المؤلفون: Nattawut Leelakanok, La-ongsri Atchaneeyasakul, Dittapong Songsaeng, Janthima Methaneethorn, Kleebsabai Sanpakit, Jassada Buaboonnam

المصدر: Siriraj Medical Journal, Vol 76, Iss 3 (2024)

مصطلحات موضوعية: retinoblastoma, metastasis, intra-arterial chemotherapy, mortality, central nervous system, Medicine

الوصف: Objective: The use of ophthalmic artery chemotherapy (OAC) as a front-line and salvage therapy for retinoblastoma has grown. However, the risk of metastatic death in these patients remains unclear. Materials and Methods: This study of metastatic deaths in OAC may benefit physicians managing retinoblastoma patients. A literature search of Medline, Scopus, Science Direct, and CINAHL was conducted from conception until November 2023. The primary outcome was metastatic death in patients treated with OAC. Results: From the 219 evaluated articles, nine met the inclusion criteria. A total of 596 (635 eyes) patients were treated with OAC; and 20 cases resulted in death due to metastasis of the retinoblastoma. The metastatic mortality rate was 2.5% (95% confidence interval: 0.8%-4.2%) which was statistically significant (p < 0.05). The central nervous system was the most common site of metastasis, followed by multiple sites of metastasis. Conclusion: OAC treatment is associated with the risk of metastatic death, but it is lower than the overall mortality rate of retinoblastoma. Further studies to identify the risk of metastasis are needed.

وصف الملف: electronic resource

العلاقة: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/266573Test; https://doaj.org/toc/2228-8082Test

الوصول الحر: https://doaj.org/article/319977f0127840ebafaef59d15e83b74Test

المؤلفون: Dittapong Songsaeng, Poonsuta Nava-apisak, Jittsupa Wongsripuemtet, Siripra Kingchan, Phuriwat Angkoondittaphong, Phattaranan Phawaphutanon, Akara Supratak

المصدر: Diagnostics, Vol 13, Iss 17, p 2840 (2023)

مصطلحات موضوعية: NPH, radiologic markers, hydrocephalus, AI, Medicine (General), R5-920

الوصف: Diagnosing normal-pressure hydrocephalus (NPH) via non-contrast computed tomography (CT) brain scans is presently a formidable task due to the lack of universally agreed-upon standards for radiographic parameter measurement. A variety of radiological parameters, such as Evans’ index, narrow sulci at high parietal convexity, Sylvian fissures’ dilation, focally enlarged sulci, and more, are currently measured by radiologists. This study aimed to enhance NPH diagnosis by comparing the accuracy, sensitivity, specificity, and predictive values of radiological parameters, as evaluated by radiologists and AI methods, utilizing cerebrospinal fluid volumetry. Results revealed a sensitivity of 77.14% for radiologists and 99.05% for AI, with specificities of 98.21% and 57.14%, respectively, in diagnosing NPH. Radiologists demonstrated NPV, PPV, and an accuracy of 82.09%, 97.59%, and 88.02%, while AI reported 98.46%, 68.42%, and 77.42%, respectively. ROC curves exhibited an area under the curve of 0.954 for radiologists and 0.784 for AI, signifying the diagnostic index for NPH. In conclusion, although radiologists exhibited superior sensitivity, specificity, and accuracy in diagnosing NPH, AI served as an effective initial screening mechanism for potential NPH cases, potentially easing the radiologists’ burden. Given the ongoing AI advancements, it is plausible that AI could eventually match or exceed radiologists’ diagnostic prowess in identifying hydrocephalus.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4418/13/17/2840Test; https://doaj.org/toc/2075-4418Test

الوصول الحر: https://doaj.org/article/c9514f86a7934fbcae582eb49e79ff87Test

المؤلفون: Alisa Kunapinun, Dittapong Songsaeng, Sittaya Buathong, Matthew N. Dailey, Chadaporn Keatmanee, Mongkol Ekpanyapong

المصدر: Sensors, Vol 23, Iss 16, p 7289 (2023)

مصطلحات موضوعية: thyroid nodule, TI-RADS, classification, deep learning, Grad-CAM, heatmap, Chemical technology, TP1-1185

الوصف: A thyroid nodule, a common abnormal growth within the thyroid gland, is often identified through ultrasound imaging of the neck. These growths may be solid- or fluid-filled, and their treatment is influenced by factors such as size and location. The Thyroid Imaging Reporting and Data System (TI-RADS) is a classification method that categorizes thyroid nodules into risk levels based on features such as size, echogenicity, margin, shape, and calcification. It guides clinicians in deciding whether a biopsy or other further evaluation is needed. Machine learning (ML) can complement TI-RADS classification, thereby improving the detection of malignant tumors. When combined with expert rules (TI-RADS) and explanations, ML models may uncover elements that TI-RADS misses, especially when TI-RADS training data are scarce. In this paper, we present an automated system for classifying thyroid nodules according to TI-RADS and assessing malignancy effectively. We use ResNet-101 and DenseNet-201 models to classify thyroid nodules according to TI-RADS and malignancy. By analyzing the models’ last layer using the Grad-CAM algorithm, we demonstrate that these models can identify risk areas and detect nodule features relevant to the TI-RADS score. By integrating Grad-CAM results with feature probability calculations, we provide a precise heat map, visualizing specific features within the nodule and potentially assisting doctors in their assessments. Our experiments show that the utilization of ResNet-101 and DenseNet-201 models, in conjunction with Grad-CAM visualization analysis, improves TI-RADS classification accuracy by up to 10%. This enhancement, achieved through iterative analysis and re-training, underscores the potential of machine learning in advancing thyroid nodule diagnosis, offering a promising direction for further exploration and clinical application.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1424-8220/23/16/7289Test; https://doaj.org/toc/1424-8220Test

الوصول الحر: https://doaj.org/article/e19a168cd0d340b89b05d7ffab9cd061Test

المؤلفون: Natsuda Kaothanthong, Kamin Atsavasirilert, Soawapot Sarampakhul, Pantid Chantangphol, Dittapong Songsaeng, Stanislav Makhanov

المصدر: PLoS ONE, Vol 17, Iss 12, p e0277573 (2022)

مصطلحات موضوعية: Medicine, Science

الوصف: A non-contrast cranial computer tomography (ncCT) is often employed for the diagnosis of the early stage of the ischemic stroke. However, the number of false negatives is high. More accurate results are obtained by an MRI. However, the MRI is not available in every hospital. Moreover, even if it is available in the clinic for the routine tests, emergency often does not have it. Therefore, this paper proposes an end-to-end framework for detection and segmentation of the brain infarct on the ncCT. The computer tomography perfusion (CTp) is used as the ground truth. The proposed ensemble model employs three deep convolution neural networks (CNNs) to process three end-to-end feature maps and a hand-craft features characterized by specific contra-lateral features. To improve the accuracy of the detected infarct area, the spatial dependencies between neighboring slices are employed at the postprocessing step. The numerical experiments have been performed on 18 ncCT-CTp paired stroke cases (804 image-pairs). The leave-one-out approach is applied for evaluating the proposed method. The model achieves 91.16% accuracy, 65.15% precision, 77.44% recall, 69.97% F1 score, and 0.4536 IoU.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/d4c9cf6f43ba46899ca2e94e2c80b8f3Test

المؤلفون: Dittapong Songsaeng, M.D., Ittichai Sakarunchai, M.D., Sasithorn Harmontree, M.D., Sakun Mongkolnaowarat, M.D., Panida Charnchaowanish, B.Sc., Shuo Zhang, Ph.D., Timo Krings, M.D., Ph.D.

المصدر: Interdisciplinary Neurosurgery, Vol 23, Iss , Pp 100920- (2021)

مصطلحات موضوعية: Saccular cerebral aneurysm, Aneurysm regrowth, Aneurysm recurrent, Vessel wall imaging, Coiling, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429

الوصف: Background: Vessel wall imaging (VWI) of cerebral aneurysms is a new tool to risk stratify unruptured aneurysms. We hypothesized that the degree and pattern of aneurysm wall enhancement may predict the regrowth of these aneurysms. The aim of this study was to identify patient risk factors and VWI parameters associated with aneurysm regrowth. Methods: We retrospectively reviewed 71 saccular aneurysms and 75 follow-up VWI studies in patients who underwent the coil embolization procedure for unruptured saccular aneurysm. The relationship between VWI enhancement and aneurysm regrowth was analyzed by Pearson’s chi-square test. Diagnostic performance of VWI enhancement in the diagnosis of regrowth aneurysm was determined to compare with digital subtraction angiography (DSA), and contrast-enhanced magnetic resonance angiography (CE-MRA) or time-of-flight MRA (TOF-MRA). Inter-rater agreement was measured by Cohen’s kappa coefficient. Results: Fourteen of 71 aneurysms (19.71%) were categorized into the aneurysm regrowth group, while aneurysm wall enhancement was found in 55 studies (73.33%). All wall enhancements were found in the aneurysm regrowth group, and no significant association was found between aneurysm regrowth and patient risk factors or VWI parameters. The diagnostic performance parameters of VWI relative to the DSA, and CE-MRA or TOF-MRA results were 100% sensitivity, 38.5% specificity, 30.4% positive predictive value, 100% negative predictive value, and 52% accuracy. Conclusions: Wall enhancement of post-coil embolization of saccular aneurysm on VWI may be used as a screening imaging test to predict aneurysm regrowth, and may help to identify an unstable aneurysm, if the degree of enhancement increase or change of the pattern.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2214751920304813Test; https://doaj.org/toc/2214-7519Test

الوصول الحر: https://doaj.org/article/fada59daa786404ebf78afda771bcb21Test

المؤلفون: Chumpol Anamnart, Dittapong Songsaeng, Sirisak Chanprasert

المصدر: BMC Neurology, Vol 19, Iss 1, Pp 1-4 (2019)

مصطلحات موضوعية: CADASIL, Cerebral microbleeds, NOTCH3 gene, Homozygous p. Arg558Cys, Case report, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Background Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary arteriopathy associated with the NOTCH3 gene. Clinical manifestations include strokes, transient ischaemic events, psychiatric disturbances, dementia, and migraines. We report a case of a Thai man with a severe CADASIL phenotype who presented with recurrent seizures and acute ischaemic stroke and classic vascular risk factors. Case presentation A 50-year-old man with a history of mood disorder and progressive cognitive decline for 20 years as well as well-controlled diabetes mellitus and hypertension presented with recurrent generalized seizures and acute right-sided weakness. An MRI of the brain showed acute infarction of the left pons, a large number of cerebral microbleeds throughout the brain and white matter abnormalities without classic anterior temporal lobe lesions. Molecular genetic testing identified a homozygous pathologic variant, c.1672C > T (p. Arg558Cys), in the NOTCH3 gene. The diagnosis of CADASIL was confirmed. His clinical symptoms deteriorated, and he died of tracheobronchitis with secretion obstruction. Conclusion This case raises awareness of an uncommon cause of acute ischaemic stroke in patients with classic vascular risk factors and emphasizes the need for a complete evaluation in cases with unexpected clinical presentation or unexpected diagnostic study results.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12883-019-1342-2Test; https://doaj.org/toc/1471-2377Test

الوصول الحر: https://doaj.org/article/90ba89d0b7794068b43f8a514d7faf5dTest

المؤلفون: Anchalee Churojana, M.D., Atithep Mongkolratnan, M.D, Boonrerk Sangpetngam, M.D., Thaweesak Aurboonyawat, M.D., Ekawut Chankaew, M.D., Pattarawit Withayasuk, M.D., Dittapong Songsaeng, M.D., Christophe Cognard, M.D.

المصدر: Siriraj Medical Journal, Vol 70, Iss 4, Pp 278-283 (2018)

مصطلحات موضوعية: Acute ischemic stroke, atrial fibrillation, mechanical thrombectomy, (Siriraj Med J 2018, 70: 278-283), Medicine

الوصف: Objective: Atrial fibrillation (AF) is one of the major risk for large vessel acute ischemic stroke. Mechanical thrombectomy is a promising therapeutic adjunct for large vessel occlusion and also the option for patients who missed the golden time window or who have contraindications for intravenous recombinant tissue plasminogen activator (rtPA). The purpose of this study was to investigate whether AF is a prognostic predictor for the patients with ischemic stroke undergoing mechanical thrombectomy. Methods: Medical records of all patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) who received mechanical thrombectomy at Siriraj Hospital between November 2009 and November 2016 were retrospectively reviewed. Clinical parameters between the two groups were retrieved and compared. Results: One hundred and thirty -eight acute ischemic stroke (AIS) patients were treated by endovascular mechanical thrombectomy at Siriraj Hospital between November 2009 and November 2016. Five patients lost from the follow-up process. Totally, 134 patients were included to this study. Fifty patients (37.3%) were in the AF group, 10 patients (7.5%) had a newly diagnosed AF. The AF patients were younger (p=0.002) and had less intracranial atherosclerosis (p=0.015) than non-AF patients. Nevertheless, gender, mean NIHSS, the mean time form puncture to recanalization, mean onset to recanalization, number of the passing of the stent, TICI, symptomatic intracranial hemorrhage, good clinical outcome at 90 days, and mortality rate were not different between two groups. Conclusion: There is no significant difference of good outcome and complications between AF and non-AF patients with AIS from LVO who underwent mechanical thrombectomy.

وصف الملف: electronic resource

العلاقة: http://www.smj.si.mahidol.ac.th/sirirajmedj/index.php/smj/article/view/2638/2590Test; https://doaj.org/toc/2228-8082Test

الوصول الحر: https://doaj.org/article/3edf6c01402a4cf6b9048d0d99f005cfTest

المؤلفون: Dittapong Songsaeng

المصدر: Siriraj Medical Journal, Vol 69, Iss 5 (2017)

مصطلحات موضوعية: Siriraj thyroid imaging reporting and data system, Siriraj-TIRADS, Medicine

الوصف: Objective: To standardize a modified practical thyroid imaging reporting and data system (Siriraj-TIRADS). Methods: 196 thyroid nodules underwent ultrasound and FNAB and were retrospectively pathologically proven. Data design was divided into 2 groups of benign and malignant. Sensitivity and specificity of cancer prediction were calculated for the comparison of Siriraj-TIRAD and TIRAD. Interobserver agreement was calculated by kappa statistics. Results: Sensitivity and specificity of Siriraj’s TIRADS on cancer prediction were 95% and 64.8%, respectively, and sensitivity and specificity of TIRADS were 45% and 92%, respectively. Conclusion: The Siriraj- TIRADS classification is easy, practical and has better sensitivity than TIRADS for the diagnosis of thyroid carcinoma. TIRADS is good for the screening management strategy but Siriraj-TIRADS has benefit to cancer management strategy.

وصف الملف: electronic resource

العلاقة: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/99630Test; https://doaj.org/toc/2228-8082Test

الوصول الحر: https://doaj.org/article/5d09fb28d70146048f95cbe87539c760Test

المؤلفون: Opal Saneetantikul, Dittapong Songsaeng, Anchalee Churojana

المصدر: Siriraj Medical Journal, Vol 59, Iss 3 (2007)

مصطلحات موضوعية: Aggressive symptoms, cerebral sinus thrombosis, cranial dural arteriovenous fistula, retrograde leptomeningeal venous, Medicine

الوصف: Objective: To evaluate the clinical and angiographic data of cranial dural arteriovenous fistula in Thai patients and to determine the predisposing factors to aggressive symptoms. Methods: Retrospective review of 71 patients with cranial dural arteriovenous fistula who underwent cerebral angiography at Siriraj Hospital between July 2002 - February 2006. Their clinical manifestations were classified as benign or aggressive symptoms. The relationship between aggressive symptoms and the following factors were studied: gender, location of the fistula, classification according to venous drainage pattern, presence of cerebral sinus thrombosis, and shunt multiplicity. Linear-bylinear association and chi-square test were used to determine statistical significance. Results: Sixteen (22.5%) of 71 patients with cranial dural arteriovenous fistula had aggressive presenting symptoms. Factors that significantly correlate with aggressive symptoms were location of the fistula, retrograde leptomeningeal venous drainage, presence of cerebral sinus thrombosis, and multiplicity. Factor which was not significantly correlated with aggressive symptoms was gender. Conclusion: This study evaluated clinical data and angiographic features of cranial dural arteriovenous fistula in Thai patients. Predisposing factors to aggressive symptoms were location of the fistula, retrograde leptomeningeal venous drainage, presence of cerebral sinus thrombosis, and multiplicity.

وصف الملف: electronic resource

العلاقة: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/246070Test; https://doaj.org/toc/2228-8082Test

الوصول الحر: https://doaj.org/article/fcd64974e3564e61bf2bbe5cbd13780bTest

المؤلفون: Dittapong Songsaeng, Wassana Peuksiripibul, Jitladda Wasinrat, Chulaluck Boonma, Patnaree Wongjaroenkit

المصدر: Asian Journal of Neurosurgery. 18:045-052

مصطلحات موضوعية: General Medicine

الوصف: Background Hematoma expansion (HE) is the most important modifiable predictor that can change the clinical outcome of intracerebral hemorrhage (ICH) patients. The study aimed to investigate the potential of satellite sign for prediction of HE in spontaneous ICH patients who had follow-up non-contrast computed tomography (NCCT) within 7 days after the initial CT scan. Methods We retrospectively reviewed data and NCCT from 142 ICH patients who were treated at our hospital at Bangkok, Thailand. All included patients were treated conservatively, had baseline NCCT within 12 hours after symptom onset, and had follow-up NCCT within 168 hours after baseline NCCT. HE was initially estimated by two radiologists, and then by image analysis software. Association between satellite sign and HE was evaluated. Results HE occurred in 45 patients (31.7%). Patients with HE had significantly higher activated partial thromboplastin time (p = 0.001) and baseline hematoma volume (p = 0.001). The prevalence of satellite sign was 43.7%, and it was significantly independently associated with HE (p = 0.021). The sensitivity, specificity, and accuracy of satellite sign for predicting HE was 57.8, 62.9, and 61.3%, respectively. From image analysis software, the cutoff of greater than 9% relative growth in hematoma volume on follow-up NCCT had the highest association with satellite sign (p = 0.024), with a sensitivity of 55%, specificity of 64.6%, and accuracy of 60.5%. Conclusion Satellite sign, a new NCCT predictor, was found to be significantly associated with HE in Thai population. With different context of Thai population, HE was found in smaller baseline hematoma volume. Satellite sign was found more common in lobar hematoma. Further studies to validate satellite sign for predicting HE and to identify an optimal cutoff in Thai population that is correlated with clinical outcomes are warranted.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::6d66de5aa133527968e59458ad4fe958Test
https://doi.org/10.1055/s-0043-1764327Test