• Korean Journal of Radiology
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• v.21 no.4
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• pp.402-412
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• 2020

Objective: To evaluate the performance of predicting early recurrence using preoperative factors only in comparison with using both pre-/postoperative factors. Materials and Methods: We retrospectively reviewed 549 patients who had undergone curative resection for single hepatcellular carcinoma (HCC) within Milan criteria. Multivariable analysis was performed to identify pre-/postoperative high-risk factors of early recurrence after hepatic resection for HCC. Two prediction models for early HCC recurrence determined by stepwise variable selection methods based on Akaike information criterion were built, either based on preoperative factors alone or both pre-/postoperative factors. Area under the curve (AUC) for each receiver operating characteristic curve of the two models was calculated, and the two curves were compared for non-inferiority testing. The predictive models of early HCC recurrence were internally validated by bootstrap resampling method. Results: Multivariable analysis on preoperative factors alone identified aspartate aminotransferase/platelet ratio index (OR, 1.632; 95% CI, 1.056-2.522; p = 0.027), tumor size (OR, 1.025; 95% CI, 0.002-1.049; p = 0.031), arterial rim enhancement of the tumor (OR, 2.350; 95% CI, 1.297-4.260; p = 0.005), and presence of nonhypervascular hepatobiliary hypointense nodules (OR, 1.983; 95% CI, 1.049-3.750; p = 0.035) on gadoxetic acid-enhanced magnetic resonance imaging as significant factors. After adding postoperative histopathologic factors, presence of microvascular invasion (OR, 1.868; 95% CI, 1.155-3.022; p = 0.011) became an additional significant factor, while tumor size became insignificant (p = 0.119). Comparison of the AUCs of the two models showed that the prediction model built on preoperative factors alone was not inferior to that including both pre-/postoperative factors {AUC for preoperative factors only, 0.673 (95% confidence interval [CI], 0.623-0.723) vs. AUC after adding postoperative factors, 0.691 (95% CI, 0.639-0.744); p = 0.0013}. Bootstrap resampling method showed that both the models were valid. Conclusion: Risk stratification solely based on preoperative imaging and laboratory factors was not inferior to that based on postoperative histopathologic risk factors in predicting early recurrence after curative resection in within Milan criteria single HCC patients.

• Investigative Magnetic Resonance Imaging
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• v.22 no.1
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• pp.18-25
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• 2018

Purpose: To investigate the various imaging factors associated with aggravation of lumbar disc herniation (LDH) and develop a scoring system for prediction of LDH aggravation. Materials and Methods: From 2015 to 2017, we retrospectively reviewed the magnetic resonance imaging (MRI) findings of 60 patients (30 patients with aggravated LDH and 30 patients without any altered LDH). Imaging factors for MRI evaluation included the level of LDH, disc degeneration, back muscle atrophy, facet joint degeneration, ligamentum flavum thickness and interspinous ligament degeneration. Flexion-extension difference was measured with simple radiography. The scoring system was analyzed using receiver operating characteristic (ROC) analysis. Results: The aggravated group manifested a higher grade of disc degeneration, back muscle atrophy and facet degeneration than the control group. The ligamentum flavum thickness in the aggravated group was thicker than in the group with unaltered LDH. The summation score was defined as the sum of the grade of disc degeneration, back muscle atrophy and facet joint degeneration. The area under the ROC curve showing the threshold value of the summation score for prediction of aggravation of LDH was 0.832 and the threshold value corresponded to 6.5. Conclusion: Disc degeneration, facet degeneration, back muscle atrophy and ligamentum flavum thickness are important factors in predicting aggravation of LDH and may facilitate the determination of treatment strategy in patients with LDH. The summation score is available as supplemental data.

• Journal of Magnetics
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• v.20 no.3
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• pp.295-301
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• 2015

We evaluated certain issues related to magnetic resonance imaging (MRI) coupled with the use of active 2.5 GHz radio frequency identification (RFID) tags for patient identification using low field (0.3 T) MRI and computed tomography (CT) scans. We also investigated the performance of the RFID reader located outside the MRI room by considering several factors. A total of ten active RFID tags were exposed to several MRI sequences and X-rays of CT scan. We found that only card type active RFID tags are suitable for patient identification purpose in MRI environment and both wristbands as well as card tags were suitable for the same in CT environment. Severe artifacts were found in the captured MRI and CT images when the area of the imaging was in proximity to the tags. No external factors affected the performance of active RFID reader stationed outside the MRI scan room.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.161-170
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• 2009

Purpose : A parallel imaging method provides us to improve temporal resolution to obtain three-dimensional (3D) MR images. The objective of this study was to optimize three 3D MRI techniques by adjusting 2D SESNE factors of the parallel imaging method in phantom and human brain. Materials and Methods : With a 3 Tesla MRI system and an 8-channel phase-array sensitivity-encoding (SENSE) coil, three 3D MRI techniques of 3D T1-weighted imaging (3D T1WI), 3D T2-weighted imaging (3D T2WI) and 3D fluid attenuated inversion recovery (3D FLAIR) imaging were optimized with adjusting SESNE factors in a water phantom and three human brains. The 2D SENSE factor was applied on the phase-encoding and the slice-encoding directions. Signal-to-noise ratio(SNR), percent signal reduction rate(%R), and contrast-to-noise ratio(CNR) were calculated by using signal intensities obtained in specific regions-of-interest (ROI). Results : In the phantom study, SENSE factor = 3 was provided in 0.2% reduction of signals against without using SENSE with imaging within 5 minutes for 3D T1WI. SENSE factor = 2 was provided in 0.98% signal reduction against without using SENSE with imaging within 5 minutes for 3D T2WI. SENSE factor = 4 was provided in 0.2% signal reduction against without using SENSE with imaging around 6 minutes for 3D FLAIR. In the human brain study, SNR and CNR were higher with SENSE factors = 3 than 4 for all three imaging techniques. Conclusion : This study was performed to optimize 2D SENSE factors in the three 3D MRI techniques that can be scanned in clinical time limitations with minimizing SNR reductions. Without compromising SNR and CNR, the optimum 2D SENSE factors were 3 and 4, yielding the scan time of about 5 to 6 minutes. Further studies are necessary to optimize 3D MRI techniques in other areas in human body.

• The Korean Journal of Nuclear Medicine
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• v.38 no.2
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• pp.171-174
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• 2004

Angiogenesis, the formation of new capillaries from existing vessels, increases oxygenation and nutrient supply to ischemic tissue and allows tumor growth and metastasis. As such, angiogenesis targeting provides a novel approach for cancer treatment with easier drug delivery and less drug resistance. Therapeutic anti-angiogenesis has shown impressive effects in animal tumor models and are now entering clinical trials. However, the successful clinical introduction of this new therapeutic approach requires diagnostic tools that can reliably measure angiogenesis in a noninvasive and repetitive manner. Molecular imaging is emerging as an exciting new discipline that deals with imaging of disease on a cellular or genetic level. Angiogenesis imaging is an important area for molecular imaging research, and the use of radiotracers offers a particularly promising technique for its development. While current perfusion and metabolism radiotracers can provide useful information related to tissue vascularity, recent endeavors are focused on the development of novel radioprobes that specifically and directly target angiogenic vessels. Presently available proges include RGD sequence containing peptides that target ${\alpha}_v\;{\beta}_3$ integrin, endothelial growth factors such as VEGF or FGF, metalloptoteinase inhibitors, and specific antiangiogenic drugs. It is now clear that nuclear medicine techniques have a remarkable potential for angiogenesis imaging, and efforts are currently continuing to develop new radioprobes with superior imaging properties. With future identification of novel targets, design of better probes, and improvements in instrumentation, radiotracer angiogenesis imaging promises to play an increasingly important role in the diagnostic evaluation and treatment of cancer and other angiogenesis related diseases.

• Applied Microscopy
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• v.46 no.4
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• pp.179-183
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• 2016

Mapping brain structural and functional connections through the whole brain is essential for understanding brain mechanisms and the physiological bases of brain diseases. Although region specific structural or functional deficits cause brain diseases, the changes of interregional connections could also be important factors of brain diseases. This review will introduce common neuroimaging modalities, including structural magnetic resonance imaging (MRI), functional MRI (fMRI), diffusion tensor imaging, and other recent neuroimaging analyses methods, such as voxel-based morphometry, cortical thickness analysis, local gyrification index, and shape analysis for structural imaging. Tract-Based Spatial Statistics, TRActs Constrained by UnderLying Anatomy for diffusion MRI, and independent component analysis for fMRI also will also be introduced.

• Korean Journal of Radiology
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• v.22 no.1
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• pp.23-40
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• 2021

In pancreatic cancer, imaging plays an essential role in surveillance, diagnosis, resectability evaluation, and treatment response evaluation. Pancreatic cancer surveillance in high-risk individuals has been attempted using endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI). Imaging diagnosis and resectability evaluation are the most important factors influencing treatment decisions, where computed tomography (CT) is the preferred modality. EUS, MRI, and positron emission tomography play a complementary role to CT. Treatment response evaluation is of increasing clinical importance, especially in patients undergoing neoadjuvant therapy. This review aimed to comprehensively review the role of imaging in relation to the current treatment strategy for pancreatic cancer, including surveillance, diagnosis, evaluation of resectability and treatment response, and prediction of prognosis.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.137-145
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• 2009

Purpose : To compare 12 and 32-element surface coil arrays for highly accelerated coronary magnetic resonance angiography (MRA) using parallel imaging. Materials and Methods : Steady state free precession coronary MRA was performed in 5 healthy volunteers at 1.5 T whole body MR scanner using both 12 and 32-element surface coil arrays. Left anterior descending and right coronary artery data sets were acquired for each volunteer. Data sets were sub-sampled for parallel imaging using reduction factors from 1 to 6. Mean geometry factor (g-factor), maximum g-factor, and artifact level were calculated for each of the two coil arrays. Results : Over all reduction factors, the mean and maximum g-factors and artifact level were significantly reduced using the 32-element array compared to the 12element array (P << 0.1). The mean g-factor was sensitive to the imaging orientations of coronary arteries while the maximum g-factor and artifact level were independent of orientation. Conclusion : The 32-element surface coil array significantly improves artifact and noise suppression for highly accelerated coronary MRA using parallel imaging. The increased acceleration factors made feasible with the 32-element array offer the potential to enhance spatial resolution or increase volumetric coverage for 3D coronary MRA.

• Journal of Veterinary Science
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• v.21 no.6
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• pp.84.1-84.11
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• 2020

Background: Gastroesophageal reflux (GER) has been reported to be a common finding in dogs under general anesthesia. Objectives: The aim of this retrospective study was to assess the esophageal and gastric contents in a population of dogs undergoing computed tomographic myelography (myeloCT) examination and to evaluate the factors influencing the presence of esophageal fluid (gastric content, duration of anesthesia, body position, and intrinsic factors). Methods: Esophageal and gastric contents of 83 non-brachycephalic dogs were retrospectively assessed based on plain and myelo-CT scans. Age, weight, breed, sex, and the time between the 2 computed tomography [CT] scans were included. Results: Esophageal fluid was present in 19% (16/83) of the animals, and 14% (12/83) and 46% (37/83), respectively, had fluid or food material in their stomachs. The frequency of observing esophageal fluid on myelo-CT scans was significantly increased compared with plain CT scans (p = 0.006). The presence of gastric fluid was significantly associated with an increased frequency of observing esophageal fluid compared to other gastric contents (p = 0.049; odds ratio, 3.1). The presence of esophageal fluid was not correlated with alimentary gastric contents (p = 0.17). Increased body weight and duration of anesthesia were significantly associated with an increased frequency of observing esophageal fluid (p = 0.022, p = 0.021). Conclusions: Unlike alimentary gastric contents, fluid gastric contents were correlated with the presence of esophageal fluid upon myelo-CT. The observation of fluid in the esophagus may be consistent with GER. This study provides data additional to pH monitoring studies of GER and may support previous studies recommending shorter pre-anesthetic fasting periods in dogs.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.512-527
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• 2018

This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.