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Roine U, Tokola AM, Autti T, Roine T. Topological Structural Brain Connectivity Alterations in Aspartylglucosaminuria: A Case-Control Study. AJNR Am J Neuroradiol 2023; 44:40-46. [PMID: 36549851 PMCID: PMC9835915 DOI: 10.3174/ajnr.a7745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE We investigated global and local properties of the structural brain connectivity networks in aspartylglucosaminuria, an autosomal recessive and progressive neurodegenerative lysosomal storage disease. Brain connectivity in aspartylglucosaminuria has not been investigated before, but previous structural MR imaging studies have shown brain atrophy, delayed myelination, and decreased thalamic and increased periventricular WM T2 signal intensity. MATERIALS AND METHODS We acquired diffusion MR imaging and T1-weighted data from 12 patients with aspartylglucosaminuria (mean age, 23 [SD, 8] years; 5 men), and 30 healthy controls (mean age, 25 [SD, 10] years; 13 men). We performed whole-brain constrained spherical deconvolution tractography, which enables the reconstruction of neural tracts through regions with complex fiber configurations, and used graph-theoretical analysis to investigate the structural brain connectivity networks. RESULTS The integration of the networks was decreased, as demonstrated by a decreased normalized global efficiency and an increased normalized characteristic path length. In addition, the average strength of the networks was decreased. In the local analyses, we found decreased strength in 11 nodes, including, for example, the right thalamus, right putamen, and, bilaterally, several occipital and temporal regions. CONCLUSIONS We found global and local structural connectivity alterations in aspartylglucosaminuria. Biomarkers related to the treatment efficacy are needed, and brain network properties may provide the means for long term follow-up.
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Affiliation(s)
- U Roine
- From the Department of Radiology (U.R., A.M.T., T.A., T.R.), HUS Medical Imaging Center
- Department of Pediatric Neurology (U.R.), Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A M Tokola
- From the Department of Radiology (U.R., A.M.T., T.A., T.R.), HUS Medical Imaging Center
| | - T Autti
- From the Department of Radiology (U.R., A.M.T., T.A., T.R.), HUS Medical Imaging Center
| | - T Roine
- From the Department of Radiology (U.R., A.M.T., T.A., T.R.), HUS Medical Imaging Center
- Department of Neuroscience and Biomedical Engineering (T.R.), Aalto University School of Science, Espoo, Finland
- Turku Brain and Mind Center (T.R.), University of Turku, Turku, Finland
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2
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Hong H, Wang S, Yu X, Jiaerken Y, Guan X, Zeng Q, Yin X, Zhang R, Zhang Y, Zhu Z, Huang P, Zhang M. White Matter Tract Injury by MRI in CADASIL Patients is Associated With Iron Accumulation. J Magn Reson Imaging 2023; 57:238-245. [PMID: 35735742 DOI: 10.1002/jmri.28301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Widespread white matter (WM) injury is a hallmark feature of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). However, controversies about the mechanism of WM tract injury exist persistently. Excessive iron accumulation, frequently reported in CADASIL patients, might cause WM tract injury. PURPOSE To test the association between iron accumulation and WM tract injury in CADASIL patients. STUDY TYPE Retrospective. POPULATION A total of 35 CADASIL patients (age = 50.4 ± 6.4, 62.9% female) and 48 healthy controls (age = 55.7 ± 8.0, 68.8% female). FIELD STRENGTH/SEQUENCE Diffusion-weighted spin-echo echo-planar sequence; enhanced susceptibility-weighted angiography (ESWAN) gradient echo sequence on a 3 T scanner. ASSESSMENT The phase images acquired by ESWAN were used to calculate quantitative susceptibility mapping (QSM). Iron accumulation was evaluated in deep gray matters using QSM. WM tract injury was quantified by diffusion metrics based on WM major tracts skeleton. We compared iron deposition between groups and analyzed the correlation between WM tract injury and iron deposition in regions showing significant differences from healthy controls. Exploratory analysis was carried out to investigate whether WM tract injury mediated the relationship between iron deposition and cognitive impairment evaluated by Mini-Mental State Examination (MMSE). STATISTICAL TESTS General linear model (GLM), partial correlation, stepwise linear regression and mediation analysis were used. The threshold of statistical significance was set as p < 0.05. RESULTS Compared with healthy controls, CADASIL patients had significantly increased iron deposition in the caudate and putamen. Aberrant iron deposition in these two regions was significantly associated with decreased WM fractional anisotropy (FA) (caudate, r = -0.373; putamen, r = - 0.421), and increased radial diffusivity (RD) (caudate, r = 0.372; putamen, r = 0.386). Furthermore, WM tract injury mediated the relationship between iron deposition and cognitive impairment. DATA CONCLUSION Patients with CADASIL show increased iron deposition in the caudate and putamen that is correlated to WM tract injury, which may in turn mediate the association with cognitive impairment. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Hui Hong
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xinfeng Yu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yeerfan Jiaerken
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xinzhen Yin
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Ruiting Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yao Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Zili Zhu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
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3
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Jin Z, Wang Y, Jokar M, Li Y, Cheng Z, Liu Y, Tang R, Shi X, Zhang Y, Min J, Liu F, He N, Yan F, Haacke EM. Automatic detection of neuromelanin and iron in the midbrain nuclei using a
magnetic resonance imaging
‐based brain template. Hum Brain Mapp 2022; 43:2011-2025. [PMID: 35072301 PMCID: PMC8933249 DOI: 10.1002/hbm.25770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/01/2021] [Accepted: 12/22/2021] [Indexed: 12/17/2022] Open
Abstract
Parkinson disease (PD) is a chronic progressive neurodegenerative disorder characterized pathologically by early loss of neuromelanin (NM) in the substantia nigra pars compacta (SNpc) and increased iron deposition in the substantia nigra (SN). Degeneration of the SN presents as a 50 to 70% loss of pigmented neurons in the ventral lateral tier of the SNpc at the onset of symptoms. Also, using magnetic resonance imaging (MRI), iron deposition and volume changes of the red nucleus (RN), and subthalamic nucleus (STN) have been reported to be associated with disease status and rate of progression. Further, the STN serves as an important target for deep brain stimulation treatment in advanced PD patients. Therefore, an accurate in‐vivo delineation of the SN, its subregions and other midbrain structures such as the RN and STN could be useful to better study iron and NM changes in PD. Our goal was to use an MRI template to create an automatic midbrain deep gray matter nuclei segmentation approach based on iron and NM contrast derived from a single, multiecho magnetization transfer contrast gradient echo (MTC‐GRE) imaging sequence. The short echo TE = 7.5 ms data from a 3D MTC‐GRE sequence was used to find the NM‐rich region, while the second echo TE = 15 ms was used to calculate the quantitative susceptibility map for 87 healthy subjects (mean age ± SD: 63.4 ± 6.2 years old, range: 45–81 years). From these data, we created both NM and iron templates and calculated the boundaries of each midbrain nucleus in template space, mapped these boundaries back to the original space and then fine‐tuned the boundaries in the original space using a dynamic programming algorithm to match the details of each individual's NM and iron features. A dual mapping approach was used to improve the performance of the morphological mapping of the midbrain of any given individual to the template space. A threshold approach was used in the NM‐rich region and susceptibility maps to optimize the DICE similarity coefficients and the volume ratios. The results for the NM of the SN as well as the iron containing SN, STN, and RN all indicate a strong agreement with manually drawn structures. The DICE similarity coefficients and volume ratios for these structures were 0.85, 0.87, 0.75, and 0.92 and 0.93, 0.95, 0.89, 1.05, respectively, before applying any threshold on the data. Using this fully automatic template‐based deep gray matter mapping approach, it is possible to accurately measure the tissue properties such as volumes, iron content, and NM content of the midbrain nuclei.
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Affiliation(s)
- Zhijia Jin
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Ying Wang
- SpinTech MRI, Inc. Detroit Michigan USA
- Department of Radiology Wayne State University Detroit Michigan USA
| | | | - Yan Li
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Yu Liu
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Xiaofeng Shi
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Youmin Zhang
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Jihua Min
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Fangtao Liu
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Naying He
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Ewart Mark Haacke
- Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
- SpinTech MRI, Inc. Detroit Michigan USA
- Department of Radiology Wayne State University Detroit Michigan USA
- Department of Biomedical Engineering Wayne State University Detroit Michigan USA
- Department of Neurology Wayne State University Detroit Michigan USA
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Li M, Ji C, Xuan W, Chen W, Lv Y, Liu T, You Y, Gao F, Zheng Q, Shao J. Effects of Daily Iron Supplementation on Motor Development and Brain Connectivity in Preterm Infants: A Diffusion Magnetic Resonance Study. Front Neurosci 2021; 15:769558. [PMID: 34819836 PMCID: PMC8606812 DOI: 10.3389/fnins.2021.769558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/12/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives: The aim of the study is to demonstrate the characteristic of motor development and MRI changes of related brain regions in preterm infants with different iron statuses and to determine whether the daily iron supplementation can promote motor development for preterm in early infancy. Methods: The 63 preterm infants were grouped into non-anemia with higher serum ferritin (NA-HF) group and anemia with lower serum ferritin (A-LF) group according to their lowest serum Hb level in the neonatal period as well as the sFer at 3 months old. Forty-nine participants underwent MRI scans and Infant Neurological International Battery (INFANIB) at their 3 months. At 6 months of corrected age, these infants received the assessment of Peabody Developmental Motor Scales (PDMS) after 2 mg/kg/day iron supplementation. Results: In total, 19 preterm infants were assigned to the NA-HF group while 44 preterm infants to the A-LF groups. The serum ferritin (sFer) level of the infants in A-LF group was lower than that in NA-HF group (44.0 ± 2.8 mg/L vs. 65.1 ± 2.8 mg/L, p < 0.05) and was with poorer scores of INFANIB (66.8 ± 0.9 vs. 64.4 ± 0.6, p < 0.05) at 3 months old. The structural connectivity between cerebellum and ipsilateral thalamus in the NA-HF group was significantly stronger than that in the A-LF group (n = 17, 109.76 ± 23.8 vs. n = 32, 70.4 ± 6.6, p < 0.05). The decreased brain structural connectivity was positively associated with the scores of PDMS (r = 0.347, p < 0.05). After 6 months of routine iron supplementation, no difference in Hb, MCV, MCHC, RDW, and sFer was detected between A-LF and NA-HF groups as well as the motor scores of PDMS-2 assessments. Conclusion: Iron status at early postnatal period of preterm infant is related to motor development and the enrichment of brain structural connectivity. The decrease in brain structural connectivity is related to the motor delay. After supplying 2 mg/kg of iron per day for 6 months, the differences in the iron status and motor ability between the A-LF and NA-HF groups were eliminated.
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Affiliation(s)
- Mingyan Li
- Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chai Ji
- Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weifeng Xuan
- Shaoxing Maternal and Child Health Care Hospital, Shaoxing, China
| | - Weijun Chen
- Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Lv
- Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tingting Liu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Yuqing You
- Department of Radiology, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fusheng Gao
- Department of Radiology, National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quan Zheng
- Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Shao
- Department of Child Health Care, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Huang W, Ogbuji R, Zhou L, Guo L, Wang Y, Kopell BH. Motoric impairment versus iron deposition gradient in the subthalamic nucleus in Parkinson's disease. J Neurosurg 2021; 135:284-290. [PMID: 32764171 DOI: 10.3171/2020.5.jns201163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/12/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the correlation between the quantitative susceptibility mapping (QSM) signal gradient of the subthalamic nucleus (STN) and motor impairment in patients with Parkinson's disease (PD). METHODS All PD patients who had undergone QSM MRI for presurgical deep brain stimulation (DBS) planning were eligible for inclusion in this study. The entire STN and its three functional subdivisions, as well as the adjacent white matter (WM), were segmented and measured. The QSM value difference between the entire STN and adjacent WM (STN-WM), between the limbic and associative regions of the STN (L-A), and between the associative and motor regions of the STN (A-M) were obtained as measures of gradient and were input into an unsupervised k-means clustering algorithm to automatically categorize the overall boundary distinctness between the STN and adjacent WM and between STN subdivisions (gradient blur [GB] and gradient sharp [GS] groups). Statistical tests were performed to compare clinical and image measurements for discrimination between GB and GS groups. RESULTS Of the 39 study patients, 19 were categorized into the GB group and 20 into the GS group, based on quantitative cluster analysis. The GB group had a significantly higher presurgical off-medication Unified Parkinson's Disease Rating Scale Part III score (51.289 ± 20.741) than the GS group (38.5 ± 16.028; p = 0.037). The GB group had significantly higher QSM values for the STN and its three subdivisions and adjacent WM than those for the GS group (p < 0.01). The GB group also demonstrated a significantly higher STN-WM gradient in the right STN (p = 0.01). The GB group demonstrated a significantly lower L-A gradient in both the left and the right STN (p < 0.02). CONCLUSIONS Advancing PD with more severe motor impairment leads to more iron deposition in the STN and adjacent WM, as shown in the QSM signal. Loss of the STN inner QSM signal gradient should be considered as an image marker for more severe motor impairment in PD patients.
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Affiliation(s)
- Weiyuan Huang
- 1Department of Radiology, Weill Medical College of Cornell University, New York
- 7Department of Radiology, Hainan General Hospital (Affiliated Hainan Hospital of Hainan Medical University), Haikou City, People's Republic of China
| | | | - Liangdong Zhou
- 1Department of Radiology, Weill Medical College of Cornell University, New York
| | - Lingfei Guo
- 1Department of Radiology, Weill Medical College of Cornell University, New York
| | - Yi Wang
- 1Department of Radiology, Weill Medical College of Cornell University, New York
- 6Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York; and
| | - Brian H Kopell
- Departments of2Neurosurgery
- 3Neurology
- 4Psychiatry, and
- 5Neuroscience, Icahn School of Medicine at Mount Sinai, New York
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6
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Direct visualization of deep brain stimulation targets in patients with Parkinson's disease via 3-T quantitative susceptibility mapping. Acta Neurochir (Wien) 2021; 163:1335-1345. [PMID: 33576911 DOI: 10.1007/s00701-021-04715-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/11/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND The direct visualization of brain nuclei on magnetic resonance (MR) images is important for target localization during deep brain stimulation (DBS) in patients with Parkinson's disease (PD). We demonstrated the superiority of 3-T high-resolution submillimeter voxel size quantitative susceptibility mapping (QSM) for delineating the subthalamic nucleus (STN) and the globus pallidus internus (GPi). METHODS Preoperative 3-T QSM and T2 weighted (T2w) images were obtained from ten patients with PD. Qualitative visualization scores were analyzed by two neurosurgeons on both images using a 4-point and 5-point scale, respectively. Images were also compared with regard to contrast-to-noise ratios (CNRs) and edge detection power for the STN and GPi. The Wilcoxon rank-sum test and the signed-rank test were used to compare measurements between the two images. RESULTS Visualization scores for the STN and GPi, the mean CNR of the STN relative to the zona incerta (ZI) and the substantia nigra, and the mean CNR of the GPi relative to the internal capsule (IC) and the globus pallidum externum, were significantly higher on QSM images than on T2w images (P < 0.01). The edge detection powers of the STN-ZI and GPi-IC on QSM were significantly larger (by 2.6- and 3.8-fold, respectively) than those on T2w images (P < 0.01). QSM detected asymmetry of the STN in two patients. CONCLUSIONS QSM images provided improved delineation ability for the STN and GPi when compared to T2w images. Our findings are important for patients with PD who undergo DBS surgery, particularly those with asymmetric bilateral nuclei.
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Zhang J, Liu Z, Zhang S, Zhang H, Spincemaille P, Nguyen TD, Sabuncu MR, Wang Y. Fidelity imposed network edit (FINE) for solving ill-posed image reconstruction. Neuroimage 2020; 211:116579. [PMID: 31981779 PMCID: PMC7093048 DOI: 10.1016/j.neuroimage.2020.116579] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/20/2019] [Accepted: 01/20/2020] [Indexed: 01/19/2023] Open
Abstract
Deep learning (DL) is increasingly used to solve ill-posed inverse problems in medical imaging, such as reconstruction from noisy and/or incomplete data, as DL offers advantages over conventional methods that rely on explicit image features and hand engineered priors. However, supervised DL-based methods may achieve poor performance when the test data deviates from the training data, for example, when it has pathologies not encountered in the training data. Furthermore, DL-based image reconstructions do not always incorporate the underlying forward physical model, which may improve performance. Therefore, in this work we introduce a novel approach, called fidelity imposed network edit (FINE), which modifies the weights of a pre-trained reconstruction network for each case in the testing dataset. This is achieved by minimizing an unsupervised fidelity loss function that is based on the forward physical model. FINE is applied to two important inverse problems in neuroimaging: quantitative susceptibility mapping (QSM) and under-sampled image reconstruction in MRI. Our experiments demonstrate that FINE can improve reconstruction accuracy.
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Affiliation(s)
- Jinwei Zhang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Zhe Liu
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Shun Zhang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Hang Zhang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA; Department of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA
| | - Pascal Spincemaille
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Thanh D Nguyen
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Mert R Sabuncu
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA; Department of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA
| | - Yi Wang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA; Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA.
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8
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Eskreis-Winkler S, Simon K, Reichman M, Spincemaille P, Nguyen T, Kee Y, Cho J, Christos PJ, Drotman M, Prince MR, Morris EA, Wang Y. Dipole modeling of multispectral signal for detecting metallic biopsy markers during MRI-guided breast biopsy: a pilot study. Magn Reson Med 2019; 83:1380-1389. [PMID: 31631408 DOI: 10.1002/mrm.28017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE During MRI-guided breast biopsy, a metallic biopsy marker is deployed at the biopsy site to guide future interventions. Conventional MRI during biopsy cannot distinguish such markers from biopsy site air, and a post-biopsy mammogram is therefore performed to localize marker placement. The purpose of this pilot study is to develop dipole modeling of multispectral signal (DIMMS) as an MRI alternative to eliminate the cost, inefficiency, inconvenience, and ionizing radiation of a mammogram for biopsy marker localization. METHODS DIMMS detects and localizes the biopsy marker by fitting the measured multispectral imaging (MSI) signal to the MRI signal model and marker properties. MSI was performed on phantoms containing titanium biopsy markers and air to illustrate the clinical challenge that DIMMS addresses and on 20 patients undergoing MRI-guided breast biopsy to assess DIMMS feasibility for marker detection. DIMMS was compared to conventional MSI field map thresholding, using the post-procedure mammogram as the reference standard. RESULTS Biopsy markers were detected and localized in 20 of 20 cases using MSI with automated DIMMS post-processing (using a threshold of 0.7) and in 18 of 20 cases using MSI field mapping (using a threshold of 0.65 kHz). CONCLUSION MSI with DIMMS post-processing is a feasible technique for biopsy marker detection and localization during MRI-guided breast biopsy. With a 2-min MSI scan, DIMMS is a promising MRI alternative to the standard-of-care post-biopsy mammogram.
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Affiliation(s)
- Sarah Eskreis-Winkler
- Department of Radiology, Weill Cornell Medicine, New York, New York.,Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Katherine Simon
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Melissa Reichman
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | | | - Thanh Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Youngwook Kee
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Junghun Cho
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Paul J Christos
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy & Research, Weill Cornell Medicine, New York, New York
| | - Michele Drotman
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Martin R Prince
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Elizabeth A Morris
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, New York, New York
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