• Title/Summary/Keyword: Apparent Diffusion Coefficient

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Unenhanced Breast MRI With Diffusion-Weighted Imaging for Breast Cancer Detection: Effects of Training on Performance and Agreement of Subspecialty Radiologists

  • Yeon Soo Kim;Su Hyun Lee;Soo-Yeon Kim;Eun Sil Kim;Ah Reum Park;Jung Min Chang;Vivian Youngjean Park;Jung Hyun Yoon;Bong Joo Kang;Bo La Yun;Tae Hee Kim;Eun Sook Ko;A Jung Chu;Jin You Kim;Inyoung Youn;Eun Young Chae;Woo Jung Choi;Hee Jeong Kim;Soo Hee Kang;Su Min Ha;Woo Kyung Moon
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.11-23
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    • 2024
  • Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm2 was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive. The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4-79.9), 90.8% (95% CI: 85.6-94.2), and 83.5% (95% CI: 78.6-87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8-97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9-89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1-79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52-0.63) before training and 0.68 (95% CI: 0.62-0.74) after training, with a difference of 0.11 (95% CI: 0.02-0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69-0.74) before training and 0.79 (95% CI: 0.76-0.80) after training (P = 0.002). Conclusion: Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

Usefulness of High-B-value Diffusion - Weighted MR Imaging for the Pre-operative Detection of Rectal Cancers (B-values 변환 자기공명영상: 국소 직장암 수술 전 검출을 위한 적합한 b-value 유용성)

  • Lee, Jae-Seung;Goo, Eun-Hoe;Lee, Sun-Yeob;Park, Cheol-Soo;Choi, Ji-Won
    • The Journal of the Korea Contents Association
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    • v.9 no.12
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    • pp.683-690
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    • 2009
  • The purpose of this study is to evaluate the usefulness of high-b-values diffusion weighted magnetic resonance imaging for the preoperative detection of focal rectum cancers. 60patients with diffusion weighted imaging were evaluated for the presence of rectal cancers. Forty were male and twenty were female, and their ages ranged from 38 to 71 (mean, 56) years. Used equipment was 1.5Tesla MRI((GE, General Electric Medical System, Excite HD). Examination protocols were used the fast spin echo T2, T1 weighted imaging. All examination protocols were performed by the same location with diffusion weighted imaging for accuracy detection. The b-values used in DWI were 250, 500, 750, 1000. 1500, 2000$(s/mm^2)$. The rectum, bladder to tumor contrast-to-noise ratio (CNR) of MR images were quantitativlely analyzed using GE software Functool tool, four experienced radiologists and three radiotechnologists qualitatively evaluated image quality in terms of image artifacts, lesion conspicuity and rectal wall. These data were analysed by using ANOVA and Freedman test with each b-value(p<0.05). Contrast to noise ratio of rectum, bladder and tumor in b-value 1000 were 27.21, 24.44, respectively(p<0.05) and aADC value was $0.73\times10^{-3}$. As a qualitative analysis, the conspicuity and discrimination from the rectal wall of lesions were high results as $4.0\pm0.14$, $4.4\pm0.16$ on b-value 1000(p<0.05), image artifacts were high results as $4.8\pm0.25$ on b-value 2000(p<0.05). In conclusion, DWI was provided useful information with depicting the pre-operative detection of rectal cancers, High-b-value 1000 image was the most excellent DWI value.

Transient Splenial Lesions in the Splenium of Corpus Callosum in Seven Patients: MR Findings and Clinical Correlations (뇌량 팽대의 일과성 병변: 7명의 환자에서의 자기공명 영상소견과 임상 양상의 연관성)

  • Park, Ju Young;Lee, In Ho;Song, Chang June;Hwang, Hee Youn
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.1-7
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    • 2013
  • Purpose : The purpose of this study is to correlate the imaging findings and the clinical findings in patients with transient splenial lesions (TSL). Materials and Methods: Total of 7 patients (M: F = 4: 3; age range 11 - 38 years, mean age 25.5 years) were studied between November 2006 and April 2011. The MRI findings and clinical findings in all patients were retrospectively reviewed. The location, MR signal intensity, restricted diffusion, enhancement pattern and reversibility from the follow up images were reviewed. Clinical features were reviewed with respect to the presented symptoms, signs, treatment and outcome. Results: The lesions were located in the splenium of corpus callosum in all patients. All lesions showed high signal intensity on diffusion weighted imaging (DWI), and six patients showed restricted diffusion on the apparent diffusion coefficient (ADC) map. ADC map was not available in one patient. All lesions (n = 7) showed high signal intensity on the T2 weighted image (T2WI). Five of the patients (71.4%) with follow up images (range 7 - 34 days) showed complete resolution of focal high signal intensity on DWI, with recovery of ADC values as well as T2WI. After contrast media administration, none of the lesions showed any enhancements. All lesions with various etiologies including TB medication were developed in younger age patients and showed reversibility after the acceptable period of minimum 7 days with conservative treatment. Conclusion: All TSL showed nonspecific imaging findings, including restricted diffusion on DWI and ADC map on the initial images. However, reversibility of the lesions and the young age preference can be a characteristic finding of TSL with acceptable period of minimum 7 days. In addition, to keep it in mind that various etiologies including TB medication may cause TSL, is important for radiologists as well as clinicians.

Correlation Analysis of Diffusion Metrics (FA and ADC) Values Derived from Diffusion Tensor Magnetic Resonance Imaging in Breast Cancer (유방암의 확산텐서 자기공명 영상에서 유도된 확산 지표(FA, ADC) 값의 연관성 분석)

  • Lee, Jae-Heun;Lee, Hyo-Yeong
    • Journal of the Korean Society of Radiology
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    • v.12 no.6
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    • pp.755-762
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    • 2018
  • The purpose of this study was to compare the FA(faractional anisotropy) and ADC(apparent diffusion coefficient) values, which were derived from diffusion tensor imaging in breast cancer patients. The diffusion gradient used in this study was derived from quantitative diffusion indices using 20 directions(b-value, 0 and $1,000s/mm^2$). Quantitative analysis was analyzed using Pearson's correction and qualitative analysis using for correction coefficients. As a result, $FA_{min}$, $FA_{mean}$ and $FA_{max}$ were $0.098{\pm}0.065$, $0.302{\pm}0.142$ and $0.634{\pm}0.236$, respectively(p > 0.05). The $ADC_{min}$, $ADC_{mean}$ and $ADC_{max}$ were $0.741{\pm}0.403$, $1.095{\pm}0.394$ and $1.530{\pm}0.447$, respectively(p > 0.05). The $FA_{min}$, $FA_{mean}$, and $FA_{max}$ mean values were $0.132{\pm}0.050$, $0.418{\pm}0.094$, and $0.770{\pm}0.164$ for Category 6 and Kinetic Curve Pattern III, respectively. $ADC_{min}$, $ADC_{mean}$, and $ADC_{max}$ were $0.753{\pm}0.189$, $1.120{\pm}0.236$, and $1.615{\pm}0.372$, respectively. Quantitative analysis showed negative correlation between $ADC_{mean}-FA_{mean}$ and $ADC_{max}-FA_{max}$(p = 0.001, 0.003). The qalitative analysis showed ADC 0.628(p = 0.001), FA 0.620(p = 0.001) in the internal evaluations, ADC 0.677(p = 0.001), FA 0.695(p = 0.001) in external evaluations. In conclusion, based on the morphological examination, time to signal intensity graph is the form of wash-out(pattern III) in the dynamic contrast enhance examination, As a result, the $ADC_{mean}$ $1.120{\pm}0.236$ and $FA_{mean}$ values were $0.032{\pm}0.142$ with a negative correlation (Y=1.44-1.12X). Therefore, If we understand the shape of time to signal intensity graph and the relationship between ADC and FA, It will be a criterion for distinguishing malignant diseases in breast cancer.

Electrochemical Hydrogenation Behavior of Surface-Treated Mg-based Alloys for Hydrogen Storage of Fuel Cell (연료전지의 수소저장용 마그네슘계 합금의 표면제어에 의한 전기화학적 수소화 거동 연구)

  • Kim, Ho-Sung;Lee, Jong-Ho;Boo, Seong-Jae
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.20 no.7
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    • pp.46-52
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    • 2006
  • The effects of surface treatment on the hydrogen storage properties of a $Mg_2Ni$ alloy particle were investigated by the microvoltammetric technique, in which a carbon-filament microelectrode was manipulated to make electrical contact with the particle in a KOH aqueous solution. It was found that the hydrogen storage properties of $Mg_2Ni$ at room temperature were improved by the surface treatment with a nickel plating solution. The sodium salts(sodium phosphate and sodium dihydrogen citrate) contained in the nickel plating solution made the alloy form an amorphous-like state, resulting in an improved hydrogen charge/discharge capacity at room temperature as high as about 150[mAh/g] from the original value of 17[mAh/g]. Potential-step experiment was carried out to determine the apparent chemical diffusion coefficient of hydrogen atom($D_{app}$) in the alloy. Since the alloy particle we used here was a dense, conductive sphere, the spherical diffusion model was employed for data analysis. $D_{app}$ was found to vary the order between $10^{-8}{\sim}10^{-9}[cm^2/s]$ over the course of hydrogenation and dehydrogenation process.

Gastric Metastasis from Gastric-Type Mucinous Adenocarcinoma of Uterine Cervix: A Case Report (자궁경부 위형 점액샘암종의 위 전이: 증례 보고)

  • Min Hye Kim;Kyeong Ah Kim;Yi Kyeong Chun;Jeong Woo Kim;Jongmee Lee;Chang Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.445-450
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    • 2024
  • Gastric metastasis (GM) from cervical cancer is extremely rare, and only a few cases have been reported in the English literature. Gastric-type mucinous adenocarcinomas (GAS) of the uterine cervix are rare. GAS is an aggressive cancer commonly found in advanced stages; however, GM has not been reported. This study presents a rare case of GM from GAS of the uterine cervix in a 61-year-old female and describes the radiological findings of both the GM and cervical mucinous adenocarcinoma. GM appeared as a poor enhancing submucosal mass. The cervical mucinous adenocarcinoma appeared as an infiltrating mass with poor contrast enhancement. It exhibited mildly high and low signal intensities on the diffusion-weighted image and apparent diffusion coefficient map, respectively. This case is extremely rare and challenging to diagnose; however, if cervical cancer is an human papillomavirus-independent GAS type and a submucosal lesion is found in the stomach, the possibility of metastasis with a pattern similar to our case could be considered.

Analysis of a Comparability Test between LX Detergent Cleaning Solution and OC Detergent Cleaning Solution Using OC Sensor PLEDIA (OC Sensor PLEDIA를 이용한 LX Detergent Cleaning Solution과 OC Detergent Cleaning Solution의 동등성 평가)

  • Cha, Kyung Jae
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.1
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    • pp.19-31
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    • 2021
  • This study aimed at comparing the performance of imported LX detergent cleaning solution (LX-CS) and the self-manufactured OC cleaning solution (OC-CS), based on functional and quantitative analysis. The functional analysis was carried out using apparent diffusion coefficient (ADC) values. For quantitative analysis, precision, linearity, and carry-over rates were measured with commercial control materials according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Using OC-Sensor PLEDIA (Eiken Chemical, Japan), the ADC value of all cuvettes satisfied the acceptance criteria. For quantitative analysis, precision was less than 5.0% for the two products, and carry-over rates were less than ±1.00%. The linearity slopes and r2 values were 1.0017 and 0.9982 in the LX-CS, and 0.9924 and 0.9996 in the OC-CS, respectively. The correlation coefficient (r) was found to be 0.9997. Also, the percent difference in correlation with 40 artificial-stool specimens was less than 10% and the p-value was less than 0.1. The result of standard deviation ratio (D: ±1 SD ratio) was similar for both products. In conclusion, the functional and quantitative analyses of the two products were compared and showed similar results. In the future, the self-manufactured OC-CS will be able to provide a much more stable and faster supply than the imported LX-CS.

Preoperative Prediction of Ductal Carcinoma in situ Underestimation of the Breast using Dynamic Contrast Enhanced and Diffusion-weighted Imaging (역동적 유방 자기공명 영상 및 확산 강조영상을 이용한 관상피내암종 저평가 수술전 예측)

  • Park, Mina;Kim, Eun-Kyung;Kim, Min Jung;Moon, Hee Jung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Objective: To investigate roles of dynamic contrast enhanced magnetic resonance (DCE MR) and diffusion-weighted (DW) imaging in preoperative prediction of underestimation of ductal carcinoma in situ (DCIS) ${\geq}2cm$ on US guided core needle biopsy. Materials and Methods: Twenty two patients with DCIS on US-guided 14 gauge core needle biopsy were included. Patients were divided into a group with and without DCIS underestimation based on histopathology. MR images including DCE and DW imaging were obtained with a 3.0-T MR. The lesion type (mass or non-mass), enhancement pattern, peak enhancement, and apparent diffusion coefficient (ADC) values of proven malignant masses were generated using software of CADstream and compared between two groups using Fisher's exact test and Mann Whitney test. Results: Eight patients were in the group with underestimation and 14 patients were in the group without underestimation. The lesion type and enhancement pattern were not different between two groups (P values = 1.000 and 0.613, respectively). The median peak enhancement of lesions with underestimation was 159.5%, higher than 133.5% of those without underestimation, but not significant (P value = 0.413). The median ADC value of lesions with underestimation was $1.26{\times}10^{-3}mm^2/sec$, substantially lower than $1.35{\times}10^{-3}mm^2/sec$ of those without underestimation (P value = 0.094). Conclusion: ADC values had the potential to preoperatively predict DCIS underestimation on US-guided core needle biopsy, although a large prospective series study should be conducted to confirm these results.

Quantitative Evaluation of the Corticospinal Tract Segmented by Using Co-registered Functional MRI and Diffusion Tensor Tractography (정상인에서 기능적 뇌 자기공명영상과 확산텐서영상 합성기법을 이용한 피질척수로의 위치에 따른 정량적 분석)

  • Jang, Sung-Ho;Hong, Ji-Heon;Byun, Woo-Mok;Hwang, Chang-Ho;Yang, Dong-Seok
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.1
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    • pp.40-46
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    • 2009
  • Purpose : The purpose of this study was to investigate the quantitative evaluation of the corticospinal tract (CST) at the multiple levels by using functional MRI (fMRI) co-registered to diffusion tensor tractography (DTT). Materials and Methods : Ten normal subjects without any history of neurological disorder participated in this study. fMRI was performed at 1.5 T MR scanner using hand grasp-release movement paradigm. DTT was performed by using DtiStudio on the basis of fiber assignment continuous tracking algorithm (FACT). The seed region of interest (ROI) was drawn in the area of maximum fMRI activation during the motor task of hand grasp-release movement on a 2-D fractional anisotropy (FA) color map, and the target ROI was drawn in the cortiocospinal portion of anterior lower pons. We have drawn five ROIs for the measurement of FA and apparent diffusion coefficient (ADC) along the corona radiata (CR) down to the medulla. Results : The contralateral primary sensorimotor cortex (SM1) was mainly found to be activated in all subjects. DTT showed that tracts originated from SM1 and ran to the medulla along the known pathway of the CST. In all subjects, FA values of the CST were higher at the level of the midbrain and posterior limb of internal capsule (PLIC) than the level of others. Conclusion : Our study showed that co-registered fMRI and DTT has elucidated the state of CST on 3-D and analyzed the quantitative values of FA and ADC at the multiple levels. We conclude that co-registered fMRI and DTT may be applied as a useful tool for clarifying and investigating the state of CST in the patients with brain injury.

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A Study on the DWI and Pathologic Findings of Cancer Cells (암 세포주의 확산강조영상과 병리학적 관계에 관한 연구)

  • Seong, Jae-Gu;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.34 no.3
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    • pp.239-244
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    • 2011
  • In this study, we evaluated diffusion weighted imaging (DWI) to investigate whether the DWI parameters can predict characteristic parameters on pathologic specimens of tumor or not. CFPAC-1 was injected subcutaneously on the back flank of athymic nude mice (n=13) then two tumors were initiated on each mouse (2${\times}$13=26 tumors). The mice were sacrificed to make specimen immediately after initial MR imaging then were compared with the MR image. A dedicated high-field (7T) small-animal MR scanner was used for image acquisitions. A T1 and T2 weighted axial image using RARE technique was acquired to measure the T2 values and tumor size. DWI MR was performed for calculating ADC values. To evaluate tumor cellularity and determine the levels of MVD, tumor cells were excised and processed for H-E staining and immunostaining using CD31. T2 values and ADC values were computed and analyzed for each half of the tumors and compared to the correlated specimens slide. Median ADC within each half of mass was compared to the cellularity and MVD in the correlated area of pathologic slide. The mean of ADC value is $0.7327{\times}10^{-3}$ $mm^2/s$ and standard deviation is $0.1075{\times}10^{-3}$ $mm^2/s$. There is a linear relationship between ADC value and tumor necrosis (R2=0.697, p< 0.001). DW image parameters including the ADC values can be utilized as surrogate markers to assess intratumoral neoangiogenesis and change of the internal structure of tumor cells.