Gaussian-Weighted Moving-Window Robust Automatic Threshold Selection. In: Petkov N, Westenberg MA, editors. Computer Analysis of Images and Patterns. Berlin: Springer Berlin Heidelberg; 2003. pp. 369-76. [DOI: 10.1007/978-3-540-45179-2_46]

Magnetic resonance measurement of muscle T2, fat-corrected T2 and fat fraction in the assessment of idiopathic inflammatory myopathies

OBJECTIVE

This study examines the utility of MRI, including T2 maps and T2 maps corrected for muscle fat content, in evaluating patients with idiopathic inflammatory myopathy.

METHODS

A total of 44 patients with idiopathic inflammatory myopathy, 18 of whom were evaluated after treatment with rituximab, underwent MRI of the thighs and detailed clinical assessment. T2, fat fraction (FF) and fat corrected T2 (fc-T2) maps were generated from standardized MRI scans, and compared with semi-quantitative scoring of short tau inversion recovery (STIR) and T1-weighted sequences, as well as various myositis disease metrics, including the Physician Global Activity, the modified Childhood Myositis Assessment Scale and the muscle domain of the Myositis Disease Activity Assessment Tool-muscle (MDAAT-muscle).

RESULTS

Mean T2 and mean fc-T2 correlated similarly with STIR scores (Spearman rs = 0.64 and 0.64, P < 0.01), while mean FF correlated with T1 damage scores (rs = 0.69, P < 0.001). Baseline T2, fc-T2 and STIR scores correlated significantly with the Physician Global Activity, modified Childhood Myositis Assessment Scale and MDAAT-muscle (rs range = 0.41-0.74, P < 0.01). The response of MRI measures to rituximab was variable, and did not significantly agree with a standardized clinical definition of improvement. Standardized response means for the MRI measures were similar.

CONCLUSION

Muscle T2, fc-T2 and FF measurements exhibit content validity with reference to semi-quantitative scoring of STIR and T1 MRI, and also exhibit construct validity with reference to several myositis activity and damage measures. T2 was as responsive as fc-T2 and STIR scoring, although progression of muscle damage was negligible during the study.

Segmentation and reconstruction of cerebral vessels from 3D rotational angiography for AVM embolization planning

Diagnosis and computer-guided therapy of cerebral Arterio-Venous Malformations (AVM) require an accurate understanding of the cerebral vascular network both from structural and biomechanical point of view. We propose to obtain such information by analyzing three Dimensional Rotational Angiography (3DRA) images. In this paper, we describe a two-step process allowing 1) the 3D automatic segmentation of cerebral vessels from 3DRA images using a region-growing based algorithm and 2) the reconstruction of the segmented vessels using the 3D constrained Delaunay Triangulation method. The proposed algorithm was successfully applied to reconstruct cerebral blood vessels from ten datasets of 3DRA images. This software allows the neuroradiologist to separately analyze cerebral vessels for pre-operative interventions planning and therapeutic decision making.

Fat-corrected T2 measurement as a marker of active muscle disease in inflammatory myopathy

OBJECTIVE

We sought to improve the utility of T2 measurement as a marker of active muscle disease in patients with idiopathic inflammatory myopathy by correcting for T2 prolongations caused by fatty replacement of muscle that accompnaies chronic muscle damage.

SUBJECTS AND METHODS

Twenty-one patients with idiopathic inflammatory myopathy underwent a standardized MRI evaluation of the thighs. Fat fraction maps were calculated from dual-echo gradient-echo images. Fat-corrected T2 maps were generated from multiecho spin-echo images on the basis of a biexponential model that incorporated voxelwise fat fraction estimates. Semiautomated summaries of conventional and fat-corrected muscle T2 values were compared with one another and with standardized visual scores of muscle disease based on T1-weighted spin-echo and STIR images.

RESULTS

Fat-corrected muscle T2 maps showed lower mean values and greater histogram entropy than conventional T2 maps, as analyzed over a standardized portion of the thigh muscles. Conventional and fat-corrected T2 values correlated with visual scores of active muscle disease on STIR images and with the varying intensity of disease depicted with STIR in focal muscle regions.

CONCLUSION

MRI T2 maps of muscle can be corrected for varying fat content by combining the information from chemical shift-sensitive gradient-echo and multiecho spin-echo images. Use of this strategy may prove useful in the study of idiopathic inflammatory myopathy and other diseases characterized by both muscle inflammation and atrophy.