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Du S, Gong G, Chen M, Liu R, Meng K, Yin Y. The effect of time-delayed contrast-enhanced scanning in determining the gross tumor target volume of large-volume brain metastases. Radiother Oncol 2024; 197:110330. [PMID: 38768715 DOI: 10.1016/j.radonc.2024.110330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/07/2024] [Accepted: 05/01/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND AND PURPOSE To assess the variation of large-volume brain metastases (BMs) boundaries and shapes using enhanced magnetic resonance (MR) scanning with different delay times and to provide a basis for determining the gross tumor target volume (GTV) for radiotherapy of BMs. MATERIALS AND METHODS We prospectively enrolled 155 patients initially diagnosed with BMs (561 lesions > 1 cm). Contrast-enhanced (CE) T1-weighted imaging scans were performed 1, 3, 5, 10, 18, and 20 min after gadolinium-based contrast agent injection and GTVs were determined as GTV-1min, GTV-3min, GTV-5min, GTV-10min, GTV-18min, and GTV-20min, respectively, which were subsequently fused in different phases. Fusion of the six GTVs was defined as GTV-total, which was set as the reference GTV. The volume, shape, and signal intensity of the GTVs and brain white matter (BWM) were compared at different delay times. RESULTS GTV-3min, GTV-5min, GTV-10min, GTV-18min, and GTV-20min volumes increased by 2.2 %, 3.8 %, 6.5 %, 9.5 %, and 10.6 %, respectively (P < 0.05) compared with GTV-1min. Compared with GTV-total, GTV-1min, GTV-3min, GTV-5min, GTV-10min, GTV-18min, and GTV-20min volumes reduced by 25.4 %, 22.1 %, 18.7 %, 15.0 %, 11.2 %, and 10.3 %, respectively (P < 0.05). Compared with GTV-total, 29 (51.8 %) fused GTVs had a volume reduction rate < 5 %, 45 (80.4 %) had a Dice similarity coefficient > 0.95, and all contained GTV-10min, GTV-18min or GTV-20min. The signal intensity ratio between the GTV and BWM peaked at 5 min (0.351 ± 0.24). CONCLUSION Enhanced MR scans with different delay times show significant differences in the boundaries and shapes of large-volume BMs, and time-delayed multi-phase CE scanning should be used in GTV determination, with time phases ≥ 10 min being mandatory.
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Affiliation(s)
- Shanshan Du
- Department of Oncology, Afliated Hospital of Southwest Medical University, No.25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan, China; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji Yan Road No.440, 250117 Jinan, China
| | - Guanzhong Gong
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji Yan Road No.440, 250117 Jinan, China
| | - Mingming Chen
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Rui Liu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji Yan Road No.440, 250117 Jinan, China
| | - Kangning Meng
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji Yan Road No.440, 250117 Jinan, China
| | - Yong Yin
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji Yan Road No.440, 250117 Jinan, China.
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Du S, Gong G, Liu R, Meng K, Yin Y. Advances in determining the gross tumor target volume for radiotherapy of brain metastases. Front Oncol 2024; 14:1338225. [PMID: 38779095 PMCID: PMC11109437 DOI: 10.3389/fonc.2024.1338225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Brain metastases (BMs) are the most prevalent intracranial malignant tumors in adults and are the leading cause of mortality attributed to malignant brain diseases. Radiotherapy (RT) plays a critical role in the treatment of BMs, with local RT techniques such as stereotactic radiosurgery (SRS)/stereotactic body radiotherapy (SBRT) showing remarkable therapeutic effectiveness. The precise determination of gross tumor target volume (GTV) is crucial for ensuring the effectiveness of SRS/SBRT. Multimodal imaging techniques such as CT, MRI, and PET are extensively used for the diagnosis of BMs and GTV determination. With the development of functional imaging and artificial intelligence (AI) technology, there are more innovative ways to determine GTV for BMs, which significantly improve the accuracy and efficiency of the determination. This article provides an overview of the progress in GTV determination for RT in BMs.
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Affiliation(s)
- Shanshan Du
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Guanzhong Gong
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Rui Liu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Kangning Meng
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Yong Yin
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Zheng Z, Liu Y, Yin H, Ren P, Zhang T, Yang J, Wang Z. Evaluating T1, T2 Relaxation, and Proton Density in Normal Brain Using Synthetic MRI with Fast Imaging Protocol. Magn Reson Med Sci 2023:tn.2022-0161. [PMID: 37690836 DOI: 10.2463/mrms.tn.2022-0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Synthetic MRI is being increasingly used for the quantification of brain longitudinal relaxation time (T1), transverse relaxation time (T2), and proton density (PD) values. However, the effect of fast imaging protocols on these quantitative values has not been fully estimated. The purpose of this study was to investigate the effect of fast scan parameters on T1, T2, and PD measured with a multi-dynamic multi-echo (MDME) sequence of normal brain at 3.0T. Thirty-four volunteers were scanned using 3 MDME sequences with different scan times (named Fast, 2 min, 29 sec; Routine, 4 min, 07 sec; and Research, 7 min, 46 sec, respectively). The measured T1, T2, and PD in 18 volumes of interest (VOI) of brain were compared between the 3 sequences using rank sum test, t test, coefficients of variation (CVs) analysis, correlation analysis, and Bland-Altman analysis. We found that even though T1, T2, and PD were significantly different between the 3 sequences in most of the brain regions, the intersequence CVs were relatively low and linear correlation were high. Bland-Altman plots showed that most of the values fall within the 95% prediction limits. We concluded that fast imaging protocols of MDME sequence used in our study can potentially be used for quantitative evaluation of brain tissues. Since changing scan parameters can affect the measured T1, T2, and PD values, it is necessary to use consistent scan parameter for comparing or following up cases quantitatively.
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Affiliation(s)
- Zuofeng Zheng
- Department of Radiology, Beijing ChuiYangLiu Hospital
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Yawen Liu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
- School of Biological Science and Medical Engineering, Beihang University
| | - Hongxia Yin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Pengling Ren
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Tingting Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
- School of Biological Science and Medical Engineering, Beihang University
| | - Jiafei Yang
- Department of Radiology, Beijing ChuiYangLiu Hospital
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
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Chen M, Guo Y, Wang P, Chen Q, Bai L, Wang S, Su Y, Wang L, Gong G. An Effective Approach to Improve the Automatic Segmentation and Classification Accuracy of Brain Metastasis by Combining Multi-phase Delay Enhanced MR Images. J Digit Imaging 2023; 36:1782-1793. [PMID: 37259008 PMCID: PMC10406988 DOI: 10.1007/s10278-023-00856-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023] Open
Abstract
The objective of this study is to analyse the diffusion rule of the contrast media in multi-phase delayed enhanced magnetic resonance (MR) T1 images using radiomics and to construct an automatic classification and segmentation model of brain metastases (BM) based on support vector machine (SVM) and Dpn-UNet. A total of 189 BM patients with 1047 metastases were enrolled. Contrast-enhanced MR images were obtained at 1, 3, 5, 10, 18, and 20 min following contrast medium injection. The tumour target volume was delineated, and the radiomics features were extracted and analysed. BM segmentation and classification models in the MR images with different enhancement phases were constructed using Dpn-UNet and SVM, and differences in the BM segmentation and classification models with different enhancement times were compared. (1) The signal intensity for BM decreased with time delay and peaked at 3 min. (2) Among the 144 optimal radiomics features, 22 showed strong correlation with time (highest R-value = 0.82), while 41 showed strong correlation with volume (highest R-value = 0.99). (3) The average dice similarity coefficients of both the training and test sets were the highest at 10 min for the automatic segmentation of BM, reaching 0.92 and 0.82, respectively. (4) The areas under the curve (AUCs) for the classification of BM pathology type applying single-phase MRI was the highest at 10 min, reaching 0.674. The AUC for the classification of BM by applying the six-phase image combination was the highest, reaching 0.9596, and improved by 42.3% compared with that by applying single-phase images at 10 min. The dynamic changes of contrast media diffusion in BM can be reflected by multi-phase delayed enhancement based on radiomics, which can more objectively reflect the pathological types and significantly improve the accuracy of BM segmentation and classification.
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Affiliation(s)
- Mingming Chen
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
- College of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yujie Guo
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
| | - Pengcheng Wang
- College of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Qi Chen
- MedMind Technology Co., Ltd, 100084, Beijing, China
| | - Lu Bai
- MedMind Technology Co., Ltd, 100084, Beijing, China
| | - Shaobin Wang
- MedMind Technology Co., Ltd, 100084, Beijing, China
| | - Ya Su
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
| | - Lizhen Wang
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
| | - Guanzhong Gong
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China.
- Department of Engineering Physics, Tsing Hua University, Beijing, 100084, China.
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Nunez-Gonzalez L, van Garderen KA, Smits M, Jaspers J, Romero AM, Poot DHJ, Hernandez-Tamames JA. Pre-contrast MAGiC in treated gliomas: a pilot study of quantitative MRI. Sci Rep 2022; 12:21820. [PMID: 36528673 PMCID: PMC9759533 DOI: 10.1038/s41598-022-24276-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
Quantitative MR imaging is becoming more feasible to be used in clinical work since new approaches have been proposed in order to substantially accelerate the acquisition and due to the possibility of synthetically deriving weighted images from the parametric maps. However, their applicability has to be thoroughly validated in order to be included in clinical practice. In this pilot study, we acquired Magnetic Resonance Image Compilation scans to obtain T1, T2 and PD maps in 14 glioma patients. Abnormal tissue was segmented based on conventional images and using a deep learning segmentation technique to define regions of interest (ROIs). The quantitative T1, T2 and PD values inside ROIs were analyzed using the mean, the standard deviation, the skewness and the kurtosis and compared to the quantitative T1, T2 and PD values found in normal white matter. We found significant differences in pre-contrast T1 and T2 values between abnormal tissue and healthy tissue, as well as between T1w-enhancing and non-enhancing regions. ROC analysis was used to evaluate the potential of quantitative T1 and T2 values for voxel-wise classification of abnormal/normal tissue (AUC = 0.95) and of T1w enhancement/non-enhancement (AUC = 0.85). A cross-validated ROC analysis found high sensitivity (73%) and specificity (73%) with AUCs up to 0.68 on the a priori distinction between abnormal tissue with and without T1w-enhancement. These results suggest that normal tissue, abnormal tissue, and tissue with T1w-enhancement are distinguishable by their pre-contrast quantitative values but further investigation is needed.
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Affiliation(s)
- Laura Nunez-Gonzalez
- grid.5645.2000000040459992XRadiology and Nuclear Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Karin A. van Garderen
- grid.5645.2000000040459992XRadiology and Nuclear Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands ,grid.508717.c0000 0004 0637 3764Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marion Smits
- grid.5645.2000000040459992XRadiology and Nuclear Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands ,grid.508717.c0000 0004 0637 3764Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Jaap Jaspers
- grid.508717.c0000 0004 0637 3764Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Alejandra Méndez Romero
- grid.508717.c0000 0004 0637 3764Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Dirk H. J. Poot
- grid.5645.2000000040459992XRadiology and Nuclear Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Juan A. Hernandez-Tamames
- grid.5645.2000000040459992XRadiology and Nuclear Medicine, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
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Ludovichetti R, Delattre B, Boto J, LaGrange D, Meling T, Vargas MI. Characterization of meningiomas with synthetic imaging. Brain Behav 2022; 12:e2769. [PMID: 36225121 PMCID: PMC9660428 DOI: 10.1002/brb3.2769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Synthetic magnetic resonance imaging (SyMRI) is a novel quantitative and qualitative technique that permits the reconstruction of multiple image contrasts and quantitative maps from a single scan, thereby providing quantitative information and reducing scan times. The purpose of this study is to characterize intracranial meningiomas using SyMRI. METHODS The study included 35 patients with meningiomas (6 males, 29 females; mean age 61 ± 17 years; range 21-90 years). Using 3T MR scanners, SyMRI was performed in addition to conventional FSET2, FLAIR, DWI, T1, and T1 with gadolinium. SyMRI software was used to generate T1, T2, and PD quantitative maps. Osirix MD was used to measure quantitative values of T1, T2, and PD using a ROI. RESULTS We analyzed 42 meningiomas, 8 of which were associated with edema, and 5 contained calcifications. Mean relaxivity values of meningiomas on synthetic T1, T2, and PD maps at 3T MRI were 1382.6 ± 391.7 ms, 95.6 ± 36.5 ms, and 89.1 ± 9.7 pu, respectively. Signal intensities in terms of T1, T2, and PD did not differ significantly between meningiomas with and without edema (p = .994, p = .356, and p = .221, respectively), nor between meningiomas containing and not containing calcifications (p = .840, p = .710, and p = .455, respectively). Values of T1 and T2 measured in meningiomas and the normal-appearing white matter approximated reference values found in the literature with other quantitative methods. CONCLUSION The presented method offers a novel approach to characterize meningiomas through their relaxation parameters measured with a SyMRI sequence.
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Affiliation(s)
- Riccardo Ludovichetti
- Division of Radiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland.,Division of Neuroradiology, University Hospitals of Zurich
| | - Bénédicte Delattre
- Division of Radiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - José Boto
- Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Daniela LaGrange
- Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - Torstein Meling
- Division of Neurosurgery, Neurosciences Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Médecine, University of Geneva, Geneva, Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Médecine, University of Geneva, Geneva, Switzerland
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Chen M, Wang P, Guo Y, Yin Y, Wang L, Su Y, Gong G. The effect of time delay for magnetic resonance contrast-enhanced scan on imaging for small-volume brain metastases. Neuroimage Clin 2022; 36:103223. [PMID: 36209620 PMCID: PMC9668622 DOI: 10.1016/j.nicl.2022.103223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE To study the effect of different enhancement timings of magnetic resonance (MR) on small-volume brain metastases (BM) visualisation and provide a basis for the contour of tumour targets. METHOD We prospectively enrolled 101 patients with BM who received radiotherapy. All patients underwent computed tomography (CT) and MR simulations. Contrast-enhanced MR scans at 1, 3, 5, 10, 18, and 20 min after injection of contrast medium were performed. The tumour target was determined on MR images at different enhancement times, and the differences of tumour target volume, maximum diameter, and MR signal intensity were compared. RESULTS (1) Of the 453 metastatic lesions, 24 (5.2 %) were not detected at 1 min and 8 (1.8 %) were not detected at 3 min; however, all metastases were detected after 5 min. The volume and maximum diameter of the 28 (6.2 %) metastases were stable at any time. (2) The average volume of metastatic lesions at 1, 3, 5, 10, 18, and 20 min was 0.09 cm3, 0.10 cm3, 0.12 cm3, 0.12 cm3, 0.13 cm3, and 0.13 cm3, respectively. Compared to 1 min, BM volume at other times increased by 13.1 %, 21.5 %, 31.6 %, 39.6 %, and 41.7 %, and the difference between the maximum and minimum volumes was statistically significant (p < 0.05). (3) The distribution of the maximum ratio of tumours to white matter mean signal intensity at different times were 39.6 %, 20 %, 14.6 %, 8.0 %, 10.4 %, and 10 %, respectively. CONCLUSION The visualisation of small-volume BM was significantly different at different enhancement times. Our results suggest that multi-timing enhancement scans for small-volume BM should be implemented and that scanning at >10 min is essential.
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Affiliation(s)
- Mingming Chen
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China,College of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Pengcheng Wang
- College of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Yujie Guo
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China
| | - Yong Yin
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China
| | - Lizhen Wang
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China
| | - Ya Su
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China
| | - Guanzhong Gong
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China,Department of Engineering Physics, Tsing Hua University, Beijing 100084, China,Corresponding author at: Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan 250117, China.
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Khosdelazad S, Jorna LS, Groen RJM, Rakers SE, Timmerman ME, Borra RJH, van der Hoorn A, Spikman JM, Buunk AM. Investigating Recovery After Subarachnoid Hemorrhage With the Imaging, Cognition and Outcome of Neuropsychological Functioning After Subarachnoid Hemorrhage (ICONS) Study: Protocol for a Longitudinal, Prospective Cohort Study. JMIR Res Protoc 2022; 11:e38190. [PMID: 36173673 PMCID: PMC9562051 DOI: 10.2196/38190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background A subarachnoid hemorrhage is a hemorrhage in the subarachnoid space that is often caused by the rupture of an aneurysm. Patients who survive a subarachnoid hemorrhage have a high risk of complications and a negative long-term outcome. Objective The aim of the Imaging, Cognition and Outcome of Neuropsychological functioning after Subarachnoid hemorrhage (ICONS) study is to investigate whether and to what extent deficits exist in multiple domains after subarachnoid hemorrhage, including cognition, emotion and behavior, and to investigate whether brain damage can be detected in patients with subarachnoid hemorrhage. We aim to determine which early measures of cognition, emotion and behavior, and brain damage in the subacute stage play a role in long-term recovery after subarachnoid hemorrhage. Recovery is defined as functioning at a societal participation level, with a focus on resuming and maintaining work, leisure activities, and social relationships over the long term. Methods The ICONS study is an observational, prospective, single-center cohort study. The study includes patients with subarachnoid hemorrhage admitted to the Neurosurgery Unit of the University Medical Centre Groningen in the Netherlands. The inclusion criteria include diagnosis of an aneurysmal subarachnoid hemorrhage or an angiographically negative subarachnoid hemorrhage, sufficient ability in the Dutch language, and age older than 18 years. Patients will undergo neuropsychological assessment and magnetic resonance imaging 6 months after the subarachnoid hemorrhage. Furthermore, patients will be asked to fill in questionnaires on multiple psychosocial measures and undergo a structured interview at 6 months, 1 year, and 2 years after the subarachnoid hemorrhage. The primary outcome measure of the ICONS study is societal participation 1 year after the subarachnoid hemorrhage, measured with the Dutch version of the Impact on Participation and Autonomy questionnaire. Results The study was launched in December 2019 and recruitment is expected to continue until June 2023. At the time of the acceptance of this paper, 76 patients and 69 healthy controls have been included. The first results are expected in early 2023. Conclusions The ICONS study is the first to collect and combine data after subarachnoid hemorrhage in a variety of domains, including cognition, emotion and behavior, and brain damage. The results will contribute to a more comprehensive understanding of the consequences of both aneurysmal subarachnoid hemorrhage and angiographically negative subarachnoid hemorrhage, which may ultimately optimize timely treatment for this patient group by setting realistic and attainable goals to improve daily functioning. Trial Registration Netherlands Trial Register NL7803; https://trialsearch.who.int/Trial2.aspx?TrialID=NL7803 International Registered Report Identifier (IRRID) DERR1-10.2196/38190
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Affiliation(s)
- Sara Khosdelazad
- Neuropsychology Unit, Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Lieke S Jorna
- Neuropsychology Unit, Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Rob J M Groen
- Department of Neurosurgery, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Sandra E Rakers
- Neuropsychology Unit, Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Marieke E Timmerman
- Department of Psychometrics and Statistics, University of Groningen, Groningen, Netherlands
| | - Ronald J H Borra
- Department of Radiology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Anouk van der Hoorn
- Department of Radiology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Jacoba M Spikman
- Neuropsychology Unit, Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Anne M Buunk
- Neuropsychology Unit, Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Zhang K, Liu C, Zhu Y, Li W, Li X, Zheng J, Hong G. Synthetic MRI in the detection and quantitative evaluation of sacroiliac joint lesions in axial spondyloarthritis. Front Immunol 2022; 13:1000314. [PMID: 36225919 PMCID: PMC9549954 DOI: 10.3389/fimmu.2022.1000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveOur primary objective was to verify the hypothesis that synthetic magnetic resonance imaging (MRI) is similar to conventional MRI in detecting sacroiliac joint lesions in patients with axial spondyloarthritis (axSpA). A secondary objective was to assess the quantitative value of synthetic mapping in bone marrow edema (BME) and fat metaplasia.MethodsA total of 132 axSpA patients who underwent synthetic and conventional MRI from October 2019 to March 2021 were included in this prospective study. Two independent readers visually evaluated active inflammatory (BME, capsulitis, enthesitis, and inflammation at site of erosion) and structural lesions (erosion, sclerosis, ankylosis, and fat metaplasia) of the sacroiliac joints on conventional and synthetic magnetic resonance (MR) images. In addition, T1, T2, and proton density (PD) values, which were generated by synthetic mapping, were used to further quantitatively evaluate BME and fat metaplasia. A McNemar test was used to compare the differences between the two methods in the detection of sacroiliac joint lesions. Intraclass correlation coefficients (ICCs) were used to assess the inter-reader consistency of quantitative values. Mann–Whitney tests were performed, and receiver operating characteristic (ROC) curves were created for all quantitative analyses.ResultsThere were no statistical difference between synthetic and conventional MRI in the detection of sacroiliac joint lesions (all p-values > 0.05). A total of 103 images of BME and 111 images of fat metaplasia were quantitatively evaluated using T1, T2, and PD values. The consistency of quantitative values among readers was good (ICC 0.903–0.970). T1 and T2 values were consistently higher in BME than in normal marrow (p < 0.001), but PD values were not significantly different (p = 0.830). T2 and PD values were higher in fat metaplasia than in normal marrow, but T1 values were lower (p < 0.001). In the case of BME, T1 values had greater diagnostic efficiency [area under the curve (AUC) 0.99] than T2 values (AUC 0.78). There were no significant differences in the diagnostic efficiency of T1 (AUC 0.88), T2 (AUC 0.88), and PD (AUC 0.88) values in the case of fat metaplasia.ConclusionSynthetic MRI is as effective as conventional MRI in detecting sacroiliac joint lesions in patients with axSpA. Furthermore, synthetic mapping can accurately quantify BME and fat metaplasia.
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Affiliation(s)
- Ke Zhang
- Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chaoran Liu
- Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yunfei Zhu
- Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wenjuan Li
- Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ximeng Li
- Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jing Zheng
- Department of Rheumatology and Immunology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- *Correspondence: Guobin Hong, ; Jing Zheng,
| | - Guobin Hong
- Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- *Correspondence: Guobin Hong, ; Jing Zheng,
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Konar AS, Paudyal R, Shah AD, Fung M, Banerjee S, Dave A, Lee N, Hatzoglou V, Shukla-Dave A. Qualitative and Quantitative Performance of Magnetic Resonance Image Compilation (MAGiC) Method: An Exploratory Analysis for Head and Neck Imaging. Cancers (Basel) 2022; 14:cancers14153624. [PMID: 35892883 PMCID: PMC9331960 DOI: 10.3390/cancers14153624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/27/2023] Open
Abstract
The present exploratory study investigates the performance of a new, rapid, synthetic MRI method for diagnostic image quality assessment and measurement of relaxometry metric values in head and neck (HN) tumors and normal-appearing masseter muscle. The multi-dynamic multi-echo (MDME) sequence was used for data acquisition, followed by synthetic image reconstruction on a 3T MRI scanner for 14 patients (3 untreated and 11 treated). The MDME enables absolute quantification of physical tissue properties, including T1 and T2, with a shorter scan time than the current state-of-the-art methods used for relaxation measurements. The vendor termed the combined package MAGnetic resonance imaging Compilation (MAGiC). In total, 48 regions of interest (ROIs) were analyzed, drawn on normal-appearing masseter muscle and tumors in the HN region. Mean T1 and T2 values obtained from normal-appearing muscle were 880 ± 52 ms and 46 ± 3 ms, respectively. Mean T1 and T2 values obtained from tumors were 1930 ± 422 ms and 77 ± 13 ms, respectively, for the untreated group, 1745 ± 410 ms and 107 ± 61 ms, for the treated group. A total of 1552 images from both synthetic MRI and conventional clinical imaging were assessed by the radiologists to provide the rating for T1w and T2w image contrasts. The synthetically generated qualitative T2w images were acceptable and comparable to conventional diagnostic images (93% acceptability rating for both). The acceptability ratings for MAGiC-generated T1w, and conventional images were 64% and 100%, respectively. The benefit of MAGiC in HN imaging is twofold, providing relaxometry maps in a clinically feasible time and the ability to generate a different combination of contrast images in a single acquisition.
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Affiliation(s)
- Amaresha Shridhar Konar
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.S.K.); (R.P.)
| | - Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.S.K.); (R.P.)
| | - Akash Deelip Shah
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.D.S.); (V.H.)
| | - Maggie Fung
- General Electric Health Care, New York, NY 10065, USA; (M.F.); (S.B.)
| | | | - Abhay Dave
- Touro College of Osteopathic Medicine, New York, NY 10027, USA;
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.D.S.); (V.H.)
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.S.K.); (R.P.)
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (A.D.S.); (V.H.)
- Correspondence: ; Tel.: +1-212-639-3184
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Quantitative Synthetic Magnetic Resonance Imaging for Brain Metastases: A Feasibility Study. Cancers (Basel) 2022; 14:cancers14112651. [PMID: 35681631 PMCID: PMC9179589 DOI: 10.3390/cancers14112651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary This preliminary study aims to characterize brain metastases (BM) using T1 and T2 maps generated from newer, rapid, synthetic MRI (MAGnetic resonance image Compilation; MAGiC) in a clinical setting. In addition, synthetic MR could provide contrast images analogous to standard T1- and T2-weighted images. The reproducibility and repeatability of this method have been previously established for brain imaging. This study reports and analyzes the quantitative T1 and T2 values for 11 BM patients (17 BM lesions) with a total of 82 regions of interest (ROIs) delineated by an experienced neuroradiologist. The initial results, which need to be further validated in a larger patient cohort, demonstrated the ability of T1 and T2 metric values to characterize BMs and normal-appearing brain tissues. The T1 and T2 metrics could be potential surrogate biomarkers for BM free water content (cellularity) and tumor morphology, respectively. Abstract The present preliminary study aims to characterize brain metastases (BM) using T1 and T2 maps generated from newer, rapid, synthetic MRI (MAGnetic resonance image Compilation; MAGiC) in a clinical setting. We acquired synthetic MRI data from 11 BM patients on a 3T scanner. A multiple-dynamic multiple-echo (MDME) sequence was used for data acquisition and synthetic image reconstruction, including post-processing. MDME is a multi-contrast sequence that enables absolute quantification of physical tissue properties, including T1 and T2, independent of the scanner settings. In total, 82 regions of interest (ROIs) were analyzed, which were obtained from both normal-appearing brain tissue and BM lesions. The mean values obtained from the 48 normal-appearing brain tissue regions and 34 ROIs of BM lesions (T1 and T2) were analyzed using standard statistical methods. The mean T1 and T2 values were 1143 ms and 78 ms, respectively, for normal-appearing gray matter, 701 ms and 64 ms for white matter, and 4206 ms and 390 ms for cerebrospinal fluid. For untreated BMs, the mean T1 and T2 values were 1868 ms and 100 ms, respectively, and 2211 ms and 114 ms for the treated group. The quantitative T1 and T2 values generated from synthetic MRI can characterize BM and normal-appearing brain tissues.
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Zheng Z, Yang J, Zhang D, Ma J, Yin H, Liu Y, Wang Z. The effect of scan parameters on T1, T2 relaxation times measured with multi-dynamic multi-echo sequence: a phantom study. Phys Eng Sci Med 2022; 45:657-664. [PMID: 35553390 PMCID: PMC9239947 DOI: 10.1007/s13246-022-01128-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022]
Abstract
Multi-Dynamic Multi-Echo (MDME) Sequence is a new method which can acquire various contrast-weighted images using quantitative relaxometric parameters measured from multicontrast images. The purpose of our study was to investigate the effect of scan parameters of MDME Sequence on measured T1, T2 values of phantoms at 3.0 T MRI scanner. Gray matter, white matter and cerebrospinal fluid simulation phantoms with different relaxation times (named GM, WM, CSF, respectively) were used in our study. All the phantoms were scanned 9 times on different days using MDME sequence with variations of echo train length, matrix, and acceleration factor. The T1, T2 measurements were acquired after each acquisition. The repeatability was characterized as the intragroup coefficient of variation (CV) of measured values over 9 times, and the discrepancies of measurements across different groups were characterized as intergroup CVs. The highest intragroup CVs of T1-GM, T2-GM, T1-WM, T2-WM, T1-CSF, T2-SCF were 1.36%, 1.75%, 0.74%, 1.41%, 1.70%, 7.79%, respectively. The highest intergroup CVs of T1-GM, T2-GM, T1-WM, T2-WM, T1-CSF, T2-SCF were 0.54%, 1.86%, 1.70%, 0.94%, 1.00%, 2.17%, respectively. Quantitative T1, T2 measurements of gray matter, white matter and cerebrospinal fluid simulation phantoms derived from the MDME sequence were not obviously affected by variations of scanning parameters, such as echo train length, matrix, and acceleration factor on 3T scanner.
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Affiliation(s)
- Zuofeng Zheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong An Road 95, Beijing, 100050, China.,Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Jiafei Yang
- Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Dongpo Zhang
- Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Jun Ma
- Department of Radiology, Beijing ChuiYangLiu Hospital, Beijing, China
| | - Hongxia Yin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong An Road 95, Beijing, 100050, China
| | - Yawen Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yong An Road 95, Beijing, 100050, China.
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13
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Huo M, Ye J, Dong Z, Cai H, Wang M, Yin G, Qian L, Li ZP, Zhong B, Feng ST. Quantification of brown adipose tissue in vivo using synthetic magnetic resonance imaging: an experimental study with mice model. Quant Imaging Med Surg 2022; 12:526-538. [PMID: 34993098 DOI: 10.21037/qims-20-1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/20/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The white adipose tissue (WAT) and brown adipose tissue (BAT) are associated with the development of several obesity-associated disorders. The use of imaging techniques to differentiate BAT from WAT and quantify BAT volume remains challenging, due to limitations such as spatial resolution and magnetic field inhomogeneity. This study aimed to investigate the feasibility for differentiating BAT from WAT, and quantify the BAT volume in vivo using synthetic magnetic resonance imaging (MRI). METHODS A total of 16 C57BL/6 mice were scanned using synthetic MRI. Quantitative longitudinal relaxation time (T1) and transverse relaxation time (T2) maps were obtained from the original synthetic MRI data using the synthetic MRI software offline. The T1 and T2 values of interscapular BAT (IBAT) and dorsal subcutaneous WAT were measured. The IBAT volume was calculated using synthetic MRI-derived T2-weighted images (T2WIs) based on its morphological characteristics and quantitative tissue values. The body weight of mice was measured, and the IBAT specimens were excised and weighted. The correlation between IBAT volume and the weight of IBAT gross specimen and between IBAT volume and mouse body weight was analyzed. RESULTS The T1 values of BAT (330.3±19.57 ms) were higher than those of WAT (304.42±4.14 ms) (P<0.001), whereas the T2 values of BAT (66.06±5.06 ms) were lower than those of WAT (88.23±7.68 ms) (P<0.001). The area under the curve (AUC) values of the T1 and T2 for differentiating BAT from WAT was 0.942 and 0.995, respectively. The AUC of the T2 values was higher than that of T1 (P=0.04) using the DeLong test. The optimal cut-off value for T2 was 76 ms for differentiating BAT from WAT (100% sensitivity, 93.7% specificity). A moderate correlation was observed between IBAT volume and the weight of the IBAT gross specimen (r=0.662, P=0.014), and between IBAT volume and mouse body weight (r=0.653, P=0.016). CONCLUSIONS The quantitative parameters derived using synthetic MRI may be used to detect and differentiate BAT from WAT in vivo. Synthetic MRI may help quantify BAT volume in vivo.
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Affiliation(s)
- Mengjuan Huo
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junzhao Ye
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi Dong
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huasong Cai
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meng Wang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guoping Yin
- GE Healthcare, MR Enhanced Application China, Beijing, China
| | - Long Qian
- MRI Research, GE Healthcare, Beijing, China
| | - Zi-Ping Li
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bihui Zhong
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shi-Ting Feng
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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14
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Parlak S, Coban G, Gumeler E, Karakaya J, Soylemezoglu F, Tezer I, Bilginer B, Saygi S, Oguz KK. Reduced myelin in patients with isolated hippocampal sclerosis as assessed by SyMRI. Neuroradiology 2021; 64:99-107. [PMID: 34611716 PMCID: PMC8492040 DOI: 10.1007/s00234-021-02824-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/25/2021] [Indexed: 02/05/2023]
Abstract
Purpose Synthetic MRI (SyMRI) enables to quantify brain tissue and morphometry. We aimed to investigate the WM and myelin alterations in patients with unilateral hippocampal sclerosis (HS) with SyMRI. Methods Adult patients with isolated unilateral HS and age-matched control subjects (CSs) were included in this study. The SyMRI sequence QRAPMASTER in the coronal plane perpendicular to the hippocampi was obtained from the whole brain. Automatic segmentation of the whole brain was processed by SyMRI Diagnostic software (Version 11.2). Two neuroradiologists also performed quantitative analyses independently from symmetrical 14 ROIs placed in temporal and extratemporal WM, hippocampi, and amygdalae in both hemispheres. Results Sixteen patients (F/M = 6/10, mean age = 32.5 ± 11.3 years; right/left HS: 8/8) and 10 CSs (F/M = 5/5, mean age = 30.7 ± 7 years) were included. Left HS patients had significantly lower myelin and WM volumes than CSs (p < .05). Myelin was reduced significantly in the ipsilateral temporal lobe of patients than CSs, greater in left HS (p < .05). Histopathological examination including luxol fast blue stain also revealed myelin pallor in all of 6 patients who were operated. Ipsilateral temporal pole and sub-insular WM had significantly reduced myelin than the corresponding contralateral regions in patients (p < .05). No significant difference was found in WM values. GM values were significantly lower in hippocampi in patients than CSs (p < .05). Conclusion SyMRI revealed myelin reduction in the ipsilateral temporal lobe and sub-insular WM of patients with HS. Whether this finding correlates with electrophysiological features and SyMRI could serve as lateralization of temporal lobe epilepsy need to be investigated. Supplementary Information The online version contains supplementary material available at 10.1007/s00234-021-02824-6.
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Affiliation(s)
- Safak Parlak
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Gokcen Coban
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ekim Gumeler
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Figen Soylemezoglu
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Irsel Tezer
- Department of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcak Bilginer
- Department of Neurosurgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Serap Saygi
- Department of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kader K Oguz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Hagiwara A, Fujimoto K, Kamagata K, Murata S, Irie R, Kaga H, Someya Y, Andica C, Fujita S, Kato S, Fukunaga I, Wada A, Hori M, Tamura Y, Kawamori R, Watada H, Aoki S. Age-Related Changes in Relaxation Times, Proton Density, Myelin, and Tissue Volumes in Adult Brain Analyzed by 2-Dimensional Quantitative Synthetic Magnetic Resonance Imaging. Invest Radiol 2021; 56:163-172. [PMID: 32858581 PMCID: PMC7864648 DOI: 10.1097/rli.0000000000000720] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Quantitative synthetic magnetic resonance imaging (MRI) enables the determination of fundamental tissue properties, namely, T1 and T2 relaxation times and proton density (PD), in a single scan. Myelin estimation and brain segmentation based on these quantitative values can also be performed automatically. This study aimed to reveal the changes in tissue characteristics and volumes of the brain according to age and provide age-specific reference values obtained by quantitative synthetic MRI. MATERIALS AND METHODS This was a prospective study of healthy subjects with no history of brain diseases scanned with a multidynamic multiecho sequence for simultaneous measurement of relaxometry of T1, T2, and PD. We performed myelin estimation and brain volumetry based on these values. We performed volume-of-interest analysis on both gray matter (GM) and white matter (WM) regions for T1, T2, PD, and myelin volume fraction maps. Tissue volumes were calculated in the whole brain, producing brain parenchymal volume, GM volume, WM volume, and myelin volume. These volumes were normalized by intracranial volume to a brain parenchymal fraction, GM fraction, WM fraction, and myelin fraction (MyF). We examined the changes in the mean regional quantitative values and segmented tissue volumes according to age. RESULTS We analyzed data of 114 adults (53 men and 61 women; median age, 66.5 years; range, 21-86 years). T1, T2, and PD values showed quadratic changes according to age and stayed stable or decreased until around 60 years of age and increased thereafter. Myelin volume fraction showed a reversed trend. Brain parenchymal fraction and GM fraction decreased throughout all ages. The approximation curves showed that WM fraction and MyF gradually increased until around the 40s to 50s and decreased thereafter. A significant decline in MyF was first noted in the 60s age group (Tukey test, P < 0.001). CONCLUSIONS Our study showed changes according to age in tissue characteristic values and brain volumes using quantitative synthetic MRI. The reference values for age demonstrated in this study may be useful to discriminate brain disorders from healthy brains.
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Affiliation(s)
- Akifumi Hagiwara
- From the Department of Radiology, Juntendo University Graduate School of Medicine
| | - Kotaro Fujimoto
- From the Department of Radiology, Juntendo University Graduate School of Medicine
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Koji Kamagata
- From the Department of Radiology, Juntendo University Graduate School of Medicine
| | - Syo Murata
- From the Department of Radiology, Juntendo University Graduate School of Medicine
| | - Ryusuke Irie
- From the Department of Radiology, Juntendo University Graduate School of Medicine
| | - Hideyoshi Kaga
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine
| | - Christina Andica
- From the Department of Radiology, Juntendo University Graduate School of Medicine
| | - Shohei Fujita
- From the Department of Radiology, Juntendo University Graduate School of Medicine
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Shimpei Kato
- From the Department of Radiology, Juntendo University Graduate School of Medicine
- Department of Radiology, Graduate School of Medicine, The University of Tokyo
| | - Issei Fukunaga
- Department of Radiological Technology, Faculty of Health Science, Juntendo University
| | - Akihiko Wada
- From the Department of Radiology, Juntendo University Graduate School of Medicine
| | - Masaaki Hori
- From the Department of Radiology, Juntendo University Graduate School of Medicine
- Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yoshifumi Tamura
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
- Sportology Center, Juntendo University Graduate School of Medicine
| | - Ryuzo Kawamori
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
- Sportology Center, Juntendo University Graduate School of Medicine
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
- Sportology Center, Juntendo University Graduate School of Medicine
| | - Shigeki Aoki
- From the Department of Radiology, Juntendo University Graduate School of Medicine
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Quantitative synthetic MRI for evaluation of the lumbar intervertebral disk degeneration in patients with chronic low back pain. Eur J Radiol 2020; 124:108858. [DOI: 10.1016/j.ejrad.2020.108858] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 12/03/2019] [Accepted: 01/24/2020] [Indexed: 12/22/2022]
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