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Sample records for perfusion weighted mri

  1. Benefits of dynamic susceptibility-weighted contrast-enhanced perfusion MRI for glioma diagnosis and therapy

    PubMed Central

    Barajas, Ramon Francisco; Cha, Soonmee

    2014-01-01

    SUMMARY Glioma are the most common supra-tentorial brain tumor in the USA with an estimated annual incidence of 17,000 new cases per year. Dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MRI noninvasively characterizes tumor biology allowing for the diagnosis and therapeutic monitoring of glioma. This MRI technique utilizes the rapid changes in signal intensity caused by a rapid intravascular bolus of paramagnetic contrast agent to calculate physiologic perfusion metrics. DSC perfusion MRI has increasingly become an integrated part of glioma imaging. The specific aim of this article is to review the benefits of DSC perfusion MRI in the therapy of glioma. PMID:25438812

  2. Perfusion-weighted MRI to evaluate cerebral autoregulation in aneurysmal subarachnoid haemorrhage.

    PubMed

    Hattingen, Elke; Blasel, Stella; Dettmann, Edgar; Vatter, Hartmut; Pilatus, Ulrich; Seifert, Volker; Zanella, Friedhelm E; Weidauer, Stefan

    2008-11-01

    The aim of this study was to evaluate autoregulatory mechanisms in different vascular territories within the first week after aneurysmal subarachnoid haemorrhage (SAH) by perfusion-weighted magnetic resonance imaging (PW-MRI). For this purpose, regional cerebral blood flow and volume (rCVF and rCBV) were measured in relation to different degrees of angiographically visible cerebral vasospasm (CVS). In 51 SAH patients, PW-MRI and digital subtraction angiography were performed about 5 days after onset of SAH. Regional CBF and rCBV were analysed in the territories of the anterior cerebral artery (ACA), the middle cerebral artery (MCA) and the basal ganglia of each hemisphere in relationship to the degree of CVS in the particular territory. Correlations between rCBF, rCBV and CVS were analysed. CVS was found in 22 out of 51 patients in at least one territory. In all territories, rCBV decreased with increasing degree of CVS, correlated with a decrease of rCBF. In the ACA territories, SAH patients with severe CVS had significantly lower rCBF compared to healthy subjects and to SAH patients without CVS. In the basal ganglia, rCBF and rCBV of the control group were significantly higher compared to the patients without and with moderate vasospasms. PW-MRI showed simultaneous decrease of rCBF and rCBV in patients with SAH. The fact that rCBV did not increase in territories with CVS to maintain rCBF reveals dysfunctional vascular autoregulation. Vasospasms in the microvasculature are most evident in the basal ganglia, showing decreased rCBV and rCBF even in SAH patients without CVS.

  3. Lung ventilation- and perfusion-weighted Fourier decomposition magnetic resonance imaging: in vivo validation with hyperpolarized 3He and dynamic contrast-enhanced MRI.

    PubMed

    Bauman, Grzegorz; Scholz, Alexander; Rivoire, Julien; Terekhov, Maxim; Friedrich, Janet; de Oliveira, Andre; Semmler, Wolfhard; Schreiber, Laura Maria; Puderbach, Michael

    2013-01-01

    The purpose of this work was to validate ventilation-weighted (VW) and perfusion-weighted (QW) Fourier decomposition (FD) magnetic resonance imaging (MRI) with hyperpolarized (3)He MRI and dynamic contrast-enhanced perfusion (DCE) MRI in a controlled animal experiment. Three healthy pigs were studied on 1.5-T MR scanner. For FD MRI, the VW and QW images were obtained by postprocessing of time-resolved lung image sets. DCE acquisitions were performed immediately after contrast agent injection. (3)He MRI data were acquired following the administration of hyperpolarized helium and nitrogen mixture. After baseline MR scans, pulmonary embolism was artificially produced. FD MRI and DCE MRI perfusion measurements were repeated. Subsequently, atelectasis and air trapping were induced, which followed with FD MRI and (3)He MRI ventilation measurements. Distributions of signal intensities in healthy and pathologic lung tissue were compared by statistical analysis. Images acquired using FD, (3)He, and DCE MRI in all animals before the interventional procedure showed homogeneous ventilation and perfusion. Functional defects were detected by all MRI techniques at identical anatomical locations. Signal intensity in VW and QW images was significantly lower in pathological than in healthy lung parenchyma. The study has shown usefulness of FD MRI as an alternative, noninvasive, and easily implementable technique for the assessment of acute changes in lung function. Copyright © 2012 Wiley Periodicals, Inc.

  4. Automated analysis of perfusion weighted MRI using asymmetry in vascular territories

    PubMed Central

    Chatterjee, Neil R.; Ansari, Sameer A; Vakil, Parmede; Prabhakaran, Shyam; Carroll, Timothy J; Hurley, Michael C

    2015-01-01

    Purpose To determine the feasibility of automatic vascular territory region of interest (ROI) construction as a method for standardized quantification of cerebral blood flow (CBF) images. Materials and Methods An algorithm for automatic construction of vascular territory ROIs was performed on 10 healthy controls and 25 patients with perfusion abnormalities identified by retrospective chart review. The ROIs were used to quantify perfusion asymmetry for each territory, and perfusion asymmetry was compared in the two cohorts and against blinded neuroradiologist interpretation. The algorithm was additionally applied to a separate cohort of 23 prospectively enrolled patients and perfusion asymmetry was correlated against clinical variables. Results There was significantly greater perfusion asymmetry in territories graded by neuroradiologists as hypoperfused compared to those graded as normally perfused (p<.05) and compared to healthy volunteers (p<.01). An ROC analysis showed that perfusion asymmetry was sensitive and specific for identifying hypoperfusion in vascular territories (84.9% sensitivity and 90.5% specificity for a threshold asymmetry index of .829). In the prospective cohort, perfusion asymmetry was correlated with initial NIH stroke scale (NIHSS) (p<.01) and length of stay (p<.05). Conclusions Automatic construction of vascular territory ROIs and calculation of perfusion asymmetry is a feasible method for analyzing CBF images. Because the technique is rapid and minimizes bias, it can facilitate analysis of larger scale research studies. PMID:25601529

  5. Brain capillary transit time heterogeneity in healthy volunteers measured by dynamic contrast-enhanced T1 -weighted perfusion MRI.

    PubMed

    Larsson, Henrik B W; Vestergaard, Mark B; Lindberg, Ulrich; Iversen, Helle K; Cramer, Stig P

    2017-06-01

    Capillary transit time heterogeneity, measured as CTH, may set the upper limit for extraction of substances in brain tissue, e.g., oxygen. The purpose of this study was to investigate the feasibility of dynamic contrast-enhanced T1 weighted MRI (DCE-MRI) at 3 Tesla (T), in estimating CTH based on a gamma-variate model of the capillary transit time distribution. In addition, we wanted to investigate if a subtle increase of the blood-brain barrier permeability can be incorporated into the model, still allowing estimation of CTH. Twenty-three healthy subjects were scanned at 3.0T MRI system applying DCE-MRI and using a gamma-variate model to estimate CTH as well as cerebral blood flow (CBF), cerebral blood volume (CBV), and permeability of the blood-brain barrier, measured as the influx constant Ki . For proof of principle we also investigated three patients with recent thromboembolic events and a patient with a high grade brain tumor. In the healthy subjects, we found a narrow symmetric delta-like capillary transit time distribution in basal ganglia gray matter with median CTH of 0.93 s and interquartile range of 1.33 s. The corresponding residue impulse response function was compatible with the adiabatic tissue homogeneity model. In two patients with complete occlusion of the internal carotid artery and in the patient with a brain tumor CTH was increased with values up to 6 s in the affected brain tissue, with an exponential like residue impulse response function. Our results open the possibility of characterizing brain perfusion by the capillary transit time distribution using DCE-MRI, theoretically a determinant of efficient blood to brain transport of important substances. 2 J. MAGN. RESON. IMAGING 2017;45:1809-1820. © 2016 International Society for Magnetic Resonance in Medicine.

  6. WE-G-18C-09: Separating Perfusion and Diffusion Components From Diffusion Weighted MRI of Rectum Tumors Based On Intravoxel Incoherent Motion (IVIM) Analysis

    SciTech Connect

    Tyagi, N; Wengler, K; Mazaheri, Y; Hunt, M; Deasy, J; Gollub, M

    2014-06-15

    Purpose: Pseudodiffusion arises from the microcirculation of blood in the randomly oriented capillary network and contributes to the signal decay acquired using a multi-b value diffusion weighted (DW)-MRI sequence. This effect is more significant at low b-values and should be properly accounted for in apparent diffusion coefficient (ADC) calculations. The purpose of this study was to separate perfusion and diffusion component based on a biexponential and a segmented monoexponential model using IVIM analysis Methods. The signal attenuation is modeled as S(b) = S0[(1−f)exp(−bD) + fexp(−bD*)]. Fitting the biexponetial decay leads to the quantification of D, the true diffusion coefficient, D*, the pseudodiffusion coefficient, and f, the perfusion fraction. A nonlinear least squares fit and two segmented monoexponential models were used to derive the values for D, D*,‘and f. In the segmented approach b = 200 s/mm{sup 2} was used as the cut-off value for calculation of D. DW-MRI's of a rectum cancer patient were acquired before chemotherapy, before radiation therapy (RT), and 4 weeks into RT and were investigated as an example case. Results: Mean ADC for the tumor drawn on the DWI cases was 0.93, 1.0 and 1.13 10{sup −3}×mm{sup 2}/s before chemotherapy, before RT and 4 weeks into RT. The mean (D.10{sup −3} × mm{sup 2}/s, D* 10{sup −3} × mm{sup 2}/s, and f %) based on biexponential fit was (0.67, 18.6, and 27.2%), (0.72, 17.7, and 28.9%) and (0.83,15.1, and 30.7%) at these time points. The mean (D, D* f) based on segmented fit was (0.72, 10.5, and 12.1%), (0.72, 8.2, and 17.4%) and (.82, 8.1, 16.5%) Conclusion: ADC values are typically higher than true diffusion coefficients. For tumors with significant perfusion effect, ADC should be analyzed at higher b-values or separated from the perfusion component. Biexponential fit overestimates the perfusion fraction because of increased sensitivity to noise at low b-values.

  7. Detection of Local Tumor Recurrence After Definitive Treatment of Head and Neck Squamous Cell Carcinoma: Histogram Analysis of Dynamic Contrast-Enhanced T1-Weighted Perfusion MRI.

    PubMed

    Choi, Sang Hyun; Lee, Jeong Hyun; Choi, Young Jun; Park, Ji Eun; Sung, Yu Sub; Kim, Namkug; Baek, Jung Hwan

    2017-01-01

    This study aimed to explore the added value of histogram analysis of the ratio of initial to final 90-second time-signal intensity AUC (AUCR) for differentiating local tumor recurrence from contrast-enhancing scar on follow-up dynamic contrast-enhanced T1-weighted perfusion MRI of patients treated for head and neck squamous cell carcinoma (HNSCC). AUCR histogram parameters were assessed among tumor recurrence (n = 19) and contrast-enhancing scar (n = 27) at primary sites and compared using the t test. ROC analysis was used to determine the best differentiating parameters. The added value of AUCR histogram parameters was assessed when they were added to inconclusive conventional MRI results. Histogram analysis showed statistically significant differences in the 50th, 75th, and 90th percentiles of the AUCR values between the two groups (p < 0.05). The 90th percentile of the AUCR values (AUCR90) was the best predictor of local tumor recurrence (AUC, 0.77; 95% CI, 0.64-0.91) with an estimated cutoff of 1.02. AUCR90 increased sensitivity by 11.7% over that of conventional MRI alone when added to inconclusive results. Histogram analysis of AUCR can improve the diagnostic yield for local tumor recurrence during surveillance after treatment for HNSCC.

  8. Perfusion MRI: The Five Most Frequently Asked Clinical Questions

    PubMed Central

    Essig, Marco; Nguyen, Thanh Binh; Shiroishi, Mark S.; Saake, Marc; Provenzale, James M.; Enterline, David S.; Anzalone, Nicoletta; Dörfler, Arnd; Rovira, Àlex; Wintermark, Max; Law, Meng

    2013-01-01

    OBJECTIVE This article addresses questions that radiologists frequently ask when planning, performing, processing, and interpreting MRI perfusion studies in CNS imaging. CONCLUSION Perfusion MRI is a promising tool in assessing stroke, brain tumors, and neurodegenerative diseases. Most of the impediments that have limited the use of perfusion MRI can be overcome to allow integration of these methods into modern neuroimaging protocols. PMID:23971482

  9. Perfusion-weighted MR imaging in persistent hemiplegic migraine.

    PubMed

    Mourand, Isabelle; Menjot de Champfleur, Nicolas; Carra-Dallière, Clarisse; Le Bars, Emmanuelle; Roubertie, Agathe; Bonafé, Alain; Thouvenot, Eric

    2012-03-01

    Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks. Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated. Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI. PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis.

  10. Leakage decrease detected by dynamic susceptibility-weighted contrast-enhanced perfusion MRI predicts survival in recurrent glioblastoma treated with bevacizumab.

    PubMed

    Hilario, A; Sepulveda, J M; Hernandez-Lain, A; Salvador, E; Koren, L; Manneh, R; Ruano, Y; Perez-Nuñez, A; Lagares, A; Ramos, A

    2017-01-01

    In glioblastoma, tumor progression appears to be triggered by expression of VEGF, a regulator of blood vessel permeability. Bevacizumab is a monoclonal antibody that inhibits angiogenesis by clearing circulating VEGF, resulting in a decline in the contrast-enhancing tumor, which does not always correlate with treatment response. Our objectives were: (1) to evaluate whether changes in DSC perfusion MRI-derived leakage could predict survival in recurrent glioblastoma, and (2) to estimate whether leakage at baseline was related to treatment outcome. We retrospectively analyzed DSC perfusion MRI in 24 recurrent glioblastomas treated with bevacizumab as second line chemotherapy. Leakage at baseline and changes in maximum leakage between baseline and the first follow-up after treatment were selected for quantitative analysis. Survival univariate analysis was made constructing survival curves using Kaplan-Meier method and comparing subgroups by log rank probability test. Leakage reduction at 8 weeks after initiation of bevacizumab treatment had a significant influence on overall survival (OS) and progression-free survival (PFS). Median OS and PFS were 2.4 and 2.8 months longer for patients with leakage reduction at the first follow-up. Higher leakage at baseline was associated with leakage reduction after treatment. Odds ratio of treatment response was 9 for patients with maximum leakage at baseline >5. Leakage decrease may predict OS and PFS in recurrent glioblastomas treated with bevacizumab. Leakage reduction postulates as a potential biomarker for treatment response evaluation. Leakage at baseline seems to predict response to treatment, but was not independently associated with survival.

  11. Quantitative pixelwise myocardial perfusion maps from first-pass perfusion MRI.

    PubMed

    Weng, A M; Ritter, C O; Beer, M; Hahn, D; Köstler, H

    2014-07-01

    To calculate and evaluate absolute quantitative myocardial perfusion maps from rest first-pass perfusion MRI. 10 patients after revascularization of myocardial infarction underwent cardiac rest first-pass perfusion MRI. Additionally, perfusion examinations were performed in 12 healthy volunteers. Quantitative myocardial perfusion maps were calculated by using a deconvolution technique, and results were compared were the findings of a sector-based quantification. Maps were typically calculated within 3 min per slice. For the volunteers, myocardial blood flow values of the maps were 0.51 ± 0.16 ml g(-1) per minute, whereas sector-based evaluation delivered 0.52 ± 0.15 ml g(-1) per minute. A t-test revealed no statistical difference between the two sets of values. For the patients, all perfusion defects visually detected in the dynamic perfusion series could be correctly reproduced in the maps. Calculation of quantitative perfusion maps from myocardial perfusion MRI examinations is feasible. The absolute quantitative maps provide additional information on the transmurality of perfusion defects compared with the visual evaluation of the perfusion series and offer a convenient way to present perfusion MRI findings. Voxelwise analysis of myocardial perfusion helps clinicians to assess the degree of tissue damage, and the resulting maps are a good tool to present findings to patients.

  12. Perfusion MRI: The Five Most Frequently Asked Technical Questions

    PubMed Central

    Essig, Marco; Shiroishi, Mark S.; Nguyen, Thanh Binh; Saake, Marc; Provenzale, James M.; Enterline, David; Anzalone, Nicoletta; Dörfler, Arnd; Rovira, Àlex; Wintermark, Max; Law, Meng

    2013-01-01

    OBJECTIVE This and its companion article address the 10 most frequently asked questions that radiologists face when planning, performing, processing, and interpreting different MR perfusion studies in CNS imaging. CONCLUSION Perfusion MRI is a promising tool in assessing stroke, brain tumors, and patients with neurodegenerative diseases. Most of the impediments that have limited the use of perfusion MRI can be overcome to allow integration of these methods into modern neuroimaging protocols. PMID:23255738

  13. The Effects of Propofol on Cerebral Perfusion MRI in Children

    PubMed Central

    Harreld, Julie H.; Helton, Kathleen J.; Kaddoum, Roland N.; Reddick, Wilburn E.; Li, Yimei; Glass, John O.; Sansgiri, Rakhee; Ji, Qing; Feng, Tianshu; Parish, Mary Edna; Gajjar, Amar; Patay, Zoltan

    2013-01-01

    Introduction The effects of anesthesia are infrequently considered when interpreting pediatric perfusion MRI. The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors. Methods Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.8–18 years) treated for infratentorial brain tumors receiving propofol (IV, n=19) or no sedation (NS, n=18) were compared between groups and correlated with age, hematocrit, end-tidal CO2 (ETCO2), dose, weight, and history of radiation therapy (RT). The model most predictive of CBF and CBV was identified by multiple linear regression. Results Anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory CBF were significantly lower, and MCA territory CBV greater (p=0.03), in IV than NS patients (p=0.01, 0.04). The usual trend of decreasing CBF with age was reversed with propofol in ACA and MCA territories (r=0.53, r=0.47; p<0.05). ACA and MCA CBF (r=0.59, 0.49; p<0.05) and CBV in ACA, MCA and posterior cerebral artery (PCA) territories (r=0.73, 0.80, 0.52; p<0.05) increased with weight in propofol-sedated children, with no significant additional influence from age, ETCO2, hematocrit, or RT. Conclusion In propofol-sedated children, usual age-related decreases in CBF were reversed, and increases in CBF and CBV were weight-dependent, not previously described. Weight-dependent increases in propofol clearance may diminish suppression of CBF and CBV. Prospective study is required to establish anesthetic-specific models of CBF and CBV in children. PMID:23673874

  14. Comparison of (18)F-FET PET and perfusion-weighted MRI for glioma grading: a hybrid PET/MR study.

    PubMed

    Verger, Antoine; Filss, Christian P; Lohmann, Philipp; Stoffels, Gabriele; Sabel, Michael; Wittsack, Hans J; Kops, Elena Rota; Galldiks, Norbert; Fink, Gereon R; Shah, Nadim J; Langen, Karl-Josef

    2017-08-22

    Both perfusion-weighted MR imaging (PWI) and O-(2-(18)F-fluoroethyl)-L-tyrosine PET ((18)F-FET) provide grading information in cerebral gliomas. The aim of this study was to compare the diagnostic value of (18)F-FET PET and PWI for tumor grading in a series of patients with newly diagnosed, untreated gliomas using an integrated PET/MR scanner. Seventy-two patients with untreated gliomas [22 low-grade gliomas (LGG), and 50 high-grade gliomas (HGG)] were investigated with (18)F-FET PET and PWI using a hybrid PET/MR scanner. After visual inspection of PET and PWI maps (rCBV, rCBF, MTT), volumes of interest (VOIs) with a diameter of 16 mm were centered upon the maximum of abnormality in the tumor area in each modality and the contralateral unaffected hemisphere. Mean and maximum tumor-to-brain ratios (TBRmean, TBRmax) were calculated. In addition, Time-to-Peak (TTP) and slopes of time-activity curves were calculated for (18)F-FET PET. Diagnostic accuracies of (18)F-FET PET and PWI for differentiating low-grade glioma (LGG) from high-grade glioma (HGG) were evaluated by receiver operating characteristic analyses (area under the curve; AUC). The diagnostic accuracy of (18)F-FET PET and PWI to discriminate LGG from HGG was similar with highest AUC values for TBRmean and TBRmax of (18)F-FET PET uptake (0.80, 0.83) and for TBRmean and TBRmax of rCBV (0.80, 0.81). In case of increased signal in the tumor area with both methods (n = 32), local hot-spots were incongruent in 25 patients (78%) with a mean distance of 10.6 ± 9.5 mm. Dynamic FET PET and combination of different parameters did not further improve diagnostic accuracy. Both (18)F-FET PET and PWI discriminate LGG from HGG with similar diagnostic performance. Regional abnormalities in the tumor area are usually not congruent indicating that tumor grading by (18)F-FET PET and PWI is based on different pathophysiological phenomena.

  15. Technical Pitfalls of Signal Truncation in Perfusion MRI of Glioblastoma

    PubMed Central

    Wong, Kelvin K.; Fung, Steve H.; New, Pamela Z.; Wong, Stephen T. C.

    2016-01-01

    Dynamic susceptibility contrast (DSC) perfusion-weighted imaging (PWI) is widely used in clinical settings for the radiological diagnosis of brain tumor. The signal change in brain tissue in gradient echo-based DSC PWI is much higher than in spin echo-based DSC PWI. Due to its exquisite sensitivity, gradient echo-based sequence is the preferred method for imaging of all tumors except those near the base of the skull. However, high sensitivity also comes with a dynamic range problem. It is not unusual for blood volume to increase in gene-mediated cytotoxic immunotherapy-treated glioblastoma patients. The increase of fractional blood volume sometimes saturates the MRI signal during first-pass contrast bolus arrival and presents signal truncation artifacts of various degrees in the tumor when a significant amount of blood exists in the image pixels. It presents a hidden challenge in PWI, as this signal floor can be either close to noise level or just above and can go no lower. This signal truncation in the signal intensity time course is a significant issue that deserves attention in DSC PWI. In this paper, we demonstrate that relative cerebral blood volume and relative cerebral blood flow (rCBF) are underestimated due to signal truncation in DSC perfusion, in glioblastoma patients. We propose the use of second-pass tissue residue function in rCBF calculation using least-absolute-deviation deconvolution to avoid the underestimation problem. PMID:27531989

  16. Technical Pitfalls of Signal Truncation in Perfusion MRI of Glioblastoma.

    PubMed

    Wong, Kelvin K; Fung, Steve H; New, Pamela Z; Wong, Stephen T C

    2016-01-01

    Dynamic susceptibility contrast (DSC) perfusion-weighted imaging (PWI) is widely used in clinical settings for the radiological diagnosis of brain tumor. The signal change in brain tissue in gradient echo-based DSC PWI is much higher than in spin echo-based DSC PWI. Due to its exquisite sensitivity, gradient echo-based sequence is the preferred method for imaging of all tumors except those near the base of the skull. However, high sensitivity also comes with a dynamic range problem. It is not unusual for blood volume to increase in gene-mediated cytotoxic immunotherapy-treated glioblastoma patients. The increase of fractional blood volume sometimes saturates the MRI signal during first-pass contrast bolus arrival and presents signal truncation artifacts of various degrees in the tumor when a significant amount of blood exists in the image pixels. It presents a hidden challenge in PWI, as this signal floor can be either close to noise level or just above and can go no lower. This signal truncation in the signal intensity time course is a significant issue that deserves attention in DSC PWI. In this paper, we demonstrate that relative cerebral blood volume and relative cerebral blood flow (rCBF) are underestimated due to signal truncation in DSC perfusion, in glioblastoma patients. We propose the use of second-pass tissue residue function in rCBF calculation using least-absolute-deviation deconvolution to avoid the underestimation problem.

  17. Continuous ASL (CASL) perfusion MRI with an array coil and parallel imaging at 3T.

    PubMed

    Wang, Ze; Wang, Jiongjiong; Connick, Thomas J; Wetmore, Gabriel S; Detre, John A

    2005-09-01

    The purpose of this work was to assess the feasibility and efficacy of using an array coil and parallel imaging in continuous arterial spin labeling (CASL) perfusion MRI. An 8-channel receive-only array head coil was used in conjunction with a surrounding detunable volume transmit coil. The signal to noise ratio (SNR), temporal stability, cerebral blood flow (CBF), and perfusion image coverage were measured from steady state CASL scans using: a standard volume coil, array coil, and array coil with 2- and 3-fold accelerated parallel imaging. Compared to the standard volume coil, the array coil provided 3 times the average SNR increase and higher temporal stability for the perfusion weighted images, even with threefold acceleration. Although perfusion images of the array coil were affected by the inhomogeneous coil sensitivities, this effect was invisible in the quantitative CBF images, which showed highly reproducible perfusion values compared to the standard volume coil. The unfolding distortions of parallel imaging were suppressed in the perfusion images by pairwise subtraction, though they sharply degraded the raw EPI images. Moreover, parallel imaging provided the potential of acquiring more slices due to the shortened acquisition time and improved coverage in brain regions with high static field inhomogeneity. Such results highlight the potential utility of array coils and parallel imaging in ASL perfusion MRI. Copyright (c) 2005 Wiley-Liss, Inc.

  18. Large enhancement of perfusion contribution on fMRI signal

    PubMed Central

    Wang, Xiao; Zhu, Xiao-Hong; Zhang, Yi; Chen, Wei

    2012-01-01

    The perfusion contribution to the total functional magnetic resonance imaging (fMRI) signal was investigated using a rat model with mild hypercapnia at 9.4 T, and human subjects with visual stimulation at 4 T. It was found that the total fMRI signal change could be approximated as a linear superposition of ‘true' blood oxygenation level-dependent (BOLD; T2/T2*) effect and the blood flow-related (T1) effect. The latter effect was significantly enhanced by using short repetition time and large radiofrequency pulse flip angle and became comparable to the ‘true' BOLD signal in response to a mild hypercapnia in the rat brain, resulting in an improved contrast-to-noise ratio (CNR). Bipolar diffusion gradients suppressed the intravascular signals but had no significant effect on the flow-related signal. Similar results of enhanced fMRI signal were observed in the human study. The overall results suggest that the observed flow-related signal enhancement is likely originated from perfusion, and this enhancement can improve CNR and the spatial specificity for mapping brain activity and physiology changes. The nature of mixed BOLD and perfusion-related contributions in the total fMRI signal also has implication on BOLD quantification, in particular, the BOLD calibration model commonly used to estimate the change of cerebral metabolic rate of oxygen. PMID:22395206

  19. UMMPerfusion: an open source software tool towards quantitative MRI perfusion analysis in clinical routine.

    PubMed

    Zöllner, Frank G; Weisser, Gerald; Reich, Marcel; Kaiser, Sven; Schoenberg, Stefan O; Sourbron, Steven P; Schad, Lothar R

    2013-04-01

    To develop a generic Open Source MRI perfusion analysis tool for quantitative parameter mapping to be used in a clinical workflow and methods for quality management of perfusion data. We implemented a classic, pixel-by-pixel deconvolution approach to quantify T1-weighted contrast-enhanced dynamic MR imaging (DCE-MRI) perfusion data as an OsiriX plug-in. It features parallel computing capabilities and an automated reporting scheme for quality management. Furthermore, by our implementation design, it could be easily extendable to other perfusion algorithms. Obtained results are saved as DICOM objects and directly added to the patient study. The plug-in was evaluated on ten MR perfusion data sets of the prostate and a calibration data set by comparing obtained parametric maps (plasma flow, volume of distribution, and mean transit time) to a widely used reference implementation in IDL. For all data, parametric maps could be calculated and the plug-in worked correctly and stable. On average, a deviation of 0.032 ± 0.02 ml/100 ml/min for the plasma flow, 0.004 ± 0.0007 ml/100 ml for the volume of distribution, and 0.037 ± 0.03 s for the mean transit time between our implementation and a reference implementation was observed. By using computer hardware with eight CPU cores, calculation time could be reduced by a factor of 2.5. We developed successfully an Open Source OsiriX plug-in for T1-DCE-MRI perfusion analysis in a routine quality managed clinical environment. Using model-free deconvolution, it allows for perfusion analysis in various clinical applications. By our plug-in, information about measured physiological processes can be obtained and transferred into clinical practice.

  20. Noninvasive stress testing of myocardial perfusion defects: head-to-head comparison of thallium-201 SPECT to MRI perfusion.

    PubMed

    Vincenti, Gabriella; Nkoulou, René; Steiner, Charles; Imperiano, Hestia; Ambrosio, Giuseppe; Mach, François; Ratib, Osman; Vallee, Jean-Paul; Schindler, Thomas H

    2009-01-01

    To evaluate the diagnostic value of magnetic resonance imaging (MRI) of myocardial perfusion in the assessment of flow-limiting epicardial stenosis in a head-to-head comparison with abnormal thallium-201 ((201)TI) single photon emission tomography (SPECT) studies in patients with predominantly known coronary artery disease (CAD). Twenty-one patients (mean age 65 +/- 10 years) with reversible myocardial perfusion defects on (201)TI-SPECT images during dipyridamole-stimulated hyperemia were recruited for study purpose. Within 5 days of the (201)TI-SPECT study, myocardial perfusion was studied again with MRI during dipyridamole stimulation and at rest. Overall, (201)TI-SPECT identified 30 reversible regional perfusion defects. The sensitivity to detect hypoperfused segments was 70% (21/30) with the GRE-MRI perfusion analysis with (201)TI-SPECT as reference. When patients were subgrouped according to the extent of regional reversible perfusion defects on (201)TI-SPECT, mild- (SDS: 2-4), moderate- (SDS: 5-8), and severe- (SDS > 8) perfusion defects were also identified by GRE-MRI perfusion analysis in 75% (6/8), in 56% (9/16) and 100% (6/6), respectively. GRE-MRI first-pass stress perfusion imaging may not identify up to 30% of mild-to-moderate perfusion defects in a group of preselected patients with predominantly known CAD and abnormal (201)TI-SPECT studies.

  1. Perfusion weighted imaging and its application in stroke

    NASA Astrophysics Data System (ADS)

    Li, Enzhong; Tian, Jie; Han, Ying; Wang, Huifang; Li, Xingfeng; Zhu, Fuping

    2003-05-01

    To study the technique and application of perfusion weighted imaging (PWI) in the diagnosis and medical treatment of acute stroke, 25 patients were examined by 1.5 T or 1.0 T MRI scanner. The Data analysis was done with "3D Med System" developed by our Lab to process the data and obtain apparent diffusion coefficient (ADC) map, cerebral blood volume (CBV) map, cerebral blood flow (CBF) map as well as mean transit time (MTT) map. In accute stage of stroke, normal or slightly hypointensity in T1-, hyperintensity in T2- and diffusion-weighted images were seen in the cerebral infarction areas. There were hypointensity in CBV map, CBF map and ADC map; and hyperintensity in MTT map that means this infarct area could be saved. If the hyperintensity area in MTT map was larger than the area in diffusion weighted imaging (DWI), the larger part was called penumbra and could be cured by an appropriate thrombolyitic or other therapy. The CBV, CBF and MTT maps are very important in the diagnosis and medical treatment of acute especially hyperacute stroke. Comparing with DWI, we can easily know the situation of penumbra and the effect of curvative therapy. Besides, we can also make a differential diagnosis with this method.

  2. Prematurity and brain perfusion: Arterial spin labeling MRI.

    PubMed

    Tortora, Domenico; Mattei, Peter Angelo; Navarra, Riccardo; Panara, Valentina; Salomone, Rita; Rossi, Andrea; Detre, John A; Caulo, Massimo

    2017-01-01

    Abnormal brain perfusion is a critical mechanism in neonatal brain injury. The aim of the present study was to compare Cerebral Blood Flow (CBF) evaluated with ASL MRI in three groups of neonates: preterms without brain lesions on MRI (PN), preterms with periventricular white matter lesions (PNp) and term neonates with normal MRI (TN). The correlation between CBF and clinical outcome was explored. The institutional review board approved this prospective study and waived informed consent. The perfusion ASL data from 49 consecutive preterm neonates (PN) studied at term-equivalent age and 15 TN were evaluated. Statistically significant differences in gray matter CBF were evaluated by using a linear mixed-model analysis and Mann-Whitney U test. Logistic regression analysis was used to assess the relation between CBF and neuromotor outcome at 12 months. Comparison of means indicated that the CBF of the whole brain were significantly higher in PN compared to TN (P = 0.011). This difference remained significant when considering the frontal (P = 0.038), parietal (P = 0.002), temporal (P = 0.030), occipital (P = 0.041) and cerebellar (P = 0.010) gray matter. In the PN group, lower CBF in basal ganglia was associated with a worse neuromotor outcome (P = 0.012). ASL MRI demonstrated differences in brain perfusion of the basal ganglia between PN and TN. In PN, a positive correlation between CBF and neuromotor outcome was demonstrated in this area.

  3. Relationship between diffusion parameters derived from intravoxel incoherent motion MRI and perfusion measured by dynamic contrast-enhanced MRI of soft tissue tumors.

    PubMed

    Marzi, Simona; Stefanetti, Linda; Sperati, Francesca; Anelli, Vincenzo

    2016-01-01

    Our aim was to evaluate the link between diffusion parameters measured by intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) and the perfusion metrics obtained with dynamic contrast-enhanced (DCE) MRI in soft tissue tumors (STTs). Twenty-eight patients affected by histopathologically confirmed STT were included in a prospective study. All patients underwent both DCE MRI and IVIM DWI. The perfusion fraction f, diffusion coefficient D and perfusion-related diffusion coefficient D* were estimated using a bi-exponential function to fit the DWI data. DCE MRI was acquired with a temporal resolution of 3-5 s. Maps of the initial area under the gadolinium concentration curve (IAUGC), time to peak (TTP) and maximum slope of increase (MSI) were derived using commercial software. The relationships between the DCE MRI and IVIM DWI measurements were assessed by Spearman's test. To exclude false positive results under multiple testing, the false discovery rate (FDR) procedure was applied. The Mann-Whitney test was used to evaluate the differences between all variables in patients with non-myxoid and myxoid STT. No significant relationship was found between IVIM parameters and any DCE MRI parameters. Higher f and D*f values were found in non-myxoid tumors compared with myxoid tumors (p = 0.004 and p = 0.003, respectively). MSI was significantly higher in non-myxoid tumors than in myxoid tumors (p = 0.029). From the visual assessments of single clinical cases, both f and D*f maps were in satisfactory agreement with DCE maps in the extreme cases of an avascular mass and a highly vascularized mass, whereas, for tumors with slight vascularity or with a highly heterogeneous perfusion pattern, this association was not straightforward. Although IVIM DWI was demonstrated to be feasible in STT, our data did not support evident relationships between perfusion-related IVIM parameters and perfusion measured by DCE MRI.

  4. 1D.09: APPLICABILITY OF MEASUREMENT OF RENAL PERFUSION USING 1.5 TESLA MRI ARTERIAL SPIN LABELLING.

    PubMed

    Kistner, I; Ott, C; Jumar, A; Friedrich, S; Grosso, R; Siegl, C; Schmieder, R E; Janka, R

    2015-06-01

    Renal perfusion is a key parameter of kidney function and the decrement of renal perfusion is a marker of target organ damage caused by hypertension. Detecting these changes in renal perfusion could help to manage antihypertensive therapy and evaluate patients[Combining Acute Accent] prognosis. Measurement of renal perfusion by MRI arterial spin labelling (ASL) is a non-invasive and non-time-consuming method without the need to inject any contrast agent. This study examined reproducibility of renal perfusion measured by 1.5 Tesla MRI. Renal perfusion was measured by ASL technique using an 1.5 Tesla MRI scanner. Subjects were scanned 3 times at two different days in an interval of two weeks to assess the test-retest reproducibility. Renal perfusion was automatically calculated for the cortex and medulla of the kidney by dedicated software. 14 patients were included with mean age 48.9 ± 12.7 and mean office blood pressure 132 ± 16/82 ± 10mmHg and estimated glomerular filtration rate> 60 ml/min/1.73m. The change of the mean total, cortical and medullary renal perfusion from the first examination to the second examination was 0.37 ± 13/0.62 ± 18/0.00 ± 12 ml/min/100 g kidney weight (p = 0.915/p = 0.898/p = 0.998), respectively. There was also no significant difference between the three renal perfusion measurements at one time point. For clinical trials these data indicate that to detect a 5% (10%) difference of cortical renal perfusion due to an intervention (vs placebo) only 38 (14) patients are required in face of the observed standard deviation for the change in renal perfusion. The inter and intra-session reproducibility of cortical renal perfusion assessed by MRI ASL 1.5 Tesla is excellent and small study cohorts can be used for examination of renal perfusion.

  5. Arterial Spin Labeling - Fast Imaging with Steady-State Free Precession (ASL-FISP): A Rapid and Quantitative Perfusion Technique for High Field MRI

    PubMed Central

    Gao, Ying; Goodnough, Candida L.; Erokwu, Bernadette O.; Farr, George W.; Darrah, Rebecca; Lu, Lan; Dell, Katherine M.; Yu, Xin; Flask, Chris A.

    2014-01-01

    Arterial Spin Labeling (ASL) is a valuable non-contrast perfusion MRI technique with numerous clinical applications. Many previous ASL MRI studies have utilized either Echo-Planar Imaging (EPI) or True Fast Imaging with Steady-State Free Precession (True FISP) readouts that are prone to off-resonance artifacts on high field MRI scanners. We have developed a rapid ASL-FISP MRI acquisition for high field preclinical MRI scanners providing perfusion-weighted images with little or no artifacts in less than 2 seconds. In this initial implementation, a FAIR (Flow-Sensitive Alternating Inversion Recovery) ASL preparation was combined with a rapid, centrically-encoded FISP readout. Validation studies on healthy C57/BL6 mice provided consistent estimation of in vivo mouse brain perfusion at 7 T and 9.4 T (249±38 ml/min/100g and 241±17 ml/min/100g, respectively). The utility of this method was further demonstrated in detecting significant perfusion deficits in a C57/BL6 mouse model of ischemic stroke. Reasonable kidney perfusion estimates were also obtained for a healthy C57/BL6 mouse exhibiting differential perfusion in the renal cortex and medulla. Overall, the ASL-FISP technique provides a rapid and quantitative in vivo assessment of tissue perfusion for high field MRI scanners with minimal image artifacts. PMID:24891124

  6. Arterial spin labeling-fast imaging with steady-state free precession (ASL-FISP): a rapid and quantitative perfusion technique for high-field MRI.

    PubMed

    Gao, Ying; Goodnough, Candida L; Erokwu, Bernadette O; Farr, George W; Darrah, Rebecca; Lu, Lan; Dell, Katherine M; Yu, Xin; Flask, Chris A

    2014-08-01

    Arterial spin labeling (ASL) is a valuable non-contrast perfusion MRI technique with numerous clinical applications. Many previous ASL MRI studies have utilized either echo-planar imaging (EPI) or true fast imaging with steady-state free precession (true FISP) readouts, which are prone to off-resonance artifacts on high-field MRI scanners. We have developed a rapid ASL-FISP MRI acquisition for high-field preclinical MRI scanners providing perfusion-weighted images with little or no artifacts in less than 2 s. In this initial implementation, a flow-sensitive alternating inversion recovery (FAIR) ASL preparation was combined with a rapid, centrically encoded FISP readout. Validation studies on healthy C57/BL6 mice provided consistent estimation of in vivo mouse brain perfusion at 7 and 9.4 T (249 ± 38 and 241 ± 17 mL/min/100 g, respectively). The utility of this method was further demonstrated in the detection of significant perfusion deficits in a C57/BL6 mouse model of ischemic stroke. Reasonable kidney perfusion estimates were also obtained for a healthy C57/BL6 mouse exhibiting differential perfusion in the renal cortex and medulla. Overall, the ASL-FISP technique provides a rapid and quantitative in vivo assessment of tissue perfusion for high-field MRI scanners with minimal image artifacts. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Diagnostic Performance of Dual-Energy CT Stress Myocardial Perfusion Imaging: Direct Comparison With Cardiovascular MRI

    PubMed Central

    Ko, Sung Min; Song, Meong Gun; Chee, Hyun Kun; Hwang, Hweung Kon; Feuchtner, Gudrun Maria; Min, James K.

    2014-01-01

    OBJECTIVE The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease. SUBJECTS AND METHODS One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥ 50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemodynamically significant stenosis was assessed before and after stress perfusion DECT on a pervessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard. RESULTS The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p = 0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone. CONCLUSION Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically

  8. Interobserver variability in the radiological assessment of magnetic resonance imaging (MRI) including perfusion MRI in glioblastoma multiforme.

    PubMed

    Kerkhof, M; Hagenbeek, R E; van der Kallen, B F W; Lycklama À Nijeholt, G J; Dirven, L; Taphoorn, M J B; Vos, M J

    2016-10-01

    Conventional magnetic resonance imaging (MRI) has limited value for differentiation of true tumor progression and pseudoprogression in treated glioblastoma multiforme (GBM). Perfusion weighted imaging (PWI) may be helpful in the differentiation of these two phenomena. Here interobserver variability in routine radiological evaluation of GBM patients is assessed using MRI, including PWI. Three experienced neuroradiologists evaluated MR scans of 28 GBM patients during temozolomide chemoradiotherapy at three time points: preoperative (MR1) and postoperative (MR2) MR scan and the follow-up MR scan after three cycles of adjuvant temozolomide (MR3). Tumor size was measured both on T1 post-contrast and T2 weighted images according to the Response Assessment in Neuro-Oncology criteria. PW images of MR3 were evaluated by visual inspection of relative cerebral blood volume (rCBV) color maps and by quantitative rCBV measurements of enhancing areas with highest rCBV. Image interpretability of PW images was also scored. Finally, the neuroradiologists gave a conclusion on tumor status, based on the interpretation of both T1 and T2 weighted images (MR1, MR2 and MR3) in combination with PWI (MR3). Interobserver agreement on visual interpretation of rCBV maps was good (κ = 0.63) but poor on quantitative rCBV measurements and on interpretability of perfusion images (intraclass correlation coefficient 0.37 and κ = 0.23, respectively). Interobserver agreement on the overall conclusion of tumor status was moderate (κ = 0.48). Interobserver agreement on the visual interpretation of PWI color maps was good. However, overall interpretation of MR scans (using both conventional and PW images) showed considerable interobserver variability. Therefore, caution should be applied when interpreting MRI results during chemoradiation therapy. © 2016 EAN.

  9. Tracer kinetic modelling in MRI: estimating perfusion and capillary permeability

    NASA Astrophysics Data System (ADS)

    Sourbron, S. P.; Buckley, D. L.

    2012-01-01

    The tracer-kinetic models developed in the early 1990s for dynamic contrast-enhanced MRI (DCE-MRI) have since become a standard in numerous applications. At the same time, the development of MRI hardware has led to increases in image quality and temporal resolution that reveal the limitations of the early models. This in turn has stimulated an interest in the development and application of a second generation of modelling approaches. They are designed to overcome these limitations and produce additional and more accurate information on tissue status. In particular, models of the second generation enable separate estimates of perfusion and capillary permeability rather than a single parameter Ktrans that represents a combination of the two. A variety of such models has been proposed in the literature, and development in the field has been constrained by a lack of transparency regarding terminology, notations and physiological assumptions. In this review, we provide an overview of these models in a manner that is both physically intuitive and mathematically rigourous. All are derived from common first principles, using concepts and notations from general tracer-kinetic theory. Explicit links to their historical origins are included to allow for a transfer of experience obtained in other fields (PET, SPECT, CT). A classification is presented that reveals the links between all models, and with the models of the first generation. Detailed formulae for all solutions are provided to facilitate implementation. Our aim is to encourage the application of these tools to DCE-MRI by offering researchers a clearer understanding of their assumptions and requirements.

  10. Perfusion weighted imaging in the assessment of the pathology and outcomes of lateral medullary infarction

    PubMed Central

    Zhang, Dao P.; Zhang, Hong T.; Yin, Suo; Yan, Fu L.

    2016-01-01

    This series case report aimed to elucidate the underlying pathology and outcomes of lateral medullary infarction (LMI) using perfusion weighted imaging (PWI). Four patients were diagnosed with LMI based on high-field diffusion-weighted magnetic resonance imaging (MRI-DWI) and PWI. The national institutes of health stroke scale (NIHSS) scores were recorded on days 1, 7, and 30, and the Barthel index was assessed on days 7 and 30. Three patients exhibited relative regional hypoperfusion of medullary lesion in the perfusion maps. Two cases exhibited ipsilateral hypoperfusion in the inferior cerebellum, whereas one patient exhibited a relatively regional hyperperfusion in the medulla oblongata. The LMI patients with a high NIHSS score and low Barthel index on days 7 and 30 exhibited regional hypoperfusion. This report of 4 LMI cases provides preliminary evidence that regional hypoperfusion may contribute to worse outcomes in LMI. PMID:27744467

  11. A study on cerebral hemodynamic analysis of moyamoya disease by using perfusion MRI

    NASA Astrophysics Data System (ADS)

    Dong, Kyung-Rae; Goo, Eun-Hoe; Lee, Jae-Seung; Chung, Woon-Kwan

    2013-10-01

    This study examined the clinical applications of perfusion magnetic resonance imaging (MRI) in patients with moyamoya disease (MMD). Twenty-two patients with moyamoya disease (9 men and 13 women) with a mean age of 9.3 years (range: 4-22 years) were enrolled in this study. Perfusion MRI was performed by scanning the patients7.5 cm upward from the base of the cerebellum before their being process for post-treatment. The scan led to the acquisition of the following four map images: the cerebral blood volume (CBV), the cerebral blood flow (CBF), the mean transit time (MTT) for the contrast medium, and the time to peak (TTP) for the contrast medium. The lesions were assessed using the CBV, the CBF, the MTT and the TTP maps of perfusion MRI; the MTT and the TTP were measured in the lesion areas, as well as in the normal and the symmetric areas. Perfusion defects were recognizable in all four perfusion MRI maps, and the MTT and the TTP showed a conspicuous delay in the parts where perfusion defects were recognized. The MTT and the TTP images of perfusion MRI reflected a significant correlation between the degrees of stenosis and occlusion in the posterior cerebral artery (PCA), as well as the development of collateral vessels. The four perfusion MRI maps could be used to predict the degrees of stenosis and occlusion in the posterior circulation, as well as the development of the collateral vessels, which enabled a hemodynamic evaluation of the parts with perfusion defects. Overall, perfusion MRI is useful for the diagnosis and the treatment of moyamoya disease and can be applied to clinical practice.

  12. Assessment of pulmonary parenchyma perfusion with FAIR in comparison with DCE-MRI--initial results.

    PubMed

    Fan, Li; Liu, Shi-yuan; Sun, Fei; Xiao, Xiang-sheng

    2009-04-01

    The aim of this study was to assess pulmonary parenchyma perfusion with flow-sensitive alternating inversion recovery (FAIR) in comparison with 3D dynamic contrast-enhanced (DCE) imaging in healthy volunteers and in patients with pulmonary embolism or lung cancer. Sixteen healthy volunteers and 16 patients with pulmonary embolism (5 cases) or lung cancer (11 cases) were included in this study. Firstly, the optimized inversion time of FAIR (TI) was determined in 12 healthy volunteers. Then, FAIR imaging with the optimized TI was performed followed by DCE-MRI on the other 4 healthy volunteers and 16 patients. Tagging efficiency of lung and SNR of perfusion images were calculated with different TI values. In the comparison of FAIR with DCE-MRI, the homogeneity of FAIR and DCE-MRI perfusion was assessed. In the cases of perfusion abnormality, the contrast between normal lung and perfusion defects was quantified by calculating a normalized signal intensity ratio. One thousand milliseconds was the optimal TI, which generated the highest lung tagging efficiency and second highest PBF SNR. In the volunteers, the signal intensity of perfusion images acquired with both FAIR and DCE-MRI was homogeneous. Wedged-shaped or triangle perfusion defects were visualized in five pulmonary embolisms and three lung cancer cases. There was no significant statistical difference in signal intensity ratio between FAIR and DCE-MRI (P>0.05). In the rest of eight lung cancers, all the lesions showed low perfusion against the higher perfused pulmonary parenchyma in both FAIR and DCE-MRI. Pulmonary parenchyma perfusion imaging with FAIR was feasible, consistent and could obtain similar functional information to that from DCE-MRI.

  13. Clinical Applications of Contrast-Enhanced Perfusion MRI Techniques in Gliomas: Recent Advances and Current Challenges

    PubMed Central

    Liu, Heng; Tong, Haipeng; Wang, Sumei; Yang, Yizeng

    2017-01-01

    Gliomas possess complex and heterogeneous vasculatures with abnormal hemodynamics. Despite considerable advances in diagnostic and therapeutic techniques for improving tumor management and patient care in recent years, the prognosis of malignant gliomas remains dismal. Perfusion-weighted magnetic resonance imaging techniques that could noninvasively provide superior information on vascular functionality have attracted much attention for evaluating brain tumors. However, nonconsensus imaging protocols and postprocessing analysis among different institutions impede their integration into standard-of-care imaging in clinic. And there have been very few studies providing a comprehensive evidence-based and systematic summary. This review first outlines the status of glioma theranostics and tumor-associated vascular pathology and then presents an overview of the principles of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast-MRI (DSC-MRI), with emphasis on their recent clinical applications in gliomas including tumor grading, identification of molecular characteristics, differentiation of glioma from other brain tumors, treatment response assessment, and predicting prognosis. Current challenges and future perspectives are also highlighted.

  14. Correlation analysis of dual-energy CT iodine maps with quantitative pulmonary perfusion MRI

    PubMed Central

    Hansmann, Jan; Apfaltrer, Paul; Zoellner, Frank G; Henzler, Thomas; Meyer, Mathias; Weisser, Gerald; Schoenberg, Stefan O; Attenberger, Ulrike I

    2013-01-01

    AIM: To correlate dual-energy computed tomography (DECT) pulmonary angiography derived iodine maps with parameter maps of quantitative pulmonary perfusion magnetic resonance imaging (MRI). METHODS: Eighteen patients with pulmonary perfusion defects detected on DECT derived iodine maps were included in this prospective study and additionally underwent time-resolved contrast-enhanced pulmonary MRI [dynamic contrast enhanced (DCE)-MRI]. DCE-MRI data were quantitatively analyzed using a pixel-by-pixel deconvolution analysis calculating regional pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) in visually normal lung parenchyma and perfusion defects. Perfusion parameters were correlated to mean attenuation values of normal lung and perfusion defects on DECT iodine maps. Two readers rated the concordance of perfusion defects in a visual analysis using a 5-point Likert-scale (1 = no correlation, 5 = excellent correlation). RESULTS: In visually normal pulmonary tissue mean DECT and MRI values were: 22.6 ± 8.3 Hounsfield units (HU); PBF: 58.8 ± 36.0 mL/100 mL per minute; PBV: 16.6 ± 8.5 mL; MTT: 17.1 ± 10.3 s. In areas with restricted perfusion mean DECT and MRI values were: 4.0 ± 3.9 HU; PBF: 10.3 ± 5.5 mL/100 mL per minute, PBV: 5 ± 4 mL, MTT: 21.6 ± 14.0 s. The differences between visually normal parenchyma and areas of restricted perfusion were statistically significant for PBF, PBV and DECT (P < 0.0001). No linear correlation was found between MRI perfusion parameters and attenuation values of DECT iodine maps (PBF: r = 0.35, P = 0.15; PBV: r = 0.34, P = 0.16; MTT: r = 0.41, P = 0.08). Visual analysis revealed a moderate correlation between perfusion defects on DECT iodine maps and the parameter maps of DCE-MRI (mean score 3.6, κ 0.45). CONCLUSION: There is a moderate visual but not statistically significant correlation between DECT iodine maps and perfusion parameter maps of DCE-MRI. PMID:23805370

  15. Correlation analysis of dual-energy CT iodine maps with quantitative pulmonary perfusion MRI.

    PubMed

    Hansmann, Jan; Apfaltrer, Paul; Zoellner, Frank G; Henzler, Thomas; Meyer, Mathias; Weisser, Gerald; Schoenberg, Stefan O; Attenberger, Ulrike I

    2013-05-28

    To correlate dual-energy computed tomography (DECT) pulmonary angiography derived iodine maps with parameter maps of quantitative pulmonary perfusion magnetic resonance imaging (MRI). Eighteen patients with pulmonary perfusion defects detected on DECT derived iodine maps were included in this prospective study and additionally underwent time-resolved contrast-enhanced pulmonary MRI [dynamic contrast enhanced (DCE)-MRI]. DCE-MRI data were quantitatively analyzed using a pixel-by-pixel deconvolution analysis calculating regional pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) in visually normal lung parenchyma and perfusion defects. Perfusion parameters were correlated to mean attenuation values of normal lung and perfusion defects on DECT iodine maps. Two readers rated the concordance of perfusion defects in a visual analysis using a 5-point Likert-scale (1 = no correlation, 5 = excellent correlation). In visually normal pulmonary tissue mean DECT and MRI values were: 22.6 ± 8.3 Hounsfield units (HU); PBF: 58.8 ± 36.0 mL/100 mL per minute; PBV: 16.6 ± 8.5 mL; MTT: 17.1 ± 10.3 s. In areas with restricted perfusion mean DECT and MRI values were: 4.0 ± 3.9 HU; PBF: 10.3 ± 5.5 mL/100 mL per minute, PBV: 5 ± 4 mL, MTT: 21.6 ± 14.0 s. The differences between visually normal parenchyma and areas of restricted perfusion were statistically significant for PBF, PBV and DECT (P < 0.0001). No linear correlation was found between MRI perfusion parameters and attenuation values of DECT iodine maps (PBF: r = 0.35, P = 0.15; PBV: r = 0.34, P = 0.16; MTT: r = 0.41, P = 0.08). Visual analysis revealed a moderate correlation between perfusion defects on DECT iodine maps and the parameter maps of DCE-MRI (mean score 3.6, κ 0.45). There is a moderate visual but not statistically significant correlation between DECT iodine maps and perfusion parameter maps of DCE-MRI.

  16. [An evaluation of ischemic stroke using dynamic contrast enhanced perfusion MRI].

    PubMed

    Yamaguchi, H; Igarashi, H; Katayama, Y; Terashi, A

    1998-04-01

    Thrombolytic therapy during the hyperacute stage is important for salvaging dying cerebral tissue. To date, however, accurate non-invasive assessment of an ischemic lesion during the hyperacute stage has not been possible. Perfusion MRI may be the key to the quick diagnosis of ischemic lesions. To assess the feasibility of dynamic contrast enhanced perfusion MRI, echo planar imaging was performed in 10 patients with ischemic stroke. The relative cerebral blood volume (rCBV), mean transit time (MTT), and relative cerebral blood flow(rCBF) were measured based on moment analysis and the gamma variate method. These measurements, however, are not suitable for the detection of cerebral ischemia during the hyperacute stage. Therefore, we additionally studied the changes in a concentration curve (time-delta R* curve) of Gd-DTPA, injected into the median vein of the forearm. From the curve the SUM (delta R*) time to peak and the delta R* peak, which may be calculated quickly, were determined and were compared to rCBV, MTT, and rCBF, respectively. The rCBV and the rCBF in the ischemic regions were less than those in the contralateral healthy regions (p < 0.05), and the MTT in the ischemic regions was longer than that in the contralateral healthy regions (p < 0.05). Additionally, SUM (delta R*) and the delta R* peak in the ischemic regions were less, and the time to peak in the ischemic regions was longer than the value in the contralateral healthy regions (p < 0.05), correlating well to the rCBV, rCBF, and MTT measurements. Also, images of these parameters, depicting the ischemic lesion earlier than conventional T2 weighted images, can be easily made by using an MRI console. These results suggest that the SUM (delta R*), time to peak and the delta R* peak images calculated with dynamic contrast enhanced perfusion MRI may be one of the best techniques for the detection of cerebral ischemic lesions during the hyperacute stage.

  17. Resolution and reproducibility of BOLD and perfusion functional MRI at 3.0 Tesla.

    PubMed

    van Gelderen, Peter; W H Wu, Carolyn; de Zwart, Jacco A; Cohen, Leonardo; Hallett, Mark; Duyn, Jeff H

    2005-09-01

    Visual and somatosensory activation studies were performed on normal subjects to compare the spatial discrimination and reproducibility between functional MRI (fMRI) methods based on blood oxygen level-dependent (BOLD) and perfusion contrast. To allow simultaneous measurement of BOLD and perfusion contrast, a dedicated MRI acquisition technique was developed. Repeated experiments of sensory stimulation of single digits of the right hand showed an average variability of activation amplitude of 25% for BOLD data, and a significantly lower variability of 21% for perfusion data. No significant difference in the variability of the locus of activity was observed between the BOLD and perfusion data. In somatotopy experiments, digits II and V were subjected to passive sensory stimulation. Both the BOLD and perfusion data showed substantial overlap in the activation patterns from the two digits. In a retinotopy study, two stimuli were alternated to excite different patches of V1. Again there was substantial overlap between the activation patterns from both stimuli, although the perfusion performed somewhat better than the BOLD method. Particularly for the visual studies, the overlap in activation patterns was more than expected based on the fine-scale retinotopic mapping of cortical activity, suggesting that both BOLD and perfusion contrast mechanisms contribute substantially to the point-spread function (PSF).

  18. [Diffusion-weighted MRI of the prostate].

    PubMed

    Mueller-Lisse, U G; Mueller-Lisse, U L; Zamecnik, P; Schlemmer, H-P W; Scherr, M K

    2011-03-01

    Diffusion-weighted magnetic resonance imaging (DWI) can complement MRI of the prostate in the detection and localization of prostate cancer, particularly after previous negative biopsy. A total of 13 original reports and 2 reviews published in 2010 demonstrate that prostate cancer can be detected by DWI due to its increased cell density and decreased diffusiveness, either qualitatively in DWI images or quantitatively by means of the apparent diffusion coefficient (ADC). In the prostate, the ADC is influenced by the strength of diffusion weighting, localization (peripheral or transitional zone), presence of prostatitis or hemorrhage and density and differentiation of prostate cancer cells. Mean differences between healthy tissue of the peripheral zone and prostate cancer appear to be smaller for ADC than for the (choline + creatine)/citrate ratio in MR spectroscopy. Test quality parameters vary greatly between different studies but appear to be slightly better for combined MRI and DWI than for MRI of the prostate alone. Clinical validation of DWI of the prostate requires both increased technical conformity and increased numbers of patients in clinical studies.

  19. Experimental design and the relative sensitivity of BOLD and perfusion fMRI.

    PubMed

    Aguirre, G K; Detre, J A; Zarahn, E; Alsop, D C

    2002-03-01

    This paper compares the statistical power of BOLD and arterial spin labeling perfusion fMRI for a variety of experimental designs within and across subjects. Based on theory and simulations, we predict that perfusion data are composed of independent observations in time under the null hypothesis, in contrast to BOLD data, which possess marked autocorrelation. We also present a method (sinc subtraction) of generating perfusion data from its raw source signal that minimizes the presence of oxygen-sensitive signal changes and can be used with any experimental design. Empirically, we demonstrate the absence of autocorrelation in perfusion noise, examine the shape of the hemodynamic response function for BOLD and perfusion, and obtain a measure of signal to noise for each method. This information is then used to generate a model of relative sensitivity of the BOLD and perfusion methods for within-subject experimental designs of varying temporal frequency. It is determined that perfusion fMRI provides superior sensitivity for within-subject experimental designs that concentrate their power at or below approximately 0.009 Hz (corresponding to a "blocked" experimental design of 60-s epochs). Additionally, evidence is presented that across-subject hypothesis tests may be more sensitive when conducted using perfusion imaging, despite the better within-subject signal to noise obtained in some cases with BOLD. ©2002 Elsevier Science (USA).

  20. MRI characterization of brown adipose tissue in obese and normal-weight children.

    PubMed

    Deng, Jie; Schoeneman, Samantha E; Zhang, Huiyuan; Kwon, Soyang; Rigsby, Cynthia K; Shore, Richard M; Josefson, Jami L

    2015-10-01

    Brown adipose tissue (BAT) is identified in mammals as an adaptive thermogenic organ for modulation of energy expenditure and heat generation. Human BAT may be primarily composed of brown-in-white (BRITE) adipocytes and stimulation of BRITE may serve as a potential target for obesity interventions. Current imaging studies of BAT detection and characterization have been mainly limited to PET/CT. MRI is an emerging application for BAT characterization in healthy children. To exploit Dixon and diffusion-weighted MRI methods to characterize cervical-supraclavicular BAT/BRITE properties in normal-weight and obese children while accounting for pubertal status. Twenty-eight healthy children (9-15 years old) with a normal or obese body mass index participated. MRI exams were performed to characterize supraclavicular adipose tissues by measuring tissue fat percentage, T2*, tissue water mobility, and microvasculature properties. We used multivariate linear regression models to compare tissue properties between normal-weight and obese groups while accounting for pubertal status. MRI measurements of BAT/BRITE tissues in obese children showed higher fat percentage (P < 0.0001), higher T2* (P < 0.0001), and lower diffusion coefficient (P = 0.015) compared with normal-weight children. Pubertal status was a significant covariate for the T2* measurement, with higher T2* (P = 0.0087) in pubertal children compared to prepubertal children. Perfusion measurements varied by pubertal status. Compared to normal-weight children, obese prepubertal children had lower perfusion fraction (P = 0.003) and pseudo-perfusion coefficient (P = 0.048); however, obese pubertal children had higher perfusion fraction (P = 0.02) and pseudo-perfusion coefficient (P = 0.028). This study utilized chemical-shift Dixon MRI and diffusion-weighted MRI methods to characterize supraclavicular BAT/BRITE tissue properties. The multi-parametric evaluation revealed evidence of

  1. Placental Perfusion In Uterine Ischemia Model as Evaluated by Dynamic Contrast Enhanced MRI

    PubMed Central

    Drobyshevsky, Alexander

    2017-01-01

    Background To validate DCE MRI method of placental perfusion estimation and to demonstrate application of the method in a rabbit model of fetal antenatal hypoxia-ischemia. Methods Placental perfusion was estimated by dynamic contrast imaging with bolus injection of Gd-DTPA in 3 Tesla GE magnet in a rabbit model of placental ischemia–reperfusion in rabbit dams at embryonic day 25 gestation age. Placental perfusion was measured using steepest slope method on DCE MRI before and after intermittent 40 min uterine ischemia. Antioxidants (n = 2 dams, 9 placentas imaged) or vehicle (n = 5 dams, 23 placenta imaged) were given systemically in a separate group of dams during reperfusion–reoxygenation. Placental perfusion was also measured in two dams from the antioxidant group (10 placentas) and two dams from the control group (12 placentas) by fluorescent microspheres method. Results While placental perfusion estimates between fluorescent microspheres and DCE MRI were significantly correlated (R2 = 0.85; P < 0.01), there was approximately 33% systematic underestimation by the latter technique. DCE MRI showed a significant decrease in maternal placental perfusion in reperfusion–reoxygenation phase in the saline, 0.44 ± 0.06 mL/min/g (P = 0.012, t-test), but not in the antioxidant group, 0.62 ± 0.06 mL/min/g, relative to preocclusion values (0.77 ± 0.07 and 0.84 ± 0.12 mL/min/g, correspondingly). Conclusion Underestimation of true perfusion in placenta by steepest slope DCE MRI is significant and the error appears to be systematic. PMID:25854322

  2. An Arterial Spin Labeling MRI Perfusion Study of Migraine without Aura Attacks.

    PubMed

    Gil-Gouveia, Raquel; Pinto, Joana; Figueiredo, Patricia; Vilela, Pedro Ferro; Martins, Isabel Pavão

    2017-01-01

    Studies of brain perfusion during migraine without aura attacks have inconsistent results. Arterial spin labeling MRI, a non-invasive quantitative perfusion technique, was used to prospectively study a spontaneous untreated migraine without aura attack and a headache-free period. Image analysis used FSL and MATLAB software; Group analysis used permutation methods for perfusion differences between sessions. Thirteen women (age 35.7) were scanned during an attack of an average intensity of 6.8 (on 0-10 Visual Analog Scale) and 16 h duration. No global or regional perfusion differences were identified when comparing migraine and migraine-free sessions. Our findings suggest that the painful phase of migraine without aura attacks is not associated with brain perfusion abnormalities.

  3. Optimization of flow-sensitive alternating inversion recovery (FAIR) for perfusion functional MRI of rodent brain.

    PubMed

    Nasrallah, Fatima A; Lee, Eugene L Q; Chuang, Kai-Hsiang

    2012-11-01

    Arterial spin labeling (ASL) MRI provides a noninvasive method to image perfusion, and has been applied to map neural activation in the brain. Although pulsed labeling methods have been widely used in humans, continuous ASL with a dedicated neck labeling coil is still the preferred method in rodent brain functional MRI (fMRI) to maximize the sensitivity and allow multislice acquisition. However, the additional hardware is not readily available and hence its application is limited. In this study, flow-sensitive alternating inversion recovery (FAIR) pulsed ASL was optimized for fMRI of rat brain. A practical challenge of FAIR is the suboptimal global inversion by the transmit coil of limited dimensions, which results in low effective labeling. By using a large volume transmit coil and proper positioning to optimize the body coverage, the perfusion signal was increased by 38.3% compared with positioning the brain at the isocenter. An additional 53.3% gain in signal was achieved using optimized repetition and inversion times compared with a long TR. Under electrical stimulation to the forepaws, a perfusion activation signal change of 63.7 ± 6.3% can be reliably detected in the primary somatosensory cortices using single slice or multislice echo planar imaging at 9.4 T. This demonstrates the potential of using pulsed ASL for multislice perfusion fMRI in functional and pharmacological applications in rat brain.

  4. 3D pulmonary perfusion MRI and MR angiography of pulmonary embolism in pigs after a single injection of a blood pool MR contrast agent.

    PubMed

    Fink, Christian; Ley, Sebastian; Puderbach, Michael; Plathow, Christian; Bock, Michael; Kauczor, Hans-Ulrich

    2004-07-01

    The purpose of this study was to assess the feasibility of contrast-enhanced 3D perfusion MRI and MR angiography (MRA) of pulmonary embolism (PE) in pigs using a single injection of the blood pool contrast Gadomer. PE was induced in five domestic pigs by injection of autologous blood thrombi. Contrast-enhanced first-pass 3D perfusion MRI (TE/TR/FA: 1.0 ms/2.2 ms/40 degrees; voxel size: 1.3 x 2.5 x 4.0 mm3; TA: 1.8 s per data set) and high-resolution 3D MRA (TE/TR/FA: 1.4 ms/3.4 ms/40 degrees; voxel size: 0.8 x 1.0 x 1.6 mm3) was performed during and after a single injection of 0.1 mmol/kg body weight of Gadomer. Image data were compared to pre-embolism Gd-DTPA-enhanced MRI and post-embolism thin-section multislice CT (n = 2). SNR measurements were performed in the pulmonary arteries and lung. One animal died after induction of PE. In all other animals, perfusion MRI and MRA could be acquired after a single injection of Gadomer. At perfusion MRI, PE could be detected by typical wedge-shaped perfusion defects. While the visualization of central PE at MRA correlated well with the CT, peripheral PE were only visualized by CT. Gadomer achieved a higher peak SNR of the lungs compared to Gd-DTPA (21 +/- 8 vs. 13 +/- 3). Contrast-enhanced 3D perfusion MRI and MRA of PE can be combined using a single injection of the blood pool contrast agent Gadomer.

  5. Visually weighted reconstruction of compressive sensing MRI.

    PubMed

    Oh, Heeseok; Lee, Sanghoon

    2014-04-01

    Compressive sensing (CS) enables the reconstruction of a magnetic resonance (MR) image from undersampled data in k-space with relatively low-quality distortion when compared to the original image. In addition, CS allows the scan time to be significantly reduced. Along with a reduction in the computational overhead, we investigate an effective way to improve visual quality through the use of a weighted optimization algorithm for reconstruction after variable density random undersampling in the phase encoding direction over k-space. In contrast to conventional magnetic resonance imaging (MRI) reconstruction methods, the visual weight, in particular, the region of interest (ROI), is investigated here for quality improvement. In addition, we employ a wavelet transform to analyze the reconstructed image in the space domain and fully utilize data sparsity over the spatial and frequency domains. The visual weight is constructed by reflecting the perceptual characteristics of the human visual system (HVS), and then applied to ℓ1 norm minimization, which gives priority to each coefficient during the reconstruction process. Using objective quality assessment metrics, it was found that an image reconstructed using the visual weight has higher local and global quality than those processed by conventional methods. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The value of resting-state functional MRI in subacute ischemic stroke: comparison with dynamic susceptibility contrast-enhanced perfusion MRI.

    PubMed

    Ni, Ling; Li, Jingwei; Li, Weiping; Zhou, Fei; Wang, Fangfang; Schwarz, Christopher G; Liu, Renyuan; Zhao, Hui; Wu, Wenbo; Zhang, Xin; Li, Ming; Yu, Haiping; Zhu, Bin; Villringer, Arno; Zang, Yufeng; Zhang, Bing; Lv, Yating; Xu, Yun

    2017-01-31

    To evaluate the potential clinical value of the time-shift analysis (TSA) approach for resting-state fMRI (rs-fMRI) blood oxygenation level-dependent (BOLD) data in detecting hypoperfusion of subacute stroke patients through comparison with dynamic susceptibility contrast perfusion weighted imaging (DSC-PWI). Forty patients with subacute stroke (3-14 days after neurological symptom onset) underwent MRI examination. Cohort A: 31 patients had MRA, DSC-PWI and BOLD data. Cohort B: 9 patients had BOLD and MRA data. The time delay between the BOLD time course in each voxel and the mean signal of global and contralateral hemisphere was calculated using TSA. Time to peak (TTP) was employed to detect hypoperfusion. Among cohort A, 14 patients who had intracranial large-vessel occlusion/stenosis with sparse collaterals showed hypoperfusion by both of the two approaches, one with abundant collaterals showed neither TTP nor TSA time delay. The remaining 16 patients without obvious MRA lesions showed neither TTP nor TSA time delay. Among cohort B, eight patients showed time delay areas. The TSA approach was a promising alternative to DSC-PWI for detecting hypoperfusion in subacute stroke patients who had obvious MRA lesions with sparse collaterals, those with abundant collaterals would keep intact local perfusion.

  7. The value of resting-state functional MRI in subacute ischemic stroke: comparison with dynamic susceptibility contrast-enhanced perfusion MRI

    PubMed Central

    Ni, Ling; Li, Jingwei; Li, Weiping; Zhou, Fei; Wang, Fangfang; Schwarz, Christopher G.; Liu, Renyuan; Zhao, Hui; Wu, Wenbo; Zhang, Xin; Li, Ming; Yu, Haiping; Zhu, Bin; Villringer, Arno; Zang, Yufeng; Zhang, Bing; Lv, Yating; Xu, Yun

    2017-01-01

    To evaluate the potential clinical value of the time-shift analysis (TSA) approach for resting-state fMRI (rs-fMRI) blood oxygenation level-dependent (BOLD) data in detecting hypoperfusion of subacute stroke patients through comparison with dynamic susceptibility contrast perfusion weighted imaging (DSC-PWI). Forty patients with subacute stroke (3–14 days after neurological symptom onset) underwent MRI examination. Cohort A: 31 patients had MRA, DSC-PWI and BOLD data. Cohort B: 9 patients had BOLD and MRA data. The time delay between the BOLD time course in each voxel and the mean signal of global and contralateral hemisphere was calculated using TSA. Time to peak (TTP) was employed to detect hypoperfusion. Among cohort A, 14 patients who had intracranial large-vessel occlusion/stenosis with sparse collaterals showed hypoperfusion by both of the two approaches, one with abundant collaterals showed neither TTP nor TSA time delay. The remaining 16 patients without obvious MRA lesions showed neither TTP nor TSA time delay. Among cohort B, eight patients showed time delay areas. The TSA approach was a promising alternative to DSC-PWI for detecting hypoperfusion in subacute stroke patients who had obvious MRA lesions with sparse collaterals, those with abundant collaterals would keep intact local perfusion. PMID:28139701

  8. Dynamic contrast-enhanced susceptibility-weighted perfusion MRI (DSC-MRI) in a glioma model of the rat brain using a conventional receive-only surface coil with a inner diameter of 47 mm at a clinical 1.5 T scanner.

    PubMed

    Ulmer, Stephan; Reeh, Matthias; Krause, Joerg; Herdegen, Thomas; Heldt-Feindt, Janka; Jansen, Olav; Rohr, Axel

    2008-07-30

    Magnetic resonance (MR) imaging in animal models is usually performed in expensive dedicated small bore animal scanners of limited availability. In the present study a standard clinical 1.5 T MR scanner was used for morphometric and dynamic contrast-enhanced susceptibility-weighted MR imaging (DSC-MRI) of a glioma model of the rat brain. Ten male Wistar rats were examined with coronal T2-weighted, and T1-weighted images (matrix 128 x 128, FOV 64 mm) after implantation of an intracerebral tumor xenografts (C6) using a conventional surface coil. For DSC-MRI a T2*-weighted sequence (TR/TE=30/14 ms, matrix 64 x 64, FOV 90 mm; slice thickness of 1.5mm) was performed. Regions of interest were defined within the tumor and the non-affected contralateral hemisphere and the mean transit time (MTT) was determined. Tumor dimensions in MR predicted well its real size as proven by histology. The MTT of contrast agent passing through the brain was significantly decelerated in the tumor compared to the unaffected hemisphere (p<0.001, paired t-test), which is most likely due to the leakage of contrast agent through the disrupted blood brain barrier. This setup offers advanced MR imaging of small animals without the need for dedicated animal scanners or dedicated custom-made coils.

  9. Nocardia brain abscess mimicking high-grade necrotic tumor on perfusion MRI.

    PubMed

    Cianfoni, Alessandro; Calandrelli, Rosalinda; De Bonis, Pasquale; Pompucci, Angelo; Lauriola, Libero; Colosimo, Cesare

    2010-08-01

    Differentiating a pyogenic cerebral abscess from a cystic brain tumor can be a challenge when using morphological and functional imaging techniques. Several studies on MRI perfusion-weighted imaging (PWI) have demonstrated that enhancing abscess capsules have lower cerebral blood volume ratios (rCBV) than the enhancing rims of necrotic tumors. We report a 67-year-old male with a Nocardia cerebral abscess showing restricted diffusion in the necrotic center, but high values for rCBV in the enhancing capsule on PWI, therefore mimicking a high-grade necrotic tumor. Differential diagnosis between cerebral abscesses and necrotic tumors is greatly improved by the adjunct of diffusion-weighted imaging (DWI) and PWI to the morphological magnetic resonance findings; yet there is still overlap. That an abscess may show increased rCBV along the capsule, therefore mimicking a hypervascular brain tumor on PWI, should be considered when attempting a radiological diagnosis of a ring-enhancing brain lesion. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. Brain/language relationships identified with diffusion and perfusion MRI: Clinical applications in neurology and neurosurgery.

    PubMed

    Hillis, Argye E

    2005-12-01

    Diffusion and perfusion MRI have contributed to stroke management by identifying patients with tissue "at risk" for further damage in acute stroke. However, the potential usefulness of these imaging modalities, along with diffusion tensor imaging, can be expanded by using these imaging techniques with concurrent assessment of language and other cognitive skills to identify the specific cognitive deficits that are associated with diffusion and perfusion abnormalities in particular brain regions. This paper illustrates how this combined behavioral and imaging methodology can yield information that is useful for predicting specific positive effects of intervention to restore blood flow in hypoperfused regions of brain identified with perfusion MRI, and for predicting negative effects of resection of particular brain regions or fiber bundles. Such data allow decisions about neurological and neurosurgical interventions to be based on specific risks and benefits in terms of functional consequences.

  11. Comparison of perfusion- and diffusion-weighted imaging parameters in brain tumor studies processed using different software platforms.

    PubMed

    Milchenko, Mikhail V; Rajderkar, Dhanashree; LaMontagne, Pamela; Massoumzadeh, Parinaz; Bogdasarian, Ronald; Schweitzer, Gordon; Benzinger, Tammie; Marcus, Dan; Shimony, Joshua S; Fouke, Sarah Jost

    2014-10-01

    To compare quantitative imaging parameter measures from diffusion- and perfusion-weighted imaging magnetic resonance imaging (MRI) sequences in subjects with brain tumors that have been processed with different software platforms. Scans from 20 subjects with primary brain tumors were selected from the Comprehensive Neuro-oncology Data Repository at Washington University School of Medicine (WUSM) and the Swedish Neuroscience Institute. MR images were coregistered, and each subject's data set was processed by three software packages: 1) vendor-specific scanner software, 2) research software developed at WUSM, and 3) a commercially available, Food and Drug Administration-approved, processing platform (Nordic Ice). Regions of interest (ROIs) were chosen within the brain tumor and normal nontumor tissue. The results obtained using these methods were compared. For diffusion parameters, including mean diffusivity and fractional anisotropy, concordance was high when comparing different processing methods. For perfusion-imaging parameters, a significant variance in cerebral blood volume, cerebral blood flow, and mean transit time (MTT) values was seen when comparing the same raw data processed using different software platforms. Correlation was better with larger ROIs (radii ≥ 5 mm). Greatest variance was observed in MTT. Diffusion parameter values were consistent across different software processing platforms. Perfusion parameter values were more variable and were influenced by the software used. Variation in the MTT was especially large suggesting that MTT estimation may be unreliable in tumor tissues using current MRI perfusion methods. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  12. Spiral Perfusion Imaging With Consecutive Echoes (SPICE™) for the Simultaneous Mapping of DSC- and DCE-MRI Parameters in Brain Tumor Patients: Theory and Initial Feasibility

    PubMed Central

    Paulson, Eric S.; Prah, Douglas E.; Schmainda, Kathleen M.

    2017-01-01

    Dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) are the perfusion imaging techniques most frequently used to probe the angiogenic character of brain neoplasms. With these methods, T1- and T2/T2*-weighted imaging sequences are used to image the distribution of gadolinium (Gd)-based contrast agents. However, it is well known that Gd exhibits combined T1, T2, and T2* shortening effects in tissue, and therefore, the results of both DCE- and DSC-MRI can be confounded by these opposing effects. In particular, residual susceptibility effects compete with T1 shortening, which can confound DCE-MRI parameters, whereas dipolar T1 and T2 leakage and residual susceptibility effects can confound DSC-MRI parameters. We introduce here a novel perfusion imaging acquisition and postprocessing method termed Spiral Perfusion Imaging with Consecutive Echoes (SPICE) that can be used to simultaneously acquire DCE- and DSC-MRI data, which requires only a single dose of the Gd contrast agent, does not require the collection of a precontrast T1 map for DCE-MRI processing, and eliminates the confounding contrast agent effects due to contrast extravasation. A detailed mathematical description of SPICE is provided here along with a demonstration of its utility in patients with high-grade glioma. PMID:28090589

  13. Spiral Perfusion Imaging With Consecutive Echoes (SPICE™) for the Simultaneous Mapping of DSC- and DCE-MRI Parameters in Brain Tumor Patients: Theory and Initial Feasibility.

    PubMed

    Paulson, Eric S; Prah, Douglas E; Schmainda, Kathleen M

    2016-12-01

    Dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) are the perfusion imaging techniques most frequently used to probe the angiogenic character of brain neoplasms. With these methods, T1- and T2/T2*-weighted imaging sequences are used to image the distribution of gadolinium (Gd)-based contrast agents. However, it is well known that Gd exhibits combined T1, T2, and T2* shortening effects in tissue, and therefore, the results of both DCE- and DSC-MRI can be confounded by these opposing effects. In particular, residual susceptibility effects compete with T1 shortening, which can confound DCE-MRI parameters, whereas dipolar T1 and T2 leakage and residual susceptibility effects can confound DSC-MRI parameters. We introduce here a novel perfusion imaging acquisition and postprocessing method termed Spiral Perfusion Imaging with Consecutive Echoes (SPICE) that can be used to simultaneously acquire DCE- and DSC-MRI data, which requires only a single dose of the Gd contrast agent, does not require the collection of a precontrast T1 map for DCE-MRI processing, and eliminates the confounding contrast agent effects due to contrast extravasation. A detailed mathematical description of SPICE is provided here along with a demonstration of its utility in patients with high-grade glioma.

  14. Interrelations of muscle functional MRI, diffusion-weighted MRI and (31) P-MRS in exercised lower back muscles.

    PubMed

    Hiepe, Patrick; Gussew, Alexander; Rzanny, Reinhard; Anders, Christoph; Walther, Mario; Scholle, Hans-Christoph; Reichenbach, Jürgen R

    2014-08-01

    Exercise-induced changes of transverse proton relaxation time (T2 ), tissue perfusion and metabolic turnover were investigated in the lower back muscles of volunteers by applying muscle functional MRI (mfMRI) and diffusion-weighted imaging (DWI) before and after as well as dynamic (31) P-MRS during the exercise. Inner (M. multifidus, MF) and outer lower back muscles (M. erector spinae, ES) were examined in 14 healthy young men performing a sustained isometric trunk-extension. Significant phosphocreatine (PCr) depletions ranging from 30% (ES) to 34% (MF) and Pi accumulations between 95% (left ES) and 120%-140% (MF muscles and right ES) were observed during the exercise, which were accompanied by significantly decreased pH values in all muscles (∆pH ≈ -0.05). Baseline T2 values were similar across all investigated muscles (approximately 27 ms at 3 T), but revealed right-left asymmetric increases (T2 ,inc ) after the exercise (right ES/MF: T2 ,inc  = 11.8/9.7%; left ES/MF: T2 ,inc  = 4.6/8.9%). Analyzed muscles also showed load-induced increases in molecular diffusion D (p = .007) and perfusion fraction f (p = .002). The latter parameter was significantly higher in the MF than in the ES muscles both at rest and post exercise. Changes in PCr (p = .03), diffusion (p < .01) and perfusion (p = .03) were strongly associated with T2,inc , and linear mixed model analysis revealed that changes in PCr and perfusion both affect T2,inc (p < .001). These findings support previous assumptions that T2 changes are not only an intra-cellular phenomenon resulting from metabolic stress but are also affected by increased perfusion in loaded muscles.

  15. Validation of diffuse correlation spectroscopy for muscle blood flow with concurrent arterial spin labeled perfusion MRI

    NASA Astrophysics Data System (ADS)

    Yu, Guoqiang; Floyd, Thomas F.; Durduran, Turgut; Zhou, Chao; Wang, Jiongjiong; Detre, John A.; Yodh, Arjun G.

    2007-02-01

    Calf blood flow was measured simultaneously in healthy human subjects (n = 7) during cuff inflation and deflation using near-infrared diffuse correlation spectroscopy (DCS) and arterial spin labeled perfusion MRI (ASL-MRI). The DCS and ASL-MRI data exhibited highly correlated absolute and relative dynamic flow responses in each individual (p < 0.001). Peak flow variations during hyperemia were also significantly correlated, though more for relative (p = 0.003) than absolute (p = 0.016) flow. Repeated measurement variation was less than 8% for both modalities. The results provide much needed quantitative blood flow validation of the diffuse optical correlation method in humans.

  16. Functional Cardiac Magnetic Resonance Imaging (MRI) in the Assessment of Myocardial Viability and Perfusion

    PubMed Central

    2003-01-01

    Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness safety and cost-effectiveness of using functional cardiac magnetic resonance imaging (MRI) for the assessment of myocardial viability and perfusion in patients with coronary artery disease and left ventricular dysfunction. Results Functional MRI has become increasingly investigated as a noninvasive method for assessing myocardial viability and perfusion. Most patients in the published literature have mild to moderate impaired LV function. It is possible that the severity of LV dysfunction may be an important factor that can alter the diagnostic accuracy of imaging techniques. There is some evidence of comparable or better performance of functional cardiac MRI for the assessment of myocardial viability and perfusion compared with other imaging techniques. However limitations to most of the studies included: Functional cardiac MRI studies that assess myocardial viability and perfusion have had small sample sizes. Some studies assessed myocardial viability/perfusion in patients who had already undergone revascularization, or excluded patients with a prior MI (Schwitter et al., 2001). Lack of explicit detail of patient recruitment. Patients with LVEF >35%. Interstudy variability in post MI imaging time(including acute or chronic MI), when patients with a prior MI were included. Poor interobserver agreement (kappa statistic) in the interpretation of the results. Traditionally, 0.80 is considered “good”. Cardiac MRI measurement of myocardial perfusion to as an adjunct tool to help diagnose CAD (prior to a definitive coronary angiography) has also been examined in some studies, with methodological limitations, yielding comparable results. Many studies examining myocardial viability and perfusion report on the accuracy of imaging methods with limited data on long-term patient outcome and management. Kim et al. (2000) revealed that the transmural

  17. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI.

    PubMed

    Pizzini, Francesca B; Farace, Paolo; Manganotti, Paolo; Zoccatelli, Giada; Bongiovanni, Luigi G; Golay, Xavier; Beltramello, Alberto; Osculati, Antonio; Bertini, Giuseppe; Fabene, Paolo F

    2013-07-01

    Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.

  18. Non-ECG-gated myocardial perfusion MRI using continuous magnetization-driven radial sampling.

    PubMed

    Sharif, Behzad; Dharmakumar, Rohan; Arsanjani, Reza; Thomson, Louise; Bairey Merz, C Noel; Berman, Daniel S; Li, Debiao

    2014-12-01

    Establishing a high-resolution non-ECG-gated first-pass perfusion (FPP) cardiac MRI technique may improve accessibility and diagnostic capability of FPP imaging. We propose a non-ECG-gated FPP imaging technique using continuous magnetization-driven golden-angle radial acquisition. The main purpose of this preliminary study is to evaluate whether, in the simple case of single-slice two-dimensional imaging, adequate myocardial contrast can be obtained for accurate visualization of hypoperfused territories in the setting of myocardial ischemia. A T1-weighted pulse sequence with continuous golden-angle radial sampling was developed for non-ECG-gated FPP imaging. A sliding-window scheme with no temporal acceleration was used to reconstruct 8 frames/s. Canines were imaged at 3T with and without coronary stenosis using the proposed scheme and a conventional magnetization-prepared ECG-gated FPP method. Our studies showed that the proposed non-ECG-gated method is capable of generating high-resolution (1.7 × 1.7 × 6 mm(3) ) artifact-free FPP images of a single slice at high heart rates (92 ± 21 beats/min), while matching the performance of conventional FPP imaging in terms of hypoperfused-to-normal myocardial contrast-to-noise ratio (proposed: 5.18 ± 0.70, conventional: 4.88 ± 0.43). Furthermore, the detected perfusion defect areas were consistent with the conventional FPP images. Non-ECG-gated FPP imaging using optimized continuous golden-angle radial acquisition achieves desirable image quality (i.e., adequate myocardial contrast, high spatial resolution, and minimal artifacts) in the setting of ischemia. © 2014 Wiley Periodicals, Inc.

  19. Non-ECG-Gated Myocardial Perfusion MRI Using Continuous Magnetization-Driven Radial Sampling

    PubMed Central

    Sharif, Behzad; Dharmakumar, Rohan; Arsanjani, Reza; Thomson, Louise; Merz, C. Noel Bairey; Berman, Daniel S.; Li, Debiao

    2014-01-01

    Purpose Establishing a high-resolution non-ECG-gated first-pass perfusion (FPP) cardiac MRI technique may improve accessibility and diagnostic capability of FPP imaging. We propose a non-ECG-gated FPP imaging technique using continuous magnetization-driven golden-angle radial acquisition. The main purpose of this preliminary study is to evaluate whether, in the simple case of single-slice 2D imaging, adequate myocardial contrast can be obtained for accurate visualization of hypoperfused territories in the setting of myocardial ischemia. Methods A T1-weighted pulse sequence with continuous golden-angle radial sampling was developed for non-ECG-gated FPP imaging. A sliding-window scheme with no temporal acceleration was used to reconstruct 8 frames/second. Canines were imaged at 3T with and without coronary stenosis using the proposed scheme and a conventional magnetization-prepared ECG-gated FPP method. Results Our studies showed that the proposed non-ECG-gated method is capable of generating high-resolution (1.7×1.7×6 mm3) artifact-free FPP images of a single slice at high heart rates (92±21 beats/minute), while matching the performance of conventional FPP imaging in terms of hypoperfused-to-normal myocardial contrast-to-noise ratio (proposed: 5.18±0.70, conventional: 4.88±0.43). Furthermore, the detected perfusion defect areas were consistent with the conventional FPP images. Conclusion Non-ECG-gated FPP imaging using optimized continuous golden-angle radial acquisition achieves desirable image quality (i.e., adequate myocardial contrast, high spatial resolution, and minimal artifacts) in the setting of ischemia. PMID:24443160

  20. A methodology for generating normal and pathological brain perfusion SPECT images for evaluation of MRI/SPECT fusion methods: application in epilepsy

    NASA Astrophysics Data System (ADS)

    Grova, C.; Jannin, P.; Biraben, A.; Buvat, I.; Benali, H.; Bernard, A. M.; Scarabin, J. M.; Gibaud, B.

    2003-12-01

    Quantitative evaluation of brain MRI/SPECT fusion methods for normal and in particular pathological datasets is difficult, due to the frequent lack of relevant ground truth. We propose a methodology to generate MRI and SPECT datasets dedicated to the evaluation of MRI/SPECT fusion methods and illustrate the method when dealing with ictal SPECT. The method consists in generating normal or pathological SPECT data perfectly aligned with a high-resolution 3D T1-weighted MRI using realistic Monte Carlo simulations that closely reproduce the response of a SPECT imaging system. Anatomical input data for the SPECT simulations are obtained from this 3D T1-weighted MRI, while functional input data result from an inter-individual analysis of anatomically standardized SPECT data. The method makes it possible to control the 'brain perfusion' function by proposing a theoretical model of brain perfusion from measurements performed on real SPECT images. Our method provides an absolute gold standard for assessing MRI/SPECT registration method accuracy since, by construction, the SPECT data are perfectly registered with the MRI data. The proposed methodology has been applied to create a theoretical model of normal brain perfusion and ictal brain perfusion characteristic of mesial temporal lobe epilepsy. To approach realistic and unbiased perfusion models, real SPECT data were corrected for uniform attenuation, scatter and partial volume effect. An anatomic standardization was used to account for anatomic variability between subjects. Realistic simulations of normal and ictal SPECT deduced from these perfusion models are presented. The comparison of real and simulated SPECT images showed relative differences in regional activity concentration of less than 20% in most anatomical structures, for both normal and ictal data, suggesting realistic models of perfusion distributions for evaluation purposes. Inter-hemispheric asymmetry coefficients measured on simulated data were found within

  1. A methodology for generating normal and pathological brain perfusion SPECT images for evaluation of MRI/SPECT fusion methods: application in epilepsy.

    PubMed

    Grova, C; Jannin, P; Biraben, A; Buvat, I; Benali, H; Bernard, A M; Scarabin, J M; Gibaud, B

    2003-12-21

    Quantitative evaluation of brain MRI/SPECT fusion methods for normal and in particular pathological datasets is difficult, due to the frequent lack of relevant ground truth. We propose a methodology to generate MRI and SPECT datasets dedicated to the evaluation of MRI/SPECT fusion methods and illustrate the method when dealing with ictal SPECT. The method consists in generating normal or pathological SPECT data perfectly aligned with a high-resolution 3D T1-weighted MRI using realistic Monte Carlo simulations that closely reproduce the response of a SPECT imaging system. Anatomical input data for the SPECT simulations are obtained from this 3D T1-weighted MRI, while functional input data result from an inter-individual analysis of anatomically standardized SPECT data. The method makes it possible to control the 'brain perfusion' function by proposing a theoretical model of brain perfusion from measurements performed on real SPECT images. Our method provides an absolute gold standard for assessing MRI/SPECT registration method accuracy since, by construction, the SPECT data are perfectly registered with the MRI data. The proposed methodology has been applied to create a theoretical model of normal brain perfusion and ictal brain perfusion characteristic of mesial temporal lobe epilepsy. To approach realistic and unbiased perfusion models, real SPECT data were corrected for uniform attenuation, scatter and partial volume effect. An anatomic standardization was used to account for anatomic variability between subjects. Realistic simulations of normal and ictal SPECT deduced from these perfusion models are presented. The comparison of real and simulated SPECT images showed relative differences in regional activity concentration of less than 20% in most anatomical structures, for both normal and ictal data, suggesting realistic models of perfusion distributions for evaluation purposes. Inter-hemispheric asymmetry coefficients measured on simulated data were found within

  2. Resting State Brain Function Analysis Using Concurrent BOLD in ASL Perfusion fMRI

    PubMed Central

    Zhu, Senhua; Fang, Zhuo; Hu, Siyuan; Wang, Ze; Rao, Hengyi

    2013-01-01

    The past decade has seen astounding discoveries about resting-state brain activity patterns in normal brain as well as their alterations in brain diseases. While the vast majority of resting-state studies are based on the blood-oxygen-level-dependent (BOLD) functional MRI (fMRI), arterial spin labeling (ASL) perfusion fMRI can simultaneously capture BOLD and cerebral blood flow (CBF) signals, providing a unique opportunity for assessing resting brain functions with concurrent BOLD (ccBOLD) and CBF signals. Before taking that benefit, it is necessary to validate the utility of ccBOLD signal for resting-state analysis using conventional BOLD (cvBOLD) signal acquired without ASL modulations. To address this technical issue, resting cvBOLD and ASL perfusion MRI were acquired from a large cohort (n = 89) of healthy subjects. Four widely used resting-state brain function analyses were conducted and compared between the two types of BOLD signal, including the posterior cingulate cortex (PCC) seed-based functional connectivity (FC) analysis, independent component analysis (ICA), analysis of amplitude of low frequency fluctuation (ALFF), and analysis of regional homogeneity (ReHo). Consistent default mode network (DMN) as well as other resting-state networks (RSNs) were observed from cvBOLD and ccBOLD using PCC-FC analysis and ICA. ALFF from both modalities were the same for most of brain regions but were different in peripheral regions suffering from the susceptibility gradients induced signal drop. ReHo showed difference in many brain regions, likely reflecting the SNR and resolution differences between the two BOLD modalities. The DMN and auditory networks showed highest CBF values among all RSNs. These results demonstrated the feasibility of ASL perfusion MRI for assessing resting brain functions using its concurrent BOLD in addition to CBF signal, which provides a potentially useful way to maximize the utility of ASL perfusion MRI. PMID:23750275

  3. ANTONIA perfusion and stroke. A software tool for the multi-purpose analysis of MR perfusion-weighted datasets and quantitative ischemic stroke assessment.

    PubMed

    Forkert, N D; Cheng, B; Kemmling, A; Thomalla, G; Fiehler, J

    2014-01-01

    The objective of this work is to present the software tool ANTONIA, which has been developed to facilitate a quantitative analysis of perfusion-weighted MRI (PWI) datasets in general as well as the subsequent multi-parametric analysis of additional datasets for the specific purpose of acute ischemic stroke patient dataset evaluation. Three different methods for the analysis of DSC or DCE PWI datasets are currently implemented in ANTONIA, which can be case-specifically selected based on the study protocol. These methods comprise a curve fitting method as well as a deconvolution-based and deconvolution-free method integrating a previously defined arterial input function. The perfusion analysis is extended for the purpose of acute ischemic stroke analysis by additional methods that enable an automatic atlas-based selection of the arterial input function, an analysis of the perfusion-diffusion and DWI-FLAIR mismatch as well as segmentation-based volumetric analyses. For reliability evaluation, the described software tool was used by two observers for quantitative analysis of 15 datasets from acute ischemic stroke patients to extract the acute lesion core volume, FLAIR ratio, perfusion-diffusion mismatch volume with manually as well as automatically selected arterial input functions, and follow-up lesion volume. The results of this evaluation revealed that the described software tool leads to highly reproducible results for all parameters if the automatic arterial input function selection method is used. Due to the broad selection of processing methods that are available in the software tool, ANTONIA is especially helpful to support image-based perfusion and acute ischemic stroke research projects.

  4. Prediction of hemorrhagic transformation following acute stroke: role of diffusion- and perfusion-weighted magnetic resonance imaging.

    PubMed

    Tong, D C; Adami, A; Moseley, M E; Marks, M P

    2001-04-01

    Acute diffusion-weighted (DWI) and perfusion-weighted (PWI) magnetic resonance imaging (MRI) findings may correlate with secondary hemorrhagic transformation (HT) risk in patients with stroke. This information could be of value, particularly in individuals being considered for thrombolytic therapy. To determine the relationship between DWI and PWI findings and the risk of secondary HT in patients with acute stroke. Retrospective case series. Academic medical center. Twenty-seven patients with acute stroke capable of being evaluated with DWI/PWI 8 hours or less after symptom onset. Apparent diffusion coefficient values, perfusion delay measurements, and subsequent MRI or computed tomographic scans detected HT. The mean +/- SD apparent diffusion coefficient of ischemic regions that experienced HT was significantly lower than the overall mean +/- SD apparent diffusion coefficient of all ischemic areas analyzed (0.510 +/- 0.140 x 10(-3) mm(2)/s vs 623 +/- 0.113 x 10(-3) mm(2)/s; P =.004). This difference remained significant when comparing the HT-destined ischemic areas with the non-HT-destined areas within the same ischemic lesion (P =.02). Patients receiving recombinant tissue-type plasminogen activator (rt-PA) experienced HT significantly earlier than patients not receiving rt-PA (P =.002). Moreover, a persistent perfusion deficit in the area of subsequent hemorrhage at 3 to 6 hours after the initial MRI scan was identified in significantly more patients who experienced HT than in those who did not (83% vs 30%; P =.03). Both DWI and PWI scans detect abnormalities that are associated with HT. These findings support a role for MRI in identifying patients who are at increased risk for secondary HT following acute ischemic stroke.

  5. Dynamic Contrast-Enhanced MRI Perfusion Parameters as Imaging Biomarkers of Angiogenesis

    PubMed Central

    2016-01-01

    Hypoxia in the tumor microenvironment is the leading factor in angiogenesis. Angiogenesis can be identified by dynamic contrast-enhanced breast MRI (DCE MRI). Here we investigate the relationship between perfusion parameters on DCE MRI and angiogenic and prognostic factors in patients with invasive ductal carcinoma (IDC). Perfusion parameters (Ktrans, kep and ve) of 81 IDC were obtained using histogram analysis. Twenty-fifth, 50th and 75th percentile values were calculated and were analyzed for association with microvessel density (MVD), vascular endothelial growth factor (VEGF) and conventional prognostic factors. Correlation between MVD and ve50 was positive (r = 0.33). Ktrans50 was higher in tumors larger than 2 cm than in tumors smaller than 2 cm. In multivariate analysis, Ktrans50 was affected by tumor size and MVD with 12.8% explanation. There was significant association between Ktrans50 and tumor size and MVD. Therefore we conclude that DCE MRI perfusion parameters are potential imaging biomarkers for prediction of tumor angiogenesis and aggressiveness. PMID:28036342

  6. Quantitative Perfusion Analysis of First-Pass Contrast Enhancement Kinetics: Application to MRI of Myocardial Perfusion in Coronary Artery Disease

    PubMed Central

    Shah, Binita; Storey, Pippa; Iqbal, Sohah; Slater, James; Axel, Leon

    2016-01-01

    Purpose Perfusion analysis from first-pass contrast enhancement kinetics requires modeling tissue contrast exchange. This study presents a new approach for numerical implementation of the tissue homogeneity model, incorporating flexible distance steps along the capillary (NTHf). Methods The proposed NTHf model considers contrast exchange in fluid packets flowing along the capillary, incorporating flexible distance steps, thus allowing more efficient and stable calculations of the transit of tracer through the tissue. We prospectively studied 8 patients (62 ± 13 years old) with suspected CAD, who underwent first-pass perfusion CMR imaging at rest and stress prior to angiography. Myocardial blood flow (MBF) and myocardial perfusion reserve index (MPRI) were estimated using both the NTHf and the conventional adiabatic approximation of the TH models. Coronary artery lesions detected at angiography were clinically assigned to one of three categories of stenosis severity (‘insignificant’, ‘mild to moderate’ and ‘severe’) and related to corresponding myocardial territories. Results The mean MBF (ml/g/min) at rest/stress and MPRI were 0.80 ± 0.33/1.25 ± 0.45 and 1.68 ± 0.54 in the insignificant regions, 0.74 ± 0.21/1.09 ± 0.28 and 1.54 ± 0.46 in the mild to moderate regions, and 0.79 ± 0.28/0.63 ± 0.34 and 0.85 ± 0.48 in the severe regions, respectively. The correlation coefficients of MBFs at rest/stress and MPRI between the NTHf and AATH models were r = 0.97/0.93 and r = 0.91, respectively. Conclusions The proposed NTHf model allows efficient quantitative analysis of the transit of tracer through tissue, particularly at higher flow. Results of initial application to MRI of myocardial perfusion in CAD are encouraging. PMID:27583385

  7. The correlation of contrast-enhanced ultrasound and MRI perfusion quantitative analysis in rabbit VX2 liver cancer.

    PubMed

    Xiang, Zhiming; Liang, Qianwen; Liang, Changhong; Zhong, Guimian

    2014-12-01

    Our objective is to explore the value of liver cancer contrast-enhanced ultrasound (CEUS) and MRI perfusion quantitative analysis in liver cancer and the correlation between these two analysis methods. Rabbit VX2 liver cancer model was established in this study. CEUS was applied. Sono Vue was applied in rabbits by ear vein to dynamically observe and record the blood perfusion and changes in the process of VX2 liver cancer and surrounding tissue. MRI perfusion quantitative analysis was used to analyze the mean enhancement time and change law of maximal slope increasing, which were further compared with the pathological examination results. Quantitative indicators of liver cancer CEUS and MRI perfusion quantitative analysis were compared, and the correlation between them was analyzed by correlation analysis. Rabbit VX2 liver cancer model was successfully established. CEUS showed that time-intensity curve of rabbit VX2 liver cancer showed "fast in, fast out" model while MRI perfusion quantitative analysis showed that quantitative parameter MTE of tumor tissue increased and MSI decreased: the difference was statistically significant (P < 0.01). The diagnostic results of CEUS and MRI perfusion quantitative analysis were not significantly different (P > 0.05). However, the quantitative parameter of them were significantly positively correlated (P < 0.05). CEUS and MRI perfusion quantitative analysis can both dynamically monitor the liver cancer lesion and surrounding liver parenchyma, and the quantitative parameters of them are correlated. The combined application of both is of importance in early diagnosis of liver cancer.

  8. Perfusion and pH MRI in familial hemiplegic migraine with prolonged aura.

    PubMed

    Blicher, Jakob Udby; Tietze, Anna; Donahue, Manus J; Smith, Seth A; Østergaard, Leif

    2016-03-01

    To investigate tissue flow disturbance and hypoxia during migraine aura, we studied a case of familial hemiplegic migraine (FHM) using novel magnetic resonance imaging (MRI) techniques. A 44-year-old male was admitted with suspected stroke because of confusion and aphasia. Initial gadolinium-based perfusion MRI showed a decrease in cerebral blood flow and an increase in capillary flow disturbances within the left hemisphere. Later during the prolonged aura phase, chemical exchange saturation transfer MRI indicated a drop in pH in the affected area. The patient was diagnosed with an R908Q mutation in the ATP1A2 gene causing FHM type 2. During prolonged aura in FHM, MRI shows reduced CBF, capillary flow disturbances and a possible pH drop that could indicate tissue hypoxia. © International Headache Society 2015.

  9. Separating blood and water: Perfusion and free water elimination from diffusion MRI in the human brain.

    PubMed

    Rydhög, Anna S; Szczepankiewicz, Filip; Wirestam, Ronnie; Ahlgren, André; Westin, Carl-Fredrik; Knutsson, Linda; Pasternak, Ofer

    2017-08-01

    The assessment of the free water fraction in the brain provides important information about extracellular processes such as atrophy and neuroinflammation in various clinical conditions as well as in normal development and aging. Free water estimates from diffusion MRI are assumed to account for freely diffusing water molecules in the extracellular space, but may be biased by other pools of molecules in rapid random motion, such as the intravoxel incoherent motion (IVIM) of blood, where water molecules perfuse in the randomly oriented capillary network. The goal of this work was to separate the signal contribution of the perfusing blood from that of free-water and of other brain diffusivities. The influence of the vascular compartment on the estimation of the free water fraction and other diffusivities was investigated by simulating perfusion in diffusion MRI data. The perfusion effect in the simulations was significant, especially for the estimation of the free water fraction, and was maintained as long as low b-value data were included in the analysis. Two approaches to reduce the perfusion effect were explored in this study: (i) increasing the minimal b-value used in the fitting, and (ii) using a three-compartment model that explicitly accounts for water molecules in the capillary blood. Estimation of the model parameters while excluding low b-values reduced the perfusion effect but was highly sensitive to noise. The three-compartment model fit was more stable and additionally, provided an estimation of the volume fraction of the capillary blood compartment. The three-compartment model thus disentangles the effects of free water diffusion and perfusion, which is of major clinical importance since changes in these components in the brain may indicate different pathologies, i.e., those originating from the extracellular space, such as neuroinflammation and atrophy, and those related to the vascular space, such as vasodilation, vasoconstriction and capillary density

  10. Non-contrast-enhanced perfusion and ventilation assessment of the human lung by means of fourier decomposition in proton MRI.

    PubMed

    Bauman, Grzegorz; Puderbach, Michael; Deimling, Michael; Jellus, Vladimir; Chefd'hotel, Christophe; Dinkel, Julien; Hintze, Christian; Kauczor, Hans-Ulrich; Schad, Lothar R

    2009-09-01

    Assessment of regional lung perfusion and ventilation has significant clinical value for the diagnosis and follow-up of pulmonary diseases. In this work a new method of non-contrast-enhanced functional lung MRI (not dependent on intravenous or inhalative contrast agents) is proposed. A two-dimensional (2D) true fast imaging with steady precession (TrueFISP) pulse sequence (TR/TE = 1.9 ms/0.8 ms, acquisition time [TA] = 112 ms/image) was implemented on a 1.5T whole-body MR scanner. The imaging protocol comprised sets of 198 lung images acquired with an imaging rate of 3.33 images/s in coronal and sagittal view. No electrocardiogram (ECG) or respiratory triggering was used. A nonrigid image registration algorithm was applied to compensate for respiratory motion. Rapid data acquisition allowed observing intensity changes in corresponding lung areas with respect to the cardiac and respiratory frequencies. After a Fourier analysis along the time domain, two spectral lines corresponding to both frequencies were used to calculate the perfusion- and ventilation-weighted images. The described method was applied in preliminary studies on volunteers and patients showing clinical relevance to obtain non-contrast-enhanced perfusion and ventilation data.

  11. Sub-band denoising and spline curve fitting method for hemodynamic measurement in perfusion MRI

    NASA Astrophysics Data System (ADS)

    Lin, Hong-Dun; Huang, Hsiao-Ling; Hsu, Yuan-Yu; Chen, Chi-Chen; Chen, Ing-Yi; Wu, Liang-Chi; Liu, Ren-Shyan; Lin, Kang-Ping

    2003-05-01

    In clinical research, non-invasive MR perfusion imaging is capable of investigating brain perfusion phenomenon via various hemodynamic measurements, such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean trasnit time (MTT). These hemodynamic parameters are useful in diagnosing brain disorders such as stroke, infarction and periinfarct ischemia by further semi-quantitative analysis. However, the accuracy of quantitative analysis is usually affected by poor signal-to-noise ratio image quality. In this paper, we propose a hemodynamic measurement method based upon sub-band denoising and spline curve fitting processes to improve image quality for better hemodynamic quantitative analysis results. Ten sets of perfusion MRI data and corresponding PET images were used to validate the performance. For quantitative comparison, we evaluate gray/white matter CBF ratio. As a result, the hemodynamic semi-quantitative analysis result of mean gray to white matter CBF ratio is 2.10 +/- 0.34. The evaluated ratio of brain tissues in perfusion MRI is comparable to PET technique is less than 1-% difference in average. Furthermore, the method features excellent noise reduction and boundary preserving in image processing, and short hemodynamic measurement time.

  12. Perfusion deconvolution in DSC-MRI with dispersion-compliant bases.

    PubMed

    Pizzolato, Marco; Boutelier, Timothé; Deriche, Rachid

    2017-02-01

    Perfusion imaging of the brain via Dynamic Susceptibility Contrast MRI (DSC-MRI) allows tissue perfusion characterization by recovering the tissue impulse response function and scalar parameters such as the cerebral blood flow (CBF), blood volume (CBV), and mean transit time (MTT). However, the presence of bolus dispersion causes the data to reflect macrovascular properties, in addition to tissue perfusion. In this case, when performing deconvolution of the measured arterial and tissue concentration time-curves it is only possible to recover the effective, i.e. dispersed, response function and parameters. We introduce Dispersion-Compliant Bases (DCB) to represent the response function in the presence and absence of dispersion. We perform in silico and in vivo experiments, and show that DCB deconvolution outperforms oSVD and the state-of-the-art CPI+VTF techniques in the estimation of effective perfusion parameters, regardless of the presence and amount of dispersion. We also show that DCB deconvolution can be used as a pre-processing step to improve the estimation of dispersion-free parameters computed with CPI+VTF, which employs a model of the vascular transport function to characterize dispersion. Indeed, in silico results show a reduction of relative errors up to 50% for dispersion-free CBF and MTT. Moreover, the DCB method recovers effective response functions that comply with healthy and pathological scenarios, and offers the advantage of making no assumptions about the presence, amount, and nature of dispersion. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Perfusion and diffusion MRI of glioblastoma progression in a four-year prospective temozolomide clinical trial

    SciTech Connect

    Leimgruber, Antoine; Ostermann, Sandrine; Yeon, Eun Jo; Buff, Evelyn; Maeder, Philippe P.; Stupp, Roger; Meuli, Reto A. . E-mail: Reto.Meuli@chuv.ch

    2006-03-01

    Purpose: This study was performed to determine the impact of perfusion and diffusion magnetic resonance imaging (MRI) sequences on patients during treatment of newly diagnosed glioblastoma. Special emphasis has been given to these imaging technologies as tools to potentially anticipate disease progression, as progression-free survival is frequently used as a surrogate endpoint. Methods and Materials: Forty-one patients from a phase II temolozomide clinical trial were included. During follow-up, images were integrated 21 to 28 days after radiochemotherapy and every 2 months thereafter. Assessment of scans included measurement of size of lesion on T1 contrast-enhanced, T2, diffusion, and perfusion images, as well as mass effect. Classical criteria on tumor size variation and clinical parameters were used to set disease progression date. Results: A total of 311 MRI examinations were reviewed. At disease progression (32 patients), a multivariate Cox regression determined 2 significant survival parameters: T1 largest diameter (p < 0.02) and T2 size variation (p < 0.05), whereas perfusion and diffusion were not significant. Conclusion: Perfusion and diffusion techniques cannot be used to anticipate tumor progression. Decision making at disease progression is critical, and classical T1 and T2 imaging remain the gold standard. Specifically, a T1 contrast enhancement over 3 cm in largest diameter together with an increased T2 hypersignal is a marker of inferior prognosis.

  14. The diagnostic performance of perfusion MRI for differentiating glioma recurrence from pseudoprogression

    PubMed Central

    Wan, Bing; Wang, Siqi; Tu, Mengqi; Wu, Bo; Han, Ping; Xu, Haibo

    2017-01-01

    Abstract Background: The purpose of this meta-analysis was to evaluate the diagnostic accuracy of perfusion magnetic resonance imaging (MRI) as a method for differentiating glioma recurrence from pseudoprogression. Methods: The PubMed, Embase, Cochrane Library, and Chinese Biomedical databases were searched comprehensively for relevant studies up to August 3, 2016 according to specific inclusion and exclusion criteria. The quality of the included studies was assessed according to the quality assessment of diagnostic accuracy studies (QUADAS-2). After performing heterogeneity and threshold effect tests, pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated. Publication bias was evaluated visually by a funnel plot and quantitatively using Deek funnel plot asymmetry test. The area under the summary receiver operating characteristic curve was calculated to demonstrate the diagnostic performance of perfusion MRI. Results: Eleven studies covering 416 patients and 418 lesions were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.88 (95% confidence interval [CI] 0.84–0.92), 0.77 (95% CI 0.69–0.84), 3.93 (95% CI 2.83–5.46), 0.16 (95% CI 0.11–0.22), and 27.17 (95% CI 14.96–49.35), respectively. The area under the summary receiver operating characteristic curve was 0.8899. There was no notable publication bias. Sensitivity analysis showed that the meta-analysis results were stable and credible. Conclusion: While perfusion MRI is not the ideal diagnostic method for differentiating glioma recurrence from pseudoprogression, it could improve diagnostic accuracy. Therefore, further research on combining perfusion MRI with other imaging modalities is warranted. PMID:28296759

  15. Local perfusion and metabolic demand during exercise: a noninvasive MRI method of assessment.

    PubMed

    Richardson, R S; Haseler, L J; Nygren, A T; Bluml, S; Frank, L R

    2001-10-01

    A noninvasive magnetic resonance imaging (MRI) method to assess the distribution of perfusion and metabolic demand (Q/VO(2)) in exercising human skeletal muscle is described. This method combines two MRI techniques that can provide accurate multiple localized measurements of Q/VO(2) during steady-state plantar flexion exercise. The first technique, (31)P chemical shift imaging, permits the acquisition of comparable phosphorus spectra from multiple voxels simultaneously. Because phosphocreatine (PCr) depletion is directly proportional to ATP hydrolysis, its relative depletion can be used as an index of muscle O(2) uptake (VO(2)). The second MRI technique allows the measurement of both spatially and temporally resolved muscle perfusion in vivo by using arterial spin labeling. Promising validity and reliability data are presented for both MRI techniques. Initial results from the combined method provide evidence of a large variation in Q/VO(2), revealing areas of apparent under- and overperfusion for a given metabolic turnover. Analysis of these data in a similar fashion to that employed in the assessment of ventilation-to-perfusion matching in the lungs revealed a similar second moment of the perfusion distribution and PCr distribution on a log scale (log SD(Q) and log SD(PCr)) (0.47). Modeling the effect of variations in log SD(Q) and log SD(PCr) in terms of attainable VO(2), assuming no diffusion limits, indicates that the log SD(Q) and log SD(PCr) would allow only 92% of the target VO(2) to be achieved. This communication documents this novel, noninvasive method for assessing Q/VO(2), and initial data suggest that the mismatch in Q/VO(2) may play a significant role in determining O(2) transport and utilization during exercise.

  16. Hyperintensities on T2-weighted images in the basal ganglia of patients with major depression: cerebral perfusion and clinical implications.

    PubMed

    Vardi, Noa; Freedman, Nanette; Lester, Hava; Gomori, John M; Chisin, Roland; Lerer, Bernard; Bonne, Omer

    2011-05-31

    White matter hyperintensities on T2-weighted images (WMH T2-WI) are prevalent in depressed, particularly elderly, patients. In an earlier study we used structural magnetic resonance imaging (MRI) to study 37 depressed and 27 healthy control subjects to show that prevalence of WMH T2-WI is higher in depressed patients and that severity of depression and cognitive impairment is associated with presence of WMH T2-WI in basal ganglia. The occurrence of WMH T2-WI in depression may also be associated with cerebrovascular deficiency, although this association has not been adequately studied. We therefore performed single photon emission computed tomography (SPECT) with Technetium-99m hexamethylpropyleneamineoxime (Tc-99m HMPAO) as tracer in this same sample to seek an association between presence/location of WMH T2-WI and cerebral perfusion deficits. In addition, we examined the relationship between presence/location of WMH T2-WI and treatment response. We found that severely depressed, cognitively compromised patients with WMH T2-WI in the basal ganglia display more profuse cerebral perfusion deficits than less depressed patients with WMH T2-WI in other regions or with no WMH T2-WI but are not less responsive to antidepressant treatment. WMH T2-WI in depression are associated with cerebral perfusion deficits, although not necessarily located in the same regions as the MRI findings. Clinical symptoms are largely reversible even in depressed patients with WMH T2-WI in basal ganglia. 2010 Elsevier Ireland Ltd. All rights reserved.

  17. 3.0T MR investigation of CLIPPERS: role of susceptibility weighted and perfusion weighted imaging.

    PubMed

    Pesaresi, Ilaria; Sabato, Mario; Desideri, Ilaria; Puglioli, Michele; Moretti, Policarpo; Cosottini, Mirco

    2013-11-01

    For the first time we describe and interpret Susceptibility Weighted Imaging (SWI) and Perfusion Weighted Imaging (PWI) findings in a case of Chronic Lymphocytic Inflammation with Perivascular Pontine Enhancement Responsive to Steroids (CLIPPERS). The diagnosis of the disease was formulated on the basis of typical Magnetic Resonance (MR) findings and its responsiveness to steroids in a 40-year-old man with acute onset of dizziness, ataxia and diplopia. The patient underwent a 3 tesla (T) MR examination including SWI and PWI sequences. SWI revealed prominent veins and multiple hypointense lesions of different size widely distributed in brainstem and cerebellum, which could be expression of iron deposition or cellular infiltrates. PWI demonstrated global infratentorial hypoperfusion. SWI and PWI provide new information on CLIPPERS that might be helpful to understand the physiopathology of the disease. Further observations are needed to evaluate if these findings are peculiar for CLIPPERS and if they might have a role in a non-invasive diagnosis of the disease.

  18. Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications

    PubMed Central

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Miura, Sachiko; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-01-01

    Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA). Perfusion scintigraphy, single-photon emission tomography (SPECT) and SPECT fused with CT have been established as clinically available scintigraphic methods; however, they are limited by perfusion information with poor spatial resolution and other shortcomings. Although positron emission tomography with 15O water can measure absolute pulmonary perfusion, it requires a cyclotron for generation of a tracer with an extremely short half-life (2 min), and can only be performed for academic purposes. Therefore, clinicians are concentrating their efforts on the application of CT-based and MRI-based quantitative and qualitative perfusion assessment to various pulmonary diseases. This review article covers 1) the basics of dual-energy CT and dynamic first-pass contrast-enhanced perfusion CT techniques, 2) the basics of time-resolved contrast-enhanced MRA and dynamic first-pass contrast-enhanced perfusion MRI, and 3) clinical applications of contrast-enhanced CT- and MRI-based perfusion assessment for patients with pulmonary nodule, lung cancer, and pulmonary vascular diseases. We believe that these new techniques can be useful in routine clinical practice for not only thoracic oncology patients, but also patients with different pulmonary vascular diseases. PMID:27523813

  19. Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications.

    PubMed

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Miura, Sachiko; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-01-01

    Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA). Perfusion scintigraphy, single-photon emission tomography (SPECT) and SPECT fused with CT have been established as clinically available scintigraphic methods; however, they are limited by perfusion information with poor spatial resolution and other shortcomings. Although positron emission tomography with 15O water can measure absolute pulmonary perfusion, it requires a cyclotron for generation of a tracer with an extremely short half-life (2 min), and can only be performed for academic purposes. Therefore, clinicians are concentrating their efforts on the application of CT-based and MRI-based quantitative and qualitative perfusion assessment to various pulmonary diseases. This review article covers 1) the basics of dual-energy CT and dynamic first-pass contrast-enhanced perfusion CT techniques, 2) the basics of time-resolved contrast-enhanced MRA and dynamic first-pass contrast-enhanced perfusion MRI, and 3) clinical applications of contrast-enhanced CT- and MRI-based perfusion assessment for patients with pulmonary nodule, lung cancer, and pulmonary vascular diseases. We believe that these new techniques can be useful in routine clinical practice for not only thoracic oncology patients, but also patients with different pulmonary vascular diseases.

  20. A linear mixed perfusion model for tissue partial volume correction of perfusion estimates in dynamic susceptibility contrast MRI: Impact on absolute quantification, repeatability, and agreement with pseudo-continuous arterial spin labeling.

    PubMed

    Ahlgren, André; Wirestam, Ronnie; Lind, Emelie; Ståhlberg, Freddy; Knutsson, Linda

    2017-06-01

    The partial volume effect (PVE) is an important source of bias in brain perfusion measurements. The impact of tissue PVEs in perfusion measurements with dynamic susceptibility contrast MRI (DSC-MRI) has not yet been well established. The purpose of this study was to suggest a partial volume correction (PVC) approach for DSC-MRI and to study how PVC affects DSC-MRI perfusion results. A linear mixed perfusion model for DSC-MRI was derived and evaluated by way of simulations. Twenty healthy volunteers were scanned twice, including DSC-MRI, arterial spin labeling (ASL), and partial volume measurements. Two different algorithms for PVC were employed and assessed. Simulations showed that the derived model had a tendency to overestimate perfusion values in voxels with high fractions of cerebrospinal fluid. PVC reduced the tissue volume dependence of DSC-MRI perfusion values from 44.4% to 4.2% in gray matter and from 55.3% to 14.2% in white matter. One PVC method significantly improved the voxel-wise repeatability, but PVC did not improve the spatial agreement between DSC-MRI and ASL perfusion maps. Significant PVEs were found for DSC-MRI perfusion estimates, and PVC successfully reduced those effects. The findings suggest that PVC might be an important consideration for DSC-MRI applications. Magn Reson Med 77:2203-2214, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  1. Repeatability of Cerebral Perfusion Using Dynamic Susceptibility Contrast MRI in Glioblastoma Patients12

    PubMed Central

    Jafari-Khouzani, Kourosh; Emblem, Kyrre E.; Kalpathy-Cramer, Jayashree; Bjørnerud, Atle; Vangel, Mark G.; Gerstner, Elizabeth R.; Schmainda, Kathleen M.; Paynabar, Kamran; Wu, Ona; Wen, Patrick Y.; Batchelor, Tracy; Rosen, Bruce; Stufflebeam, Steven M.

    2015-01-01

    OBJECTIVES This study evaluates the repeatability of brain perfusion using dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) with a variety of post-processing methods. METHODS Thirty-two patients with newly diagnosed glioblastoma were recruited. On a 3-T MRI using a dual-echo, gradient-echo spin-echo DSC-MRI protocol, the patients were scanned twice 1 to 5 days apart. Perfusion maps including cerebral blood volume (CBV) and cerebral blood flow (CBF) were generated using two contrast agent leakage correction methods, along with testing normalization to reference tissue, and application of arterial input function (AIF). Repeatability of CBV and CBF within tumor regions and healthy tissues, identified by structural images, was assessed with intra-class correlation coefficients (ICCs) and repeatability coefficients (RCs). Coefficients of variation (CVs) were reported for selected methods. RESULTS CBV and CBF were highly repeatable within tumor with ICC values up to 0.97. However, both CBV and CBF showed lower ICCs for healthy cortical tissues (up to 0.83), healthy gray matter (up to 0.95), and healthy white matter (WM; up to 0.93). The values of CV ranged from 6% to 10% in tumor and 3% to 11% in healthy tissues. The values of RC relative to the mean value of measurement within healthy WM ranged from 22% to 42% in tumor and 7% to 43% in healthy tissues. These percentages show how much variation in perfusion parameter, relative to that in healthy WM, we expect to observe to consider it statistically significant. We also found that normalization improved repeatability, but AIF deconvolution did not. CONCLUSIONS DSC-MRI is highly repeatable in high-grade glioma patients. PMID:26055170

  2. Pulmonary perfusion quantification with flow-sensitive inversion recovery (FAIR) UTE MRI in small animal imaging.

    PubMed

    Tibiletti, Marta; Bianchi, Andrea; Stiller, Detlef; Rasche, Volker

    2016-12-01

    Blood perfusion in lung parenchyma is an important property for assessing lung function. In small animals, its quantitation is limited even with radioactive isotopes or dynamic contrast-enhanced MRI techniques. In this study, the feasibility flow-sensitive alternating inversion recovery (FAIR) for the quantification of blood flow in lung parenchyma in free breathing rats at 7 T has been investigated. In order to obtain sufficient signal from the short T2 * lung parenchyma, a 2D ultra-short echo time (UTE) Look-Locker read-out has been implemented. Acquisitions were segmented to maintain acquisition time within an acceptable range. A method to perform retrospective respiratory gating (DC-SG) has been applied to investigate the impact of respiratory movement. Reproducibilities within and between sessions were estimated, and the ability of FAIR-UTE to identify the decrease of lung perfusion under hyperoxic conditions was tested. The implemented technique allowed for the visualization of lung parenchyma with excellent SNR and no respiratory artifact even in ungated acquisitions. Lung parenchyma perfusion was obtained as 32.54 ± 2.26 mL/g/min in the left lung, and 34.09 ± 2.75 mL/g/min in the right lung. Application of retrospective gating significantly but minimally changes the perfusion values, implying that respiratory gating may not be necessary with this center-our acquisition method. A decrease of 10% in lung perfusion was found between normoxic and hyperoxic conditions, proving the feasibility of the FAIR-UTE approach to quantify lung perfusion changes. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Automated scoring of regional lung perfusion in children from contrast enhanced 3D MRI

    NASA Astrophysics Data System (ADS)

    Heimann, Tobias; Eichinger, Monika; Bauman, Grzegorz; Bischoff, Arved; Puderbach, Michael; Meinzer, Hans-Peter

    2012-03-01

    MRI perfusion images give information about regional lung function and can be used to detect pulmonary pathologies in cystic fibrosis (CF) children. However, manual assessment of the percentage of pathologic tissue in defined lung subvolumes features large inter- and intra-observer variation, making it difficult to determine disease progression consistently. We present an automated method to calculate a regional score for this purpose. First, lungs are located based on thresholding and morphological operations. Second, statistical shape models of left and right children's lungs are initialized at the determined locations and used to precisely segment morphological images. Segmentation results are transferred to perfusion maps and employed as masks to calculate perfusion statistics. An automated threshold to determine pathologic tissue is calculated and used to determine accurate regional scores. We evaluated the method on 10 MRI images and achieved an average surface distance of less than 1.5 mm compared to manual reference segmentations. Pathologic tissue was detected correctly in 9 cases. The approach seems suitable for detecting early signs of CF and monitoring response to therapy.

  4. Combination of Compressed Sensing and Parallel Imaging for Highly Accelerated First-Pass Cardiac Perfusion MRI

    PubMed Central

    Otazo, Ricardo; Kim, Daniel; Axel, Leon; Sodickson, Daniel K.

    2010-01-01

    First-pass cardiac perfusion MRI is a natural candidate for compressed sensing acceleration since its representation in the combined temporal Fourier and spatial domain is sparse and the required incoherence can be effectively accomplished by k-t random undersampling. However, the required number of samples in practice (three to five times the number of sparse coefficients) limits the acceleration for compressed sensing alone. Parallel imaging may also be used to accelerate cardiac perfusion MRI, with acceleration factors ultimately limited by noise amplification. In this work, compressed sensing and parallel imaging are combined by merging the k-t SPARSE technique with SENSE reconstruction to substantially increase the acceleration rate for perfusion imaging. We also present a new theoretical framework for understanding the combination of k-t SPARSE with SENSE based on distributed compressed sensing theory. This framework, which identifies parallel imaging as a distributed multisensor implementation of compressed sensing, enables an estimate of feasible acceleration for the combined approach. We demonstrate feasibility of 8-fold acceleration in vivo with whole-heart coverage and high spatial and temporal resolution using standard coil arrays. The method is relatively insensitive to respiratory motion artifacts and presents similar temporal fidelity and image quality when compared to GRAPPA with 2-fold acceleration. PMID:20535813

  5. Semi-quantitative assessment of pulmonary perfusion in children using dynamic contrast-enhanced MRI

    NASA Astrophysics Data System (ADS)

    Fetita, Catalin; Thong, William E.; Ou, Phalla

    2013-03-01

    This paper addresses the study of semi-quantitative assessment of pulmonary perfusion acquired from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in a study population mainly composed of children with pulmonary malformations. The automatic analysis approach proposed is based on the indicator-dilution theory introduced in 1954. First, a robust method is developed to segment the pulmonary artery and the lungs from anatomical MRI data, exploiting 2D and 3D mathematical morphology operators. Second, the time-dependent contrast signal of the lung regions is deconvolved by the arterial input function for the assessment of the local hemodynamic system parameters, ie. mean transit time, pulmonary blood volume and pulmonary blood flow. The discrete deconvolution method implements here a truncated singular value decomposition (tSVD) method. Parametric images for the entire lungs are generated as additional elements for diagnosis and quantitative follow-up. The preliminary results attest the feasibility of perfusion quantification in pulmonary DCE-MRI and open an interesting alternative to scintigraphy for this type of evaluation, to be considered at least as a preliminary decision in the diagnostic due to the large availability of the technique and to the non-invasive aspects.

  6. Stepwise heterogeneity analysis of breast tumors in perfusion DCE-MRI datasets

    NASA Astrophysics Data System (ADS)

    Mohajer, Mojgan; Schmid, Volker J.; Engels, Nina A.; Noel, Peter B.; Rummeny, Ernst; Englmeier, Karl-Hans

    2012-03-01

    The signal curves in perfusion dynamic contrast enhanced MRI (DCE-MRI) of cancerous breast tissue reveal valuable information about tumor angiogenesis. Pathological studies have illustrated that breast tumors consist of different subregions, especially with more homogeneous properties during their growth. Differences should be identifiable in DCEMRI signal curves if the characteristics of these sub-regions are related to the perfusion and angiogenesis. We introduce a stepwise clustering method which in a first step uses a new similarity measure. The new similarity measure (PM) compares how parallel washout phases of two curves are. To distinguish the starting point of the washout phase, a linear regression method is partially fitted to the curves. In the next step, the minimum signal value of the washout phase is normalized to zero. Finally, PM is calculated according to maximal variation among the point wise differences during washout phases. In the second step of clustering the groups of signal curves with parallel washout are clustered using Euclidean distance. The introduced method is evaluated on 15 DCE-MRI breast datasets with different types of breast tumors. The use of our new heterogeneity analysis is feasible in single patient examination and improves breast MR diagnostics.

  7. 3D pulmonary perfusion MRI with radial ultra-short echo time and spatial-temporal constrained reconstruction

    PubMed Central

    Bauman, Grzegorz; Johnson, Kevin M.; Bell, Laura C.; Velikina, Julia V.; Samsonov, Alexey A.; Nagle, Scott K.; Fain, Sean B.

    2014-01-01

    Purpose To assess the feasibility of spatial-temporal constrained reconstruction for accelerated regional lung perfusion using highly undersampled dynamic contrast-enhanced (DCE) 3D radial MRI with ultra-short echo time (UTE). Methods A combined strategy was used to accelerate DCE MRI for 3D pulmonary perfusion with whole lung coverage. A highly undersampled 3D radial UTE MRI acquisition was combined with an iterative constrained reconstruction exploiting principal component analysis and wavelet soft-thresholding for dimensionality reduction in space and time. The performance of the method was evaluated using a 3D fractal-based DCE digital lung phantom. Simulated perfusion maps and contrast enhancement curves were compared to ground truth using the structural similarity index (SSIM) to determine robust threshold and regularization levels. Feasibility studies were then performed in a canine and a human subject with 3D radial UTE (TE = 0.08 ms) acquisition to assess feasibility of mapping regional 3D perfusion. Results The method was able to accurately recover perfusion maps in the phantom with a nominal isotropic spatial resolution of 1.5 mm (SSIM of 0.949). The canine and human subject studies demonstrated feasibility for providing artifact-free perfusion maps in a simple 3D breath-held acquisition. Conclusion The proposed method is promising for fast and flexible 3D pulmonary perfusion imaging. PMID:24604452

  8. Study on the cerebrovascular reserve capacity by MR perfusion weighted imaging in SHR

    NASA Astrophysics Data System (ADS)

    Zhou, Quan; Dong, Yang; Chen, WenLi; Lin, Xueying; Xing, Da; Huang, Li

    2007-05-01

    Cerebrovascular disease is one of the leading causes of death, and approximately 50% of survivors have a residual neurologic deficit and greater than 25% require chronic care. Cerebrovascular reserve capacity (CVRC) describes how far cerebral perfusion can increase from a baseline value after stimulation. High blood pressure is the most important independent risk factor for stroke and other vascular diseases. The incidence of stroke in the hypertensive is six times higher than in the patient with normal blood pressure. CVRC in the hypertensive was even lower than in control patients. MR perfusion weighted imaging (MR PWI) with the well-established acetazolamide (ACZ) stimulation test has been used for assessing brain function. The aim of this work is to assess the cerebrovascular reserve capacity by MR PWI with "ACZ" tolerance test in spontaneous hypertensive rat (SHR) and to identify its value in evaluating the CVRC. Experimental animal including 3 groups: Wistar-Kyoto rats (WKY) (12-week-old) as control group, SHR (12-week-old and 20-week-old) as experimental group. MR PWI was performed respectively before and after acetazolamide administrated orally in 3 groups on a clinical 1.5 Tesla GE Signa MR fx/i whole-body MR system. The ROI was chosen in the bilateral frontal lobe to measure the value of rCBV, rCBF and MTT. The results showed that before ACZ-test, there was statistic differences between the WKY and SHR(12-week-old), and between SHR(12-week-old) and SHR(20-week-old) in the values of rCBV and rCBF (P>0.05), and after ACZ-test, there were statistic differences between WKY and SHR (20-week-old), and between SHR(12-week-old) and SHR(20-week-old) in the rCBV value (P<0.05). It is concluded that the method of MRI PWI combined with the "ACZ stress test" can provide more qualitative and half-quantitative information on the cerebral perfusion to evaluate the CVRC in SHR.

  9. Free-breathing myocardial perfusion MRI using SW-CG-HYPR and motion correction.

    PubMed

    Ge, Lan; Kino, Aya; Griswold, Mark; Carr, James C; Li, Debiao

    2010-10-01

    First-pass perfusion MRI is a promising technique to detect ischemic heart disease. Sliding window (SW) conjugate-gradient (CG) highly constrained back-projection reconstruction (HYPR) (SW-CG-HYPR) has been proposed to increase spatial coverage, spatial resolution, and SNR. However, this method is sensitive to respiratory motion and thus requires breath-hold. This work presents a non-model-based motion correction method combined with SW-CG-HYPR to perform free-breathing myocardial MR imaging. Simulation studies were first performed to show the effectiveness of the proposed motion correction method and its independence from the pattern of the respiratory motion. After that, in vivo studies were performed in six healthy volunteers. From all of the volunteer studies, the image quality score of free breathing perfusion images with motion correction (3.11 ± 0.34) is improved compared with that of images without motion correction (2.27 ± 0.32), and is comparable with that of successful breath-hold images (3.12 ± 0.38). This result was further validated by a quantitative sharpness analysis. The left ventricle and myocardium signal changes in motion corrected free-breathing perfusion images were closely correlated to those observed in breath-hold images. The correlation coefficient is 0.9764 for myocardial signals. Bland-Altman analysis confirmed the agreement between the free-breathing SW-CG-HYPR method with motion correction and the breath-hold SW-CG-HYPR. This technique may allow myocardial perfusion MRI during free breathing.

  10. Uncertainty in the analysis of tracer kinetics using dynamic contrast-enhanced T1-weighted MRI.

    PubMed

    Buckley, David L

    2002-03-01

    In recent years a number of physiological models have gained prominence in the analysis of dynamic contrast-enhanced T1-weighted MRI data. However, there remains little evidence to support their use in estimating the absolute values of tissue physiological parameters such as perfusion, capillary permeability, and blood volume. In an attempt to address this issue, data were simulated using a distributed pathway model of tracer kinetics, and three published models were fitted to the resultant concentration-time curves. Parameter estimates obtained from these fits were compared with the parameters used for the simulations. The results indicate that the use of commonly accepted models leads to systematic overestimation of the transfer constant, Ktrans, and potentially large underestimates of the blood plasma volume fraction, Vp. In summary, proposals for a practical approach to physiological modeling using MRI data are outlined.

  11. Matrix pencil decomposition of time-resolved proton MRI for robust and improved assessment of pulmonary ventilation and perfusion.

    PubMed

    Bauman, Grzegorz; Bieri, Oliver

    2017-01-01

    To present an improved and robust method of pulmonary function assessment from time-resolved proton MRI using a matrix pencil (MP) method in combination with a linear least squares analysis. Simulations of the signal time course in lung parenchyma were performed to compare the accuracy of Fourier decomposition (FD) and MP methods for the estimation of respiratory and cardiac amplitudes. Series of two-dimensional time-resolved lung images were acquired in healthy volunteers at 1.5 T using ultra-fast steady-state free precession. Qualitative lung ventilation- and perfusion-weighted images as well as a quantitative map of fractional ventilation, perfusion, and blood arrival time were calculated using the proposed MP method and compared with the contemporary FD technique. A region-of-interest analysis was performed on the quantitative data. The signal analysis performed using MP decomposition resulted in reduced variability of the estimated respiratory and cardiac amplitudes in comparison with FD for both simulated and in vivo data. MP decomposition provides an automatic, robust, and more accurate estimation of amplitudes of respiratory and cardiac signal modulations in the lung parenchyma than the contemporary FD technique. Magn Reson Med 77:336-342, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Correlation of oxygenation and perfusion sensitive MRI with invasive micro probe measurements in healthy mice brain.

    PubMed

    Sedlacik, Jan; Reitz, Matthias; Bolar, Divya S; Adalsteinsson, Elfar; Schmidt, Nils O; Fiehler, Jens

    2015-03-01

    The non-invasive assessment of (patho-)physiological parameters such as, perfusion and oxygenation, is of great importance for the characterization of pathologies e.g., tumors, which may be helpful to better predict treatment response and potential outcome. To better understand the influence of physiological parameters on the investigated oxygenation and perfusion sensitive MRI methods, MRI measurements were correlated with subsequent invasive micro probe measurements during free breathing conditions of air, air+10% CO2 and 100% O2 in healthy mice brain. MRI parameters were the irreversible (R2), reversible (R2') and effective (R2*) transverse relaxation rates, venous blood oxygenation level assessed by quantitative blood oxygenation level dependent (qBOLD) method and cerebral blood flow (CBF) assessed by arterial spin labeling (ASL) using a 7 T small animal MRI scanner. One to two days after MRI, tissue perfusion and pO2 were measured by Laser-Doppler flowmetry and fluorescence quenching micro probes, respectively. The tissue pO2 values were converted to blood oxygen saturation by using the Hill equation. The animals were anesthetized by intra peritoneal injection of ketamine-xylazine-acepromazine (10-2-0.3 mg/ml · kg). Results for normal/hypercapnia/hyperoxia conditions were: R2[s(∧)-1] = 20.7/20.4/20.1, R2*[s(∧)-1] = 31.6/29.6/25.9, R2'[s-(∧)1] = 10.9/9.2/5.7, qBOLD venous blood oxygenation level = 0.43/0.51/0.56, CBF[ml · min(∧)-1 · 100 g(∧)-1] = 70.6/105.5/81.8, Laser-Doppler flowmetry[a.u.] = 89.2/120.2/90.6 and pO2[mmHg] = 6.3/32.3/46.7. All parameters were statistically significantly different with P < 0.001 between all breathing conditions. All MRI and the corresponding micro probe measurements were also statistically significantly (P ≤ 0.03) correlated with each other. However, converting the tissue pO2 to blood oxygen saturation = 0.02/0.34/0.63, showed only very limited agreement with the qBOLD venous blood oxygenation level. We found

  13. Can Dynamic Contrast-Enhanced MRI (DCE-MRI) and Diffusion-Weighted MRI (DW-MRI) Evaluate Inflammation Disease

    PubMed Central

    Zhu, Jianguo; Zhang, Faming; Luan, Yun; Cao, Peng; Liu, Fei; He, Wenwen; Wang, Dehang

    2016-01-01

    Abstract The aim of the study was to investigate diagnosis efficacy of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in Crohn's disease (CD). To find out the correlations between functional MRI parameters including Ktrans, Kep, Ve, Vp, and apparent diffusion coefficient (ADC) with a serologic biomarker. The relationships between pharmacokinetic parameters and ADC were also studied. Thirty-two patients with CD (22 men, 10 women; mean age: 30.5 years) and 18 healthy volunteers without any inflammatory disease (10 men, 8 women; mean age, 34.11 years) were enrolled into this approved prospective study. Pearson analysis was used to evaluate the correlation between Ktrans, Kep, Ve, Vp, and C-reactive protein (CRP), ADC, and CRP respectively. The diagnostic efficacy of the functional MRI parameters in terms of sensitivity and specificity were analyzed by receiver operating characteristic (ROC) curve analyses. Optimal cut-off values of each functional MRI parameters for differentiation of inflammatory from normal bowel were determined according to the Youden criterion. Mean value of Ktrans in the CD group was significantly higher than that of normal control group. Similar results were observed for Kep and Ve. On the contrary, the ADC value was lower in the CD group than that in the control group. Ktrans and Ve were shown to be correlated with CRP (r = 0.725, P < 0.001; r = 0.533, P = 0.002), meanwhile ADC showed negative correlation with CRP (r = −0.630, P < 0.001). There were negative correlations between the pharmacokinetic parameters and ADC, such as Ktrans to ADC (r = −0.856, P < 0.001), and Ve to ADC (r = −0.451, P = 0.01). The area under the curve (AUC) was 0.994 for Ktrans (P < 0.001), 0.905 for ADC (P < 0.001), 0.806 for Ve (P < 0.001), and 0.764 for Kep (P = 0.002). The cut-off point of the Ktrans was found to be 0.931 min–1. This value provided the best trade-off between

  14. Parkinson's disease-related perfusion and glucose metabolic brain patterns identified with PCASL-MRI and FDG-PET imaging.

    PubMed

    Teune, Laura K; Renken, Remco J; de Jong, Bauke M; Willemsen, Antoon T; van Osch, Matthias J; Roerdink, Jos B T M; Dierckx, Rudi A; Leenders, Klaus L

    2014-01-01

    Under normal conditions, the spatial distribution of resting cerebral blood flow and cerebral metabolic rate of glucose are closely related. A relatively new magnetic resonance (MR) technique, pseudo-continuous arterial spin labeling (PCASL), can be used to measure regional brain perfusion. We identified a Parkinson's disease (PD)-related perfusion and metabolic covariance pattern in the same patients using PCASL and FDG-PET imaging and assessed (dis)similarities in the disease-related pattern between perfusion and metabolism in PD patients. Nineteen PD patients and seventeen healthy controls underwent [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging. Of 14 PD patients and all healthy controls PCASL-MRI could be obtained. Data were analyzed using scaled subprofile model/principal component analysis (SSM/PCA). Unique Parkinson's disease-related perfusion and metabolic covariance patterns were identified using PCASL and FDG-PET in the same patients. The PD-related metabolic covariance brain pattern is in high accordance with previously reports. Also our disease-related perfusion pattern is comparable to the earlier described perfusion pattern. The most marked difference between our perfusion and metabolic patterns is the larger perfusion decrease in cortical regions including the insula. We identified PD-related perfusion and metabolic brain patterns using PCASL and FDG-PET in the same patients which were comparable with results of existing research. In this respect, PCASL appears to be a promising addition in the early diagnosis of individual parkinsonian patients.

  15. Parkinson's disease-related perfusion and glucose metabolic brain patterns identified with PCASL-MRI and FDG-PET imaging

    PubMed Central

    Teune, Laura K.; Renken, Remco J.; de Jong, Bauke M.; Willemsen, Antoon T.; van Osch, Matthias J.; Roerdink, Jos B.T.M.; Dierckx, Rudi A.; Leenders, Klaus L.

    2014-01-01

    Introduction Under normal conditions, the spatial distribution of resting cerebral blood flow and cerebral metabolic rate of glucose are closely related. A relatively new magnetic resonance (MR) technique, pseudo-continuous arterial spin labeling (PCASL), can be used to measure regional brain perfusion. We identified a Parkinson's disease (PD)-related perfusion and metabolic covariance pattern in the same patients using PCASL and FDG-PET imaging and assessed (dis)similarities in the disease-related pattern between perfusion and metabolism in PD patients. Methods Nineteen PD patients and seventeen healthy controls underwent [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging. Of 14 PD patients and all healthy controls PCASL-MRI could be obtained. Data were analyzed using scaled subprofile model/principal component analysis (SSM/PCA). Results Unique Parkinson's disease-related perfusion and metabolic covariance patterns were identified using PCASL and FDG-PET in the same patients. The PD-related metabolic covariance brain pattern is in high accordance with previously reports. Also our disease-related perfusion pattern is comparable to the earlier described perfusion pattern. The most marked difference between our perfusion and metabolic patterns is the larger perfusion decrease in cortical regions including the insula. Conclusion We identified PD-related perfusion and metabolic brain patterns using PCASL and FDG-PET in the same patients which were comparable with results of existing research. In this respect, PCASL appears to be a promising addition in the early diagnosis of individual parkinsonian patients. PMID:25068113

  16. Groupwise registration of cardiac perfusion MRI sequences using normalized mutual information in high dimension

    NASA Astrophysics Data System (ADS)

    Hamrouni, Sameh; Rougon, Nicolas; Pr"teux, Françoise

    2011-03-01

    In perfusion MRI (p-MRI) exams, short-axis (SA) image sequences are captured at multiple slice levels along the long-axis of the heart during the transit of a vascular contrast agent (Gd-DTPA) through the cardiac chambers and muscle. Compensating cardio-thoracic motions is a requirement for enabling computer-aided quantitative assessment of myocardial ischaemia from contrast-enhanced p-MRI sequences. The classical paradigm consists of registering each sequence frame on a reference image using some intensity-based matching criterion. In this paper, we introduce a novel unsupervised method for the spatio-temporal groupwise registration of cardiac p-MRI exams based on normalized mutual information (NMI) between high-dimensional feature distributions. Here, local contrast enhancement curves are used as a dense set of spatio-temporal features, and statistically matched through variational optimization to a target feature distribution derived from a registered reference template. The hard issue of probability density estimation in high-dimensional state spaces is bypassed by using consistent geometric entropy estimators, allowing NMI to be computed directly from feature samples. Specifically, a computationally efficient kth-nearest neighbor (kNN) estimation framework is retained, leading to closed-form expressions for the gradient flow of NMI over finite- and infinite-dimensional motion spaces. This approach is applied to the groupwise alignment of cardiac p-MRI exams using a free-form Deformation (FFD) model for cardio-thoracic motions. Experiments on simulated and natural datasets suggest its accuracy and robustness for registering p-MRI exams comprising more than 30 frames.

  17. Accelerating free breathing myocardial perfusion MRI using multi coil radial k-t SLR

    PubMed Central

    Lingala, Sajan Goud; DiBella, Edward; Adluru, Ganesh; McGann, Christopher; Jacob, Mathews

    2013-01-01

    The clinical utility of myocardial perfusion MR imaging (MPI) is often restricted by the inability of current acquisition schemes to simultaneously achieve high spatio-temporal resolution, good volume coverage, and high signal to noise ratio. Moreover, many subjects often find it difficult to hold their breath for sufficiently long durations making it difficult to obtain reliable MPI data. Accelerated acquisition of free breathing MPI data can overcome some of these challenges. Recently, an algorithm termed as k − t SLR has been proposed to accelerate dynamic MRI by exploiting sparsity and low rank properties of dynamic MRI data. The main focus of this paper is to further improve k − t SLR and demonstrate its utility in considerably accelerating free breathing MPI. We extend its previous implementation to account for multi-coil radial MPI acquisitions. We perform k − t sampling experiments to compare different radial trajectories and determine the best sampling pattern. We also introduce a novel augmented Lagrangian framework to considerably improve the algorithm's convergence rate. The proposed algorithm is validated using free breathing rest and stress radial perfusion data sets from two normal subjects and one patient with ischemia. k − t SLR was observed to provide faithful reconstructions at high acceleration levels with minimal artifacts compared to existing MPI acceleration schemes such as spatio-temporal constrained reconstruction (STCR) and k − t SPARSE/SENSE. PMID:24077063

  18. Diagnosis of pseudoprogression using MRI perfusion in patients with glioblastoma multiforme may predict improved survival

    PubMed Central

    Gahramanov, Seymur; Varallyay, Csanad; Tyson, Rose Marie; Lacy, Cynthia; Fu, Rongwei; Netto, Joao Prola; Nasseri, Morad; White, Tricia; Woltjer, Randy L; Gultekin, Sakir Humayun; Neuwelt, Edward A

    2015-01-01

    SUMMARY Aims This retrospective study determined the survival of glioblastoma patients with or without pseudoprogression. Methods A total of 68 patients were included. Overall survival was compared between patients showing pseudoprogression (in most cases diagnosed using perfusion MRI with ferumoxytol) and in patients without pseudoprogession. MGMT methylation status was also analyzed in the pseudoprogression cases. Results Median survival in 24 (35.3%) patients with pseudoprogression was 34.7 months (95% CI: 20.3–54.1), and 13.4 months (95% CI: 11.1–19.5) in 44 (64.7%) patients without pseudoprogression (p < 0.0001). The longest survival was a median of 54.1 months in patients with combination of pseudoprogression and (MGMT) promoter methylation. Conclusion Pseudoprogression is associated with better outcome, especially if concurring with MGMT promoter methylation. Patients never diagnosed with pseudoprogression had poor survival. This study emphasizes the importance of differentiating tumor progression and pseudoprogression using perfusion MRI. PMID:25438810

  19. Accelerating free breathing myocardial perfusion MRI using multi coil radial k - t SLR

    NASA Astrophysics Data System (ADS)

    Goud Lingala, Sajan; DiBella, Edward; Adluru, Ganesh; McGann, Christopher; Jacob, Mathews

    2013-10-01

    The clinical utility of myocardial perfusion MR imaging (MPI) is often restricted by the inability of current acquisition schemes to simultaneously achieve high spatio-temporal resolution, good volume coverage, and high signal to noise ratio. Moreover, many subjects often find it difficult to hold their breath for sufficiently long durations making it difficult to obtain reliable MPI data. Accelerated acquisition of free breathing MPI data can overcome some of these challenges. Recently, an algorithm termed as k - t SLR has been proposed to accelerate dynamic MRI by exploiting sparsity and low rank properties of dynamic MRI data. The main focus of this paper is to further improve k - t SLR and demonstrate its utility in considerably accelerating free breathing MPI. We extend its previous implementation to account for multi-coil radial MPI acquisitions. We perform k - t sampling experiments to compare different radial trajectories and determine the best sampling pattern. We also introduce a novel augmented Lagrangian framework to considerably improve the algorithm’s convergence rate. The proposed algorithm is validated using free breathing rest and stress radial perfusion data sets from two normal subjects and one patient with ischemia. k - t SLR was observed to provide faithful reconstructions at high acceleration levels with minimal artifacts compared to existing MPI acceleration schemes such as spatio-temporal constrained reconstruction and k - t SPARSE/SENSE.

  20. Perfusion MRI Indexes Variability in the Functional Brain Effects of Theta-Burst Transcranial Magnetic Stimulation

    PubMed Central

    Gratton, Caterina; Lee, Taraz G.; Nomura, Emi M.; D’Esposito, Mark

    2014-01-01

    Transcranial Magnetic Stimulation (TMS) is an important tool for testing causal relationships in cognitive neuroscience research. However, the efficacy of TMS can be variable across individuals and difficult to measure. This variability is especially a challenge when TMS is applied to regions without well-characterized behavioral effects, such as in studies using TMS on multi-modal areas in intrinsic networks. Here, we examined whether perfusion fMRI recordings of Cerebral Blood Flow (CBF), a quantitative measure sensitive to slow functional changes, reliably index variability in the effects of stimulation. Twenty-seven participants each completed four combined TMS-fMRI sessions during which both resting state Blood Oxygen Level Dependent (BOLD) and perfusion Arterial Spin Labeling (ASL) scans were recorded. In each session after the first baseline day, continuous theta-burst TMS (TBS) was applied to one of three locations: left dorsolateral prefrontal cortex (L dlPFC), left anterior insula/frontal operculum (L aI/fO), or left primary somatosensory cortex (L S1). The two frontal targets are components of intrinsic networks and L S1 was used as an experimental control. CBF changes were measured both before and after TMS on each day from a series of interleaved resting state and perfusion scans. Although TBS led to weak selective increases under the coil in CBF measurements across the group, individual subjects showed wide variability in their responses. TBS-induced changes in rCBF were related to TBS-induced changes in functional connectivity of the relevant intrinsic networks measured during separate resting-state BOLD scans. This relationship was selective: CBF and functional connectivity of these networks were not related before TBS or after TBS to the experimental control region (S1). Furthermore, subject groups with different directions of CBF change after TBS showed distinct modulations in the functional interactions of targeted networks. These results suggest

  1. Cardiac function and myocardial perfusion immediately following maximal treadmill exercise inside the MRI room

    PubMed Central

    Jekic, Mihaela; Foster, Eric L; Ballinger, Michelle R; Raman, Subha V; Simonetti, Orlando P

    2008-01-01

    Treadmill exercise stress testing is an essential tool in the prevention, detection, and treatment of a broad spectrum of cardiovascular disease. After maximal exercise, cardiac images at peak stress are typically acquired using nuclear scintigraphy or echocardiography, both of which have inherent limitations. Although CMR offers superior image quality, the lack of MRI-compatible exercise and monitoring equipment has prevented the realization of treadmill exercise CMR. It is critical to commence imaging as quickly as possible after exercise to capture exercise-induced cardiac wall motion abnormalities. We modified a commercial treadmill such that it could be safely positioned inside the MRI room to minimize the distance between the treadmill and the scan table. We optimized the treadmill exercise CMR protocol in 20 healthy volunteers and successfully imaged cardiac function and myocardial perfusion at peak stress, followed by viability imaging at rest. Imaging commenced an average of 30 seconds after maximal exercise. Real-time cine of seven slices with no breath-hold and no ECG-gating was completed within 45 seconds of exercise, immediately followed by stress perfusion imaging of three short-axis slices which showed an average time to peak enhancement within 57 seconds of exercise. We observed a 3.1-fold increase in cardiac output and a myocardial perfusion reserve index of 1.9, which agree with reported values for healthy subjects at peak stress. This study successfully demonstrates in-room treadmill exercise CMR in healthy volunteers, but confirmation of feasibility in patients with heart disease is still needed. PMID:18272005

  2. Association of developmental venous anomalies with perfusion abnormalities on arterial spin labeling and bolus perfusion-weighted imaging.

    PubMed

    Iv, Michael; Fischbein, Nancy J; Zaharchuk, Greg

    2015-01-01

    To investigate the frequency and characteristics of developmental venous anomaly (DVA)-associated perfusion abnormalities on arterial spin labeling (ASL) and bolus perfusion-weighted imaging (PWI) and discuss their potential causes. We reviewed brain MR reports to identify all DVAs reported on studies performed between 2009 and 2012. DVA location and findings on PWI and/or ASL imaging were assessed by visual inspection. Sizes of DVAs were categorized as small (<15 mm), medium (15-25 mm), and large (>25 mm). For ASL, signal in the DVA, surrounding parenchyma, or associated draining vein was recorded. For PWI, changes on hemodynamic maps (cerebral blood volume [CBV], cerebral blood flow [CBF], mean transit time [MTT], and normalized time-to-peak of the residue function [Tmax]) were evaluated. Coexisting vascular malformations in association with DVAs were also identified. Six hundred and fifty-two DVAs were identified in 632 subjects. Of these, 121 underwent both perfusion modalities, 15 only PWI, and 127 only ASL. ASL abnormalities were seen in 21/248 (8%), including signal in a draining vein (2/21, 10%), in the DVA (11/21, 52%), and in the parenchyma (8/21, 38%). On PWI, the majority of DVAs demonstrated abnormalities (108/136, 79%), typically increased CBF, CBV, MTT, and Tmax. There was no association between DVA size and presence of ASL signal (P = .836). Borderline statistical significance was found between DVA size and presence of PWI abnormality (P = .046). No relationship was found between the presence of a coexisting vascular malformation and presence of ASL (P = .468) or PWI abnormality (P = .745). Perfusion changes with DVAs are common on PWI but uncommon on ASL. PWI findings are expected based on the anatomy and physiology of DVAs and are accentuated by gradient echo acquisition. DVAs with intrinsic ASL signal or signal in draining veins may be associated with arteriovenous shunting (transitional lesions). Copyright © 2014 by the American Society of

  3. Quantitative Myocardial Perfusion with Dynamic Contrast-Enhanced Imaging in MRI and CT: Theoretical Models and Current Implementation

    PubMed Central

    Handayani, A.; Dijkstra, H.; Prakken, N. H. J.; Slart, R. H. J. A.; Oudkerk, M.; Van Ooijen, P. M. A.; Vliegenthart, R.; Sijens, P. E.

    2016-01-01

    Technological advances in magnetic resonance imaging (MRI) and computed tomography (CT), including higher spatial and temporal resolution, have made the prospect of performing absolute myocardial perfusion quantification possible, previously only achievable with positron emission tomography (PET). This could facilitate integration of myocardial perfusion biomarkers into the current workup for coronary artery disease (CAD), as MRI and CT systems are more widely available than PET scanners. Cardiac PET scanning remains expensive and is restricted by the requirement of a nearby cyclotron. Clinical evidence is needed to demonstrate that MRI and CT have similar accuracy for myocardial perfusion quantification as PET. However, lack of standardization of acquisition protocols and tracer kinetic model selection complicates comparison between different studies and modalities. The aim of this overview is to provide insight into the different tracer kinetic models for quantitative myocardial perfusion analysis and to address typical implementation issues in MRI and CT. We compare different models based on their theoretical derivations and present the respective consequences for MRI and CT acquisition parameters, highlighting the interplay between tracer kinetic modeling and acquisition settings. PMID:27088083

  4. Minimum Field Strength Simulator for Proton Density Weighted MRI

    PubMed Central

    Chen, Weiyi; Nayak, Krishna S.

    2016-01-01

    Objective To develop and evaluate a framework for simulating low-field proton-density weighted MRI acquisitions based on high-field acquisitions, which could be used to predict the minimum B0 field strength requirements for MRI techniques. This framework would be particularly useful in the evaluation of de-noising and constrained reconstruction techniques. Materials and Methods Given MRI raw data, lower field MRI acquisitions can be simulated based on the signal and noise scaling with field strength. Certain assumptions are imposed for the simulation and their validity is discussed. A validation experiment was performed using a standard resolution phantom imaged at 0.35 T, 1.5 T, 3 T, and 7 T. This framework was then applied to two sample proton-density weighted MRI applications that demonstrated estimation of minimum field strength requirements: real-time upper airway imaging and liver proton-density fat fraction measurement. Results The phantom experiment showed good agreement between simulated and measured images. The SNR difference between simulated and measured was ≤ 8% for the 1.5T, 3T, and 7T cases which utilized scanners with the same geometry and from the same vendor. The measured SNR at 0.35T was 1.8- to 2.5-fold less than predicted likely due to unaccounted differences in the RF receive chain. The predicted minimum field strength requirements for the two sample applications were 0.2 T and 0.3 T, respectively. Conclusions Under certain assumptions, low-field MRI acquisitions can be simulated from high-field MRI data. This enables prediction of the minimum field strength requirements for a broad range of MRI techniques. PMID:27136334

  5. Resolution of NASH with weight loss documented by hepatic MRI.

    PubMed

    Singh, Vasvi; Luthra, Saurav; Elajami, Tarec K; Welty, Francine K

    2015-01-06

    A 57-year-old Asian woman with type 2 diabetes mellitus, hypertension, obesity, dyslipidaemia and history of breast cancer, was referred to the cardiovascular health and lipid centre for evaluation and management of dyslipidaemia and NASH (Non-alcoholic steatohepatitis) in 2010. She originally had a detailed work up at the liver clinic for elevated liver enzymes, with no associated symptoms. Initial hepatic MRI on 22 January 2007 showed diffuse fatty infiltration quantitated at 15%. We counselled her on lifestyle modifications, including dietary measures and exercise, geared toward weight loss. Over the next 2 years, she lost 24.5 lbs; repeat hepatic MRI on 22 December 2011 showed 6% hepatic fat, which is within the normal range. This case demonstrates the efficacy of significant weight loss in the improvement and resolution of NASH. We believe that this is the first case report documenting this through liver MRI. 2015 BMJ Publishing Group Ltd.

  6. Resolution of NASH with weight loss documented by hepatic MRI

    PubMed Central

    Singh, Vasvi; Luthra, Saurav; Elajami, Tarec K; Welty, Francine K

    2015-01-01

    A 57-year-old Asian woman with type 2 diabetes mellitus, hypertension, obesity, dyslipidaemia and history of breast cancer, was referred to the cardiovascular health and lipid centre for evaluation and management of dyslipidaemia and NASH (Non-alcoholic steatohepatitis) in 2010. She originally had a detailed work up at the liver clinic for elevated liver enzymes, with no associated symptoms. Initial hepatic MRI on 22 January 2007 showed diffuse fatty infiltration quantitated at 15%. We counselled her on lifestyle modifications, including dietary measures and exercise, geared toward weight loss. Over the next 2 years, she lost 24.5 lbs; repeat hepatic MRI on 22 December 2011 showed 6% hepatic fat, which is within the normal range. This case demonstrates the efficacy of significant weight loss in the improvement and resolution of NASH. We believe that this is the first case report documenting this through liver MRI. PMID:25564638

  7. Characterization of stroke lesions using a histogram-based data analysis including diffusion- and perfusion-weighted imaging

    NASA Astrophysics Data System (ADS)

    Grzesik, Alexander; Bernarding, Johannes; Braun, Juergen; Koennecke, Hans-Christian; Wolf, Karl J.; Tolxdorff, Thomas

    2000-04-01

    Diffusion- and perfusion-weighted magnetic resonance imaging (DWI, PWI) allows the diagnosis of ischemic brain injury at a time when ischemic lesions may not yet be detectable in computer tomography or T2-weighted (T2w) MRI. However, regions with pathologic apparent diffusion coefficients (ADC) do not necessarily match with regions of prolonged mean transit times (MTT) or pathologic relative cerebral blood flow (rCBF). Mismatching parts are thought to correlate with tissues that can be saved by appropriate treatment. Ten patients with cerebral ischemia underwent standard T1w and T2w imaging as well as single-shot echo planar imaging (EPI) DWI, and PWI. Multidimensional histograms were constructed from T2w images, DWI, ADC, rCBF, and MTT maps. After segmenting different tissues, signal changes of ischemic tissues relative to unaffected parenchyma were calculated. Combining different information allowed the segmentation of lesions and unaffected tissues. Acute infarcts exhibited decreased ADC values as well as hypo- and hyperperfused areas. Correlating ADC, T2w, and rCBF with clinical symptoms allowed the estimation of age and perfusion state of the lesions. Combining DWI, PWI, and standard imaging overcomes strongly fluctuating parameters such as ADC values. A multidimensional parameter-set characterizes unaffected and pathologic tissues which may help in the evaluation of new therapeutic strategies.

  8. Effects of cerebral ischemic and reperfusion on T2*-weighted MRI responses to brief oxygen challenge.

    PubMed

    Shen, Qiang; Du, Fang; Huang, Shiliang; Duong, Timothy Q

    2014-01-01

    This study characterized the effects of cerebral ischemia and reperfusion on T2*-weighted magnetic resonance image (MRI) responses to brief oxygen challenge (OC) in transient (60 minutes) cerebral ischemia in rats. During occlusion, the ischemic core tissue showed no significant OC response, whereas the perfusion-diffusion mismatch tissue showed markedly higher percent changes relative to normal tissue. After reperfusion, much of the pixels with initial exaggerated OC responses showed normal OC responses, and the majority of these tissues were salvaged as defined by endpoint T2 MRI. The initial core pixels showed exaggerated OC responses after reperfusion, but the majority of the core pixels eventually became infarct, suggesting exaggerated OC responses do not necessarily reflect salvageable tissue. Twenty-four hours after stroke, basal T1 increased in the ischemic core. Oxygen challenge decreased T1 significantly in the core, indicative of the substantial increases in dissolved oxygen in the core as the result of hyperperfusion. We concluded that exaggerated T2*-weighted MRI responses to OC offer useful insight in ischemic tissue fates. However, exaggerated OC pixels are not all salvageable, and they exhibited complex dynamics depending on reperfusion status, hyperperfusion, and edema effects.

  9. Dynamic contrast-enhanced MRI perfusion for differentiating between melanoma and lung cancer brain metastases.

    PubMed

    Hatzoglou, Vaios; Tisnado, Jamie; Mehta, Alpesh; Peck, Kyung K; Daras, Mariza; Omuro, Antonio M; Beal, Kathryn; Holodny, Andrei I

    2017-04-01

    Brain metastases originating from different primary sites overlap in appearance and are difficult to differentiate with conventional MRI. Dynamic contrast-enhanced (DCE)-MRI can assess tumor microvasculature and has demonstrated utility in characterizing primary brain tumors. Our aim was to evaluate the performance of plasma volume (Vp) and volume transfer coefficient (K(trans) ) derived from DCE-MRI in distinguishing between melanoma and nonsmall cell lung cancer (NSCLC) brain metastases. Forty-seven NSCLC and 23 melanoma brain metastases were retrospectively assessed with DCE-MRI. Regions of interest were manually drawn around the metastases to calculate Vpmean and Kmeantrans. The Mann-Whitney U test and receiver operating characteristic analysis (ROC) were performed to compare perfusion parameters between the two groups. The Vpmean of melanoma brain metastases (4.35, standard deviation [SD] = 1.31) was significantly higher (P = 0.03) than Vpmean of NSCLC brain metastases (2.27, SD = 0.96). The Kmeantrans values were higher in melanoma brain metastases, but the difference between the two groups was not significant (P = 0.12). Based on ROC analysis, a cut-off value of 3.02 for Vpmean (area under curve = 0.659 with SD = 0.074) distinguished between melanoma brain metastases and NSCLC brain metastases (P < 0.01) with 72% specificity. Our data show the DCE-MRI parameter Vpmean can differentiate between melanoma and NSCLC brain metastases. The ability to noninvasively predict tumor histology of brain metastases in patients with multiple malignancies can have important clinical implications.

  10. Inter-operator variability in perfusion assessment of tumors in MRI using automated AIF detection.

    PubMed

    Ashton, Edward; McShane, Teresa; Evelhoch, Jeffrey

    2005-01-01

    A method is presented for the calculation of perfusion parameters in dynamic contrast enhanced MRI. This method requires identification of enhancement curves for both tumor tissue and plasma. Inter-operator variability in the derived rate constant between plasma and extra-cellular extra-vascular space is assessed in both canine and human subjects using semi-automated tumor margin identification with both manual and automated arterial input function (AIF) identification. Experimental results show a median coefficient of variability (CV) for parameter measurement with manual AIF identification of 21.5% in canines and 11% in humans, with a median CV for parameter measurement with automated AIF identification of 6.7% in canines and 6% in humans.

  11. Acute baclofen diminishes resting baseline blood flow to limbic structures: A perfusion fMRI study

    PubMed Central

    Franklin, Teresa R.; Shin, Joshua; Jagannathan, Kanchana; Suh, Jesse J.; Detre, John A.; O’Brien, Charles P.; Childress, Anna Rose

    2012-01-01

    Background Preclinical and clinical evidence show that the GABA B agonist, baclofen is a promising treatment for addictive disorders; however, until recently its mechanism of action in the human brain was unknown. In previous work we utilized a laboratory model that included a medication versus placebo regimen to examine baclofen’s actions on brain circuitry. Perfusion fMRI [measure of cerebral blood flow (CBF)] data acquired ‘at rest’ before and on the last day of the 21-day medication regimen showed that baclofen diminished CBF bilaterally in the VS, insula and medial orbitofrontal cortex (mOFC). In the present study, we hypothesized that a single dose of baclofen would have effects similar to repeated dosing. Methods To test our hypothesis, in a crossover design, CBF data were acquired using pseudo continuous arterial spin labeled (pCASL) perfusion fMRI. Subjects were either un-medicated or were administered a 20 mg dose of baclofen approximately 110 min prior to scanning. Results Acute baclofen diminished mOFC, amygdala, and ventral anterior insula CBF without causing sedation (family-wise error corrected at p = 0.001). Conclusions Results demonstrate that similar to repeated dosing, an acute dose of baclofen blunts the ‘limbic’ substrate that is hyper-responsive to drugs and drug cues. Smokers often manage their craving and can remain abstinent for extended periods after quitting, however the risk of eventual relapse approaches 90%. Given that chronic medication may not be a practical solution to the long-term risk of relapse, acute baclofen may be useful on an ‘as-needed’ basis to block craving during ‘at risk’ situations. PMID:22513380

  12. Three-dimensional MRI perfusion maps: a step beyond volumetric analysis in mental disorders

    PubMed Central

    Fabene, Paolo F; Farace, Paolo; Brambilla, Paolo; Andreone, Nicola; Cerini, Roberto; Pelizza, Luisa; Versace, Amelia; Rambaldelli, Gianluca; Birbaumer, Niels; Tansella, Michele; Sbarbati, Andrea

    2007-01-01

    A new type of magnetic resonance imaging analysis, based on fusion of three-dimensional reconstructions of time-to-peak parametric maps and high-resolution T1-weighted images, is proposed in order to evaluate the perfusion of selected volumes of interest. Because in recent years a wealth of data have suggested the crucial involvement of vascular alterations in mental diseases, we tested our new method on a restricted sample of schizophrenic patients and matched healthy controls. The perfusion of the whole brain was compared with that of the caudate nucleus by means of intrasubject analysis. As expected, owing to the encephalic vascular pattern, a significantly lower time-to-peak was observed in the caudate nucleus than in the whole brain in all healthy controls, indicating that the suggested method has enough sensitivity to detect subtle perfusion changes even in small volumes of interest. Interestingly, a less uniform pattern was observed in the schizophrenic patients. The latter finding needs to be replicated in an adequate number of subjects. In summary, the three-dimensional analysis method we propose has been shown to be a feasible tool for revealing subtle vascular changes both in normal subjects and in pathological conditions. PMID:17229290

  13. The precision of DCE-MRI using the tissue homogeneity model with continuous formulation of the perfusion parameters.

    PubMed

    Bartoš, Michal; Jiřík, Radovan; Kratochvíla, Jiří; Standara, Michal; Starčuk, Zenon; Taxt, Torfinn

    2014-06-01

    The present trend in dynamic contrast-enhanced MRI is to increase the number of estimated perfusion parameters using complex pharmacokinetic models. However, less attention is given to the precision analysis of the parameter estimates. In this paper, the distributed capillary adiabatic tissue homogeneity pharmacokinetic model is extended by the bolus arrival time formulated as a free continuous parameter. With the continuous formulation of all perfusion parameters, it is possible to use standard gradient-based optimization algorithms in the approximation of the tissue concentration time sequences. This new six-parameter model is investigated by comparing Monte-Carlo simulations with theoretically derived covariance matrices. The covariance-matrix approach is extended from the usual analysis of the primary perfusion parameters of the pharmacokinetic model to the analysis of the perfusion parameters derived from the primary ones. The results indicate that the precision of the estimated perfusion parameters can be described by the covariance matrix for signal-to-noise ratio higher than~20dB. The application of the new analysis model on a real DCE-MRI data set is also presented. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Sensitivity of diffusion- and perfusion-weighted imaging for diagnosing acute ischemic stroke is 97.5%.

    PubMed

    Simonsen, Claus Z; Madsen, Mette H; Schmitz, Marie L; Mikkelsen, Irene K; Fisher, Marc; Andersen, Grethe

    2015-01-01

    MRI using diffusion-weighted imaging (DWI) is the most sensitive diagnostic imaging modality for early detection of ischemia, but how accurate is it and how much does perfusion-weighted imaging (PWI) add to the sensitivity have to be known. In this single-center study, we collected epidemiological, imaging, and outcome data on all patients with stroke undergoing MRI-based treatment with intravenous tissue-type plasminogen activator at our center from 2004 to 2010. The DWI negative patients were identified, and we calculated the sensitivity and specificity of DWI and additional PWI for diagnosing acute ischemic stroke. We compared DWI positive and negative patients to identify characteristics associated with DWI negativity. Five hundred sixty-nine consecutive patients were treated with intravenous tissue-type plasminogen activator on the basis of an acute MRI. A DWI lesion was evident in 518 patients. Forty-seven patients were DWI negative; however, a relevant PWI lesion was found in 33 of these patients. Four stroke mimics were treated with intravenous tissue-type plasminogen activator and 1 of these patients had a DWI lesion. Thus, 8% of all patients with stroke were DWI negative. The combination of DWI and PWI resulted in a sensitivity of 97.5% for the ischemic stroke diagnosis. DWI negativity was associated with less severe strokes, location in the posterior circulation, a longer time from onset to scan, and an improved 90-day outcome. The cause of small-vessel disease was more likely to be DWI negative. The combination of DWI and PWI before intravenous tissue-type plasminogen activator confirms the diagnosis in 97.5% of all ischemic strokes. © 2014 American Heart Association, Inc.

  15. 3D ECG- and respiratory-gated non-contrast-enhanced (CE) perfusion MRI for postoperative lung function prediction in non-small-cell lung cancer patients: A comparison with thin-section quantitative computed tomography, dynamic CE-perfusion MRI, and perfusion scan.

    PubMed

    Ohno, Yoshiharu; Seki, Shinichiro; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Takenaka, Daisuke; Kassai, Yoshimori; Yui, Masao; Sugimura, Kazuro

    2015-08-01

    To compare predictive capabilities of non-contrast-enhanced (CE)- and dynamic CE-perfusion MRIs, thin-section multidetector computed tomography (CT) (MDCT), and perfusion scan for postoperative lung function in non-small cell lung cancer (NSCLC) patients. Sixty consecutive pathologically diagnosed NSCLC patients were included and prospectively underwent thin-section MDCT, non-CE-, and dynamic CE-perfusion MRIs and perfusion scan, and had their pre- and postoperative forced expiratory volume in one second (FEV1 ) measured. Postoperative percent FEV1 (po%FEV1 ) was then predicted from the fractional lung volume determined on semiquantitatively assessed non-CE- and dynamic CE-perfusion MRIs, from the functional lung volumes determined on quantitative CT, from the number of segments observed on qualitative CT, and from uptakes detected on perfusion scans within total and resected lungs. Predicted po%FEV1 s were then correlated with actual po%FEV1 s, which were %FEV1 s measured postoperatively. The limits of agreement were also determined. All predicted po%FEV1 s showed significant correlation (0.73 ≤ r ≤ 0.93, P < 0.0001) and limits of agreement with actual po%FEV1 (non-CE-perfusion MRI: 0.3 ± 10.0%, dynamic CE-perfusion MRI: 1.0 ± 10.8%, perfusion scan: 2.2 ± 14.1%, quantitative CT: 1.2 ± 9.0%, qualitative CT: 1.5 ± 10.2%). Non-CE-perfusion MRI may be able to predict postoperative lung function more accurately than qualitatively assessed MDCT and perfusion scan. © 2014 Wiley Periodicals, Inc.

  16. Diffusion-weighted MRI in neuro-oncology.

    PubMed

    Baehring, Joachim M; Fulbright, Robert K

    2012-11-01

    Diffusion-weighted MRI (DW-MRI) provides image contrast dependent on the molecular movement of water. It has been most widely used in the diagnosis of cytotoxic edema secondary to acute cerebral ischemia, but has also proven useful in assessing tumor cellularity and grade, abscess formation, cysts and various forms of white matter disorders. Furthermore, DW-MRI is used to generate maps of subcortical white matter tracts and their relationship to structural brain lesions that may serve for preoperative planning and intraoperative guidance. We provide a comprehensive review of current practical applications of DW-MRI in the diagnosis and treatment of primary brain tumors, metastases and nonmetastatic neurologic complications of cancer. A detailed description of diffusion tensor imaging is beyond the scope of this review. We performed a comprehensive search of the PubMed database of the USA National Library of Medicine with use of various combinations of the following search terms: diffusion-weighted imaging, apparent diffusion coefficient, diffusion tensor imaging, diffusion tensor, brain, tumor, glioblastoma, lymphoma, primary CNS lymphoma, stroke, cancer, abscess, leukoencephalopathy, methotrexate, fluorouracil, capecitabine. We identified original articles and well-documented case reports of DW-MRI applications in patients with primary brain neoplasms, metastases and nonmetastatic neurologic complications that we judged to be of high impact on the field. We largely selected publications from the past 10 years, but did not exclude commonly referenced and highly regarded older publications. We also searched the reference lists of articles identified by this search strategy and selected those we judged relevant. Review articles are cited to provide readers with more details and more references than can be covered here.

  17. Tumor classification using perfusion volume fractions in breast DCE-MRI

    NASA Astrophysics Data System (ADS)

    Lee, Sang Ho; Kim, Jong Hyo; Park, Jeong Seon; Park, Sang Joon; Jung, Yun Sub; Song, Jung Joo; Moon, Woo Kyung

    2008-03-01

    This study was designed to classify contrast enhancement curves using both three-time-points (3TP) method and clustering approach at full-time points, and to introduce a novel evaluation method using perfusion volume fractions for differentiation of malignant and benign lesions. DCE-MRI was applied to 24 lesions (12 malignant, 12 benign). After region growing segmentation for each lesion, hole-filling and 3D morphological erosion and dilation were performed for extracting final lesion volume. 3TP method and k-means clustering at full-time points were applied for classifying kinetic curves into six classes. Intratumoral volume fraction for each class was calculated. ROC and linear discriminant analyses were performed with distributions of the volume fractions for each class, pairwise and whole classes, respectively. The best performance in each class showed accuracy (ACC), 84.7% (sensitivity (SE), 100%; specificity (SP), 66.7% to a single class) to 3TP method, whereas ACC, 73.6% (SE, 41.7%; SP, 100% to a single class) to k-means clustering. The best performance in pairwise classes showed ACC, 75% (SE, 83.3%; SP, 66.7% to four class pairs and SE, 58.3%; SP, 91.7% to a single class pair) to 3TP method and ACC, 75% (SE, 75%; SP, 75% to a single class pair and SE, 66.7%; SP, 83.3% to three class pairs) to k-means clustering. The performance in whole classes showed ACC, 75% (SE, 83.3%; SP, 66.7%) to 3TP method and ACC, 75% (SE, 91.7%; 58.3%) to k-means clustering. The results indicate that tumor classification using perfusion volume fractions is helpful in selecting meaningful kinetic patterns for differentiation of malignant and benign lesions, and that two different classification methods are complementary to each other.

  18. Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study

    PubMed Central

    Schlumpf, Yolanda R.; Reinders, Antje A. T. S.; Nijenhuis, Ellert R. S.; Luechinger, Roger; van Osch, Matthias J. P.; Jäncke, Lutz

    2014-01-01

    Background In accordance with the Theory of Structural Dissociation of the Personality (TSDP), studies of dissociative identity disorder (DID) have documented that two prototypical dissociative subsystems of the personality, the “Emotional Part” (EP) and the “Apparently Normal Part” (ANP), have different biopsychosocial reactions to supraliminal and subliminal trauma-related cues and that these reactions cannot be mimicked by fantasy prone healthy controls nor by actors. Methods Arterial spin labeling perfusion MRI was used to test the hypotheses that ANP and EP in DID have different perfusion patterns in response to rest instructions, and that perfusion is different in actors who were instructed to simulate ANP and EP. In a follow-up study, regional cerebral blood flow of DID patients was compared with the activation pattern of healthy non-simulating controls. Results Compared to EP, ANP showed elevated perfusion in bilateral thalamus. Compared to ANP, EP had increased perfusion in the dorsomedial prefrontal cortex, primary somatosensory cortex, and motor-related areas. Perfusion patterns for simulated ANP and EP were different. Fitting their reported role-play strategies, the actors activated brain structures involved in visual mental imagery and empathizing feelings. The follow-up study demonstrated elevated perfusion in the left temporal lobe in DID patients, whereas non-simulating healthy controls had increased activity in areas which mediate the mental construction of past and future episodic events. Conclusion DID involves dissociative part-dependent resting-state differences. Compared to ANP, EP activated brain structures involved in self-referencing and sensorimotor actions more. Actors had different perfusion patterns compared to genuine ANP and EP. Comparisons of neural activity for individuals with DID and non-DID simulating controls suggest that the resting-state features of ANP and EP in DID are not due to imagination. The findings are

  19. Perfusion and vascular permeability: basic concepts and measurement in DCE-CT and DCE-MRI.

    PubMed

    Cuenod, C A; Balvay, D

    2013-12-01

    The microvascular network formed by the capillaries supplies the tissues and permits their function. It provides a considerable surface area for exchanges between blood and tissues. All pathological conditions cause changes in the microcirculation. These changes can be used as imaging biomarkers for the diagnosis of lesions and optimisation of treatment. Among the many imaging techniques developed to study the microcirculation, the analysis of the tissue kinetics of intravenously injected contrast agents is the most widely used, either as positive enhancement for CT, T1-weighted MRI and ultrasound - dynamic contrast-enhanced-imaging (DCE-imaging) - or negative enhancement in T2*-weighted brain MRI - dynamic susceptibility contrast-MRI (DSC-MRI) -. Acquisition involves an injection of contrast agent during the acquisition of a dynamic series of images on a zone of interest. These kinetics may be analyzed visually, to define qualitative criteria, or with software using mathematical modelling, to extract quantitative physiological parameters. The results depend on the acquisition conditions (type of imaging device, imaging mode, frequency and total duration of acquisition), the type of contrast agent, the data pre-processing (motion correction, conversion of the signal into concentration) and the data analysis method. Because of these multiple choices it is necessary to understand the physiological processes involved and understand the advantages and limits of each strategy.

  20. MO-G-18C-05: Real-Time Prediction in Free-Breathing Perfusion MRI

    SciTech Connect

    Song, H; Liu, W; Ruan, D; Jung, S; Gach, M

    2014-06-15

    Purpose: The aim is to minimize frame-wise difference errors caused by respiratory motion and eliminate the need for breath-holds in magnetic resonance imaging (MRI) sequences with long acquisitions and repeat times (TRs). The technique is being applied to perfusion MRI using arterial spin labeling (ASL). Methods: Respiratory motion prediction (RMP) using navigator echoes was implemented in ASL. A least-square method was used to extract the respiratory motion information from the 1D navigator. A generalized artificial neutral network (ANN) with three layers was developed to simultaneously predict 10 time points forward in time and correct for respiratory motion during MRI acquisition. During the training phase, the parameters of the ANN were optimized to minimize the aggregated prediction error based on acquired navigator data. During realtime prediction, the trained ANN was applied to the most recent estimated displacement trajectory to determine in real-time the amount of spatial Results: The respiratory motion information extracted from the least-square method can accurately represent the navigator profiles, with a normalized chi-square value of 0.037±0.015 across the training phase. During the 60-second training phase, the ANN successfully learned the respiratory motion pattern from the navigator training data. During real-time prediction, the ANN received displacement estimates and predicted the motion in the continuum of a 1.0 s prediction window. The ANN prediction was able to provide corrections for different respiratory states (i.e., inhalation/exhalation) during real-time scanning with a mean absolute error of < 1.8 mm. Conclusion: A new technique enabling free-breathing acquisition during MRI is being developed. A generalized ANN development has demonstrated its efficacy in predicting a continuum of motion profile for volumetric imaging based on navigator inputs. Future work will enhance the robustness of ANN and verify its effectiveness with human

  1. The role of susceptibility weighted imaging in functional MRI.

    PubMed

    Haacke, E Mark; Ye, Yongquan

    2012-08-15

    The development of functional brain magnetic resonance imaging (fMRI) has been a boon for neuroscientists and radiologists alike. It provides for fundamental information on brain function and better diagnostic tools to study disease. In this paper, we will review some of the early concepts in high resolution gradient echo imaging with a particular emphasis on susceptibility weighted imaging (SWI) and MR angiography (MRA). We begin with the history of our own experience in this area, followed by a discussion of the role of high resolution in studying the vasculature of the brain and how this relates to the BOLD (blood oxygenation level dependent) signal. We introduce the role of SWI and susceptibility mapping (SWIM) in fMRI and close with recommendations for future high resolution experiments.

  2. MRI-based assessment of liver perfusion and hepatocyte injury in the murine model of acute hepatitis.

    PubMed

    Byk, Katarzyna; Jasinski, Krzysztof; Bartel, Zaneta; Jasztal, Agnieszka; Sitek, Barbara; Tomanek, Boguslaw; Chlopicki, Stefan; Skorka, Tomasz

    2016-12-01

    To assess alterations in perfusion and liver function in the concanavalin A (ConA)-induced mouse model of acute liver failure (ALF) using two magnetic resonance imaging (MRI)-based methods: dynamic contrast-enhanced MRI (DCE-MRI) with Gd-EOB-DTPA contrast agent and arterial spin labelling (ASL). BALB/c mice were studied using a 9.4 T MRI system. The IntraGateFLASH(TM) and FAIR-EPI pulse sequences were used for optimum mouse abdomen imaging. The average perfusion values for the liver of the control and ConA group were equal to 245 ± 20 and 200 ± 32 ml/min/100 g (p = 0.008, respectively). DCE-MRI showed that the time to the peak of the image enhancement was 6.14 ± 1.07 min and 9.72 ± 1.69 min in the control and ConA group (p < 0.001, respectively), while the rate of the contrast wash-out in the control and ConA group was 0.037 ± 0.008 and 0.021 ± 0.008 min(-1) (p = 0.004, respectively). These results were consistent with hepatocyte injury in the ConA-treated mice as confirmed by histopathological staining. Both the ASL and DCE-MRI techniques represent a reliable methodology to assess alterations in liver perfusion and hepatocyte integrity in murine hepatitis.

  3. Comparison of Arterial Spin Labeling and Bolus Perfusion-Weighted Imaging for Detecting Mismatch in Acute Stroke

    PubMed Central

    Zaharchuk, Greg; El Mogy, Ibraheem S.; Fischbein, Nancy J.; Albers, Gregory W.

    2012-01-01

    PURPOSE The perfusion-weighted imaging (PWI) – diffusion-weighted imaging (DWI) mismatch paradigm is widely used in stroke imaging studies. Arterial spin labeling (ASL) is an alternative perfusion method that does not require contrast. This study compares the agreement of ASL-DWI and PWI-DWI mismatch classification in stroke patients. MATERIALS AND METHODS This was a retrospective study drawn from all 1.5T MRI studies performed in 2010 at a single institution. Inclusion criteria were: symptom onset<5 days, DWI lesion>10 ml, acquisition of both PWI and ASL. DWI and PWI-Tmax>6 sec lesion volumes were determined using automated software. Patients were classified into reperfused, matched, or mismatch groups. Two radiologists classified ASL-DWI qualitatively into the same categories, blinded to DWI-PWI. Agreement between both individual readers and methods was assessed. RESULTS 51 studies met the inclusion criteria. Seven cases were excluded (1 due to PWI susceptibility artifact, 2 due to motion, and 4 due to severe ASL borderzone sign), resulting in 44 studies for comparison. Inter-rater agreement for ASL–DWI mismatch status was high (κ =0.92, 95% CI 0.80–1.00). ASL-DWI and PWI-DWI mismatch categories agreed in 25/44 cases (57%). In the 16 of 19 discrepant cases (84%), ASL overestimated the PWI lesion size. In 34/44 cases (77%), they agreed regarding the presence of mismatch versus no mismatch. CONCLUSION Mismatch classification based on ASL and PWI agree frequently but not perfectly. ASL tends to overestimate the PWI-Tmax lesion volume. Improved ASL methodologies and/or higher field strength are necessary before ASL can be recommended for routine use in acute stroke. PMID:22539548

  4. Thoracic Splenosis after a Gunshot: Diffusion-Weighted MRI Findings

    PubMed Central

    Tutar, Onur; Bakan, Selim; Samanci, Cesur; Nurili, Fuat; Sayman, Haluk Burcak; Akman, Canan

    2015-01-01

    Summary Background Intrathoracic splenosis is a rare condition resulting from concomitant rupture of the spleen and left hemidiaphragm after a traumatic event involving the spleen and the diaphragma and is defined as autotransplantation of splenic tissue in thorax. Case Report The aim of this study was to present a case report of a combined intrathoracic and subcutaneous splenosis in a patient 19 years after penetrating trauma. She has left dorsal side pain and routine chest roentgenogram shows pleural nodular masses. The patient was referred to us for radiologic work up. Conclusions The MRI scans revealed the intrathoracic and subcutan masses as mainly hypointense on T1-weighted images and hyperintense on T2-weighted images and significant restriction in diffusion-weighted images. Scintigraphy revealed abnormal hot spots in subcutaneous tissue and diaphragmatic pleura of the left hemithorax. PMID:25745523

  5. Qualitative and semi-quantitative evaluation of myocardium perfusion with 3 T stress cardiac MRI.

    PubMed

    Yun, Chun-Ho; Tsai, Jui-Peng; Tsai, Cheng-Ting; Mok, Greta S P; Sun, Jing-Yi; Hung, Chung-Lieh; Wu, Tung-Hsin; Huang, Wu-Ta; Yang, Fei-Shih; Lee, Jason Jeun-Shenn; Cury, Ricardo C; Fares, Anas; Nshisso, Lemba Dina; Bezerra, Hiram G

    2015-12-07

    3 T MRI has been adopted by some centers as the primary choice for assessment of myocardial perfusion over conventional 1.5 T MRI. However, there is no data published on the potential additional value of incorporating semi-quantitative data from 3 T MRI. This study sought to determine the performance of qualitative 3 T stress magnetic resonance myocardial perfusion imaging (3 T-MRMPI) and the potential incremental benefit of using a semi-quantitative perfusion technique in patients with suspected coronary artery disease (CAD). Fifty eight patients (41 men; mean age: 59 years) referred for elective diagnostic angiography underwent stress 3 T MRMPI with a 32-channel cardiac receiver coil. The MR protocol included gadolinium-enhanced stress first-pass perfusion (0.56 mg/kg, dipyridamole), rest perfusion, and delayed enhancement (DE). Visual analysis was performed in two steps. Ischemia was defined as a territory with perfusion defect at stress study but no DE or a territory with DE but additional peri-infarcted perfusion defect at stress study. Semi-quantitative analysis was calculated by using the upslope of the signal intensity-time curve during the first pass of contrast medium during dipyridamole stress and at rest. ROC analysis was used to determine the MPRI threshold that maximized sensitivity. Quantitative coronary angiography served as the reference standard with significant stenosis defined as >70 % diameter stenosis. Diagnostic performance was determined on a per-patient and per-vessel basis. Qualitative assessment had an overall sensitivity and specificity for detecting significant stenoses of 77 % and 80 %, respectively. By adding MPRI analysis, in cases with negative qualitative assessment, the overall sensitivity increased to 83 %. The impact of MPRI differed depending on the territory; with the sensitivity for detection of left circumflex (LCx) stenosis improving the most after semi-quantification analysis, (66 % versus 83 %). Pure

  6. Functional MRI for characterization of renal perfusion impairment and edema formation due to acute kidney injury in different mouse strains

    PubMed Central

    Chen, Rongjun; Gutberlet, Marcel; Jang, Mi-Sun; Meier, Martin; Mengel, Michael; Hartung, Dagmar; Wacker, Frank; Rong, Song; Hueper, Katja

    2017-01-01

    Purpose The purpose was to characterize acute kidney injury (AKI) in C57BL/6 (B6)- and 129/Sv (Sv)-mice by noninvasive measurement of renal perfusion and tissue edema using functional MRI. Methods Different severities of AKI were induced in B6- and Sv-mice by renal ischemia reperfusion injury (IRI). Unilateral clamping of the renal pedicle for 35 min (moderate AKI) or 45 min (severe AKI) was done. MRI (7-Tesla) was performed 1, 7 and 28 days after surgery using a flow alternating inversion recovery (FAIR) arterial spin labeling (ASL) sequence. Maps of perfusion and T1-relaxation time were calculated. Relative MRI-parameters of the IRI kidney compared to the contralateral not-clipped kidney were compared between AKI severities and between mouse strains using unpaired t-tests. In addition, fibrosis was assessed by Masson Trichrome and collagen IV staining. Results After moderate AKI relative perfusion impairment was significantly higher in B6- than in Sv-mice at d7 (55±7% vs. 82±8%, p<0.05) and d28 (76±7% vs. 102±3%, p<0.01). T1-values increased in the early phase after AKI in both mouse strains. T1-increase was more severe after prolonged ischemia times of 45 min compared to 35 min in both mouse strains, measured in the renal cortex and outer stripe of outer medulla. Kidney volume loss (compared to the contralateral kidney) occurred already after 7 days but proceeded markedly towards 4 weeks in severe AKI. Early renal perfusion impairment was predictive for later kidney volume loss. The progression to chronic kidney disease (CKD) in the severe AKI model was similar in both mouse strains as revealed by histology. Conclusion Quantification of renal perfusion and tissue edema by functional MRI allows characterization of strain differences upon AKI. Renal perfusion impairment was stronger in B6- compared to Sv-animals following moderate AKI. Prolonged ischemia times were associated with more severe perfusion impairment and edema formation in the early phase and

  7. Alterations of the Blood-Brain Barrier and Regional Perfusion in Tumor Development: MRI Insights from a Rat C6 Glioma Model

    PubMed Central

    Huhndorf, Monika; Moussavi, Amir; Kramann, Nadine; Will, Olga; Hattermann, Kirsten; Stadelmann, Christine; Jansen, Olav

    2016-01-01

    Objectives Angiogenesis and anti-angiogenetic medications play an important role in progression and therapy of glioblastoma. In this context, in vivo characterization of the blood-brain-barrier and tumor vascularization may be important for individual prognosis and therapy optimization. Methods We analyzed perfusion and capillary permeability of C6-gliomas in rats at different stages of tumor-growth by contrast enhanced MRI and dynamic susceptibility contrast (DSC) MRI at 7 Tesla. The analyses included maps of relative cerebral blood volume (CBV) and signal recovery derived from DSC data over a time period of up to 35 days after tumor cell injections. Results In all rats tumor progression was accompanied by temporal and spatial changes in CBV and capillary permeability. A leakage of the blood-brain barrier (slow contrast enhancement) was observed as soon as the tumor became detectable on T2-weighted images. Interestingly, areas of strong capillary permeability (fast signal enhancement) were predominantly localized in the center of the tumor. In contrast, the tumor rim was dominated by an increased CBV and showed the highest vessel density compared to the tumor center and the contralateral hemisphere as confirmed by histology. Conclusion Substantial regional differences in the tumor highlight the importance of parameter maps in contrast or in addition to region-of-interest analyses. The data vividly illustrate how MRI including contrast-enhanced and DSC-MRI may contribute to a better understanding of tumor development. PMID:28005983

  8. Effects on resting cerebral blood flow and functional connectivity induced by metoclopramide: a perfusion MRI study in healthy volunteers.

    PubMed

    Fernández-Seara, María A; Aznárez-Sanado, Maite; Mengual, Elisa; Irigoyen, Jaione; Heukamp, Franz; Pastor, María A

    2011-08-01

    BACKGROUND AND PURPOSE The substituted benzamide, metoclopramide, is a dopamine receptor antagonist and is widely prescribed in the symptomatic treatment of nausea and vomiting, although it can cause adverse motor and non-motor side effects. The effects of metoclopramide on brain metabolism have not been investigated to date. EXPERIMENTAL APPROACH To determine the effects of metoclopramide on brain function, cerebral perfusion changes after a single oral dose were assessed in healthy volunteers using magnetic resonance imaging (MRI) techniques. Arterial spin labelling (ASL) perfusion MRI was used to measure cerebral blood flow before and after metoclopramide. Blood haemodynamics in the vertebral and internal carotid arteries were evaluated using phase-contrast MRI. KEY RESULTS Metoclopramide altered haemodynamics in the carotid arteries and the cerebral perfusion. Perfusion increased bilaterally in the putamen, consistent with antagonism of dopamine D(2) receptors by metoclopramide and possibly related to its motor side effects. In contrast, reduced perfusion was observed in the insular cortices and anterior temporal lobes. In addition, functional connectivity between the insular cortex and the dorsolateral prefrontal cortex was decreased. These cortical changes affecting neural circuits between high-order association areas may underlie certain neuropsychiatric conditions occasionally reported after metoclopramide administration. CONCLUSIONS AND IMPLICATIONS The present results show the sensitivity of ASL to detect small changes in regional blood flow, closely related to brain function, after a single pharmacological challenge, highlighting the potential of this technique for human pharmacological studies. © 2011 FUNDACIÓN PARA LA INVESTIGACIÓN MÉDICA APLICADA. British Journal of Pharmacology © 2011 The British Pharmacological Society.

  9. Effects on resting cerebral blood flow and functional connectivity induced by metoclopramide: a perfusion MRI study in healthy volunteers

    PubMed Central

    Fernández-Seara, María A; Aznárez-Sanado, Maite; Mengual, Elisa; Irigoyen, Jaione; Heukamp, Franz; Pastor, María A

    2011-01-01

    BACKGROUND AND PURPOSE The substituted benzamide, metoclopramide, is a dopamine receptor antagonist and is widely prescribed in the symptomatic treatment of nausea and vomiting, although it can cause adverse motor and non-motor side effects. The effects of metoclopramide on brain metabolism have not been investigated to date. EXPERIMENTAL APPROACH To determine the effects of metoclopramide on brain function, cerebral perfusion changes after a single oral dose were assessed in healthy volunteers using magnetic resonance imaging (MRI) techniques. Arterial spin labelling (ASL) perfusion MRI was used to measure cerebral blood flow before and after metoclopramide. Blood haemodynamics in the vertebral and internal carotid arteries were evaluated using phase-contrast MRI. KEY RESULTS Metoclopramide altered haemodynamics in the carotid arteries and the cerebral perfusion. Perfusion increased bilaterally in the putamen, consistent with antagonism of dopamine D2 receptors by metoclopramide and possibly related to its motor side effects. In contrast, reduced perfusion was observed in the insular cortices and anterior temporal lobes. In addition, functional connectivity between the insular cortex and the dorsolateral prefrontal cortex was decreased. These cortical changes affecting neural circuits between high-order association areas may underlie certain neuropsychiatric conditions occasionally reported after metoclopramide administration. CONCLUSIONS AND IMPLICATIONS The present results show the sensitivity of ASL to detect small changes in regional blood flow, closely related to brain function, after a single pharmacological challenge, highlighting the potential of this technique for human pharmacological studies. LINKED ARTICLES This article is part of a themed section on Imaging. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2011.163.issue-8BJP has previously published an Imaging in Pharmacology themed section, edited by A Davenport and C

  10. Differentiation of recurrent spinal ependymoma from postradiation treatment necrosis through multiparametric PET-MR and perfusion MRI.

    PubMed

    Hojjati, Mojgan; Garg, Vasant; Badve, Chaitra A; Abboud, Salim E; Sloan, Andrew E; Wolansky, Leo J

    A 67-year-old male presented with papilledema and back pain localized to the T10 level. Initial workup revealed multifocal spinal ependymoma which was resected and treated with external beam radiotherapy. Nine years after treatment, the patient had a relapse of back pain, and MRI was inconclusive in distinguishing posttreatment radiation necrosis from recurrent tumor. We present the first described report with the utilization of multiparametric positron emission tomography-magnetic resonance imaging and perfusion MRI to distinguish recurrent spinal ependymoma from radiation necrosis.

  11. A component based noise correction method (CompCor) for BOLD and perfusion based fMRI.

    PubMed

    Behzadi, Yashar; Restom, Khaled; Liau, Joy; Liu, Thomas T

    2007-08-01

    A component based method (CompCor) for the reduction of noise in both blood oxygenation level-dependent (BOLD) and perfusion-based functional magnetic resonance imaging (fMRI) data is presented. In the proposed method, significant principal components are derived from noise regions-of-interest (ROI) in which the time series data are unlikely to be modulated by neural activity. These components are then included as nuisance parameters within general linear models for BOLD and perfusion-based fMRI time series data. Two approaches for the determination of the noise ROI are considered. The first method uses high-resolution anatomical data to define a region of interest composed primarily of white matter and cerebrospinal fluid, while the second method defines a region based upon the temporal standard deviation of the time series data. With the application of CompCor, the temporal standard deviation of resting-state perfusion and BOLD data in gray matter regions was significantly reduced as compared to either no correction or the application of a previously described retrospective image based correction scheme (RETROICOR). For both functional perfusion and BOLD data, the application of CompCor significantly increased the number of activated voxels as compared to no correction. In addition, for functional BOLD data, there were significantly more activated voxels detected with CompCor as compared to RETROICOR. In comparison to RETROICOR, CompCor has the advantage of not requiring external monitoring of physiological fluctuations.

  12. Quantifying fluctuations of resting state networks using arterial spin labeling perfusion MRI

    PubMed Central

    Varma, Gopal; Scheidegger, Rachel; Alsop, David C

    2015-01-01

    Blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) has been widely used to investigate spontaneous low-frequency signal fluctuations across brain resting state networks. However, BOLD only provides relative measures of signal fluctuations. Arterial Spin Labeling (ASL) MRI holds great potential for quantitative measurements of resting state network fluctuations. This study systematically quantified signal fluctuations of the large-scale resting state networks using ASL data from 20 healthy volunteers by separating them from global signal fluctuations and fluctuations caused by residual noise. Global ASL signal fluctuation was 7.59% ± 1.47% relative to the ASL baseline perfusion. Fluctuations of seven detected resting state networks vary from 2.96% ± 0.93% to 6.71% ± 2.35%. Fluctuations of networks and residual noise were 6.05% ± 1.18% and 6.78% ± 1.16% using 4-mm resolution ASL data applied with Gaussian smoothing kernel of 6mm. However, network fluctuations were reduced by 7.77% ± 1.56% while residual noise fluctuation was markedly reduced by 39.75% ± 2.90% when smoothing kernel of 12 mm was applied to the ASL data. Therefore, global and network fluctuations are the dominant structured noise sources in ASL data. Quantitative measurements of resting state networks may enable improved noise reduction and provide insights into the function of healthy and diseased brain. PMID:26661226

  13. Neural Substrates Associated with Weather-Induced Mood Variability: An Exploratory Study Using ASL Perfusion fMRI

    PubMed Central

    Gillihan, Seth J.; Detre, John A.; Farah, Martha J.; Rao, Hengyi

    2013-01-01

    Daily variations in weather are known to be associated with variations in mood. However, little is known about the specific brain regions that instantiate weather-related mood changes. We used a data-driven approach and ASL perfusion fMRI to assess the neural substrates associated with weather-induced mood variability. The data-driven approach was conducted with mood ratings under various weather conditions (N = 464). Forward stepwise regression was conducted to develop a statistical model of mood as a function of weather conditions. The model results were used to calculate the mood-relevant weather index which served as the covariate in the regression analysis of the resting CBF (N = 42) measured by ASL perfusion fMRI under various weather conditions. The resting CBF activities in the left insula-prefrontal cortex and left superior parietal lobe were negatively correlated (corrected p<0.05) with the weather index, indicating that better mood-relevant weather conditions were associated with lower CBF in these regions within the brain’s emotional network. The present study represents a first step toward the investigation of the effect of natural environment on baseline human brain function, and suggests the feasibility of ASL perfusion fMRI for such study. PMID:24834022

  14. MRI findings in multifetal pregnancies complicated by twin reversed arterial perfusion sequence (TRAP).

    PubMed

    Guimaraes, Carolina V A; Kline-Fath, Beth M; Linam, Leann E; Garcia, Maria A Calvo; Rubio, Eva I; Lim, Foong-Yen

    2011-06-01

    Twin reversed arterial perfusion sequence (TRAP) is a rare complication in multifetal monochorionic pregnancies in which a normal "pump" twin provides circulation to an abnormal acardiac co-twin, resulting in high-output cardiac dysfunction in the pump twin. To define fetal MRI findings of TRAP sequence. Fetal MR images were retrospectively reviewed in 35 pregnancies complicated by TRAP sequence. Abnormalities of the pump twin, acardiac twin, umbilical cord, placenta and amniotic fluid were reviewed. Acardiac twins were classified as: acephalus (51%), anceps (40%), amorphus (9%), acormus (0%). Common findings in acardiac twins include subcutaneous edema (77%), absent cardiac structures (86%), absent or abnormal thoracic cavity (100%), abnormal abdominal organs (100%), superior limbs absent (46%) or abnormal (51%), and inferior limbs present but abnormal (83%). There were pump twin findings of cardiac dysfunction in 43% and intracranial ischemic changes in 3%. Umbilical cord anomalies were present in 97%. Acardiac twins present with a predictable pattern of malformation with poorly developed superior structures, more normally formed inferior structures and absent or rudimentary heart. Although usually absent, abnormal heart structures can be seen and do not exclude TRAP sequence. Pump twins are commonly normal with exception of findings of cardiac dysfunction and possible brain ischemia.

  15. Perfusion functional MRI reveals cerebral blood flow pattern under psychological stress

    NASA Astrophysics Data System (ADS)

    Wang, Jiongjiong; Rao, Hengyi; Wetmore, Gabriel S.; Furlan, Patricia M.; Korczykowski, Marc; Dinges, David F.; Detre, John A.

    2005-12-01

    Despite the prevalence of stress in everyday life and its impact on happiness, health, and cognition, little is known about the neural substrate of the experience of everyday stress in humans. We use a quantitative and noninvasive neuroimaging technique, arterial spin-labeling perfusion MRI, to measure cerebral blood flow (CBF) changes associated with mild to moderate stress induced by a mental arithmetic task with performance monitoring. Elicitation of stress was verified by self-report of stress and emotional state and measures of heart rate and salivary-cortisol level. The change in CBF induced by the stress task was positively correlated with subjective stress rating in the ventral right prefrontal cortex (RPFC) and left insula/putamen area. The ventral RPFC along with right insula/putamen and anterior cingulate showed sustained activation after task completion in subjects reporting a high stress level during arithmetic tasks. Additionally, variations of baseline CBF in the ventral RPFC and right orbitofrontal cortex were found to correlate with changes in salivary-cortisol level and heart rate caused by undergoing stress tasks. We further demonstrated that the observed right prefrontal activation could not be attributed to increased cognitive demand accompanying stress tasks and extended beyond neural pathways associated with negative emotions. Our results provide neuroimaging evidence that psychological stress induces negative emotion and vigilance and that the ventral RPFC plays a key role in the central stress response. anterior cingulate cortex | arterial spin labeling | right prefrontal cortex

  16. Perfusion kinetics in human brain tumor with DCE-MRI derived model and CFD analysis.

    PubMed

    Bhandari, A; Bansal, A; Singh, A; Sinha, N

    2017-07-05

    Cancer is one of the leading causes of death all over the world. Among the strategies that are used for cancer treatment, the effectiveness of chemotherapy is often hindered by factors such as irregular and non-uniform uptake of drugs inside tumor. Thus, accurate prediction of drug transport and deposition inside tumor is crucial for increasing the effectiveness of chemotherapeutic treatment. In this study, a computational model of human brain tumor is developed that incorporates dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) data into a voxelized porous media model. The model takes into account realistic transport and perfusion kinetics parameters together with realistic heterogeneous tumor vasculature and accurate arterial input function (AIF), which makes it patient specific. The computational results for interstitial fluid pressure (IFP), interstitial fluid velocity (IFV) and tracer concentration show good agreement with the experimental results. The computational model can be extended further for predicting the deposition of chemotherapeutic drugs in tumor environment as well as selection of the best chemotherapeutic drug for a specific patient. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Perfusion MRI in hips with metal-on-metal and metal-on-polyethylene total hip arthroplasty

    PubMed Central

    Anwander, H.; Cron, G. O.; Rakhra, K.

    2016-01-01

    Objectives Hips with metal-on-metal total hip arthroplasty (MoM THA) have a high rate of adverse local tissue reactions (ALTR), often associated with hypersensitivity reactions. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) measures tissue perfusion with the parameter Ktrans (volume transfer constant of contrast agent). Our purpose was 1) to evaluate the feasibility of DCE-MRI in patients with THA and 2) to compare DCE-MRI in patients with MoM bearings with metal-on-polyethylene (MoP) bearings, hypothesising that the perfusion index Ktrans in hips with MoM THA is higher than in hips with MoP THA. Methods In this pilot study, 16 patients with primary THA were recruited (eight MoM, eight MoP). DCE-MRI of the hip was performed at 1.5 Tesla (T). For each patient, Ktrans was computed voxel-by-voxel in all tissue lateral to the bladder. The mean Ktrans for all voxels was then calculated. These values were compared with respect to implant type and gender, and further correlated with clinical parameters. Results There was no significant difference between the two bearing types with both genders combined. However, dividing patients by THA bearing and gender, women with MoM bearings had the highest Ktrans values, exceeding those of women with MoP bearings (0.067 min−1 versus 0.053 min−1; p-value < 0.05) and men with MoM bearings (0.067 min−1 versus 0.034 min−1; p-value < 0.001). Considering only the men, patients with MoM bearings had lower Ktrans than those with MoP bearings (0.034 min−1 versus 0.046 min−1; p < 0.05). Conclusion DCE-MRI is feasible to perform in tissues surrounding THA. Females with MoM THA show high Ktrans values in DCE-MRI, suggesting altered tissue perfusion kinematics which may reflect relatively greater inflammation. Cite this article: Dr P. E. Beaule. Perfusion MRI in hips with metal-on-metal and metal-on-polyethylene total hip arthroplasty: A pilot stud. Bone Joint Res 2016;5:73–79. DOI: 10

  18. Comparison of stroke infarction between CT perfusion and diffusion weighted imaging: preliminary results

    NASA Astrophysics Data System (ADS)

    Abd. Rahni, Ashrani Aizzuddin; Arka, Israna Hossain; Chellappan, Kalaivani; Mukari, Shahizon Azura; Law, Zhe Kang; Sahathevan, Ramesh

    2016-03-01

    In this paper we present preliminary results of comparison of automatic segmentations of the infarct core, between that obtained from CT perfusion (based on time to peak parameter) and diffusion weighted imaging (DWI). For each patient, the two imaging volumes were automatically co-registered to a common frame of reference based on an acquired CT angiography image. The accuracy of image registration is measured by the overlap of the segmented brain from both images (CT perfusion and DWI), measured within their common field of view. Due to the limitations of the study, DWI was acquired as a follow up scan up to a week after initial CT based imaging. However, we found significant overlap of the segmented brain (Jaccard indices of approximately 0.8) and the percentage of infarcted brain tissue from the two modalities were still fairly highly correlated (correlation coefficient of approximately 0.9). The results are promising with more data needed in future for clinical inference.

  19. Simultaneous myocardial strain and dark-blood perfusion imaging using a displacement-encoded MRI pulse sequence.

    PubMed

    Le, Yuan; Stein, Ashley; Berry, Colin; Kellman, Peter; Bennett, Eric E; Taylor, Joni; Lucas, Katherine; Kopace, Rael; Chefd'Hotel, Christophe; Lorenz, Christine H; Croisille, Pierre; Wen, Han

    2010-09-01

    The purpose of this study is to develop and evaluate a displacement-encoded pulse sequence for simultaneous perfusion and strain imaging. Displacement-encoded images in two to three myocardial slices were repeatedly acquired using a single-shot pulse sequence for 3 to 4 min, which covers a bolus infusion of Gadolinium contrast. The magnitudes of the images were T(1) weighted and provided quantitative measures of perfusion, while the phase maps yielded strain measurements. In an acute coronary occlusion swine protocol (n = 9), segmental perfusion measurements were validated against microsphere reference standard with a linear regression (slope 0.986, R(2) = 0.765, Bland-Altman standard deviation = 0.15 mL/min/g). In a group of ST-elevation myocardial infarction patients (n = 11), the scan success rate was 76%. Short-term contrast washout rate and perfusion are highly correlated (R(2) = 0.72), and the pixelwise relationship between circumferential strain and perfusion was better described with a sigmoidal Hill curve than linear functions. This study demonstrates the feasibility of measuring strain and perfusion from a single set of images.

  20. Simultaneous Myocardial Strain and Dark-Blood Perfusion Imaging Using a Displacement-Encoded MRI Pulse Sequence

    PubMed Central

    Le, Yuan; Stein, Ashley; Berry, Colin; Kellman, Peter; Bennett, Eric E.; Taylor, Joni; Lucas, Katherine; Kopace, Rael; Chefd’Hotel, Christophe; Lorenz, Christine H.; Croisille, Pierre; Wen, Han

    2010-01-01

    The purpose of this study is to develop and evaluate a displacement-encoded pulse sequence for simultaneous perfusion and strain imaging. Displacement-encoded images in 2–3 myocardial slices were repeatedly acquired using a single shot pulse sequence for 3 to 4 minutes, which covers a bolus infusion of Gd. The magnitudes of the images were T1 weighted and provided quantitative measures of perfusion, while the phase maps yielded strain measurements. In an acute coronary occlusion swine protocol (n=9), segmental perfusion measurements were validated against microsphere reference standard with a linear regression (slope 0.986, R2 = 0.765, Bland-Altman standard deviation = 0.15 ml/min/g). In a group of ST-elevation myocardial infarction(STEMI) patients (n=11), the scan success rate was 76%. Short-term contrast washout rate and perfusion are highly correlated (R2=0.72), and the pixel-wise relationship between circumferential strain and perfusion was better described with a sigmoidal Hill curve than linear functions. This study demonstrates the feasibility of measuring strain and perfusion from a single set of images. PMID:20544714

  1. DCE-MRI Perfusion and Permeability Parameters as predictors of tumor response to CCRT in Patients with locally advanced NSCLC

    PubMed Central

    Tao, Xiuli; Wang, Lvhua; Hui, Zhouguang; Liu, Li; Ye, Feng; Song, Ying; Tang, Yu; Men, Yu; Lambrou, Tryphon; Su, Zihua; Xu, Xiao; Ouyang, Han; Wu, Ning

    2016-01-01

    In this prospective study, 36 patients with stage III non-small cell lung cancers (NSCLC), who underwent dynamic contrast-enhanced MRI (DCE-MRI) before concurrent chemo-radiotherapy (CCRT) were enrolled. Pharmacokinetic analysis was carried out after non-rigid motion registration. The perfusion parameters [including Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT)] and permeability parameters [including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), fractional plasma volume (Vp)] were calculated, and their relationship with tumor regression was evaluated. The value of these parameters on predicting responders were calculated by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was conducted to find the independent variables. Tumor regression rate is negatively correlated with Ve and its standard variation Ve_SD and positively correlated with Ktrans and Kep. Significant differences between responders and non-responders existed in Ktrans, Kep, Ve, Ve_SD, MTT, BV_SD and MTT_SD (P < 0.05). ROC indicated that Ve < 0.24 gave the largest area under curve of 0.865 to predict responders. Multivariate logistic regression analysis also showed Ve was a significant predictor. Baseline perfusion and permeability parameters calculated from DCE-MRI were seen to be a viable tool for predicting the early treatment response after CCRT of NSCLC. PMID:27762331

  2. Using Perfusion fMRI to Measure Continuous Changes in Neural Activity with Learning

    ERIC Educational Resources Information Center

    Olson, Ingrid R.; Rao, Hengyi; Moore, Katherine Sledge; Wang, Jiongjiong; Detre, John A.; Aguirre, Geoffrey K.

    2006-01-01

    In this study, we examine the suitability of a relatively new imaging technique, "arterial spin labeled perfusion imaging," for the study of continuous, gradual changes in neural activity. Unlike BOLD imaging, the perfusion signal is stable over long time-scales, allowing for accurate assessment of continuous performance. In addition, perfusion…

  3. Using Perfusion fMRI to Measure Continuous Changes in Neural Activity with Learning

    ERIC Educational Resources Information Center

    Olson, Ingrid R.; Rao, Hengyi; Moore, Katherine Sledge; Wang, Jiongjiong; Detre, John A.; Aguirre, Geoffrey K.

    2006-01-01

    In this study, we examine the suitability of a relatively new imaging technique, "arterial spin labeled perfusion imaging," for the study of continuous, gradual changes in neural activity. Unlike BOLD imaging, the perfusion signal is stable over long time-scales, allowing for accurate assessment of continuous performance. In addition, perfusion…

  4. Dynamic contrast-enhanced MRI as a valuable non-invasive tool to evaluate tissue perfusion of free flaps: Preliminary results.

    PubMed

    Fellner, Claudia; Jung, Ernst M; Prantl, Lukas

    2010-01-01

    Early detection of a compromised circulation of free flaps and an immediate revision may lead to higher rates of flap salvage. The aim of this study was to evaluate the perfusion of the entire flap using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). DCE was performed in 11 patients after flap transplantation using an optimized 3D gradient echo sequence to cover the whole flap. The percentage increase of signal intensity over time was evaluated for the free flap as well as for a reference tissue. Furthermore, normalized signal increase was calculated as the ratio of signal increase within the flaps to the signal increase in the reference tissue. Signal increase in free flaps and reference tissue was compared using the Wilcoxon-test (p < 0.05), normalized signal increase in normally perfused (n = 9) and in flaps with compromised perfusion (n = 2) using Mann-Whitney-test (p < 0.05). Signal increase within normally perfused flaps was similar to the reference tissue. In flaps with compromised perfusion the increase was significantly lower than in reference tissue. Normalized signal increase in adequately perfused flaps and flaps with compromised perfusion also showed a significant difference. DCE MRI may be a valuable non-invasive tool to evaluate tissue perfusion of the complete free flap.

  5. The role of magnetic resonance diffusion-weighted imaging and three-dimensional arterial spin labelling perfusion imaging in the differentiation of parasellar meningioma and cavernous haemangioma.

    PubMed

    Xiao, Hua-Feng; Lou, Xin; Liu, Meng-Yu; Wang, Yu-Lin; Wang, Yan; Chen, Zhi-Ye; Shi, Kai-Ning; Ma, Lin

    2014-08-01

    To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) and three-dimensional arterial spin labelling perfusion imaging (3D-ASL) in distinguishing cavernous haemangioma from parasellar meningioma, using histological data as a reference standard. Patients with parasellar meningioma or parasellar cavernous haemangioma underwent conventional T1- and T2-weighted magnetic resonance imaging (MRI) followed by DWI and 3D-ASL using a 3.0 Tesla MRI. The minimum apparent diffusion coefficient (minADC) from DWI and the maximal normalized cerebral blood flow (nCBF) from 3D-ASL were measured in each tumour. Diagnosis was confirmed by histology. MinADC was significantly lower and nCBF significantly higher in meningioma (n = 19) than cavernous haemangioma (n = 15). There was a significant negative correlation between minADC and nCBF (r = -0.605). DWI and 3D-ASL are useful in differentiating cavernous haemangiomas from parasellar meningiomas, particularly in situations when the appearance on conventional MRI sequences is otherwise ambiguous. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Longitudinal assessment of renal perfusion and oxygenation in transplant donor-recipient pairs using ASL and BOLD MRI

    PubMed Central

    Niles, David J; Artz, Nathan S; Djamali, Arjang; Sadowski, Elizabeth A; Grist, Thomas M; Fain, Sean B

    2015-01-01

    Objectives To assess renal function in kidney transplant recipients and their respective donors over two years using arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) MRI, and to prospectively evaluate the effect of losartan on functional MRI measures in recipients. Materials and Methods The study included 15 matched pairs of renal transplant donors and recipients. ASL and BOLD MRI of the kidneys were performed on donors prior to transplant surgery (baseline) and on both donors and recipients at 3 months, 1 year and 2 years post-transplant. After 3 months, seven of the 15 recipients were prescribed 25–50 mg/day losartan for the remainder of the study. A linear mixed-effects model was used to evaluate perfusion, R2*, estimated glomerular filtration rate (eGFR), and fractional excretion of sodium (FENa) for changes across time or associated with losartan treatment. Results In donors, cortical perfusion in the remaining kidney decreased by 50 ± 19 ml/min/100g (11.8%) between baseline and 2 years (P < 0.05), while cortical R2* declined modestly by 0.7 ± 0.3 s−1 (5.6%; P < 0.05). In transplanted kidneys, cortical perfusion decreased markedly by 141 ± 21 ml/min/100g (34.2%) between baseline and 2 years (P < 0.001), while medullary R2* declined by 1.5 ± 0.8 s−1 (8.3%; P = 0.06). Single-kidney eGFR increased between baseline and 2 years by 17.7 ± 2.7 ml/min/1.73m2 (40.3%; P < 0.0001) in donors and to 14.6 ± 4.3 ml/min/1.73m2 (33.3%; P < 0.01) in recipients. Cortical perfusion at 1 and 2 years in recipients receiving 25–50 mg/day losartan was 62 ± 24 ml/min/100g higher than recipients not receiving the drug (P < 0.05). No significant effects of losartan were observed for any other markers of renal function. Conclusions The results suggest an important role for non-invasive functional monitoring with ASL and BOLD MRI in kidney transplant recipients and donors, and they indicate a potentially beneficial effect of losartan in recipients. PMID

  7. Principles of T2 *-weighted dynamic susceptibility contrast MRI technique in brain tumor imaging.

    PubMed

    Shiroishi, Mark S; Castellazzi, Gloria; Boxerman, Jerrold L; D'Amore, Francesco; Essig, Marco; Nguyen, Thanh B; Provenzale, James M; Enterline, David S; Anzalone, Nicoletta; Dörfler, Arnd; Rovira, Àlex; Wintermark, Max; Law, Meng

    2015-02-01

    Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) is used to track the first pass of an exogenous, paramagnetic, nondiffusible contrast agent through brain tissue, and has emerged as a powerful tool in the characterization of brain tumor hemodynamics. DSC-MRI parameters can be helpful in many aspects, including tumor grading, prediction of treatment response, likelihood of malignant transformation, discrimination between tumor recurrence and radiation necrosis, and differentiation between true early progression and pseudoprogression. This review aims to provide a conceptual overview of the underlying principles of DSC-MRI of the brain for clinical neuroradiologists, scientists, or students wishing to improve their understanding of the technical aspects, pitfalls, and controversies of DSC perfusion MRI of the brain. Future consensus on image acquisition parameters and postprocessing of DSC-MRI will most likely allow this technique to be evaluated and used in high-quality multicenter studies and ultimately help guide clinical care. © 2014 Wiley Periodicals, Inc.

  8. Novel Diffusion-Weighted MRI for High-Grade Prostate Cancer Detection

    DTIC Science & Technology

    2016-10-01

    1 1 AWARD NUMBER: W81XWH-15-1-0346 TITLE: Novel Diffusion-Weighted MRI for High-Grade Prostate Cancer Detection PRINCIPAL INVESTIGATOR...2016 4. TITLE AND SUBTITLE Novel Diffusion-Weighted MRI for High-Grade Prostate Cancer Detection 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1...therapy, and reduce biopsies needed on surveillance of indolent disease. 15. SUBJECT TERMS FROC, Prostate Cancer, MRI , Diffusion 16. SECURITY

  9. Robust dynamic myocardial perfusion CT deconvolution using adaptive-weighted tensor total variation regularization

    NASA Astrophysics Data System (ADS)

    Gong, Changfei; Zeng, Dong; Bian, Zhaoying; Huang, Jing; Zhang, Xinyu; Zhang, Hua; Lu, Lijun; Feng, Qianjin; Liang, Zhengrong; Ma, Jianhua

    2016-03-01

    Dynamic myocardial perfusion computed tomography (MPCT) is a promising technique for diagnosis and risk stratification of coronary artery disease by assessing the myocardial perfusion hemodynamic maps (MPHM). Meanwhile, the repeated scanning of the same region results in a relatively large radiation dose to patients potentially. In this work, we present a robust MPCT deconvolution algorithm with adaptive-weighted tensor total variation regularization to estimate residue function accurately under the low-dose context, which is termed `MPD-AwTTV'. More specifically, the AwTTV regularization takes into account the anisotropic edge property of the MPCT images compared with the conventional total variation (TV) regularization, which can mitigate the drawbacks of TV regularization. Subsequently, an effective iterative algorithm was adopted to minimize the associative objective function. Experimental results on a modified XCAT phantom demonstrated that the present MPD-AwTTV algorithm outperforms and is superior to other existing deconvolution algorithms in terms of noise-induced artifacts suppression, edge details preservation and accurate MPHM estimation.

  10. Dynamic subcortical blood flow during male sexual activity with ecological validity: a perfusion fMRI study.

    PubMed

    Georgiadis, Janniko R; Farrell, Michael J; Boessen, Ruud; Denton, Derek A; Gavrilescu, Maria; Kortekaas, Rudie; Renken, Remco J; Hoogduin, Johannes M; Egan, Gary F

    2010-03-01

    This study used arterial spin labeling (ASL) fMRI to measure brain perfusion in a group of healthy men under conditions that closely resembled customary sexual behavior. Serial perfusion measures for 30 min during two self-limited periods of partnered penis stimulation, and during post-stimulatory periods, revealed novel sexual activity-related cerebral blood flow (rCBF) changes, mainly in subcortical parts of the brain. Ventral pallidum rCBF was highest during the onset of penile erection, and lowest after the termination of penis stimulation. The perceived level of sexual arousal showed the strongest positive association with rCBF in the right basal forebrain. In addition, our results demonstrate that distinct subregions of the hypothalamus and cingulate cortex subserve opposite functions during human male sexual behavior. The lateral hypothalamus and anterior part of the middle cingulate cortex showed increased rCBF correlated with penile erection. By contrast, the anteroventral hypothalamus and subgenual anterior cingulate cortex exhibited rCBF changes correlated with penile detumescence after penile stimulation. Continuous rapid and high-resolution brain perfusion imaging during normal sexual activity has provided novel insights into the central mechanisms that control male sexual arousal. Copyright (c) 2009 Elsevier Inc. All rights reserved.

  11. Influence of perfusion on high-intensity focused ultrasound prostate ablation: a first-pass MRI study.

    PubMed

    Wiart, Marlène; Curiel, Laura; Gelet, Albert; Lyonnet, Denis; Chapelon, Jean-Yves; Rouvière, Olivier

    2007-07-01

    Our aim was to evaluate the influence of regional prostate blood flow (rPBF) on high-intensity focused ultrasound (HIFU) treatment outcome. A total of 48 patients with clinically localized prostate cancer were examined by dynamic contrast-enhanced (DCE)-MRI prior to HIFU therapy. A prostate-specific antigen (PSA) nadir threshold of 0.2 ng/ml was used to define the populations of responders and nonresponders. A dedicated tracer kinetic model, namely "monoexponential plus constant" (MPC) deconvolution, was implemented to provide quantitative estimates of rPBF. The results were compared with those obtained by semiquantitative (steepest slope, mean gradient) and quantitative (Fermi deconvolution) approaches. Of the four methods studied, quantitative rPBF obtained by MPC deconvolution proved the most sensitive to the perfusion changes encountered in this study. Furthermore, blood-flow values obtained with MPC deconvolution in the prostate and muscle (12 +/- 8 and 5 +/- 3 ml/min/100 g, respectively) were in good agreement with literature data. The mean pretreatment rPBF obtained with MPC deconvolution was significantly higher in nonresponders compared to responders (16 +/- 9 vs. 10 +/- 6 ml/min/100 g), suggesting a correlation between baseline perfusion and treatment outcome. The present work describes and validates the use of dynamic MRI to estimate rPBF in patients, which in the future may help to refine the conduct of HIFU therapy.

  12. Quantification of myocardial perfusion based on signal intensity of flow sensitized MRI

    NASA Astrophysics Data System (ADS)

    Abeykoon, Sumeda B.

    The quantitative assessment of perfusion is important for early recognition of a variety of heart diseases, determination of disease severity and their cure. In conventional approach of measuring cardiac perfusion by arterial spin labeling, the relative difference in the apparent T1 relaxation times in response to selective and non-selective inversion of blood entering the region of interest is related to perfusion via a two-compartment tissue model. But accurate determination of T1 in small animal hearts is difficult and prone to errors due to long scan times. The purpose of this study is to develop a fast, robust and simple method to quantitatively assess myocardial perfusion using arterial spin labeling. The proposed method is based on signal intensities (SI) of inversion recovery slice-select, non-select and steady-state images. Especially in this method data are acquired at a single inversion time and at short repetition times. This study began by investigating the accuracy of assessment of perfusion using a two compartment system. First, determination of perfusion by T1 and SI were implemented to a simple, two-compartment phantom model. Mathematical model developed for full spin exchange models (in-vivo experiments) by solving a modified Bloch equation was modified to develop mathematical models (T1 and SI) for a phantom (zero spin exchange). The phantom result at different flow rates shows remarkable evidence of accuracy of the two-compartment model and SI, T1 methods: the SI method has less propagation error and less scan time. Next, twelve healthy C57BL/6 mice were scanned for quantitative perfusion assessment and three of them were repeatedly scanned at three different time points for a reproducibility test. The myocardial perfusion of healthy mice obtained by the SI-method, 5.7+/-1.6 ml/g/min, was similar (p=0.38) to that obtained by the conventional T1 method, 5.6+/- 2.3 ml/g/min. The reproducibility of the SI method shows acceptable results: the

  13. Investigation of the mechanisms mediating MDMA "Ecstasy"-induced increases in cerebro-cortical perfusion determined by btASL MRI.

    PubMed

    Rouine, J; Kelly, M E; Jennings-Murphy, C; Duffy, P; Gorman, I; Gormley, S; Kerskens, C M; Harkin, Andrew

    2015-05-01

    Acute administration of the recreational drug of abuse 3,4-methylenedioxymethamphetamine (MDMA; Ecstasy) has previously been shown to increase cerebro-cortical perfusion as determined by bolus-tracking arterial spin labelling (btASL) MRI. The purpose of the current study was to assess the mechanisms mediating these changes following systemic administration of MDMA to rats. Pharmacological manipulation of serotonergic, dopaminergic and nitrergic transmission was carried out to determine the mechanism of action of MDMA-induced increases in cortical perfusion using btASL MRI. Fenfluramine (10 mg/kg), like MDMA (20 mg/kg), increased cortical perfusion. Increased cortical perfusion was not obtained with the 5-HT2 receptor agonist 2,5-dimethoxy-4-iodophenyl-aminopropane hydrochloride (DOI) (1 mg/kg). Depletion of central 5-HT following systemic administration of the tryptophan hydroxylase inhibitor para-chlorophenylalanine (pCPA) produced effects similar to those observed with MDMA. Pre-treatment with the 5-HT receptor antagonist metergoline (4 mg/kg) or with the 5-HT reuptake inhibitor citalopram (30 mg/kg), however, failed to produce any effect alone or influence the response to MDMA. Pre-treatment with the dopamine D1 receptor antagonist SCH 23390 (1 mg/kg) failed to influence the changes in cortical perfusion obtained with MDMA. Treatment with the neuronal nitric oxide (NO) synthase inhibitor 7-nitroindazole (7-NI) (25 mg/kg) provoked no change in cerebral perfusion alone yet attenuated the MDMA-related increase in cortical perfusion. Cortical 5-HT depletion is associated with increases in perfusion although this mechanism alone does not account for MDMA-related changes. A role for NO, a key regulator of cerebrovascular perfusion, is implicated in MDMA-induced increases in cortical perfusion.

  14. Comparison of dynamic susceptibility contrast-MRI perfusion quantification methods in the presence of delay and dispersion

    NASA Astrophysics Data System (ADS)

    Maan, Bianca; Simões, Rita Lopes; Meijer, Frederick J. A.; Klaas Jan Renema, W.; Slump, Cornelis H.

    2011-03-01

    The perfusion of the brain is essential to maintain brain function. Stroke is an example of a decrease in blood flow and reduced perfusion. During ischemic stroke the blood flow to tissue is hampered due to a clot inside a vessel. To investigate the recovery of stroke patients, follow up studies are necessary. MRI is the preferred imaging modality for follow up because of the absence of radiation dose concerns, contrary to CT. Dynamic Susceptibility Contrast (DSC) MRI is an imaging technique used for measuring perfusion of the brain, however, is not standard applied in the clinical routine due to lack of immediate patient benefit. Several post processing algorithms are described in the literature to obtain cerebral blood flow (CBF). The quantification of CBF relies on the deconvolution of a tracer concentration-time curve in an arterial and a tissue voxel. There are several methods to obtain this deconvolution based on singular-value decomposition (SVD). This contribution describes a comparison between the different approaches as currently there is no best practice for (all) clinical relevant situations. We investigate the influence of tracer delay, dispersion and recirculation on the performance of the methods. In the presence of negative delays, the truncated SVD approach overestimates the CBF. Block-circulant and reformulated SVD are delay-independent. Due to its delay dependent behavior, the truncated SVD approach performs worse in the presence of dispersion as well. However all SVD approaches are dependent on the amount of dispersion. Moreover, we observe that the optimal truncation parameter varies when recirculation is added to noisy data, suggesting that, in practice, these methods are not immune to tracer recirculation. Finally, applying the methods to clinical data resulted in a large variability of the CBF estimates. Block-circulant SVD will work in all situations and is the method with the highest potential.

  15. A patient-specific visualization tool for comprehensive analysis of coronary CTA and perfusion MRI data

    NASA Astrophysics Data System (ADS)

    Kirisli, H. A.; Gupta, V.; Kirschbaum, S.; Neefjes, L.; van Geuns, R. J.; Mollet, N.; Lelieveldt, B. P. F.; Reiber, J. H. C.; van Walsum, T.; Niessen, W. J.

    2011-03-01

    Cardiac magnetic resonance perfusion imaging (CMR) and computed tomography angiography (CTA) are widely used to assess heart disease. CMR is used to measure the global and regional myocardial function and to evaluate the presence of ischemia; CTA is used for diagnosing coronary artery disease, such as coronary stenoses. Nowadays, the hemodynamic significance of coronary artery stenoses is determined subjectively by combining information on myocardial function with assumptions on coronary artery territories. As the anatomy of coronary arteries varies greatly between individuals, we developed a patient-specific tool for relating CTA and perfusion CMR data. The anatomical and functional information extracted from CTA and CMR data are combined into a single frame of reference. Our graphical user interface provides various options for visualization. In addition to the standard perfusion Bull's Eye Plot (BEP), it is possible to overlay a 2D projection of the coronary tree on the BEP, to add a 3D coronary tree model and to add a 3D heart model. The perfusion BEP, the 3D-models and the CTA data are also interactively linked. Using the CMR and CTA data of 14 patients, our tool directly established a spatial correspondence between diseased coronary artery segments and myocardial regions with abnormal perfusion. The location of coronary stenoses and perfusion abnormalities were visualized jointly in 3D, thereby facilitating the study of the relationship between the anatomic causes of a blocked artery and the physiological effects on the myocardial perfusion. This tool is expected to improve diagnosis and therapy planning of early-stage coronary artery disease.

  16. Pediatric abdominal masses: diagnostic accuracy of diffusion weighted MRI.

    PubMed

    Kocaoglu, Murat; Bulakbasi, Nail; Sanal, Hatice T; Kismet, Erol; Caliskan, Bahadir; Akgun, Veysel; Tayfun, Cem

    2010-06-01

    To retrospectively identify apparent diffusion coefficient (ADC) values of pediatric abdominal mass lesions, to determine whether measured ADC of the lesions and signal intensity on diffusion-weighted (DW) images allow discrimination between benign and malignant mass lesions. Approval for this retrospective study was obtained from the institutional review board. Children with abdominal mass lesions, who were examined by DW magnetic resonance imaging (MRI) were included in this study. DW MR images were obtained in the axial plane by using a non breath-hold single-shot spin-echo sequence on a 1.5-T MR scanner. ADCs were calculated for each lesion. ADC values were compared with Mann-Whitney U test. Receiver operating characteristic curve analysis was performed to determine cut-off values for ADC. The results of visual assessment on b800 images and ADC map images were compared with chi-square test. Thirty-one abdominal mass lesions (16 benign, 15 malignant) in 26 patients (15 girls, 11 boys, ranging from 2 days to 17 years with 6.9 years mean) underwent MRI. Benign lesions had significantly higher ADC values than malignant ones (P < .001). The mean ADCs of malignant lesions were 0.84 +/- 1.7x10(-3) mm2/s, while the mean ADCs of the benign ones were 2.28 +/- 1.00x10(-3) mm2/s. With respect to cutoff values of ADC: 1.11x10(-3) mm2/s, sensitivity and negative predictive values were 100%, specificity was 78.6% and positive predictive value was 83.3%. For b800 and ADC map images, there were statistically significant differences on visual assessment. All malignant lesions had variable degrees of high signal intensity whereas eight of the 16 benign ones had low signal intensities on b800 images (P < .001). On ADC map images, all malignant lesions were hypointense and most of the benign ones (n=11, 68.7%) were hyperintense (P < .001). DW imaging can be used for reliable discrimination of benign and malignant pediatric abdominal mass lesions based on considerable differences in

  17. Perfusion abnormalities in hemimegalencephaly.

    PubMed

    Wintermark, P; Roulet-Perez, E; Maeder-Ingvar, M; Moessinger, A C; Gudinchet, F; Meuli, R

    2009-04-01

    Cerebrovascular changes are rarely discussed in patients with hemimegalencephaly. These alterations have previously been associated with epileptical activity. We report the case of a 36-week gestation neonate presenting with total right hemimegalencephaly, as demonstrated by a magnetic resonance imaging (MRI) performed in the first days of life. Perfusion-weighted imaging displayed a clear hypervascularization of the right hemisphere. Diffusion-tensor imaging showed an arrangement of white matter fibers concentrically around the ventricle on the right hemisphere. AngioMRI showed an obvious asymmetry in the size of the middle cerebral arteries, with the right middle cerebral artery being prominent. The baby was free of clinical seizures during his first week of life. An electroencephalogram at that time displayed an asymmetric background activity, but no electrical seizures. Perfusion anomalies in hemimegalencephaly may not necessarily be related to epileptical activity, but may be related to vessel alterations. (c) Georg Thieme Verlag KG Stuttgart, New York.

  18. Endovascular thrombolysis and stenting of a middle cerebral artery occlusion beyond 6 hours post-attack: special reference to the usefulness of diffusion-perfusion MRI.

    PubMed

    Ahn, Jung Yong; Han, In Bo; Chung, Sang Sup; Chung, Young Sun; Kim, Sang Heum; Yoon, Pyeong Ho

    2006-12-01

    Intra-arterial thrombolysis and percutaneous angioplasty is feasible in patients with acute middle cerebral artery (MCA) occlusion limited to 6 hours post-ictus, but there are some limitations such as reocclusion or hemorrhagic complications. In this report, we describe a stent placement in the treatment of a refractory artherothrombotic MCA occlusion beyond 6 hours of symptom onset. A 57-year-old man presented with a progressive left-sided weakness and verbal disturbance resulting from an acute thrombotic occlusion of the right MCA superimposed on severe proximal atheromatous stenosis. Diffusion-perfusion magnetic resonance imaging (MRI) demonstrated the significant diffusion-perfusion mismatch. After chemical and mechanical thrombolysis of the clot, balloon angioplasty of the underlying MCA stenosis was performed 2 days post-attack, without significant angiographic improvement. Percutaneous endovascular deployment of a stent (Driver 2.5 x 12 mm, MTI, Irvine, CA) was subsequently performed, with excellent angiographic results. Follow-up diffusion-perfusion MRI showed improved perfusion in the hypoperfused area. The patient's National Institutes of Health Stroke Scale (NIHSS) score was increased from 12 to 3. Clot thrombolysis and subsequent stenting in patients with refractory proximal MCA occlusion is feasible and allows for a significant reduction in the amount of thrombolytic drug required. In selective patients with acute MCA occlusion, the therapeutic window for recanalization procedures can be safely and effectively extended beyond the 'traditional 6 hours'. Diffusion-perfusion MRI in acute MCA occlusion is important for indication of therapy.

  19. Pyogenic abscess from Providencia stuartii mimicking necrotic tumour at perfusion-weighted imaging.

    PubMed

    Muccio, Carmine Franco; Leonini, Sara; Esposito, Gennaro; Cerase, Alfonso

    2011-10-01

    The purpose of this case report is to increase the knowledge about magnetic resonance spectrum of pyogenic abscesses of the brain. A 74-year-old woman presented with a left frontal lobe cystic mass, developed in the site of post-traumatic contusions after surgical evacuation of a subdural hematoma. MR imaging showed an ipsilateral mass lesion with a thin, regular rim of T1 high-intensity signal, T2 low-intensity signal, and gadolinium-enhancement. Diffusion-weighted imaging with measure of apparent diffusion coefficient value showed inhomogenous diffusion restriction in the lesion core. Perfusion-weighted imaging (PWI) demonstrated high relative cerebral blood volume (rCBV) in both the lesion wall and perilesional area, with a maximal rCBV ratio (rCBV of the lesion/rCBV of the normal contralateral white matter) of 5.65 and 0.58, respectively. As a result, surgery and pathology showed a pyogenic abscess. Cultures grew were Providencia stuartii species. In conclusion, a pyogenic brain abscess from P. stuartii may show high rCBV at PWI, thus mimicking a necrotic tumour.

  20. Decreased Cerebral Blood Flow in Chronic Pediatric Mild TBI: An MRI Perfusion Study

    PubMed Central

    Wang, Yang; West, John D.; Bailey, Jessica N.; Westfall, Daniel R.; Xiao, Hui; Arnold, Todd W.; Kersey, Patrick A.; Saykin, Andrew J.; McDonald, Brenna C.

    2015-01-01

    We evaluated cerebral blood flow (CBF) in chronic pediatric mild traumatic brain injury (mTBI) using arterial spin labeling (ASL) magnetic resonance imaging perfusion. mTBI patients showed lower CBF than controls in bilateral frontotemporal regions, with no between-group cognitive differences. Findings suggest ASL may be useful to assess functional abnormalities in pediatric mTBI. PMID:25649779

  1. MRI-based quantification of renal perfusion in mice: Improving sensitivity and stability in FAIR ASL.

    PubMed

    Gutjahr, Fabian Tobias; Günster, Stephan Michael; Kampf, Thomas; Winter, Patrick; Herold, Volker; Bauer, Wolfgang Rudolf; Jakob, Peter Michael

    2017-04-18

    The importance of the orientation of the selective inversion slice in relation to the anatomy in flow-sensitive alternating inversion recovery arterial spin labeling (FAIR ASL) kidney perfusion measurements is demonstrated by comparing the standard FAIR scheme to a scheme with an improved slice selective control experiment. A FAIR ASL method is used. The selective inversion preparation slice is set perpendicular to the measurement slice to decrease the unintended labeling of arterial spins in the control experiment. A T1(*)-based quantification method compensates for the effects of the imperfect inversion on the edge of the selective inversion slice. The quantified perfusion values are compared to the standard experiment with parallel orientation of imaging and selective inversion slice. Perfusion maps acquired with the perpendicular inversion slice orientation show higher sensitivity compared to the parallel orientation. The T1(*)-based quantification method removes artifacts arising from imperfect inversion slice profiles. The stability is improved. Adjusting the labeling technique to the anatomy is of high importance. Improved sensitivity and reproducibility could be demonstrated. The proposed method provides a solution to the problem of FAIR ASL measurements of renal perfusion in coronal view. Copyright © 2017. Published by Elsevier GmbH.

  2. Assessment of cerebral blood perfusion reserve with acetazolamide using 3D spiral ASL MRI: Preliminary experience in pediatric patients.

    PubMed

    Hu, Houchun H; Li, Zhiqiang; Pokorney, Amber L; Chia, Jonathan M; Stefani, Niccolo; Pipe, James G; Miller, Jeffrey H

    2017-01-01

    To demonstrate the clinical feasibility of a new non-Cartesian cylindrically-distributed spiral 3D pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI) pulse sequence in pediatric patients in quantifying cerebral blood flow (CBF) response to an acetazolamide (ACZ) vasodilator challenge. MRI exams were performed on two 3 Tesla Philips Ingenia systems using 32 channel head coil arrays. After local institutional review board approval, the 3D spiral-based pCASL technique was added to a standard brain MRI exam and evaluated in 13 pediatric patients (average age: 11.7±6.4years, range: 1.4-22.2years). All patients were administered ACZ for clinically indicated reasons. Quantitative whole-brain CBF measurements were computed pre- and post-ACZ to assess cerebrovascular reserve. 3D spiral pCASL data were successfully reconstructed in all 13 cases. In 11 patients, CBF increased 2.8% to 93.2% after administration of ACZ. In the two remaining patients, CBF decreased by 2.4 to 6.0% after ACZ. The group average change in CBF due to ACZ was approximately 25.0% and individual changes were statistically significant (p<0.01) in all patients using a paired t-test analysis. CBF perfusion data were diagnostically useful in supporting conventional MR angiography and clinical findings. 3D cylindrically-distributed spiral pCASL MRI provides a robust approach to assess cerebral blood flow and reserve in pediatric patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Perfusion MRI as the predictive/prognostic and pharmacodynamic biomarkers in recurrent malignant glioma treated with bevacizumab: a systematic review and a time-to-event meta-analysis.

    PubMed

    Choi, Sang Hyun; Jung, Seung Chai; Kim, Kyung Won; Lee, Ja Youn; Choi, Yoonseok; Park, Seong Ho; Kim, Ho Sung

    2016-06-01

    This study aims to evaluate the value of perfusion MRI as a predictive/prognostic biomarker and a pharmacodynamic biomarker in patients with recurrent glioma treated with a bevacizumab-based regimen. We identified thirteen literature reports that investigated dynamic susceptibility-contrast (DSC) MRI or dynamic contrast-enhanced (DCE) MRI for predicting the patient outcome and analyzing the anti-angiogenic effect of bevacizumab by performing a systematic search of MEDLINE and EMBASE. The relative cerebral volume (rCBV) of DSC-MRI is currently the most common perfusion MRI parameter used as a predictive/prognostic biomarker. Pooled hazard ratios between responders and non-responders, as determined by rCBV, were 0.46 (95 % CI 0.28-0.76) for progression-free survival from five articles with a total 226 patients and 0.47 (95 % CI 0.29-0.76) for overall survival from six articles with a total 247 patients, and thus indicating that rCBV is helpful for predicting disease progression and the eventual outcome after treatment. Regarding the pharmacodynamic value of perfusion MRI parameters derived from either DSC-MRI or DCE-MRI, most perfusion MRI parameters (rCBV, Ktrans, CBVmax, Kpsmax, fpv, Ve and Kep) demonstrated a consistent decrease on the follow-up MRI after treatment, indicating that perfusion MRI may be helpful for evaluating the anti-angiogenic effect of a bevacizumab-based treatment regimen. However, the lack of standardization of imaging acquisition and analysis techniques for various perfusion MRI parameters needs to be resolved in the future. Despite these unsolved issues, the current evidence favoring the use of perfusion MRI as a predictive/prognostic or pharmacodynamic biomarker should be considered in patients with glioma treated using a bevacizumab-based regimen.

  4. Methylphenidate modulates sustained attention and cortical activation in survivors of traumatic brain injury: A perfusion fMRI study

    PubMed Central

    Kim, Junghoon; Whyte, John; Patel, Sunil; Europa, Eduardo; Wang, Jiongjiong; Coslett, H. Branch; Detre, John A.

    2012-01-01

    Rationale Methylphenidate (MPH), the most widely prescribed psychostimulant to treat many neuropsychiatric conditions, is reported to improve attention and speed of processing in survivors of traumatic brain injury (TBI). The neural correlate of this efficacy, however, remains unclear. Objective Using perfusion fMRI as a biomarker of regional neural activity, the current study aimed to examine the neural correlates of single-dose (0.3 mg/kg) MPH administration in a randomized double-blind placebo-controlled cross-over study design. Methods Twenty-three individuals with moderate to severe TBI were tested on two occasions approximately one week apart. Perfusion fMRI scanning was carried out at rest and while participants performed cognitive tasks requiring sustained attention and working memory. Results Behaviorally, MPH significantly improved both accuracy and reaction time (RT) in the sustained attention task, but only RT in the working memory task. A trend of global reduction of cerebral blood flow by MPH was observed in all task conditions including resting. Voxel-wise whole-brain analysis revealed an interaction effect of drug by condition (MPH-placebo X task-rest) for the sustained attention task in the left posterior superior parietal cortex and parieto-occipital junction (BA 7/19). The magnitude of drug-related deactivation of this area during task performance was correlated with improvement in RT. Conclusion Suppression of activity in this area during task performance may reflect a compensatory mechanism by which MPH ameliorates attention impairments in TBI. PMID:22203319

  5. Respiratory motion prediction and prospective correction for free-breathing arterial spin-labeled perfusion MRI of the kidneys.

    PubMed

    Song, Hao; Ruan, Dan; Liu, Wenyang; Stenger, V Andrew; Pohmann, Rolf; Fernández-Seara, Maria A; Nair, Tejas; Jung, Sungkyu; Luo, Jingqin; Motai, Yuichi; Ma, Jingfei; Hazle, John D; Gach, H Michael

    2017-03-01

    Respiratory motion prediction using an artificial neural network (ANN) was integrated with pseudocontinuous arterial spin labeling (pCASL) MRI to allow free-breathing perfusion measurements in the kidney. In this study, we evaluated the performance of the ANN to accurately predict the location of the kidneys during image acquisition. A pencil-beam navigator was integrated with a pCASL sequence to measure lung/diaphragm motion during ANN training and the pCASL transit delay. The ANN algorithm ran concurrently in the background to predict organ location during the 0.7-s 15-slice acquisition based on the navigator data. The predictions were supplied to the pulse sequence to prospectively adjust the axial slice acquisition to match the predicted organ location. Additional navigators were acquired immediately after the multislice acquisition to assess the performance and accuracy of the ANN. The technique was tested in eight healthy volunteers. The root-mean-square error (RMSE) and mean absolute error (MAE) for the eight volunteers were 1.91 ± 0.17 mm and 1.43 ± 0.17 mm, respectively, for the ANN. The RMSE increased with transit delay. The MAE typically increased from the first to last prediction in the image acquisition. The overshoot was 23.58% ± 3.05% using the target prediction accuracy of ± 1 mm. Respiratory motion prediction with prospective motion correction was successfully demonstrated for free-breathing perfusion MRI of the kidney. The method serves as an alternative to multiple breathholds and requires minimal effort from the patient. © 2017 American Association of Physicists in Medicine.

  6. Modulation of resting brain cerebral blood flow by the GABA B agonist, baclofen: A longitudinal perfusion fMRI study

    PubMed Central

    Franklin, Teresa R.; Wang, Ze; Sciortino, Nathan; Harper, Derek; Li, Yin; Hakun, Jonathan; Kildea, Susan; Kampman, Kyle; Ehrman, Ron; Detre, John A.; O’Brien, Charles P.; Childress, Anna Rose

    2011-01-01

    Background Preclinical studies confirm that the GABA B agonist, baclofen blocks dopamine release in the reward-responsive ventral striatum (VS) and medial prefrontal cortex, and consequently, blocks drug motivated behavior. Its mechanism in humans is unknown. Here, we used continuous arterial spin labeled (CASL) perfusion fMRI to examine baclofen’s effects on blood flow in the human brain. Methods Twenty-one subjects (all smokers, 12 females) were randomized to receive either baclofen (80 mg/day; N = 10) or placebo (N = 11). A five minute quantitative perfusion fMRI resting baseline (RB) scan was acquired at two time points; prior to the dosing regimen (Time 1) and on the last day of 21 days of drug administration (Time 2). SPM2 was employed to compare changes in RB from Time 1 to 2. Results Baclofen diminished cerebral blood flow (CBF) in the VS and mOFC and increased it in the lateral OFC, a region involved in suppressing previously rewarded behavior. CBF in bilateral insula was also blunted by baclofen (T values ranged from −11.29 to 15.3 at p = 0.001, 20 contiguous voxels). CBF at Time 2 was unchanged in placebo subjects. There were no differences between groups in side effects or cigarettes smoked per day (at either time point). Conclusions Baclofen’s modulatory actions on regions involved in motivated behavior in humans are reflected in the resting state and provide insight into the underlying mechanism behind its potential to block drug-motivated behavior, in preclinical studies, and its putative effectiveness as an anti-craving/anti-relapse agent in humans. PMID:21333466

  7. Repeatability and Variability of Myocardial Perfusion Imaging Techniques in Mice: Comparison of Arterial Spin Labeling and First-pass Contrast-enhanced MRI

    PubMed Central

    Naresh, Nivedita K.; Chen, Xiao; Moran, Eric; Tian, Yikui; French, Brent A.; Epstein, Frederick H.

    2015-01-01

    Purpose Preclinical imaging of myocardial blood flow (MBF) can elucidate molecular mechanisms underlying cardiovascular disease. We compared the repeatability and variability of two methods, first-pass MRI and arterial spin labeling (ASL), for imaging MBF in mice. Methods Quantitative perfusion MRI in mice was performed using both methods at rest, with a vasodilator, and one day after myocardial infarction (MI). Image quality (score of 1–5, 5 best), between-session coefficient of variability (CVbs), intra-user coefficient of variability (CVintra-user) and inter-user coefficient of variability (CVinter-user) were assessed. Acquisition time was 1–2 minutes for first-pass MRI and approximately 40 minutes for ASL. Results Image quality was higher for ASL (3.94±0.09 vs. 2.88±0.10, p<0.05). Infarct zone CVbs was lower with first-pass (17±3% vs. 46±9%, p<0.05). The stress perfusion CVintra-user was lower for ASL (3±1% vs. 14±3%, p<0.05). The stress perfusion CVinter-user was lower for ASL (4±1% vs. 17±4%, p<0.05). Conclusion For low MBF conditions such as infarct, first-pass MRI is preferred due to better repeatability and variability. At high MBF such as at vasodilation, ASL may be more suitable due to superior image quality and lower user variability. First-pass MRI has a substantial speed advantage. PMID:26190350

  8. On the Dark Rim Artifact in Dynamic Contrast-Enhanced MRI Myocardial Perfusion Studies

    PubMed Central

    Di Bella, E.V.R.; Parker, D.L.; Sinusas, A.J.

    2008-01-01

    A dark band or rim along parts of the subendocardial border of the left ventricle (LV) and the myocardium has been noticed in some dynamic contrast-enhanced MR perfusion studies. The artifact is thought to be due to susceptibility effects from the gadolinium bolus, motion, or resolution, or a combination of these. Here motionless ex vivo hearts in which the cavity was filled with gadolinium are used to show that dark rim artifacts can be consistent with resolution effects alone. PMID:16200553

  9. Bayesian optimization of perfusion and transit time estimation in PASL-MRI.

    PubMed

    Santos, Nuno; Sanches, João; Figueiredo, Patrícia

    2010-01-01

    Pulsed Arterial Spin Labeling (PASL) techniques potentially allow the absolute, non-invasive quantification of brain perfusion and arterial transit time. This can be achieved by fitting a kinetic model to the data acquired at a number of inversion time points (TI). The intrinsically low SNR of PASL data, together with the uncertainty in the model parameters, can hinder the estimation of the parameters of interest. Here, a two-compartment kinetic model is used to estimate perfusion and transit time, based on a Maximum a Posteriori (MAP) criterion. A priori information concerning the physiological variation of the multiple model parameters is used to guide the solution. Monte Carlo simulations are performed to compare the accuracy of our proposed Bayesian estimation method with a conventional Least Squares (LS) approach, using four different sets of TI points. Each set is obtained either with a uniform distribution or an optimal sampling strategy designed based on the same MAP criterion. We show that the estimation errors are minimized when our proposed Bayesian estimation method is employed in combination with an optimal set of sampling points. In conclusion, our results indicate that PASL perfusion and transit time measurements would benefit from a Bayesian approach for the optimization of both the sampling strategy and the estimation algorithm, whereby prior information on the parameters is used.

  10. Perfusion-weighted magnetic resonance imaging detects recurrent isolated vertigo caused by cerebral hypoperfusion.

    PubMed

    Xu, Xiaowei; Jiang, Li; Luo, Man; Li, Jiaoxing; Li, Weidong; Sheng, Wenli

    2015-06-01

    The etiology of isolated vertigo has been a substantial diagnostic challenge for both neurologists and otolaryngologists. This study was designed to detect recurrent isolated vertigo due to cerebral hypoperfusion using perfusion-weighted magnetic resonance imaging (PWI). We recruited isolated vertigo patients whose clinical condition was suspected to be caused by hypodynamics of the brain; these individuals formed the case group. We generated two additional groups: a negative group composed of vertigo patients whose symptoms were caused by problems associated with the ear and a healthy control group. Each subject underwent PWI, and seven regions of interest (ROIs) were chosen. The relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), and mean transit time (MTT) were obtained from each ROI. We further calculated the absolute difference of relative parameter values between two mirrored ROIs. The significant difference in the relative MTT from the mirrored cerebellar ROI (|rMTTleft-right|) of the case group was larger than those from the negative and healthy control groups (p = 0.026 and p = 0.038, respectively). Signal differences in |rrCBVleft-right| and |rrCBFleft-right| were not found among the three groups. In summary, disequilibrium in the rMTT of the bilateral cerebellum in the case group implied that hypoperfusion of the posterior circulation could trigger recurrent isolated vertigo and could be shown efficiently using PWI.

  11. Whole-body diffusion-weighted MRI: tips, tricks, and pitfalls.

    PubMed

    Koh, Dow-Mu; Blackledge, Matthew; Padhani, Anwar R; Takahara, Taro; Kwee, Thomas C; Leach, Martin O; Collins, David J

    2012-08-01

    We examine the clinical impetus for whole-body diffusion-weighted MRI and discuss how to implement the technique with clinical MRI systems. We include practical tips and tricks to optimize image quality and reduce artifacts. The interpretative pitfalls are enumerated, and potential challenges are highlighted. Whole-body diffusion-weighted MRI can be used for tumor staging and assessment of treatment response. Meticulous technique and knowledge of potential interpretive pitfalls will help to avoid mistakes and establish this modality in radiologic practice.

  12. Quantification of in vivo pH-weighted amide proton transfer (APT) MRI in acute ischemic stroke

    NASA Astrophysics Data System (ADS)

    Zhou, Iris Y.; Igarashi, Takahiro; Guo, Yingkun; Sun, Phillip Z.

    2015-03-01

    Amide proton transfer (APT) imaging is a specific form of chemical exchange saturation transfer (CEST) MRI that probes the pH-dependent amide proton exchange.The endogenous APT MRI is sensitive to tissue acidosis, which may complement the commonly used perfusion and diffusion scans for characterizing heterogeneous ischemic tissue damage. Whereas the saturation transfer asymmetry analysis (MTRasym) may reasonably compensate for direct RF saturation, in vivo MTRasym is however, susceptible to an intrinsically asymmetric shift (MTR'asym). Specifically, the reference scan for the endogenous APT MRI is 7 ppm upfield from that of the label scan, and subjects to concomitant RF irradiation effects, including nuclear overhauser effect (NOE)-mediated saturation transfer and semisolid macromolecular magnetization transfer. As such, the commonly used asymmetry analysis could not fully compensate for such slightly asymmetric concomitant RF irradiation effects, and MTRasym has to be delineated in order to properly characterize the pH-weighted APT MRI contrast. Given that there is very little change in relaxation time immediately after ischemia and the concomitant RF irradiation effects only minimally depends on pH, the APT contrast can be obtained as the difference of MTRasym between the normal and ischemic regions. Thereby, the endogenous amide proton concentration and exchange rate can be solved using a dual 2-pool model, and the in vivo MTR'asym can be calculated by subtracting the solved APT contrast from asymmetry analysis (i.e., MTR'asym =MTRasym-APTR). In addition, MTR'asym can be quantified using the classical 2-pool exchange model. In sum, our study delineated the conventional in vivo pH-sensitive MTRasym contrast so that pHspecific contrast can be obtained for imaging ischemic tissue acidosis.

  13. Perfusion-weighted imaging and dynamic 4D angiograms for the estimation of collateral blood flow in lacunar infarction.

    PubMed

    Förster, Alex; Mürle, Bettina; Böhme, Johannes; Al-Zghloul, Mansour; Kerl, Hans U; Wenz, Holger; Groden, Christoph

    2016-10-01

    Although lacunar infarction accounts for approximately 25% of ischemic strokes, collateral blood flow through anastomoses is not well evaluated in lacunar infarction. In 111 lacunar infarction patients, we analyzed diffusion-weighted images, perfusion-weighted images, and blood flow on dynamic four-dimensional angiograms generated by use of Signal Processing In NMR-Software. Blood flow was classified as absent (type 1), from periphery to center (type 2), from center to periphery (type 3), and combination of type 2 and 3 (type 4). On diffusion-weighted images, lacunar infarction was found in the basal ganglia (11.7%), internal capsule (24.3%), corona radiata (30.6%), thalamus (24.3%), and brainstem (9.0%). In 58 (52.2%) patients, perfusion-weighted image showed a circumscribed hypoperfusion, in one (0.9%) a circumscribed hyperperfusion, whereas the remainder was normal. In 36 (62.1%) patients, a larger perfusion deficit (>7 mm) was observed. In these, blood flow was classified type 1 in four (11.1%), 2 in 17 (47.2%), 3 in 9 (25.0%), and 4 in six (16.7%) patients. Patients with lacunar infarction in the posterior circulation more often demonstrated blood flow type 2 and less often type 3 (p = 0.01). Detailed examination and graduation of blood flow in lacunar infarction by use of dynamic four-dimensional angiograms is feasible and may serve for a better characterization of this stroke subtype.

  14. Improving cerebral blood flow quantification for arterial spin labeled perfusion MRI by removing residual motion artifacts and global signal fluctuations.

    PubMed

    Wang, Ze

    2012-12-01

    Denoising is critical to improving the quality and stability of cerebral blood flow (CBF) quantification in arterial spin labeled (ASL) perfusion magnetic resonance imaging (MRI) due to the intrinsic low signal-to-noise-ratio (SNR) of ASL data. Previous studies have been focused on reducing the spatial or temporal noise using standard filtering techniques, and less attention has been paid to two global nuisance effects, the residual motion artifacts and the global signal fluctuations. Since both nuisances affect the whole brain, removing them in advance should enhance the CBF quantification quality for ASL MRI. The purpose of this paper was to assess this potential benefit. Three methods were proposed to suppress each or both of the two global nuisances. Their performances for CBF quantification were validated using ASL data acquired from 13 subjects. Evaluation results showed that covarying out both global nuisances significantly improved temporal SNR and test-retest stability of CBF measurement. Although the concept of removing both nuisances is not technically novel per se, this paper clearly showed the benefits for ASL CBF quantification. Dissemination of the proposed methods in a free ASL data processing toolbox should be of interest to a broad range of ASL users.

  15. [Abnormal cerebral blood flow distributions during the post-ictal phase of febrile status epilepticus in three pediatric patients measured by arterial spin labeling perfusion MRI].

    PubMed

    Hirano, Keiko; Fukuda, Tokiko

    2016-05-01

    The ability to visualize brain perfusion is important for identifying epileptic foci. We present three pediatric cases showing asymmetrical cerebral blood flow (CBF) distributions during the post-ictal phase of febrile status epilepticus measured by arterial spin labeling (ASL) perfusion MRI. During the acute phase, regional CBF measurements in the areas considered including epileptic foci were higher than in the corresponding area of the contralateral hemisphere, though the exact quantitative value varied between cases. We could not identify the correct epileptogenic foci, because those ASL images were taken after the prolonged and extraordinary activation of neurons in the affected area. During the recovery phase, the differences reduced and the average regional CBF measurement was 54.6 ± 6.1 ml/100 g per minute, which was a little less than the number of previous ASL studies. ASL perfusion MRI imaging provides a method for evaluating regional CBF by using magnetically labeled arterial blood water as an endogenous tracer. With this technique, we can repeatedly evaluate both the brain structure and the level of perfusion at the same time. ASL is noninvasive and easily accessible, and therefore it could become a routine tool for assessment of perfusion in daily practice of pediatric neurology.

  16. Boosting BOLD fMRI by K-Space Density Weighted Echo Planar Imaging

    PubMed Central

    Zeller, Mario; Müller, Alexander; Gutberlet, Marcel; Nichols, Thomas; Hahn, Dietbert; Köstler, Herbert; Bartsch, Andreas J.

    2013-01-01

    Functional magnetic resonance imaging (fMRI) has become a powerful and influential method to non-invasively study neuronal brain activity. For this purpose, the blood oxygenation level-dependent (BOLD) effect is most widely used. T2* weighted echo planar imaging (EPI) is BOLD sensitive and the prevailing fMRI acquisition technique. Here, we present an alternative to its standard Cartesian recordings, i.e. k-space density weighted EPI, which is expected to increase the signal-to-noise ratio in fMRI data. Based on in vitro and in vivo pilot measurements, we show that fMRI by k-space density weighted EPI is feasible and that this new acquisition technique in fact boosted spatial and temporal SNR as well as the detection of local fMRI activations. Spatial resolution, spatial response function and echo time were identical for density weighted and conventional Cartesian EPI. The signal-to-noise ratio gain of density weighting can improve activation detection and has the potential to further increase the sensitivity of fMRI investigations. PMID:24040262

  17. Complete Separation of Intracellular and Extracellular Information in NMR Spectra of Perfused Cells by Diffusion-Weighted Spectroscopy

    NASA Astrophysics Data System (ADS)

    van Zijl, Peter C. M.; Moonen, Chrit T. W.; Faustino, Patrick; Pekar, James; Kaplan, Ofer; Cohen, Jack S.

    1991-04-01

    A method is outlined that completely separates intracellular and extracellular information in NMR spectra of perfused cells. The technique uses diffusion weighting to exploit differences in motional properties between intra- and extracellular constituents. This allows monitoring of intracellular metabolism, and of transport of small drugs and nutrients through the cell membrane, under controlled physiological conditions. As a first example, proton spectra of drug-resistant MCF-7 human breast cancer cells are studied, and uptake of phenylalanine is monitored.

  18. Multimodal MRI can identify perfusion and metabolic changes in the invasive margin of glioblastomas

    PubMed Central

    Young, Adam M.H.; Scotton, William J.; Ching, Jared; Mohsen, Laila A.; Boonzaier, Natalie R.; Lupson, Victoria C.; Griffiths, John R.; McLean, Mary A.; Larkin, Timothy J.

    2015-01-01

    Purpose To use perfusion and magnetic resonance (MR) spectroscopy to compare the diffusion tensor imaging (DTI)‐defined invasive and noninvasive regions. Invasion of normal brain is a cardinal feature of glioblastomas (GBM) and a major cause of treatment failure. DTI can identify invasive regions. Materials and Methods In all, 50 GBM patients were imaged preoperatively at 3T with anatomic sequences, DTI, dynamic susceptibility perfusion MR (DSCI), and multivoxel spectroscopy. The DTI and DSCI data were coregistered to the spectroscopy data and regions of interest (ROIs) were made in the invasive (determined by DTI), noninvasive regions, and normal brain. Values of relative cerebral blood volume (rCBV), N‐acetyl aspartate (NAA), myoinositol (mI), total choline (Cho), and glutamate + glutamine (Glx) normalized to creatine (Cr) and Cho/NAA were measured at each ROI. Results Invasive regions showed significant increases in rCBV, suggesting angiogenesis (invasive rCBV 1.64 [95% confidence interval, CI: 1.5–1.76] vs. noninvasive 1.14 [1.09–1.18]; P < 0.001), Cho/Cr (invasive 0.42 [0.38–0.46] vs. noninvasive 0.35 [0.31–0.38]; P = 0.02) and Cho/NAA (invasive 0.54 [0.41–0.68] vs. noninvasive 0.37 [0.29–0.45]; P = < 0.03), suggesting proliferation, and Glx/Cr (invasive 1.54 [1.27–1.82] vs. noninvasive 1.3 [1.13–1.47]; P = 0.028), suggesting glutamate release; and a significantly reduced NAA/Cr (invasive 0.95 [0.85–1.05] vs. noninvasive 1.19 [1.06–1.31]; P = 0.008). The mI/Cr was not different between the three ROIs (invasive 1.2 [0.99–1.41] vs. noninvasive 1.3 [1.14–1.46]; P = 0.68). In the noninvasive regions, the values were not different from normal brain. Conclusion Combining DTI to identify the invasive region with perfusion and spectroscopy, we can identify changes in invasive regions not seen in noninvasive regions. J. Magn. Reson. Imaging 2016;43:487–494. PMID:26140696

  19. Altered resting-state functional connectivity in post-traumatic stress disorder: a perfusion MRI study

    NASA Astrophysics Data System (ADS)

    Li, Baojuan; Liu, Jian; Liu, Yang; Lu, Hong-Bing; Yin, Hong

    2013-03-01

    The majority of studies on posttraumatic stress disorder (PTSD) so far have focused on delineating patterns of activations during cognitive processes. Recently, more and more researches have started to investigate functional connectivity in PTSD subjects using BOLD-fMRI. Functional connectivity analysis has been demonstrated as a powerful approach to identify biomarkers of different brain diseases. This study aimed to detect resting-state functional connectivity abnormities in patients with PTSD using arterial spin labeling (ASL) fMRI. As a completely non-invasive technique, ASL allows quantitative estimates of cerebral blood flow (CBF). Compared with BOLD-fMRI, ASL fMRI has many advantages, including less low-frequency signal drifts, superior functional localization, etc. In the current study, ASL images were collected from 10 survivors in mining disaster with recent onset PTSD and 10 survivors without PTSD. Decreased regional CBF in the right middle temporal gyrus, lingual gyrus, and postcentral gyrus was detected in the PTSD patients. Seed-based resting-state functional connectivity analysis was performed using an area in the right middle temporal gyrus as region of interest. Compared with the non-PTSD group, the PTSD subjects demonstrated increased functional connectivity between the right middle temporal gyrus and the right superior temporal gyrus, the left middle temporal gyrus. Meanwhile, decreased functional connectivity between the right middle temporal gyrus and the right postcentral gyrus, the right superior parietal lobule was also found in the PTSD patients. This is the first study which investigated resting-state functional connectivity in PTSD using ASL images. The results may provide new insight into the neural substrates of PTSD.

  20. Resting Cerebral Blood Flow Alterations in Chronic Traumatic Brain Injury: An Arterial Spin Labeling Perfusion fMRI Study

    PubMed Central

    Whyte, John; Patel, Sunil; Avants, Brian; Europa, Eduardo; Wang, Jiongjiong; Slattery, John; Gee, James C.; Coslett, H. Branch; Detre, John A.

    2010-01-01

    Abstract Non-invasive measurement of resting state cerebral blood flow (CBF) may reflect alterations of brain structure and function after traumatic brain injury (TBI). However, previous imaging studies of resting state brain in chronic TBI have been limited by several factors, including measurement in relative rather than absolute units, use of crude spatial registration methods, exclusion of subjects with substantial focal lesions, and exposure to ionizing radiation, which limits repeated assessments. This study aimed to overcome those obstacles by measuring absolute CBF with an arterial spin labeling perfusion fMRI technique, and using an image preprocessing protocol that is optimized for brains with mixed diffuse and focal injuries characteristic of moderate and severe TBI. Resting state CBF was quantified in 27 individuals with moderate to severe TBI in the chronic stage, and 22 demographically matched healthy controls. In addition to global CBF reductions in the TBI subjects, more prominent regional hypoperfusion was found in the posterior cingulate cortices, the thalami, and multiple locations in the frontal cortices. Diffuse injury, as assessed by tensor-based morphometry, was mainly associated with reduced CBF in the posterior cingulate cortices and the thalami, where the greatest volume losses were detected. Hypoperfusion in superior and middle frontal cortices, in contrast, was associated with focal lesions. These results suggest that structural lesions, both focal and diffuse, are the main contributors to the absolute CBF alterations seen in chronic TBI, and that CBF may serve as a tool to assess functioning neuronal volume. We also speculate that resting reductions in posterior cingulate perfusion may reflect alterations in the default-mode network, and may contribute to the attentional deficits common in TBI. PMID:20528163

  1. The Efficiency of Diffusion Weighted MRI and MR Spectroscopy On Breast MR Imaging

    PubMed Central

    Altay, Canan; Balcı, Pınar

    2014-01-01

    The main purpose of breast magnetic resonance imaging (MRI) in radiologically routine is to establish an imaging protocol that will create high quality images with a short period of time. Fort this purpose, an imaging protocol should include a conventional breast MRI and contrast enhanced sequences. Proton MR spectroscopy (MRS) and diffusion weighted imaging (DWI) are important MR techniques for evaluation to complicated breast lesions. In this article, we will evaluate that technical properties of the MRS and DWI as additional MR imaging.

  2. Real Diffusion-Weighted MRI Enabling True Signal Averaging and Increased Diffusion Contrast

    PubMed Central

    Eichner, Cornelius; Cauley, Stephen F; Cohen-Adad, Julien; Möller, Harald E; Turner, Robert; Setsompop, Kawin; Wald, Lawrence L

    2015-01-01

    This project aims to characterize the impact of underlying noise distributions on diffusion-weighted imaging. The noise floor is a well-known problem for traditional magnitude-based diffusion-weighted MRI (dMRI) data, leading to biased diffusion model fits and inaccurate signal averaging. Here, we introduce a total-variation-based algorithm to eliminate shot-to-shot phase variations of complex-valued diffusion data with the intention to extract real-valued dMRI datasets. The obtained real-valued diffusion data are no longer superimposed by a noise floor but instead by a zero-mean Gaussian noise distribution, yielding dMRI data without signal bias. We acquired high-resolution dMRI data with strong diffusion weighting and, thus, low signal-to-noise ratio. Both the extracted real-valued and traditional magnitude data were compared regarding signal averaging, diffusion model fitting and accuracy in resolving crossing fibers. Our results clearly indicate that real-valued diffusion data enables idealized conditions for signal averaging. Furthermore, the proposed method enables unbiased use of widely employed linear least squares estimators for model fitting and demonstrates an increased sensitivity to detect secondary fiber directions with reduced angular error. The use of phase-corrected, real-valued data for dMRI will therefore help to clear the way for more detailed and accurate studies of white matter microstructure and structural connectivity on a fine scale. PMID:26241680

  3. Real diffusion-weighted MRI enabling true signal averaging and increased diffusion contrast.

    PubMed

    Eichner, Cornelius; Cauley, Stephen F; Cohen-Adad, Julien; Möller, Harald E; Turner, Robert; Setsompop, Kawin; Wald, Lawrence L

    2015-11-15

    This project aims to characterize the impact of underlying noise distributions on diffusion-weighted imaging. The noise floor is a well-known problem for traditional magnitude-based diffusion-weighted MRI (dMRI) data, leading to biased diffusion model fits and inaccurate signal averaging. Here, we introduce a total-variation-based algorithm to eliminate shot-to-shot phase variations of complex-valued diffusion data with the intention to extract real-valued dMRI datasets. The obtained real-valued diffusion data are no longer superimposed by a noise floor but instead by a zero-mean Gaussian noise distribution, yielding dMRI data without signal bias. We acquired high-resolution dMRI data with strong diffusion weighting and, thus, low signal-to-noise ratio. Both the extracted real-valued and traditional magnitude data were compared regarding signal averaging, diffusion model fitting and accuracy in resolving crossing fibers. Our results clearly indicate that real-valued diffusion data enables idealized conditions for signal averaging. Furthermore, the proposed method enables unbiased use of widely employed linear least squares estimators for model fitting and demonstrates an increased sensitivity to detect secondary fiber directions with reduced angular error. The use of phase-corrected, real-valued data for dMRI will therefore help to clear the way for more detailed and accurate studies of white matter microstructure and structural connectivity on a fine scale. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Semi-automatic delineation using weighted CT-MRI registered images for radiotherapy of nasopharyngeal cancer

    SciTech Connect

    Fitton, I.; Cornelissen, S. A. P.; Duppen, J. C.; Rasch, C. R. N.; Herk, M. van; Steenbakkers, R. J. H. M.; Peeters, S. T. H.; Hoebers, F. J. P.; Kaanders, J. H. A. M.; Nowak, P. J. C. M.

    2011-08-15

    Purpose: To develop a delineation tool that refines physician-drawn contours of the gross tumor volume (GTV) in nasopharynx cancer, using combined pixel value information from x-ray computed tomography (CT) and magnetic resonance imaging (MRI) during delineation. Methods: Operator-guided delineation assisted by a so-called ''snake'' algorithm was applied on weighted CT-MRI registered images. The physician delineates a rough tumor contour that is continuously adjusted by the snake algorithm using the underlying image characteristics. The algorithm was evaluated on five nasopharyngeal cancer patients. Different linear weightings CT and MRI were tested as input for the snake algorithm and compared according to contrast and tumor to noise ratio (TNR). The semi-automatic delineation was compared with manual contouring by seven experienced radiation oncologists. Results: A good compromise for TNR and contrast was obtained by weighing CT twice as strong as MRI. The new algorithm did not notably reduce interobserver variability, it did however, reduce the average delineation time by 6 min per case. Conclusions: The authors developed a user-driven tool for delineation and correction based a snake algorithm and registered weighted CT image and MRI. The algorithm adds morphological information from CT during the delineation on MRI and accelerates the delineation task.

  5. Comparison of single- and dual-tracer pharmacokinetic modeling of dynamic contrast-enhanced MRI data using low, medium, and high molecular weight contrast agents.

    PubMed

    Orth, Robert C; Bankson, James; Price, Roger; Jackson, Edward F

    2007-10-01

    Pharmacokinetic parameters corresponding to perfused microvascular volume determined from dynamic contrast-enhanced (DCE) MRI data were compared to immunohistochemical measures of microvascular density (MVD) and perfused microvascular density. DCE MRI data from human mammary tumors (MDA-MB-435) implanted in nude mice using low (Gd-DTPA, MW approximately equal 0.6 kDa), medium (Gadomer-17, MW(eff) approximately equal 35 kDa), and high (PG-Gd-DTPA, MW approximately equal 220 kDa) molecular weight contrast agents were analyzed with single- and dual-tracer pharmacokinetic models. MVD values were determined by two manual counting methods, "hot spot" and summed region of interest (SROI). Pharmacokinetic parameters determined using the single-tracer model (Gd-DTPA [n = 15] and Gadomer-17 [n = 13]) did not correlate with MVD measures using either manual counting method. For dual-tracer studies (Gadomer-17/Gd-DTPA [n = 15] and PG-Gd-DTPA/Gd-DTPA [n = 13]), pharmacokinetic parameters demonstrated a statistically significant correlation with MVD determined by the SROI method, but not the "hot spot" method. Ten mice successfully underwent intravital FITC-labeled lectin perfusion with the hemisphere of highest lectin labeling correlating with pharmacokinetic parameter values in 9 of 10 tumors (single-tracer Gd-DTPA [n = 2], single-tracer Gadomer-17 [n = 3], and dual-tracer Gadomer-17/Gd-DTPA [n = 5]). This study demonstrates that dual-tracer DCE MRI studies yield pharmacokinetic parameters that correlate with immunohistochemical measures of MVD.

  6. Increased cortical capillary transit time heterogeneity in Alzheimer's disease: a DSC-MRI perfusion study.

    PubMed

    Eskildsen, Simon F; Gyldensted, Louise; Nagenthiraja, Kartheeban; Nielsen, Rune B; Hansen, Mikkel Bo; Dalby, Rikke B; Frandsen, Jesper; Rodell, Anders; Gyldensted, Carsten; Jespersen, Sune N; Lund, Torben E; Mouridsen, Kim; Brændgaard, Hans; Østergaard, Leif

    2017-02-01

    Alzheimer's disease (AD) is characterized by the accumulation of hyperphosphorylated tau and neurotoxic Aβ in the brain parenchyma. Hypoxia caused by microvascular changes and disturbed capillary flows could stimulate this build-up of AD-specific proteins in the brain. In this study, we compared cerebral microcirculation in a cohort of AD and mild cognitive impairment (MCI) patients with that of age-matched controls, all without a history of diabetes or of hypertension for more than 2 years, using dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI). Vascular flow disturbances were quantified using a parametric model and mapped to the mid-cortical surface for group-wise statistical analysis. We found widespread hypoperfusion in patients compared with controls and identified areas of increased relative capillary transit time heterogeneity (RTH), consistent with low tissue oxygen tension. Notably, RTH was positively correlated with white matter hyperintensities and positively correlated with symptom severity in the patient cohort. These correlations extended over large parts of the temporal, parietal, and frontal cortices. The results support the hypothesis of disturbed capillary flow patterns in AD and suggest that DSC-MRI may provide imaging biomarkers of impaired cerebral microcirculation in AD.

  7. Structural and Perfusion Abnormalities of Brain on MRI and Technetium-99m-ECD SPECT in Children With Cerebral Palsy: A Comparative Study.

    PubMed

    Rana, Kamer Singh; Narwal, Varun; Chauhan, Lokesh; Singh, Giriraj; Sharma, Monica; Chauhan, Suneel

    2016-04-01

    Cerebral palsy has traditionally been associated with hypoxic ischemic brain damage. This study was undertaken to demonstrate structural and perfusion brain abnormalities. Fifty-six children diagnosed clinically as having cerebral palsy were studied between 1 to 14 years of age and were subjected to 3 Tesla magnetic resonance imaging (MRI). Brain and Technetium-99m-ECD brain single-photon emission computed tomography (SPECT) scan. Male to female ratio was 1.8:1 with a mean age of 4.16 ± 2.274 years. Spastic cerebral palsy was the most common type, observed in 91%. Birth asphyxia was the most common etiology (69.6%). White matter changes (73.2%) such as periventricular leukomalacia and corpus callosal thinning were the most common findings on MRI. On SPECT all cases except one revealed perfusion impairments in different regions of brain. MRI is more sensitive in detecting white matter changes, whereas SPECT is better in detecting cortical and subcortical gray matter abnormalities of perfusion. © The Author(s) 2015.

  8. DCE-MRI of hepatocellular carcinoma: perfusion quantification with Tofts model versus shutter-speed model—initial experience

    PubMed Central

    Jajamovich, Guido H.; Huang, Wei; Besa, Cecilia; Li, Xin; Afzal, Aneela; Dyvorne, Hadrien A.; Taouli, Bachir

    2016-01-01

    Objective To quantify hepatocellular carcinoma (HCC) perfusion and flow with the fast exchange regime-allowed Shutter-Speed model (SSM) compared to the Tofts model (TM). Materials and methods In this prospective study, 25 patients with HCC underwent DCE-MRI. ROIs were placed in liver parenchyma, portal vein, aorta and HCC lesions. Signal intensities were analyzed employing dual-input TM and SSM models. ART (arterial fraction), Ktrans (contrast agent transfer rate constant from plasma to extravascular extracellular space), ve (extravascular extracellular volume fraction), kep (contrast agent intravasation rate constant), and τi (mean intracellular water molecule lifetime) were compared between liver parenchyma and HCC, and ART, Ktrans, ve and kep were compared between models using Wilcoxon tests and limits of agreement. Test–retest reproducibility was assessed in 10 patients. Results ART and ve obtained with TM; ART, ve, ke and τi obtained with SSM were significantly different between liver parenchyma and HCC (p < 0.04). Parameters showed variable reproducibility (CV range 14.7–66.5 % for both models). Liver Ktrans and ve; HCC ve and kep were significantly different when estimated with the two models (p < 0.03). Conclusion Our results show differences when computed between the TM and the SSM. However, these differences are smaller than parameter reproducibilities and may be of limited clinical significance. PMID:26646522

  9. Repeatability and variability of myocardial perfusion imaging techniques in mice: Comparison of arterial spin labeling and first-pass contrast-enhanced MRI.

    PubMed

    Naresh, Nivedita K; Chen, Xiao; Moran, Eric; Tian, Yikui; French, Brent A; Epstein, Frederick H

    2016-06-01

    Preclinical imaging of myocardial blood flow (MBF) can elucidate molecular mechanisms underlying cardiovascular disease. We compared the repeatability and variability of two methods, first-pass MRI and arterial spin labeling (ASL), for imaging MBF in mice. Quantitative perfusion MRI in mice was performed using both methods at rest, with a vasodilator, and one day after myocardial infarction. Image quality (score of 1-5; 5 best), between-session coefficient of variability (CVbs ), intra-user coefficient of variability (CVintra-user ), and inter-user coefficient of variability (CVinter-user ) were assessed. Acquisition time was 1-2 min for first-pass MRI and approximately 40 min for ASL. Image quality was higher for ASL (3.94 ± 0.09 versus 2.88 ± 0.10; P < 0.05). Infarct zone CVbs was lower with first-pass (17 ± 3% versus 46 ± 9%; P < 0.05). The stress perfusion CVintra-user was lower for ASL (3 ± 1% versus 14 ± 3%; P < 0.05). The stress perfusion CVinter-user was lower for ASL (4 ± 1% versus 17 ± 4%; P < 0.05). For low MBF conditions such as infarct, first-pass MRI is preferred due to better repeatability and variability. At high MBF such as at vasodilation, ASL may be more suitable due to superior image quality and lower user variability. First-pass MRI has a substantial speed advantage. Magn Reson Med 75:2394-2405, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  10. Non-local means variants for denoising of diffusion-weighted and diffusion tensor MRI.

    PubMed

    Wiest-Daesslé, Nicolas; Prima, Sylvain; Coupé, Pierrick; Morrissey, Sean Patrick; Barillot, Christian

    2007-01-01

    Diffusion tensor imaging (DT-MRI) is very sensitive to corrupting noise due to the non linear relationship between the diffusion-weighted image intensities (DW-MRI) and the resulting diffusion tensor. Denoising is a crucial step to increase the quality of the estimated tensor field. This enhanced quality allows for a better quantification and a better image interpretation. The methods proposed in this paper are based on the Non-Local (NL) means algorithm. This approach uses the natural redundancy of information in images to remove the noise. We introduce three variations of the NL-means algorithms adapted to DW-MRI and to DT-MRI. Experiments were carried out on a set of 12 diffusion-weighted images (DW-MRI) of the same subject. The results show that the intensity based NL-means approaches give better results in the context of DT-MRI than other classical denoising methods, such as Gaussian Smoothing, Anisotropic Diffusion and Total Variation.

  11. Upright, weight-bearing, dynamic-kinetic MRI of the spine: initial results.

    PubMed

    Jinkins, J Randy; Dworkin, Jay S; Damadian, Raymond V

    2005-09-01

    The potential relative beneficial aspects of upright, weight-bearing (pMRI), dynamic-kinetic (kMRI) spinal imaging over that of recumbent MRI (rMRI) include the revelation of occult spinal disease dependent on true axial loading, the unmasking of kinetic-dependent spinal disease and the ability to scan the patient in the position of clinically relevant signs and symptoms. This imaging unit under study also demonstrated low claustrophobic potential and yielded comparatively high resolution images with little motion/magnetic susceptibility/chemical shift artifact. Overall, it was found that rMRI underestimated the presence and maximum degree of gravity-dependent spinal pathology and missed altogether pathology of a dynamic nature, factors that are optimally revealed with p/kMRI. Furthermore, p/kMRI enabled optimal linkage of the patient's clinical syndrome with the medical imaging abnormality responsible for the clinical presentation, thereby allowing for the first time an improvement at once in both imaging sensitivity and specificity.

  12. Defining a local arterial input function for perfusion MRI using independent component analysis.

    PubMed

    Calamante, Fernando; Mørup, Morten; Hansen, Lars Kai

    2004-10-01

    Quantification of cerebral blood flow (CBF) using dynamic-susceptibility contrast MRI relies on the deconvolution of the arterial input function (AIF), which is commonly estimated from the signal changes in a major artery. However, it has been shown that the presence of bolus delay/dispersion between the artery and the tissue of interest can be a significant source of error. These effects could be minimized if a local AIF were used, although the measurement of a local AIF can be problematic. This work describes a new methodology to define a local AIF using independent component analysis (ICA). The methodology was tested on data from patients with various cerebrovascular abnormalities and compared to the conventional approach of using a global AIF. The new methodology produced higher CBF and shorter mean transit time values (compared to the global AIF case) in areas with distorted AIFs, suggesting that the effects of delay/dispersion are minimized. The minimization of these effects using the calculated local AIF should lead to a more accurate quantification of CBF, which can have important implications for diagnosis and management of patients with cerebral ischemia.

  13. First-pass myocardial perfusion MRI with reduced subendocardial dark-rim artifact using optimized Cartesian sampling.

    PubMed

    Zhou, Zhengwei; Bi, Xiaoming; Wei, Janet; Yang, Hsin-Jung; Dharmakumar, Rohan; Arsanjani, Reza; Bairey Merz, C Noel; Li, Debiao; Sharif, Behzad

    2017-02-01

    The presence of subendocardial dark-rim artifact (DRA) remains an ongoing challenge in first-pass perfusion (FPP) cardiac magnetic resonance imaging (MRI). We propose a free-breathing FPP imaging scheme with Cartesian sampling that is optimized to minimize the DRA and readily enables near-instantaneous image reconstruction. The proposed FPP method suppresses Gibbs ringing effects-a major underlying factor for the DRA-by "shaping" the underlying point spread function through a two-step process: 1) an undersampled Cartesian sampling scheme that widens the k-space coverage compared to the conventional scheme; and 2) a modified parallel-imaging scheme that incorporates optimized apodization (k-space data filtering) to suppress Gibbs-ringing effects. Healthy volunteer studies (n = 10) were performed to compare the proposed method against the conventional Cartesian technique-both using a saturation-recovery gradient-echo sequence at 3T. Furthermore, FPP imaging studies using the proposed method were performed in infarcted canines (n = 3), and in two symptomatic patients with suspected coronary microvascular dysfunction for assessment of myocardial hypoperfusion. Width of the DRA and the number of DRA-affected myocardial segments were significantly reduced in the proposed method compared to the conventional approach (width: 1.3 vs. 2.9 mm, P < 0.001; number of segments: 2.6 vs. 8.7; P < 0.0001). The number of slices with severe DRA was markedly lower for the proposed method (by 10-fold). The reader-assigned image quality scores were similar (P = 0.2), although the quantified myocardial signal-to-noise ratio was lower for the proposed method (P < 0.05). Animal studies showed that the proposed method can detect subendocardial perfusion defects and patient results were consistent with the gold-standard invasive test. The proposed free-breathing Cartesian FPP imaging method significantly reduces the prevalence of severe DRAs compared to the conventional approach

  14. Current concepts on magnetic resonance imaging (MRI) perfusion-diffusion assessment in acute ischaemic stroke: a review & an update for the clinicians

    PubMed Central

    Roldan-Valadez, Ernesto; Lopez-Mejia, Mariana

    2014-01-01

    Recently, several medical societies published joint statements about imaging recommendations for acute stroke and transient ischaemic attack patients. In following with these published guidelines, we considered it appropriate to present a brief, practical and updated review of the most relevant concepts on the MRI assessment of acute stroke. Basic principles of the clinical interpretation of diffusion, perfusion, and MRI angiography (as part of a global MRI protocol) are discussed with accompanying images for each sequence. Brief comments on incidence and differential diagnosis are also included, together with limitations of the techniques and levels of evidence. The purpose of this article is to present knowledge that can be applied in day-to-day clinical practice in specialized stroke units or emergency rooms to attend patients with acute ischaemic stroke or transient ischaemic attack according to international standards. PMID:25758570

  15. Diffusion-weighted MRI evaluation of breast cancer extension.

    PubMed

    Long-Hua, Qiu; Qin, Xiao; Wen-Tao, Yang; Feng, Tang; Kun-Wei, Shen; Bin, Wu; Ya-Jia, Gu

    2010-01-01

    To investigate the feasibility of using diffusion-weighted MR imaging (DWI) to accurately measure breast cancer extension. The extensions of 59 breast lesions were investigated on DW images and apparent diffusion coefficient (ADC) maps and compared to the pathological exams. Three groups were observed: accurate, overdiagnosis, and false negative. There were no significant differences seen in accurate or false-negative group when b was 500 and 1000 s/mm(2) when two lesions in the overdiagnosis group at both b values. DWI and the ADC value have potential for evaluating cancer extension. Copyright 2010 Elsevier Inc. All rights reserved.

  16. Reproducibility of BOLD, Perfusion, and CMRO2 Measurements with Calibrated-BOLD fMRI

    PubMed Central

    Leontiev, Oleg; Buxton, Richard B.

    2007-01-01

    The coupling of changes in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) during brain activation can be characterized by an empirical index, n, defined as the ratio between fractional CBF change and fractional CMRO2 change. The combination of blood oxygenation level dependent (BOLD) imaging with CBF measurements from arterial spin labeling (ASL) provides a potentially powerful experimental approach for measuring n, but the reproducibility of the technique previously has not been assessed. In this study, inter-subject variance and intra-subject reproducibility of the method were determined. Block design %BOLD and %CBF responses to visual stimulation and mild hypercapnia (5% CO2) were measured, and these data were used to compute the BOLD scaling factor M, %CMRO2 change with activation, and the coupling index n. Reproducibility was determined for three approaches to defining regions-of-interest (ROIs): 1) Visual area V1 determined from prior retinotopic maps, 2) BOLD-activated voxels from a separate functional localizer, and 3) CBF–activated voxels from a separate functional localizer. For estimates of %BOLD, %CMRO2 and n, intra-subject reproducibility was found to be best for regions selected according to CBF activation. Among all fMRI measurements, estimates of n were the most robust and were substantially more stable within individual subjects (coefficient of variation, CV=7.4%) than across the subject pool (CV=36.9%). The stability of n across days, despite wider variability of CBF and CMRO2 responses, suggests that the reproducibility of blood flow changes is limited by variation in the oxidative metabolic demand. We conclude that the calibrated BOLD approach provides a highly reproducible measurement of n that can serve as a useful quantitative probe of the coupling of blood flow and energy metabolism in the brain. PMID:17208013

  17. Reproducibility of BOLD, perfusion, and CMRO2 measurements with calibrated-BOLD fMRI.

    PubMed

    Leontiev, Oleg; Buxton, Richard B

    2007-03-01

    The coupling of changes in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO(2)) during brain activation can be characterized by an empirical index, n, defined as the ratio between fractional CBF change and fractional CMRO(2) change. The combination of blood oxygenation level dependent (BOLD) imaging with CBF measurements from arterial spin labeling (ASL) provides a potentially powerful experimental approach for measuring n, but the reproducibility of the technique previously has not been assessed. In this study, inter-subject variance and intra-subject reproducibility of the method were determined. Block design %BOLD and %CBF responses to visual stimulation and mild hypercapnia (5% CO(2)) were measured, and these data were used to compute the BOLD scaling factor M, %CMRO(2) change with activation, and the coupling index n. Reproducibility was determined for three approaches to defining regions-of-interest (ROIs): 1) Visual area V1 determined from prior retinotopic maps, 2) BOLD-activated voxels from a separate functional localizer, and 3) CBF-activated voxels from a separate functional localizer. For estimates of %BOLD, %CMRO(2) and n, intra-subject reproducibility was found to be best for regions selected according to CBF activation. Among all fMRI measurements, estimates of n were the most robust and were substantially more stable within individual subjects (coefficient of variation, CV=7.4%) than across the subject pool (CV=36.9%). The stability of n across days, despite wider variability of CBF and CMRO(2) responses, suggests that the reproducibility of blood flow changes is limited by variation in the oxidative metabolic demand. We conclude that the calibrated BOLD approach provides a highly reproducible measurement of n that can serve as a useful quantitative probe of the coupling of blood flow and energy metabolism in the brain.

  18. Postischemic hyperperfusion on arterial spin labeled perfusion MRI is linked to hemorrhagic transformation in stroke

    PubMed Central

    Yu, Songlin; Liebeskind, David S; Dua, Sumit; Wilhalme, Holly; Elashoff, David; Qiao, Xin J; Alger, Jeffry R; Sanossian, Nerses; Starkman, Sidney; Ali, Latisha K; Scalzo, Fabien; Lou, Xin; Yoo, Bryan; Saver, Jeffrey L; Salamon, Noriko; Wang, Danny JJ

    2015-01-01

    The purpose of this study was to investigate the relationship between hyperperfusion and hemorrhagic transformation (HT) in acute ischemic stroke (AIS). Pseudo-continuous arterial spin labeling (ASL) with background suppressed 3D GRASE was performed during routine clinical magnetic resonance imaging (MRI) on AIS patients at various time points. Arterial spin labeling cerebral blood flow (CBF) maps were visually inspected for the presence of hyperperfusion. Hemorrhagic transformation was followed during hospitalization and was graded on gradient recalled echo (GRE) scans into hemorrhagic infarction (HI) and parenchymal hematoma (PH). A total of 361 ASL scans were collected from 221 consecutive patients with middle cerebral artery stroke from May 2010 to September 2013. Hyperperfusion was more frequently detected posttreatment (odds ratio (OR)=4.8, 95% confidence interval (CI) 2.5 to 8.9, P<0.001) and with high National Institutes of Health Stroke Scale (NIHSS) scores at admission (P<0.001). There was a significant association between having hyperperfusion at any time point and HT (OR=3.5, 95% CI 2.0 to 6.3, P<0.001). There was a positive relationship between the grade of HT and time–hyperperfusion with the Spearman's rank correlation of 0.44 (P=0.003). Arterial spin labeling hyperperfusion may provide an imaging marker of HT, which may guide the management of AIS patients post tissue-type plasminogen activator (tPA) and/or endovascular treatments. Late hyperperfusion should be given more attention to prevent high-grade HT. PMID:25564233

  19. A weighted block-PCA infrared face recognition method based on blood perfusion image

    NASA Astrophysics Data System (ADS)

    Xie, Zhihua; Liu, Guodong; Wu, Shiqian; Fang, Zhijun

    2009-10-01

    In this paper, a novel method for infrared face recognition based on blood perfusion is proposed in this paper. Firstly, thermal images are converted into blood perfusion domain to enlarge between-class distance and lessen within-class distance, which makes full use of the biological feature of the human face. Based on the ratio of between-class distance to within-class distance (Ratio of Distance (RD)) in sub-blocks, block-PCA is utilized to get the local discrimination information, which can solve the small sample size problem (the null space problem). Finally, The FLD is applied to the holistic features combined by the extracted coefficients from the information of all sub-blocks. The experiments illustrate that the block-PCA+FLD doesn't discard the useful discriminant information in the holistic characters and the method proposed in this paper has better performance compared with traditional methods.

  20. Diffusion-weighted MRI in the characterization of pleural effusions.

    PubMed

    Inan, Nagihan; Arslan, Arzu; Akansel, Gür; Arslan, Zeliha; Elemen, Levent; Eleman, Levent; Demirci, Ali

    2009-03-01

    To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of pleural effusions. 58 pleural effusions (21 transudative, 37 exudative) were included in this prospective study. Single-shot echo-planar spin echo DWI was performed with two b factors (500 and 1000 s/mm (2)), and apparent diffusion coefficients (ADCs) were calculated. On diffusion- weighted (DW) trace images, signal intensity (SI) of the pleural effusions was visually compared to the SI of the paraspinal muscles with the use of a 3-point scale: 0: isointense, 1: moderately hyperintense, 2: significantly hyperintense. For quantitative evaluation, effusion- to-paraspinal muscle SI ratios, and ADCs of the effusions were compared between the groups. On visual evaluation, most of the transudative effusions were isointense, while most of the exudative effusions were hyperintense on DWI with b factors of 500 and 1000 s/mm (2). Quantitatively, with a b factor of 500 and 1000 s/mm(2), effusion-to-paraspinal muscle SI ratios of the exudative effusions were significantly higher than those of transudative effusions. The ADCs of the exudative effusions were significantly lower than those of transudative effusions (mean ADC was 3.3 x 10 (-3)+/- 0.7 mm(2)/s for exudative effusions, and 3.7 x 10 (-3)+/-0.3 mm(2)/s for transudative effusions). Setting the cutoff value at 3.6 x 10(-3), ADC had a sensitivity of 71% and a specificity of 63% for differentiating transudative from exudative effusions. DWI may help in the differential diagnosis of pleural effusions.

  1. Contrast enhanced MRI characterization of the perfusion territories fed by individual coronary arteries in ex-vivo porcine heart

    NASA Astrophysics Data System (ADS)

    Szeverenyi, Nikolaus M.; Searles, Bruce; Pertsov, Arkady

    2008-03-01

    Sudden cardiac death is often caused by ventricular arrhythmias. These arrhythmias are believed to originate from the border zones where tissue was damaged by an ischemic event involving the coronary arteries. The specific mechanisms relating the geometry of these territories to the electrical behavior remains poorly understood. A major problem is the lack of detailed information describing the morphology of the affected perfusion bed. We present the first perfusion MR images of excised whole heart preparations where the irregular boundaries of perfusion territories are described. The filling pattern and final volume of the RCA perfusion territory are clearly visualized.

  2. Diagnostic accuracy of diffusion-weighted MRI for differentiation of cervical cancer and benign cervical lesions at 3.0T: Comparison with routine MRI and dynamic contrast-enhanced MRI.

    PubMed

    Kuang, Fei; Yan, Zhiping; Li, Huili; Feng, Hao

    2015-10-01

    To compare the diagnostic accuracy of routine magnetic resonance imaging (MRI) (T1 WI and T2 WI), diffusion-weighted MRI (DWI), and DCE-MRI (dynamic contrast-enhanced MRI) at 3.0T for differentiation of cervical cancer and benign cervical lesions. A cohort of 75 cervical cancer patients, 26 cervical leiomyoma patients, 22 patients with cervical polyps consecutively underwent pelvic MRI scanning on a 3T MR unit. Two radiologists independently evaluated images at three imaging settings; routine MRI alone, DWI combined with routine MRI (DWI+routine MRI), and DCE-MRI. The apparent diffusion coefficients (ADCs) were calculated from b 0, 600 s/mm(2) and b 0, 1000 s/mm(2). DWI+routine MRI was significantly better than routine MRI and obtained high accuracy (0.95); the diagnostic performance was not significantly different between DWI+routine MRI and DCE-MRI. Reader agreement was excellent for both DWI+routine MRI (κ, 0.90) and DCE-MRI (κ, 0.92). The ADCs of cervical cancer were significantly lower than those of benign cervical lesions at both ADC maps (P = 0.0001). The diagnostic accuracy was not different at both ADC maps (P = 0.375). For differentiation of cervical cancer and benign cervical lesions, unenhanced MRI with combined diffusion-weighted and routine MRI (DWI+routine MRI) at 3T can provide accurate information and may be preferable to DCE. © 2015 Wiley Periodicals, Inc.

  3. Focal and Generalized Patterns of Cerebral Cortical Veins Due to Non-Convulsive Status Epilepticus or Prolonged Seizure Episode after Convulsive Status Epilepticus – A MRI Study Using Susceptibility Weighted Imaging

    PubMed Central

    Verma, Rajeev Kumar; Abela, Eugenio; Schindler, Kaspar; Krestel, Heinz; Springer, Elisabeth; Huber, Adrian; Weisstanner, Christian; Hauf, Martinus; Gralla, Jan; Wiest, Roland

    2016-01-01

    Objective The aim of this study was to investigate variant patterns of cortical venous oxygenation during status epilepticus (SE) using susceptibility-weighted imaging (SWI). Methods We analyzed magnetic resonance imaging (MRI) scans of 26 patients with clinically witnessed prolonged seizures and/or EEG-confirmed SE. All MRI exams encompassed SWI, dynamic susceptibility contrast perfusion MRI (MRI-DSC) and diffusion-weighted imaging (DWI). We aimed to identify distinct patterns of SWI signal alterations that revealed regional or global increases of cerebral blood flow (CBF) and DWI restrictions. We hypothesized that SWI-related oxygenation patterns reflect ictal or postictal patterns that resemble SE or sequelae of seizures. Results Sixteen patients were examined during nonconvulsive status epilepticus (NCSE) as confirmed by EEG, a further ten patients suffered from witnessed and prolonged seizure episode ahead of imaging without initial EEG. MRI patterns of 15 of the 26 patients revealed generalized hyperoxygenation by SWI in keeping with either global or multifocal cortical hyperperfusion. Eight patients revealed a focal hyperoxygenation pattern related to focal CBF increase and three patients showed a focal deoxygenation pattern related to focal CBF decrease. Conclusions SWI-related hyper- and deoxygenation patterns resemble ictal and postictal CBF changes within a range from globally increased to focally decreased perfusion. In all 26 patients the SWI patterns were in keeping with ictal hyperperfusion (hyperoxygenation patterns) or postictal hypoperfusion (deoxygenation patterns) respectively. A new finding of this study is that cortical venous patterns in SWI can be not only focally, but globally attenuated. SWI may thus be considered as an alternative contrast-free MR sequence to identify perfusion changes related to ictal or postictal conditions. PMID:27486662

  4. Diffusion Weighted MRI by Spatiotemporal Encoding: Analytical Description and In Vivo Validations

    PubMed Central

    Solomon, Eddy; Shemesh, Noam; Frydman, Lucio

    2016-01-01

    Diffusion-Weighted (DW) MRI is a powerful modality for studying microstructure in normal and pathological tissues. DW MRI, however, is of limited use in regions suffering from large magnetic field or chemical shift heterogeneities. Spatio-temporal encoding (SPEN) is a single-scan imaging technique that can deliver its information with a remarkable insensitivity to field inhomogeneities; this study explores the use of diffusion-weighted SPEN (dSPEN) MRI as an alternative for acquiring this kind of information. Owing to SPEN’s combined use of gradients and radiofrequency-swept pulses, spatially-dependent diffusion weightings arise in these sequences that are not present in conventional k-space DW MRI. In order to account for these phenomena an analytical formalism is presented that extends Stejskal & Tanner’s and Karlicek & Lowe’s work, to derive the b-values arising upon taking into account the effects of adiabatic pulses, of imaging as well as diffusion gradients, and of cross-terms between them. Excellent agreement is found between the new features predicted by these analytical and numerical derivations, and SPEN diffusion experiments in phantoms and in anisotropic ex vivo systems. Examinations of apparent diffusion coefficients in human breast volunteers also verify the advantages of the new methods in vivo, which exhibit substantial robustness vis-à-vis comparable DW echo planar imaging. PMID:23562003

  5. Flow versus permeability weighting in estimating the forward volumetric transfer constant (K(trans)) obtained by DCE-MRI with contrast agents of differing molecular sizes.

    PubMed

    Li, Cheng-He; Chen, Fang-Hsin; Schellingerhout, Dawid; Lin, Yu-Shi; Hong, Ji-Hong; Liu, Ho-Ling

    2017-02-01

    To quantify the differential plasma flow- (Fp-) and permeability surface area product per unit mass of tissue- (PS-) weighting in forward volumetric transfer constant (K(trans)) estimates by using a low molecular (Gd-DTPA) versus high molecular (Gadomer) weight contrast agent in dynamic contrast enhanced (DCE) MRI. DCE MRI was performed using a 7T animal scanner in 14 C57BL/6J mice syngeneic for TRAMP tumors, by administering Gd-DTPA (0.9kD) in eight mice and Gadomer (35kD) in the remainder. The acquisition time was 10min with a sampling rate of one image every 2s. Pharmacokinetic modeling was performed to obtain K(trans) by using Extended Tofts model (ETM). In addition, the adiabatic approximation to the tissue homogeneity (AATH) model was employed to obtain the relative contributions of Fp and PS. The K(trans) values derived from DCE-MRI with Gd-DTPA showed significant correlations with both PS (r(2)=0.64, p=0.009) and Fp (r(2)=0.57, p=0.016), whereas those with Gadomer were found only significantly correlated with PS (r(2)=0.96, p=0.0003) but not with Fp (r(2)=0.34, p=0.111). A voxel-based analysis showed that K(trans) approximated PS (<30% difference) in 78.3% of perfused tumor volume for Gadomer, but only 37.3% for Gd-DTPA. The differential contributions of Fp and PS in estimating K(trans) values vary with the molecular weight of the contrast agent used. The macromolecular contrast agent resulted in K(trans) values that were much less dependent on flow. These findings support the use of macromolecular contrast agents for estimating tumor vessel permeability with DCE-MRI. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Gd-doped BNNTs as T2-weighted MRI contrast agents

    NASA Astrophysics Data System (ADS)

    Ciofani, Gianni; Boni, Adriano; Calucci, Lucia; Forte, Claudia; Gozzi, Alessandro; Mazzolai, Barbara; Mattoli, Virgilio

    2013-08-01

    This work describes, for the first time, doping of boron nitride nanotubes (BNNTs) with gadolinium (Gd@BNNTs), a stable functionalization that permits non-invasive BNNT tracking via magnetic resonance imaging (MRI). We report the structure, Gd loading, and relaxometric properties in water suspension at 7 T of Gd@BNNTs, and show the behaviour of these nanostructures as promising T2-weighted contrast agents. Finally, we demonstrate their complete biocompatibility in vitro on human neuroblastoma cells, together with their ability to effectively label and affect contrast in MRI images at 7 T.

  7. Diffusion-weighted MRI for differentiating Wilms tumor from neuroblastoma

    PubMed Central

    Aslan, Mine; Aslan, Ahmet; Habibi, Hatice Arıöz; Uçar, Ayşe Kalyoncu; Özmen, Evrim; Bakan, Selim; Kuruğoğlu, Sebuh; Adaletli, İbrahim

    2017-01-01

    PURPOSE Wilms tumor (WT) and neuroblastoma (NB) are the most common pediatric abdominal malignant neoplasms of the kidney and adrenal gland. Differentiating them from each other is essential since their treatments are different. Here, we aimed to show the diffusion characteristics of WT and NB for differentiation. METHODS Diffusion-weighted imaging (DWI) of 17 histopathologically diagnosed lesions (10 NB and 7 WT in 8 female and 9 male patients) was evaluated retrospectively. The apparent diffusion coefficient (ADC) value for each tumor was calculated using region-of-interest (ROI) measurements by two observers. The mean ADC values were compared, and receiver operating characteristics (ROC) curve analysis was performed. Intraclass correlation was evaluated for the reliability of ADC measurement. RESULTS The mean ADC values measured by two observers were 0.787±0.09 ×10−3 mm2/s and 0.768±0.08 ×10−3 mm2/s for WT, and 0.524±0.16 ×10−3 mm2/s and 0.529±0.16 ×10−3 mm2/s for NB, respectively (P = 0.006 and P = 0.011). Intraclass correlation coefficient was 0.955. Utilizing ROC curve analysis, a cutoff ADC value of ≤0.645 ×10−3 mm2/s was obtained to differentiate NB from WT. CONCLUSION ADC values of NBs were significantly lower than WT with a perfect interobserver agreement. We suggest that DWI may have a role in differentiating the two tumors. PMID:28830846

  8. Diffusion-weighted MRI for differentiating Wilms tumor from neuroblastoma.

    PubMed

    Aslan, Mine; Aslan, Ahmet; Arıöz Habibi, Hatice; Kalyoncu Uçar, Ayşe; Özmen, Evrim; Bakan, Selim; Kuruğoğlu, Sebuh; Adaletli, İbrahim

    2017-01-01

    Wilms tumor (WT) and neuroblastoma (NB) are the most common pediatric abdominal malignant neoplasms of the kidney and adrenal gland. Differentiating them from each other is essential since their treatments are different. Here, we aimed to show the diffusion characteristics of WT and NB for differentiation. Diffusion-weighted imaging (DWI) of 17 histopathologically diagnosed lesions (10 NB and 7 WT in 8 female and 9 male patients) was evaluated retrospectively. The apparent diffusion coefficient (ADC) value for each tumor was calculated using region-of-interest (ROI) measurements by two observers. The mean ADC values were compared, and receiver operating characteristics (ROC) curve analysis was performed. Intraclass correlation was evaluated for the reliability of ADC measurement. The mean ADC values measured by two observers were 0.787±0.09 ×10-3 mm2/s and 0.768±0.08 ×10-3 mm2/s for WT, and 0.524±0.16 ×10-3 mm2/s and 0.529±0.16 ×10-3 mm2/s for NB, respectively (P = 0.006 and P = 0.011). Intraclass correlation coefficient was 0.955. Utilizing ROC curve analysis, a cutoff ADC value of ≤0.645 ×10-3 mm2/s was obtained to differentiate NB from WT. ADC values of NBs were significantly lower than WT with a perfect interobserver agreement. We suggest that DWI may have a role in differentiating the two tumors.

  9. Dynamic Susceptibility Contrast Perfusion-Weighted Magnetic Resonance Imaging and Diffusion-Weighted Magnetic Resonance Imaging in Differentiating Recurrent Head and Neck Cancer From Postradiation Changes.

    PubMed

    Abdel Razek, Ahmed Abdel Khalek; Gaballa, Gada; Ashamalla, Germin; Alashry, Mohamed Saad; Nada, Nadia

    2015-01-01

    The aim of this study was to assess dynamic susceptibility contrast (DSC) perfusion-weighted magnetic resonance (MR) imaging and diffusion-weighted MR imaging in differentiating recurrent head and neck cancer from postradiation changes. A prospective study was done on 41 patients with head and neck cancer after radiotherapy who underwent diffusion-weighted MR imaging, DSC perfusion-weighted MR imaging, and routine postcontrast MR imaging. The apparent diffusion coefficient (ADC) map and time signal intensity curve of the lesion were created. The ADC value, DSC percentage (DSC%), and contrast enhancement percentage of the lesion were calculated. The final diagnosis was done with biopsy. There was significant difference (P = 0.001) in ADC between recurrent cancer (0.94 ± 0.16 × 10mm/s) and postradiation changes (1.37 ± 0.12 × 10mm/s). There was significant difference (P = 0.001) in DSC% of recurrent cancer (30.9% ± 5.16%) and postradiation changes (12.1% ± 3.06%). Selection of ADC equal to or less than 1.07 × 10mm/s and DSC% greater than 16.6% to predict recurrence have areas under the curve of 0.822 and 0.900 and accuracy of 92.7% and 95.1%, respectively. Combination of ADC and DSC% has are under the curve of 0.992 and accuracy of 97.6%. Combined ADC and DSC% are noninvasive imaging parameters that can play a role in the differentiation of recurrent head and neck cancer from postradiation changes.

  10. Methanol-induced toxic optic neuropathy with diffusion weighted MRI findings.

    PubMed

    Tanrivermis Sayit, Asli; Aslan, Kerim; Elmali, Muzaffer; Gungor, Inci

    2016-12-01

    We report a 52-year-old man with methanol intoxication who showed optic nerve damage as assessed by magnetic resonance imaging (MRI). He was admitted to the hospital with blurred vision after the consumption of alcohol (600-700 ml of cologne). He was treated with intravenous ethanol, NaHCO3 and hemodialysis. On admission, a brain and orbital MRI was performed. Bilateral mild contrast enhancement was detected on the contrast-enhanced images in the retrobulbar segment of the optic nerves (RBONs). Also, diffusion-weighted images showed restricted diffusion in the RBONs. Diagnosis was considered as methanol-induced optic neuropathy based on the MRI findings of the optic nerves.

  11. [Breast MRI: the usefulness of diffusion-weighted sequences for differentiating between benign and malignant lesions].

    PubMed

    Barceló, J; Vilanova, J C; Albanell, J; Ferrer, J; Castañer, F; Viejo, N; Argelaguet, M

    2009-01-01

    To evaluate the usefulness of diffusion-weighted MRI sequences and of the apparent diffusion coefficient (ADC) to differentiate between benign and malignant breast lesions. We prospectively studied 88 patients (aged 31 to 79 years) with 94 lesions (80 malignant and 14 benign) who were referred for preoperative local staging. All patients underwent dynamic MRI examination after intravenous contrast administration and a diffusion-weighted sequence with ADC calculation. The results obtained at diffusion-weighted imaging were correlated with those obtained at histological examination. The mean value of the ADC for malignant lesions (1.12+/-0.25x10(-3)mm(2)/s) was significantly lower (p<0.001) than for benign lesions (1.61+/-0.52x10(-3)mm(2)/s). No significant differences in ADC values were found between the different subtypes of invasive carcinomas or between intraductal carcinoma and invasive carcinoma (p>0.05). Using an ADC lower than 0.95x10(-3)mm(2)/s as a threshold for malignancy, the sensitivity is 52% and the specificity is 100%. Diffusion-weighted sequences provide additional information in breast MRI that is useful for differentiating between benign and malignant lesions, thus improving the specificity of the technique.

  12. Differentiation of Reactive and Tumor Metastatic Lymph Nodes with Diffusion-weighted and SPIO Enhanced MRI

    PubMed Central

    Zhang, Fan; Zhu, Lei; Huang, Xinglu; Niu, Gang; Chen, Siouan

    2012-01-01

    Objectives Determination of lymphatic metastasis is of great importance for both treatment planning and patient prognosis. We aim to distinguish tumor metastatic lymph nodes (TLNs) and reactive lymph nodes (RLNs) with diffusion-weighted and superparamagnetic iron oxide (SPIO) enhanced magnetic resonance imaging (MRI). Materials and methods Ipsilateral popliteal lymph node metastasis or lymphadenitis model was established by hock injection of either luciferase-expressing 4T1 murine breast cancer cells or Complete Freund Adjuvant (CFA) in male Balb/C mice. At different time points after inoculation, bioluminescence imaging, T2-weighted, diffusion-weighted and SPIO enhanced MRI were performed. Imaging findings were confirmed by histopathological staining. Results Size enlargement was observed in both TLNs and RLNs. At day 28, TLNs showed strong bioluminescence signal and bigger size than RLNs (p < 0.01). At early stages up to day 21, both TLNs and RLNs appeared homogeneous on diffusion-weighted imaging (DWI). At day 28, TLNs showed heterogeneous apparent diffusion coefficient (ADC) map with significantly higher average ADC value of 0.41 ± 0.03 × 10−3 mm2/s than that of RLNs (0.34 ± 0.02 10−3 mm2/s, p < 0.05). On SPIO enhanced MRI, both TLNs and RLNs showed distinct T2 signal reduction at day 21 after inoculation. At day 28, TLNs demonstrated partial uptake of the iron oxide particles, which was confirmed by Prussian blue staining. Conclusions Both diffusion-weighted and SPIO enhanced MRI can distinguish tumor metastatic lymph nodes from reactive lymph nodes. However, neither method is able to detect tumor metastasis to the draining lymph nodes at early stages. PMID:22588595

  13. Accuracy and feasibility of dynamic contrast-enhanced 3D MR imaging in the assessment of lung perfusion: comparison with Tc-99 MAA perfusion scintigraphy.

    PubMed

    Yilmaz, E; Akkoclu, A; Degirmenci, B; Cooper, R A; Sengun, B; Gulcu, A; Osma, E; Ucan, E S

    2005-08-01

    The aim of this study was to correlate findings of perfusion magnetic resonance imaging (MRI) and perfusion scintigraphy in cases where there was a suspicion of abnormal pulmonary vasculature, and to evaluate the usefulness of MRI in the detection of perfusion deficits of the lung. In all, 17 patients with suspected abnormality of the pulmonary vasculature underwent dynamic contrast-enhanced MRI. T1-weighted 3D fast-field echo pulse sequences were obtained (TR/TE 3.3/1.58 ms; flip angle 30 degrees; slice thickness 12 to 15 mm). The dynamic study was acquired in the coronal plane following administration of 0.1 mmol/kg gadopentetate dimeglumine. A total of 8 to 10 sections repeated 20 to 25 times at intervals of 1s were performed. Perfusion lung scintigraphy was carried out a maximum of 48 h before the MR examination in all cases. Two radiologists, who were blinded to the clinical data and results of other imaging methods, reviewed all coronal sections. MR perfusion images were independently assessed in terms of segmental or lobar perfusion defects in the 85 lobes of the 17 individuals, and the findings were compared with the results of scintigraphy. Of the 17 patients, 8 were found to have pulmonary emboli, 2 chronic obstructive pulmonary disease with emphysema, 2 bullous emphysema, 2 Takayasu arteritis and 1 had a hypoplastic pulmonary artery. Pulmonary perfusion was completely normal in 2 cases. In 35 lobes, perfusion defects were detected using both methods, in 4 with MR alone and in 9 only with scintigraphy. There was good agreement between MRI and scintigraphy findings (kappa=0.695). Pulmonary perfusion MRI is a new alternative to scintigraphy in the evaluation of pulmonary perfusion for various lung disorders. In addition, this technique allows measurement and quantification of pulmonary perfusion abnormalities.

  14. Realistic microwave breast models through T1-weighted 3-D MRI data.

    PubMed

    Tunçay, Ahmet Hakan; Akduman, Ibrahim

    2015-02-01

    In this paper we present an effective method for developing realistic numerical three-dimensional (3-D) microwave breast models of different shape, size, and tissue density. These models are especially convenient for microwave breast cancer imaging applications and numerical analysis of human breast-microwave interactions. As in the recent studies on this area, anatomical information of the breast tissue is collected from T1-weighted 3-D MRI data of different patients' in prone position. The method presented in this paper offers significant improvements including efficient noise reduction and tissue segmentation, nonlinear mapping of electromagnetic properties, realistically asymmetric phantom shape, and a realistic classification of breast phantoms. Our method contains a five-step approach where each MRI voxel is classified and mapped to the appropriate dielectric properties. In the first step, the MRI data are denoised by estimating and removing the bias field from each slice, after which the voxels are segmented into two main tissues as fibro-glandular and adipose. Using the distribution of the voxel intensities in MRI histogram, two nonlinear mapping functions are generated for dielectric permittivity and conductivity profiles, which allow each MRI voxel to map to its proper dielectric properties. Obtained dielectric profiles are then converted into 3-D numerical breast phantoms using several image processing techniques, including morphologic operations, filtering. Resultant phantoms are classified according to their adipose content, which is a critical parameter that affects penetration depth during microwave breast imaging.

  15. Advantage of Adding Diffusion Weighted Imaging to Routine MRI Examinations in the Diagnostics of Scrotal Lesions

    PubMed Central

    Algebally, Ahmed Mohamed; Tantawy, Hazim Ibrahim; Yousef, Reda Ramadan Hussein; Szmigielski, Wojciech; Darweesh, Adham

    2015-01-01

    Summary Background The purpose of the study is to identify the diagnostic value of adding diffusion weighted images (DWI) to routine MRI examinations of the scrotum. Material/Methods The study included 100 testes of 50 patients with a unilateral testicular disease. Fifty normal contralateral testes were used as a control group. All patients underwent conventional MRI and DWI examinations of the scrotum. The results of MRI and DWI of the group of patients treated surgically were correlated with histopathological findings. The MRI and DWI results of non-surgical cases were correlated with the results of clinical, laboratory and other imaging studies. Comparison of the ADC value of normal and pathological tissues was carried out followed by a statistical analysis. Results There was a significant difference between ADC values of malignant testicular lesions and normal testicular tissues as well as benign testicular lesions (P=0.000). At a cut-off ADC value of ≤0.99, it had a sensitivity of 93.3%, specificity of 90%, positive predictive value of 87.5%, and negative predictive value of 94.7% in the characterization of intratesticular masses. Conclusions Inclusion of DWI to routine MRI has a substantial value in improving diagnosis in patients with scrotal lesions and consequently can reduce unnecessary radical surgical procedures in these patients. PMID:26491491

  16. Fast and Quantitative T1ρ-weighted Dynamic Glucose Enhanced MRI

    PubMed Central

    Schuenke, Patrick; Paech, Daniel; Koehler, Christina; Windschuh, Johannes; Bachert, Peter; Ladd, Mark E.; Schlemmer, Heinz-Peter; Radbruch, Alexander; Zaiss, Moritz

    2017-01-01

    Common medical imaging techniques usually employ contrast agents that are chemically labeled, e.g. with radioisotopes in the case of PET, iodine in the case of CT or paramagnetic metals in the case of MRI to visualize the heterogeneity of the tumor microenvironment. Recently, it was shown that natural unlabeled D-glucose can be used as a nontoxic biodegradable contrast agent in Chemical Exchange sensitive Spin-Lock (CESL) magnetic resonance imaging (MRI) to detect the glucose uptake and potentially the metabolism of tumors. As an important step to fulfill the clinical needs for practicability, reproducibility and imaging speed we present here a robust and quantitative T1ρ-weighted technique for dynamic glucose enhanced MRI (DGE-MRI) with a temporal resolution of less than 7 seconds. Applied to a brain tumor patient, the new technique provided a distinct DGE contrast between tumor and healthy brain tissue and showed the detailed dynamics of the glucose enhancement after intravenous injection. Development of this fast and quantitative DGE-MRI technique allows for a more detailed analysis of DGE correlations in the future and potentially enables non-invasive diagnosis, staging and monitoring of tumor response to therapy. PMID:28169369

  17. Motion Compensated Abdominal Diffusion Weighted MRI by Simultaneous Image Registration and Model Estimation (SIR-ME).

    PubMed

    Kurugol, Sila; Freiman, Moti; Afacan, Onur; Domachevsky, Liran; Perez-Rossello, Jeannette M; Callahan, Michael J; Warfield, Simon K

    2015-01-01

    Non-invasive characterization of water molecule's mobility variations by quantitative analysis of diffusion-weighted MRI (DW-MRI) signal decay in the abdomen has the potential to serve as a biomarker in gastrointestinal and oncological applications. Accurate and reproducible estimation of the signal decay model parameters is challenging due to the presence of respiratory, cardiac, and peristalsis motion. Independent registration of each b-value image to the b-value=0 s/mm(2) image prior to parameter estimation might be sub-optimal because of the low SNR and contrast difference between images of varying b-value. In this work, we introduce a motion-compensated parameter estimation framework that simultaneously solves image registration and model estimation (SIR-ME) problems by utilizing the interdependence of acquired volumes along the diffusion weighting dimension. We evaluated the improvement in model parameters estimation accuracy using 16 in-vivo DW-MRI data sets of Crohn's disease patients by comparing parameter estimates obtained using the SIR-ME model to the parameter estimates obtained by fitting the signal decay model to the acquired DW-MRI images. The proposed SIR-ME model reduced the average root-mean-square error between the observed signal and the fitted model by more than 50%. Moreover, the SIR-ME model estimates discriminate between normal and abnormal bowel loops better than the standard parameter estimates.

  18. The role of diffusion and perfusion weighted imaging in the differential diagnosis of cerebral tumors: a review and future perspectives

    PubMed Central

    2014-01-01

    The role of conventional Magnetic Resonance Imaging (MRI) in the detection of cerebral tumors has been well established. However its excellent soft tissue visualization and variety of imaging sequences are in many cases non-specific for the assessment of brain tumor grading. Hence, advanced MRI techniques, like Diffusion-Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI) and Dynamic-Susceptibility Contrast Imaging (DSCI), which are based on different contrast principles, have been used in the clinical routine to improve diagnostic accuracy. The variety of quantitative information derived from these techniques provides significant structural and functional information in a cellular level, highlighting aspects of the underlying brain pathophysiology. The present work, reviews physical principles and recent results obtained using DWI/DTI and DSCI, in tumor characterization and grading of the most common cerebral neoplasms, and discusses how the available MR quantitative data can be utilized through advanced methods of analysis, in order to optimize clinical decision making. PMID:25609475

  19. Chemotherapy response evaluation in a mouse model of gastric cancer using intravoxel incoherent motion diffusion-weighted MRI and histopathology

    PubMed Central

    Cheng, Jin; Wang, Yi; Zhang, Chun-Fang; Wang, He; Wu, Wei-Zhen; Pan, Feng; Hong, Nan; Deng, Jie

    2017-01-01

    AIM To determine the role of intravoxel incoherent motion (IVIM) diffusion-weighted (DW) magnetic resonance imaging (MRI) using a bi-exponential model in chemotherapy response evaluation in a gastric cancer mouse model. METHODS Mice bearing MKN-45 human gastric adenocarcinoma xenografts were divided into four treated groups (TG1, 2, 3 and 4, n = 5 in each group) which received Fluorouracil and Calcium Folinate and a control group (CG, n = 7). DW-MRI scans with 14 b-values (0-1500 s/mm2) were performed before and after treatment on days 3, 7, 14 and 21. Fast diffusion component (presumably pseudo-perfusion) parameters including the fast diffusion coefficient (D*) and fraction volume (fp), slow diffusion coefficient (D) and the conventional apparent diffusion coefficients (ADC) were calculated by fitting the IVIM model to the measured DW signals. The median changes from the baseline to each post-treatment time point for each measurement (ΔADC, ΔD* and Δfp) were calculated. The differences in the median changes between the two groups were compared using the mixed linear regression model by the restricted maximum likelihood method shown as z values. Histopathological analyses including Ki-67, CD31, TUNEL and H&E were conducted in conjunction with the MRI scans. The median percentage changes were compared with the histopathological analyses between the pre- and post-treatment for each measurement. RESULTS Compared with the control group, D* in the treated group decreased significantly (ΔD*treated% = -30%, -34% and -20%, with z = -5.40, -4.18 and -1.95. P = 0.0001, 0.0001 and 0.0244) and fp increased significantly (Δfptreated% = 93%, 113% and 181%, with z = 4.63, 5.52, and 2.12, P = 0.001, 0.0001 and 0.0336) on day 3, 7 and 14, respectively. Increases in ADC in the treated group were higher than those in the control group on days 3 and 14 (z = 2.44 and 2.40, P = 0.0147 and P = 0.0164). CONCLUSION Fast diffusion measurements derived from the bi-exponential IVIM model

  20. [Early Detection of Manganese Intoxication Based on Occupational History and T1-weighted MRI].

    PubMed

    Fukutake, Toshio; Yano, Hajime; Kushida, Ryutaro; Sunada, Yoshihide

    2016-02-01

    Manganese regulates many enzymes and is essential for normal cell function. Chronic manganese intoxication has an insidious and progressive course terminating to atypical parkinsonism with little therapeutic efficacy. For subjects with chronic manganese exposure such as welders, manganese intoxication can be detected early based on the presence of hyperintensity in the globus pallidus on T(1)-weighted MRI and abnormally high urinary excretion of manganese with a chelating agent even in cases of normal serum/urine level of manganese.

  1. Determining Functional Connectivity using fMRI Data with Diffusion-Based Anatomical Weighting

    PubMed Central

    Bowman, F. DuBois; Zhang, Lijun; Derado, Gordana; Chen, Shuo

    2012-01-01

    There is strong interest in investigating both functional connectivity (FC) using functional magnetic resonance imaging (fMRI) and structural connectivity (SC) using diffusion tensor imaging (DTI). There is also emerging evidence of correspondence between functional and structural pathways within many networks (Skudlarski et al., 2008; van den Heuvel et al., 2009; Greicius, et al., 2009), although some regions without SC exhibit strong FC (Honey et al., 2009). These findings suggest that FC may be mediated by (direct or indirect) anatomical connections, offering an opportunity to supplement fMRI data with DTI data when determining FC. We develop a novel statistical method for determining FC, called anatomically-weighted FC (awFC), which combines fMRI and DTI data. Our awFC approach implements a hierarchical clustering algorithm that establishes neural processing networks using a new distance measure consisting of two components, a primary functional component that captures correlations between fMRI signals from different regions and a secondary anatomical weight reflecting probabilities of SC. The awFC approach defaults to conventional unweighted clustering for specific parameter settings. We optimize awFC parameters using a strictly functional criterion, therefore our approach will generally perform at least as well as an unweighted analysis, with respect to intracluster coherence or autocorrelation. AwFC also yields more informative results since it provides structural properties associated with identified functional networks. We apply awFC to two fMRI data sets: resting-state data from 6 healthy subjects and data from 17 subjects performing an auditory task. In these examples, awFC leads to more highly autocorrelated networks than a conventional analysis. We also conduct a simulation study, which demonstrates accurate performance of awFC and confirms that awFC generally yields comparable, if not superior, accuracy relative to a standard approach. PMID:22634220

  2. Perfusion patterns in postictal 99mTc-HMPAO SPECT after coregistration with MRI in patients with mesial temporal lobe epilepsy

    PubMed Central

    Hogan, R; Cook, M.; Binns, D.; Desmond, P.; Kilpatrick, C.; Murrie, V.; Morris, K.

    1997-01-01

    OBJECTIVES—To assess patterns of postictal cerebral blood flow in the mesial temporal lobe by coregistration of postictal 99mTc-HMPAO SPECT with MRI in patients with confirmed mesial temporal lobe epilepsy.
METHODS—Ten postictal and interictal 99mTc-HMPAO SPECT scans were coregistered with MRI in 10 patients with confirmed mesial temporal lobe epilepsy. Volumetric tracings of the hippocampus and amygdala from the MRI were superimposed on the postictal and interictal SPECT. Asymmetries in hippocampal and amygdala SPECT signal were then calculated using the equation:
 % Asymmetry =100 × (right − left) / (right + left)/2.
RESULTS—In the postictal studies, quantitative measurements of amygdala SPECT intensities were greatest on the side of seizure onset in all cases, with an average % asymmetry of 11.1, range 5.2-21.9.Hippocampal intensities were greatest on the side of seizure onset in six studies, with an average % asymmetry of 9.6, range 4.7-12.0.In four scans the hippocampal intensities were less on the side of seizure onset, with an average % asymmetry of 10.2, range 5.7-15.5.There was no localising quantitative pattern in interictal studies.
CONCLUSIONS—Postictal SPECT shows distinctive perfusion patterns when coregistered with MRI, which assist in lateralisation of temporal lobe seizures. Hyperperfusion in the region of the amygdala is more consistently lateralising than hyperperfusion in the region of the hippocampus in postictal studies.

 PMID:9285464

  3. [The actions of diffusion weighted imaging (DWI) and dynamic contrast enhanced MRI in differentiating breast tumors].

    PubMed

    Luo, Yi; Yu, Jianqun; Chen, Dongdong; Xu, Zhongzi; Zeng, Hanjiang

    2013-12-01

    We studied the actions of diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) in differentiating breast tumors. From January 2010 to February 2012, we retrospectively analyzed data of 95 cases with breast tumor pathologically confirmed from DWI and DCE-MRI. We compared the ADC value, time-intensity curve (TIC) and DCE-MRI parameters between breast tumors, and calculated the sensitivity and specificity for differentiating breast tumors. The results were as follows: (1) On DWI, mean ADC value of malignant tumor was lower than that of benign tumor (P < 0.05). For differentiating breast malignant tumors from benign neoplasm, a cut-off ADC value of 1.2 x 10(-3) mm2/s achieved a sensitivity of 74.1% and specificity of 70.3%. (2) On DCE-MRI, early enhancement ratio (EER) value of malignant tumor was higher than that of benign tumor whereas value of time to peak (Tpeak) and maximal enhancement ratio (SImax) were lower than that of benign tumor (all P < 0.05). As for TIC, type II and III were more frequently seen in malignant tumor than in benign tumor whereas type I was more common in benign tumor than in malignant tumor (all P < 0.05). For differentiating breast malignant tumors from benign neoplasm, DCE-MRI obtained a sensitivity of 89.7% and specificity of 70.3%. (3) For differentiating breast malignant tumors from benign neoplasm, ADC value together with TIC obtained a sensitivity of 79.3% and specificity of 78.4%. Malignant or benign breast tumors could have their own unique characteristics on DWI and DCE-MRI. These characteristics might be helpful for differentiating these tumors.

  4. Initial experience of dual-energy lung perfusion CT using a dual-source CT system in children.

    PubMed

    Goo, Hyun Woo

    2010-09-01

    Initial experience of dual-source dual-energy (DE) lung perfusion CT in children is described. In addition to traditional identification of pulmonary emboli, the assessment of lung perfusion is technically feasible with dual-source DE CT in children with acceptable radiation dose. This article describes how to perform dual-source DE lung perfusion CT in children, including the optimization of intravenous injection method and CT dose parameters. How to produce weighted-average CT images for the assessment of pulmonary emboli and colour-coded perfusion maps for the assessment of regional lung perfusion is also detailed. Lung perfusion status can then be evaluated on perfusion maps by means of either qualitative or quantitative analysis. Potential advantages and disadvantages of this emerging CT technique compared to lung perfusion scintigraphy and cardiac MRI are discussed.

  5. Comparison of susceptibility-weighted and perfusion-weighted magnetic resonance imaging in the detection of penumbra in acute ischemic stroke.

    PubMed

    Luo, Song; Yang, Lijuan; Wang, Lijin

    2015-10-01

    To investigate detection of ischemic penumbra in stroke patients with acute cerebral infarction by susceptibility-weighted imaging (SWI) in comparison with perfusion-weighted imaging (PWI). This study included 18 stroke patients with acute infarction who underwent diffusion-weighted imaging (DWI), SWI, PWI, and magnetic resonance angiography (MRA) within 3 days after symptom onset. The Alberta Stroke Program Early CT Score (ASPECTS) was used to evaluate lesions on DWI, SWI, and PWI. DWI-SWI and DWI-PWI mismatches were calculated. The DWI-SWI mismatch was not significantly different from the DWI-mean transit time (MTT) mismatch (P=0.163) in evaluating ischemic penumbra. The susceptibility vessel sign (SVS) in SWI occurred in 11 (61%) of 18 patients with cerebral infarction. Stenosis or occlusion of the affected vessels was identified by MRA in 10 (91%) of the 11 SVS-positive patients. The SVS on SWI was significantly associated with the occurrence of damaged vessels or the presence of thrombus in the affected vessels (P=0.047). DWI-SWI mismatch is a good marker for evaluating ischemic penumbra in stroke patients with cerebral infarction. SWI can detect thrombus in the affected vessels, and may be useful for guiding intra-arterial thrombolytic therapy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Accelerated Dual-contrast First-pass Perfusion MRI of the Mouse Heart: Development and Application to Diet-induced Obese Mice

    PubMed Central

    Naresh, Nivedita K.; Chen, Xiao; Roy, Rene J.; Antkowiak, Patrick F.; Annex, Brian H.; Epstein, Frederick H.

    2014-01-01

    Background Gene-modified mice may be used to elucidate molecular mechanisms underlying abnormal myocardial blood flow (MBF). We sought to develop a quantitative myocardial perfusion imaging technique for mice and to test the hypothesis that myocardial perfusion reserve (MPR) is reduced in a mouse model of diet-induced obesity (DIO). Methods A dual-contrast saturation-recovery sequence with ky-t undersampling and a motion-compensated compressed sensing reconstruction algorithm was developed for first-pass MRI on a small-bore 7T system. Control mice were imaged at rest and with the vasodilators ATL313 and Regadenoson (n=6 each). In addition, we imaged mice fed a high-fat diet (HFD) for 24 weeks. Results In control mice, MBF was 5.7±0.8 ml/g/min at rest and it increased to 11.8±0.6 ml/g/min with ATL313 and to 10.4±0.3 ml/g/min with Regadenoson. In HFD mice we detected normal resting MBF (5.6±0.4 vs. 5.0±0.3 on control diet), low MBF at stress (7.7±0.4 vs. 10.4±0.3 on control diet, p<0.05), and reduced MPR (1.4±0.2 vs. 2.0±0.3 on control diet, p<0.05). Conclusions Accelerated dual-contrast first-pass MRI with motion-compensated compressed sensing provides spatiotemporal resolution suitable for measuring MBF in free-breathing mice, and detected reduced MPR in DIO mice. These techniques may be used to study molecular mechanisms that underlie abnormal myocardial perfusion. PMID:24760707

  7. Organic Nitrate Maintains Bone Marrow Blood Perfusion in Ovariectomized Female Rats: A Dynamic, Contrast-Enhanced Magnetic Resonance Imaging (MRI) Study

    PubMed Central

    Wang, Yi-Xiang J.; Ko, Chun Hay; Griffith, James F.; Deng, Min; Wong, Hing Lok; Gu, Tao; Huang, Yu

    2012-01-01

    This study investigated the effects of nitrate on bone mineral density (BMD) and bone marrow perfusion in ovariectomized (OVX) female rats, and also the effects of nitrate on in vitro osteoblastic activity and osteoclastic differentiation of murine monocyte/macrophage RAW 264.7 cells. Female Sprague–Dawley rats were divided into OVX + nitrate group (isosorbide-5-mononitrate, ISM, 150 mg/kg/ day b.i.d), OVX + vehicle group, and control group. Lumbar spine CT bone densitometry and perfusion MRI were performed on the rats at baseline and week 8 post-OVX. The OVX rats’ BMD decreased by 22.5% ± 5.7% at week 8 (p < 0.001); while the OVX + ISM rats’ BMD decreased by 13.1% ± 2.7% (p < 0.001). The BMD loss difference between the two groups of rats was significant (p = 0.018). The OVX rats’ lumbar vertebral perfusion MRI maximum enhancement (Emax) decreased by 10.3% ± 5.0% at week 8 (p < 0.005), while in OVX + ISM rats, the Emax increased by 5.5% ± 6.9% (p > 0.05). The proliferation of osteoblast-like UMR-106 cells increased significantly with ISM treatment at 0.78 µM to 50 μM. Treatment of UMR-106 cells with ISM also stimulated the BrdU uptake. After the RAW 264.7 cells were co-treated with osteoclastogenesis inducer RANKL and 6.25 μM ~ 100 μM of ISM for 3 days, a trend of dose-dependent increase of osteoclast number was noted. PMID:24300395

  8. Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI.

    PubMed

    Neubauer, Henning; Pabst, Thomas; Dick, Anke; Machann, Wolfram; Evangelista, Laura; Wirth, Clemens; Köstler, Herbert; Hahn, Dietbert; Beer, Meinrad

    2013-01-01

    Small-bowel MRI based on contrast-enhanced T1-weighted sequences has been challenged by diffusion-weighted imaging (DWI) for detection of inflammatory bowel lesions and complications in patients with Crohn disease. To evaluate free-breathing DWI, as compared to contrast-enhanced MRI, in children, adolescents and young adults with Crohn disease. This retrospective study included 33 children and young adults with Crohn disease ages 17 ± 3 years (mean ± standard deviation) and 27 matched controls who underwent small-bowel MRI with contrast-enhanced T1-weighted sequences and DWI at 1.5 T. The detectability of Crohn manifestations was determined. Concurrent colonoscopy as reference was available in two-thirds of the children with Crohn disease. DWI and contrast-enhanced MRI correctly identified 32 and 31 patients, respectively. All 22 small-bowel lesions and all Crohn complications were detected. False-positive findings (two on DWI, one on contrast-enhanced MRI), compared to colonoscopy, were a result of large-bowel lumen collapse. Inflammatory wall thickening was comparable on DWI and contrast-enhanced MRI. DWI was superior to contrast-enhanced MRI for detection of lesions in 27% of the assessed bowel segments and equal to contrast-enhanced MRI in 71% of segments. DWI facilitates fast, accurate and comprehensive workup in Crohn disease without the need for intravenous administration of contrast medium. Contrast-enhanced MRI is superior in terms of spatial resolution and multiplanar acquisition.

  9. Perfusion CT improves diagnostic accuracy for hyperacute ischemic stroke in the 3-hour window: study of 100 patients with diffusion MRI confirmation.

    PubMed

    Lin, Ke; Do, Kinh G; Ong, Phat; Shapiro, Maksim; Babb, James S; Siller, Keith A; Pramanik, Bidyut K

    2009-01-01

    Conventional noncontrast CT (NCCT) is insensitive to hyperacute cerebral infarction in the first 3 h. Our aim was to determine if CT perfusion (CTP) can improve diagnostic accuracy over NCCT for patients presenting with stroke symptoms in the 3-hour window. Consecutive patients presenting to our emergency department with symptoms of ischemic stroke <3 h old and receiving NCCT and CTP as part of their triage evaluation were retrospectively reviewed. Patients with follow-up diffusion-weighted MRI (DWI) <7 days from ictus were included. Two readers rated the NCCT and CTP for evidence of acute infarct and its vascular territory. CTP selectively covered 24 mm of brain centered at the basal ganglia with low relative cerebral blood volume in a region of low cerebral blood flow or elevated time to peak as the operational definition for infarction. A third reader rated all follow-up DWI for acute infarct and its vascular territory as the reference standard. Sensitivity, specificity, and predictive values were calculated. An exact McNemar test and generalized estimating equations from a binary logistic regression model were used to assess the difference in detection rates between modalities. A two-sided p value <0.05 was considered significant. 100 patients were included. Sixty-five (65%) patients had follow-up DWI confirmation of acute infarct. NCCT revealed 17 (26.2%) acute infarcts without false positives. CTP revealed 42 (64.6%) acute infarcts with one false positive. Of the 23 infarcts missed on CTP, 10 (43.5%) were outside the volume of coverage while the remaining 13 (56.5%) were small cortical or lacunar type infarcts (

  10. Evaluation of three inverse problem models to quantify skin microcirculation using diffusion-weighted MRI

    NASA Astrophysics Data System (ADS)

    Cordier, G.; Choi, J.; Raguin, L. G.

    2008-11-01

    Skin microcirculation plays an important role in diseases such as chronic venous insufficiency and diabetes. Magnetic resonance imaging (MRI) can provide quantitative information with a better penetration depth than other noninvasive methods, such as laser Doppler flowmetry or optical coherence tomography. Moreover, successful MRI skin studies have recently been reported. In this article, we investigate three potential inverse models to quantify skin microcirculation using diffusion-weighted MRI (DWI), also known as q-space MRI. The model parameters are estimated based on nonlinear least-squares (NLS). For each of the three models, an optimal DWI sampling scheme is proposed based on D-optimality in order to minimize the size of the confidence region of the NLS estimates and thus the effect of the experimental noise inherent to DWI. The resulting covariance matrices of the NLS estimates are predicted by asymptotic normality and compared to the ones computed by Monte-Carlo simulations. Our numerical results demonstrate the effectiveness of the proposed models and corresponding DWI sampling schemes as compared to conventional approaches.

  11. PCLR: Phase-Constrained Low-Rank Model for Compressive Diffusion-Weighted MRI

    PubMed Central

    Zhang, Kai; Zhou, Weifeng; Hu, Xiaoping

    2015-01-01

    Purpose This work develops a compressive sensing approach for diffusion-weighted (DW) MRI. Methods A phase-constrained low-rank (PCLR) approach was developed using the image coherence across the DW directions for efficient compressive DW MRI, while accounting for drastic phase changes across the DW directions, possibly as a result of eddy current, and rigid and non-rigid motions. In PCLR, a low-resolution phase estimation was used for removing phase inconsistency between DW directions. In our implementation, GRAPPA was incorporated for better phase estimation while allowing higher undersampling factor. An efficient and easy-to-implement image reconstruction algorithm, consisting mainly of partial Fourier update and singular value decomposition, was developed for solving PCLR. Results The error measures based on diffusion-tensor-derived metrics and tractography indicated that PCLR, with its joint reconstruction of all DW images using the image coherence, outperformed the frame-independent reconstruction through zero-padding FFT. Furthermore, using GRAPPA for phase estimation, PCLR readily achieved a 4-fold undersampling. Conclusion The PCLR is developed and demonstrated for compressive DW MRI. A 4-fold reduction in k-space sampling could be readily achieved without substantial degradation of reconstructed images and diffusion tensor measures, making it possible to significantly reduce the data acquisition in DW MRI and/or improve spatial and angular resolutions. PMID:24327553

  12. PCLR: phase-constrained low-rank model for compressive diffusion-weighted MRI.

    PubMed

    Gao, Hao; Li, Longchuan; Zhang, Kai; Zhou, Weifeng; Hu, Xiaoping

    2014-11-01

    This work develops a compressive sensing approach for diffusion-weighted (DW) MRI. A phase-constrained low-rank (PCLR) approach was developed using the image coherence across the DW directions for efficient compressive DW MRI, while accounting for drastic phase changes across the DW directions, possibly as a result of eddy current, and rigid and nonrigid motions. In PCLR, a low-resolution phase estimation was used for removing phase inconsistency between DW directions. In our implementation, GRAPPA (generalized autocalibrating partial parallel acquisition) was incorporated for better phase estimation while allowing higher undersampling factor. An efficient and easy-to-implement image reconstruction algorithm, consisting mainly of partial Fourier update and singular value decomposition, was developed for solving PCLR. The error measures based on diffusion-tensor-derived metrics and tractography indicated that PCLR, with its joint reconstruction of all DW images using the image coherence, outperformed the frame-independent reconstruction through zero-padding FFT. Furthermore, using GRAPPA for phase estimation, PCLR readily achieved a four-fold undersampling. The PCLR is developed and demonstrated for compressive DW MRI. A four-fold reduction in k-space sampling could be readily achieved without substantial degradation of reconstructed images and diffusion tensor measures, making it possible to significantly reduce the data acquisition in DW MRI and/or improve spatial and angular resolutions. Copyright © 2013 Wiley Periodicals, Inc.

  13. SU-F-I-16: Short Breast MRI with High-Resolution T2-Weighted and Dynamic Contrast Enhanced T1-Weighted Images

    SciTech Connect

    Ma, J; Son, J; Arun, B; Hazle, J; Hwang, K; Madewell, J; Yang, W; Dogan, B; Wang, K; Bayram, E

    2016-06-15

    Purpose: To develop and demonstrate a short breast (sb) MRI protocol that acquires both T2-weighted and dynamic contrast-enhanced T1-weighted images in approximately ten minutes. Methods: The sb-MRI protocol consists of two novel pulse sequences. The first is a flexible fast spin-echo triple-echo Dixon (FTED) sequence for high-resolution fat-suppressed T2-weighted imaging, and the second is a 3D fast dual-echo spoiled gradient sequence (FLEX) for volumetric fat-suppressed T1-weighted imaging before and post contrast agent injection. The flexible FTED sequence replaces each single readout during every echo-spacing period of FSE with three fast-switching bipolar readouts to produce three raw images in a single acquisition. These three raw images are then post-processed using a Dixon algorithm to generate separate water-only and fat-only images. The FLEX sequence acquires two echoes using dual-echo readout after each RF excitation and the corresponding images are post-processed using a similar Dixon algorithm to yield water-only and fat-only images. The sb-MRI protocol was implemented on a 3T MRI scanner and used for patients who had undergone concurrent clinical MRI for breast cancer screening. Results: With the same scan parameters (eg, spatial coverage, field of view, spatial and temporal resolution) as the clinical protocol, the total scan-time of the sb-MRI protocol (including the localizer, bilateral T2-weighted, and dynamic contrast-enhanced T1-weighted images) was 11 minutes. In comparison, the clinical breast MRI protocol took 43 minutes. Uniform fat suppression and high image quality were consistently achieved by sb-MRI. Conclusion: We demonstrated a sb-MRI protocol comprising both T2-weighted and dynamic contrast-enhanced T1-weighted images can be performed in approximately ten minutes. The spatial and temporal resolution of the images easily satisfies the current breast MRI accreditation guidelines by the American College of Radiology. The protocol has the

  14. Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: A consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia.

    PubMed

    Alsop, David C; Detre, John A; Golay, Xavier; Günther, Matthias; Hendrikse, Jeroen; Hernandez-Garcia, Luis; Lu, Hanzhang; MacIntosh, Bradley J; Parkes, Laura M; Smits, Marion; van Osch, Matthias J P; Wang, Danny J J; Wong, Eric C; Zaharchuk, Greg

    2015-01-01

    This review provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ASL in Dementia consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this review, we describe the major considerations and trade-offs in implementing an ASL protocol and provide specific recommendations for a standard approach. Our conclusion is that as an optimal default implementation, we recommend pseudo-continuous labeling, background suppression, a segmented three-dimensional readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model.

  15. Jacobian weighted temporal total variation for motion compensated compressed sensing reconstruction of dynamic MRI.

    PubMed

    Royuela-Del-Val, Javier; Cordero-Grande, Lucilio; Simmross-Wattenberg, Federico; Martín-Fernández, Marcos; Alberola-López, Carlos

    2017-03-01

    To eliminate the need of spatial intraframe regularization in a recently reported dynamic MRI compressed-sensing-based reconstruction method with motion compensation and to increase its performance. We propose a new regularization metric based on the introduction of a spatial weighting measure given by the Jacobian of the estimated deformations. It shows convenient discretization properties and, as a byproduct, it also provides a theoretical support to a result reported by others based on an intuitive design. The method has been applied to the reconstruction of both short and long axis views of the heart of four healthy volunteers. Quantitative image quality metrics as well as straightforward visual assessment are reported. Short and long axis reconstructions of cardiac cine MRI sequences have shown superior results than previously reported methods both in terms of quantitative metrics and of visual assessment. Fine details are better preserved due to the lack of additional intraframe regularization, with no significant image artifacts even for an acceleration factor of 12. The proposed Jacobian Weighted temporal Total Variation results in better reconstructions of highly undersampled cardiac cine MRI than previously proposed methods and sets a theoretical ground for forward and backward predictors used elsewhere. Magn Reson Med 77:1208-1215, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  16. T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly.

    PubMed

    Potorac, Iulia; Petrossians, Patrick; Daly, Adrian F; Alexopoulou, Orsalia; Borot, Sophie; Sahnoun-Fathallah, Mona; Castinetti, Frederic; Devuyst, France; Jaffrain-Rea, Marie-Lise; Briet, Claire; Luca, Florina; Lapoirie, Marion; Zoicas, Flavius; Simoneau, Isabelle; Diallo, Alpha M; Muhammad, Ammar; Kelestimur, Fahrettin; Nazzari, Elena; Centeno, Rogelio Garcia; Webb, Susan M; Nunes, Marie-Laure; Hana, Vaclav; Pascal-Vigneron, Véronique; Ilovayskaya, Irena; Nasybullina, Farida; Achir, Samia; Ferone, Diego; Neggers, Sebastian J C M M; Delemer, Brigitte; Petit, Jean-Michel; Schöfl, Christof; Raverot, Gerald; Goichot, Bernard; Rodien, Patrice; Corvilain, Bernard; Brue, Thierry; Schillo, Franck; Tshibanda, Luaba; Maiter, Dominique; Bonneville, Jean-François; Beckers, Albert

    2016-11-01

    GH-secreting pituitary adenomas can be hypo-, iso- or hyper-intense on T2-weighted MRI sequences. We conducted the current multicenter study in a large population of patients with acromegaly to analyze the relationship between T2-weighted signal intensity on diagnostic MRI and hormonal and tumoral responses to somatostatin analogs (SSA) as primary monotherapy. Acromegaly patients receiving primary SSA for at least 3 months were included in the study. Hormonal, clinical and general MRI assessments were performed and assessed centrally. We included 120 patients with acromegaly. At diagnosis, 84, 17 and 19 tumors were T2-hypo-, iso- and hyper-intense, respectively. SSA treatment duration, cumulative and mean monthly doses were similar in the three groups. Patients with T2-hypo-intense adenomas had median SSA-induced decreases in GH and IGF-1 of 88% and 59% respectively, which were significantly greater than the decreases observed in the T2-iso- and hyper-intense groups (P < 0.001). Tumor shrinkage on SSA was also significantly greater in the T2-hypo-intense group (38%) compared with the T2-iso- and hyper-intense groups (8% and 3%, respectively; P < 0.0001). The response to SSA correlated with the calculated T2 intensity: the lower the T2-weighted intensity, the greater the decrease in random GH (P < 0.0001, r = 0.22), IGF-1 (P < 0.0001, r = 0.14) and adenoma volume (P < 0.0001, r = 0.33). The T2-weighted signal intensity of GH-secreting adenomas at diagnosis correlates with hormone reduction and tumor shrinkage in response to primary SSA treatment in acromegaly. This study supports its use as a generally available predictive tool at diagnosis that could help to guide subsequent treatment choices in acromegaly. © 2016 Society for Endocrinology.

  17. Clinical investigation survival prediction in high-grade gliomas by MRI perfusion before and during early stage of RT

    SciTech Connect

    Cao Yue . E-mail: yuecao@med.umich.edu; Tsien, Christina I.; Nagesh, Vijaya; Junck, Larry; Haken, Randall ten; Ross, Brian D.; Chenevert, Thomas L.; Lawrence, Theodore S.

    2006-03-01

    Purpose: To determine whether cerebral blood volume (CBV) and cerebral blood flow can predict the response of high-grade gliomas to radiotherapy (RT) by taking into account spatial heterogeneity and temporal changes in perfusion. Methods and Materials: Twenty-three patients with high-grade gliomas underwent conformal RT, with magnetic resonance imaging perfusion before and at Weeks 1-2 and 3-4 during RT. Tumor perfusion was classified as high, medium, or low. The prognostic values of pre-RT perfusion and the changes during RT for early prediction of tumor response to RT were evaluated. Results: The fractional high-CBV tumor volume before RT and the fluid-attenuated inversion recovery imaging tumor volume were identified as predictors for survival (p = 0.01). Changes in tumor CBV during the early treatment course also predicted for survival. Better survival was predicted by a decrease in the fractional low-CBV tumor volume at Week 1 of RT vs. before RT, a decrease in the fractional high-CBV tumor volume at Week 3 vs. Week 1 of RT, and a smaller pre-RT fluid-attenuated inversion recovery imaging tumor volume (p = 0.01). Conclusion: Early temporal changes during RT in heterogeneous regions of high and low perfusion in gliomas might predict for different physiologic responses to RT. This might also open the opportunity to identify tumor subvolumes that are radioresistant and might benefit from intensified RT.

  18. FAIR exempting separate T (1) measurement (FAIREST): a novel technique for online quantitative perfusion imaging and multi-contrast fMRI.

    PubMed

    Lai, S; Wang, J; Jahng, G H

    2001-01-01

    A new pulse sequence, dubbed FAIR exempting separate T(1) measurement (FAIREST) in which a slice-selective saturation recovery acquisition is added in addition to the standard FAIR (flow-sensitive alternating inversion recovery) scheme, was developed for quantitative perfusion imaging and multi-contrast fMRI. The technique allows for clean separation between and thus simultaneous assessment of BOLD and perfusion effects, whereas quantitative cerebral blood flow (CBF) and tissue T(1) values are monitored online. Online CBF maps were obtained using the FAIREST technique and the measured CBF values were consistent with the off-line CBF maps obtained from using the FAIR technique in combination with a separate sequence for T(1) measurement. Finger tapping activation studies were carried out to demonstrate the applicability of the FAIREST technique in a typical fMRI setting for multi-contrast fMRI. The relative CBF and BOLD changes induced by finger-tapping were 75.1 +/- 18.3 and 1.8 +/- 0.4%, respectively, and the relative oxygen consumption rate change was 2.5 +/- 7.7%. The results from correlation of the T(1) maps with the activation images on a pixel-by-pixel basis show that the mean T(1) value of the CBF activation pixels is close to the T(1) of gray matter while the mean T(1) value of the BOLD activation pixels is close to the T(1) range of blood and cerebrospinal fluid. Copyright 2001 John Wiley & Sons, Ltd.

  19. Limitations and Prospects for Diffusion-Weighted MRI of the Prostate

    PubMed Central

    Bourne, Roger; Panagiotaki, Eleftheria

    2016-01-01

    Diffusion-weighted imaging (DWI) is the most effective component of the modern multi-parametric magnetic resonance imaging (mpMRI) scan for prostate pathology. DWI provides the strongest prediction of cancer volume, and the apparent diffusion coefficient (ADC) correlates moderately with Gleason grade. Notwithstanding the demonstrated cancer assessment value of DWI, the standard measurement and signal analysis methods are based on a model of water diffusion dynamics that is well known to be invalid in human tissue. This review describes the biophysical limitations of the DWI component of the current standard mpMRI protocol and the potential for significantly improved cancer assessment performance based on more sophisticated measurement and signal modeling techniques. PMID:27240408

  20. Use of 3D DCE-MRI for the estimation of renal perfusion and glomerular filtration rate: an intrasubject comparison of FLASH and KWIC with a comprehensive framework for evaluation.

    PubMed

    Eikefjord, Eli; Andersen, Erling; Hodneland, Erlend; Zöllner, Frank; Lundervold, Arvid; Svarstad, Einar; Rørvik, Jarle

    2015-03-01

    OBJECTIVE. The purpose of this article is to compare two 3D dynamic contrast-enhanced (DCE) MRI measurement techniques for MR renography, a radial k-space weighted image contrast (KWIC) sequence and a cartesian FLASH sequence, in terms of intrasubject differences in estimates of renal functional parameters and image quality characteristics. SUBJECTS AND METHODS. Ten healthy volunteers underwent repeated breath-hold KWIC and FLASH sequence examinations with temporal resolutions of 2.5 and 2.8 seconds, respectively. A two-compartment model was used to estimate MRI-derived perfusion parameters and glomerular filtration rate (GFR). The latter was compared with the iohexol GFR and the estimated GFR. Image quality was assessed using a visual grading characteristic analysis of relevant image quality criteria and signal-to-noise ratio calculations. RESULTS. Perfusion estimates from FLASH were closer to literature reference values than were the KWIC sequences. In relation to the iohexol GFR (mean [± SD], 103 ± 11 mL/min/1.73 m(2)), KWIC produced significant underestimations and larger bias in GFR values (mean, 70 ± 30 mL/min/1.73 m(2); bias = -33.2 mL/min/1.73 m(2)) compared with the FLASH GFR (110 ± 29 mL/min/1.73 m(2); bias = 6.4 mL/min/1.73 m(2)). KWIC was statistically significantly (p < 0.005) more impaired by artifacts than was FLASH (AUC = 0.18). The average signal-enhancement ratio (delta ratio) in the cortex was significantly lower for KWIC (delta ratio = 0.99) than for FLASH (delta ratio = 1.40). Other visually graded image quality characteristics and signal-to-noise ratio measurements were not statistically significantly different. CONCLUSION. Using the same postprocessing scheme and pharmacokinetic model, FLASH produced more accurate perfusion and filtration parameters than did KWIC compared with clinical reference methods. Our data suggest an apparent relationship between image quality characteristics and the degree of stability in the numeric model

  1. Detection of electroporation-induced membrane permeabilization states in the brain using diffusion-weighted MRI

    PubMed Central

    Mahmood, Faisal; Hansen, Rasmus H.; Agerholm-Larsen, Birgit; Gissel, Hanne; Ibsen, Per

    2015-01-01

    Background Tissue permeabilization by electroporation (EP) is a promising technique to treat certain cancers. Non-invasive methods for verification of induced permeabilization are important, especially in deep-seated cancers. In this study we evaluated diffusion-weighted magnetic resonance imaging (DW-MRI) as a quantitative method for detecting EP-induced membrane permeabilization of brain tissue using a rat brain model. Material and methods Fifty-four anesthetized Sprague-Dawley male rats were electroporated in the right hemisphere, using different voltage levels to induce no permeabilization (NP), transient membrane permeabilization (TMP), and permanent membrane permeabilization (PMP), respectively. DW-MRI was acquired 5 minutes, 2 hours, 24 hours and 48 hours after EP. Histology was performed for validation of the permeabilization states. Tissue content of water, Na+, K+, Ca2+, and extracellular volume were determined. The Kruskal-Wallis test was used to compare the DW-MRI parameters, apparent diffusion coefficient (ADC) and kurtosis, at different voltage levels. The two-sample Mann- Whitney test with Holm's Bonferroni correction was used to identify pairs of significantly different groups. The study was approved by the Danish Animal Experiments Inspectorate. Results and conclusion Results showed significant difference in the ADC between TMP and PMP at 2 hours (p < 0.001) and 24 hours (p < 0.05) after EP. Kurtosis was significantly increased both at TMP (p < 0.05) and PMP (p < 0.001) 5 minutes after EP, compared to NP. Kurtosis was also significantly higher at 24 hours (p < 0.05) and 48 hours (p < 0.05) at PMP compared to NP. Physiological parameters indicated correlation with the permeabilization states, supporting the DW-MRI findings. We conclude that DW-MRI is capable of detecting EP-induced permeabilization of brain tissue and to some extent of differentiating NP, TMP and PMP using appropriate scan timing. PMID:25591820

  2. Whole-body diffusion-weighted MR image stitching and alignment to anatomical MRI

    NASA Astrophysics Data System (ADS)

    Ceranka, Jakub; Polfliet, Mathias; Lecouvet, Frederic; Michoux, Nicolas; Vandemeulebroucke, Jef

    2017-02-01

    Whole-body diffusion-weighted (WB-DW) MRI in combination with anatomical MRI has shown a great poten- tial in bone and soft tissue tumour detection, evaluation of lymph nodes and treatment response assessment. Because of the vast body coverage, whole-body MRI is acquired in separate stations, which are subsequently combined into a whole-body image. However, inter-station and inter-modality image misalignments can occur due to image distortions and patient motion during acquisition, which may lead to inaccurate representations of patient anatomy and hinder visual assessment. Automated and accurate whole-body image formation and alignment of the multi-modal MRI images is therefore crucial. We investigated several registration approaches for the formation or stitching of the whole-body image stations, followed by a deformable alignment of the multi- modal whole-body images. We compared a pairwise approach, where diffusion-weighted (DW) image stations were sequentially aligned to a reference station (pelvis), to a groupwise approach, where all stations were simultaneously mapped to a common reference space while minimizing the overall transformation. For each, a choice of input images and corresponding metrics was investigated. Performance was evaluated by assessing the quality of the obtained whole-body images, and by verifying the accuracy of the alignment with whole-body anatomical sequences. The groupwise registration approach provided the best compromise between the formation of WB- DW images and multi-modal alignment. The fully automated method was found to be robust, making its use in the clinic feasible.

  3. Intramuscular adipose tissue determined by T1-weighted MRI at 3T primarily reflects extramyocellular lipids.

    PubMed

    Akima, Hiroshi; Hioki, Maya; Yoshiko, Akito; Koike, Teruhiko; Sakakibara, Hisataka; Takahashi, Hideyuki; Oshida, Yoshiharu

    2016-05-01

    The purpose of this study was to assess relationships between intramuscular adipose tissue (IntraMAT) content determined by MRI and intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) determined by (1)H magnetic resonance spectroscopy ((1)H MRS) or echo intensity determined by B-mode ultrasonography of human skeletal muscles. Thirty young and elderly men and women were included. T1-weighted MRI was taken from the right mid-thigh to measure IntraMAT content of the vastus lateralis (VL) and biceps femoris (BF) using a histogram shape-based thresholding technique. IMCL and EMCL were measured from the VL and BF at the right mid-thigh using (1)H MRS. Ultrasonographic images were taken from the VL and BF of the right mid-thigh to measure echo intensity based on gray-scale level for quantitative analysis. There was a significant correlation between IntraMAT content by MRI and EMCL of the VL and BF (VL, r=0.506, P<0.01; BF, r=0.591, P<0.001) and between echo intensity and EMCL of the VL and BF (VL, r=0.485, P<0.05; BF, r=0.648, P<0.01). IntraMAT content was also significantly correlated with echo intensity of the VL and BF (VL, r=0.404, P<0.05; BF, r=0.493, P<0.01). Our study suggests that IntraMAT content determined by T1-weighted MRI at 3T primarily reflects extramyocellular lipids, not intramyocellular lipids, in human skeletal muscles. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug-resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG-PET.

    PubMed

    Sierra-Marcos, A; Carreño, M; Setoain, X; López-Rueda, A; Aparicio, J; Donaire, A; Bargalló, N

    2016-01-01

    Locating the epileptogenic zone (EZ) in patients with neocortical epilepsy presents major challenges. Our aim was to assess the accuracy of arterial spin labeling (ASL), an emerging non-invasive magnetic resonance imaging (MRI) perfusion technique, to locate the EZ in patients with drug-resistant neocortical epilepsy. Twenty-five consecutive patients with neocortical epilepsy referred to our epilepsy unit for pre-surgical evaluation underwent a standardized assessment including video-electroencephalography (EEG) monitoring, structural MRI, subtraction ictal single-photon emission computed tomography co-registered to MRI (SISCOM) and fluorodeoxyglucose positron emission tomography (FDG-PET) studies. An ASL sequence was included in the MRI studies. Areas of hypoperfusion or hyperperfusion on ASL were classified into 15 anatomic-functional cortical regions; these regional cerebral blood flow maps were compared with the EZ determined by the other tests and the strength of concordance was assessed with the kappa coefficient. Of the 25 patients [16 (64%) women; mean age 32.4 (±13.8) years], 18 (72%) had lesions on structural MRI. ASL abnormalities were seen in 15 (60%) patients (nine hypoperfusion, six hyperperfusion). ASL had a very good concordance with FDG-PET (k = 0.84), a good concordance with structural MRI (k = 0.76), a moderate concordance with video-EEG monitoring (k = 0.53) and a fair concordance with SISCOM (k = 0.28). Arterial spin labeling might help to confirm the location and extent of the EZ in the pre-surgical workup of patients with drug-resistant neocortical epilepsy. © 2015 EAN.

  5. Implementation and evaluation of a new workflow for registration and segmentation of pulmonary MRI data for regional lung perfusion assessment.

    PubMed

    Böttger, T; Grunewald, K; Schöbinger, M; Fink, C; Risse, F; Kauczor, H U; Meinzer, H P; Wolf, Ivo

    2007-03-07

    Recently it has been shown that regional lung perfusion can be assessed using time-resolved contrast-enhanced magnetic resonance (MR) imaging. Quantification of the perfusion images has been attempted, based on definition of small regions of interest (ROIs). Use of complete lung segmentations instead of ROIs could possibly increase quantification accuracy. Due to the low signal-to-noise ratio, automatic segmentation algorithms cannot be applied. On the other hand, manual segmentation of the lung tissue is very time consuming and can become inaccurate, as the borders of the lung to adjacent tissues are not always clearly visible. We propose a new workflow for semi-automatic segmentation of the lung from additionally acquired morphological HASTE MR images. First the lung is delineated semi-automatically in the HASTE image. Next the HASTE image is automatically registered with the perfusion images. Finally, the transformation resulting from the registration is used to align the lung segmentation from the morphological dataset with the perfusion images. We evaluated rigid, affine and locally elastic transformations, suitable optimizers and different implementations of mutual information (MI) metrics to determine the best possible registration algorithm. We located the shortcomings of the registration procedure and under which conditions automatic registration will succeed or fail. Segmentation results were evaluated using overlap and distance measures. Integration of the new workflow reduces the time needed for post-processing of the data, simplifies the perfusion quantification and reduces interobserver variability in the segmentation process. In addition, the matched morphological data set can be used to identify morphologic changes as the source for the perfusion abnormalities.

  6. A new look at the fetus: thick-slab T2-weighted sequences in fetal MRI.

    PubMed

    Brugger, Peter C; Mittermayer, Christoph; Prayer, Daniela

    2006-02-01

    Although magnetic resonance imaging (MRI) of the fetus is considered an established adjunct to fetal ultrasound, stacks of images alone cannot provide an overall impression of the fetus. The present study evaluates the use of thick-slab T2-weighted MR images to obtain a three-dimensional impression of the fetus using MRI. A thick-slab T2-weighted sequence was added to the routine protocol in 100 fetal MRIs obtained for various indications (19th to 37th gestational weeks) on a 1.5 T magnet using a five-element phased-array surface coil. Slice thickness adapted to fetal size and uterine geometry varied between 25 and 50mm, as did the field of view (250-350 mm). Acquisition of one image took less than 1s. The pictorial essay shows that these images visualize fetal anatomy in a more comprehensive way than is possible with a series of 3-4mm thick slices. These thick-slab images facilitate the assessment of the whole fetus, fetal proportions, surface structures, and extremities. Fetal pathology may be captured in one image. Thick-slab T2-weighted images provide additional information that cannot be gathered from a series of images and are considered a valuable adjunct to conventional 2D MR images.

  7. Diffusion weighted MRI by spatiotemporal encoding: Analytical description and in vivo validations

    NASA Astrophysics Data System (ADS)

    Solomon, Eddy; Shemesh, Noam; Frydman, Lucio

    2013-07-01

    Diffusion-weighted (DW) MRI is a powerful modality for studying microstructure in normal and pathological tissues. The accuracy derived from DW MRI depends on the acquisition of quality images, and on a precise assessment of the b-values involved. Conventional DW MRI tends to be of limited use in regions suffering from large magnetic field or chemical shift heterogeneities, which severely distort the MR images. In this study we propose novel sequences based on SPatio-temporal ENcoding (SPEN), which overcome such shortcomings owing to SPEN's inherent robustness to offsets. SPEN, however, relies on the simultaneous application of gradients and radiofrequency-swept pulses, which may impart different diffusion weightings along the spatial axes. These will be further complicated in DW measurements by the diffusion-sensitizing gradients, and will in general lead to complex, spatially-dependent b-values. This study presents a formalism for analyzing these diffusion-weighted SPEN (dSPEN) data, which takes into account the concomitant effects of adiabatic pulses, of the imaging as well as diffusion gradients, and of the cross-terms between them. These analytical b-values derivations are subject to experimental validations in phantom systems and ex vivo spinal cords. Excellent agreement is found between the theoretical predictions and these dSPEN experiments. The ensuing methodology is then demonstrated by in vivo mapping of diffusion in human breast - organs where conventional k-space DW acquisition methods are challenged by both field and chemical shift heterogeneities. These studies demonstrate the increased robustness of dSPEN vis-à-vis comparable DW echo planar imaging, and demonstrate the value of this new methodology for medium- or high-field diffusion measurements in heterogeneous systems.

  8. Fast T2*-Weighted MRI of the Prostate at 3 Tesla

    PubMed Central

    Hardman, Rulon L.; El-Merhi, Fadi; Jung, Adam J.; Ware, Steve; Thompson, Ian M.; Friel, Harry T.; Peng, Qi

    2011-01-01

    Purpose To describe a rapid T2*-weighted (T2*W), three-dimensional (3D) echo planar imaging (EPI) sequence and its application in mapping local magnetic susceptibility variations in 3 Tesla (T) prostate MRI. To compare the sensitivity of T2*W EPI with routinely used T1-weighted turbo-spin echo sequence (T1W TSE) in detecting hemorrhage and the implications on sequences sensitive to field inhomogeneities such as MR spectroscopy (MRS). Materials and Methods B0 susceptibility weighted mapping was performed using a 3D EPI sequence featuring a 2D spatial excitation pulse with gradients of spiral k-space trajectory. A series of 11 subjects were imaged using 3T MRI and combination endorectal (ER) and six-channel phased array cardiac coils. T1W TSE and T2*W EPI sequences were analyzed quantitatively for hemorrhage contrast. Point resolved spectroscopy (PRESS MRS) was performed and data quality was analyzed. Results Two types of susceptibility variation were identified: hemorrhagic and nonhemorrhagic T2*W-positive areas. Post-biopsy hemorrhage lesions showed on average five times greater contrast on the T2*W images than T1W TSE images. Six nonhemorrhage regions of severe susceptibility artifact were apparent on the T2*W images that were not seen on standard T1W or T2W images. All nonhemorrhagic susceptibility artifact regions demonstrated compromised spectral quality on 3D MRS. Conclusion The fast T2*W EPI sequence identifies hemorrhagic and nonhemorrhagic areas of susceptibility variation that may be helpful in prostate MRI planning at 3.0T. PMID:21448956

  9. Arterial Spin-Labeling MRI Can Identify the Presence and Intensity of Collateral Perfusion in Patients With Moyamoya Disease

    PubMed Central

    Zaharchuk, Greg; Do, Huy M.; Marks, Michael P.; Rosenberg, Jarrett; Moseley, Michael E.; Steinberg, Gary K.

    2011-01-01

    Background and Purpose Determining the presence and adequacy of collateral blood flow is important in cerebrovascular disease. Therefore, we explored whether a noninvasive imaging modality, arterial spin labeling (ASL) MRI, could be used to detect the presence and intensity of collateral flow using digital subtraction angiography (DSA) and stable xenon CT cerebral blood flow as gold standards for collaterals and cerebral blood flow, respectively. Methods ASL and DSA were obtained within 4 days of each other in 18 patients with Moyamoya disease. Two neurointerventionalists scored DSA images using a collateral grading scale in regions of interest corresponding to ASPECTS methodology. Two neuroradiologists similarly scored ASL images based on the presence of arterial transit artifact. Agreement of ASL and DSA consensus scores was determined, including kappa statistics. In 15 patients, additional quantitative xenon CT cerebral blood flow measurements were performed and compared with collateral grades. Results The agreement between ASL and DSA consensus readings was moderate to strong, with a weighted kappa value of 0.58 (95% confidence interval, 0.52–0.64), but there was better agreement between readers for ASL compared with DSA. Sensitivity and specificity for identifying collaterals with ASL were 0.83 (95% confidence interval, 0.77–0.88) and 0.82 (95% confidence interval, 0.76–0.87), respectively. Xenon CT cerebral blood flow increased with increasing DSA and ASL collateral grade (P<0.05). Conclusions ASL can noninvasively predict the presence and intensity of collateral flow in patients with Moyamoya disease using DSA as a gold standard. Further study of other cerebrovascular diseases, including acute ischemic stroke, is warranted. PMID:21799169

  10. Severe Posterior Reversible Encephalopathy in Pheochromocytoma: Importance of Susceptibility-Weighted MRI

    PubMed Central

    Alkan, Alpay; Aralasmak, Ayse; Kocakoc, Ercan

    2013-01-01

    Pheochromocytoma is a rare cause of hypertension in children. Hypertension is one of the common reasons of posterior reversible encephalopathy. Intracerebral hemorrhage is a serious and unexpected complication of hypertensive encephalopathy due to pheochromocytoma, and very rarely seen in the childhood. Intracerebral hemorrhages should be searched if there are hypertensive reversible signal changes on the brain. Susceptibility weighted imaging (SWI) is a more sensitive method than conventional MRI when demonstrating cerebral microhemorrhagic foci. This is the first report of SWI findings on intracerebral hemorrhages in basal ganglia, brain stem and periventricular white matter due to hypertensive encephalopathy in a child with pheochromocytoma. PMID:24043985

  11. Multimodal MRI of experimental stroke

    PubMed Central

    Duong, Timothy Q

    2014-01-01

    Stroke is the fourth leading cause of death and the leading cause of long-term disability in the United States. Brain imaging data from experimental stroke models and stroke patients have shown that there is often a gradual progression of potentially reversible ischemic injury toward infarction. Reestablishing tissue perfusion and/or treating with neuroprotective drugs in a timely fashion are expected to salvage some ischemic tissues. Diffusion-weighted imaging based on magnetic resonance imaging (MRI) in which contrast is based on water motion can detect ischemic injury within minutes after onsets, whereas computed tomography and other imaging modalities fail to detect stroke injury for at least a few hours. Along with quantitative perfusion imaging, the perfusion-diffusion mismatch which approximates the ischemic penumbra could be imaged non-invasively. This review describes recent progresses in the development and application of multimodal MRI and image analysis techniques to study ischemic tissue at risk in experimental stroke in rats. PMID:24323751

  12. Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Cardiac MRI

    PubMed Central

    Chung, Hyun Woo; Hwang, Hweung Kon; So, Young; Yi, Jeong Geun; Lee, Eun Jeong

    2017-01-01

    Objective To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. Materials and Methods We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. Results For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. Conclusion The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR. PMID:28458600

  13. Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Cardiac MRI.

    PubMed

    Chung, Hyun Woo; Ko, Sung Min; Hwang, Hweung Kon; So, Young; Yi, Jeong Geun; Lee, Eun Jeong

    2017-01-01

    To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.

  14. Whole-body MRI including diffusion-weighted MRI compared with 5-HTP PET/CT in the detection of neuroendocrine tumors

    PubMed Central

    Carlbom, Lina; Caballero-Corbalán, José; Granberg, Dan; Sörensen, Jens; Eriksson, Barbro; Ahlström, Håkan

    2017-01-01

    Aim We wanted to explore if whole-body magnetic resonance imaging (MRI) including diffusion-weighted (DW) and liver-specific contrast agent-enhanced imaging could be valuable in lesion detection of neuroendocrine tumors (NET). [11C]-5-Hydroxytryptophan positron emission tomography/computed tomography (5-HTP PET/CT) was used for comparison. Materials and methods Twenty-one patients with NET were investigated with whole-body MRI, including DW imaging (DWI) and contrast-enhanced imaging of the liver, and whole-body 5-HTP PET/CT. Seven additional patients underwent upper abdomen MRI including DWI, liver-specific contrast agent-enhanced imaging, and 5-HTP PET/CT. Results There was a patient-based concordance of 61% and a lesion-based concordance of 53% between the modalities. MRI showed good concordance with PET in detecting bone metastases but was less sensitive in detecting metastases in mediastinal lymph nodes. MRI detected more liver metastases than 5-HTP PET/CT. Conclusion Whole-body MRI with DWI did not detect all NET lesions found with whole-body 5-HTP PET/CT. Our findings indicate that MRI of the liver including liver-specific contrast agent-enhanced imaging and DWI could be a useful complement to whole-body 5-HTP PET/CT. PMID:27894208

  15. Whole-body MRI including diffusion-weighted MRI compared with 5-HTP PET/CT in the detection of neuroendocrine tumors.

    PubMed

    Carlbom, Lina; Caballero-Corbalán, José; Granberg, Dan; Sörensen, Jens; Eriksson, Barbro; Ahlström, Håkan

    2017-03-01

    We wanted to explore if whole-body magnetic resonance imaging (MRI) including diffusion-weighted (DW) and liver-specific contrast agent-enhanced imaging could be valuable in lesion detection of neuroendocrine tumors (NET). [11C]-5-Hydroxytryptophan positron emission tomography/computed tomography (5-HTP PET/CT) was used for comparison. Twenty-one patients with NET were investigated with whole-body MRI, including DW imaging (DWI) and contrast-enhanced imaging of the liver, and whole-body 5-HTP PET/CT. Seven additional patients underwent upper abdomen MRI including DWI, liver-specific contrast agent-enhanced imaging, and 5-HTP PET/CT. There was a patient-based concordance of 61% and a lesion-based concordance of 53% between the modalities. MRI showed good concordance with PET in detecting bone metastases but was less sensitive in detecting metastases in mediastinal lymph nodes. MRI detected more liver metastases than 5-HTP PET/CT. Whole-body MRI with DWI did not detect all NET lesions found with whole-body 5-HTP PET/CT. Our findings indicate that MRI of the liver including liver-specific contrast agent-enhanced imaging and DWI could be a useful complement to whole-body 5-HTP PET/CT.

  16. Diffusion-weighted whole-body MRI for evaluation of early response in multiple myeloma.

    PubMed

    Lacognata, C; Crimì, F; Guolo, A; Varin, C; De March, E; Vio, S; Ponzoni, A; Barilà, G; Lico, A; Branca, A; De Biasi, E; Gherlinzoni, F; Scapin, V; Bissoli, E; Berno, T; Zambello, R

    2017-10-01

    To evaluate the modifications of the apparent diffusion coefficient (ADC) in myelomatous lesions before and after induction treatment and the correlation with patient response to therapy according to International Myeloma Working Group (IMWG) criteria. A homogeneous group of 18 patients with a diagnosis of symptomatic multiple myeloma who underwent whole-body MRI with diffusion-weighted imaging (DWI-MRI) before and after bortezomib-based induction chemotherapy were evaluated prospectively. Quantitative analysis of ADC maps of myelomatous lesions was performed with the following pattern types: focal pattern, diffuse pattern (moderate and severe), and "salt and pepper" pattern. Lesions were evaluated by quantitative image analysis including measurement of the mean ADC in three measurements. Imaging results were compared to laboratory results as the clinical reference standard. A statistically significant increase in ADC values were found in the lesions of patients that responded to treatment. Interestingly, focal lesions showed a strongly significant increase in ADC values in responders, whereas no significant variation in ADC value in non-focal lesions (diffuse pattern and "salt and peppers" pattern) between responders and non-responders group was demonstrated. DWI-MRI could provide additional quantitative information useful in monitoring early therapy response according to ADC changes of focal lesions. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Fast and accurate simulations of diffusion-weighted MRI signals for the evaluation of acquisition sequences

    NASA Astrophysics Data System (ADS)

    Rensonnet, Gaëtan; Jacobs, Damien; Macq, Benoît.; Taquet, Maxime

    2016-03-01

    Diffusion-weighted magnetic resonance imaging (DW-MRI) is a powerful tool to probe the diffusion of water through tissues. Through the application of magnetic gradients of appropriate direction, intensity and duration constituting the acquisition parameters, information can be retrieved about the underlying microstructural organization of the brain. In this context, an important and open question is to determine an optimal sequence of such acquisition parameters for a specific purpose. The use of simulated DW-MRI data for a given microstructural configuration provides a convenient and efficient way to address this problem. We first present a novel hybrid method for the synthetic simulation of DW-MRI signals that combines analytic expressions in simple geometries such as spheres and cylinders and Monte Carlo (MC) simulations elsewhere. Our hybrid method remains valid for any acquisition parameters and provides identical levels of accuracy with a computational time that is 90% shorter than that required by MC simulations for commonly-encountered microstructural configurations. We apply our novel simulation technique to estimate the radius of axons under various noise levels with different acquisition protocols commonly used in the literature. The results of our comparison suggest that protocols favoring a large number of gradient intensities such as a Cube and Sphere (CUSP) imaging provide more accurate radius estimation than conventional single-shell HARDI acquisitions for an identical acquisition time.

  18. Attentional Bias to Food Images Associated With Elevated Weight and Future Weight Gain: An fMRI Study

    PubMed Central

    Yokum, Sonja; Ng, Janet; Stice, Eric

    2014-01-01

    Behavioral studies reveal that obese vs. lean individuals show attentional bias to food stimuli. Yet research has not investigated this relation using objective brain imaging or tested whether attentional bias to food stimuli predicts future weight gain, which are important aims given the prominence of food cues in the environment. We used functional magnetic resonance imaging (fMRI) to examine attentional bias in 35 adolescent girls ranging from lean to obese using an attention network task involving food and neutral stimuli. BMI correlated positively with speed of behavioral response to both appetizing food stimuli and unappetizing food stimuli, but not to neutral stimuli. BMI correlated positively with activation in brain regions related to attention and food reward, including the anterior insula/frontal operculum, lateral orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (vlPFC), and superior parietal lobe, during initial orientation to food cues. BMI also correlated with greater activation in the anterior insula/frontal operculum during reallocation of attention to appetizing food images and with weaker activation in the medial OFC and ventral pallidum during reallocation of attention to unappetizing food images. Greater lateral OFC activation during initial orientation to appetizing food cues predicted future increases in BMI. Results indicate that overweight is related to greater attentional bias to food cues and that youth who show elevated reward circuitry responsivity during food cue exposure are at increased risk for weight gain. PMID:21681221

  19. Comparison of computed tomography perfusion and magnetic resonance imaging perfusion-diffusion mismatch in ischemic stroke.

    PubMed

    Campbell, Bruce C V; Christensen, Søren; Levi, Christopher R; Desmond, Patricia M; Donnan, Geoffrey A; Davis, Stephen M; Parsons, Mark W

    2012-10-01

    Perfusion imaging has the potential to select patients most likely to respond to thrombolysis. We tested the correspondence of computed tomography perfusion (CTP)-derived mismatch with contemporaneous perfusion-diffusion magnetic resonance imaging (MRI). Acute ischemic stroke patients 3 to 6 hours after onset had CTP and perfusion-diffusion MRI within 1 hour, before thrombolysis. Relative cerebral blood flow (relCBF) and time to peak of the deconvolved tissue residue function (Tmax) were calculated. The diffusion lesion (diffusion-weighted imaging) was registered to the CTP slabs and manually outlined to its maximal visual extent. Volumetric accuracy of CT-relCBF infarct core (compared with diffusion-weighted imaging) was tested. To reduce false-positive low CBF regions, relCBF core was restricted to voxels within a relative time-to-peak (relTTP) >4 seconds for lesion region of interest. The MR-Tmax >6 seconds perfusion lesion was automatically segmented and registered to CTP. Receiver-operating characteristic analysis determined the optimal CT-Tmax threshold to match MR-Tmax >6 seconds. Agreement of these CT parameters with MR perfusion-diffusion mismatch in coregistered slabs was assessed (mismatch ratio >1.2, absolute mismatch >10 mL, infarct core <70 mL). In analysis of 49 patients (mean onset to CT, 213 minutes; mean CT to MR, 31 minutes), constraining relCBF <31% within the automated relTTP perfusion lesion region of interest reduced the median magnitude of volumetric error (vs diffusion-weighted imaging) from 47.5 mL to 15.8 mL (P<0.001). The optimal CT-Tmax threshold to match MR-Tmax >6 seconds was 6.2 seconds (95% confidence interval, 5.6-7.3 seconds; sensitivity, 91%; specificity, 70%; area under the curve, 0.87). Using CT-Tmax >6 seconds "penumbra" and relTTP-constrained relCBF "core," CT-based and MRI-based mismatch status was concordant in 90% (kappa=0.80). Quantitative CTP mismatch classification using relCBF and Tmax is similar to perfusion

  20. Hybrid Multidimensional T2 and Diffusion-Weighted MRI for Prostate Cancer Detection

    PubMed Central

    Wang, Shiyang; Peng, Yahui; Medved, Milica; Yousuf, Ambereen N.; Ivancevic, Marko K.; Karademir, Ibrahim; Jiang, Yulei; Antic, Tatjana; Sammet, Steffen; Oto, Aytekin; Karczmar, Gregory S.

    2014-01-01

    Purpose To study the dependence of apparent diffusion coefficient (ADC) and T2 on echo time (TE) and b-value, respectively, in normal prostate and prostate cancer, using two-dimensional MRI sampling, referred to as “hybrid multidimensional imaging.” Materials and Methods The study included 10 patients with biopsy-proven prostate cancer who underwent 3 Tesla prostate MRI. Diffusion-weighted MRI (DWI) data were acquired at b = 0, 750, and 1500 s/mm2. For each b-value, data were acquired at TEs of 47, 75, and 100 ms. ADC and T2 were measured as a function of b-value and TE, respectively, in 15 cancer and 10 normal regions of interest (ROIs). The Friedman test was used to test the significance of changes in ADC as a function of TE and of T2 as a function of b-value. Results In normal prostate ROIs, the ADC at TE of 47 ms is significantly smaller than ADC at TE of 100 ms (P = 0.0003) and T2 at b-value of 0 s/mm2 is significantly longer than T2 at b-value of 1500 s/mm2 (P = 0.001). In cancer ROIs, average ADC and T2 values do not change as a function of TE and b-value, respectively. However, in many cancer pixels, there are large decreases in the ADC as a function of TE and large increases in T2 as a function of b-value. Cancers are more conspicuous in ADC maps at longer TEs. Conclusion Parameters derived from hybrid imaging that depend on coupled/associated values of ADC and T2 may improve the accuracy of MRI in diagnosing prostate cancer. PMID:23908146

  1. Detection of Lesions Underlying Intractable Epilepsy on T1-Weighted MRI as an Outlier Detection Problem

    PubMed Central

    El Azami, Meriem; Hammers, Alexander; Jung, Julien; Costes, Nicolas; Bouet, Romain; Lartizien, Carole

    2016-01-01

    Pattern recognition methods, such as computer aided diagnosis (CAD) systems, can help clinicians in their diagnosis by marking abnormal regions in an image. We propose a machine learning system based on a one-class support vector machine (OC-SVM) classifier for the detection of abnormalities in magnetic resonance images (MRI) applied to patients with intractable epilepsy. The system learns the features associated with healthy control subjects, allowing a voxelwise assessment of the deviation of a test subject pattern from the learned patterns. While any number of various features can be chosen and learned, here we focus on two texture parameters capturing image patterns associated with epileptogenic lesions on T1-weighted brain MRI e.g. heterotopia and blurred junction between the grey and white matter. The CAD output consists of patient specific 3D maps locating clusters of suspicious voxels ranked by size and degree of deviation from control patterns. System performance was evaluated using realistic simulations of challenging detection tasks as well as clinical data of 77 healthy control subjects and of eleven patients (13 lesions). It was compared to that of a mass univariate statistical parametric mapping (SPM) single subject analysis based on the same set of features. For all simulations, OC-SVM yielded significantly higher values of the area under the ROC curve (AUC) and higher sensitivity at low false positive rate. For the clinical data, both OC-SVM and SPM successfully detected 100% of the lesions in the MRI positive cases (3/13). For the MRI negative cases (10/13), OC-SVM detected 7/10 lesions and SPM analysis detected 5/10 lesions. In all experiments, OC-SVM produced fewer false positive detections than SPM. OC-SVM may be a versatile system for unbiased lesion detection. PMID:27603778

  2. Detection of Lesions Underlying Intractable Epilepsy on T1-Weighted MRI as an Outlier Detection Problem.

    PubMed

    El Azami, Meriem; Hammers, Alexander; Jung, Julien; Costes, Nicolas; Bouet, Romain; Lartizien, Carole

    2016-01-01

    Pattern recognition methods, such as computer aided diagnosis (CAD) systems, can help clinicians in their diagnosis by marking abnormal regions in an image. We propose a machine learning system based on a one-class support vector machine (OC-SVM) classifier for the detection of abnormalities in magnetic resonance images (MRI) applied to patients with intractable epilepsy. The system learns the features associated with healthy control subjects, allowing a voxelwise assessment of the deviation of a test subject pattern from the learned patterns. While any number of various features can be chosen and learned, here we focus on two texture parameters capturing image patterns associated with epileptogenic lesions on T1-weighted brain MRI e.g. heterotopia and blurred junction between the grey and white matter. The CAD output consists of patient specific 3D maps locating clusters of suspicious voxels ranked by size and degree of deviation from control patterns. System performance was evaluated using realistic simulations of challenging detection tasks as well as clinical data of 77 healthy control subjects and of eleven patients (13 lesions). It was compared to that of a mass univariate statistical parametric mapping (SPM) single subject analysis based on the same set of features. For all simulations, OC-SVM yielded significantly higher values of the area under the ROC curve (AUC) and higher sensitivity at low false positive rate. For the clinical data, both OC-SVM and SPM successfully detected 100% of the lesions in the MRI positive cases (3/13). For the MRI negative cases (10/13), OC-SVM detected 7/10 lesions and SPM analysis detected 5/10 lesions. In all experiments, OC-SVM produced fewer false positive detections than SPM. OC-SVM may be a versatile system for unbiased lesion detection.

  3. Role of diffusion-weighted MRI in acute pyelonephritis: a prospective study.

    PubMed

    Rathod, Santosh B; Kumbhar, Sachin S; Nanivadekar, Avinash; Aman, Kumar

    2015-02-01

    Imaging is vital in diagnosis of complicated pyelonephritis and has been traditionally performed by computed tomography (CT). However, CT with contrast agents cannot be performed in patients with renal failure. Diffusion-weighted (DW) magnetic resonance imaging (MRI) has the potential to overcome this disadvantage. To prospectively evaluate the accuracy of quantitative apparent diffusion coefficient (ADC) values to differentiate nephritis from renal abscesses in patients with pyelonephritis. Forty-two patients with clinical and laboratory diagnosis of pyelonephritis underwent CT and DW MRI examinations. Diffusion images were obtained by using a non-breath-hold, single-shot echo-planar sequence with b values of 0, 600, and 1000 s/mm(2). Circular regions of interest were places on areas of nephritis, normal renal parenchyma, and renal abscesses as localized by CT and DW MRI images to obtain the ADC values of each of these regions. The ADC values of these three different tissue types were statistically compared using the one-way analysis of variance test for statistical significance. A P value <0.05 was considered to be statistically significant. For the diagnosis of pyelonephritis, DW MRI had a higher sensitivity of 95.3% as compared to that of non-contrast CT (66.7%) and contrast-enhanced CT (88.1%). Areas of nephritis had significantly lower ADC values (P < 0.001) than the normal renal cortical parenchyma. Also, renal abscesses had significantly lower ADC values (P < 0.001) than areas of nephritis. However, CT is more useful for the diagnosis of renal calculi and emphysematous pyelonephritis. ADC values derived from the diffusion sequence have significantly lower values in renal abscesses than in areas of nephritis. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Proceedings of the State-of-the-Art Symposium on Diagnostic and Interventional Radiology of the Spine, Antwerp, September 7, 2002 (Part two). Upright, weight-bearing, dynamic-kinetic MRI of the spine: pMRI/kMRI.

    PubMed

    Jinkins, J Randy; Dworkin, Jay

    2003-01-01

    To review the general clinical utility of the first dedicated magnetic resonance imaging (MRI) unit enabling upright, weight-bearing positional evaluation of the spinal column (pMRI) during various dynamic-kinetic maneuvers (kMRI) in patients with degenerative conditions of the spine. This study consisted of a prospective non-statistical analysis of cervical or lumbar imaging examinations. All studies were performed on a recently introduced whole body MRI system (Stand-Up MRI, Fonar Corp, Melville, NY). The system operates at 0.6T using an electromagnet with a horizontal field, transverse to the longitudinal axis of the patient's body. Depending upon spinal level, all examinations were acquired with either a cervical or lumbar solenoidal radiofrequency receiver coil. This unit was configured with a top-front open design, incorporating a patient-scanning table with tilt, translation and elevation functions. The unique motorized patient handling system developed for the scanner allowed for vertical (upright, weight bearing) and horizontal (recumbent) positioning of all patients. The top-open construction also allowed dynamic-kinetic flexion and extension maneuvers of the spine. Patterns of bony and soft tissue change occurring among recumbent (rMRI) and upright neutral positions (pMRI), and dynamic-kinetic acquisitions (kMRI) were sought. Depending on the specific underlying pathologic degenerative condition, significant alterations observed on pMRI and kMRI that were either more or less pronounced than on rMRI included: fluctuating anterior and posterior disc herniations, hypermobile spinal instability, central spinal canal and spinal neural foramen stenosis and general sagittal spinal contour changes. No patient suffered from feelings of claustrophobia that resulted in termination of the examination. To conclude, the potential relative beneficial aspects of upright, weight-bearing (pMRI), dynamic-kinetic (kMRI) spinal imaging on this system over that of recumbent

  5. The Application of Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging in the Diagnosis and Therapy of Acute Cerebral Infarction

    PubMed Central

    Li, Enzhong; Tian, Jie; Chen, Jian; Wang, Huifang; Dai, Jianping

    2006-01-01

    Diffusion- and perfusion-weighted magnetic resonance imaging (DWI and PWI) was applied for stroke diagnose in 120 acute (< 48 h) ischemic stroke patients. At hyperacute (< 6 h) stage, it is difficult to find out the infarction zone in conventional T1 or T2 image, but it is easy in DWI, apparent diffusion coefficient (ADC) map; when at 3–6-hour stage it is also easy in PWI, cerebral blood flow (CBF) map, cerebral blood volume (CBV) map, and mean transit time (MTT) map; at acute (6–48 h) stage, DWI or PWI is more sensitive than conventional T1 or T2 image too. Combining DWI with ADC, acute and chronic infarction can be distinguished. Besides, penumbra which should be developed in meaning was used as an indication or to evaluate the therapeutic efficacy. There were two cases (< 1.5 h) that broke the model of penumbra because abnormity was found in DWI but not that in PWI, finally they recovered without any sequela. PMID:23165020

  6. Automated segmentation of multifocal basal ganglia T2*-weighted MRI hypointensities

    PubMed Central

    Glatz, Andreas; Bastin, Mark E.; Kiker, Alexander J.; Deary, Ian J.; Wardlaw, Joanna M.; Valdés Hernández, Maria C.

    2015-01-01

    Multifocal basal ganglia T2*-weighted (T2*w) hypointensities, which are believed to arise mainly from vascular mineralization, were recently proposed as a novel MRI biomarker for small vessel disease and ageing. These T2*w hypointensities are typically segmented semi-automatically, which is time consuming, associated with a high intra-rater variability and low inter-rater agreement. To address these limitations, we developed a fully automated, unsupervised segmentation method for basal ganglia T2*w hypointensities. This method requires conventional, co-registered T2*w and T1-weighted (T1w) volumes, as well as region-of-interest (ROI) masks for the basal ganglia and adjacent internal capsule generated automatically from T1w MRI. The basal ganglia T2*w hypointensities were then segmented with thresholds derived with an adaptive outlier detection method from respective bivariate T2*w/T1w intensity distributions in each ROI. Artefacts were reduced by filtering connected components in the initial masks based on their standardised T2*w intensity variance. The segmentation method was validated using a custom-built phantom containing mineral deposit models, i.e. gel beads doped with 3 different contrast agents in 7 different concentrations, as well as with MRI data from 98 community-dwelling older subjects in their seventies with a wide range of basal ganglia T2*w hypointensities. The method produced basal ganglia T2*w hypointensity masks that were in substantial volumetric and spatial agreement with those generated by an experienced rater (Jaccard index = 0.62 ± 0.40). These promising results suggest that this method may have use in automatic segmentation of basal ganglia T2*w hypointensities in studies of small vessel disease and ageing. PMID:25451469

  7. Computational Fluid Dynamics Simulations of Contrast Agent Bolus Dispersion in a Coronary Bifurcation: Impact on MRI-Based Quantification of Myocardial Perfusion

    PubMed Central

    Schmidt, Regine; Graafen, Dirk; Weber, Stefan; Schreiber, Laura M.

    2013-01-01

    Contrast-enhanced first-pass magnetic resonance imaging (MRI) in combination with a tracer kinetic model, for example, MMID4, can be used to determine myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). Typically, the arterial input function (AIF) required for this methodology is estimated from the left ventricle (LV). Dispersion of the contrast agent bolus might occur between the LV and the myocardial tissue. Negligence of bolus dispersion could cause an error in MBF determination. The aim of this study was to investigate the influence of bolus dispersion in a simplified coronary bifurcation geometry including one healthy and one stenotic branch on the quantification of MBF and MPR. Computational fluid dynamics (CFD) simulations were combined with MMID4. Different inlet boundary conditions describing pulsatile and constant flows for rest and hyperemia and differing outflow conditions have been investigated. In the bifurcation region, the increase of the dispersion was smaller than inside the straight vessels. A systematic underestimation of MBF values up to −16.1% for pulsatile flow and an overestimation of MPR up to 7.5% were found. It was shown that, under the conditions considered in this study, bolus dispersion can significantly influence the results of quantitative myocardial MR-perfusion measurements. PMID:23533541

  8. Diffusion Weighted MRI and MRS to Differentiate Radiation Necrosis and Recurrent Disease in Gliomas

    NASA Astrophysics Data System (ADS)

    Ewell, Lars

    2006-03-01

    A difficulty encountered in the diagnosis of patients with gliomas is the differentiation between recurrent disease and Radiation Induced Necrosis (RIN). Both can appear as ‘enhancing lesions’ on a typical T2 weighted MRI scan. Magnetic Resonance Spectroscopy (MRS) and Diffusion Weighted MRI (DWMRI) have the potential to be helpful regarding this differentiation. MRS has the ability to measure the concentration of brain metabolites, such as Choline, Creatin and N- Acetyl Aspartate, the ratios of which have been shown to discriminate between RIN and recurrent disease. DWMRI has been linked via a rise in the Apparent Diffusion Coefficient (ADC) to successful treatment of disease. Using both of these complimentary non-invasive imaging modalities, we intend to initiate an imaging protocol whereby we will study how best to combine metabolite ratios and ADC values to obtain the most useful information in the least amount of scan time. We will look for correlations over time between ADC values, and MRS, among different sized voxels.

  9. Computer-aided detection of prostate cancer in T2-weighted MRI within the peripheral zone

    NASA Astrophysics Data System (ADS)

    Rampun, Andrik; Zheng, Ling; Malcolm, Paul; Tiddeman, Bernie; Zwiggelaar, Reyer

    2016-07-01

    In this paper we propose a prostate cancer computer-aided diagnosis (CAD) system and suggest a set of discriminant texture descriptors extracted from T2-weighted MRI data which can be used as a good basis for a multimodality system. For this purpose, 215 texture descriptors were extracted and eleven different classifiers were employed to achieve the best possible results. The proposed method was tested based on 418 T2-weighted MR images taken from 45 patients and evaluated using 9-fold cross validation with five patients in each fold. The results demonstrated comparable results to existing CAD systems using multimodality MRI. We achieved an area under the receiver operating curve (A z ) values equal to 90.0%+/- 7.6% , 89.5%+/- 8.9% , 87.9%+/- 9.3% and 87.4%+/- 9.2% for Bayesian networks, ADTree, random forest and multilayer perceptron classifiers, respectively, while a meta-voting classifier using average probability as a combination rule achieved 92.7%+/- 7.4% .

  10. [Effect of vibration caused by time-varying magnetic fields on diffusion-weighted MRI].

    PubMed

    Ogura, Akio; Maeda, Fumie; Miyai, Akira; Hayashi, Kohji; Hongoh, Takaharu

    2006-04-20

    Diffusion-weighted images (DWIs) with high b-factor in the body are often used to detect and diagnose cancer at MRI. The echo planar imaging (EPI) sequence and high motion probing gradient pulse are used at diffusion weighted imaging, causing high table vibration. The purpose of this study was to assess whether the diffusion signal and apparent diffusion coefficient (ADC) values are influenced by this vibration because of time-varying magnetic fields. Two DWIs were compared. In one, phantoms were fixed on the MRI unit's table transmitting the vibration. In the other, phantoms were supported in air, in the absence of vibration. The phantoms called "solution phantoms" were made from agarose of a particular density. The phantoms called "jelly phantoms" were made from agarose that was heated. The diffusion signal and ADC value of each image were compared. The results showed that the signal of DWI units using the solution phantom was not affected by vibration. However, the signal of DWI and ADC were increased in the low-density jelly phantom as a result of vibration, causing the jelly phantom to vibrate. The DWIs of vibrating regions such as the breast maybe be subject to error. A countermeasure seems to be to support the region adequately.

  11. Acute caffeine administration impact on working memory-related brain activation and functional connectivity in the elderly: a BOLD and perfusion MRI study.

    PubMed

    Haller, S; Rodriguez, C; Moser, D; Toma, S; Hofmeister, J; Sinanaj, I; Van De Ville, D; Giannakopoulos, P; Lovblad, K-O

    2013-10-10

    In young individuals, caffeine-mediated blockade of adenosine receptors and vasoconstriction has direct repercussions on task-related activations, changes in functional connectivity, as well as global vascular effects. To date, no study has explored the effect of caffeine on brain activation patterns during highly demanding cognitive tasks in the elderly. This prospective, placebo-controlled crossover design comprises 24 healthy elderly individuals (mean age 68.8 ± 4.0 years, 17 females) performing a 2-back working memory (WM) task in functional magnetic resonance imaging (fMRI). Analyses include complimentary assessment of task-related activations (general linear model, GLM), functional connectivity (tensorial independent component analysis, TICA), and baseline perfusion (arterial spin labeling). Despite a reduction in whole-brain global perfusion (-22.7%), caffeine-enhanced task-related GLM activation in a local and distributed network is most pronounced in the bilateral striatum and to a lesser degree in the right middle and inferior frontal gyrus, bilateral insula, left superior and inferior parietal lobule as well as in the cerebellum bilaterally. TICA was significantly enhanced (+8.2%) in caffeine versus placebo in a distributed and task-relevant network including the pre-frontal cortex, the supplementary motor area, the ventral premotor cortex and the parietal cortex as well as the occipital cortex (visual stimuli) and basal ganglia. The inverse comparison of placebo versus caffeine had no significant difference. Activation strength of the task-relevant-network component correlated with response accuracy for caffeine yet not for placebo, indicating a selective cognitive effect of caffeine. The present findings suggest that acute caffeine intake enhances WM-related brain activation as well as functional connectivity of blood oxygen level-dependent fMRI in elderly individuals.

  12. Comparison of TTP and Tmax estimation techniques in perfusion-weighted MR datasets for tissue-at-risk definition

    NASA Astrophysics Data System (ADS)

    Forkert, Nils Daniel; Kaesemann, Philipp; Fiehler, Jens; Thomalla, Götz

    2012-03-01

    Acute stroke is a major cause for death and disability among adults in the western hemisphere. Time-resolved perfusion-weighted (PWI) and diffusion-weighted (DWI) MR datasets are typically used for the estimation of tissue-at-risk, which is an important variable for acute stroke therapy decision-making. Although several parameters, which can be estimated based on PWI concentration curves, have been proposed for tissue-at-risk definition in the past, the time-to-peak (TTP) or time-to-max (Tmax) parameter is used most frequently in recent trials. Unfortunately, there is no clear consensus which method should be used for estimation of Tmax or TTP maps. Consequently, tissue-at-risk estimations and following treatment decision might vary considerably with the method used. In this work, 5 PWI datasets of acute stroke patients were used to calculate TTP or Tmax maps using 10 different estimation techniques. The resulting maps were segmented using a typical threshold of +4s and the corresponding PWI-lesions were calculated. The first results suggest that the TTP or Tmax method used has a major impact on the resulting tissue-at-risk volume. Numerically, the calculated volumes differed up to a factor of 3. In general, the deconvolution-based Tmax techniques estimate the ischemic penumbra rather smaller compared to direct TTP based techniques. In conclusion, the comparison of different methods for TTP or Tmax estimation revealed high variations regarding the resulting tissue-at-risk volume, which might lead to different therapy decisions. Therefore, a consensus how TTP or Tmax maps should be calculated seems necessary.

  13. Predictive values of diffusion-weighted imaging and perfusion-weighted imaging in evaluating the efficacy of transcatheter arterial chemoembolization for hepatocellular carcinoma

    PubMed Central

    Lin, Min; Tian, Man-Man; Zhang, Wei-Ping; Xu, Li; Jin, Ping

    2016-01-01

    This study explored the predictive values of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in evaluating the efficacy of transcatheter arterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC). A total of 118 HCC patients treated with TACE were selected from April 2013 to November 2015. T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI), DWI, and PWI were performed on all patients before and after TACE. Efficacy was evaluated according to modified Response Evaluation Criteria in Solid Tumors 1.1. Receiver operating characteristic curve was used to evaluate the diagnostic power of quantitative DWI and PWI parameters in evaluating the efficacy of TACE for HCC patients. Among the 118 HCC patients, there were 17 cases (14.4%) with complete response, 50 cases (42.4%) with partial response, 28 cases (23.7%) with stable disease, and 23 cases (19.5%) with progressive disease. There were 67 patients in the effective group (complete response + partial response) and 51 patients in the ineffective group (stable disease + progressive disease). Before TACE, there were significant differences in maximum tumor diameter (MTD), apparent diffusion coefficient (ADC), slow ADC (Dslow), fast ADC (Dfast), transfer constant of vessel at the maximum level (Ktrans), and rate constant of backflux (Kep) between the effective and ineffective groups (all P<0.05). After TACE, the effective group exhibited lower MTD, Dfast, and Kep and higher ADC and Dslow than the ineffective group (all P<0.05). Tumor regression rate negatively correlated with MTD, Ktrans, Kep, and Dfast but positively correlated with ADC and Dslow. Receiver operating characteristic curve analysis suggested that the area under the curve of ADC, Dslow, Dfast, Ktrans, and Kep were 0.869, 0.833, 0.812, 0.802, and 0.809, respectively. In conclusion, these results suggest that quantitative DWI and PWI parameters might be useful in evaluating the efficacy of TACE in the treatment of

  14. Towards higher sensitivity and stability of axon diameter estimation with diffusion-weighted MRI.

    PubMed

    Sepehrband, Farshid; Alexander, Daniel C; Kurniawan, Nyoman D; Reutens, David C; Yang, Zhengyi

    2016-03-01

    Diffusion-weighted MRI is an important tool for in vivo and non-invasive axon morphometry. The ActiveAx technique utilises an optimised acquisition protocol to infer orientationally invariant indices of axon diameter and density by fitting a model of white matter to the acquired data. In this study, we investigated the factors that influence the sensitivity to small-diameter axons, namely the gradient strength of the acquisition protocol and the model fitting routine. Diffusion-weighted ex. vivo images of the mouse brain were acquired using 16.4-T MRI with high (Gmax of 300 mT/m) and ultra-high (Gmax of 1350 mT/m) gradient strength acquisitions. The estimated axon diameter indices of the mid-sagittal corpus callosum were validated using electron microscopy. In addition, a dictionary-based fitting routine was employed and evaluated. Axon diameter indices were closer to electron microscopy measures when higher gradient strengths were employed. Despite the improvement, estimated axon diameter indices (a lower bound of ~ 1.8 μm) remained higher than the measurements obtained using electron microscopy (~1.2 μm). We further observed that limitations of pulsed gradient spin echo (PGSE) acquisition sequences and axonal dispersion could also influence the sensitivity with which axon diameter indices could be estimated. Our results highlight the influence of acquisition protocol, tissue model and model fitting, in addition to gradient strength, on advanced microstructural diffusion-weighted imaging techniques. © 2016 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd. © 2016 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.

  15. Differentiating locally recurrent rectal cancer from scar tissue: Value of diffusion-weighted MRI.

    PubMed

    Grosu, Sergio; Schäfer, Arnd-Oliver; Baumann, Tobias; Manegold, Philipp; Langer, Mathias; Gerstmair, Axel

    2016-07-01

    To determine a cut-off apparent diffusion coefficient (ADC) value distinguishing local recurrence from scar tissue in patients with rectal cancer treated with complete surgical tumour removal. 72 patients were retrospectively included. Patients underwent 1.5T MRI including multiplanar T2-weighted turbo-spin-echo sequences (TSE) and axial single-shot epi-diffusion-weighted sequences (EPSE). Two independent observers measured mean tumour and scar tissue ADCs by manually drawing regions of interest (ROIs). The t-test and ROC analysis were used for comparison and determining an optimal discrimination threshold. As reference standard histopathological results were used in 23 patients (32%) and clinical follow-up in 49 patients (68%). Recurrent rectal cancer was found in 30 patients (4 female, 26 male, median age 63.13 years) and treatment related changes such as scar tissue in 42 patients (11 female, 31 male, median age 63.67 years). The mean ADC value of tumour recurrence was 1.02×10(-3)mm(2)/s (0.63-1.44×10(-3)mm(2)/s) and of scar tissue 1.77×10(-3)mm(2)/s (1.11-2.41×10(-3)mm(2)/s) showing a statistically significant difference (p<0.001). The cut-off ADC value was 1.34×10(-3)mm(2)/s with a sensitivity, specificity, and accuracy of 93%, 91%, and 92% respectively. Diffusion weighted MRI allows for the differentiation of tumour recurrence from scar tissue after surgical resection of rectal cancer. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Modeling diffusion-weighted MRI as a spatially variant Gaussian mixture: Application to image denoising.

    PubMed

    Gonzalez, Juan Eugenio Iglesias; Thompson, Paul M; Zhao, Aishan; Tu, Zhuowen

    2011-07-01

    This work describes a spatially variant mixture model constrained by a Markov random field to model high angular resolution diffusion imaging (HARDI) data. Mixture models suit HARDI well because the attenuation by diffusion is inherently a mixture. The goal is to create a general model that can be used in different applications. This study focuses on image denoising and segmentation (primarily the former). HARDI signal attenuation data are used to train a Gaussian mixture model in which the mean vectors and covariance matrices are assumed to be independent of spatial locations, whereas the mixture weights are allowed to vary at different lattice positions. Spatial smoothness of the data is ensured by imposing a Markov random field prior on the mixture weights. The model is trained in an unsupervised fashion using the expectation maximization algorithm. The number of mixture components is determined using the minimum message length criterion from information theory. Once the model has been trained, it can be fitted to a noisy diffusion MRI volume by maximizing the posterior probability of the underlying noiseless data in a Bayesian framework, recovering a denoised version of the image. Moreover, the fitted probability maps of the mixture components can be used as features for posterior image segmentation. The model-based denoising algorithm proposed here was compared on real data with three other approaches that are commonly used in the literature: Gaussian filtering, anisotropic diffusion, and Rician-adapted nonlocal means. The comparison shows that, at low signal-to-noise ratio, when these methods falter, our algorithm considerably outperforms them. When tractography is performed on the model-fitted data rather than on the noisy measurements, the quality of the output improves substantially. Finally, ventricle and caudate nucleus segmentation experiments also show the potential usefulness of the mixture probability maps for classification tasks. The presented

  17. Modeling diffusion-weighted MRI as a spatially variant Gaussian mixture: Application to image denoising

    PubMed Central

    Gonzalez, Juan Eugenio Iglesias; Thompson, Paul M.; Zhao, Aishan; Tu, Zhuowen

    2011-01-01

    Purpose: This work describes a spatially variant mixture model constrained by a Markov random field to model high angular resolution diffusion imaging (HARDI) data. Mixture models suit HARDI well because the attenuation by diffusion is inherently a mixture. The goal is to create a general model that can be used in different applications. This study focuses on image denoising and segmentation (primarily the former). Methods: HARDI signal attenuation data are used to train a Gaussian mixture model in which the mean vectors and covariance matrices are assumed to be independent of spatial locations, whereas the mixture weights are allowed to vary at different lattice positions. Spatial smoothness of the data is ensured by imposing a Markov random field prior on the mixture weights. The model is trained in an unsupervised fashion using the expectation maximization algorithm. The number of mixture components is determined using the minimum message length criterion from information theory. Once the model has been trained, it can be fitted to a noisy diffusion MRI volume by maximizing the posterior probability of the underlying noiseless data in a Bayesian framework, recovering a denoised version of the image. Moreover, the fitted probability maps of the mixture components can be used as features for posterior image segmentation. Results: The model-based denoising algorithm proposed here was compared on real data with three other approaches that are commonly used in the literature: Gaussian filtering, anisotropic diffusion, and Rician-adapted nonlocal means. The comparison shows that, at low signal-to-noise ratio, when these methods falter, our algorithm considerably outperforms them. When tractography is performed on the model-fitted data rather than on the noisy measurements, the quality of the output improves substantially. Finally, ventricle and caudate nucleus segmentation experiments also show the potential usefulness of the mixture probability maps for

  18. T1-weighted dual-echo MRI for fat quantification in pediatric nonalcoholic fatty liver disease

    PubMed Central

    Pacifico, Lucia; Martino, Michele Di; Catalano, Carlo; Panebianco, Valeria; Bezzi, Mario; Anania, Caterina; Chiesa, Claudio

    2011-01-01

    AIM: To determine in obese children with nonalcoholic fatty liver disease (NAFLD) the accuracy of magnetic resonance imaging (MRI) in assessing liver fat concentration. METHODS: A case-control study was performed. Cases were 25 obese children with biopsy-proven NAFLD. Controls were 25 obese children matched for age and gender, without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin. Hepatic fat fraction (HFF) by MRI was obtained using a modification of the Dixon method. RESULTS: HFF ranged from 2% to 44% [mean, 19.0% (95% CI, 15.1-27.4)] in children with NAFLD, while in the controls this value ranged from 0.08% to 4.69% [2.0% (1.3-2.5), P < 0.0001]. HFF was highly correlated with histological steatosis (r = 0.883, P < 0.0001) in the NAFLD children. According to the histological grade of steatosis, the mean HFF was 8.7% (95% CI, 6.0-11.6) for mild, 21.6% (15.3-27.0) for moderate, and 39.7% (34.4-45.0) for severe fatty liver infiltration. With a cutoff of 4.85%, HFF had a sensitivity of 95.8% for the diagnosis of histological steatosis ≥ 5%. All control children had HFF lower than 4.85%; thus, the specificity was 100%. After 12 mo, children with weight loss displayed a significant decrease in HFF. CONCLUSION: MRI is an accurate methodology for liver fat quantification in pediatric NAFLD. PMID:21799647

  19. Quantitative diffusion weighted MRI: a functional biomarker of nodal disease in Hodgkin lymphoma?

    PubMed

    Punwani, Shonit; Prakash, Vineet; Bainbridge, Alan; Taylor, Stuart A; Bandula, Steven; Olsen, Oystein E; Hain, Sharon F; Shankar, Ananth; Daw, Stephen; Humphries, Paul

    2010-01-01

    This study explores the relationship between MRI Apparent Diffusion Coefficient (ADC) and PET Standardized Uptake Value (SUV) measurements in pediatric Hodgkin lymphoma. Sixteen patients (mean age 15.4 yrs, 8 male) with proven Hodgkin lymphoma were recruited and staged using PET-CT, anatomical MRI and additional 1.5T diffusion weighted imaging (DWI) prior to and following chemotherapy. Pre-treatment lymph nodes and anatomically paired post-treatment residual tissue located on MRI were matched to the corresponding PET-CT. Region of interest (ROI) analysis was used to extract quantitative measurements. Mean ADC (ADC(mean)) and maximum SUV (SUV(max)) were recorded and correlation assessed using Spearman statistics. Fifty-three ROIs were sampled. Pre- and post-treatment ADC(mean) ranged from 0.77 × 10(−3) to 1.79 × 10(−3) (median 1.15 × 10(−3) mm(2)s(−1)) and 1.08 × 10(−3) to 3.18 ×10(−3) (median 1.88 × 10(−3) mm(2)s(−1)), and SUV(max) from 2.60 to 25.4 (median 8.85 mg/ml) and 1.00 to 3.50 mg/ml (median 1.90 mg/ml). Median post-treatment ADC(mean) was higher, and median SUV(max) lower than pretreatment values (p < 0.0001). There was an inverse correlation between pre-treatment ADC(mean) and SUV(max) (p = 0.005) and between fractional change ([post-treatment – pre-treatment]/pre-treatment)in ADC(mean) and SUV(max) (p =0.002). Our results confirm a strong reciprocal relationship between nodal ADC(mean) and SUV(max) in Hodgkin lymphoma;supporting the potential application of quantitative DWI as a functional biomarker of disease.

  20. Diffusion-Weighted MRI of Malignant versus Benign Portal Vein Thrombosis

    PubMed Central

    Ahn, Jhii-Hyun; Cho, Eun-Suk; Chung, Jae-Joon; Kim, Joo Hee; Kim, Ki Whang

    2016-01-01

    Objective To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. Materials and Methods The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40–85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm2 at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. Results The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10-3 mm2/sec and 0.92 ± 0.25 × 10-3 mm2/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10-3 mm2/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9–98.9%) and a sensitivity of 22.2% (95% CI: 6.4–47.6%), respectively. Conclusion Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently. PMID:27390544

  1. Temporal and spatial profile of brain diffusion-weighted MRI after cardiac arrest

    PubMed Central

    Mlynash, M.; Campbell, D.M.; Leproust, E.M.; Fischbein, N.J.; Bammer, R.; Eyngorn, I.; Hsia, A.W.; Moseley, M.; Wijman, C.A.C.

    2010-01-01

    Background and Purpose Diffusion-weighted MRI (DWI) of the brain is a promising technique to help predict functional outcome in comatose survivors of cardiac arrest. We aimed to evaluate prospectively the temporal-spatial profile of brain apparent diffusion coefficient (ADC) changes in comatose survivors during the first 8 days after cardiac arrest. Methods ADC values were measured by two independent and blinded investigators in predefined brain regions in 18 good and 15 poor outcome patients with 38 brain MRIs, and compared with 14 normal controls. The same brain regions were also assessed qualitatively by two other independent and blinded investigators. Results In poor outcome patients, cortical structures, in particular the occipital and temporal lobes, and the putamen exhibited the most profound ADC reductions, which were noted as early as 1.5 days and reached nadir between 3 to 5 days after the arrest. Conversely, when compared to normal controls, good outcome patients exhibited increased diffusivity, in particular in the hippocampus, temporal and occipital lobes, and corona radiata. By the qualitative MRI readings, one or more cortical gray matter structures were read as moderately-to-severely abnormal in all poor outcome patients imaged beyond 54 hours after the arrest, but not in the three patients imaged earlier. Conclusions Brain DWI changes in comatose post-cardiac arrest survivors in the first week after the arrest are region- and time-dependent and differ between good and poor outcome patients. With the increasing use of MRI in this context, it is important to be aware of these relationships. PMID:20595666

  2. Prognostic relevance of apparent diffusion coefficient obtained by diffusion-weighted MRI in pancreatic cancer.

    PubMed

    Kurosawa, Jo; Tawada, Katsunobu; Mikata, Rintaro; Ishihara, Takeshi; Tsuyuguchi, Toshio; Saito, Masayoshi; Shimofusa, Ryota; Yoshitomi, Hideyuki; Ohtsuka, Masayuki; Miyazaki, Masaru; Yokosuka, Osamu

    2015-12-01

    Diffusion-weighted magnetic resonance imaging (DW-MRI) is utilized as a method of oncologic imaging for predicting treatment outcomes. This study explored the role of DW-MRI in the treatment of patients with resected pancreatic cancer by comparing apparent diffusion coefficient (ADC) values with clinicopathological findings and survival rates. Records of 54 patients in whom DW-MRI at 1.5T was performed (b values: 0 and 1000 mm(2) /s) before macroscopically curative resection were analyzed. ADC values were then calculated and compared with clinicopathological factors including age, gender, serum carcinoembryonic antigen levels, serum carbohydrate antigen 19-9 levels, lymph node metastasis, primary tumoral location, size, differentiation, resectability, and pT stage. A survival analysis of clinicopathological factors and ADC values was performed using the Kaplan-Meier method, and the results were evaluated with the log-rank test. Prognostic significance was assessed using the Cox proportional hazard model. Significant associations were found between tumor differentiation and ADC values (P = 0.001). In a univariate analysis of overall survival, tumor differentiation (P = 0.037) and ADC values (P = 0.002) were identified as significant prognostic factors. However, age, gender, carcinoembryonic antigen levels, carbohydrate antigen 19-9 levels, lymph node metastasis, primary tumoral location, size, resectability, and pT stage were not associated with overall survival. In a multivariate analysis of overall survival, only ADC values were identified as significant prognostic factors (hazard ratio 2.293, 95% confidence interval 1.147-4.585, P = 0.019). ADC values were found to be associated with prognosis in patients with resected pancreatic cancer. © 2015 Wiley Periodicals, Inc.

  3. All-Systolic Non-ECG-gated Myocardial Perfusion MRI: Feasibility of Multi-Slice Continuous First-Pass Imaging

    PubMed Central

    Sharif, Behzad; Arsanjani, Reza; Dharmakumar, Rohan; Bairey Merz, C. Noel; Berman, Daniel S.; Li, Debiao

    2015-01-01

    Purpose To develop and test the feasibility of a new method for non-ECG-gated first-pass perfusion (FPP) cardiac MR capable of imaging multiple short-axis slices at the same systolic cardiac phase. Methods A magnetization-driven pulse sequence was developed for non-ECG-gated FPP imaging without saturation-recovery preparation using continuous slice-interleaved radial sampling. The image reconstruction method, dubbed TRACE, employed self-gating based on reconstruction of a real-time image-based navigator combined with reference-constrained compressed sensing. Data from ischemic animal studies (n=5) was used in a simulation framework to evaluate temporal fidelity. Healthy subjects (n=5) were studied using both the proposed and conventional method to compare the myocardial contrast-to-noise ratio (CNR). Patients (n=2) underwent adenosine stress studies using the proposed method. Results Temporal fidelity of the developed method was shown to be sufficient at high heart-rates. The healthy volunteers studies demonstrated normal perfusion and no artifacts. Compared to the conventional scheme, myocardial CNR for the proposed method was slightly higher (8.6±0.6 vs. 8.0±0.7). Patient studies showed stress-induced perfusion defects consistent with invasive angiography. Conclusions The presented methods and results demonstrate feasibility of the proposed approach for high-resolution non-ECG-gated FPP imaging and indicate its potential for achieving desirable image quality (high CNR, no dark-rim artifacts) with a 3-slice spatial coverage, all imaged at the same systolic phase. PMID:26052843

  4. Crossed cerebellar diaschisis after stroke identified noninvasively with cerebral blood flow-weighted arterial spin labeling MRI

    PubMed Central

    Strother, Megan K.; Buckingham, Cari; Faraco, Carlos C.; Arteaga, Daniel; Lu, Pengcheng; Xu, Yaomin; Donahue, Manus J.

    2015-01-01

    Background and Purpose Crossed cerebellar diaschisis (CCD) is most commonly investigated using hemodynamic PET and SPECT imaging. However, noninvasive MRI offers advantages of improved spatial resolution, allowing hemodynamic changes to be compared directly with structural findings and without concerns related to ionizing radiation exposure. The aim of this study was to evaluate relationships between CCD identified from cerebral blood flow (CBF)-weighted arterial spin labeling (ASL) MRI with cerebrovascular reactivity (CVR)-weighted blood oxygenation level dependent (BOLD) MRI, Wallerian degeneration, clinical motor impairment, and corticospinal tract involvement. Methods Subjects (n=74) enrolled in an ongoing observational stroke trial underwent CBF-weighted ASL and hypercapnic CVR-weighted BOLD MRI. Hemispheric asymmetry indices for basal cerebellar CBF, cerebellar CVR, and cerebral peduncular area were compared between subjects with unilateral supratentorial infarcts (n=18) and control subjects without infarcts (n=16). CCD required (1) supratentorial infarct and (2) asymmetric cerebellar CBF (>95% confidence interval relative to controls). Results In CCD subjects (n=9), CVR (p=0.04) and cerebral peduncular area (p < 0.01) were significantly asymmetric compared to controls. Compared to infarct subjects not meeting CCD criteria (n=9), CCD subjects had no difference in corticospinal tract location for infarct (p=1.0) or motor impairment (p=0.08). Conclusions CCD correlated with cerebellar CVR asymmetry and Wallerian degeneration. These findings suggest that noninvasive MRI may be a useful alternative to PET or SPECT to study structural correlates and clinical consequences of CCD following supratentorial stroke. PMID:26724658

  5. Impairments in Brain Perfusion, Metabolites, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients: An Integrated MRI Study

    PubMed Central

    Wang, Tao

    2017-01-01

    Carotid artery stenosis without transient ischemic attack (TIA) or stroke is considered as “asymptomatic.” However, recent studies have demonstrated that these asymptomatic carotid artery stenosis (aCAS) patients had cognitive impairment in tests of executive function, psychomotor speed, and memory, indicating that “asymptomatic” carotid stenosis may not be truly asymptomatic. In this study, when 19 aCAS patients compared with 24 healthy controls, aCAS patients showed significantly poorer performance on global cognition, memory, and executive function. By utilizing an integrated MRI including pulsed arterial spin labeling (pASL) MRI, Proton MR Spectroscopy (MRS), and resting-state functional MRI (R-fMRI), we also found that aCAS patients suffered decreased cerebral blood flow (CBF) mainly in the Left Frontal Gyrus and had decreased NAA/Cr ratio in the left hippocampus and decreased connectivity to the posterior cingulate cortex (PCC) in the anterior part of default mode network (DMN). PMID:28255464

  6. Comparison of CT perfusion summary maps to early diffusion-weighted images in suspected acute middle cerebral artery stroke.

    PubMed

    Benson, John; Payabvash, Seyedmehdi; Salazar, Pascal; Jagadeesan, Bharathi; Palmer, Christopher S; Truwit, Charles L; McKinney, Alexander M

    2015-04-01

    To assess the accuracy and reliability of one vendor's (Vital Images, Toshiba Medical, Minnetonka, MN) automated CT perfusion (CTP) summary maps in identification and volume estimation of infarcted tissue in patients with acute middle cerebral artery (MCA) distribution infarcts. From 1085 CTP examinations over 5.5 years, 43 diffusion-weighted imaging (DWI)-positive patients were included who underwent both CTP and DWI <12 h after symptom onset, with another 43 age-matched patients as controls (DWI-negative). Automated delay-corrected postprocessing software (DC-SVD) generated both infarct "core only" and "core+penumbra" CTP summary maps. Three reviewers independently tabulated Alberta Stroke Program Early CT scores (ASPECTS) of both CTP summary maps and coregistered DWI. Of 86 included patients, 36 had DWI infarct volumes ≤70 ml, 7 had volumes >70 ml, and 43 were negative; the automated CTP "core only" map correctly classified each as >70 ml or ≤70 ml, while the "core+penumbra" map misclassified 4 as >70 ml. There were strong correlations between DWI volume with both summary map-based volumes: "core only" (r=0.93), and "core+penumbra" (r=0.77) (both p<0.0001). Agreement between ASPECTS scores of infarct core on DWI with summary maps was 0.65-0.74 for "core only" map, and 0.61-0.65 for "core+penumbra" (both p<0.0001). Using DWI-based ASPECTS scores as the standard, the accuracy of the CTP-based maps were 79.1-86.0% for the "core only" map, and 83.7-88.4% for "core+penumbra." Automated CTP summary maps appear to be relatively accurate in both the detection of acute MCA distribution infarcts, and the discrimination of volumes using a 70 ml threshold. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Susceptibility-weighted MRI of extrapyramidal brain structures in Parkinsonian disorders

    PubMed Central

    Schneider, Eva; Ng, Kia-Min; Yeoh, Chooi-Sum; Rumpel, Helmut; Fook-Chong, Stephanie; Li, Hui-Hua; Tan, Eng-King; Chan, Ling-Ling

    2016-01-01

    Abstract Susceptibility-weighted MRI (SWI) is sensitive to T2∗ effects and mineralization. We investigated differences in the extrapyramidal brain structures on SWI between Parkinson disease (PD) and postural instability gait disorder (PIGD) patients and correlated the SWI values with the degree of gait dysfunction. Forty patients diagnosed with PD and PIGD underwent 3 Tesla magnetic resonance imaging (MRI) brain study. An SWI sequence (TE/TR/FA 20/33/15) was used. Ten regions of interest were placed in the midbrain and basal ganglia by 2 independent raters blinded to subject data and quantitatively evaluated. The inter-rater reliability between the raters was excellent (interclass correlation coefficient >0.8). The SWI intensity values in all regions were on average lower in PIGD than in PD patients, with the lowest results found in globus pallidus. Multivariate analysis showed a lower SWI hypointensity in the putamen and globus pallidus in PIGD compared with PD patients, with a similar trend for the other basal ganglia nuclei. Pearson correlation analysis showed a statistically significant positive correlation between SWI putaminal hypointensity and the Tinetti total score (r = 0.39, P = 0.01) in both PD and PIGD. SWI putaminal hypointensity may be a useful imaging marker in prospective evaluation for clinical progression for Parkinsonian disorders. PMID:27367979

  8. Amide proton transfer-weighted MRI detection of traumatic brain injury in rats.

    PubMed

    Zhang, Hong; Wang, Wenzhu; Jiang, Shanshan; Zhang, Yi; Heo, Hye-Young; Wang, Xianlong; Peng, Yun; Wang, Jian; Zhou, Jinyuan

    2017-01-01

    The purpose of this study was to explore the capability and uniqueness of amide proton transfer-weighted (APTw) imaging in the detection of primary and secondary injury after controlled cortical impact (CCI)-induced traumatic brain injury (TBI) in rats. Eleven adult rats had craniotomy plus CCI surgery under isoflurane anesthesia. Multi-parameter MRI data were acquired at 4.7 T, at eight time points (1, 6 h, and 1, 2, 3, 7, 14, and 28 days after TBI). At one and six hours post-injury, average APTw signal intensities decreased significantly in the impacted and peri-lesional areas due to tissue acidosis. A slightly high APTw signal was seen in the core lesion area with respect to the peri-lesional area, which was due to hemorrhage, as shown by T2*w. After the initial drop, the APTw signals dramatically increased in some peri-lesional areas at two and three days post-injury, likely due to the secondary inflammatory response. The use of APTw MRI has the potential to introduce a novel molecular neuroimaging approach for the simultaneous detection of ischemia, hemorrhage, and neuroinflammation in TBI.

  9. Whole body MRI: Improved Lesion Detection and Characterization With Diffusion Weighted Techniques

    PubMed Central

    Attariwala, Rajpaul; Picker, Wayne

    2013-01-01

    Diffusion-weighted imaging (DWI) is an established functional imaging technique that interrogates the delicate balance of water movement at the cellular level. Technological advances enable this technique to be applied to whole-body MRI. Theory, b-value selection, common artifacts and target to background for optimized viewing will be reviewed for applications in the neck, chest, abdomen, and pelvis. Whole-body imaging with DWI allows novel applications of MRI to aid in evaluation of conditions such as multiple myeloma, lymphoma, and skeletal metastases, while the quantitative nature of this technique permits evaluation of response to therapy. Persisting signal at high b-values from restricted hypercellular tissue and viscous fluid also permits applications of DWI beyond oncologic imaging. DWI, when used in conjunction with routine imaging, can assist in detecting hemorrhagic degradation products, infection/abscess, and inflammation in colitis, while aiding with discrimination of free fluid and empyema, while limiting the need for intravenous contrast. DWI in conjunction with routine anatomic images provides a platform to improve lesion detection and characterization with findings rivaling other combined anatomic and functional imaging techniques, with the added benefit of no ionizing radiation. PMID:23960006

  10. Susceptibility-weighted MRI of extrapyramidal brain structures in Parkinsonian disorders.

    PubMed

    Schneider, Eva; Ng, Kia-Min; Yeoh, Chooi-Sum; Rumpel, Helmut; Fook-Chong, Stephanie; Li, Hui-Hua; Tan, Eng-King; Chan, Ling-Ling

    2016-06-01

    Susceptibility-weighted MRI (SWI) is sensitive to T2 effects and mineralization.We investigated differences in the extrapyramidal brain structures on SWI between Parkinson disease (PD) and postural instability gait disorder (PIGD) patients and correlated the SWI values with the degree of gait dysfunction.Forty patients diagnosed with PD and PIGD underwent 3 Tesla magnetic resonance imaging (MRI) brain study. An SWI sequence (TE/TR/FA 20/33/15) was used. Ten regions of interest were placed in the midbrain and basal ganglia by 2 independent raters blinded to subject data and quantitatively evaluated.The inter-rater reliability between the raters was excellent (interclass correlation coefficient >0.8). The SWI intensity values in all regions were on average lower in PIGD than in PD patients, with the lowest results found in globus pallidus.Multivariate analysis showed a lower SWI hypointensity in the putamen and globus pallidus in PIGD compared with PD patients, with a similar trend for the other basal ganglia nuclei. Pearson correlation analysis showed a statistically significant positive correlation between SWI putaminal hypointensity and the Tinetti total score (r = 0.39, P = 0.01) in both PD and PIGD.SWI putaminal hypointensity may be a useful imaging marker in prospective evaluation for clinical progression for Parkinsonian disorders.

  11. GRE T2∗-Weighted MRI: Principles and Clinical Applications

    PubMed Central

    Tang, Meng Yue; Chen, Tian Wu; Zhang, Xiao Ming; Huang, Xiao Hua

    2014-01-01

    The sequence of a multiecho gradient recalled echo (GRE) T2*-weighted imaging (T2*WI) is a relatively new magnetic resonance imaging (MRI) technique. In contrast to T2 relaxation, which acquires a spin echo signal, T2* relaxation acquires a gradient echo signal. The sequence of a GRE T2*WI requires high uniformity of the magnetic field. GRE T2*WI can detect the smallest changes in uniformity in the magnetic field and can improve the rate of small lesion detection. In addition, the T2* value can indirectly reflect changes in tissue biochemical components. Moreover, it can be used for the early diagnosis and quantitative diagnosis of some diseases. This paper reviews the principles and clinical applications as well as the advantages and disadvantages of GRE T2*WI. PMID:24987676

  12. Asymptomatic choroid plexus cysts in the lateral ventricles: an incidental finding on diffusion-weighted MRI.

    PubMed

    Cakir, B; Karakas, H M; Unlu, E; Tuncbilek, N

    2002-10-01

    We assessed the role of diffusion-weighted imaging (DWI) in the detection of choroid plexus cysts. We reviewed more than 1000 patients who had undergone MRI in a 1-year period. We reviewed echo-planar DWI with b=1000 s/mm(2), acquired at 1.0 tesla, for any difference in signal intensity which might indicate choroid plexus cysts. On conventional images, all cystic lesions were isointense with cerebrospinal fluid, and 72 cysts could not be identified. On DWI, 90 rounded high-signal foci were detected in 58 patients; 64 cysts were bilateral. Focal ventricular expansion due to large cysts was observed in nine cases. DWI were found to show choroid plexus cysts undetected within the cerebrospinal fluid on conventional images.

  13. Correlation of diffusion-weighted MRI with whole mount radical prostatectomy specimens.

    PubMed

    Van As, N; Charles-Edwards, E; Jackson, A; Jhavar, S; Reinsberg, S; Desouza, N; Dearnaley, D; Bailey, M; Thompson, A; Christmas, T; Fisher, C; Corbishley, C; Sohaib, S

    2008-06-01

    The purpose of this study was to compare the apparent diffusion coefficient (ADC) of benign central gland (bCG), benign peripheral zone (bPZ) and cancer using diffusion-weighted MRI and whole mount specimens. 11 patients with biopsy-proven prostate cancer underwent diffusion-weighted MRI prior to radical prostatectomy. A single-shot echo planar image technique was used with b-values of 0 s mm(-2), 300 s mm(-2), 500 s mm(-2) and 800 s mm(-2). Whole mount specimens were compared with ADC maps. Areas of cancer, bCG and bPZ were identified, and regions of interest were drawn on ADC maps. Mean ADC values were recorded for all regions of interest, and paired t-tests were performed to compare mean values. Cancer was outlined in nine patients. In two patients, the tumours were too small to correlate with images; bCG was identified in 11 patients and bPZ was identified in 10 patients. Mean ADC values for bCG, bPZ and cancer were, 1.5 x 10(-3) mm(2) s(-1) (standard error (SE) = 0.04), 1.7 x 10(-3) mm(2) s(-1) (SE = 0.1), and 1.3 x 10(-3) mm(2) s(-1) (SE = 0.09), respectively. The most significant difference between benign tissue and cancer existed at b-values of 0-300 s mm(-2) (bCG vs cancer: mean difference = 0. 29, p = 0.001, 95% confidence interval (CI) = 0.17-0.41; bPZ vs cancer: mean difference = 0.34, p = 0.003, 95% CI = 0.18-0.61). In conclusion, we have confirmed, using whole mount verification, a significant difference in the ADC between benign tissue and cancer.

  14. Evolution of Cerebral Ischemia Assessed by Amide Proton Transfer-Weighted MRI

    PubMed Central

    Song, Guodong; Li, Chunmei; Luo, Xiaojie; Zhao, Xuna; Zhang, Shuai; Zhang, Yi; Jiang, Shanshan; Wang, Xianlong; Chen, Yuhui; Chen, Haibo; Gong, Tao; Zhou, Jinyuan; Chen, Min

    2017-01-01

    Amide proton transfer-weighted (APTW) magnetic resonance imaging (MRI) has recently become a potentially important tool for evaluating acidosis in ischemic stroke. The purpose of this study was to evaluate the dynamic pH-related changes in the lesions in patients with ischemia. Thirty-nine patients with ischemic stroke (symptom onset to imaging time ranging 2 h–7 days) were examined with a 3.0-T MRI system. Patients were divided into four groups: at the hyperacute stage (onset time ≤ 6 h), at the acute stage (6 h < onset time ≤ 48 h), at the early subacute stage (48 h < onset time ≤ 96 h), and at the late subacute stage (96 h < onset time ≤ 168 h). The APTW signal intensities were quantitatively measured in multiple ischemic regions for each patient. Compared with the contralateral normal white matter, APTW signals were significantly lower in ischemic tissue for all four stages (P < 0.05). The APTW signal intensities (APTWave and APTWmin) increased consistently with onset time (R2 = 0.11, P = 0.040; R2 = 0.13, P = 0.022, respectively). APTWmax–min showed a continued reduction with onset time (R2 = 0.44, P < 0.001). Our results suggest that persistent tissue acidification could occur after ischemia, and as the time from stroke onset increases, the acidotic environment would alleviate. APTW signal intensities could reflect pH-weighted properties in ischemic tissue at different stages and time points. PMID:28303115

  15. The adverse effects of reduced cerebral perfusion on cognition and brain structure in older adults with cardiovascular disease

    PubMed Central

    Alosco, Michael L; Gunstad, John; Jerskey, Beth A; Xu, Xiaomeng; Clark, Uraina S; Hassenstab, Jason; Cote, Denise M; Walsh, Edward G; Labbe, Donald R; Hoge, Richard; Cohen, Ronald A; Sweet, Lawrence H

    2013-01-01

    Background It is well established that aging and vascular processes interact to disrupt cerebral hemodynamics in older adults. However, the independent effects of cerebral perfusion on neurocognitive function among older adults remain poorly understood. We examined the associations among cerebral perfusion, cognitive function, and brain structure in older adults with varying degrees of vascular disease using perfusion magnetic resonance imaging (MRI) arterial spin labeling (ASL). Materials and methods 52 older adults underwent neuroimaging and were administered the Mini Mental State Examination (MMSE), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and measures of attention/executive function. ASL and T1-weighted MRI were used to quantify total brain perfusion, total brain volume (TBV), and cortical thickness. Results Regression analyses showed reduced total brain perfusion was associated with poorer performance on the MMSE, RBANS total index, immediate and delayed memory composites, and Trail Making Test B. Reduced frontal lobe perfusion was associated with worse executive and memory function. A similar pattern emerged between temporal lobe perfusion and immediate memory. Regression analyses revealed that decreased total brain perfusion was associated with smaller TBV and mean cortical thickness. Regional effects of reduced total cerebral perfusion were found on temporal and parietal lobe volumes and frontal and temporal cortical thickness. Discussion Reduced cerebral perfusion is independently associated with poorer cognition, smaller TBV, and reduced cortical thickness in older adults. Conclusion Prospective studies are needed to clarify patterns of cognitive decline and brain atrophy associated with cerebral hypoperfusion. PMID:24363966

  16. Visualization of the eloquent motor system by integration of MEG, functional, and anisotropic diffusion-weighted MRI in functional neuronavigation.

    PubMed

    Kamada, Kyousuke; Houkin, Kiyohiro; Takeuchi, Fumiya; Ishii, Nobuaki; Ikeda, Jun; Sawamura, Yutaka; Kuriki, Shinya; Kawaguchi, Hideaki; Iwasaki, Yoshinobu

    2003-05-01

    In this study, we visualized the eloquent motor system including the somatosensory-motor cortex and corticospinal tract on a neuronavigation system, integrating magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI), and anisotropic diffusion-weighted MRI (ADWI). Four patients with brain lesions adjacent to the eloquent motor system were studied. Motor-evoked responses (MER) by finger-tapping paradigm were acquired with a 1.5-Tesla MR scanner, and somatosensory-evoked magnetic fields (SEF) by median nerve stimulation were measured with a 204-channel MEG system. In the same fMRI examination, ADWI and anatomic three-dimensional T1-weighted imaging (3-D MRI) were obtained. Activated areas of MER, estimated SEF dipoles, and the corticospinal tract on ADWI were coregistered to 3-D MRI, and the combined MR data were transferred to a neuronavigation system (functional neuronavigation). Intraoperative recording of cortical somatosensory-evoked potentials was performed for confirmation of the central sulcus. Combination of fMRI and MEG enabled firm identification of the central sulcus. Functional neuronavigation facilitated extensive tumor resection, having the advantage of sparing the motor cortex and corticospinal tract in all cases. The proposed functional neuronavigation allows neurosurgeons to perform effective and maximal resection of brain lesions, identifying and sparing eloquent cortical components and their subcortical connections. Potential clinical application of this technique is discussed.

  17. Functional localization of the human color center by decreased water displacement using diffusion-weighted fMRI.

    PubMed

    Williams, Rebecca J; Reutens, David C; Hocking, Julia

    2015-11-01

    Decreased water displacement following increased neural activity has been observed using diffusion-weighted functional MRI (DfMRI) at high b-values. The physiological mechanisms underlying the diffusion signal change may be unique from the standard blood oxygenation level-dependent (BOLD) contrast and closer to the source of neural activity. Whether DfMRI reflects neural activity more directly than BOLD outside the primary cerebral regions remains unclear. Colored and achromatic Mondrian visual stimuli were statistically contrasted to functionally localize the human color center Area V4 in neurologically intact adults. Spatial and temporal properties of DfMRI and BOLD activation were examined across regions of the visual cortex. At the individual level, DfMRI activation patterns showed greater spatial specificity to V4 than BOLD. The BOLD activation patterns were more prominent in the primary visual cortex than DfMRI, where activation was localized to the ventral temporal lobe. Temporally, the diffusion signal change in V4 and V1 both preceded the corresponding hemodynamic response, however the early diffusion signal change was more evident in V1. DfMRI may be of use in imaging applications implementing cognitive subtraction paradigms, and where highly precise individual functional localization is required.

  18. Quantitative cerebral blood flow mapping and functional connectivity of postherpetic neuralgia pain: a perfusion fMRI study.

    PubMed

    Liu, Jing; Hao, Ying; Du, Minyi; Wang, Xiaoying; Zhang, Jue; Manor, Brad; Jiang, Xuexiang; Fang, Wenxue; Wang, Dongxin

    2013-01-01

    This article investigates the effects of postherpetic neuralgia (PHN) on resting-state brain activity utilizing arterial spin labeling (ASL) techniques. Features of static and dynamic cerebral blood flow (CBF) were analyzed to reflect the specific brain response to PHN pain. Eleven consecutive patients suffering from PHN and 11 age- and gender-matched control subjects underwent perfusion functional magnetic resonance imaging brain scanning during the resting state. Group comparison was conducted to detect the regions with significant changes of CBF in PHN patients. Then we chose those regions that were highly correlated with the self-reported pain intensity as "seeds" to calculate the functional connectivity of both groups. Absolute CBF values of these regions were also compared across PHN patients and control subjects. Significant increases in CBF of the patient group were observed in left striatum, right thalamus, left primary somatosensory cortex (S1), left insula, left amygdala, left primary somatomotor cortex, and left inferior parietal lobule. Significant decreases in CBF were mainly located in the frontal cortex. Regional CBF in the left caudate, left insula, left S1, and right thalamus was highly correlated with the pain intensity, and further comparison showed that the regional CBF in these regions is significantly higher in PHN groups. Functional connectivity results demonstrated that the reward circuitry involved in striatum, prefrontal cortex, amygdala, and parahippocampal gyrus and the circuitry among striatum, thalamus, and insula were highly correlated with each element in PHN patients. In addition, noninvasive brain perfusion imaging at rest may provide novel insights into the central mechanisms underlying PHN pain.

  19. Accuracy of percentage of signal intensity recovery and relative cerebral blood volume derived from dynamic susceptibility-weighted, contrast-enhanced MRI in the preoperative diagnosis of cerebral tumours

    PubMed Central

    Steel, Timothy; Chaganti, Joga

    2015-01-01

    Conventional magnetic resonance imaging (MRI) is the technique of choice for diagnosis of cerebral tumours, and has become an increasingly powerful tool for their evaluation; however, the diagnosis of common contrast-enhancing lesions can be challenging, as it is sometimes impossible to differentiate them using conventional imaging. Histopathological analysis of biopsy specimens is the gold standard for diagnosis; however, there are significant risks associated with the invasive procedure and definitive diagnosis is not always achieved. Early accurate diagnosis is important, as management differs accordingly. Advanced MRI techniques have increasing utility for aiding diagnosis in a variety of clinical scenarios. Dynamic susceptibility-weighted contrast-enhanced (DSC) MRI is a perfusion imaging technique and a potentially important tool for the characterisation of cerebral tumours. The percentage of signal intensity recovery (PSR) and relative cerebral blood volume (rCBV) derived from DSC MRI provide information about tumour capillary permeability and neoangiogenesis, which can be used to characterise tumour type and grade, and distinguish tumour recurrence from treatment-related effects. Therefore, PSR and rCBV potentially represent a non-invasive means of diagnosis; however, the clinical utility of these parameters has yet to be established. We present a review of the literature to date. PMID:26475485

  20. Nearly Automatic Segmentation of Hippocampal Subfields in In Vivo Focal T2-Weighted MRI

    PubMed Central

    Yushkevich, Paul A.; Wang, Hongzhi; Pluta, John; Das, Sandhitsu R.; Craige, Caryne; Avants, Brian B.; Weiner, Michael W.; Mueller, Susanne

    2010-01-01

    We present and evaluate a new method for automatically labeling the subfields of the hippocampal formation in focal 0.4×0.5×2.0mm3 resolution T2-weighted magnetic resonance images that can be acquired in the routine clinical setting with under 5 min scan time. The method combines multi-atlas segmentation, similarity-weighted voting, and a novel learning-based bias correction technique to achieve excellent agreement with manual segmentation. Initial partitioning of MRI slices into hippocampal ‘head’, ‘body’ and ‘tail’ slices is the only input required from the user, necessitated by the nature of the underlying segmentation protocol. Dice overlap between manual and automatic segmentation is above 0.87 for the larger subfields, CA1 and dentate gyrus, and is competitive with the best results for whole-hippocampus segmentation in the literature. Intraclass correlation of volume measurements in CA1 and dentate gyrus is above 0.89. Overlap in smaller hippocampal subfields is lower in magnitude (0.54 for CA2, 0.62 for CA3, 0.77 for subiculum and 0.79 for entorhinal cortex) but comparable to overlap between manual segmentations by trained human raters. These results support the feasibility of subfield-specific hippocampal morphometry in clinical studies of memory and neurodegenerative disease. PMID:20600984

  1. Water-dispersible magnetic carbon nanotubes as T2-weighted MRI contrast agents.

    PubMed

    Liu, Yue; Hughes, Timothy C; Muir, Benjamin W; Waddington, Lynne J; Gengenbach, Thomas R; Easton, Christopher D; Hinton, Tracey M; Moffat, Bradford A; Hao, Xiaojuan; Qiu, Jieshan

    2014-01-01

    An efficient MRI T2-weighted contrast agent incorporating a potential liver targeting functionality was synthesized via the combination of superparamagnetic iron oxide (SPIO) nanoparticles with multiwalled carbon nanotubes (MWCNTs). Poly(diallyldimethylammonium chloride) (PDDA) was coated on the surface of acid treated MWCNTs via electrostatic interactions and SPIO nanoparticles modified with a potential targeting agent, lactose-glycine adduct (Lac-Gly), were subsequently immobilized on the surface of the PDDA-MWCNTs. A narrow magnetic hysteresis loop indicated that the product displayed superparamagnetism at room temperature which was further confirmed by ZFC (zero field cooling)/FC (field cooling) curves measured by SQUID. The multifunctional MWCNT-based magnetic nanocomposites showed low cytotoxicity in vitro to HEK293 and Huh7 cell lines. Enhanced T2 relaxivities were observed for the hybrid material (186 mM(-1) s(-1)) in comparison with the pure magnetic nanoparticles (92 mM(-1) s(-1)) due to the capacity of the MWCNTs to "carry" more nanoparticles as clusters. More importantly, after administration of the composite material to an in vivo liver cancer model in mice, a significant increase in tumor to liver contrast ratio (277%) was observed in T2 weighted magnetic resonance images. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  2. Diffusion, Perfusion, and Histopathologic Characteristics of Desmoplastic Infantile Ganglioglioma

    PubMed Central

    Ho, Chang Y; Gener, Melissa; Bonnin, Jose; Kralik, Stephen F

    2016-01-01

    We present a case series of a rare tumor, the desmoplastic infantile ganglioglioma (DIG) with MRI diffusion and perfusion imaging quantification as well as histopathologic characterization. Four cases with pathologically-proven DIG had diffusion weighted imaging (DWI) and two of the four had dynamic susceptibility contrast imaging. All four tumors demonstrate DWI findings compatible with low-grade pediatric tumors. For the two cases with perfusion imaging, a higher relative cerebral blood volume was associated with higher proliferation index on histopathology for one of the cases. Our results are discussed in conjunction with a literature review. PMID:27761184

  3. High Temporospatial Resolution Dynamic Contrast Enhanced (DCE) Wrist MRI with Variable-Density Pseudo-Random CIRcular Cartesian UnderSampling (CIRCUS) Acquisition: Evaluation of Perfusion in Rheumatoid Arthritis Patients

    PubMed Central

    Liu, Jing; Pedoia, Valentina; Heilmeier, Ursula; Ku, Eric; Su, Favian; Khanna, Sameer; Imboden, John; Graf, Jonathan; Link, Thomas; Li, Xiaojuan

    2016-01-01

    This study is to evaluate highly accelerated 3D dynamic contrast-enhanced (DCE) wrist MRI for assessment of perfusion in rheumatoid arthritis (RA) patients. A pseudo-random variable-density undersampling strategy, CIRcular Cartesian UnderSampling (CIRCUS), was combined with k-t SPARSE-SENSE reconstruction to achieve a highly accelerated 3D DCE wrist MRI. Two healthy volunteers and ten RA patients were studied. Two patients were on methotrexate (MTX) only (Group I) and the other eight were treated with a combination therapy of MTX and Anti-Tumour Necrosis Factor (TNF) therapy (Group II). Patients were scanned at baseline and 3-month follow-up. DCE MR images were used to evaluate perfusion in synovitis and bone marrow edema pattern in the RA wrist joints. A series of perfusion parameters were derived and compared with clinical disease activity scores of 28 joints (DAS28). 3D DCE wrist MR images were obtained with a spatial resolution of 0.3×0.3×1.5mm3 and temporal resolution of 5 s (with an acceleration factor of 20). The derived perfusion parameters, most notably, transition time (dT) of synovitis, showed significant negative correlations with DAS28-ESR (r=-0.80, p<0.05) and DAS28-CRP (r=-0.87, p<0.05) at baseline and also correlated significantly with treatment responses evaluated by clinical score changes between baseline and 3-month follow-up (with DAS28-ESR: r=-0.79, p<0.05, and DAS28-CRP: r=-0.82, p<0.05). Highly accelerated 3D DCE wrist MRI with improved temporospatial resolution has been achieved in RA patients and provides accurate assessment of neovascularization and perfusion in RA joints, showing promise as a potential tool for evaluating treatment responses. PMID:26608949

  4. Whole-body diffusion-weighted imaging: the added value to whole-body MRI at initial diagnosis of lymphoma.

    PubMed

    Gu, Jing; Chan, Tao; Zhang, Jingbo; Leung, Anskar Y H; Kwong, Yok-Lam; Khong, Pek-Lan

    2011-09-01

    The objective of our study was to evaluate the diagnostic performance of conventional whole-body MRI without and with diffusion-weighted imaging (DWI) in the detection of known (18)F-FDG-avid lymphomas. The conventional whole-body MRI protocol consisted of a T2-weighted sequence and a T2-weighted spectral attenuated inversion recovery (SPAIR) sequence with frequency-selective fat suppression. The second protocol used the same sequences as the first protocol but also included DWI. Seventeen patients with pathologically confirmed, newly diagnosed, untreated lymphoma were recruited. T2-weighted and T2-weighted SPAIR images were evaluated first, separate from the DW images, and then were evaluated with the DW images. We used (18)F-FDG PET/CT as the standard of reference. True-positive, false-positive, and false-negative values were evaluated on a per-lesion basis. Tumor staging based on T2-weighted and T2-weighted SPAIR imaging without DWI and then with DWI was compared using the Ann Arbor staging system. True-positive lesions were increased from 89% to 97%, false-positive lesions were increased from 3% to 6%, and false-negative lesions were decreased from 11% to 3% by the addition of DWI. Diagnostic sensitivity was significantly increased (p = 0.002) by adding DWI. Lesions detected on DWI but not on T2-weighted and T2-weighted SPAIR imaging were located in renal (n = 1), paraaortic (n = 6), and pelvic (n = 3) lymph nodes. On DWI, 47% of the lesions (n = 55) were more conspicuous than on T2-weighted and T2-weighted SPAIR imaging; most of these lesions (58%, n = 32) were from lymph nodes in the pelvic or abdominal regions and bone marrow. No difference was found between T2-weighted and T2-weighted SPAIR imaging without DWI and T2-weighted and T2-weighted SPAIR imaging with DWI in lymphoma staging, being consistent with PET/CT in 88% of the patients (n = 15). The addition of DWI to conventional whole-body MRI sequences enhanced lesion conspicuity and improved diagnostic

  5. Dynamic measurement of patello-femoral joint alignment using weight-bearing magnetic resonance imaging (WB-MRI).

    PubMed

    Mariani, Silvia; La Marra, Alice; Arrigoni, Francesco; Necozione, Stefano; Splendiani, Alessandra; Di Cesare, Ernesto; Barile, Antonio; Masciocchi, Carlo

    2015-12-01

    Aim of our work was to compare standard and weight-bearing WB-MRI to define their contribution in unmasking patello-femoral (PF) maltracking and to define what measurement of patellar alignment is the most reliable. We prospectively collected 95 non consecutive patients, clinically divided into 2 groups: group A (the control group), including 20 patients (negative for patellar maltracking), and group B including 75 patients (positive for patellar maltracking). The patients underwent a dedicated 0.25 T MRI, in supine and WB position, with knee flexion of 12-15°. The following measurements were performed: Insall-Salvati index (IS), lateral patellar displacement (LPD), lateral patello-femoral angle (LPA) and lateral patellar tilt (LPT). Quantitative and qualitative statistical analyses were performed to compare the results obtained before and after WB-MRI. Measurements were subsequently performed on both groups. Group A patients showed no statistically significant variations at all measurements both on standard and WB-MRI. On the basis of measurements made on standard MRI, group B patients were divided into group B1 (23 patients) (negative or positive at 1 measurement) and group B2 (52 patients) (positive at 2 or more measurements). After WB-MRI, group B1 patients were divided into group B1a (6 patients), in case they remained positive at 0/1 measurement, and group B1b (17 patients), in case they became positive at 2 or more measurements. All group B2 patients confirmed to be positive at 2 or more measurements at WB-MRI. Quantitative statistical analysis showed that LPT and LPA were the most reproducible and clinically useful measurements. Qualitative statistical analysis performed on standard and WB-MRI demonstrated that LPT was the best predictive measurement. This study demonstrates both the high diagnostic value of WB-MRI in unmasking PF-maltracking and the best predictive value of LPT measurement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. On the fallacy of quantitative segmentation for T1-weighted MRI

    NASA Astrophysics Data System (ADS)

    Plassard, Andrew J.; Harrigan, Robert L.; Newton, Allen T.; Rane, Swati; Pallavaram, Srivatsan; D'Haese, Pierre F.; Dawant, Benoit M.; Claassen, Daniel O.; Landman, Bennett A.

    2016-03-01

    T1-weighted magnetic resonance imaging (MRI) generates contrasts with primary sensitivity to local T1 properties (with lesser T2 and PD contributions). The observed signal intensity is determined by these local properties and the sequence parameters of the acquisition. In common practice, a range of acceptable parameters is used to ensure "similar" contrast across scanners used for any particular study (e.g., the ADNI standard MPRAGE). However, different studies may use different ranges of parameters and report the derived data as simply "T1-weighted". Physics and imaging authors pay strong heed to the specifics of the imaging sequences, but image processing authors have historically been more lax. Herein, we consider three T1-weighted sequences acquired the same underlying protocol (MPRAGE) and vendor (Philips), but "normal study-to-study variation" in parameters. We show that the gray matter/white matter/cerebrospinal fluid contrast is subtly but systemically different between these images and yields systemically different measurements of brain volume. The problem derives from the visually apparent boundary shifts, which would also be seen by a human rater. We present and evaluate two solutions to produce consistent segmentation results across imaging protocols. First, we propose to acquire multiple sequences on a subset of the data and use the multi-modal imaging as atlases to segment target images any of the available sequences. Second (if additional imaging is not available), we propose to synthesize atlases of the target imaging sequence and use the synthesized atlases in place of atlas imaging data. Both approaches significantly improve consistency of target labeling.

  7. A geometric flow for segmenting vasculature in proton-density weighted MRI.

    PubMed

    Descoteaux, Maxime; Collins, D Louis; Siddiqi, Kaleem

    2008-08-01

    Modern neurosurgery takes advantage of magnetic resonance images (MRI) of a patient's cerebral anatomy and vasculature for planning before surgery and guidance during the procedure. Dual echo acquisitions are often performed that yield proton-density (PD) and T2-weighted images to evaluate edema near a tumor or lesion. In this paper we develop a novel geometric flow for segmenting vasculature in PD images, which can also be applied to the easier cases of MR angiography data or Gadolinium enhanced MRI. Obtaining vasculature from PD data is of clinical interest since the acquisition of such images is widespread, the scanning process is non-invasive, and the availability of vessel segmentation methods could obviate the need for an additional angiographic or contrast-based sequence during preoperative imaging. The key idea is to first apply Frangi's vesselness measure [Frangi, A., Niessen, W., Vincken, K.L., Viergever, M.A., 1998. Multiscale vessel enhancement filtering. In: International Conference on Medical Image Computing and Computer Assisted Intervention, vol. 1496 of Lecture Notes in Computer Science, pp. 130-137] to find putative centerlines of tubular structures along with their estimated radii. This measure is then distributed to create a vector field which allows the flux maximizing flow algorithm of Vasilevskiy and Siddiqi [Vasilevskiy, A., Siddiqi, K., 2002. Flux maximizing geometric flows. IEEE Transactions on Pattern Analysis and Machine Intelligence 24 (12), 1565-1578] to be applied to recover vessel boundaries. We carry out a qualitative validation of the approach on PD, MR angiography and Gadolinium enhanced MRI volumes and suggest a new way to visualize the segmentations in 2D with masked projections. We validate the approach quantitatively on a single-subject data set consisting of PD, phase contrast (PC) angiography and time of flight (TOF) angiography volumes, with an expert segmented version of the TOF volume viewed as the ground truth. We then

  8. Detection of the index tumour and tumour volume in prostate cancer using T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) alone.

    PubMed

    Rud, Erik; Klotz, Dagmar; Rennesund, Kristin; Baco, Eduard; Berge, Viktor; Lien, Diep; Svindland, Aud; Lundeby, Eskild; Berg, Rolf E; Eri, Lars M; Eggesbø, Heidi B

    2014-12-01

    To examine the performance of T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for detecting the index tumour in patients with prostate cancer and to examine the agreement between MRI and histology when assessing tumour volume (TV) and overall tumour burden. The study included 199 consecutive patients with biopsy confirmed prostate cancer randomised to MRI before radical prostatectomy from December 2009 to July 2012. MRI-detected tumours (MRTs) were ranked from 1 to 3 according to decreasing volume and were compared with histologically detected tumours (HTs) ranked from 1 to 3, with HT 1 = index tumour. Whole-mount section histology was used as a reference standard. The TVs of true-positive MRTs (MRTVs 1-3) were compared with the TVs found by histology (HTVs 1-3). All tumours were registered on a 30-sector map and by classifying each sector as positive/negative, the rate of true-positive and -negative sectors was calculated. The detection rate for the HT 1 (index tumour) was 92%; HT 2, 45%; and HT 3, 37%. The MRTV 1-3 vs the HTV 1-3 were 2.8 mL vs 4.0 mL (index tumour, P < 0.001), 1.0 mL vs 0.9 mL (tumour 2, P = 0.413), and 0.6 mL vs 0.5 mL (tumour 3, P = 0.492). The rate of true-positive and -negative sectors was 50% and 88%, κ = 0.39. A combination of T2W and DW MRI detects the index tumour in 92% of cases, although MRI underestimates both TV and tumour burden compared with histology. © 2014 The Authors. BJU International © 2014 BJU International.

  9. Measurement of perfusion and permeability from dynamic contrast-enhanced MRI in normal and pathological vertebral bone marrow.

    PubMed

    Biffar, Andreas; Sourbron, Steven; Schmidt, Gerwin; Ingrisch, Michael; Dietrich, Olaf; Reiser, Maximilian F; Baur-Melnyk, Andrea

    2010-07-01

    Dynamic contrast-enhanced MRI data in vertebral bone marrow (vBM) are currently analyzed with descriptive indices. The purpose of this study was to develop and evaluate a quantitative approach, considering the tissue composition of vBM. Therefore, a measurement of the water fraction, f(wat), and the precontrast relaxation times, T(10 wat), T(10 fat), was added to the routine protocol. Signal analysis was generalized by allowing for an arbitrary fraction of fat. Plasma flow, plasma volume, extraction flow, and interstitial volume were determined from dynamic contrast-enhanced-MRI data. Simulations were used to determine the sensitivity to the precontrast values and to retrospectively verify the choice of the sequence parameters. Measurements were performed in healthy vertebral bodies (n = 30) and lesions of 15 patients with vertebral fractures. Extraction flow (milliliters per 100 mL/min) provided the strongest normal/abnormal separation: mean (standard deviation) was 0.3 (0.8) in healthy vBM and 6(4) in the fractures. Neglecting the fat component and the approximated signal analysis using relative signal enhancement produced significant differences. We conclude that correcting for the fat component in the signal and parametrization by tracer-kinetic analysis is necessary to avoid misinterpretation and/or systematic errors. The quantitative analysis is equally well suited as a descriptive parameter for the differentiation between normal and abnormal vertebral bone marrow. (c) 2010 Wiley-Liss, Inc.

  10. Role of respiratory-triggered diffusion-weighted MRI in the assessment of pleural disease

    PubMed Central

    Chiesa, Fabio; Del Prato, Alberto; Tagliafico, Alberto; Rosenberg, Ilan; Canessa, Pier Aldo; Pinelli, Valentina; Villa, Alessandro

    2016-01-01

    Objective: To evaluate the correlation between apparent diffusion coefficient (ADC) values and histopathological features in a cohort of patients with suspected malignant pleural disease. Methods: We evaluated 56 consecutive patients undergoing a chest MRI examination for clinical suspicion of malignant pleural disease; all patients underwent thoracoscopic biopsy for histological assessment. All MRI examinations were performed with a 1.5-T scanner using a dedicated protocol, including a respiratory-triggered diffusion-weighted sequence with three b-values (0, 100 and 750). The ADC values were calculated, and a statistical analysis was performed. Results: The average ADC value in non-neoplastic pleural disease (NNPD) resulted in 1.84 ± 0.37 × 10−3 mm2 s−1, whereas we obtained an average value of 0.96 ± 0.19 × 10−3 mm2 s−1 in epitheliod, of 0.76 ± 0.33 × 10−3 mm2 s−1 in biphasic and of 0.67 ± 0.2 × 10−3 mm2 s−1 in sarcomatoid pleural mesotheliomas. Histology revealed the presence of malignant pleural mesothelioma (MPM) in 44 patients, chronic pleuritis in 8 patients and atypical mesothelial hyperplasia in 4 patients. Statistical analysis showed a significant difference between NNPD and MPM (p < 0.001) and between epithelioid and sarcomatoid MPM subtypes (p = 0.0004), whereas biphasic MPMs showed a wide range of overlapping with the other groups. Conclusion: We observed a statistically significant difference between NNPD, epitheliod and sarcomatoid subtypes of MPM regarding ADC values. Advances in knowledge: Our study confirmed previous data regarding distribution of ADC values in pleural disease using a respiratory-triggered diffusion-weighted technique that allowed us to minimize motion artefacts and to reduct acquisition time. PMID:27302493

  11. Prostate cancer transrectal HIFU ablation: detection of local recurrences using T2-weighted and dynamic contrast-enhanced MRI.

    PubMed

    Rouvière, Olivier; Girouin, Nicolas; Glas, Ludivine; Ben Cheikh, Alexandre; Gelet, Albert; Mège-Lechevallier, Florence; Rabilloud, Muriel; Chapelon, Jean-Yves; Lyonnet, Denis

    2010-01-01

    The objective was to evaluate T2-weighted (T2w) and dynamic contrast-enhanced (DCE) MRI in detecting local cancer recurrences after prostate high-intensity focused ultrasound (HIFU) ablation. Fifty-nine patients with biochemical recurrence after prostate HIFU ablation underwent T2-weighted and DCE MRI before transrectal biopsy. For each patient, biopsies were performed by two operators: operator 1 (blinded to MR results) performed random and colour Doppler-guided biopsies ("routine biopsies"); operator 2 obtained up to three cores per suspicious lesion on MRI ("targeted biopsies"). Seventy-seven suspicious lesions were detected on DCE images (n = 52), T2w images (n = 2) or both (n = 23). Forty patients and 41 MR lesions were positive at biopsy. Of the 36 remaining MR lesions, 20 contained viable benign glands. Targeted biopsy detected more cancers than routine biopsy (36 versus 27 patients, p = 0.0523). The mean percentages of positive cores per patient and of tumour invasion of the cores were significantly higher for targeted biopsies (p < 0.0001). The odds ratios of the probability of finding viable cancer and viable prostate tissue (benign or malignant) at targeted versus routine biopsy were respectively 3.35 (95% CI 3.05-3.64) and 1.38 (95% CI 1.13-1.63). MRI combining T2-weighted and DCE images is a promising method for guiding post-HIFU biopsy towards areas containing recurrent cancer and viable prostate tissue.

  12. Fast pseudo-CT synthesis from MRI T1-weighted images using a patch-based approach

    NASA Astrophysics Data System (ADS)

    Torrado-Carvajal, A.; Alcain, E.; Montemayor, A. S.; Herraiz, J. L.; Rozenholc, Y.; Hernandez-Tamames, J. A.; Adalsteinsson, E.; Wald, L. L.; Malpica, N.

    2015-12-01

    MRI-based bone segmentation is a challenging task because bone tissue and air both present low signal intensity on MR images, making it difficult to accurately delimit the bone boundaries. However, estimating bone from MRI images may allow decreasing patient ionization by removing the need of patient-specific CT acquisition in several applications. In this work, we propose a fast GPU-based pseudo-CT generation from a patient-specific MRI T1-weighted image using a group-wise patch-based approach and a limited MRI and CT atlas dictionary. For every voxel in the input MR image, we compute the similarity of the patch containing that voxel with the patches of all MR images in the database, which lie in a certain anatomical neighborhood. The pseudo-CT is obtained as a local weighted linear combination of the CT values of the corresponding patches. The algorithm was implemented in a GPU. The use of patch-based techniques allows a fast and accurate estimation of the pseudo-CT from MR T1-weighted images, with a similar accuracy as the patient-specific CT. The experimental normalized cross correlation reaches 0.9324±0.0048 for an atlas with 10 datasets. The high NCC values indicate how our method can accurately approximate the patient-specific CT. The GPU implementation led to a substantial decrease in computational time making the approach suitable for real applications.

  13. In vivo T2* weighted MRI visualizes cardiac lesions in murine models of acute and chronic viral myocarditis

    PubMed Central

    Helluy, Xavier; Sauter, Martina; Ye, Yu-Xiang; Lykowsky, Gunthard; Kreutner, Jakob; Yilmaz, Ali; Jahns, Roland; Boivin, Valerie; Kandolf, Reinhard; Jakob, Peter M.; Hiller, Karl-Heinz; Klingel, Karin

    2017-01-01

    Objective Acute and chronic forms of myocarditis are mainly induced by virus infections. As a consequence of myocardial damage and inflammation dilated cardiomyopathy and chronic heart failure may develop. The gold standard for the diagnosis of myocarditis is endomyocardial biopsies which are required to determine the etiopathogenesis of cardiac inflammatory processes. However, new non-invasive MRI techniques hold great potential in visualizing cardiac non-ischemic inflammatory lesions at high spatial resolution, which could improve the investigation of the pathophysiology of viral myocarditis. Results Here we present the discovery of a novel endogenous T2* MRI contrast of myocardial lesions in murine models of acute and chronic CVB3 myocarditis. The evaluation of infected hearts ex vivo and in vivo by 3D T2w and T2*w MRI allowed direct localization of virus-induced myocardial lesions without any MRI tracer or contrast agent. T2*w weighted MRI is able to detect both small cardiac lesions of acute myocarditis and larger necrotic areas at later stages of chronic myocarditis, which was confirmed by spatial correlation of MRI hypointensity in myocardium with myocardial lesions histologically. Additional in vivo and ex vivo MRI analysis proved that the contrast mechanism was due to a strong paramagnetic tissue alteration in the vicinity of myocardial lesions, effectively pointing towards iron deposits as the primary contributor of contrast. The evaluation of the biological origin of the MR contrast by specific histological staining and transmission electron microscopy revealed that impaired iron metabolism primarily in mitochondria caused iron deposits within necrotic myocytes, which induces strong magnetic susceptibility in myocardial lesions and results in strong T2* contrast. Conclusion This T2*w MRI technique provides a fast and sensitive diagnostic tool to determine the patterns and the severity of acute and chronic enteroviral myocarditis and the precise

  14. MRI-guided breast vacuum biopsy: Localization of the lesion without contrast-agent application using diffusion-weighted imaging.

    PubMed

    Berger, Nicole; Varga, Zsuzsanna; Frauenfelder, Thomas; Boss, Andreas

    2017-05-01

    In magnetic resonance-guided breast vacuum biopsies, the contrast agent for targeting suspicious lesions can typically be applied only once during an intervention, due to the slow elimination of the gadolinium chelate from the extracellular fluid space. This study evaluated the feasibility of diffusion-weighted imaging (DWI) for lesion targeting in vacuum assisted magnetic resonance imaging (MRI) biopsies. DWI may be used as an alternative to dynamic contrast-enhanced MRI with the advantage of reproducibility. However, the targeted lesion requires the characteristics of a mass-like lesion, substantial diffusion restriction, and a minimum size of approximately 1cm. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. On the Fallacy of Quantitative Segmentation for T1-Weighted MRI

    PubMed Central

    Harrigan, Robert L.; Newton, Allen T.; Rane, Swati; Pallavaram, Srivatsan; D'Haese, Pierre F.; Dawant, Benoit M.; Claassen, Daniel O.; Landman, Bennett A.

    2016-01-01

    T1-weighted magnetic resonance imaging (MRI) generates contrasts with primary sensitivity to local T1 properties (with lesser T2 and PD contributions). The observed signal intensity is determined by these local properties and the sequence parameters of the acquisition. In common practice, a range of acceptable parameters is used to ensure “similar” contrast across scanners used for any particular study (e.g., the ADNI standard MPRAGE). However, different studies may use different ranges of parameters and report the derived data as simply “T1-weighted”. Physics and imaging authors pay strong heed to the specifics of the imaging sequences, but image processing authors have historically been more lax. Herein, we consider three T1-weighted sequences acquired the same underlying protocol (MPRAGE) and vendor (Philips), but “normal study-to-study variation” in parameters. We show that the gray matter/white matter/cerebrospinal fluid contrast is subtly but systemically different between these images and yields systemically different measurements of brain volume. The problem derives from the visually apparent boundary shifts, which would also be seen by a human rater. We present and evaluate two solutions to produce consistent segmentation results across imaging protocols. First, we propose to acquire multiple sequences on a subset of the data and use the multi-modal imaging as atlases to segment target images any of the available sequences. Second (if additional imaging is not available), we propose to synthesize atlases of the target imaging sequence and use the synthesized atlases in place of atlas imaging data. Both approaches significantly improve consistency of target labeling. PMID:27127328

  16. Usefulness of T2*-weighted MRI in the detection of adnexal torsion

    PubMed Central

    Kawai, Nobuyuki; Kanematsu, Masayuki; Kawaguchi, Shimpei; Kojima, Toshihisa; Furui, Tatsuro; Morishige, Ken-ichirou; Matsuo, Masayuki

    2016-01-01

    Background The usefulness of T2*-weighted (T2*W) imaging for the detection of adnexal torsion has yet to be determined. Purpose To assess the usefulness of T2*W imaging for detecting and differentiating adnexal torsion. Material and Methods Eight patients with eight ovaries with torsion and 44 patients with 72 ovaries without torsion were included in this study. All patients underwent 1.5-T magnetic resonance imaging (MRI) including T2*W images. The frequency and distribution of hypointensity on T2*W images were compared between ovaries with torsion and ovaries without torsion. Results Hypointensity on T2*W images was significantly more frequent in ovaries with torsion than in ovaries without torsion (75% vs. 36%; P < 0.05). Among patients with hypointensity on T2*W images, the frequency of diffuse hypointensity was significantly higher in ovaries with torsion than in ovaries without torsion (83% vs. 0%; P < 0.01); whereas the frequency of focal hypointensity was significantly lower in ovaries with torsion than in ovaries without torsion (17% vs. 100%; P < 0.01). Conclusion The presence and distribution of hypointensity on T2*W images may play a supplementary role in the detection of adnexal torsion. PMID:27478621

  17. Diffusion weighted MRI imaging and MES detection in the assessment of stroke origin.

    PubMed

    Droste, Dirk W; Knapp, Jan; Freund, Michael; Nágy, Ildikó; Schulte, Volker; Schomacher, Guido; Csiba, László; Ringelstein, E Bernd

    2007-07-01

    This study compares the additional benefit of diffusion-weighted MRI (DWI) and microembolus detection by transcranial Doppler ultrasonography (TCD) in the assessment of stroke etiology. Fifty-five acute anterior circulation stroke or TIA patients were investigated by both cranial DWI and bilateral TCD of the middle cerebral arteries (1 hour). In one of the 13 patients without acute ischemic lesions visualized on DWI, microembolic signal (MES) detection was positive. However, in 33 out of 44 patients without MES, DWI revealed at least one lesion. In two patients with unilateral territorial infarction and otherwise normal cardiovascular work-up, bilateral MES were found thus localizing the embolic source into the aortic arch or the heart. In a further patient with a dissection, the occurrence of contralateral MES raised doubts on a dissection to be the cause of the infarct. There is a contribution of both techniques to the understanding of stroke etiology. The impact of DWI is, however, superior to that of MES detection. Longer TCD recording times may diminish this discrepancy.

  18. MR Susceptibility Weighted Imaging (SWI) Complements Conventional Contrast Enhanced T1 Weighted MRI in Characterizing Brain Abnormalities of Sturge-Weber Syndrome

    PubMed Central

    Hu, Jiani; Yu, Yingjian; Juhasz, Csaba; Kou, Zhifeng; Xuan, Yang; Latif, Zahid; Kudo, Kohsuke; Chugani, Harry T.; Haacke, E. Mark

    2009-01-01

    PURPOSE To evaluate the efficacy of susceptibility weighted imaging (SWI) in comparison to standard T1 weighted post gadolinium contrast (T1-Gd) MRI in patients with Sturge-Weber Syndrome (SWS). MATERIALS AND METHODS Twelve children (mean age 5.6 years) with the diagnosis of SWS and unilateral hemispheric involvement were recruited prospectively and examined with high resolution 3D SWI and conventional T1-Gd. Both SWI and T1-Gd images were evaluated using a four-grade scoring system according to six types of imaging findings (enlargement of transmedullary veins, periventricular veins and choroid plexus, as well as leptomeningeal abnormality, cortical gyriform abnormality, and gray matter/white matter junctional abnormality). The scores of SWI vs. T1-Gd images were then compared for each type of abnormality. RESULTS SWI was superior to T1-Gd in identifying the enlarged transmedullary veins (p=0.0020), abnormal periventricular veins (p=0.0078), cortical gyriform abnormalities (p=0.0020), and grey matter/white matter junction abnormalities (p=0.0078). Conversely, T1-Gd was better than SWI in identifying enlarged choroid plexus (p=0.0050) and leptomeningeal abnormalities (p=0.0050). CONCLUSION SWI can provide useful and unique information complementary to conventional contrast enhanced T1 weighted MRI for characterizing SWS. Therefore, SWI should be integrated into routine clinical MRI protocols for suspected SWS. PMID:18666142

  19. Probabilistic atlas-based segmentation of combined T1-weighted and DUTE MRI for calculation of head attenuation maps in integrated PET/MRI scanners

    PubMed Central

    Poynton, Clare B; Chen, Kevin T; Chonde, Daniel B; Izquierdo-Garcia, David; Gollub, Randy L; Gerstner, Elizabeth R; Batchelor, Tracy T; Catana, Ciprian

    2014-01-01

    We present a new MRI-based attenuation correction (AC) approach for integrated PET/MRI systems that combines both segmentation- and atlas-based methods by incorporating dual-echo ultra-short echo-time (DUTE) and T1-weighted (T1w) MRI data and a probabilistic atlas. Segmented atlases were constructed from CT training data using a leave-one-out framework and combined with T1w, DUTE, and CT data to train a classifier that computes the probability of air/soft tissue/bone at each voxel. This classifier was applied to segment the MRI of the subject of interest and attenuation maps (μ-maps) were generated by assigning specific linear attenuation coefficients (LACs) to each tissue class. The μ-maps generated with this “Atlas-T1w-DUTE” approach were compared to those obtained from DUTE data using a previously proposed method. For validation of the segmentation results, segmented CT μ-maps were considered to the “silver standard”; the segmentation accuracy was assessed qualitatively and quantitatively through calculation of the Dice similarity coefficient (DSC). Relative change (RC) maps between the CT and MRI-based attenuation corrected PET volumes were also calculated for a global voxel-wise assessment of the reconstruction results. The μ-maps obtained using the Atlas-T1w-DUTE classifier agreed well with those derived from CT; the mean DSCs for the Atlas-T1w-DUTE-based μ-maps across all subjects were higher than those for DUTE-based μ-maps; the atlas-based μ-maps also showed a lower percentage of misclassified voxels across all subjects. RC maps from the atlas-based technique also demonstrated improvement in the PET data compared to the DUTE method, both globally as well as regionally. PMID:24753982

  20. Probabilistic atlas-based segmentation of combined T1-weighted and DUTE MRI for calculation of head attenuation maps in integrated PET/MRI scanners.

    PubMed

    Poynton, Clare B; Chen, Kevin T; Chonde, Daniel B; Izquierdo-Garcia, David; Gollub, Randy L; Gerstner, Elizabeth R; Batchelor, Tracy T; Catana, Ciprian

    2014-01-01

    We present a new MRI-based attenuation correction (AC) approach for integrated PET/MRI systems that combines both segmentation- and atlas-based methods by incorporating dual-echo ultra-short echo-time (DUTE) and T1-weighted (T1w) MRI data and a probabilistic atlas. Segmented atlases were constructed from CT training data using a leave-one-out framework and combined with T1w, DUTE, and CT data to train a classifier that computes the probability of air/soft tissue/bone at each voxel. This classifier was applied to segment the MRI of the subject of interest and attenuation maps (μ-maps) were generated by assigning specific linear attenuation coefficients (LACs) to each tissue class. The μ-maps generated with this "Atlas-T1w-DUTE" approach were compared to those obtained from DUTE data using a previously proposed method. For validation of the segmentation results, segmented CT μ-maps were considered to the "silver standard"; the segmentation accuracy was assessed qualitatively and quantitatively through calculation of the Dice similarity coefficient (DSC). Relative change (RC) maps between the CT and MRI-based attenuation corrected PET volumes were also calculated for a global voxel-wise assessment of the reconstruction results. The μ-maps obtained using the Atlas-T1w-DUTE classifier agreed well with those derived from CT; the mean DSCs for the Atlas-T1w-DUTE-based μ-maps across all subjects were higher than those for DUTE-based μ-maps; the atlas-based μ-maps also showed a lower percentage of misclassified voxels across all subjects. RC maps from the atlas-based technique also demonstrated improvement in the PET data compared to the DUTE method, both globally as well as regionally.

  1. Intratumor Heterogeneity of Perfusion and Diffusion in Clear-Cell Renal Cell Carcinoma: Correlation With Tumor Cellularity.

    PubMed

    Yuan, Qing; Kapur, Payal; Zhang, Yue; Xi, Yin; Carvo, Ingrid; Signoretti, Sabina; Dimitrov, Ivan E; Cadeddu, Jeffrey A; Margulis, Vitaly; Brugarolas, James; Madhuranthakam, Ananth J; Pedrosa, Ivan

    2016-12-01

    Magnetic resonance imaging (MRI) has the potential to noninvasively provide information about the tumor microenvironment. A correlation between arterial spin-labeled (ASL) MRI and tumor vasculature has been previously demonstrated; however, its correlation with tumor cellularity is unknown. We sought to assess intratumor heterogeneity of perfusion and diffusion in vivo in clear-cell renal cell carcinoma (ccRCC) using MRI and to correlate these findings with tumor vascularity and cellularity at histopathology. Twenty-three ccRCC patients underwent ASL and diffusion-weighted MRI before surgery after signing an informed consent in this prospective institutional review board-approved, HIPAA (Insurance Portability and Accountability Act)-compliant study. Quantitative ASL perfusion and diffusion were measured in 2 areas within the same tumor with high and low perfusion. Microvessel density (MVD) on CD31 and CD34 immunostains and tumor cellularity in anatomically coregistered tissue samples were correlated to MRI measurements (Spearman; P < .05 statistically significant). ASL perfusion (P < .0001), CD31 MVD (P = .02), CD34 MVD (P = .04), and cellularity (P = .002) from high and low perfusion areas were significantly different across all tumors. There were positive correlations between tumor cellularity and CD31 MVD (ρ = 0.350, P = .021), CD31 and CD34 MVD (ρ = 0.838, P < .0001), ASL perfusion and cellularity (ρ = 0.406, P = .011), and ASL perfusion and CD31 MVD (ρ = 0.468, P = .003), and a negative correlation between tissue diffusion coefficient and cellularity (ρ = -0.316, P = .039). Tumor areas with high ASL perfusion exhibit higher cellularity and MVD compared to areas with low perfusion in the same tumor. A positive correlation between tumor vascularity and cellularity in ccRCC is newly reported. A negative correlation between tumor diffusion and cellularity is confirmed. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Accounting for the Confound of Meninges in Segmenting Entorhinal and Perirhinal Cortices in T1-Weighted MRI

    PubMed Central

    Wisse, Laura E.M.; Das, Sandhitsu R.; Wang, Hongzhi; Wolk, David A.; Manjón, Jose V.; Yushkevich, Paul A.

    2017-01-01

    Quantification of medial temporal lobe (MTL) cortices, including entorhinal cortex (ERC) and perirhinal cortex (PRC), from in vivo MRI is desirable for studying the human memory system as well as in early diagnosis and monitoring of Alzheimer’s disease. However, ERC and PRC are commonly over-segmented in T1-weighted (T1w) MRI because of the adjacent meninges that have similar intensity to gray matter in T1 contrast. This introduces errors in the quantification and could potentially confound imaging studies of ERC/PRC. In this paper, we propose to segment MTL cortices along with the adjacent meninges in T1w MRI using an established multi-atlas segmentation framework together with super-resolution technique. Experimental results comparing the proposed pipeline with existing pipelines support the notion that a large portion of meninges is segmented as gray matter by existing algorithms but not by our algorithm. Cross-validation experiments demonstrate promising segmentation accuracy. Further, agreement between the volume and thickness measures from the proposed pipeline and those from the manual segmentations increase dramatically as a result of accounting for the confound of meninges. Evaluated in the context of group discrimination between patients with amnestic mild cognitive impairment and normal controls, the proposed pipeline generates more biologically plausible results and improves the statistical power in discriminating groups in absolute terms comparing to other techniques using T1w MRI. Although the performance of the proposed pipeline is inferior to that using T2-weighted MRI, which is optimized to image MTL sub-structures, the proposed pipeline could still provide important utilities in analyzing many existing large datasets that only have T1w MRI available. PMID:28752156

  3. Accounting for the Confound of Meninges in Segmenting Entorhinal and Perirhinal Cortices in T1-Weighted MRI.

    PubMed

    Xie, Long; Wisse, Laura E M; Das, Sandhitsu R; Wang, Hongzhi; Wolk, David A; Manjón, Jose V; Yushkevich, Paul A

    2016-10-01

    Quantification of medial temporal lobe (MTL) cortices, including entorhinal cortex (ERC) and perirhinal cortex (PRC), from in vivo MRI is desirable for studying the human memory system as well as in early diagnosis and monitoring of Alzheimer's disease. However, ERC and PRC are commonly over-segmented in T1-weighted (T1w) MRI because of the adjacent meninges that have similar intensity to gray matter in T1 contrast. This introduces errors in the quantification and could potentially confound imaging studies of ERC/PRC. In this paper, we propose to segment MTL cortices along with the adjacent meninges in T1w MRI using an established multi-atlas segmentation framework together with super-resolution technique. Experimental results comparing the proposed pipeline with existing pipelines support the notion that a large portion of meninges is segmented as gray matter by existing algorithms but not by our algorithm. Cross-validation experiments demonstrate promising segmentation accuracy. Further, agreement between the volume and thickness measures from the proposed pipeline and those from the manual segmentations increase dramatically as a result of accounting for the confound of meninges. Evaluated in the context of group discrimination between patients with amnestic mild cognitive impairment and normal controls, the proposed pipeline generates more biologically plausible results and improves the statistical power in discriminating groups in absolute terms comparing to other techniques using T1w MRI. Although the performance of the proposed pipeline is inferior to that using T2-weighted MRI, which is optimized to image MTL sub-structures, the proposed pipeline could still provide important utilities in analyzing many existing large datasets that only have T1w MRI available.

  4. Diffusion-weighted MRI as a potential imaging biomarker reflecting the metastatic potential of upper urinary tract cancer

    PubMed Central

    Uchida, Y; Kobayashi, S; Koga, F; Ishioka, J; Satoh, S; Ishii, C; Tanaka, H; Matsuoka, Y; Numao, N; Saito, K; Masuda, H; Fujii, Y; Kihara, K

    2014-01-01

    Objective: To evaluate the role of diffusion-weighted MRI (DW-MRI) as an imaging biomarker for upper urinary tract cancer (UUTC) that has already metastasized or will metastasize soon. Methods: 61 patients clinically diagnosed with UUTC were prospectively enrolled in this study. All the patients underwent MRI, including DW-MRI, prior to any interventions. Correlations between apparent diffusion coefficient (ADC) and other clinicopathological variables, including metastasis-free survival, were analysed. Results: Median follow-up period was 938 days. Of the 61 patients, 12 had any metastases at the initial diagnosis. 11 patients developed metastases during the follow-up period. These 23 patients were categorized as “Metastatic”. Of the remaining 38 patients, 35 with a follow-up period longer than 400 days were categorized as “Localized”. ADC was significantly lower in the Metastatic category than in the Localized (p = 0.0002) category. Multivariate analysis of pre-operative variables identified ADC (cut-off value, 1.08 × 10−3 mm2 s−1) and clinical T stage based on T2 weighted MRI as an independent predictive factor of metastatic UUTC. 46 patients without any metastases during the initial diagnosis were stratified into a high-risk group (16 patients with low ADC and clinical T3–4) and a low-risk group (30 patients with high ADC or clinical Ta-2). The 3-year metastasis-free survivals were 45% and 93%, respectively. Conclusion: In the current study, UUTC with lower ADC value is more likely to have metastatic potential. Incorporating ADC with clinical T stage helps to differentiate metastatic UUTC at the initial diagnosis. Advances in knowledge: DW-MRI is a potential imaging biomarker reflecting metastatic propensity of UUTC. PMID:25074719

  5. M2 occlusions as targets for endovascular therapy: comprehensive analysis of diffusion/perfusion MRI, angiography, and clinical outcomes

    PubMed Central

    Sheth, Sunil A; Yoo, Bryan; Saver, Jeffrey L; Starkman, Sidney; Ali, Latisha K; Kim, Doojin; Gonzalez, Nestor R; Jahan, Reza; Tateshima, Satoshi; Duckwiler, Gary; Vinuela, Fernando; Liebeskind, David S

    2014-01-01

    Background The ideal population of patients for endovascular therapy (ET) in acute ischemic stroke remains undefined. Recent ET trials have moved towards selecting patients with proximal middle cerebral artery (MCA) or internal carotid artery occlusions, which will likely leave a gap in our understanding of the treatment outcomes of M2 occlusions. Objective and methods To examine the presentation, treatment, and outcomes of M2 compared with M1 MCA occlusions in patients undergoing ET by assessing comprehensive MRI, angiography, and clinical data. Results We found that M2 occlusions can lead to massive strokes defined by hypoperfused and infarcted volumes as well as death or moderate to severe disability in nearly 50% of patients at discharge. Compared with M1 occlusions, M2 occlusions achieved similar Thrombolysis in Cerebral Infarction (TICI) 2b/3 recanalization rates, with significantly less hemorrhage. M2 occlusions presented with smaller infarct and hypoperfused volumes and had smaller final infarct volumes regardless of recanalization. TICI 2b/3 recanalization of M2 occlusions was associated with smaller infarct volumes compared with TICI 0–2a recanalization, as well as less infarct expansion, in patients who received IV tissue plasminogen activator as well as those that did not. Successful reperfusion of M2 occlusions was associated with improved discharge modified Rankin scale. Conclusions If suitable as targets of ET, M2 occlusions should be given the same consideration as M1 occlusions. PMID:24821842

  6. Dynamic contrast-enhanced MRI in mouse tumors at 11.7 T: comparison of three contrast agents with different molecular weights to assess the early effects of combretastatin A4.

    PubMed

    Fruytier, A-C; Magat, J; Neveu, M-A; Karroum, O; Bouzin, C; Feron, O; Jordan, B; Cron, G O; Gallez, B

    2014-11-01

    Dynamic contrast-enhanced (DCE)-MRI is useful to assess the early effects of drugs acting on tumor vasculature, namely anti-angiogenic and vascular disrupting agents. Ultra-high-field MRI allows higher-resolution scanning for DCE-MRI while maintaining an adequate signal-to-noise ratio. However, increases in susceptibility effects, combined with decreases in longitudinal relaxivity of gadolinium-based contrast agents (GdCAs), make DCE-MRI more challenging at high field. The aim of this work was to explore the feasibility of using DCE-MRI at 11.7 T to assess the tumor hemodynamics of mice. Three GdCAs possessing different molecular weights (gadoterate: 560 Da, 0.29 mmol Gd/kg; p846: 3.5 kDa, 0.10 mmol Gd/kg; and p792: 6.47 kDa, 0.15 mmol Gd/kg) were compared to see the influence of the molecular weight in the highlight of the biologic effects induced by combretastatin A4 (CA4). Mice bearing transplantable liver tumor (TLT) hepatocarcinoma were divided into two groups (n = 5-6 per group and per GdCA): a treated group receiving 100 mg/kg CA4, and a control group receiving vehicle. The mice were imaged at 11.7 T with a T1 -weighted FLASH sequence 2 h after the treatment. Individual arterial input functions (AIFs) were computed using phase imaging. These AIFs were used in the Extended Tofts Model to determine K(trans) and vp values. A separate immunohistochemistry study was performed to assess the vascular perfusion and the vascular density. Phase imaging was used successfully to measure the AIF for the three GdCAs. In control groups, an inverse relationship between the molecular weight of the GdCA and K(trans) and vp values was observed. K(trans) was significantly decreased in the treated group compared with the control group for each GdCA. DCE-MRI at 11.7 T is feasible to assess tumor hemodynamics in mice. With K(trans) , the three GdCAs were able to track the early vascular effects induced by CA4 treatment.

  7. T1-weighted MRI as a substitute to CT for refocusing planning in MR-guided focused ultrasound.

    PubMed

    Wintermark, Max; Tustison, Nicholas J; Elias, William J; Patrie, James T; Xin, Wenjun; Demartini, Nicholas; Eames, Matt; Sumer, Suna; Lau, Benison; Cupino, Alan; Snell, John; Hananel, Arik; Kassell, Neal; Aubry, Jean-Francois

    2014-07-07

    Precise focusing is essential for transcranial MRI-guided focused ultrasound (TcMRgFUS) to minimize collateral damage to non-diseased tissues and to achieve temperatures capable of inducing coagulative necrosis at acceptable power deposition levels. CT is usually used for this refocusing but requires a separate study (CT) ahead of the TcMRgFUS procedure. The goal of this study was to determine whether MRI using an appropriate sequence would be a viable alternative to CT for planning ultrasound refocusing in TcMRgFUS. We tested three MRI pulse sequences (3D T1 weighted 3D volume interpolated breath hold examination (VIBE), proton density weighted 3D sampling perfection with applications optimized contrasts using different flip angle evolution and 3D true fast imaging with steady state precision T2-weighted imaging) on patients who have already had a CT scan performed. We made detailed measurements of the calvarial structure based on the MRI data and compared those so-called 'virtual CT' to detailed measurements of the calvarial structure based on the CT data, used as a reference standard. We then loaded both standard and virtual CT in a TcMRgFUS device and compared the calculated phase correction values, as well as the temperature elevation in a phantom. A series of Bland-Altman measurement agreement analyses showed T1 3D VIBE as the optimal MRI sequence, with respect to minimizing the measurement discrepancy between the MRI derived total skull thickness measurement and the CT derived total skull thickness measurement (mean measurement discrepancy: 0.025; 95% CL (-0.22-0.27); p = 0.825). The T1-weighted sequence was also optimal in estimating skull CT density and skull layer thickness. The mean difference between the phase shifts calculated with the standard CT and the virtual CT reconstructed from the T1 dataset was 0.08 ± 1.2 rad on patients and 0.1 ± 0.9 rad on phantom. Compared to the real CT, the MR-based correction showed a 1 °C drop on the maximum

  8. Diffusion-weighted magnetic resonance imaging reveals the effects of different cooling temperatures on the diffusion of water molecules and perfusion within human skeletal muscle.

    PubMed

    Yanagisawa, O; Fukubayashi, T

    2010-11-01

    To evaluate the effect of local cooling on the diffusion of water molecules and perfusion within muscle at different cooling temperatures. Magnetic resonance diffusion-weighted (DW) images of the leg (seven males) were obtained before and after 30 min cooling (0, 10, and 20°C), and after a 30 min recovery period. Two types of apparent diffusion coefficient (ADC; ADC1, reflecting both water diffusion and perfusion within muscle, and ADC2, approximating the true water diffusion coefficient) of the ankle dorsiflexors were calculated from DW images. T2-weighted images were also obtained to calculate T2 values of the ankle dorsiflexors. The skin temperature was measured before, during, and after cooling. Both ADC values significantly decreased after cooling under all cooling conditions; the rate of decrease depended on the cooling temperature used (ADC1: -36% at 0°C, -27.8% at 10°C, and -22.6% at 20°C; ADC2: -26% at 0°C, -21.1% at 10°C, and -14.6% at 20°C). These significant decreases were maintained during the recovery period. Conversely, the T2 value showed no significant changes. Under all cooling conditions, skin temperature significantly decreased during cooling; the rate of decrease depended on the cooling temperature used (-74.8% at 0°C, -51.1% at 10°C, and -26.8% at 20°C). Decreased skin temperatures were not restored to pre-cooling values during the recovery period under any cooling conditions. Local cooling decreased the water diffusion and perfusion within muscle with decreased skin temperature; the rates of decrease depended on the cooling temperature used. These decreases were maintained for 30 min after cooling. Copyright © 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  9. Diffusion-Weighted MRI for Nodal Staging of Head and Neck Squamous Cell Carcinoma: Impact on Radiotherapy Planning

    SciTech Connect

    Dirix, Piet; Vandecaveye, Vincent; De Keyzer, Frederik; Op de beeck, Katya; Poorten, Vincent Vander; Delaere, Pierre; Verbeken, Eric; Hermans, Robert; Nuyts, Sandra

    2010-03-01

    Purpose: To evaluate the use of diffusion-weighted magnetic resonance imaging (DW-MRI) for nodal staging and its impact on radiotherapy (RT) planning. Methods and Materials: Twenty-two patients with locally advanced head and neck squamous cell carcinoma underwent contrast-enhanced computed tomography (CT), as well as MRI (with routine and DW sequences) prior to neck dissection. After topographic correlation, lymph nodes were evaluated microscopically with prekeratin immunostaining. Pathology results were correlated with imaging findings and an RT planning study was performed for these surgically treated patients. One set of target volumes was based on conventional imaging only, and another set was based on the corresponding DW-MRI images. A third reference set was contoured based solely on pathology results. Results: A sensitivity of 89% and a specificity of 97% per lymph node were found for DW-MRI. Nodal staging agreement between imaging and pathology was significantly stronger for DW-MRI (kappa = 0.97; 95% confidence interval [CI], 0.84-1.00) than for conventional imaging (kappa = 0.56; 95% CI, 0.16-0.96; p = 0.019, by McNemar's test). For both imaging modalities, the absolute differences between RT volumes and those obtained by pathology were calculated. Using an exact paired Wilcoxon test, the observed difference was significantly larger for conventional imaging than for DW-MRI for nodal gross tumor volume (p = 0.0013), as well as for nodal clinical target volume (p = 0.0415) delineation. Conclusions: These results suggest that DW-MRI is superior to conventional imaging for preradiotherapy nodal staging of head and neck squamous cell carcinoma, and provides a potential impact on organsparing and tumor control.

  10. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    PubMed Central

    Copen, William A.; Morais, Livia T.; Wu, Ona; Schwamm, Lee H.; Schaefer, Pamela W.; González, R. Gilberto; Yoo, Albert J.

    2015-01-01

    Background and Purpose In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured “ischemic core.” The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI), but many authors suggest that maps of regional cerebral blood volume (CBV) derived from computed tomography perfusion imaging (CTP) can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume. Methods 58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: “objective absolute,” i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9–2.5 mL/100 g), “objective relative,” whose six thresholds (51%-60%) were fractions of mean contralateral CBV, and “subjective,” in which two radiologists (R1, R2) outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred. Results DWI was positive in 72% (42/58) of patients. CBV maps’ sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156–699 mL for objective absolute thresholds, and 127–200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124

  11. Comparison of Diffuse Weighted Imaging and Fluid Attenuation Inversion Recovery Sequences of MRI in Brain Multiple Sclerosis Plaques Detection.

    PubMed

    Nafisi-Moghadam, Reza; Rahimdel, Abolghasem; Shanbehzadeh, Tahereh; Fallah, Razieh

    2017-01-01

    Suitable magnetic resonance imaging (MRI) techniques from conventional to new devices can help physicians in diagnosis and follow up of Multiple Sclerosis (MS) patients. The aim of present research was to compare effectiveness of Fluid Attenuation Inversion Recovery (FLAIR) sequence of conventional MRI and Diffuse Weighted Imaging (DWI) sequence as a new technique in detection of brain MS plaques. In this analytic cross sectional study, sample size was assessed as 40 people to detect any significant difference between two sequences with a level of 0.05. DWI and FLAIR sequences of without contrast brain MRI of consecutive MS patients referred to MRI center of Shahid Sadoughi Hospital, Yazd, Iran from January to May 2012, were evaluated. Thirty-two females and 8 males with mean age of 35.20±9.80 yr (range = 11-66 yr) were evaluated and finally 340 plaques including 127(37.2%) in T2WI, 127(37.2%) in FLAIR, 63(18.5%) in DWI and 24(7.1%) in T1WI were detected. FLAIR sequence was more efficient than DWI in detection of brain MS plaques, oval, round, amorphous plaque shapes, frontal and occipital lobes, periventricular, intracapsular, corpus callosum, centrum semiovale, subcortical, basal ganglia plaques and diameter of detected MS plaques in DWI sequence was smaller than in FLAIR. Old lesion can be detected by conventional MRI and new techniques might be more useful in early inflammatory phase of MS and assessment of experimental treatments.

  12. Assessment of differential pulmonary blood flow using perfusion magnetic resonance imaging: comparison with radionuclide perfusion scintigraphy.

    PubMed

    Molinari, Francesco; Fink, Christian; Risse, Frank; Tuengerthal, Siegfried; Bonomo, Lorenzo; Kauczor, Hans-Ulrich

    2006-08-01

    We sought to assess the agreement between lung perfusion ratios calculated from pulmonary perfusion magnetic resonance imaging (MRI) and those calculated from radionuclide (RN) perfusion scintigraphy. A retrospective analysis of MR and RN perfusion scans was conducted in 23 patients (mean age, 60 +/- 14 years) with different lung diseases (lung cancer = 15, chronic obstructive pulmonary disease = 4, cystic fibrosis = 2, and mesothelioma = 2). Pulmonary perfusion was assessed by a time-resolved contrast-enhanced 3D gradient-echo pulse sequence using parallel imaging and view sharing (TR = 1.9 milliseconds; TE = 0.8 milliseconds; parallel imaging acceleration factor = 2; partition thickness = 4 mm; matrix = 256 x 96; in-plane spatial resolution = 1.87 x 3.75 mm; scan time for each 3D dataset = 1.5 seconds), using gadolinium-based contrast agents (injection flow rate = 5 mL/s, dose = 0.1 mmol/kg of body weight). The peak concentration (PC) of the contrast agent bolus, the pulmonary blood flow (PBF), and blood volume (PBV) were computed from the signal-time curves of the lung. Left-to-right ratios of pulmonary perfusion were calculated from the MR parameters and RN counts. The agreement between these ratios was assessed for side prevalence (sign test) and quantitatively (Deming-regression). MR and RN ratios agreed on side prevalence in 21 patients (91%) with PC, in 20 (87%) with PBF, and in 17 (74%) with PBV. The MR estimations of left-to-right perfusion ratios correlated significantly with those of RN perfusion scans (P < 0.01). The correlation was higher using PC (r = 0.67) and PBF (r = 0.66) than using PBV (r = 0.50). The MR ratios computed from PBF showed the highest accuracy, followed by those from PC and PBV. Independently from the MR parameter used, in some patients the quantitative difference between the MR and RN ratios was not negligible. Pulmonary perfusion MRI can be used to assess the differential blood flow of the lung. Further studies in a larger group

  13. Intravoxel incoherent motion diffusion‐weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma

    PubMed Central

    Paudyal, Ramesh; Oh, Jung Hun; Riaz, Nadeem; Venigalla, Praveen; Li, Jingao; Hatzoglou, Vaios; Leeman, Jonathan; Nunez, David Aramburu; Lu, Yonggang; Deasy, Joseph O.; Lee, Nancy

    2016-01-01

    Purpose Characterize and monitor treatment response in human papillomavirus (HPV) head and neck squamous cell carcinoma (HNSCC) using intra‐treatment (intra‐TX) imaging metrics derived from intravoxel incoherent motion (IVIM) diffusion‐weighted magnetic resonance imaging (DW‐MRI). Materials and Methods Thirty‐four (30 HPV positive [+] and 4 HPV negative [‐]) HNSCC patients underwent a total of 136 MRI including multi‐b value DW‐MRI (pretreatment [pre‐TX] and intra‐TX weeks 1, 2, and 3) at 3.0 Tesla. All patients were treated with chemo‐radiation therapy. Monoexponential (yielding apparent diffusion coefficient [ADC]) and bi‐exponential (yielding perfusion fraction [f], diffusion [D], and pseudo‐diffusion [D*] coefficients) fits were performed on a region of interest and voxel‐by‐voxel basis, on metastatic neck nodes. Response was assessed using RECISTv1.1. The relative percentage change in D, f, and D* between the pre‐ and intra‐TX weeks were used for hierarchical clustering. A Wilcoxon rank‐sum test was performed to assess the difference in metrics within and between the complete response (CR) and non‐CR groups. Results The delta (Δ) change in volume (V)1wk‐0wk for the CR group differed significantly (P = 0.016) from the non‐CR group, while not for V2wk‐0wk and V3wk‐0wk (P > 0.05). The mean increase in ΔD3wk‐0wk for the CR group was significantly higher (P = 0.017) than the non‐CR group. ADC and D showed an increasing trend at each intra‐TX week when compared with pre‐TX in CR group (P < 0.003). Hierarchical clustering demonstrated the existence of clusters in HPV + patients. Conclusion After appropriate validation in a larger population, these IVIM imaging metrics may be useful for individualized treatment in HNSCC patients. Level of Evidence: 2 J. Magn. Reson. Imaging 2017;45:1013–1023 PMID:27862553

  14. Dynamic contrast-enhanced and diffusion-weighted MRI of estrogen receptor-positive invasive breast cancers: Associations between quantitative MR parameters and Ki-67 proliferation status.

    PubMed

    Shin, Jong Ki; Kim, Jin You

    2017-01-01

    To explore the association between quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) and Ki-67 proliferation status in patients with estrogen receptor (ER)-positive invasive breast cancer. We retrospectively reviewed the records of 88 patients with ER-positive invasive breast cancer who underwent preoperative DCE-MRI and DWI on a 3T scanner. Perfusion parameters (K(trans) , Kep , and Ve ) and apparent diffusion coefficients (ADCs) were recorded, and we correlated these data with the Ki-67 status. The Ki-67 proliferation index was categorized as high (≥14%) or low (<14%). In the high-Ki-67 group, the mean K(trans) was significantly higher (P < 0.001) than that of the low-Ki-67 group, and the mean ADC significantly lower (P < 0.001). However, the mean Kep and Ve values did not differ between the two groups (P = 0.248 and P = 0.055, respectively). Univariate analysis showed that a higher K(trans) (>0.274), a lower ADC (≤0.893 × 10(-3) mm(2) /s), a larger tumor size (>2 cm), a higher histological grade (grade 3), the presence of axillary metastasis, and positive P53 status were significantly associated with high-Ki-67 status (all P values < 0.05). Of these variables, a higher K(trans) (>0.274; adjusted odds ratio [OR] = 9.027, 95% confidence interval [CI] = 1.929-42.245; P = 0.005) and a higher histological grade (grade 3; adjusted OR = 7.510, 95% CI = 1.305-43.205; P = 0.024) independently predicted a high Ki-67 status. K(trans) derived from DCE-MRI is associated independently with the Ki-67 proliferation status in patients with ER-positive invasive breast cancer. 4 J. Magn. Reson. Imaging 2017;45:94-102. © 2016 International Society for Magnetic Resonance in Medicine.

  15. Automatic brain tumor extraction from T1-weighted coronal MRI using fast bounding box and dynamic snake.

    PubMed

    Xu, Tao; Mandal, Mrinal

    2012-01-01

    Brain tumor segmentation from MRI data is an important but challenging task. This paper presents an efficient and fully automatic brain tumor segmentation technique. The proposed technique includes a fuzzy C-means (FCM) based preprocessing to enhance the quality of T1-weighted coronal MR images, a fast bounding box (FBB) detection algorithm to locate a rectangle around tumor, and a new dynamic snake using modified Hausdorff distance (MHD) for the final tumor extraction.

  16. Positional pelvic organ prolapse (POP) evaluation using open, weight-bearing magnetic resonance imaging (MRI).

    PubMed

    Friedman, Boris; Stothers, Lynn; Lazare, Darren; Macnab, Andrew

    2015-01-01

    Magnetic resonance imaging (MRI) of patients with pelvic organ prolapse (POP) is completed in the supine position. Open magnetic resonance imaging (MRO) uses vertical magnets, allowing imaging in a variety of upright postures. This pilot study used MRO to evaluate the change of prolapse in different positions compared to non-prolapsed images. In total, 11 women (6 POP, 5 controls) aged 24 to 65 years had 12 MRO images (midline sagittal pelvic line) consecutively when supine, sitting and standing with a full and empty bladder. Lengths between the lowest point of the bladder to the pubococcygeal (PC) and pubopromontoreal (PP) lines in each image were compared, and the ratio of bladder area under the PC and PP lines to the total bladder area. Significant elongation between the PC line and lowest point of the bladder was evident in subjects with POP comparing supine and standing images (p = 0.03), but not controls (p = 0.07). Similarly, this axis was significantly longer in cystocele subjects versus controls only in the standing position. Bladder area under the PC line was significantly increased between supine and standing positions only among subjects with cystocele (p < 0.01), and significantly larger among the study group in the standing position (p < 0.005), less significant in the supine position (p = 0.015), and not significant in the sitting position (p = 0.3). MRO imaging allows us to investigate the effects of upright position and weight bearing on the staging of POP. Imaging patients when sitting and standing identified that significant changes occur in the maximal descent of the bladder.

  17. Automated image quality evaluation of T2 -weighted liver MRI utilizing deep learning architecture.

    PubMed

    Esses, Steven J; Lu, Xiaoguang; Zhao, Tiejun; Shanbhogue, Krishna; Dane, Bari; Bruno, Mary; Chandarana, Hersh

    2017-06-03

    To develop and test a deep learning approach named Convolutional Neural Network (CNN) for automated screening of T2 -weighted (T2 WI) liver acquisitions for nondiagnostic images, and compare this automated approach to evaluation by two radiologists. We evaluated 522 liver magnetic resonance imaging (MRI) exams performed at 1.5T and 3T at our institution between November 2014 and May 2016 for CNN training and validation. The CNN consisted of an input layer, convolutional layer, fully connected layer, and output layer. 351 T2 WI were anonymized for training. Each case was annotated with a label of being diagnostic or nondiagnostic for detecting lesions and assessing liver morphology. Another independently collected 171 cases were sequestered for a blind test. These 171 T2 WI were assessed independently by two radiologists and annotated as being diagnostic or nondiagnostic. These 171 T2 WI were presented to the CNN algorithm and image quality (IQ) output of the algorithm was compared to that of two radiologists. There was concordance in IQ label between Reader 1 and CNN in 79% of cases and between Reader 2 and CNN in 73%. The sensitivity and the specificity of the CNN algorithm in identifying nondiagnostic IQ was 67% and 81% with respect to Reader 1 and 47% and 80% with respect to Reader 2. The negative predictive value of the algorithm for identifying nondiagnostic IQ was 94% and 86% (relative to Readers 1 and 2). We demonstrate a CNN algorithm that yields a high negative predictive value when screening for nondiagnostic T2 WI of the liver. 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017. © 2017 International Society for Magnetic Resonance in Medicine.

  18. No evidence of perfusion abnormalities in the basal ganglia of a patient with generalized chorea-ballism and polycythaemia vera: analysis using subtraction SPECT co-registered to MRI.

    PubMed

    Kim, Woojun; Kim, Joong-Seok; Lee, Kwang-Soo; Kim, Yeong-In; Park, Chong-Won; Chung, Yong-An

    2008-10-01

    Polycythaemia vera is a well-known cause of symptomatic chorea, however, the pathophysiology of this correlation remains unclear. We report on a patient with generalized chorea-ballism associated with polycythaemia vera, and we present the findings of 99mTc-hexamethylpropylene amine oxime (HMPAO) SPECT done in both the choreic state and the non-choreic state. The SPECT during both the choreic and the non-choreic states did not reveal any definite perfusion changes in specific regions of the brain, as compared with 6 age-matched controls. In addition, the subtraction SPECT co-registered to MRI (SISCOM) analysis did not show any difference in cerebral blood flow during the choreic and non-choreic states. This result suggests that the basic mechanism of chorea associated with polycythaemia vera does not appear to be associated with a reduction in cerebral perfusion to a specific cerebral area, such as the basal ganglia or its thalamocortical connections.

  19. Multiparametric MRI for prostate cancer detection: Preliminary results on quantitative analysis of dynamic contrast enhanced imaging, diffusion-weighted imaging and spectroscopy imaging.

    PubMed

    Fusco, Roberta; Sansone, Mario; Petrillo, Mario; Setola, Sergio Venanzio; Granata, Vincenza; Botti, Gerardo; Perdonà, Sisto; Borzillo, Valentina; Muto, Paolo; Petrillo, Antonella

    2016-09-01

    Early promising data suggest that combined use of both morphological and functional MRI (multi-parametric MR, mpMRI) including MRSI, DWI and DCE may be of additional value for prostate cancer localization and its local staging. The objective of this paper is to evaluate the diagnostic performance of mpMRI in the detection of prostate cancer. Thirty-one consecutive male patients were screened to be enrolled in a single center prospective observational study. All eligible patients underwent multi-parametric MRI and TRUS (Trans Rectal Ultra Sound) guided prostate biopsies. A register, approved by the Institutional Ethics Committee, included patients enrolled in this study. All patients who decided to undergo the MRI examination signed an explicit informed consensus. MRI data were aligned on a common spatial grid and several functional parameters (perfusion, diffusion and metabolic parameters) were computed. Statistical analysis was conducted in order to compare mpMRI with biopsy-based analysis. Statistically significant differences between median values in high Gleason score (≥5) and low Gleason score (<5) to Wilcox on rank sum test were obtained for MRSI parameters and for plasma fraction (Tofts model) of DCE-MRI. The area under curve obtained with ROC analysis showed that the best-performing single-parameter was vp (plasma fraction of Tofts model), while the best parameters combination to discriminate the area with high Gleason score were (Cho+Cr)/Cit and Cho+Cr. Linear Discrimination Analysis showed that the best results were obtained considering the linear combination of all MRSI parameters and the linear combination of all features (perfusion, diffusion and metabolic parameters). In conclusion, our findings showed that by combining morphological MRI, DWI, DCE-MRI and MRSI, an increase in sensitivity and specificity correlated to biopsy Gleason grade could be obtained. Furthermore, morphological and functional MRI could have a diagnostic role in patients with

  20. MRI diffusion-weighted imaging (DWI) in pediatric small bowel Crohn disease: correlation with MRI findings of active bowel wall inflammation.

    PubMed

    Ream, Justin M; Dillman, Jonathan R; Adler, Jeremy; Khalatbari, Shokoufeh; McHugh, Jonathan B; Strouse, Peter J; Dhanani, Muhammad; Shpeen, Benjamin; Al-Hawary, Mahmoud M

    2013-09-01

    Restricted diffusion on diffusion-weighted imaging (DWI) sequences during magnetic resonance enterography (MRE) has been shown in segments of bowel affected by Crohn disease. However, the exact meaning of this finding, particularly within the pediatric Crohn disease population, is poorly understood. The purpose of this study was to determine the significance of bowel wall restricted diffusion in children with small bowel Crohn disease by correlating apparent diffusion coefficient (ADC) values with other MRI markers of disease activity. A retrospective review of pediatric patients (≤ 18 years of age) with Crohn disease terminal ileitis who underwent MRE with DWI at our institution between May 1, 2009 and May 31, 2011 was undertaken. All of the children had either biopsy-proven Crohn disease terminal ileitis or clinically diagnosed Crohn disease, including terminal ileal involvement by imaging. The mean minimum ADC value within the wall of the terminal ileum was determined for each examination. ADC values were tested for correlation/association with other MRI findings to determine whether a relationship exists between bowel wall restricted diffusion and disease activity. Forty-six MRE examinations with DWI in children with terminal ileitis were identified (23 girls and 23 boys; mean age, 14.3 years). There was significant negative correlation or association between bowel wall minimum ADC value and established MRI markers of disease activity, including degree of bowel wall thickening (R = (-)0.43; P = 0.003), striated pattern of arterial enhancement (P = 0.01), degree of arterial enhancement (P = 0.01), degree of delayed enhancement (P = 0.045), amount of mesenteric inflammatory changes (P < 0.0001) and presence of a stricture (P = 0.02). ADC values were not significantly associated with bowel wall T2-weighted signal intensity, length of disease involvement or mesenteric fibrofatty proliferation. Increasing bowel wall restricted diffusion

  1. Using longitudinal metamorphosis to examine ischemic stroke lesion dynamics on perfusion-weighted images and in relation to final outcome on T2-w images

    PubMed Central

    Rekik, Islem; Allassonnière, Stéphanie; Carpenter, Trevor K.; Wardlaw, Joanna M.

    2014-01-01

    We extend the image-to-image metamorphosis into constrained longitudinal metamorphosis. We apply it to estimate an evolution scenario, in patients with acute ischemic stroke, of both scattered and solitary ischemic lesions visible on serial MR perfusion weighted imaging from acute to subacute stages. We then estimate a patient-specific residual map that enables us to capture the most relevant shape and intensity changes, continuously, as the lesion evolves from acute through subacute to chronic timepoints until merging into the final image. We detect areas with high residuals (i.e., high dynamics) and identify areas that became part of the final T2-w lesion obtained at ≥ 1 month after stroke. This allows the investigation of the dynamic influence of perfusion values on the final lesion outcome as seen on T2-w imaging. The model provides detailed insights into stroke lesion dynamic evolution in space and time that will help identify factors that determine final outcome and identify targets for interventions to improve outcome. PMID:25161899

  2. Detection of ischaemic myocardial lesions with coronary CT angiography and adenosine-stress dynamic perfusion imaging using a 128-slice dual-source CT: diagnostic performance in comparison with cardiac MRI

    PubMed Central

    Kim, S M; Choi, J-H; Chang, S-A

    2013-01-01

    Objective: We assessed the diagnostic performance of adenosine-stress dynamic CT perfusion (ASDCTP) imaging and coronary CT angiography (CCTA) for the detection of ischaemic myocardial lesions using 128-slice dual-source CT compared with that of 1.5 T cardiac MRI. Methods: This prospective study included 33 patients (61±8 years, 82% male) with suspected coronary artery diseases who underwent ASDCTP imaging and adenosine-stress cardiac MRI. Two investigators independently evaluated ASDCTP images in correlation with significant coronary stenosis on CCTA using two different thresholds of 50% and 70% diameter stenosis. Hypoattenuated myocardial lesions on ASDCTP associated with significant coronary stenoses on CCTA were regarded as true perfusion defects. All estimates of diagnostic performance were calculated and compared with those of cardiac MRI. Results: With use of a threshold of 50% diameter stenosis on CCTA, the diagnostic estimates per-myocardial segment were as follows: sensitivity, 81% [95% confidence interval (CI): 70–92%]; specificity, 94% (95% CI: 92–96%); and accuracy 93% (95% CI: 91–95%). With use of a threshold of 70%, the diagnostic estimates were as follows: sensitivity, 48% (95% CI: 34–62%); specificity, 99% (95% CI: 98–100%); and accuracy, 94% (95% CI: 92–96%). Conclusion: Dynamic CTP using 128-slice dual-source CT enables the assessment of the physiological significance of coronary artery lesions with high diagnostic accuracy in patients with clinically suspected coronary artery disease. Advances in knowledge: Combined CCTA and ASDCTP yielded high accuracy in the detection of perfusion defects regardless of the threshold of significant coronary stenosis. PMID:24096592

  3. Evaluating the Role of Reduced Oxygen Saturation and Vascular Damage in Traumatic Brain Injury Using Magnetic Resonance Perfusion-Weighted Imaging and Susceptibility-Weighted Imaging and Mapping.

    PubMed

    Kou, Zhifeng; Ye, Yongquan; Haacke, Ewart Mark

    2015-10-01

    The cerebral vasculature, along with neurons and axons, is vulnerable to biomechanical insult during traumatic brain injury (TBI). Trauma-induced vascular injury is still an underinvestigated area in TBI research. Cerebral blood flow and metabolism could be important future treatment targets in neural critical care. Magnetic resonance imaging offers a number of key methods to probe vascular injury and its relationship with traumatic hemorrhage, perfusion deficits, venous blood oxygen saturation changes, and resultant tissue damage. They make it possible to image the hemodynamics of the brain, monitor regional damage, and potentially show changes induced in the brain's function not only acutely but also longitudinally following treatment. These methods have recently been used to show that even mild TBI (mTBI) subjects can have vascular abnormalities, and thus they provide a major step forward in better diagnosing mTBI patients.

  4. High-resolution T2-weighted cervical cancer imaging: a feasibility study on ultra-high-field 7.0-T MRI with an endorectal monopole antenna.

    PubMed

    Hoogendam, Jacob P; Kalleveen, Irene M L; de Castro, Catalina S Arteaga; Raaijmakers, Alexander J E; Verheijen, René H M; van den Bosch, Maurice A A J; Klomp, Dennis W J; Zweemer, Ronald P; Veldhuis, Wouter B

    2017-03-01

    We studied the feasibility of high-resolution T2-weighted cervical cancer imaging on an ultra-high-field 7.0-T magnetic resonance imaging (MRI) system using an endorectal antenna of 4.7-mm thickness. A feasibility study on 20 stage IB1-IIB cervical cancer patients was conducted. All underwent pre-treatment 1.5-T MRI. At 7.0-T MRI, an external transmit/receive array with seven dipole antennae and a single endorectal monopole receive antenna were used. Discomfort levels were assessed. Following individualised phase-based B1(+) shimming, T2-weighted turbo spin echo sequences were completed. Patients had stage IB1 (n = 9), IB2 (n = 4), IIA1 (n = 1) or IIB (n = 6) cervical cancer. Discomfort (ten-point scale) was minimal at placement and removal of the endorectal antenna with a median score of 1 (range, 0-5) and 0 (range, 0-2) respectively. Its use did not result in adverse events or pre-term session discontinuation. To demonstrate feasibility, T2-weighted acquisitions from 7.0-T MRI are presented in comparison to 1.5-T MRI. Artefacts on 7.0-T MRI were due to motion, locally destructive B1 interference, excessive B1 under the external antennae and SENSE reconstruction. High-resolution T2-weighted 7.0-T MRI of stage IB1-IIB cervical cancer is feasible. The addition of an endorectal antenna is well tolerated by patients. • High resolution T 2 -weighted 7.0-T MRI of the inner female pelvis is challenging • We demonstrate a feasible approach for T 2 -weighted 7.0-T MRI of cervical cancer • An endorectal monopole receive antenna is well tolerated by participants • The endorectal antenna did not lead to adverse events or session discontinuation.

  5. Intravoxel incoherent motion diffusion-weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma.

    PubMed

    Bokacheva, Louisa; Kaplan, Jennifer B; Giri, Dilip D; Patil, Sujata; Gnanasigamani, Merlin; Nyman, C Gregory; Deasy, Joseph O; Morris, Elizabeth A; Thakur, Sunitha B

    2014-10-01

    To study the differentiation of malignant breast lesions from benign lesions and fibroglandular tissue (FGT) using apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters. This retrospective study included 26 malignant and 14 benign breast lesions in 35 patients who underwent diffusion-weighted MRI at 3.0T and nine b-values (0-1000 s/mm(2) ). ADC and IVIM parameters (perfusion fraction fp , pseudodiffusion coefficient Dp , and true diffusion coefficient Dd ) were determined in lesions and FGT. For comparison, IVIM was also measured in 16 high-risk normal patients. A predictive model was constructed using linear discriminant analysis. Lesion discrimination based on ADC and IVIM parameters was assessed using receiver operating characteristic (ROC) and area under the ROC curve (AUC). In FGT of normal subjects, fp was 1.1 ± 1.1%. In malignant lesions, fp (6.4 ± 3.1%) was significantly higher than in benign lesions (3.1 ± 3.3%, P = 0.0025) or FGT (1.5 ± 1.2%, P < 0.001), and Dd ((1.29 ± 0.28) × 10(-3) mm(2) /s) was lower than in benign lesions ((1.56 ± 0.28) × 10(-3) mm(2) /s, P = 0.011) or FGT ((1.86 ± 0.34) × 10(-3) mm(2) /s, P < 0.001). A combination of Dd and fp provided higher AUC for discrimination between malignant and benign lesions (0.84) or FGT (0.97) than ADC (0.72 and 0.86, respectively). The IVIM parameters provide accurate identification of malignant lesions. © 2013 Wiley Periodicals, Inc.

  6. Comparison of Diffuse Weighted Imaging and Fluid Attenuation Inversion Recovery Sequences of MRI in Brain Multiple Sclerosis Plaques Detection

    PubMed Central

    NAFISI-MOGHADAM, Reza; RAHIMDEL, Abolghasem; SHANBEHZADEH, Tahereh; FALLAH, Razieh

    2017-01-01

    Objective Suitable magnetic resonance imaging (MRI) techniques from conventional to new devices can help physicians in diagnosis and follow up of Multiple Sclerosis (MS) patients. The aim of present research was to compare effectiveness of Fluid Attenuation Inversion Recovery (FLAIR) sequence of conventional MRI and Diffuse Weighted Imaging (DWI) sequence as a new technique in detection of brain MS plaques. Materials & Methods In this analytic cross sectional study, sample size was assessed as 40 people to detect any significant difference between two sequences with a level of 0.05. DWI and FLAIR sequences of without contrast brain MRI of consecutive MS patients referred to MRI center of Shahid Sadoughi Hospital, Yazd, Iran from January to May 2012, were evaluated. Results Thirty-two females and 8 males with mean age of 35.20±9.80 yr (range = 11-66 yr) were evaluated and finally 340 plaques including 127(37.2%) in T2WI, 127(37.2%) in FLAIR, 63(18.5%) in DWI and 24(7.1%) in T1WI were detected. FLAIR sequence was more efficient than DWI in detection of brain MS plaques, oval, round, amorphous plaque shapes, frontal and occipital lobes, periventricular, intracapsular, corpus callosum, centrum semiovale, subcortical, basal ganglia plaques and diameter of detected MS plaques in DWI sequence was smaller than in FLAIR. Conclusion Old lesion can be detected by conventional MRI and new techniques might be more useful in early inflammatory phase of MS and assessment of experimental treatments. PMID:28277551

  7. Predictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo.

    PubMed

    Akoglu, Ebru Unal; Akoglu, Haldun; Cimilli Ozturk, Tuba; Onur, Bahaeddin; Eroglu, Serkan Emre; Onur, Ozge; Denizbasi, Arzu

    2017-09-23

    Vertigo is classified as peripheral and central. Differentiation of stroke mimics is the most important diagnostic challenge. There is no clinical guidance for the indications of neuroimaging in isolated vertigo patients. The primary aim of this study is to test the diagnostic value of a DWI-MRI protocol to rule-out a central cause in patients with acute isolated vertigo in the ED. We prospectively enrolled 144 patients who were presented with isolated vertigo to the ED. A detailed neurological examination and maneuvers were performed for differential diagnosis. All patients underwent CT and/or DW-MRI either during ED visit or at the follow-up, if necessary. Out-patient follow-up exams and evaluations were repeated until all patients had a definitive diagnosis. In the study, 137 of the 144 patients completed the follow-up period, and 34 of 137 patients were diagnosed with central vertigo. Six of 34 central vertigo patients had normal DW-MRI findings. One was diagnosed with migraine headache and five with vertebra-basilar insufficiency during the out-patient follow-up. One of the 28 patients with a pathological MRI was diagnosed with mass and the rest was stroke. The utility of DW-MRI in vertigo patients was moderately high (sensitivity: 82%, specificity: 100%). We found that age, history of HT, history of CAD and vertigo unresponsive to ED treatment were significantly associated with a central cause of vertigo. We suggest that unresponsiveness to ED treatment, especially in patients with a history of HT and CAD, should alert physicians for central causes and warrant DW-MRI imaging. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Salicylic acid analogues as chemical exchange saturation transfer MRI contrast agents for the assessment of brain perfusion territory and blood-brain barrier opening after intra-arterial infusion.

    PubMed

    Song, Xiaolei; Walczak, Piotr; He, Xiaowei; Yang, Xing; Pearl, Monica; Bulte, Jeff Wm; Pomper, Martin G; McMahon, Michael T; Janowski, Mirosław

    2016-07-01

    The blood-brain barrier (BBB) is a major obstacle for drug delivery to the brain. Predicted, focal opening of the BBB through intra-arterial infusion of hyperosmolar mannitol is feasible, but there is a need to facilitate imaging techniques (e.g. MRI) to guide interventional procedures and assess the outcomes. Here, we show that salicylic acid analogues (SAA) can depict the brain territory supplied by the catheter and detect the BBB opening, through chemical exchange saturation transfer (CEST) MRI. Hyperosmolar SAA solutions themselves are also capable of opening the BBB, and, when multiple SAA agents were co-injected, their locoregional perfusion could be differentiated. © The Author(s) 2016.

  9. In vivo cardiac diffusion-weighted magnetic resonance imaging: quantification of normal perfusion and diffusion coefficients with intravoxel incoherent motion imaging.

    PubMed

    Delattre, Benedicte M A; Viallon, Magalie; Wei, Hongjiang; Zhu, Yuemin M; Feiweier, Thorsten; Pai, Vinay M; Wen, Han; Croisille, Pierre

    2012-11-01

    Diffusion-weighted imaging (DWI) and the introduction of the intravoxel incoherent motion (IVIM) model have provided a unique method for evaluating perfusion and diffusion within a tissue without the need for a contrast agent. Despite its relevance, cardiac DWI has thus far been limited by low b values because of signal loss induced by physiological motion. The goal of this study was to develop a methodology for estimating IVIM parameters of in vivo cardiac magnetic resonance imaging using an efficient DWI acquisition framework. This was achieved by investigating various acquisition strategies (principal component analysis [PCA] filtering and temporal maximum intensity projection [PCATMIP] and single trigger delay [TD]) and fitting methods. Simulations were performed on a synthetic dataset of diffusion-weighted signal intensity (SI) to determine the fitting method that would yield IVIM parameters with the greatest accuracy. The required number of b values to correctly estimate IVIM parameters was also investigated. Breath-hold DWI scans were performed for 12 volunteers to collect several TD values during diastole. Thirteen b values ranging from 0 to 550 s/mm were used. The IVIM parameters derived using the data from all the acquired TDs (PCATMIP technique) were compared with those derived using a single acquisition performed at an optimized diastolic time point (1TD). The main result of this study was that PCATMIP, when combined with a fitting model that accounted for T1 and T2 relaxation, provided IVIM parameters with less variability. However, an acquisition performed with 1 optimized diastolic TD provided results that were as good as those provided using PCATMIP if the R-R variability during the acquisition was sufficiently low (± 5%). Furthermore, the use of only 9 b values (that could be acquired in 2 breath-holds), instead of 13 b values (requiring 3 breath-holds), was sufficient to determine the IVIM parameters. This study demonstrates that IVIM is

  10. Visual assessment of perfusion-diffusion mismatch is inadequate to select patients for thrombolysis.

    PubMed

    Campbell, Bruce C V; Christensen, Søren; Foster, Sarah J; Desmond, Patricia M; Parsons, Mark W; Butcher, Kenneth S; Barber, P Alan; Levi, Christopher R; Bladin, Christopher F; Donnan, Geoffrey A; Davis, Stephen M

    2010-01-01

    For MR perfusion-diffusion mismatch to be clinically useful as a means of selecting patients for thrombolysis, it needs to occur in real time at the MRI console. Visual mismatch assessment has been used clinically and in trials but has not been systematically validated. We compared the accuracy of visually rating console-generated images with offline volumetric measurements using data from the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET). Perfusion time-to-peak (TTP) and diffusion-weighted images (DWI) (as generated by commercial MRI console software) and T(max) perfusion maps (which required offline calculation) were visually rated. Perfusion-diffusion mismatch, defined as a ratio of perfusion:diffusion lesion volume of >1.2, was independently scored by 1 expert and 2 inexperienced raters blinded to calculated volumes and clinical information. Visual mismatch was compared with region-of-interest-based volumetric calculation, which was used as the gold standard. Volumetric calculation demonstrated perfusion-diffusion mismatch in 85/99 patients. Visual TTP-DWI mismatch was correctly classified by the experienced rater in 82% of the cases (sensitivity: 0.86; specificity: 0.54) compared to 73% for the inexperienced raters (sensitivity: 0.75; specificity: 0.57). The interrater reliability for TTP-DWI mismatch was moderate (kappa = 0.50). Visual T(max)-DWI mismatch performed better (agreement - 93 and 87%, sensitivity - 95 and 88%, specificity - 77 and 82% for the experienced and inexperienced raters, respectively). The assessment of visual TTP-DWI mismatch at the MRI console is insufficiently reliable for use in clinical trials. Differences in perfusion analysis technique and visual inaccuracies combine to make visual TTP-DWI mismatch substantially different to volumetric T(max)-DWI mismatch. Automated software that applies perfusion thresholds may improve the reproducibility of real-time mismatch assessment. Copyright 2010 S. Karger AG, Basel.

  11. Differentiation of Recurrent Glioblastoma Multiforme from Radiation Necrosis after External Beam Radiation Therapy with Dynamic Susceptibility-weighted Contrast-enhanced Perfusion MR Imaging1

    PubMed Central

    Barajas, Ramon F.; Chang, Jamie S.; Segal, Mark R.; Parsa, Andrew T.; McDermott, Michael W.; Berger, Mitchel S.; Cha, Soonmee

    2009-01-01

    Purpose: To investigate whether cerebral blood volume (CBV), peak height (PH), and percentage of signal intensity recovery (PSR) measurements derived from the results of T2*-weighted dynamic susceptibility-weighted contrast material–enhanced (DSC) magnetic resonance (MR) imaging performed after external beam radiation therapy (EBRT) can be used to distinguish recurrent glioblastoma multiforme (GBM) from radiation necrosis. Materials and Methods: Fifty-seven patients were enrolled in this HIPAA-compliant institutional review board–approved retrospective study after they received a diagnosis of GBM, underwent EBRT, and were examined with DSC MR imaging, which revealed progressive contrast enhancement within the radiation field. A definitive diagnosis was established at subsequent surgical resection or clinicoradiologic follow-up. Regions of interest were retrospectively drawn around the entire contrast-enhanced region. This created T2*-weighted signal intensity–time curves that produced three cerebral hemodynamic MR imaging measurements: CBV, PH, and PSR. Welch t tests were used to compare measurements between groups. Results: Mean, maximum, and minimum relative PH and relative CBV were significantly higher (P < .01) in patients with recurrent GBM than in patients with radiation necrosis. Mean, maximum, and minimum relative PSR values were significantly lower (P < .05) in patients with recurrent GBM than in patients with radiation necrosis. Conclusion: These findings suggest that DSC perfusion MR imaging may be used to differentiate recurrent GBM from EBRT-induced radiation necrosis. © RSNA, 2009 PMID:19789240

  12. MRI texture analysis (MRTA) of T2-weighted images in Crohn's disease may provide information on histological and MRI disease activity in patients undergoing ileal resection.

    PubMed

    Makanyanga, Jesica; Ganeshan, Balaji; Rodriguez-Justo, Manuel; Bhatnagar, Gauraang; Groves, Ashley; Halligan, Steve; Miles, Ken; Taylor, Stuart A

    2017-02-01

    To associate MRI textural analysis (MRTA) with MRI and histological Crohn's disease (CD) activity. Sixteen patients (mean age 39.5 years, 9 male) undergoing MR enterography before ileal resection were retrospectively analysed. Thirty-six small (≤3 mm) ROIs were placed on T2-weighted images and location-matched histological acute inflammatory scores (AIS) measured. MRI activity (mural thickness, T2 signal, T1 enhancement) (CDA) was scored in large ROIs. MRTA features (mean, standard deviation, mean of positive pixels (MPP), entropy, kurtosis, skewness) were extracted using a filtration histogram technique. Spatial scale filtration (SSF) ranged from 2 to 5 mm. Regression (linear/logistic) tested associations between MRTA and AIS (small ROIs), and CDA/constituent parameters (large ROIs). Skewness (SSF = 2 mm) was associated with AIS [regression coefficient (rc) 4.27, p = 0.02]. Of 120 large ROI analyses (for each MRI, MRTA feature and SSF), 15 were significant. Entropy (SSF = 2, 3 mm) and kurtosis (SSF = 3 mm) were associated with CDA (rc 0.9, 1.0, -0.45, p = 0.006-0.01). Entropy and mean (SSF = 2-4 mm) were associated with T2 signal [odds ratio (OR) 2.32-3.16, p = 0.02-0.004], [OR 1.22-1.28, p = 0.03-0.04]. MPP (SSF = 2 mm) was associated with mural thickness (OR 0.91, p = 0.04). Kurtosis (SSF = 3 mm), standard deviation (SSF = 5 mm) were associated with decreased T1 enhancement (OR 0.59, 0.42, p = 0.004, 0.007). MRTA features may be associated with CD activity. • MR texture analysis features may be associated with Crohn's disease histological activity. • Texture analysis features may correlate with MR-dependent Crohn's disease activity scores. • The utility of MR texture analysis in Crohn's disease merits further investigation.

  13. The utility of whole-body diffusion-weighted MRI for delineating regions of interest in PET

    NASA Astrophysics Data System (ADS)

    Blackledge, M. D.; Koh, D. M.; Collins, D. J.; Chua, S.; Leach, M. O.

    2013-02-01

    In this technological report, we investigate the utility of whole-body diffusion-weighted MRI (WBDWI) as a prior for defining regions of interest (ROI) in PET data. Due to its comparatively high resolution and excellent lesion-to-background ratio, semi-automatic segmentation is possible in WBDWI. Following rigid registration of PET to WBDWI, a simple, fast and automatic algorithm can be used to define ROIs in PET data. This approach is applied to a test cohort of patients diagnosed with lymphoma who underwent both 18FDG-PET/CT and WBDWI studies to demonstrate its potential application.

  14. Uncertainty in MR tracer kinetic parameters and water exchange rates estimated from T1-weighted dynamic contrast enhanced MRI

    PubMed Central

    Zhang, Jin; Kim, Sungheon

    2014-01-01

    Purpose The aim of this study was to assess the uncertainty in estimation of MR tracer kinetic parameters and water exchange rates in T1-weighted dynamic contrast enhanced (DCE)-MRI. Methods Simulated DCE-MRI data were used to assess four kinetic models; general kinetic model with a vascular compartment (GKM2), GKM2 combined with the 3S2X model (SSM2), adiabatic approximation of the tissue homogeneity model (ATH), and ATH combined 3S2X model (ATHX). Results In GKM2 and SSM2, increase in transfer constant (Ktrans) led to underestimation of vascular volume fraction (vb), and increase in vb led to overestimation of Ktrans. Such coupling between Ktrans and vb was not observed in ATH and ATHX. The precision of estimated intracellular water lifetime (τi) was substantially improved in both SSM2 and ATHX when Ktrans > 0.3 min−1. Ktrans and vb from ATHX model had significantly smaller errors than those from ATH model (p<0.05). Conclusion The results of this study demonstrated the feasibility of measuring τi from DCE-MRI data albeit low precision. While the inclusion of the water exchange model improved the accuracy of Ktrans, vb, and the interstitial volume fraction estimation (ve), it lowered the precision of other kinetic model parameters within the conditions investigated in this study. PMID:24006341

  15. Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy.

    PubMed

    Cheikh, Alexandre Ben; Girouin, Nicolas; Colombel, Marc; Maréchal, Jean-Marie; Gelet, Albert; Bissery, Alvine; Rabilloud, Muriel; Lyonnet, Denis; Rouvière, Olivier

    2009-03-01

    We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV.

  16. Evaluation of Fat Suppression of Diffusion-weighted Imaging Using Section Select Gradient Reversal Technique on 3 T Breast MRI.

    PubMed

    Takemori, Daichi; Kimura, Daisuke; Yamada, Eiji; Higashida, Mitsuji

    2016-07-01

    This study evaluates fat suppression of diffusion-weighted imaging (DWI) using section select gradient reversal (SSGR) technique in clinical images on 3 T breast MRI. A total of 20 patients with breast cancer were examined at a Philips Ingenia 3 T MRI. We acquired DWI with SPAIR, SSGR-SPAIR, STIR, and SSGR-STIR. We evaluated contrast between the fat region and lesion, the coefficient of variance (CV) of the fat region and the apparent diffusion coefficient (ADC) of normal breast tissue and lesion. The contrast between the fat region and lesion was improved with SSGR technique. The CV of the fattest region did not have any significant difference in SPAIR technique (p>0.05), but it was significantly decreased in the STIR technique using SSGR technique (p<0.05). Positive correlation was observed in ADC value between SPAIR and other fat suppression techniques (SSGR-SPAIR, STIR, SSGR-STIR). DWI using SSGR technique was suggested to be effective on 3 T breast MRI.

  17. Molecular imaging of water binding state and diffusion in breast cancer using diffuse optical spectroscopy and diffusion weighted MRI

    NASA Astrophysics Data System (ADS)

    Chung, So Hyun; Yu, Hon; Su, Min-Ying; Cerussi, Albert E.; Tromberg, Bruce J.

    2012-07-01

    Tissue water content and molecular microenvironment can provide important intrinsic contrast for cancer imaging. In this work, we examine the relationship between water optical spectroscopic features related to binding state and magnetic resonance imaging (MRI)-measured water diffusion dynamics. Broadband diffuse optical spectroscopic imaging (DOSI) and MR images were obtained from eight patients with locally-advanced infiltrating ductal carcinomas (tumor size=5.5±3.2 cm). A DOSI-derived bound water index (BWI) was compared to the apparent diffusion coefficient (ADC) of diffusion weighted (DW) MRI. BWI and ADC were positively correlated (R=0.90, p-value=0.003) and BWI and ADC both decreased as the bulk water content increased (R=-0.81 and -0.89, respectively). BWI correlated inversely with tumor size (R=-0.85, p-value=0.008). Our results suggest underlying sensitivity differences between BWI and ADC to water in different tissue compartments (e.g., extracellular vs cellular). These data highlight the potential complementary role of DOSI and DW-MRI in providing detailed information on the molecular disposition of water in breast tumors. Because DOSI is a portable technology that can be used at the bedside, BWI may provide a low-cost measure of tissue water properties related to breast cancer biology.

  18. Theoretical considerations in measurement of time discrepancies between input and myocardial time-signal intensity curves in estimates of regional myocardial perfusion with first-pass contrast-enhanced MRI.

    PubMed

    Natsume, Takahiro; Ishida, Masaki; Kitagawa, Kakuya; Nagata, Motonori; Sakuma, Hajime; Ichihara, Takashi

    2015-11-01

    The purpose of this study was to develop a method to determine time discrepancies between input and myocardial time-signal intensity (TSI) curves for accurate estimation of myocardial perfusion with first-pass contrast-enhanced MRI. Estimation of myocardial perfusion with contrast-enhanced MRI using kinetic models requires faithful recording of contrast content in the blood and myocardium. Typically, the arterial input function (AIF) is obtained by setting a region of interest in the left ventricular cavity. However, there is a small delay between the AIF and the myocardial curves, and such time discrepancies can lead to errors in flow estimation using Patlak plot analysis. In this study, the time discrepancies between the arterial TSI curve and the myocardial tissue TSI curve were estimated based on the compartment model. In the early phase after the arrival of the contrast agent in the myocardium, the relationship between rate constant K1 and the concentrations of Gd-DTPA contrast agent in the myocardium and arterial blood (LV blood) can be described by the equation K1={dCmyo(tpeak)/dt}/Ca(tpeak), where Cmyo(t) and Ca(t) are the relative concentrations of Gd-DTPA contrast agent in the myocardium and in the LV blood, respectively, and tpeak is the time corresponding to the peak of Ca(t). In the ideal case, the time corresponding to the maximum upslope of Cmyo(t), tmax, is equal to tpeak. In practice, however, there is a small difference in the arrival times of the contrast agent into the LV and into the myocardium. This difference was estimated to correspond to the difference between tpeak and tmax. The magnitudes of such time discrepancies and the effectiveness of the correction for these time discrepancies were measured in 18 subjects who underwent myocardial perfusion MRI under rest and stress conditions. The effects of the time discrepancies could be corrected effectively in the myocardial perfusion estimates. Copyright © 2015 Elsevier Inc. All rights

  19. Application of probabilistically weighted graphs to image-based diagnosis of Alzheimer's disease using diffusion MRI

    NASA Astrophysics Data System (ADS)

    Maryam, Syeda; McCrackin, Laura; Crowley, Mark; Rathi, Yogesh; Michailovich, Oleg

    2017-03-01

    The world's aging population has given rise to an increasing awareness towards neurodegenerative disorders, including Alzheimers Disease (AD). Treatment options for AD are currently limited, but it is believed that future success depends on our ability to detect the onset of the disease in its early stages. The most frequently used tools for this include neuropsychological assessments, along with genetic, proteomic, and image-based diagnosis. Recently, the applicability of Diffusion Magnetic Resonance Imaging (dMRI) analysis for early diagnosis of AD has also been reported. The sensitivity of dMRI to the microstructural organization of cerebral tissue makes it particularly well-suited to detecting changes which are known to occur in the early stages of AD. Existing dMRI approaches can be divided into two broad categories: region-based and tract-based. In this work, we propose a new approach, which extends region-based approaches to the simultaneous characterization of multiple brain regions. Given a predefined set of features derived from dMRI data, we compute the probabilistic distances between different brain regions and treat the resulting connectivity pattern as an undirected, fully-connected graph. The characteristics of this graph are then used as markers to discriminate between AD subjects and normal controls (NC). Although in this preliminary work we omit subjects in the prodromal stage of AD, mild cognitive impairment (MCI), our method demonstrates perfect separability between AD and NC subject groups with substantial margin, and thus holds promise for fine-grained stratification of NC, MCI and AD populations.

  20. Brain Tissue Compartment Density Estimated Using Diffusion-Weighted MRI Yields Tissue Parameters Consistent With Histology

    PubMed Central

    Sepehrband, Farshid; Clark, Kristi A.; Ullmann, Jeremy F.P.; Kurniawan, Nyoman D.; Leanage, Gayeshika; Reutens, David C.; Yang, Zhengyi

    2015-01-01

    We examined whether quantitative density measures of cerebral tissue consistent with histology can be obtained from diffusion magnetic resonance imaging (MRI). By incorporating prior knowledge of myelin and cell membrane densities, absolute tissue density values were estimated from relative intra-cellular and intra-neurite density values obtained from diffusion MRI. The NODDI (neurite orientation distribution and density imaging) technique, which can be applied clinically, was used. Myelin density estimates were compared with the results of electron and light microscopy in ex vivo mouse brain and with published density estimates in a healthy human brain. In ex vivo mouse brain, estimated myelin densities in different sub-regions of the mouse corpus callosum were almost identical to values obtained from electron microscopy (Diffusion MRI: 42±6%, 36±4% and 43±5%; electron microscopy: 41±10%, 36±8% and 44±12% in genu, body and splenium, respectively). In the human brain, good agreement was observed between estimated fiber density measurements and previously reported values based on electron microscopy. Estimated density values were unaffected by crossing fibers. PMID:26096639

  1. Prediction of infarct volume and neurologic outcome by using automated multiparametric perfusion-weighted magnetic resonance imaging in a primate model of permanent middle cerebral artery occlusion.

    PubMed

    Sasaki, Makoto; Kudo, Kohsuke; Honjo, Kaneyoshi; Hu, Jin-Qing; Wang, Hai-Bin; Shintaku, Katsuya

    2011-02-01

    By optimizing thresholds, we identified the perfusion-weighted magnetic resonance imaging (PWI) parameters that accurately predict final infarct volume and neurologic outcome in a primate model of permanent middle cerebral artery (MCA) occlusion. Ten cynomolgus monkeys underwent PWI and diffusion-weighted imaging (DWI) at 3 and 47 hours, respectively, after right MCA occlusion using platinum coils, and were killed at 48 hours. Volumes of the hypoperfused areas on PWI were automatically measured using different thresholds and 11 parametric maps to determine the optimum threshold (at which least difference was found between the average volumes on PWI and those determined using specimens or DWI). In the case of arrival time (AT), cerebral blood volume (CBV), time to peak (TTP), time to maximum (T(max)), and cerebral blood flow (CBF) determined using deconvolution techniques, the volume of the hypoperfused area significantly correlated with the infarct volumes and the neurologic deficit scores with small variations, whereas in the case of mean transit time and nondeconvolution CBF, relatively poor correlations with large variations were seen. At optimum threshold, AT, CBV, TTP, T(max), and deconvolution CBF can accurately predict the final infarct volume and neurologic outcome in monkeys with permanent MCA occlusion.

  2. Spatially constrained incoherent motion method improves diffusion-weighted MRI signal decay analysis in the liver and spleen

    PubMed Central

    Taimouri, Vahid; Afacan, Onur; Perez-Rossello, Jeannette M.; Callahan, Michael J.; Mulkern, Robert V.; Warfield, Simon K.; Freiman, Moti

    2015-01-01

    Purpose: To evaluate the effect of the spatially constrained incoherent motion (SCIM) method on improving the precision and robustness of fast and slow diffusion parameter estimates from diffusion-weighted MRI in liver and spleen in comparison to the independent voxel-wise intravoxel incoherent motion (IVIM) model. Methods: We collected diffusion-weighted MRI (DW-MRI) data of 29 subjects (5 healthy subjects and 24 patients with Crohn’s disease in the ileum). We evaluated parameters estimates’ robustness against different combinations of b-values (i.e., 4 b-values and 7 b-values) by comparing the variance of the estimates obtained with the SCIM and the independent voxel-wise IVIM model. We also evaluated the improvement in the precision of parameter estimates by comparing the coefficient of variation (CV) of the SCIM parameter estimates to that of the IVIM. Results: The SCIM method was more robust compared to IVIM (up to 70% in liver and spleen) for different combinations of b-values. Also, the CV values of the parameter estimations using the SCIM method were significantly lower compared to repeated acquisition and signal averaging estimated using IVIM, especially for the fast diffusion parameter in liver (CVIV IM = 46.61 ± 11.22, CVSCIM = 16.85 ± 2.160, p < 0.001) and spleen (CVIV IM = 95.15 ± 19.82, CVSCIM = 52.55 ± 1.91, p < 0.001). Conclusions: The SCIM method characterizes fast and slow diffusion more precisely compared to the independent voxel-wise IVIM model fitting in the liver and spleen. PMID:25832079

  3. Diagnostic capacity of non-echo planar diffusion-weighted MRI in the detection of primary and recurrent cholesteatoma.

    PubMed

    Garrido, Laura; Cenjor, Carlos; Montoya, Julia; Alonso, Ana; Granell, Jose; Gutiérrez-Fonseca, Raimundo

    2015-01-01

    the aim of this study was to determine the certainty of non-echo-planar imaging diffusion-weighted magnetic resonance imaging (non-EPI DW MRI) in the diagnosis of primary and recurrent cholesteatoma in patients with clinical suspicion of cholesteatoma, assessing the sensitivity and specificity of the test in both groups. Seventy-five patients with clinical suspicion of cholesteatoma were included in our study. Forty-eight cases had primary suspicion of cholesteatoma and 27 cases had recurrent suspicion of cholesteatoma. All patients received non-EPI DW MRI tests before surgery, and radiological and surgical findings were compared. Sensitivity, specificity and the positive and negative predictive value for primary diagnosis of cholesteatoma group were 91.2%, 50%, 81.6% and 70%, respectively. For the recurrent cholesteatoma group these results were 100%, 66.7%, 90.9% and 100%, respectively. Non-echo-planar imaging diffusion-weighted magnetic resonance imaging is a high sensitivity imaging test for detecting cholesteatoma, for both primary diagnosis and for recurrent cases. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  4. High-resolution diffusion imaging with DIFRAD-FSE (diffusion-weighted radial acquisition with fast spin echo) MRI

    NASA Astrophysics Data System (ADS)

    Theilmann, Rebecca Jean

    2001-12-01

    A novel MRI method, DIFRAD-FSE (Diffusion with R_adial A_cquisition of D_ata with F_ast S_pin-E_cho) is presented that enables rapid, high-resolution, multi-shot diffusion-weighted MRI without significant artifacts due to motion. Following a diffusion-weighted spin-echo preparation, multiple radial lines of Fourier data are acquired using spin-echo refocusing. Data can be acquired in either 2D or 3D Fourier space. Motion correction is accomplished via one of four correction techniques: phase correction, shift correction, a combination of the phase and shift correction, or magnitude. Images from a radial data set are reconstructed with filtered back projection reconstruction. Results from human brain imaging will demonstrate the ability of DIFRAD-FSE to acquire high- resolution images without significant artifacts due to motion in both 2D and 3D. Results from liver and heart imaging demonstrate the versatility of the 2D DIFRAD-FSE.

  5. Perfusion patterns in migraine with aura.

    PubMed

    Förster, Alex; Wenz, Holger; Kerl, Hans U; Brockmann, Marc A; Groden, Christoph

    2014-10-01

    Migraine with aura is a common neurological disorder, and differentiation from transient ischemic attack or stroke based on clinical symptoms may be difficult. From an MRI report database we identified 33 patients with migraine with aura and compared these to 33 age-matched ischemic stroke patients regarding perfusion patterns on perfusion-weighted imaging (PWI)-derived maps: time to peak (TTP), mean transit time (MTT), and cerebral blood flow and volume (CBF, CBV). In 18/33 (54.5%) patients with migraine with aura, TTP showed areas of hypoperfusion, most of these not limited to the territory of a specific artery but affecting two or more vascular territories. In patients with migraine with aura, TTP (1.09 ± 0.05 vs. 1.47 ± 0.40, p < 0.001) and MTT ratios (1.01 ± 0.10 vs. 1.19 ± 0.21, p = 0.003) were significantly lower compared to patients with ischemic stroke. In contrast to this, CBF and CBV ratios did not differ significantly between both groups. Migraine aura is usually associated with a perfusion deficit not limited to a specific vascular territory, and only a moderate increase of TTP. Thus, hypoperfusion restricted to a single vascular territory in combination with a marked increase of TTP or MTT may be regarded as atypical for migraine aura and suggestive of acute ischemic stroke. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Advanced MR imaging techniques in the evaluation of nonenhancing gliomas: perfusion-weighted imaging compared with proton magnetic resonance spectroscopy and tumor grade.

    PubMed

    Sahin, Neslin; Melhem, Elias R; Wang, Sumei; Krejza, Jaroslaw; Poptani, Harish; Chawla, Sanjeev; Verma, Gaurav

    2013-10-01

    A significant number of nonenhancing (NE) gliomas are reported to be malignant. The purpose of this study was to compare the value of advanced MR imaging techniques, including T2*-dynamic susceptibility contrast PWI (DSC-PWI) and proton magnetic resonance spectroscopy ((1)HMRS) in the evaluation of NE gliomas. Twenty patients with NE gliomas underwent MRI including DSC-PWI and (1)HMRS. The relative CBV (rCBV) measurements were obtained from regions of maximum perfusion. The peak ratios of choline/creatine (Cho/Cr) and myo-inositol/creatine (mIns/Cr) were measured at a TE of 30 ms. Demographic features, tumor volumes, and PWI- and (1)HMRS-derived measures were compared between low-grade gliomas (LGGs) and high-grade gliomas (HGGs). In addition, the association of initial rCBV ratio with tumor progression was evaluated in LGGs. No significant difference was noted in age, sex or tumor size between LGGs and HGGs. Cho/Cr ratios were significantly higher in HGGs (1.7±0.63) than in LGGs (1.2±0.38). The receiver operating characteristic analysis demonstrated that a Cho/Cr ratio with a cutoff value of 1.3 could differentiate between LGG and HGG with a specificity of 100% and a sensitivity of 71.4%. There was no significant difference in the rCBV ratio and the mIns/Cr ratio between LGG and HGG. However, higher rCBV ratios were observed with more rapid progressions in LGGs. The results imply that Cho/Cr ratios are useful in distinguishing NE LGG from HGG and can be helpful in preoperative grading and biopsy guidance. On the other hand, rCBV ratios do not help in the distinction.

  7. Comparative study of microelectrode recording-based STN location and MRI-based STN location in low to ultra-high field (7.0 T) T2-weighted MRI images

    NASA Astrophysics Data System (ADS)

    Verhagen, Rens; Schuurman, P. Richard; van den Munckhof, Pepijn; Fiorella Contarino, M.; de Bie, Rob M. A.; Bour, Lo J.

    2016-12-01

    Objective. The correspondence between the anatomical STN and the STN observed in T2-weighted MRI images used for deep brain stimulation (DBS) targeting remains unclear. Using a new method, we compared the STN borders seen on MRI images with those estimated by intraoperative microelectrode recordings (MER). Approach. We developed a method to automatically generate a detailed estimation of STN shape and the location of its borders, based on multiple-channel MER measurements. In 33 STNs of 19 Parkinson patients, we quantitatively compared the dorsal and lateral borders of this MER-based STN model with the STN borders visualized by 1.5 T (n = 14), 3.0 T (n = 10) and 7.0 T (n = 9) T2-weighted MRI. Main results. The dorsal border was identified more dorsally on coronal T2 MRI than by the MER-based STN model, with a significant difference in the 3.0 T (range 0.97-1.19 mm) and 7.0 T (range 1.23-1.25 mm) groups. The lateral border was significantly more medial on 1.5 T (mean: 1.97 mm) and 3.0 T (mean: 2.49 mm) MRI than in the MER-based STN; a difference that was not found in the 7.0 T group. Significance. The STN extends further in the dorsal direction on coronal T2 MRI images than is measured by MER. Increasing MRI field strength to 3.0 T or 7.0 T yields similar discrepancies between MER and MRI at the dorsal STN border. In contrast, increasing MRI field strength to 7.0 T may be useful for identification of the lateral STN border and thereby improve DBS targeting.

  8. The radiation dose to overweighted patients undergoing myocardial perfusion SPECT can be significantly reduced: validation of a linear weight-adjusted activity administration protocol.

    PubMed

    Oddstig, Jenny; Hindorf, Cecilia; Hedeer, Fredrik; Jögi, Jonas; Arheden, Håkan; Hansson, Magnus J; Engblom, Henrik

    2016-08-09

    Large body size can cause a higher proportion of emitted photons being attenuated within the patient. Therefore, clinical myocardial perfusion SPECT (MPS) protocols often include unproportionally higher radioisotope activity to obese patients. The aim was to evaluate if a linear weight-adjusted low-dose protocol can be applied to obese patients and thereby decrease radiation exposure. Two hundred patients (>110 kg, BMI 18-41, [n = 69], ≤ 110 kg, BMI 31-58, [n = 131]) underwent (99m)Tc-tetrofosmin stress examination on a Cadmium Zinc Telluride or a conventional gamma camera using new generations of reconstruction algorithm (Resolution Recovery). Patients <110 kg were administered 2.5 MBq/kg, patients between 110 and 120 kg received 430 MBq and patients >120 kg received 570 MBq according to clinical routine. Patients >110 kg had 130% total number of counts in the images compared to patients <110 kg. Recalculating the counts to correspond to an administered activity of 2.5 MBq/kg resulted in similar number of counts across the groups. Image analyses in a subgroup with images corresponding to high activity and 2.5 MBq/kg showed no difference in image quality or ischemia quantification. Linear low-dose weight-adjusted protocol of 2.5 MBq/kg in MPS can be applied over a large weight span without loss of counts or image quality, resulting in a significant reduction in radiation exposure to obese patients.

  9. Reproducibility of Kidney Perfusion Measurements With Arterial Spin Labeling at 1.5 Tesla MRI Combined With Semiautomatic Segmentation for Differential Cortical and Medullary Assessment

    PubMed Central

    Hammon, Matthias; Janka, Rolf; Siegl, Christian; Seuss, Hannes; Grosso, Roberto; Martirosian, Petros; Schmieder, Roland E.; Uder, Michael; Kistner, Iris

    2016-01-01

    Abstract Magnetic resonance imaging with arterial spin labeling (ASL) is a noninvasive approach to measure organ perfusion. The purpose of this study was to evaluate the reproducibility of ASL kidney perfusion measurements with semiautomatic segmentation, which allows separate quantification of cortical and medullary perfusion. The right kidneys of 14 healthy volunteers were examined 6 times on 2 occasions (3 times at each occasion). There was a 10-minute pause between each examination and a 14-day interval between the 2 occasions. Cortical, medullary, and whole kidney parenchymal perfusion was determined with customized semiautomatic segmentation software. Coefficient of variances (CVs) and intraclass correlations (ICCs) were calculated. Mean whole, cortical, and medullary kidney perfusion was 307.26 ± 25.65, 337.10 ± 34.83, and 279.61 ± 26.73 mL/min/100 g, respectively. On session 1, mean perfusion for the whole kidney, cortex, and medulla was 307.08 ± 26.91, 336.79 ± 36.54, and 279.60 ± 27.81 mL/min/100 g, respectively, and on session 2, 307.45 ± 24.65, 337.41 ± 33.48, and 279.61 ± 25.94 mL/min/100 g, respectively (P > 0.05; R2 = 0.60/0.59/0.54). For whole, cortical, and medullary kidney perfusion, the total ICC/CV were 0.97/3.43 ± 0.86%, 0.97/4.19 ± 1.33%, and 0.96/4.12 ± 1.36%, respectively. Measurements did not differ significantly and showed a very good correlation (P > 0.05; R2 = 0.75/0.76/0.65). ASL kidney measurements combined with operator-independent semiautomatic segmentation revealed high correlation and low variance of cortical, medullary, and whole kidney perfusion. PMID:26986143

  10. A Unified Computational Framework for Deconvolution to Reconstruct Multiple Fibers From Diffusion Weighted MRI

    PubMed Central

    Jian, Bing

    2008-01-01

    Diffusion magnetic resonance imaging (MRI) is a relatively new imaging modality which is capable of measuring the diffusion of water molecules in biological systems noninvasively. The measurements from diffusion MRI provide unique clues for extracting orientation information of brain white matter fibers and can be potentially used to infer the brain connectivity in vivo using tractography techniques. Diffusion tensor imaging (DTI), currently the most widely used technique, fails to extract multiple fiber orientations in regions with complex microstructure. In order to overcome this limitation of DTI, a variety of reconstruction algorithms have been introduced in the recent past. One of the key ingredients in several model-based approaches is deconvolution operation which is presented in a unified deconvolution framework in this paper. Additionally, some important computational issues in solving the deconvolution problem that are not addressed adequately in previous studies are described in detail here. Further, we investigate several deconvolution schemes towards achieving stable, sparse, and accurate solutions. Experimental results on both simulations and real data are presented. The comparisons empirically suggest that nonnegative least squares method is the technique of choice for the multifiber reconstruction problem in the presence of intravoxel orientational heterogeneity. PMID:18041262

  11. Advanced MRI for Pediatric Brain Tumors with Emphasis on Clinical Benefits.

    PubMed

    Goo, Hyun Woo; Ra, Young-Shin

    2017-01-01

    Conventional anatomic brain MRI is often limited in evaluating pediatric brain tumors, the most common solid tumors and a leading cause of death in children. Advanced brain MRI techniques have great potential to improve diagnostic performance in children with brain tumors and overcome diagnostic pitfalls resulting from diverse tumor pathologies as well as nonspecific or overlapped imaging findings. Advanced MRI techniques used for evaluating pediatric brain tumors include diffusion-weighted imaging, diffusion tensor imaging, functional MRI, perfusion imaging, spectroscopy, susceptibility-weighted imaging, and chemical exchange saturation transfer imaging. Because pediatric brain tumors differ from adult counterparts in various aspects, MRI protocols should be designed to achieve maximal clinical benefits in pediatric brain tumors. In this study, we review advanced MRI techniques and interpretation algorithms for pediatric brain tumors.

  12. Advanced MRI for Pediatric Brain Tumors with Emphasis on Clinical Benefits

    PubMed Central

    Ra, Young-Shin

    2017-01-01

    Conventional anatomic brain MRI is often limited in evaluating pediatric brain tumors, the most common solid tumors and a leading cause of death in children. Advanced brain MRI techniques have great potential to improve diagnostic performance in children with brain tumors and overcome diagnostic pitfalls resulting from diverse tumor pathologies as well as nonspecific or overlapped imaging findings. Advanced MRI techniques used for evaluating pediatric brain tumors include diffusion-weighted imaging, diffusion tensor imaging, functional MRI, perfusion imaging, spectroscopy, susceptibility-weighted imaging, and chemical exchange saturation transfer imaging. Because pediatric brain tumors differ from adult counterparts in various aspects, MRI protocols should be designed to achieve maximal clinical benefits in pediatric brain tumors. In this study, we review advanced MRI techniques and interpretation algorithms for pediatric brain tumors. PMID:28096729

  13. Prognosis Prediction of Measurable Enhancing Lesion after Completion of Standard Concomitant Chemoradiotherapy and Adjuvant Temozolomide in Glioblastoma Patients: Application of Dynamic Susceptibility Contrast Perfusion and Diffusion-Weighted Imaging

    PubMed Central

    Kim, Jae Hyun; Choi, Seung Hong; Ryoo, Inseon; Yun, Tae Jin; Kim, Tae Min; Lee, Se-Hoon; Park, Chul-Kee; Kim, Ji-Hoon; Sohn, Chul-Ho; Park, Sung-Hye; Kim, Il Han

    2014-01-01

    Purpose To assess the prognosis predictability of a measurable enhancing lesion using histogram parameters produced by the normalized cerebral blood volume (nCBV) and normalized apparent diffusion coefficient (nADC) after completion of standard concomitant chemoradiotherapy (CCRT) and adjuvant temozolomide (TMZ) medication in glioblastoma multiforme (GBM) patients. Materials and Methods This study was approved by the institutional review board (IRB), and the requirement for informed consent was waived. A total of 59 patients with newly diagnosed GBM who received standard CCRT with TMZ and adjuvant TMZ for six cycles underwent perfusion-weighted and diffusion-weighted imaging. Twenty-seven patients had a measurable enhancing lesion and 32 patients lacked a measurable enhancing lesion based on the Response Assessment in Neuro-Oncology (RANO) criteria in the follow-up MRI, which was performed within 3 months after adjuvant TMZ therapy was completed. We measured the nCBV and nADC histogram parameters based on the measurable enhancing lesion. The progression free survival (PFS) was analyzed by the Kaplan-Meier method with the use of the log-rank test. Results The median PFS of patients lacking measurable enhancing lesion was longer than for those with measurable enhancing lesions (17.6 vs 3.3 months, P<.0001). There was a significant, positive correlation between the 99th percentile nCBV value of a measurable enhancing lesion and the PFS (P = .044, R2 = .152). In addition, the median PFS was longer in patients with a 99th percentile nCBV value ≧4.5 than it was in those with a value <4.5 (4.4 vs 3.1 months, P = .036). Conclusion We found that the nCBV value can be used for the prognosis prediction of a measurable enhancing lesion after the completion of standard treatment for GBM, wherein a high 99th percentile nCBV value (≧4.5) suggests a better PFS for GBM patients. PMID:25419975

  14. Differentiation of central lung cancer from atelectasis: comparison of diffusion-weighted MRI with PET/CT.

    PubMed

    Yang, Rui-Meng; Li, Long; Wei, Xin-Hua; Guo, Yong-Mei; Huang, Yun-Hai; Lai, Li-Sha; Chen, A-Mei; Liu, Guo-Shun; Xiong, Wei-Feng; Luo, Liang-Ping; Jiang, Xin-Qing

    2013-01-01

    Prospectively assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis. 38 consecutive lung cancer patients (26 males, 12 females; age range: 28-71 years; mean age: 49 years) who were referred for thoracic MR imaging examinations were enrolled. MR examinations were performed using a 1.5-T clinical scanner and scanning sequences of T1WI, T2WI, and DWI. Cancers and atelectasis were measured by mapping of the apparent diffusion coefficients (ADCs) obtained with a b-value of 500 s/mm(2). PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm(2)/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both). DW-MR imaging provides valuable information not obtained by conventional MR and may be useful for differentiation of central lung carcinoma from atelectasis. Future developments may allow DW-MR imaging to be used as an alternative to PET-CT in imaging of patients with lung cancer.

  15. Differentiation of Central Lung Cancer from Atelectasis: Comparison of Diffusion-Weighted MRI with PET/CT

    PubMed Central

    Yang, Rui-Meng; Li, Long; Wei, Xin-Hua; Guo, Yong-Mei; Huang, Yun-Hai; Lai, Li-Sha; Chen, A-Mei; Liu, Guo-Shun; Xiong, Wei-Feng; Luo, Liang-Ping; Jiang, Xin-Qing

    2013-01-01

    Objective Prospectively assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis. Materials and Methods 38 consecutive lung cancer patients (26 males, 12 females; age range: 28–71 years; mean age: 49 years) who were referred for thoracic MR imaging examinations were enrolled. MR examinations were performed using a 1.5-T clinical scanner and scanning sequences of T1WI, T2WI, and DWI. Cancers and atelectasis were measured by mapping of the apparent diffusion coefficients (ADCs) obtained with a b-value of 500 s/mm2. Results PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm2/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both). Conclusions DW-MR imaging provides valuable information not obtained by conventional MR and may be useful for differentiation of central lung carcinoma from atelectasis. Future developments may allow DW-MR imaging to be used as an alternative to PET-CT in imaging of patients with lung cancer. PMID:23593186

  16. Lesion patterns and etiology of ischemia in the anterior inferior cerebellar artery territory involvement: a clinical - diffusion weighted - MRI study.

    PubMed

    Kumral, E; Kisabay, A; Ataç, C

    2006-04-01

    The topography and mechanism of stroke in the anterior inferior cerebellar artery (AICA) territory are delineated before, but the detailed clinical spectrum of lesions involving AICA territory was not studied by diffusion weighted imaging (DWI). We reviewed 1350 patients with posterior circulation ischemic stroke in our registry. We included patients if the diagnosis of AICA territory involvement was confirmed, and DWI, and magnetic resonance angiography were obtained in the 3 days of symptoms onset. The potential feeding arteries of the AICA territory were evaluated on magnetic resonance imaging (MRI) using a three-dimensional rotating cineoangiographic method. There were 23 consecutive patients with lesion involving AICA territory, six with isolated lesion in the AICA territory, six with posterior inferior cerebellar artery, 11 with multiple posterior circulation infarcts (MPCIs). The clinical feature of isolated AICA infarct was vertigo, tinnitus, dysmetria, ataxia, facial weakness, facial sensory deficits, lateral gaze palsy, and sensory-motor deficits in patients with pontine involvement. Patients with largest lesion extending to the anterior and inferolateral cerebellum showed mixed symptomatology of the lateral medullary (Wallenberg's syndrome) and AICA territory involvement. Patients with MPCIs presented various clinical pictures with consciousness disturbances and diverse clinical signs because of involvement of different anatomical structures. Large-artery atherosclerotic disease in the vertebrobasilar system was the main cause of stroke in 12 (52%) patients, cardioembolism (CE) in one (4%), and coexisting large-artery disease and a source of CE in four (17%). The main cause of stroke was atheromatous vertebrobasilar artery disease either in the distal vertebral or proximal basilar artery. The outcome was usually good except those with multiple lesions. The new MRI techniques and clinical correlations allow better definition of the diverse topographical

  17. Immunochemotherapy with Intensive Consolidation for Primary CNS Lymphoma: A Pilot Study and Prognostic Assessment by Diffusion-Weighted MRI

    PubMed Central

    Wieduwilt, Matthew J.; Valles, Francisco; Issa, Samar; Behler, Caroline M.; Hwang, James; McDermott, Michael; Treseler, Patrick; O’Brien, Joan; Shuman, Marc A.; Cha, Soonmee; Damon, Lloyd E.; Rubenstein, James L.

    2012-01-01

    Purpose We evaluated a novel therapy for primary central nervous system (CNS) lymphoma (PCNSL) using induction immunochemotherapy with high-dose methotrexate, temozolomide and rituximab (MT-R) followed by intensive consolidation with infusional etoposide and high-dose cytarabine (EA). In addition, we evaluated the prognostic value of the minimum apparent diffusion coefficient (ADCmin) derived from diffusion-weighted magnetic resonance imaging (DW-MRI) in patients treated with this regimen. Experimental Design Thirty-one patients (median age, 61; median KPS, 60) received induction with methotrexate every 14 days for 8 planned cycles. Rituximab was administered the first 6 cycles and temozolomide administered on odd-numbered cycles. Patients with responsive or stable CNS disease received EA consolidation. Pretreatment DW-MRI was used to calculate the ADCmin of contrast-enhancing lesions. Results The complete response rate for MT-R induction was 52%. At a median follow-up of 79 months, the 2-year progression-free and overall survival were 45% and 58%, respectively. For patients receiving EA consolidation, the 2-year progression-free and overall survival were 78% and 93%, respectively. EA consolidation was also effective in an additional 3 patients who presented with synchronous CNS and systemic lymphoma. Tumor ADCmin <384 × 10−6 mm2/s was significantly associated with shorter progression-free and overall survival. Conclusions MT-R induction was effective and well-tolerated. MT-R followed by EA consolidation yielded progression-free and overall survival outcomes comparable to regimens using chemotherapy followed by whole-brain radiotherapy consolidation but without evidence of neurotoxicity. Tumor ADCmin derived from DW-MRI provided better prognostic information for PCNSL patients treated with the MTR-EA regimen than established clinical risk scores. PMID:22228634

  18. Interictal diffusion and perfusion magnetic resonance imaging features of cats with familial spontaneous epilepsy.

    PubMed

    Mizoguchi, Shunta; Hasegawa, Daisuke; Hamamoto, Yuji; Yu, Yoshihiko; Kuwabara, Takayuki; Fujiwara-Igarashi, Aki; Fujita, Michio

    2017-03-01

    OBJECTIVE To evaluate the usefulness of diffusion and perfusion MRI of the cerebrum in cats with familial spontaneous epilepsy (FSECs) and identify microstructural and functional deficit zones in affected cats. ANIMALS 19 FSECs and 12 healthy cats. PROCEDURES Diffusion-weighted, diffusion tensor, and perfusion-weighted MRI of the cerebrum were performed during interictal periods in FSECs. Imaging findings were compared between FSECs and control cats. Diffusion (apparent diffusion coefficient and fractional anisotropy) and perfusion (relative cerebral blood volume [rCBV], relative cerebral blood flow [rCBF], and mean transit time) variables were measured bilaterally in the hippocampus, amygdala, thalamus, parietal cortex gray matter, and subcortical white matter. Asymmetry of these variables in each region was also evaluated and compared between FSECs and control cats. RESULTS The apparent diffusion coefficient of the total amygdala of FSECs was significantly higher, compared with that of control cats. The fractional anisotropy of the right side and total hippocampus of FSECs was significantly lower, compared with that of control cats. The left and right sides and total hippocampal rCBV and rCBF were significantly lower in FSECs than in control cats. The rCBV and rCBF of the parietal cortex gray matter in FSECs were significantly lower than in control cats. CONCLUSIONS AND CLINICAL RELEVANCE In FSECs, diffusion and perfusion MRI detected microstructural changes and hypoperfusion (lowered function) in the cerebrum during interictal periods from that of healthy cats. These findings indicated that diffusion and perfusion MRI may be useful for noninvasive evaluation of epileptogenic foci in cats.

  19. Predicting Cerebral Hyperperfusion Syndrome Following Superficial Temporal Artery to Middle Cerebral Artery Bypass based on Intraoperative Perfusion-Weighted Magnetic Resonance Imaging.

    PubMed

    Wang, Defeng; Zhu, Fengping; Fung, Ka Ming; Zhu, Wei; Luo, Yishan; Chu, Winnie Chiu Wing; Mok, Vincent Chung Tong; Wu, Jinsong; Shi, Lin; Ahuja, Anil T; Mao, Ying

    2015-09-14

    Moyamoya disease leads to the formation of stenosis in the cerebrovasculature. A superficial temporal artery to middle cerebral artery (STA-MCA) bypass is an effective treatment for the disease, yet it is usually associated with postoperative cerebral hyperperfusion syndrome (CHS). This study aimed to evaluate cerebral hemodynamic changes immediately after surgery and assess whether a semiquantitative analysis of an intraoperative magnetic resonance perfusion-weighted image (PWI) is useful for predicting postoperative CHS. Fourteen patients who underwent the STA-MCA bypass surgery were included in this study. An atlas-based registration method was employed for studying hemodynamics in different cerebral regions. Pre- versus intraoperative and group-wise comparisons were conducted to evaluate the hemodynamic changes. A postoperative increase in relative cerebral blood flow (CBF) at the terminal MCA territory (P = 0.035) and drop in relative mean-time-transit at the central MCA territory (P = 0.012) were observed in all patients. However, a significant raise in the increasing ratio of relative-CBF at the terminal MCA territory was only found in CHS patients (P = 0.023). The cerebrovascular changes of the patients after revascularization treatment were confirmed. Intraoperative PWI might be helpful in predicting the change in relative-CBF at MCA terminal territory which might indicate a risk of CHS.

  20. Robust dynamic myocardial perfusion CT deconvolution for accurate residue function estimation via adaptive-weighted tensor total variation regularization: a preclinical study

    NASA Astrophysics Data System (ADS)

    Zeng, Dong; Gong, Changfei; Bian, Zhaoying; Huang, Jing; Zhang, Xinyu; Zhang, Hua; Lu, Lijun; Niu, Shanzhou; Zhang, Zhang; Liang, Zhengrong; Feng, Qianjin; Chen, Wufan; Ma, Jianhua

    2016-11-01

    Dynamic myocardial perfusion computed tomography (MPCT) is a promising technique for quick diagnosis and risk stratification of coronary artery disease. However, one major drawback of dynamic MPCT imaging is the heavy radiation dose to patients due to its dynamic image acquisition protocol. In this work, to address this issue, we present a robust dynamic MPCT deconvolution algorithm via adaptive-weighted tensor total variation (AwTTV) regularization for accurate residue function estimation with low-mA s data acquisitions. For simplicity, the presented method is termed ‘MPD-AwTTV’. More specifically, the gains of the AwTTV regularization over the original tensor total variation regularization are from the anisotropic edge property of the sequential MPCT images. To minimize the associative objective function we propose an efficient iterative optimization strategy with fast convergence rate in the framework of an iterative shrinkage/thresholding algorithm. We validate and evaluate the presented algorithm using both digital XCAT phantom and preclinical porcine data. The preliminary experimental results have demonstrated that the presented MPD-AwTTV deconvolution algorithm can achieve remarkable gains in noise-induced artifact suppression, edge detail preservation, and accurate flow-scaled residue function and MPHM estimation as compared with the other existing deconvolution algorithms in digital phantom studies, and similar gains can be obtained in the porcine data experiment.

  1. Resource Atlases for Multi-Atlas Brain Segmentations with Multiple Ontology Levels Based on T1-Weighted MRI

    PubMed Central

    Wu, Dan; Ma, Ting; Ceritoglu, Can; Li, Yue; Chotiyanonta, Jill; Hou, Zhipeng; Hsu, John; Xu, Xin; Brown, Timothy; Miller, Michael I.; Mori, Susumu

    2015-01-01

    Technologies for multi-atlas brain segmentation of T1-weighted MRI images have rapidly progressed in recent years, with highly promising results. This approach, however, relies on a large number of atlases with accurate and consistent structural identifications. Here, we introduce our atlas inventories (n = 90), which cover ages 4 – 82 years with unique hierarchical structural definitions (286 structures at the finest level). This multi-atlas library resource provides the flexibility to choose appropriate atlases for various studies with different age ranges and structure-definition criteria. In this paper, we describe the details of the atlas resources and demonstrate the improved accuracy achievable with a dynamic age-matching approach, in which atlases that most closely match the subject’s age are dynamically selected. The advanced atlas creation strategy, together with atlas pre-selection principles, are expected to support the further development of multi-atlas image segmentation. PMID:26499813

  2. Resource atlases for multi-atlas brain segmentations with multiple ontology levels based on T1-weighted MRI.

    PubMed

    Wu, Dan; Ma, Ting; Ceritoglu, Can; Li, Yue; Chotiyanonta, Jill; Hou, Zhipeng; Hsu, John; Xu, Xin; Brown, Timothy; Miller, Michael I; Mori, Susumu

    2016-01-15

    Technologies for multi-atlas brain segmentation of T1-weighted MRI images have rapidly progressed in recent years, with highly promising results. This approach, however, relies on a large number of atlases with accurate and consistent structural identifications. Here, we introduce our atlas inventories (n=90), which cover ages 4-82years with unique hierarchical structural definitions (286 structures at the finest level). This multi-atlas library resource provides the flexibility to choose appropriate atlases for various studies with different age ranges and structure-definition criteria. In this paper, we describe the details of the atlas resources and demonstrate the improved accuracy achievable with a dynamic age-matching approach, in which atlases that most closely match the subject's age are dynamically selected. The advanced atlas creation strategy, together with atlas pre-selection principles, is expected to support the further development of multi-atlas image segmentation.

  3. MRI assessment of local acute radiation syndrome.

    PubMed

    Weber-Donat, G; Amabile, J-C; Lahutte-Auboin, M; Potet, J; Baccialone, J; Bey, E; Teriitehau, C; Laroche, P

    2012-12-01

    To describe local acute radiation syndrome and its radiological imaging characteristics. We performed a retrospective study of patients who had suffered skin and deeper radiation damage who were investigated by magnetic resonance imaging (MRI). We compared the clinical findings, C-reactive protein (CRP) levels and MRI results. A total of 22 MRI examinations were performed between 2005 and 2010 in 7 patients; 6 patients had increased CRP levels and MRI abnormalities. They were treated by surgery and local cellular therapy. One patient had no CRP or MRI abnormalities, and had a spontaneous good outcome. Eighteen abnormal MR examinations demonstrated high STIR signal and/or abnormal enhancement in the dermis and muscle tissues. Three MRI examinations demonstrated skeletal abnormalities, consistent with radionecrosis. The four normal MRI examinations were associated only with minor clinical manifestations such as pain and pigmentation disorders. MRI seems to be a useful and promising imaging investigation in radiation burns management i.e. initial lesion evaluation, treatment evaluation and complication diagnosis. MRI findings correlated perfectly with clinical stage and no false negative examinations were obtained. In particular, the association between normal MRI and low CRP level seems to be related to good outcome without specific treatment. Local acute radiation syndrome (radioepidermitis) mainly affects the skin and superficial tissues. MRI findings correspond with clinical stage (with a strong negative predictive value). MRI outperformed X-ray examination for the diagnosis of bone radionecrosis. Diffusion-weighted imaging shows low ADC in bone and soft tissue necrosis. Perfusion sequence allows assessment of tissue microcirculation impairment.

  4. Relationship between pretreatment FDG-PET and diffusion-weighted MRI biomarkers in diffuse large B-cell lymphoma

    PubMed Central

    de Jong, Antoinette; Kwee, Thomas C; de Klerk, John MH; Adam, Judit A; de Keizer, Bart; Fijnheer, Rob; Kersten, Marie José; Ludwig, Inge; Jauw, Yvonne WS; Zijlstra, Josée M; den Bos, Indra C Pieters - Van; Stoker, Jaap; Hoekstra, Otto S; Nievelstein, Rutger AJ

    2014-01-01

    The purpose of this study was to determine the correlation between the 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) standardized uptake value (SUV) and the diffusion-weighted magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Pretreatment FDG-PET and diffusion-weighted MRI of 21 patients with histologically proven DLBCL were prospectively analyzed. In each patient, maximum, mean and peak standardized uptake value (SUV) was measured in the lesion with visually highest FDG uptake and in the largest lesion. Mean ADC (ADCmean, calculated with b-values of 0 and 1000 s/mm2) was measured in the same lesions. Correlations between FDG-PET metrics (SUVmax, SUVmean, SUVpeak) and ADCmean were assessed using Pearson’s correlation coefficients. In the lesions with visually highest FDG uptake, no significant correlations were found between the SUVmax, SUVmean, SUVpeak and the ADCmean (P=0.498, P=0.609 and P=0.595, respectively). In the largest lesions, there were no significant correlations either between the SUVmax, SUVmean, SUVpeak and the ADCmean (P=0.992, P=0.843 and P=0.894, respectively). The results of this study indicate that the glycolytic rate as measured by FDG-PET and changes in water compartmentalization and water diffusion as measured by the ADC are independent biological phenomena in newly diagnosed DLBCL. Further studies are warranted to assess the complementary roles of these different imaging biomarkers in the evaluation and follow-up of DLBCL. PMID:24795837

  5. [An advantage of T2*-weighted MRI for early detection of straight sinus thrombosis: a case report].

    PubMed

    Saito, Satoshi; Takahashi, Makio; Nonoguchi, Naosuke; Ohta, Tsuyoshi; Takahashi, Jun A; Matsumoto, Sadayuki

    2009-10-01

    A 44-year-old man presented with a 12-day history of severe non-throbbing headache. He showed no physical abnormality but obesity. On day 12, ring-shaped low intensity lesions inside straight sinus were revealed on T2*-weighted MRI image (T2*WI). On the following day (day 13), he was found unresponsive at home, and ambulated with disturbed consciousness. FLAIR and diffusion-weighted MRI image disclosed high intensity signals in bilateral thalamus which were postulated as vasogenic edema. MR venography and conventional cerebral angiography showed an absence of flow in inferior sagittal sinus, vein of Galen, and straight sinus. These findings confirmed the diagnosis of cerebral venous thrombosis (CVT). Anticoagulant treatment was introduced and his consciousness level was gradually improved. On day 43, he was discharged with no neurological sequelae. A delay of correct diagnosis and treatment with CVT can lead to devastating disability or even to death. An early diagnosis of CVT is often dismissed owing to the nonspecific symptoms such as headache and nausea. Recent reports described high sensitivity of T2*WI for detecting CVT. Alterations in blood flow and oxyhemoglobin reduced products, deoxyhemoglobin, in thrombosed veins often produce the magnetic susceptibility on T2*WI. A detection of ring-shaped low intensity lesions within venous sinus on T2*WI were quite rare, and the signal changes of these sinus lesions were successfully visualized by chronological T2*WI. Taken together, our case implies that T2*WI is the powerful tool for the early detection of CVT, even before the critical symptoms might happen.

  6. Therapeutic response in musculoskeletal soft tissue sarcomas: evaluation by MRI.

    PubMed

    Wang, Xin; Jacobs, Michael A; Fayad, Laura

    2011-07-01

    This article provides a literature review of the use of MRI in monitoring the treatment response of soft tissue sarcomas. The basic classification and physiology of soft tissue tumors are introduced. Then, the major treatment options for soft tissue sarcomas are summarized with brief coverage of possible responses and grading systems. Four major branches of MRI techniques are covered, including conventional T(1) - and T(2) -weighted imaging, contrast-enhanced MRI, MR diffusion and perfusion imaging, and MRS, with a focus on the tumor microenvironment. Although this literature survey focuses on recent clinical developments using these MRI techniques, research venues in preclinical studies, as well as in potential applications other than soft tissue sarcomas, are also included when comparable and/or mutually supporting. Examples from other less-discussed MRI modalities are also briefly covered, not only to complement, but also to expand, the scope and depth of information for various kinds of lesions. Copyright © 2011 John Wiley & Sons, Ltd.

  7. Liver metastases from colorectal cancer treated with conventional and antiangiogenetic chemotherapy: evaluation with liver computed tomography perfusion and magnetic resonance diffusion-weighted imaging.

    PubMed

    Anzidei, Michele; Napoli, Alessandro; Zaccagna, Fulvio; Cartocci, Gaia; Saba, Luca; Menichini, Guendalina; Cavallo Marincola, Beatrice; Marincola, Beatrice Cavallo; Marotta, Eugenio; Di Mare, Luisa; Catalano, Carlo; Passariello, Roberto

    2011-01-01

    The objectives of the study were to determine whether perfusion computed tomography (CT-p) and magnetic resonance diffusion-weighted imaging (MR-DWI) can allow evaluation of the effects of chemotherapy combined with antiangiogenetic treatment on liver metastases in patients with advanced colorectal cancer and to determine if changes in CT-p and MR-DWI correlate with the response to therapy as assessed by conventional Response Evaluation Criteria in Solid Tumors (RECIST). Eighteen patients with liver metastases from colorectal cancer underwent CT-p and MR-DWI before and 6 months after chemotherapy and antiangiogenetic treatment. Lesions were classified according to RECIST criteria (complete response [CR], partial response [PR], stable disease [SD], and progressive disease) and calculations of CT-p parameters including blood flow (BF), blood volume (BV), capillary permeability (CP), and MR-DWI apparent diffusion coefficient (ADC) values were performed; RECIST, CT-p, and MR-DWI measurements at baseline and follow-up were tested for statistically significant differences using the paired-samples t test. Baseline and follow-up perfusion parameters of the lesions were also compared on the basis of therapy response assessed by RECIST criteria using independent-samples t test. P < 0.05 was considered indicative of a statistically significant difference for all statistical test. Six patients (6/18; 33.3%) were classified as PR (), and the remaining 12 (12/18; 66.7%) were classified as SD. On a per-lesion basis, 2 (2/32; 6.3%) cannot be identified at follow-up, 6 (6/32; 18.8%) showed a decrease in size of more than 30%, and 24 (24/32; 75%) were substantially stable in size. No cases of progressive disease were demonstrated at follow-up. No statistically significant differences were demonstrated between PR, CR, and SD lesions for BF (P = 0.19), BV (P = 0.14), and ADC (P = 0.68) measurements, whereas CP was significantly higher in CR and PR lesions (P = 0.038). Considering

  8. [The evaluation of cerebral function by diffusion weighted imaging after norepinephrine-induced hypertensive perfusion therapy in pig model of cardiac arrest].

    PubMed

    Su, Zhi-yu; Li, Chun-sheng

    2013-02-01

    To evaluate the changes in cerebral function of pigs with cardiac arrest (CA) after recovery of spontaneous circulation (ROSC) after hypertension perfusion therapy induced by norepinephrine (NE). Ventricular fibrillation (VF) was induced by electrical stimulation, and standard cardiopulmonary resuscitation (CPR) was performed after VF for 4 minutes. The pigs with successful ROSC were randomly divided into two group, each n=5. The pigs in the hypertensive reperfusion group were given with NE immediately to maintain the mean arterial pressure (MAP) at 130% before VF for 4 hours; MAP of the pigs in normal reperfusion group was maintained for 4 hours as baseline. The changes in hemodynamics were observed for 4 hours in both groups. Cerebral cortex was scanned with diffusion weighted imaging (DWI) before VF and 1 hour and 3 hours after ROSC, and the dynamic changes in brain functional imaging were observed. Twenty-four hours after ROSC, brain biopsy were collected and examined after hematoxylin and eosin staining (HE). Compared with the normal reperfusion group, heart rate (HR), MAP, cardiac output (CO) and coronary perfusion pressure (CPP) in the hypertensive reperfusion group showed a tendency to increase (ROSC 30 minutes HR: 167±8 bpm vs. 140±15 bpm, ROSC 1 hour MAP: 131±9 mm Hg vs. 108±10 mm Hg, ROSC 1 hour CO: 4.9±0.1 L/min vs. 3.4±0.5 L/min, ROSC 2 hours CPP: 118±12 mm Hg vs. 88±1 mm Hg, P<0.05 or P<0.01). There was no obvious abnormality as shown by DWI before and after resuscitation, and the apparent diffusion coefficient (ADC) showed a tendency to decrease after resuscitation in both groups. The ADC in the normal reperfusion group was decreased more than that in the hypertensive reperfusion. Pathological study showed that the protective effect of the hypertensive reperfusion on brain tissue was better than that of the normal reperfusion group. Hypertensive reperfusion can produce hemodynamic changes, and an increase in cerebral blood flow, thus it

  9. Clinically silent choroid plexus cyst: evaluation by diffusion-weighted MRI.

    PubMed

    Kinoshita, Toshibumi; Moritani, Toshio; Hiwatashi, Akio; Numaguchi, Yuji; Wang, Henry Z; Westesson, Per-Lennart A; Sugihara, Shuji; Matsusue, Eiji; Fujii, Shinya; Ohama, Eisaku; Ogawa, Toshihide

    2005-04-01

    We retrospectively reviewed diffusion-weighted magnetic resonance images of 57 patients with a choroid plexus cyst diagnosed by contrast-enhanced T1-weighted imaging. All the cysts appeared to represent incidental findings. Thirty-eight of 57 patients had bilateral cysts and 19 had unilateral ones. On diffusion-weighted images, 78 of 95 cysts showed homogeneously high signal intensity, 12 showed focal high signal areas, and 5 had no portion with a high signal. The apparent diffusion coefficient of the high signal areas in the cysts was (1.46+/-0.14) x10(-3) mm(2)/s, intermediate between the apparent diffusion coefficients of cerebrospinal fluid and cerebral white matter, (3.15+/-0.67) x10(-3) and (0.79+/-0.22) x10(-3) mm(2)/s, respectively. Pathological correlation was available in one case, showing high signal intensity areas in the glomera of the choroid plexuses in the lateral ventricles on diffusion-weighted images corresponding to gelatinous cysts with highly proteinaceous content.

  10. Staging of Primary Abdominal Lymphomas: Comparison of Whole-Body MRI with Diffusion-Weighted Imaging and 18F-FDG-PET/CT

    PubMed Central

    Stecco, Alessandro; Buemi, Francesco; Quagliozzi, Martina; Lombardi, Mariangela; Santagostino, Alberto; Sacchetti, Gian Mauro; Carriero, Alessandro

    2015-01-01

    Background. The purpose of this study was to compare the accuracy of whole-body MRI with diffusion-weighted sequences (WB-DW-MRI) with that of 18F-FDG-PET/CT in the staging of patients with primary gastrointestinal lymphoma. Methods. This retrospective study involved 17 untreated patients with primary abdominal gastrointestinal lymphoma. All patients underwent 18F-FDG-PET/CT and WB-DW-MRI. Histopathology findings or at least 6 months of clinical and radiological follow-up was the gold standard. The Musshoff-modified Ann Arbor system was used for staging, and diagnostic accuracy was evaluated on a per-node basis. Results. WB-DW-MRI exhibited 100% sensitivity, 96.3% specificity, and 96.1% and 100% positive and negative predictive values (PPV and NPV), respectively. The sensitivity, specificity, and PPV and NPV of PET/CT were 95.9%, 100%, and 100% and 96.4%, respectively. There were no statistically significant differences between the two techniques (p = 0.05). The weighted kappa agreement statistics with a 95% confidence interval were 0.97 (0.95–0.99) between the two MRI readers and 0.87 (0.82–0.92) between the two methods. Conclusions. WB-DW-MRI appears to have a comparable diagnostic value to 18F-FDG-PET/CT in staging patients with gastrointestinal lymphoma. PMID:26798331

  11. Can T2-weighted 3-T breast MRI predict clinically occult inflammatory breast cancer before pathological examination? A single-center experience.

    PubMed

    Uematsu, Takayoshi; Kasami, Masako; Watanabe, Junichiro

    2014-01-01

    Occult inflammatory breast cancer (IBC) is defined as an invasive cancer without any clinical inflammatory signs but with pathologically proven dermal lymphovascular invasion. The purpose of this study is to evaluate the ability of 3-T breast MRI to predict occult IBC before pathological examination and compare its effectiveness with that of mammography (MMG) and ultrasound (US). A retrospective review of clinical, radiological, and pathological records of 460 consecutive breast cancers revealed five proved occult IBCs. We analyzed the findings of 3-T MRI, MMG, and US for these five occult IBCs. Primary breast lesions were detected by 3-T MRI, MMG, and US in all five breasts with occult IBCs. 3-T MRI revealed 40% mass type lesions and 60% non-mass-like type lesions. Kinetic curve analysis of the primary breast lesions showed a rapid initial kinetic phase in 80% of lesions and a delayed washout pattern in 60% of lesions. 3-T MRI showed slight skin thickness in 60% of breasts, whereas MMG and US showed slight skin thickness in 40 and 20% of breasts, respectively. Subcutaneous and prepectoral edema, as evaluated on T2-weighted images, was present in all five breasts with occult IBCs. The presence of subcutaneous and prepectoral edema on T2-weighted 3-T breast MRI is an important finding that should suggest the diagnosis of occult IBC before pathological examination.

  12. Slowly resolving global myocardial inflammation/oedema in Tako-Tsubo cardiomyopathy: evidence from T2-weighted cardiac MRI.

    PubMed

    Neil, Christopher; Nguyen, Thanh Ha; Kucia, Angela; Crouch, Benjamin; Sverdlov, Aaron; Chirkov, Yuliy; Mahadavan, Gnanadevan; Selvanayagam, Joseph; Dawson, Dana; Beltrame, John; Zeitz, Christopher; Unger, Steven; Redpath, Thomas; Frenneaux, Michael; Horowitz, John

    2012-09-01

    Tako-Tsubo cardiomyopathy (TTC) is associated with regional left ventricular dysfunction, independent of the presence of fixed coronary artery disease. Previous studies have used T2-weighted cardiac MRI to demonstrate the presence of periapical oedema. The authors sought to determine the distribution, resolution and correlates of oedema in TTC. 32 patients with TTC were evaluated at a median of 2 days after presentation, along with 10 age-matched female controls. Extent of oedema was quantified both regionally and globally; scanning was repeated in patients with TTC after 3 months. Correlations were sought between oedema and the extent of hypokinesis, catecholamine release, release of N-terminal prohormone of B-type natriuretic peptide (NT-proBNP), and markers of systemic inflammatory activation (high-sensitivity C-reactive protein and platelet response to nitric oxide). In the acute phase of TTC, T2-weighted signal intensity was greater at the apex than at the base (p<0.0001) but was nevertheless significantly elevated at the base (p<0.0001), relative to control values. Over 3 months, T2-weighted signal decreased substantially, but remained abnormally elevated (p<0.02). The regional extent of oedema correlated inversely with radial myocardial strain (except at the apex). There were also direct correlations between global T2-weighted signal and (1) plasma normetanephrine (r=0.39, p=0.04) and (2) peak NT-proBNP (r=0.39, p=0.03), but not with systemic inflammatory markers. TTC is associated with slowly resolving global myocardial oedema, the acute extent of which correlates with regional contractile disturbance and acute release of both catecholamines and NT-proBNP.

  13. Investigation Of High Intensity Focused Ultrasound Ablation In Isolated Kidneys By MRI — Preliminary Results

    NASA Astrophysics Data System (ADS)

    Jenne, J. W.; Risse, F.; Häcker, A.; Peters, K.; Divkovic, G. Wilzbach; Siegler, P.; Fink, C.; Michel, M. S.; Huber, P. E.

    2006-05-01

    High intensity focused ultrasound (HIFU) under magnetic resonance imaging (MRI) guidance is an attractive instrument to ablate tissue non-invasively. The aim of this work was to investigate the coagulation volume and the perfusion changes after HIFU-ablation in an isolated kidney model using MRI. Ablation was performed at least at two regions of the renal cortex. Morphological T1-/T2-weighted, temperature sensitive images and contrast-enhanced perfusion measurements were performed. The detection of single HIFU induced coagulation necroses and HIFU induced tissue cavities was feasible. Perfusion changes could only be detected in few experiments because of relatively inhomogeneous kidney perfusion patterns. MR-imaging is a sensitive method to detect and to quantify the HIFU-focus. Moreover, MRI is a valuable approach for the detection of HIFU induced coagulation necroses. The investigation of perfusion changes, particularly important in tumor treatment, was sometimes hampered due to limitations in the used organ model. However, in patients MR perfusion imaging as well as volumetric and morphological imaging can be used to control the outcome of HIFU-therapy.

  14. Negative predictive value of normal adenosine-stress cardiac MRI in the assessment of coronary artery disease and correlation with semiquantitative perfusion analysis.

    PubMed

    Pilz, Guenter; Eierle, Susanne; Heer, Tobias; Klos, Markus; Ali, Eman; Scheck, Roland; Wild, Michael; Bernhardt, Peter; Hoefling, Berthold

    2010-09-01

    To prospectively determine the negative predictive value of normal adenosine stress cardiac MR (CMR) in routine patients referred for evaluation of coronary artery disease (CAD), predominantly with intermediate to high pretest risk. Consecutive patients referred for coronary angiography were examined in a 1.5 Tesla whole-body scanner before catheterization. A total of 158 patients with normal CMR on qualitative assessment were included, and semiquantitative perfusion analysis was performed. Significant CAD was regarded as luminal narrowing of >or=70% in coronary angiography. In the 158 study patients, negative predictive value of normal adenosine-stress CMR for significant CAD was 96.2% (for stenosis >or=90%: 98.1%). True-negative and false-negative patients were comparable regarding clinical presentation, risk factors, and CMR findings. Semiquantitative perfusion analysis gave significantly prolonged arrival time index and peak time index in the false-negative group. Using cutoff values >1.8 for arrival time index or >1.2 for peak time index, the CMR negative predictive value increased to 98.7% (for stenosis >or=90%: to 100%). The very high negative predictive value for CAD supports CMR-based decision making for the indication to coronary angiography. Semiquantitative perfusion analysis seems promising to identify the small group of CAD patients not detectable by qualitative CMR assessment.

  15. Changes in T2-weighted MRI of supinator muscle, pronator teres muscle, and extensor indicis muscle with manual muscle testing

    PubMed Central

    Yoshida, Kazuya; Akiyama, Sumikazu; Takamori, Masayoshi; Otsuka, D. Eng, Hiroshi; Seo, Yoshiteru

    2017-01-01

    [Purpose] In order to detect muscle activity with manual muscle testing, T2-weighted magnetic resonance (T2w-MR) images were detected by a 0.2 T compact MRI system. [Subjects and Methods] The subjects were 3 adult males. Transverse T2-weighted multi-slice spin-echo images of the left forearm were measured by a 39 ms echo-time with a 2,000 ms repetition time, a 9.5 mm slice thickness, 1 accumulation and a total image acquisition time of 4 min 16 s. First, T2w-MR images in the resting condition were measured. Then, manipulative isometric contraction exercise (5 sec duration) to the supinator muscle, the pronator teres muscle or the extensor indicis muscle was performed using Borg’s rating of perceived exertion (RPE) scale of 15–17. The T2w-MR images were measured immediately after the exercise. [Results] T2w-MR image intensities increased significantly in the supinator muscle, the pronator teres muscle and the extensor indicis muscle after the exercise. However, the image intensities in the rest of the muscle did not change. [Conclusion] Using T2w-MR images, we could detect muscle activity in a deep muscle, the supinator muscle, and a small muscle, the extensor indicis muscle. These results also support the reliability of the manual muscle testing method. PMID:28356621

  16. Fetal lung apparent diffusion coefficient measurement using diffusion-weighted MRI at 3 Tesla: Correlation with gestational age.

    PubMed

    Afacan, Onur; Gholipour, Ali; Mulkern, Robert V; Barnewolt, Carol E; Estroff, Judy A; Connolly, Susan A; Parad, Richard B; Bairdain, Sigrid; Warfield, Simon K

    2016-12-01

    To evaluate the feasibility of using diffusion-weighted magnetic resonance imaging (DW-MRI) to assess the fetal lung apparent diffusion coefficient (ADC) at 3 Tesla (T). Seventy-one pregnant women (32 second trimester, 39 third trimester) were scanned with a twice-refocused Echo-planar diffusion-weighted imaging sequence with 6 different b-values in 3 orthogonal diffusion orientations at 3T. After each scan, a region-of-interest (ROI) mask was drawn to select a region in the fetal lung and an automated robust maximum likelihood estimation algorithm was used to compute the ADC parameter. The amount of motion in each scan was visually rated. When scans with unacceptable levels of motion were eliminated, the lung ADC values showed a strong association with gestational age (P < 0.01), increasing dramatically between 16 and 27 weeks and then achieving a plateau around 27 weeks. We show that to get reliable estimates of ADC values of fetal lungs, a multiple b-value acquisition, where motion is either corrected or considered, can be performed. J. Magn. Reson. Imaging 2016;44:1650-1655. © 2016 International Society for Magnetic Resonance in Medicine.

  17. Prostate segmentation in MRI using fused T2-weighted and elastography images

    NASA Astrophysics Data System (ADS)

    Nir, Guy; Sahebjavaher, Ramin S.; Baghani, Ali; Sinkus, Ralph; Salcudean, Septimiu E.

    2014-03-01

    Segmentation of the prostate in medical imaging is a challenging and important task for surgical planning and delivery of prostate cancer treatment. Automatic prostate segmentation can improve speed, reproducibility and consistency of the process. In this work, we propose a method for automatic segmentation of the prostate in magnetic resonance elastography (MRE) images. The method utilizes the complementary property of the elastogram and the corresponding T2-weighted image, which are obtained from the phase and magnitude components of the imaging signal, respectively. It follows a variational approach to propagate an active contour model based on the combination of region statistics in the elastogram and the edge map of the T2-weighted image. The method is fast and does not require prior shape information. The proposed algorithm is tested on 35 clinical image pairs from five MRE data sets, and is evaluated in comparison with manual contouring. The mean absolute distance between the automatic and manual contours is 1.8mm, with a maximum distance of 5.6mm. The relative area error is 7.6%, and the duration of the segmentation process is 2s per slice.

  18. Cardiovascular magnetic resonance in patients with magnetic resonance conditional pacemaker systems at 1.5 T: influence of pacemaker related artifacts on image quality including first pass perfusion, aortic and mitral valve assessment, flow measurement, short tau inversion recovery and T1-weighted imaging.

    PubMed

    Klein-Wiele, Oliver; Garmer, Marietta; Busch, Martin; Mateiescu, Serban; Urbien, Rhyan; Barbone, Gianluca; Kara, Kaffer; Schulte-Hermes, Michael; Metz, Frauke; Hailer, Birgit; Grönemeyer, Dietrich

    2017-03-01

    There are only limited data on the impact of device-related artifacts on image quality in cardiovascular magnetic resonance imaging (CMR) in patients with pacemakers (PM). Adenosine stress perfusion, T1-weighted imaging and flow measurement as well as valve characterization have not been evaluated previously concerning artifact burden. We aimed to assess image quality in all routinely used CMR sequences. We analyzed 2623 myocardial segments in CMR scans of 61 patients with MR conditional PM (mean age 72.1 ± 11.5 years), 23 (37.7%) with right sided, 38 (62.3%) with left-sided devices. There were no relevant artifacts in patients with right-sided devices irrespective of the imaging sequence. In left-sided implants no PM-induced artifacts were found in first pass perfusion sequence, flow analysis and T1 weighted imaging. Only few patients with left-sided devices showed significant PM-artifacts in aortic (3/38, 7.9%)/mitral (n = 2/38, 5.3%) valve imaging and STIR (n = 3/35, 8.6%). In STIR only 14/805 (1.7%) segments were involved. In left-sided PM SSFP cine sequences had more artifact burden than LGE with 377/1505 (25.0%) vs. 162/1505 (10.8%) myocardial segments involved by relevant artifacts respectively (p < 0.001). Apart from cine and LGE imaging in anterior myocardial segments with left-sided implants presence of MRI conditional pacemakers does not affect CMR image quality in multimodal CMR examinations to a significant extent. Our data supports evidence that reduced image quality does not need to be a major concern in PM patients undergoing CMR.

  19. Evaluation of Treatment Associated Inflammatory Response on Diffusion Weighted-MRI and FDG-PET Imaging Biomarkers

    PubMed Central

    Galbán, Craig J.; Bhojani, Mahaveer S; Lee, Kuei C.; Meyer, Charles R.; Van Dort, Marcian; Kuszpit, Kyle; Koeppe, Robert A.; Ranga, Rajesh; Moffat, Bradford A.; Johnson, Timothy D.; Chenevert, Thomas L.; Rehemtulla, Alnawaz; Ross, Brian D.

    2010-01-01

    Purpose Functional imaging biomarkers of cancer treatment response offer the potential for early determination of outcome through assessment of biochemical, physiological, and micro-environmental readouts. Cell death may result in an immunological response thus complicating interpretation of biomarker readouts. This study evaluated the temporal impact of treatment-associated inflammatory activity on diffusion-MRI and FDG-PET imaging biomarkers to delineate the effects of the inflammatory response on imaging readouts. Experimental Design Rats with intracerebral 9L gliosarcomas were separated into four groups consisting of control, an immunosuppressive agent dexamethasone (Dex), 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), and BCNU+Dex (BCNU+Dex). Animals were imaged using diffusion-weighted MRI and FDG-PET at 0, 3 and 7 days post-treatment. Results In the BCNU and BCNU+Dex treated animal groups, diffusion values increased progressively over the 7 day study period to about 23% over baseline. FDG %SUV decreased at day 3 (−30.9%) but increased over baseline levels at day 7 (+20.1%). FDG-PET of BCNU+Dex treated animals were found to have %SUV reductions of −31.4% and −24.7% at days 3 and 7, respectively following treatment. Activated macrophages were observed on day 7 in the BCNU treatment group with much fewer found in the BCNU+Dex group. Conclusions Results revealed treatment-associated inflammatory response following tumor therapy resulted in accentuation of tumor diffusion response along with a corresponding increase in tumor FDG uptake due to the presence of glucose-consuming activated macrophages. The dynamics and magnitude of potential inflammatory response should be considered when interpreting imaging biomarker results. PMID:20160061

  20. Quantification of fibrosis in infarcted swine hearts by ex vivo late gadolinium-enhancement and diffusion-weighted MRI methods

    NASA Astrophysics Data System (ADS)

    Pop, Mihaela; Ghugre, Nilesh R.; Ramanan, Venkat; Morikawa, Lily; Stanisz, Greg; Dick, Alexander J.; Wright, Graham A.

    2013-08-01

    Many have speculated that MRI signal characteristics can be used to identify regions of heterogeneous infarct associated with an arrhythmogenic substrate; however, direct evidence of this relationship is limited. The aim of this study was to demonstrate the remodelling characteristics of fibrosis by means of histology and high-resolution MR imaging. For this purpose, we performed whole-mount histology in heart samples (n = 9) collected from five swine at six weeks post-infarction and compared the extent of fibrosis in the infarcted areas delineated in these histological images with that obtained ex vivo by MRI using late gadolinium-enhancement (LGE) and diffusion-weighted imaging (DWI) methods. All MR images were obtained at a submillimetre resolution (i.e., voxel size of 0.6×0.6×1.2 mm3). Specifically, in the histology images, we differentiated moderate fibrosis (consisting of a mixture of viable and non-viable myocytes, known as border zone, BZ) from severe fibrosis (i.e., the dense scar). Correspondingly, tissue heterogeneities in the MR images were categorized by a Gaussian mixture model into healthy, BZ and scar. Our results showed that (a) both MRI methods were capable of qualitatively distinguishing sharp edges between dense scar and healthy tissue from regions of heterogeneous BZ; (b) the BZ and dense scar areas had intermediate-to-high increased values of signal intensity in the LGE images and of apparent diffusion coefficient in the DWI, respectively. In addition, as demonstrated by the Picrosirius Red and immunohistochemistry stains, the viable bundles in the BZ were clearly separated by thin collagen strands and had reduced expression of Cx43, whereas the core scar was composed of dense fibrosis. A quantitative analysis demonstrated that the comparison between BZ/scar extent in LGE and DWI to the corresponding areas identified in histology yielded very good correlations (i.e., for the scar identified by LGE, R2 was 0.96 compared to R2 = 0.93 for the

  1. WE-G-BRD-01: Diffusion Weighted MRI for Response Assessment of Inoperable Lung Tumors for Patients Undergoing SBRT Treatment

    SciTech Connect

    Tyagi, N; Wengler, K; Yorke, E; Hunt, M; Deasy, J; Rimner, A

    2014-06-15

    Purpose: To investigate early changes in tumor Apparent Diffusion Coefficients derived from diffusion weighted (DW)-MRI of lung cancer patients undergoing SBRT, as a possible early predictor of treatment response. Methods: DW-MRI scans were performed in this prospective phase I IRB-approved study of inoperable lung tumors at various time-points during the course of SBRT treatments. Axial DW scan using multi b-values ranging from 0–1000 s/mm{sup 2} were acquired in treatment position on a 3T Philips MR scanner during simulation, one hour after the first fraction (8 Gy), after a total of 5 fractions (40 Gy) and 4 weeks after SBRT delivery. A monoexponential model based on a least square fit from all b values was performed on a pixel-by-pixel basis and ADC was calculated. GTVs drawn on 4DCT for planning were mapped on the T2w MRI (acquired at exhale) after deformable registration. These volumes were then mapped on DWI scan for ADC calculation after rigid registration between the anatomical scan and diffusion scan. T2w scan on followup time points were deformably registered to the pretreatment T2 scan. Results: The first two patients in this study were analyzed. Median ADC values were 1.48, 1.48, 1.62 and 1.83 (10{sup −3}×) mm{sup 2}/s at pretreatment, after 8 Gy, after 40 Gy and 4 weeks posttreatment for the first patient and 1.57, 1.53, 1.66 and 1.72 (10{sup −3}×) mm{sup 2}/s for the second patient. ADC increased more significantly after 4 weeks of treatment rather than immediately post treatment, implying that late ADC value may be a better predictor of tumor response for SBRT treatment. The fraction of tumor pixels at high ADC values increased at 4 weeks post treatment. Conclusion: The observed increase in ADC values before the end of radiotherapy may be a surrogate for tumor response, but further patient accrual will be necessary to determine its value.

  2. Maple syrup urine disease: diffusion-weighted MRI findings during acute metabolic encephalopathic crisis.

    PubMed

    Kilicarslan, Rukiye; Alkan, Alpay; Demirkol, Demet; Toprak, Huseyin; Sharifov, Rasul

    2012-07-01

    Maple syrup urine disease (MSUD) is caused by a genetic defect of branched-chain amino acids, which include leucine, isoleucine and valine. We report diffusion-weighted imaging (DWI) findings in a newborn child with MSUD who presented with acute metabolic encephalopathic crisis. DWI (b = 1,000 s/mm(2)) showed high signal localized within the myelinated white matter (WM) areas including the cerebellar white matter, pons, bulbus, cerebral peduncles, lentiform nucleus, posterior limbs of the internal capsules, corona radiata and bilateral perirolandic cortex. The apparent diffusion coefficient values of these regions were markedly low in the affected areas. The presence of these findings was considered cytotoxic or intramyelinic edema evidenced by restricted water diffusion. In conclusion, our findings suggest that during the acute phase and early encephalopathic crisis stage of MSUD, DWI can demonstrate the involvement of myelinated WM in newborns.

  3. Sensitivity of Diffusion-Weighted STEAM MRI and EPI-DWI to Infratentorial Ischemic Stroke

    PubMed Central

    Hohenhaus, Marc; Kunze, Claudia; Schmidt, Wolf; Brunecker, Peter; Villringer, Kersten; Merboldt, Klaus-Dietmar; Frahm, Jens; Fiebach, Jochen B.

    2016-01-01

    Objectives To assess the sensitivity of stimulated echo acquisition mode diffusion weighted imaging (STEAM-DWI) to ischemic stroke in comparison to echo-planar imaging diffusion weighted imaging (EPI-DWI) in the infratentorial compartment. Methods Fifty-seven patients presenting with clinical features of infratentorial stroke underwent STEAM-DWI, high-resolution EPI-DWI (HR-DWI, 2.5 mm slice thickness) and low-resolution EPI-DWI (LR-DWI, 5 mm slice thickness). Four readers assessed the presence of ischemic lesions and artifacts. Agreement between sequences and interobserver agreement on the presence of ischemia were calculated. The sensitivities of the DWI sequences were calculated in 45 patients with a confirmed diagnosis of infratentorial stroke. Results Median time from symptom onset to imaging was 24 hours. STEAM-DWI agreed with LR-DWI in 89.5% of cases (kappa = 0.72, p<0.0001) and with HR-DWI in 89.5% of cases (kappa = 0.68, p<0.0001). STEAM-DWI showed fewer intraparenchymal artifacts (1/57) than HR-DWI (44/57) and LR-DWI (41/57). Ischemia was visible in 87% of cases for LR-DWI, 93% of cases for HR-DWI, and 89% of cases for STEAM-DWI. Interobserver agreement was good for STEAM-DWI (kappa = 0.62, p<0.0001). Conclusions Compared to the best currently available MR sequence for detecting ischemia (HR-DWI), STEAM-DWI shows fewer artifacts and a similar sensitivity to infratentorial stroke. PMID:27529697

  4. Automatic quantification of ischemic injury on diffusion-weighted MRI of neonatal hypoxic ischemic encephalopathy.

    PubMed

    Murphy, Keelin; van der Aa, Niek E; Negro, Simona; Groenendaal, Floris; de Vries, Linda S; Viergever, Max A; Boylan, Geraldine B; Benders, Manon J N L; Išgum, Ivana

    2017-01-01

    A fully automatic method for detection and quantification of ischemic lesions in diffusion-weighted MR images of neonatal hypoxic ischemic encephalopathy (HIE) is presented. Ischemic lesions are manually segmented by two independent observers in 1.5 T data from 20 subjects and an automatic algorithm using a random forest classifier is developed and trained on the annotations of observer 1. The algorithm obtains a median sensitivity and specificity of 0.72 and 0.99 respectively. F1-scores are calculated per subject for algorithm performance (median = 0.52) and observer 2 performance (median = 0.56). A paired t-test on the F1-scores shows no statistical difference between the algorithm and observer 2 performances. The method is applied to a larger dataset including 54 additional subjects scanned at both 1.5 T and 3.0 T. The algorithm findings are shown to correspond well with the injury pattern noted by clinicians in both 1.5 T and 3.0 T data and to have a strong relationship with outcome. The results of the automatic method are condensed to a single score for each subject which has significant correlation with an MR score assigned by experienced clinicians (p < 0.0001). This work represents a quantitative method of evaluating diffusion-weighted MR images in neonatal HIE and a first step in the development of an automatic system for more in-depth analysis and prognostication.

  5. A review of technical aspects of T1-weighted dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in human brain tumors.

    PubMed

    Bergamino, M; Bonzano, L; Levrero, F; Mancardi, G L; Roccatagliata, L

    2014-09-01

    In the last few years, several imaging methods, such as magnetic resonance imaging (MRI) and computed tomography, have been used to investigate the degree of blood-brain barrier (BBB) permeability in patients with neurological diseases including multiple sclerosis, ischemic stroke, and brain tumors. One promising MRI method for assessing the BBB permeability of patients with neurological diseases in vivo is T1-weighted dynamic contrast-enhanced (DCE)-MRI. Here we review the technical issues involved in DCE-MRI in the study of human brain tumors. In the first part of this paper, theoretical models for the DCE-MRI analysis will be described, including the Toft-Kety models, the adiabatic approximation to the tissue homogeneity model and the two-compartment exchange model. These models can be used to estimate important kinetic parameters related to BBB permeability. In the second part of this paper, details of the data acquisition, issues related to the arterial input function, and procedures for DCE-MRI image analysis are illustrated. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  6. Brain perfusion: computed tomography and magnetic resonance techniques.

    PubMed

    Copen, William A; Lev, Michael H; Rapalino, Otto

    2016-01-01

    Cerebral perfusion imaging provides assessment of regional microvascular hemodynamics in the living brain, enabling in vivo measurement of a variety of different hemodynamic parameters. Perfusion imaging techniques that are used in the clinical setting usually rely upon X-ray computed tomography (CT) or magnetic resonance imaging (MRI). This chapter reviews CT- and MRI-based perfusion imaging techniques, with attention to image acquisition, clinically relevant aspects of image postprocessing, and fundamental differences between CT- and MRI-based techniques. Correlations with cerebrovascular physiology and potential clinical applications of perfusion imaging are reviewed, focusing upon the two major classes of neurologic disease in which perfusion imaging is most often performed: primary perfusion disorders (including ischemic stroke, transient ischemic attack, and reperfusion syndrome), and brain tumors. © 2016 Elsevier B.V. All rights reserved.

  7. Smoothing fields of weighted collections with applications to diffusion MRI processing

    NASA Astrophysics Data System (ADS)

    Sigurdsson, Gunnar A.; Prince, Jerry L.

    2014-03-01

    Using modern diffusion weighted magnetic resonance imaging protocols, the orientations of multiple neuronal fiber tracts within each voxel can be estimated. Further analysis of these populations, including application of fiber tracking and tract segmentation methods, is often hindered by lack of spatial smoothness of the estimated orientations. For example, a single noisy voxel can cause a fiber tracking method to switch tracts in a simple crossing tract geometry. In this work, a generalized spatial smoothing framework that handles multiple orientations as well as their fractional contributions within each voxel is proposed. The approach estimates an optimal fuzzy correspondence of orientations and fractional contributions between voxels and smooths only between these correspondences. Avoiding a requirement to obtain exact correspondences of orientations reduces smoothing anomalies due to propagation of erroneous correspondences around noisy voxels. Phantom experiments are used to demonstrate both visual and quantitative improvements in postprocessing steps. Improvement over smoothing in the measurement domain is also demonstrated using both phantoms and in vivo human data.

  8. Visualising inter-subject variability in fMRI using threshold-weighted overlap maps

    NASA Astrophysics Data System (ADS)

    Seghier, Mohamed L.; Price, Cathy J.

    2016-02-01

    Functional neuroimaging studies are revealing the neural systems sustaining many sensory, motor and cognitive abilities. A proper understanding of these systems requires an appreciation of the degree to which they vary across subjects. Some sources of inter-subject variability might be easy to measure (demographics, behavioural scores, or experimental factors), while others are more difficult (cognitive strategies, learning effects, and other hidden sources). Here, we introduce a simple way of visualising whole-brain consistency and variability in brain responses across subjects using threshold-weighted voxel-based overlap maps. The output quantifies the proportion of subjects activating a particular voxel or region over a wide range of statistical thresholds. The sensitivity of our approach was assessed in 30 healthy adults performing a matching task with their dominant hand. We show how overlap maps revealed many effects that were only present in a subsample of our group; we discuss how overlap maps can provide information that may be missed or misrepresented by standard group analysis, and how this information can help users to understand their data. In particular, we emphasize that functional overlap maps can be particularly useful when it comes to explaining typical (or atypical) compensatory mechanisms used by patients following brain damage.

  9. Computer-assisted delineation of cerebral infarct from diffusion-weighted MRI using Gaussian mixture model.

    PubMed

    Nag, Manas Kumar; Koley, Subhranil; China, Debarghya; Sadhu, Anup Kumar; Balaji, Ravikanth; Ghosh, Siddharth; Chakraborty, Chandan

    2017-04-01

    Diffusion-weighted imaging (DWI) is a widely used medical imaging modality for diagnosis and monitoring of cerebral stroke. The identification of exact location of stroke lesion helps in perceiving its characteristics, an essential part of diagnosis and treatment planning. This task is challenging due to the typical shape of the stroke lesion. This paper proposes an efficient method for computer-aided delineation of stroke lesions from DWI images. Proposed methodology comprises of three steps. At the initial step, image contrast has been improved by applying fuzzy intensifier leading to the better visual quality of the stroke lesion. In the following step, a two-class (stroke lesion area vs. non-stroke lesion area) segmentation technique based on Gaussian mixture model has been designed for the localization of stroke lesion. To eliminate the artifacts which would appear during segmentation process, a binary morphological post-processing through area operator has been defined for exact delineation of the lesion area. The performance of the proposed methodology has been compared with the manually delineated images (ground truth) obtained from different experts, individually. Quantitative evaluation with respect to various performance measures (such as dice coefficient, Jaccard score, and correlation coefficient) shows the efficient performance of the proposed technique.

  10. Diffusion-weighted MRI as a predictor of extracapsular extension in prostate cancer.

    PubMed

    Kim, Chan Kyo; Park, Sung Yoon; Park, Jung Jae; Park, Byung Kwan

    2014-03-01

    The objective of our study was to evaluate the value of the apparent diffusion coefficient (ADC) from diffusion-weighted imaging (DWI) as a predictor of extracapsular extension (ECE) in patients with localized prostate cancer. Enrolled in this study were 167 patients who underwent preoperative DWI at 3 T followed by surgery. Univariate and multivariate analyses including clinical variables (serum prostate-specific antigen level, biopsy-based Gleason score, clinical stage, greatest percentage of cancer in all biopsy cores, and presence of perineural invasion) and tumor ADC data were performed for predicting ECE. Receiver operating characteristic curve analysis was also performed to investigate the diagnostic performance of the clinical variables and tumor ADC for predicting ECE. Histopathologic results indicated that 23 (13.8%) patients had ECE. At univariate analysis, tumor ADC, biopsy-based Gleason score, the presence of perineural invasion, and greatest percentage of cancer in all biopsy cores were associated with ECE (p<0.05). Multivariate analysis revealed that the greatest percentage of cancer in all biopsy cores (p=0.001), biopsy-based Gleason score (p=0.015), and tumor ADC (p=0.032) were independent predictors of ECE. For predicting ECE, the area under the curve (AUC) of tumor ADC was 0.771, which is the second best AUC of all the variables evaluated. As an imaging biomarker, tumor ADC may have potential for predicting ECE before surgery in patients with prostate cancer. Further studies investigating this possibility are warranted.

  11. Visualising inter-subject variability in fMRI using threshold-weighted overlap maps

    PubMed Central

    Seghier, Mohamed L.; Price, Cathy J.

    2016-01-01

    Functional neuroimaging studies are revealing the neural systems sustaining many sensory, motor and cognitive abilities. A proper understanding of these systems requires an appreciation of the degree to which they vary across subjects. Some sources of inter-subject variability might be easy to measure (demographics, behavioural scores, or experimental factors), while others are more difficult (cognitive strategies, learning effects, and other hidden sources). Here, we introduce a simple way of visualising whole-brain consistency and variability in brain responses across subjects using threshold-weighted voxel-based overlap maps. The output quantifies the proportion of subjects activating a particular voxel or region over a wide range of statistical thresholds. The sensitivity of our approach was assessed in 30 healthy adults performing a matching task with their dominant hand. We show how overlap maps revealed many effects that were only present in a subsample of our group; we discuss how overlap maps can provide information that may be missed or misrepresented by standard group analysis, and how this information can help users to understand their data. In particular, we emphasize that functional overlap maps can be particularly useful when it comes to explaining typical (or atypical) compensatory mechanisms used by patients following brain damage. PMID:26846561

  12. A method for u-fiber quantification from 7 T diffusion-weighted MRI data tested in patients with nonlesional focal epilepsy.

    PubMed

    O'Halloran, Rafael; Feldman, Rebecca; Marcuse, Lara; Fields, Madeline; Delman, Bradley; Frangou, Sophia; Balchandani, Priti

    2017-05-24

    In this methods development, we present an ultra-high-field, diffusion-weighted MRI method to quantitatively assess u-fibers and use it to compare u-fiber counts in nonlesional epilepsy patients with controls. Emerging evidence implicates white matter abnormalities in nonlesional epilepsy, including the short-range, cortical-cortical connections, or u-fibers. Eight patients with nonlesional epilepsy and eight demographically matched controls underwent 7 T MRI consisting of a T1-weighted sequence (0.7 mm isotropic resolution) and high-angular-resolved diffusion-weighted MRI (1.05 mm isotropic resolution, 68 directions). MRI data were used to quantify u-fiber counts in known u-fiber populations on the basis of an atlas and fiber tractography. From tractography, connectivity matrices summarizing the u-fiber counts were computed. Quantitative group comparisons were performed on the connectivity matrices. U-fiber counts were found to be lower on average in patients with epilepsy than in healthy controls. The results indicate that the density or the number of u-fibers is reduced in patients with nonlesional epilepsy. Future work will focus on histological validation and determining whether differences in u-fiber counts can be used clinically to noninvasively identify seizure-onset zones.

  13. Value of Perfusion-Weighted MR Imaging in the Assessment of Early Cerebral Alterations in Neurologically Asymptomatic HIV-1-Positive and HCV-Positive Patients

    PubMed Central

    Bladowska, Joanna; Knysz, Brygida; Zimny, Anna; Małyszczak, Krzysztof; Kołtowska, Anna; Szewczyk, Paweł; Gąsiorowski, Jacek; Furdal, Michał; Sąsiadek, Marek J.

    2014-01-01

    Background and Purpose Asymptomatic central nervous system (CNS) involvement occurs in the early stage of the human immunodeficiency virus (HIV) infection. It has been documented that the hepatitis C virus (HCV) can replicate in the CNS. The aim of the study was to evaluate early disturbances in cerebral microcirculation using magnetic resonance (MR) perfusion-weighted imaging (PWI) in asymptomatic HIV-1-positive and HCV-positive patients, as well as to assess the correlation between PWI measurements and the clinical data. Materials and Methods Fifty-six patients: 17 HIV-1-positive non-treated, 18 HIV-1-positive treated with combination antiretroviral therapy (cART), 7 HIV-1/HCV-positive non-treated, 14 HCV-positive before antiviral therapy and 18 control subjects were enrolled in the study. PWI was performed with a 1.5T MR unit using dynamic susceptibility contrast (DSC) method. Cerebral blood volume (CBV) measurements relative to cerebellum (rCBV) were evaluated in the posterior cingulated region (PCG), basal ganglia (BG), temporoparietal (TPC) and frontal cortices (FC), as well as in white matter of frontoparietal areas. Correlations of rCBV values with immunologic data and liver histology activity index (HAI) were analyzed. Results Significantly lower rCBV values were found in the right TPC and left FC as well as in PCG in HIV-1-positive naïve (p = 0.009; p = 0.020; p = 0.012), HIV-1 cART treated (p = 0.007; p = 0.009; p = 0.033), HIV-1/HCV-positive (p = 0.007; p = 0.027; p = 0.045) and HCV-positive patients (p = 0.010; p = 0.005; p = 0.045) compared to controls. HIV-1-positive cART treated and HIV-1/HCV-positive patients demonstrated lower rCBV values in the right FC (p = 0.009; p = 0.032, respectively) and the left TPC (p = 0.036; p = 0.005, respectively), while HCV-positive subjects revealed lower rCBV values in the left TPC region (p = 0.003). We found significantly elevated rCBV values in

  14. 3T diffusion-weighted MRI of the thyroid gland with reduced distortion: preliminary results

    PubMed Central

    Nagala, S; Priest, A N; McLean, M A; Jani, P; Graves, M J

    2013-01-01

    Objective: Single-shot diffusion-weighted (DW) echo planar imaging (EPI), which is commonly used for imaging the thyroid, is characterised by severe blurring and distortion. The objectives of this work were: 1, to show that a reduced-field of view (r-FOV) DW EPI technique can improve image quality; and 2, to investigate the effect of different reconstruction strategies on the resulting apparent diffusion coefficients (ADCs). Methods: We implemented a single-shot, r-FOV DW EPI technique with a two-dimensional radiofrequency excitation pulse for DW imaging of the thyroid at 3T. Images were reconstructed using root sum of squares (SOS) and an optimal-B1 reconstruction (OBR). Phantom and in vivo experiments were performed to compare r-FOV and conventional full-FOV DW EPI with root SOS and OBR. Results: r-FOV with OBR substantially improved image quality at 3T. In phantoms, r-FOV gave more accurate ADCs than full-FOV. In vivo r-FOV always gave lower ADC values with respect to the full-FOV technique irrespective of the reconstruction used and whether only two or multiple b-values were used to compute the ADCs. Conclusion: r-FOV DW EPI can reduce image blurring and distortion at the expense of a low signal-to-noise ratio. OBR is a promising reconstruction technique for accurate ADC measurements in lower signal-to-noise ratio regimes, although further studies are needed to characterise its performance. Advances in knowledge: DW imaging of the thyroid at 3T could potentially benefit from r-FOV acquisition strategies, such as the r-FOV DW EPI technique proposed in this paper. PMID:23770539

  15. Multimodality Functional Imaging in Radiation Therapy Planning: Relationships between Dynamic Contrast-Enhanced MRI, Diffusion-Weighted MRI, and 18F-FDG PET

    PubMed Central

    Mera Iglesias, Moisés; Aramburu Núñez, David; del Olmo Claudio, José Luis; Salvador Gómez, Francisco; Driscoll, Brandon; Coolens, Catherine; Alba Castro, José L.; Muñoz, Victor

    2015-01-01

    Objectives. Biologically guided radiotherapy needs an understanding of how different functional imaging techniques interact and link together. We analyse three functional imaging techniques that can be useful tools for achieving this objective. Materials and Methods. The three different imaging modalities from one selected patient are ADC maps, DCE-MRI, and 18F-FDG PET/CT, because they are widely used and give a great amount of complementary information. We show the relationship between these three datasets and evaluate them as markers for tumour response or hypoxia marker. Thus, vascularization measured using DCE-MRI parameters can determine tumour hypoxia, and ADC maps can be used for evaluating tumour response. Results. ADC and DCE-MRI include information from 18F-FDG, as glucose metabolism is associated with hypoxia and tumour cell density, although 18F-FDG includes more information about the malignancy of the tumour. The main disadvantage of ADC maps is the distortion, and we used only low distorted regions, and extracellular volume calculated from DCE-MRI can be considered equivalent to ADC in well-vascularized areas. Conclusion. A dataset for achieving the biologically guided radiotherapy must include a tumour density study and a hypoxia marker. This information can be achieved using only MRI data or only PET/CT studies or mixing both datasets. PMID:25788972

  16. Mapping Human Cortical Areas in vivo Based on Myelin Content as Revealed by T1- and T2-weighted MRI

    PubMed Central

    Glasser, Matthew F.; Van Essen, David C.

    2011-01-01

    Non-invasively mapping the layout of cortical areas in humans is a continuing challenge for neuroscience. We present a new method of mapping cortical areas based on myelin content as revealed by T1-weighted (T1w) and T2-weighted (T2w) MRI. The method is generalizable across different 3T scanners and pulse sequences. We use the ratio of T1w/T2w image intensities to eliminate the MR-related image intensity bias and enhance the contrast to noise ratio for myelin. Data from each subject was mapped to the cortical surface and aligned across individuals using surface-based registration. The spatial gradient of the group average myelin map provides an observer-independent measure of sharp transitions in myelin content across the surface—i.e. putative cortical areal borders. We found excellent agreement between the gradients of the myelin maps and the gradients of published probabilistic cytoarchitectonically defined cortical areas that were registered to the same surface-based atlas. For other cortical regions, we used published anatomical and functional information to make putative identifications of dozens of cortical areas or candidate areas. In general, primary and early unimodal association cortices are heavily myelinated and higher, multi-modal, association cortices are more lightly myelinated, but there are notable exceptions in the literature that are confirmed by our results. The overall pattern in the myelin maps also has important correlations with the developmental onset of subcortical white matter myelination, evolutionary cortical areal expansion in humans compared to macaques, postnatal cortical expansion in humans, and maps of neuronal density in non-human primates. PMID:21832190

  17. Case Report of False-Negative Diffusion-Weighted Image of Brain Magnetic Resonance Imaging (MRI) in Acute Ischemic Stroke

    PubMed Central

    Chang, Wei-Lun; Lai, Ji-Ching; Chen, Rong-Fu; Hu, Han-Hwa; Pan, Chau-Shiung

    2017-01-01

    Patient