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Murugesan G, Yu FF, Achilleos M, DeBevits J, Nalawade S, Ganesh C, Wagner B, Madhuranthakam AJ, Maldjian JA. Synthesizing Contrast-Enhanced MR Images from Noncontrast MR Images Using Deep Learning. AJNR Am J Neuroradiol 2024; 45:312-319. [PMID: 38453408 DOI: 10.3174/ajnr.a8107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/27/2022] [Accepted: 12/01/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND PURPOSE Recent developments in deep learning methods offer a potential solution to the need for alternative imaging methods due to concerns about the toxicity of gadolinium-based contrast agents. The purpose of the study was to synthesize virtual gadolinium contrast-enhanced T1-weighted MR images from noncontrast multiparametric MR images in patients with primary brain tumors by using deep learning. MATERIALS AND METHODS We trained and validated a deep learning network by using MR images from 335 subjects in the Brain Tumor Segmentation Challenge 2019 training data set. A held out set of 125 subjects from the Brain Tumor Segmentation Challenge 2019 validation data set was used to test the generalization of the model. A residual inception DenseNet network, called T1c-ET, was developed and trained to simultaneously synthesize virtual contrast-enhanced T1-weighted (vT1c) images and segment the enhancing portions of the tumor. Three expert neuroradiologists independently scored the synthesized vT1c images by using a 3-point Likert scale, evaluating image quality and contrast enhancement against ground truth T1c images (1 = poor, 2 = good, 3 = excellent). RESULTS The synthesized vT1c images achieved structural similarity index, peak signal-to-noise ratio, and normalized mean square error scores of 0.91, 64.35, and 0.03, respectively. There was moderate interobserver agreement between the 3 raters, regarding the algorithm's performance in predicting contrast enhancement, with a Fleiss kappa value of 0.61. Our model was able to accurately predict contrast enhancement in 88.8% of the cases (scores of 2 to 3 on the 3-point scale). CONCLUSIONS We developed a novel deep learning architecture to synthesize virtual postcontrast enhancement by using only conventional noncontrast brain MR images. Our results demonstrate the potential of deep learning methods to reduce the need for gadolinium contrast in the evaluation of primary brain tumors.
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Affiliation(s)
- Gowtham Murugesan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Fang F Yu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michael Achilleos
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - John DeBevits
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sahil Nalawade
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chandan Ganesh
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ben Wagner
- 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
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Askari P, Cardoso da Fonseca N, Pruitt T, Maldjian JA, Alick-Lindstrom S, Davenport EM. Magnetoencephalography (MEG) Data Processing in Epilepsy Patients with Implanted Responsive Neurostimulation (RNS) Devices. Brain Sci 2024; 14:173. [PMID: 38391747 PMCID: PMC10887328 DOI: 10.3390/brainsci14020173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Drug-resistant epilepsy (DRE) is often treated with surgery or neuromodulation. Specifically, responsive neurostimulation (RNS) is a widely used therapy that is programmed to detect abnormal brain activity and intervene with tailored stimulation. Despite the success of RNS, some patients require further interventions. However, having an RNS device in situ is a hindrance to the performance of neuroimaging techniques. Magnetoencephalography (MEG), a non-invasive neurophysiologic and functional imaging technique, aids epilepsy assessment and surgery planning. MEG performed post-RNS is complicated by signal distortions. This study proposes an independent component analysis (ICA)-based approach to enhance MEG signal quality, facilitating improved assessment for epilepsy patients with implanted RNS devices. Three epilepsy patients, two with RNS implants and one without, underwent MEG scans. Preprocessing included temporal signal space separation (tSSS) and an automated ICA-based approach with MNE-Python. Power spectral density (PSD) and signal-to-noise ratio (SNR) were analyzed, and MEG dipole analysis was conducted using single equivalent current dipole (SECD) modeling. The ICA-based noise removal preprocessing method substantially improved the signal-to-noise ratio (SNR) for MEG data from epilepsy patients with implanted RNS devices. Qualitative assessment confirmed enhanced signal readability and improved MEG dipole analysis. ICA-based processing markedly enhanced MEG data quality in RNS patients, emphasizing its clinical relevance.
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Affiliation(s)
- Pegah Askari
- Radiology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- MEG Center of Excellence, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Biomedical Engineering Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Biomedical Engineering Department, The University of Texas at Arlington, Arlington, TX 76010, USA
| | - Natascha Cardoso da Fonseca
- Radiology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- MEG Center of Excellence, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Tyrell Pruitt
- Radiology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- MEG Center of Excellence, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Joseph A Maldjian
- Radiology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- MEG Center of Excellence, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Biomedical Engineering Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Sasha Alick-Lindstrom
- Radiology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- MEG Center of Excellence, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Neurology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Elizabeth M Davenport
- Radiology Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- MEG Center of Excellence, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Biomedical Engineering Department, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Tejani AS, Berson E, Phillip J, Feltrin FS, Bazan C, Raj KM, Agarwal AK, Maldjian JA, Lee WC, Yu FF. Diffusion-weighted imaging of the orbit. Clin Radiol 2024; 79:10-18. [PMID: 37926649 DOI: 10.1016/j.crad.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/27/2023] [Revised: 09/14/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023]
Abstract
Orbital lesions compose a heterogeneous group of pathologies that often present with non-specific imaging findings on conventional magnetic resonance imaging (MRI) sequences (T1-and T2-weighted). Accordingly, the application of diffusion MRI offers an opportunity to further distinguish between lesions along this spectrum. Diffusion-weighted imaging (DWI) represents the simplest and most frequent clinically utilised diffusion imaging technique. Recent advances in DWI techniques have extended its application to the evaluation of a wider spectrum of neurological pathology, including orbital lesions. This review details the manifestations of select orbital pathology on DWI and underscores specific situations where diffusion imaging allows for increased diagnostic sensitivity compared to more conventional MRI techniques. These examples also describe preferred management for orbital lesions identified by DWI.
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Affiliation(s)
- A S Tejani
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - E Berson
- Department of Radiology, Yale School of Medicine, New Haven, CT, USA
| | - J Phillip
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - F S Feltrin
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Bazan
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - K M Raj
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - A K Agarwal
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J A Maldjian
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - W-C Lee
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - F F Yu
- Department of Raddsiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Holcomb JM, Maldjian JA, Xi Y, O'Suilleabhain PE, Louis ED, Shah BR. ELectronic Archimedes spiral Neural Network (ELANN). Parkinsonism Relat Disord 2023; 115:105837. [PMID: 37683422 DOI: 10.1016/j.parkreldis.2023.105837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/11/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023]
Abstract
The Archimedes spiral is a clinical tool that aids in the diagnosis and monitoring of essential tremor. However, spiral ratings may vary based on experience and training of the rating physician. This study sought to generate an objective standard model for tremor evaluation using convolutional neural networks. One senior movement disorders neurologist (Neurologist 1) with over 30 years of clinical experience used the Bain and Findley Spirography Rating Scale to rate 1653 Archimedes spiral images from 46 essential tremor patients (mild to severe tremor) and 75 control subjects (no to mild tremor). Neurologist 1's labels were used as the reference standard to train the model. After training the model, a randomly selected subset of spiral testing data was re-evaluated by Neurologist 1, by a second senior movement disorders neurologist (Neurologist 2) with over 27 years of clinical experience, and by our model. Cohen's Weighted Kappa 95% confidence intervals were calculated from all rater comparisons to determine if our model performs with the same proficiency as two senior movement disorders neurologists. The Cohen's Weighted Kappa 95% confidence intervals for the agreement between the reference standard scores and Neurologist 1's rerated scores, for the agreement between the reference standard scores and Neurologist 2's scores, and for the agreement between the reference standard scores and our model's scores were 0.93-0.98, 0.86-0.94, and 0.89-0.96, respectively. With overlapping Cohen's Weighted Kappa 95% confidence intervals for all agreement comparisons, we demonstrate that our model evaluates spirals with the same proficiency as two senior movement disorders neurologists.
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Affiliation(s)
- James M Holcomb
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX, USA; Advanced Neuroscience Imaging Research Lab, Department of Radiology, UTSW Medical Center, Dallas, TX, USA
| | - Joseph A Maldjian
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX, USA; Advanced Neuroscience Imaging Research Lab, Department of Radiology, UTSW Medical Center, Dallas, TX, USA; O'Donnell Brain Institute, UTSW Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, UTSW Medical Center, Dallas, TX, USA; Center for Alzheimer's and Neurodegenerative Diseases, UTSW Medical Center, Dallas, TX, USA
| | - Yin Xi
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX, USA; Advanced Neuroscience Imaging Research Lab, Department of Radiology, UTSW Medical Center, Dallas, TX, USA
| | | | - Elan D Louis
- Department of Neurology, UTSW Medical Center, Dallas, TX, USA
| | - Bhavya R Shah
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX, USA; Advanced Neuroscience Imaging Research Lab, Department of Radiology, UTSW Medical Center, Dallas, TX, USA; O'Donnell Brain Institute, UTSW Medical Center, Dallas, TX, USA; Department of Neurological Surgery, UTSW Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, UTSW Medical Center, Dallas, TX, USA.
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Bangalore Yogananda CG, Wagner BC, Truong NCD, Holcomb JM, Reddy DD, Saadat N, Hatanpaa KJ, Patel TR, Fei B, Lee MD, Jain R, Bruce RJ, Pinho MC, Madhuranthakam AJ, Maldjian JA. MRI-Based Deep Learning Method for Classification of IDH Mutation Status. Bioengineering (Basel) 2023; 10:1045. [PMID: 37760146 PMCID: PMC10525372 DOI: 10.3390/bioengineering10091045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Isocitrate dehydrogenase (IDH) mutation status has emerged as an important prognostic marker in gliomas. This study sought to develop deep learning networks for non-invasive IDH classification using T2w MR images while comparing their performance to a multi-contrast network. Methods: Multi-contrast brain tumor MRI and genomic data were obtained from The Cancer Imaging Archive (TCIA) and The Erasmus Glioma Database (EGD). Two separate 2D networks were developed using nnU-Net, a T2w-image-only network (T2-net) and a multi-contrast network (MC-net). Each network was separately trained using TCIA (227 subjects) or TCIA + EGD data (683 subjects combined). The networks were trained to classify IDH mutation status and implement single-label tumor segmentation simultaneously. The trained networks were tested on over 1100 held-out datasets including 360 cases from UT Southwestern Medical Center, 136 cases from New York University, 175 cases from the University of Wisconsin-Madison, 456 cases from EGD (for the TCIA-trained network), and 495 cases from the University of California, San Francisco public database. A receiver operating characteristic curve (ROC) was drawn to calculate the AUC value to determine classifier performance. Results: T2-net trained on TCIA and TCIA + EGD datasets achieved an overall accuracy of 85.4% and 87.6% with AUCs of 0.86 and 0.89, respectively. MC-net trained on TCIA and TCIA + EGD datasets achieved an overall accuracy of 91.0% and 92.8% with AUCs of 0.94 and 0.96, respectively. We developed reliable, high-performing deep learning algorithms for IDH classification using both a T2-image-only and a multi-contrast approach. The networks were tested on more than 1100 subjects from diverse databases, making this the largest study on image-based IDH classification to date.
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Affiliation(s)
- Chandan Ganesh Bangalore Yogananda
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Benjamin C. Wagner
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Nghi C. D. Truong
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - James M. Holcomb
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Divya D. Reddy
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Niloufar Saadat
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Kimmo J. Hatanpaa
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Toral R. Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Baowei Fei
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Matthew D. Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY 10016, USA; (M.D.L.); (R.J.)
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY 10016, USA; (M.D.L.); (R.J.)
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Richard J. Bruce
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
| | - Marco C. Pinho
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Ananth J. Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Joseph A. Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
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Holcomb JM, Chopra R, Feltrin FS, Elkurd M, El-Nazer R, McKenzie L, O’Suilleabhain P, Maldjian JA, Dauer W, Shah BR. Improving tremor response to focused ultrasound thalamotomy. Brain Commun 2023; 5:fcad165. [PMID: 37533544 PMCID: PMC10390385 DOI: 10.1093/braincomms/fcad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/18/2023] [Accepted: 05/19/2023] [Indexed: 08/04/2023] Open
Abstract
MRI-guided high-intensity focused ultrasound thalamotomy is an incisionless therapy for essential tremor. To reduce adverse effects, the field has migrated to treating at 2 mm above the anterior commissure-posterior commissure plane. We perform MRI-guided high-intensity focused ultrasound with an advanced imaging targeting technique, four-tract tractography. Four-tract tractography uses diffusion tensor imaging to identify the critical white matter targets for tremor control, the decussating and non-decussating dentatorubrothalamic tracts, while the corticospinal tract and medial lemniscus are identified to be avoided. In some patients, four-tract tractography identified a risk of damaging the medial lemniscus or corticospinal tract if treated at 2 mm superior to the anterior commissure-posterior commissure plane. In these patients, we chose to target 1.2-1.5 mm superior to the anterior commissure-posterior commissure plane. In these patients, post-operative imaging revealed that the focused ultrasound lesion extended into the posterior subthalamic area. This study sought to determine if patients with focused ultrasound lesions that extend into the posterior subthalamic area have a differnce in tremor improvement than those without. Twenty essential tremor patients underwent MRI-guided high-intensity focused ultrasound and were retrospectively classified into two groups. Group 1 included patients with an extension of the thalamic-focused ultrasound lesion into the posterior subthalamic area. Group 2 included patients without extension of the thalamic-focused ultrasound lesion into the posterior subthalamic area. For each patient, the percent change in postural tremor, kinetic tremor and Archimedes spiral scores were calculated between baseline and a 3-month follow-up. Two-tailed Wilcoxon rank-sum tests were used to compare the improvement in tremor scores, the total number of sonications, thermal dose to achieve initial tremor response, and skull density ratio between groups. Group 1 had significantly greater postural, kinetic, and Archimedes spiral score percent improvement than Group 2 (P values: 5.41 × 10-5, 4.87 × 10-4, and 5.41 × 10-5, respectively). Group 1 also required significantly fewer total sonications to control the tremor and a significantly lower thermal dose to achieve tremor response (P values: 6.60 × 10-4 and 1.08 × 10-5, respectively). No significant group differences in skull density ratio were observed (P = 1.0). We do not advocate directly targeting the posterior subthalamic area with MRI-guided high-intensity focused ultrasound because the shape of the focused ultrasound lesion can result in a high risk of adverse effects. However, when focused ultrasound lesions naturally extend from the thalamus into the posterior subthalamic area, they provide greater tremor control than those that only involve the thalamus.
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Affiliation(s)
- James M Holcomb
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX 75235, USA
| | - Rajiv Chopra
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX 75235, USA
| | - Fabricio S Feltrin
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX 75235, USA
| | - Mazen Elkurd
- Department of Neurology, UTSW Medical Center, Dallas, TX 75235, USA
| | - Rasheda El-Nazer
- Department of Neurology, UTSW Medical Center, Dallas, TX 75235, USA
| | - Lauren McKenzie
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX 75235, USA
| | | | - Joseph A Maldjian
- Focused Ultrasound Lab and Program, Department of Radiology, UTSW Medical Center, Dallas, TX 75235, USA
| | - William Dauer
- Department of Neurology, UTSW Medical Center, Dallas, TX 75235, USA
- O’Donnell Brain Institute, UTSW Medical Center, Dallas, TX 75235, USA
| | - Bhavya R Shah
- Correspondence to: Bhavya R. Shah Department of Radiology, UTSW Medical Center, 1801 Inwood Rd Dallas, TX 75235, USA E-mail:
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Singh S, Alhasan MSM, Wang Z, Clarke R, Xi Y, Maldjian JA, Wagner B, Booth T. Establishing language laterality: does resting-state functional MRI help? J Neurosurg Pediatr 2023; 31:496-502. [PMID: 36883636 DOI: 10.3171/2023.1.peds22497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/11/2022] [Accepted: 01/20/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE Task-based functional MRI (tb-fMRI) is now considered the standard, noninvasive technique in establishing language laterality in children for surgical planning. The evaluation can be limited due to several factors such as age, language barriers, and developmental and cognitive delays. Resting-state functional MRI (rs-fMRI) offers a potential path to establish language dominance without active task participation. The authors sought to compare the ability of rs-fMRI for language lateralization in the pediatric population with conventional tb-fMRI used as the gold standard. METHODS The authors performed a retrospective evaluation of all pediatric patients at a dedicated quaternary pediatric hospital who underwent tb-fMRI and rs-fMRI from 2019 to 2021 as part of the surgical workup for patients with seizures and brain tumors. Task-based fMRI language laterality was based on a patient's adequate performance on one or more of the following: sentence completion, verb generation, antonym generation, or passive listening tasks. Resting-state fMRI data were postprocessed using statistical parametric mapping, FMRIB Software Library, and FreeSurfer as described in the literature. The laterality index (LI) was calculated from the independent component (IC) with the highest Jaccard Index (JI) for the language mask. Additionally, the authors visually inspected the activation maps for two ICs with the highest JIs. The rs-fMRI LI of IC1 and the authors' image-based subjective interpretation of language lateralization were compared with tb-fMRI, which was considered the gold standard for this study. RESULTS A retrospective search yielded 33 patients with language fMRI data. Eight patients were excluded (5 with suboptimal tb-fMRI and 3 with suboptimal rs-fMRI data). Twenty-five patients (age range 7-19 years, male/female ratio 15:10) were included in the study. The language laterality concordance between tb-fMRI and rs-fMRI ranged from 68% to 80% for assessment based on LI of independent component analysis with highest JI and for subjective evaluation by visual inspection of activation maps, respectively. CONCLUSIONS The concordance rates between tb-fMRI and rs-fMRI of 68% to 80% show the limitation of rs-fMRI in determining language dominance. Resting-state fMRI should not be used as the sole method for language lateralization in clinical practice.
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Affiliation(s)
- Sumit Singh
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
| | | | - Zhiyue Wang
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
| | - Rebekah Clarke
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
| | - Yin Xi
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
| | - Joseph A Maldjian
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
| | - Ben Wagner
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
| | - Timothy Booth
- 1Department of Radiology, UT Southwestern Medical Center, Dallas, Texas; and
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Pati S, Baid U, Edwards B, Sheller M, Wang SH, Reina GA, Foley P, Gruzdev A, Karkada D, Davatzikos C, Sako C, Ghodasara S, Bilello M, Mohan S, Vollmuth P, Brugnara G, Preetha CJ, Sahm F, Maier-Hein K, Zenk M, Bendszus M, Wick W, Calabrese E, Rudie J, Villanueva-Meyer J, Cha S, Ingalhalikar M, Jadhav M, Pandey U, Saini J, Garrett J, Larson M, Jeraj R, Currie S, Frood R, Fatania K, Huang RY, Chang K, Balaña C, Capellades J, Puig J, Trenkler J, Pichler J, Necker G, Haunschmidt A, Meckel S, Shukla G, Liem S, Alexander GS, Lombardo J, Palmer JD, Flanders AE, Dicker AP, Sair HI, Jones CK, Venkataraman A, Jiang M, So TY, Chen C, Heng PA, Dou Q, Kozubek M, Lux F, Michálek J, Matula P, Keřkovský M, Kopřivová T, Dostál M, Vybíhal V, Vogelbaum MA, Mitchell JR, Farinhas J, Maldjian JA, Yogananda CGB, Pinho MC, Reddy D, Holcomb J, Wagner BC, Ellingson BM, Cloughesy TF, Raymond C, Oughourlian T, Hagiwara A, Wang C, To MS, Bhardwaj S, Chong C, Agzarian M, Falcão AX, Martins SB, Teixeira BCA, Sprenger F, Menotti D, Lucio DR, LaMontagne P, Marcus D, Wiestler B, Kofler F, Ezhov I, Metz M, Jain R, Lee M, Lui YW, McKinley R, Slotboom J, Radojewski P, Meier R, Wiest R, Murcia D, Fu E, Haas R, Thompson J, Ormond DR, Badve C, Sloan AE, Vadmal V, Waite K, Colen RR, Pei L, Ak M, Srinivasan A, Bapuraj JR, Rao A, Wang N, Yoshiaki O, Moritani T, Turk S, Lee J, Prabhudesai S, Morón F, Mandel J, Kamnitsas K, Glocker B, Dixon LVM, Williams M, Zampakis P, Panagiotopoulos V, Tsiganos P, Alexiou S, Haliassos I, Zacharaki EI, Moustakas K, Kalogeropoulou C, Kardamakis DM, Choi YS, Lee SK, Chang JH, Ahn SS, Luo B, Poisson L, Wen N, Tiwari P, Verma R, Bareja R, Yadav I, Chen J, Kumar N, Smits M, van der Voort SR, Alafandi A, Incekara F, Wijnenga MMJ, Kapsas G, Gahrmann R, Schouten JW, Dubbink HJ, Vincent AJPE, van den Bent MJ, French PJ, Klein S, Yuan Y, Sharma S, Tseng TC, Adabi S, Niclou SP, Keunen O, Hau AC, Vallières M, Fortin D, Lepage M, Landman B, Ramadass K, Xu K, Chotai S, Chambless LB, Mistry A, Thompson RC, Gusev Y, Bhuvaneshwar K, Sayah A, Bencheqroun C, Belouali A, Madhavan S, Booth TC, Chelliah A, Modat M, Shuaib H, Dragos C, Abayazeed A, Kolodziej K, Hill M, Abbassy A, Gamal S, Mekhaimar M, Qayati M, Reyes M, Park JE, Yun J, Kim HS, Mahajan A, Muzi M, Benson S, Beets-Tan RGH, Teuwen J, Herrera-Trujillo A, Trujillo M, Escobar W, Abello A, Bernal J, Gómez J, Choi J, Baek S, Kim Y, Ismael H, Allen B, Buatti JM, Kotrotsou A, Li H, Weiss T, Weller M, Bink A, Pouymayou B, Shaykh HF, Saltz J, Prasanna P, Shrestha S, Mani KM, Payne D, Kurc T, Pelaez E, Franco-Maldonado H, Loayza F, Quevedo S, Guevara P, Torche E, Mendoza C, Vera F, Ríos E, López E, Velastin SA, Ogbole G, Soneye M, Oyekunle D, Odafe-Oyibotha O, Osobu B, Shu'aibu M, Dorcas A, Dako F, Simpson AL, Hamghalam M, Peoples JJ, Hu R, Tran A, Cutler D, Moraes FY, Boss MA, Gimpel J, Veettil DK, Schmidt K, Bialecki B, Marella S, Price C, Cimino L, Apgar C, Shah P, Menze B, Barnholtz-Sloan JS, Martin J, Bakas S. Author Correction: Federated learning enables big data for rare cancer boundary detection. Nat Commun 2023; 14:436. [PMID: 36702828 PMCID: PMC9879935 DOI: 10.1038/s41467-023-36188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Sarthak Pati
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Satyam Ghodasara
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suyash Mohan
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Zenk
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany
| | - Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey Rudie
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Manali Jadhav
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - John Garrett
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Matthew Larson
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert Jeraj
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Stuart Currie
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Russell Frood
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Kavi Fatania
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | | | - Josep Puig
- Department of Radiology (IDI), Girona Biomedical Research Institute (IdIBGi), Josep Trueta University Hospital, Girona, Spain
| | - Johannes Trenkler
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Josef Pichler
- Department of Neurooncology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Georg Necker
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Andreas Haunschmidt
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Stephan Meckel
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
- Institute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, Christiana Care Health System, Philadelphia, PA, USA
| | - Spencer Liem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gregory S Alexander
- Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA
| | - Joseph Lombardo
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Craig K Jones
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Archana Venkataraman
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meirui Jiang
- The Chinese University of Hong Kong, Hong Kong, China
| | - Tiffany Y So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Cheng Chen
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Qi Dou
- The Chinese University of Hong Kong, Hong Kong, China
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Filip Lux
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jan Michálek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Petr Matula
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
- Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, and University Hospital and Czech Republic, Brno, Czech Republic
| | - Michael A Vogelbaum
- Department of Neuro Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - J Ross Mitchell
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Joaquim Farinhas
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | - Marco C Pinho
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Divya Reddy
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Holcomb
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Minh-Son To
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sargam Bhardwaj
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Chee Chong
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Bernardo C A Teixeira
- Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - David Menotti
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Diego R Lucio
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Pamela LaMontagne
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
| | - Florian Kofler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Marie Metz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Matthew Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvonne W Lui
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Raphael Meier
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Derrick Murcia
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Eric Fu
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Rourke Haas
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - John Thompson
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - David Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vachan Vadmal
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristin Waite
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Rivka R Colen
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Linmin Pei
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat Ak
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashok Srinivasan
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - J Rajiv Bapuraj
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Arvind Rao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Ota Yoshiaki
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Toshio Moritani
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Sevcan Turk
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Joonsang Lee
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Prabhudesai
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Fanny Morón
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Jacob Mandel
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantinos Kamnitsas
- Department of Computing, Imperial College London, London, UK
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ben Glocker
- Department of Computing, Imperial College London, London, UK
| | - Luke V M Dixon
- Department of Radiology, Imperial College NHS Healthcare Trust, London, UK
| | - Matthew Williams
- Computational Oncology Group, Institute for Global Health Innovation, Imperial College London, London, UK
| | - Peter Zampakis
- Department of NeuroRadiology, University of Patras, Patras, Greece
| | | | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Sotiris Alexiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Ilias Haliassos
- Department of Neuro-Oncology, University of Patras, Patras, Greece
| | - Evangelia I Zacharaki
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | | | | | | | | | | | | | - Sung Soo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Bing Luo
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Laila Poisson
- Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | | | - Ruchika Verma
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
- Case Western Reserve University, Cleveland, OH, USA
| | - Rohan Bareja
- Case Western Reserve University, Cleveland, OH, USA
| | - Ipsa Yadav
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Neeraj Kumar
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Ahmed Alafandi
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Maarten M J Wijnenga
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Georgios Kapsas
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Joost W Schouten
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Yading Yuan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tzu-Chi Tseng
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saba Adabi
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olivier Keunen
- Translation Radiomics, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Ann-Christin Hau
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
- Luxembourg Center of Neuropathology, Laboratoire National De Santé, Luxembourg, Luxembourg
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - David Fortin
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Neurosurgery and Neuro-Oncology, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Centre, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bennett Landman
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Silky Chotai
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lola B Chambless
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akshitkumar Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reid C Thompson
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Krithika Bhuvaneshwar
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anousheh Sayah
- Division of Neuroradiology & Neurointerventional Radiology, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Camelia Bencheqroun
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anas Belouali
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Subha Madhavan
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK
| | - Alysha Chelliah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Haris Shuaib
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Carmen Dragos
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
| | | | | | | | | | - Shady Gamal
- University of Cairo School of Medicine, Giza, Egypt
| | | | | | | | - Ji Eun Park
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Jihye Yun
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place, Liverpool, UK
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Sean Benson
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht, Netherlands
| | - Jonas Teuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - William Escobar
- Clínica Imbanaco Grupo Quirón Salud, Cali, Colombia
- Universidad del Valle, Cali, Colombia
| | | | - Jose Bernal
- Universidad del Valle, Cali, Colombia
- The University of Edinburgh, Edinburgh, UK
| | | | - Joseph Choi
- Department of Industrial and Systems Engineering, University of Iowa, Iowa, USA
| | - Stephen Baek
- Department of Industrial and Systems Engineering, Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Heba Ismael
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Bryan Allen
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Hongwei Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bertrand Pouymayou
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Sampurna Shrestha
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Kartik M Mani
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Department of Radiation Oncology, Stony Brook University, Stony Brook, NY, USA
| | - David Payne
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Scientific Data Group, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Enrique Pelaez
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | - Francis Loayza
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | | | | | | | - Franco Vera
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Elvis Ríos
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Eduardo López
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Sergio A Velastin
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mayowa Soneye
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Dotun Oyekunle
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | | | - Babatunde Osobu
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mustapha Shu'aibu
- Department of Radiology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Adeleye Dorcas
- Department of Radiology, Obafemi Awolowo University Ile-Ife, Ile-Ife, Osun, Nigeria
| | - Farouk Dako
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Simpson
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Mohammad Hamghalam
- School of Computing, Queen's University, Kingston, ON, Canada
- Department of Electrical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Jacob J Peoples
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Ricky Hu
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Anh Tran
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Danielle Cutler
- The Faculty of Arts & Sciences, Queen's University, Kingston, ON, Canada
| | - Fabio Y Moraes
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - James Gimpel
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Deepak Kattil Veettil
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Kendall Schmidt
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Brian Bialecki
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Sailaja Marella
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Cynthia Price
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Lisa Cimino
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Charles Apgar
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | | | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Jill S Barnholtz-Sloan
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), National Institute of Health, Bethesda, MD, USA
| | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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9
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Yogananda CGB, Shah BR, Yu FF, Pinho MC, Nalawade SS, Murugesan GK, Wagner BC, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. Corrigendum to: A novel fully automated MRI-based deep-learning method for classification of 1p/19q co-deletion status in brain gliomas. Neurooncol Adv 2023; 5:vdac187. [PMID: 36632567 PMCID: PMC9830946 DOI: 10.1093/noajnl/vdac187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
[This corrects the article DOI: 10.1093/noajnl/vdaa066.].
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10
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Nalawade SS, Yu FF, Yogananda CGB, Murugesan GK, Shah BR, Pinho MC, Wagner BC, Xi Y, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. Errata: Brain tumor IDH, 1p/19q, and MGMT molecular classification using MRI-based deep learning: an initial study on the effect of motion and motion correction. J Med Imaging (Bellingham) 2023; 10:019801. [PMID: 36761698 PMCID: PMC9888547 DOI: 10.1117/1.jmi.10.1.019801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
[This corrects the article DOI: 10.1117/1.JMI.9.1.016001.].
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Affiliation(s)
- Sahil S. Nalawade
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Fang F. Yu
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Chandan Ganesh Bangalore Yogananda
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Gowtham K. Murugesan
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Bhavya R. Shah
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Marco C. Pinho
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Benjamin C. Wagner
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Yin Xi
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Bruce Mickey
- University of Texas Southwestern Medical Center, Department of Neurological Surgery, Dallas, Texas, United States
| | - Toral R. Patel
- University of Texas Southwestern Medical Center, Department of Neurological Surgery, Dallas, Texas, United States
| | - Baowei Fei
- University of Texas at Dallas, Department of Bioengineering, Richardson, Texas, United States
| | - Ananth J. Madhuranthakam
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Joseph A. Maldjian
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
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11
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Pati S, Baid U, Edwards B, Sheller M, Wang SH, Reina GA, Foley P, Gruzdev A, Karkada D, Davatzikos C, Sako C, Ghodasara S, Bilello M, Mohan S, Vollmuth P, Brugnara G, Preetha CJ, Sahm F, Maier-Hein K, Zenk M, Bendszus M, Wick W, Calabrese E, Rudie J, Villanueva-Meyer J, Cha S, Ingalhalikar M, Jadhav M, Pandey U, Saini J, Garrett J, Larson M, Jeraj R, Currie S, Frood R, Fatania K, Huang RY, Chang K, Balaña C, Capellades J, Puig J, Trenkler J, Pichler J, Necker G, Haunschmidt A, Meckel S, Shukla G, Liem S, Alexander GS, Lombardo J, Palmer JD, Flanders AE, Dicker AP, Sair HI, Jones CK, Venkataraman A, Jiang M, So TY, Chen C, Heng PA, Dou Q, Kozubek M, Lux F, Michálek J, Matula P, Keřkovský M, Kopřivová T, Dostál M, Vybíhal V, Vogelbaum MA, Mitchell JR, Farinhas J, Maldjian JA, Yogananda CGB, Pinho MC, Reddy D, Holcomb J, Wagner BC, Ellingson BM, Cloughesy TF, Raymond C, Oughourlian T, Hagiwara A, Wang C, To MS, Bhardwaj S, Chong C, Agzarian M, Falcão AX, Martins SB, Teixeira BCA, Sprenger F, Menotti D, Lucio DR, LaMontagne P, Marcus D, Wiestler B, Kofler F, Ezhov I, Metz M, Jain R, Lee M, Lui YW, McKinley R, Slotboom J, Radojewski P, Meier R, Wiest R, Murcia D, Fu E, Haas R, Thompson J, Ormond DR, Badve C, Sloan AE, Vadmal V, Waite K, Colen RR, Pei L, Ak M, Srinivasan A, Bapuraj JR, Rao A, Wang N, Yoshiaki O, Moritani T, Turk S, Lee J, Prabhudesai S, Morón F, Mandel J, Kamnitsas K, Glocker B, Dixon LVM, Williams M, Zampakis P, Panagiotopoulos V, Tsiganos P, Alexiou S, Haliassos I, Zacharaki EI, Moustakas K, Kalogeropoulou C, Kardamakis DM, Choi YS, Lee SK, Chang JH, Ahn SS, Luo B, Poisson L, Wen N, Tiwari P, Verma R, Bareja R, Yadav I, Chen J, Kumar N, Smits M, van der Voort SR, Alafandi A, Incekara F, Wijnenga MMJ, Kapsas G, Gahrmann R, Schouten JW, Dubbink HJ, Vincent AJPE, van den Bent MJ, French PJ, Klein S, Yuan Y, Sharma S, Tseng TC, Adabi S, Niclou SP, Keunen O, Hau AC, Vallières M, Fortin D, Lepage M, Landman B, Ramadass K, Xu K, Chotai S, Chambless LB, Mistry A, Thompson RC, Gusev Y, Bhuvaneshwar K, Sayah A, Bencheqroun C, Belouali A, Madhavan S, Booth TC, Chelliah A, Modat M, Shuaib H, Dragos C, Abayazeed A, Kolodziej K, Hill M, Abbassy A, Gamal S, Mekhaimar M, Qayati M, Reyes M, Park JE, Yun J, Kim HS, Mahajan A, Muzi M, Benson S, Beets-Tan RGH, Teuwen J, Herrera-Trujillo A, Trujillo M, Escobar W, Abello A, Bernal J, Gómez J, Choi J, Baek S, Kim Y, Ismael H, Allen B, Buatti JM, Kotrotsou A, Li H, Weiss T, Weller M, Bink A, Pouymayou B, Shaykh HF, Saltz J, Prasanna P, Shrestha S, Mani KM, Payne D, Kurc T, Pelaez E, Franco-Maldonado H, Loayza F, Quevedo S, Guevara P, Torche E, Mendoza C, Vera F, Ríos E, López E, Velastin SA, Ogbole G, Soneye M, Oyekunle D, Odafe-Oyibotha O, Osobu B, Shu'aibu M, Dorcas A, Dako F, Simpson AL, Hamghalam M, Peoples JJ, Hu R, Tran A, Cutler D, Moraes FY, Boss MA, Gimpel J, Veettil DK, Schmidt K, Bialecki B, Marella S, Price C, Cimino L, Apgar C, Shah P, Menze B, Barnholtz-Sloan JS, Martin J, Bakas S. Federated learning enables big data for rare cancer boundary detection. Nat Commun 2022; 13:7346. [PMID: 36470898 PMCID: PMC9722782 DOI: 10.1038/s41467-022-33407-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/16/2022] [Indexed: 12/12/2022] Open
Abstract
Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing.
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Affiliation(s)
- Sarthak Pati
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Satyam Ghodasara
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michel Bilello
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suyash Mohan
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gianluca Brugnara
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Felix Sahm
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Zenk
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Wick
- Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic, Heidelberg University Hospital, Heidelberg, Germany
| | - Evan Calabrese
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey Rudie
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Javier Villanueva-Meyer
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Manali Jadhav
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Umang Pandey
- Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, Maharashtra, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - John Garrett
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Matthew Larson
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert Jeraj
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Stuart Currie
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Russell Frood
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Kavi Fatania
- Leeds Teaching Hospitals Trust, Department of Radiology, Leeds, UK
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | | | | | - Josep Puig
- Department of Radiology (IDI), Girona Biomedical Research Institute (IdIBGi), Josep Trueta University Hospital, Girona, Spain
| | - Johannes Trenkler
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Josef Pichler
- Department of Neurooncology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Georg Necker
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Andreas Haunschmidt
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
| | - Stephan Meckel
- Institute of Neuroradiology, Neuromed Campus (NMC), Kepler University Hospital Linz, Linz, Austria
- Institute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Gaurav Shukla
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, Christiana Care Health System, Philadelphia, PA, USA
| | - Spencer Liem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Gregory S Alexander
- Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA
| | - Joseph Lombardo
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D Palmer
- Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Adam E Flanders
- Department of Radiology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Adam P Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Craig K Jones
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Archana Venkataraman
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meirui Jiang
- The Chinese University of Hong Kong, Hong Kong, China
| | - Tiffany Y So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Cheng Chen
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Qi Dou
- The Chinese University of Hong Kong, Hong Kong, China
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Filip Lux
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jan Michálek
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Petr Matula
- Centre for Biomedical Image Analysis, Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Miloš Keřkovský
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Tereza Kopřivová
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
| | - Marek Dostál
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Masaryk University, Brno and University Hospital Brno, Brno, Czech Republic
- Department of Biophysics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Václav Vybíhal
- Department of Neurosurgery, Faculty of Medicine, Masaryk University, Brno, and University Hospital and Czech Republic, Brno, Czech Republic
| | - Michael A Vogelbaum
- Department of Neuro Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - J Ross Mitchell
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Joaquim Farinhas
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | - Marco C Pinho
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Divya Reddy
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - James Holcomb
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Timothy F Cloughesy
- UCLA Neuro-Oncology Program, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CaA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Talia Oughourlian
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Akifumi Hagiwara
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Minh-Son To
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sargam Bhardwaj
- College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Chee Chong
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, Bedford Park, SA, Australia
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Bernardo C A Teixeira
- Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - David Menotti
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Diego R Lucio
- Department of Informatics, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Pamela LaMontagne
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
| | - Florian Kofler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Ivan Ezhov
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Klinikum rechts der Isar, Munich, Germany
- Image-Based Biomedical Modeling, Department of Informatics, Technical University of Munich, Munich, Germany
| | - Marie Metz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Matthew Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Yvonne W Lui
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Johannes Slotboom
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Piotr Radojewski
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Raphael Meier
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Derrick Murcia
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Eric Fu
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Rourke Haas
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - John Thompson
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - David Ryan Ormond
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
| | - Andrew E Sloan
- Department of Neurological Surgery, University Hospitals-Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vachan Vadmal
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristin Waite
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Rivka R Colen
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Linmin Pei
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat Ak
- Department of Radiology, Neuroradiology Division, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashok Srinivasan
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - J Rajiv Bapuraj
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Arvind Rao
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas Wang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Ota Yoshiaki
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Toshio Moritani
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Sevcan Turk
- Department of Neuroradiology, University of Michigan, Ann Arbor, MI, USA
| | - Joonsang Lee
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Prabhudesai
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Fanny Morón
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Jacob Mandel
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Konstantinos Kamnitsas
- Department of Computing, Imperial College London, London, UK
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Ben Glocker
- Department of Computing, Imperial College London, London, UK
| | - Luke V M Dixon
- Department of Radiology, Imperial College NHS Healthcare Trust, London, UK
| | - Matthew Williams
- Computational Oncology Group, Institute for Global Health Innovation, Imperial College London, London, UK
| | - Peter Zampakis
- Department of NeuroRadiology, University of Patras, Patras, Greece
| | | | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Sotiris Alexiou
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | - Ilias Haliassos
- Department of Neuro-Oncology, University of Patras, Patras, Greece
| | - Evangelia I Zacharaki
- Department of Electrical and Computer Engineering, University of Patras, Patras, Greece
| | | | | | | | | | | | | | - Sung Soo Ahn
- Yonsei University College of Medicine, Seoul, Korea
| | - Bing Luo
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Laila Poisson
- Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Ning Wen
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | | | - Ruchika Verma
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
- Case Western Reserve University, Cleveland, OH, USA
| | - Rohan Bareja
- Case Western Reserve University, Cleveland, OH, USA
| | - Ipsa Yadav
- Case Western Reserve University, Cleveland, OH, USA
| | | | - Neeraj Kumar
- University of Alberta, Edmonton, AB, Canada
- Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Sebastian R van der Voort
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Ahmed Alafandi
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Fatih Incekara
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Maarten M J Wijnenga
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Georgios Kapsas
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Renske Gahrmann
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Joost W Schouten
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J Dubbink
- Department of Pathology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Arnaud J P E Vincent
- Department of Neurosurgery, Brain Tumor Center, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Yading Yuan
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tzu-Chi Tseng
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saba Adabi
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone P Niclou
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Olivier Keunen
- Translation Radiomics, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Ann-Christin Hau
- NORLUX Neuro-Oncology Laboratory, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
- Luxembourg Center of Neuropathology, Laboratoire National De Santé, Luxembourg, Luxembourg
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - David Fortin
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Division of Neurosurgery and Neuro-Oncology, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Lepage
- Centre de Recherche du Centre Hospitalière Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Department of Nuclear Medicine and Radiobiology, Sherbrooke Molecular Imaging Centre, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bennett Landman
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kaiwen Xu
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Silky Chotai
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lola B Chambless
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akshitkumar Mistry
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reid C Thompson
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuriy Gusev
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Krithika Bhuvaneshwar
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anousheh Sayah
- Division of Neuroradiology & Neurointerventional Radiology, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Camelia Bencheqroun
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Anas Belouali
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Subha Madhavan
- Innovation Center for Biomedical Informatics (ICBI), Georgetown University, Washington, DC, USA
| | - Thomas C Booth
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
- Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK
| | - Alysha Chelliah
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Haris Shuaib
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Carmen Dragos
- Stoke Mandeville Hospital, Mandeville Road, Aylesbury, UK
| | | | | | | | | | - Shady Gamal
- University of Cairo School of Medicine, Giza, Egypt
| | | | | | | | - Ji Eun Park
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Jihye Yun
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Ho Sung Kim
- Department of Radiology, Asan Medical Center, Seoul, South Korea
| | - Abhishek Mahajan
- The Clatterbridge Cancer Centre NHS Foundation Trust Pembroke Place, Liverpool, UK
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Sean Benson
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, Netherlands
- GROW School of Oncology and Developmental Biology, Maastricht, Netherlands
| | - Jonas Teuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | | | - William Escobar
- Clínica Imbanaco Grupo Quirón Salud, Cali, Colombia
- Universidad del Valle, Cali, Colombia
| | | | - Jose Bernal
- Universidad del Valle, Cali, Colombia
- The University of Edinburgh, Edinburgh, UK
| | | | - Joseph Choi
- Department of Industrial and Systems Engineering, University of Iowa, Iowa, USA
| | - Stephen Baek
- Department of Industrial and Systems Engineering, Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Yusung Kim
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Heba Ismael
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - Bryan Allen
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | - John M Buatti
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Hongwei Li
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Tobias Weiss
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andrea Bink
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bertrand Pouymayou
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Prateek Prasanna
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Sampurna Shrestha
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
| | - Kartik M Mani
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Department of Radiation Oncology, Stony Brook University, Stony Brook, NY, USA
| | - David Payne
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, New York, USA
- Scientific Data Group, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - Enrique Pelaez
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | - Francis Loayza
- Escuela Superior Politecnica del Litoral, Guayaquil, Guayas, Ecuador
| | | | | | | | | | - Franco Vera
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Elvis Ríos
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Eduardo López
- Universidad de Concepción, Concepción, Biobío, Chile
| | - Sergio A Velastin
- School of Electronic Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mayowa Soneye
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Dotun Oyekunle
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | | | - Babatunde Osobu
- Department of Radiology, University College Hospital Ibadan, Oyo, Nigeria
| | - Mustapha Shu'aibu
- Department of Radiology, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Adeleye Dorcas
- Department of Radiology, Obafemi Awolowo University Ile-Ife, Ile-Ife, Osun, Nigeria
| | - Farouk Dako
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber L Simpson
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Mohammad Hamghalam
- School of Computing, Queen's University, Kingston, ON, Canada
- Department of Electrical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - Jacob J Peoples
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Ricky Hu
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Anh Tran
- School of Computing, Queen's University, Kingston, ON, Canada
| | - Danielle Cutler
- The Faculty of Arts & Sciences, Queen's University, Kingston, ON, Canada
| | - Fabio Y Moraes
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Michael A Boss
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - James Gimpel
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Deepak Kattil Veettil
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Kendall Schmidt
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Brian Bialecki
- Data Science Institute, American College of Radiology, Reston, VA, USA
| | - Sailaja Marella
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Cynthia Price
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Lisa Cimino
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | - Charles Apgar
- Center for Research and Innovation, American College of Radiology, Philadelphia, PA, USA
| | | | - Bjoern Menze
- Department of Informatics, Technical University of Munich, Munich, Bavaria, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Jill S Barnholtz-Sloan
- National Cancer Institute, National Institute of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute (NCI), National Institute of Health, Bethesda, MD, USA
| | | | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Maldjian JA, Lee R, Jordan J, Davenport EM, Proskovec AL, Wintermark M, Stufflebeam S, Anderson J, Mukherjee P, Nagarajan SS, Ferrari P, Gaetz W, Schwartz E, Roberts TPL. ACR White Paper on Magnetoencephalography and Magnetic Source Imaging: A Report from the ACR Commission on Neuroradiology. AJNR Am J Neuroradiol 2022; 43:E46-E53. [PMID: 36456085 DOI: 10.3174/ajnr.a7714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 12/04/2022]
Abstract
Magnetoencephalography, the extracranial detection of tiny magnetic fields emanating from intracranial electrical activity of neurons, and its source modeling relation, magnetic source imaging, represent a powerful functional neuroimaging technique, able to detect and localize both spontaneous and evoked activity of the brain in health and disease. Recent years have seen an increased utilization of this technique for both clinical practice and research, in the United States and worldwide. This report summarizes current thinking, presents recommendations for clinical implementation, and offers an outlook for emerging new clinical indications.
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Affiliation(s)
- J A Maldjian
- From the Advanced Neuroscience Imaging Research Laboratory (J.A.M., E.M.D., A.L.P.) .,MEG Center of Excellence (J.A.M., E.M.D., A.L.P.).,Department of Radiology (J.A.M., E.M.D., A.L.P.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - R Lee
- Department of Neuroradiology (R.L.), University of California San Diego, San Diego, California
| | - J Jordan
- ACR Commission on Neuroradiology (J.J.), American College of Radiology, Reston, Virginia.,Stanford University School of Medicine (J.J.), Stanford, California
| | - E M Davenport
- From the Advanced Neuroscience Imaging Research Laboratory (J.A.M., E.M.D., A.L.P.).,MEG Center of Excellence (J.A.M., E.M.D., A.L.P.).,Department of Radiology (J.A.M., E.M.D., A.L.P.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - A L Proskovec
- From the Advanced Neuroscience Imaging Research Laboratory (J.A.M., E.M.D., A.L.P.).,MEG Center of Excellence (J.A.M., E.M.D., A.L.P.).,Department of Radiology (J.A.M., E.M.D., A.L.P.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - M Wintermark
- Department of Neuroradiology (M.W.), University of Texas MD Anderson Center, Houston, Texas
| | - S Stufflebeam
- Athinoula A. Martinos Center for Biomedical Imaging (S.S.), Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | - J Anderson
- Department of Radiology and Imaging Sciences (J.A.), University of Utah School of Medicine, Salt Lake City, Utah
| | - P Mukherjee
- Department of Radiology and Biomedical Imaging (P.M., S.S.N.), University of California, San Francisco, San Francisco, California
| | - S S Nagarajan
- Department of Radiology and Biomedical Imaging (P.M., S.S.N.), University of California, San Francisco, San Francisco, California
| | - P Ferrari
- Pediatric Neurosciences (P.F.), Helen DeVos Children's Hospital, Grand Rapids, Michigan.,Department of Pediatrics and Human Development (P.F.), College of Human Medicine, Michigan State University, Grand Rapids, Michigan
| | - W Gaetz
- Department of Radiology (W.G., E.S., T.P.L.R.), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - E Schwartz
- Department of Radiology (W.G., E.S., T.P.L.R.), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - T P L Roberts
- Department of Radiology (W.G., E.S., T.P.L.R.), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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13
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Davenport EM, Urban JE, Vaughan C, DeSimone JC, Wagner B, Espeland MA, Powers AK, Whitlow CT, Stitzel JD, Maldjian JA. MEG measured delta waves increase in adolescents after concussion. Brain Behav 2022; 12:e2720. [PMID: 36053126 PMCID: PMC9480906 DOI: 10.1002/brb3.2720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/22/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The purpose of this study is to determine if delta waves, measured by magnetoencephalography (MEG), increase in adolescents due to a sports concussion. METHODS Twenty-four adolescents (age 14-17) completed pre- and postseason MRI and MEG scanning. MEG whole-brain delta power was calculated for each subject and normalized by the subject's total power. In eight high school football players diagnosed with a concussion during the season (mean age = 15.8), preseason delta power was subtracted from their postseason scan. In eight high school football players without a concussion (mean age = 15.7), preseason delta power was subtracted from postseason delta power and in eight age-matched noncontact controls (mean age = 15.9), baseline delta power was subtracted from a 4-month follow-up scan. ANOVA was used to compare the mean differences between preseason and postseason scans for the three groups of players, with pairwise comparisons based on Student's t-test method. RESULTS Players with concussions had significantly increased delta wave power at their postseason scans than nonconcussed players (p = .018) and controls (p = .027). CONCLUSION We demonstrate that a single concussion during the season in adolescent subjects can increase MEG measured delta frequency power at their postseason scan. This adds to the growing body of literature indicating increased delta power following a concussion.
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Affiliation(s)
- Elizabeth M Davenport
- Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jillian E Urban
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Virginia Tech-Wake Forest School of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Christopher Vaughan
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jesse C DeSimone
- Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ben Wagner
- Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mark A Espeland
- Department of Radiology-Neuroradiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alexander K Powers
- Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Christopher T Whitlow
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Childress Institute for Pediatric Trauma, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Division of Pediatric Neuropsychology, Children's National Health System, Washington, District of Columbia
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Virginia Tech-Wake Forest School of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Division of Pediatric Neuropsychology, Children's National Health System, Washington, District of Columbia.,Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A Maldjian
- Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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14
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Mehta R, Filos A, Baid U, Sako C, McKinley R, Rebsamen M, Dätwyler K, Meier R, Radojewski P, Murugesan GK, Nalawade S, Ganesh C, Wagner B, Yu FF, Fei B, Madhuranthakam AJ, Maldjian JA, Daza L, Gómez C, Arbeláez P, Dai C, Wang S, Reynaud H, Mo Y, Angelini E, Guo Y, Bai W, Banerjee S, Pei L, AK M, Rosas-González S, Zemmoura I, Tauber C, Vu MH, Nyholm T, Löfstedt T, Ballestar LM, Vilaplana V, McHugh H, Maso Talou G, Wang A, Patel J, Chang K, Hoebel K, Gidwani M, Arun N, Gupta S, Aggarwal M, Singh P, Gerstner ER, Kalpathy-Cramer J, Boutry N, Huard A, Vidyaratne L, Rahman MM, Iftekharuddin KM, Chazalon J, Puybareau E, Tochon G, Ma J, Cabezas M, Llado X, Oliver A, Valencia L, Valverde S, Amian M, Soltaninejad M, Myronenko A, Hatamizadeh A, Feng X, Dou Q, Tustison N, Meyer C, Shah NA, Talbar S, Weber MA, Mahajan A, Jakab A, Wiest R, Fathallah-Shaykh HM, Nazeri A, Milchenko1 M, Marcus D, Kotrotsou A, Colen R, Freymann J, Kirby J, Davatzikos C, Menze B, Bakas S, Gal Y, Arbel T. QU-BraTS: MICCAI BraTS 2020 Challenge on Quantifying Uncertainty in Brain Tumor Segmentation - Analysis of Ranking Scores and Benchmarking Results. J Mach Learn Biomed Imaging 2022; 2022:https://www.melba-journal.org/papers/2022:026.html. [PMID: 36998700 PMCID: PMC10060060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Deep learning (DL) models have provided state-of-the-art performance in various medical imaging benchmarking challenges, including the Brain Tumor Segmentation (BraTS) challenges. However, the task of focal pathology multi-compartment segmentation (e.g., tumor and lesion sub-regions) is particularly challenging, and potential errors hinder translating DL models into clinical workflows. Quantifying the reliability of DL model predictions in the form of uncertainties could enable clinical review of the most uncertain regions, thereby building trust and paving the way toward clinical translation. Several uncertainty estimation methods have recently been introduced for DL medical image segmentation tasks. Developing scores to evaluate and compare the performance of uncertainty measures will assist the end-user in making more informed decisions. In this study, we explore and evaluate a score developed during the BraTS 2019 and BraTS 2020 task on uncertainty quantification (QU-BraTS) and designed to assess and rank uncertainty estimates for brain tumor multi-compartment segmentation. This score (1) rewards uncertainty estimates that produce high confidence in correct assertions and those that assign low confidence levels at incorrect assertions, and (2) penalizes uncertainty measures that lead to a higher percentage of under-confident correct assertions. We further benchmark the segmentation uncertainties generated by 14 independent participating teams of QU-BraTS 2020, all of which also participated in the main BraTS segmentation task. Overall, our findings confirm the importance and complementary value that uncertainty estimates provide to segmentation algorithms, highlighting the need for uncertainty quantification in medical image analyses. Finally, in favor of transparency and reproducibility, our evaluation code is made publicly available at https://github.com/RagMeh11/QU-BraTS.
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Affiliation(s)
- Raghav Mehta
- Centre for Intelligent Machines (CIM), McGill University, Montreal, QC, Canada
| | - Angelos Filos
- Oxford Applied and Theoretical Machine Learning (OATML) Group, University of Oxford, Oxford, England
| | - Ujjwal Baid
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chiharu Sako
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Richard McKinley
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Katrin Dätwyler
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern University Hospital, Bern, Switzerland
- Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | | | - Piotr Radojewski
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern University Hospital, Bern, Switzerland
| | | | - Sahil Nalawade
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Chandan Ganesh
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ben Wagner
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Fang F. Yu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Texas, USA
| | - Ananth J. Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joseph A. Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Laura Daza
- Universidad de los Andes, Bogotá, Colombia
| | | | | | - Chengliang Dai
- Data Science Institute, Imperial College London, London, UK
| | - Shuo Wang
- Data Science Institute, Imperial College London, London, UK
| | | | - Yuanhan Mo
- Data Science Institute, Imperial College London, London, UK
| | - Elsa Angelini
- NIHR Imperial BRC, ITMAT Data Science Group, Imperial College London, London, UK
| | - Yike Guo
- Data Science Institute, Imperial College London, London, UK
| | - Wenjia Bai
- Data Science Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Subhashis Banerjee
- Machine Intelligence Unit, Indian Statistical Institute, Kolkata, India
- Department of CSE, University of Calcutta, Kolkata, India
- Division of Visual Information and Interaction (Vi2), Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Linmin Pei
- Department of Diagnostic Radiology, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Murat AK
- Department of Diagnostic Radiology, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Ilyess Zemmoura
- UMR U1253 iBrain, Université de Tours, Inserm, Tours, France
- Neurosurgery department, CHRU de Tours, Tours, France
| | - Clovis Tauber
- UMR U1253 iBrain, Université de Tours, Inserm, Tours, France
| | - Minh H. Vu
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Tufve Nyholm
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Tommy Löfstedt
- Department of Computing Science, Umeå University, Umeå, Sweden
| | - Laura Mora Ballestar
- Signal Theory and Communications Department, Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Veronica Vilaplana
- Signal Theory and Communications Department, Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Hugh McHugh
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Radiology Department, Auckland City Hospital, Auckland, New Zealand
| | | | - Alan Wang
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Auckland Bioengineering Institute, University of Auckland, New Zealand
| | - Jay Patel
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ken Chang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Katharina Hoebel
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Mishka Gidwani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Nishanth Arun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Sharut Gupta
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Mehak Aggarwal
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Praveer Singh
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth R. Gerstner
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Jayashree Kalpathy-Cramer
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Nicolas Boutry
- EPITA Research and Development Laboratory (LRDE), France
| | - Alexis Huard
- EPITA Research and Development Laboratory (LRDE), France
| | - Lasitha Vidyaratne
- Vision Lab, Electrical and Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA
| | - Md Monibor Rahman
- Vision Lab, Electrical and Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA
| | - Khan M. Iftekharuddin
- Vision Lab, Electrical and Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA
| | - Joseph Chazalon
- EPITA Research and Development Laboratory (LRDE), Le Kremlin-Biĉetre, France
| | - Elodie Puybareau
- EPITA Research and Development Laboratory (LRDE), Le Kremlin-Biĉetre, France
| | - Guillaume Tochon
- EPITA Research and Development Laboratory (LRDE), Le Kremlin-Biĉetre, France
| | - Jun Ma
- School of Science, Nanjing University of Science and Technology
| | - Mariano Cabezas
- Research Institute of Computer Vision and Robotics, University of Girona, Spain
| | - Xavier Llado
- Research Institute of Computer Vision and Robotics, University of Girona, Spain
| | - Arnau Oliver
- Research Institute of Computer Vision and Robotics, University of Girona, Spain
| | - Liliana Valencia
- Research Institute of Computer Vision and Robotics, University of Girona, Spain
| | - Sergi Valverde
- Research Institute of Computer Vision and Robotics, University of Girona, Spain
| | - Mehdi Amian
- Department of Electrical and Computer Engineering, University of Tehran, Iran
| | | | | | | | - Xue Feng
- Biomedical Engineering, University of Virginia, Charlottesville, USA
| | - Quan Dou
- Biomedical Engineering, University of Virginia, Charlottesville, USA
| | - Nicholas Tustison
- Radiology and Medical Imaging, University of Virginia, Charlottesville, USA
| | - Craig Meyer
- Biomedical Engineering, University of Virginia, Charlottesville, USA
- Radiology and Medical Imaging, University of Virginia, Charlottesville, USA
| | - Nisarg A. Shah
- Department of Electrical Engineering, Indian Institute of Technology - Jodhpur, Jodhpur, India
| | - Sanjay Talbar
- SGGS Institute of Engineering and Technology, Nanded, India
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Abhishek Mahajan
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Andras Jakab
- Center for MR-Research, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern University Hospital, Bern, Switzerland
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | | | - Arash Nazeri
- Department of Radiology, Washington University, St. Louis, MO, USA
| | - Mikhail Milchenko1
- Department of Radiology, Washington University, St. Louis, MO, USA
- Neuroimaging Informatics and Analysis Center, Washington University, St. Louis, MO, USA
| | - Daniel Marcus
- Department of Radiology, Washington University, St. Louis, MO, USA
- Neuroimaging Informatics and Analysis Center, Washington University, St. Louis, MO, USA
| | - Aikaterini Kotrotsou
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rivka Colen
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Freymann
- Leidos Biomedical Research, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
- Cancer Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Justin Kirby
- Leidos Biomedical Research, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
- Cancer Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Bjoern Menze
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
- Department of Informatics, Technical University of Munich, Munich, Germany
| | - Spyridon Bakas
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yarin Gal
- Oxford Applied and Theoretical Machine Learning (OATML) Group, University of Oxford, Oxford, England
| | - Tal Arbel
- Centre for Intelligent Machines (CIM), McGill University, Montreal, QC, Canada
- MILA - Quebec Artificial Intelligence Institute, Montreal, QC, Canada
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15
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Miller LE, Urban JE, Espeland MA, Walkup MP, Holcomb JM, Davenport EM, Powers AK, Whitlow CT, Maldjian JA, Stitzel JD. Cumulative strain-based metrics for predicting subconcussive head impact exposure-related imaging changes in a cohort of American youth football players. J Neurosurg Pediatr 2022; 29:387-396. [PMID: 35061991 PMCID: PMC9404368 DOI: 10.3171/2021.10.peds21355] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 07/08/2021] [Accepted: 10/27/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Youth football athletes are exposed to repetitive subconcussive head impacts during normal participation in the sport, and there is increasing concern about the long-term effects of these impacts. The objective of the current study was to determine if strain-based cumulative exposure measures are superior to kinematic-based exposure measures for predicting imaging changes in the brain. METHODS This prospective, longitudinal cohort study was conducted from 2012 to 2017 and assessed youth, male football athletes. Kinematic data were collected at all practices and games from enrolled athletes participating in local youth football organizations in Winston-Salem, North Carolina, and were used to calculate multiple risk-weighted cumulative exposure (RWE) kinematic metrics and 36 strain-based exposure metrics. Pre- and postseason imaging was performed at Wake Forest School of Medicine, and diffusion tensor imaging (DTI) measures, including fractional anisotropy (FA), and its components (CL, CP, and CS), and mean diffusivity (MD), were investigated. Included participants were youth football players ranging in age from 9 to 13 years. Exclusion criteria included any history of previous neurological illness, psychiatric illness, brain tumor, concussion within the past 6 months, and/or contraindication to MRI. RESULTS A total of 95 male athletes (mean age 11.9 years [SD 1.0 years]) participated between 2012 and 2017, with some participating for multiple seasons, resulting in 116 unique athlete-seasons. Regression analysis revealed statistically significant linear relationships between the FA, linear coefficient (CL), and spherical coefficient (CS) and all strain exposure measures, and well as the planar coefficient (CP) and 8 strain measures. For the kinematic exposure measures, there were statistically significant relationships between FA and RWE linear (RWEL) and RWE combined probability (RWECP) as well as CS and RWEL. According to area under the receiver operating characteristic (ROC) curve (AUC) analysis, the best-performing metrics were all strain measures, and included metrics based on tensile, compressive, and shear strain. CONCLUSIONS Using ROC curves and AUC analysis, all exposure metrics were ranked in order of performance, and the results demonstrated that all the strain-based metrics performed better than any of the kinematic metrics, indicating that strain-based metrics are better discriminators of imaging changes than kinematic-based measures. Studies relating the biomechanics of head impacts with brain imaging and cognitive function may allow equipment designers, care providers, and organizations to prevent, identify, and treat injuries in order to make football a safer activity.
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Affiliation(s)
- Logan E. Miller
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem,School of Biomedical Engineering and Sciences, Virginia Tech–Wake Forest University, Winston-Salem
| | - Jillian E. Urban
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem,School of Biomedical Engineering and Sciences, Virginia Tech–Wake Forest University, Winston-Salem
| | - Mark A. Espeland
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem
| | - Michael P. Walkup
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem
| | - James M. Holcomb
- Department of Radiology, University of Texas Southwestern Medical School, Dallas, Texas
| | | | - Alexander K. Powers
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem,Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem
| | - Christopher T. Whitlow
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem,Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A. Maldjian
- Department of Radiology, University of Texas Southwestern Medical School, Dallas, Texas
| | - Joel D. Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem,School of Biomedical Engineering and Sciences, Virginia Tech–Wake Forest University, Winston-Salem
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16
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Nalawade SS, Yu FF, Bangalore Yogananda CG, Murugesan GK, Shah BR, Pinho MC, Wagner BC, Xi Y, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. Brain tumor IDH, 1p/19q, and MGMT molecular classification using MRI-based deep learning: an initial study on the effect of motion and motion correction. J Med Imaging (Bellingham) 2022; 9:016001. [PMID: 35118164 PMCID: PMC8794036 DOI: 10.1117/1.jmi.9.1.016001] [Citation(s) in RCA: 1] [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: 06/17/2021] [Accepted: 01/03/2022] [Indexed: 01/29/2023] Open
Abstract
Purpose: Deep learning has shown promise for predicting the molecular profiles of gliomas using MR images. Prior to clinical implementation, ensuring robustness to real-world problems, such as patient motion, is crucial. The purpose of this study is to perform a preliminary evaluation on the effects of simulated motion artifact on glioma marker classifier performance and determine if motion correction can restore classification accuracies. Approach: T2w images and molecular information were retrieved from the TCIA and TCGA databases. Simulated motion was added in the k-space domain along the phase encoding direction. Classifier performance for IDH mutation, 1p/19q co-deletion, and MGMT methylation was assessed over the range of 0% to 100% corrupted k-space lines. Rudimentary motion correction networks were trained on the motion-corrupted images. The performance of the three glioma marker classifiers was then evaluated on the motion-corrected images. Results: Glioma marker classifier performance decreased markedly with increasing motion corruption. Applying motion correction effectively restored classification accuracy for even the most motion-corrupted images. For isocitrate dehydrogenase (IDH) classification, 99% accuracy was achieved, exceeding the original performance of the network and representing a new benchmark in non-invasive MRI-based IDH classification. Conclusions: Robust motion correction can facilitate highly accurate deep learning MRI-based molecular marker classification, rivaling invasive tissue-based characterization methods. Motion correction may be able to increase classification accuracy even in the absence of a visible artifact, representing a new strategy for boosting classifier performance.
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Affiliation(s)
- Sahil S. Nalawade
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Fang F. Yu
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Chandan Ganesh Bangalore Yogananda
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Gowtham K. Murugesan
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Bhavya R. Shah
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Marco C. Pinho
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Benjamin C. Wagner
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Yin Xi
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Bruce Mickey
- University of Texas Southwestern Medical Center, Department of Neurological Surgery, Dallas, Texas, United States
| | - Toral R. Patel
- University of Texas Southwestern Medical Center, Department of Neurological Surgery, Dallas, Texas, United States
| | - Baowei Fei
- University of Texas at Dallas, Department of Bioengineering, Richardson, Texas, United States
| | - Ananth J. Madhuranthakam
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States
| | - Joseph A. Maldjian
- University of Texas Southwestern Medical Center, Advanced Neuroscience Imaging Research Lab, Department of Radiology, Dallas, Texas, United States,Address all correspondence to Joseph A. Maldjian,
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17
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Treacher AH, Garg P, Davenport E, Godwin R, Proskovec A, Bezerra LG, Murugesan G, Wagner B, Whitlow CT, Stitzel JD, Maldjian JA, Montillo AA. MEGnet: Automatic ICA-based artifact removal for MEG using spatiotemporal convolutional neural networks. Neuroimage 2021; 241:118402. [PMID: 34274419 PMCID: PMC9125748 DOI: 10.1016/j.neuroimage.2021.118402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/18/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022] Open
Abstract
Magnetoencephalography (MEG) is a functional neuroimaging tool that records the magnetic fields induced by neuronal activity; however, signal from non-neuronal sources can corrupt the data. Eye-blinks, saccades, and cardiac activity are three of the most common sources of non-neuronal artifacts. They can be measured by affixing eye proximal electrodes, as in electrooculography (EOG), and chest electrodes, as in electrocardiography (ECG), however this complicates imaging setup, decreases patient comfort, and can induce further artifacts from movement. This work proposes an EOG- and ECG-free approach to identify eye-blinks, saccades, and cardiac activity signals for automated artifact suppression. The contribution of this work is three-fold. First, using a data driven, multivariate decomposition approach based on Independent Component Analysis (ICA), a highly accurate artifact classifier is constructed as an amalgam of deep 1-D and 2-D Convolutional Neural Networks (CNNs) to automate the identification and removal of ubiquitous whole brain artifacts including eye-blink, saccade, and cardiac artifacts. The specific architecture of this network is optimized through an unbiased, computer-based hyperparameter random search. Second, visualization methods are applied to the learned abstraction to reveal what features the model uses and to bolster user confidence in the model's training and potential for generalization. Finally, the model is trained and tested on both resting-state and task MEG data from 217 subjects, and achieves a new state-of-the-art in artifact detection accuracy of 98.95% including 96.74% sensitivity and 99.34% specificity on the held out test-set. This work automates MEG processing for both clinical and research use, adapts to the acquired acquisition time, and can obviate the need for EOG or ECG electrodes for artifact detection.
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Affiliation(s)
- Alex H Treacher
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, United States
| | - Prabhat Garg
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, United States; Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States
| | - Elizabeth Davenport
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States; Magnetoencephalography Center of Excellence, UT Southwestern Medical Center, Dallas, TX, United States
| | - Ryan Godwin
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Amy Proskovec
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States; Magnetoencephalography Center of Excellence, UT Southwestern Medical Center, Dallas, TX, United States
| | | | - Gowtham Murugesan
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States
| | - Ben Wagner
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States; Magnetoencephalography Center of Excellence, UT Southwestern Medical Center, Dallas, TX, United States
| | | | - Joel D Stitzel
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Joseph A Maldjian
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, United States; Magnetoencephalography Center of Excellence, UT Southwestern Medical Center, Dallas, TX, United States
| | - Albert A Montillo
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, United States; Department of Radiology, UT Southwestern Medical Center, Dallas, TX, United States; Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, United States.
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18
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Holcomb JM, Fisicaro RA, Miller LE, Yu FF, Davenport EM, Xi Y, Urban JE, Wagner BC, Powers AK, Whitlow CT, Stitzel JD, Maldjian JA. Regional White Matter Diffusion Changes Associated with the Cumulative Tensile Strain and Strain Rate in Nonconcussed Youth Football Players. J Neurotrauma 2021; 38:2763-2771. [PMID: 34039024 PMCID: PMC8820832 DOI: 10.1089/neu.2020.7580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study is to assess the relationship between regional white matter diffusion imaging changes and finite element strain measures in nonconcussed youth football players. Pre- and post-season diffusion-weighted imaging was performed in 102 youth football subject-seasons, in which no concussions were diagnosed. The diffusion data were normalized to the IXI template. Percent change in fractional anisotropy (%ΔFA) images were generated. Using data from the head impact telemetry system, the cumulative maximum principal strain one times strain rate (CMPS1 × SR), a measure of the cumulative tensile brain strain and strain rate for one season, was calculated for each subject. Two linear regression analyses were performed to identify significant positive or inverse relationships between CMPS1 × SR and %ΔFA within the international consortium for brain mapping white matter mask. Age, body mass index, days between pre- and post-season imaging, previous brain injury, attention disorder diagnosis, and imaging protocol were included as covariates. False discovery rate correction was used with corrected alphas of 0.025 and voxel thresholds of zero. Controlling for all covariates, a significant, positive linear relationship between %ΔFA and CMPS1 × SR was identified in the bilateral cingulum, fornix, internal capsule, external capsule, corpus callosum, corona radiata, corticospinal tract, cerebral and middle cerebellar peduncle, superior longitudinal fasciculus, and right superior fronto-occipital fasciculus. Post hoc analyses further demonstrated significant %ΔFA differences between high-strain football subjects and noncollision control athletes, no significant %ΔFA differences between low-strain subjects and noncollision control athletes, and that CMPS1 × SR significantly explained more %ΔFA variance than number of head impacts alone.
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Affiliation(s)
- James M. Holcomb
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ryan A. Fisicaro
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Logan E. Miller
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Fang F. Yu
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Yin Xi
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jillian E. Urban
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Ben C. Wagner
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | - Joel D. Stitzel
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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19
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Reddy DD, Davenport EM, Yu FF, Wagner B, Urban JE, Whitlow CT, Stitzel JD, Maldjian JA. Alterations in the Magnetoencephalography Default Mode Effective Connectivity following Concussion. AJNR Am J Neuroradiol 2021; 42:1776-1782. [PMID: 34503943 DOI: 10.3174/ajnr.a7232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/05/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Magnetoencephalography is sensitive to functional connectivity changes associated with concussion. However, the directional influences between functionally related regions remain unexplored. In this study, we therefore evaluated concussion-related magnetoencephalography-based effective connectivity changes within resting-state default mode network regions. MATERIALS AND METHODS Resting-state magnetoencephalography was acquired for 8 high school football players with concussion at 3 time points (preseason, postconcussion, postseason), as well as 8 high school football players without concussion and 8 age-matched controls at 2 time points (preseason, postseason). Time-series from the default mode network regions were extracted, and effective connectivity between them was computed for 5 different frequency bands. The default mode network regions were grouped into anterior and posterior default mode networks. The combined posterior-to-anterior and anterior-to-posterior effective connectivity values were averaged to generate 2 sets of values for each subject. The effective connectivity values were compared using a repeated measures ANOVA across time points for the concussed, nonconcussed, and control groups, separately. RESULTS A significant increase in posterior-to-anterior effective connectivity from preseason to postconcussion (corrected P value = .013) and a significant decrease in posterior-to-anterior effective connectivity from postconcussion to postseason (corrected P value = .028) were observed in the concussed group. Changes in effective connectivity were only significant within the delta band. Anterior-to-posterior connectivity demonstrated no significant change. Effective connectivity in the nonconcussed group and controls did not show significant differences. CONCLUSIONS The unidirectional increase in effective connectivity postconcussion may elucidate compensatory processes, invoking use of posterior regions to aid the function of susceptible anterior regions following brain injury. These findings support the potential value of magnetoencephalography in exploring directional changes of the brain network following concussion.
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Affiliation(s)
- D D Reddy
- From the Department of Radiology (D.D.R., E.M.D., F.F.Y., B.W., J.A.M.), University of Texas Southwestern, Dallas, Texas
| | - E M Davenport
- From the Department of Radiology (D.D.R., E.M.D., F.F.Y., B.W., J.A.M.), University of Texas Southwestern, Dallas, Texas
| | - F F Yu
- From the Department of Radiology (D.D.R., E.M.D., F.F.Y., B.W., J.A.M.), University of Texas Southwestern, Dallas, Texas
| | - B Wagner
- From the Department of Radiology (D.D.R., E.M.D., F.F.Y., B.W., J.A.M.), University of Texas Southwestern, Dallas, Texas
| | - J E Urban
- Wake Forest School of Medicine (J.E.U. C.T.W., J.D.S.), Winston-Salem, North Carolina
| | - C T Whitlow
- Wake Forest School of Medicine (J.E.U. C.T.W., J.D.S.), Winston-Salem, North Carolina
| | - J D Stitzel
- Wake Forest School of Medicine (J.E.U. C.T.W., J.D.S.), Winston-Salem, North Carolina
| | - J A Maldjian
- From the Department of Radiology (D.D.R., E.M.D., F.F.Y., B.W., J.A.M.), University of Texas Southwestern, Dallas, Texas
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20
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Zhou L, Wang Y, Pinho MC, Pan E, Xi Y, Maldjian JA, Madhuranthakam AJ. Intrasession Reliability of Arterial Spin-Labeled MRI-Measured Noncontrast Perfusion in Glioblastoma at 3 T. ACTA ACUST UNITED AC 2021; 6:139-147. [PMID: 32548290 PMCID: PMC7289238 DOI: 10.18383/j.tom.2020.00010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Indexed: 12/11/2022]
Abstract
Arterial spin-labeled magnetic resonance imaging can provide quantitative perfusion measurements in the brain and can be potentially used to evaluate therapy response assessment in glioblastoma (GBM). The reliability and reproducibility of this method to measure noncontrast perfusion in GBM, however, are lacking. We evaluated the intrasession reliability of brain and tumor perfusion in both healthy volunteers and patients with GBM at 3 T using pseudocontinuous labeling (pCASL) and 3D turbo spin echo (TSE) using Cartesian acquisition with spiral profile reordering (CASPR). Two healthy volunteers at a single time point and 6 newly diagnosed patients with GBM at multiple time points (before, during, and after chemoradiation) underwent scanning (total, 14 sessions). Compared with 3D GraSE, 3D TSE-CASPR generated cerebral blood flow maps with better tumor-to-normal background tissue contrast and reduced image distortions. The intraclass correlation coefficient between the 2 runs of 3D pCASL with TSE-CASPR was consistently high (≥0.90) across all normal-appearing gray matter (NAGM) regions of interest (ROIs), and was particularly high in tumors (0.98 with 95% confidence interval [CI]: 0.97-0.99). The within-subject coefficients of variation were relatively low in all normal-appearing gray matter regions of interest (3.40%-7.12%), and in tumors (4.91%). Noncontrast perfusion measured using 3D pCASL with TSE-CASPR provided robust cerebral blood flow maps in both healthy volunteers and patients with GBM with high intrasession repeatability at 3 T. This approach can be an appropriate noncontrast and noninvasive quantitative perfusion imaging method for longitudinal assessment of therapy response and management of patients with GBM.
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Affiliation(s)
| | | | - Marco C Pinho
- Department of Radiology.,Advanced Imaging Research Center
| | - Edward Pan
- Department of Neurology and Neurotherapeutics.,Department of Neurological Surgery.,Harold C. Simmons Cancer Center; and
| | - Yin Xi
- Department of Radiology.,Department of Population and Data Sciences, University of Texas Southwestern Medical Center at Dallas, Dallas, TX
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21
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Bangalore Yogananda CG, Shah BR, Vejdani-Jahromi M, Nalawade SS, Murugesan GK, Yu FF, Pinho MC, Wagner BC, Emblem KE, Bjørnerud A, Fei B, Madhuranthakam AJ, Maldjian JA. A Fully Automated Deep Learning Network for Brain Tumor Segmentation. ACTA ACUST UNITED AC 2021; 6:186-193. [PMID: 32548295 PMCID: PMC7289260 DOI: 10.18383/j.tom.2019.00026] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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] [Indexed: 11/24/2022]
Abstract
We developed a fully automated method for brain tumor segmentation using deep learning; 285 brain tumor cases with multiparametric magnetic resonance images from the BraTS2018 data set were used. We designed 3 separate 3D-Dense-UNets to simplify the complex multiclass segmentation problem into individual binary-segmentation problems for each subcomponent. We implemented a 3-fold cross-validation to generalize the network's performance. The mean cross-validation Dice-scores for whole tumor (WT), tumor core (TC), and enhancing tumor (ET) segmentations were 0.92, 0.84, and 0.80, respectively. We then retrained the individual binary-segmentation networks using 265 of the 285 cases, with 20 cases held-out for testing. We also tested the network on 46 cases from the BraTS2017 validation data set, 66 cases from the BraTS2018 validation data set, and 52 cases from an independent clinical data set. The average Dice-scores for WT, TC, and ET were 0.90, 0.84, and 0.80, respectively, on the 20 held-out testing cases. The average Dice-scores for WT, TC, and ET on the BraTS2017 validation data set, the BraTS2018 validation data set, and the clinical data set were as follows: 0.90, 0.80, and 0.78; 0.90, 0.82, and 0.80; and 0.85, 0.80, and 0.77, respectively. A fully automated deep learning method was developed to segment brain tumors into their subcomponents, which achieved high prediction accuracy on the BraTS data set and on the independent clinical data set. This method is promising for implementation into a clinical workflow.
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Affiliation(s)
- Chandan Ganesh Bangalore Yogananda
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Bhavya R Shah
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Maryam Vejdani-Jahromi
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Sahil S Nalawade
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Gowtham K Murugesan
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Frank F Yu
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Marco C Pinho
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Benjamin C Wagner
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Kyrre E Emblem
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Atle Bjørnerud
- Computational Radiology and Artificial Intelligence (CRAI), Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; and
| | - Baowei Fei
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX
| | - Ananth J Madhuranthakam
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
| | - Joseph A Maldjian
- Department of Radiology, Advanced Neuroscience Imaging Research Lab (ANSIR Lab), University of Texas Southwestern Medical Center, Dallas, TX
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22
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Kelley ME, Urban JE, Jones DA, Davenport EM, Miller LE, Snively BM, Powers AK, Whitlow CT, Maldjian JA, Stitzel JD. Analysis of longitudinal head impact exposure and white matter integrity in returning youth football players. J Neurosurg Pediatr 2021:1-10. [PMID: 34130257 PMCID: PMC10193468 DOI: 10.3171/2021.1.peds20586] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/11/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to characterize changes in head impact exposure (HIE) across multiple football seasons and to determine whether changes in HIE correlate with changes in imaging metrics in youth football players. METHODS On-field head impact data and pre- and postseason imaging data, including those produced by diffusion tensor imaging (DTI), were collected from youth football athletes with at least two consecutive seasons of data. ANCOVA was used to evaluate HIE variations (number of impacts, peak linear and rotational accelerations, and risk-weighted cumulative exposure) by season number. DTI scalar metrics, including fractional anisotropy, mean diffusivity, and linear, planar, and spherical anisotropy coefficients, were evaluated. A control group was used to determine the number of abnormal white matter voxels, which were defined as 2 standard deviations above or below the control group mean. The difference in the number of abnormal voxels between consecutive seasons was computed for each scalar metric and athlete. Linear regression analyses were performed to evaluate relationships between changes in HIE metrics and changes in DTI scalar metrics. RESULTS There were 47 athletes with multiple consecutive seasons of HIE, and corresponding imaging data were available in a subsample (n = 19) of these. Increases and decreases in HIE metrics were observed among individual athletes from one season to the next, and no significant differences (all p > 0.05) in HIE metrics were observed by season number. Changes in the number of practice impacts, 50th percentile impacts per practice session, and 50th percentile impacts per session were significantly positively correlated with changes in abnormal voxels for all DTI metrics. CONCLUSIONS These results demonstrate a significant positive association between changes in HIE metrics and changes in the numbers of abnormal voxels between consecutive seasons of youth football. Reducing the number and frequency of head impacts, especially during practice sessions, may decrease the number of abnormal imaging findings from one season to the next in youth football.
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Affiliation(s)
- Mireille E. Kelley
- Departments of Biomedical Engineering
- Virginia Tech–Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina; and
| | - Jillian E. Urban
- Departments of Biomedical Engineering
- Virginia Tech–Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina; and
| | - Derek A. Jones
- Departments of Biomedical Engineering
- Virginia Tech–Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina; and
| | | | - Logan E. Miller
- Departments of Biomedical Engineering
- Virginia Tech–Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina; and
| | | | | | - Christopher T. Whitlow
- Departments of Biomedical Engineering
- Radiology (Neuroradiology), and
- Clinical and Translational Sciences Institute, Wake Forest School of Medicine, Winston-Salem
| | - Joseph A. Maldjian
- Department of Radiology, University of Texas Southwestern, Dallas, Texas
| | - Joel D. Stitzel
- Departments of Biomedical Engineering
- Virginia Tech–Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina; and
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23
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Yogananda CGB, Shah BR, Nalawade SS, Murugesan GK, Yu FF, Pinho MC, Wagner BC, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. MRI-Based Deep-Learning Method for Determining Glioma MGMT Promoter Methylation Status. AJNR Am J Neuroradiol 2021; 42:845-852. [PMID: 33664111 PMCID: PMC8115363 DOI: 10.3174/ajnr.a7029] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/21/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE O6-Methylguanine-DNA methyltransferase (MGMT) promoter methylation confers an improved prognosis and treatment response in gliomas. We developed a deep learning network for determining MGMT promoter methylation status using T2 weighted Images (T2WI) only. MATERIALS AND METHODS Brain MR imaging and corresponding genomic information were obtained for 247 subjects from The Cancer Imaging Archive and The Cancer Genome Atlas. One hundred sixty-three subjects had a methylated MGMT promoter. A T2WI-only network (MGMT-net) was developed to determine MGMT promoter methylation status and simultaneous single-label tumor segmentation. The network was trained using 3D-dense-UNets. Three-fold cross-validation was performed to generalize the performance of the networks. Dice scores were computed to determine tumor-segmentation accuracy. RESULTS The MGMT-net demonstrated a mean cross-validation accuracy of 94.73% across the 3 folds (95.12%, 93.98%, and 95.12%, [SD, 0.66%]) in predicting MGMT methylation status with a sensitivity and specificity of 96.31% [SD, 0.04%] and 91.66% [SD, 2.06%], respectively, and a mean area under the curve of 0.93 [SD, 0.01]. The whole tumor-segmentation mean Dice score was 0.82 [SD, 0.008]. CONCLUSIONS We demonstrate high classification accuracy in predicting MGMT promoter methylation status using only T2WI. Our network surpasses the sensitivity, specificity, and accuracy of histologic and molecular methods. This result represents an important milestone toward using MR imaging to predict prognosis and treatment response.
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Affiliation(s)
- C G B Yogananda
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - B R Shah
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S S Nalawade
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - G K Murugesan
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - F F Yu
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - M C Pinho
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - B C Wagner
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - B Mickey
- Department of Neurological Surgery (B.M., T.R.P.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - T R Patel
- Department of Neurological Surgery (B.M., T.R.P.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - B Fei
- Department of Bioengineering (B.F.), University of Texas at Dallas, Richardson, Texas
| | - A J Madhuranthakam
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - J A Maldjian
- From the Advanced Neuroscience Imaging Research Lab (C.G.B.Y., B.R.S., S.S.N., G.K.M., F.F.Y., M.C.P., B.C.W., A.J.M., J.A.M.), Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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24
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DeSimone JC, Davenport EM, Urban J, Xi Y, Holcomb JM, Kelley ME, Whitlow CT, Powers AK, Stitzel JD, Maldjian JA. Mapping default mode connectivity alterations following a single season of subconcussive impact exposure in youth football. Hum Brain Mapp 2021; 42:2529-2545. [PMID: 33734521 PMCID: PMC8090779 DOI: 10.1002/hbm.25384] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
Repetitive head impact (RHI) exposure in collision sports may contribute to adverse neurological outcomes in former players. In contrast to a concussion, or mild traumatic brain injury, “subconcussive” RHIs represent a more frequent and asymptomatic form of exposure. The neural network‐level signatures characterizing subconcussive RHIs in youth collision‐sport cohorts such as American Football are not known. Here, we used resting‐state functional MRI to examine default mode network (DMN) functional connectivity (FC) following a single football season in youth players (n = 50, ages 8–14) without concussion. Football players demonstrated reduced FC across widespread DMN regions compared with non‐collision sport controls at postseason but not preseason. In a subsample from the original cohort (n = 17), players revealed a negative change in FC between preseason and postseason and a positive and compensatory change in FC during the offseason across the majority of DMN regions. Lastly, significant FC changes, including between preseason and postseason and between in‐ and off‐season, were specific to players at the upper end of the head impact frequency distribution. These findings represent initial evidence of network‐level FC abnormalities following repetitive, non‐concussive RHIs in youth football. Furthermore, the number of subconcussive RHIs proved to be a key factor influencing DMN FC.
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Affiliation(s)
- Jesse C. DeSimone
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Elizabeth M. Davenport
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Jillian Urban
- Department of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Yin Xi
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - James M. Holcomb
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Mireille E. Kelley
- Department of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Christopher T. Whitlow
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Department of Radiology – NeuroradiologyWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Clinical and Translational Sciences InstituteWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Alexander K. Powers
- Department of NeurosurgeryWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Joel D. Stitzel
- Department of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Virginia Tech – Wake Forest School of Biomedical EngineeringWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Clinical and Translational Sciences InstituteWake Forest School of MedicineWinston SalemNorth CarolinaUSA
- Childress Institute for Pediatric TraumaWake Forest School of MedicineWinston SalemNorth CarolinaUSA
| | - Joseph A. Maldjian
- Advanced Neuroscience Imaging Research (ANSIR) LaboratoryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- Department of RadiologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
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25
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Miller LE, Urban JE, Davenport EM, Powers AK, Whitlow CT, Maldjian JA, Stitzel JD. Brain Strain: Computational Model-Based Metrics for Head Impact Exposure and Injury Correlation. Ann Biomed Eng 2021; 49:1083-1096. [PMID: 33258089 PMCID: PMC10032321 DOI: 10.1007/s10439-020-02685-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 06/18/2020] [Accepted: 10/20/2020] [Indexed: 12/20/2022]
Abstract
Athletes participating in contact sports are exposed to repetitive subconcussive head impacts that may have long-term neurological consequences. To better understand these impacts and their effects, head impacts are often measured during football to characterize head impact exposure and estimate injury risk. Despite widespread use of kinematic-based metrics, it remains unclear whether any single metric derived from head kinematics is well-correlated with measurable changes in the brain. This shortcoming has motivated the increasing use of finite element (FE)-based metrics, which quantify local brain deformations. Additionally, quantifying cumulative exposure is of increased interest to examine the relationship to brain changes over time. The current study uses the atlas-based brain model (ABM) to predict the strain response to impacts sustained by 116 youth football athletes and proposes 36 new, or derivative, cumulative strain-based metrics that quantify the combined burden of head impacts over the course of a season. The strain-based metrics developed and evaluated for FE modeling and presented in the current study present potential for improved analytics over existing kinematically-based and cumulative metrics. Additionally, the findings highlight the importance of accounting for directional dependence and expand the techniques to explore spatial distribution of the strain response throughout the brain.
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Affiliation(s)
- Logan E Miller
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA.
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA.
| | - Jillian E Urban
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
| | - Elizabeth M Davenport
- Department of Radiology, Southwestern Medical School, University of Texas, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA
| | - Alexander K Powers
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- Department of Neurosurgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Christopher T Whitlow
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Joseph A Maldjian
- Department of Radiology, Southwestern Medical School, University of Texas, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, 575 N. Patterson Avenue, Suite 530, Winston-Salem, NC, 27101, USA
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Yogananda CGB, Shah BR, Yu FF, Pinho MC, Nalawade SS, Murugesan GK, Wagner BC, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. A novel fully automated MRI-based deep-learning method for classification of 1p/19q co-deletion status in brain gliomas. Neurooncol Adv 2021; 2:vdaa066. [PMID: 32705083 PMCID: PMC7367418 DOI: 10.1093/noajnl/vdaa066] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND One of the most important recent discoveries in brain glioma biology has been the identification of the isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion status as markers for therapy and prognosis. 1p/19q co-deletion is the defining genomic marker for oligodendrogliomas and confers a better prognosis and treatment response than gliomas without it. Our group has previously developed a highly accurate deep-learning network for determining IDH mutation status using T2-weighted (T2w) MRI only. The purpose of this study was to develop a similar 1p/19q deep-learning classification network. METHODS Multiparametric brain MRI and corresponding genomic information were obtained for 368 subjects from The Cancer Imaging Archive and The Cancer Genome Atlas. 1p/19 co-deletions were present in 130 subjects. Two-hundred and thirty-eight subjects were non-co-deleted. A T2w image-only network (1p/19q-net) was developed to perform 1p/19q co-deletion status classification and simultaneous single-label tumor segmentation using 3D-Dense-UNets. Three-fold cross-validation was performed to generalize the network performance. Receiver operating characteristic analysis was also performed. Dice scores were computed to determine tumor segmentation accuracy. RESULTS 1p/19q-net demonstrated a mean cross-validation accuracy of 93.46% across the 3 folds (93.4%, 94.35%, and 92.62%, SD = 0.8) in predicting 1p/19q co-deletion status with a sensitivity and specificity of 0.90 ± 0.003 and 0.95 ± 0.01, respectively and a mean area under the curve of 0.95 ± 0.01. The whole tumor segmentation mean Dice score was 0.80 ± 0.007. CONCLUSION We demonstrate high 1p/19q co-deletion classification accuracy using only T2w MR images. This represents an important milestone toward using MRI to predict glioma histology, prognosis, and response to treatment.
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Affiliation(s)
| | - Bhavya R Shah
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Frank F Yu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marco C Pinho
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sahil S Nalawade
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Gowtham K Murugesan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Benjamin C Wagner
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Bruce Mickey
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Toral R Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Ananth J Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Joseph A Maldjian
- Corresponding Author: Joseph A. Maldjian, MD, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390-9178, USA ()
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Shah BR, Holcomb JM, Davenport EM, Lack CM, McDaniel JM, Imphean DM, Xi Y, Rosenbaum DA, Urban JE, Wagner BC, Powers AK, Whitlow CT, Stitzel JD, Maldjian JA. Prevalence and Incidence of Microhemorrhages in Adolescent Football Players. AJNR Am J Neuroradiol 2020; 41:1263-1268. [PMID: 32661051 DOI: 10.3174/ajnr.a6618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/20/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE SWI is an advanced imaging modality that is especially useful in cerebral microhemorrhage detection. Such microhemorrhages have been identified in adult contact sport athletes, and the sequelae of these focal bleeds are thought to contribute to neurodegeneration. The purpose of this study was to utilize SWI to determine whether the prevalence and incidence of microhemorrhages in adolescent football players are significantly greater than those of adolescent noncontact athletes. MATERIALS AND METHODS Preseason and postseason SWI was performed and evaluated on 78 adolescent football players. SWI was also performed on 27 adolescent athletes who reported no contact sport history. Two separate one-tailed Fisher exact tests were performed to determine whether the prevalence and incidence of microhemorrhages in adolescent football players are greater than those of noncontact athlete controls. RESULTS Microhemorrhages were observed in 12 football players. No microhemorrhages were observed in any controls. Adolescent football players demonstrated a significantly greater prevalence of microhemorrhages than adolescent noncontact controls (P = .02). Although 2 football players developed new microhemorrhages during the season, microhemorrhage incidence during 1 football season was not statistically greater in the football population than in noncontact control athletes (P = .55). CONCLUSIONS Adolescent football players have a greater prevalence of microhemorrhages compared with adolescent athletes who have never engaged in contact sports. While microhemorrhage incidence during 1 season is not significantly greater in adolescent football players compared to adolescent controls, there is a temporal association between playing football and the appearance of new microhemorrhages.
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Affiliation(s)
- B R Shah
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - J M Holcomb
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - E M Davenport
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - C M Lack
- Departments of Radiology (C.M.L., C.T.W.)
| | - J M McDaniel
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - D M Imphean
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Y Xi
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - J E Urban
- Biomedical Engineering (J.E.U., J.D.S.)
| | - B C Wagner
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - A K Powers
- Neurosurgery (A.K.P.), Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - J A Maldjian
- From the Department of Radiology (B.R.S., J.M.H., E.M.D., J.M.M., D.M.I., Y.X., B.C.W., J.A.M.), University of Texas Southwestern Medical Center, Dallas, Texas
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Murugesan GK, Ganesh C, Nalawade S, Davenport EM, Wagner B, Kim WH, Maldjian JA. BrainNET: Inference of Brain Network Topology Using Machine Learning. Brain Connect 2020; 10:422-435. [PMID: 33030350 DOI: 10.1089/brain.2020.0745] [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] [Indexed: 11/12/2022] Open
Abstract
Background: To develop a new functional magnetic resonance image (fMRI) network inference method, BrainNET, that utilizes an efficient machine learning algorithm to quantify contributions of various regions of interests (ROIs) in the brain to a specific ROI. Methods: BrainNET is based on extremely randomized trees to estimate network topology from fMRI data and modified to generate an adjacency matrix representing brain network topology, without reliance on arbitrary thresholds. Open-source simulated fMRI data of 50 subjects in 28 different simulations under various confounding conditions with known ground truth were used to validate the method. Performance was compared with correlation and partial correlation (PC). The real-world performance was then evaluated in a publicly available attention-deficit/hyperactivity disorder (ADHD) data set, including 134 typically developing children (mean age: 12.03, males: 83), 75 ADHD inattentive (mean age: 11.46, males: 56), and 93 ADHD combined (mean age: 11.86, males: 77) subjects. Network topologies in ADHD were inferred using BrainNET, correlation, and PC. Graph metrics were extracted to determine differences between the ADHD groups. Results: BrainNET demonstrated excellent performance across all simulations and varying confounders in identifying the true presence of connections. In the ADHD data set, BrainNET was able to identify significant changes (p < 0.05) in graph metrics between groups. No significant changes in graph metrics between ADHD groups were identified using correlation and PC. Conclusion: We describe BrainNET, a new network inference method to estimate fMRI connectivity that was adapted from gene regulatory methods. BrainNET out-performed Pearson correlation and PC in fMRI simulation data and real-world ADHD data. BrainNET can be used independently or combined with other existing methods as a useful tool to understand network changes and to determine the true network topology of the brain under various conditions and disease states. Impact statement Developed a new functional magnetic resonance image (fMRI) network inference method named as BrainNET using machine learning. BrainNET out-performed Pearson correlation and partial correlation in fMRI simulation data and real-world attention-deficit/hyperactivity disorder data. BrainNET does not need to be pretrained and can be applied to infer fMRI network topology independently on individual subjects and for varying number of nodes.
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Affiliation(s)
| | - Chandan Ganesh
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Sahil Nalawade
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Ben Wagner
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Won Hwa Kim
- Department of Computer Science, The University of Texas at Arlington, Arlington, Texas, USA
| | - Joseph A Maldjian
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
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Kelley ME, Jones DA, Espeland MA, Rosenberg ML, Miles CM, Whitlow CT, Maldjian JA, Stitzel JD, Urban JE. Physical Performance Measures Correlate with Head Impact Exposure in Youth Football. Med Sci Sports Exerc 2020; 52:449-456. [PMID: 31469712 DOI: 10.1249/mss.0000000000002144] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Head impact exposure (HIE) (i.e., magnitude and frequency of impacts) can vary considerably among individuals within a single football team. To better understand individual-specific factors that may explain variation in head impact biomechanics, this study aimed to evaluate the relationship between physical performance measures and HIE metrics in youth football players. METHODS Head impact data were collected from youth football players using the Head Impact Telemetry System. Head impact exposure was quantified in terms of impact frequency, linear and rotational head acceleration, and risk-weighted cumulative exposure metrics (RWELinear, RWERotational, and RWECP). Study participants completed four physical performance tests: vertical jump, shuttle run, three-cone, and 40-yard sprint. The relationships between performance measures, and HIE metrics were evaluated using linear regression analyses. RESULTS A total of 51 youth football athletes (ages, 9-13 yr) completed performance testing and received combined 13,770 head impacts measured with the Head Impact Telemetry System for a full season. All performance measures were significantly correlated with total number of impacts in a season, RWELinear-Season, and all RWE-Game metrics. The strongest relationships were between 40-yard sprint speed and all RWE-Game metrics (all P ≤ 0.0001 and partial R > 0.3). The only significant relationships among HIE metrics in practice were between shuttle run speed and total practice impacts and RWELinear-Practices, 40 yard sprint speed and total number of practice impacts, and three-cone speed and 95th percentile number of impacts/practice. CONCLUSIONS Generally, higher vertical jump height and faster times in speed and agility drills were associated with higher HIE, especially in games. Physical performance explained less variation in HIE in practices, where drills and other factors, such as coaching style, may have a larger influence on HIE.
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Affiliation(s)
| | | | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Meagan L Rosenberg
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC
| | - Christopher M Miles
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Christopher T Whitlow
- Department of Radiology (Neuroradiology), Wake Forest School of Medicine, Winston-Salem, NC
| | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern, Dallas, TX
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Shah BR, Lehman VT, Kaufmann TJ, Blezek D, Waugh J, Imphean D, Yu FF, Patel TR, Chitnis S, Dewey RB, Maldjian JA, Chopra R. Advanced MRI techniques for transcranial high intensity focused ultrasound targeting. Brain 2020; 143:2664-2672. [DOI: 10.1093/brain/awaa107] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/07/2020] [Accepted: 02/20/2020] [Indexed: 11/14/2022] Open
Abstract
Abstract
Magnetic resonance guided high intensity focused ultrasound is a novel, non-invasive, image-guided procedure that is able to ablate intracranial tissue with submillimetre precision. It is currently FDA approved for essential tremor and tremor dominant Parkinson’s disease. The aim of this update is to review the limitations of current landmark-based targeting techniques of the ventral intermediate nucleus and demonstrate the role of emerging imaging techniques that are relevant for both magnetic resonance guided high intensity focused ultrasound and deep brain stimulation. A significant limitation of standard MRI sequences is that the ventral intermediate nucleus, dentatorubrothalamic tract, and other deep brain nuclei cannot be clearly identified. This paper provides original, annotated images demarcating the ventral intermediate nucleus, dentatorubrothalamic tract, and other deep brain nuclei on advanced MRI sequences such as fast grey matter acquisition T1 inversion recovery, quantitative susceptibility mapping, susceptibility weighted imaging, and diffusion tensor imaging tractography. Additionally, the paper reviews clinical efficacy of targeting with these novel MRI techniques when compared to current established landmark-based targeting techniques. The paper has widespread applicability to both deep brain stimulation and magnetic resonance guided high intensity focused ultrasound.
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Affiliation(s)
- Bhavya R Shah
- Department of Radiology, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Neurosurgery, University of Texas Southwestern, Dallas, TX 75390, USA
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
- Advanced Imaging Research Center, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Vance T Lehman
- Department of Radiology, The Mayo Clinic, Rochester, MN 55905, USA
| | | | - Daniel Blezek
- Department of Radiology, The Mayo Clinic, Rochester, MN 55905, USA
| | - Jeff Waugh
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Pediatrics, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Neurology, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Darren Imphean
- University of Texas Southwestern Medical School, Dallas, TX 75390, USA
| | - Frank F Yu
- Department of Radiology, University of Texas Southwestern, Dallas, TX 75390, USA
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
- Advanced Imaging Research Center, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Toral R Patel
- Department of Neurosurgery, University of Texas Southwestern, Dallas, TX 75390, USA
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Shilpa Chitnis
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Neurology, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Richard B Dewey
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Neurology, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern, Dallas, TX 75390, USA
- O’Donnell Brain Institute, University of Texas Southwestern, Dallas, TX 75390, USA
- Advanced Imaging Research Center, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Rajiv Chopra
- Department of Radiology, University of Texas Southwestern, Dallas, TX 75390, USA
- Advanced Imaging Research Center, University of Texas Southwestern, Dallas, TX 75390, USA
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Bangalore Yogananda CG, Shah BR, Vejdani-Jahromi M, Nalawade SS, Murugesan GK, Yu FF, Pinho MC, Wagner BC, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. A novel fully automated MRI-based deep-learning method for classification of IDH mutation status in brain gliomas. Neuro Oncol 2020; 22:402-411. [PMID: 31637430 PMCID: PMC7442388 DOI: 10.1093/neuonc/noz199] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [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: 07/15/2019] [Accepted: 10/16/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH) mutation status has emerged as an important prognostic marker in gliomas. Currently, reliable IDH mutation determination requires invasive surgical procedures. The purpose of this study was to develop a highly accurate, MRI-based, voxelwise deep-learning IDH classification network using T2-weighted (T2w) MR images and compare its performance to a multicontrast network. METHODS Multiparametric brain MRI data and corresponding genomic information were obtained for 214 subjects (94 IDH-mutated, 120 IDH wild-type) from The Cancer Imaging Archive and The Cancer Genome Atlas. Two separate networks were developed, including a T2w image-only network (T2-net) and a multicontrast (T2w, fluid attenuated inversion recovery, and T1 postcontrast) network (TS-net) to perform IDH classification and simultaneous single label tumor segmentation. The networks were trained using 3D Dense-UNets. Three-fold cross-validation was performed to generalize the networks' performance. Receiver operating characteristic analysis was also performed. Dice scores were computed to determine tumor segmentation accuracy. RESULTS T2-net demonstrated a mean cross-validation accuracy of 97.14% ± 0.04 in predicting IDH mutation status, with a sensitivity of 0.97 ± 0.03, specificity of 0.98 ± 0.01, and an area under the curve (AUC) of 0.98 ± 0.01. TS-net achieved a mean cross-validation accuracy of 97.12% ± 0.09, with a sensitivity of 0.98 ± 0.02, specificity of 0.97 ± 0.001, and an AUC of 0.99 ± 0.01. The mean whole tumor segmentation Dice scores were 0.85 ± 0.009 for T2-net and 0.89 ± 0.006 for TS-net. CONCLUSION We demonstrate high IDH classification accuracy using only T2-weighted MR images. This represents an important milestone toward clinical translation.
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Affiliation(s)
| | - Bhavya R Shah
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Sahil S Nalawade
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gowtham K Murugesan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Frank F Yu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marco C Pinho
- 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
| | - Bruce Mickey
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Toral R Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas
| | - Ananth J Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas,Corresponding Author: Joseph A. Maldjian, MD, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390–9178 ()
| | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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Nalawade S, Murugesan GK, Vejdani-Jahromi M, Fisicaro RA, Bangalore Yogananda CG, Wagner B, Mickey B, Maher E, Pinho MC, Fei B, Madhuranthakam AJ, Maldjian JA. Classification of brain tumor isocitrate dehydrogenase status using MRI and deep learning. J Med Imaging (Bellingham) 2019; 6:046003. [PMID: 31824982 DOI: 10.1117/1.jmi.6.4.046003] [Citation(s) in RCA: 5] [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: 06/28/2019] [Accepted: 11/18/2019] [Indexed: 11/14/2022] Open
Abstract
Isocitrate dehydrogenase (IDH) mutation status is an important marker in glioma diagnosis and therapy. We propose an automated pipeline for noninvasively predicting IDH status using deep learning and T2-weighted (T2w) magnetic resonance (MR) images with minimal preprocessing (N4 bias correction and normalization to zero mean and unit variance). T2w MR images and genomic data were obtained from The Cancer Imaging Archive dataset for 260 subjects (120 high-grade and 140 low-grade gliomas). A fully automated two-dimensional densely connected model was trained to classify IDH mutation status on 208 subjects and tested on another held-out set of 52 subjects using fivefold cross validation. Data leakage was avoided by ensuring subject separation during the slice-wise randomization. Mean classification accuracy of 90.5% was achieved for each axial slice in predicting the three classes of no tumor, IDH mutated, and IDH wild type. Test accuracy of 83.8% was achieved in predicting IDH mutation status for individual subjects on the test dataset of 52 subjects. We demonstrate a deep learning method to predict IDH mutation status using T2w MRI alone. Radiologic imaging studies using deep learning methods must address data leakage (subject duplication) in the randomization process to avoid upward bias in the reported classification accuracy.
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Affiliation(s)
- Sahil Nalawade
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | - Gowtham K Murugesan
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | | | - Ryan A Fisicaro
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | | | - Ben Wagner
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | - Bruce Mickey
- UT Southwestern Medical Center, Department of Neurological Surgery, Dallas, Texas, United States
| | - Elizabeth Maher
- UT Southwestern Medical Center, Department of Neurology and Neurotherapeutics, Dallas, Texas, United States
| | - Marco C Pinho
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
| | - Baowei Fei
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States.,UT Dallas, Department of Bioengineering, Richardson, Texas, United States
| | | | - Joseph A Maldjian
- UT Southwestern Medical Center, Department of Radiology, Dallas, Texas, United States
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Dash D, Ferrari P, Malik S, Montillo A, Maldjian JA, Wang J. Determining the Optimal Number of MEG Trials: A Machine Learning and Speech Decoding Perspective. Brain Inform (2018) 2019; 11309:163-172. [PMID: 31768504 PMCID: PMC6876632 DOI: 10.1007/978-3-030-05587-5_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Advancing the knowledge about neural speech mechanisms is critical for developing next-generation, faster brain computer interface to assist in speech communication for the patients with severe neurological conditions (e.g., locked-in syndrome). Among current neuroimaging techniques, Magnetoencephalography (MEG) provides direct representation for the large-scale neural dynamics of underlying cognitive processes based on its optimal spatiotemporal resolution. However, the MEG measured neural signals are smaller in magnitude compared to the background noise and hence, MEG usually suffers from a low signal-to-noise ratio (SNR) at the single-trial level. To overcome this limitation, it is common to record many trials of the same event-task and use the time-locked average signal for analysis, which can be very time consuming. In this study, we investigated the effect of the number of MEG recording trials required for speech decoding using a machine learning algorithm. We used a wavelet filter for generating the denoised neural features to train an Artificial Neural Network (ANN) for speech decoding. We found that wavelet based denoising increased the SNR of the neural signal prior to analysis and facilitated accurate speech decoding performance using as few as 40 single-trials. This study may open up the possibility of limiting MEG trials for other task evoked studies as well.
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Affiliation(s)
- Debadatta Dash
- Department of Bioengineering, University of Texas at Dallas, Richardson, USA
| | - Paul Ferrari
- Department of Psychology, University of Texas at Austin, Austin, USA
- MEG Laboratory, Dell Children's Medical Center, Austin, USA
| | - Saleem Malik
- MEG Lab, Cook Children's Hospital, Fort Worth, TX, USA
| | - Albert Montillo
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA
- Department of Bioinformatics, UT Southwestern Medical Center, Dallas, USA
| | - Joseph A Maldjian
- Department of Radiology, UT Southwestern Medical Center, Dallas, USA
| | - Jun Wang
- Department of Bioengineering, University of Texas at Dallas, Richardson, USA
- Callier Center for Communication Disorders, University of Texas at Dallas, Richardson, USA
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Greer JS, Wang X, Wang Y, Pinho MC, Maldjian JA, Pedrosa I, Madhuranthakam AJ. Robust pCASL perfusion imaging using a 3D Cartesian acquisition with spiral profile reordering (CASPR). Magn Reson Med 2019; 82:1713-1724. [PMID: 31231894 PMCID: PMC6743738 DOI: 10.1002/mrm.27862] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 12/07/2018] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE To improve the robustness of arterial spin-labeled measured perfusion using a novel Cartesian acquisition with spiral profile reordering (CASPR) 3D turbo spin echo (TSE) in the brain and kidneys. METHODS The CASPR view ordering followed a pseudo-spiral trajectory on a Cartesian grid, by sampling the center of k-space at the beginning of each echo train of a segmented 3D TSE acquisition. With institutional review board approval and written informed consent, 14 normal subjects (9 brain and 5 kidneys) were scanned with pCASL perfusion imaging using 3D CASPR and compared against 3D linear TSE (brain and kidneys), the established 2D EPI and 3D gradient and spin echo perfusion (brain), and 2D single-shot turbo spin-echo perfusion (kidneys). The SNR and the quantitative perfusion values were compared among different acquisitions. RESULTS 3D CASPR TSE achieved robust perfusion across all slices compared to 3D linear TSE in the brain and kidneys. Compared to 2D EPI, 3D CASPR TSE showed higher SNR across the brain (P < 0.01), and exhibited good agreement (36.4 ± 4.7 and 36.9 ± 5.3 mL/100 g/min with 2D EPI and 3D CASPR, respectively), and with 3D gradient and spin echo (27.9 ± 7.2 mL/100 g/min). Compared to a single slice 2D single-shot turbo spin-echo acquisition, 3D CASPR TSE achieved robust perfusion across the entire kidneys in similar scan time with comparable quantified perfusion values (154.1 ± 74.6 and 151.7 ± 70.6 mL/100 g/min with 2D single-shot turbo spin-echo and 3D CASPR, respectively). CONCLUSION The CASPR view ordering with 3D TSE achieves robust arterial spin-labeled perfusion in the brain and kidneys because of the sampling of the center of k-space at the beginning of each echo train.
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Affiliation(s)
- Joshua S. Greer
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Xinzeng Wang
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Yiming Wang
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Marco C. Pinho
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX
| | - Joseph A. Maldjian
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX
| | - Ivan Pedrosa
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX
| | - Ananth J. Madhuranthakam
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX
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Jian X, Satizabal CL, Smith AV, Wittfeld K, Bis JC, Smith JA, Hsu FC, Nho K, Hofer E, Hagenaars SP, Nyquist PA, Mishra A, Adams HHH, Li S, Teumer A, Zhao W, Freedman BI, Saba Y, Yanek LR, Chauhan G, van Buchem MA, Cushman M, Royle NA, Bryan RN, Niessen WJ, Windham BG, DeStefano AL, Habes M, Heckbert SR, Palmer ND, Lewis CE, Eiriksdottir G, Maillard P, Mathias RA, Homuth G, Valdés-Hernández MDC, Divers J, Beiser AS, Langner S, Rice KM, Bastin ME, Yang Q, Maldjian JA, Starr JM, Sidney S, Risacher SL, Uitterlinden AG, Gudnason VG, Nauck M, Rotter JI, Schreiner PJ, Boerwinkle E, van Duijn CM, Mazoyer B, von Sarnowski B, Gottesman RF, Levy D, Sigurdsson S, Vernooij MW, Turner ST, Schmidt R, Wardlaw JM, Psaty BM, Mosley TH, DeCarli CS, Saykin AJ, Bowden DW, Becker DM, Deary IJ, Schmidt H, Kardia SLR, Ikram MA, Debette S, Grabe HJ, Longstreth WT, Seshadri S, Launer LJ, Fornage M. Exome Chip Analysis Identifies Low-Frequency and Rare Variants in MRPL38 for White Matter Hyperintensities on Brain Magnetic Resonance Imaging. Stroke 2019; 49:1812-1819. [PMID: 30002152 DOI: 10.1161/strokeaha.118.020689] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background and Purpose- White matter hyperintensities (WMH) on brain magnetic resonance imaging are typical signs of cerebral small vessel disease and may indicate various preclinical, age-related neurological disorders, such as stroke. Though WMH are highly heritable, known common variants explain a small proportion of the WMH variance. The contribution of low-frequency/rare coding variants to WMH burden has not been explored. Methods- In the discovery sample we recruited 20 719 stroke/dementia-free adults from 13 population-based cohort studies within the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, among which 17 790 were of European ancestry and 2929 of African ancestry. We genotyped these participants at ≈250 000 mostly exonic variants with Illumina HumanExome BeadChip arrays. We performed ethnicity-specific linear regression on rank-normalized WMH in each study separately, which were then combined in meta-analyses to test for association with single variants and genes aggregating the effects of putatively functional low-frequency/rare variants. We then sought replication of the top findings in 1192 adults (European ancestry) with whole exome/genome sequencing data from 2 independent studies. Results- At 17q25, we confirmed the association of multiple common variants in TRIM65, FBF1, and ACOX1 ( P<6×10-7). We also identified a novel association with 2 low-frequency nonsynonymous variants in MRPL38 (lead, rs34136221; PEA=4.5×10-8) partially independent of known common signal ( PEA(conditional)=1.4×10-3). We further identified a locus at 2q33 containing common variants in NBEAL1, CARF, and WDR12 (lead, rs2351524; Pall=1.9×10-10). Although our novel findings were not replicated because of limited power and possible differences in study design, meta-analysis of the discovery and replication samples yielded stronger association for the 2 low-frequency MRPL38 variants ( Prs34136221=2.8×10-8). Conclusions- Both common and low-frequency/rare functional variants influence WMH. Larger replication and experimental follow-up are essential to confirm our findings and uncover the biological causal mechanisms of age-related WMH.
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Affiliation(s)
- Xueqiu Jian
- From the Institute of Molecular Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (M.F., X.J.)
| | - Claudia L Satizabal
- Department of Neurology, Boston University School of Medicine, MA (C.L.S., S. Seshadri)
| | - Albert V Smith
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases, Site Rostock/Greifswald, Germany (K.W.)
| | - Joshua C Bis
- Cardiovascular Health Research Unit (B.M.P., J.C.B., S.R.H.)
| | - Jennifer A Smith
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (J.A.S., S.L.R.K., W.Z.)
| | - Fang-Chi Hsu
- Division of Public Health Sciences (F.-C.H., J.D.)
| | - Kwangsik Nho
- Center for Neuroimaging, Indiana University School of Medicine, Indianapolis (K.N., S.L.R.)
| | | | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Paul A Nyquist
- Department of Neurology and Neurosurgery (P.A.N., R.F.G.)
| | - Aniket Mishra
- Bordeaux Population Health Research Centre U1219, Inserm, France (A.M., G.C., S.D.)
| | | | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | | | - Wei Zhao
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (J.A.S., S.L.R.K., W.Z.)
| | | | - Yasaman Saba
- Institute of Molecular Biology and Biochemistry (H.S., Y.S.), Medical University of Graz, Austria
| | - Lisa R Yanek
- Department of Medicine (D.M.B., L.R.Y., R.A.M.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Ganesh Chauhan
- Bordeaux Population Health Research Centre U1219, Inserm, France (A.M., G.C., S.D.)
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, the Netherlands (M.A.v.B.)
| | - Mary Cushman
- Department of Medicine, The University of Vermont Larner College of Medicine, Burlington (M.C.)
| | - Natalie A Royle
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - R Nick Bryan
- Department of Diagnostic Medicine, Dell Medical School at The University of Texas at Austin (R.N.B.)
| | - Wiro J Niessen
- Departments of Radiology and Medical Informatics (W.J.N.).,Department of Medicine, The University of Mississippi School of Medicine, Jackson (W.J.N.)
| | | | - Anita L DeStefano
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | - Mohamad Habes
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia (M.H.)
| | | | - Nicholette D Palmer
- Department of Biochemistry (D.W.B., N.D.P.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Cora E Lewis
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health (C.E.L.)
| | - Gudny Eiriksdottir
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | - Pauline Maillard
- Department of Neurology, UC Davis School of Medicine (C.S.D., P.M.), CA
| | - Rasika A Mathias
- Department of Medicine (D.M.B., L.R.Y., R.A.M.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Georg Homuth
- Institute of Genetics and Functional Genomics, University of Greifswald, Germany (G.H.)
| | - Maria Del C Valdés-Hernández
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | | | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology (S.L.)
| | - Kenneth M Rice
- Department of Biostatistics, University of Washington School of Public Health, Seattle (K.M.R.)
| | - Mark E Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | - Joseph A Maldjian
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas (J.A.M.)
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland (S. Sidney)
| | - Shannon L Risacher
- Center for Neuroimaging, Indiana University School of Medicine, Indianapolis (K.N., S.L.R.)
| | | | - Vilmundur G Gudnason
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | - Matthias Nauck
- Institute for Clinical Chemistry and Laboratory Medicine (M.N.)
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, CA (J.I.R.)
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis (P.J.S.)
| | - Eric Boerwinkle
- Human Genetics Center, The University of Texas Health Science Center at Houston School of Public Health (E.B.)
| | | | - Bernard Mazoyer
- Neurodegeneratives Diseases Institute-CNRS UMR 5293 (B.M.), University of Bordeaux, France
| | | | | | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (D.L.)
| | - Sigurdur Sigurdsson
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | | | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (S.T.T.)
| | | | - Joanna M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Bruce M Psaty
- Cardiovascular Health Research Unit (B.M.P., J.C.B., S.R.H.)
| | | | - Charles S DeCarli
- Department of Neurology, UC Davis School of Medicine (C.S.D., P.M.), CA
| | | | - Donald W Bowden
- Department of Biochemistry (D.W.B., N.D.P.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Diane M Becker
- Department of Medicine (D.M.B., L.R.Y., R.A.M.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Helena Schmidt
- Institute of Molecular Biology and Biochemistry (H.S., Y.S.), Medical University of Graz, Austria
| | - Sharon L R Kardia
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (J.A.S., S.L.R.K., W.Z.)
| | - M Arfan Ikram
- Departments of Epidemiology, Radiology and Neurology (M.A.I.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Debette
- Bordeaux Population Health Research Centre U1219, Inserm, France (A.M., G.C., S.D.)
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy (H.J.G.), University Medicine Greifswald, Germany
| | - W T Longstreth
- Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle, WA
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, MA (C.L.S., S. Seshadri)
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Myriam Fornage
- From the Institute of Molecular Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (M.F., X.J.)
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Urban JE, Flood WC, Zimmerman BJ, Kelley ME, Espeland MA, McNamara L, Davenport EM, Powers AK, Whitlow CT, Maldjian JA, Stitzel JD. Evaluation of head impact exposure measured from youth football game plays. J Neurosurg Pediatr 2019; 24:190-199. [PMID: 31075762 PMCID: PMC10958456 DOI: 10.3171/2019.2.peds18558] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/19/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE There is a growing body of literature informing efforts to improve the safety of football; however, research relating on-field activity to head impacts in youth football is limited. Therefore, the objective of this study was to compare head impact exposure (HIE) measured in game plays among 3 youth football teams. METHODS Head impact and video data were collected from athletes (ages 10-13 years) participating on 3 youth football teams. Video analysis was performed to verify head impacts and assign each to a specific play type. Each play was categorized as a down, punt, kickoff, field goal, or false start. Kickoffs and punts were classified as special teams. Downs were classified as running, passing, or other. HIE was quantified by play type in terms of mean, median, and 95th percentile linear and rotational acceleration. Mixed-effects models were used to assess differences in acceleration among play types. Contact occurring on special teams plays was evaluated using a standardized video abstraction form. RESULTS A total of 3003 head impacts over 27.5 games were analyzed and paired with detailed video coding of plays. Most head impacts were attributed to running (79.6%), followed by passing (14.0%), and special teams (6.4%) plays. The 95th percentile linear acceleration measured during each play type was 52.6g, 50.7g, and 65.5g, respectively. Special teams had significantly greater mean linear acceleration than running and passing plays (both p = 0.03). The most common kick result on special teams was a deep kick, of which 85% were attempted to be returned. No special teams plays resulted in a touchback, and one resulted in a fair catch. One-third of all special teams plays and 92% of all nonreturned kicks resulted in athletes diving toward the ball. CONCLUSIONS The results demonstrate a trend toward higher head impact magnitudes on special teams than for running and passing plays, but a greater number of impacts were measured during running plays. Deep kicks were most common on special teams, and many returned and nonreturned kicks resulted in athletes diving toward the ball. These results support policy changes to youth special teams plays, including modifying the yard line the ball is kicked from and coaching proper return technique. Further investigation into biomechanical exposure measured during game impact scenarios is needed to inform policy relevant to the youth level.
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Affiliation(s)
- Jillian E. Urban
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem
- Department of Biomedical Engineering, Winston-Salem, North Carolina
| | - William C. Flood
- Department of Radiology (Neuroradiology), Winston-Salem, North Carolina
| | | | - Mireille E. Kelley
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem
- Department of Biomedical Engineering, Winston-Salem, North Carolina
| | - Mark A. Espeland
- Department of Biostatistical Sciences, Winston-Salem, North Carolina
| | - Liam McNamara
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem
- Department of Biomedical Engineering, Winston-Salem, North Carolina
| | | | | | - Christopher T. Whitlow
- Department of Radiology (Neuroradiology), Winston-Salem, North Carolina
- Department of Clinical and Translational Sciences Institute, Winston-Salem, North Carolina
| | - Joseph A. Maldjian
- Department of Radiology, University of Texas Southwestern, Dallas, Texas
| | - Joel D. Stitzel
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem
- Department of Biomedical Engineering, Winston-Salem, North Carolina
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Miller LE, Urban JE, Kelley ME, Powers AK, Whitlow CT, Maldjian JA, Rowson S, Stitzel JD. Evaluation of Brain Response during Head Impact in Youth Athletes Using an Anatomically Accurate Finite Element Model. J Neurotrauma 2019; 36:1561-1570. [PMID: 30489208 DOI: 10.1089/neu.2018.6037] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
During normal participation in football, players are exposed to repetitive subconcussive head impacts, or impacts that do not result in signs and symptoms of concussion. To better understand the effects of repetitive subconcussive impacts, the biomechanics of on-field head impacts and resulting brain deformation need to be well characterized. The current study evaluates local brain response to typical youth football head impacts using the atlas-based brain model (ABM), an anatomically accurate brain finite element (FE) model. Head impact kinematic data were collected from three local youth football teams using the Head Impact Telemetry (HIT) System. The azimuth and elevation angles were used to identify impacts near six locations of interest, and low, moderate, and high acceleration magnitudes (5th, 50th, and 95th percentiles, respectively) were calculated from the grouped impacts for FE simulation. Strain response in the brain was evaluated by examining the range and peak maximum principal strain (MPS) values in each element. A total of 40,538 impacts from 119 individual athletes were analyzed. Impacts to the facemask resulted in 0.18 MPS for the high magnitude impact category. This was 1.5 times greater than the oblique impact location, which resulted in the lowest strain value of 0.12 for high magnitude impacts. Overall, higher strains resulted from a 95th percentile lateral impact (41.0g, 2556 rad/sec2) with two predominant axes of rotation than from a 95th percentile frontal impact (67.6g, 2641 rad/sec2) with a single predominant axis of rotation. These findings highlight the importance of accounting for directional dependence and relative contribution of axes of rotation when evaluating head impact response.
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Affiliation(s)
- Logan E Miller
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jillian E Urban
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mireille E Kelley
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alexander K Powers
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Christopher T Whitlow
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A Maldjian
- 2 Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Steven Rowson
- 3 Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia
| | - Joel D Stitzel
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Kelley ME, Espeland MA, Flood WC, Powers AK, Whitlow CT, Maldjian JA, Stitzel JD, Urban JE. Comparison of head impact exposure in practice drills among multiple youth football teams. J Neurosurg Pediatr 2018; 23:381-389. [PMID: 30579266 DOI: 10.3171/2018.9.peds18314] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/26/2018] [Indexed: 11/06/2022]
Abstract
Objective Limiting contact in football practice can reduce the number of head impacts a player receives, but further research is needed to inform the modification of optimal drills that mitigate head impact exposure (HIE) while the player develops the skills needed to safely play the game. This study aimed to compare HIE in practice drills among 6 youth football teams and to evaluate the effect of a team on HIE. Methods On-field head impact data were collected from athletes (ages 10–13 years) playing on 6 local youth football teams (teams A–F) during all practices using the Head Impact Telemetry System. Video was recorded and analyzed to verify and assign impacts to a specific drill. Drills were identified as follows: dummy/sled tackling, half install, install, install walk through, multiplayer tackle, Oklahoma, one-on-one, open field tackling, other, passing, position skill work, scrimmage, special teams, tackling drill stations, and technique. HIE was quantified in terms of impacts per player per minute (ppm) and peak linear and rotational head acceleration. Generalized linear models were used to assess differences in head impact magnitude and frequency among drills as well as among teams within the most common drills. Results Among 67 athlete-seasons, a total of 14,718 impacts during contact practices were collected and evaluated in this study. Among all 6 teams, the mean linear (p < 0.0001) and rotational (p < 0.0001) acceleration varied significantly among all drills. Open field tackling had significantly (p < 0.001) higher mean linear acceleration than all other drills. Multiplayer tackle had the highest mean impact rate (0.35 ppm). Significant variations in linear acceleration and impact rate were observed among teams within specific drills. Team A had the highest mean linear acceleration in install, one-on-one, and open field tackling and the highest mean impact rate in Oklahoma and position skill work. Although team A spent the greatest proportion of their practice on minimal- or no-player versus player contact drills (27%) compared to other teams, they had the highest median (20.2g) and 95th percentile (56.4g) linear acceleration in practice. Conclusions Full-speed tackling and blocking drills resulted in the highest HIE. Reducing time spent on contact drills relative to minimal or no contact drills may not lower overall HIE. Instead, interventions such as reducing the speed of players engaged in contact, correcting tackling technique, and progressing to contact may reduce HIE more effectively.
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Affiliation(s)
- Mireille E Kelley
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences
- Departments of Biomedical Engineering
| | | | - William C Flood
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences
- Departments of Biomedical Engineering
| | | | - Christopher T Whitlow
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences
- Radiology (Neuroradiology); and
- Clinical and Translational Sciences Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina; and
| | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern, Dallas, Texas
| | - Joel D Stitzel
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences
- Departments of Biomedical Engineering
| | - Jillian E Urban
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences
- Departments of Biomedical Engineering
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Mahapatra G, Smith SC, Hughes TM, Wagner B, Maldjian JA, Freedman BI, Molina AJA. Blood-based bioenergetic profiling is related to differences in brain morphology in African Americans with Type 2 diabetes. Clin Sci (Lond) 2018; 132:2509-2518. [PMID: 30401689 PMCID: PMC6512318 DOI: 10.1042/cs20180690] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/18/2018] [Accepted: 11/05/2018] [Indexed: 02/07/2023]
Abstract
Blood-based bioenergetic profiling has promising applications as a minimally invasive biomarker of systemic bioenergetic capacity. In the present study, we examined peripheral blood mononuclear cell (PBMC) mitochondrial function and brain morphology in a cohort of African Americans with long-standing Type 2 diabetes. Key parameters of PBMC respiration were correlated with white matter, gray matter, and total intracranial volumes. Our analyses indicate that these relationships are primarily driven by the relationship of systemic bioenergetic capacity with total intracranial volume, suggesting that systemic differences in mitochondrial function may play a role in overall brain morphology.
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Affiliation(s)
- Gargi Mahapatra
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, U.S.A
| | - S Carrie Smith
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, U.S.A
| | - Benjamin Wagner
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, U.S.A
| | - Joseph A Maldjian
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, U.S.A
| | - Barry I Freedman
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A
| | - Anthony J A Molina
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, U.S.A.
- Department of Medicine, Division of Geriatrics and Gerontology, University of California San Diego School of Medicine, La Jolla, CA 92093, U.S.A
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Hughes TM, Sink KM, Williamson JD, Hugenschmidt CE, Wagner BC, Whitlow CT, Xu J, Smith SC, Launer LJ, Barzilay JI, Ismail-Beigi F, Bryan RN, Hsu FC, Bowden DW, Maldjian JA, Divers J, Freedman BI. Relationships between cerebral structure and cognitive function in African Americans with type 2 diabetes. J Diabetes Complications 2018; 32:916-921. [PMID: 30042057 PMCID: PMC6138531 DOI: 10.1016/j.jdiacomp.2018.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Relationships between cognitive function and brain structure remain poorly defined in African Americans with type 2 diabetes. METHODS Cognitive testing and cerebral magnetic resonance imaging in African Americans from the Diabetes Heart Study Memory IN Diabetes (n = 480) and Action to Control Cardiovascular Risk in Diabetes MIND (n = 104) studies were examined for associations. Cerebral gray matter volume (GMV), white matter volume (WMV) and white matter lesion volume (WMLV) and cognitive performance (Mini-mental State Exam [MMSE and 3MSE], Digit Symbol Coding (DSC), Stroop test, and Rey Auditory Verbal Learning Test) were recorded. Multivariable models adjusted for age, sex, BMI, scanner, intracranial volume, education, diabetes duration, HbA1c, LDL-cholesterol, smoking, hypertension and cardiovascular disease assessed associations between cognitive tests and brain volumes by study and meta-analysis. RESULTS Mean(SD) participant age was 60.1(7.9) years, diabetes duration 12.1(7.7) years, and HbA1c 8.3(1.7)%. In the fully-adjusted meta-analysis, lower GMV associated with poorer global performance on MMSE/3MSE (β̂ = 7.1 × 10-3, SE 2.4 × 10-3, p = 3.6 × 10-3), higher WMLV associated with poorer performance on DSC (β̂ = -3 × 10-2, SE 6.4 × 10-3, p = 5.2 × 10-5) and higher WMV associated with poorer MMSE/3MSE performance (β̂ = -7.1 × 10-3, SE = 2.4 × 10-3, p = 3.6 × 10-3). CONCLUSIONS In African Americans with diabetes, smaller GMV and increased WMLV associated with poorer performance on tests of global cognitive and executive function. These data suggest that WML burden and gray matter atrophy associate with cognitive performance independent of diabetes-related factors in this population.
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Affiliation(s)
- Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Kaycee M Sink
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeff D Williamson
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Benjamin C Wagner
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | | | - Jianzhao Xu
- Departments of Biochemistry & Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - S Carrie Smith
- Departments of Biochemistry & Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Lenore J Launer
- National Institutes of Health, National Institute on Aging, Laboratory of Epidemiology, Demography, and Biometry, Bethesda, MD, USA.
| | | | - Faramarz Ismail-Beigi
- Department of Internal Medicine, Division of Endocrinology, University of Cincinnati, Veterans Administration Medical Center, Cincinnati, OH.
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
| | - Fang-Chi Hsu
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Donald W Bowden
- Departments of Biochemistry & Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Joseph A Maldjian
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Jasmin Divers
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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41
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Urban JE, Kelley ME, Espeland MA, Davenport EM, Whitlow CT, Powers AK, Maldjian JA, Stitzel JD. In-Season Variations in Head Impact Exposure among Youth Football Players. J Neurotrauma 2018; 36:275-281. [PMID: 29921164 DOI: 10.1089/neu.2018.5699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Head impact exposure (HIE) is often summarized by the total exposure measured during the season and does not indicate how the exposure was accumulated, or how it varied during the season. Therefore, the objective of this study was to compare HIE during pre-season, the first and second halves of the regular season, and playoffs in a sample of youth football players (n = 119, aged 9-13 years). Athletes were divided into one of four exposure groups based on quartiles computed from the distribution of risk-weighted cumulative exposure (RWECP). Mean impacts per session and mean 95th percentile linear and rotational acceleration in practices and games were compared across the four exposure groups and time frames using mixed effects models. Within games, the mean 95th percentile accelerations for the entire sample ranged from 47.2g and 2331.3 rad/sec2 during pre-season to 52.1g and 2533.4 rad/sec2 during the second half of regular season. Mean impacts per practice increased from pre-season to the second half of regular season and declined into playoffs among all exposure groups; however, the variation between time frames was not greater than two impacts per practice. Time of season had a significant relationship with mean 95th percentile linear and rotational acceleration in games (both, p = 0.01) but not with practice accelerations or impacts per session. The in-practice mean levels of 95th percentile linear and rotational acceleration remained fairly constant across the four time frames, but in games these changed over time depending on exposure group (interactions, p ≤ 0.05). The results of this study improve our understanding of in-season variations in HIE in youth football and may inform important opportunities for future interventions.
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Affiliation(s)
- Jillian E Urban
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,2 Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina
| | - Mireille E Kelley
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,2 Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina
| | - Mark A Espeland
- 3 Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Christopher T Whitlow
- 2 Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina.,5 Department of Radiology (Neuroradiology), Wake Forest School of Medicine, Winston-Salem, North Carolina.,6 Clinical and Translational Sciences Institute, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alexander K Powers
- 7 Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A Maldjian
- 4 University of Texas Southwestern, Department of Radiology, Dallas, Texas
| | - Joel D Stitzel
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina.,2 Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Winston-Salem, North Carolina
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42
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Waugh CE, Shing EZ, Avery BM, Jung Y, Whitlow CT, Maldjian JA. Neural predictors of emotional inertia in daily life. Soc Cogn Affect Neurosci 2018; 12:1448-1459. [PMID: 28992272 PMCID: PMC5629827 DOI: 10.1093/scan/nsx071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 05/27/2016] [Accepted: 05/23/2017] [Indexed: 11/13/2022] Open
Abstract
Assessing emotional dynamics in the brain offers insight into the fundamental neural and psychological mechanisms underlying emotion. One such dynamic is emotional inertia-the influence of one's emotional state at one time point on one's emotional state at a subsequent time point. Emotion inertia reflects emotional rigidity and poor emotion regulation as evidenced by its relationship to depression and neuroticism. In this study, we assessed changes in cerebral blood flow (CBF) from before to after an emotional task and used these changes to predict stress, positive and negative emotional inertia in daily life events. Cerebral blood flow changes in the lateral prefrontal cortex (lPFC) predicted decreased non-specific emotional inertia, suggesting that the lPFC may feature a general inhibitory mechanism responsible for limiting the impact that an emotional state from one event has on the emotional state of a subsequent event. CBF changes in the ventromedial prefrontal cortex and lateral occipital cortex were associated with positive emotional inertia and negative/stress inertia, respectively. These data advance the blossoming literature on the temporal dynamics of emotion in the brain and on the use of neural indices to predict mental health-relevant behavior in daily life.
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Affiliation(s)
- Christian E Waugh
- Department of Psychology, Wake Forest University, Winston Salem, NC, USA
| | - Elaine Z Shing
- Department of Neuroscience, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Bradley M Avery
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Youngkyoo Jung
- Department of Radiology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | | | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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43
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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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44
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Hsu FC, Sink KM, Hugenschmidt CE, Williamson JD, Hughes TM, Palmer ND, Xu J, Smith SC, Wagner BC, Whitlow CT, Bowden DW, Maldjian JA, Divers J, Freedman BI. Cerebral Structure and Cognitive Performance in African Americans and European Americans With Type 2 Diabetes. J Gerontol A Biol Sci Med Sci 2018; 73:407-414. [PMID: 29309525 PMCID: PMC5861881 DOI: 10.1093/gerona/glx255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 06/20/2017] [Accepted: 12/28/2017] [Indexed: 11/13/2022] Open
Abstract
Background African Americans typically perform worse than European Americans on cognitive testing. Contributions of cardiovascular disease (CVD) risk factors and educational quality to cognitive performance and brain volumes were compared in European Americans and African Americans with type 2 diabetes. Methods Association between magnetic resonance imaging-determined cerebral volumes of white matter (WMV), gray matter (GMV), white matter lesions (WMLV), hippocampal GMV, and modified mini-mental state exam (3MSE), digit symbol coding (DSC), Rey Auditory Verbal Learning Test (RAVLT), Stroop, and verbal fluency performance were assessed in Diabetes Heart Study Memory in Diabetes (MIND) participants. Marginal models incorporating generalized estimating equations were employed with serial adjustment for risk factors. Results The sample included 520 African Americans and 684 European Americans; 56 per cent female with mean ± SD age 62.8 ± 10.3 years and diabetes duration 14.3 ± 7.8 years. Adjusting for age, sex, diabetes duration, BMI, HbA1c, total intracranial volume, scanner, statins, CVD, smoking, and hypertension, WMV (p = .001) was lower and WMLV higher in African Americans than European Americans (p = .001), with similar GMV (p = .30). Adjusting for age, sex, education, HbA1c, diabetes duration, hypertension, BMI, statins, CVD, smoking, and depression, poorer performance on 3MSE, RAVLT, and DSC were seen in African Americans (p = 6 × 10-23-7 × 10-62). Racial differences in cognitive performance were attenuated after additional adjustment for WMLV and nearly fully resolved after adjustment for wide-range achievement test (WRAT) performance (p = .0009-.65). Conclusions African Americans with type 2 diabetes had higher WMLV and poorer cognitive performance than European Americans. Differences in cognitive performance were attenuated after considering WMLV and apparent poorer educational quality based on WRAT.
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Affiliation(s)
- Fang-Chi Hsu
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kaycee M Sink
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jeff D Williamson
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nicholette D Palmer
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jianzhao Xu
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - S Carrie Smith
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Benjamin C Wagner
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory; University of Texas Southwestern Medical Center, Dallas, Texas
| | - Christopher T Whitlow
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Donald W Bowden
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A Maldjian
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory; University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jasmin Divers
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Barry I Freedman
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Centers for Genomics and Personalized Medicine Research and Diabetes Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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45
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Maldjian JA. Football and the Brain: Does Career Duration Provide Protective Effects? Radiology 2018; 286:978-980. [PMID: 29461951 DOI: 10.1148/radiol.2018172614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Joseph A Maldjian
- From the Advanced Neuroscience Imaging Research (ANSIR) Laboratory and Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9178
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46
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Abstract
Traumatic brain injury (TBI) is an important public health issue. TBI includes a broad spectrum of injury severities and abnormalities. Functional MR imaging (fMR imaging), both resting state (rs) and task, has been used often in research to study the effects of TBI. Although rs-fMR imaging is not currently applicable in clinical diagnosis of TBI, computer-aided tools are making this a possibility for the future. Specifically, graph theory is being used to study the change in networks after TBI. Machine learning methods allow researchers to build models capable of predicting injury severity and recovery trajectories.
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Affiliation(s)
- Thomas J O'Neill
- Radiology, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Elizabeth M Davenport
- Radiology, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Gowtham Murugesan
- Radiology, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Albert Montillo
- Radiology, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Joseph A Maldjian
- Radiology, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
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47
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Freedman BI, Sink KM, Hugenschmidt CE, Hughes TM, Williamson JD, Whitlow CT, Palmer ND, Miller ME, Lovato LC, Xu J, Smith SC, Launer LJ, Barzilay JI, Cohen RM, Sullivan MD, Bryan RN, Wagner BC, Bowden DW, Maldjian JA, Divers J. Associations of Early Kidney Disease With Brain Magnetic Resonance Imaging and Cognitive Function in African Americans With Type 2 Diabetes Mellitus. Am J Kidney Dis 2017. [PMID: 28648301 DOI: 10.1053/j.ajkd.2017.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Relationships between early kidney disease, neurocognitive function, and brain anatomy are poorly defined in African Americans with type 2 diabetes mellitus (T2DM). STUDY DESIGN Cross-sectional associations were assessed between cerebral anatomy and cognitive performance with estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) in African Americans with T2DM. SETTING & PARTICIPANTS African Americans with cognitive testing and cerebral magnetic resonance imaging (MRI) in the African American-Diabetes Heart Study Memory in Diabetes (AA-DHS MIND; n=512; 480 with MRI) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) MIND (n=484; 104 with MRI) studies. PREDICTORS eGFR (CKD-EPI creatinine equation), spot UACR. MEASUREMENTS MRI-based cerebral white matter volume (WMV), gray matter volume (GMV), and white matter lesion volume; cognitive performance (Mini-Mental State Examination, Digit Symbol Coding, Stroop Test, and Rey Auditory Verbal Learning Test). Multivariable models adjusted for age, sex, body mass index, scanner, intracranial volume, education, diabetes duration, hemoglobin A1c concentration, low-density lipoprotein cholesterol concentration, smoking, hypertension, and cardiovascular disease were used to test for associations between kidney phenotypes and the brain in each study; a meta-analysis was performed. RESULTS Mean participant age was 60.1±7.9 (SD) years; diabetes duration, 12.1±7.7 years; hemoglobin A1c concentration, 8.3%±1.7%; eGFR, 88.7±21.6mL/min/1.73m2; and UACR, 119.2±336.4mg/g. In the fully adjusted meta-analysis, higher GMV associated with lower UACR (P<0.05), with a trend toward association with higher eGFR. Higher white matter lesion volume was associated with higher UACR (P<0.05) and lower eGFR (P<0.001). WMV was not associated with either kidney parameter. Higher UACR was associated with lower Digit Symbol Coding performance (P<0.001) and a trend toward association with higher Stroop interference; eGFR was not associated with cognitive tests. LIMITATIONS Cross-sectional; single UACR measurement. CONCLUSIONS In African Americans with T2DM, mildly high UACR and mildly low eGFR were associated with smaller GMV and increased white matter lesion volume. UACR was associated with poorer processing speed and working memory.
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Affiliation(s)
- Barry I Freedman
- Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
| | - Kaycee M Sink
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Christina E Hugenschmidt
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Timothy M Hughes
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jeff D Williamson
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Nicholette D Palmer
- Department of Biochemistry and Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Michael E Miller
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Laura C Lovato
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jianzhao Xu
- Department of Biochemistry and Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - S Carrie Smith
- Department of Biochemistry and Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lenore J Launer
- National Institute on Aging, Laboratory of Epidemiology, Demography, and Biometry, National Institutes of Health, Bethesda, MD
| | | | - Robert M Cohen
- Division of Endocrinology, Department of Internal Medicine, University of Cincinnati, Veterans Administration Medical Center, Cincinnati, OH
| | - Mark D Sullivan
- Department of Psychiatry, University of Washington, Seattle, WA; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Benjamin C Wagner
- Advanced Neuroscience Imaging Research (ANSIR) Laboratory, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Donald W Bowden
- Department of Biochemistry and Center for Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Joseph A Maldjian
- Advanced Neuroscience Imaging Research (ANSIR) Laboratory, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jasmin Divers
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
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Kelley ME, Urban JE, Miller LE, Jones DA, Espeland MA, Davenport EM, Whitlow CT, Maldjian JA, Stitzel JD. Head Impact Exposure in Youth Football: Comparing Age- and Weight-Based Levels of Play. J Neurotrauma 2017; 34:1939-1947. [PMID: 28274184 DOI: 10.1089/neu.2016.4812] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Approximately 5,000,000 athletes play organized football in the United States, and youth athletes constitute the largest proportion with ∼3,500,000 participants. Investigations of head impact exposure (HIE) in youth football have been limited in size and duration. The objective of this study was to evaluate HIE of athletes participating in three age- and weight-based levels of play within a single youth football organization over four seasons. Head impact data were collected using the Head Impact Telemetry (HIT) System. Mixed effects linear models were fitted, and Wald tests were used to assess differences in head accelerations and number of impacts among levels and session type (competitions vs. practices). The three levels studied were levels A (n = 39, age = 10.8 ± 0.7 years, weight = 97.5 ± 11.8 lb), B (n = 48, age = 11.9 ± 0.5 years, weight = 106.1 ± 13.8 lb), and C (n = 32, age = 13.0 ± 0.5 years, weight = 126.5 ± 18.6 lb). A total of 40,538 head impacts were measured. The median/95th percentile linear head acceleration for levels A, B, and C was 19.8/49.4g, 20.6/51.0g, and 22.0/57.9g, respectively. Level C had significantly greater mean linear acceleration than both levels A (p = 0.005) and B (p = 0.02). There were a significantly greater number of impacts per player in a competition than in a practice session for all levels (A, p = 0.0005, B, p = 0.0019, and C, p < 0.0001). Athletes at lower levels experienced a greater percentage of their high magnitude impacts (≥ 80g) in practice, whereas those at the highest level experienced a greater percentage of their high magnitude impacts in competition. These data improve our understanding of HIE within youth football and are an important step in making evidence-based decisions to reduce HIE.
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Affiliation(s)
- Mireille E Kelley
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine , Winston-Salem, North Carolina.,2 Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences , Winston-Salem, North Carolina
| | - Jillian E Urban
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine , Winston-Salem, North Carolina.,2 Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences , Winston-Salem, North Carolina
| | - Logan E Miller
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine , Winston-Salem, North Carolina.,2 Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences , Winston-Salem, North Carolina
| | - Derek A Jones
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine , Winston-Salem, North Carolina.,2 Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences , Winston-Salem, North Carolina
| | - Mark A Espeland
- 3 Department of Biostatistical Sciences, Wake Forest School of Medicine , Winston-Salem, North Carolina
| | | | - Christopher T Whitlow
- 2 Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences , Winston-Salem, North Carolina.,5 Department of Radiology (Neuroradiology), Wake Forest School of Medicine , Winston-Salem, North Carolina.,6 Clinical and Translational Sciences Institute , Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A Maldjian
- 4 Department of Radiology, University of Texas Southwestern , Dallas, Texas
| | - Joel D Stitzel
- 1 Department of Biomedical Engineering, Wake Forest School of Medicine , Winston-Salem, North Carolina.,2 Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences , Winston-Salem, North Carolina
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Palmer Allred ND, Raffield LM, Hardy JC, Hsu FC, Divers J, Xu J, Smith SC, Hugenschmidt CE, Wagner BC, Whitlow CT, Sink KM, Maldjian JA, Williamson JD, Bowden DW, Freedman BI. APOE Genotypes Associate With Cognitive Performance but Not Cerebral Structure: Diabetes Heart Study MIND. Diabetes Care 2016; 39:2225-2231. [PMID: 27703028 PMCID: PMC5127235 DOI: 10.2337/dc16-0843] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 04/18/2016] [Accepted: 09/07/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Dementia is a debilitating illness with a disproportionate burden in patients with type 2 diabetes (T2D). Among the contributors, genetic variation at the apolipoprotein E locus (APOE) is posited to convey a strong effect. This study compared and contrasted the association of APOE with cognitive performance and cerebral structure in the setting of T2D. RESEARCH DESIGN AND METHODS European Americans from the Diabetes Heart Study (DHS) MIND (n = 754) and African Americans from the African American (AA)-DHS MIND (n = 517) were examined. The cognitive battery assessed executive function, memory, and global cognition, and brain MRI was performed. RESULTS In European Americans and African Americans, the APOE E4 risk haplotype group was associated with poorer performance on the modified Mini-Mental Status Examination (P < 0.017), a measure of global cognition. In contrast to the literature, the APOE E2 haplotype group, which was overrepresented in these participants with T2D, was associated with poorer Rey Auditory Verbal Learning Test performance (P < 0.032). Nominal associations between APOE haplotype groups and MRI-determined cerebral structure were observed. CONCLUSIONS Compared with APOE E3 carriers, E2 and E4 carriers performed worse in the cognitive domains of memory and global cognition. Identification of genetic contributors remains critical to understanding new pathways to prevent and treat dementia in the setting of T2D.
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Affiliation(s)
- Nicholette D Palmer Allred
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC .,Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Laura M Raffield
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC.,Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC
| | - Joycelyn C Hardy
- Department of Biological Sciences, Clemson University, Clemson, SC
| | - Fang-Chi Hsu
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jasmin Divers
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jianzhao Xu
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - S Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC
| | - Christina E Hugenschmidt
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Benjamin C Wagner
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Kaycee M Sink
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Joseph A Maldjian
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jeff D Williamson
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC.,Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC
| | - Barry I Freedman
- Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
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50
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Hsu FC, Yuan M, Bowden DW, Xu J, Smith SC, Wagenknecht LE, Langefeld CD, Divers J, Register TC, Carr JJ, Williamson JD, Sink KM, Maldjian JA, Freedman BI. Adiposity is inversely associated with hippocampal volume in African Americans and European Americans with diabetes. J Diabetes Complications 2016; 30:1506-1512. [PMID: 27615667 PMCID: PMC5050135 DOI: 10.1016/j.jdiacomp.2016.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/08/2016] [Accepted: 08/11/2016] [Indexed: 11/29/2022]
Abstract
AIMS To assess associations between body mass index (BMI), waist circumference (WC), and computed tomography-determined volumes of pericardial, visceral, and subcutaneous adipose tissue with magnetic resonance imaging-(MRI) based cerebral structure and cognitive performance in individuals with type 2 diabetes (T2D). METHODS This study was performed in 348 African Americans (AAs) and 256 European Americans (EAs) with T2D. Associations between adiposity measures with cerebral volumes of white matter (WMV), gray matter (GMV), white matter lesions, hippocampal GMV, and hippocampal WMV, cognitive performance and depression were examined using marginal models incorporating generalized estimating equations. All models were adjusted for age, sex, education, smoking, HbA1c, hypertension, statins, cardiovascular disease, MRI scanner (MRI outcomes only), and time between scans; some neuroimaging measures were additionally adjusted for intracranial volume. RESULTS Participants were 59.9% female with mean (SD) age 57.7(9.3)years, diabetes duration 9.6(6.8)years, and HbA1c 7.8(1.9)%. In AAs, inverse associations were detected between hippocampal GMV and both BMI (β [95% CI]-0.18 [-0.30, -0.07], P=0.0018) and WC (-0.23 [-0.35, -0.12], P=0.0001). In the full bi-ethnic sample, inverse associations were detected between hippocampal WMV and WC (P≤0.0001). Positive relationships were observed between BMI (P=0.0007) and WC (P<0.0001) with depression in EAs. CONCLUSIONS In patients with T2D, adiposity is inversely associated with hippocampal gray and white matter volumes.
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Affiliation(s)
- Fang-Chi Hsu
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mingxia Yuan
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Donald W Bowden
- Centers for Genomics and Personalized Medicine Research & Diabetes Research, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jianzhao Xu
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - S Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lynne E Wagenknecht
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Carl D Langefeld
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jasmin Divers
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Thomas C Register
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeff D Williamson
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kaycee M Sink
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Joseph A Maldjian
- Department of Radiology, Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Barry I Freedman
- Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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