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Yiannakas MC, Liechti MD, Budtarad N, Cullinane P, Yang X, Toosy AT, Panicker JN, Gandini Wheeler-Kingshott CAM. Gray vs. White Matter Segmentation of the Conus Medullaris: Reliability and Variability in Healthy Volunteers. J Neuroimaging 2018; 29:410-417. [PMID: 30582252 DOI: 10.1111/jon.12591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/09/2018] [Accepted: 12/13/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Magnetic resonance imaging (MRI)-derived spinal cord (SC) gray and white matter (GM/WM) volume are useful indirect measures of atrophy and neurodegeneration over time, typically obtained in the upper SC. Neuropathological evidence suggests that in certain neurological conditions, early degeneration may occur as low as the sacral SC. In this study, the feasibility of GM/WM segmentation of the conus medullaris (CM) was assessed in vivo. METHODS Twenty-three healthy volunteers (11 female, mean age 47 years) underwent high-resolution 3T MRI of the CM using a 3-dimensional fast field echo sequence. Reproducibility of the volume measurements was assessed in 5 subjects (2 female, 25-37 years) by one rater who repeated the analysis 3 times and also with 2 additional raters working independently in order to calculate the intra- and interrater coefficient of variation (COV), respectively. Furthermore, the influence of age, gender, spine and SC metrics on tissue-specific measures of the CM was investigated. RESULTS Volumetric CM analyses (N = 23) for the SC, GM, and WM revealed a mean (SD) total volume of CM-TV = 1746.9 (296.7) mm3 , CM-GM-TV = 731.2 (106.0) mm3 , and CM-WM-TV = 1014.6 (211.3) mm3 , respectively. The intra-rater COV for measuring the CM-TV and CM-GM-TV was 3.38% and 7.42%, respectively; the interrater COV was 3.43% and 10.80%, respectively. Using age, gender, spine and SC metrics in regression models substantially reduced group variability for CM-TV, CM-WM-TV, and CM-GM-TV by up to 39.2%, 42.7%, and 21.2%, respectively. CONCLUSIONS The results from this study demonstrate the feasibility of obtaining tissue-specific volume measurements in the CM by means of MRI with good reproducibility and provide normative data for future applications in neurological diseases affecting the lower SC.
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Affiliation(s)
- Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Martina D Liechti
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, United Kingdom
| | - Nuttakarn Budtarad
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Patrick Cullinane
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Xixi Yang
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, United Kingdom
| | - Ahmed T Toosy
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jalesh N Panicker
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, United Kingdom
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, PV, Italy
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53
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Petracca M, Margoni M, Bommarito G, Inglese M. Monitoring Progressive Multiple Sclerosis with Novel Imaging Techniques. Neurol Ther 2018; 7:265-285. [PMID: 29956263 PMCID: PMC6283788 DOI: 10.1007/s40120-018-0103-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Indexed: 02/04/2023] Open
Abstract
Imaging markers for monitoring disease progression in progressive multiple sclerosis (PMS) are scarce, thereby limiting the possibility to monitor disease evolution and to test effective treatments in clinical trials. Advanced imaging techniques that have the advantage of metrics with increased sensitivity to short-term tissue changes and increased specificity to the structural abnormalities characteristic of PMS have recently been applied in clinical trials of PMS. In this review, we (1) provide an overview of the pathological features of PMS, (2) summarize the findings of research and clinical trials conducted in PMS which have applied conventional and advanced magnetic resonance imaging techniques and (3) discuss recent advancements and future perspectives in monitoring PMS with imaging techniques.
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Affiliation(s)
- Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Monica Margoni
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Multiple Sclerosis Centre, Department of Neurosciences DNS, University Hospital, University of Padua, Padua, Italy
| | - Giulia Bommarito
- Department of Neuroscience, Rehabilitation, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genoa, Italy.
- Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Olney NT, Bischof A, Rosen H, Caverzasi E, Stern WA, Lomen-Hoerth C, Miller BL, Henry RG, Papinutto N. Measurement of spinal cord atrophy using phase sensitive inversion recovery (PSIR) imaging in motor neuron disease. PLoS One 2018; 13:e0208255. [PMID: 30496320 PMCID: PMC6264489 DOI: 10.1371/journal.pone.0208255] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 11/14/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The spectrum of motor neuron disease (MND) includes numerous phenotypes with various life expectancies. The degree of upper and lower motor neuron involvement can impact prognosis. Phase sensitive inversion recovery (PSIR) imaging has been shown to detect in vivo gray matter (GM) and white matter (WM) atrophy in the spinal cord of other patient populations but has not been explored in MND. METHODS In this study, total cord, WM and GM areas of ten patients with a diagnosis within the MND spectrum were compared to those of ten healthy controls (HC). Patients' diagnosis included amyotrophic lateral sclerosis (ALS), primary lateral sclerosis, primary muscular atrophy, facial onset sensory and motor neuronopathy and ALS-Frontotemporal dementia. Axial 2D PSIR images were acquired at four cervical disc levels (C2-C3, C3-C4, C5-C6 and C7-T1) with a short acquisition time (2 minutes) protocol. Total cross-sectional areas (TCA), GM and WM areas were measured using a combination of highly reliable manual and semi-automated methods. Cord areas in MND patients were compared with HC using linear regression analyses adjusted for age and sex. Correlation of WM and GM areas in MND patients was explored to gain insights into underlying atrophy patterns. RESULTS MND patients as a group had significantly smaller cervical cord GM area compared to HC at all four levels (C2-C3: p = .009; C3-C4: p = .001; C5-C6: p = .006; C7-T1: p = .002). WM area at C5-C6 level was significantly smaller (p = .001). TCA was significantly smaller at C3-C4 (p = .018) and C5-C6 (p = .002). No significant GM and WM atrophy was detected in the two patients with predominantly bulbar phenotype. Concomitant GM and WM atrophy was detected in solely upper or lower motor neuron level phenotypes. There was a significant correlation between GM and WM areas at all four levels in this diverse population of MND. CONCLUSION Spinal cord GM and WM atrophy can be detected in vivo in patients within the MND spectrum using a short acquisition time 2D PSIR imaging protocol. PSIR imaging shows promise as a method for quantifying spinal cord involvement and thus may be useful for diagnosis, prognosis and for monitoring disease progression.
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Affiliation(s)
- Nicholas T. Olney
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, California, United States of America
- Department of Neurology, University of California San Francisco Amyotrophic Lateral Sclerosis Center, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Antje Bischof
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
- Department of Neurology and Immunology Clinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Howard Rosen
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, California, United States of America
| | - Eduardo Caverzasi
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
| | - William A. Stern
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
| | - Catherine Lomen-Hoerth
- Department of Neurology, University of California San Francisco Amyotrophic Lateral Sclerosis Center, University of California San Francisco, San Francisco, California, United States of America
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, California, United States of America
| | - Roland G. Henry
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
| | - Nico Papinutto
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
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Fouladivanda M, Kazemi K, Helfroush MS, Shakibafard A. Morphological active contour driven by local and global intensity fitting for spinal cord segmentation from MR images. J Neurosci Methods 2018; 308:116-128. [DOI: 10.1016/j.jneumeth.2018.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 07/18/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
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Grussu F, Ianuş A, Tur C, Prados F, Schneider T, Kaden E, Ourselin S, Drobnjak I, Zhang H, Alexander DC, Gandini Wheeler-Kingshott CAM. Relevance of time-dependence for clinically viable diffusion imaging of the spinal cord. Magn Reson Med 2018; 81:1247-1264. [PMID: 30229564 PMCID: PMC6586052 DOI: 10.1002/mrm.27463] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 12/17/2022]
Abstract
Purpose Time‐dependence is a key feature of the diffusion‐weighted (DW) signal, knowledge of which informs biophysical modelling. Here, we study time‐dependence in the human spinal cord, as its axonal structure is specific and different from the brain. Methods We run Monte Carlo simulations using a synthetic model of spinal cord white matter (WM) (large axons), and of brain WM (smaller axons). Furthermore, we study clinically feasible multi‐shell DW scans of the cervical spinal cord (b = 0; b = 711 s mm−2; b = 2855 s mm−2), obtained using three diffusion times (Δ of 29, 52 and 76 ms) from three volunteers. Results Both intra‐/extra‐axonal perpendicular diffusivities and kurtosis excess show time‐dependence in our synthetic spinal cord model. This time‐dependence is reflected mostly in the intra‐axonal perpendicular DW signal, which also exhibits strong decay, unlike our brain model. Time‐dependence of the total DW signal appears detectable in the presence of noise in our synthetic spinal cord model, but not in the brain. In WM in vivo, we observe time‐dependent macroscopic and microscopic diffusivities and diffusion kurtosis, NODDI and two‐compartment SMT metrics. Accounting for large axon calibers improves fitting of multi‐compartment models to a minor extent. Conclusions Time‐dependence of clinically viable DW MRI metrics can be detected in vivo in spinal cord WM, thus providing new opportunities for the non‐invasive estimation of microstructural properties. The time‐dependence of the perpendicular DW signal may feature strong intra‐axonal contributions due to large spinal axon caliber. Hence, a popular model known as “stick” (zero‐radius cylinder) may be sub‐optimal to describe signals from the largest spinal axons.
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Affiliation(s)
- Francesco Grussu
- Queen Square MS Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom.,Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Andrada Ianuş
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom.,Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
| | - Carmen Tur
- Queen Square MS Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Ferran Prados
- Queen Square MS Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom.,Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | | | - Enrico Kaden
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Sébastien Ourselin
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Ivana Drobnjak
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Hui Zhang
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom.,Clinical Imaging Research Centre, National University of Singapore, Singapore, Singapore
| | - Claudia A M Gandini Wheeler-Kingshott
- Queen Square MS Centre, UCL Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom.,Brain MRI 3T Research Centre, C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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Sprenger C, Stenmans P, Tinnermann A, Büchel C. Evidence for a spinal involvement in temporal pain contrast enhancement. Neuroimage 2018; 183:788-799. [PMID: 30189340 DOI: 10.1016/j.neuroimage.2018.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/19/2018] [Accepted: 09/02/2018] [Indexed: 12/25/2022] Open
Abstract
Spatiotemporal filtering and amplification of sensory information at multiple levels during the generation of perceptual representations is a fundamental processing principle of the nervous system. While for the visual and auditory system temporal filtering of sensory signals has been noticed for a long time, respective contrast mechanisms within the nociceptive system became only recently subject of investigations, mainly in the context of offset analgesia (OA) subsequent to noxious stimulus decreases. In the present study we corroborate in a first experiment the assumption that offset analgesia involves a central component by showing that an OA-like effect accounting for 74% of a corresponding OA reference can be evoked by decomposing the stimulus offset into two separate box-car stimuli applied within the same dermatome but to separate populations of primary afferent neurons. In order to draw conclusions about the levels of the CNS at which temporal filtering of nociceptive information takes place during OA we investigate in a second experiment neuronal activity in the spinal cord during a painful thermal stimulus offset employing high-resolution fMRI in healthy volunteers. Pain-related BOLD responses in the spinal cord were significantly reduced during OA and their time course followed widely behavioral hypoalgesia, but not the thermal stimulation profile. In summary, the results suggest that temporal pain contrast enhancement during OA comprises a central mechanism and this mechanism becomes already effective at the level of the spinal cord.
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Affiliation(s)
- Christian Sprenger
- Department of Systems Neuroscience, University-Medical-Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Philip Stenmans
- Department of Systems Neuroscience, University-Medical-Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Alexandra Tinnermann
- Department of Systems Neuroscience, University-Medical-Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christian Büchel
- Department of Systems Neuroscience, University-Medical-Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Optimising complementary soft tissue synchrotron X-ray microtomography for reversibly-stained central nervous system samples. Sci Rep 2018; 8:12017. [PMID: 30104610 PMCID: PMC6089931 DOI: 10.1038/s41598-018-30520-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/24/2018] [Indexed: 11/08/2022] Open
Abstract
Synchrotron radiation microtomography (SRμCT) is a nominally non-destructive 3D imaging technique which can visualise the internal structures of whole soft tissues. As a multi-stage technique, the cumulative benefits of optimising sample preparation, scanning parameters and signal processing can improve SRμCT imaging efficiency, image quality, accuracy and ultimately, data utility. By evaluating different sample preparations (embedding media, tissue stains), imaging (projection number, propagation distance) and reconstruction (artefact correction, phase retrieval) parameters, a novel methodology (combining reversible iodine stain, wax embedding and inline phase contrast) was optimised for fast (~12 minutes), high-resolution (3.2-4.8 μm diameter capillaries resolved) imaging of the full diameter of a 3.5 mm length of rat spinal cord. White-grey matter macro-features and micro-features such as motoneurons and capillary-level vasculature could then be completely segmented from the imaged volume for analysis through the shallow machine learning SuRVoS Workbench. Imaged spinal cord tissue was preserved for subsequent histology, establishing a complementary SRμCT methodology that can be applied to study spinal cord pathologies or other nervous system tissues such as ganglia, nerves and brain. Further, our 'single-scan iterative downsampling' approach and side-by-side comparisons of mounting options, sample stains and phase contrast parameters should inform efficient, effective future soft tissue SRμCT experiment design.
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Noristani HN, Saint-Martin GP, Cardoso M, Sidiboulenouar R, Catteau M, Coillot C, Goze-Bac C, Perrin FE. Longitudinal Magnetic Resonance Imaging Analysis and Histological Characterization after Spinal Cord Injury in Two Mouse Strains with Different Functional Recovery: Gliosis as a Key Factor. J Neurotrauma 2018; 35:2924-2940. [PMID: 29877129 DOI: 10.1089/neu.2017.5613] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Spinal cord injuries (SCI) are disastrous neuropathologies causing permanent disabilities. The availability of different strains of mice is valuable for studying the pathophysiological mechanisms involved in SCI. However, strain differences have a profound effect on spontaneous functional recovery after SCI. CX3CR1+/eGFP and Aldh1l1-EGFP mice that express green fluorescent protein in microglia/monocytes and astrocytes, respectively, are particularly useful to study glial reactivity. Whereas CX3CR1+/eGFP mice have C57BL/6 background, Aldh1l1-EGFP are in Swiss Webster background. We first assessed spontaneous functional recovery in CX3CR1+/eGFP and Aldh1l1-EGFP mice over 6 weeks after lateral spinal cord hemisection. Second, we carried out a longitudinal follow-up of lesion evolution using in vivo T2-weighted magnetic resonance imaging (MRI). Finally, we performed in-depth analysis of the spinal cord tissue using ex vivo T2-weighted MRI as well as detailed histology. We demonstrate that CX3CR1+/eGFP mice have improved functional recovery and reduced anxiety after SCI compared with Aldh1l1-EGFP mice. We also found a strong correlation between in vivo MRI, ex vivo MRI, and histological analyses of the injured spinal cord in both strain of mice. All three modalities revealed no difference in lesion extension and volume between the two strains of mice. Importantly, histopathological analysis identified decreased gliosis and increased serotonergic axons in CX3CR1+/eGFP compared with Aldh1l1-EGFP mice following SCI. These results thus suggest that the strain-dependent improved functional recovery after SCI may be linked with reduced gliosis and increased serotonergic innervation.
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Affiliation(s)
- Harun N Noristani
- 1 INSERM U1198, University of Montpellier, Montpellier, France.,2 INSERM U1051, University of Montpellier, Montpellier, France
| | - Guillaume P Saint-Martin
- 1 INSERM U1198, University of Montpellier, Montpellier, France.,3 UMR 5221 CNRS, University of Montpellier, Montpellier, France
| | - Maïda Cardoso
- 2 INSERM U1051, University of Montpellier, Montpellier, France.,3 UMR 5221 CNRS, University of Montpellier, Montpellier, France
| | | | | | | | | | - Florence E Perrin
- 1 INSERM U1198, University of Montpellier, Montpellier, France.,2 INSERM U1051, University of Montpellier, Montpellier, France.,3 UMR 5221 CNRS, University of Montpellier, Montpellier, France
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Abstract
Spinal cord (SC) MRI in multiple sclerosis (MS) has significant usefulness in clinical and investigational settings. Conventional MRI of the SC is used in clinical practice, because it has both diagnostic and prognostic value. A number of advanced, quantitative SC MRI measures that assess the structural and functional integrity of the SC have been evaluated in investigational settings. These techniques have collectively demonstrated usefulness in providing insight into microstructural and functional changes relevant to disability in MS. With further development, these techniques may be useful in clinical trial settings as biomarkers of neurodegeneration and protection, and in day-to-day clinical practice.
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Affiliation(s)
- Alexandra Muccilli
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Division of Neurology, Centre Hospitalier de L'Université de Montréal, Université de Montréal, 1058 Saint-Denis Street, Montreal, Quebec H2X 3J4, Canada
| | - Estelle Seyman
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
| | - Jiwon Oh
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
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Paquette T, Jeffrey-Gauthier R, Leblond H, PichÉ M. Functional Neuroimaging of Nociceptive and Pain-Related Activity in the Spinal Cord and Brain: Insights From Neurovascular Coupling Studies. Anat Rec (Hoboken) 2018; 301:1585-1595. [PMID: 29752872 DOI: 10.1002/ar.23854] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/22/2018] [Accepted: 03/31/2018] [Indexed: 12/12/2022]
Abstract
Spinal cord and brain processes underlie pain perception, which produces systemic cardiovascular changes. In turn, the autonomic nervous system regulates vascular function in the spinal cord and brain in order to adapt to these systemic changes, while neuronal activity induces local vascular changes. Thus, autonomic regulation and pain processes in the brain and spinal cord are tightly linked and interrelated. The objective of this topical review is to discuss work on neurovascular coupling during nociceptive processing in order to highlight supporting evidence and limitations for the use of cerebral and spinal fMRI to investigate pain mechanisms and spinal nociceptive processes. Work on functional neuroimaging of pain is presented and discussed in relation to available neurovascular coupling studies and related issues. Perspectives on future work are also discussed with an emphasis on differences between the brain and the spinal cord and on different approaches that may be useful to improve current methods, data analyses and interpretation. In summary, this review highlights the lack of data on neurovascular coupling during nociceptive stimulation and indicates that hemodynamic and BOLD responses measured with fMRI may be biased by nonspecific vascular changes. Future neuroimaging studies on nociceptive and pain-related processes would gain further understanding of neurovascular coupling in the brain and spinal cord and should take into account the effects of systemic vascular changes that may affect hemodynamic responses. Anat Rec, 301:1585-1595, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Thierry Paquette
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Renaud Jeffrey-Gauthier
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Hugues Leblond
- CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Mathieu PichÉ
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.,CogNAC Research Group, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Solstrand Dahlberg L, Becerra L, Borsook D, Linnman C. Brain changes after spinal cord injury, a quantitative meta-analysis and review. Neurosci Biobehav Rev 2018; 90:272-293. [DOI: 10.1016/j.neubiorev.2018.04.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/21/2018] [Accepted: 04/23/2018] [Indexed: 12/11/2022]
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Tsagkas C, Altermatt A, Bonati U, Pezold S, Reinhard J, Amann M, Cattin P, Wuerfel J, Fischer D, Parmar K, Fischmann A. Reliable and fast volumetry of the lumbar spinal cord using cord image analyser (Cordial). Eur Radiol 2018; 28:4488-4495. [PMID: 29713776 DOI: 10.1007/s00330-018-5431-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 02/28/2018] [Accepted: 03/16/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To validate the precision and accuracy of the semi-automated cord image analyser (Cordial) for lumbar spinal cord (SC) volumetry in 3D T1w MRI data of healthy controls (HC). MATERIALS AND METHODS 40 3D T1w images of 10 HC (w/m: 6/4; age range: 18-41 years) were acquired at one 3T-scanner in two MRI sessions (time interval 14.9±6.1 days). Each subject was scanned twice per session, allowing determination of test-retest reliability both in back-to-back (intra-session) and scan-rescan images (inter-session). Cordial was applied for lumbar cord segmentation twice per image by two raters, allowing for assessment of intra- and inter-rater reliability, and compared to a manual gold standard. RESULTS While manually segmented volumes were larger (mean: 2028±245 mm3 vs. Cordial: 1636±300 mm3, p<0.001), accuracy assessments between manually and semi-automatically segmented images showed a mean Dice-coefficient of 0.88±0.05. Calculation of within-subject coefficients of variation (COV) demonstrated high intra-session (1.22-1.86%), inter-session (1.26-1.84%), as well as intra-rater (1.73-1.83%) reproducibility. No significant difference was shown between intra- and inter-session reproducibility or between intra-rater reliabilities. Although inter-rater reproducibility (COV: 2.87%) was slightly lower compared to all other reproducibility measures, between rater consistency was very strong (intraclass correlation coefficient: 0.974). CONCLUSION While under-estimating the lumbar SCV, Cordial still provides excellent inter- and intra-session reproducibility showing high potential for application in longitudinal trials. KEY POINTS • Lumbar spinal cord segmentation using the semi-automated cord image analyser (Cordial) is feasible. • Lumbar spinal cord is 40-mm cord segment 60 mm above conus medullaris. • Cordial provides excellent inter- and intra-session reproducibility in lumbar spinal cord region. • Cordial shows high potential for application in longitudinal trials.
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Affiliation(s)
- Charidimos Tsagkas
- Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
- Medical Image Analysis Center (MIAC AG), Basel, Mittlere Strasse 83, CH - 4031, Basel, Switzerland
| | - Anna Altermatt
- Medical Image Analysis Center (MIAC AG), Basel, Mittlere Strasse 83, CH - 4031, Basel, Switzerland
- Center for medical Image Analysis & Navigation (CIAN), Department of Bioengineering, University Basel, Gewerbestrasse 14, CH-4123, Allschwil, Switzerland
| | - Ulrike Bonati
- Division of Neuropediatrics, University of Basel Children's Hospital, Spitalstrasse 33, CH-4056, Basel, Switzerland
| | - Simon Pezold
- Center for medical Image Analysis & Navigation (CIAN), Department of Bioengineering, University Basel, Gewerbestrasse 14, CH-4123, Allschwil, Switzerland
| | - Julia Reinhard
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
| | - Michael Amann
- Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
- Medical Image Analysis Center (MIAC AG), Basel, Mittlere Strasse 83, CH - 4031, Basel, Switzerland
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
| | - Philippe Cattin
- Center for medical Image Analysis & Navigation (CIAN), Department of Bioengineering, University Basel, Gewerbestrasse 14, CH-4123, Allschwil, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center (MIAC AG), Basel, Mittlere Strasse 83, CH - 4031, Basel, Switzerland
- Center for medical Image Analysis & Navigation (CIAN), Department of Bioengineering, University Basel, Gewerbestrasse 14, CH-4123, Allschwil, Switzerland
| | - Dirk Fischer
- Division of Neuropediatrics, University of Basel Children's Hospital, Spitalstrasse 33, CH-4056, Basel, Switzerland
| | - Katrin Parmar
- Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
| | - Arne Fischmann
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
- Division of Neuroradiology, Hirslanden Klinik St. Anna, St. Anna-Strasse 32, CH-6006, Luzern, Switzerland
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Duval T, Smith V, Stikov N, Klawiter EC, Cohen-Adad J. Scan-rescan of axcaliber, macromolecular tissue volume, and g-ratio in the spinal cord. Magn Reson Med 2018; 79:2759-2765. [PMID: 28994487 PMCID: PMC5821542 DOI: 10.1002/mrm.26945] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/01/2017] [Accepted: 09/03/2017] [Indexed: 01/25/2023]
Abstract
PURPOSE Recent MRI techniques have been introduced that can extract microstructural information in the white matter, such as the density or macromolecular content. Translating quantitative MRI to the clinic raises many challenges in terms of acquisition strategy, modeling of the MRI signal, artifact corrections, and metric extraction (template registration and partial volume effects). In this work, we investigated the scan-rescan repeatability of several quantitative MRI techniques in the human spinal cord. METHODS AxCaliber metrics, macromolecular tissue volume, and the fiber g-ratio were estimated in the spinal cord of eight healthy subjects, scanned and rescanned the same day in two different sessions. RESULTS Scan-rescan repeatability deviation was 3% for all metrics, in average in the white matter of all subjects. Intraclass correlation coefficient was up to 0.9. A three-way analysis of variance showed significant effects of white matter pathway, laterality, and subject. CONCLUSION The present study suggests that quantitative MRI gives stable measurements of white matter microstructure in the spinal cord of healthy subjects. Our findings remain to be evaluated in diseased populations. Magn Reson Med 79:2759-2765, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Tanguy Duval
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Victoria Smith
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Nikola Stikov
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
- Montreal Heart Institute, Montreal, QC, Canada
| | - Eric C. Klawiter
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
- Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montréal, QC, Canada
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Wu TL, Wang F, Mishra A, Wilson GH, Byun N, Chen LM, Gore JC. Resting-state functional connectivity in the rat cervical spinal cord at 9.4 T. Magn Reson Med 2018; 79:2773-2783. [PMID: 28905408 PMCID: PMC5821555 DOI: 10.1002/mrm.26905] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/25/2017] [Accepted: 08/16/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE Numerous studies have adopted resting-state functional MRI methods to infer functional connectivity between cortical regions, but very few have translated them to the spinal cord, despite its critical role in the central nervous system. Resting-state functional connectivity between gray matter horns of the spinal cord has previously been shown to be detectable in humans and nonhuman primates, but it has not been reported previously in rodents. METHODS Resting-state functional MRI of the cervical spinal cord of live anesthetized rats was performed at 9.4 T. The quality of the functional images acquired was assessed, and quantitative analyses of functional connectivity in C4-C7 of the spinal cord were derived. RESULTS Robust gray matter horn-to-horn connectivity patterns were found that were statistically significant when compared with adjacent control regions. Specifically, dorsal-dorsal and ventral-ventral connectivity measurements were most prominent, while ipsilateral dorsal-ventral connectivity was also observed but to a lesser extent. Quantitative evaluation of reproducibility also revealed moderate robustness in the bilateral sensory and motor networks that was weaker in the dorsal-ventral connections. CONCLUSIONS This study reports the first evidence of resting-state functional circuits within gray matter in the rat spinal cord, and verifies their detectability using resting-state functional MRI at 9.4 T. Magn Reson Med 79:2773-2783, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Tung-Lin Wu
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Arabinda Mishra
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States
| | - George H. Wilson
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
| | - Nellie Byun
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Nashville, TN, United States
- Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
- Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States
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Martin AR, De Leener B, Cohen-Adad J, Cadotte DW, Nouri A, Wilson JR, Tetreault L, Crawley AP, Mikulis DJ, Ginsberg H, Fehlings MG. Can microstructural MRI detect subclinical tissue injury in subjects with asymptomatic cervical spinal cord compression? A prospective cohort study. BMJ Open 2018; 8:e019809. [PMID: 29654015 PMCID: PMC5905727 DOI: 10.1136/bmjopen-2017-019809] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Degenerative cervical myelopathy (DCM) involves extrinsic spinal cord compression causing tissue injury and neurological dysfunction. Asymptomatic spinal cord compression (ASCC) is more common, but its significance is poorly defined. This study investigates if: (1) ASCC can be automatically diagnosed using spinal cord shape analysis; (2) multiparametric quantitative MRI can detect similar spinal cord tissue injury as previously observed in DCM. DESIGN Prospective observational longitudinal cohort study. SETTING Single centre, tertiary care and research institution. PARTICIPANTS 40 neurologically intact subjects (19 female, 21 male) divided into groups with and without ASCC. INTERVENTIONS None. OUTCOME MEASURES Clinical assessments: modified Japanese Orthopaedic Association score and physical examination. 3T MRI assessments: automated morphometric analysis compared with consensus ratings of spinal cord compression, and measures of tissue injury: cross-sectional area, diffusion fractional anisotropy, magnetisation transfer ratio and T2*-weighted imaging white to grey matter signal intensity ratio (T2*WI WM/GM) extracted from rostral (C1-3), caudal (C6-7) and maximally compressed levels. RESULTS ASCC was present in 20/40 subjects. Diagnosis with automated shape analysis showed area under the curve >97%. Five MRI metrics showed differences suggestive of tissue injury in ASCC compared with uncompressed subjects (p<0.05), while a composite of all 10 measures (average of z scores) showed highly significant differences (p=0.002). At follow-up (median 21 months), two ASCC subjects developed DCM. CONCLUSIONS ASCC appears to be common and can be accurately and objectively diagnosed with automated morphometric analysis. Quantitative MRI appears to detect subclinical tissue injury in ASCC prior to the onset of neurological symptoms and signs. These findings require further validation, but offer the intriguing possibility of presymptomatic diagnosis and treatment of DCM and other spinal pathologies.
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Affiliation(s)
- Allan R Martin
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin De Leener
- Institute of Biomedical Engineering, École Polytechnique de Montréal, Montréal, Québec, Canada
| | - Julien Cohen-Adad
- Institute of Biomedical Engineering, École Polytechnique de Montréal, Montréal, Québec, Canada
| | - David W Cadotte
- Department of Neurosurgery, University of Calgary, Calgary, Alberta, Canada
| | - Aria Nouri
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jefferson R Wilson
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Tetreault
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University College Cork, Cork, Ireland
| | - Adrian P Crawley
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - David J Mikulis
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Howard Ginsberg
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Michael G Fehlings
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Cohen-Adad J. Microstructural imaging in the spinal cord and validation strategies. Neuroimage 2018; 182:169-183. [PMID: 29635029 DOI: 10.1016/j.neuroimage.2018.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/02/2018] [Accepted: 04/06/2018] [Indexed: 12/13/2022] Open
Abstract
In vivo histology using magnetic resonance imaging (MRI) is a newly emerging research field that aims to non-invasively characterize tissue microstructure. The implications of in vivo histology are many, from discovering novel biomarkers to studying human development, to providing tools for disease diagnosis and monitoring the effects of novel treatments on tissue. This review focuses on quantitative MRI (qMRI) techniques that are used to map spinal cord microstructure. Opening with a rationale for non-invasive imaging of the spinal cord, this article continues with a brief overview of the existing MRI techniques for axon and myelin imaging, followed by the specific challenges and potential solutions for acquiring and processing such data. The final part of this review focuses on histological validation, with suggested tissue preparation, acquisition and processing protocols for large-scale microscopy.
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Affiliation(s)
- J Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada.
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Calabrese E, Adil SM, Cofer G, Perone CS, Cohen-Adad J, Lad SP, Johnson GA. Postmortem diffusion MRI of the entire human spinal cord at microscopic resolution. Neuroimage Clin 2018; 18:963-971. [PMID: 29876281 PMCID: PMC5988447 DOI: 10.1016/j.nicl.2018.03.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/15/2018] [Accepted: 03/21/2018] [Indexed: 11/20/2022]
Abstract
The human spinal cord is a central nervous system structure that plays an important role in normal motor and sensory function, and can be affected by many debilitating neurologic diseases. Due to its clinical importance, the spinal cord is frequently the subject of imaging research. Common methods for visualizing spinal cord anatomy and pathology include histology and magnetic resonance imaging (MRI), both of which have unique benefits and drawbacks. Postmortem microscopic resolution MRI of fixed specimens, sometimes referred to as magnetic resonance microscopy (MRM), combines many of the benefits inherent to both techniques. However, the elongated shape of the human spinal cord, along with hardware and scan time limitations, have restricted previous microscopic resolution MRI studies (both in vivo and ex vivo) to small sections of the cord. Here we present the first MRM dataset of the entire postmortem human spinal cord. These data include 50 μm isotropic resolution anatomic image data and 100 μm isotropic resolution diffusion data, made possible by a 280 h long multi-segment acquisition and automated image segment composition. We demonstrate the use of these data for spinal cord lesion detection, automated volumetric gray matter segmentation, and quantitative spinal cord morphometry including estimates of cross sectional dimensions and gray matter fraction throughout the length of the cord.
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Affiliation(s)
- Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA; Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA.
| | - Syed M Adil
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Gary Cofer
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA
| | - Christian S Perone
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Shivanand P Lad
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - G Allan Johnson
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA
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Massire A, Rasoanandrianina H, Taso M, Guye M, Ranjeva JP, Feiweier T, Callot V. Feasibility of single-shot multi-level multi-angle diffusion tensor imaging of the human cervical spinal cord at 7T. Magn Reson Med 2018; 80:947-957. [DOI: 10.1002/mrm.27087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/07/2017] [Accepted: 12/26/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Aurélien Massire
- Aix-Marseille Univ, CNRS, AP-HM, CRMBM, Hôpital de la Timone; CEMEREM Marseille France
- iLab-Spine - Laboratoire international associé - Imagerie et Biomécanique du rachis, France; Canada
| | - Henitsoa Rasoanandrianina
- Aix-Marseille Univ, CNRS, AP-HM, CRMBM, Hôpital de la Timone; CEMEREM Marseille France
- iLab-Spine - Laboratoire international associé - Imagerie et Biomécanique du rachis, France; Canada
| | - Manuel Taso
- Aix-Marseille Univ, CNRS, AP-HM, CRMBM, Hôpital de la Timone; CEMEREM Marseille France
- iLab-Spine - Laboratoire international associé - Imagerie et Biomécanique du rachis, France; Canada
- Division of MRI Research, Department of Radiology; Beth Israel Deaconess Medical Center & Harvard Medical School; Boston Massachusetts USA
| | - Maxime Guye
- Aix-Marseille Univ, CNRS, AP-HM, CRMBM, Hôpital de la Timone; CEMEREM Marseille France
| | - Jean-Philippe Ranjeva
- Aix-Marseille Univ, CNRS, AP-HM, CRMBM, Hôpital de la Timone; CEMEREM Marseille France
- iLab-Spine - Laboratoire international associé - Imagerie et Biomécanique du rachis, France; Canada
| | | | - Virginie Callot
- Aix-Marseille Univ, CNRS, AP-HM, CRMBM, Hôpital de la Timone; CEMEREM Marseille France
- iLab-Spine - Laboratoire international associé - Imagerie et Biomécanique du rachis, France; Canada
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Gatto RG, Mustafi SM, Amin MY, Mareci TH, Wu YC, Magin RL. Neurite orientation dispersion and density imaging can detect presymptomatic axonal degeneration in the spinal cord of ALS mice. FUNCTIONAL NEUROLOGY 2018; 33:155-163. [PMID: 30457969 PMCID: PMC7212765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neurite orientation dispersion and density imaging (NODDI), a MRI multi-shell diffusion technique, has offered new insights for the study of microstructural changes in neurodegenerative diseases. Mainly, the present study aimed to determine the connection between NODDI-derived parameters and changes in white matter (WM) abnormalities at early stages of amyotrophic lateral sclerosis (ALS). Spinal cords from ALS mice (G93A-SOD1 mice) were scanned in a Bruker Avance III HD 17.6T magnet. Fluorescent axonal-tagged mice (YFP, G93A-SOD1 mice) were used for quantitative histological analysis. NODDI showed a decrease in intra-cellular volume fraction (-24%) and increases in orientation dispersion index (+35%) and isotropic volume fraction (+33%). In addition, histoathological results demonstrated a reductions in axonal area (-11%) and myelin content (-29%). A histological decrease in WM intra-axonal space (-71%) and an increase in the extra-axonal compartment (+22%) were also detected. Our studies demonstrate that NODDI may be a suitable technique for detecting presymptomatic spinal cord WM microstructural degeneration in ALS.
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Affiliation(s)
- Rodolfo G. Gatto
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Sourajit M. Mustafi
- Department of Radiology and Imaging Sciences, Indiana University, School of Medicine Indianapolis, IN, USA
| | - Manish Y. Amin
- Department of Physics, University of Florida, Gainesville, FL, USA
| | - Thomas H. Mareci
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, USA
| | - Yu-Chien Wu
- Department of Radiology and Imaging Sciences, Indiana University, School of Medicine Indianapolis, IN, USA
| | - Richard L. Magin
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
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PAM50: Unbiased multimodal template of the brainstem and spinal cord aligned with the ICBM152 space. Neuroimage 2018; 165:170-179. [DOI: 10.1016/j.neuroimage.2017.10.041] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/16/2017] [Accepted: 10/20/2017] [Indexed: 11/17/2022] Open
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72
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Ganau M, Holly LT, Mizuno J, Fehlings MG. Future Directions and New Technologies for the Management of Degenerative Cervical Myelopathy. Neurosurg Clin N Am 2018; 29:185-193. [DOI: 10.1016/j.nec.2017.09.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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73
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Martin AR, Tadokoro N, Tetreault L, Arocho-Quinones EV, Budde MD, Kurpad SN, Fehlings MG. Imaging Evaluation of Degenerative Cervical Myelopathy. Neurosurg Clin N Am 2018; 29:33-45. [DOI: 10.1016/j.nec.2017.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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74
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Budde MD, Skinner NP, Muftuler LT, Schmit BD, Kurpad SN. Optimizing Filter-Probe Diffusion Weighting in the Rat Spinal Cord for Human Translation. Front Neurosci 2017; 11:706. [PMID: 29311786 PMCID: PMC5742102 DOI: 10.3389/fnins.2017.00706] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/01/2017] [Indexed: 12/15/2022] Open
Abstract
Diffusion tensor imaging (DTI) is a promising biomarker of spinal cord injury (SCI). In the acute aftermath, DTI in SCI animal models consistently demonstrates high sensitivity and prognostic performance, yet translation of DTI to acute human SCI has been limited. In addition to technical challenges, interpretation of the resulting metrics is ambiguous, with contributions in the acute setting from both axonal injury and edema. Novel diffusion MRI acquisition strategies such as double diffusion encoding (DDE) have recently enabled detection of features not available with DTI or similar methods. In this work, we perform a systematic optimization of DDE using simulations and an in vivo rat model of SCI and subsequently implement the protocol to the healthy human spinal cord. First, two complementary DDE approaches were evaluated using an orientationally invariant or a filter-probe diffusion encoding approach. While the two methods were similar in their ability to detect acute SCI, the filter-probe DDE approach had greater predictive power for functional outcomes. Next, the filter-probe DDE was compared to an analogous single diffusion encoding (SDE) approach, with the results indicating that in the spinal cord, SDE provides similar contrast with improved signal to noise. In the SCI rat model, the filter-probe SDE scheme was coupled with a reduced field of view (rFOV) excitation, and the results demonstrate high quality maps of the spinal cord without contamination from edema and cerebrospinal fluid, thereby providing high sensitivity to injury severity. The optimized protocol was demonstrated in the healthy human spinal cord using the commercially-available diffusion MRI sequence with modifications only to the diffusion encoding directions. Maps of axial diffusivity devoid of CSF partial volume effects were obtained in a clinically feasible imaging time with a straightforward analysis and variability comparable to axial diffusivity derived from DTI. Overall, the results and optimizations describe a protocol that mitigates several difficulties with DTI of the spinal cord. Detection of acute axonal damage in the injured or diseased spinal cord will benefit the optimized filter-probe diffusion MRI protocol outlined here.
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Affiliation(s)
- Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Nathan P Skinner
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States.,Medical Scientist Training Program, Medical College of Wisconsin, Milwaukee, WI, United States
| | - L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Brian D Schmit
- Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, United States
| | - Shekar N Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
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75
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Rasoanandrianina H, Grapperon AM, Taso M, Girard OM, Duhamel G, Guye M, Ranjeva JP, Attarian S, Verschueren A, Callot V. Region-specific impairment of the cervical spinal cord (SC) in amyotrophic lateral sclerosis: A preliminary study using SC templates and quantitative MRI (diffusion tensor imaging/inhomogeneous magnetization transfer). NMR IN BIOMEDICINE 2017; 30:e3801. [PMID: 28926131 DOI: 10.1002/nbm.3801] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/24/2017] [Accepted: 08/07/2017] [Indexed: 06/07/2023]
Abstract
In this preliminary study, our objective was to investigate the potential of high-resolution anatomical imaging, diffusion tensor imaging (DTI) and conventional/inhomogeneous magnetization transfer imaging [magnetization transfer (MT)/inhomogeneous magnetization transfer (ihMT)] at 3 T, analyzed with template-extracted regions of interest, to measure the atrophy and structural changes of white (WM) and gray (GM) matter spinal cord (SC) occurring in patients with amyotrophic lateral sclerosis (ALS). Ten patients with ALS and 20 age-matched healthy controls were recruited. SC GM and WM areas were automatically segmented using dedicated templates. Atrophy indices were evaluated from T2 *-weighted images at each vertebral level from cervical C1 to C6. DTI and ihMT metrics were quantified within the corticospinal tract (CST), posterior sensory tract (PST) and anterior GM (aGM) horns at the C2 and C5 levels. Clinical disabilities of patients with ALS were evaluated using the Revised ALS Functional Rating Scale, upper motor neuron (UMN) and Medical Research Council scorings, and correlated with MR metrics. Compared with healthy controls, GM and WM atrophy was observed in patients with ALS, especially at lower cervical levels, where a strong correlation was also observed between GM atrophy and the UMN score (R = -0.75, p = 0.05 at C6). Interestingly, a significant decrease in ihMT ratio was found in all regions of interest (p < 0.0008), fractional anisotropy (FA) and MT ratios decreased significantly in CST, especially at C5 (p < 0.005), and λ// (axial diffusivity) decreased significantly in CST (p = 0.0004) and PST (p = 0.003) at C2. Strong correlations between MRI metrics and clinical scores were also found (0.47 < |R| < 0.87, p < 0.05). Altogether, these preliminary results suggest that high-resolution anatomical imaging and ihMT imaging, in addition to DTI, are valuable for the characterization of SC tissue impairment in ALS. In this study, in addition to an important SC WM demyelination, we also observed, for the first time in ALS, impairments of cervical aGM.
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Affiliation(s)
- Henitsoa Rasoanandrianina
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
- iLab-Spine International Associated Laboratory, Marseille-Montreal, France-Canada
- Aix-Marseille Université, IFSTTAR, LBA UMR T 24, Marseille, France
| | - Aude-Marie Grapperon
- Centre de Référence des Maladies neuro-musculaires et de la SLA, Hopital de La Timone, Marseille, France
| | - Manuel Taso
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
- iLab-Spine International Associated Laboratory, Marseille-Montreal, France-Canada
- Aix-Marseille Université, IFSTTAR, LBA UMR T 24, Marseille, France
| | - Olivier M Girard
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
| | - Guillaume Duhamel
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
| | - Maxime Guye
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
| | - Jean-Philippe Ranjeva
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
| | - Shahram Attarian
- Centre de Référence des Maladies neuro-musculaires et de la SLA, Hopital de La Timone, Marseille, France
- Aix Marseille Université, INSERM, GMGF, Marseille, France
| | - Annie Verschueren
- Centre de Référence des Maladies neuro-musculaires et de la SLA, Hopital de La Timone, Marseille, France
| | - Virginie Callot
- Aix-Marseille Université, CNRS, APHM, CRMBM, Hôpital de la Timone, CEMEREM, Marseille, France
- iLab-Spine International Associated Laboratory, Marseille-Montreal, France-Canada
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Weber KA, Sentis AI, Bernadel-Huey ON, Chen Y, Wang X, Parrish TB, Mackey S. Thermal Stimulation Alters Cervical Spinal Cord Functional Connectivity in Humans. Neuroscience 2017; 369:40-50. [PMID: 29101078 DOI: 10.1016/j.neuroscience.2017.10.035] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 11/28/2022]
Abstract
The spinal cord has an active role in the modulation and transmission of the neural signals traveling between the body and the brain. Recent advancements in functional magnetic resonance imaging (fMRI) have made the in vivo examination of spinal cord function in humans now possible. This technology has been recently extended to the investigation of resting state functional networks in the spinal cord, leading to the identification of distinct patterns of spinal cord functional connectivity. In this study, we expand on the previous work and further investigate resting state cervical spinal cord functional connectivity in healthy participants (n = 15) using high resolution imaging coupled with both seed-based functional connectivity analyses and graph theory-based metrics. Within spinal cord segment functional connectivity was present between the left and right ventral horns (bilateral motor network), left and right dorsal horns (bilateral sensory network), and the ipsilateral ventral and dorsal horns (unilateral sensory-motor network). Functional connectivity between the spinal cord segments was less apparent with the connectivity centered at the region of interest and spanning <20 mm along the superior-inferior axis. In a subset of participants (n = 10), the cervical spinal cord functional network was demonstrated to be state-dependent as thermal stimulation of the right ventrolateral forearm resulted in significant disruption of the bilateral sensory network, increased network global efficiency, and decreased network modularity.
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Affiliation(s)
- Kenneth A Weber
- Systems Neuroscience and Pain Lab, Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, Palo Alto 94304, CA, USA.
| | - Amy I Sentis
- Systems Neuroscience and Pain Lab, Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, Palo Alto 94304, CA, USA
| | - Olivia N Bernadel-Huey
- Systems Neuroscience and Pain Lab, Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, Palo Alto 94304, CA, USA
| | - Yufen Chen
- Department of Radiology, Northwestern University, Chicago, IL 60611, USA
| | - Xue Wang
- Department of Radiology, Northwestern University, Chicago, IL 60611, USA
| | - Todd B Parrish
- Department of Radiology, Northwestern University, Chicago, IL 60611, USA
| | - Sean Mackey
- Systems Neuroscience and Pain Lab, Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, Palo Alto 94304, CA, USA
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77
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Lundell H, Svolgaard O, Dogonowski AM, Romme Christensen J, Selleberg F, Soelberg Sørensen P, Blinkenberg M, Siebner HR, Garde E. Spinal cord atrophy in anterior-posterior direction reflects impairment in multiple sclerosis. Acta Neurol Scand 2017; 136:330-337. [PMID: 28070886 DOI: 10.1111/ane.12729] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate how atrophy is distributed over the cross section of the upper cervical spinal cord and how this relates to functional impairment in multiple sclerosis (MS). METHODS We analysed the structural brain MRI scans of 54 patients with relapsing-remitting MS (n=22), primary progressive MS (n=9), secondary progressive MS (n=23) and 23 age- and sex-matched healthy controls. We measured the cross-sectional area (CSA), left-right width (LRW) and anterior-posterior width (APW) of the spinal cord at the segmental level C2. We tested for a nonparametric linear relationship between these atrophy measures and clinical impairments as reflected by the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Impairment Scale (MSIS). RESULTS In patients with MS, CSA and APW but not LRW were reduced compared to healthy controls (P<.02) and showed significant correlations with EDSS, MSIS and specific MSIS subscores. CONCLUSION In patients with MS, atrophy of the upper cervical cord is most evident in the antero-posterior direction. As APW of the cervical cord can be readily derived from standard structural MRI of the brain, APW constitutes a clinically useful neuroimaging marker of disease-related neurodegeneration in MS.
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Affiliation(s)
- H. Lundell
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre Denmark
| | - O. Svolgaard
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre Denmark
| | - A.-M. Dogonowski
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre Denmark
| | - J. Romme Christensen
- Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - F. Selleberg
- Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - P. Soelberg Sørensen
- Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - M. Blinkenberg
- Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - H. R. Siebner
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre Denmark
- Department of Neurology; Copenhagen University Hospital Bispebjerg; Copenhagen Denmark
| | - E. Garde
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre Denmark
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78
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Guan L, Chen X, Hai Y, Ma X, He L, Wang G, Yuan C, Guo H. High-resolution diffusion tensor imaging in cervical spondylotic myelopathy: a preliminary follow-up study. NMR IN BIOMEDICINE 2017; 30:e3769. [PMID: 28703331 DOI: 10.1002/nbm.3769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
Diffusion imaging is a promising technique as it can provide microstructural tissue information and thus potentially show viable changes in spinal cord. However, the traditional single-shot imaging method is limited as a result of various image artifacts. In order to improve measurement accuracy, we used a newly developed, multi-shot, high-resolution, diffusion tensor imaging (DTI) method to investigate diffusion metric changes and compare them with T2 -weighted (T2W) images before and after decompressive surgery for cervical spondylotic myelopathy (CSM). T2W imaging, single-shot DTI and multi-shot DTI were employed to scan seven patients with CSM before and 3 months after decompressive surgery. High signal intensities were scored using the T2 W images. DTI metrics, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were quantified and compared pre- and post-surgery. In addition, the relationship between imaging metrics and neurological assessments was examined. The reproducibility of multi-shot DTI was also assessed in 10 healthy volunteers. Post-surgery, the mean grade of cervical canal stenosis was reduced from grade 3 to normal after 3 months. Compared with single-shot DTI, multi-shot DTI provided better images with lower artifact levels, especially following surgery, as a result of reduced artifacts from metal implants. The new method also showed acceptable reproducibility. Both FA and RD values from the new acquisition showed significant differences post-surgery (FA, p = 0.026; RD, p = 0.048). These changes were consistent with neurological assessments. In contrast, T2W images did not show significant changes before and after surgery. Multi-shot diffusion imaging showed improved image quality over single-shot DWI, and presented superior performance in diagnosis and recovery monitoring for patients with CSM compared with T2W imaging. DTI metrics can reflect the pathological conditions of spondylotic spinal cord quantitatively and may serve as a sensitive biomarker for potential CSM management.
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Affiliation(s)
- Li Guan
- Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaolong Chen
- Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yong Hai
- Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaodong Ma
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Guangzhi Wang
- Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China
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79
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Mahajan KR, Ontaneda D. The Role of Advanced Magnetic Resonance Imaging Techniques in Multiple Sclerosis Clinical Trials. Neurotherapeutics 2017; 14:905-923. [PMID: 28770481 PMCID: PMC5722766 DOI: 10.1007/s13311-017-0561-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Magnetic resonance imaging has been crucial in the development of anti-inflammatory disease-modifying treatments. The current landscape of multiple sclerosis clinical trials is currently expanding to include testing not only of anti-inflammatory agents, but also neuroprotective, remyelinating, neuromodulating, and restorative therapies. This is especially true of therapies targeting progressive forms of the disease where neurodegeneration is a prominent feature. Imaging techniques of the brain and spinal cord have rapidly evolved in the last decade to permit in vivo characterization of tissue microstructural changes, connectivity, metabolic changes, neuronal loss, glial activity, and demyelination. Advanced magnetic resonance imaging techniques hold significant promise for accelerating the development of different treatment modalities targeting a variety of pathways in MS.
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Affiliation(s)
- Kedar R Mahajan
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, U-10, Cleveland, OH, 44195, USA
| | - Daniel Ontaneda
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, U-10, Cleveland, OH, 44195, USA.
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80
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Battiston M, Grussu F, Ianus A, Schneider T, Prados F, Fairney J, Ourselin S, Alexander DC, Cercignani M, Gandini Wheeler-Kingshott CAM, Samson RS. An optimized framework for quantitative magnetization transfer imaging of the cervical spinal cord in vivo. Magn Reson Med 2017; 79:2576-2588. [PMID: 28921614 PMCID: PMC5836910 DOI: 10.1002/mrm.26909] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 11/06/2022]
Abstract
PURPOSE To develop a framework to fully characterize quantitative magnetization transfer indices in the human cervical cord in vivo within a clinically feasible time. METHODS A dedicated spinal cord imaging protocol for quantitative magnetization transfer was developed using a reduced field-of-view approach with echo planar imaging (EPI) readout. Sequence parameters were optimized based in the Cramer-Rao-lower bound. Quantitative model parameters (i.e., bound pool fraction, free and bound pool transverse relaxation times [ T2F, T2B], and forward exchange rate [kFB ]) were estimated implementing a numerical model capable of dealing with the novelties of the sequence adopted. The framework was tested on five healthy subjects. RESULTS Cramer-Rao-lower bound minimization produces optimal sampling schemes without requiring the establishment of a steady-state MT effect. The proposed framework allows quantitative voxel-wise estimation of model parameters at the resolution typically used for spinal cord imaging (i.e. 0.75 × 0.75 × 5 mm3 ), with a protocol duration of ∼35 min. Quantitative magnetization transfer parametric maps agree with literature values. Whole-cord mean values are: bound pool fraction = 0.11(±0.01), T2F = 46.5(±1.6) ms, T2B = 11.0(±0.2) µs, and kFB = 1.95(±0.06) Hz. Protocol optimization has a beneficial effect on reproducibility, especially for T2B and kFB . CONCLUSION The framework developed enables robust characterization of spinal cord microstructure in vivo using qMT. Magn Reson Med 79:2576-2588, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Marco Battiston
- Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Francesco Grussu
- Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Andrada Ianus
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom.,Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | | | - Ferran Prados
- Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom.,Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - James Fairney
- Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom.,UCL Department of Medical Physics and Bioengineering, University College London, London, United Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - Mara Cercignani
- CISC, Department of Neuroscience, Brighton & Sussex Medical School, Brighton, Sussex, United Kingdom
| | - Claudia A M Gandini Wheeler-Kingshott
- Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Brain MRI 3T Mondino Research Center, C. Mondino National Neurological Institute, Pavia, Italy
| | - Rebecca S Samson
- Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom
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81
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Fehlings MG, Martin AR, Tetreault LA, Aarabi B, Anderson P, Arnold PM, Brodke D, Burns AS, Chiba K, Dettori JR, Furlan JC, Hawryluk G, Holly LT, Howley S, Jeji T, Kalsi-Ryan S, Kotter M, Kurpad S, Kwon BK, Marino RJ, Massicotte E, Merli G, Middleton JW, Nakashima H, Nagoshi N, Palmieri K, Singh A, Skelly AC, Tsai EC, Vaccaro A, Wilson JR, Yee A, Harrop JS. A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Role of Baseline Magnetic Resonance Imaging in Clinical Decision Making and Outcome Prediction. Global Spine J 2017; 7:221S-230S. [PMID: 29164028 PMCID: PMC5684845 DOI: 10.1177/2192568217703089] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The objective of this guideline is to outline the role of magnetic resonance imaging (MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury (SCI). METHODS A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI. This review focused on longitudinal studies that controlled for baseline neurologic status. A multidisciplinary Guideline Development Group (GDG) used this information, their clinical expertise, and patient input to develop recommendations on the use of MRI for SCI patients. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as "we recommend," whereas a weaker recommendation is indicated by "we suggest." RESULTS Based on the limited available evidence and the clinical expertise of the GDG, our recommendations were: (1) "We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention, when feasible, to facilitate improved clinical decision-making" (quality of evidence, very low) and (2) "We suggest that MRI should be performed in adult patients in the acute period following SCI, before or after surgical intervention, to improve prediction of neurologic outcome" (quality of evidence, low). CONCLUSIONS These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI.
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Affiliation(s)
- Michael G. Fehlings
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Michael G. Fehlings, MD, PhD, FRCSC, FACS, Division of Neurosurgery, Toronto Western Hospital, University Health Network, 399 Bathurst Street (SCI-CRU, 11th Floor McLaughlin Pavilion), Toronto, Ontario M5T 2S8, Canada.
| | - Allan R. Martin
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Lindsay A. Tetreault
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- University College Cork, Cork, Ireland
| | | | | | - Paul M. Arnold
- University of Kansas Medical Center, The University of Kansas, Kansas City, KS, USA
| | | | - Anthony S. Burns
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | | | | | - Julio C. Furlan
- University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | | | | | - Susan Howley
- Christopher & Dana Reeve Foundation, Short Hills, NJ, USA
| | - Tara Jeji
- Ontario Neurotrauma Foundation, Toronto, Ontario, Canada
| | | | | | | | - Brian K. Kwon
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Eric Massicotte
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Geno Merli
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | | | | | - Narihito Nagoshi
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Keio University, Keio, Japan
| | | | - Anoushka Singh
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | | | - Eve C. Tsai
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Jefferson R. Wilson
- University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Albert Yee
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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82
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Mohammadi S, Weiskopf N. [Computational neuroanatomy and microstructure imaging using magnetic resonance imaging]. DER NERVENARZT 2017; 88:839-849. [PMID: 28721539 DOI: 10.1007/s00115-017-0373-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Current computational neuroanatomy focuses on morphological measurements of the brain using standard magnetic resonance imaging (MRI) techniques. In comparison quantitative MRI (qMRI) typically provides a better tissue contrast and also greatly improves the sensitivity and specificity with respect to the microstructural characteristics of tissue. OBJECTIVE Current methodological developments in qMRI are presented, which go beyond morphology because this provides standardized measurements of the microstructure of the brain. The concept of in-vivo histology is introduced, based on biophysical modelling of qMRI data (hMRI) for determination of quantitative histology-like markers of the microstructure. RESULTS The qMRI metrics can be used as direct biomarkers of the microstructural mechanisms driving observed morphological findings. The hMRI metrics utilize biophysical models of the MRI signal in order to determine 3‑dimensional maps of histology-like measurements in the white matter. CONCLUSION Non-invasive brain tissue characterization using qMRI or hMRI has significant implications for both scientific and clinical applications. Both approaches improve the comparability across sites and time points, facilitate multicenter and longitudinal studies as well as standardized diagnostics. The hMRI is expected to shed new light on the relationship between brain microstructure, function and behavior both in health and disease. In the future hMRI will play an indispensable role in the field of computational neuroanatomy.
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Affiliation(s)
- S Mohammadi
- Institut für systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Max-Planck-Institut für Kognitions- und Neurowissenschaften, Stephanstr. 1a, 04103, Leipzig, Deutschland
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, Großbritannien
| | - N Weiskopf
- Max-Planck-Institut für Kognitions- und Neurowissenschaften, Stephanstr. 1a, 04103, Leipzig, Deutschland.
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, Großbritannien.
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83
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Wang-Leandro A, Hobert MK, Alisauskaite N, Dziallas P, Rohn K, Stein VM, Tipold A. Spontaneous acute and chronic spinal cord injuries in paraplegic dogs: a comparative study of in vivo diffusion tensor imaging. Spinal Cord 2017; 55:1108-1116. [DOI: 10.1038/sc.2017.83] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 06/12/2017] [Accepted: 06/20/2017] [Indexed: 12/17/2022]
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84
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Battiston M, Schneider T, Prados F, Grussu F, Yiannakas MC, Ourselin S, Gandini Wheeler-Kingshott CAM, Samson RS. Fast and reproducible in vivo T 1 mapping of the human cervical spinal cord. Magn Reson Med 2017; 79:2142-2148. [PMID: 28736946 DOI: 10.1002/mrm.26852] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE To develop a fast and robust method for measuring T1 in the whole cervical spinal cord in vivo, and to assess its reproducibility. METHODS A spatially nonselective adiabatic inversion pulse is combined with zonally oblique-magnified multislice echo-planar imaging to produce a reduced field-of-view inversion-recovery echo-planar imaging protocol. Multi- inversion time data are obtained by cycling slice order throughout sequence repetitions. Measurement of T1 is performed using 12 inversion times for a total protocol duration of 7 min. Reproducibility of regional T1 estimates is assessed in a scan-rescan experiment on five heathy subjects. RESULTS Regional mean (standard deviation) T1 was: 1108.5 (±77.2) ms for left lateral column, 1110.1 (±83.2) ms for right lateral column, 1150.4 (±102.6) ms for dorsal column, and 1136.4 (±90.8) ms for gray matter. Regional T1 estimates showed good correlation between sessions (Pearson correlation coefficient = 0.89 (P value < 0.01); mean difference = 2 ms, 95% confidence interval ± 20 ms); and high reproducibility (intersession coefficient of variation approximately 1% in all the regions considered, intraclass correlation coefficient = 0.88 (P value < 0.01, confidence interval 0.71-0.95)). CONCLUSIONS T1 estimates in the cervical spinal cord are reproducible using inversion-recovery zonally oblique-magnified multislice echo-planar imaging. The short acquisition time and large coverage of this method paves the way for accurate T1 mapping for various spinal cord pathologies. Magn Reson Med 79:2142-2148, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Marco Battiston
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | | | - Ferran Prados
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Translational Imaging Group, Center for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Francesco Grussu
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Sebastien Ourselin
- Translational Imaging Group, Center for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Brain MRI 3T Mondino Research Center, C. Mondino National Neurological Institute, Pavia, Italy
| | - Rebecca S Samson
- NMR Research Unit, Queen Square MS Center, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, United Kingdom
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85
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Noristani HN, Boukhaddaoui H, Saint-Martin G, Auzer P, Sidiboulenouar R, Lonjon N, Alibert E, Tricaud N, Goze-Bac C, Coillot C, Perrin FE. A Combination of Ex vivo Diffusion MRI and Multiphoton to Study Microglia/Monocytes Alterations after Spinal Cord Injury. Front Aging Neurosci 2017; 9:230. [PMID: 28769787 PMCID: PMC5515855 DOI: 10.3389/fnagi.2017.00230] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/04/2017] [Indexed: 12/11/2022] Open
Abstract
Central nervous system (CNS) injury has been observed to lead to microglia activation and monocytes infiltration at the lesion site. Ex vivo diffusion magnetic resonance imaging (diffusion MRI or DWI) allows detailed examination of CNS tissues, and recent advances in clearing procedures allow detailed imaging of fluorescent-labeled cells at high resolution. No study has yet combined ex vivo diffusion MRI and clearing procedures to establish a possible link between microglia/monocytes response and diffusion coefficient in the context of spinal cord injury (SCI). We carried out ex vivo MRI of the spinal cord at different time-points after spinal cord transection followed by tetrahydrofuran based clearing and examined the density and morphology of microglia/monocytes using two-photon microscopy. Quantitative analysis revealed an early marked increase in microglial/monocytes density that is associated with an increase in the extension of the lesion measured using diffusion MRI. Morphological examination of microglia/monocytes somata at the lesion site revealed a significant increase in their surface area and volume as early as 72 hours post-injury. Time-course analysis showed differential microglial/monocytes response rostral and caudal to the lesion site. Microglia/monocytes showed a decrease in reactivity over time caudal to the lesion site, but an increase was observed rostrally. Direct comparison of microglia/monocytes morphology, obtained through multiphoton, and the longitudinal apparent diffusion coefficient (ADC), measured with diffusion MRI, highlighted that axonal integrity does not correlate with the density of microglia/monocytes or their somata morphology. We emphasize that differential microglial/monocytes reactivity rostral and caudal to the lesion site may thus coincide, at least partially, with reported temporal differences in debris clearance. Our study demonstrates that the combination of ex vivo diffusion MRI and two-photon microscopy may be used to follow structural tissue alteration. Lesion extension coincides with microglia/monocytes density; however, a direct relationship between ADC and microglia/monocytes density and morphology was not observed. We highlighted a differential rostro-caudal microglia/monocytes reactivity that may correspond to a temporal difference in debris clearance and axonal integrity. Thus, potential therapeutic strategies targeting microglia/monocytes after SCI may need to be adjusted not only with the time after injury but also relative to the location to the lesion site.
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Affiliation(s)
- Harun N Noristani
- Institut National de la Santé et de la Recherche Médicale, U1051Montpellier, France.,University of Montpellier, Montpellier; Institut National de la Santé et de la Recherche Médicale, U1198, Montpellier; École Pratique des Hautes ÉtudesParis, France
| | - Hassan Boukhaddaoui
- Institut National de la Santé et de la Recherche Médicale, U1051Montpellier, France
| | - Guillaume Saint-Martin
- University of Montpellier, Montpellier; Institut National de la Santé et de la Recherche Médicale, U1198, Montpellier; École Pratique des Hautes ÉtudesParis, France.,Charles Coulomb Laboratory, UMR 5221 Centre National de la Recherche ScientifiqueMontpellier, France
| | - Pauline Auzer
- Institut National de la Santé et de la Recherche Médicale, U1051Montpellier, France
| | - Rahima Sidiboulenouar
- Charles Coulomb Laboratory, UMR 5221 Centre National de la Recherche ScientifiqueMontpellier, France
| | - Nicolas Lonjon
- University of Montpellier, Montpellier; Institut National de la Santé et de la Recherche Médicale, U1198, Montpellier; École Pratique des Hautes ÉtudesParis, France.,Centre Hospitalier Universitaire de Montpellier (CHRU), Gui de Chauliac HospitalMontpellier, France
| | - Eric Alibert
- Charles Coulomb Laboratory, UMR 5221 Centre National de la Recherche ScientifiqueMontpellier, France
| | - Nicolas Tricaud
- Institut National de la Santé et de la Recherche Médicale, U1051Montpellier, France
| | - Christophe Goze-Bac
- Charles Coulomb Laboratory, UMR 5221 Centre National de la Recherche ScientifiqueMontpellier, France
| | - Christophe Coillot
- Charles Coulomb Laboratory, UMR 5221 Centre National de la Recherche ScientifiqueMontpellier, France
| | - Florence E Perrin
- Institut National de la Santé et de la Recherche Médicale, U1051Montpellier, France.,University of Montpellier, Montpellier; Institut National de la Santé et de la Recherche Médicale, U1198, Montpellier; École Pratique des Hautes ÉtudesParis, France
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86
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Weigel M, Bieri O. Spinal cord imaging using averaged magnetization inversion recovery acquisitions. Magn Reson Med 2017; 79:1870-1881. [PMID: 28714105 DOI: 10.1002/mrm.26833] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 06/19/2017] [Accepted: 06/19/2017] [Indexed: 11/06/2022]
Abstract
PURPOSE To establish a novel approach for fast high-resolution spinal cord (SC) imaging using averaged magnetization inversion recovery acquisitions (AMIRA). METHODS The AMIRA concept is based on an inversion recovery (IR) prepared, segmented, and time-limited cine balanced steady state free precession sequence. Typically, for the fastest SC imaging without any signal averaging, eight consecutive images in time with an in-plane resolution of 0.67 × 0.67 mm2 and 6 mm to 8 mm slice thickness are acquired in 51 s. AMIRA does not require parallel acquisition techniques. RESULTS AMIRA measures eight images of remarkable tissue contrast variation between spinal cord gray (GM) and white matter (WM) and cerebrospinal fluid (CSF). Following the AMIRA concept, averaging the first IR contrast images not only improves the signal-to-noise ratio but also offers a surprising enhancement of the contrast-to-noise ratio between GM and WM, whereas averaging the last images considerably improves the contrast-to-noise ratio between WM and CSF. These observations are supported by quantitative data. CONCLUSION The AMIRA concept provides 2D spinal cord imaging with multiple tissue contrasts and enhanced contrast-to-noise ratios with a typical 0.67 × 0.67 mm2 in-plane resolution and a slice thickness between 4 mm and 8 mm acquired in only 1 to 2 min per slice. Magn Reson Med 79:1870-1881, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Matthias Weigel
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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87
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Panara V, Navarra R, Mattei PA, Piccirilli E, Cotroneo AR, Papinutto N, Henry RG, Uncini A, Caulo M. Spinal cord microstructure integrating phase-sensitive inversion recovery and diffusional kurtosis imaging. Neuroradiology 2017; 59:819-827. [PMID: 28676888 DOI: 10.1007/s00234-017-1864-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/13/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of this prospective study was to determine the feasibility in terms of repeatability and reproducibility of diffusional kurtosis imaging (DKI) for microstructural assessment of the normal cervical spinal cord (cSC) using a phase-sensitive inversion recovery (PSIR) sequence as the anatomical reference for accurately defining white-matter (WM) and gray-matter (GM) regions of interests (ROIs). METHODS Thirteen young healthy subjects were enrolled to undergo DKI and PSIR sequences in the cSC. The repeatability and reproducibility of kurtosis metrics and fractional anisotropy (FA) were calculated in GM, WM, and cerebral-spinal-fluid (CSF) ROIs drawn by two independent readers on PSIR images of three different levels (C1-C4). The presence of statistically significant differences in DKI metrics for levels, ROIs (GM, WM, and CSF) repeatability, reproducibility, and inter-reader agreement was evaluated. RESULTS Intra-class correlation coefficients between the two readers ranged from good to excellent (0.75 to 0.90). The inferior level consistently had the highest concordance. The lower values of scan-rescan variability for all DKI parameters were found for the inferior level. Statistically significant differences in kurtosis values were not found in the lateral white-matter bundles of the spinal cord. CONCLUSION The integration of DKI and PSIR sequences in a clinical MR acquisition to explore the regional microstructure of the cSC in healthy subjects is feasible, and the results obtainable are reproducible. Further investigation will be required to verify the possibility to translate this method to a clinical setting to study patients with SC involvement especially in the absence of MRI abnormalities on standard sequences.
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Affiliation(s)
- V Panara
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. "D'Annunzio", Chieti, Italy. .,ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi, 11 66100, Chieti, Italy.
| | - R Navarra
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. "D'Annunzio", Chieti, Italy.,ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi, 11 66100, Chieti, Italy
| | - P A Mattei
- ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi, 11 66100, Chieti, Italy.,Department of Medicine and Science of Aging, Ophthalmology Clinic, University "G. d'Annunzio", Chieti, Italy
| | - E Piccirilli
- ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi, 11 66100, Chieti, Italy
| | - A R Cotroneo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. "D'Annunzio", Chieti, Italy
| | - N Papinutto
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - R G Henry
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - A Uncini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. "D'Annunzio", Chieti, Italy
| | - M Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. "D'Annunzio", Chieti, Italy.,ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi, 11 66100, Chieti, Italy
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88
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Tight neurovascular coupling in the spinal cord during nociceptive stimulation in intact and spinal rats. Neuroscience 2017; 355:1-8. [DOI: 10.1016/j.neuroscience.2017.04.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/19/2017] [Accepted: 04/25/2017] [Indexed: 12/14/2022]
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89
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David G, Freund P, Mohammadi S. The efficiency of retrospective artifact correction methods in improving the statistical power of between-group differences in spinal cord DTI. Neuroimage 2017; 158:296-307. [PMID: 28669912 PMCID: PMC6168644 DOI: 10.1016/j.neuroimage.2017.06.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/10/2022] Open
Abstract
Diffusion tensor imaging (DTI) is a promising approach for investigating the white matter microstructure of the spinal cord. However, it suffers from severe susceptibility, physiological, and instrumental artifacts present in the cord. Retrospective correction techniques are popular approaches to reduce these artifacts, because they are widely applicable and do not increase scan time. In this paper, we present a novel outlier rejection approach (reliability masking) which is designed to supplement existing correction approaches by excluding irreversibly corrupted and thus unreliable data points from the DTI index maps. Then, we investigate how chains of retrospective correction techniques including (i) registration, (ii) registration and robust fitting, and (iii) registration, robust fitting, and reliability masking affect the statistical power of a previously reported finding of lower fractional anisotropy values in the posterior column and lateral corticospinal tracts in cervical spondylotic myelopathy (CSM) patients. While established post-processing steps had small effect on the statistical power of the clinical finding (slice-wise registration: −0.5%, robust fitting: +0.6%), adding reliability masking to the post-processing chain increased it by 4.7%. Interestingly, reliability masking and registration affected the t-score metric differently: while the gain in statistical power due to reliability masking was mainly driven by decreased variability in both groups, registration slightly increased variability. In conclusion, reliability masking is particularly attractive for neuroscience and clinical research studies, as it increases statistical power by reducing group variability and thus provides a cost-efficient alternative to increasing the group size. A novel outlier rejection technique (reliability masking) is introduced. Standard artifact correction has little effect on the statistical power of between-group differences. Reliability masking improves the statistical power of between-group differences. This improvement is driven by decreased group-level variability.
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Affiliation(s)
- Gergely David
- Spinal Cord Injury Center Balgrist, Balgrist University Hospital, Zurich, Switzerland; Department of Systems Neuroscience, Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Patrick Freund
- Spinal Cord Injury Center Balgrist, Balgrist University Hospital, Zurich, Switzerland; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom; Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, United Kingdom; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Siawoosh Mohammadi
- Department of Systems Neuroscience, Medical Center Hamburg-Eppendorf, Hamburg, Germany; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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90
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Martin AR, De Leener B, Cohen-Adad J, Cadotte DW, Kalsi-Ryan S, Lange SF, Tetreault L, Nouri A, Crawley A, Mikulis DJ, Ginsberg H, Fehlings MG. Clinically Feasible Microstructural MRI to Quantify Cervical Spinal Cord Tissue Injury Using DTI, MT, and T2*-Weighted Imaging: Assessment of Normative Data and Reliability. AJNR Am J Neuroradiol 2017; 38:1257-1265. [PMID: 28428213 DOI: 10.3174/ajnr.a5163] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/28/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DTI, magnetization transfer, T2*-weighted imaging, and cross-sectional area can quantify aspects of spinal cord microstructure. However, clinical adoption remains elusive due to complex acquisitions, cumbersome analysis, limited reliability, and wide ranges of normal values. We propose a simple multiparametric protocol with automated analysis and report normative data, analysis of confounding variables, and reliability. MATERIALS AND METHODS Forty healthy subjects underwent T2WI, DTI, magnetization transfer, and T2*WI at 3T in <35 minutes using standard hardware and pulse sequences. Cross-sectional area, fractional anisotropy, magnetization transfer ratio, and T2*WI WM/GM signal intensity ratio were calculated. Relationships between MR imaging metrics and age, sex, height, weight, cervical cord length, and rostrocaudal level were analyzed. Test-retest coefficient of variation measured reliability in 24 DTI, 17 magnetization transfer, and 16 T2*WI datasets. DTI with and without cardiac triggering was compared in 10 subjects. RESULTS T2*WI WM/GM showed lower intersubject coefficient of variation (3.5%) compared with magnetization transfer ratio (5.8%), fractional anisotropy (6.0%), and cross-sectional area (12.2%). Linear correction of cross-sectional area with cervical cord length, fractional anisotropy with age, and magnetization transfer ratio with age and height led to decreased coefficients of variation (4.8%, 5.4%, and 10.2%, respectively). Acceptable reliability was achieved for all metrics/levels (test-retest coefficient of variation < 5%), with T2*WI WM/GM comparing favorably with fractional anisotropy and magnetization transfer ratio. DTI with and without cardiac triggering showed no significant differences for fractional anisotropy and test-retest coefficient of variation. CONCLUSIONS Reliable multiparametric assessment of spinal cord microstructure is possible by using clinically suitable methods. These results establish normalization procedures and pave the way for clinical studies, with the potential for improving diagnostics, objectively monitoring disease progression, and predicting outcomes in spinal pathologies.
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Affiliation(s)
- A R Martin
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - B De Leener
- Polytechnique Montreal (B.D.L., J.C.-A.), Montréal, Quebec, Canada
| | - J Cohen-Adad
- Polytechnique Montreal (B.D.L., J.C.-A.), Montréal, Quebec, Canada
- Functional Neuroimaging Unit (J.C.-A.), Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montréal, Quebec, Canada
| | - D W Cadotte
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - S Kalsi-Ryan
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - S F Lange
- University of Groningen (S.F.L.), Groningen, the Netherlands
| | - L Tetreault
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - A Nouri
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - A Crawley
- Department of Medical Imaging (A.C., D.J.M.), University of Toronto and the University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - D J Mikulis
- Department of Medical Imaging (A.C., D.J.M.), University of Toronto and the University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - H Ginsberg
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - M G Fehlings
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
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91
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Wang F, Zu Z, Wu R, Wu TL, Gore JC, Chen LM. MRI evaluation of regional and longitudinal changes in Z-spectra of injured spinal cord of monkeys. Magn Reson Med 2017; 79:1070-1082. [PMID: 28547862 DOI: 10.1002/mrm.26756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/21/2017] [Accepted: 04/22/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE In principle, MR methods that exploit magnetization transfer (MT) may be used to quantify changes in the molecular composition of tissues after injury. The ability to track such changes in injured spinal cord may allow more precise assessment of the state of neural tissues. METHODS Z-Spectra were obtained from the cervical spinal cord before and after a unilateral dorsal column lesion in monkeys at 9.4T. The amplitudes of chemical exchange saturation transfer (CEST) and nuclear Overhauser enhancement (NOE) effects from multiple proton pools, along with nonspecific semisolid MT effects from immobile macromolecules, were quantified using a five-peak Lorenzian fitting of each Z-spectrum. RESULTS Abnormal tissues/cysts that formed around lesion sites exhibited relatively low correlations between their Z-spectra and that of normal gray matter (GM). Compared with normal GM, cysts showed strong CEST but weak semisolid MT and NOE effects after injury. The abnormal tissues around lesion sites were heterogeneous and showed different regional Z-spectra. Different regional correlations between proton pools were observed. Longitudinally, injured spinal cord tissue exhibited remarkable recovery in all subjects. CONCLUSION Characterization of multiple proton pools from Z-spectra permitted noninvasive, regional, quantitative assessments of changes in tissue composition of injured spinal cord over time. Magn Reson Med 79:1070-1082, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Feng Wang
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Zhongliang Zu
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Ruiqi Wu
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Tung-Lin Wu
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - John C Gore
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Li Min Chen
- Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee, USA
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92
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A novel approach for assigning levels to monkey and human lumbosacral spinal cord based on ventral horn morphology. PLoS One 2017; 12:e0177243. [PMID: 28542213 PMCID: PMC5443490 DOI: 10.1371/journal.pone.0177243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/24/2017] [Indexed: 12/11/2022] Open
Abstract
Proper identification of spinal cord levels is crucial for clinical-pathological and imaging studies in humans, but can be a challenge given technical limitations. We have previously demonstrated in non-primate models that the contours of the spinal ventral horn are determined by the position of motoneuron pools. These positions are preserved within and among individuals and can be used to identify lumbosacral spinal levels. Here we tested the hypothesis that this approach can be extended to identify monkey and human spinal levels. In 7 rhesus monkeys, we retrogradely labeled motoneuron pools that represent rostral, middle and caudal landmarks of the lumbosacral enlargement. We then aligned the lumbosacral enlargements among animals using absolute length, segmental level or a relative scale based upon rostral and caudal landmarks. Inter-animal matching of labeled motoneurons across the lumbosacral enlargement was most precise when using internal landmarks. We then reconstructed 3 human lumbosacral spinal cords, and aligned these based upon homologous internal landmarks. Changes in shape of the ventral horn were consistent among human subjects using this relative scale, despite marked differences in absolute length or age. These data suggest that the relative position of spinal motoneuron pools is conserved across species, including primates. Therefore, in clinical-pathological or imaging studies in humans, one can assign spinal cord levels to even single sections by matching ventral horn shape to standardized series.
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93
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Prados F, Ashburner J, Blaiotta C, Brosch T, Carballido-Gamio J, Cardoso MJ, Conrad BN, Datta E, Dávid G, Leener BD, Dupont SM, Freund P, Wheeler-Kingshott CAMG, Grussu F, Henry R, Landman BA, Ljungberg E, Lyttle B, Ourselin S, Papinutto N, Saporito S, Schlaeger R, Smith SA, Summers P, Tam R, Yiannakas MC, Zhu A, Cohen-Adad J. Spinal cord grey matter segmentation challenge. Neuroimage 2017; 152:312-329. [PMID: 28286318 PMCID: PMC5440179 DOI: 10.1016/j.neuroimage.2017.03.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/27/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022] Open
Abstract
An important image processing step in spinal cord magnetic resonance imaging is the ability to reliably and accurately segment grey and white matter for tissue specific analysis. There are several semi- or fully-automated segmentation methods for cervical cord cross-sectional area measurement with an excellent performance close or equal to the manual segmentation. However, grey matter segmentation is still challenging due to small cross-sectional size and shape, and active research is being conducted by several groups around the world in this field. Therefore a grey matter spinal cord segmentation challenge was organised to test different capabilities of various methods using the same multi-centre and multi-vendor dataset acquired with distinct 3D gradient-echo sequences. This challenge aimed to characterize the state-of-the-art in the field as well as identifying new opportunities for future improvements. Six different spinal cord grey matter segmentation methods developed independently by various research groups across the world and their performance were compared to manual segmentation outcomes, the present gold-standard. All algorithms provided good overall results for detecting the grey matter butterfly, albeit with variable performance in certain quality-of-segmentation metrics. The data have been made publicly available and the challenge web site remains open to new submissions. No modifications were introduced to any of the presented methods as a result of this challenge for the purposes of this publication.
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Affiliation(s)
- Ferran Prados
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK.
| | - John Ashburner
- Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - Claudia Blaiotta
- Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - Tom Brosch
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada V6T 1Z4
| | | | - Manuel Jorge Cardoso
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK; Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
| | - Benjamin N Conrad
- Department of Electrical Engineering, Computer Science, Biomedical Engineering, Radiology and Radiological Sciences, Institute of Image Science at Vanderbilt University, Nashville, TN, USA
| | - Esha Datta
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gergely Dávid
- Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Switzerland
| | | | - Sara M Dupont
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada
| | - Patrick Freund
- Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Switzerland
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK; Brain MRI 3T Centre, C. Mondino National Neurological Institute, Pavia, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Italy
| | - Francesco Grussu
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK
| | - Roland Henry
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Bennett A Landman
- Department of Electrical Engineering, Computer Science, Biomedical Engineering, Radiology and Radiological Sciences, Institute of Image Science at Vanderbilt University, Nashville, TN, USA
| | - Emil Ljungberg
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 2B5
| | - Bailey Lyttle
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, London WC1E 6BT, UK; Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
| | - Nico Papinutto
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | | | - Regina Schlaeger
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Seth A Smith
- Department of Radiology and Radiological Sciences, Biomedical Engineering, Ophthalmology, Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
| | - Paul Summers
- Department of Radiology, European Institute of Oncology, University of Modena and Reggio Emilia, 41121, Modena, MO, Italy
| | - Roger Tam
- Department of Radiology, UBC MS/MRI Research Group, University of British Columbia, Vancouver, BC, Canada V6T 2B5
| | - Marios C Yiannakas
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, Russell Square, London WC1B 5EH, UK
| | - Alyssa Zhu
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Julien Cohen-Adad
- NeuroPoly Lab, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada.
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94
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Li D, Wang X. Application value of diffusional kurtosis imaging (DKI) in evaluating microstructural changes in the spinal cord of patients with early cervical spondylotic myelopathy. Clin Neurol Neurosurg 2017; 156:71-76. [DOI: 10.1016/j.clineuro.2017.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/13/2017] [Accepted: 03/17/2017] [Indexed: 11/29/2022]
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95
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Martin AR, De Leener B, Cohen-Adad J, Cadotte DW, Kalsi-Ryan S, Lange SF, Tetreault L, Nouri A, Crawley A, Mikulis DJ, Ginsberg H, Fehlings MG. A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio. AJNR Am J Neuroradiol 2017; 38:1266-1273. [PMID: 28428212 DOI: 10.3174/ajnr.a5162] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/29/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy. MATERIALS AND METHODS Fifty-eight patients with degenerative cervical myelopathy and 40 healthy subjects underwent 3T MR imaging, covering C1-C7. Metrics were automatically extracted at maximally compressed and uncompressed rostral/caudal levels. Normalized metrics were compared with t tests, area under the curve, and logistic regression. Relationships with clinical measures were analyzed by using Pearson correlation and multiple linear regression. RESULTS The maximally compressed level cross-sectional area demonstrated superior differences (P = 1 × 10-13), diagnostic accuracy (area under the curve = 0.890), and univariate correlation with the modified Japanese Orthopedic Association score (0.66). T2*WI WM/GM showed strong differences (rostral: P = 8 × 10-7; maximally compressed level: P = 1 × 10-11; caudal: P = 1 × 10-4), correlations (modified Japanese Orthopedic Association score; rostral: -0.52; maximally compressed level: -0.59; caudal: -0.36), and diagnostic accuracy (rostral: 0.775; maximally compressed level: 0.860; caudal: 0.721), outperforming fractional anisotropy and magnetization transfer ratio in most comparisons and cross-sectional area at rostral/caudal levels. Rostral T2*WI WM/GM showed the strongest correlations with focal motor (-0.45) and sensory (-0.49) deficits and was the strongest independent predictor of the modified Japanese Orthopedic Association score (P = .01) and diagnosis (P = .02) in multivariate models (R2 = 0.59, P = 8 × 10-13; area under the curve = 0.954, respectively). CONCLUSIONS T2*WI WM/GM shows promise as a novel biomarker of WM injury. It detects damage in compressed and uncompressed regions and contributes substantially to multivariate models for diagnosis and correlation with impairment. Our multiparametric approach overcomes limitations of individual measures, having the potential to improve diagnostics, monitor progression, and predict outcomes.
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Affiliation(s)
- A R Martin
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - B De Leener
- Polytechnique Montreal (B.D.L., J.C.-A.), Montreal, Quebec, Canada
| | - J Cohen-Adad
- Polytechnique Montreal (B.D.L., J.C.-A.), Montreal, Quebec, Canada.,Functional Neuroimaging Unit (J.C.-A.), Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Université de Montréal, Montreal, Quebec, Canada
| | - D W Cadotte
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - S Kalsi-Ryan
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - S F Lange
- University of Groningen (S.F.L.), Groningen, the Netherlands
| | - L Tetreault
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - A Nouri
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - A Crawley
- Department of Medical Imaging (A.C., D.J.M.), University of Toronto and the University Health Network, Toronto, Ontario, Canada
| | - D J Mikulis
- Department of Medical Imaging (A.C., D.J.M.), University of Toronto and the University Health Network, Toronto, Ontario, Canada
| | - H Ginsberg
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
| | - M G Fehlings
- From the Division of Neurosurgery, Department of Surgery (A.R.M., D.W.C., S.K.-R., L.T., A.N., H.G., M.G.F.)
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96
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Delayed injection of polypyrrole doped with iodine particle suspension after spinal cord injury in rats improves functional recovery and decreased tissue damage evaluated by 3.0 Tesla in vivo magnetic resonance imaging. Spine J 2017; 17:562-573. [PMID: 26911415 DOI: 10.1016/j.spinee.2016.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/25/2016] [Accepted: 02/04/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND CONTEXT Traumatic spinal cord injury (SCI) causes irreversible damage with loss of motor, sensory, and autonomic functions. Currently, there is not an effective treatment to restore the lost neurologic functions. PURPOSE Injection of polypyrrole-iodine(PPy-I) particle suspension is proposed as a therapeutic strategy. STUDY DESIGN This is an in vivo animal study. METHODS This study evaluates the use of such particles in rats after SCI by examining spared nervous tissue and the Basso, Beattie, and Bresnahan (BBB) scale to evaluate the functional outcome. Diffusive magnetic resonance imaging (MRI) was employed to measure the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) as non-invasive biomarkers of damage after SCI. RESULTS Fractional anisotropy decreased, whereas ADC increased in all groups after the lesion. There were significant differences in FA when compared with the SCI-PPy-I group versus the SCI group (p<.05). Significant positive correlations between BBB and FA (r2=0.449, p<.05) and between FA and preserved tissue (r2=0.395, p<.05) were observed, whereas significant negative associations between BBB and ADC (r2=0.367, p<.05) and between ADC and preserved tissue (r2=0.421, p<.05) were observed. CONCLUSIONS The results suggested that PPy-I is neuroprotective as it decreased the amount of damaged tissue while improving the motor function. Non-invasive MRI proved to be useful in the characterization of SCI and recovery.
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97
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Morales H. Letter from the Guest Editor: Spinal Cord Imaging II—Pediatrics and Advanced Techniques. Semin Ultrasound CT MR 2017; 38:97. [DOI: 10.1053/j.sult.2016.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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98
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Wang LL, Bierbrauer KS. Congenital and Hereditary Diseases of the Spinal Cord. Semin Ultrasound CT MR 2017; 38:105-125. [PMID: 28347415 DOI: 10.1053/j.sult.2016.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Congenital anomalies of the spinal cord can pose a diagnostic dilemma to the radiologist. Several classification systems of these anomalies exist. Antenatal ultrasound and fetal magnetic resonance imaging is playing an increasingly important role in the early diagnosis and management of patients. Understanding the underlying anatomy as well as embryology of these disorders can be valuable in correctly identifying the type of spinal cord dysraphic defect. Hereditary spinal cord diseases are rare but can be devastating. When the onset is in adulthood, delay in diagnosis is common. Although the spine findings are nonspecific, some imaging features combined with brain imaging findings can be distinctive. Sometimes, the radiologist may be the first to raise the possibility of these disorders.
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Affiliation(s)
- Lily L Wang
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH.
| | - Karin S Bierbrauer
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH
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99
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Cohen Y, Anaby D, Morozov D. Diffusion MRI of the spinal cord: from structural studies to pathology. NMR IN BIOMEDICINE 2017; 30:e3592. [PMID: 27598689 DOI: 10.1002/nbm.3592] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 06/01/2016] [Accepted: 07/05/2016] [Indexed: 05/27/2023]
Abstract
Diffusion MRI is extensively used to study brain microarchitecture and pathologies, and water diffusion appears highly anisotropic in the white matter (WM) of the spinal cord (SC). Despite these facts, the use of diffusion MRI to study the SC, which has increased in recent years, is much less common than that in the brain. In the present review, after a brief outline of early studies of diffusion MRI (DWI) and diffusion tensor MRI (DTI) of the SC, we provide a short survey on DTI and on diffusion MRI methods beyond the tensor that have been used to study SC microstructure and pathologies. After introducing the porous view of WM and describing the q-space approach and q-space diffusion MRI (QSI), we describe other methodologies that can be applied to study the SC. Selected applications of the use of DTI, QSI, and other more advanced diffusion MRI methods to study SC microstructure and pathologies are presented, with some emphasis on the use of less conventional diffusion methodologies. Because of length constraints, we concentrate on structural studies and on a few selected pathologies. Examples of the use of diffusion MRI to study dysmyelination, demyelination as in experimental autoimmune encephalomyelitis and multiple sclerosis, amyotrophic lateral sclerosis, and traumatic SC injury are presented. We conclude with a brief summary and a discussion of challenges and future directions for diffusion MRI of the SC. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Yoram Cohen
- The Sackler School of Chemistry, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
- The Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Debbie Anaby
- The Sackler School of Chemistry, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Darya Morozov
- The Sackler School of Chemistry, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
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100
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Spinal Diffusion Tensor Imaging in Evaluation of Preoperative and Postoperative Severity of Cervical Spondylotic Myelopathy: Systematic Review of Literature. World Neurosurg 2017; 99:150-158. [DOI: 10.1016/j.wneu.2016.11.141] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 11/26/2016] [Accepted: 11/28/2016] [Indexed: 11/20/2022]
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