• Korean Journal of Digital Imaging in Medicine
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• v.15 no.1
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• pp.27-31
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• 2013

Perfusion MR imaging is how to use exogenous and endogenous contrast agent. Exogenous perfusion MRI methods which are dynamic susceptibility contrast using $T2^*$ effect and dynamic contrast-enhanced using T1 weighted image after injection contrast media. An endogenous perfusion MRI method which is arterial spin labeling using arterial blood flow in body. In order to exam perfusion MRI in human, technical access are very important according to disease conditions. For instance, dynamic susceptibility contrast is used in patients with acute stroke because of short exam time, while dynamic susceptibility contrast or dynamic contrast enhancement provides the various perfusion information for patients with tumor, vascular stenosis. Arterial spin labeling is useful for children, women who are expected to be pregnant. In this regard, perfusion MR imaging is required to understanding, and the author would like to share information with clinical users

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.38-43
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• 2002

Background & Purpose : Dynamic susceptibility contrast MR imaging, one method of perfusion MRI, was developed to define cerebral hemodynamic status with good anatomical resolution. The authors investigated hemodynamic parameters using this imaging method, in an effort to identify hemodynamic changes on the remote crossed cerebellum of patients with a supratentorial infarct. Methods : Dynamic susceptibility contrast MR imaging was performed in 15 patients with only unilateral supratentorial infarcts. Imaging was obtained at the anatomic level of the cerebellum. rCBF, rCBV, MTT and TP were determined over both cerebellar hemispheres of interest. Results : The rCBF and rCBV values of the contralateral cerebellar hemisphere were significantly more decreased than those of the ipsilateral cerebellar hemisphere in 12 patients(p=0.028, 0.033). MTT and TP values of the contralateral and ipsilateral cerebellar hemispheres didn't reveal any differences(p=0.130, 0.121). Conclusions : The results of this work suggest that the region which are remote from the ischemic brain lesion shows no changes of MTT or TP but show decrease of rCBF and rCBV, mean to diaschisis, it also demonstrates that perfusion MRI is an easily available method to evaluate the hemodynamic status of the brain.

• Investigative Magnetic Resonance Imaging
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• v.21 no.1
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• pp.9-19
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• 2017

Background: Normalized cerebral blood volume (nCBV) can be measured using manual or semiautomatic segmentation method. However, the difference in diagnostic performance on brain tumor differentiation between differently measured nCBV has not been evaluated. Purpose: To compare the diagnostic performance of manually obtained nCBV to that of semiautomatically obtained nCBV on glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) differentiation. Materials and Methods: Histopathologically confirmed forty GBM and eleven PCNSL patients underwent 3T MR imaging with dynamic susceptibility contrast-enhanced perfusion MR imaging before any treatment or biopsy. Based on the contrast-enhanced T1-weighted imaging, the mean nCBV (mCBV) was measured using the manual method (manual mCBV), random regions of interest (ROIs) placement by the observer, or the semiautomatic segmentation method (semiautomatic mCBV). The volume of enhancing portion of the tumor was also measured during semiautomatic segmentation process. T-test, ROC curve analysis, Fisher's exact test and multivariate regression analysis were performed to compare the value and evaluate the diagnostic performance of each parameter. Results: GBM showed a higher enhancing volume (P = 0.0307), a higher manual mCBV (P = 0.018) and a higher semiautomatic mCBV (P = 0.0111) than that of the PCNSL. Semiautomatic mCBV had the highest value (0.815) for the area under the curve (AUC), however, the AUCs of the three parameters were not significantly different from each other. The semiautomatic mCBV was the best independent predictor for the GBM and PCNSL differential diagnosis according to the stepwise multiple regression analysis. Conclusion: We found that the semiautomatic mCBV could be a better predictor than the manual mCBV for the GBM and PCNSL differentiation. We believe that the semiautomatic segmentation method can contribute to the advancement of perfusion based brain tumor evaluation.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.79-80
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• 2003

In existing method, the threshold has determined the points to be used in extrapolation and only pre-peak points were used to find t0. However, to reduce error in using this fitting method, in this study, finding t0is considered the correlation between fitting result and each profile in using iteration method. And the proposed method is compared with the existing method.

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1369-1378
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• 2021

Objective: Few attempts have been made to investigate the prognostic value of dynamic contrast-enhanced (DCE) MRI or dynamic susceptibility contrast (DSC) MRI of non-enhancing, T2-high-signal-intensity (T2-HSI) lesions of glioblastoma multiforme (GBM) in newly diagnosed patients. This study aimed to investigate the prognostic values of DCE MRI and DSC MRI parameters from non-enhancing, T2-HSI lesions of GBM. Materials and Methods: A total of 76 patients with GBM who underwent preoperative DCE MRI and DSC MRI and standard treatment were retrospectively included. Six months after surgery, the patients were categorized into early progression (n = 15) and non-early progression (n = 61) groups. We extracted and analyzed the permeability and perfusion parameters of both modalities for the non-enhancing, T2-HSI lesions of the tumors. The optimal percentiles of the respective parameters obtained from cumulative histograms were determined using receiver operating characteristic (ROC) curve and univariable Cox regression analyses. The results were compared using multivariable Cox proportional hazards regression analysis of progression-free survival. Results: The 95th percentile value (PV) of Ktrans, mean Ktrans, and median Ve were significant predictors of early progression as identified by the ROC curve analysis (area under the ROC curve [AUC] = 0.704, p = 0.005; AUC = 0.684, p = 0.021; and AUC = 0.670, p = 0.0325, respectively). Univariable Cox regression analysis of the above three parametric values showed that the 95th PV of Ktrans and the mean Ktrans were significant predictors of early progression (hazard ratio [HR] = 1.06, p = 0.009; HR = 1.25, p = 0.017, respectively). Multivariable Cox regression analysis, which also incorporated clinical parameters, revealed that the 95th PV of Ktrans was the sole significant independent predictor of early progression (HR = 1.062, p < 0.009). Conclusion: The 95th PV of Ktrans from the non-enhancing, T2-HSI lesions of GBM is a potential prognostic marker for disease progression.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.281-282
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• 1998

Recently, there has been growing interest in the assessment of physiological parameters on brain perfusion that provide more information than pure morphologic diagnosis. Quantification of parameters that characterize cerebral micro-circulation with magnetic resonance imaging is of great relevance for clinical application. We determine the local tissue concentration by exponential relationship between the relative signal reduction S(t)/$S_0$ and local tissue concentration of contrast material $C_m(t)$ in dynamic susceptibility contrast enhanced MR imaging. And then we made relative regional blood volume map by calculating the area under the measured concentration-time curves $C_m(t)$ during first pass of paramagnetic contrast material as a preliminary step for perfusion map. These images make it possible to compare the rCBV in different brain regions in one individual at a time. We have it in contemplation to obtain arterial and brain signal time curves simultaneously to make absolute rCBV and perfusion (rCBF) map. These maps may provide the method of comparative investigations of different patients having strong variation in AIF.

• Journal of the Korean Magnetic Resonance Society
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• v.9 no.2
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• pp.93-102
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• 2005

Purpose: To develop an advanced non-linear curve fitting (NLCF) algorithm for dynamic susceptibility contrast study of brain. Materials and Methods: The first pass effects give rise to spuriously high estimates of $K^{trans}$ in voxels with large vascular components. An explicit threshold value has been used to reject voxels. Results: By using this non-linear curve fitting algorithm, the blood perfusion and the volume estimation were accurately evaluated in T2*-weighted dynamic contrast enhanced (DCE)-MR images. From the recalculated each parameters, perfusion weighted image were outlined by using modified non-linear curve fitting algorithm. This results were improved estimation of T2*-weighted dynamic series. Conclusion: The present study demonstrated an improvement of an estimation of kinetic parameters from dynamic contrast-enhanced (DCE) T2*-weighted magnetic resonance imaging data, using contrast agents. The advanced kinetic models include the relation of volume transfer constant $K^{trans}\;(min^{-1})$ and the volume of extravascular extracellular space (EES) per unit volume of tissue $\nu_e$.

• Investigative Magnetic Resonance Imaging
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• v.11 no.2
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• pp.103-109
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• 2007

To develop an advanced non-linear curve fitting (NLCF) algorithm for performing dynamic susceptibility contrast study of the brain. The first pass effects give rise to spuriously high estimates of $K^{trans}$ for the voxels that represent the large vascular components. An explicit threshold value was used to reject voxels. The blood perfusion and volume estimation were accurately evaluated in the $T2^*$-weighted dynamic contrast enhanced (DCE)-MR images. From each of the recalculated parameters, a perfusion weighted image was outlined by using the modified non-linear curve fitting algorithm. The present study demonstrated an improvement of an estimation of the kinetic parameters from the DCE $T2^*$-weighted magnetic resonance imaging data with using contrast agents.

• Korean Journal of Digital Imaging in Medicine
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• v.9 no.2
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• pp.11-16
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• 2007

We have evaluated and compared of gradient echo and spin echo EPI for compensating about deeply distortion aspect in case of post-operation patients in magnetic resonance image. A total of 100 patients were performed on 3.0 T(GE Signa Excite E2, USA) with 8ch head coil. As a result of analysis, The SNRs of whiter and gray matter areas were 36.74 $\pm$ 06 and 39.96 $\pm$ 09 in the gradient echo EPI, the SNRs which white and gray matter areas were slightly higher than gradient echo EPI(P<0.005, paired student t-test). It was 46.24 $\pm$ 11 and 51.38 $\pm$ 13 in gradient and spin echo EPI, respectively. The signal intensity in the whiter and gray matter areas also were 87.33 $\pm$ 15.24 and 140.66 $\pm$ 13.45 in the gradient echo EPI techniques, The signal intensity of gradient echo EPI showed higher values compared to spin echo EPI. Otherwise, gradient echo EPI technique is distortion enough to operation wound and edge of the image, while spin echo EPI technique did not appear almost. In this point, the spin echo EPI technique, after surgical operation according to patient state beside gradient echo EPI techniques that signalbeside gradient echo EPI techniques that signal intensity is high and patient's case which image distortion is serious by metal etc, will be provide the useful information in adults and pediatric patients.

• Investigative Magnetic Resonance Imaging
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• v.22 no.3
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• pp.158-167
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• 2018

Purpose: To investigate the surgical, perfusion, and molecular characteristics of glioblastomas which influence long-term survival after treatment, and to explore the association between MR perfusion parameters and the presence of MGMT methylation and 1p/19q deletions. Materials and Methods: This retrospective study was approved by our institutional review board. A total 43 patients were included, all with pathologic diagnosis of glioblastoma with known MGMT methylation and 1p/19q deletion statuses. We divided these patients into long-term (${\geq}60\;months$, n = 7) and short-term (< 60 months, n = 36) survivors, then compared surgical extent, molecular status, and rCBV parameters between the two groups using Fisher's exact test or Mann-Whitney test. The rCBV parameters were analyzed according to the presence of MGMT methylation and 1p/19q deletions. We investigated the relationship between the mean rCBV and overall survival using linear correlation. Multivariable linear regression was performed in order to find the variables related to overall survival. Results: Long-term survivors (100% [7 of 7]) demonstrated a greater percentage of gross total or near total resection than short-term survivors (54.5% [18 of 33]). A higher prevalence of 1p/19q deletions was also noted among the long-term survivors (42.9% [3 of 7]) than the short-term survivors (0.0% [0 of 36]). The rCBV parameters did not differ between the long-term and short-term survivors. The rCBV values were marginally lower in patients with MGMT methylation and 1p/19q deletions. Despite no correlation found between overall survival and rCBV in the whole group, the short-term survivor group showed negative correlation ($R^2=0.181$, P = 0.025). Multivariable linear regression revealed that surgical extent and 1p/19q deletions, but not rCBV values, were associated with prolonged overall survival. Conclusion: While preoperative rCBV and 1p/19q deletion status are related to each other, only surgical extent and the presence of 1p/19q deletion in GBM patients may predict long-term survival.