Subject-specific optimization of background suppression for arterial spin labeling magnetic resonance imaging using a feedback loop on the scanner.

Background suppression (BGS) in arterial spin labeling (ASL) magnetic resonance imaging leads to a higher temporal signal-to-noise ratio (tSNR) of the perfusion images compared with ASL without BGS. The performance of the BGS, however, depends on the tissue relaxation times and on inhomogeneities of the scanner's magnetic fields, which differ between subjects and are unknown at the moment of scanning. Therefore, we developed a feedback loop (FBL) mechanism that optimizes the BGS for each subject in the scanner during acquisition. We implemented the FBL for 2D pseudo-continuous ASL scans with an echo-planar imaging readout. After each dynamic scan, the acquired ASL images were automatically sent to an external computer and processed with a Python processing tool. Inversion times were optimized on the fly using 80 iterations of the Nelder-Mead method, by minimizing the signal intensity in the label image while maximizing the signal intensity in the perfusion image. The performance of this method was first tested in a four-component phantom. The regularization parameter was then tuned in six healthy subjects (three males, three females, age 24-62 years) and set as λ = 4 for all other experiments. The resulting ASL images, perfusion images, and tSNR maps obtained from the last 20 iterations of the FBL scan were compared with those obtained without BGS and with standard BGS in 12 healthy volunteers (five males, seven females, age 24-62 years) (including the six volunteers used for tuning of λ). The FBL resulted in perfusion images with a statistically significantly higher tSNR (2.20) compared with standard BGS (1.96) ( p < 5 x 10 - 3 , two-sided paired t-test). Minimizing signal in the label image furthermore resulted in control images, from which approximate changes in perfusion signal can directly be appreciated. This could be relevant to ASL applications that require a high temporal resolution. Future work is needed to minimize the number of initial acquisitions during which the performance of BGS is reduced compared with standard BGS, and to extend the technique to 3D ASL.

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange During Electroconvulsive Therapy: A Feasibility Study.

BACKGROUND: In electroconvulsive therapy (ECT), a generalized seizure is provoked under general anesthesia. Standard airway management is done by face mask ventilation, but this is difficult during generalized seizure. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a method to increase apnea tolerance and permit apnea oxygenation. We hypothesize that THRIVE can oxygenate the patient during ECT and that it is comfortable for patients. METHODS: In this single-center feasibility study, 13 patients with a pharmacotherapy-resistant depressive disorder underwent 20 ECT sessions with the use of THRIVE. They received general anesthesia under standard monitoring and transcutaneous carbon dioxide monitoring. Afterward, they completed a survey comparing their prior experience with face mask oxygenation. RESULTS: There were no desaturations during the procedure, and patient comfort showed no difference in comparison to face mask. Compared with data from earlier ECT with face mask ventilation in the same patient, THRIVE did not seem to shorten seizure duration. CONCLUSIONS: THRIVE is a novel, safe oxygenation method during ECT.

Experimental investigation of a metasurface resonator for in vivo imaging at 1.5 T.

In this work, we experimentally demonstrate an increase in the local transmit efficiency of a 1.5 T MRI scanner by using a metasurface formed by an array of brass wires embedded in a high permittivity low loss medium. Placement of such a structure inside the scanner results in strong coupling of the radiofrequency field produced by the body coil with the lowest frequency electromagnetic eigenmode of the metasurface. This leads to spatial redistribution of the near fields with enhancement of the local magnetic field and an increase in the transmit efficiency per square root maximum specific absorption rate in the region-of-interest. We have investigated this structure in vivo and achieved a factor of 3.3 enhancement in the local radiofrequency transmit efficiency.

X-ray computed tomography library of shark anatomy and lower jaw surface models.

The cranial diversity of sharks reflects disparate biomechanical adaptations to feeding. In order to be able to investigate and better understand the ecomorphology of extant shark feeding systems, we created a x-ray computed tomography (CT) library of shark cranial anatomy with three-dimensional (3D) lower jaw reconstructions. This is used to examine and quantify lower jaw disparity in extant shark species in a separate study. The library is divided in a dataset comprised of medical CT scans of 122 sharks (Selachimorpha, Chondrichthyes) representing 73 extant species, including digitized morphology of entire shark specimens. This CT dataset and additional data provided by other researchers was used to reconstruct a second dataset containing 3D models of the left lower jaw for 153 individuals representing 94 extant shark species. These datasets form an extensive anatomical record of shark skeletal anatomy, necessary for comparative morphological, biomechanical, ecological and phylogenetic studies.

Time-efficient interleaved human (23)Na and (1)H data acquisition at 7 T.

The aim of this study was to implement and evaluate a flexible and time-efficient interleaved imaging approach for the acquisition of proton and sodium images of the human knee at 7 T within a clinically relevant timescale. A flexible software framework was established which allowed the interleaving of multiple, different, fully specific absorption ratio (SAR)-validated scans. The system was able to switch between these different scans at flexible time points. The practical example presented consists of interleaved proton (Dixon imaging and T2* mapping) and sodium (mapping the sodium content and fluid-suppressed component separately) sequences with the key idea to perform proton MRI whilst the sodium nuclei relax towards thermal equilibrium, and vice versa. Comparisons were made between these four scans being acquired sequentially in the normal mode of scanner operation and those acquired in an interleaved fashion. Images acquired in the interleaved mode were very similar to those acquired in sequential scans with no image artifacts produced by the slight intra-sequence variation in steady-state magnetization. A reduction in scanning time of almost a factor of two was established using the interleaved scans, allowing such a protocol to be completed within 30 min. Phantom experiments and in vivo scans performed in healthy volunteers and in one patient proved the basic feasibility of this approach. This approach for the interleaving of multiple proton and sodium scans, each with different contrasts, is an efficient method for the design of new practical clinical protocols for sodium MRI.

Evolution and development of ventricular septation in the amniote heart.

During cardiogenesis the epicardium, covering the surface of the myocardial tube, has been ascribed several functions essential for normal heart development of vertebrates from lampreys to mammals. We investigated a novel function of the epicardium in ventricular development in species with partial and complete septation. These species include reptiles, birds and mammals. Adult turtles, lizards and snakes have a complex ventricle with three cava, partially separated by the horizontal and vertical septa. The crocodilians, birds and mammals with origins some 100 million years apart, however, have a left and right ventricle that are completely separated, being a clear example of convergent evolution. In specific embryonic stages these species show similarities in development, prompting us to investigate the mechanisms underlying epicardial involvement. The primitive ventricle of early embryos becomes septated by folding and fusion of the anterior ventricular wall, trapping epicardium in its core. This folding septum develops as the horizontal septum in reptiles and the anterior part of the interventricular septum in the other taxa. The mechanism of folding is confirmed using DiI tattoos of the ventricular surface. Trapping of epicardium-derived cells is studied by transplanting embryonic quail pro-epicardial organ into chicken hosts. The effect of decreased epicardium involvement is studied in knock-out mice, and pro-epicardium ablated chicken, resulting in diminished and even absent septum formation. Proper folding followed by diminished ventricular fusion may explain the deep interventricular cleft observed in elephants. The vertical septum, although indistinct in most reptiles except in crocodilians and pythonidsis apparently homologous to the inlet septum. Eventually the various septal components merge to form the completely septated heart. In our attempt to discover homologies between the various septum components we aim to elucidate the evolution and development of this part of the vertebrate heart as well as understand the etiology of septal defects in human congenital heart malformations.

Metal artifact reduction for CT: development, implementation, and clinical comparison of a generic and a scanner-specific technique.

PURPOSE: To develop, implement, and compare two metal artifact reduction methods for CT. METHODS: Two methods for metal artifact reduction were developed. The first is based on applying corrections in a Radon transformation of the CT images. The second method is based on a forward projection of the CT images and applying corrections in the scanner's original raw data. The first method is generic since it does not depend on the scanner specifications. For the second method, detailed information on the design of the CT scanner and the raw data of the study is required. Clinical implementation and evaluation were performed using pre- and post-operative CT scans of four patients with shoulder prosthesis. For comparison of these methods, the authors developed a quantitative technique that compares improvement in image quality for the two metal artifact reduction techniques with the image quality of the uncorrected images. RESULTS: Metal artifact reduction using either of the two methods yields a decrease of noise and artifacts in CT scans of patients with shoulder prostheses. Artifacts that appeared as bright and dark streaks were reduced or eliminated and as a result image quality improved. Quantitative assessment of clinical images showed improved image quality for both techniques of metal artifact reduction, but the method based on correction in original raw data performed better in all comparisons. CONCLUSION: Both methods are effective for metal artifact reduction, but better performance was observed for the method that is based on correcting the original raw data. The used evaluation technique provides an objective way of evaluating the metal artifacts in clinical CT images.

Assessment of coronary artery calcium by using volumetric 320-row multi-detector computed tomography: comparison of 0.5 mm with 3.0 mm slice reconstructions.

The purpose of this study was to assess the performance of 0.5 versus 3.0 mm slice reconstructions in depicting coronary calcium with special attention to patients having zero calcium scores at 3.0 mm reconstructions by using computed tomography (CT). Imaging was performed by volumetric 320-detector row CT. Scans of 100 patients with a negative and 100 patients with a positive Agatston score at 3.0 mm reconstructions were consecutively selected. Non-overlapping volume sets with 3.0 and 0.5 mm slice thickness were reconstructed from the same raw data and Agatston and volume scores were obtained. The Wilcoxon signed ranks test was used to determine statistical differences between 3.0 and 0.5 mm calcium scores. Agatston and volume scores obtained at 0.5 mm were significantly higher than at 3.0 mm reconstructions (mean Agatston score: 266 +/- 495 vs. 231 +/- 461. Mean volume score: 223 +/- 399 vs. 206 +/- 385, both P < 0.01). In 21% of patients with zero 3.0 mm Agatston scores, a positive Agatston and/or volume score was found at 0.5 mm reconstructions. With volumetric 320-detector row CT, prospective ECG-triggered calcium scoring at 0.5 mm compared to 3.0 mm reconstructions leads to an increase in Agatston and volume scores and small amounts of coronary calcium are earlier depicted. This may be of special interest in patients with zero calcium scores with traditional 3.0 mm measures, where 0.5 mm reconstructions may help in superior depicting or ruling out coronary artery disease.