Molecular Imaging with Aquaporin-Based Reporter Genes: Quantitative Considerations from Monte Carlo Diffusion Simulations.

Aquaporins provide a unique approach for imaging genetic activity in deep tissues by increasing the rate of cellular water diffusion, which generates a magnetic resonance contrast. However, distinguishing aquaporin signals from the tissue background is challenging because water diffusion is influenced by structural factors, such as cell size and packing density. Here, we developed a Monte Carlo model to analyze how cell radius and intracellular volume fraction quantitatively affect aquaporin signals. We demonstrated that a differential imaging approach based on subtracting signals at two diffusion times can improve specificity by unambiguously isolating aquaporin signals from the tissue background. We further used Monte Carlo simulations to analyze the connection between diffusivity and the percentage of cells engineered to express aquaporin and established a mapping that accurately determined the volume fraction of aquaporin-expressing cells in mixed populations. The quantitative framework developed in this study will enable a broad range of applications in biomedical synthetic biology, requiring the use of aquaporins to noninvasively monitor the location and function of genetically engineered devices in live animals.

Molecular imaging with aquaporin-based reporter genes: quantitative considerations from Monte Carlo diffusion simulations.

Aquaporins provide a new class of genetic tools for imaging molecular activity in deep tissues by increasing the rate of cellular water diffusion, which generates magnetic resonance contrast. However, distinguishing aquaporin contrast from the tissue background is challenging because water diffusion is also influenced by structural factors such as cell size and packing density. Here, we developed and experimentally validated a Monte Carlo model to analyze how cell radius and intracellular volume fraction quantitatively affect aquaporin signals. We demonstrated that a differential imaging approach based on time-dependent changes in diffusivity can improve specificity by unambiguously isolating aquaporin-driven contrast from the tissue background. Finally, we used Monte Carlo simulations to analyze the connection between diffusivity and the percentage of cells engineered to express aquaporin, and established a simple mapping that accurately determined the volume fraction of aquaporin-expressing cells in mixed populations. This study creates a framework for broad applications of aquaporins, particularly in biomedicine and in vivo synthetic biology, where quantitative methods to measure the location and performance of genetic devices in whole vertebrates are necessary.

Telecytologic diagnosis of cervical smears for triage of self-sampled human papillomavirus-positive women in a resource-limited setting: concept development before implementation.

INTRODUCTION: Cytology is an option for triaging human papillomavirus (HPV)-positive women. The interpretation of cytologic slides requires expertise and financial resources that are not always available in resource-limited settings. A solution could be offered by manual preparation and digitization of slides on site for real-time remote cytologic diagnosis by specialists. In the present study, we evaluated the operational feasibility and cost of manual preparation and digitization of thin-layer slides and the diagnostic accuracy of screening with virtual microscopy. MATERIALS AND METHODS: Operational feasibility was evaluated on 30 cervical samples obtained during colposcopy. The simplicity of the process and cellularity and quality of digitized thin-layer slides were evaluated. The diagnostic accuracy of digital versus glass slides to detect cervical intraepithelial neoplasia grade 2 or worse was assessed using a cohort of 264 HPV-positive Cameroonian women aged 30 to 49 years. The histologic results served as the reference standard. RESULTS: Manual preparation was found to be feasible and economically viable. The quality characteristics of the digital slides were satisfactory, and the mean cellularity was 6078 squamous cells per slide. When using the atypical squamous cells of undetermined significance or worse threshold for positivity, the diagnostic performance of screening digital slides was not significantly different statistically compared with the same set of slides screened using a light microscope (P = 0.26). CONCLUSIONS: We have developed an innovative triage concept for HPV-positive women. A quality-ensured telecytologic diagnosis could be an effective solution in areas with a shortage of specialists, applying a same day "test-triage-treat" approach. Our results warrant further on-site clinical validation in a large prospective screening trial.

Robust Monte-Carlo Simulations in Diffusion-MRI: Effect of the Substrate Complexity and Parameter Choice on the Reproducibility of Results.

Monte-Carlo Diffusion Simulations (MCDS) have been used extensively as a ground truth tool for the validation of microstructure models for Diffusion-Weighted MRI. However, methodological pitfalls in the design of the biomimicking geometrical configurations and the simulation parameters can lead to approximation biases. Such pitfalls affect the reliability of the estimated signal, as well as its validity and reproducibility as ground truth data. In this work, we first present a set of experiments in order to study three critical pitfalls encountered in the design of MCDS in the literature, namely, the number of simulated particles and time steps, simplifications in the intra-axonal substrate representation, and the impact of the substrate's size on the signal stemming from the extra-axonal space. The results obtained show important changes in the simulated signals and the recovered microstructure features when changes in those parameters are introduced. Thereupon, driven by our findings from the first studies, we outline a general framework able to generate complex substrates. We show the framework's capability to overcome the aforementioned simplifications by generating a complex crossing substrate, which preserves the volume in the crossing area and achieves a high packing density. The results presented in this work, along with the simulator developed, pave the way toward more realistic and reproducible Monte-Carlo simulations for Diffusion-Weighted MRI.

ActiveAxADD : Toward non-parametric and orientationally invariant axon diameter distribution mapping using PGSE.

PURPOSE: Non-invasive axon diameter distribution (ADD) mapping using diffusion MRI is an ill-posed problem. Current ADD mapping methods require knowledge of axon orientation before performing the acquisition. Instead, ActiveAx uses a 3D sampling scheme to estimate the orientation from the signal, providing orientationally invariant estimates. The mean diameter is estimated instead of the distribution for the solution to be tractable. Here, we propose an extension (ActiveAxADD ) that provides non-parametric and orientationally invariant estimates of the whole distribution. THEORY: The accelerated microstructure imaging with convex optimization (AMICO) framework accelerates mean diameter estimation using a linear formulation combined with Tikhonov regularization to stabilize the solution. Here, we implement a new formulation (ActiveAxADD ) that uses Laplacian regularization to provide robust estimates of the whole ADD. METHODS: The performance of ActiveAxADD was evaluated using Monte Carlo simulations on synthetic white matter samples mimicking axon distributions reported in histological studies. RESULTS: ActiveAxADD provided robust ADD reconstructions when considering the isolated intra-axonal signal. However, our formulation inherited some common microstructure imaging limitations. When accounting for the extra axonal compartment, estimated ADDs showed spurious peaks and increased variability because of the difficulty of disentangling intra and extra axonal contributions. CONCLUSION: Laplacian regularization solves the ill-posedness regarding the intra axonal compartment. ActiveAxADD can potentially provide non-parametric and orientationally invariant ADDs from isolated intra-axonal signals. However, further work is required before ActiveAxADD can be applied to real data containing extra-axonal contributions, as disentangling the 2 compartment appears to be an overlooked challenge that affects microstructure imaging methods in general.

Towards microstructure fingerprinting: Estimation of tissue properties from a dictionary of Monte Carlo diffusion MRI simulations.

Many closed-form analytical models have been proposed to relate the diffusion-weighted magnetic resonance imaging (DW-MRI) signal to microstructural features of white matter tissues. These models generally make assumptions about the tissue and the diffusion processes which often depart from the biophysical reality, limiting their reliability and interpretability in practice. Monte Carlo simulations of the random walk of water molecules are widely recognized to provide near groundtruth for DW-MRI signals. However, they have mostly been limited to the validation of simpler models rather than used for the estimation of microstructural properties. This work proposes a general framework which leverages Monte Carlo simulations for the estimation of physically interpretable microstructural parameters, both in single and in crossing fascicles of axons. Monte Carlo simulations of DW-MRI signals, or fingerprints, are pre-computed for a large collection of microstructural configurations. At every voxel, the microstructural parameters are estimated by optimizing a sparse combination of these fingerprints. Extensive synthetic experiments showed that our approach achieves accurate and robust estimates in the presence of noise and uncertainties over fixed or input parameters. In an in vivo rat model of spinal cord injury, our approach provided microstructural parameters that showed better correspondence with histology than five closed-form models of the diffusion signal: MMWMD, NODDI, DIAMOND, WMTI and MAPL. On whole-brain in vivo data from the human connectome project (HCP), our method exhibited spatial distributions of apparent axonal radius and axonal density indices in keeping with ex vivo studies. This work paves the way for microstructure fingerprinting with Monte Carlo simulations used directly at the modeling stage and not only as a validation tool.

MBIS: multivariate Bayesian image segmentation tool.

We present MBIS (Multivariate Bayesian Image Segmentation tool), a clustering tool based on the mixture of multivariate normal distributions model. MBIS supports multichannel bias field correction based on a B-spline model. A second methodological novelty is the inclusion of graph-cuts optimization for the stationary anisotropic hidden Markov random field model. Along with MBIS, we release an evaluation framework that contains three different experiments on multi-site data. We first validate the accuracy of segmentation and the estimated bias field for each channel. MBIS outperforms a widely used segmentation tool in a cross-comparison evaluation. The second experiment demonstrates the robustness of results on atlas-free segmentation of two image sets from scan-rescan protocols on 21 healthy subjects. Multivariate segmentation is more replicable than the monospectral counterpart on T1-weighted images. Finally, we provide a third experiment to illustrate how MBIS can be used in a large-scale study of tissue volume change with increasing age in 584 healthy subjects. This last result is meaningful as multivariate segmentation performs robustly without the need for prior knowledge.

Soft tissue artifact assessment during treadmill walking in subjects with total knee arthroplasty.

Accurate measurement of knee kinematics during functional activities suffers mainly from soft tissue artifact (STA): the combination of local surface deformations and rigid movement of markers relative to the underlying bone (also called rigid STA movement: RSTAM). This study proposes to assess RSTAM on the thigh, shank, and knee joint and to observe possible features between subjects. Nineteen subjects with knee arthroplasty were asked to walk on a treadmill while a biplane fluoroscopic system (X-rays) and a stereophotogrammetric system (skin markers) recorded their knee movement. The RSTAM was defined as the rigid movement of the cluster of skin markers relative to the prosthesis. The results showed that RSTAM amplitude represents approximately 80-100% of the STA. The vertical axis of the anatomical frame of the femur was influenced the most by RSTAM. Combined with tibial error, internal/external rotation angle and distraction-compression were the knee kinematics parameters most affected by RSTAM during the gait cycle, with average rms values of 3.8° and 11.1 mm. This study highlighted higher RSTAM during the swing phase particularly in the thigh segment and suggests new features for RSTAM such as the particular shape of some RSTAM waveforms and the absence of RSTAM in certain kinematics during the gait phases. The comparison of coefficient of multiple correlations showed some similarities of RSTAM between subjects, while some correlations were found with gait speed and BMI. These new insights could potentially allow the development of new methods of compensation to avoid STA.

Automatic quality assessment in structural brain magnetic resonance imaging.

MRI has evolved into an important diagnostic technique in medical imaging. However, reliability of the derived diagnosis can be degraded by artifacts, which challenge both radiologists and automatic computer-aided diagnosis. This work proposes a fully-automatic method for measuring image quality of three-dimensional (3D) structural MRI. Quality measures are derived by analyzing the air background of magnitude images and are capable of detecting image degradation from several sources, including bulk motion, residual magnetization from incomplete spoiling, blurring, and ghosting. The method has been validated on 749 3D T(1)-weighted 1.5T and 3T head scans acquired at 36 Alzheimer's Disease Neuroimaging Initiative (ADNI) study sites operating with various software and hardware combinations. Results are compared against qualitative grades assigned by the ADNI quality control center (taken as the reference standard). The derived quality indices are independent of the MRI system used and agree with the reference standard quality ratings with high sensitivity and specificity (>85%). The proposed procedures for quality assessment could be of great value for both research and routine clinical imaging. It could greatly improve workflow through its ability to rule out the need for a repeat scan while the patient is still in the magnet bore.

Fibertract segmentation in position orientation space from high angular resolution diffusion MRI.

In diffusion MRI, standard approaches for fibertract identification are based on algorithms that generate lines of coherent diffusion, currently known as tractography. A tract is then identified as a set of such lines selected on some criteria. In the present study, we investigate whether fibertract identification can be formulated as a segmentation task that recognizes a fibertract as a region where diffusion is intense and coherent. Indeed, we show that it is possible to segment efficiently well-known fibertracts with classical image processing methods provided that the problem is formulated in a five-dimensional space of position and orientation. As an example, we choose to adapt to this newly defined high-dimensional non-Euclidean space, called position orientation space, an algorithm based on the hidden Markov random field framework. Structures such as the cerebellar peduncles, corticospinal tract, association bundles can be identified and represented in three dimensions by a back projection technique similar to maximum intensity projection. Potential advantages and drawbacks as compared to classical tractography are discussed; for example, it appears that our formulation handles naturally crossing tracts and is not biased by human intervention.

An open Internet platform to distributed image processing applied to dermoscopy.

Proprietary systems for dermoscopy images analysis are available to improve the diagnosis and follow-up of the pigmented skin lesions. Their performance seems comparable with that of a human expert. Progress in computer-aided classification of melanocytic lesions depends notably on judicious choices of the algorithms dedicated to the extraction of signs from the dermoscopy images and of the method which combines these signs to classify the lesions. To allow the researcher's community to benefit from their large set of elementary algorithms already available for dermoscopy, we set up a system accessible through the Internet which: allows the engineers to register their algorithms while preserving their secrecy: their programs run on their own server; lets a user to define its own sequence of image analysis and to apply it to its images: the system automatically calls the appropriate remote programs; makes possible and stimulates the synergy of worldwide researchers in order to validate algorithms of images analysis best suited to achieve the correct diagnosis and to track the malignant melanoma; makes these techniques available to the greatest number of users through the Web and thus to support a mass screening; reduces the maintenance of the system to the minimum: it requires users only an Internet browser and engineers to follow a simple widespread standardised interface for distributed programs. Various problems should be addressed: the lack of standardisation of images acquisition: algorithms based on relative colours are best suited to this system; the copyrights on images and algorithms; charging the use of remote computer resources. This system allows for an international collaborative work in the fight against the malignant melanoma by offering a conceptual and technical platform of teledermoscopy. It is intended to support synergy between the engineers and the users implied in the diagnosis and teaching of dermoscopy.