• Korean Journal of Radiology
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• 제24권7호
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• pp.640-646
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• 2023

Objective: Prospective studies on postoperative residual breast tissue (RBT) after robotic-assisted nipple-sparing mastectomy (R-NSM) for breast cancer are limited. RBT presents an unknown risk of local recurrence or the development of new cancer after curative or risk-reducing mastectomies. This study investigated the technical feasibility of using magnetic resonance imaging (MRI) to evaluate RBT after R-NSM in women with breast cancer. Materials and Methods: In this prospective pilot study, 105 patients, who underwent R-NSM for breast cancer at Changhua Christian Hospital between March 2017 and May 2022, were subjected to postoperative breast MRI to evaluate the presence and location of RBT. The postoperative MRI scans of 43 patients (age, 47.8 ± 8.5 years), with existing preoperative MRI scans, were evaluated for the presence and location of RBT. In total, 54 R-NSM procedures were performed. In parallel, we reviewed the literature on RBT after nipple-sparing mastectomy, considering its prevalence. Results: RBT was detected in 7 (13.0%) of the 54 mastectomies (6 of the 48 therapeutic mastectomies and 1 of the 6 prophylactic mastectomies). The most common location for RBT was behind the nipple-areolar complex (5 of 7 [71.4%]). Another RBT was found in the upper inner quadrant (2 of 7 [28.6%]). Among the six patients who underwent RBT after therapeutic mastectomies, one patient developed a local recurrence of the skin flap. The other five patients with RBT after therapeutic mastectomies remained disease-free. Conclusion: R-NSM, a surgical innovation, does not seem to increase the prevalence of RBT, and breast MRI showed feasibility as a noninvasive imaging tool for evaluating the presence and location of RBT.

• Nuclear Engineering and Technology
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• 제55권1호
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• pp.222-228
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• 2023

This study aimed to analyze the applicability of the improved median filter in positron emission tomography (PET)/magnetic resonance (MR) fusion images based on parallel imaging using generalized autocalibrating partially parallel acquisition (GRAPPA). In this study, a PET/MR fusion imaging system based on a 3.0T magnetic field and ¹⁸F radioisotope were used. An improved median filter that can set a mask of the median value more efficiently than before was modeled and applied to the acquired image. As quantitative evaluation parameters of the noise level, the contrast to noise ratio (CNR) and coefficient of variation (COV) were calculated. Additionally, no-reference-based evaluation parameters were used to analyze the overall image quality. We confirmed that the CNR and COV values of the PET/MR fusion images to which the improved median filter was applied improved by approximately 3.32 and 2.19 times on average, respectively, compared to the noisy image. In addition, the no-reference-based evaluation results showed a similar trend for the noise-level results. In conclusion, we demonstrated that it can be supplemented by using an improved median filter, which suggests the problem of image quality degradation of PET/MR fusion images that shortens scan time using GRAPPA.

• Investigative Magnetic Resonance Imaging
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• 제24권3호
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• pp.95-122
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• 2020

In this article, we evaluated the performance of radiofrequency (RF) coils in terms of the signal-to-noise ratio (S/N) and homogeneity of magnetic resonance images when used for ultrahigh-frequency (UHF) 7T magnetic resonance imaging (MRI). High-quality MRI can be obtained when these two basic requirements are met. However, because of the dielectric effect, 7T magnetic resonance imaging still produces essentially a non-uniform magnetic flux (|B₁|) density distribution. In general, heterogeneous and homogeneous RF coils may be designed using electromagnetic (EM) modeling. Heterogeneous coils, which are surface coils, are used in consideration of scalability in the |B₁| region with a high S/N as multichannel loop coils rather than selecting a single loop. Loop coils are considered state of the art for their simplicity yet effective |B₁|-field distribution and intensity. In addition, combining multiple loop coils allows phase arrays (PA). PA coils have gained great interest for use in receiving signals because of parallel imaging (PI) techniques, such as sensitivity encoding (SENSE) and generalized autocalibrating partial parallel acquisition (GRAPPA), which drastically reduce the acquisition time. With the introduction of a parallel transmit coil (pTx) system, a form of transceiver loop arrays has also been proposed. In this article, we discussed the applications and proposed designs of loop coils. RF homogeneous coils for volume imaging include Alderman-Grant resonators, birdcage coils, saddle coils, traveling wave coils, transmission line arrays, composite right-/left-handed arrays, and fusion coils. In this article, we also discussed the basic operation, design, and applications of these coils.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.41-46
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• 2001

Objective : The exact position of the lesion during the pallidotomy is critical to obtain the clinical improvement of parkinson's disease without damage to surrounding structure. Ventriculogrphy, CT(computed tomograpy) or MRI(magnetic resonance imaging) have been used to determine the initial coordinates of stereotactic target for pallidotomy. The goal of this study was to determine whether microelectrode recording significantly improves the neurophysiologic localization of the target obtained from MRI. Methods : Twenty patients were studied. They underwent a unilateral pallidotomy. Leksell frame was applied and T1 axial images parallel to the AC-PC(anterior commissure-posterior commissure) plane using a 1.5 Tesla MRI with 3mm slice thickness were obtained. Anteroposterior coordinate of target was chosen at 2mm in front of the midcommissural point and lateral coordinate between 19 and 22mm from the midline. The vertical coordinate was calculated on coronal slice using a fast spin echo inversion recovery sequence(FSEIR) related to the position of the choroidal fissure and ranged over 4-5mm below the AC-PC plane. Confirmation of the anatomical target was done on axial slices using the same FSEIR sequence . Microrecording was done at the pallidum contralateral to the symptomatic side using an electrode with a tip diameter of $1{{\mu}m}$ diameter tip and 1.1-1.4 mOhm impedance at 1000Hz. Electrophysiologic localization of the target was also confirmed intraoperatively by macrostimulation. Results : Microrecording techniques were reliable to define the transition from the base of the pallidum which was characterized by the disappearance of spike activity and by the change of the audible background activity. Signals from high amplitude neurons firing at 200-400Hz were recorded in the pallidal base. X, Y and Z coordinates of target obtained from the MRI were within 1mm from the X, Y, Z coordinates obtained with microrecording in 16 patients (80%), 15 patients(75%), 10 patients(50%) respectively. The difference of Y coordinate between on MRI and on microrecording was 4mm in only one patient. Conclusion : The MRI was accurate to localize the target within 1mm of the error from microrecording target in 70% of the patients. 4mm discrepancy was observed only once. We conclude that MRI alone can be used to determine the target for pallidotomy in most patients. However, microrecording technique can still be extremely valuable in patents with aberrant anatomy or unusual MRI coordinates. We also consider physiologic confirmation of the target using macrostimulation to be mandatory in all cases.

• Investigative Magnetic Resonance Imaging
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• 제13권2호
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• pp.161-170
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• 2009

목적 : 평행영상(Parallel imaging)기법의 개발로 긴 촬영시간 때문에 종종 사용되지 못하던 삼차원 영상기법이 최근 들어 환자 병을 진단하는데 새로이 사용되고 있다. 이 연구의 목적은 최근에 뇌 영상에서 개발되어 이용되고 있는 삼차원 자기공명영상을 사람의 뇌에서 짧은 시간 내에 얻을 수 있도록 2차원 평행영상 기법을 사용한 최적화 방법을 연구하는데 있다. 대상 및 방법 : 검사 장비는 3.0T 자기공명영상장치를 이용하였으며 8-채널 SENSE(sensitivity encoding) 머리 코일을 이용하였다. 팬텀 및 3명의 사람 머리에서 영상을 얻었다. 세 가지의 삼차원 영상법인 3D T1WI, 3D T2WI 및 3D FLAIR 영상 방법에 대하여 평행인자(SENSE factor)의 변화에 따른 팬텀 영상을 얻었다. 각각의 영상법에서 영상획득에 적당한 SENSE 인자를 찾기 위해 Phase encoding 방향과 Slice encoding 방향을 조합한 SENSE 인자를 변화시키면서 영상을 얻었다. 영상분석을 위하여 특정영역(ROI)를 설정한 후에 신호대 잡음비 (Signal-to-noise ratio, SNR), 감소분율(Percent Signal Reduction Rate, %R), 대조도(contrast-to-noise ratio, CNR)를 계산하였다. 결과 : 팬텀을 이용한 SENSE 인자 변화에 따른 SNR 및 %R 값의 변화 결과 3D T1WI 방법에서 SENSE 인자를 사용한 것들 중에서 SENSE 인자를 총 3인 경우 약 0.2%의 신호 감소가 나타났고 영상시간은 5분 이내였다. 3D T2WI 방법의 경우 SENSE 인자를 사용한 것들 중에서 SENSE 인자를 총 3인 경우에 약 1.0% 신호 감소가 나타났고 영상 시간은 약 5분 이내였다. 3D FLAIR 방법의 경우 SENSE 인자를 사용한 것들 중에서 SENSE 인자를 4를 사용한 경우에 약 0.2% 신호 감소가 나타났고 영상시간은 약 6분이었다. 사람을 대상으로 할 경우 3D T1W 및 3D T2W영상에서 SNR 및 CNR은 SENSE 인자를 3으로 한 경우에서 SENSE 인자를 4로 한 경우 보다 높게 나타났다. 3D FALIR 영상의 경우 CNR은 SENSE 4에서는 SENSE 3에 비하여 낮았다. 결론 : 본 연구에서는 3가지 3차원 영상법을 실제 임상적용이 가능한 시간 영역에서 SENSE 인자를 변화 시키면서 치적의 영상을 얻도록 하는 연구를 실시한 결과 SNR 감소를 최소화 하면서 영상획득 시간을 약 5분에서 6분 정도 소요되는 2차원 SENSE 인자를 찾았다. 이를 뇌 영상에 적용하였을 경우 SENSE 인자를 적용하지 않은 경우와 비교하면 신호 감소는 최소화 하면서 영상의 질은 큰 영향을 주지 않은 것으로 나타났다. 3D T1W및 3D T2W는 SENSE 인자를 3으로 3D FLAIR인자는 SENSE 인자를 4로 하는 것이 환자를 대상으로 한 뇌 영상에 적합하다고 생각된다. 앞으로는 이들 영상법이 뇌 영상뿐만 아니라 다른 영역의 영상에 적용을 위한 최적화가 필요하다고 생각된다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권1호
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• pp.105-125
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• 2024

Gliomas are the most common malignant brain tumor and cause the most deaths. Manual brain tumor segmentation is expensive, time-consuming, error-prone, and dependent on the radiologist's expertise and experience. Manual brain tumor segmentation outcomes by different radiologists for the same patient may differ. Thus, more robust, and dependable methods are needed. Medical imaging researchers produced numerous semi-automatic and fully automatic brain tumor segmentation algorithms using ML pipelines and accurate (handcrafted feature-based, etc.) or data-driven strategies. Current methods use CNN or handmade features such symmetry analysis, alignment-based features analysis, or textural qualities. CNN approaches provide unsupervised features, while manual features model domain knowledge. Cascaded algorithms may outperform feature-based or data-driven like CNN methods. A revolutionary cascaded strategy is presented that intelligently supplies CNN with past information from handmade feature-based ML algorithms. Each patient receives manual ground truth and four MRI modalities (T1, T1c, T2, and FLAIR). Handcrafted characteristics and deep learning are used to segment brain tumors in a Global Convolutional Neural Network (GCNN). The proposed GCNN architecture with two parallel CNNs, CSPathways CNN (CSPCNN) and MRI Pathways CNN (MRIPCNN), segmented BraTS brain tumors with high accuracy. The proposed model achieved a Dice score of 87% higher than the state of the art. This research could improve brain tumor segmentation, helping clinicians diagnose and treat patients.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2002년도 제7차 학술대회 초록집
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• pp.76-76
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• 2002

Purpose： The purpose of this study is to optimize the configuration of body RF coil composed of 4 planar subcoils for low field open MRI. Method： Our low field RE coil is composed of 4 subcoils assumed to be located at both the bottom and top sides of permanent magnet. Each subcoils has 3 main strips. The coil system has mirror inversion symmetry. First, the currents on the strips are obtained by inductance calculation and circuit analysis, Second, all the strips are divided into line strip elements across the strips, the self Inductances of line strip elements and the mutual inductances among the line strip elements are calculated, and current distributions of strip are obtained by circuit analysis, where each strip is considered as parallel combination of line strip elements. Finally all the line strip elements are segmented, magnetic field has been calculated by pseudo electric dipole radiation method, where the current elements are regarded as pseudo electric dipole radiation sources. We have performed above procedures for various configurations of RE coil. The field homogeneity is calculated in the 25 cm DSV.

• Investigative Magnetic Resonance Imaging
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• 제14권1호
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• pp.56-63
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• 2010

목적 : 본 논문에서는 DIR 영상을 이용하여 두뇌의 피질두께측정 연구를 수행하는 한편 평행 영상기법 중 하나인 GRAPPA (generalized autocalibrating partially parallel acquisitions)를 이용하여 GRAPPA 인자 (reduction factor, R)가 2일 때와 평행 영상기법을 이용하지 않았을 때의 결과 비교를 통해 3D DIR 영상의 획득시간 단축 가능성을 제시하고자 한다. 대상 및 방법 : 3.0T 자기공명영상장치 (Siemens Tim Trio MRI scanner)의 3D DIR 펄스열을 이용하여 6명(남자 3명, 여자 3명, $25.33{\pm}2.25$살)의 정상인 뇌에 대한 3차원 영상을 얻었다. GRAPPA 시뮬레이션은 R=2 일 때를 가정하여 수행되었고 두뇌 피질두께측정을 위해 Analyze 9.0과 Freesurfer v.4.3.0 프로그램을 사용하였다. 결과로 얻은 데이터를 T-검증을 이용하여 비교분석 하였다. 결과 : GRAPPA 기법을 통하여 복원한 영상이 잡음이 증가하는 경향을 보였으나 두뇌 피질두께 측정에는 별다른 영향을 미치지 않았다. 통계분석을 통해 비교한 결과 대부분의 두뇌 영역에서 참조영상과 GRAPPA 기법을 이용한 영상의 차이가 유의하지 않았다. 결론 : 피질두께측정 연구에 있어서 3D DIR영상의 문제점 중 하나는 긴 영상획득시간이다. 따라서 평행영상 기법 중 하나인 GRAPPA 영상기법을 적용하면 피질두께측정 연구결과의 큰 차이없이 영상 획득 시간을 단축시킬 수 있다.

• 대한의용생체공학회:의공학회지
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• 제18권3호
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• pp.243-251
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• 1997

본 연구에서는 유체보상 경사자장 기법(flow-compensation-gradient of gradient-moment nulling method)을 이용하지 않은 Tailored RF를 이용한 TRFGE(tailored rf gradient echo) 영상에는 유체유입효과(in-flow effect)가 나타나지 않지만 절편(slice)내에서 판독경사자장(reading gradient)과 같은 방향으로 흐르는 유체는 신호가 강조가 됨을 이론과 실험으로 보였다. 절편 내에서 판독경사자장과 같은 방향으로 흐르는 유체의 신호가 TRFGE 영상에서 강조되는 이유를 이론적으로 설명하였으며 이 이론을 뒷받침 할 실험을 위해 유체 모형을 제작하였다. 원통 모양의 물 모형 중앙으로 유체 관을 통해 식염수(saline)가 주자장(B$B_0$)와 평행인 z 축 방향으로 흐를 수 있도록 하였다. 유체가 흐를 때와 흐르지 않을 때 CGE(conventional gradient echo) 영상과 TRFGE 영사을 얻어 각각 비교하였다. 유체 유입효과를 관찰하기 위해서는 횡단면(axial)의 영상을 얻었고 절편 내에서 판독경사자장과 같은 방향으로 흐르는 유체의 영상신호를 관찰하기 위해서 시상면(sagittal) 영상을 얻었다.

• Investigative Magnetic Resonance Imaging
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• 제19권2호
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• pp.76-87
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• 2015

Purpose: There is an ongoing search for a stent material that produces a reduced susceptibility artifact. This study evaluated the effect of manganese (Mn) content on the MRI susceptibility artifact of ferrous-manganese (Fe-Mn) alloys, and investigated the correlation between MRI findings and measurements of Fe-Mn microstructure on X-ray diffraction (XRD). Materials and Methods: Fe-Mn binary alloys were prepared with Mn contents varying from 10% to 35% by weight (i.e., 10%, 15%, 20%, 25%, 30%, and 35%; designated as Fe-10Mn, Fe-15Mn, Fe-20Mn, Fe-25Mn, Fe-30Mn, and Fe-35Mn, respectively), and their microstructure was evaluated using XRD. Three-dimensional spoiled gradient echo sequences of cylindrical specimens were obtained in parallel and perpendicular to the static magnetic field (B0). In addition, T1-weighted spin echo, T2-weighted fast spin echo, and $T2^*$weighted gradient echo images were obtained. The size of the low-intensity area on MRI was measured for each of the Fe-Mn binary alloys prepared. Results: Three phases of ${\alpha}^{\prime}$-martensite, ${\gamma}$-austenite, and ${\varepsilon}$-martensite were seen on XRD, and their composition changed from ${\alpha}^{\prime}$-martensite to ${\gamma}$-austenite and/or ${\varepsilon}$-martensite, with increasing Mn content. The Fe-10Mn and Fe-15Mn specimens comprised ${\alpha}^{\prime}$-martensite, the Fe-20Mn and Fe-25Mn specimens comprised ${\gamma}+{\varepsilon}$ phases, and the Fe-30Mn and Fe-35Mn specimens exhibited a single ${\gamma}$ phase. The size of the low-intensity areas of Fe-Mn on MRI decreased relative to its microstructure on XRD with increasing Mn content. Conclusion: Based on these findings, proper conditioning of the Mn content in Fe-Mn alloys will improve its visibility on MR angiography, and a Mn content of more than 25% is recommended to reduce the magnetic susceptibility artifacts on MRI. A reduced artifact of Fe-Mn alloys on MRI is closely related to the paramagnetic constitution of ${\gamma}$-austenite and/or ${\varepsilon}$-martensite.