• Radiation Oncology Journal
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• v.36 no.2
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• pp.114-121
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• 2018

Purpose: To explore the feasibility of maximum diameter as a response assessment method for vestibular schwannomas (VS) after stereotactic radiosurgery or fractionated stereotactic radiotherapy (RT), we analyzed the concordance of RT responses between maximum diameters and volumetric measurements. Materials and Methods: Forty-two patients receiving curative stereotactic radiosurgery or fractionated stereotactic RT for VS were analyzed retrospectively. Twelve patients were excluded: 4 did not receive follow-up magnetic resonance imaging (MRI) scans and 8 had initial MRI scans with a slice thickness >3 mm. The maximum diameter, tumor volume (TV), and enhanced tumor volume (ETV) were measured in each MRI study. The percent change after RT was evaluated according to the measurement methods and their concordances were calculated with the Pearson correlation. The response classifications were determined by the assessment modalities, and their agreement was analyzed with Cohen kappa statistics. Results: Median follow-up was 31.0 months (range, 3.5 to 86.5 months), and 90 follow-up MRI studies were analyzed. The percent change of maximum diameter correlated strongly with TV and ETV (r(p) = 0.85, 0.63, p = 0.000, respectively). Concordance of responses between the Response Evaluation Criteria in Solid Tumors (RECIST) using the maximum diameters and either TV or ETV were moderate (kappa = 0.58; 95% confidence interval, 0.32-0.85) or fair (kappa = 0.32; 95% confidence interval, 0.05-0.59), respectively. Conclusions: The percent changes in maximum diameter and the responses in RECIST were significantly concordant with those in the volumetric measurements. Therefore, the maximum diameters can be used for the response evaluation of VS following stereotactic RT.

• Radiation Oncology Journal
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• v.34 no.1
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• pp.64-75
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• 2016

Purpose: In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. Materials and Methods: In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45-60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. Results: The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median $R^2$ of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Conclusion: Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.

• Hip & pelvis
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• v.30 no.4
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• pp.219-225
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• 2018

Purpose: Ischiofemoral impingement (IFI)-primarily diagnosed by magnetic resonance imaging (MRI)-is an easily overlooked disease due to its low incidence. The purpose of this study was to evaluate the usefulness of false profile view as a screening test for IFI. Materials and Methods: Fifty-eight patients diagnosed with IFI between June 2013 and July 2017 were enrolled in this retrospective study. A control group (n=58) with matching propensity scores (age, gender, and body mass index) were also included. Ischiofemoral space (IFS) was measured as the shortest distance between the lateral cortex of the ischium and the medial cortex of lesser trochanter in weight bearing hip anteroposterior (AP) view and false profile view. MRI was used to measure IFS and quadratus femoris space (QFS). The receiver operating characteristics (ROC), area under the ROC curve (AUC) and cutoff point of the IFS were measured by false profile images, and the correlation between the IFS and QFS was analyzed using the MRI scans. Results: In the false profile view and hip AP view, patients with IFI had significantly decreased IFS (P<0.01). In the false profile view, ROC AUC (0.967) was higher than in the hip AP view (0.841). Cutoff value for differential diagnosis of IFI in the false profile view was 10.3 mm (sensitivity, 88.2%; specificity, 88.4%). IFS correlated with IFS (r=0.744) QFS (0.740) in MRI and IFS (0.621) in hip AP view (P<0.01). Conclusion: IFS on false profile view can be used as a screening tool for potential IFI.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2009.05a
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• pp.101-104
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• 2009

This study investigated compensatory mechanisms in the brain during a verbal working memory task among people with Alcohol Use Disorders (AUD). A total of 21 college male students participated in the study: eleven AUD participants and 10 normal controls. Study participants were asked to complete the Korean version of the Wechsler Adult Intelligence Scale-III (K-WAIS-III) prior to the fMRI experiment. Verbal 0-back and 2-back tasks were used to assess brain activities of the participants' verbal working memory. Brain scanning was performed on Siemens SONATA 1.5T Scanner while participants were performing the 0-back and 2-back tasks. Within the AUD group, participants with greater dependency to alcohol (based on DSM-IV criteria) in the past 1 year showed lower mean score on the 'Similarities' of the K-WAIS-III (r=-0.63, p<0.05, N=11). The more participants experienced alcohol withdrawal symptoms in the past 1 year, the lower the score they received on the K-WAIS-III 'Picture Arrangement' (r=-0.69, p<0.05, n=11). The fMRI regression results showed that individuals who present greater degree of alcohol dependency symptoms are likely to show greater brain activation in the bilateral middle frontal gyri (BA 9) during the verbal working memory task. The degree of alcohol withdrawal symptoms were associated with increased brain activation in the left superior and middle frontal gyri (BA8), left precentral gyrus (BA 6), and left inferior parietal lobule (BA 40). The study findings showed that the degree of alcohol abuse/dependence and withdrawal symptoms were associated with decreased cognitive function and increased activations in brain regions particularly important for abstract reasoning (BA 9), central executive (BA 9), or spatial storage (BA 40) during a working memory task. Therefore, these results could support previous studies suggesting that the neural system of people with ADD may adopt a brain compensatory mechanism to maintain normal level of cognitive functions.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.183-189
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• 2009

Purpose : To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. Materials and Methods : Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using TIPS and early stage of contrast-enhanced TIPS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR $BIRADS^{(R)}$ MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. Results : 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value < 0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. Conclusion : 3D MIP image has some limitations but is useful as additional image of routine breast MR Images.

• Investigative Magnetic Resonance Imaging
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• v.18 no.3
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• pp.244-252
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• 2014

Purpose : We proposed a multi-physiological signals based real-time intelligent triggering system(MITS) for Cardiac MRI. Induced noise of the system was analyzed. Materials and Methods: MITS makes cardiac MR imaging sequence synchronize to the cardiac motion using ECG, respiratory signal and second order derivative of $SPO_2$signal. Abnormal peaks due to arrhythmia or subject's motion are rejected using the average R-R intervals and R-peak values. Induced eddy currents by gradients switching in cardiac MR imaging are analyzed. The induced eddy currents were removed by hardware and software filters. Results: Cardiac MR images that synchronized to the cardiac and respiratory motion are acquired using MITS successfully without artifacts caused by induced eddy currents of gradient switching or subject's motion or arrhythmia. We showed that the second order derivative of the $SPO_2$ signal can be used as a complement to the ECG signals. Conclusion: The proposed system performs cardiac and respiratory gating with multi-physiological signals in real time. During the cardiac gating, induced noise caused by eddy currents is removed. False triggers due to subject's motion or arrhythmia are rejected. The cardiac MR imaging with free breathing is obtained using MITS.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.18-22
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• 2007

Purpose: To provide basic data on anatomy of the ankle joint in adults using magnetic resonance imaging as well as to compare measurements with available data of corresponding dimension in the different sizes of the total ankle replacements design ($HINTEGRA^{(R)}$). Materials and Methods: Magnetic resonance (MR) sagittal and coronal images from one hundred-forty nine were studied. Post traumatic, arthritic, or grossly deformed ankles at any reason were excluded. Lengths, widths of the main parts of this articulation and also the radius of curvature of talar dome were measured in the MR images. Statistical analysis was performed on these measurements. Results: On MR coronal image data, average tibial width was $30.0{\pm}4.1\;mm$ and talar width was $27.0{\pm}3.4\;mm$. On sagittal image date, average anteroposterior length of the distal tibia was $39.0{\pm}4.2\;mm$, average anteroposterior length of the talus was $31.3{\pm}2.8\;mm$, and average sagittal radius of curvature of talar dome was $20.1{\pm}2.9\;mm$. All measurements in male were significantly larger than in female (p<0.01), but a significant difference according to age was not found. Conclusion: Ankle morphometric data define a basis of size, particularly useful in the design of ankle prostheses.

• Proceedings of the Korea Contents Association Conference
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• 2011.05a
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• pp.201-202
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• 2011

본 연구에는 7.0T 동물용 자기공명영상장치를 이용하여 인간의 췌장암 세포인 CFPAC-1를 이종 이식한 쥐에서 자기공명영상을 획득하여 최적화된 검사 Protocol을 정립하며, 동물 실험에서 밝혀진 종양특성과 확산강조영상과의 비교 분석을 해보고 현성확산계수 영상이 췌장암 이종이식 모형의 종양 세포 내부 구조에 관하여 어떠한 정보를 제공 할 수 있는지 알아보고자 한다. 13마리의 쥐의 26개의 종양을 전형적으로 주입 후에 2~4주 뒤에 직경이 5~10mm가 되었을 때 imaged 하였으며, pathologic specimenm을 위해 sacrificed 하였다. isofluoran gas anesthesia를 이용하여 동물 마취 하였다. 사용된 장비로는 small-animal MR images (7.0-T)를 (Bruker BioSpin GmbH, Rheinstetten, Germany)이용하여 Fast T2-weighted 와 single-shot EPI DW image를 얻었다. 종양은 H&E 염색과 CD31와 VEGF에 대한 면역조직학 염색을 하여 종양의 cellularity와 microvessel density(MVD), 종양 내 괴사 정도를 평가하였다. CFPAC-1의 현성확산계수값은 $0.7327{\pm}0.1075{\pm}10^{-3}mm2/s$이였으며, 현성확산계수는 종양내 괴사 정도와 연관성을 보였다(R = 0.7417, p = 0.0001) 이처럼 현성확산계수는 종양 내 괴사 정도 등의 현미경적구조변화를 반영하는 대리인자로 사용될 수 있음을 확인하였다.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.384-394
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• 2021

Objective: To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. Materials and Methods: This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student's t test, and Pearson's correlation coefficient. Results: T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p < 0.05). However, there were no significant differences in T2 values in subtalar and midtarsal joints between patients with isolated ATFL injuries and healthy controls (all p > 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). Conclusion: CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.325-334
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• 2009

Purpose : This study was conducted to assess how effective the permeability ratio and relative cerebral blood volume ratio are to tumor through perfusion MRI by measuring and reflecting the grade assessment and differential diagnosis and the permeability and relative cerebral blood volume of contrast media plunged from blood vessel into organ due to breakdown of blood-brain barrier in cerebral. Subject and Method : Subject of study was 29 patients whose diagnosis were confirmed by biopsy after surgery and 550 (11 slice$\times$50 image) perfusion MRI were used to make image of relative cerebral blood volume with the program furnished on instrument. The other method was to transmit to private computer and the image analysis was made additionally by making image of relative cerebral blood volume-reformulated singular value decomposition, rCBV-rSVD and permeability using IDL.6.2. In addition, Kruskal-wallis test tonggyein non numerical average by a comparative analysis of brain tumors Results : The rCBV ratio (Functool PF; GE Medical Systems and IDL 6.2 program by analysis) and permeability ratio of tumors were as follows; high grade glioma(n=4), (14.75, 19.25) 13.13. low grade astrocytoma(n=5) (14.80, 15.90) 11.60, glioblastoma(n=5) (10.90, 18.60), 22.00, metastasis(n=6) (11.00, 15.08). 22.33. meningioma(n=6) (18.58, 7.67), 5.58. oliogodendroglioma(n=3) (23.33, 16.33, 15.67. Conclusion : It was not easy to classify the grade with the relative cerebral blood volume ratio measured by using the relative cerebral blood image by type of tumors, however, permeability ratio measured by permeability image revealed that the higher the grade of tumor, the higher the measured permeability ratio, showing the assessment of tumor grade is more effective to differential diagnosis.