• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.29-38
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• 2008

Purpose: The aim of this study was to investigate the feasibility of 3 ' -[F-18]fluoro-3 ' -deoxythymidine positron emission tomography(FLT-PET) for the detection of locally advanced breast cancer and to compare the degree of FLT and 2' -deoxy-2 ' -[F-18]fluoro-d-glucose(FDG) uptake in primary tumor, lymph nodes and other normal organs. Material & Methods: The study subjects consisted of 22 female patients (mean age; $42{\pm}6$ years) with biopsy-confirmed infiltrating ductal carcinoma between Aug 2005 and Nov 2006. We performed conventional imaging workup, FDG-PET and FLT PET/CT. Average tumor size measured by MRI was $7.2{\pm}3.4$ cm. With visual analysis, Tumor and Lymph node uptakes of FLT and FDG were determined by calculation of standardized uptake value (SUV) and tumor to background (TB) ratio. We compared FLT tumor uptake with FDG tumor uptake. We also investigated the correlation between FLT tumor uptake and FDG tumor uptake and the concordant rate with lymph node uptakes of FLT and FDG. FLT and FDG uptakes of bone marrow and liver were measured to compare the biodistribution of each other. Results: All tumor lesions were visually detected in both FLT-PET and FDG-PET. There was no significant correlation between maximal tumor size by MRI and SUVmax of FLT-PET or FDG-PET (p>0.05). SUVmax and $$SUV_{75} (average SUV within volume of interest using 75% isocontour) of FLT-PET were significantly lower than those of FDG-PET in primary tumor (SUVmax; $6.3{\pm}5.2\;vs\;8.3{\pm}4.9$, p=0.02 /$SUV_{75};\;5.3{\pm}4.3\;vs\;6.9{\pm}4.2$, p=0.02). There is significant moderate correlation between uptake of FLT and FDG in primary tumor (SUVmax; rho=0.450, p=0.04 / SUV75; rho=0.472, p=0.03). But, TB ratio of FLT-PET was higher than that of FDG-PET($11.7{\pm}7.7\;vs\;6.3{\pm}3.8$, p=0.001). The concordant rate between FLT and FDG uptake of lymph node was reasonably good (33/34). The FLT SUVs of liver and bone marrow were $4.2{\pm}1.2\;and\;8.3{\pm}4.9$. The FDG SUVs of liver and bone marrow were $1.8{\pm}0.4\;and\;1.6{\pm}0.4$. Conclusion: The uptakes of FLT were lower than those of FDG, but all patients of this study revealed good FLT uptakes of tumor and lymph node. Because FLT-PET revealed high TB ratio and concordant rate with lymph node uptakes of FDG-PET, FLT-PET could be a useful diagnostic tool in locally advanced breast cancer. But, physiological uptake and individual variation of FLT in bone marrow and liver will limit the diagnosis of bone and liver metastases.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.20-25
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• 2006

Purpose : To evaluate the NMR relaxation properties of newly developed high performance paramagnetic complexes. Materials and methods : 4-aminomethylcyclohexane carboxylic acid (0.63g, 4 mmol) was mixed with the suspension solution of DMF (15mL) and DTPA-bis-anhydride (0.71g, 2 mmol) to synthesize the ligand. The ligand was then mixed with Gd2O3 (0.18g, 0.5 mmol) to synthesize Gd-chelate. For the measurement of magnetic relaxivity of paramagnetic compounds, the compounds were diluted to 1mM and then the relaxation times were measured at 1.5T(64 MHz). Inversion-recovery pulse sequence was employed for T1 relaxation measurement and CPMG(Carr-Purcell-Meiboon-Gill) pulse sequence was employed for T2 relaxation measurement. Using MATLAB(Version 7.1) program, T1 magnetic relaxation map, R1 map, T2 magnetic relaxation map and R2 map were developed to represent magnetic relaxation time and magnetic relaxivity as image. Results : Compared to $R1=4.9mM^{-1}sec^{-1}$ and $R2=4.8mM^{-1}sec^{-1}$ of Omniscan (Gadodiamide), which is commercially available paramagnetic MR agent, R1 of SUK090(Gd-C32H74N5O24) was $12.46mM^{-1}sec^{-1}$ and R1 of SUK091(Gd-C34H78N5O24) was $12.77mM^{-1}sec^{-1}$. However, R1 of SUK092(Gd-C30H56N5O17) was decreased to $2.09mM^{-1}sec^{-1}$. In case of R2, SUK090(Gd-C32H74N5O24) was $8.76mM^{-1}sec^{-1}$ and SUK091(Gd-C34H78N5O24) was $7.60mM^{-}1sec^{-1}$ whereas SUK092(Gd-C30H56N5O17) was decreased to $1.82mM^{-1}sec^{-1}$. Conclusion : Among three new paramagnetic complexes, SUK090(Gd-C32H74N5O24) and SUK091(Gd-C34H78N5O24) showed higher T1, T2 magnetic relaxation rates than that of commercially available paramagnetic MR agent and thus expected to have more contrast enhancement effect.

• Journal of the Korean Society of Radiology
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• v.8 no.6
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• pp.317-323
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• 2014

This study aims to suggest and test methods using an orally inserted guiding device in order to improve a motion artifact by involuntary oral motor such as removing one's dentures and swallowing saliva clinically structured cervical spine scan and to make the optimal image by minimizing motion artifact. A cervical spine test was conducted with 30 patients who wore dentures among those who had a cervical spinal disease from January 1, 2014 through June 30, 2014. As for testing methods, after removing denture, T1-TSE-Sagittal, T2-TSE-Sagittal, T1-TSE-Axial and T2-TSE-Axial were obtained in a normal position and a supine position; the orally inserted guiding device was inserted in patients' mouth; and then T1-TSE-Axial and T2-TSE-Axial were retested. As a result, in SNR, T1-TSE-Axial before inserting an orally inserted guiding device was $22.33{\pm}8.59$; T1-TSE-Axial after inserting the orally inserted guiding device was $25.21{\pm}7.93$; T2-TSE-Axial before inserting the orally inserted guiding device was $14.49{\pm}5.74$; and T2-TSE-Axial after inserting the orally inserted guiding device was $16.61{\pm}6.72$. In CNR, T1-TSE-Axial was measured at $0.23{\pm}0.01$ while T2-TSE-Axial at $0.21{\pm}0.01$. As a result of the qualitative analysis, T1-TSE-Axial before inserting the orally inserted guiding device was $3.49{\pm}0.11$; T1-TSE-Axial after inserting the orally inserted guiding device was $3.95{\pm}0.14$; T2-TSE-Axial before inserting the orally inserted guiding device was $3.25{\pm}0.18$; and T2-TSE-Axial after inserting the orally inserted guiding device was $3.68{\pm}0.09$. As a result of using an orally inserted guiding device, the resolution and contrast of the images improved as the patients' involuntary artifact decreased because of removing dentures and swallowing saliva, and it was found that the interpretation of the images and identification of the diseases improved.

• Progress in Medical Physics
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• v.14 no.1
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• pp.34-42
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• 2003

In medical imaging, three-dimensional (3D) display using Virtual Reality Modeling Language (VRML) as a portable file format can give intuitive information more efficiently on the World Wide Web (WWW). The web-based 3D visualization of functional images combined with anatomical images has not studied much in systematic ways. The goal of this study was to achieve a simultaneous observation of 3D anatomic and functional models with planar images on the WWW, providing their locational information in 3D space with a measuring implement using VRML. MRI and ictal-interictal SPECT images were obtained from one epileptic patient. Subtraction ictal SPECT co-registered to MRI (SISCOM) was performed to improve identification of a seizure focus. SISCOM image volumes were held by thresholds above one standard deviation (1-SD) and two standard deviations (2-SD). SISCOM foci and boundaries of gray matter, white matter, and cerebrospinal fluid (CSF) in the MRI volume were segmented and rendered to VRML polygonal surfaces by marching cube algorithm. Line profiles of x and y-axis that represent real lengths on an image were acquired and their maximum lengths were the same as 211.67 mm. The real size vs. the rendered VRML surface size was approximately the ratio of 1 to 605.9. A VRML measuring tool was made and merged with previous VRML surfaces. User interface tools were embedded with Java Script routines to display MRI planar images as cross sections of 3D surface models and to set transparencies of 3D surface models. When transparencies of 3D surface models were properly controlled, a fused display of the brain geometry with 3D distributions of focal activated regions provided intuitively spatial correlations among three 3D surface models. The epileptic seizure focus was in the right temporal lobe of the brain. The real position of the seizure focus could be verified by the VRML measuring tool and the anatomy corresponding to the seizure focus could be confirmed by MRI planar images crossing 3D surface models. The VRML application developed in this study may have several advantages. Firstly, 3D fused display and control of anatomic and functional image were achieved on the m. Secondly, the vector analysis of a 3D surface model was defined by the VRML measuring tool based on the real size. Finally, the anatomy corresponding to the seizure focus was intuitively detected by correlations with MRI images. Our web based visualization of 3-D fusion image and its localization will be a help to online research and education in diagnostic radiology, therapeutic radiology, and surgery applications.

• Neonatal Medicine
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• v.18 no.2
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• pp.310-319
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• 2011

Purpose: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. Methods: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. Results: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1${\pm}$2.1 weeks, and mean birth weight was 781.5${\pm}$143.9 g. The mean TMS was 10.8${\pm}$2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. Conclusion: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.17-21
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• 2001

Purpose : To analyze changes of the anterior translation, MRI findings and associated injuries at scarring of the torn ACL in the chronic ACL rupture. Materials & Method : From Dec. 1996 to May 2000, 19 patients who were diagnosed as the chronic ACL rupture were studied. We analyzed KT-2000 side to side difference of maximal manual anterior displacement(MMAD), MRI findings and associated injuries. Results : There was statistically significant difference in the average MMAD between the 7 cases$(37\%)$ with scar formation$(2.78{\pm}2.41mm)$ and the 12 cases without scarring$(5.75{\pm}2.52mm)$. The chronic ACL rupture without scarring had more meniscal injuries$(67\%)$ than with scarring$(28\%)$. MRI showed that relatively straight bands toward expected insertion site with single large fragment(5 cases) and continuous band with focal angulation(2 cases). Conclusion : If relatively straight bands toward expected insertion site with single large fragment or continuous band with focal angulation on MR imaging is showed in the patient without significant anterior translation at arthrometer, the possibility of the scar formation of the torn ACL should be considered. We think that the chronic ACL rupture with scarring had less meniscal injuries than without scarring will give additional information on the natural history of ACL injuries.

• Journal of Korean Neurosurgical Society
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• v.30 no.8
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• pp.985-991
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• 2001

Objectives : The craniopharyngioma is a benign tumor located at least in part in the suprasellar cistern. However, the symptoms and signs from this tumor may be determined not only by the location of the tumor but also by its size and the age of the patient. The objective of our study is to analyze retrospectively the clinical manifestations of craniopharyngiomas with regards to tumor characteristics in children and adults. Material and Methods: Twenty-three patients(16 adults, 7 children) treated for craniopharyngioma between 1990 and 1999 were studied to demonstrate the relationship of tumor size, growth pattern, and its invasiveness with clinical symptoms. As part of the assessment, 16 adults(M : F=8 : 8, mean age : 43.7 years) and 7 children(M : F=5 : 2, mean age : 10.1 years) underwent magnetic resonance(MR) imaging and computerized tomography(CT) scanning with a three-dimensional volume acquisition sequence. Results : The three major cardinal signs were defined to increased intracranial pressure, endocrine dysfunction, and visual problems. The tumor size in child group was larger than that in adult group. Also, visual problems, symptoms of increased intracranial pressure and hydrocephalus were more frequently observed in child group. However, endocrine dysfunction and neuropsychological symptoms related with hypothalamic connections to the thalamus, pituitary, frontal lobe, and other cortical areas were more frequent in adult group. Conclusions: In our series, the tumor size and invasiveness of craniopharyngioma revealed to be relevent with initial symptoms of increased intracranial pressure and visual symptoms which were more frequent in child group. As for the growth pattern, we did not find major difference between adults and children.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.123-129
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• 2002

Purpose : The purpose of this study 띤as to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Materials and Methods : Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from $36\~60\;Gy$ (median; 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at $4\~8$ weeks following the completion of treatment. The acute and subacute toxicities were monitored. Results : An objective response was observed in 11 out of 17 patients, giving a response rate of $64.7\%$. The actuarial survival rate at 2 years was $21.2\%$ from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 30-CRT were gastro-duodenitis $(\geq\;grade\;2)$ in 2 patients. There were no treatment related deaths and radiation induced hepatitis. Conclusion : The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.1-6
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• 2014

Purpose : $T_2{^*}$ relaxation time which includes susceptibility information represents unique feature of tissue. The objective of this study was to investigate $T_2{^*}$ relaxation times of the normal glandular tissue and fat of breast using a 3T MRI system. Materials and Methods: Seven-echo MR Images were acquired from 52 female subjects (age $49{\pm}12 $years; range, 25 to 75) using a three-dimensional (3D) gradient-echo sequence. Echo times were between 2.28 ms to 25.72 ms in 3.91 ms steps. Voxel-based $T_2{^*}$ relaxation times and $R_2{^*}$ relaxation rate maps were calculated by using the linear curve fitting for each subject. The 3D regions-of-interest (ROI) of the normal glandular tissue and fat were drawn on the longest echo-time image to obtain $T_2{^*}$ and $R_2{^*}$ values. Mean values of those parameters were calculated over all subjects. Results: The 3D ROI sizes were $4818{\pm}4679$ voxels and $1455{\pm}785$ voxels for the normal glandular tissue and fat, respectively. The mean $T_2{^*}$ values were $22.40{\pm}5.61ms$ and $36.36{\pm}8.77ms$ for normal glandular tissue and fat, respectively. The mean $R_2{^*}$ values were $0.0524{\pm}0.0134/ms$ and $0.0297{\pm}0.0069/ms$ for the normal glandular tissue and fat, respectively. Conclusion: $T_2{^*}$ and $R_2{^*}$ values were measured from human breast tissues. $T_2{^*}$ of the normal glandular tissue was shorter than that of fat. Measurement of $T_2{^*}$ relaxation time could be important to understand susceptibility effects in the breast cancer and the normal tissue.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.201-208
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• 2018

The purpose of this study was to investigate the optimal flip angle by measuring the SNR and CNR according to the angle of changes of the MRI technique using the Image J program. A total of 30 normal volunteers were assessed by using a 1.5T magnetic resonance imaging system (Philips, Medical System, Achieva). For the MRI angiography, we set the region of interest in four regions and evaluated the SNR and CNR. The statistical significance of SNR and CNR was calculated by one-way ANOVA using quantitative analysis at five different positions. The Bonferroni method was used for post-hoc analyzes. Statistical significance was determined by using ANOVA analysis at p<0.05 and Bonferroni method was used as a post-hoc analysis. The results of this study, the measurement values of ACA(SNR:$876.59{\pm}14.22$, CNR:$1999.7{\pm}12.5$), PCA(SNR:$863.48{\pm}13.29$, CNR:$1870.18{\pm}12.56$), ICA(SNR:$1116.87{\pm}08.34$, CNR:$2979.37{\pm}14.69$) and MCA(SNR:$848.66{\pm}15.25$, CNR:$2199.25{\pm}13.48$) were obtained with the high signal intensity at $25^{\circ}$(p<0.05). The values of a1, a2, a3, p1, p2, p3, m1, m2 and m3 were also the same (p<0.05). Post-hoc analysis results, There was a statistically significant difference (p=0.000) between $10^{\circ}$, $15^{\circ}$, $20^{\circ}$ on the $25^{\circ}$ reference for the flip angle, but no significant results were obtained with $30^{\circ}$(p<0.05). In concision, because the signal intensity decreased at $30^{\circ}$, this study revealed that the optimal flip angles were $25^{\circ}$ in cerebrovascular MR angiography.