• Korean Journal of Digital Imaging in Medicine
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• v.14 no.2
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• pp.57-61
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• 2012

To compare the accuracy of breath-hold magnetic resonance imaging sequences to establish the most effective superparamagnetic iron oxide-enhanced sequence for detection of hepatic metastases. A total of 100 patients(50men and 50women, mean age: 60years) with liver disease(including malignant and benign liver lesions) were investigated at 3.0T machine (GE, General Electric Medical System, Excite HD) with 8Ch body coil. Pulse sequence for MR imaging decided to the FS-T2-FSE-RT(TR/TE/Thick./Freq./Phase=12857ms/100ms/7mm/512/384), MGRE(TR/TE/Thick./Freq./Phase=100ms/9.7ms/7mm/384/288), in-out of phase echo(TR/$TE_1$, $TE_2$/Thick./Freq./Phase=140ms/2.4, 5.8ms/7mm/352/300), Images obtained before the injection of SPIO. Six sequences were optimized for lesion detection: FS-T2-FSE-RT, multigradient recalled echo data image(MGRE), T2-weighted MGRE with an 9.7msec echo time. Images were reviewed independently by five blinded observers. The accuracy of each sequence was measured by using picture archiving communication system analysis. All results were correlated with findings at multidectator computed tomography examination. Differences between the mean results of the six observers were measured by using paired student t-test analysis. Postcontrast T2-weighted MGRE sequences were the most accurate and were significantly superior to postcontrast FS-T2-FSE-RT, T2-weighted MGRE, in-out of phase MR sequences(p < .05). For all lesions that were malignant or smaller than 1 cm, respectively, contrast to noise ratio of pre and postcontrast sequences were -1and -0.3 for T2-weighted FSE, 0.53 and 4.5 in-out of phase, 7, 7.08, 5.08, 3.32, 1.7, 1.16, 0.79, 0.68 for GRE with 2.9, 7.5, 12.1, 16.6, 21.2, 25.8, 30.4, 35.0 TE values. Breath-hold various TE precontrast sequences offer improvement in sensitivity compared with fixed multigradient recalled echo sequences alone.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.22-31
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• 2011

Purpose : To compare free-breathing and respiratory-triggered diffusion-weighted imaging on 1.5-T MR system in the detection of hepatic lesions. Materials and Methods: This single-institution study was approved by our institutional review board. Forty-seven patients (mean 57.9 year; M:F = 25:22) underwent hepatic MR imaging on 1.5-T MR system using both free-breathing and respiratory-triggered diffusion-weighted imaging (DWI) at a single examination. Two radiologists retrospectively reviewed respiratory-triggered and free-breathing sets (B50, B400, B800 diffusion weighted images and ADC map) in random order with a time interval of 2 weeks. Liver SNR and lesion-to-liver CNR of DWI were calculated measuring ROI. Results : Total of 62 lesions (53 benign, 9 malignant) that included 32 cysts, 13 hemangiomas, 7 hepatocellular carcinomas (HCCs), 5 eosinophilic infiltration, 2 metastases, 1 eosinophilic abscess, focal nodular hyperplasia, and pseudolipoma of Glisson's capsule were reviewed by two reviewers. Though not reaching statistical significance, the overall lesion sensitivities were increased in respiratory-triggered DWI [reviewer1: reviewer2, 47/62(75.81%):45/62(72.58%)] than free-breathing DWI [44/62(70.97%):41/62(66.13%)]. Especially for smaller than 1 cm hepatic lesions, sensitivity of respiratory-triggered DWI [24/30(80%):21/30(70%)] was superior to free-breathing DWI [17/30(56.7%):15/30(50%)]. The diagnostic accuracy measuring the area under the ROC curve (Az value) of free-breathing and respiratory-triggered DWI was not statistically different. Liver SNR and lesion-to-liver CNR of respiratory-triggered DWI ($87.6{\pm}41.4$, $41.2{\pm}62.5$) were higher than free-breathing DWI ($38.8:{\pm}13.6$, $24.8{\pm}36.8$) (p value < 0.001, respectively). Conclusion: Respiratory-triggered diffusion-weighted MR imaging seemed to be better than free-breathing diffusion-weighted MR imaging on 1.5-T MR system for the detection of smaller than 1 cm lesions by providing high SNR and CNR.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.912-921
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• 2021

Objective: To compare the performance of the deep learning-based lesion detection algorithm (DLLD) in detecting liver metastasis with that of radiologists. Materials and Methods: This clinical retrospective study used 4386-slice computed tomography (CT) images and labels from a training cohort (502 patients with colorectal cancer [CRC] from November 2005 to December 2010) to train the DLLD for detecting liver metastasis, and used CT images of a validation cohort (40 patients with 99 liver metastatic lesions and 45 patients without liver metastasis from January 2011 to December 2011) for comparing the performance of the DLLD with that of readers (three abdominal radiologists and three radiology residents). For per-lesion binary classification, the sensitivity and false positives per patient were measured. Results: A total of 85 patients with CRC were included in the validation cohort. In the comparison based on per-lesion binary classification, the sensitivity of DLLD (81.82%, [81/99]) was comparable to that of abdominal radiologists (80.81%, p = 0.80) and radiology residents (79.46%, p = 0.57). However, the false positives per patient with DLLD (1.330) was higher than that of abdominal radiologists (0.357, p < 0.001) and radiology residents (0.667, p < 0.001). Conclusion: DLLD showed a sensitivity comparable to that of radiologists when detecting liver metastasis in patients initially diagnosed with CRC. However, the false positives of DLLD were higher than those of radiologists. Therefore, DLLD could serve as an assistant tool for detecting liver metastasis instead of a standalone diagnostic tool.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1998.05a
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• pp.1-4
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• 1998

Impaired insulin action in Type 2 diabetes is thought to lead to hyperglycemia, with both environmental and complex genetic factors playing key roles. Although the primary lesion in Type 2 diabetes is unknown, a number of studies suggest that metabolic defects in the liver, skeletal muscle and fat, and pancreatic ${\beta}$-cells contribute to the disease. These metabolic abnormalities are characterized by the overproduction of hepatic glucose, impaired insulin secretion, and peripheral insulin resistance. In current pharmacological treatment of Type 2 diabetes, sulfonylurea (SU) drugs have mainly been used as oral hypoglycemic drugs to stimulate endogenous insulin secretion from ${\beta}$ cells. SU drugs, however, sometimes aggravate the disease by causing fatigue of the pancreatic ${\beta}$ cells, which leads to reduced drug efficacy after long-term treatment. This class of drugs also leads to enhanced obesity arising from the stimulation of endogenous insulin secretion in obese Type 2 diabetic patients, plus an increased incidence of SU-induced hypoglycemia. Since 1980, a major challenge has been made by us to develop a potential pharmacological therapy for the treatment of insulin resistance in peripheral tissues and/or suppression of abnormal hepatic glucose production in Type 2 diabetic patients. Such a drug would be expected to have fewer side effects and retain long-term efficacy.

• Journal of Food Hygiene and Safety
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• v.14 no.1
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• pp.60-66
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• 1999

Diethylnitrosamine (DEN) is known as a potential hepatic carcinogen by single administration. This study was designed to measure the effects of DEN-induced cell damage on the triglyceride and cholesterol concentration in the liver, excluding dietary effects. Fertilized chicken eggs, 10 days before hatching, were randomly divided into three groups (n=20) and each egg was injected 10 ${mu}ell$ of corn oil (vehicle control), 5 $\mu\textrm{g}$ of DEN/10 ${mu}ell$ of DEN/10 ${mu}ell$ into yolk via air sac. After 48 hr and 96 hr incubation, the damage of the chick-embryo liver cell was investigated by electron microscopy and by measuring the concentration of lipid components (total cholesterol, free cholesterol, phospholipid and triglyceride). For eggs administered 10 $\mu\textrm{g}$ of DEN and incuvated 96 hr, in hepatocyte, the nucleus membrane was roughed, the size of nucleolus was apparently increased and euchromatin was accumulated. Mitochondria were condensed and cristae, located mitochondiral inner membrane, were obscured. Additionally, the leaves of triglyceride and cholesterol classes were significantly increased depend on the amount treated with 10 $\mu\textrm{g}$ DEN at 96 hr, but phospholipids component of cell membrane, were decreased with significance. As a conclusion, carcinogen induced hepatic lesion was correlated with the changes in lipid component of liver.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.186-191
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• 2005

A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.213-217
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• 2009

Solitary necrotic nodule (SNN) of the liver is a very uncommon benign lesion, and it is detected incidentally as a rule. It is important to differentiate SNN radiologically from various single hepatic nodules because SNN mimics hepatic metastasis, especially in staging work up of known primary malignancy. The reported imaging findings of SNN are well-defined nodule without enhancement or with subtle peripheral enhancement. There has been no report about the target-like SNN of the liver and about the imaging finding of 3T magnetic resonance imaging and positron emission tomography. We report a case of targetlike SNN of the liver, mimicking hepatic metastasis, with findings of various imaging modalities and try to find a cause of this nodule according to the pathologic and literature review.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.12-18
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• 2003

The purpose of this study is to evaluate children who underwent hepatic resection for primary malignant hepatic tumor in the period from January 1994 to December 2001. A total of 8 patients, seven with hepatoblastoma (HB) and one with hepatocellular carcinoma (HCC), were studied. One HCC was resectable at the initial diagnosis, but five cases of unresectable HB received two cycles of transarterial chemoembolization (TACE) before operation. One patient with an unresectable HB with bone marrow metastasis was operated after one cycle of TACE and one cycle of systemic chemotherapy based on CCG-823F protocol. Another unresectable HB patient received systemic chemotherapy instead of TACE before operation. Postoperative chemotherapy was administered to all of the patients after complete surgical resection on CCG-823F protocol. All 6 patients who underwent TACE and neoadjuvant chemotherapy showed marked reduction in tumor volume and a clear outline of the lesion. Major complication was not noticed. Mean alpha-fetoprotein (${\alpha}$-FP) level at diagnosis, after neoadjuvant chemotherapy and after postoperative chemotherapy was 9,818 (42-35,350), 664, and 10.1 ng/mL, respectively. Half life of the ${\alpha}$-FP after complete resection was 5.1 days (3.0-8.7 days). Median follow up period was 57.1 months (10-97 months) and all the patients are alive with NED. In conclusion, preoperative chemotherapy, especially TACE, is effective, safe, and useful to treat initially unresectable hepatoblastoma, and serial level of the serum ${\alpha}$-FP is a useful tumor marker for diagnosis and monitoring therapeutic responses.

• Journal of the Korean Society of Food Science and Nutrition
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• v.28 no.3
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• pp.638-645
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• 1999

This study was done to investigate effects of ${\gamma}$ irradiated beef feeding on the formation of gluta thione S transferase placental form positive(GST P+) foci, lipid peroxidation, cytochrome P450 system and microsomal glucose 6 phosphate activity in diethylnitrosamine(DEN) initiated rat hepatocarci nogenesis. Weaning Sprague Dawley male rats were fed the diet containing ${\gamma}$ irradiatied ground beef at the dose of 0, 3, 5kGy as a 20% of protein source for 8 weeks. One week after feeding, rats were intraperitoneally injected twice with a dose of DEN(50mg/kg BW). As a promoter, 0.05% phenobarbital was fed in drinking water from one week after DEN treatment until the end of experiment. At the end of 8th week, rats were sacrificed and hepatic GST P+ foci, microsomal malondialdehyde(MDA) and conjugated diene contents were determined. In addition, cytochrome P450 content and the activities of NADPH cytochrome P450 reductase and glucose 6 phosphatase were also measured. There was no significant effect by gamma irradiation on microsomal MDA content, conjugated diene, cytochrome P450 content and activities of NADPH cytochrome P450 reductase and glucose 6 phosphatase. However with DEN treatment, microsomal MDA content and conjugated diene contents were significantly changed. Cytochrome P450 content was also significantly increased while microsomal glucose 6 phophatase activity was significantly decreased with DEN treatment. However activity of NADPH cytochrome P450 reductase was not affected. An interesting finding in this study was that the number and area of hepatic GST P+ foci of the rats fed gamma irradiated beef were significantly(p<0.05) lower than those of the control. Such a lowering effect on GST P+ foci formation was highest at the dose of 3kGy than others. Overall results suggest that the consumption of low dose of gamma irradiated beef does not affect the formation of lipid peroxide, cytochrome P450 system and membrane stability.

• Journal of Yeungnam Medical Science
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• v.12 no.2
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• pp.400-404
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• 1995

Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonography and hyperdense mass lesion on early-phase IV bolus CT and isodense mass lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.