Automated three-dimensional registration of magnetic resonance and positron emission tomography brain images by multiresolution optimization of voxel similarity measures

Assessment of neurovascular uncoupling: APOE status is a key driver of early metabolic and vascular dysfunction

BACKGROUND

Alzheimer's disease (AD) is the most common cause of dementia worldwide, with apolipoprotein Eε4 (APOEε4) being the strongest genetic risk factor. Current clinical diagnostic imaging focuses on amyloid and tau; however, new methods are needed for earlier detection.

METHODS

PET imaging was used to assess metabolism-perfusion in both sexes of aging C57BL/6J, and hAPOE mice, and were verified by transcriptomics, and immunopathology.

RESULTS

All hAPOE strains showed AD phenotype progression by 8 months, with females exhibiting the regional changes, which correlated with GO-term enrichments for glucose metabolism, perfusion, and immunity. Uncoupling analysis revealed APOEε4/ε4 exhibited significant Type-1 uncoupling (↓ glucose uptake, ↑ perfusion) at 8 and 12 months, while APOEε3/ε4 demonstrated Type-2 uncoupling (↑ glucose uptake, ↓ perfusion), while immunopathology confirmed cell specific contributions.

DISCUSSION

This work highlights APOEε4 status in AD progression manifests as neurovascular uncoupling driven by immunological activation, and may serve as an early diagnostic biomarker.

HIGHLIGHTS

We developed a novel analytical method to analyze PET imaging of 18F-FDG and 64Cu-PTSM data in both sexes of aging C57BL/6J, and hAPOEε3/ε3, hAPOEε4/ε4, and hAPOEε3/ε4 mice to assess metabolism-perfusion profiles termed neurovascular uncoupling. This analysis revealed APOEε4/ε4 exhibited significant Type-1 uncoupling (decreased glucose uptake, increased perfusion) at 8 and 12 months, while APOEε3/ε4 demonstrated significant Type-2 uncoupling (increased glucose uptake, decreased perfusion) by 8 months which aligns with immunopathology and transcriptomic signatures. This work highlights that there may be different mechanisms underlying age related changes in APOEε4/ε4 compared with APOEε3/ε4. We predict that these changes may be driven by immunological activation and response, and may serve as an early diagnostic biomarker.

MRI atlas of the pituitary gland in young female adults

The probabilistic topography and inter-individual variability of the pituitary gland (PG) remain undetermined. The absence of a standardized reference atlas hinders research on PG volumetrics. In this study, we aimed at creating maximum probability maps for the anterior and posterior PG in young female adults. We manually delineated the anterior and posterior parts of the pituitary glands in 26 healthy subjects using high-resolution MRI T1 images. A three-step procedure and a cost function-masking approach were employed to optimize spatial normalization for the PG. We generated probabilistic atlases and maximum probability maps, which were subsequently coregistered back to the subjects' space and compared to manual delineations. Manual measurements led to a total pituitary volume of 705 ± 88 mm³, with the anterior and posterior volumes measuring 614 ± 82 mm³ and 91 ± 20 mm³, respectively. The mean relative volume difference between manual and atlas-based estimations was 1.3%. The global pituitary atlas exhibited an 80% (± 9%) overlap for the DICE index and 67% (± 11%) for the Jaccard index. Similarly, these values were 77% (± 13%) and 64% (± 14%) for the anterior pituitary atlas and 62% (± 21%) and 47% (± 17%) for the posterior PG atlas, respectively. We observed a substantial concordance and a significant correlation between the volume estimations of the manual and atlas-based methods for the global pituitary and anterior volumes. The maximum probability maps of the anterior and posterior PG lay the groundwork for automatic atlas-based segmentation methods and the standardized analysis of large PG datasets.

Assessment of Neurovascular Uncoupling: APOE Status is a Key Driver of Early Metabolic and Vascular Dysfunction

BACKGROUND

Alzheimer's disease (AD) is the most common cause of dementia worldwide, with apolipoprotein ε4 (APOEε4) being the strongest genetic risk factor. Current clinical diagnostic imaging focuses on amyloid and tau; however, new methods are needed for earlier detection.

METHODS

PET imaging was used to assess metabolism-perfusion in both sexes of aging C57BL/6J, and hAPOE mice, and were verified by transcriptomics, and immunopathology.

RESULTS

All hAPOE strains showed AD phenotype progression by 8 mo, with females exhibiting the regional changes, which correlated with GO-term enrichments for glucose metabolism, perfusion, and immunity. Uncoupling analysis revealed APOEε4/ε4 exhibited significant Type-1 uncoupling (↓ glucose uptake, ↑ perfusion) at 8 and 12 mo, while APOEε3/ε4 demonstrated Type-2 uncoupling (↑ glucose uptake, ↓ perfusion), while immunopathology confirmed cell specific contributions.

DISCUSSION

This work highlights APOEε4 status in AD progression manifest as neurovascular uncoupling driven by immunological activation, and may serve as an early diagnostic biomarker.

All-optical interrogation of brain-wide activity in freely swimming larval zebrafish

We introduce an all-optical technique that enables volumetric imaging of brain-wide calcium activity and targeted optogenetic stimulation of specific brain regions in unrestrained larval zebrafish. The system consists of three main components: a 3D tracking module, a dual-color fluorescence imaging module, and a real-time activity manipulation module. Our approach uses a sensitive genetically encoded calcium indicator in combination with a long Stokes shift red fluorescence protein as a reference channel, allowing the extraction of Ca2+ activity from signals contaminated by motion artifacts. The method also incorporates rapid 3D image reconstruction and registration, facilitating real-time selective optogenetic stimulation of different regions of the brain. By demonstrating that selective light activation of the midbrain regions in larval zebrafish could reliably trigger biased turning behavior and changes of brain-wide neural activity, we present a valuable tool for investigating the causal relationship between distributed neural circuit dynamics and naturalistic behavior.

Identifying sex-specific risk architectures for predicting amyloid deposition using neural networks

In older adults without dementia, White Matter Hyperintensities (WMH) in MRI have been shown to be highly associated with cerebral amyloid deposition, measured by the Pittsburgh compound B (PiB) PET. However, the relation to age, sex, and education in explaining this association is not well understood. We use the voxel counts of regional WMH, age, one-hot encoded sex, and education to predict the regional PiB using a multilayer perceptron with only rectilinear activations using mean squared error. We then develop a novel, robust metric to understand the relevance of each input variable for prediction. Our observations indicate that sex is the most relevant predictor of PiB and that WMH is not relevant for prediction. These results indicate that there is a sex-specific risk architecture for Aβ deposition.

Quantifying the Growth of Glioblastoma Tumors Using Multimodal MRI Brain Images

Predicting the eventual volume of tumor cells, that might proliferate from a given tumor, can help in cancer early detection and medical procedure planning to prevent their migration to other organs. In this work, a new statistical framework is proposed using Bayesian techniques for detecting the eventual volume of cells expected to proliferate from a glioblastoma (GBM) tumor. Specifically, the tumor region was first extracted using a parallel image segmentation algorithm. Once the tumor region was determined, we were interested in the number of cells that could proliferate from this tumor until its survival time. For this, we constructed the posterior distribution of the tumor cell numbers based on the proposed likelihood function and a certain prior volume. Furthermore, we extended the detection model and conducted a Bayesian regression analysis by incorporating radiomic features to discover those non-tumor cells that remained undetected. The main focus of the study was to develop a time-independent prediction model that could reliably predict the ultimate volume a malignant tumor of the fourth-grade severity could attain and which could also determine if the incorporation of the radiomic properties of the tumor enhanced the chances of no malignant cells remaining undetected.

SPECT and CT misregistration reduction in [99mTc]Tc-MAA SPECT/CT for precision liver radioembolization treatment planning

PURPOSE

Respiration and body movement induce misregistration between static [99mTc]Tc-MAA SPECT and CT, causing lung shunting fraction (LSF) and tumor-to-normal liver ratio (TNR) errors for 90Y radioembolization planning. We aim to alleviate the misregistration between [99mTc]Tc-MAA SPECT and CT using two registration schemes on simulation and clinical data.

METHODS

In the simulation study, 70 XCAT phantoms were modeled. The SIMIND Monte Carlo program and OS-EM algorithm were used for projection generation and reconstruction, respectively. Low-dose CT (LDCT) at end-inspiration was simulated for attenuation correction (AC), lungs and liver segmentation, while contrast-enhanced CT (CECT) was simulated for tumor and perfused liver segmentation. In the clinical study, 16 patient data including [99mTc]Tc-MAA SPECT/LDCT and CECT with observed SPECT and CT mismatch were analyzed. Two liver-based registration schemes were studied: SPECT registered to LDCT/CECT and vice versa. Mean count density (MCD) of different volumes-of-interest (VOIs), normalized mutual information (NMI), LSF, TNR, and maximum injected activity (MIA) based on the partition model before and after registration were compared. Wilcoxon signed-rank test was performed.

RESULTS

In the simulation study, compared to before registration, registrations significantly reduced estimation errors of MCD of all VOIs, LSF (Scheme 1: - 100.28%, Scheme 2: - 101.59%), and TNR (Scheme 1: - 7.00%, Scheme 2: - 5.67%), as well as MIA (Scheme 1: - 3.22%, Scheme 2: - 2.40%). In the clinical study, Scheme 1 reduced 33.68% LSF and increased 14.75% TNR, while Scheme 2 reduced 38.88% LSF and increased 6.28% TNR compared to before registration. One patient may change from 90Y radioembolization untreatable to treatable and other patients may change the MIA up to 25% after registration. NMI between SPECT and CT was significantly increased after registrations in both studies.

CONCLUSION

Registration between static [99mTc]Tc-MAA SPECT and corresponding CTs is feasible to reduce their spatial mismatch and improve dosimetric estimation. The improvement of LSF is larger than TNR. Our method can potentially improve patient selection and personalized treatment planning for liver radioembolization.

Comparisons of healthy human brain temperature predicted from biophysical modeling and measured with whole brain MR thermometry

Brain temperature is an understudied parameter relevant to brain injury and ischemia. To advance our understanding of thermal dynamics in the human brain, combined with the challenges of routine experimental measurements, a biophysical modeling framework was developed to facilitate individualized brain temperature predictions. Model-predicted brain temperatures using our fully conserved model were compared with whole brain chemical shift thermometry acquired in 30 healthy human subjects (15 male and 15 female, age range 18-36 years old). Magnetic resonance (MR) thermometry, as well as structural imaging, angiography, and venography, were acquired prospectively on a Siemens Prisma whole body 3 T MR scanner. Bland-Altman plots demonstrate agreement between model-predicted and MR-measured brain temperatures at the voxel-level. Regional variations were similar between predicted and measured temperatures (< 0.55 °C for all 10 cortical and 12 subcortical regions of interest), and subcortical white matter temperatures were higher than cortical regions. We anticipate the advancement of brain temperature as a marker of health and injury will be facilitated by a well-validated computational model which can enable predictions when experiments are not feasible.

Prophylactic evaluation of verubecestat on disease- and symptom-modifying effects in 5XFAD mice

Introduction

Alzheimer's disease (AD) is the most common form of dementia. Beta-secretase (BACE) inhibitors have been proposed as potential therapeutic interventions; however, initiating treatment once disease has significantly progressed has failed to effectively stop or treat disease. Whether BACE inhibition may have efficacy when administered prophylactically in the early stages of AD has been under-investigated. The present studies aimed to evaluate prophylactic treatment of the BACE inhibitor verubecestat in an AD mouse model using the National Institute on Aging (NIA) resources of the Model Organism Development for Late-Onset Alzheimer's Disease (MODEL-AD) Preclinical Testing Core (PTC) Drug Screening Pipeline.

Methods

5XFAD mice were administered verubecestat ad libitum in chow from 3 to 6 months of age, prior to the onset of significant disease pathology. Following treatment (6 months of age), in vivo imaging was conducted with 18F-florbetapir (AV-45/Amyvid) (18F-AV45) and 18-FDG (fluorodeoxyglucose)-PET (positron emission tomography)/MRI (magnetic resonance imaging), brain and plasma amyloid beta (Aβ) were measured, and the clinical and behavioral characteristics of the mice were assessed and correlated with the pharmacokinetic data.

Results

Prophylactic verubecestat treatment resulted in dose- and region-dependent attenuations of 18F-AV45 uptake in male and female 5XFAD mice. Plasma Aβ40 and Aβ42 were also dose-dependently attenuated with treatment. Across the dose range evaluated, side effects including coat color changes and motor alterations were reported, in the absence of cognitive improvement or changes in 18F-FDG uptake.

Discussion

Prophylactic treatment with verubecestat resulted in attenuated amyloid plaque deposition when treatment was initiated prior to significant pathology in 5XFAD mice. At the same dose range effective at attenuating Aβ levels, verubecestat produced side effects in the absence of improvements in cognitive function. Taken together these data demonstrate the rigorous translational approaches of the MODEL-AD PTC for interrogating potential therapeutics and provide insight into the limitations of verubecestat as a prophylactic intervention for early-stage AD.

PLOSL: Population learning followed by one shot learning pulmonary image registration using tissue volume preserving and vesselness constraints

This paper presents the Population Learning followed by One Shot Learning (PLOSL) pulmonary image registration method. PLOSL is a fast unsupervised learning-based framework for 3D-CT pulmonary image registration algorithm based on combining population learning (PL) and one-shot learning (OSL). The PLOSL image registration has the advantages of the PL and OSL approaches while reducing their respective drawbacks. The advantages of PLOSL include improved performance over PL, substantially reducing OSL training time and reducing the likelihood of OSL getting stuck in local minima. PLOSL pulmonary image registration uses tissue volume preserving and vesselness constraints for registration of inspiration-to-expiration and expiration-to-inspiration pulmonary CT images. A coarse-to-fine convolution encoder-decoder CNN architecture is used to register large and small shape features. During training, the sum of squared tissue volume difference (SSTVD) compensates for intensity differences between inspiration and expiration computed tomography (CT) images and the sum of squared vesselness measure difference (SSVMD) helps match the lung vessel tree. Results show that the PLOSL (SSTVD+SSVMD) algorithm achieved subvoxel landmark error while preserving pulmonary topology on the SPIROMICS data set, the public DIR-LAB COPDGene and 4DCT data sets.

Plcg2M28L Interacts With High Fat/High Sugar Diet to Accelerate Alzheimer’s Disease-Relevant Phenotypes in Mice

Obesity is recognized as a significant risk factor for Alzheimer’s disease (AD). Studies have supported the notion that obesity accelerates AD-related pathophysiology in mouse models of AD. The majority of studies, to date, have focused on the use of early-onset AD models. Here, we evaluate the impact of genetic risk factors on late-onset AD (LOAD) in mice fed with a high fat/high sugar diet (HFD). We focused on three mouse models created through the IU/JAX/PITT MODEL-AD Center. These included a combined risk model with APOE4 and a variant in triggering receptor expressed on myeloid cells 2 (Trem2^R47H). We have termed this model, LOAD1. Additional variants including the M28L variant in phospholipase C Gamma 2 (Plcg2^M28L) and the 677C > T variant in methylenetetrahydrofolate reductase (Mthfr^{677C >T}) were engineered by CRISPR onto LOAD1 to generate LOAD1.Plcg2^M28L and LOAD1.Mthfr^{677C >T}. At 2 months of age, animals were placed on an HFD that induces obesity or a control diet (CD), until 12 months of age. Throughout the study, blood was collected to assess the levels of cholesterol and glucose. Positron emission tomography/computed tomography (PET/CT) was completed prior to sacrifice to image for glucose utilization and brain perfusion. After the completion of the study, blood and brains were collected for analysis. As expected, animals fed a HFD, showed a significant increase in body weight compared to those fed a CD. Glucose increased as a function of HFD in females only with cholesterol increasing in both sexes. Interestingly, LOAD1.Plcg2^M28L demonstrated an increase in microglia density and alterations in regional brain glucose and perfusion on HFD. These changes were not observed in LOAD1 or LOAD1.Mthfr^{677C >T} animals fed with HFD. Furthermore, LOAD1.Plcg2^M28L but not LOAD1.Mthfr^{677C >T} or LOAD1 animals showed transcriptomics correlations with human AD modules. Our results show that HFD affects the brain in a genotype-specific manner. Further insight into this process may have significant implications for the development of lifestyle interventions for the treatment of AD.

VMAT2 availability in Parkinson's disease with probable REM sleep behaviour disorder

REM sleep behaviour disorder (RBD) can be an early non-motor symptom of Parkinson’s disease (PD) with pathology involving mainly the pontine nuclei. Beyond the brainstem, it is unclear if RBD patients comorbid with PD have more affected striatal dopamine denervation compared to PD patients unaffected by RBD (PD-RBD−). To elucidate this, we evaluated the availability of vesicular monoamine transporter 2 (VMAT2), an index of nigrostriatal dopamine innervation, in 15 PD patients with probable RBD (PD-RBD+), 15 PD-RBD−, and 15 age-matched healthy controls (HC) using [¹¹C]DTBZ PET imaging. This technique measured VMAT2 availability within striatal regions of interest (ROI). A mixed effect model was used to compare the radioligand binding of VMAT2 between the three groups for each striatal ROI, while co-varying for sex, cognitive function and depression scores. Multiple regressions were also computed to predict clinical measures from group condition and VMAT2 binding within all ROIs explored. We observed a significant main effect of group condition on VMAT2 availability within the caudate, putamen, ventral striatum, globus pallidus, substantia nigra, and subthalamus. Specifically, our results revealed that PD-RBD+ had lower VMAT2 availability compared to HC in all these regions except for the subthalamus and substantia nigra, while PD-RBD− was significantly lower than HC in all these regions. PD-RBD− showed a negative relationship between motor severity and VMAT2 availability within the left caudate. Our findings reflect that both PD patient subgroups had similar denervation within the nigrostriatal pathway. There were no significant interactions detected between radioligand binding and clinical scores in PD-RBD+. Taken together, VMAT2 and striatal dopamine denervation in general may not be a significant contributor to the pathophysiology of RBD in PD patients. Future studies are encouraged to explore other underlying neural chemistry mechanisms contributing to RBD in PD patients.

Uncovering Disease Mechanisms in a Novel Mouse Model Expressing Humanized APOEε4 and Trem2*R47H

Late-onset Alzheimer's disease (AD; LOAD) is the most common human neurodegenerative disease, however, the availability and efficacy of disease-modifying interventions is severely lacking. Despite exceptional efforts to understand disease progression via legacy amyloidogenic transgene mouse models, focus on disease translation with innovative mouse strains that better model the complexity of human AD is required to accelerate the development of future treatment modalities. LOAD within the human population is a polygenic and environmentally influenced disease with many risk factors acting in concert to produce disease processes parallel to those often muted by the early and aggressive aggregate formation in popular mouse strains. In addition to extracellular deposits of amyloid plaques and inclusions of the microtubule-associated protein tau, AD is also defined by synaptic/neuronal loss, vascular deficits, and neuroinflammation. These underlying processes need to be better defined, how the disease progresses with age, and compared to human-relevant outcomes. To create more translatable mouse models, MODEL-AD (Model Organism Development and Evaluation for Late-onset AD) groups are identifying and integrating disease-relevant, humanized gene sequences from public databases beginning with APOEε4 and Trem2*R47H, two of the most powerful risk factors present in human LOAD populations. Mice expressing endogenous, humanized APOEε4 and Trem2*R47H gene sequences were extensively aged and assayed using a multi-disciplined phenotyping approach associated with and relative to human AD pathology. Robust analytical pipelines measured behavioral, transcriptomic, metabolic, and neuropathological phenotypes in cross-sectional cohorts for progression of disease hallmarks at all life stages. In vivo PET/MRI neuroimaging revealed regional alterations in glycolytic metabolism and vascular perfusion. Transcriptional profiling by RNA-Seq of brain hemispheres identified sex and age as the main sources of variation between genotypes including age-specific enrichment of AD-related processes. Similarly, age was the strongest determinant of behavioral change. In the absence of mouse amyloid plaque formation, many of the hallmarks of AD were not observed in this strain. However, as a sensitized baseline model with many additional alleles and environmental modifications already appended, the dataset from this initial MODEL-AD strain serves an important role in establishing the individual effects and interaction between two strong genetic risk factors for LOAD in a mouse host.

Validation and Optimization of Proximal Femurs Microstructure Analysis Using High Field and Ultra-High Field MRI

Trabecular bone could be assessed non-invasively using MRI. However, MRI does not yet provide resolutions lower than trabecular thickness and a comparative analysis between different MRI sequences at different field strengths and X-ray microtomography (μCT) is still missing. In this study, we compared bone microstructure parameters and bone mineral density (BMD) computed using various MRI approaches, i.e., turbo spin echo (TSE) and gradient recalled echo (GRE) images used at different magnetic fields, i.e., 7T and 3T. The corresponding parameters computed from μCT images and BMD derived from dual-energy X-ray absorptiometry (DXA) were used as the ground truth. The correlation between morphological parameters, BMD and fracture load assessed by mechanical compression tests was evaluated. Histomorphometric parameters showed a good agreement between 7T TSE and μCT, with 8% error for trabecular thickness with no significative statistical difference and a good intraclass correlation coefficient (ICC > 0.5) for all the extrapolated parameters. No correlation was found between DXA-BMD and all morphological parameters, except for trabecular interconnectivity (R2 > 0.69). Good correlation (p-value < 0.05) was found between failure load and trabecular interconnectivity (R2 > 0.79). These results suggest that MRI could be of interest for bone microstructure assessment. Moreover, the combination of morphological parameters and BMD could provide a more comprehensive view of bone quality.

Extra-striatal dopamine in Parkinson's disease with rapid eye movement sleep behavior disorder

Rapid eye movement sleep behavior disorder (RBD) is a common condition found in more than 50% of the patients with Parkinson's disease (PD). Molecular imaging shows that PD with RBD (PD-RBD+) have lower striatal dopamine transporter activity within the caudate and putamen relative to PD without RBD (PD-RBD-). However, the characterization of the extra-striatal dopamine within the mesocortical and mesolimbic pathways remains unknown. We aim to elucidate this with PET imaging in 15 PD-RBD+ and 15 PD-RBD- patients, while having 15 age-matched healthy controls (HC). Each participant underwent a single PET scan with [¹¹ C]FLB-457 to detect the D2 receptor availability within the extra-striatal regions of interest (ROI), including the prefrontal, temporal, and limbic areas. [¹¹ C]FLB-457 retention was expressed as the nondisplaceable binding potential. Our results reveal that relative to HC, PD-RBD+ and PD-RBD- patients have lower levels of D2 receptor availability within the uncus parahippocampus, superior, lateral, and inferior temporal cortex. PD-RBD+ showed steep decline in D2 receptors within the left uncus parahippocampus with increasing disease severity, but this was not observed for PD-RBD- patients. Findings imply that extra-striatal dopaminergic system may play a role in contributing to symptomatic progress in PD patients with RBD. However, validation with more advanced PD patients are needed.

Non-Rigid Respiratory Motion Estimation of Whole-Heart Coronary MR Images Using Unsupervised Deep Learning

Non-rigid motion-corrected reconstruction has been proposed to account for the complex motion of the heart in free-breathing 3D coronary magnetic resonance angiography (CMRA). This reconstruction framework requires efficient and accurate estimation of non-rigid motion fields from undersampled images at different respiratory positions (or bins). However, state-of-the-art registration methods can be time-consuming. This article presents a novel unsupervised deep learning-based strategy for fast estimation of inter-bin 3D non-rigid respiratory motion fields for motion-corrected free-breathing CMRA. The proposed 3D respiratory motion estimation network (RespME-net) is trained as a deep encoder-decoder network, taking pairs of 3D image patches extracted from CMRA volumes as input and outputting the motion field between image patches. Using image warping by the estimated motion field, a loss function that imposes image similarity and motion smoothness is adopted to enable training without ground truth motion field. RespME-net is trained patch-wise to circumvent the challenges of training a 3D network volume-wise which requires large amounts of GPU memory and 3D datasets. We perform 5-fold cross-validation with 45 CMRA datasets and demonstrate that RespME-net can predict 3D non-rigid motion fields with subpixel accuracy (0.44 ± 0.38 mm) within ~10 seconds, being ~20 times faster than a GPU-implemented state-of-the-art non-rigid registration method. Moreover, we perform non-rigid motion-compensated CMRA reconstruction for 9 additional patients. The proposed RespME-net has achieved similar motion-corrected CMRA image quality to the conventional registration method regarding coronary artery length and sharpness.

Model organism development and evaluation for late-onset Alzheimer's disease: MODEL-AD

Alzheimer's disease (AD) is a major cause of dementia, disability, and death in the elderly. Despite recent advances in our understanding of the basic biological mechanisms underlying AD, we do not know how to prevent it, nor do we have an approved disease-modifying intervention. Both are essential to slow or stop the growth in dementia prevalence. While our current animal models of AD have provided novel insights into AD disease mechanisms, thus far, they have not been successfully used to predict the effectiveness of therapies that have moved into AD clinical trials. The Model Organism Development and Evaluation for Late-onset Alzheimer's Disease (MODEL-AD; www.model-ad.org) Consortium was established to maximize human datasets to identify putative variants, genes, and biomarkers for AD; to generate, characterize, and validate the next generation of mouse models of AD; and to develop a preclinical testing pipeline. MODEL-AD is a collaboration among Indiana University (IU); The Jackson Laboratory (JAX); University of Pittsburgh School of Medicine (Pitt); Sage BioNetworks (Sage); and the University of California, Irvine (UCI) that will generate new AD modeling processes and pipelines, data resources, research results, standardized protocols, and models that will be shared through JAX's and Sage's proven dissemination pipelines with the National Institute on Aging-supported AD Centers, academic and medical research centers, research institutions, and the pharmaceutical industry worldwide.

Effects of using different software packages for BOLD analysis in planning a neurosurgical treatment in patients with brain tumours

BACKGROUND

The authors of the present thesis carried out a comparative analysis of three different computer software packages - FSL, SPM and FuncTool - for the processing of fMRI scans.

PURPOSE

The aim of the thesis was the analysis of the volume of regions functionally active during the stimulation of the centres evaluated as well as the location of those regions in relation to the tumour boundaries, and then the comparison of the results.

MATERIAL AND METHODS

Thirty eight patients with a diagnosed tumour of the left hemisphere, qualified for a neurosurgical operation, underwent fMRI. The functions of speech, motion and sensation were evaluated. Imaging data were processed for all the acquired scans with the use of each of the three software packages assessed.

RESULTS

For the FuncTool software package the calculated differences in the distances were several times greater than those calculated using FSL and SPM. The differences in the volume of the functionally active regions derived from the calculations with the use of the FSL and SPM software packages were statistically different for four out of the six functions evaluated.

CONCLUSIONS

The conclusions of the analysis in question showed that the FSL and SPM packages could be used interchangeably in the functional mapping of the brain with the purpose of the planning of neurosurgical operations. The FuncTool software package is less precise than FSL and SPM.

Concurrent EEG- and fMRI-derived functional connectomes exhibit linked dynamics

Long-range connectivity has become the most studied feature of human functional Magnetic Resonance Imaging (fMRI), yet the spatial and temporal relationship between its whole-brain dynamics and electrophysiological connectivity remains largely unknown. FMRI-derived functional connectivity exhibits spatial reconfigurations or time-varying dynamics at infraslow (<0.1Hz) speeds. Conversely, electrophysiological connectivity is based on cross-region coupling of fast oscillations (~1-100Hz). It is unclear whether such fast oscillation-based coupling varies at infraslow speeds, temporally coinciding with infraslow dynamics across the fMRI-based connectome. If so, does the association of fMRI-derived and electrophysiological dynamics spatially vary over the connectome across the functionally distinct electrophysiological oscillation bands? In two concurrent electroencephalography (EEG)-fMRI resting-state datasets, oscillation-based coherence in all canonical bands (delta through gamma) indeed reconfigured at infraslow speeds in tandem with fMRI-derived connectivity changes in corresponding region-pairs. Interestingly, irrespective of EEG frequency-band the cross-modal tie of connectivity dynamics comprised a large proportion of connections distributed across the entire connectome. However, there were frequency-specific differences in the relative strength of the cross-modal association. This association was strongest in visual to somatomotor connections for slower EEG-bands, and in connections involving the Default Mode Network for faster EEG-bands. Methodologically, the findings imply that neural connectivity dynamics can be reliably measured by fMRI despite heavy susceptibility to noise, and by EEG despite shortcomings of source reconstruction. Biologically, the findings provide evidence that contrast with known territories of oscillation power, oscillation coupling in all bands slowly reconfigures in a highly distributed manner across the whole-brain connectome.

Further in vivo characterization of [11 C]-(+)-PHNO uptake into a retina-like region of interest in humans

The neurotransmitter dopamine is present in the retina and is involved in several modulatory functions. Unlike in rodents, dopamine D₃ receptors are expressed in the retina of humans. Recently, uptake of the D₃ receptor-preferring radiotracer [¹¹ C]-(+)-PHNO has been observed in a retina-like region of interest (ROI) in humans. Here, we attempted to quantify [¹¹ C]-(+)-PHNO uptake into this ROI using an independent sample, employing an extended scan acquisition time (120 min) and arterial kinetic modeling. Data from 14 healthy controls were analyzed (Mean Age: 38.41 ± 9.55, 3 female), 8 of which provided arterial line input function data (Mean Age: 41.07 ± 7.82, 3 female). Using Ichise's multilinear analysis (MA1) method, it was possible to quantify the volume of distribution (V_T ) of [¹¹ C]-(+)-PHNO in this retina-like region (Mean V_T  = 13.56 ± 3.52; Mean χ²  = 2.08 ± 2.20). Notably, the shape of the time activity curve resembled closely that of the globus pallidus. Moreover, the V_T values in the retina correlated well with binding potential (BP_ND ) values calculated using the simplified reference tissue model (Mean BP_ND  = 2.11 ± .94; Mean χ²  = 5.76 ± 2.56), employing the cerebellum as the reference region (r = .76, r²  = .58). In summary, we provide evidence that the in vivo uptake of [¹¹ C]-(+)-PHNO into a retina-like ROI in humans can be quantified using both arterial blood sampling (V_T ) and simplified reference tissue methods (BP_ND ).

DRD2 Genotype-Based Variants Modulates D2 Receptor Distribution in Ventral Striatum

Dopaminergic signaling within the striatum is crucial for motor planning and mental function. Neurons within the striatum contain two dopamine D2 receptor isoforms-D2 long and D2 short. The amount of expression for these receptor isoforms is affected by the genotype within two single nucleotide polymorphisms (SNPs), rs2283265 and rs1076560 (both are in high linkage disequilibrium; C > A), found in the DRD2 gene. However, it is unclear how these SNPs affect the distribution of D2 receptors in vivo within the nigrostriatal dopaminergic system. We aim to elucidate this with PET imaging in healthy young adults using [¹¹C]-(+)-PHNO. Participants were genotyped for the DRD2 rs2283265 SNP and a total of 20 enrolled: 9 with CC, 6 with CA, and 5 with AA genotype. The main effect of genotype on [¹¹C]-(+)-PHNO binding was tested and we found significant group effect within the ventral striatum. Specifically, CC and CA carriers had higher binding in this region compared to AA carriers. There were no observed differences between genotypes in other regions within the basal ganglia. Our preliminary results implicate that the polymorphism genotype affects the dopaminergic signaling by controlling either the quantity of D2 receptors, D2 affinity, or a combination thereof within the ventral striatum.

The effect of the DISC1 Ser704Cys polymorphism on striatal dopamine synthesis capacity: an [18F]-DOPA PET study

Whilst the role of the Disrupted-in-Schizophrenia 1 (DISC1) gene in the aetiology of major mental illnesses is debated, the characterization of its function lends it credibility as a candidate. A key aspect of this functional characterization is the determination of the role of common non-synonymous polymorphisms on normal variation within these functions. The common allele (A) of the DISC1 single-nucleotide polymorphism (SNP) rs821616 encodes a serine (ser) at the Ser704Cys polymorphism, and has been shown to increase the phosphorylation of extracellular signal-regulated protein Kinases 1 and 2 (ERK1/2) that stimulate the phosphorylation of tyrosine hydroxylase, the rate-limiting enzyme for dopamine biosynthesis. We therefore set out to test the hypothesis that human ser (A) homozygotes would show elevated dopamine synthesis capacity compared with cysteine (cys) homozygotes and heterozygotes (TT and AT) for rs821616. [18F]-DOPA positron emission tomography (PET) was used to index striatal dopamine synthesis capacity as the influx rate constant Kicer in healthy volunteers DISC1 rs821616 ser homozygotes (N = 46) and healthy volunteers DISC1 rs821616 cys homozygotes and heterozygotes (N = 56), matched for age, gender, ethnicity and using three scanners. We found DISC1 rs821616 ser homozygotes exhibited a significantly higher striatal Kicer compared with cys homozygotes and heterozygotes (P = 0.012) explaining 6.4% of the variance (partial η2 = 0.064). Our finding is consistent with its previous association with heightened activation of ERK1/2, which stimulates tyrosine hydroxylase activity for dopamine synthesis. This could be a potential mechanism mediating risk for psychosis, lending further credibility to the fact that DISC1 is of functional interest in the aetiology of major mental illness.

Technical Note: Virtual CT for reducing CT dose in targeted radionuclide therapy dosimetry

PURPOSE

Previously we have shown that using sequential CT images is superior to sequential SPECT for nonrigid registration in three-dimensional (3D) targeted radionuclide therapy (TRT) dosimetry. However, sequential CTs are often not available due to radiation concerns. In this paper, we propose a virtual CT (vCT) method for attenuation and scatter correction, image registration, and segmentation for improved dosimetric accuracy with single CT acquisition.

METHODS

We used a population of nine XCAT phantoms with different In-111 Zevalin biokinetics and anatomical variations for the simulations. An analytical projector was used to simulate sequential SPECT/CT acquisitions for a medium energy general purpose collimator at 1, 12, 24, 72, and 144 h postinjection, modeling attenuation, scatter, and geometric collimator-detector response. The corresponding sequential attenuation maps of the phantoms served as real CT (rCT) images. For vCT generation, we investigated three registration methods, that is, (a) SPECT to SPECT; (b) SPECT to CT, and (c) CT to SPECT, and the optimal time point for single CT acquisition. Difference images and average normalized mean square errors (NMSE) were calculated between different vCTs and their corresponding rCTs. Absorbed dose and dose-volume histograms (DVHs) for critical organs were computed for the rCT, optimized vCT, and conventional single CT (1CT) protocols, respectively, for dosimetric analyses.

RESULTS

For vCT generation, SPECT to SPECT registration with a single CT acquired at the first time point shows the smallest difference and NMSE. For organ absorbed doses, the results of vCT were similar to those of rCT and were superior to 1CT, that is, -0.24 ± 1.56% vs -0.49 ± 1.76% vs -6.37 ± 5.63% for the liver, -1.05 ± 2.89% vs -0.69 ± 2.74% vs -4.87 ± 4.35% for kidneys, respectively. The results of DVHs also showed improvement for all organs using vCTs as compared to the conventional 1CT protocol.

CONCLUSION

The optimized vCT method can effectively increase the TRT dosimetric results if there is only a single CT available in the sequential imaging protocol, reducing the substantial increase in radiation burden from repeated CT scans.

Region-by-region analysis of PET, MRI, and histology in en bloc-resected oligodendrogliomas reveals intra-tumoral heterogeneity

Purpose

Oligodendrogliomas are heterogeneous tumors in terms of imaging appearance, and a deeper understanding of the histopathological tumor characteristics in correlation to imaging parameters is needed. We used PET-to-MRI-to-histology co-registration with the aim of studying intra-tumoral ¹¹C-methionine (MET) uptake in relation to tumor perfusion and the protein expression of histological cell markers in corresponding areas.

Methods

Consecutive histological sections of four tumors covering the entire en bloc-removed tumor were immunostained with antibodies against IDH1-mutated protein (tumor cells), Ki67 (proliferating cells), and CD34 (blood vessels). Software was developed for anatomical landmarks-based co-registration of subsequent histological images, which were overlaid on corresponding MET PET scans and MRI perfusion maps. Regions of interest (ROIs) on PET were selected throughout the entire tumor volume, covering hot spot areas, areas adjacent to hot spots, and tumor borders with infiltrating zone. Tumor-to-normal tissue (T/N) ratios of MET uptake and mean relative cerebral blood volume (rCBV) were measured in the ROIs and protein expression of histological cell markers was quantified in corresponding regions. Statistical correlations were calculated between MET uptake, rCBV, and quantified protein expression.

Results

A total of 84 ROIs were selected in four oligodendrogliomas. A significant correlation (p < 0.05) between MET uptake and tumor cell density was demonstrated in all tumors separately. In two tumors, MET correlated with the density of proliferating cells and vessel cell density. There were no significant correlations between MET uptake and rCBV, and between rCBV and histological cell markers.

Conclusions

The MET uptake in hot spots, outside hotspots, and in infiltrating tumor edges unanimously reflects tumor cell density. The correlation between MET uptake and vessel density and density of proliferating cells is less stringent in infiltrating tumor edges and is probably more susceptible to artifacts caused by larger blood vessels surrounding the tumor. Although based on a limited number of samples, this study provides histological proof for MET as an indicator of tumor cell density and for the lack of statistically significant correlations between rCBV and histological cell markers in oligodendrogliomas.

Electronic supplementary material

The online version of this article (10.1007/s00259-018-4107-z) contains supplementary material, which is available to authorized users.

Dynamic volumetric changes of hippocampal subfields in clinically isolated syndrome patients: A 2-year MRI study

Background:

Different subregional patterns of hippocampal involvement have been observed in diverse multiple sclerosis (MS) phenotypes.

Objective:

To evaluate the occurrence of regional hippocampal variations in clinically isolated syndrome (CIS) patients, their relationships with focal white matter (WM) lesions, and their prognostic implications.

Methods:

Brain dual-echo and three-dimensional (3D) T1-weighted scans were acquired from 14 healthy controls and 36 CIS patients within 2 months from clinical onset and after 3, 12, and 24 months. Radial distance distribution was assessed using 3D parametric surface mesh models. A cognitive screening was also performed.

Results:

Patients showed clusters of reduced radial distance in the Cornu Ammonis 1 from month 3, progressively extending to the subiculum, negatively correlated with ipsilateral T2 and T1 lesion volume. Increased radial distance appeared in the right dentate gyrus after 3 ( p < 0.05), 12, and 24 ( p < 0.001) months, and in the left one after 3 and 24 months ( p < 0.001), positively correlated with lesional measures. Hippocampal volume variations were more pronounced in patients converting to MS after 24 months and did not correlate with cognitive performance.

Conclusion:

Regional hippocampal changes occur in CIS, are more pronounced in patients converting to MS, and are modulated by focal WM lesions.

Expression of dopamine D2 and D3 receptors in the human retina revealed by positron emission tomography and targeted mass spectrometry

Dopamine D₂ receptors (D₂R) are expressed in the human retina and play an important role in the modulation of neural responses to light-adaptation. However, it is unknown whether dopamine D₃ receptors (D₃R) are expressed in the human retina. Using positron emission tomography (PET), we have observed significant uptake of the D₃R-preferring agonist radiotracer [¹¹C]-(+)-PHNO into the retina of humans in vivo. This led us to examine whether [¹¹C]-(+)-PHNO binding in the retina was quantifiable using reference tissue methods and if D₃R are expressed in human post-mortem retinal tissue. [¹¹C]-(+)-PHNO data from 49 healthy controls (mean age: 39.96 ± 14.36; 16 female) and 12 antipsychotic-naïve patients with schizophrenia (mean age: 25.75 ± 6.25; 4 female) were analyzed. We observed no differences in [¹¹C]-(+)-PHNO binding in the retina between first-episode, drug-naïve patients with schizophrenia and healthy controls. Post-mortem retinal tissues from four healthy persons (mean age: 59.75 ± 9.11; 2 female) and four patients with schizophrenia (mean age: 54 ± 17.11; 2 female) were analyzed using a targeted mass spectrometry technique: parallel reaction monitoring (PRM) analysis. Using targeted mass spectrometry, we confirmed that D₃R are expressed in human retinal tissue ex vivo. Notably, there was far greater expression of D₂R relative to D₃R in the healthy human retina (∼12:1). Moreover, PRM analysis revealed reduced D₂R, but not D₃R, expression in the retinas of non-first episode patients with schizophrenia compared to healthy controls. We confirm that D₃R are expressed in the human retina. Future studies are needed to determine what proportion of the [¹¹C]-(+)-PHNO signal in the human retina in vivo is due to binding to D₃R versus D₂R. Knowledge that both D₂R and D₃R are expressed in the human retina, and potentially quantifiable in vivo using [¹¹C]-(+)-PHNO, poses new research avenues for better understanding the role of retinal dopamine in human vision. This work may have important implications for elucidating pathophysiological and antipsychotic induced visual deficits in schizophrenia.

Quantitative Computer-Aided Computed Tomography Analysis of Sphenoid Sinus Anatomical Relationships

Background

This study describes a novel computer-generated anatomic symmetry plane as a framework for the quantitative description of sphenoid sinus anatomy. The aim of this study was to (1) determine relationships and distances between a midline sphenoid reference point (called the central sphenoid point [CSP]) and lateral sphenoid wall structures and (2) assess the incidence of anterior clinoid process (ACP) pneumatization and pterygoid recess (PR) pneumatization.

Methods

Axial computed tomography (CT) scans (1-mm slice thickness) were obtained on a VolumeZoom CT scanner (Siemens Medical, Erlangen, Germany). Mathematically derived anatomic symmetry planes were created using custom postprocessing software. A standardized review of each CT scan using surgical planning software (CBYON Suite version 2.6; CBYON, Mountain View, CA) was performed. The CSP was defined as a reference point in the midline sagittal plane at the intersection of the vertical sellar face and the horizontal sellar floor.

Results

A total of 128 sides in 64 cadaveric specimens were available for review. The incidences of ACP pneumatization and PR pneumatization were 23.4 and 37.5%. The mean distances from the CSP to the left optic canal midpoint, the left ACP entrance point, and the left PR lateral wall were 17.2, 15.6, and 27.6 mm, respectively. The corresponding distances from the CSP on the right side were 17.3, 15.8, and 28.0 mm, respectively. Measurements from the maxillary spine to the optic canal midpoint, ACP entrance point, and PR lateral wall on each side were performed also.

Conclusion

This approach provides both quantitative and qualitative understanding of sphenoid osteology and may be coupled with intraoperative surgical navigation to reduce the risks of sphenoid surgery. Both PR and ACP pneumatization are surprisingly common. Because the CSP-derived relationships may be referenced during endoscopic surgical navigation, they may provide greater clinical utility than traditional alternatives. This paradigm may facilitate a greater understanding of sphenoid anatomy and enhance surgical safety and precision.

Reward motivation in humans and its relationship to dopamine D2/3 receptor availability: A pilot study with dual [11C]-raclopride and [11C]-(+)-PHNO imaging

Rodent studies suggest that dopamine signaling at D_2/3 receptors in the ventral striatum is critical for reward motivation. Whether this is also true in humans is unclear. Positron emission tomography studies in healthy humans have generally not observed a relationship between D_2/3 receptor availability in the ventral striatum and motivation. We developed the "mounting-effort for reward task" to assess high motivational demand for (a) gaining money (CS+), (b) losing money or avoiding electric shock (CS-), and (c) non-reward (Neutral). Receipt was contingent on participants making sufficient button responses relative to a "reward-threshold" determined by prior motor performance. This reward-threshold was dynamically increased if surpassed, making the task increasingly more difficult on every trial. The mounting-effort for reward task was preliminarily validated in 29 healthy volunteers (mean age: 25.83±3.58; 15 female). In this sample, %CS+ and %CS- significantly correlated with different dimensions of self-reported apathy. In a sub-sample of eight healthy volunteers (mean age: 25.75±1.91; four female), the mounting-effort for reward task demonstrated good test-retest reliability (%variance: 0.20-2.61%). Seven healthy male volunteers (mean age: 31.14±5.43) completed the mounting-effort for reward task and provided both [¹¹C]-raclopride and [¹¹C]-(+)-PHNO PET scans to assess D_2/3 receptor availability. %CS+ and %CS- were positively correlated with [¹¹C]-raclopride binding in the dorsal striatum. %CS+, %Cs-, and %Neutral were positively correlated with [¹¹C]-(+)-PHNO binding in the globus pallidus. Thus, increased expression of D₂ receptors in the dorsal striatum, and D₃ receptors in the globus pallidus, may be related to motivation for rewards. Larger positron emission tomography studies are required to formally validate the mounting-effort for reward task and replicate our pilot findings.

Amotivation is associated with smaller ventral striatum volumes in older patients with schizophrenia

OBJECTIVE

Motivational deficits are prevalent in patients with schizophrenia, persist despite antipsychotic treatment, and predict long-term outcomes. Evidence suggests that patients with greater amotivation have smaller ventral striatum (VS) volumes. We wished to replicate this finding in a sample of older, chronically medicated patients with schizophrenia. Using structural imaging and positron emission tomography, we examined whether amotivation uniquely predicted VS volumes beyond the effects of striatal dopamine D2/3 receptor (D2/3 R) blockade by antipsychotics.

METHODS

Data from 41 older schizophrenia patients (mean age: 60.2 ± 6.7; 11 female) were reanalysed from previously published imaging data. We constructed multivariate linear stepwise regression models with VS volumes as the dependent variable and various sociodemographic and clinical variables as the initial predictors: age, gender, total brain volume, and antipsychotic striatal D2/3 R occupancy. Amotivation was included as a subsequent step to determine any unique relationships with VS volumes beyond the contribution of the covariates. In a reduced sample (n = 36), general cognition was also included as a covariate.

RESULTS

Amotivation uniquely explained 8% and 6% of the variance in right and left VS volumes, respectively (right: β = -.38, t = -2.48, P = .01; left: β = -.31, t = -2.17, P = .03). Considering cognition, amotivation levels uniquely explained 9% of the variance in right VS volumes (β = -.43, t = -0.26, P = .03).

CONCLUSION

We replicate and extend the finding of reduced VS volumes with greater amotivation. We demonstrate this relationship uniquely beyond the potential contributions of striatal D2/3 R blockade by antipsychotics. Elucidating the structural correlates of amotivation in schizophrenia may help develop treatments for this presently irremediable deficit.

Potential of metric homotopy between intensity and geometry information for multi-modal 3D registration

This paper focuses on a novel strategy increasing robustness with respect to local optima when using Mutual Information (MI) in multi-modal image registration. This is realized by integrating additional geometry information in the cost function. Hereby, the main innovation is a generalization of multi-metric registration approaches by means of a metric homotopy. Particularly we realize a method which automatically determines the parameters of the metric homotopy. To construct the cost function independent of the choice of the optimizer, the weighting is defined as a function of one of the metrics instead of optimizer steps. In addition, a differentiable cost function is developed. In comparison to the commonly used technique to process an intensity based registration on different resolutions, the proposed method is three times faster with unchanged accuracy. It is also shown that in the presence of large landmark errors the proposed method outperforms an approach in accuracy in which both similarity functionals are applied one after the other. The method is evaluated on 3D multi-modal human brain data sets from the Retrospective Image Registration Evaluation Project (RIRE). The evaluation is performed using the evaluation website of the RIRE project to make the registration results of the proposed method easily comparable to other methods. Therefore, the presented results are also available online on the RIRE project page.

Contribution of cervical cord MRI and brain magnetization transfer imaging to the assessment of individual patients with multiple sclerosis: a preliminary study

This study was performed to assess how established diagnostic criteria for brain magnetic resonance imaging (MRI) interpretation in cases of suspected multiple sclerosis (MS) (Barkhofs criteria) would perform in the distinction of MS from other diseases and whether other MR techniques (cervical cord imaging and brain magnetization transfer imaging [MTI]), might help in the diagnostic work-up of these patients. We retrospectively identified 64 MS and 59 non-MS patients. The latter group included patients with systemic immune-mediated disorders (SID; n=44) and migraine (n=15). All patients had undergone MRI scans of the brain (dual echo and MTI) and of the cervical cord (fast short-tau inversion recovery). The number and location of brain T2-hyperintense lesions and the number and size of cervical cord lesions were assessed. Brain images were also postprocessed to quantify the total lesion volumes (TLV) and to create histograms of magnetization transfer ratio (MTR) values from the whole of the brain tissue. Barkhofs criteria correctly classified 108/123 patients, thus showing an accuracy of 87.8%. "False negative" MS patients were 13, while 2 patients with systemic lupus erythematosus (SLE) were considered as "false positives". Using brain T2 TLV, nine of the"false negative" patients were correctly classified. Correct classification of 10 MS patients and both the SLE patients was possible based upon the presence or absence of one cervical cord lesion. Two MS patients with negative Barkhofs criteria and no cervical cord lesions were correctly classified based on their brain MTR values. Overall, only one MS patient could not be correctly classified by any of the assessed MR quantities. These preliminary data support a more extensive use of cervical cord MRI and brain MTI to differentiate between MS and other disorders in case of inconclusive findings on T2-weighted MRI scans of the brain. Multiple Sclerosis (2002) 8, 52-58

Spectral decomposition for resolving partial volume effects in MRSI

PURPOSE

Estimation of brain metabolite concentrations by MR spectroscopic imaging (MRSI) is complicated by partial volume contributions from different tissues. This study evaluates a method for increasing tissue specificity that incorporates prior knowledge of tissue distributions.

METHODS

A spectral decomposition (sDec) technique was evaluated for separation of spectra from white matter (WM) and gray matter (GM), and for measurements in small brain regions using whole-brain MRSI. Simulation and in vivo studies compare results of metabolite quantifications obtained with the sDec technique to those obtained by spectral fitting of individual voxels using mean values and linear regression against tissue fractions and spectral fitting of regionally integrated spectra.

RESULTS

Simulation studies showed that, for GM and the putamen, the sDec method offers < 2% and 3.5% error, respectively, in metabolite estimates. These errors are considerably reduced in comparison to methods that do not account for partial volume effects or use regressions against tissue fractions. In an analysis of data from 197 studies, significant differences in mean metabolite values and changes with age were found. Spectral decomposition resulted in significantly better linewidth, signal-to-noise ratio, and spectral fitting quality as compared to individual spectral analysis. Moreover, significant partial volume effects were seen on correlations of neurometabolite estimates with age.

CONCLUSION

The sDec analysis approach is of considerable value in studies of pathologies that may preferentially affect WM or GM, as well as smaller brain regions significantly affected by partial volume effects. Magn Reson Med 79:2886-2895, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Stereotaxic 18F-FDG PET and MRI templates with three-dimensional digital atlas for statistical parametric mapping analysis of tree shrew brain

BACKGROUND

Tree shrews are proposed as an alternative animal model to nonhuman primates due to their close affinity to primates. Neuroimaging techniques are widely used to study brain functions and structures of humans and animals. However, tree shrews are rarely applied in neuroimaging field partly due to the lack of available species specific analysis methods.

NEW METHOD

In this study, 10 PET/CT and 10 MRI images of tree shrew brain were used to construct PET and MRI templates; based on histological atlas we reconstructed a three-dimensional digital atlas with 628 structures delineated; then the digital atlas and templates were aligned into a stereotaxic space. Finally, we integrated the digital atlas and templates into a toolbox for tree shrew brain spatial normalization, statistical analysis and results localization.

RESULTS

We validated the feasibility of the toolbox by simulated data with lesions in laterodorsal thalamic nucleus (LD). The lesion volumes of simulated PET and MRI images were (12.97±3.91)mm³ and (7.04±0.84)mm³. Statistical results at p<0.005 showed the lesion volumes of PET and MRI were 13.18mm³ and 8.06mm³ in LD.

COMPARISON WITH EXISTING METHOD(S)

To our knowledge, we report the first PET template and digital atlas of tree shrew brain. Compared to the existing MRI templates, our MRI template was aligned into stereotaxic space. And the toolbox is the first software dedicated for tree shrew brain analysis.

CONCLUSIONS

The templates and digital atlas of tree shrew brain, as well as the toolbox, facilitate the use of tree shrews in neuroimaging field.

Ultrasound 2D strain measurement for arm lymphedema using deformable registration: A feasibility study

Purpose

Lymphedema, a swelling of the extremity, is a debilitating morbidity of cancer treatment. Current clinical evaluation of lymphedema is often based on medical history and physical examinations, which is subjective. In this paper, the authors report an objective, quantitative 2D strain imaging approach using a hybrid deformable registration to measure soft-tissue stiffness and assess the severity of lymphedema.

Methods

The authors have developed a new 2D strain imaging method using registration of pre- and post-compression ultrasound B-mode images, which combines the statistical intensity- and structure-based similarity measures using normalized mutual information (NMI) metric and normalized sum-of-squared-differences (NSSD), with an affine-based global and B-spline-based local transformation model. This 2D strain method was tested through a series of experiments using elastography phantom under various pressures. Clinical feasibility was tested with four participants: two patients with arm lymphedema following breast-cancer radiotherapy and two healthy volunteers.

Results

The phantom experiments have shown that the proposed registration-based strain method significantly increased the signal-to-noise and contrast-to-noise ratio under various pressures as compared with the commonly used cross-correlation-based elastography method. In the pilot study, the strain images were successfully generated for all participants. The averaged strain values of the lymphedema affected arms were much higher than those of the normal arms.

Conclusions

The authors have developed a deformable registration-based 2D strain method for the evaluation of arm lymphedema. The initial findings are encouraging and a large clinical study is warranted to further evaluate this 2D ultrasound strain imaging technology.

Chronic exposure to dopamine agonists affects the integrity of striatal D2 receptors in Parkinson's patients

We aimed to investigate the integrity and clinical relevance of striatal dopamine receptor type-2 (D₂R) availability in Parkinson's disease (PD) patients. We studied 68 PD patients, spanning from early to advanced disease stages, and 12 healthy controls. All participants received one [¹¹C]raclopride PET scan in an OFF medication condition for quantification of striatal D₂R availability in vivo. Parametric images of [¹¹C]raclopride non-displaceable binding potential were generated from the dynamic [¹¹C]raclopride scans using implementation of the simplified reference tissue model with cerebellum as the reference tissue. PET data were interrogated for correlations with clinical data related to disease burden and dopaminergic treatment. PD patients showed a mean 16.7% decrease in caudate D₂R and a mean 3.5% increase in putaminal D₂R availability compared to healthy controls. Lower caudate [¹¹C]raclopride BP_ND correlated with longer PD duration. PD patients on dopamine agonist treatment had 9.2% reduced D₂R availability in the caudate and 12.8% in the putamen compared to PD patients who never received treatment with dopamine agonists. Higher amounts of lifetime dopamine agonist therapy correlated with reduced D₂Rs availability in both caudate and putamen. No associations between striatal D₂R availability and levodopa treatment and dyskinesias were found. In advancing PD the caudate and putamen D₂R availability are differentially affected. Chronic exposure to treatment with dopamine agonists, but no levodopa, suppresses striatal D₂R availability, which may have relevance to output signaling to frontal lobes and the occurrence of executive deficits, but not dyskinesias.

•

D₂R in caudate and putamen are differentially affected in PD.

•

Loss of D₂R in caudate correlates with longer disease duration.

•

Dopamine agonists treatment, but not levodopa, suppresses caudate and putamen D₂Rs.

•

No association between striatal D₂R availability, levodopa treatment and dyskinesia.

The relationship between subcortical brain volume and striatal dopamine D2/3 receptor availability in healthy humans assessed with [11 C]-raclopride and [11 C]-(+)-PHNO PET

BACKGROUND

Abnormalities in dopamine (DA) and brain morphology are observed in several neuropsychiatric disorders. However, it is not fully understood how these abnormalities may relate to one another. For such in vivo findings to be used as biomarkers for neuropsychiatric disease, it must be understood how variability in DA relates to brain structure under healthy conditions. We explored how the availability of striatal DA D_2/3 receptors (D_2/3 R) is related to the volume of subcortical brain structures in a sample of healthy humans. Differences in D_2/3 R availability measured with an antagonist radiotracer ([¹¹ C]-raclopride) versus an agonist radiotracer ([¹¹ C]-(+)-PHNO) were examined.

METHODS

Data from 62 subjects scanned with [¹¹ C]-raclopride (mean age = 38.98 ± 14.45; 23 female) and 68 subjects scanned with [¹¹ C]-(+)-PHNO (mean age = 38.54 ± 14.59; 25 female) were used. Subcortical volumes were extracted from T1-weighted images using the Multiple Automatically Generated Templates (MAGeT-Brain) algorithm. Partial correlations were used controlling for age, gender, and total brain volume.

RESULTS

For [¹¹ C]-(+)-PHNO, ventral caudate volumes were positively correlated with BP_ND in the dorsal caudate and globus pallidus (GP). Ventral striatum (VS) volumes were positively correlated with BP_ND in the VS. With [¹¹ C]-raclopride, BP_ND in the VS was negatively correlated with subiculum volume of the hippocampus. Moreover, BP_ND in the GP was negatively correlated with the volume of the lateral posterior nucleus of the thalamus.

CONCLUSION

Findings are purely exploratory and presented corrected and uncorrected for multiple comparisons. We hope they will help inform the interpretation of future PET studies where concurrent changes in D_2/3 R and brain morphology are observed. Hum Brain Mapp 38:5519-5534, 2017. © 2017 Wiley Periodicals, Inc.

A Preliminary Investigation of the Effect of Acute Alcohol on Dopamine Transmission as Assessed by [11 C]-(+)-PHNO

BACKGROUND

Previous positron emission tomography (PET) studies exploring the effect of acute alcohol on dopamine (DA) levels have yielded inconsistent results, with only some studies suggesting increased synaptic DA levels after an alcohol challenge. The D₂ /D₃ agonist radiotracer, [¹¹ C]-(+)-propyl-hexahydro-naphtho-oxazin ([¹¹ C]-(+)-PHNO), has greater sensitivity to synaptic DA fluctuation than previously used antagonist radiotracers and is in principle more suitable for imaging alcohol-induced changes in DA. Its high affinity for the D₃ receptor also enables measuring changes in D₃ -rich brain areas which have previously been unexplored. The aim of this study was to investigate whether alcohol reduces [¹¹ C]-(+)-PHNO binding in the striatum and in D₃ -rich extra-striatal areas.

METHODS

Eight healthy drinkers underwent 2 [¹¹ C]-(+)-PHNO PET scans following alcohol and placebo in a randomized, single-blind, crossover design. [¹¹ C]-(+)-PHNO binding in the striatum and in the extra-striatal regions were compared between the 2 scans.

RESULTS

Acute alcohol administration did not significantly reduce [¹¹ C]-(+)-PHNO binding in either the limbic striatum (d = 0.64), associative striatum (d < 0.20), or the sensorimotor striatum (d < 0.15). Similarly, there were no changes in binding in the D₃ -rich areas of the ventral pallidum (d = 0.53), substantia nigra (d < 0.15), or globus pallidus (d < 0.15). However, greater percent change in [¹¹ C]-(+)-PHNO binding (ΔBP_ND ) between scans was related to lower blood alcohol levels.

CONCLUSIONS

Using the agonist radiotracer, [¹¹ C]-(+)-PHNO, our preliminary findings suggest that alcohol is not associated with robust changes in tracer binding in striatal or extra-striatal regions. However, we found that changes in [¹¹ C]-(+)-PHNO binding following alcohol are dependent on blood alcohol levels suggesting that increases in DA may occur at lower stimulating doses. The effect of lower doses of alcohol on DA warrants further investigation in a larger study.

Use of image registration and fusion algorithms and techniques in radiotherapy: Report of the AAPM Radiation Therapy Committee Task Group No. 132

Image registration and fusion algorithms exist in almost every software system that creates or uses images in radiotherapy. Most treatment planning systems support some form of image registration and fusion to allow the use of multimodality and time-series image data and even anatomical atlases to assist in target volume and normal tissue delineation. Treatment delivery systems perform registration and fusion between the planning images and the in-room images acquired during the treatment to assist patient positioning. Advanced applications are beginning to support daily dose assessment and enable adaptive radiotherapy using image registration and fusion to propagate contours and accumulate dose between image data taken over the course of therapy to provide up-to-date estimates of anatomical changes and delivered dose. This information aids in the detection of anatomical and functional changes that might elicit changes in the treatment plan or prescription. As the output of the image registration process is always used as the input of another process for planning or delivery, it is important to understand and communicate the uncertainty associated with the software in general and the result of a specific registration. Unfortunately, there is no standard mathematical formalism to perform this for real-world situations where noise, distortion, and complex anatomical variations can occur. Validation of the software systems performance is also complicated by the lack of documentation available from commercial systems leading to use of these systems in undesirable 'black-box' fashion. In view of this situation and the central role that image registration and fusion play in treatment planning and delivery, the Therapy Physics Committee of the American Association of Physicists in Medicine commissioned Task Group 132 to review current approaches and solutions for image registration (both rigid and deformable) in radiotherapy and to provide recommendations for quality assurance and quality control of these clinical processes.

Test-retest reproducibility of quantitative binding measures of [11C]Ro15-4513, a PET ligand for GABAA receptors containing alpha5 subunits

INTRODUCTION

Alteration of γ-aminobutyric acid "A" (GABAA) receptor-mediated neurotransmission has been associated with various neurological and psychiatric disorders. [11C]Ro15-4513 is a PET ligand with high affinity for α5-subunit-containing GABAA receptors, which are highly expressed in limbic regions of the human brain (Sur et al., 1998). We quantified the test-retest reproducibility of measures of [11C]Ro15-4513 binding derived from six different quantification methods (12 variants).

METHODS

Five healthy males (median age 40 years, range 38-49 years) had a 90-min PET scan on two occasions (median interval 12 days, range 11-30 days), after injection of a median dose of 441 MegaBequerels of [11C]Ro15-4513. Metabolite-corrected arterial plasma input functions (parent plasma input functions, ppIFs) were generated for all scans. We quantified regional binding using six methods (12 variants), some of which were region-based (applied to the average time-activity curve within a region) and others were voxel-based: 1) Models requiring arterial ppIFs - regional reversible compartmental models with one and two tissue compartments (2kbv and 4kbv); 2) Regional and voxelwise Logan's graphical analyses (Logan et al., 1990), which required arterial ppIFs; 3) Model-free regional and voxelwise (exponential) spectral analyses (SA; (Cunningham and Jones, 1993)), which also required arterial ppIFs; 4) methods not requiring arterial ppIFs - voxelwise standardised uptake values (Kenney et al., 1941), and regional and voxelwise simplified reference tissue models (SRTM/SRTM2) using brainstem or alternatively cerebellum as pseudo-reference regions (Lammertsma and Hume, 1996; Gunn et al., 1997). To compare the variants, we sampled the mean values of the outcome parameters within six bilateral, non-reference grey matter regions-of-interest. Reliability was quantified in terms of median absolute percentage test-retest differences (MA-TDs; preferentially low) and between-subject coefficient of variation (BS-CV, preferentially high), both compounded by the intraclass correlation coefficient (ICC). These measures were compared between variants, with particular interest in the hippocampus.

RESULTS

Two of the six methods (5/12 variants) yielded reproducible data (i.e. MA-TD <10%): regional SRTMs and voxelwise SRTM2s, both using either the brainstem or the cerebellum; and voxelwise SA. However, the SRTMs using the brainstem yielded a lower median BS-CV (7% for regional, 7% voxelwise) than the other variants (8-11%), resulting in lower ICCs. The median ICCs across six regions were 0.89 (interquartile range 0.75-0.90) for voxelwise SA, 0.71 (0.64-0.84) for regional SRTM-cerebellum and 0.83 (0.70-0.86) for voxelwise SRTM-cerebellum. The ICCs for the hippocampus were 0.89 for voxelwise SA, 0.95 for regional SRTM-cerebellum and 0.93 for voxelwise SRTM-cerebellum.

CONCLUSION

Quantification of [11C]Ro15-4513 binding shows very good to excellent reproducibility with SRTM and with voxelwise SA which, however, requires an arterial ppIF. Quantification in the α5 subunit-rich hippocampus is particularly reliable. The very low expression of the α5 in the cerebellum (Fritschy and Mohler, 1995; Veronese et al., 2016) and the substantial α1 subunit density in this region may hamper the application of reference tissue methods.

From clinical imaging and computational models to personalised medicine and image guided interventions

This short paper describes the development of the UCL Centre for Medical Image Computing (CMIC) from 2006 to 2016, together with reference to historical developments of the Computational Imaging sciences Group (CISG) at Guy's Hospital. Key early work in automated image registration led to developments in image guided surgery and improved cancer diagnosis and therapy. The work is illustrated with examples from neurosurgery, laparoscopic liver and gastric surgery, diagnosis and treatment of prostate cancer and breast cancer, and image guided radiotherapy for lung cancer.

Lack of association between dopaminergic antagonism and negative symptoms in schizophrenia: a positron emission tomography dopamine D2/3 receptor occupancy study

RATIONALE

Several pre-clinical studies suggest that antipsychotic medications cause secondary negative symptoms. However, direct evidence for a relationship among antipsychotic medications, their direct effects on neurotransmitter systems, and negative symptoms in schizophrenia remains controversial.

OBJECTIVE

The objective of this study was to examine the relationship between antipsychotic-related dopamine D_2/3 receptor occupancy and negative symptoms in patients with schizophrenia.

METHODS

Forty-one clinically stable outpatients with schizophrenia participated in this prospective dose reduction positron emission tomography (PET) study. Clinical assessments and [¹¹C]-raclopride PET scans were performed before and after participants underwent gradual dose reduction of their antipsychotic medication by up to 40 % from the baseline dose.

RESULTS

No significant relationship was found between antipsychotic-related dopamine D_2/3 receptor occupancy and negative symptom severity at baseline or follow-up. Similar null findings were found for subdomains of negative symptoms (amotivation and diminished expression). Occupancy was significantly lower following dose reduction; however, negative symptom severity did not change significantly, though a trend toward reduction was noted. Examination of change scores between these two variables revealed no systematic relationship.

CONCLUSIONS

Our cross-sectional and longitudinal results failed to find a significant dose-dependent relationship between severity of negative symptoms and antipsychotic-related dopaminergic antagonism in schizophrenia. These findings argue against the notion that antipsychotics necessarily cause secondary negative symptoms. Our results are also in contrast with the behavioral effects of dopaminergic antagonism routinely reported in pre-clinical investigations, suggesting that the role of this variable in the context of chronic treatment and schizophrenia needs to be re-examined.

Amyloid deposition in semantic dementia: a positron emission tomography study

BACKGROUND

Pittsburgh compound B ([11C]-PIB) identifies amyloid-β (Aβ) deposition in vivo. Asymptomatic Aβ deposition has been reported consistently in some healthy older subjects. Of patients with frontotemporal dementia, those who have later onset have a higher potential for Aβ deposition.

OBJECTIVE

Comparison of Aβ deposition in Alzheimer's disease (AD), healthy older controls, and patients with early- and late-onset semantic dementia (SD), a subtype of frontotemporal dementia.

METHODS

Subjects were recruited from tertiary academic care centers specializing in assessment and management of patients with neurodegenerative disease. We used the radiotracer [11C]-PIB in a high-resolution positron emission tomography scanner to evaluate 11 participants with SD (six with onset before age 65 and five with later onset), 9 with probable AD, and 10 controls over age 60. The main outcome measures were frontal, temporal, parietal, and total [11C]-PIB standardized uptake value ratios to establish PIB-positive (PIB+) cutoff.

RESULTS

The five patients with late-onset SD were PIB-negative. Two of six with early-onset SD, seven of nine with AD, and 1 of 10 controls were PIB+. The SD participants who were PIB+ did not have memory or visuospatial deficits that are typical in AD.

CONCLUSIONS

Aβ deposition does not seem to be associated with late-onset SD. Future larger studies might confirm whether a significant minority of early-onset SD patients exhibit Aβ deposition. Copyright © 2016 John Wiley & Sons, Ltd.

Regional distributions of brain glutamate and glutamine in normal subjects

Glutamate (Glu) and glutamine (Gln) play an important role in neuronal regulation and are of value as MRS-observable diagnostic biomarkers. In this study the relative concentrations of these metabolites have been measured in multiple regions in the normal brain using a short-TE whole-brain MRSI measurement at 3 T combined with a modified data analysis approach that used spatial averaging to obtain high-SNR spectra from atlas-registered anatomic regions or interest. By spectral fitting of high-SNR spectra this approach yielded reliable measurements across a wide volume of the brain. Spectral averaging also demonstrated increased SNR and improved fitting accuracy for the sum of Glu and Gln (Glx) compared with individual voxel fitting. Results in 26 healthy controls showed relatively constant Glu/Cr and Gln/Cr throughout the cerebrum, although with increased values in the anterior cingulum and paracentral lobule, and increased Gln/Cr in the superior motor area. The deep gray-matter regions of thalamus, putamen, and pallidum show lower Glu/Cr compared with cortical white-matter regions. Lobar measurements demonstrated reduced Glu/Cr and Gln/Cr in the cerebellum as compared with the cerebrum, where white-matter regions show significantly lower Glu/Cr and Gln/Cr as compared with gray-matter regions across multiple brain lobes. Regression analysis showed no significant effect of gender on Glu/Cr or Gln/Cr measurement; however, Glx/Cr ratio was found to be significantly negatively correlated with age in some lobar brain regions. In summary, this methodology provides the spectral quality necessary for reliable separation of Glu and Gln at 3 T from a single MRSI acquisition enabling generation of regional distributions of metabolites over a large volume of the brain, including cortical regions. Copyright © 2016 John Wiley & Sons, Ltd.

Comparison of Similarity Measures for Rigid-body CT/Dual X-ray Image Registrations

A set of experiments were conducted to evaluate six similarity measures for intensity-based rigid-body 3D/2D image registration. Similarity measure is an index that measures the similarity between a digitally reconstructed radiograph (DRR) and an x-ray planar image. The registration is accomplished by maximizing the sum of the similarity measures between biplane x-ray images and the corresponding DRRs in an iterative fashion. We have evaluated the accuracy and attraction ranges of the registrations using six different similarity measures on phantom experiments for head, thorax, and pelvis. The images were acquired using Varian Medial System On-Board Imager. Our results indicated that normalized cross correlation and entropy of difference showed a wide attraction range (62 deg and 83 mm mean attraction range, ωmean), but the worst accuracy (4.2 mm maximum error, emax). The gradient-based similarity measures, gradient correlation and gradient difference, and the pattern intensity showed sub-millimeter accuracy, but narrow attraction ranges ( ωmean=29 deg, 31 mm). Mutual information was in-between of these two groups ( emax=2.5 mm, ωmean= 48 deg, 52 mm). On the data of 120 x-ray pairs from eight IRB approved prostate patients, the gradient difference showed the best accuracy. In the clinical applications, registrations starting with the mutual information followed by the gradient difference may provide the best accuracy and the most robustness.

Automated alignment of perioperative MRI scans: A technical note and application in pediatric epilepsy surgery

Conventional image registration utilizing brain voxel information may be erroneous in a neurosurgical setting due to pathology and surgery-related anatomical distortions. We report a novel application of an automated image registration procedure based on skull segmentation for magnetic resonance imaging (MRI) scans acquired before, during and after surgery (i.e., perioperative). The procedure was implemented to assist analysis of intraoperative brain shift in 11 pediatric epilepsy surgery cases, each of whom had up to five consecutive perioperative MRI scans. The procedure consisted of the following steps: (1) Skull segmentation using tissue classification tools. (2) Estimation of rigid body transformation between image pairs using registration driven by the skull segmentation. (3) Composition of transformations to provide transformations between each scan and a common space. The procedure was validated using locations of three types of reference structural landmarks: the skull pin sites, the eye positions, and the scalp skin surface, detected using the peak intensity gradient. The mean target registration error (TRE) scores by skull pin sites and scalp skin rendering were around 1 mm and <1 mm, respectively. Validation by eye position demonstrated >1 mm TRE scores, suggesting it is not a reliable reference landmark in surgical scenarios. Comparable registration accuracy was achieved between opened and closed skull scan pairs and closed and closed skull scan pairs. Our procedure offers a reliable registration framework for processing intrasubject time series perioperative MRI data, with potential of improving intraoperative MRI-based image guidance in neurosurgical practice. Hum Brain Mapp 37:3530-3543, 2016. © 2016 Wiley Periodicals, Inc.

Exploring personality traits related to dopamine D2/3 receptor availability in striatal subregions of humans

While several studies have examined how particular personality traits are related to dopamine D2/3 receptor (D2/3R) availability in the striatum of humans, few studies have reported how multiple traits measured in the same persons are differentially related to D2/3R availability in different striatal sub-regions. We examined how personality traits measured with the Karolinska Scales of Personality are related to striatal D2/3R availability measured with [(11)C]-raclopride in 30 healthy humans. Based on previous the literature, five personality traits were hypothesized to be most likely related to D2/3R availability: impulsiveness, monotony avoidance, detachment, social desirability, and socialization. We found self-reported impulsiveness was negatively correlated with D2/3R availability in the ventral striatum and globus pallidus. After controlling for age and gender, monotony avoidance was also negatively correlated with D2/3R availability in the ventral striatum and globus pallidus. Socialization was positively correlated with D2/3R availability in the ventral striatum and putamen. After controlling for age and gender, the relationship between socialization and D2/3R availability in these regions survived correction for multiple comparisons (p-threshold=.003). Thus, within the same persons, different personality traits are differentially related to in vivo D2/3R availability in different striatal sub-regions.