• Korean Journal of Radiology
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• v.23 no.6
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• pp.598-614
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• 2022

While ultrasound (US) is considered an important tool for hepatocellular carcinoma (HCC) surveillance, it has limited sensitivity for detecting early-stage HCC. Abbreviated MRI (AMRI) has recently gained popularity owing to better sensitivity in its detection of early-stage HCC than US, while also minimizing the time and cost in comparison to complete contrast-enhanced MRI, as AMRI includes only a few essential sequences tailored for detecting HCC. Currently, three AMRI protocols exist, namely gadoxetic acid-enhanced hepatobiliary-phase AMRI, dynamic contrast-enhanced AMRI, and non-enhanced AMRI. In this study, we discussed the rationale and technical details of AMRI techniques for achieving optimal surveillance performance. The strengths, weaknesses, and current issues of each AMRI protocol were also elucidated. Moreover, we scrutinized previously performed AMRI studies regarding clinical and technical factors. Reporting and recall strategies were discussed while considering the differences in AMRI protocols. A risk-stratified approach for the target population should be taken to maximize the benefits of AMRI and the cost-effectiveness should be considered. In the era of multiple HCC surveillance tools, patients need to be fully informed about their choices for better adherence to a surveillance program.

• Proceedings of the KOSOMBE Conference
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• v.1992 no.05
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• pp.85-91
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• 1992

In MRI, an image contrast can be developed as a result of the susceptibility effect if an object has paramagnetic substances. This is mainly due to the non-uniform phase distribution or linear gradient developed by the magnetic susceptibility within a voxel, which in turn reduces the signal intensity; e.g., spin phases are dephased and thereby cancel each other resulting in a reduced signal. In this paper, a new concept for manipulating the susceptibility effect through the use of tailored RF pulses is proposed. As potential applications of the method, two different types of tailored RF pulses are introduced: one for susceptibility artifact correction and the other for contrast enhancement. The latter, for example, can be applied to angiography utilizing the paramagnetic property of deoxygenated blood. Both a theoretical study of the method and experimental results are reported.

• Investigative Magnetic Resonance Imaging
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• v.25 no.4
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• pp.313-322
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• 2021

Purpose: To find diagnostic image features, to compare diagnostic performance of multiphase CT versus gadoxetic acid disodium-enhanced MRI (GAD-MRI), and to evaluate the impact of analyzing Liver Imaging Reporting and Data System (LI-RADS) imaging features, for distinguishing combined hepatocellular-cholangiocarcinoma (CHC) from hepatocellular carcinoma (HCC). Materials and Methods: Ninety-six patients with pathologically proven CHC (n = 48) or HCC (n = 48), diagnosed June 2008 to May 2018 were retrospectively analyzed in random order by three radiologists with different experience levels. In the first analysis, the readers independently determined the probability of CHC based on their own knowledge and experiences. In the second analysis, they evaluated imaging features defined in LI-RADS 2018. Area under the curve (AUC) values for CHC diagnosis were compared between CT and MRI, and between the first and second analyses. Interobserver agreement was assessed using Cohen's weighted κ values. Results: Targetoid LR-M image features showed better specificities and positive predictive values (PPV) than the others. Among them, rim arterial phase hyperenhancement had the highest specificity and PPV. Average sensitivity, specificity, and AUC values were higher for MRI than for CT in both the first (P = 0.008, 0.005, 0.002, respectively) and second (P = 0.017, 0.026, 0.036) analyses. Interobserver agreements were higher for MRI in both analyses (κ = 0.307 for CT, κ = 0.332 for MRI in the first analysis; κ = 0.467 for CT, κ = 0.531 for MRI in the second analysis), with greater agreement in the second analysis for both CT (P = 0.001) and MRI (P < 0.001). Conclusion: Rim arterial phase hyperenhancement on GAD-MRI can be a good indicator suggesting CHC more than HCC. GAD-MRI may provide greater accuracy than CT for distinguishing CHC from HCC. Interobserver agreement can be improved for both CT and MRI by analyzing LI-RADS imaging features.

• Investigative Magnetic Resonance Imaging
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• v.19 no.1
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• pp.52-55
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• 2015

Supradiaphragmatic liver is a rare condition. Establishing an accurate preoperative diagnosis is difficult. Operative exploration is necessary to differentiate this lesion from intrathoracic masses, such as a pleural based tumor, diaphragmatic tumor and peripheral lung tumor. However, with the aid of the hepatocyte-specific magnetic resonance imaging contrast agent, gadoxetic acid (Gd-EOB-DTPA), functional hepatocytes in the lesion can be identified in the hepatobiliary phase, potentially allowing an accurate and non-invasive diagnosis. We report a case of supradiaphragmatic liver diagnosed by Gd-EOB-DTPA-enhanced magnetic resonance imaging.

• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.619-625
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• 2017

The sudy was intended to evaluate the optimal equipment selection by quantitatively assessing the SNR(signal to noise ratio) and CNR(contrast to noise ratio) on the abdominal organ. This study performed on 1.5 T and 3.0 T MRI units focusing on HASTE, HASTE(f/s) and FFE(in of phase), FFE(out of phase) without using the contrast medium(Gadolinium). The data analysis was performed by randomly selecting on 1.5 T and 3.0 T abdominal MRI images. As a results, SNR and CNR values of 3.0 T is higher than 1.5 T at liver, kidney and spleen(p<0.05). Stomach, abdominal fat and pancreas was obtained a higher value at 1.5 T(p<0.05). On conclusion, the organs of outer part in the body showed generally a high value at 3.0 T, and the organs of inner part in the body including the gas showed a high value at 3.0 T because of a large difference on magnetic susceptibility.

• Korean Journal of Applied Biomechanics
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• v.17 no.1
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• pp.121-127
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• 2007

Muscle force produced by muscle fibers is transmitted to bones via tendinous structures(aponeuroses and tendon), resulting in joint(s) movement. As force-transmitting elements, mechanical behavior of aponeuroses and tendon are closely related with the function of muscle-tendon complex. The purpose of this study was to determine strain characteristics of aponeuroses for in-vivo human soleus muscle during submaximal voluntary contractions using an advanced medical imaging technique, velocity-encoded phase-contrast magnetic resonance imaging (VE-PC MRI). VE-PC MRI of the soleus muscle-tendon complex was acquired during submaximal isometric plantarflexion contraction-relaxation cycle (n = 7), using 3.0T Trio MRI scanner(Siemens AG, Malvern, MA). From the VE-PC MRI containing the tissue velocity in superior-inferior direction, twenty regions of interest(20 ROI; 10 on the anterior aponeurosis and 10 on the posterior aponeurosis) were tracked. During the isometric plantarflexion contraction-relaxation cycle, velocity and displacement profiles were different between the anterior and posterior aponeuroses, indicating heterogeneous strain behavior along the length of the leg. The anterior aponeurosis elongated while the posterior aponeurosis shortened during the initial phase of the contraction. Moreover, strain behavior of the posterior aponeurosis was different from that of the Achilles tendon. Possible explanation for the observed variations in strain behavior of aponeuroses was investigated with morphological assessment of the soleus muscle and it was found that the intramuscular tendinous structures significantly vary among subjects. In conclusion, the heterogeneous mechanical behavior of the soleus aponeuroses and the Achilles tendon suggests that the complexity of skeletal muscle-tendon complex should be taken into consideration when modeling the complex for better understanding of its functions.

• Journal of the Korean Magnetic Resonance Society
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• v.7 no.1
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• pp.46-54
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• 2003

We synthesized a contrast agent for MRI that is capable of binding to the ABP-1 receptor and enhancing the contrast of the targeted cells. We used a lysine dendrimer (G=3)DTPA[Gd] as the contrast agent and synthesized a biotinylated polyclonal antibody for ABP-1 as the first antibody. Lysine dendrimers were prepared using the solid phase peptide synthesis method.$^3$ Amino-terminated lysine dendrimers were then coupled to DTPA using the anhydride method. Gd was complexed with the DTPA-lysine dendrimer in an acidic solution of 3 eq GdCl$_3$ to one of DTPA. The lysine dendrimer-DTPA[Gd] and avidin were conjugated in MES solution, pH 6.0, using EDC as the coupling reagent. The biotin-avidin system was used to link the polyclonal antibody and contrast agent. K562 cells were used for imaging.

• Investigative Magnetic Resonance Imaging
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• v.5 no.1
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• pp.57-65
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• 2001

Purpose : $T_2$-weighted half courier Echo Planar Imaging (T2HEPI) method is proposed to reduce measurement time of existing EPI by a factor of 2. In addition, high $T_2$ contrast is obtained for clinical applications. High resolution single-shot EPI images with $T_2$ contrast are obtained with $128{\times}128$ matrix size by the proposed method. Materials and methods : In order to reduce measurement time in EPI, half courier space is measured, and rest of half courier data is obtained by conjugate symmetric filling. Thus high resolution single shot EPI image with $128{\times}128$ matrix size is obtained with 64 echoes. By the arrangement of phase encoding gradients, high $T_2$ weighted images are obtained. The acquired data in k-space are shifted if there exists residual gradient field due to eddy current along phase encoding gradient, which results in a serious problem in the reconstructed image. The residual field is estimated by the correlation coefficient between the echo signal for dc and the corresponding reference data acquired during the pre-scan. Once the residual gradient field is properly estimated, it can be removed by the adjustment of initial phase encoding gradient field between $70^{\circ}$ and $180^{\circ}$ rf pulses. Results : The suggested T2EPl is implemented in a 1.0 Tela whole body MRI system. Experiments are done with the effective echo times of 72ms and 96ms with single shot acquisitions. High resolution($128{\times}128$) volunteer head images with high $T_2$ contrast are obtained in a single scan by the proposed method. Conclusion : Using the half courier technique, higher resolution EPI images are obtained with matrix size of $128{\times}128$ in a single scan. Furthermore $T_2$ contrast is controlled by the effective echo time. Since the suggested method can be implemented by software alone (pulse sequence and corresponding tuning and reconstruction algorithms) without addition of special hardware, it can be widely used in existing MRI systems.

• Progress in Medical Physics
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• v.23 no.3
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• pp.177-187
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• 2012

Magnetic resonance angiography (MRA) techniques are widely used in diagnosis of vascular disorders such as hemadostenosis and aneurism. Especially, phase contrast (PC) MRA technique, which is a typical non contrast-enhanced MRA technique, provides not only the anatomy of blood vessels but also flow velocity. In this study, we developed the 2- and 3-dimensional PC MRA pulse sequences for a low magnetic field MRI system. Vessel images were acquired using 2D and 3D PC MRA and the velocities of the blood flow were measured in the superior sagittal sinus, straight sinus and the confluence of the two. The 2D PC MRA provided the good quality of vascular images for large vessels but the poor quality for small ones. Although 3D PC MRA gave more improved visualization of small vessels than 2D PC MRA, the image quality was not enough to be used for diagnosis of the small vessels due to the low SNR and field homogeneity of the low field MRI system. The measured blood velocities were $25.46{\pm}0.73cm/sec$, $24.02{\pm}0.34cm/sec$ and $26.15{\pm}1.50cm/sec$ in the superior sagittal sinus, straight sinus and the confluence of the two, respectively, which showed good agreement with the previous experimental values. Thus, the developed PC MRA technique for low field MRI system is expected to provide the useful velocity information to diagnose the large brain vessels.

• Investigative Magnetic Resonance Imaging
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• v.9 no.2
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• pp.109-116
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• 2005

Purpose : To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. Materials and Methods : Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm<, 1-2 cm, and >2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. Results : In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p=0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm<, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28%, p=0.023). Conclusion : Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (<2 cm) and could improve detection of the small hepatic metastases (<1 cm) from colorectal carcinoma.