Improving MRI differentiation of gray and white matter in epileptogenic lesions based on nonlinear feedback

Improving Long-Term Outcomes After Extracorporeal Membrane Oxygenation: From Observational Follow-Up Programs Toward Risk Stratification

Since the introduction of extracorporeal membrane oxygenation (ECMO), more neonates and children with cardiorespiratory failure survive. Interest has therefore shifted from reduction of mortality toward evaluation of long-term outcomes and prevention of morbidity. This review addresses the changes in ECMO population and the ECMO-treatment that may affect long-term outcomes, the diagnostic modalities to evaluate neurological morbidities and their contributions to prognostication of long-term outcomes. Most follow-up data have only become available from observational follow-up programs in neonatal ECMO-survivors. The main topics are discussed in this review. Recommendations for long-term follow up depend on the presence of neurological comorbidity, the nature and extent of the underlying disease, and the indication for ECMO. Follow up should preferably be offered as standard of care, and in an interdisciplinary, structured and standardized way. This permits evaluation of outcome data and effect of interventions. We propose a standardized approach and recommend that multiple domains should be evaluated during long-term follow up of neonates and children who needed extracorporeal life support.

Multi-chromatic magnetic resonance imaging using frequency lock-in suppression

This study developed a multi-chromatic MR contrast using the frequency lock-in technique. An electronic feedback device that generates a specific narrow-frequency-bandwidth RF field is presented. The effects of this RF field on MR images are assessed both theoretically and experimentally. Spectroscopy and imaging experiments were performed. Frequency tuning allowed the selected spectral peak to be suppressed. Phantom tests using methanol, ethanol, and water showed different contrasts using different feedback RF field frequencies. The frequency lock-in was also found to help differentiate among the small structural variations in biological tissues. The contrast achieved in in vivo mouse brain imaging using the lock-in suppressed technique indicated a better spatial discrimination when compared with that achieved using conventional imaging methods, especially in the hippocampus region. Selective lock-in suppressed imaging is a new approach to provide frequency information in MRI; rather than determining the evolution of image contrast over time, this approach allows small susceptibility variations to be distinguished by tuning the frequency of the narrow-bandwidth lock-in RF field. A new and enhanced contrast can be achieved using this technique.

Sensitivity Enhancement of an Inductively Coupled Local Detector Using a HEMT-Based Current Amplifier

PURPOSE

To improve the signal transmission efficiency and sensitivity of a local detection coil that is weakly inductively coupled to a larger receive coil.

METHODS

The resonant detection coil is connected in parallel with the gate of a high electron mobility transistor (HEMT) transistor without impedance matching. When the drain of the transistor is capacitively shunted to ground, current amplification occurs in the resonator by feedback that transforms a capacitive impedance on the transistor's source to a negative resistance on its gate.

RESULTS

High resolution images were obtained from a mouse brain using a small, 11 mm diameter surface coil that was inductively coupled to a commercial, phased array chest coil. Although the power consumption of the amplifier was only 88 μW, 14 dB gain was obtained with excellent noise performance.

CONCLUSION

An integrated current amplifier based on a HEMT can enhance the sensitivity of inductively coupled local detectors when weakly coupled. This amplifier enables efficient signal transmission between customized user coils and commercial clinical coils, without the need for a specialized signal interface. Magn Reson Med 75:2573-2578, 2016. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Sensitive imaging of magnetic nanoparticles for cancer detection by active feedback MR

PURPOSE

Sensitive imaging of superparamagnetic nanoparticles or aggregates is of great importance in MR molecular imaging and medical diagnosis. For this purpose, a conceptually new approach, termed active feedback magnetic resonance, was developed.

METHODS

In the presence of the Zeeman field, a dipolar field is induced by the superparamagnetic nanoparticles or aggregates. Such dipolar field creates spatial and temporal (due to water diffusion) variations to the precession frequency of the nearby water ¹ H magnetization. Sensitive imaging of magnetic nanoparticles or aggregates can be achieved by manipulating the intrinsic spin dynamics by selective self-excitation and fixed-point dynamics under active feedback fields.

RESULTS

Phantom experiments of superparamagnetic nanoparticles; in vitro experiments of brain tissue with blood clots; and in vivo mouse images of colon cancers, with and without labeling by magnetic nanoparticles, suggest that this new approach provides enhanced, robust, and positive contrast in imaging magnetic nanoparticles or aggregates for cancer detection.

CONCLUSION

The spin dynamics originated from selective self-excitation and fixed-point dynamics under active feedback fields have been shown to be sensitive to dipolar fields generated by magnetic nanoparticles. Magn Reson Med 74:33-41, 2015. © 2014 Wiley Periodicals, Inc.

Novel MRI contrast development by lock-in suppression

PURPOSE

The goal of this study is to develop novel MR contrast by frequency lock-in technique.

METHODS

An electronic feedback device that can control the frequency and bandwidth of the feedback RF field is presented. In this study, the effects of lock-in suppressed imaging are discussed both theoretically and experimentally.

RESULTS

Two important imaging experiments were performed. The first experiment used magnetizations with the same central frequency but different frequency distributions and was compared with MR images obtained with T2 contrast agents. Lock-in suppressed images showed an improvement in contrast relative to the conventional imaging method. The second experiment used magnetizations with small shifts in frequency and a broad frequency distribution. This is helpful for differentiating between small structural variations in biological tissues. The contrast achieved in in vivo tumor imaging using the lock-in suppressed technique provide higher spatial resolutions and discriminate the regimes of necrosis and activation consistent with pathologic results.

CONCLUSION

Lock-in suppressed imaging introduces a conceptually new approach to MRI. Heightened sensitivity to underlying susceptibility variations and their relative contribution to total magnetization may thus be achieved to yield new and enhanced contrast.

Etiology associated with developing posthemispherectomy hydrocephalus after resection-disconnection procedures

OBJECT

The authors sought to determine if clinical epilepsy variables, maximum daily temperature (Tmax), and blood and CSF findings were associated with the risk of developing hydrocephalus after first-time resection-disconnection hemispherectomy.

METHODS

Patients who underwent cerebral hemispherectomy in whom a standardized perioperative protocol was used, including the use of ventriculostomies (n = 79), were classified into those who developed and those who did not develop hydrocephalus requiring CSF shunts. The authors compared these 2 groups for clinical variables, Tmax, and blood and CSF studies through postoperative Day 12.

RESULTS

In this cohort, 30% of the patients required CSF shunts, of which 8% developed late hydrocephalus up to 3 years posthemispherectomy. Multivariate analysis found that etiology was associated with developing posthemispherectomy hydrocephalus. Higher shunt rates were observed for patients with hemimegalencephaly (40%; n = 15) and a history of CNS infection (100%; n = 4) compared with cortical dysplasia (17%; n = 23) and Rasmussen encephalitis (17%; n = 12). In univariate analysis, other factors associated with developing hydrocephalus were elevated maximum daily temperatures, elevated white blood cell counts, decreased CSF protein, and increased CSF red blood cell counts.

CONCLUSIONS

The findings of the study indicate that etiology was the factor most strongly associated with developing posthemispherectomy hydrocephalus. These findings suggest that there are variable mechanisms for developing hydrocephalus after cerebral hemispherectomy depending on the procedure, and in resection-disconnection operations the mechanism may involve changes in CSF bulk flow that varies by histopathology.

Total compensation of pulse transients inside a resonator

The profile of rf pulses that nuclear spins experience inside a resonator deviates from that of rf voltage signals generated by a NMR spectrometer according to users' pulse programming, when change of the profile in time is comparable to or shorter than the time constant of the resonator. In our previous work [Takeda et al., J. Magn. Reson. 197 (2009) 242-244], we proposed active compensation of rf pulse transients, in which the amplitude transient of the rf pulse can be suppressed without sacrificing the Q factor of the probe. Here we extend the idea of active compensation toward total compensation of the amplitude as well as phase transients. By measuring the transient response of the probe to a given excitation using a pickup coil, the response function determining the transient behavior of the probe is numerically obtained. Then, by numerically solving the convolution equation with the help of Laplace transformation, one can obtain the amplitude and phase profiles of the pulse that should be programmed in the spectrometer in order to apply the rf pulses to the nuclear spins as intended. Accurate rf pulsing based on this idea is experimentally demonstrated, and prospect and requirements for coping with the receiver dead-time problem are discussed.

Accelerated radiation damping for increased spin equilibrium (ARISE): a new method for controlling the recovery of longitudinal magnetization

Control of the longitudinal magnetization in fast gradient-echo (GRE) sequences is an important factor in enabling the high efficiency of balanced steady-state free precession (bSSFP) sequences. We introduce a new method for accelerating the return of the longitudinal magnetization to the +z-axis that is independent of externally applied RF pulses and shows improved off-resonance performance. The accelerated radiation damping for increased spin equilibrium (ARISE) method uses an external feedback circuit to strengthen the radiation damping (RD) field. The enhanced RD field rotates the magnetization back to the +z-axis at a rate faster than T(1) relaxation. The method is characterized in GRE phantom imaging at 3T as a function of feedback gain, phase, and duration, and compared with results from numerical simulations of the Bloch equations incorporating RD. A short period of feedback (10 ms) during a refocused interval of a crushed GRE sequence allowed greater than 99% recovery of the longitudinal magnetization when very little T(2) relaxation had time to occur. An appropriate application might be to improve navigated sequences. Unlike conventional flip-back schemes, the ARISE "flip-back" is generated by the spins themselves, thereby offering a potentially useful building block for enhancing GRE sequences.

T1 relaxation in in vivo mouse brain at ultra-high field

Accurate knowledge of relaxation times is imperative for adjustment of MRI parameters to obtain optimal signal-to-noise ratio (SNR) and contrast. As small animal MRI studies are extended to increasingly higher magnetic fields, these parameters must be assessed anew. The goal of this study was to obtain accurate spin-lattice (T(1)) relaxation times for the normal mouse brain at field strengths of 9.4 and 17.6 T. T(1) relaxation times were determined for cortex, corpus callosum, caudate putamen, hippocampus, periaqueductal gray, lateral ventricle, and cerebellum and varied from 1651 +/- 28 to 2449 +/- 150 ms at 9.4 T and 1824 +/- 101 to 2772 +/- 235 ms at 17.6 T. A field strength-dependent increase of T(1) relaxation times is shown. The SNR increase at 17.6 T is in good agreement with the expected SNR increase for a sample-dominated noise regime.

Designing feedback-based contrast enhancement for in vivo imaging

OBJECTIVE

Nonlinear feedback interactions induced by the spins themselves have recently been introduced as novel MRI contrast enhancement mechanisms sensitive to small differences in MR parameters. Developing feedback-based contrast enhancement into a useful tool for in vivo imaging requires improved techniques that are robust to inhomogeneity and sensitive to subtle anatomical/physiological variations.

MATERIALS AND METHODS

Three different imaging methods combining the radiation damping feedback field with the distant dipolar field, applied radio-frequency (RF) fields, and local dipole fields, respectively, were designed and tested through numerical simulations on simple phantoms. These methods were demonstrated experimentally on live guppy fish, developing frog embryos, and blood in in vitro tissue samples by microimaging at 14.1 T.

RESULTS

The developed feedback-based methods yielded images that identified distinct morphological features with superior contrast compared with conventional MR images and those acquired under radiation damping only. Positive contrast due to evolution under radiation damping and local dipole fields was also observed in SPIOs and blood.

CONCLUSION

Approaches to enhancing feedback-based contrast were successfully designed and demonstrated in vitro and in vivo. The newly devised methods were less sensitive to field inhomogeneity and prolonged evolution under the feedback fields, allowing for better visualization of contrast in vivo.