Browsing by Author "Lin, Jung-Chun"

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Accurate Classification of Diminutive Colorectal Polyps Using Computer-Aided Analysis
(2018-02-01)
Chen, Peng-Jen
;
Lin, Meng-Chiung
;
Lai, Mei-Ju
;
Lin, Jung-Chun
;
Lu, Henry Horng-Shing
BACKGROUND & AIMS: Narrow-band imaging is an image-enhanced form of endoscopy used to observed microstructures and capillaries of the mucosal epithelium which allows for real-time prediction of histologic features of colorectal polyps. However, narrow-band imaging expertise is required to differentiate hyperplastic from neoplastic polyps with high levels of accuracy. We developed and tested a system of computer-aided diagnosis with a deep neural network (DNN-CAD) to analyze narrow-band images of diminutive colorectal polyps. METHODS: We collected 1476 images of neoplastic polyps and 681 images of hyperplastic polyps, obtained from the picture archiving and communications system database in a tertiary hospital in Taiwan. Histologic findings from the polyps were also collected and used as the reference standard. The images and data were used to train the DNN. A test set of images (96 hyperplastic and 188 neoplastic polyps, smaller than 5 mm), obtained from patients who underwent colonoscopies from March 2017 through August 2017, was then used to test the diagnostic ability of the DNN-CAD vs endoscopists (2 expert and 4 novice), who were asked to classify the images of the test set as neoplastic or hyperplastic. Their classifications were compared with findings from histologic analysis. The primary outcome measures were diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic time. The accuracy, sensitivity, specificity, PPV, NPV, and diagnostic time were compared among DNN-CAD, the novice endoscopists, and the expert endoscopists. The study was designed to detect a difference of 10% in accuracy by a 2-sided McNemar test. RESULTS: In the test set, the DNN-CAD identified neoplastic or hyperplastic polyps with 96.3% sensitivity, 78.1% specificity, a PPV of 89.6%, and a NPV of 91.5%. Fewer than half of the novice endoscopists classified polyps with a NPV of 90% (their NPVs ranged from 73.9% to 84.0%). DNN-CAD classified polyps as neoplastic or hyperplastic in 0.45 +/- 0.07 seconds-shorter than the time required by experts (1.54 +/- 1.30 seconds) and nonexperts (1.77 +/- 1.37 seconds) (both P < .001). DNN-CAD classified polyps with perfect intra-observer agreement (kappa score of 1). There was a low level of intra-observer and inter-observer agreement in classification among endoscopists. CONCLUSIONS: We developed a system called DNN-CAD to identify neoplastic or hyperplastic colorectal polyps less than 5 mm. The system classified polyps with a PPV of 89.6%, and a NPV of 91.5%, and in a shorter time than endoscopists. This deep-learning model has potential for not only endoscopic image recognition but for other forms of medical image analysis, including sonography, computed tomography, and magnetic resonance images.
Association Between Chronic Hepatitis C Virus Infection and Bone Mineral Density
(2012-12-01)
Lin, Jung-Chun
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Hsieh, Tsai-Yuan
;
Wu, Chia-Chun
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Chen, Peng-Jen
;
Chueh, Tung-Hung
Whether chronic hepatitis C virus (HCV) infection is a risk factor for the development of bone disease has long been controversial. For this reason, chronic HCV-infected participants (n = 69) were recruited into a prospective cohort study and underwent dual-energy X-ray absorptiometry for determination of bone mineral density (BMD). Fibrosis staging was evaluated according to the noninvasive index FIB-4. T scores at the femoral neck and lumbar spine were used as the primary outcome variables to assess the association between degree of liver disease and BMD. The study cohort was 41 % male with a mean age of 53.6 years. The mean BMD, Z score, and T score values of lumbar spine in chronic hepatitis C (CHC) patients were significantly lower than those in healthy controls (p < 0.001). The rate of osteoporosis for CHC patients aged 45-54 years was significantly higher than that of the control group (p = 0.011). Bone alkaline phosphatase and C-terminal cross-linking telopeptide of type I collagen levels were also significantly higher in CHC patients with reduced BMD. Patients with more advanced liver fibrosis had significantly lower BMD. In conclusion, reduced BMD is common in this population of chronic HCV-infected patients and associated with liver disease severity. This extrahepatic manifestation is probably secondary to increased bone turnover in osteodystrophy pathogenesis.
Changes in serum vitamin D levels during therapy for chronic hepatitis C virus infection
(2018-11-01)
Lin, Jung-Chun
;
Chueh, Tung-Hung
;
Lin, Hsuan-Hwai
;
Chen, Peng-Jen
;
Shih, Yu-Lueng
Clinical Characteristics of Early Onset Pancreatic Adenocarcinoma A Medical Center Experience and Review of the Literature
(2011-05-01)
Lin, Jung-Chun
;
Chan, De-Chuan
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Chen, Peng-Jen
;
Chu, Heng-Cheng
;
Chueh, Tung-Hung
Effect of Chronic Hepatitis C Virus Infection on Bone Mineral Density
(2012-10-01)
Lin, Jung-Chun
;
Hsieh, Tsai-Yuan
;
Chueh, Tung-Hung
;
Chen, Peng-Jen
;
Chang, Wei-Kuo
Effect of Chronic Hepatitis C Virus Infection on Bone Mineral Density
(2012-10-01)
Lin, Jung-Chun
;
Hsieh, Tsai-Yuan
;
Chueh, Tung-Hung
;
Chen, Peng-Jen
;
Chang, Wei-Kuo