Publications by authors named "Yeun Chung Chang"

Article Synopsis
  • Stereotactic arrhythmia radioablation (STAR) has shown effectiveness for treating refractory ventricular tachyarrhythmia (VT), with a focus on a Taiwanese patient group.
  • The study involved 11 patients, using advanced imaging techniques to treat VT with a single radiation dose, resulting in a significant 88% reduction in VT episodes within the first six months post-treatment.
  • Despite initial success, many patients experienced late VT recurrence, with a one-year survival rate of 83%, leading to some requiring additional treatments such as heart transplants or HeartMate III implantation.
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Purpose: This study aimed to quantitatively assess changes in lung perfusion after thoracic radiotherapy in lung cancer patients.

Materials And Methods: Patients underwent chest computed tomography (CT) for pulmonary vasculature analysis before radiotherapy and at 3 and 12 months after radiotherapy. The correlation between the percentage decrease in lung perfusion after radiotherapy and the delivered radiotherapy dose was analyzed.

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Introduction: With the implementation of low-dose computed tomography screening, multiple pulmonary tumor nodules are diagnosed with increasing frequency and the selection of surgical treatments versus systemic therapies has become challenging on a daily basis in clinical practice. In the presence of multiple carcinomas, especially adenocarcinomas, pathologically determined to be of pulmonary origin, the distinction between separate primary lung carcinomas (SPLCs) and intrapulmonary metastases (IPMs) is important for staging, management, and prognostication.

Methods: We systemically reviewed various means that aid in the differentiation between SPLCs and IPMs explored by histopathologic evaluation and molecular profiling, the latter includes DNA microsatellite analysis, array comparative genomic hybridization, TP53 and oncogenic driver mutation testing and, more recently, with promising effectiveness, next-generation sequencing comprising small- or large-scale multi-gene panels.

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Article Synopsis
  • Lung cancer is the biggest reason people die from cancer in Taiwan, and it costs a lot of money to treat.
  • This study looked at how often low-dose CT scans were used for people who might have lung cancer and how much they cost until they were diagnosed.
  • They found that over 17,000 people suspected of having lung cancer were tracked for around 2 years, needing a couple of CT scans, and it didn’t cost as much as expected with the National Health Insurance helping out.
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Background And Objective: Registration of pulmonary computed tomography (CT) images with radiation-induced lung diseases (RILD) was essential to investigate the voxel-wise relationship between the formation of RILD and the radiation dose received by different tissues. Although various approaches had been developed for the registration of lung CTs, their performances remained clinically unsatisfactory for registration of lung CT images with RILD. The main difficulties arose from the longitudinal change in lung parenchyma, including RILD and volumetric change of lung cancers, after radiation therapy, leading to inaccurate registration and artifacts caused by erroneous matching of the RILD tissues.

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Sublobar resection has emerged as a standard treatment option for early-stage peripheral non-small cell lung cancer. Achieving an adequate resection margin is crucial to prevent local tumor recurrence. However, gross measurement of the resection margin may lack accuracy due to the elasticity of lung tissue and interobserver variability.

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In this article, the multidisciplinary team of the Taiwan Academy of Tumor Ablation, who have expertise in treating lung cancer, present their perspectives on percutaneous image-guided thermal ablation (IGTA) of lung tumors. The modified Delphi technique was applied to reach a consensus on clinical practice guidelines concerning ablation procedures, including a comprehensive literature review, selection of panelists, creation of a rating form and survey, and arrangement of an in-person meeting where panelists agreed or disagreed on various points. The conclusion was a final rating and written summary of the agreement.

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Purpose To develop a prediction model combining both clinical and CT texture analysis radiomics features for predicting pneumothorax complications in patients undergoing CT-guided core needle biopsy. Materials and Methods A total of 424 patients (mean age, 65.6 years ± 12.

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Purpose: Mycobacterium abscessus complex (MABC) commonly causes lung disease (LD) and has a high treatment failure rate of around 50%. In this study, our objective is to investigate specific CT patterns for predicting treatment prognosis and monitoring treatment response, thus providing valuable insights for clinical physicians in the management of MABC-LD treatment.

Methods: We retrospectively assessed 34 patients with MABC-LD treated between January 2015 and December 2020.

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Background/purpose: We evaluated the utility of combining quantitative pulmonary vasculature measures with clinical factors for predicting pulmonary hemorrhage after computed tomography (CT)-guided lung biopsy.

Methods: Patients who underwent CT-guided lung biopsy were retrospectively included in this study. Clinical and radiographic vasculature variables were evaluated as predictors of pulmonary hemorrhage.

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Purpose: To ascertain the performance of dual-energy CT (DECT) with iodine quantification in differentiating malignant mediastinal and hilar lymph nodes (LNs) from benign ones, focusing on patients with lung adenocarcinoma.

Materials And Methods: In this study, patients with suspected lung cancer received a preoperative contrast-enhanced DECT scan from Jun 2018 to Dec 2020. Quantitative DECT parameters and the size were compared between metastatic and benign LNs.

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Article Synopsis
  • In Taiwan, a study called TALENT is examining the effectiveness of low-dose CT (LDCT) screening for lung cancer in never-smokers who have other risk factors, as nearly 60% of such patients are diagnosed at advanced stages.
  • The study involved 17 medical centers and included individuals aged 55-75 who met specific eligibility criteria, like having never smoked or having a very limited smoking history, and certain risk factors for lung cancer.
  • Preliminary results from a 1-year follow-up after the initial LDCT screenings were analyzed, focusing on the detection rates of lung cancer and using various statistical methods to evaluate the outcomes.
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Background: Sublobar resection is strongly associated with poor prognosis in early-stage lung adenocarcinoma, with the presence of tumor spread through air spaces (STAS). Thus, preoperative prediction of STAS is important for surgical planning. This study aimed to develop a STAS deep-learning (STAS-DL) prediction model in lung adenocarcinoma with tumor smaller than 3 cm and a consolidation-to-tumor (C/T) ratio less than 0.

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Objectives: The experience of thermal ablation of lung lesions is limited, especially performing the procedure under localisation by cone-beam CT in the hybrid operation room (HOR). Here, we present the experience of microwave ablation (MWA) of lung nodules in the HOR.

Methods: We reviewed patients who underwent image-guide percutaneous MWA for lung nodules in the HOR under general anaesthesia between July 2020 and July 2022.

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Objectives: Invasive adenocarcinomas (IADs) have been identified among nonsolid nodules (NSNs) assigned as Lung Imaging Reporting and Data System (Lung-RADS) category 2. This study used visual assessment for differentiating IADs from noninvasive lesions (NILs) in this category.

Methods: This retrospective study included 222 patients with 242 NSNs, which were resected after preoperative computed tomography (CT)-guided dye localization.

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The automated marker-free longitudinal Infrared (IR) breast image registration overcomes several challenges like no anatomic fiducial markers on the body surface, blurry boundaries, heat pattern variation by environmental and physiological factors, nonrigid deformation, etc, has the ability of quantitative pixel-wise analysis with the heat energy and patterns change in a time course study. To achieve the goal, scale-invariant feature transform, Harris corner, and Hessian matrix were employed to generate the feature points as anatomic fiducial markers, and hybrid genetic algorithm and particle swarm optimization minimizing the matching errors was used to find the appropriate corresponding pairs between the 1st IR image and theth IR image. Moreover, the mechanism of the IR spectrogram hardware system has a high level of reproducibility.

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Background/purpose: Patients with influenza infection during their period of admission may have worse computed tomography (CT) manifestation according to the clinical status. This study aimed to evaluate the CT findings of in-hospital patients due to clinically significant influenza pneumonia with correlation of clinical presentations.

Methods: In this retrospective, single center case series, 144 patients were included.

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Background: To investigate the clinical outcomes and risk factors associated with progressive fibrosing interstitial lung disease (PF-ILD) in patients with primary Sjögren's syndrome-associated interstitial lung disease (pSjS-ILD).

Methods: During 2015-2021, pSjS patients with ILD were retrospectively identified. Patients were grouped into non-PF-ILD and PF-ILD.

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Article Synopsis
  • Lung cancer incidence and mortality rates are notably higher in Asia, particularly East Asia, necessitating improved early detection and treatment strategies compared to Western countries.
  • A virtual meeting of 19 healthcare advisors from 11 Asian countries led to the recommendation of annual low-dose computed tomography screening for those at high risk, along with tailored reassessment intervals based on individual risk factors.
  • Challenges such as economic constraints and insufficient government programs hinder the implementation of effective lung cancer screening in Asia, prompting the need for strategic solutions.
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Objective: To quantitatively assess the pulmonary vasculature using non-contrast computed tomography (CT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) pre- and post-treatment and correlate CT-based parameters with right heart catheterization (RHC) hemodynamic and clinical parameters.

Materials And Methods: A total of 30 patients with CTEPH (mean age, 57.9 years; 53% female) who received multimodal treatment, including riociguat for ≥ 16 weeks with or without balloon pulmonary angioplasty and underwent both non-contrast CT for pulmonary vasculature analysis and RHC pre- and post-treatment were included.

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Background: The initial diagnosis of ductal carcinoma in situ (DCIS) can be upstaged to invasive cancer after definitive surgery. This study aimed to identify risk factors for DCIS upstaging using routine breast ultrasonography and mammography (MG) and to propose a prediction model.

Methods: In this single-center retrospective study, patients initially diagnosed with DCIS (January 2016-December 2017) were enrolled (final sample size = 272 lesions).

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Background And Objective: Lung cancer has the highest cancer-related mortality worldwide, and lung nodule usually presents with no symptom. Low-dose computed tomography (LDCT) was an important tool for lung cancer detection and diagnosis. It provided a complete three-dimensional (3-D) chest image with a high resolution.

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Background: Preoperative two-dimensional manual measurement of pulmonary artery diameter in a single-cut axial view computed tomography (CT) image is a commonly used non-invasive prediction method for pulmonary hypertension. However, the accuracy may be unreliable. Thus, this study aimed to evaluate the correlation of short-term surgical outcomes and pulmonary artery/aorta (PA/Ao) diameter ratio measured by automated three-dimensional (3D) segmentation in lung cancer patients who underwent thoracoscopic lobectomy.

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