Fact-finding survey on the competencies and literacy of radiological technologists regarding radiation disasters.

BACKGROUND: Radiological technologists serve as risk communicators who aim to lessen patients' anxiety about radiation exposure, in addition to performing radiological examinations. OBJECTIVE: We conducted a fact-finding survey on knowledge and awareness of radiation disasters among the radiological technologists to reveal their literacy and competencies regarding radiation disasters. METHODS: A paper questionnaire was distributed to 1,835 radiological technologists at 166 National Hospital Organization facilities in Japan. The 28-item questionnaire covered knowledge and awareness of radiation protection and radiation disasters. Radiological technologists were divided into 2 groups by regionality: areas where a nuclear power station was present/nearby (NPS areas) and non-NPS areas. RESULTS: Completed questionnaires were returned from 148 facilities with a facility response rate of 89.2% and from 1,391 radiological technologists with a response rate of 75.8%. There were 1,290 valid responses with a valid response rate of 70.3%. The correct answer rate for knowledge of radiation protection and radiation disasters was high in the 24 NPS areas. There were no differences in awareness of radiation disasters between NPS and non-NPS areas. CONCLUSIONS: Establishing a nationwide, region-independent training system can be expected to improve literacy regarding radiation disasters among radiological technologists. Willingness to assist during disasters was high among radiological technologists irrespective of area, indicating that the competencies of radiological technologists represent a competency model for radiation disaster assistance.

Using modulated and smoothed data improves detectability of volume difference in group comparison, but reduces accuracy with atlas-based volumetry using Statistical Parametric Mapping 12 software.

BACKGROUND: Atlas-based volumetry using three-dimensional T1-weighted (3D-T1W) magnetic resonance imaging (MRI) has been used previously to evaluate the volumes of intracranial tissues. PURPOSE: To evaluate the detectability of volume difference and accuracy for volumetry using smoothed data with an atlas-based method. MATERIAL AND METHODS: Twenty healthy individuals and 24 patients with idiopathic normal-pressure hydrocephalus (iNPH) underwent 3-T MRI, and sagittal 3D-T1W images were obtained in all participants. Signal values (as tissue probability) of voxels in five segmented data types (gray matter, white matter, cerebrospinal fluid [CSF], skull, soft tissue) derived from the 3D-T1W images with SPM 12 software were assigned simulated 3D-T1W signal intensities to each tissue image. The assigned data were termed "reference data." We created a reference 3D-T1W image that included the reference data of all five tissue types. Standard volumes were measured for the reference CSF data with region of interest of lateral ventricle in native space, and measured volumes were obtained for non-smoothed and smoothed-modulated data. Detectability was evaluated between measured volumes in the healthy control and iNPH groups. Accuracy was evaluated as the difference between the mean measured and standard volumes. RESULTS: In group comparison of measured volumes between the healthy control and iNPH groups, the lowest P value was for smoothed-modulated CSF data. In both groups, the largest difference from the standard volume was found for the mean of the measured volumes for smoothed-modulated CSF data. CONCLUSION: Our study shows that using smoothed data can improve detectability in group comparison. However, using smoothed data reduces the accuracy of volumetry.

Connectome analysis of male world-class gymnasts using probabilistic multishell, multitissue constrained spherical deconvolution tracking.

In athletes, long-term intensive training has been shown to increase unparalleled athletic ability and might induce brain plasticity. We evaluated the structural connectome of world-class gymnasts (WCGs), as mapped by diffusion-weighted magnetic resonance imaging probabilistic tractography and a multishell, multitissue constrained spherical deconvolution method to increase the precision of tractography at the tissue interfaces. The connectome was mapped in 10 Japanese male WCGs and in 10 age-matched male controls. Network-based statistic identified subnetworks with increased connectivity density in WCGs, involving the sensorimotor, default mode, attentional, visual, and limbic areas. It also revealed a significant association between the structural connectivity of some brain structures with functions closely related to the gymnastic skills and the D-score, which is used as an index of the gymnasts' specific physical abilities for each apparatus. Furthermore, graph theory analysis demonstrated the characteristics of brain anatomical topology in the WCGs. They displayed significantly increased global connectivity strength with decreased characteristic path length at the global level and higher nodal strength and degree in the sensorimotor, default mode, attention, and limbic/subcortical areas at the local level as compared with controls. Together, these findings extend the current understanding of neural mechanisms that distinguish WCGs from controls and suggest brain anatomical network plasticity in WCGs resulting from long-term intensive training. Future studies should assess the contribution of genetic or early-life environmental factors in the brain network organization of WCGs. Furthermore, the indices of brain topology (i.e., connection density and graph theory indices) could become markers for the objective evaluation of gymnastic performance.

Sema4A is implicated in the acceleration of Th17 cell-mediated neuroinflammation in the effector phase.

BACKGROUND: Sema4A is a regulator of helper T cell (Th) activation and differentiation in the priming phase, which plays an important role in the pathogenesis of experimental autoimmune encephalomyelitis (EAE) and multiple sclerosis (MS). However, the role of Sema4A in the effector phase remains elusive. We aimed to investigate the role of Sema4A at the effector phase in adoptively transferred EAE model. Clinical features and cytokine profiles of MS patients with high Sema4A levels were also examined in detail to clarify the correlation between Sema4A levels and disease activity of patients with MS. METHODS: We adoptively transferred encephalitogenic Th1 or Th17 cells to wild type (WT) or Sema4A-deficient (Sema4A KO) mice and assessed severity of symptoms and cellular infiltration within the central nervous system (CNS). In addition, we analyzed clinical and radiological features (n = 201), levels of serum IFN-γ and IL-17A (n = 86), complete remission ratio by IFN-ß (n = 38) in all of relapsing-remitting multiple sclerosis (RRMS) patients enrolled in this study. RESULTS: Sema4A KO recipient mice receiving Th17-skewed WT myelin oligodendrocyte glycoprotein (MOG)-specific encephalitogenic T cells showed a significant reduction in the clinical score compared to the WT recipient mice. However, Sema4A KO recipient mice showed similar disease activity to the WT recipient mice when transferred with Th1-skewed encephalitogenic T cells. Bone marrow chimeric study indicated that Sema4A expressed on hematopoietic cells, but not the CNS resident cells, are responsible for augmenting Th17-mediated neuroinflammation. Additionally, in contrast to comparable IFN-γ levels, IL-17A is significantly higher in RRMS patients with high Sema4A level than those with low Sema4A patients with high Sema4A levels showed earlier disease onset, more severe disease activity and IFN-ß unresponsiveness than those with low Sema4A levels. CONCLUSIONS: Sema4A is involved not only in the Th cell priming but also in the acceleration of Th17 cell-mediated neuroinflammation in the effector phase, which could contribute to the higher disease activity observed in RRMS patients with high serum Sema4A levels.

Neurocognitive and psychiatric disorders-related axonal degeneration in Parkinson's disease.

Neurocognitive and psychiatric disorders have significant consequences for quality of life in patients with Parkinson's disease (PD). In the current study, we evaluated microstructural white matter (WM) alterations associated with neurocognitive and psychiatric disorders in PD using neurite orientation dispersion and density imaging (NODDI) and linked independent component analysis (LICA). The indices of NODDI were compared between 20 and 19 patients with PD with and without neurocognitive and psychiatric disorders, respectively, and 25 healthy controls using tract-based spatial statistics and tract-of-interest analyses. LICA was applied to model inter-subject variability across measures. A widespread reduction in axonal density (indexed by intracellular volume fraction [ICVF]) was demonstrated in PD patients with and without neurocognitive and psychiatric disorders, as compared with healthy controls. Compared with patients without neurocognitive and psychiatric disorders, patients with neurocognitive and psychiatric disorders exhibited more extensive (posterior predominant) decreases in axonal density. Using LICA, ICVF demonstrated the highest contribution (59% weight) to the main effects of diagnosis that reflected widespread decreases in axonal density. These findings suggest that axonal loss is a major factor underlying WM pathology related to neurocognitive and psychiatric disorders in PD, whereas patients with neurocognitive and psychiatric disorders had broader axonal pathology, as compared with those without. LICA suggested that the ICVF can be used as a useful biomarker of microstructural changes in the WM related to neurocognitive and psychiatric disorders in PD.

Microstructural Damage in Normal-Appearing Brain Parenchyma and Neurocognitive Dysfunction in Adult Moyamoya Disease.

Background and Purpose -Microstructural damage in the brain induced by chronic ischemia is suggested to play a pivotal role in the neurocognitive dysfunction of adults with Moyamoya disease (MMD). We investigated specific changes in the brain microstructure and their correlations with neurocognitive dysfunction in patients with MMD using a multishell diffusion magnetic resonance imaging technique called neurite orientation dispersion and density imaging. Methods- We evaluated 26 patients with MMD (16-63 years old, 20 females) and 20 age- and sex-matched normal volunteers using neurite orientation dispersion and density imaging and neuropsychological batteries. Neurite orientation dispersion and density imaging calculates 2 parameters: the intracellular volume fraction (Vic), which reflects the axon density in the white matter and dendrite density in the cortex, and the orientation dispersion index (OD), which reflects the network complexity. The microstructural damage and its correlation with neurocognitive performance were evaluated by performing a whole-brain analysis using SPM12 and correlation analysis with regional values. Results- Patients with MMD had significantly lower Vic in the white matter and a lower OD mainly in the cortex than those of the controls ( P<0.001, family-wise error corrected). Of all neuropsychological scores, Processing Speed Index (PS) exhibited the strongest correlation with Vic in the white matter ( P<0.001, family-wise error corrected). The Vic and OD values for regions with group differences, including both temporoparietal and frontal areas, correlated with neurocognitive performance (absolute r=0.37-0.64; P<0.01). Conclusions- Chronic ischemia in MMD may decrease the axon density in the white matter and dendrite density in the cortex (Vic) and simplify network complexity (OD), leading to neurocognitive dysfunction. Processing Speed Index may be the most sensitive index used to evaluate the ischemic burden, and the posterior part of the brain may play an important role in neurocognitive function. Clinical Trial Registration- URL: http://www.umin.ac.jp/ctr/ . Unique identifier: UMIN000023082.

Comparison of Brain Volume Measurements Made with 0.3- and 3-T MR Imaging.

The volumes of intracranial tissues of 40 healthy volunteers acquired from 0.3- and 3-T scanners were compared using intraclass correlation coefficients, correlation analyses, and Bland-Altman analyses. We found high intraclass correlation coefficients, high Pearson's correlation coefficients, and low percentage biases in all tissues and most of the brain regions, although small differences were observed in some areas. These findings may support the validity of brain volumetry with low-field magnetic resonance imaging.

Neurite orientation dispersion and density imaging reveals white matter microstructural alterations in adults with autism.

BACKGROUND: Evidences suggesting the association between behavioral anomalies in autism and white matter (WM) microstructural alterations are increasing. Diffusion tensor imaging (DTI) is widely used to infer tissue microstructure. However, due to its lack of specificity, the underlying pathology of reported differences in DTI measures in autism remains poorly understood. Herein, we applied neurite orientation dispersion and density imaging (NODDI) to quantify and define more specific causes of WM microstructural changes associated with autism in adults. METHODS: NODDI (neurite density index [NDI], orientation dispersion index, and isotropic volume fraction [ISOVF]) and DTI (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity, and radial diffusivity [RD]) measures were compared between autism (N = 26; 19 males and 7 females; 32.93 ± 9.24 years old) and age- and sex-matched typically developing (TD; N = 25; 17 males and 8 females; 34.43 ± 9.02 years old) groups using tract-based spatial statistics and region-of-interest analyses. Linear discriminant analysis using leave-one-out cross-validation (LDA-LOOCV) was also performed to assess the discriminative power of diffusion measures in autism and TD. RESULTS: Significantly lower NDI and higher ISOVF, suggestive of decreased neurite density and increased extracellular free-water, respectively, were demonstrated in the autism group compared with the TD group, mainly in commissural and long-range association tracts, but with distinct predominant sides. Consistent with previous reports, the autism group showed lower FA and higher MD and RD when compared with TD group. Notably, LDA-LOOCV suggests that NDI and ISOVF have relatively higher accuracy (82%) and specificity (NDI, 84%; ISOVF, 88%) compared with that of FA, MD, and RD (accuracy, 67-73%; specificity, 68-80%). LIMITATIONS: The absence of histopathological confirmation limit the interpretation of our findings. CONCLUSIONS: Our results suggest that NODDI measures might be useful as imaging biomarkers to diagnose autism in adults and assess its behavioral characteristics. Furthermore, NODDI allows interpretation of previous findings on changes in WM diffusion tensor metrics in individuals with autism.

Effect of hybrid of compressed sensing and parallel imaging on the quantitative values measured by 3D quantitative synthetic MRI: A phantom study.

INTRODUCTION: Recently, three-dimensional (3D) quantitative synthetic magnetic resonance imaging (MRI), which quantifies tissue properties and creates multiple contrast-weighted images, has been enabled by 3D-quantification using an interleaved Look-Locker acquisition sequence with a T2 preparation pulse (3D-QALAS). However, the relatively long scan time has hindered its introduction into clinical practice. A hybrid of compressed sensing and parallel imaging (Compressed sensing-sensitivity encoding: CS-SENSE) can accelerate 3D-QALAS; however, whether CS-SENSE affects the quantitative values acquired by 3D-QALAS remains unexplored. Therefore, this study aimed to examine the effects of reduction factors of CS-SENSE (RCSS) on the quantitative values derived from 3D-QALAS, by assessing the signal-to-noise ratio (SNR) of the quantitative maps, as well as accuracy (linearity and bias) and repeatability of measured quantitative values. METHODS: In this study, the ISMRM/NIST standardized phantom was scanned on a 1.5-T MRI scanner with 3D-QALAS using RCSS in the range between 1 and 3, with intervals of 0.2, and between 3 and 10 with intervals of 0.5. The T1, T2, and proton density (PD) values were calculated from the imaging data. For each quantitative value, the SNR, the coefficient of determination (R2) of a linear regression model, the error rate, and the within-subject coefficient of variation (wCV) were calculated for each RCSS and compared. RESULTS: Within the clinically-relevant dynamic range of the brain of T1 and T2 (T1: 200-1400 ms; T2; 50-400 ms) and PD value of 15-100% calculated from 3D-QALAS, the effects of RCSS on quantitative values was small between 1 and 2.8, with SNR ≧ 10, R2 ≧ 0.9, error rate ≦ 10%, and wCV ≦ 10%, except for T2 values of 186.1 and 258.4 ms. CONCLUSIONS: CS-SENSE enabled the reduction of the scan time of 3D-QALAS by 63.5% (RCSS = 2.8) while maintaining the SNR of quantitative maps and accuracy and repeatability of the quantitative values.

Age-Related Changes in Relaxation Times, Proton Density, Myelin, and Tissue Volumes in Adult Brain Analyzed by 2-Dimensional Quantitative Synthetic Magnetic Resonance Imaging.

OBJECTIVES: Quantitative synthetic magnetic resonance imaging (MRI) enables the determination of fundamental tissue properties, namely, T1 and T2 relaxation times and proton density (PD), in a single scan. Myelin estimation and brain segmentation based on these quantitative values can also be performed automatically. This study aimed to reveal the changes in tissue characteristics and volumes of the brain according to age and provide age-specific reference values obtained by quantitative synthetic MRI. MATERIALS AND METHODS: This was a prospective study of healthy subjects with no history of brain diseases scanned with a multidynamic multiecho sequence for simultaneous measurement of relaxometry of T1, T2, and PD. We performed myelin estimation and brain volumetry based on these values. We performed volume-of-interest analysis on both gray matter (GM) and white matter (WM) regions for T1, T2, PD, and myelin volume fraction maps. Tissue volumes were calculated in the whole brain, producing brain parenchymal volume, GM volume, WM volume, and myelin volume. These volumes were normalized by intracranial volume to a brain parenchymal fraction, GM fraction, WM fraction, and myelin fraction (MyF). We examined the changes in the mean regional quantitative values and segmented tissue volumes according to age. RESULTS: We analyzed data of 114 adults (53 men and 61 women; median age, 66.5 years; range, 21-86 years). T1, T2, and PD values showed quadratic changes according to age and stayed stable or decreased until around 60 years of age and increased thereafter. Myelin volume fraction showed a reversed trend. Brain parenchymal fraction and GM fraction decreased throughout all ages. The approximation curves showed that WM fraction and MyF gradually increased until around the 40s to 50s and decreased thereafter. A significant decline in MyF was first noted in the 60s age group (Tukey test, P < 0.001). CONCLUSIONS: Our study showed changes according to age in tissue characteristic values and brain volumes using quantitative synthetic MRI. The reference values for age demonstrated in this study may be useful to discriminate brain disorders from healthy brains.

Brain White-Matter Degeneration Due to Aging and Parkinson Disease as Revealed by Double Diffusion Encoding.

Microstructure imaging by means of multidimensional diffusion encoding is increasingly applied in clinical research, with expectations that it yields a parameter that better correlates with clinical disability than current methods based on single diffusion encoding. Under the assumption that diffusion within a voxel can be well described by a collection of diffusion tensors, several parameters of this diffusion tensor distribution can be derived, including mean size, variance of sizes, orientational dispersion, and microscopic anisotropy. The information provided by multidimensional diffusion encoding also enables us to decompose the sources of the conventional fractional anisotropy and mean kurtosis. In this study, we explored the utility of the diffusion tensor distribution approach for characterizing white-matter degeneration in aging and in Parkinson disease by using double diffusion encoding. Data from 23 healthy older subjects and 27 patients with Parkinson disease were analyzed. Advanced age was associated with greater mean size and size variances, as well as smaller microscopic anisotropy. By analyzing the parameters underlying diffusion kurtosis, we found that the reductions of kurtosis in aging and Parkinson disease reported in the literature are likely driven by the reduction in microscopic anisotropy. Furthermore, microscopic anisotropy correlated with the severity of motor impairment in the patients with Parkinson disease. The present results support the use of multidimensional diffusion encoding in clinical studies and are encouraging for its future clinical implementation.

Comparison of magnetization transfer contrast of conventional and simultaneous multislice turbo spin echo acquisitions focusing on excitation time interval.

PURPOSE: Image contrast differs between conventional multislice turbo spin echo (conventional TSE) and multiband turbo spin echo (SMS-TSE). Difference in time interval between excitations for adjacent slices (SETI) might cause this difference. This study aimed to evaluate the influence of SETI on MT effect for conventional TSE and compare conventional TSE with SMS-TSE in this respect. MATERIALS AND METHODS: Three different agar concentration phantoms were scanned with conventional TSE by adjusting SETI and TR. Signal change for different SETI was evaluated using Pearson's correlation analysis. SMS-TSE was acquired by changing TR similarly. Three human volunteers were scanned with similar settings to evaluate reproducibility of the phantom results in human brain. RESULTS: In conventional TSE, shorter SETI induced larger signal reduction. Longer TR and higher agar concentration emphasized this characteristic. Significant linear correlation (P < 0.05) was found in the major cases. The SMS-TSE signal intensity in each TR and phantom was smaller than the assumable levels in conventional TSE when the slices were simultaneously excited. Similar characteristic was observed in human brain. CONCLUSION: Shorter SETI results in larger MT effect in conventional TSE. The contrast change in SMS-TSE was larger than the supposable level from simultaneous excitation, which needs consideration in clinics.