• KSII Transactions on Internet and Information Systems (TIIS)
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• v.16 no.1
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• pp.16-37
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• 2022

Accurate liver segment segmentation based on radiological images is indispensable for the preoperative analysis of liver tumor resection surgery. However, most of the existing segmentation methods are not feasible to be used directly for this task due to the challenge of exact edge prediction with some tiny and slender vessels as its clinical segmentation criterion. To address this problem, we propose a novel deep learning based segmentation model, called Boundary-Aware Dual Attention Liver Segment Segmentation Model (BADA). This model can improve the segmentation accuracy of liver segments with enhancing the edges including the vessels serving as segment boundaries. In our model, the dual gated attention is proposed, which composes of a spatial attention module and a semantic attention module. The spatial attention module enhances the weights of key edge regions by concerning about the salient intensity changes, while the semantic attention amplifies the contribution of filters that can extract more discriminative feature information by weighting the significant convolution channels. Simultaneously, we build a dataset of liver segments including 59 clinic cases with dynamically contrast enhanced MRI(Magnetic Resonance Imaging) of portal vein stage, which annotated by several professional radiologists. Comparing with several state-of-the-art methods and baseline segmentation methods, we achieve the best results on this clinic liver segment segmentation dataset, where Mean Dice, Mean Sensitivity and Mean Positive Predicted Value reach 89.01%, 87.71% and 90.67%, respectively.

• Journal of Sasang Constitutional Medicine
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• v.19 no.1
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• pp.90-97
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• 2007

1. Objectives and Methods This study was done to investigate the relationships of Sound parameters between Liver Heat Symptom and Esophagus Symptom of Taeumin using PSSC(Phonetic System of Sasang Constitution) in a sentence. Experimental Participants were 20 Korean adult males including, each 10 Liver Heat Symptom and Esophagus Symptom of Taeumin. 2. Results In Pitch segment, APQ segment and Shimmer segment, there were no significant differences between Liver Heat Symptom and Esophagus Symptom of Taeumin. In Octave segment, there were significant differences in Octave 1, Octave 3, Octave 4, Octave 6 of Liver Heat Symptom of Taeumin were significantly high compared with Esophagus Symptom of Taeumin. In Energy segment, FreQ Domain Total Sum / cnt(0), 0k-2k Total Sum,0k-2k sum dev., 2k-4k Total Sum, 2k-4k sum dev., A# Tot E, B__TOT_E, C__TOT_E, C# Tot E, D__TOT_E, A sum dev., A# sum dev., B sum dev., C sum dev., C# sum dev., Dsum dev., D# sum dev., E sum dev., F sum dev., F# sum dev., G sum dev., G# sum dev. of Liver Heat Symptom of Taeumin were significantly high compared with Esophagus Symptom of Taeumin. In Voice Recording time segment, Total Voice Recording Time, Voice Recording Time, Divide By Time3, Divide By Energy10, Total Unit, Max Unit Position, U_0 TO 3 of Liver Heat Symptom of Taeumin were significantly high compared with Esophagus Symptom of Taeumin. 3. Conclusion From above result, there is the postbility of efficiency quide constitutional sx. of Taeumin by Voice characteristics. More Soeumin, Soyangin and Taeyangin Symptoms are needed to determine Sasang Constitution using PSSC and to make PSSC effective.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.252-254
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• 2013

A hepatic hemangioma is the most frequent benign liver tumor. Once rupture occurs, the bleeding can barely be controlled by using conservative management or endovascular treatment. We report a case of traumatic hepatic hemangioma rupture. A 60-year-old man was referred to our hospital under cardiopulmonary cerebral resuscitation (CPCR). CPCR was continued for 16 minutes after his admission to the emergency room (ER). Computed tomography (CT) showed fluid accumulation in the peritoneal cavity with active contrast extravasation in the left lateral segment of the liver. Percutaneous transarterial embolization and massive transfusion were carried out. Embolization did not stop the bleeding, we decided on an exploration and then resected the lateral segment of the liver to control the bleeding. The specimen showed a ruptured hemangioma in the liver segment.

• Radiation Oncology Journal
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• v.26 no.4
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• pp.280-288
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• 2008

Purpose: To identify the inter-fractional shift pattern and to assess an adequate treatment margin in the radiotherapy of a liver tumor using mega-voltage computed tomography (MVCT) of a tomotherapy unit. Materials and Methods: Twenty-six patients were treated for liver tumors by tomotherapy from April 2006 to August 2007. The MVCT images of each patient were analyzed from the $1^{st}$ to the $10^{th}$ fraction for the assessment of the daily liver shift by four groups based on Couinard's proposal. Daily setup errors were corrected by bony landmarks as a prerequisite. Subsequently, the anterior-, posterior-, right-, and left shifts of the liver edges were measured by maximum linear discrepancies between the kilo-voltage computed tomography (KVCT) image and MVCT image. All data were set in the 2-dimensional right angle coordinate system of the transverse section of each patient's body. Results: The liver boundary shift had different patterns for each group. In group II (segment 2, 3, and 4), the anterior mean shift was $2.80{\pm}1.73\;mm$ outwards, while the left mean shift was $2.23{\pm}1.37\;mm$ inwards. In group IV (segment 7 and 8), the anterior-, posterior-, right-, and left mean shifts were $0.15{\pm}3.93\;mm$ inwards, $3.15{\pm}6.58\;mm$ inwards, $0.60{\pm}3.58\;mm$ inwards, and $4.50{\pm}5.35\;mm$ inwards, respectively. The reduced volume in group II after MVCT reassessment might be a consequence of stomach toxicity. Conclusion: Inter-fractional liver shifts of each group based on Couinard's proposal were somewhat systematic despite certain variations observed in each patient. The geometrical deformation of the liver by respiratory movement can cause shrinkage in the left margins of liver. We recommend a more sophisticated approach in free-breathing mode when irradiating the left lobe of liver in order to avoid stomach toxicity.

• Smart Media Journal
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• v.5 no.1
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• pp.49-54
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• 2016

Medical image processing is a compulsory process to diagnose many kinds of disease. Therefore, an automatic algorithm for this task is highly demanded as an important part to construct a computer-aided diagnosis system. In this paper, we introduce an automatic method to segment the liver region from 3D abdominal CT images using Otsu method. First, we choose a 2D slice which has most liver information from the whole 3D image. Secondly, on the chosen slice, we enhanced the image based on its intensity using Otsu method with multiple thresholds and use the threshold to enhance the whole 3D image. Then, we apply a liver mask to mark the candidate liver region. After that, we execute the Otsu method again to segment the liver region from the chosen slice and propagate the result to the whole 3D image. Finally, we apply preprocessing on the frontal side of 3D images to crop only the liver region from the image.

• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.32-36
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• 2014

We report a patient with combined hepatocellular-cholangiocarcinoma confined in the common hepatic duct and scirrhous type of hepatocellular carcinoma in the caudate lobe of liver simultaneously. The patient was a 55-yearsold Korean man with hepatitis B virus (HBV) carrier who was referred from a local hospital due to detected liver mass on abdominal computed tomography (CT). He has presented jaundice and weight loss for the previous 3 weeks. Laboratory examination showed AST/ALT elevation and hyperbilirubinemia. HBsAg was positive. The tumor marker study showed elevated AFP and DCP, not CEA and CA 19-9. Abdominal CT disclosed an about 2.1×0.9 cm sized soft tissue density in hilum with both intrahepatic duct (IHD) dilatations and an about 3×2.1 cm sized arterial enhancing lesion at segment 8 of the liver. Patient received 15 cycles of Gemcitabine/Cisplantin chemotherapy from February 27, 2013 to December 31, 2013. Caudate lobectomy of liver, segmental resection of bile duct and Roux-en-Y hepaticojejunostomy was performed on February 10, 2014. The final pathologic report showed double primary liver cancer, combined hepatocellular-cholangiocarcinoma in common hepatic bile duct and scirrhous type of hepatocellular carcinoma in segment 1 of the liver. This is a very unusual case in which combined hepatocellular-cholangiocarcinoma confined in the large bile duct and two rare hepatic cancers coexisted.

• Proceedings of the IEEK Conference
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• 2003.11b
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• pp.153-156
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• 2003

In this paper, we propose a new scheme for automatic segmentation of the liver in CT images. The proposed scheme is carried out on region of interest(ROI) blocks that include regions of the liver with high probabilities. The ROI approach saves unnecessary computational loss in finding the accurate boundary of the liver. The proposed method utilizes the composition of multi-size morphological filters with a prior knowledge, such as the general location or the approximate intensity of the liver to detect the initial boundary of the liver. Then, we make the gradient image with the weight of the initial liver boundary and segment the liver legion by using an immersion-based waters hed algorithm in the gradient image. finally, the refining process is carried out to acquire a more accurate liver region.

• Journal of Digestive Cancer Research
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• v.6 no.2
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• pp.73-77
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• 2018

A 70-year-old female diagnosed with pancreatic ductal adenocarcinoma was treated by pylorus-preserving pancreaticoduodenectomy (PPPD) and adjuvant concurrent chemoradiotherapy with 5-fluorouracil. Pancreatic ductal adenocarcinoma pT3N0 (stage IIA) was pathologically confirmed. Abdominal computed tomography (CT) findings 14 months after PPPD showed 10 mm sized solitary liver metastasis in segment 3. After 12 cycles of gemcitabine and 9 cycles of capecitabine plus oxaliplatin, the metastatic nodule increased in size to 27 mm. Tumorectomy at segment 3 of liver was done. 25 months after tumorectomy, chest CT showed 23 mm sized cavitary nodule in right upper lobe of lung. The result of percutaneous biopsy favored metastatic adenocarcinoma. Two sets of stereotactic body radiation therapy were done and the patient has survived without further disease progression for 6 years after initial diagnosis. This case suggests that selected population of recurrent pancreatic cancer patients with solitary liver or pulmonary metastasis can be treated by resection of metastatic site and ablative therapies.

• Journal of Korean Biological Nursing Science
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• v.16 no.4
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• pp.292-299
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• 2014

Purpose: This is a study on the structural model that aims to build a path model of multivariates affecting the quality of health-related living for liver cirrhosis patients and specify causal relations affecting the quality of health-related living for liver cirrhosis patients. Methods: The research was conducted on 244 patients diagnosed with liver cirrhosis and the data were collected from July 2013 to January 2014. The collected data were analyzed using IBM SPSS 19.0 and AMOS 21.0 statistical programs. Results: All the fit indexes of the path model properly met the assessment criteria. Anxiety, depression, functional status, and perceived health directly affected the quality of health-related living for liver cirrhosis patients and anxiety, depression, and functional status directly affected perceived health. Social support, anxiety, and depression directly affected the functional status. Conclusion: It is necessary to segment the severity of liver cirrhosis in testing its direct and indirect effects on the quality of health-related living for patients with the condition.

• Journal of Gastric Cancer
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• v.11 no.1
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• pp.64-68
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• 2011

A 54 year old man was referred to our hospital with gastric cancer. The patient had a history of splenectomy and a left nephrectomy as a result of a traffic accident 15 years earlier. The endoscopic findings were advanced gastric cancer at the lower body of the stomach. Abdominal ultrasonography (USG) and magnetic resonance imaging demonstrated a metastatic nodule in the S2 segment of the liver. Eventually, the clinical stage was determined to be cT2cN1cM1 and a radical distal gastrectomy, lateral segmentectomy of the liver were performed. The histopathology findings confirmed the diagnosis of intrahepatic splenosis, omental splenosis. Hepatic splenosis is not rare in patients with a history of splenic trauma or splenectomy. Nevertheless, this is the first report describing a patient with gastric cancer and intrahepatic splenosis that was misinterpreted as a liver metastatic nodule. Intra-operative USG guided fine needle aspiration should be considered to avoid unnecessary liver resections in patients with a suspicious hepatic metastasis.