• Journal of the Institute of Electronics and Information Engineers
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• v.53 no.3
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• pp.151-159
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• 2016

In this research, we tried to suggest moderate FA(Flip Angle) for CE(Contrast Enhnaced)-Head&Neck MR Angiography with Gadoteridol. For this study, we did test MR phantom and clinical study according to FA change. After that, quantitative analysis was progressed. The results of MR phantom study were as follow: RSP(Reaction Starting Point)was recorded within 300~400 mmol. MPSI(Max Peak Signal Intensity) was 2,086, 3,705, 5,109, 6,194, 7.096, 7,192 [a.u]. MPP(Max Peak Point) was shown at 30, 50, 50, 40, 50, 40 mmol. IRMPSI(Increase Rate of MPSI) was 77.6%, 37.9%, 21.2%, 14.6%, 1.4% as increasing of FA. The results of clinical study were as follow SICB(Signal Intensity of Carotid artery Bifurcation) was recorded respectively 392.5, 4165.2, 4270, 3502.2, 3263.7, 3119.6 [a.u]. ORA(Occurence Rate of Artifact) was increased as 0, 0, 20, 40, 50, 70%. According to this research, we are not only able to assure that increase of FA can be effect on H1 spin's SI(Signal Intensity) which was combined with gadolinium agent, but also be effect on artifact rate in blood vessel. In clinical field, we expect that CE-Head&Neck MR Angiography can be performed in a practical way with this research.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.131-143
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• 2015

Purpose : By comparing a CT fusion plan based on MRI with a plan based on only MRI without CT, we intended to study usefulness of a plan based on only MRI. And furthermore, we intended to realize a realtime MR-IGRT by MRI image without CT scan during the course of simulation, treatment planning, and radiation treatment. Materials and Methods : BBB CT (Brilliance Big Bore CT, 16slice, Philips), Viewray MRIdian system (Viewray, USA) were used for CT & MR simulation and Treatment plan of 11 patients (1 Head and Neck, 5 Breast, 1 Lung, 3 Liver, 1 Prostate). When scanning for treatment, Free Breathing was enacted for Head&Neck, Breast, Prostate and Inhalation Breathing Holding for Lung and Liver. Considering the difference of size between CT and Viewray, the patient's position and devices were in the same condition. Using Viewray MRIdian system, two treatment plans were established. The one was CT fusion treatment plan based on MR image. Another was MR treatment plan including electron density that [ICRU 46] recommend for Lung, Air and Bone. For Head&Neck, Breast and Prostate, IMRT was established and for Lung and Liver, Gating treatment plan was established. PTV's Homogeneity Index(HI) and Conformity Index(CI) were use to estimate the treatment plan. And DVH and dose difference of each PTV and OAR were compared to estimate the treatment plan. Results : Between the two treatment plan, each difference of PTV's HI value is 0.089% (Head&Neck), 0.26% (Breast), 0.67% (Lung), 0.2% (Liver), 0.4% (Prostate) and in case of CI, 0.043% (Head&Neck), 0.84% (Breast), 0.68% (Lung), 0.46% (Liver), 0.3% (Prostate). As showed above, it is on Head&Neck that HI and CI's difference value is smallest. Each difference of average dose on PTV is 0.07 Gy (Head&Neck), 0.29 Gy (Breast), 0.18 Gy (Lung), 0.3 Gy (Liver), 0.18 Gy (Prostate). And by percentage, it is 0.06% (Head&Neck), 0.7% (Breast), 0.29% (Lung), 0.69% (Liver), 0.44% (Prostate). Likewise, All is under 1%. In Head&Neck, average dose difference of each OAR is 0.01~0.12 Gy, 0.04~0.06 Gy in Breast, 0.01~0.21 Gy in Lung, 0.06~0.27 Gy in Liver and 0.02~0.23 Gy in Prostate. Conclusion : PTV's HI, CI dose difference on the Treatment plan using MR image is under 1% and OAR's dose difference is maximum 0.89 Gy as heterogeneous tissue increases when comparing with that fused CT image. Besides, It characterizes excellent contrast in soft tissue. So, radiation therapy using only MR image without CT scan is useful in the part like Head&Neck, partial breast and prostate cancer which has a little difference of heterogeneity.

• Investigative Magnetic Resonance Imaging
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• v.2 no.1
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• pp.96-103
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• 1998

Purpose : To assess the clinical utility of turbo contrast-enhanced magnetic resonance angiography(CE MRA) in the evaluation of the aortic arch and its major branches and to compare the image quality of CE MRA among different coils used. Materials and Methods : Turbo three-phase dynamic CE MRA encompassing aortic arch and its major branches was prospectively performed after manual bolus IV injection of contrast material in 29 patients with suspected cerebrovascular diseases at 1.0T MR unit. the raw data were obtained with 3-D FISH sequence (TR 5.4ms, TE 2.3ms, flip angle 30, slab thickness 80nm, effective slice thickness 4.0mm, matrix size $100{\times}256$, FOV 280mm). Total data acquisition time was 4. to 60 seconds. We subjectively evaluated the imge quality with three-rating scheme : "good" for unequivocal normal finding, "fair" for relatively satisfactory quality to diagnose 'normal' despite intravascular low signal, and "poor" for equivocal diagnosis or non-visualization of the origin or segment of the vessels due to low signal or artifacts which needs catheter angiography. At the level of the carotid bifurcation, it was compared with conventional 2D-TOF MRA image. Overall image quality was also compared visually and quantitatively by measuring signal-to-noise ratios (SNRs) of the ascending aorta, the innominate artery and both common carotid arteries among the three different coils used(CP body array(n=12), CP neck array(n=9), and head-and-neck(n=8). Results : Demonstration of the aortic arch and its major branches was rated as "good" in 55% (16/29) and "fair" in 34%(10/29). At the level of the carotid bifurcation, image quality of turbo CE MRA was same as or better than conventional 2D-TOF MRA in 65% (17/26). Overall image quality and SNR were significantlygreater with CP body array coil than with CP neck array or head-and-neck coil. Conclusions : Turbo CE MRA can be used as a screening exam in the evaluation of the major branches of the aortic arch from their origin to the skull base. Overall imagequality appears to be better with CP body array coil than with CP neck array coil or head-and-neck coil.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.26-32
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• 2014

Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

• Progress in Medical Physics
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• v.15 no.2
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• pp.112-119
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• 2004

We tried to build human models based on medical images of live Korean, instead of using standard data of human body structures. Characteristics of mechanical structures of human bodies were obtained from medical images such as CT and MR images. For each constitutional part of mechanical structures CT images were analyzed in terms of gray levels and MR images were analyzed in terms of pulse sequence. Characteristic features of various mechanical structures were extracted from the analyses. Based on the characteristics of each structuring element we peformed image segmentation on CT and MR images. We delineated bones, muscles, ligaments and tendons from CT and MR images using image segmentation or manual drawing. For the image segmentation we compared the edge detection method, region growing method and intensity threshold method and applied an optimal compound of these methods for the best segmentation results. Segmented mechanical structures of the head/neck part were three dimensionally reconstructed.

• Investigative Magnetic Resonance Imaging
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• v.20 no.1
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• pp.44-52
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• 2016

Purpose: To quantitatively and qualitatively compare fat-suppressed MRI quality using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) with that using frequency selective fat-suppression (FSFS) T2- and postcontrast T1-weighted fast spin-echo images of the head and neck at 3T. Materials and Methods: The study was approved by our Institutional Review Board. Prospective MR image analysis was performed in 36 individuals at a single-center. Axial fat suppressed T2- and postcontrast T1-weighted images with IDEAL and FSFS were compared. Visual assessment was performed by two independent readers with respect to; 1) metallic artifacts around oral cavity, 2) susceptibility artifacts around upper airway, paranasal sinus, and head-neck junction, 3) homogeneity of fat suppression, 4) image sharpness, 5) tissue contrast of pathologies and lymph nodes. The signal-to-noise ratios (SNR) for each image sequence were assessed. Results: Both IDEAL fat suppressed T2- and T1-weighted images significantly reduced artifacts around airway, paranasal sinus, and head-neck junction, and significantly improved homogeneous fat suppression in compared to those using FSFS (P < 0.05 for all). IDEAL significantly decreased artifacts around oral cavity on T2-weighted images (P < 0.05, respectively) and improved sharpness, lesion-to-tissue, and lymph node-to-tissue contrast on T1-weighted images (P < 0.05 for all). The mean SNRs were significantly improved on both T1- and T2-weighted IDEAL images (P < 0.05 for all). Conclusion: IDEAL technique improves image quality in the head and neck by reducing artifacts with homogeneous fat suppression, while maintaining a high SNR.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.2
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• pp.83-90
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• 2011

To prospectively determine the diagnostic performance a combination of standard bolus-chase magnetic resonance (MR) angiography and MR angiography with time-resolved imaging of contrast kinetics (TRICKS) for depicting severity of the head and neck vascular diseases. Over a period of two months, A total of 100 patients(average ages : $50{\pm}8$, male : 60, female : 40) with head and neck vascular diseases were performed on the GE excite 3.0 T units with 8-channel head coil and 4-channel NV coil. Imaging parameters for a typical study were as follow: SBC(TR/ TE/ FA/ SliceThicken./ Slab/ Freq./ FOV/ BW/Scan Time) = 5.4/ min/ 30/ 2/ zip2/ 70/ $224{\times}448$/ 30/ 62.50/ 28, TRICKS(TR/ TE/ FA/ Slice Thicken/Slab/ Freq./ FOV/ BW/ Temp Res./ Scan Time = 3.6/ min/ 25/ 4/ 30/ $160{\pm}384$, zip512/ 30/ 100/ 1 to 1.5/ 23). The analysis of all MR images, which have respect-ively classified two techniques into some diseases. The results of the former were divided into two groups(SBC, TRICKS)with 4 grading of two reader, respectively. Wilcoxon signed rank test was used to determine if a significant difference between imaging techniques existed(p < 0.05). In 33 of 100 patients, arterio-venous malformation was 11% at TRICKS, subclavian vein stenosis : 8%, fistular sinus : 4%, jugular vein stenosis:6%, Middle Cerebral Artery bypass surgery : 4%, p < 0.05). The rest of 67 patients were considered as the results of SBC(14% in the basilar artery stenosis, carotid stenosis : 16%, vertebral stenosis : 17%, central neuro-cytoma : 5%, meningioma : 5%, Not appliable : 10%, p < 0.05). Sensitivity and specificity of TRICKS MR angiography in SVS, FS, JVS, MCABS were improved compared with those at standard MR angiography. In SBS MR angiography which were improved in BAS, CS, VS, CN, Meningioma. In conclusion, TRICKS MR angiography of the SVS, FS, JVS, MCABS is superior to standard MR angiography regarding the number of diagnostic grading. The SBS MR angiography were improved in BAS, CS, VS, CN, Meningioma. and assessment of the degree of luminal narrowing on both TRICKS and SBS.

• Journal of radiological science and technology
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• v.45 no.1
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• pp.11-17
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• 2022

This study was purpose to quantitative assessment of the resolution characteristics by using American college of radiology(ACR) phantom for magnetic resonance imaging (MRI). The MRI equipment was used (Achiva 3.0T MRI, Philips system, Netherlands) and the head/neck matrix shim SENSE head coil were 32 channels(elements) receive MR coil. And the MRI equipment was used (Discovery MR 750, 3.0T MRI, GE medical system, America) and the head/neck matrix shim MC 3003G-32R 32-CH head coil were receive MR coil. As for the modulation transfer function(MTF) comparison result by using ACR magnetic resonance imaging phantom, the MTF value of the ACR standard T2 image in GE equipment is 0.199 when the frequency is 1.0 mm^-1 and the MTF value of the hospital T2 image in Philips equipment is 0.528. It was used efficiently by using a general sequence more than the standard sequence method using the ACR phantom. In addition it is significant that the quantitative quality assurance evaluation method for resolution characteristics was applied mutatis mutandis, and the result values of the physical image characteristics of the 3.0T MRI device were presented.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1053-1068
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• 2020

In accordance with the new healthcare policy of government (Moon Jae-In Care) to strengthen health insurance coverage, the National Health Insurance (NHI) coverage of brain magnetic resonance imaging (MRI), brain/neck MR angiography (MRA), and head and neck MRI have been expanded since 2018 in Korea. This article has been reviewed focusing on the "Detailed matter concerning criteria and method for providing reimbursed services in the NHI. Some revisions" regarding reimbursement for MRI, which was revised from October 2018 to April 2020 and is currently in effect. It included the MRI reimbursement system in Korea, recent adjustment of the reimbursement coverage for patients with headache or dizziness, and reimbursement coverage, standard imaging, and radiologic report of brain MRI, brain/neck MRA and head and neck MRI. This article could help radiologists gain knowledge on health insurance to protect the expertise of the radiologist and to play a leading role in the hospital. As the policy changes, detailed matter concerning criteria and method for providing reimbursed services in the NHI may be revised. Therefore, radiologists should update issues related to insurance reimbursement for MRI continuously.

• The Journal of the Korea Contents Association
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• v.15 no.11
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• pp.313-321
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• 2015

To minimize CT examination for Hip FAI diagnosis and operation plan. also, whether the MRI 3D images can replace Hip Clock face image was evaluated when performing Hip FAI MRI by using additional 3D image. This study analyzed Hip MRI and 3D Hip CT images of 31 patients in this hospital. For the purpose of evaluating the images, one orthopedic surgeon and one radiology specialist reconstructed Clock face, at MR and CT modality, by superior 12 o'clock, labrum front 3 o'clock, and the other side 9 o'clock, centering on Hip joint articular transverse ligament 6 o'clock. Afterwards, by the Likert Scale 5 point scale (independent t-test p<0.005), this study evaluated the check-up of A. retinacular vessel, B. head neck junction at 11 o'clock, A. Epiphyseal line, B. Cam lesion at 12 o'clock, and Cam lesion, Posterior Cam lesion at 1,2,3 and 4 o'clock. As for the verification of reliability among observers, this study verified coincidence by Cohen's weighted Kappa verification. As a result of Likert scale for the purpose of qualitative evaluation about the image, 11 o'clock A. retinacular vessel MR average was $3.69{\pm}1.0$ and CT average was $2.8{\pm}0.78$. B. head neck juncton didn't have a difference between two observers (p <0.416). 12 o'clock A. Epiphyseal line MR average was $3.54{\pm}1.00$ and CT average was $4.5{\pm}0.62$(p<0.000). B. Cam lesion didn't have a difference between two observers (p <0.532). 1,2,3,4 Cam lesion and Posterior Cam lesion were not statistically significant (p <0.656, p <0.658). As a result of weighted Kappa verification, 11 o'clock A.retinacular vessel CT K value was 0.663 and the lowest conformity. As a result of coincidence evaluation on respective item, a very high result was drawn, and two observers showed high reliability.