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1.
Theranostics ; 14(13): 5022-5101, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39267777

RESUMO

The potential of intranasal administered imaging agents to altogether bypass the blood-brain barrier offers a promising non-invasive approach for delivery directly to the brain. This review provides a comprehensive analysis of the advancements and challenges of delivering neuroimaging agents to the brain by way of the intranasal route, focusing on the various imaging modalities and their applications in central nervous system diagnostics and therapeutics. The various imaging modalities provide distinct insights into the pharmacokinetics, biodistribution, and specific interactions of imaging agents within the brain, facilitated by the use of tailored tracers and contrast agents. Methods: A comprehensive literature search spanned PubMed, Scopus, Embase, and Web of Science, covering publications from 1989 to 2024 inclusive. Starting with advancements in tracer development, we going to explore the rationale for integration of imaging techniques, and the critical role novel formulations such as nanoparticles, nano- and micro-emulsions in enhancing imaging agent delivery and visualisation. Results: The review highlights the use of innovative formulations in improving intranasal administration of neuroimaging agents, showcasing their ability to navigate the complex anatomical and physiological barriers of the nose-to-brain pathway. Various imaging techniques, MRI, PET, SPECT, CT, FUS and OI, were evaluated for their effectiveness in tracking these agents. The findings indicate significant improvements in brain targeting efficiency, rapid uptake, and sustained brain presence using innovative formulations. Conclusion: Future directions involve the development of optimised tracers tailored for intranasal administration, the potential of multimodal imaging approaches, and the implications of these advancements for diagnosing and treating neurological disorders.


Assuntos
Administração Intranasal , Encéfalo , Humanos , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Animais , Meios de Contraste/administração & dosagem , Meios de Contraste/farmacocinética , Neuroimagem/métodos , Sistemas de Liberação de Medicamentos/métodos , Barreira Hematoencefálica/metabolismo , Barreira Hematoencefálica/diagnóstico por imagem , Nanopartículas/química , Nanopartículas/administração & dosagem , Distribuição Tecidual , Imageamento por Ressonância Magnética/métodos
2.
Front Radiol ; 4: 1466498, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39328298

RESUMO

Introduction: The reconstruction of PET images involves converting sinograms, which represent the measured counts of radioactive emissions using detector rings encircling the patient, into meaningful images. However, the quality of PET data acquisition is impacted by physical factors, photon count statistics and detector characteristics, which affect the signal-to-noise ratio, resolution and quantitative accuracy of the resulting images. To address these influences, correction methods have been developed to mitigate each of these issues separately. Recently, generative adversarial networks (GANs) based on machine learning have shown promise in learning the complex mapping between acquired PET data and reconstructed tomographic images. This study aims to investigate the properties of training images that contribute to GAN performance when non-clinical images are used for training. Additionally, we describe a method to correct common PET imaging artefacts without relying on patient-specific anatomical images. Methods: The modular GAN framework includes two GANs. Module 1, resembling Pix2pix architecture, is trained on non-clinical sinogram-image pairs. Training data are optimised by considering image properties defined by metrics. The second module utilises adaptive instance normalisation and style embedding to enhance the quality of images from Module 1. Additional perceptual and patch-based loss functions are employed in training both modules. The performance of the new framework was compared with that of existing methods, (filtered backprojection (FBP) and ordered subset expectation maximisation (OSEM) without and with point spread function (OSEM-PSF)) with respect to correction for attenuation, patient motion and noise in simulated, NEMA phantom and human imaging data. Evaluation metrics included structural similarity (SSIM), peak-signal-to-noise ratio (PSNR), relative root mean squared error (rRMSE) for simulated data, and contrast-to-noise ratio (CNR) for NEMA phantom and human data. Results: For simulated test data, the performance of the proposed framework was both qualitatively and quantitatively superior to that of FBP and OSEM. In the presence of noise, Module 1 generated images with a SSIM of 0.48 and higher. These images exhibited coarse structures that were subsequently refined by Module 2, yielding images with an SSIM higher than 0.71 (at least 22% higher than OSEM). The proposed method was robust against noise and motion. For NEMA phantoms, it achieved higher CNR values than OSEM. For human images, the CNR in brain regions was significantly higher than that of FBP and OSEM (p < 0.05, paired t-test). The CNR of images reconstructed with OSEM-PSF was similar to those reconstructed using the proposed method. Conclusion: The proposed image reconstruction method can produce PET images with artefact correction.

3.
Front Neurol ; 15: 1383773, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38988603

RESUMO

Background: Cross-modality image estimation can be performed using generative adversarial networks (GANs). To date, SPECT image estimation from another medical imaging modality using this technique has not been considered. We evaluate the estimation of SPECT from MRI and PET, and additionally assess the necessity for cross-modality image registration for GAN training. Methods: We estimated interictal SPECT from PET and MRI as a single-channel input, and as a multi-channel input to the GAN. We collected data from 48 individuals with epilepsy and converted them to 3D isotropic images for consistence across the modalities. Training and testing data were prepared in native and template spaces. The Pix2pix framework within the GAN network was adopted. We evaluated the addition of the structural similarity index metric to the loss function in the GAN implementation. Root-mean-square error, structural similarity index, and peak signal-to-noise ratio were used to assess how well SPECT images were able to be synthesised. Results: High quality SPECT images could be synthesised in each case. On average, the use of native space images resulted in a 5.4% percentage improvement in SSIM than the use of images registered to template space. The addition of structural similarity index metric to the GAN loss function did not result in improved synthetic SPECT images. Using PET in either the single channel or dual channel implementation led to the best results, however MRI could produce SPECT images close in quality. Conclusion: Synthesis of SPECT from MRI or PET can potentially reduce the number of scans needed for epilepsy patient evaluation and reduce patient exposure to radiation.

4.
EJNMMI Res ; 14(1): 33, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38558200

RESUMO

BACKGROUND: Accurate measurement of the arterial input function (AIF) is crucial for parametric PET studies, but the AIF is commonly derived from invasive arterial blood sampling. It is possible to use an image-derived input function (IDIF) obtained by imaging a large blood pool, but IDIF measurement in PET brain studies performed on standard field of view scanners is challenging due to lack of a large blood pool in the field-of-view. Here we describe a novel automated approach to estimate the AIF from brain images. RESULTS: Total body 18F-FDG PET data from 12 subjects were split into a model adjustment group (n = 6) and a validation group (n = 6). We developed an AIF estimation framework using wavelet-based methods and unsupervised machine learning to distinguish arterial and venous activity curves, compared to the IDIF from the descending aorta. All of the automatically extracted AIFs in the validation group had similar shape to the IDIF derived from the descending aorta IDIF. The average area under the curve error and normalised root mean square error across validation data were - 1.59 ± 2.93% and 0.17 ± 0.07. CONCLUSIONS: Our automated AIF framework accurately estimates the AIF from brain images. It reduces operator-dependence, and could facilitate the clinical adoption of parametric PET.

5.
EJNMMI Res ; 14(1): 10, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38289518

RESUMO

BACKGROUND: The indirect method for generating parametric images in positron emission tomography (PET) involves the acquisition and reconstruction of dynamic images and temporal modelling of tissue activity given a measured arterial input function. This approach is not robust, as noise in each dynamic image leads to a degradation in parameter estimation. Direct methods incorporate into the image reconstruction step both the kinetic and noise models, leading to improved parametric images. These methods require extensive computational time and large computing resources. Machine learning methods have demonstrated significant potential in overcoming these challenges. But they are limited by the requirement of a paired training dataset. A further challenge within the existing framework is the use of state-of-the-art arterial input function estimation via temporal arterial blood sampling, which is an invasive procedure, or an additional magnetic resonance imaging (MRI) scan for selecting a region where arterial blood signal can be measured from the PET image. We propose a novel machine learning approach for reconstructing high-quality parametric brain images from histoimages produced from time-of-flight PET data without requiring invasive arterial sampling, an MRI scan, or paired training data from standard field-of-view scanners. RESULT: The proposed is tested on a simulated phantom and five oncological subjects undergoing an 18F-FDG-PET scan of the brain using Siemens Biograph Vision Quadra. Kinetic parameters set in the brain phantom correlated strongly with the estimated parameters (K1, k2 and k3, Pearson correlation coefficient of 0.91, 0.92 and 0.93) and a mean squared error of less than 0.0004. In addition, our method significantly outperforms (p < 0.05, paired t-test) the conventional nonlinear least squares method in terms of contrast-to-noise ratio. At last, the proposed method was found to be 37% faster than the conventional method. CONCLUSION: We proposed a direct non-invasive DL-based reconstruction method and produced high-quality parametric maps of the brain. The use of histoimages holds promising potential for enhancing the estimation of parametric images, an area that has not been extensively explored thus far. The proposed method can be applied to subject-specific dynamic PET data alone.

6.
EJNMMI Res ; 14(1): 1, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38169031

RESUMO

BACKGROUND: In parametric PET, kinetic parameters are extracted from dynamic PET images. It is not commonly used in clinical practice because of long scan times and the requirement for an arterial input function (AIF). To address these limitations, we designed an 18F-fluorodeoxyglucose (18F-FDG) triple injection dynamic PET protocol for brain imaging with a standard field of view PET scanner using a 24-min imaging window and an input function modeled using measurements from a region of interest placed over the left ventricle. METHODS: To test the protocol in 6 healthy participants, we examined the quality of voxel-based maps of kinetic parameters in the brain generated using the two-tissue compartment model and compared estimated parameter values with previously published values. We also utilized data from a 36-min validation imaging window to compare (1) the modeled AIF against the input function measured in the validation window; and (2) the net influx rate ([Formula: see text]) computed using parameter estimates from the short imaging window against the net influx rate obtained using Patlak analysis in the validation window. RESULTS: Compared to the AIF measured in the validation window, the input function estimated from the short imaging window achieved a mean area under the curve error of 9%. The voxel-wise Pearson's correlation between [Formula: see text] estimates from the short imaging window and the validation imaging window exceeded 0.95. CONCLUSION: The proposed 24-min triple injection protocol enables parametric 18F-FDG neuroimaging with noninvasive estimation of the AIF from cardiac images using a standard field of view PET scanner.

7.
Exp Neurol ; 365: 114406, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37062352

RESUMO

Structural and functional deficits in the hippocampus are a prominent feature of moderate-severe traumatic brain injury (TBI). In this work, we investigated the potential of Quantitative Susceptibility Imaging (QSM) to reveal the temporal changes in myelin integrity in a mouse model of concussion (mild TBI). We employed a cross-sectional design wherein we assigned 43 mice to cohorts undergoing either a concussive impact or a sham procedure, with QSM imaging at day 2, 7, or 14 post-injury, followed by Luxol Fast Blue (LFB) myelin staining to assess the structural integrity of hippocampal white matter (WM). We assessed spatial learning in the mice using the Active Place Avoidance Test (APA), recording their ability to use visual cues to locate and avoid zone-dependent mild electrical shocks. QSM and LFB staining indicated changes in the stratum lacunosum-molecular layer of the hippocampus in the concussion groups, suggesting impairment of this key relay between the entorhinal cortex and the CA1 regions. These imaging and histology findings were consistent with demyelination, namely increased magnetic susceptibility to MR imaging and decreased LFB staining. In the APA test, sham animals showed fewer entries into the shock zone compared to the concussed cohort. Thus, we present radiological, histological, and behavioral findings that concussion can induce significant and alterations in hippocampal integrity and function that evolve over time after the injury.


Assuntos
Concussão Encefálica , Doenças Desmielinizantes , Modelos Animais de Doenças , Hipocampo , Fenômenos Magnéticos , Animais , Camundongos , Concussão Encefálica/patologia , Estudos Transversais , Doenças Desmielinizantes/patologia , Hipocampo/patologia , Eletrochoque , Aprendizagem Espacial , Substância Branca/patologia , Córtex Entorrinal/patologia , Aprendizagem da Esquiva , Sinais (Psicologia) , Estimulação Luminosa , Região CA1 Hipocampal/patologia , Masculino , Axônios/patologia , Região CA3 Hipocampal/patologia
8.
Cereb Cortex ; 33(5): 1550-1565, 2023 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-35483706

RESUMO

BACKGROUND: Accurate parcellation of the cerebral cortex in an individual is a guide to its underlying organization. The most promising in vivo quantitative magnetic resonance (MR)-based microstructural cortical mapping methods are yet to achieve a level of parcellation accuracy comparable to quantitative histology. METHODS: We scanned 6 participants using a 3D echo-planar imaging MR fingerprinting (EPI-MRF) sequence on a 7T Siemens scanner. After projecting MRF signals to the individual-specific inflated model of the cortical surface, normalized autocorrelations of MRF residuals of vertices of 8 microstructurally distinct areas (BA1, BA2, BA4a, BA6, BA44, BA45, BA17, and BA18) from 3 cortical regions were used as feature vector inputs into linear support vector machine (SVM), radial basis function SVM (RBF-SVM), random forest, and k-nearest neighbors supervised classification algorithms. The algorithms' prediction performance was compared using: (i) features from each vertex or (ii) features from neighboring vertices. RESULTS: The neighborhood-based RBF-SVM classifier achieved the highest prediction score of 0.85 for classification of MRF residuals in the central region from a held-out participant. CONCLUSIONS: We developed an automated method of cortical parcellation using a combination of MR fingerprinting residual analysis and machine learning classification. Our findings provide the basis for employing unsupervised learning algorithms for whole-cortex structural parcellation in individuals.


Assuntos
Algoritmos , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Imagem Ecoplanar , Córtex Cerebral/diagnóstico por imagem , Máquina de Vetores de Suporte , Espectroscopia de Ressonância Magnética
9.
Neuroimage ; 259: 119410, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35753595

RESUMO

Quantitative susceptibility mapping (QSM) is an MRI post-processing technique that produces spatially resolved magnetic susceptibility maps from phase data. However, the traditional QSM reconstruction pipeline involves multiple non-trivial steps, including phase unwrapping, background field removal, and dipole inversion. These intermediate steps not only increase the reconstruction time but accumulates errors. This study aims to overcome existing limitations by developing a Laplacian-of-Trigonometric-functions (LoT) enhanced deep neural network for near-instant quantitative field and susceptibility mapping (i.e., iQFM and iQSM) from raw MRI phase data. The proposed iQFM and iQSM methods were compared with established reconstruction pipelines on simulated and in vivo datasets. In addition, experiments on patients with intracranial hemorrhage and multiple sclerosis were also performed to test the generalization of the proposed neural networks. The proposed iQFM and iQSM methods in healthy subjects yielded comparable results to those involving the intermediate steps while dramatically improving reconstruction accuracies on intracranial hemorrhages with large susceptibilities. High susceptibility contrast between multiple sclerosis lesions and healthy tissue was also achieved using the proposed methods. Comparative studies indicated that the most significant contributor to iQFM and iQSM over conventional multi-step methods was the elimination of traditional Laplacian unwrapping. The reconstruction time on the order of minutes for traditional approaches was shortened to around 0.1 s using the trained iQFM and iQSM neural networks.


Assuntos
Encéfalo , Esclerose Múltipla , Algoritmos , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Hemorragias Intracranianas , Imageamento por Ressonância Magnética/métodos , Esclerose Múltipla/diagnóstico por imagem , Redes Neurais de Computação
11.
Comput Biol Med ; 146: 105556, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35504221

RESUMO

Cross-modality image estimation involves the generation of images of one medical imaging modality from that of another modality. Convolutional neural networks (CNNs) have been shown to be useful in image-to-image intensity projections, in addition to identifying, characterising and extracting image patterns. Generative adversarial networks (GANs) use CNNs as generators and estimated images are classified as true or false based on an additional discriminator network. CNNs and GANs within the image estimation framework may be considered more generally as deep learning approaches, since medical images tend to be large in size, leading to the need for large neural networks. Most research in the CNN/GAN image estimation literature has involved the use of MRI data with the other modality primarily being PET or CT. This review provides an overview of the use of CNNs and GANs for cross-modality medical image estimation. We outline recently proposed neural networks and detail the constructs employed for CNN and GAN image-to-image synthesis. Motivations behind cross-modality image estimation are outlined as well. GANs appear to provide better utility in cross-modality image estimation in comparison with CNNs, a finding drawn based on our analysis involving metrics comparing estimated and actual images. Our final remarks highlight key challenges faced by the cross-modality medical image estimation field, including how intensity projection can be constrained by registration (unpaired versus paired data), use of image patches, additional networks, and spatially sensitive loss functions.


Assuntos
Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Benchmarking , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos
12.
IEEE Trans Med Imaging ; 41(5): 1007-1016, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35089856

RESUMO

The shielding of electromagnetic noise is critical in obtaining magnetic resonance imaging measurements in the ultra-low magnetic field regime where the intrinsic signal-to-noise ratio is very small. The traditional approach of using an enclosure for electromagnetic shielding is expensive and hinders system portability. We describe here the use of a CNN-based software gradiometer to suppress the effect of electromagnetic ambient background noise sources that inductively couple into the signal detection coils. The system involves three ambient noise monitoring coils placed at a distance from the magnetic resonance signal detector. The three coils were used to synthesize the ambient noise captured by the signal detector; a convolutional neural network approach was used. Mathematical foundations are provided to justify the noise suppression framework. The results show that as much as 20-fold noise suppression can be achieved using an optimized convolutional neural network and simultaneous ambient noise measurements. The proposed approach has the potential to replace the requirement for magnetically shielded enclosures and make ultra-low field magnetic resonance imaging truly portable.


Assuntos
Fenômenos Eletromagnéticos , Imageamento por Ressonância Magnética , Imageamento por Ressonância Magnética/métodos , Redes Neurais de Computação , Razão Sinal-Ruído , Software
13.
Neuroimage ; 250: 118903, 2022 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-35033674

RESUMO

Diffusion MRI measures of the human brain provide key insight into microstructural variations across individuals and into the impact of central nervous system diseases and disorders. One approach to extract information from diffusion signals has been to use biologically relevant analytical models to link millimetre scale diffusion MRI measures with microscale influences. The other approach has been to represent diffusion as an anomalous transport process and infer microstructural information from the different anomalous diffusion equation parameters. In this study, we investigated how parameters of various anomalous diffusion models vary with age in the human brain white matter, particularly focusing on the corpus callosum. We first unified several established anomalous diffusion models (the super-diffusion, sub-diffusion, quasi-diffusion and fractional Bloch-Torrey models) under the continuous time random walk modelling framework. This unification allows a consistent parameter fitting strategy to be applied from which meaningful model parameter comparisons can be made. We then provided a novel way to derive the diffusional kurtosis imaging (DKI) model, which is shown to be a degree two approximation of the sub-diffusion model. This link between the DKI and sub-diffusion models led to a new robust technique for generating maps of kurtosis and diffusivity using the sub-diffusion parameters ßSUB and DSUB. Superior tissue contrast is achieved in kurtosis maps based on the sub-diffusion model. 7T diffusion weighted MRI data for 65 healthy participants in the age range 19-78 years was used in this study. Results revealed that anomalous diffusion model parameters α and ß have shown consistent positive correlation with age in the corpus callosum, indicating α and ß are sensitive to tissue microstructural changes in ageing.


Assuntos
Envelhecimento/fisiologia , Corpo Caloso/anatomia & histologia , Corpo Caloso/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Substância Branca/diagnóstico por imagem , Substância Branca/ultraestrutura , Adulto , Idoso , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade
14.
J Neurosci Methods ; 366: 109411, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34793852

RESUMO

BACKGROUND: A trend in the development of resting-state fMRI (rsfMRI) data analysis is the drive towards more data-driven methods. Group Independent Component Analysis (GICA) is a well-proven data-driven method for performing fMRI group analysis, though not without issues, especially the back-reconstruction from group-level independent components to individual-level components. Group information-guided ICA (GIG-ICA) and Independent Vector Analysis (IVA) are recent extensions of GICA that were shown to outperform GICA in the identification of unique rsfMRI biomarkers in psychiatric conditions. NEW METHOD: In this work, GICA, GIG-ICA, and IVA-GL analysis methods were applied to rsfMRI data acquired from 9 mice under different doses of medetomidine (0.1 - 0.3 mg/kg/h) in the before and after forepaw stimulation, and their performance was compared to determine whether GIG-ICA and IVA-GL outperform GICA in identifying robust and reliable resting-state networks in the rodent brain. RESULTS: Our results showed IVA-GL method had certain desirable performance characteristics over the other two methods under minimal data pre-processing and data-driven assumptions in application to analysis of mouse resting-state functional MRI. COMPARISON WITH EXISTING METHODS: IVA-GL provides better stability towards detecting group differences at different model order assumptions and performed better at separating data well-defined and functionally reasonable components in mouse resting-state fMRI. At higher model order and more likely functional component assumptions, GIG-ICA and IVA-GL were found to have greater sensitivity at detecting functional connectivity changes due to physiological challenges compared to GICA. CONCLUSIONS: This study indicates that IVA-GL yields better detection of resting-state networks in the rodent brain compared to other ICA methods and a promising data-driven analysis method for rodent rsfMRI.


Assuntos
Imageamento por Ressonância Magnética , Roedores , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Camundongos
15.
Brain Struct Funct ; 227(1): 313-329, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34697684

RESUMO

The importance of accurate structural discrimination of the human grey matter regions has motivated the development of observer-independent reproducible methods that account for inter-individual architectonic variations. We introduce a non-invasive statistical residual analysis framework, employing unique tissue-specific magnetic resonance fingerprinting (MRF) signals after adjusting for the effect of T1 and T2* MR relaxometry parameters (here termed MRF residuals). A 7 T Siemens MR scanner was used to acquire MRF signals, quantitative transmit magnetic field (B1+) maps and T1-weighted anatomical images of eleven cortical areas (5L, 5M, 5Ci, 7A, 7P, 7PC, hIP3, BA2, BA4a, BA4p and BA6) from six female participants. MRF residual signal for each voxel was calculated as the difference between the actual and best matching MRF signal evolutions from a precomputed MRF dictionary covering a range of T1, T2* and B1+ values. To compare MRF residuals between regions of interest, normalised autocorrelation was used as a shape-based statistical signal characterisation method and the Euclidean distance between autocorrelation profiles of residuals was used to measure the interareal dissimilarity. In the eleven cortical areas in both cerebral hemispheres of six participants, the proposed MRF residual analysis consistently showed interareal dissimilarity profiles that concorded with histological studies, indicating that MRF residuals potentially contain tissue microstructural information. MRF residual signals provide additional area-specific information that is complementary to the MR relaxometry-based (T1, T2*) information used previously for distinguishing microstructural differences between human cerebral cortex regions in vivo. The proposed approach led to more accurate identification of structural variations across cortical areas of interest.


Assuntos
Substância Cinzenta , Imageamento por Ressonância Magnética , Encéfalo , Córtex Cerebral , Feminino , Substância Cinzenta/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Espectroscopia de Ressonância Magnética , Imagens de Fantasmas
16.
Front Physiol ; 12: 746044, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34744786

RESUMO

Purpose: The recognition and treatment of high-altitude illness (HAI) is increasingly important in global emergency medicine. High altitude related hypobaric hypoxia can lead to acute mountain sickness (AMS), which may relate to increased expression of vascular endothelial growth factor (VEGF), and subsequent blood-brain barrier (BBB) compromise. This study aimed to establish the relationship between AMS and changes in plasma VEGF levels during a high-altitude ascent. VEGF level changes with dexamethasone, a commonly used AMS medication, may provide additional insight into AMS. Methods: Twelve healthy volunteers ascended Mt Fuji (3,700 m) and blood samples were obtained at distinct altitudes for VEGF analysis. Oxygen saturation (SPO2) measurements were also documented at the same time-point. Six out of the 12 study participants were prescribed dexamethasone for a second ascent performed 48 h later, and blood was again collected to establish VEGF levels. Results: Four key VEGF observations could be made based on the data collected: (i) the baseline VEGF levels between the two ascents trended upwards; (ii) those deemed to have AMS in the first ascent had increased VEGF levels (23.8-30.3 pg/ml), which decreased otherwise (23.8-30.3 pg/ml); (iii) first ascent AMS participants had higher VEGF level variability for the second ascent, and similar to those not treated with dexamethasone; and (iv) for the second ascent dexamethasone participants had similar VEGF levels to non-AMS first ascent participants, and the variability was lower than for first ascent AMS and non-dexamethasone participants. SPO2 changes were unremarkable, other than reducing by around 5% irrespective of whether measurement was taken for the first or second ascent. Conclusion: First ascent findings suggest a hallmark of AMS could be elevated VEGF levels. The lack of an exercise-induced VEGF level change strengthened the notion that elevated plasma VEGF was brain-derived, and related to AMS.

17.
Neuroimage Clin ; 31: 102741, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34225019

RESUMO

OBJECTIVES: To determine if radiological evidence of blood brain barrier (BBB) dysfunction, measured using Dynamic Contrast Enhanced MRI (DCE-MRI), correlates with serum matrix metalloproteinase (MMP) levels in traumatic brain injury (TBI) patients, and thereby, identify a potential biomarker for BBB dysfunction. PATIENTS AND METHODS: 20 patients with a mild, moderate, or severe TBI underwent a DCE-MRI scan and BBB dysfunction was interpreted from KTrans. KTrans is a measure of capillary permeability that reflects the efflux of gadolinium contrast into the extra-cellar space. The serum samples were concurrently collected and later analysed for MMP-1, -2, -7, -9, and -10 levels using an ELISA assay. Statistical correlations between MMP levels and the KTrans value were calculated. Multiple testing was corrected using the Benjamin-Hochberg method to control the false-discovery rate (FDR). RESULTS: Serum MMP-1 values ranged from 1.5 to 49.6 ng/ml (12 ± 12.7), MMP-2 values from 58.3 to 174.1 ng/ml (109.5 ± 26.7), MMP-7 from 1.5 to 31.5 ng/mL (10 ± 7.4), MMP-9 from 128.6 to 1917.5 ng/ml (647.7 ± 749.6) and MMP-10 from 0.1 to 0.6 ng/mL (0.3 ± 0.2). Non-parametric Spearman correlation analysis on the data showed significant positive relationship between KTrans and MMP-7 (r = 0.55, p < 0.01). Correlations were also found between KTrans and MMP-1 (r = 0.74, p < 0.0002) and MMP-2 (r = 0.5, p < 0.025) but the actual MMP values were not above reference ranges, limiting the interpretation of results. Statistically significant correlations between KTrans and either MMP-9 or -10 were not found. CONCLUSION: This is the first study to show a correlation between DCE measures and MMP values in patients with a TBI. Our results support the suggestion that serum MMP-7 may be considered as a peripheral biomarker quantifying BBB dysfunction in TBI patients.


Assuntos
Lesões Encefálicas Traumáticas , Metaloproteinase 7 da Matriz/sangue , Barreira Hematoencefálica/metabolismo , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Metaloproteinase 9 da Matriz/metabolismo
18.
Magn Reson Med ; 85(5): 2462-2476, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33226685

RESUMO

PURPOSE: The purpose of this study is to demonstrate a method for specific absorption rate (SAR) reduction for 2D T2 -FLAIR MRI sequences at 7 T by predicting the required adiabatic radiofrequency (RF) pulse power and scaling the RF amplitude in a slice-wise fashion. METHODS: We used a time-resampled frequency-offset corrected inversion (TR-FOCI) adiabatic pulse for spin inversion in a T2 -FLAIR sequence to improve B1+ homogeneity and calculated the pulse power required for adiabaticity slice-by-slice to minimize the SAR. Drawing on the implicit B1+ inhomogeneity in a standard localizer scan, we acquired 3D AutoAlign localizers and SA2RAGE B1+ maps in 28 volunteers. Then, we trained a convolutional neural network (CNN) to estimate the B1+ profile from the localizers and calculated pulse scale factors for each slice. We assessed the predicted B1+ profiles and the effect of scaled pulse amplitudes on the FLAIR inversion efficiency in oblique transverse, sagittal, and coronal orientations. RESULTS: The predicted B1+ amplitude maps matched the measured ones with a mean difference of 9.5% across all slices and participants. The slice-by-slice scaling of the TR-FOCI inversion pulse was most effective in oblique transverse orientation and resulted in a 1 min and 30 s reduction in SAR induced delay time while delivering identical image quality. CONCLUSION: We propose a SAR reduction technique based on the estimation of B1+ profiles from standard localizer scans using a CNN and show that scaling the inversion pulse power slice-by-slice for FLAIR sequences at 7T reduces SAR and scan time without compromising image quality.


Assuntos
Aprendizado Profundo , Encéfalo , Frequência Cardíaca , Humanos , Imageamento por Ressonância Magnética , Ondas de Rádio , Cintilografia
19.
Sci Rep ; 10(1): 18141, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097737

RESUMO

Dynamically adjustable permanent magnet arrays have been proposed to generate switchable magnetic fields for pre-polarisation in Ultra-Low Field magnetic resonance imaging. However, the optimal switching dynamics of the pre-polarisation magnetic field as well as the energy requirements, mechanical forces and stresses during switching of the pre-polarisation field have not been evaluated. We analysed these requirements numerically and estimated the magnetic resonance signal strength and image quality for two practical switching modes in an instrument suitable for scanning the human head. Von Mises stress analysis showed that although magnetic forces were significantly higher for two specific rungs, the structural integrity of magnet rungs would not be compromised. Our simulations suggest that a significantly higher signal yield is obtained by switching off the pre-polarisation field with the angular velocity in each rung dependent on its location.

20.
Magn Reson Imaging ; 74: 139-151, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32890674

RESUMO

Individual channel ultra-high field (7T) phase images have to be phase offset corrected prior to the mapping of magnetic susceptibility of tissue. Whilst numerous methods have been proposed for gradient recalled echo MRI phase offset correction, it remains unclear how they affect quantitative magnetic susceptibility values derived from phase images. Methods already proposed either employ a single or multiple echo time MRI data. In terms of the latter, offsets can be derived using an ultra-short echo time acquisition, or by estimating the offset based on two echo points with the assumption of linear phase evolution with echo time. Our evaluation involved 32 channel multi-echo time 7T GRE (Gradient Recalled Echo) and ultra-short echo time PETRA (Pointwise Encoding Time Reduction with Radial Acquisition) MRI data collected for a susceptibility phantom and three human brains. The combined phase images generated using four established offset correction methods (two single and two multiple echo time) were analysed, followed by an assessment of quantitative susceptibility values obtained for a phantom and human brains. The effectiveness of each method in removing the offsets was shown to reduce with increased echo time, decreased signal intensity and reduced overlap in coil sensitivity profiles. Quantitative susceptibility values and how they change with echo time were found to be method specific. Phase offset correction methods based on single echo time data have a tendency to produce more accurate and less noisy quantitative susceptibility maps in comparison with methods employing multiple echo time data.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética , Artefatos , Encéfalo/diagnóstico por imagem , Humanos , Imagens de Fantasmas
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