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Li S, Fan Z, Guo J, Li D, Chen Z, Zhang X, Wang Y, Li Y, Yang G, Wang X. Compressed sensing 3D T2WI radiomics model: improving diagnostic performance in muscle invasion of bladder cancer. BMC Med Imaging 2024; 24:148. [PMID: 38886638 PMCID: PMC11181529 DOI: 10.1186/s12880-024-01318-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Preoperative discrimination between non-muscle-invasive bladder cancer (NMIBC) and the muscle invasive bladder cancer (MIBC) is a determinant of management. The purpose of this research is to employ radiomics to evaluate the diagnostic value in determining muscle invasiveness of compressed sensing (CS) accelerated 3D T2-weighted-SPACE sequence with high resolution and short acquisition time. METHODS This prospective study involved 108 participants who underwent preoperative 3D-CS-T2-weighted-SPACE, 3D-T2-weighted-SPACE and T2-weighted sequences. The cohort was divided into training and validation cohorts in a 7:3 ratio. In the training cohort, a Rad-score was constructed based on radiomic features selected by intraclass correlation coefficients, pearson correlation coefficient and least absolute shrinkage and selection operator . Multivariate logistic regression was used to develop a nomogram combined radiomics and clinical indices. In the validation cohort, the performances of the models were evaluated by ROC, calibration, and decision curves. RESULTS In the validation cohort, the area under ROC curve of 3D-CS-T2-weighted-SPACE, 3D-T2-weighted-SPACE and T2-weighted models were 0.87(95% confidence interval (CI):0.73-1.00), 0.79(95%CI:0.63-0.96) and 0.77(95%CI:0.60-0.93), respectively. The differences in signal-to-noise ratio and contrast-to-noise ratio between 3D-CS-T2-weighted-SPACE and 3D-T2-weighted-SPACE sequences were not statistically significant(p > 0.05). While the clinical model composed of three clinical indices was 0.74(95%CI:0.55-0.94) and the radiomics-clinical nomogram model was 0.88(95%CI:0.75-1.00). The calibration curves confirmed high goodness of fit, and the decision curve also showed that the radiomics model and combined nomogram model yielded higher net benefits than the clinical model. CONCLUSION The radiomics model based on compressed sensing 3D T2WI sequence, which was acquired within a shorter acquisition time, showed superior diagnostic efficacy in muscle invasion of bladder cancer. Additionally, the nomogram model could enhance the diagnostic performance.
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Affiliation(s)
- Shuo Li
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Zhichang Fan
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Junting Guo
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Ding Li
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Zeke Chen
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Xiaoyue Zhang
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Yongfang Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Yan Li
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Guoqiang Yang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Xiaochun Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China.
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Zhou L, Wu H, Luo G, Zhou H. Deep learning-based 3D cerebrovascular segmentation workflow on bright and black blood sequences magnetic resonance angiography. Insights Imaging 2024; 15:81. [PMID: 38517610 PMCID: PMC10959883 DOI: 10.1186/s13244-024-01657-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/18/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Cerebrovascular diseases have emerged as significant threats to human life and health. Effectively segmenting brain blood vessels has become a crucial scientific challenge. We aimed to develop a fully automated deep learning workflow that achieves accurate 3D segmentation of cerebral blood vessels by incorporating classic convolutional neural networks (CNNs) and transformer models. METHODS We used a public cerebrovascular segmentation dataset (CSD) containing 45 volumes of 1.5 T time-of-flight magnetic resonance angiography images. We collected data from another private middle cerebral artery (MCA) with lenticulostriate artery (LSA) segmentation dataset (MLD), which encompassed 3.0 T three-dimensional T1-weighted sequences of volumetric isotropic turbo spin echo acquisition MRI images of 107 patients aged 62 ± 11 years (42 females). The workflow includes data analysis, preprocessing, augmentation, model training with validation, and postprocessing techniques. Brain vessels were segmented using the U-Net, V-Net, UNETR, and SwinUNETR models. The model performances were evaluated using the dice similarity coefficient (DSC), average surface distance (ASD), precision (PRE), sensitivity (SEN), and specificity (SPE). RESULTS During 4-fold cross-validation, SwinUNETR obtained the highest DSC in each fold. On the CSD test set, SwinUNETR achieved the best DSC (0.853), PRE (0.848), SEN (0.860), and SPE (0.9996), while V-Net achieved the best ASD (0.99). On the MLD test set, SwinUNETR demonstrated good MCA segmentation performance and had the best DSC, ASD, PRE, and SPE for segmenting the LSA. CONCLUSIONS The workflow demonstrated excellent performance on different sequences of MRI images for vessels of varying sizes. This method allows doctors to visualize cerebrovascular structures. CRITICAL RELEVANCE STATEMENT A deep learning-based 3D cerebrovascular segmentation workflow is feasible and promising for visualizing cerebrovascular structures and monitoring cerebral small vessels, such as lenticulostriate arteries. KEY POINTS • The proposed deep learning-based workflow performs well in cerebrovascular segmentation tasks. • Among comparison models, SwinUNETR achieved the best DSC, ASD, PRE, and SPE values in lenticulostriate artery segmentation. • The proposed workflow can be used for different MR sequences, such as bright and black blood imaging.
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Affiliation(s)
- Langtao Zhou
- School of Cyberspace Security, Guangzhou University, Guangzhou, 510006, China
- Department of Radiology of the First Affiliated Hospital of the University of South China, Hengyang, 421001, China
| | - Huiting Wu
- Department of Radiology of the First Affiliated Hospital of the University of South China, Hengyang, 421001, China
| | - Guanghua Luo
- Department of Radiology of the First Affiliated Hospital of the University of South China, Hengyang, 421001, China.
| | - Hong Zhou
- Department of Radiology of the First Affiliated Hospital of the University of South China, Hengyang, 421001, China.
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Prasad Balasubramanian A, Kumar Kannath S, Thomas B, Enakshy Rajan J, Kesavadas C. Comparative study of non-contrast silent and time-of-flight magnetic resonance angiographic sequences in the evaluation of intracranial dural arteriovenous fistula. Clin Radiol 2024; 79:e393-e400. [PMID: 38182477 DOI: 10.1016/j.crad.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 06/02/2023] [Accepted: 11/21/2023] [Indexed: 01/07/2024]
Abstract
AIM To compare the performance of two non-contrast magnetic resonance angiography (MRA) sequences, silent MRA and time of flight (TOF) MRA, in the evaluation of intracranial dural arteriovenous fistula (DAVF). MATERIALS AND METHODS Forty consecutive patients with DAVF were enrolled and evaluated prospectively using silent MRA, TOF MRA, and digital subtraction angiography (DSA). The location, Cognard classification, arterial feeders, and venous drainage were evaluated. The therapeutic strategy and possible route were predicted on both silent and TOF MRA and these were compared with DSA during subsequent endovascular treatment. RESULTS Sensitivity and accuracy of silent and TOF MRA for localisation (96.4% versus 96% and 96% versus 95%, respectively) and classification (96% versus 94% and 96% versus 93.5%, respectively) were high. Silent MRA showed higher sensitivity than TOF MRA for arterial feeders and draining veins (87% versus 79% and 81.6% versus 67%). This improved to a sensitivity of 96.4% and 89% when prominent feeders were considered. The sensitivity and accuracy were 92.6% and 85.8% for immediate draining veins. Both silent and TOF MRA were accurate for therapeutic planning (96% versus 85%), although silent MRA was more accurate. CONCLUSION Silent MRA can more reliably evaluate the various angioarchtectural components of DAVF compared to TOF MRA.
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Affiliation(s)
- A Prasad Balasubramanian
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - S Kumar Kannath
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
| | - B Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - J Enakshy Rajan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - C Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Schubert T, Husain HS, Thurner P, Madjidyar J, Barnaure I, Piccirelli M, Klarhöfer M, Schmidt M, Speier P, Forman C, Kulcsar Z. Ultra-High-Resolution Time-of-Flight MR-Angiography for the Noninvasive Assessment of Intracranial Aneurysms, Alternative to Preinterventional DSA? Clin Neuroradiol 2023; 33:1115-1122. [PMID: 37401949 PMCID: PMC10654166 DOI: 10.1007/s00062-023-01320-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/29/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE The 3D time-of-flight (TOF) magnetic resonance angiography (MRA) at 3T shows high sensitivity for intracranial aneurysms but is inferior to three-dimensional digital subtraction angiography (3D-DSA) regarding aneurysm characteristics. We applied an ultra-high-resolution (UHR) TOF-MRA using compressed sensing reconstruction to investigate the diagnostic performance in preinterventional evaluation of intracranial aneurysms compared to conventional TOF-MRA and 3D-DSA. METHODS In this study 17 patients with unruptured intracranial aneurysms were included. Aneurysm dimensions, configuration, image quality and sizing of endovascular devices were compared between conventional TOF-MRA at 3T and UHR-TOF with 3D-DSA as gold standard. Quantitatively, contrast-to-noise ratios (CNR) were compared between TOF-MRAs. RESULTS On 3D-DSA, 25 aneurysms in 17 patients were detected. On conventional TOF, 23 aneurysms were detected (sensitivity: 92.6%). On UHR-TOF, 25 aneurysms were detected (sensitivity: 100%). Image quality was not significantly different between TOF and UHR-TOF (p = 0.17). Aneurysm dimension measurements were significantly different between conventional TOF (3.89 mm) and 3D-DSA (4.2 mm, p = 0.08) but not between UHR-TOF (4.12 mm) and 3D-DSA (p = 0.19). Irregularities and small vessels at the aneurysm neck were more frequently correctly depicted on UHR-TOF compared to conventional TOF. Comparison of the planned framing coil diameter and flow-diverter (FD) diameter revealed neither a statistically significant difference between TOF and 3D-DSA (coil p = 0.19, FD p = 0.45) nor between UHR-TOF and 3D-DSA (coil: p = 0.53, FD 0.33). The CNR was significantly higher in conventional TOF (p = 0.009). CONCLUSION In this pilot study, ultra-high-resolution TOF-MRA visualized all aneurysms and accurately depicted aneurysm irregularities and vessels at the base of the aneurysm comparably to DSA, outperforming conventional TOF. UHR-TOF with compressed sensing reconstruction seems to represent a non-invasive alternative to pre-interventional DSA for intracranial aneurysms.
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Affiliation(s)
- Tilman Schubert
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
| | - Hakim Shakir Husain
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
- Baby Memorial Hospital, Calicut, Kerala, India
- Parco Institute of Medical Sciences, Vatakara, Kerala, India
- Neo Hospital, Noida, Uttar Pradesh, India
| | - Patrick Thurner
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Jawid Madjidyar
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Isabelle Barnaure
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | - Zsolt Kulcsar
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
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Venkatesh R, Sharief S, Prashanti CVS, Reddy NG, Mangla R, Parmar Y, Anilkumar A, Yadav NK, Chhablani J. Aberrant filling of the retinal vein on fluorescein angiography in branch and hemi-central retinal artery occlusion. Eye (Lond) 2023; 37:2659-2663. [PMID: 36577803 PMCID: PMC10482961 DOI: 10.1038/s41433-022-02379-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 11/21/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To study aberrant filling of the retinal vessels on fluorescein angiography (FA) images in patients with branch (BRAO) or hemi-central retinal artery occlusions (hemi-CRAO) and correlate with associated changes on optical coherence tomography (OCT). METHODS Cases of acute BRAO or hemi-CRAO having FA and OCT images at presentation between June 2017 to May 2022 were included. Comparisons were made between the cases with and without aberrant filling of the retinal vessel. RESULTS Thirty-nine eyes of 39 patients with acute retinal artery occlusions underwent FA and OCT imaging. Seven of the ten cases with either BRAO or hemi-CRAO showed aberrant filling of the retinal vein on FA. No case with CRAO showed aberrant filling on FA. The cases with aberrant filling showed a better presenting visual acuity and lesser severity of retinal ischemia on OCT. Shunts between the retinal artery in the unaffected region and the retinal vein in the affected segment was seen in two eyes. The remaining five eyes showed no arteriovenous anastomosis. Cases with aberrant filling had a better visual function even at the last visit. CONCLUSION Aberrant retinal vein filling across the horizontal median raphe in the affected region in BRAO or hemi-CRAO eyes had less severity of retinal ischemia and better presenting and final visual acuities. Reduced perfusion in retinal capillaries with altered retinal vascular anatomy or arteriovenous shunts could be probable reasons for the development of this FA finding. Presence of aberrant filling of the retinal vein could indicate better final visual prognosis.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India.
| | - Shama Sharief
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Chitturi Venkata Sai Prashanti
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Nikitha Gurram Reddy
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
- Anand Bajaj Retina Institute, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Rubble Mangla
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Yash Parmar
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Aaditi Anilkumar
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, 203 Lothrop Street, Suite 800, Pittsburgh, PA, 15213, USA
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Panda A, Francois CJ, Bookwalter CA, Chaturvedi A, Collins JD, Leiner T, Rajiah PS. Non-Contrast Magnetic Resonance Angiography: Techniques, Principles, and Applications. Magn Reson Imaging Clin N Am 2023; 31:337-360. [PMID: 37414465 DOI: 10.1016/j.mric.2023.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Several non-contrast magnetic resonance angiography (MRA) techniques have been developed, providing an attractive alternative to contrast-enhanced MRA and a radiation-free alternative to computed tomography (CT) CT angiography. This review describes the physical principles, limitations, and clinical applications of bright-blood (BB) non-contrast MRA techniques. The principles of BB MRA techniques can be broadly divided into (a) flow-independent MRA, (b) blood-inflow-based MRA, (c) cardiac phase dependent, flow-based MRA, (d) velocity sensitive MRA, and (e) arterial spin-labeling MRA. The review also includes emerging multi-contrast MRA techniques that provide simultaneous BB and black-blood images for combined luminal and vessel wall evaluation.
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Affiliation(s)
- Ananya Panda
- Department of Radiology, All India Institute of Medical Sciences, Jodhpur, India
| | | | | | - Abhishek Chaturvedi
- Department of Radiology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Tim Leiner
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Abstract
Vessel wall MR imaging (VW-MRI) has been introduced into clinical practice and applied to a variety of diseases, and its usefulness has been reported. High-resolution VW-MRI is essential in the diagnostic workup and provides more information than other routine MR imaging protocols. VW-MRI is useful in assessing lesion location, morphology, and severity. Additional information, such as vessel wall enhancement, which is useful in the differential diagnosis of atherosclerotic disease and vasculitis could be assessed by this special imaging technique. This review describes the VW-MRI technique and its clinical applications in arterial disease, venous disease, vasculitis, and leptomeningeal disease.
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Vornetti G, Bartiromo F, Toni F, Dall’Olio M, Cirillo M, Speier P, Princiotta C, Schmidt M, Tonon C, Zacà D, Lodi R, Cirillo L. Follow-Up Assessment of Intracranial Aneurysms Treated with Endovascular Coiling: Comparison of Compressed Sensing and Parallel Imaging Time-of-Flight Magnetic Resonance Angiography. Tomography 2022; 8:1608-1617. [PMID: 35736881 PMCID: PMC9227072 DOI: 10.3390/tomography8030133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
The aim of our study was to compare compressed sensing (CS) time-of-flight (TOF) magnetic resonance angiography (MRA) with parallel imaging (PI) TOF MRA in the evaluation of patients with intracranial aneurysms treated with coil embolization or stent-assisted coiling. We enrolled 22 patients who underwent follow-up imaging after intracranial aneurysm coil embolization. All patients underwent both PI TOF and CS TOF MRA during the same examination. Image evaluation aimed to compare the performance of CS to PI TOF MRA in determining the degree of aneurysm occlusion, as well as the depiction of parent vessel and vessels adjacent to the aneurysm dome. The reference standard for the evaluation of aneurysm occlusion was PI TOF MRA. The inter-modality agreement between CS and PI TOF MRA in the evaluation of aneurysm occlusion was almost perfect (κ = 0.98, p < 0.001) and the overall inter-rater agreement was substantial (κ = 0.70, p < 0.001). The visualization of aneurysm parent vessel in CS TOF images compared with PI TOF images was evaluated to be better in 11.4%, equal in 86.4%, and worse in 2.3%. CS TOF MRA, with almost 70% scan time reduction with respect to PI TOF MRA, yields comparable results for assessing the occlusion status of coiled intracranial aneurysms. Short scan times increase patient comfort, reduce the risk of motion artifacts, and increase patient throughput, with a resulting reduction in costs. CS TOF MRA may therefore be a potential replacement for PI TOF MRA as a first-line follow-up examination in patients with intracranial aneurysms treated with coil embolization.
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Affiliation(s)
- Gianfranco Vornetti
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, 40139 Bologna, Italy; (G.V.);; (M.D.); (C.P.)
| | - Fiorina Bartiromo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, 40139 Bologna, Italy; (F.B.); (C.T.); (R.L.)
| | - Francesco Toni
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neuroradiologia con Tecniche ad Elevata Complessità, 40139 Bologna, Italy;
| | - Massimo Dall’Olio
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, 40139 Bologna, Italy; (G.V.);; (M.D.); (C.P.)
| | - Mario Cirillo
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate, Università della Campania "Luigi Vanvitelli", 81100 Napoli, Italy;
| | - Peter Speier
- Siemens Healthineers, 91052 Erlangen, Germany; (P.S.); (M.S.); (D.Z.)
| | - Ciro Princiotta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, 40139 Bologna, Italy; (G.V.);; (M.D.); (C.P.)
| | - Michaela Schmidt
- Siemens Healthineers, 91052 Erlangen, Germany; (P.S.); (M.S.); (D.Z.)
| | - Caterina Tonon
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, 40139 Bologna, Italy; (F.B.); (C.T.); (R.L.)
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40138 Bologna, Italy
| | - Domenico Zacà
- Siemens Healthineers, 91052 Erlangen, Germany; (P.S.); (M.S.); (D.Z.)
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, 40139 Bologna, Italy; (F.B.); (C.T.); (R.L.)
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40138 Bologna, Italy
| | - Luigi Cirillo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, 40139 Bologna, Italy; (G.V.);; (M.D.); (C.P.)
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40138 Bologna, Italy
- Correspondence:
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Sakata A, Sakamoto R, Fushimi Y, Nakajima S, Hinoda T, Oshima S, Wetzl J, Schmidt M, Okawa M, Yoshida K, Miyamoto S, Nakamoto Y. Low-dose contrast-enhanced time-resolved angiography with stochastic trajectories with iterative reconstruction (IT-TWIST-MRA) in brain arteriovenous shunt. Eur Radiol 2022; 32:5392-5401. [PMID: 35298680 DOI: 10.1007/s00330-022-08678-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the feasibility of low-dose contrast-enhanced four-dimensional (4D) time-resolved angiography with stochastic trajectories (TWIST) with iterative reconstruction (hereafter IT-TWIST-MRA) covering the whole brain and to compare IT-TWIST-MRA and TWIST-MRA with reference to digital subtraction angiography (DSA) in the evaluation of arteriovenous shunts (AVS). METHODS Institutional Review Board approval was obtained for this observational study, and the requirement for written informed consent was waived. Twenty-nine patients with known AVS underwent TWIST-MRA on a 3-T MRI scanner, using low-dose injection (0.02 mmol/kg) of gadolinium-based contrast agent (GBCA) with each of Fourier and iterative reconstruction between September 2016 and October 2019. Visual evaluation of image quality was conducted for delineation of (a) the normal cerebral arteries and veins and (b) AVS feeder, shunt, and drainer vessels. Region-of-interest evaluation was conducted to evaluate bolus sharpness and baseline signal fluctuation in the signal intensity of the cerebral vessels. We compared the detection of AVS between TWIST-MRA and IT-TWIST-MRA. The paired-samples Wilcoxon test was used to test the differences between TWIST-MRA and IT-TWIST-MRA. RESULTS Visualization scores for normal vasculature and AVS angioarchitecture were significantly better for images produced using IT-TWIST-MRA than those using TWIST-MRA. Peak signal and the enhancement slope of the time-intensity curve were significantly higher for IT-TWIST-MRA than for TWIST-MRA, except for the superior sagittal sinus (SSS). Baseline intensity fluctuation was significantly lower for IT-TWIST-MRA than for TWIST, except for SSS. CONCLUSIONS IT-TWIST-MRA yields clinically feasible 4D MR-DSA images and delineates AVS even with low-dose GBCA. KEY POINTS • Iterative reconstruction significantly improves the image quality of TWIST-MRA covering the whole brain. • The short temporal footprint and denoising effect of iterative reconstruction enhances the quality of 4D-MRA. • IT-TWIST-MRA yields clinically feasible images of AVS with low-dose GBCA.
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Affiliation(s)
- Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sonoko Oshima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Jens Wetzl
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Michaela Schmidt
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Masakazu Okawa
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Cummins DD, Caton MT, Shah V, Meisel K, Glastonbury C, Amans MR. MRI and MR angiography evaluation of pulsatile tinnitus: A focused, physiology-based protocol. J Neuroimaging 2022; 32:253-263. [PMID: 34910345 PMCID: PMC8917066 DOI: 10.1111/jon.12955] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE Pulsatile tinnitus (PT) is the subjective sensation of a pulse-synchronous sound, most often due to a cerebrovascular etiology. PT can severely impact quality of life and may indicate a life-threatening process, yet a timely and accurate diagnosis can often lead to effective treatment. Clinical assessment with a history and physical examination can often suggest a diagnosis for PT, but is rarely definitive. Therefore, PT should be evaluated with a comprehensive and targeted radiographic imaging protocol. MR imaging provides a safe and effective means to evaluate PT. Specific MR sequences may be used to highlight different elements of cerebrovascular anatomy and physiology. However, routine MR evaluation of PT must comply with economic and practical constraints, while effectively capturing both common and rarer, life-threatening etiologies of PT. METHODS In this state-of-the-art review, we describe our institutional MR protocol for evaluating PT. RESULTS This protocol includes the following dedicated sequences: time-of-flight magnetic resonance angiography; arterial spin labeling; spoiled gradient recalled acquisition in the steady state; time-resolved imaging of contrast kinetics; diffusion weighted imaging, and 3-dimensional fluid-attenuated inversion recovery. CONCLUSIONS We describe the physiologic and clinical rationale for including each MR sequence in a comprehensive PT imaging protocol, and detail the role of MR within the broader evaluation of PT, from clinical presentation to treatment.
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Affiliation(s)
- Daniel D. Cummins
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Michael T. Caton
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Vinil Shah
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Karl Meisel
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Christine Glastonbury
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Matthew R. Amans
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA,Corresponding author: Matthew R. Amans, Address: 505 Parnassus Ave, Room L349, San Francisco, CA 94143, Telephone: 415-353-1863, Fax: 415-353-8606,
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