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Kupczyk PA, Mesropyan N, Isaak A, Endler C, Faron A, Kuetting D, Sprinkart AM, Mädler B, Thomas D, Attenberger UI, Luetkens JA. Quantitative MRI of the liver: Evaluation of extracellular volume fraction and other quantitative parameters in comparison to MR elastography for the assessment of hepatopathy. Magn Reson Imaging 2020; 77:7-13. [PMID: 33309923 DOI: 10.1016/j.mri.2020.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/27/2020] [Accepted: 12/06/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Chronic liver diseases pose a major health problem worldwide, while common tests for diagnosis and monitoring of diffuse hepatopathy have considerable limitations. Preliminary data on the quantification of hepatic extracellular volume fraction (ECV) with magnetic resonance imaging (MRI) for non-invasive assessment of liver fibrosis are encouraging, with ECV having the potential to overcome several of these constraints. PURPOSE To clinically evaluate ECV provided by quantitative MRI for assessing the severity of liver disease. MATERIALS AND METHODS In this prospective study, multiparametric liver MRI, including T1 mapping and magnetic resonance elastography (MRE), was performed in subjects with and without hepatopathy between November 2018 and October 2019. T1, T2, T2*, proton density fat fraction and stiffness were extracted from parametric maps by regions of interest and ECV was calculated from T1 relaxometries. Serum markers of liver disease were obtained by clinical database research. For correlation analysis, Spearman rank correlation was used. ROC analysis of serum markers and quantitative MRI data for discrimination of liver cirrhosis was performed with MRE as reference standard. RESULTS 109 participants were enrolled (50.7 ± 16.1 years, 61 men). ECV, T1 and MRE correlated significantly with almost all serum markers of liver disease, with ECV showing the strongest associations (up to r = 0.67 with MELD, p < 0.01). ECV and T1 correlated with MRE (0.75 and 0.73, p < 0.01 each). ECV (AUC 0.89, cutoff 32.2%, sensitivity 85%, specificity 87%) and T1 mapping (AUC 0.85, cutoff 592.5 ms, sensitivity 83%, specificity 75%) featured good performances in detection of liver cirrhosis with only ECV performing significantly superior to model of end stage liver disease (MELD), AST/ALT ratio and international normalized ratio (p < 0.01, respectively). CONCLUSION Quantification of hepatic extracellular volume fraction with MRI is suitable for estimating the severity of liver disease when using MRE as the standard of reference. It represents a promising tool for non-invasive assessment of liver fibrosis and cirrhosis.
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Affiliation(s)
- P A Kupczyk
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany.
| | - N Mesropyan
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - A Isaak
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - C Endler
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - A Faron
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - D Kuetting
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - A M Sprinkart
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - B Mädler
- Philips Healthcare, Hamburg, Germany
| | - D Thomas
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - U I Attenberger
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - J A Luetkens
- University Hospital Bonn, Department of Diagnostic and Interventional Radiology, Quantitative Imaging Lab Bonn (QILaB), Venusberg-Campus 1, 53127 Bonn, Germany
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Keil VC, Bakoeva SP, Jurcoane A, Doneva M, Amthor T, Koken P, Mädler B, Lüchters G, Block W, Wüllner U, Hattingen E. A pilot study of magnetic resonance fingerprinting in Parkinson's disease. NMR Biomed 2020; 33:e4389. [PMID: 32783321 DOI: 10.1002/nbm.4389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 06/11/2023]
Abstract
Parkinson's disease (PD) affects more than six million people, but reliable MRI biomarkers with which to diagnose patients have not been established. Magnetic resonance fingerprinting (MRF) is a recent quantitative technique that can provide relaxometric maps from a single sequence. The purpose of this study is to assess the potential of MRF to identify PD in patients and their disease severity, as well as to evaluate comfort during MRF. Twenty-five PD patients and 25 matching controls underwent 3 T MRI, including an axial 2D spoiled gradient echo MRF sequence. T1 and T2 maps were generated by voxel-wise matching the measured MRF signal to a precomputed dictionary. All participants also received standard inversion recovery T1 and multi-echo T2 mapping. An ROI-based analysis of relaxation times was performed. Differences between patients and controls as well as techniques were determined by logistic regression, Spearman correlation and t-test. Patients were asked to estimate the subjective comfort of the MRF sequence. Both MRF-based T1 and T2 mapping discriminated patients from controls: T1 relaxation times differed most in cortical grey matter (PD 1337 ± 38 vs. control 1386 ± 37 ms; mean ± SD; P = .0001) and, in combination with normal-appearing white matter, enabled correct discrimination in 85.7% of cases (sensitivity 83.3%; specificity 88.0%; receiver-operating characteristic [ROC]) area under the curve [AUC] 0.87), while for T2 mapping the left putamen was the strongest classifier (40.54 ± 6.28 vs. 34.17 ± 4.96 ms; P = .0001), enabling differentiation of groups in 84.0% of all cases (sensitivity 80.0%; specificity 88.0%; ROC AUC 0.87). Relaxation time differences were not associated with disease severity. Standard mapping techniques generated significantly different relaxation time values and identified other structures as different between groups other than MRF. Twenty-three out of 25 PD patients preferred the MRF examination instead of a standard MRI. MRF-based mapping can identify PD patients with good comfort but needs further assessment regarding disease severity identification and its potential for comparability with standard mapping technique results.
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Affiliation(s)
- Vera Catharina Keil
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Radiology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Stilyana Peteva Bakoeva
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Neurology, University Hospital Duesseldorf, Düsseldorf, Germany
| | - Alina Jurcoane
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Institute for Neuroradiology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | | | | | | | | | - Guido Lüchters
- Zentrum für Entwicklungsforschung, University of Bonn, Bonn, Germany
| | - Wolfgang Block
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Ullrich Wüllner
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Germany
| | - Elke Hattingen
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Institute for Neuroradiology, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
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Beaulieu C, Yip E, Low PB, Mädler B, Lebel CA, Siegel L, Mackay AL, Laule C. Myelin Water Imaging Demonstrates Lower Brain Myelination in Children and Adolescents With Poor Reading Ability. Front Hum Neurosci 2020; 14:568395. [PMID: 33192398 PMCID: PMC7596275 DOI: 10.3389/fnhum.2020.568395] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/31/2020] [Indexed: 01/18/2023] Open
Abstract
Magnetic resonance imaging (MRI) provides a means to non-invasively investigate the neurological links with dyslexia, a learning disability that affects one’s ability to read. Most previous brain MRI studies of dyslexia and reading skill have used structural or diffusion imaging to reveal regional brain abnormalities. However, volumetric and diffusion MRI lack specificity in their interpretation at the microstructural level. Myelin is a critical neural component for brain function and plasticity, and as such, deficits in myelin may impact reading ability. MRI can estimate myelin using myelin water fraction (MWF) imaging, which is based on evaluation of the proportion of short T2 myelin-associated water from multi-exponential T2 relaxation analysis, but has not yet been applied to the study of reading or dyslexia. In this study, MWF MRI, intelligence, and reading assessments were acquired in 20 participants aged 10–18 years with a wide range of reading ability to investigate the relationship between reading ability and myelination. Group comparisons showed markedly lower MWF by 16–69% in poor readers relative to good readers in the left and right thalamus, as well as the left posterior limb of the internal capsule, left/right anterior limb of the internal capsule, left/right centrum semiovale, and splenium of the corpus callosum. MWF over the entire group also correlated positively with three different reading scores in the bilateral thalamus as well as white matter, including the splenium of the corpus callosum, left posterior limb of the internal capsule, left anterior limb of the internal capsule, and left centrum semiovale. MWF imaging from T2 relaxation suggests that myelination, particularly in the bilateral thalamus, splenium, and left hemisphere white matter, plays a role in reading abilities. Myelin water imaging thus provides a potentially valuable in vivo imaging tool for the study of dyslexia and its remediation.
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Affiliation(s)
- Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Eugene Yip
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Pauline B Low
- Department of Education and Counseling Psychology, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Linda Siegel
- Department of Education and Counseling Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Alex L Mackay
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Cornelia Laule
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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4
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Nagtegaal M, Koken P, Amthor T, de Bresser J, Mädler B, Vos F, Doneva M. Myelin water imaging from multi-echo T2 MR relaxometry data using a joint sparsity constraint. Neuroimage 2020; 219:117014. [DOI: 10.1016/j.neuroimage.2020.117014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 11/24/2022] Open
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5
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Morris SR, Holmes RD, Dvorak AV, Liu H, Yoo Y, Vavasour IM, Mazabel S, Mädler B, Kolind SH, Li DKB, Siegel L, Beaulieu C, MacKay AL, Laule C. Brain Myelin Water Fraction and Diffusion Tensor Imaging Atlases for 9-10 Year-Old Children. J Neuroimaging 2020; 30:150-160. [PMID: 32064721 DOI: 10.1111/jon.12689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/18/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE Myelin water imaging (MWI) and diffusion tensor imaging (DTI) provide information about myelin and axon-related brain microstructure, which can be useful for investigating normal brain development and many childhood brain disorders. While pediatric DTI atlases exist, there are no pediatric MWI atlases available for the 9-10 years old age group. As myelination and structural development occurs throughout childhood and adolescence, studies of pediatric brain pathologies must use age-specific MWI and DTI healthy control data. We created atlases of myelin water fraction (MWF) and DTI metrics for healthy children aged 9-10 years for use as normative data in pediatric neuroimaging studies. METHODS 3D-T1 , DTI, and MWI scans were acquired from 20 healthy children (mean age: 9.6 years, range: 9.2-10.3 years, 4 females). ANTs and FSL registration were used to create quantitative MWF and DTI atlases. Region of interest (ROI) analysis in nine white matter regions was used to compare pediatric MWF with adult MWF values from a recent study and to investigate the correlation between pediatric MWF and DTI metrics. RESULTS Adults had significantly higher MWF than the pediatric cohort in seven of the nine white matter ROIs, but not in the genu of the corpus callosum or the cingulum. In the pediatric data, MWF correlated significantly with mean diffusivity, but not with axial diffusivity, radial diffusivity, or fractional anisotropy. CONCLUSIONS Normative MWF and DTI metrics from a group of 9-10 year old healthy children provide a resource for comparison to pathologies. The age-specific atlases are ready for use in pediatric neuroimaging research and can be accessed: https://sourceforge.net/projects/pediatric-mri-myelin-diffusion/.
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Affiliation(s)
- Sarah R Morris
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | | | - Adam V Dvorak
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Hanwen Liu
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Youngjin Yoo
- Medical Imaging Technologies, Siemens Healthineers, Princeton, NJ
| | - Irene M Vavasour
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Silvia Mazabel
- Educational and Counseling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | | | - Shannon H Kolind
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David K B Li
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Linda Siegel
- Educational and Counseling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Alex L MacKay
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Cornelia Laule
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada.,Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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6
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Friedrich P, Fraenz C, Schlüter C, Ocklenburg S, Mädler B, Güntürkün O, Genç E. The Relationship Between Axon Density, Myelination, and Fractional Anisotropy in the Human Corpus Callosum. Cereb Cortex 2020; 30:2042-2056. [DOI: 10.1093/cercor/bhz221] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/26/2019] [Accepted: 08/21/2019] [Indexed: 02/06/2023] Open
Abstract
Abstract
The corpus callosum serves the functional integration and interaction between the two hemispheres. Many studies investigate callosal microstructure via diffusion tensor imaging (DTI) fractional anisotropy (FA) in geometrically parcellated segments. However, FA is influenced by several different microstructural properties such as myelination and axon density, hindering a neurobiological interpretation. This study explores the relationship between FA and more specific measures of microstructure within the corpus callosum in a sample of 271 healthy participants. DTI tractography was used to assess 11 callosal segments and gain estimates of FA. We quantified axon density and myelination via neurite orientation dispersion and density imaging (NODDI) to assess intra-neurite volume fraction and a multiecho gradient spin-echo sequence estimating myelin water fraction. The results indicate three common factors in the distribution of FA, myelin content and axon density, indicating potentially shared rules of topographical distribution. Moreover, the relationship between measures varied across the corpus callosum, suggesting that FA should not be interpreted uniformly. More specific magnetic resonance imaging-based quantification techniques, such as NODDI and multiecho myelin water imaging, may thus play a key role in future studies of clinical trials and individual differences.
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Affiliation(s)
- Patrick Friedrich
- Department of Psychology, Institute of Cognitive Neuroscience, Biopsychology, Ruhr University Bochum, 44801 Bochum, Germany
- Brain Connectivity and Behaviour Laboratory (BCBLab), Sorbonne Universities, 75013 Paris, France
| | - Christoph Fraenz
- Department of Psychology, Institute of Cognitive Neuroscience, Biopsychology, Ruhr University Bochum, 44801 Bochum, Germany
| | - Caroline Schlüter
- Department of Psychology, Institute of Cognitive Neuroscience, Biopsychology, Ruhr University Bochum, 44801 Bochum, Germany
| | - Sebastian Ocklenburg
- Department of Psychology, Institute of Cognitive Neuroscience, Biopsychology, Ruhr University Bochum, 44801 Bochum, Germany
| | - Burkhard Mädler
- Health Systems Department, Philips GmBH, 22335 Hamburg, Germany
| | - Onur Güntürkün
- Department of Psychology, Institute of Cognitive Neuroscience, Biopsychology, Ruhr University Bochum, 44801 Bochum, Germany
| | - Erhan Genç
- Department of Psychology, Institute of Cognitive Neuroscience, Biopsychology, Ruhr University Bochum, 44801 Bochum, Germany
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7
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Keil VC, Bakoeva SP, Jurcoane A, Doneva M, Amthor T, Koken P, Mädler B, Block W, Fimmers R, Fliessbach K, Hattingen E. MR fingerprinting as a diagnostic tool in patients with frontotemporal lobe degeneration: A pilot study. NMR Biomed 2019; 32:e4157. [PMID: 31393654 DOI: 10.1002/nbm.4157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/27/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
Several very rare forms of dementia are associated with characteristic focal atrophy predominantly of the frontal and/or temporal lobes and currently lack imaging solutions to monitor disease. Magnetic resonance fingerprinting (MRF) is a recently developed technique providing quantitative relaxivity maps and images with various tissue contrasts out of a single sequence acquisition. This pilot study explores the utility of MRF-based T1 and T2 mapping to discover focal differences in relaxation times between patients with frontotemporal lobe degenerative dementia and healthy controls. 8 patients and 30 healthy controls underwent a 3 T MRI including an axial 2D spoiled gradient echo MRF sequence. T1 and T2 relaxation maps were generated based on an extended phase graphs algorithm-founded dictionary involving inner product pattern matching. A region of interest (ROI)-based analysis of T1 and T2 relaxation times was performed with FSL and ITK-SNAP. Depending on the brain region analyzed, T1 relaxation times were up to 10.28% longer in patients than in controls reaching significant differences in cortical gray matter (P = .047) and global white matter (P = .023) as well as in both hippocampi (P = .001 left; P = .027 right). T2 relaxation times were similarly longer in the hippocampus by up to 19.18% in patients compared with controls. The clinically most affected patient had the most control-deviant relaxation times. There was a strong correlation of T1 relaxation time in the amygdala with duration of the clinically manifest disease (Spearman Rho = .94; P = .001) and of T1 relaxation times in the left hippocampus with disease severity (Rho = .90, P = .002). In conclusion, MRF-based relaxometry is a promising and time-saving new MRI tool to study focal cerebral alterations and identify patients with frontotemporal lobe degeneration. To validate the results of this pilot study, MRF is worth further exploration as a diagnostic tool in neurodegenerative diseases.
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Affiliation(s)
- Vera Catharina Keil
- Department of Radiology, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany
| | | | - Alina Jurcoane
- Department of Radiology, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany
- Institute for Neuroradiology, University Hospital Frankfurt/Main, Schleusenweg 2-16, Haus 95, Frankfurt, Germany
| | - Mariya Doneva
- Philips Research, Röntgenstrasse 24-26, Hamburg, Germany
| | - Thomas Amthor
- Philips Research, Röntgenstrasse 24-26, Hamburg, Germany
| | - Peter Koken
- Philips Research, Röntgenstrasse 24-26, Hamburg, Germany
| | - Burkhard Mädler
- Philips Healthcare, Philips GmbH, Röntgenstrasse 22, 22335 Hamburg, Germany
| | - Wolfgang Block
- Department of Radiology, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany
| | - Rolf Fimmers
- IMBIE, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany
| | - Klaus Fliessbach
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany
| | - Elke Hattingen
- Department of Radiology, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany
- Institute for Neuroradiology, University Hospital Frankfurt/Main, Schleusenweg 2-16, Haus 95, Frankfurt, Germany
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Graf C, MacMillan EL, Fu E, Harris T, Traboulsee A, Vavasour IM, MacKay AL, Mädler B, Li DKB, Laule C. Intra- and inter-site reproducibility of human brain single-voxel proton MRS at 3 T. NMR Biomed 2019; 32:e4083. [PMID: 30889311 DOI: 10.1002/nbm.4083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Clinical trials that involve participants from multiple sites necessitate standardized and reliable quantitative MRI outcomes to detect significant group differences over time. Metabolite concentrations measured by proton MRS (1 H-MRS) provide valuable information about in vivo metabolism of the central nervous system, but can vary based on the acquisition and quantitation methods used by different MR sites. Therefore, we investigated the intra- and inter-site reproducibility of metabolite concentrations measured by 1 H-MRS on MRI scanners from a single manufacturer across six sites. METHODS Five healthy controls were scanned twice within 24 h at six participating 3 T MR sites with large single-voxel PRESS (TE/TR/NSA = 36 ms/4000 ms/56) and anatomical images for voxel positioning and correction of partial volume relaxation. Absolute metabolite concentrations were calculated relative to the T1 and T2 relaxation corrected signal from water. Intra- and inter-site reproducibility was assessed using Bland-Altman plots and intra- and inter-site coefficient of variation (CoV) as well as intra- and inter-site intra-class correlation coefficient. RESULTS The median intra-site CoVs for the five major metabolite concentrations ([NAA], [tCr], [Glu], [tCho] and [Ins]) were between 2.5 and 5.3%. Inter-site CoVs were also low, with the median CoVs for all metabolites between 3.7 and 6.4%. Metabolite concentrations were robust to small inconsistencies in voxel placement and site was not the driving factor in the variance of the measurement of any metabolite concentration. Between-subject differences accounted for the majority of the concentration variability for creatine, choline and myo-inositol (42-65% of the variance). CONCLUSION A large single-voxel 1 H-MRS acquisition from a single manufacturer's MRI scanner is highly reproducible and reliable for multi-site clinical trials.
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Affiliation(s)
- Carina Graf
- Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada
| | - Erin L MacMillan
- MR Clinical Science, Philips Canada, Markham, Ontario, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- ImageTech Lab, Simon Fraser University, Surrey, British Columbia, Canada
| | - Eric Fu
- Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trudy Harris
- UBC MRI Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anthony Traboulsee
- Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Irene M Vavasour
- UBC MRI Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alex L MacKay
- Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- UBC MRI Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - David K B Li
- UBC MRI Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada
- Medicine (Neurology), University of British Columbia, Vancouver, British Columbia, Canada
| | - Cornelia Laule
- Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada
- Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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9
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Ocklenburg S, Anderson C, Gerding WM, Fraenz C, Schlüter C, Friedrich P, Raane M, Mädler B, Schlaffke L, Arning L, Epplen JT, Güntürkün O, Beste C, Genç E. Myelin Water Fraction Imaging Reveals Hemispheric Asymmetries in Human White Matter That Are Associated with Genetic Variation in PLP1. Mol Neurobiol 2018; 56:3999-4012. [PMID: 30242727 DOI: 10.1007/s12035-018-1351-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/13/2018] [Indexed: 12/18/2022]
Abstract
Myelination of axons in the central nervous system is critical for human cognition and behavior. The predominant protein in myelin is proteolipid protein-making PLP1, the gene that encodes for proteolipid protein, one of the primary candidate genes for white matter structure in the human brain. Here, we investigated the relation of genetic variation within PLP1 and white matter microstructure as assessed with myelin water fraction imaging, a neuroimaging technique that has the advantage over conventional diffusion tensor imaging in that it allows for a more direct assessment of myelin content. We observed significant asymmetries in myelin water fraction that were strongest and rightward in the parietal lobe. Importantly, these parietal myelin water fraction asymmetries were associated with genetic variation in PLP1. These findings support the assumption that genetic variation in PLP1 affects white matter myelination in the healthy human brain.
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Affiliation(s)
- Sebastian Ocklenburg
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Catrona Anderson
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany.,Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Wanda M Gerding
- Department of Human Genetics, Ruhr University Bochum, Bochum, Germany
| | - Christoph Fraenz
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Caroline Schlüter
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Patrick Friedrich
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Maximilian Raane
- Faculty of Health, ZBAF, University of Witten/Herdecke, Witten, Germany
| | | | - Lara Schlaffke
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Larissa Arning
- Department of Human Genetics, Ruhr University Bochum, Bochum, Germany
| | - Jörg T Epplen
- Department of Human Genetics, Ruhr University Bochum, Bochum, Germany.,Faculty of Health, ZBAF, University of Witten/Herdecke, Witten, Germany
| | - Onur Güntürkün
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Erhan Genç
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr University Bochum, Bochum, Germany
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10
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Keil VC, Eichhorn L, Mutsaerts HJMM, Träber F, Block W, Mädler B, van de Ven K, Siero JCW, MacIntosh BJ, Petr J, Fimmers R, Schild HH, Hattingen E. Cerebrovascular Reactivity during Prolonged Breath-Hold in Experienced Freedivers. AJNR Am J Neuroradiol 2018; 39:1839-1847. [PMID: 30237299 DOI: 10.3174/ajnr.a5790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 07/19/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND PURPOSE Experienced freedivers can endure prolonged breath-holds despite severe hypoxemia and are therefore ideal subjects to study apnea-induced cerebrovascular reactivity. This multiparametric study investigated CBF, the spatial coefficient of variation as a correlate of arterial transit time and brain metabolism, dynamics during prolonged apnea. MATERIALS AND METHODS Fifteen male freedivers (age range, 20-64 years; cumulative previous prolonged breath-holds >2 minutes and 30 seconds: 4-79,200) underwent repetitive 3T pseudocontinuous arterial spin-labeling and 31P-/1H-MR spectroscopy before, during, and after a 5-minute breath-hold (split into early and late phases) and gave temporally matching venous blood gas samples. Correlation of temporal and regional cerebrovascular reactivity to blood gases and cumulative previous breath-holds of >2 minutes and 30 seconds in a lifetime was assessed. RESULTS The spatial coefficient of variation of CBF (by arterial spin-labeling) decreased during the early breath-hold phase (-30.0%, P = .002), whereas CBF remained almost stable during this phase and increased in the late phase (+51.8%, P = .001). CBF differed between the anterior and the posterior circulation during all phases (eg, during late breath-hold: MCA, 57.3 ± 14.2 versus posterior cerebral artery, 42.7 ± 10.8 mL/100 g/min; P = .001). There was an association between breath-hold experience and lower CBF (1000 previous breath-holds reduced WM CBF by 0.6 mL/100 g/min; 95% CI, 0.15-1.1 mL/100 g/min; P = .01). While breath-hold caused peripheral lactate rise (+18.5%) and hypoxemia (oxygen saturation, -24.0%), cerebral lactate and adenosine diphosphate remained within physiologic ranges despite early signs of oxidative stress [-6.4% phosphocreatine / (adenosine triphosphate + adenosine diphosphate); P = .02]. CONCLUSIONS This study revealed that the cerebral energy metabolism of trained freedivers withstands severe hypoxic hypercarbia in prolonged breath-hold due to a complex cerebrovascular hemodynamic response.
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Affiliation(s)
- V C Keil
- From the Departments of Radiology (V.C.K., F.T., W.B., H.H.S., E.H.)
| | - L Eichhorn
- Anesthesiology and Intensive Care Medicine (L.E.)
| | - H J M M Mutsaerts
- Department of Radiology (H.J.M.M.M.), Academic Medical Center, Amsterdam, the Netherlands.,Sunnybrook Research Institute (H.J.M.M.M., B.J.M.), University of Toronto, Toronto, Ontario, Canada.,Department of Radiology (H.J.M.M.M., J.C.W.S.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - F Träber
- From the Departments of Radiology (V.C.K., F.T., W.B., H.H.S., E.H.)
| | - W Block
- From the Departments of Radiology (V.C.K., F.T., W.B., H.H.S., E.H.)
| | - B Mädler
- Philips GmbH (B.M), Bonn, Germany
| | - K van de Ven
- Philips Healthcare (K.v.d.V.), Best, the Netherlands
| | - J C W Siero
- Department of Radiology (H.J.M.M.M., J.C.W.S.), University Medical Center Utrecht, Utrecht, the Netherlands.,Spinoza Centre for Neuroimaging (J.C.W.S.), Amsterdam, the Netherlands
| | - B J MacIntosh
- Sunnybrook Research Institute (H.J.M.M.M., B.J.M.), University of Toronto, Toronto, Ontario, Canada
| | - J Petr
- Helmholtz Center Dresden-Rossendorf, Institute for Radiopharmaceutic Cancer Research (J.P.), PET Center, Dresden-Rossendorf, Germany
| | - R Fimmers
- Institut für Medizinische Biometrie, Informatik und Epidemiologie (R.F.), University Hospital Bonn, Bonn, Germany
| | - H H Schild
- From the Departments of Radiology (V.C.K., F.T., W.B., H.H.S., E.H.)
| | - E Hattingen
- From the Departments of Radiology (V.C.K., F.T., W.B., H.H.S., E.H.)
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11
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Vavasour IM, Meyers SM, Mädler B, Harris T, Fu E, Li DK, Traboulsee A, MacKay AL, Laule C. Multicenter Measurements of T1
Relaxation and Diffusion Tensor Imaging: Intra and Intersite Reproducibility. J Neuroimaging 2018; 29:42-51. [DOI: 10.1111/jon.12559] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/20/2018] [Accepted: 08/26/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Irene M. Vavasour
- Department of Radiology; University of British Columbia, UBC MRI Research Centre; Vancouver British Columbia Canada
| | - Sandra M. Meyers
- Department of Physics and Astronomy; University of British Columbia; Vancouver British Columbia Canada
| | | | - Trudy Harris
- Department of Radiology; University of British Columbia, UBC MRI Research Centre; Vancouver British Columbia Canada
| | - Eric Fu
- Department of Statistics; University of British Columbia; Vancouver British Columbia Canada
| | - David K.B. Li
- Department of Radiology; University of British Columbia, UBC MRI Research Centre; Vancouver British Columbia Canada
- Department of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Anthony Traboulsee
- Department of Medicine; University of British Columbia; Vancouver British Columbia Canada
| | - Alex L. MacKay
- Department of Radiology; University of British Columbia, UBC MRI Research Centre; Vancouver British Columbia Canada
- Department of Physics and Astronomy; University of British Columbia; Vancouver British Columbia Canada
| | - Cornelia Laule
- Department of Radiology; University of British Columbia, UBC MRI Research Centre; Vancouver British Columbia Canada
- Department of Physics and Astronomy; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver British Columbia Canada
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12
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Coenen VA, Sajonz B, Reisert M, Bostroem J, Bewernick B, Urbach H, Jenkner C, Reinacher PC, Schlaepfer TE, Mädler B. Tractography-assisted deep brain stimulation of the superolateral branch of the medial forebrain bundle (slMFB DBS) in major depression. Neuroimage Clin 2018; 20:580-593. [PMID: 30186762 PMCID: PMC6120598 DOI: 10.1016/j.nicl.2018.08.020] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 01/01/2023]
Abstract
Background Deep brain stimulation (DBS) of the superolateral branch of the medial forebrain bundle (slMFB) emerges as a - yet experimental - treatment for major depressive disorder (MDD) and other treatment refractory psychiatric diseases. First experiences have been reported from two open label pilot trials in major depression (MDD) and long-term effectiveness for MDD (50 months) has been reported. Objective To give a detailed description of the surgical technique for DBS of the superolateral branch of the medial forebrain bundle (slMFB) in MDD. Methods Surgical experience from bilateral implantation procedures in n = 24 patients with MDD is reported. The detailed procedure of tractography-assisted targeting together with detailed electrophysiology in 144 trajectories in the target region (recording and stimulation) is described. Achieved electrode positions were evaluated based on postoperative helical CT and fused to preoperative high resolution anatomical magnetic resonance imaging (MRI; Philips Medical Systems, Best, Netherlands), including the pre-operative diffusion tensor imaging (DTI) tractographic information (StealthViz DTI, Medtronic, USA; Framelink 5.0, Medtronic, USA). Midcommissural point (MCP) coordinates of effective contact (EC) location, together with angles of entry into the target region were evaluated. To investigate incidental stimulation of surrounding nuclei (subthalamic nucleus, STN; substantia nigra, SNr; and red nucleus, RN) as a possible mechanism, a therapeutic triangle (TT) was defined, located between these structures (based on MRI criteria in T2) and evaluated with respect to EC locations. Results Bilateral slMFB DBS was performed in all patients. We identified an electrophysiological environment (defined by autonomic reaction, passive microelectrode recording, acute effects and oculomotor effects) that helps to identify the proper target site on the operation table. Postoperative MCP-evaluation of effective contacts (EC) shows a significant variability with respect to localization. Evaluation of the TT shows that responders will typically have their active contacts inside the triangle and that surrounding nuclei (STN, SNr, RN) are not directly hit by EC, indicating a predominant white matter stimulation. The individual EC position within the triangle cannot be predicted and is based on individual slMFB (tractography) geometry. There was one intracranial bleeding (FORESEE I study) during a first implantation attempt in a patient who later received full bilateral implantation. Typical oculomotor side effects are idiosyncratic for the target region and at inferior contacts. Conclusion The detailed surgical procedure of slMFB DBS implantation has not been described before. The slMFB emerges as an interesting region for the treatment of major depression (and other psychiatric diseases) with DBS. So far it has only been successfully researched in open label clinical case series and in 15 patients published. Stimulation probably achieves its effect through direct white-matter modulation of slMFB fibers. The surgical implantation comprises a standardized protocol combining tractographic imaging based on DTI, targeting and electrophysiological evaluation of the target region. To this end, slMFB DBS surgery is in technical aspects comparable to typical movement disorder surgery. In our view, slMFB DBS should only be performed under tractographic assistance. The slMFB is an emerging target for DBS in therapy refractory Depression. The therapeutic effect is related to modulation of white matter. Surgery for slMFB DBS is tractography assisted surgery. DBS of the slMFB is in many aspects similar to movement disorder surgery.
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Key Words
- CT, computed tomography
- DBS, deep brain stimulation
- DTI FT, DTI fiber tractography
- DTI, diffusion tensor magnetic resonance imaging
- Deep brain stimulation
- Depression
- Diffusion tensor imaging
- EC, effective contact
- FT, fiber tractography
- Fiber tracking
- HF, high frequency
- Hz, Hertz [1/s]
- IPG, internal pulse generator
- MADRS, Montgomery-Åsberg Depression Rating Scale
- MCP, mid-commissural point
- MDD, major depressive disorder
- MRI, magnetic resonance imaging
- Medial forebrain bundle
- OCD
- RN, red nucleus
- SNr, substantia nigra pars reticulata
- STN, subthalamic nucleus
- Stereotactic surgery
- Tractography
- VAT, volume of activated tissue
- VTA, ventral tegmental area
- mA, milli-ampere
- slMFB
- μs, micro second
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Affiliation(s)
- Volker A Coenen
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany; Department of Neurosurgery, Bonn University Medical Center, Germany; BrainLinks/BrainTools, Cluster of Excellence, Freiburg University, Germany.
| | - Bastian Sajonz
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany
| | - Marco Reisert
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany
| | - Jan Bostroem
- Department of Neurosurgery, Bonn University Medical Center, Germany
| | - Bettina Bewernick
- Division of Interventional Biological Psychiatry, Department of Psychiatry and Psychotherapy, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany; Department of Psychiatry and Psychotherapy, Geriatric Psychiatry and Neurodegenerative Disorders, Bonn University Medical Center, Germany
| | - Horst Urbach
- Department of Neuroradiology, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany; Division of Neuroradiology, Department of Radiology, Bonn University Medical Center, Germany
| | - Carolin Jenkner
- Clinical Trials Unit, Freiburg University, Germany; Medical Faculty, Freiburg University, Freiburg, Germany
| | - Peter C Reinacher
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany
| | - Thomas E Schlaepfer
- Division of Interventional Biological Psychiatry, Department of Psychiatry and Psychotherapy, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany; Department of Psychiatry and Psychotherapy, Geriatric Psychiatry and Neurodegenerative Disorders, Bonn University Medical Center, Germany; BrainLinks/BrainTools, Cluster of Excellence, Freiburg University, Germany
| | - Burkhard Mädler
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Germany; Medical Faculty, Freiburg University, Freiburg, Germany; Philips GmbH DACH, Hamburg, Germany
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13
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Schievelkamp AH, Jurcoane A, Rüber T, Ernst L, Müller A, Mädler B, Schild HH, Hattingen E. Limbic Encephalitis in Patients with Epilepsy-is Quantitative MRI Diagnostic? Clin Neuroradiol 2018; 29:623-630. [PMID: 30014154 DOI: 10.1007/s00062-018-0705-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE Limbic encephalitis (LE) is an immune-related disease with limbic symptoms, variable and asymmetric magnetic resonance imaging (MRI) aspects and antibody profiles. This study investigated the diagnostic value of quantitative relaxation times T2 (qT2) and MRI signal intensities (SI) in LE. METHODS The prospective 3T-MRI study included 39 epilepsy patients with initially suspected LE and 20 healthy controls. Values and asymmetry indices of qT2, T2-weighted (T2-w) and proton density (PD)-w SI of manually delineated and automatically segmented amygdala and hippocampus were measured. Additionally, two raters made a blinded visual analysis on FLAIR (fluid attenuation inversion recovery) and T2-w images. RESULTS According to diagnostic guidelines, 22 patients had probable LE and 17 patients had possible LE. The qT2 was higher (p < 0.01) in patients than in controls (mean ± SD, amygdala 98 ± 7 ms vs. 90 ± 5 ms, hippocampus 101 ± 7 ms vs. 92 ± 3 ms), but was not different between probable and possible LE or between sides (left and right). The PD-w SI and T2-w SI were lower in patients than in controls but were not different between patient subgroups or between sides. Diagnostic performance of visual analysis was relatively poor. CONCLUSIONS Epilepsy patients with suspected LE had elevated qT2 in amygdala and hippocampus, whereas the expected T2-w SI increase was not found; however, the diagnostic value of qT2 remains questionable since it did not discriminate probable from possible LE.
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Affiliation(s)
- Arndt-Hendrik Schievelkamp
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, 53127, Bonn, Germany
| | - Alina Jurcoane
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, 53127, Bonn, Germany
| | - Theodor Rüber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Leon Ernst
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Andreas Müller
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, 53127, Bonn, Germany
| | - Burkhard Mädler
- Philips GmbH, UB Healthcare, Lübeckertordamm 5, 20099, Hamburg, Germany
| | - Hans Heinz Schild
- Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, 53127, Bonn, Germany
| | - Elke Hattingen
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, 53127, Bonn, Germany.
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14
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Ercan E, Varma G, Mädler B, Dimitrov IE, Pinho MC, Xi Y, Wagner BC, Davenport EM, Maldjian JA, Alsop DC, Lenkinski RE, Vinogradov E. Microstructural correlates of 3D steady-state inhomogeneous magnetization transfer (ihMT) in the human brain white matter assessed by myelin water imaging and diffusion tensor imaging. Magn Reson Med 2018; 80:2402-2414. [PMID: 29707813 DOI: 10.1002/mrm.27211] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE To compare the recently introduced inhomogeneous magnetization transfer (ihMT) technique with more established MRI techniques including myelin water imaging (MWI) and diffusion tensor imaging (DTI), and to evaluate the microstructural attributes correlating with this new contrast method in the human brain white matter. METHODS Eight adult healthy volunteers underwent T1 -weighted, ihMT, MWI, and DTI imaging on a 3T human scanner. The ihMT ratio (ihMTR), myelin water fraction (MWF), fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), and mean diffusivity (MD) values were calculated from different white matter tracts. The angle ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>θ</mml:mi></mml:math> ) between the directions of the principal eigenvector, as measured by DTI, and the main magnetic field was calculated for all voxels from various fiber tracts. The ihMTR was correlated with MWF and DTI metrics. RESULTS A strong correlation was found between ihMTR and MWF (ρ = 0.77, P < 0.0001). This was followed by moderate to weak correlations between ihMTR and DTI metrics: RD (ρ = -0.30, P < 0.0001), FA (ρ = 0.20, P < 0.0001), MD (ρ = -0.19, P < 0.0001), AD (ρ = 0.02, P < 0.0001). A strong correlation was found between ihMTR and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>θ</mml:mi></mml:math> (ρ = -0.541, P < 0.0001). CONCLUSION The strong correlation with myelin water imaging and its low coefficient of variation suggest that ihMT has the potential to become a new structural imaging marker of myelin. The substantial orientational dependence of ihMT should be taken into account when evaluating and quantitatively interpreting ihMT results.
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Affiliation(s)
- Ece Ercan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gopal Varma
- Department of Radiology, Division of MR Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | | | - Ivan E Dimitrov
- Philips Healthcare, Gainesville, Florida.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marco C Pinho
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yin Xi
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Benjamin C Wagner
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth M Davenport
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - David C Alsop
- Department of Radiology, Division of MR Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Robert E Lenkinski
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
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15
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Laule C, Vavasour IM, Shahinfard E, Mädler B, Zhang J, Li DKB, MacKay AL, Sirrs SM. Hematopoietic Stem Cell Transplantation in Late‐Onset Krabbe Disease: No Evidence of Worsening Demyelination and Axonal Loss 4 Years Post‐allograft. J Neuroimaging 2018; 28:252-255. [DOI: 10.1111/jon.12502] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/16/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- Cornelia Laule
- Department of RadiologyUniversity of British Columbia Vancouver Canada
- Department of Pathology & Laboratory MedicineUniversity of British Columbia Vancouver Canada
- International Collaboration on Repair Discoveries (ICORD)University of British Columbia Vancouver Canada
- Department of Physics & AstronomyUniversity of British Columbia Vancouver Canada
| | - Irene M. Vavasour
- Department of RadiologyUniversity of British Columbia Vancouver Canada
| | - Elham Shahinfard
- Department of RadiologyUniversity of British Columbia Vancouver Canada
| | | | - Jing Zhang
- Department of RadiologyUniversity of British Columbia Vancouver Canada
| | - David K. B. Li
- Department of RadiologyUniversity of British Columbia Vancouver Canada
- Department of Medicine (Neurology)University of British Columbia Vancouver Canada
| | - Alex L. MacKay
- Department of RadiologyUniversity of British Columbia Vancouver Canada
- Department of Physics & AstronomyUniversity of British Columbia Vancouver Canada
| | - Sandra M. Sirrs
- Department of Medicine (Endocrinology)University of British Columbia Vancouver Canada
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16
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Liu H, MacMillan EL, Jutzeler CR, Ljungberg E, MacKay AL, Kolind SH, Mädler B, Li DKB, Dvorak MF, Curt A, Laule C, Kramer JLK. Assessing structure and function of myelin in cervical spondylotic myelopathy: Evidence of demyelination. Neurology 2017; 89:602-610. [PMID: 28701500 PMCID: PMC5562959 DOI: 10.1212/wnl.0000000000004197] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 05/12/2017] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques. METHODS Somatosensory evoked potentials (SSEPs) and MWI were acquired in 14 patients with CSM and 18 age-matched healthy controls. MWI was performed on a 3.0T whole body magnetic resonance scanner. Myelin water fraction (MWF) was extracted for the dorsal columns and whole cord. SSEPs and MWF were also compared with conventional MRI outcomes, including T2 signal intensity, compression ratio, maximum spinal cord compression (MSCC), and maximum canal compromise (MCC). RESULTS Group analysis showed marked differences in T2 signal intensity, compression ratio, MSCC, and MCC between healthy controls and patients with CSM. There were no group differences in MWF and SSEP latencies. However, patients with CSM with pathologic SSEPs exhibited reduction in MWF (p < 0.05). MWF was also correlated with SSEP latencies. CONCLUSION Our findings provide evidence of decreased myelin content in the spinal cord associated with impaired spinal cord conduction in patients with CSM. While conventional MRI are of great value to define the extent of cord compression, they show a limited correlation with functional deficits (i.e., delayed SSEPs). MWI provides independent and complementary readouts to spinal cord compression, with a high specificity to detect impaired conduction.
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Affiliation(s)
- Hanwen Liu
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany.
| | - Erin L MacMillan
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Catherine R Jutzeler
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Emil Ljungberg
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Alex L MacKay
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Shannon H Kolind
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Burkhard Mädler
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - David K B Li
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Marcel F Dvorak
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Armin Curt
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - Cornelia Laule
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
| | - John L K Kramer
- From Physics and Astronomy (H.L., A.L.M., B.M.), ICORD (H.L., C.R.J., M.F.D., C.L., J.L.K.K.), Medicine (Neurology) (E.L.M., E.L., S.H.K., D.K.B.L.), Radiology (A.L.M., D.K.B.L., C.L.), Orthopaedics (M.F.D.), Pathology & Laboratory Medicine (C.L.), and School of Kinesiology (J.L.K.K.), University of British Columbia, Vancouver, Canada; Spinal Cord Injury Center (C.R.J., A.C.), University Hospital Balgrist, University of Zurich, Switzerland; and Philips Healthcare (B.M.), Hamburg, Germany
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17
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Vavasour IM, Huijskens SC, Li DKB, Traboulsee AL, Mädler B, Kolind SH, Rauscher A, Moore GRW, MacKay AL, Laule C. Global loss of myelin water over 5 years in multiple sclerosis normal-appearing white matter. Mult Scler 2017; 24:1557-1568. [DOI: 10.1177/1352458517723717] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Reduced myelin water fraction (MWF, a marker for myelin), increased geometric mean T2 (ieGMT2, reflecting intra/extracellular water properties), and increased T1 (related to total water content) have been observed in cross-sectional studies of multiple sclerosis (MS) normal-appearing white matter (NAWM). Objective: To assess longitudinal changes of magnetic resonance (MR) measures in relapsing-remitting MS (RRMS) brain NAWM. Methods: A total of 11 subjects with RRMS and 4 controls were scanned on a 3T MRI at baseline and long-term follow-up (LTFU; 3.2–5.8 years) with a 32-echo T2 relaxation and an inversion recovery T1 sequence. For every voxel, MWF, ieGMT2, and T1 were obtained. Mean, peak height, and peak location from NAWM mask-based histograms were determined. Results: In MS subjects, NAWM MWF mean decreased by 8% ( p = 0.0016). No longitudinal changes were measured in T1 or ieGMT2. There was no relationship between change in any MR metric and change in EDSS. Control white matter showed no differences over time in any metric. Conclusion: The decreases we observed in MWF suggest that changes in myelin integrity and loss of myelin may be occurring diffusely and over long time periods in the MS brain. The timescale of these changes indicates that chronic, progressive myelin damage is an evolving process occurring over many years.
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Affiliation(s)
- Irene M Vavasour
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
| | - Sophie C Huijskens
- Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada
| | - David KB Li
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Anthony L Traboulsee
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | | | - Shannon H Kolind
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Alexander Rauscher
- Paediatrics, Centre for Brain Health, Child and Family Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - GR Wayne Moore
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada/Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada/International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada
| | - Alex L MacKay
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada
| | - Cornelia Laule
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada/Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada/International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada
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18
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Keil VC, Mädler B, Gieseke J, Fimmers R, Hattingen E, Schild HH, Hadizadeh DR. Effects of arterial input function selection on kinetic parameters in brain dynamic contrast-enhanced MRI. Magn Reson Imaging 2017; 40:83-90. [PMID: 28438713 DOI: 10.1016/j.mri.2017.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/20/2017] [Accepted: 04/20/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE Kinetic parameters derived from dynamic contrast-enhanced MRI (DCE-MRI) were suggested as a possible instrument for multi-parametric lesion characterization, but have not found their way into clinical practice yet due to inconsistent results. The quantification is heavily influenced by the definition of an appropriate arterial input functions (AIF). Regarding brain tumor DCE-MRI, there are currently several co-existing methods to determine the AIF frequently including different brain vessels as sources. This study quantitatively and qualitatively analyzes the impact of AIF source selection on kinetic parameters derived from commonly selected AIF source vessels compared to a population-based AIF model. MATERIAL AND METHODS 74 patients with brain lesions underwent 3D DCE-MRI. Kinetic parameters [transfer constants of contrast agent efflux and reflux Ktrans and kep and, their ratio, ve, that is used to measure extravascular-extracellular volume fraction and plasma volume fraction vp] were determined using extended Tofts model in 821 ROI from 4 AIF sources [the internal carotid artery (ICA), the closest artery to the lesion, the superior sagittal sinus (SSS), the population-based Parker model]. The effect of AIF source alteration on kinetic parameters was evaluated by tissue type selective intra-class correlation (ICC) and capacity to differentiate gliomas by WHO grade [area under the curve analysis (AUC)]. RESULTS Arterial AIF more often led to implausible ve >100% values (p<0.0001). AIF source alteration rendered different absolute kinetic parameters (p<0.0001), except for kep. ICC between kinetic parameters of different AIF sources and tissues were variable (0.08-0.87) and only consistent >0.5 between arterial AIF derived kinetic parameters. Differentiation between WHO III and II glioma was exclusively possible with vp derived from an AIF in the SSS (p=0.03; AUC 0.74). CONCLUSION The AIF source has a significant impact on absolute kinetic parameters in DCE-MRI, which limits the comparability of kinetic parameters derived from different AIF sources. The effect is also tissue-dependent. The SSS appears to be the best choice for AIF source vessel selection in brain tumor DCE-MRI as it exclusively allowed for WHO grades II/III and III/IV glioma distinction (by vp) and showed the least number of implausible ve values.
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Affiliation(s)
- Vera C Keil
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
| | - Burkhard Mädler
- Philips Healthcare, Röntgenstrasse 22, 22335 Hamburg, Germany.
| | - Jürgen Gieseke
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany; Philips Healthcare, Röntgenstrasse 22, 22335 Hamburg, Germany.
| | - Rolf Fimmers
- IMBIE (Statistics Department), University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
| | - Elke Hattingen
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
| | - Hans H Schild
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
| | - Dariusch R Hadizadeh
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
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19
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Keil V, Eichhorn L, Mädler B, Gieseke J, Müller A, Block W, Träber F, Sprinkart M, Scheef L, Schneider C, Hadizadeh D, Hattingen E, Schild H. The Deep Blue im MRT – Eine komparative 3D pCASL und IVIM-MRT Studie zur Adaptation der cerebralen Perfusion bei Apnoetauchern. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- V Keil
- UK Bonn, Radiologie, Bonn
| | | | - B Mädler
- Philips Healthcare, Clinical Science, Hamburg
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20
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Schievelkamp A, Jurcoane A, Mädler B, Rüber T, Ernst L, Elger C, Schild H, Hattingen E. Limbische Enzephalitis, Fallstrick der MRT-Bildgebung. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - A Jurcoane
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - B Mädler
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - T Rüber
- Universitätsklinikum Bonn, Epileptologie, Bonn
| | - L Ernst
- Universitätsklinikum Bonn, Epileptologie, Bonn
| | - C Elger
- Universitätsklinikum Bonn, Epileptologie, Bonn
| | - H Schild
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - E Hattingen
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
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21
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Keil VC, Mädler B, Gielen GH, Pintea B, Hiththetiya K, Gaspranova AR, Gieseke J, Simon M, Schild HH, Hadizadeh DR. Intravoxel incoherent motion MRI in the brain: Impact of the fitting model on perfusion fraction and lesion differentiability. J Magn Reson Imaging 2017; 46:1187-1199. [PMID: 28152250 DOI: 10.1002/jmri.25615] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/13/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To investigate the effect of the choice of the curve-fitting model on the perfusion fraction (fIVIM ) with regard to tissue type characterization, correlation with microvascular anatomy, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters. Several curve-fitting models coexist in intravoxel incoherent motion (IVIM) MRI to derive the (fIVIM ). MATERIALS AND METHODS In all, 29 patients with brain lesions (12 gliomas, 11 meningiomas, three metastases, two gliotic scars, one multiple sclerosis) underwent IVIM-MRI (32 b-values, 0 to 2000 s/mm2 ) at 3T. fIVIM was determined by classic monoexponential, biexponential, and a novel nonnegative least squares (NNLS) fitting in 352 regions of interest (lesion-containing and normal-appearing tissue) and tested their correlation with DCE-MRI kinetic parameters and microvascular anatomy derived from 57 region of interest (ROI)-based biopsies and their capacities to differentiate histologically different lesions. RESULTS fIVIM differed significantly between all three models and all tissue types (monoexponential confidence interval in percent [CI 3.4-3.8]; biexponential [CI 11.21-12.45]; NNLS [CI 2.06-2.60]; all P < 0.001). For all models an increase in fIVIM was associated with a shift to larger vessels and higher vessel area / tissue area ratio (regression coefficient 0.07-0.52; P = 0.04-0.001). Correlation with kinetic parameters derived from DCE-MRI was usually not significant. Only biexponential fitting allowed differentiation of both gliosis from edema and high- from low-grade glioma (both P < 0.001). CONCLUSION The curve-fitting model has an important impact on fIVIM and its capacity to differentiate tissues. fIVIM may possibly be used to assess microvascular anatomy and is weakly correlated with DCE-MRI kinetic parameters. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1187-1199.
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Affiliation(s)
- Vera C Keil
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
| | | | - Gerrit H Gielen
- University Hospital Bonn/Germany, Department of Neuropathology, Center for Pathology, Bonn, Germany
| | - Bogdan Pintea
- BG Krankenhaus Bergmannsheil, Bochum/Germany, Bochum, Germany
| | | | - Alisa R Gaspranova
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
| | | | - Matthias Simon
- Ev. Krankenhaus Bielefeld/Germany, Department of Neurosurgery, Bielefeld, Germany.,University Hospital Bonn/Germany, Department of Neurosurgery and Stereotaxy, Bonn, Germany
| | - Hans H Schild
- University Hospital Bonn/Germany, Department of Radiology, Bonn, Germany
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22
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Müller A, Jurcoane A, Kebir S, Ditter P, Schrader F, Herrlinger U, Tzaridis T, Mädler B, Schild HH, Glas M, Hattingen E. Quantitative T1-mapping detects cloudy-enhancing tumor compartments predicting outcome of patients with glioblastoma. Cancer Med 2016; 6:89-99. [PMID: 27891815 PMCID: PMC5269700 DOI: 10.1002/cam4.966] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/11/2016] [Accepted: 10/25/2016] [Indexed: 12/13/2022] Open
Abstract
Contrast enhancement of glioblastomas (GBM) is caused by the decrease in relaxation time, T1. Here, we demonstrate that the quantitative measurement of T1 (qT1) discovers a subtle enhancement in GBM patients that is invisible in standard MRI. We assessed the volume change of this “cloudy” enhancement during radio‐chemotherapy and its impact on patients’ progression‐free survival (PFS). We enrolled 18 GBM patients in this observational, prospective cohort study and measured 3T‐MRI pre‐ and post contrast agent with standard T1‐weighted (T1w) and with sequences to quantify T1 before radiation, and at 6‐week intervals during radio‐chemotherapy. We measured contrast enhancement by subtracting pre from post contrast contrast images, yielding relative signal increase ∆T1w and relative T1 shortening ∆qT1. On ∆qT1, we identified a solid and a cloudy‐enhancing compartment and evaluated the impact of their therapy‐related volume change upon PFS. In ∆qT1 maps cloudy‐enhancing compartments were found in all but two patients at baseline and in all patients during therapy. The qT1 decrease in the cloudy‐enhancing compartment post contrast was 21.64% versus 1.96% in the contralateral control tissue (P < 0.001). It was located at the margin of solid enhancement which was also seen on T1w. In contrast, the cloudy‐enhancing compartment was visually undetectable on ∆T1w. A volume decrease of more than 21.4% of the cloudy‐enhancing compartment at first follow‐up predicted longer PFS (P = 0.038). Cloudy‐enhancing compartment outside the solid contrast‐enhancing area of GBM is a new observation which is only visually detectable with qT1‐mapping and may represent tumor infiltration. Its early volume decrease predicts a longer PFS in GBM patients during standard radio‐chemotherapy.
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Affiliation(s)
- Andreas Müller
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Alina Jurcoane
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Sied Kebir
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Philip Ditter
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Felix Schrader
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Theophilos Tzaridis
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Burkhard Mädler
- Philips GmbH, UB Healthcare, Lübeckertordamm 5, Hamburg, 20099, Germany
| | - Hans H Schild
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Martin Glas
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany.,Division of Experimental and Translational Neurooncology, Department of Neurology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany.,Clinical Cooperation Unit Neurooncology, MediClin Robert Janker Clinic & University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
| | - Elke Hattingen
- Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund Freud Str. 25, Bonn, 53127, Germany
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23
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Coenen VA, Jenkner C, Honey CR, Mädler B. Electrophysiologic Validation of Diffusion Tensor Imaging Tractography during Deep Brain Stimulation Surgery. AJNR Am J Neuroradiol 2016; 37:1470-8. [PMID: 27032969 DOI: 10.3174/ajnr.a4753] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/22/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Diffusion tensor imaging fiber tractography-assisted planning of deep brain stimulation is an emerging technology. We investigated its accuracy by using electrophysiology under clinical conditions. We hypothesized that a level of concordance between electrophysiology and DTI fiber tractography can be reached, comparable with published modeling approaches for deep brain stimulation surgery. MATERIALS AND METHODS Eleven patients underwent subthalamic nucleus deep brain stimulation. DTI scans and high-resolution T1- and T2-weighted MR imaging was performed at 3T. Corticospinal tracts were traced. We studied electrode positions and current amplitudes that elicited corticospinal tract effects during the operation to determine relative corticospinal tract distance. Postoperatively, 3D deep brain stimulation electrode contact locations and stimulation patterns were applied for the same corticospinal tract distance estimation. RESULTS Intraoperative electrophysiologic (n = 40) clinical effects in 11 patients were detected. The mean intraoperative electrophysiologic corticospinal tract distance was 3.0 ± 0.6 mm; the mean image-derived corticospinal tract distance (DTI fiber tractography) was 3.0 ± 1.3 mm. The 95% limits of agreement were ±2.4 mm. Postoperative electrophysiology (n = 44) corticospinal tract activation effects were encountered in 9 patients; 39 were further evaluated. Mean electrophysiologic corticospinal tract distance was 3.7 ± 0.7 mm; for DTI fiber tractography, it was 3.2 ± 1.9 mm. The 95% limits of agreement were ±2.5 mm. CONCLUSIONS DTI fiber tractography depicted the medial corticospinal tract border with proved concordance. Although the overall range of measurements was relatively small and variance was high, we believe that further use of DTI fiber tractography to assist deep brain stimulation procedures is advisable if inherent limitations are respected. These results confirm our previously published electric field simulation studies.
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Affiliation(s)
- V A Coenen
- From the Department of Stereotactic and Functional Neurosurgery (V.A.C., B.M.)
| | - C Jenkner
- the Clinical Trial Unit (C.J.), Freiburg University Medical Center, Freiburg, Germany
| | - C R Honey
- Surgical Center for Movement Disorders/Division of Neurosurgery (C.R.H.)
| | - B Mädler
- From the Department of Stereotactic and Functional Neurosurgery (V.A.C., B.M.) Department of Physics and Astronomy (B.M.), University of British Columbia, Vancouver, British Columbia, Canada Philips Healthcare (B.M.), Hamburg, Germany
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24
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Sajonz BEA, Mädler B, Herberhold S, Paus S, Allert N, Coenen VA. Stimulation induced hypogeusia in thalamic deep brain stimulation for tremor: an underestimated yet common side effect. J Neurol Neurosurg Psychiatry 2016; 87:565-7. [PMID: 25901034 DOI: 10.1136/jnnp-2015-310368] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 03/30/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Bastian E A Sajonz
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg (iBr), Germany Department of Neurosurgery, Freiburg University Medical Center, Freiburg (iBr), Germany
| | - Burkhard Mädler
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg (iBr), Germany
| | | | - Sebastian Paus
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Niels Allert
- Neurological Rehabilitation Center Godeshoehe, Bonn, Germany
| | - Volker A Coenen
- Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg (iBr), Germany
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25
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Meyers SM, Tam R, Lee JS, Kolind SH, Vavasour IM, Mackie E, Zhao Y, Laule C, Mädler B, Li DK, MacKay AL, Traboulsee AL. Does hydration status affect MRI measures of brain volume or water content? J Magn Reson Imaging 2016; 44:296-304. [DOI: 10.1002/jmri.25168] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/11/2016] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sandra M. Meyers
- Physics and Astronomy; University of British Columbia; Vancouver BC Canada
| | - Roger Tam
- MS/MRI Research Group; University of British Columbia; Vancouver BC Canada
- Radiology; University of British Columbia; Vancouver BC Canada
| | - Jimmy S. Lee
- Radiology; University of British Columbia; Vancouver BC Canada
| | | | | | - Emilie Mackie
- Medicine; University of British Columbia; Vancouver BC Canada
| | - Yinshan Zhao
- Medicine; University of British Columbia; Vancouver BC Canada
| | - Cornelia Laule
- Radiology; University of British Columbia; Vancouver BC Canada
- Pathology & Laboratory Medicine; University of British Columbia; Vancouver BC Canada
- International Collaboration on Repair Discoveries; University of British Columbia; Vancouver BC Canada
| | | | - David K.B. Li
- MS/MRI Research Group; University of British Columbia; Vancouver BC Canada
- Radiology; University of British Columbia; Vancouver BC Canada
- Medicine; University of British Columbia; Vancouver BC Canada
| | - Alex L. MacKay
- Physics and Astronomy; University of British Columbia; Vancouver BC Canada
- Radiology; University of British Columbia; Vancouver BC Canada
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26
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Abstract
Measurement of basic quantitative magnetic resonance (MR) parameters (e.g., relaxation times T1, T2*, T2 or respective rates R (1/T)) corrected for radiofrequency (RF) coil bias yields different conventional and new tissue contrasts as well as volumes for tissue segmentation. This approach also provides quantitative measures of microstructural and functional tissue changes. We herein demonstrate some prospects of quantitative MR imaging in neurological diagnostics and science.
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Affiliation(s)
- E Hattingen
- Neuroradiologie, Radiologische Klinik des Universitätsklinikums Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany.
| | - A Jurcoane
- Neuroradiologie, Radiologische Klinik des Universitätsklinikums Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany
| | - M Nelles
- Neuroradiologie, Radiologische Klinik des Universitätsklinikums Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany
| | - A Müller
- Neuroradiologie, Radiologische Klinik des Universitätsklinikums Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany
| | - U Nöth
- Brain Imaging Center, Universitätsklinikum Frankfurt, Frankfurt/Main, Germany
| | - B Mädler
- Philips Medical Systems, Philips GmbH, Hamburg, Germany
| | - P Mürtz
- Neuroradiologie, Radiologische Klinik des Universitätsklinikums Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany
| | - R Deichmann
- Brain Imaging Center, Universitätsklinikum Frankfurt, Frankfurt/Main, Germany
| | - H H Schild
- Radiologische Klinik des Universitätsklinikums Bonn, Sigmund Freud Strasse 25, 53127, Bonn, Germany
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Billiet T, Vandenbulcke M, Mädler B, Peeters R, Dhollander T, Zhang H, Deprez S, Van den Bergh BR, Sunaert S, Emsell L. Age-related microstructural differences quantified using myelin water imaging and advanced diffusion MRI. Neurobiol Aging 2015; 36:2107-21. [PMID: 25840837 DOI: 10.1016/j.neurobiolaging.2015.02.029] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/26/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022]
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Vavasour IM, Meyers SM, MacMillan EL, Mädler B, Li DKB, Rauscher A, Vertinsky T, Venu V, MacKay AL, Curt A. Increased spinal cord movements in cervical spondylotic myelopathy. Spine J 2014; 14:2344-54. [PMID: 24462810 DOI: 10.1016/j.spinee.2014.01.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 12/10/2013] [Accepted: 01/17/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Magnetic resonance imaging (MRI) is a very useful diagnostic test for cervical spondylotic myelopathy (CSM) because it can identify degenerative changes within the spinal cord (SC), disclose the extent, localization, and the kind of SC compression, and help rule out other SC disorders. However, the relationships between changes in cerebrospinal fluid (CSF) flow, cord motion, the extent and severity of spinal canal stenosis, and the development of CSM symptoms are not well understood. PURPOSE To evaluate if changes in the velocity of CSF and SC movements provide additional insight into the pathophysiological mechanisms underlying CSM beyond MRI observations of cord compression. STUDY DESIGN Prospective radiologic study of recruited patients. PATIENT SAMPLE Thirteen CSM subjects and 15 age and gender matched controls. OUTCOME MEASURES Magnetic resonance imaging measures included CSF and SC movement. Cervical cord condition was assessed by the Japanese Orthopaedic Association (JOA) score, compression ratio (CR), and somatosensory evoked potentials (SSEPs) of the tibial and ulnar nerves. METHODS Phase-contrast imaging at the level of stenosis for patients and at C5 for controls and T2-weighted images were compared with clinical findings. RESULTS Cerebrospinal fluid velocity was significantly reduced in CSM subjects as compared with controls and was related to cord CR. Changes in CSF velocity and cord compression were not correlated with clinical measures (JOA scores, SSEP) or the presence of T2 hyperintensities. Spinal cord movements, that is, cord displacement and velocity in the craniocaudal axis, were increased in CSM patients. Increased SC movements (ie, total cord displacement) both in the controls and CSM subjects were associated with altered spinal conduction as assessed by SSEP. CONCLUSIONS This study revealed rather unexpected increased cord movements in the craniocaudal axis in CSM patients that may contribute to myelopathic deteriorations in combination with spinal canal compression. Understanding the relevance of cord movements with respect to supporting the clinical CSM diagnosis or disease monitoring requires further long-term follow-up studies.
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Affiliation(s)
- Irene M Vavasour
- Department of Radiology, 2211 Wesbrook Mall, University of British Columbia, Vancouver, BC, Canada, V6T 2B5.
| | - Sandra M Meyers
- Department of Physics and Astronomy, 6224 Agricultural Rd, University of British Columbia, Vancouver, BC, Canada, V6T 1Z1
| | - Erin L MacMillan
- Department of Medicine, 2775 Laurel St, 10th Floor, Vancouver, BC, Canada, V5Z 1M9
| | - Burkhard Mädler
- Department of Neurosurgery, Sigmund-Freud-Str. 25, Univerity of Bonn, Germany, 53105
| | - David K B Li
- Department of Radiology, 2211 Wesbrook Mall, University of British Columbia, Vancouver, BC, Canada, V6T 2B5
| | - Alexander Rauscher
- Department of Radiology, 2211 Wesbrook Mall, University of British Columbia, Vancouver, BC, Canada, V6T 2B5; UBC MRI Research Centre, M10 Purdy Pavilion, 2111 Wesbrook Mall, University of British Columbia, Vancouver, BC, Canada, V6T 2B5
| | - Talia Vertinsky
- Department of Radiology, 855 W 12th Ave, Vancouver General Hospital, Vancouver, BC, Canada, V5Z 4E3
| | - Vic Venu
- Department of Radiology, 855 W 12th Ave, Vancouver General Hospital, Vancouver, BC, Canada, V5Z 4E3
| | - Alex L MacKay
- Department of Radiology, 2211 Wesbrook Mall, University of British Columbia, Vancouver, BC, Canada, V6T 2B5; Department of Physics and Astronomy, 6224 Agricultural Rd, University of British Columbia, Vancouver, BC, Canada, V6T 1Z1
| | - Armin Curt
- Spinal Cord Injury Center, Forchstrasse 340, University of Zurich, CH-8008 Zurich, Switzerland; International Collaboration on Repair Discoveries (ICORD), 818 West 10th Ave, University of British Columbia, Vancouver, BC, Canada, V5Z 1M9
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d'Entremont AG, Kolind SH, Mädler B, Wilson DR, MacKay AL. Using the dGEMRIC technique to evaluate cartilage health in the presence of surgical hardware at 3T: comparison of inversion recovery and saturation recovery approaches. Skeletal Radiol 2014; 43:331-44. [PMID: 24357123 DOI: 10.1007/s00256-013-1777-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 10/18/2013] [Accepted: 11/04/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the effect of metal artifact reduction techniques on dGEMRIC T(1) calculation with surgical hardware present. MATERIALS AND METHODS We examined the effect of stainless-steel and titanium hardware on dGEMRIC T(1) maps. We tested two strategies to reduce metal artifact in dGEMRIC: (1) saturation recovery (SR) instead of inversion recovery (IR) and (2) applying the metal artifact reduction sequence (MARS), in a gadolinium-doped agarose gel phantom and in vivo with titanium hardware. T(1) maps were obtained using custom curve-fitting software and phantom ROIs were defined to compare conditions (metal, MARS, IR, SR). RESULTS A large area of artifact appeared in phantom IR images with metal when T(I) ≤ 700 ms. IR maps with metal had additional artifact both in vivo and in the phantom (shifted null points, increased mean T(1) (+151 % IR ROI(artifact)) and decreased mean inversion efficiency (f; 0.45 ROI(artifact), versus 2 for perfect inversion)) compared to the SR maps (ROI(artifact): +13 % T(1) SR, 0.95 versus 1 for perfect excitation), however, SR produced noisier T(1) maps than IR (phantom SNR: 118 SR, 212 IR). MARS subtly reduced the extent of artifact in the phantom (IR and SR). CONCLUSIONS dGEMRIC measurement in the presence of surgical hardware at 3T is possible with appropriately applied strategies. Measurements may work best in the presence of titanium and are severely limited with stainless steel. For regions near hardware where IR produces large artifacts making dGEMRIC analysis impossible, SR-MARS may allow dGEMRIC measurements. The position and size of the IR artifact is variable, and must be assessed for each implant/imaging set-up.
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Affiliation(s)
- Agnes G d'Entremont
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada,
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Schlaepfer TE, Bewernick BH, Kayser S, Mädler B, Coenen VA. Rapid effects of deep brain stimulation for treatment-resistant major depression. Biol Psychiatry 2013; 73:1204-12. [PMID: 23562618 DOI: 10.1016/j.biopsych.2013.01.034] [Citation(s) in RCA: 354] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 12/22/2012] [Accepted: 01/30/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Treatment-resistant major depressive disorder is a prevalent and debilitating condition. Deep brain stimulation to different targets has been proposed as a putative treatment. METHODS In this pilot study, we assessed safety and efficacy of deep brain stimulation to the supero-lateral branch of the medial forebrain bundle in seven patients with highly refractory depression. Primary outcome criterion was severity of treatment-resistant major depressive disorder as assessed with the Montgomery-Åsberg Depression Rating Scale. General psychopathologic parameters, social functioning, and tolerance were assessed with standardized scales, the Global Assessment of Functioning scale, quality of life (Short-Form Health Survey Questionnaire), and neuropsychological tests. RESULTS All patients showed strikingly similar intraoperative effects of increased appetitive motivation. Six patients attained the response criterion; response was rapid--mean Montgomery-Åsberg Depression Rating Scale of the whole sample was reduced by>50% at day 7 after onset of stimulation. At last observation (12-33 weeks), six patients were responders; among them, four were classified as remitters. Social functioning (Global Assessment of Functioning) improved in the sample as a whole from serious to mild impairment. Mean stimulation current was 2.86 mA; all side effects (strabismus at higher stimulation current, one small intracranial bleeding during surgery, infection at the implanted pulse generator site) could be resolved at short term. CONCLUSIONS These preliminary findings suggest that bilateral stimulation of the supero-lateral branch of the medial forebrain bundle may significantly reduce symptoms in treatment-resistant major depressive disorder. Onset of antidepressant efficacy was rapid (days), and a higher proportion of the population responded at lower stimulation intensities than observed in previous studies.
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Affiliation(s)
- Thomas E Schlaepfer
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
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Meyers SM, Vavasour IM, Mädler B, Harris T, Fu E, Li DK, Traboulsee AL, MacKay AL, Laule C. Multicenter measurements of myelin water fraction and geometric mean T2: Intra- and intersite reproducibility. J Magn Reson Imaging 2013; 38:1445-53. [DOI: 10.1002/jmri.24106] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 02/11/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- Sandra M. Meyers
- Physics and Astronomy; University of British Columbia; Vancouver BC Canada
| | | | | | - Trudy Harris
- UBC MRI Research Centre; University of British Columbia; Vancouver BC Canada
| | - Eric Fu
- Centre for Health Evaluation and Outcome Sciences; St Paul's Hospital; BC Canada
| | - David K.B. Li
- Radiology; University of British Columbia; Vancouver BC Canada
- UBC MRI Research Centre; University of British Columbia; Vancouver BC Canada
- Medicine, University of British Columbia; Vancouver BC Canada
| | | | - Alex L. MacKay
- Physics and Astronomy; University of British Columbia; Vancouver BC Canada
- Radiology; University of British Columbia; Vancouver BC Canada
- UBC MRI Research Centre; University of British Columbia; Vancouver BC Canada
| | - Cornelia Laule
- Radiology; University of British Columbia; Vancouver BC Canada
- UBC MRI Research Centre; University of British Columbia; Vancouver BC Canada
- Pathology and Laboratory Medicine; University of British Columbia; Vancouver BC Canada
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Coenen VA, Panksepp J, Hurwitz TA, Urbach H, Mädler B. Human medial forebrain bundle (MFB) and anterior thalamic radiation (ATR): imaging of two major subcortical pathways and the dynamic balance of opposite affects in understanding depression. J Neuropsychiatry Clin Neurosci 2012; 24:223-36. [PMID: 22772671 DOI: 10.1176/appi.neuropsych.11080180] [Citation(s) in RCA: 234] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The medial forebrain bundle (MFB), a key structure of reward-seeking circuitry, remains inadequately characterized in humans despite its vast importance for emotional processing and development of addictions and depression. Using Diffusion Tensor Imaging Fiber Tracking (DTI FT) the authors describe potential converging ascending and descending MFB and anterior thalamic radiation (ATR) that may mediate major brain reward-seeking and punishment functions. Authors highlight novel connectivity, such as supero-lateral-branch MFB and ATR convergence, caudally as well as rostrally, in the anterior limb of the internal capsule and medial prefrontal cortex. These anatomical convergences may sustain a dynamic equilibrium between positive and negative affective states in human mood-regulation and its various disorders, especially evident in addictions and depression.
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Partanen M, Fitzpatrick K, Mädler B, Edgell D, Bjornson B, Giaschi DE. Cortical basis for dichotic pitch perception in developmental dyslexia. Brain Lang 2012; 123:104-112. [PMID: 23043968 DOI: 10.1016/j.bandl.2012.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Revised: 07/14/2012] [Accepted: 09/05/2012] [Indexed: 06/01/2023]
Abstract
The current study examined auditory processing deficits in dyslexia using a dichotic pitch stimulus and functional MRI. Cortical activation by the dichotic pitch task occurred in bilateral Heschl's gyri, right planum temporale, and right superior temporal sulcus. Adolescents with dyslexia, relative to age-matched controls, illustrated greater activity in left Heschl's gyrus for random noise, less activity in right Heschl's gyrus for all auditory conditions, and less activity in right superior temporal sulcus for a dichotic melody. Subsequent analyses showed that these group differences were attributable to dyslexic readers who performed poorly on the psychophysical task. Furthermore, behavioral performance on phonological reading was correlated to activity from dichotic conditions in right Heschl's gyrus and right superior temporal sulcus. It is postulated that these differences between reader groups is primarily due to a noise exclusion deficit shown previously in dyslexia.
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Affiliation(s)
- Marita Partanen
- British Columbia Children's Hospital, University of British Columbia, 4480 Oak St., Vancouver, BC V6H 3V4, Canada.
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Prasloski T, Rauscher A, MacKay AL, Hodgson M, Vavasour IM, Laule C, Mädler B. Rapid whole cerebrum myelin water imaging using a 3D GRASE sequence. Neuroimage 2012; 63:533-9. [PMID: 22776448 DOI: 10.1016/j.neuroimage.2012.06.064] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 06/25/2012] [Accepted: 06/28/2012] [Indexed: 11/30/2022] Open
Affiliation(s)
- Thomas Prasloski
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, Canada V6T 1Z1.
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Coenen VA, Mädler B, Schiffbauer H, Urbach H, Allert N. Individual fiber anatomy of the subthalamic region revealed with diffusion tensor imaging: a concept to identify the deep brain stimulation target for tremor suppression. Neurosurgery 2012; 68:1069-75; discussion 1075-6. [PMID: 21242831 DOI: 10.1227/neu.0b013e31820a1a20] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) has been proven to alleviate tremor of various origins. Distinct regions have been targeted. One explanation for good clinical tremor control might be the involvement of the dentatorubrothalamic tract (DRT) as has been suggested in superficial (thalamic) and inferior (posterior subthalamic) target regions. Beyond a correlation with atlas data and the postmortem evaluation of patients treated with lesion surgery, proof for the involvement of DRT in tremor reduction in the living, the scope of this work, is elusive. OBJECTIVE To report a case of unilateral refractory tremor in tremor-dominant Parkinson disease treated with thalamic DBS. METHODS Preoperative diffusion tensor imaging (DTI) was performed. Correlation with individual DBS electrode contact locations was obtained through postoperative fusion of helical computed tomography (CT) data with DTI fiber tracking. RESULTS Tremor was alleviated effectively. An evaluation of the active electrode contact position revealed clear involvement of the DRT in tremor control. A closer evaluation of clinical effects and side effects revealed a highly detailed individual fiber map of the subthalamic region with DTI fiber tracking. CONCLUSION This is the first time the involvement of the DRT in tremor reduction through DBS has been shown in the living. The combination of DTI with postoperative CT and the evaluation of the electrophysiological environment of distinct electrode contacts led to an individual detailed fiber map and might be extrapolated to refined DTI-based targeting strategies in the future. Data acquisition for a larger study group is the topic of our ongoing research.
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Affiliation(s)
- Volker A Coenen
- Division of Stereotaxy and MR-Based Operative Techniques/Department of Neurosurgery, Bonn University, Bonn, Germany.
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Mädler B, Coenen VA. Explaining clinical effects of deep brain stimulation through simplified target-specific modeling of the volume of activated tissue. AJNR Am J Neuroradiol 2012; 33:1072-80. [PMID: 22300931 DOI: 10.3174/ajnr.a2906] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although progress has been made in understanding the optimal anatomic structures as target areas for DBS, little effort has been put into modeling and predicting electromagnetic field properties of activated DBS electrodes and understanding their interactions with the adjacent tissue. Currently, DBS is performed with the patient awake to assess the effectiveness and the side effect spectrum of stimulation. This study was designed to create a robust and rather simple numeric and visual tool that provides sufficient and practical relevant information to visualize the patient's individual VAT. MATERIALS AND METHODS Multivariate polynomial fitting of previously obtained data from a finite-element model, based on a similar DBS system, was used. The model estimates VAT as a first-approximation sphere around the active DBS contact, using stimulation voltages and individual tissue-electrode impedances. Validation uses data from 2 patients with PD by MR imaging, DTI, fiber tractography, and postoperative CT data. RESULTS Our model can predict VAT for impedances between 500 and 2000 Ω with stimulation voltages up to 10 V. It is based on assumptions for monopolar DBS. Evaluation of 2 DBS cases showed a convincing correspondence between predicted VAT and neurologic (side) effects (internal capsule activation). CONCLUSIONS Stimulation effects during DBS can be readily explained with this simple VAT model. Its implementation in daily clinical routine might help in understanding the types of tissues activated during DBS. This technique might have the potential to facilitate DBS implantations with the patient under general anesthesia while yielding acceptable clinical effectiveness.
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Affiliation(s)
- B Mädler
- Division of Stereotaxy and MR-Based Operative Techniques, Department of Neurosurgery, Bonn University Hospital, Bonn, Germany.
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Coenen VA, Schlaepfer TE, Allert N, Mädler B. Diffusion tensor imaging and neuromodulation: DTI as key technology for deep brain stimulation. Int Rev Neurobiol 2012. [PMID: 23206684 DOI: 10.1016/b978-0-12-404706-8.00011-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion tensor imaging (DTI) is more than just a useful adjunct to invasive techniques like optogenetics which recently have tremendously influenced our understanding of the mechanisms of deep brain stimulation (DBS). In combination with other technologies, DTI helps us to understand which parts of the brain tissue are connected to others and which ones are truly influenced with neuromodulation. The complex interaction of DBS with the surrounding tissues-scrutinized with DTI-allows to create testable hypotheses that can explain network interactions. Those interactions are vital for our understanding of the net effects of neuromodulation. This work naturally was first done in the field of movement disorder surgery, where a lot of experience regarding therapeutic effects and only a short latency between initiation of neuromodulation and alleviation of symptoms exist. This chapter shows the journey over the past 10 years with first applications in DBS toward current research in affect regulating network balances and their therapeutic alterations with the neuromodulation technology.
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Affiliation(s)
- Volker Arnd Coenen
- Division of Stereotaxy and Functional Neurosurgery, Department of Neurosurgery, Bonn University Medical Center, Bonn, Germany.
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Liang ALW, Vavasour IM, Mädler B, Traboulsee AL, Lang DJ, Li DKB, MacKay AL, Laule C. Short-term stability of T1 and T2 relaxation measures in multiple sclerosis normal appearing white matter. J Neurol 2011; 259:1151-8. [PMID: 22119771 DOI: 10.1007/s00415-011-6318-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/01/2011] [Accepted: 11/04/2011] [Indexed: 12/19/2022]
Abstract
The presence of diffuse and widespread abnormalities within the 'normal appearing' white matter (NAWM) of multiple sclerosis (MS) brain has been established. T(1) histogram analysis has revealed increased T(1) (related to water content) in segmented NAWM, while quantitative assessment of T(2) relaxation measures has demonstrated decreased myelin water fraction (MWF, related to myelin content) and increased geometric mean T(2) (GMT(2)) of the intra/extracellular water pool. Previous studies with follow-up periods of 1-5 years have demonstrated longitudinal changes in T(1) histogram metrics over time; however, longitudinal changes in MWF and GMT(2) of segmented NAWM have not been examined. We examined the short-term evolution of MWF, GMT(2) and T(1) in MS NAWM based on monthly scanning over 6 months in 18 relapsing remitting (RR) MS subjects. Histogram metrics demonstrated short-term stability of T(1), MWF and remitting (RR) MS subjects. We observed no change in MWF, GMT(2) or T(1) histogram metrics in NAWM in RRMS over the course of 6 months. Longer follow-up periods may be required to establish demonstrable changes in NAWM based on of MWF, GMT(2) and T(1) metrics.
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Affiliation(s)
- Alice L W Liang
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.
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Prasloski T, Mädler B, Xiang QS, MacKay A, Jones C. Applications of stimulated echo correction to multicomponent T2 analysis. Magn Reson Med 2011; 67:1803-14. [PMID: 22012743 DOI: 10.1002/mrm.23157] [Citation(s) in RCA: 191] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 07/11/2011] [Accepted: 07/26/2011] [Indexed: 11/05/2022]
Abstract
We propose a multicomponent fitting algorithm for multiecho T(2) data which allows for correction of T(2) distributions in the presence of stimulated echoes. Tracking the population of spins in many coherence pathways via the iterated method of the Extended Phase Graph algorithm allows for accurate quantification of echo magnitudes. The resulting decay curves allow for correction of errors due to nonideal refocusing pulses as a result of inhomogeneities in the B(1) transmit field. Non-Negative Least Squares fitting is used to quantify the magnitude of T(2) components at various T(2) values. This method, allowing calculation of the T(2) distribution with simultaneous extraction of the refocusing pulse flip angle, requires no change to image acquisition procedures and no extra data input. Validation by means of both simulations and in vivo data shows excellent interscan reproducibility while vastly improving the accuracy of extracted T(2) parameters in voxels where poor B(1) homogeneity leads to refocusing pulse flip angles significantly less than 180°. Most notably, myelin water fraction values in these regions are found to have increased consistency and accuracy.
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Affiliation(s)
- Thomas Prasloski
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada.
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Coenen VA, Allert N, Mädler B. A role of diffusion tensor imaging fiber tracking in deep brain stimulation surgery: DBS of the dentato-rubro-thalamic tract (drt) for the treatment of therapy-refractory tremor. Acta Neurochir (Wien) 2011; 153:1579-85; discussion 1585. [PMID: 21553318 DOI: 10.1007/s00701-011-1036-z] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 04/18/2011] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Deep brain stimulation (DBS) can alleviate tremor of various origins. A number of regions are targeted. In recent work our group was able to show the involvement of the dentato-rubro-thalamic tract (drt) in tremor control with fiber tracking techniques. Here we report for the first time the successful use of magnetic resonance tractography in combination with traditional landmark-based targeting techniques to perform the implantation of a bilateral DBS system in a patient with dystonic head tremor. METHODS We report on a 37-year-old female with long-standing pure head tremor from myoclonus dystonia. She was identified as a candidate for thalamic DBS. The use of head fixation in a stereotactic frame would blur target symptoms (head tremor) during surgery and was therefore avoided. Her dentate-rubro-thalamic tracts were visualized with preoperative diffusion tensor imaging (DTI) and tractography, and then directly targeted stereotactically with DBS electrodes. RESULTS Three months after implantation, tremor control was excellent (>90%). A close evaluation of the active electrode contact positions revealed clear involvement of the drt. CONCLUSION This is the first time that direct visualization of fiber tracts has been employed for direct targeting and successful movement disorder tremor surgery. In the reported case, additional knowledge about the position of the drt, which previously has been shown to be a structure for modulation to achieve tremor control, led to a successful implantation of a DBS system, although there was a lack of intra-operatively testable tremor symptoms. In concordance with studies in optogenetic neuromodulation, fiber tracts are the emerging target structures for DBS. The routine integration of DTI tractography into surgical planning might be a leading path into the future of DBS surgery and will add to our understanding of the pathophysiology of movement disorders. Larger study populations will have to prove these concepts in future research.
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Affiliation(s)
- Volker A Coenen
- Division of Stereotaxy and MR-based Operative Techniques/Department of Neurosurgery, University of Bonn, Sigmund Freud Straße 25, 53105 Bonn, Germany.
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Levin DI, Gilles B, Mädler B, Pai DK. Extracting skeletal muscle fiber fields from noisy diffusion tensor data. Med Image Anal 2011; 15:340-53. [DOI: 10.1016/j.media.2011.01.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 01/10/2011] [Accepted: 01/29/2011] [Indexed: 11/28/2022]
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Pollard TCB, McNally EG, Wilson DC, Wilson DR, Mädler B, Watson M, Gill HS, Carr AJ. Localized cartilage assessment with three-dimensional dGEMRIC in asymptomatic hips with normal morphology and cam deformity. J Bone Joint Surg Am 2010; 92:2557-69. [PMID: 21048174 DOI: 10.2106/jbjs.i.01200] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cam deformities cause femoroacetabular impingement and damage the acetabular labral-chondral complex. The aims of this study were to investigate the potential of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) to detect cartilage disease in asymptomatic hips with cam deformities compared with morphologically normal hips, establish whether dGEMRIC could identify advanced disease in hips with positive clinical findings, and establish whether cartilage damage correlated with the severity of the cam deformity. METHODS Subjects were recruited from a prospective study of individuals with a family history of osteoarthritis and their spouses who served as control subjects. Their symptoms and impingement test results were recorded. Asymptomatic hips with normal radiographic joint-space width were placed in a subgroup according to the presence of a cam deformity and the impingement test result. dGEMRIC was performed on a 3-T system, studying two regions of interest: the anterosuperior aspect of the acetabular cartilage (T1(acet)) and the total femoral and acetabular cartilage (T1(total)). The ratio T1(acet)/T1(total) gave the relative glycosaminoglycan content in the anterosuperior aspect of the acetabular cartilage. The cohort was placed in subgroups by joint morphology, impingement test status, and genetic predisposition; the mean T1 scores were compared, and the alpha angle and T1 were correlated. RESULTS Of thirty-two subjects (mean age, fifty-two years), nineteen had cam deformities. Hips with a cam deformity had reduced acetabular glycosaminoglycan content compared with normal hips (mean T1(acet)/T1(total), 0.949 and 1.093, respectively; p = 0.0008). Hips with a positive impingement test result had global depletion of glycosaminoglycan compared with hips with a negative result (mean T1(total), 625 ms versus 710 ms; p = 0.0152). T1(acet) inversely correlated with the magnitude of the alpha angle (r = -0.483, p = 0.0038), suggesting that the severity of cartilage damage correlates with the magnitude of the cam deformity. All of these differences occurred irrespective of genetic predisposition. CONCLUSIONS The dGEMRIC technique can detect cartilage damage in asymptomatic hips with cam deformities and no radiographic evidence of joint space narrowing. This damage correlates with cam deformity severity. Further study of the application of dGEMRIC as an imaging biomarker of early osteoarthritis is justified to validate its prognostic accuracy, identify subjects for clinical trials, and evaluate the effectiveness of surgical procedures.
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Affiliation(s)
- T C B Pollard
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Headington, Oxford, OX3 7LD, UK.
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Kozlowski P, Chang SD, Meng R, Mädler B, Bell R, Jones EC, Goldenberg SL. Combined prostate diffusion tensor imaging and dynamic contrast enhanced MRI at 3T--quantitative correlation with biopsy. Magn Reson Imaging 2010; 28:621-8. [PMID: 20392586 PMCID: PMC2943947 DOI: 10.1016/j.mri.2010.03.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 02/18/2010] [Accepted: 03/05/2010] [Indexed: 01/31/2023]
Abstract
The purpose of this work was to compare diagnostic accuracy of Diffusion Tensor Imaging (DTI), dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) and their combination in diagnosing prostate cancer. Twenty-five patients with clinical suspicion of prostate cancer underwent MRI, prior to transrectal ultrasound-guided biopsies. MRI data were correlated to biopsy results. Logistic regression models were constructed for the DTI parameters, DCE MRI parameters, and their combination. The areas under the receiver operator characteristic curves (AUC) were compared between the models. The nonparametric Wilcoxon signed rank test was used for statistical analysis. The sensitivity and specificity values were respectively 81% (74-87%) and 85% (79-90%) for DTI and 63% (55-70%) and 90% (85-94%) for DCE. The combination "DTI or DCE MRI" had 100% (97-100%) sensitivity and 77% (69-83%) specificity, while "DTI and DCE MRI" had 44% (37-52%) sensitivity and 98% (94-100%) specificity. The AUC for DTI+DCE parameters was significantly higher than that for either DTI (0.96 vs. 0.92, P=.0143) or DCE MRI parameters (0.96 vs. 0.87, P=.00187) alone. In conclusion, the combination of DTI and DCE MRI has significantly better accuracy in prostate cancer diagnosis than either technique alone.
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Affiliation(s)
- Piotr Kozlowski
- The Prostate Centre at Vancouver General Hospital, Vancouver, BC, Canada.
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Coenen VA, Hurwitz T, Panksepp J, Mädler B, Honey CR. Medial forebrain bundle stimulation elicits psychotropic side effects in Subthalamic Nucleus Deep Brain Stimulation for PD – new insights through Diffusion Tensor Imaging. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kolind SH, Mädler B, Fischer S, Li DKB, MacKay AL. Myelin water imaging: Implementation and development at 3.0T and comparison to 1.5T measurements. Magn Reson Med 2009; 62:106-15. [PMID: 19353659 DOI: 10.1002/mrm.21966] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Multicomponent T(2) relaxation imaging can be used to measure signal from water trapped between myelin bilayers; the ratio of myelin water signal to total water is termed the myelin water fraction (MWF). The goal of this study was to implement and develop the single-slice T(2)-imaging technique proposed by Poon and Henkelman. For refinement, scan parameters (gradient crusher height and slew rate, bandwidth, echo spacing, matrix size, repetition time, and phase rewinding) were varied in water-based phantoms and in fixed and in vivo brain. Changes in the standard deviation of the residuals of the multiexponential fit, MWF, T(2), and peak width of the intra/extracellular water were monitored to determine which scan parameters minimized artifacts. Subsequently, we compared multicomponent T(2) measurements at 1.5T and 3.0T for 10 healthy volunteers, and investigated the differences in SNR, fit residuals, MWF, and T(2) and peak width of the intra/extracellular water, at higher magnetic field. MWF maps were found to be qualitatively similar between field strengths. MWFs were found to be significantly higher at 3.0T than at 1.5T, but with a strongly significant correlation between measurements (R(2) > 0.92, P < 0.0005). The signal-to-noise ratio (SNR) was nearly double at 3.0T, but the standard deviation of residuals was increased in most cases.
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Affiliation(s)
- Shannon H Kolind
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada.
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Coenen VA, Honey CR, Hurwitz T, Rahman AA, McMaster J, Bürgel U, Mädler B. Medial forebrain bundle stimulation as a pathophysiological mechanism for hypomania in subthalamic nucleus deep brain stimulation for Parkinson's disease. Neurosurgery 2009; 64:1106-14; discussion 1114-5. [PMID: 19487890 DOI: 10.1227/01.neu.0000345631.54446.06] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Hypomania accounts for approximately 4% to 13% of psychotropic adverse events during subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease. Diffusion of current into the inferior and medial "limbic" STN is often reported to be the cause. We suggest a different explanation, in which the coactivation of the medial forebrain bundle (MFB), outside the STN, leads to hypomania during STN DBS. METHODS Six patients with advanced Parkinson's disease (age, 54 +/- 11 years) underwent bilateral STN DBS surgery. Preoperative diffusion tensor imaging scans for fiber tracking of the MFB were conducted on a 3T magnetic resonance imaging scanner. After implantation, the electrode positions were determined with computed tomography and integrated in a diffusion tensor imaging software environment. RESULTS The medial STN was shown to send tributaries to the MFB using it as a pathway to connect to the reward circuitry. One patient, who had a transient, stimulation-induced acute hypomanic episode, showed a direct contact between 1 active electrode contact and these putative limbic STN tributaries to the MFB unilaterally on the left. In 5 asymptomatic patients, the active contacts were between 2.9 and 7.5 mm distant from the MFB or its limbic STN tributaries. CONCLUSION We hypothesize that STN DBS-induced reversible acute hypomania might be elicited by inadvertent and unilateral coactivation of putative limbic STN tributaries to the MFB. These findings may provide insight into the neural pathways of hypomania and may facilitate future investigations of the pathophysiology of mood disorders.
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Affiliation(s)
- Volker A Coenen
- Surgical Center for Movement Disorders, University of British Columbia, Vancouver, BC, Canada.
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Christoff K, Keramatian K, Gordon AM, Smith R, Mädler B. Prefrontal organization of cognitive control according to levels of abstraction. Brain Res 2009; 1286:94-105. [PMID: 19505444 DOI: 10.1016/j.brainres.2009.05.096] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 04/29/2009] [Accepted: 05/23/2009] [Indexed: 10/20/2022]
Abstract
The prefrontal cortex (PFC) plays a crucial role in cognitive control and higher mental functions by maintaining working memory representations of currently relevant information, thereby inducing a mindset that facilitates the processing of such information. Using fMRI, we examined how the human PFC implements mindsets for information at varying levels of abstraction. Subjects solved anagrams grouped into three kinds of blocks (concrete, moderately abstract, and highly abstract) according to the degree of abstraction of their solutions. Mindsets were induced by cuing subjects at the beginning of every block as to the degree of abstraction of solutions they should look for. Different levels of abstraction were matched for accuracy and reaction time, allowing us to examine the effects of varying abstraction in the absence of variations in cognitive complexity. Mindsets for concrete, moderately abstract, and highly abstract information were associated with stronger relative recruitment of ventrolateral, dorsolateral, and rostrolateral PFC regions, respectively, suggesting a functional topography whereby increasingly anterior regions are preferentially associated with representations of increasing abstraction. Rather than being a structural property of the neurons in different prefrontal subregions, this relative specialization may reflect one of the principles according to which lateral PFC adaptively codes and organizes task-relevant information.
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Affiliation(s)
- Kalina Christoff
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada V6T 1Z4.
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Trudel G, Payne M, Mädler B, Ramachandran N, Lecompte M, Wade C, Biolo G, Blanc S, Hughson R, Bear L, Uhthoff HK. Bone marrow fat accumulation after 60 days of bed rest persisted 1 year after activities were resumed along with hemopoietic stimulation: the Women International Space Simulation for Exploration study. J Appl Physiol (1985) 2009; 107:540-8. [PMID: 19478189 DOI: 10.1152/japplphysiol.91530.2008] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Immobility in bed and decreased mobility cause adaptations to most human body systems. The effect of immobility on fat accumulation in hemopoietic bone marrow has never been measured prospectively. The reversibility of marrow fat accumulation and the effects on hemopoiesis are not known. In the present study, 24 healthy women (age: 25-40 yr) underwent -6 degrees head-down bed rest for 60 days. We used MRI to noninvasively measure the lumbar vertebral fat fraction at various time points. We also measured hemoglobin, erythropoietin, reticulocytes, leukocytes, platelet count, peripheral fat mass, leptin, cortisol, and C-reactive protein during bed rest and for 1 yr after bed rest ended. Compared with baseline, the mean (+/-SE) fat fraction was increased after 60 days of bed rest (+2.5+/-1.1%, P<0.05); the increase persisted 1 yr after the resumption of regular activities (+2.3+/-0.8%, P<0.05). Mean hemoglobin levels were significantly decreased 6 days after bed rest ended (-1.36+/-0.20 g/dl, P<0.05) but had recovered at 1 yr, with significantly lower mean circulating erythropoietin levels (-3.8+/-1.2 mU/ml, P<0.05). Mean numbers of neutrophils and lymphocytes remained significantly elevated at 1 yr (+617+/-218 neutrophils/microl and +498+/-112 lymphocytes/microl, both P<0.05). These results constitute direct evidence that bed rest irreversibly accelerated fat accumulation in hemopoietic bone marrow. The 2.5% increase in fat fraction after 60 days of bed rest was 25-fold larger than expected from historical ambulatory controls. Sixty days of bed rest accelerated by 4 yr the normal bone marrow involution. Bed rest and marrow adiposity were associated with hemopoietic stimulation. One year after subjects returned to normal activities, hemoglobin levels were maintained, with 43% lower circulating erythropoietin levels, and leukocytes remained significantly elevated across lineages. Lack of mobility alters hemopoiesis, possibly through marrow fat accumulation, with potentially wide-ranging clinical consequences.
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Affiliation(s)
- Guy Trudel
- Bone and Joint Laboratory, University of Ottawa, The Ottawa Hospital Rehabilitation Centre, 505 Smyth Rd., Ottawa, ON, Canada K1H 8M2.
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Meyers SM, Laule C, Vavasour IM, Kolind SH, Mädler B, Tam R, Traboulsee AL, Lee J, Li DKB, MacKay AL. Reproducibility of myelin water fraction analysis: a comparison of region of interest and voxel-based analysis methods. Magn Reson Imaging 2009; 27:1096-103. [PMID: 19356875 DOI: 10.1016/j.mri.2009.02.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2008] [Revised: 01/30/2009] [Accepted: 02/19/2009] [Indexed: 11/26/2022]
Abstract
This study compared region of interest (ROI) and voxel-based analysis (VBA) methods to determine the optimal method of myelin water fraction (MWF) analysis. Twenty healthy controls were scanned twice using a multi-echo T(2) relaxation sequence and ROIs were drawn in white and grey matter. MWF was defined as the fractional signal from 15 to 40 ms in the T(2) distribution. For ROI analysis, the mean intensity of voxels within an ROI was fit using non-negative least squares. For VBA, MWF was obtained for each voxel and the mean and median values within an ROI were calculated. There was a slightly higher correlation between Scan 1 and 2 for the VBA method (R(2)=0.98) relative to the ROI method (R(2)=0.95), and the VBA mean square difference between scans was 300% lower, indicating VBA was the most consistent between scans. For the VBA method, mean MWF was found to be more reproducible than median MWF. As the VBA method is more reproducible and gives more options for visualization and analysis of MWF, it is recommended over the ROI method of MWF analysis.
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Affiliation(s)
- Sandra M Meyers
- Department of Physics, University of Alberta, Edmonton, Canada
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Abstract
This article provides an overview of relaxation times and their application to normal brain and brain and cord affected by multiple sclerosis. The goal is to provide readers with an intuitive understanding of what influences relaxation times, how relaxation times can be accurately measured, and how they provide specific information about the pathology of MS. The article summarizes significant results from relaxation time studies in the normal human brain and cord and from people who have multiple sclerosis. It also reports on studies that have compared relaxation time results with results from other MR techniques.
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Affiliation(s)
- A L MacKay
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
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