• Investigative Magnetic Resonance Imaging
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• v.21 no.1
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• pp.43-50
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• 2017

Chronic expanding organizing hematoma (CEH) occasionally mimics a soft tissue tumor on MRI, which becomes more problematic in patients with a history of surgical resection for musculoskeletal malignancy. Herein, we present a case of CEH which we were able to differentiate from recurrent tumor through MRI follow-up, including diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) imaging. A 66-year-old male visited our institution under suspicion of recurrent leiomyosarcoma of the thigh, 19 months after surgery and radiation therapy. Due to inconclusive results, three US-guided biopsies and 6 MRI examinations were performed over 2 years. In the end, we could diagnose a CEH using conventional and functional MRI techniques, and it was histopathologically confirmed after surgical resection. A CEH may occur remotely after an initiating event, and it may persist and expand over several years. Functional MR sequences, in addition to conventional sequences, are helpful in differentiating CEH from malignant neoplasms.

• Investigative Magnetic Resonance Imaging
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• v.25 no.4
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• pp.218-228
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• 2021

Due to their high degree of freedom to transfer and acquire light, fiber optics can be used in the presence of strong magnetic fields. Hence, optical sensing and imaging based on fiber optics can be integrated with magnetic resonance imaging (MRI) diagnostic systems to acquire valuable information on biological tissues and organs based on a magnetic field. In this article, we explored the combination of MRI and optical sensing/imaging techniques by classifying them into the following topics: 1) functional near-infrared spectroscopy with functional MRI for brain studies and brain disease diagnoses, 2) integration of fiber-optic molecular imaging and optogenetic stimulation with MRI, and 3) optical therapeutic applications with an MRI guidance system. Through these investigations, we believe that a combination of MRI and optical sensing/imaging techniques can be employed as both research methods for multidisciplinary studies and clinical diagnostic/therapeutic devices.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.634-651
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• 2021

Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD). This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

• Proceedings of the KSMRM Conference
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• 2001.11a
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• pp.15-19
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• 2001

지난 10년간 신경계의 MR영상은 컴퓨터를 비롯한 하드웨어적인 발달에 힘입어 functional imaging, perfusion imaging, diffusion imaging, MR spectroscopy, MR angiography 등의 분야에서 괄목한 만한 성장이 있었다. 지난 2001년 4월 국제자기공명의과학회 (ISMRM) 학술대회에 약 2300개의 논문이 발표되었으며 이 중 신경계와 관련된 논문의 수는 저자가 파악하기에 약 500개 정도이었다. 매년 수많은 논문이 발표되고 있으나 이 중 기초 또는 임상의학적으로 유용한 논문만이 후속 연구로 연결되어 궁극적으로 많은 사람들이 활용할 수 있게 되고 있다. 따라서 지난 수 년 동안의 연구 동향을 모두 follow-up하는 것은 무의미하며, 이 중 functional, perfusion, diffusion imaging을 중심으로 이들 영상 기법의 기술적 측면과 적용 분야를 알아보고자 한다.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.147-147
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• 2006

• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.59-75
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• 2021

The fornix is the major white-matter outflow tract from the hippocampus; it has a significant role in cognitive function. It is readily imaged via magnetic resonance imaging; its main parts are the crura, commissure, body, and columns. In this pictorial essay, we describe and illustrate the functional and imaging anatomy of the fornix and limbic system, as well as various disease entities involving the fornix.

• Progress in Medical Physics
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• v.30 no.2
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• pp.39-48
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• 2019

Deep learning has been applied to various medical data. In particular, current deep learning models exhibit remarkable performance at specific tasks, sometimes offering higher accuracy than that of experts for discriminating specific diseases from medical images. The current status of deep learning applications to molecular imaging can be divided into a few subtypes in terms of their purposes: differential diagnostic classification, enhancement of image acquisition, and image-based quantification. As functional and pathophysiologic information is key to molecular imaging, this review will emphasize the need for accurate biomarker acquisition by deep learning in molecular imaging. Furthermore, this review addresses practical issues that include clinical validation, data distribution, labeling issues, and harmonization to achieve clinically feasible deep learning models. Eventually, deep learning will enhance the role of theranostics, which aims at precision targeting of pathophysiology by maximizing molecular imaging functional information.

• Journal of Korea Multimedia Society
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• v.24 no.5
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• pp.684-694
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• 2021

Resting-state Functional Magnetic Resonance Imaging(fMRI) data detects the temporal correlations in Blood Oxygen Level Dependent(BOLD) signal and these temporal correlations are regarded to reflect intrinsic cortical connectivity, which is deactivated during attention demanding, non-self referential tasks, called Default Mode Network(DMN). The relationship between fMRI and anatomical connectivity has not been studied in detail, however, the preceded studies have tried to clarify this relationship using Diffusion Tensor Imaging(DTI) and fMRI. These studies use method that fMRI data assists DTI data or vice versa and it is used as guider to perform DTI tractography on the brain image. In this study, we hypothesized that functional connectivity in resting state would reflect anatomical connectivity of DMN and the combined images include information of fMRI and DTI showed visible connection between brain regions related in DMN. In the previous study, functional connectivity was determined by subjective region of interest method. However, in this study, functional connectivity was determined by objective and advanced method through Independent Component Analysis. There was a stronger connection between Posterior Congulate Cortex(PCC) and PHG(Parahippocampa Gyrus) than Anterior Cingulate Cortex(ACC) and PCC. This technique might be used in several clinical field and will be the basis for future studies related to aging and the brain diseases, which are needed to be translated not only functional connectivity, but structural connectivity.

• Clinical and Experimental Pediatrics
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• v.63 no.3
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• pp.88-95
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• 2020

Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone, particularly when it is interpreted by experienced neuroradiologists. Ultra-high-field imaging and postprocessing analysis with automated machine learning algorithms can detect subtle structural abnormalities in MRI-negative patients. Tractography derived from diffusion tensor imaging can delineate white matter connections associated with epilepsy or eloquent function, thus, preventing deficits after epilepsy surgery. Arterial spin-labeling perfusion MRI, simultaneous electroencephalography (EEG)-functional MRI (fMRI), and magnetoencephalography (MEG) are noinvasive imaging modalities that can be used to localize the epileptogenic foci and assist in planning epilepsy surgery with positron emission tomography, ictal single-photon emission computed tomography, and intracranial EEG monitoring. MEG and fMRI can localize and lateralize the area of the cortex that is essential for language, motor, and memory function and identify its relationship with planned surgical resection sites to reduce the risk of neurological impairments. These advanced structural and functional imaging modalities can be combined with postprocessing methods to better understand the epileptic network and obtain valuable clinical information for predicting long-term outcomes in pediatric epilepsy.

• Korean Journal of Radiology
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• v.20 no.1
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• pp.83-93
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• 2019

Objective: The purpose of this study was to prospectively investigate the value of the myocardial extracellular volume fraction (ECV) in predicting myocardial functional outcome after revascularization of coronary chronic total occlusion (CTO). Materials and Methods: Thirty patients with CTO underwent cardiovascular magnetic resonance (CMR) before and 6 months after revascularization. Three baseline markers of functional outcome were evaluated in the dysfunctional segments assigned to the CTO vessels: ECV, transmural extent of infarction (TEI), and unenhanced rim thickness (RIM). At the global level, the ECV values of the whole myocardium with and without a hyperenhanced region (global and remote ECV) were respectively measured. Results: In per-segment analysis, ECV was superior to TEI and RIM in predicting functional recovery (area under receiver operating characteristic curve [AUC]: 0.86 vs. 0.75 and 0.73, all p values < 0.010), and it emerged as the only independent predictor of regional functional outcome (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.77-0.89; p < 0.001) independent of collateral circulation. In per-patient analysis, global baseline ECV was indicative of ejection fraction (EF) at the follow-up examination (β = -0.61, p < 0.001) and changes in EF (β = -0.57, p = 0.001) in multivariate regression analysis. A patient with global baseline ECV less than 30.0% (AUC, 0.93; sensitivity 94%, specificity 80%) was more likely to demonstrate significant EF improvement (OR: 0.38; 95% CI: 0.17-0.85; p = 0.019). Conclusion: Extracellular volume fraction obtained by CMR may provide incremental value for the prediction of functional recovery both at the segmental and global levels in CTO patients, and may facilitate the identification of patients who can benefit from revascularization.