• Korean Journal of Radiology
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• v.21 no.1
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• pp.77-87
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• 2020

Objective: To assess the feasibility of simultaneous multislice-accelerated diffusion-weighted imaging (SMS-DWI) of the rectum in comparison with conventional DWI (C-DWI) in rectal cancer patients. Materials and Methods: This study included 65 patients with initially-diagnosed rectal cancer. All patients underwent C-DWI and SMS-DWI with acceleration factors of 2 and 3 (SMS2-DWI and SMS3-DWI, respectively) using a 3T scanner. Acquisition times of the three DWI sequences were measured. Image quality in the three DWI sequences was reviewed by two independent radiologists using a 4-point Likert scale and subsequently compared using the Friedman test. Apparent diffusion coefficient (ADC) values for rectal cancer and the normal rectal wall were compared among the three sequences using repeated measures analysis of variance. Results: Acquisition times using C-DWI, SMS2-DWI, and SMS3-DWI were 173 seconds, 107 seconds, (38.2% shorter than C-DWI), and 77 seconds (55.5% shorter than C-DWI), respectively. For all image quality parameters other than distortion (margin sharpness, artifact, lesion conspicuity, and overall image quality), C-DWI and SMS2-DWI yielded better results than did SMS3-DWI (Ps < 0.001), with no significant differences observed between C-DWI and SMS2-DWI (Ps ≥ 0.054). ADC values of rectal cancer (p = 0.943) and normal rectal wall (p = 0.360) were not significantly different among C-DWI, SMS2-DWI, and SMS3-DWI. Conclusion: SMS-DWI using an acceleration factor of 2 is feasible for rectal MRI resulting in substantial reductions in acquisition time while maintaining diagnostic image quality and similar ADC values to those of C-DWI.

• Journal of Radiation Industry
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• v.10 no.4
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• pp.227-230
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• 2016

DWI of biological effects are independent of magnetic field strength in various regions. High field strength, however, does affect the signal to noise ratio (SNR) and artifacts of diffusion weighted imaging (DWI) images, which ultimately will influence the quantitative of diffusion imaging. In this study, the effects of field strength on DWI are reviewed. The effects of the diseases also are discussed. Comparing DWI in cerebellum, WM, GM, Hyperacute region measurements both as a function of field strength (1.5T and 3.0T). Overall, the SNR of the DWI roughly doubled going from 1.5 T to 3.0 T. In summary, DWI studies at 3.0 T is provided significantly improved DWI measurements relative to studies at 1.5T.

• Korean Journal of Radiology
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• v.21 no.9
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• pp.1036-1044
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• 2020

Objective: To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patients with breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventional diffusion-weighted imaging (cDWI). Materials and Methods: Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm² (cDWI₈₀₀ and cDWI₁₅₀₀) and sDWI at b-values of 1000 and 1500 s/mm² (sDWI₁₀₀₀ and sDWI₁₅₀₀). Qualitative analysis (normal glandular tissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI sets and the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI set in 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test, one-way analysis of variance, and Cochran's Q test. Results: All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasing b-values, regardless of the type of imaging (synthetic or conventional) (p < 0.001). Additionally, sDWI₁₅₀₀ provided better lesion conspicuity than cDWI₁₅₀₀ (3.52 ± 0.92 vs. 3.39 ± 0.90, p < 0.05). Although cDWI₁₅₀₀ showed better normal glandular tissue suppression and overall image quality than sDWI₁₅₀₀ (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively; p < 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater in sDWI₁₅₀₀ than in cDWI₁₅₀₀ (0.63 ± 0.17 vs. 0.55 ± 0.18, p < 0.001). Conclusion: sDWI₁₅₀₀ can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity, better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI₁₅₀₀.

• Journal of Magnetics
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• v.17 no.2
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• pp.153-157
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• 2012

This study evaluated the ability of Diffusion-Weight Image (DWI), which is one of pulse sequences used in MRI based on the T2 weighted images, to detect samples placed within phantoms according to their size. Two identically sized phantoms, which could be inserted into the breast coil bilaterally, were prepared. Five samples with different sizes were placed in the phantoms, and the T2 weighted images and DWI were obtained. The Breast 2 channel coil of SIEMENS MAGNETOM Avanto 1.5 Tesla equipment was used for the experiments. 2D T2 weighted images were obtained using the following parameters: TR/TE = 6700/74 msec, Thickness/gap = 5/1 mm, Inversion Time (TI) = 130 ms, and matrix = $224{\times}448$. The parameters of DWI were that TR/TE = 8100/90 msec, Thickness/gap = 5/1 mm, matrix = $128{\times}128$, Inversion Time = 185 ms, and b-value = 0, 100, 300, 600, 1000 s/mm. The ratio of the sample volume on DWI compared to the T2 weighted images, which show excellent ability to detect lesions on MR images, was presented as the mean b-value. The measured b-value of the samples was obtained: 0.5${\times}$0.5 cm=0.33/0.34 square ${\times}$ cm (103%), 1${\times}$1 cm=1.28/1.25 square ${\times}$ cm (102.4%), 1.5${\times}$1.5 cm = 2.28/2.67 square ${\times}$ cm (85.39%), 2${\times}$2 cm=3.56/4.08 square ${\times}$ cm (87.25%), and 2.5${\times}$2.5 cm=7.53/8.77 square ${\times}$ cm (85.86%). In conclusion, the detection ability by the size of a sample was measured to be over 85% compared to T2 weighted image, but the detection ability of DWI was relatively lower than that of T2 weighted image.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.356-358
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• 2002

MRI, particularly diffusion weighted imaging (DWI), plays vital roles in detection of the acute brain infarction$\^$1-4/ and others metabolic changes of biological tissues. In general, every molecule in biological tissues may diffuse and move randomly in three-dimensional space. However, in clinical diagnosis, only 2D-DWI is used. The authors have developed a new method for rapid three-dimensional DWI (3D-DWI). In this method, by refocusing of the magnetized spin with the applied gradient field, direction of which is opposite to phase encoding field. Magnetized spin of $^1$H is kept under the SSFP (steady state free precession)$\^$5-6/. Under SSFP, in addition of FID, spin echo and stimulated echo are also generated, so the acquired signal is increased. The signal intensity is increased depending on flip angle (FA) of magnetized spin. This phenomenon is confirmed by human brain and phantom studies. The performance of this method is quantitatively analyzed by using both of conventional spin echo DWI and 3D-DWI. From experimental results, three dimensional diffusion weighted images are obtained correctly for liquid phantoms (water, acetone and oil), diffusion coefficient is enhanced in each image. Therefore, this method will provide useful information for clinical diagnosis.

• Investigative Magnetic Resonance Imaging
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• v.20 no.4
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• pp.250-253
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• 2016

Acute Japanese encephalitis (JE) is an endemic viral infectious disease in various parts of Far East and Southeast Asian countries including Korea. Bilateral thalami are the most common involving sites in JE. Other areas including the basal ganglia, substantia nigra, red nucleus, pons, cerebral cortex and cerebellum may be also involved. We report an extremely unusual brain diffusion-weighted MR imaging (DWI) findings in a 53-year-old man with serologically proven JE involving unilateral deep gray matter and temporal lobe, which shows multifocal high signal intensities in left thalamus, left substantia nigra, left caudate nucleus and left medial temporal cortex on T2-weighted image and DWI with iso-intensity on apparent diffusion coefficient (ADC) map.

• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.19-24
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• 2013

Objective : The purpose of this study was to retrospectively evaluate and compare the incidence of diffusion-weighted image (DWI) lesions between the Guglielmi detachable coil (GDC) and the Target coil for treating unruptured intracranial aneurysm. Methods : From 2010 to 2011, consecutive 222 patients with an intracranial aneurysm underwent coil embolization. Inclusion criterias were : 1) unruptured intracranial aneurysm, 2) one or more GDC or Target coils used with or without other coils, 3) DWI examination within 24 hours after coiling, and 4) coiling performed without a balloon or stent. Results : Ninety patients (92 cases) met the inclusion criteria. DWI lesions were detected in 55 (61.1%) of 90 patients. In the GDC group (n=44), DWI lesions were detected in 31 (70.5%). The average number of DWI lesions was $5.0{\pm}8.7$ (mean${\pm}$SD; range, 1-40) in aneurysm-related territory. In the Target coil group (n=48), DWI lesions were detected in 24 (50.0%). The number of DWI lesion was $2.1{\pm}5.4$ (range, 1-32) in aneurysm-related territory. There was no significant correlation between a number of coils and DWI lesions. No significant differences were also observed in the number of DWI lesions in each group. Conclusion : The GDC and Target coils, which have an electrolytic detachable system, showed no differences in the incidence of DWI lesion.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.305-306
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• 1998

In this paper, we infer the onset of the brain infarction from the MR image using evaluate signal intensities on diffusion weighted and turbo spin echo T2-weighted and FLAIR images. Infarcts were divided into four stages (hyperacute, acute, subacute, chronic) depending on period of onset. DWI is useful for the detection of early ischemic infarct, and stages of ischemic infarctions can be estimated by evaluating CR(conspicuity ratio) and CNR(contrast to noise ratio) on DW, T2, FLAIR images Hyperacute infarcts were visualized DWI. Acute infarcts were visualialized both DWI and T2 Weighted image.

• Investigative Magnetic Resonance Imaging
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• v.22 no.2
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• pp.131-134
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• 2018

Susceptibility-weighted imaging (SWI) is well known for detecting the presence of hemorrhagic transformation, microbleeds and the susceptibility of vessel signs in acute ischemic stroke. But in some cases, it can provide the tissue perfusion state as well. We describe a case of a patient with hyperacute ischemic infarction that had a slightly hypodense, patchy lesion at the left thalamus on the initial SWI, with a left proximal posterior cerebral artery occlusion on a magnetic resonance (MR) angiography and delayed time-to-peak on an MR perfusion performed two hours after symptom onset. No obvious abnormal signals at any intensity were found on the initial diffusion-weighted imaging (DWI). On a follow-up MR image (MRI), an acute ischemic infarction was seen on DWI, which is the same location as the lesion on SWI. The hypointensity on the initial SWI reflects the susceptibility artifact caused by an increased deoxyhemoglobin in the affected tissue and vessels, which reflects the hypoperfusion state due to decreasing arterial flow. It precedes the signal change on DWI that reflects a cytotoxic edema. This case highlights that, in some hyperacute stages of ischemic stroke, hypointensity on an SWI may be a finding before the hyperintensity is seen on a DWI.

• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.118-128
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• 2021

Purpose: To investigate the value of MR textural analysis, including use of diffusion-weighted imaging (DWI) to differentiate malignant from benign soft-tissue tumors on 3T MRI. Materials and Methods: We enrolled 69 patients (25 men, 44 women, ages 18 to 84 years) with pathologically confirmed soft-tissue tumors (29 benign, 40 malignant) who underwent pre-treatment 3T-MRI. We calculated MR texture, including mean, standard deviation (SD), skewness, kurtosis, mean of positive pixels (MPP), and entropy, according to different spatial-scale factors (SSF, 0, 2, 4, 6) on axial T1- and T2-weighted images (T1WI, T2WI), contrast-enhanced T1WI (CE-T1WI), high b-value DWI (800 sec/mm²), and apparent diffusion coefficient (ADC) map. We used the Mann-Whitney U test, logistic regression, and area under the receiver operating characteristic curve (AUC) for statistical analysis. Results: Malignant soft-tissue tumors had significantly lower mean values of DWI, ADC, T2WI and CE-T1WI, MPP of ADC, and CE-T1WI, but significantly higher kurtosis of DWI, T1WI, and CE-T1WI, and entropy of DWI, ADC, and T2WI than did benign tumors (P < 0.050). In multivariate logistic regression, the mean ADC value (SSF, 6) and kurtosis of CE-T1WI (SSF, 4) were independently associated with malignancy (P ≤ 0.009). A multivariate model of MR features worked well for diagnosis of malignant soft-tissue tumors (AUC, 0.909). Conclusion: Accurate diagnosis could be obtained using MR textural analysis with DWI and CE-T1WI in differentiating benign from malignant soft-tissue tumors.