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Perry JL, Snodgrass TD, Gilbert IR, Sutton BP, Baylis AL, Weidler EM, Tse RW, Ishman SL, Sitzman TJ. Establishing a Clinical Protocol for Velopharyngeal MRI and Interpreting Imaging Findings. Cleft Palate Craniofac J 2024; 61:748-758. [PMID: 36448363 PMCID: PMC10243551 DOI: 10.1177/10556656221141188] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Traditional imaging modalities used to assess velopharyngeal insufficiency (VPI) do not allow for direct visualization of underlying velopharyngeal (VP) structures and musculature which could impact surgical planning. This limitation can be overcome via structural magnetic resonance imaging (MRI), the only current imaging tool that provides direct visualization of salient VP structures. MRI has been used extensively in research; however, it has had limited clinical use. Factors that restrict clinical use of VP MRI include limited access to optimized VP MRI protocols and uncertainty regarding how to interpret VP MRI findings. The purpose of this paper is to outline a framework for establishing a novel VP MRI scan protocol and to detail the process of interpreting scans of the velopharynx at rest and during speech tasks. Additionally, this paper includes common scan parameters needed to allow for visualization of velopharynx and techniques for the elicitation of speech during scans.
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Affiliation(s)
- Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Taylor D Snodgrass
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Imani R Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Bradley P Sutton
- Bioengineering Department, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Adriane L Baylis
- Department of Plastic and Reconstructive Surgery, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - Erica M Weidler
- Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Raymond W Tse
- Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Stacey L Ishman
- Division of HealthVine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas J Sitzman
- Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA
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Jin R, Li Y, Shosted RK, Xing F, Gilbert I, Perry JL, Woo J, Liang ZP, Sutton BP. Optimization of 3D dynamic speech MRI: Poisson-disc undersampling and locally higher-rank reconstruction through partial separability model with regional optimized temporal basis. Magn Reson Med 2024; 91:61-74. [PMID: 37677043 PMCID: PMC10847962 DOI: 10.1002/mrm.29812] [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: 05/22/2023] [Revised: 07/09/2023] [Accepted: 07/12/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE To improve the spatiotemporal qualities of images and dynamics of speech MRI through an improved data sampling and image reconstruction approach. METHODS For data acquisition, we used a Poisson-disc random under sampling scheme that reduced the undersampling coherence. For image reconstruction, we proposed a novel locally higher-rank partial separability model. This reconstruction model represented the oral and static regions using separate low-rank subspaces, therefore, preserving their distinct temporal signal characteristics. Regional optimized temporal basis was determined from the regional-optimized virtual coil approach. Overall, we achieved a better spatiotemporal image reconstruction quality with the potential of reducing total acquisition time by 50%. RESULTS The proposed method was demonstrated through several 2-mm isotropic, 64 mm total thickness, dynamic acquisitions with 40 frames per second and compared to the previous approach using a global subspace model along with other k-space sampling patterns. Individual timeframe images and temporal profiles of speech samples were shown to illustrate the ability of the Poisson-disc under sampling pattern in reducing total acquisition time. Temporal information of sagittal and coronal directions was also shown to illustrate the effectiveness of the locally higher-rank operator and regional optimized temporal basis. To compare the reconstruction qualities of different regions, voxel-wise temporal SNR analysis were performed. CONCLUSION Poisson-disc sampling combined with a locally higher-rank model and a regional-optimized temporal basis can drastically improve the spatiotemporal image quality and provide a 50% reduction in overall acquisition time.
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Affiliation(s)
- Riwei Jin
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Yudu Li
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- National Center for Supercomputing Applications, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ryan K Shosted
- Department of Linguistics, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Fangxu Xing
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Imani Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
| | - Jonghye Woo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Zhi-Pei Liang
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- National Center for Supercomputing Applications, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Electrical and Computer Engineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Bradley P Sutton
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- National Center for Supercomputing Applications, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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Perry JL, Lee MK, Tahmasebifard N, Gilbert IR, Snodgrass TD, Shaffer JR, Schleif EP, Weinberg SM. Sex Differences in Velopharyngeal Anatomy of 9- and 10-Year-Old Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4828-4837. [PMID: 37902502 PMCID: PMC11008425 DOI: 10.1044/2023_jslhr-23-00279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/26/2023] [Accepted: 08/14/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Understanding the normal anatomy of velopharyngeal (VP) mechanism and the emergence of sexual dimorphism provides valuable insights into differences of VP anatomy among males and females. The purpose of this study is to examine sex differences in VP anatomy in a large data set of 3,248 9- and 10-year-old children. METHOD Static three-dimensional magnetic resonance imaging was used to compare five VP characteristics including velar length, velar thickness, effective velar length, levator veli palatini muscle length, and pharyngeal depth between age-matched males (n = 1,670) and females (n = 1,578). Additionally, these dimensions were used to determine the VP ratio and effective VP ratio. RESULTS Males showed significantly larger dimensions for all VP distances and significantly lower ratios of velar length and effective velar length to pharyngeal depth (p < .05). The magnitude of these effect sizes was small to medium, with Cohen's d values ranging from 0.12 to 0.63. Additionally, the VP ratio and effective VP ratio are lower among males compared to females (p < .05). CONCLUSIONS Results suggest the presence of sexual dimorphism in the VP mechanism among 9- and 10-year-old children. These findings emphasize the necessity of using different normative data for males and females when making comparisons to patients with cleft palate.
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Affiliation(s)
- Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Myoung Keun Lee
- Department of Oral and Craniofacial Sciences, University of Pittsburgh, PA
| | - Neda Tahmasebifard
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Imani R Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Taylor D Snodgrass
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - John R Shaffer
- Department of Oral and Craniofacial Sciences, University of Pittsburgh, PA
- Department of Human Genetics, University of Pittsburgh, PA
| | - Eshan Pua Schleif
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Seth M Weinberg
- Department of Oral and Craniofacial Sciences, University of Pittsburgh, PA
- Department of Human Genetics, University of Pittsburgh, PA
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Perry JL, Gilbert IR, Xing F, Jin R, Kuehn DP, Shosted RK, Woo J, Liang ZP, Sutton BP. Preliminary Development of an MRI Atlas for Application to Cleft Care: Findings and Future Recommendations. Cleft Palate Craniofac J 2023:10556656231183385. [PMID: 37335134 DOI: 10.1177/10556656231183385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE To introduce a highly innovative imaging method to study the complex velopharyngeal (VP) system and introduce the potential future clinical applications of a VP atlas in cleft care. DESIGN Four healthy adults participated in a 20-min dynamic magnetic resonance imaging scan that included a high-resolution T2-weighted turbo-spin-echo 3D structural scan and five custom dynamic speech imaging scans. Subjects repeated a variety of phrases when in the scanner as real-time audio was captured. SETTING Multisite institution and clinical setting. PARTICIPANTS Four adult subjects with normal anatomy were recruited for this study. MAIN OUTCOME Establishment of 4-D atlas constructed from dynamic VP MRI data. RESULTS Three-dimensional dynamic magnetic resonance imaging was successfully used to obtain high quality dynamic speech scans in an adult population. Scans were able to be re-sliced in various imaging planes. Subject-specific MR data were then reconstructed and time-aligned to create a velopharyngeal atlas representing the averaged physiological movements across the four subjects. CONCLUSIONS The current preliminary study examined the feasibility of developing a VP atlas for potential clinical applications in cleft care. Our results indicate excellent potential for the development and use of a VP atlas for assessing VP physiology during speech.
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Affiliation(s)
- Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Imani R Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Fangxu Xing
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Riwei Jin
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - David P Kuehn
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Ryan K Shosted
- Department of Linguistics, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Jonghye Woo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Zhi-Pei Liang
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Bradley P Sutton
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Xing F, Jin R, Gilbert I, El Fakhri G, Perry J, Sutton B, Woo J. Quantifying Velopharyngeal Motion Variation in Speech Sound Production Using an Audio-Informed Dynamic MRI Atlas. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2023; 12464:124642M. [PMID: 37621417 PMCID: PMC10448831 DOI: 10.1117/12.2654082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
New developments in dynamic magnetic resonance imaging (MRI) facilitate high-quality data acquisition of human velopharyngeal deformations in real-time speech. With recently established speech motion atlases, group analysis is made possible via spatially and temporally aligned datasets in the atlas space from a desired population of interest. In practice, when analyzing motion characteristics from various subjects performing a designated speech task, it is observed that different subjects' velopharyngeal deformation patterns could vary during the pronunciation of the same utterance, regardless of the spatial and temporal alignment of their MRI. Since such variation can be subtle, identification and extraction of unique patterns out of these high-dimensional datasets is a challenging task. In this work, we present a method that computes and visualizes subtle deformation variation patterns as principal components of a subject group's dynamic motion fields in the atlas space. Coupled with the real-time speech audio recordings during image acquisition, the key time frames that contain maximum speech variations are identified by the principal components of temporally aligned audio waveforms, which in turn inform the temporal location of the maximum spatial deformation variation. Henceforth, the motion fields between the key frames and the reference frame for each subject are computed and warped into the common atlas space, enabling a direct extraction of motion variation patterns via quantitative analysis. The method was evaluated on a dataset of twelve healthy subjects. Subtle velopharyngeal motion differences were visualized quantitatively to reveal pronunciation-specific patterns among different subjects.
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Affiliation(s)
- Fangxu Xing
- Dept. Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, US 02114
| | - Riwei Jin
- Dept. Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL, US 61801
| | - Imani Gilbert
- Dept. Communication Sciences and Disorders, East Carolina University, Greenville, NC, US 27858
| | - Georges El Fakhri
- Dept. Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, US 02114
| | - Jamie Perry
- Dept. Communication Sciences and Disorders, East Carolina University, Greenville, NC, US 27858
| | - Bradley Sutton
- Dept. Bioengineering, University of Illinois at Urbana-Champaign, Champaign, IL, US 61801
| | - Jonghye Woo
- Dept. Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, US 02114
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