brain, respectively ($p{\leqq}0.05$). In the cerebral blood flow (CBF), there were significant differences between the tumor core and both normal brains ($p{\leqq}0.05$), but no significant differences between ipsilateral and contralateral normal brains ($962.91{\pm}75.96$ vs. $357.82{\pm}12.82$ vs. $323.19{\pm}83.24$ ml/100g/min). In the mean transit time (MTT), there were significant differences between the tumor core and both normal brains ($p{\leqq}0.05$), but no significant differences between ipsilateral and contralateral normal brains ($4.37{\pm}0.19$ vs. $3.02{\pm}0.41$ vs. $2.86{\pm}0.22$ sec). In the permeability surface (PS), there were significant differences among the tumor core, ipsilateral and contralateral normal brains ($47.23{\pm}25.45$ vs. $14.54{\pm}1.60$ vs. $6.81{\pm}4.20$ ml/100g/min)($p{\leqq}0.05$). In the time to peak (TTP) were no significant differences among the tumor core, ipsilateral and contralateral normal brains. In the positive enhancement integral (PEI), there were significant differences among the tumor core, ipsilateral and contralateral brains ($61.56{\pm}16.07$ vs. $12.58{\pm}2.61$ vs. $8.26{\pm}5.55$ ml/100g). ($p{\leqq}0.05$). In the maximum slope of increase (MSI), there were significant differences between the tumor core and both normal brain($p{\leqq}0.05$), but no significant differences between ipsilateral and contralateral normal brains ($13.18{\pm}2.81$ vs. $6.99{\pm}1.73$ vs. $6.41{\pm}1.39$ HU/sec). Additionally, in the maximum slope of decrease (MSD), there were significant differences between the tumor core and contralateral normal brain($p{\leqq}0.05$), but no significant differences between the tumor core and ipsilateral normal brain($4.02{\pm}1.37$ vs. $4.66{\pm}0.83$ vs. $6.47{\pm}1.53$ HU/sec). In conclusion, the VX2 tumors were implanted in the rabbit brain successfully, and stereotactic inoculation method make single-nodular type of tumor that was no metastasis in intracranial, suitable for comparative study between tumors and normal tissues. Therefore, perfusion CT would be a useful diagnostic tool capable of reflecting the vascularity of the tumors.

• Investigative Magnetic Resonance Imaging
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• v.2 no.1
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• pp.104-112
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• 1998

Purpose : To evaluate the clinical utility of diffusion-weighted imaging by analyzing the signal intersity of lesions in patients with various intracranial diseases. Materials and Methods : difusion-weighted MR imaging was prospectively perormed in randomly selected 70 patients with various intracranial idseases. They consisted of 20 patients with acute infarct, 21 patients with chronic infarct of small vessel disease, 14 patients with primary intracranial tumor, three patients with brain metastasis, five patient with brain abscess, five patients with brain abscess, five patients with cerebral hemorrhage, one patient with neurocysticercosis, and one patient with epidermoid cyst. the diffusion-weighted images were obtained immediately after routine T2-weighted imaging on a 1.5T MR unit using single shot spin echo EPI technique with 6500 ms TR, 107ms TE, $128{\times}128$ matrix, 1 number of excitation, $24{\times}24$ field of view, 5-7 mm slice thickness, 2-3 mm inter-slice gap. The diffusion-gradients (b value of ($1000s{\;}/{\;}textrm{mm}^2$)) were applied along three directions(x, y, z). On visual inspection of diffusion-weighted images, the signal intersity of lesions was arbitrarily graded as one of 5 grades. In quantitative assessment, we measured the signal intensity of all the lesions and the contralateral corresponding normal area using round region of interest(ROI), and then calculated the signal intensity ratio of the lesion to the normal brain parenchyma. Results : On visual inspection, markedly hyperintense signals were seen in all cases of acute infarct, brain abscess, epidermoid cyst, and neurocysticercosis in degenerating stage. In all cases of cerebral hematoma, the very high signal internsity was intermingled with low signal intensity. focal very high signal intersity was also seen in a solid portion of the tumor in a patient. the mean signal intensity ratios of all those lesions to the normal brain parenchyma were above 2.5. Gliosis, solid component of brain tumor, brain metastasis, and vasogenic dedma appeared isointense to the normal brain parenchyma in 71%, 64%, 100%, and 67%, respectively ; the mean signal intensity ratios of those lesions to the normal brain parenchyma ranged 1.15 to 1.28 and there was no significant difference among these(p>0.1). Cystic cerebromalacia and necrotic or cystic portions in tumor were markedly or slightly hypointense, and the mean signal intensity ratios were 0.45 and 0.42, respectively. Conclusion : Very high signal intensity of acute infarct, brain abscess, epidermoid cyst, and cystic neurocysticercosis in degenerating stage on diffusion-weighted images may be helpful in differentiating from other diseases that are hypointense or isointense to the normal brain parenchyma. It may be especially useful differentiation of brain abscess from brain tumor with necrotic or cystic portion.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.157-165
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• 2011

Objective : We have introduced a method of characterization of invading glioma cells by using molecular analysis of marginal invading tumor cells and molecular profiles of glioma tumor margin. Methods : Each of tumor core and marginal tissues was obtained in 22 glioma patients. Tumor core cells and marginal cells from each glial tumor were collected by laser capture microdissection or intraoperative microdissection under the operating microscope. Expression of MMP-2, MMP-9, CD44 and RHAMM mRNA by invading glioma cells compared with tumor core was confirmed by realtime-PCR of twenty-four glioma specimens. Clinical data also were reviewed for invasion and recurrence pattern of the gliomas radiologically and invasive rim pattern microscopically. Results : Overall results of the molecular analysis showed that relative overexpression of MMP-2, MMP-9 and RHAMM were noted at the invasive edge of human glioma specimens comparing to the tumor core but CD44 was highly expressed in the tumor core comparing to the margin. High marginal expression of MMP-2 and MMP-9 were noted in poorly ill-defined margin on the pathological finding. High marginal expression of CD44 and MMP-2 were demonstrated in the midline cross group on the radiological review, and that of RHAMM and MMP-2 were showed in the aggressive recurrence group. High expression of MMP-2 seems to be involved in the various invasion-related phenomenons. Conclusion : Up-regulation of MMP-2, MMP-9, CD44 and RHAMM was noted in invasive edge of gliomas according to the various clinical situations.

• Radiation Oncology Journal
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• v.30 no.2
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• pp.53-61
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• 2012

Purpose: To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. Materials and Methods: Nine patients with multiple (${\geq}4$) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10-12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. Results: The median biologically effective dose to metastatic tumors was 68.1 $Gy_{10}$ and 67.2 $Gy_{10}$ and the median brain volume irradiated more than 100 $Gy_3$ were 1.9% (24 $cm^3$) and 0.8% (13 $cm^3$) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. Conclusion: RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5929-5934
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• 2013

Background: Primary brain tumors constitute a small percent of all malignant cancers, but their etiology remains poorly understood. ${\beta}3$ integrin (ITGB3) has been recognized to play influential roles in angiogenesis, tumor growth and metastasis. Intercellular adhesion molecule-1 (ICAM-1) is a surface glycoprotein important for tumor invasion and angiogenesis. The aim of this study was to investigate whether specific genetic polymorphisms of ICAM-1 and ITGB3 could be associated with brain cancer development and progression in a Turkish population. Our study is the first to our knowledge to investigate the relationship between brain tumor risk and ICAM-1 and ${\beta}3$ integrin gene polymorphisms. Materials and Methods: The study covered 92 patients with primary brain tumors and 92 age-matched healthy control subjects. Evaluation of ${\beta}3$ integrin (Leu33Pro (rs5918)) and ICAM-1 (R241G (rs1799969) and K469E (rs5498)) gene polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: According to results of our research, the A allele of the ICAM-1 R241G gene polymorphism appeared to be a risk factor for primary brain tumors (p<0.001). Similarly, the frequency of the A mutant allele of ICAM-1 R241G was statistically significant in patients with brain tumors classified as glioma (p<0.001). When allele and genotype distributions of ICAM-1 K469E, ICAM-1 R241G and ${\beta}3$ integrin Leu33Pro gene polymorphisms were evaluated with age, sex, and smoking, there were no statistically significant differences. Haplotype analysis revealed that the frequencies of GAC (rs1799969-rs5498-rs5918) and GAT (rs1799969-rs5498-rs5918) haplotypes were significantly lower in patients as compared with controls (p=0.001; p=0.036 respectively). Conclusions: This study provides the first evidence that ICAM-1 R241G SNP significantly contributes to the risk of primary brain tumors in a Turkish population. In addition, our results suggest that ICAM-1 R241G in combination ICAM-1 K469E may have protective effects against the development of brain cancer.