{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:23:54Z","timestamp":1783686234814,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Although 3.0-Tesla (3.0 T) MRI is widely used and affects quantitative imaging, its impact on predicting outcomes for cardiac arrest survivors remains unexplored. This study investigated how magnetic field strength affects voxel-based apparent diffusion coefficient (ADC) analysis in resuscitated cardiac arrest patients. Methods: Using multicenter data from the Korean Hypothermia Network, ADC images were extracted from patients who underwent diffusion-weighted imaging. For each patient, the mean ADC and the percentage of voxels (PV) below specific thresholds were calculated. Receiver operating characteristic (ROC) analysis evaluated predictive performance for poor outcomes and established cut-off values. All parameters were compared between 1.5 T and 3.0 T MRI groups. Results: In the poor outcome group, mean ADC and PV indices showed no significant differences between the two magnetic strengths. However, in the good outcome group, the 3.0 T group exhibited significantly higher PV indices than the 1.5 T group. For predicting poor outcomes, 3.0 T MRI showed numerically higher area under the curve (AUC) values (0.877\u20130.895) than 1.5 T MRI (0.821\u20130.831). Cut-off values for predicting poor outcomes were also generally higher in the 3.0 T group. Conclusions: Magnetic field strength may affect quantitative ADC values and prognostic performance in cardiac arrest patients. Although AUCs were numerically higher at 3.0 T for all evaluated indices, this difference reached statistical significance only for PV500. Field strength should therefore be considered when establishing quantitative ADC thresholds.<\/jats:p>","DOI":"10.3390\/jcm15145411","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:43:34Z","timestamp":1783683814000},"page":"5411","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Magnetic Field Strength (1.5 T vs. 3.0 T) on the Prognostic Value of Quantitative ADC Indices in Patients After Out-of-Hospital Cardiac Arrest: A Prospective Multicenter Observational Study in Korea (The KORHN-PRO Registry)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4558-2596","authenticated-orcid":false,"given":"Jae Hun","family":"Oh","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3141-9413","authenticated-orcid":false,"given":"Soo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3385-573X","authenticated-orcid":false,"given":"Seung Pill","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1336-4498","authenticated-orcid":false,"given":"Se Won","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0503-1397","authenticated-orcid":false,"given":"In Soo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Hanil General Hospital, Seoul 01450, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-1086","authenticated-orcid":false,"given":"Yong Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 16419, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3478-6967","authenticated-orcid":false,"given":"Kyung Woon","family":"Jeung","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Donggu, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Korean Hypothermia Network Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s00134-021-06548-2","article-title":"Brain injury after cardiac arrest: Pathophysiology, treatment, and prognosis","volume":"47","author":"Sandroni","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S673","DOI":"10.1161\/CIR.0000000000001375","article-title":"Part 11: Post-Cardiac Arrest Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"152","author":"Hirsch","year":"2025","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1007\/s00134-025-08117-3","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: Post-resuscitation care","volume":"51","author":"Nolan","year":"2025","journal-title":"Intensive Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"R17","DOI":"10.1186\/cc8874","article-title":"Diffusion-weighted magnetic resonance imaging for predicting the clinical outcome of comatose survivors after cardiac arrest: A cohort study","volume":"14","author":"Choi","year":"2010","journal-title":"Crit. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e1684","DOI":"10.1212\/WNL.0000000000009289","article-title":"Prognostic value of diffusion-weighted MRI for post-cardiac arrest coma","volume":"94","author":"Hirsch","year":"2020","journal-title":"Neurology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s12028-015-0179-9","article-title":"Multi-Center Study of Diffusion-Weighted Imaging in Coma After Cardiac Arrest","volume":"24","author":"Hirsch","year":"2016","journal-title":"Neurocrit. Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.resuscitation.2018.02.020","article-title":"Quantitative analysis of relative volume of low apparent diffusion coefficient value can predict neurologic outcome after cardiac arrest","volume":"126","author":"Moon","year":"2018","journal-title":"Resuscitation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/ana.21632","article-title":"Prognostic value of brain diffusion-weighted imaging after cardiac arrest","volume":"65","author":"Wijman","year":"2009","journal-title":"Ann. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.ejrad.2007.11.006","article-title":"Clinical advantages of 3.0 T MRI over 1.5 T","volume":"65","author":"Willinek","year":"2008","journal-title":"Eur. J. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3905","DOI":"10.1002\/hbm.25473","article-title":"Comparison of structural MRI brain measures between 1.5 and 3 T: Data from the Lothian Birth Cohort 1936","volume":"42","author":"Buchanan","year":"2021","journal-title":"Hum. Brain Mapp."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.1111\/j.1552-6569.2009.00449.x","article-title":"Brain MRI lesion load at 1.5 T and 3 T versus clinical status in multiple sclerosis","volume":"21","author":"Stankiewicz","year":"2011","journal-title":"J. Neuroimaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e421","DOI":"10.5114\/pjr.2022.118685","article-title":"Diagnostic value of 3.0 T versus 1.5 T MRI in staging prostate cancer: Systematic review and meta-analysis","volume":"87","author":"Virarkar","year":"2022","journal-title":"Pol. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"250","DOI":"10.15441\/ceem.20.035","article-title":"Outcome and status of postcardiac arrest care in Korea: Results from the Korean Hypothermia Network prospective registry","volume":"7","author":"Kim","year":"2020","journal-title":"Clin. Exp. Emerg. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.resuscitation.2015.11.009","article-title":"The prognostic value of the grey-to-white matter ratio in cardiac arrest patients treated with extracorporeal membrane oxygenation","volume":"99","author":"Lee","year":"2016","journal-title":"Resuscitation"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Oh, J.H., Choi, S.P., Zhu, J.H., Kim, S.H., Park, K.N., Youn, C.S., Oh, S.H., Kim, H.J., and Park, S.H. (2021). Differences in the gray-to-white matter ratio according to different computed tomography scanners for outcome prediction in post-cardiac arrest patients receiving target temperature management. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0258480"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"9842732","DOI":"10.1155\/2020\/9842732","article-title":"Magnetic Resonance of Rectal Cancer Response to Therapy: An Image Quality Comparison between 3.0 and 1.5 Tesla","volume":"2020","author":"Caruso","year":"2020","journal-title":"BioMed Res. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1159\/000106983","article-title":"3-Tesla versus 1.5-Tesla magnetic resonance diffusion and perfusion imaging in hyperacute ischemic stroke","volume":"24","author":"Kosior","year":"2007","journal-title":"Cerebrovasc. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1212\/WNL.0b013e3181e396d1","article-title":"Diffusion-weighted MRI in acute stroke within the first 6 hours: 1.5 or 3.0 Tesla?","volume":"74","author":"Rosso","year":"2010","journal-title":"Neurology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1148\/radiol.2492071681","article-title":"Variability in absolute apparent diffusion coefficient values across different platforms may be substantial: A multivendor, multi-institutional comparison study","volume":"249","author":"Sasaki","year":"2008","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4514","DOI":"10.1007\/s00330-020-07522-0","article-title":"Repeatability and reproducibility of ADC measurements: A prospective multicenter whole-body-MRI study","volume":"31","author":"Michoux","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1002\/jmri.23825","article-title":"Multi-system repeatability and reproducibility of apparent diffusion coefficient measurement using an ice-water phantom","volume":"37","author":"Malyarenko","year":"2013","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1148\/radiology.217.2.r00nv24331","article-title":"Diffusion-weighted MR imaging of the brain","volume":"217","author":"Schaefer","year":"2000","journal-title":"Radiology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5411\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:07:41Z","timestamp":1783685261000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/14\/5411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":22,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15145411"],"URL":"https:\/\/doi.org\/10.3390\/jcm15145411","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]}}}