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Stocker D, King MJ, Homsi ME, Gnerre J, Marinelli B, Wurnig M, Schwartz M, Kim E, Taouli B. Early post-treatment MRI predicts long-term hepatocellular carcinoma response to radiation segmentectomy. Eur Radiol 2024; 34:475-484. [PMID: 37540318 PMCID: PMC10791774 DOI: 10.1007/s00330-023-10045-z] [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] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/29/2023] [Accepted: 06/20/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Radiation segmentectomy using yttrium-90 plays an emerging role in the management of early-stage HCC. However, the value of early post-treatment MRI for response assessment is uncertain. We assessed the value of response criteria obtained early after radiation segmentectomy in predicting long-term response in patients with HCC. MATERIALS AND METHODS Patients with HCC who underwent contrast-enhanced MRI before, early, and 12 months after radiation segmentectomy were included in this retrospective single-center study. Three independent radiologists reviewed images at baseline and 1st follow-up after radiation segmentectomy and assessed lesion-based response according to mRECIST, LI-RADS treatment response algorithm (TRA), and image subtraction. The endpoint was response at 12 months based on consensus readout of two separate radiologists. Diagnostic accuracy for predicting complete response (CR) at 12 months based on the 1st post-treatment MRI was calculated. RESULTS Eighty patients (M/F 60/20, mean age 67.7 years) with 80 HCCs were assessed (median size baseline, 1.8 cm [IQR, 1.4-2.9 cm]). At 12 months, 74 patients were classified as CR (92.5%), 5 as partial response (6.3%), and 1 as progressive disease (1.2%). Diagnostic accuracy for predicting CR was fair to good for all readers with excellent positive predictive value (PPV): mRECIST (range between 3 readers, accuracy: 0.763-0.825, PPV: 0.966-1), LI-RADS TRA (accuracy: 0.700-0.825, PPV: 0.983-1), and subtraction (accuracy: 0.775-0.825, PPV: 0.967-1), with no difference in accuracy between criteria (p range 0.053 to > 0.9). CONCLUSION mRECIST, LI-RADS TRA, and subtraction obtained on early post-treatment MRI show similar performance for predicting long-term response in patients with HCC treated with radiation segmentectomy. CLINICAL RELEVANCE STATEMENT Response assessment extracted from early post-treatment MRI after radiation segmentectomy predicts complete response in patients with HCC with high PPV (≥ 0.96). KEY POINTS • Early post-treatment response assessment on MRI predicts response in patients with HCC treated with radiation segmentectomy with fair to good accuracy and excellent positive predictive value. • There was no difference in diagnostic accuracy between mRECIST, LI-RADS, and subtraction for predicting HCC response to radiation segmentectomy.
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Affiliation(s)
- Daniel Stocker
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Michael J King
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria El Homsi
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeffrey Gnerre
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brett Marinelli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Interventional Radiology, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Moritz Wurnig
- Institute of Radiology, Spital Lachen AG, Lachen, Switzerland
| | - Myron Schwartz
- Recanati Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edward Kim
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Schawkat K, Sah BR, Ter Voert EE, Delso G, Wurnig M, Becker AS, Leibl S, Schneider PM, Reiner CS, Huellner MW, Veit-Haibach P. Role of intravoxel incoherent motion parameters in gastroesophageal cancer: relationship with 18F-FDG-positron emission tomography, computed tomography perfusion and magnetic resonance perfusion imaging parameters. Q J Nucl Med Mol Imaging 2019; 65:178-186. [PMID: 31496202 DOI: 10.23736/s1824-4785.19.03153-4] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Identification of pretherapeutic predictive markers in gastro-esophageal cancer is essential for individual-oriented treatment. This study evaluated the relationship of multimodality parameters derived from intravoxel incoherent motion method (IVIM), 18F-FDG-positron emission tomography (PET), computed tomography (CT) perfusion and dynamic contrast enhanced magnetic resonance imaging (MRI) in patients with gastro-esophageal cancer and investigated their histopathological correlation. METHODS Thirty-one consecutive patients (28 males; median age 63.9 years; range 37-84 years) with gastro-esophageal adenocarcinoma (N.=22) and esophageal squamous cell carcinoma (N.=9) were analyzed. IVIM parameters: pseudodiffusion (D*), perfusion fraction (fp), true diffusion (D) and the threshold b-value (bval); PET-parameters: SUV<inf>max</inf>, metabolic tumor volume (MTV) and total lesion glycolysis (TLG); CT perfusion parameters: blood flow (BF), blood volume (BV) and mean transit time (MTT); and MR perfusion parameters: time to enhance, positive enhancement integral, time-to-peak (TTP), maximum-slope-of-increase, and maximum-slope-of-decrease were determined, and correlated to each other and to histopathology. RESULTS IVIM and PET parameters showed significant negative correlations: MTV and bval (r<inf>s</inf> =-0.643, P=0.002), TLG and bval (r<inf>s</inf>=-0.699, P<0.01) and TLG and fp (r<inf>s</inf>=-0.577, P=0.006). Positive correlation was found for TLG and D (r<inf>s</inf>=0.705, P=0.000). Negative correlation was found for bval and staging (r<inf>s</inf>=0.590, P=0.005). Positive correlation was found for positive enhancement interval and BV (r<inf>s</inf>=0.547, P=0.007), BF and regression index (r<inf>s</inf>=0.753, P=0.005) and for time-to-peak and staging (r<inf>s</inf>=0.557, P=0.005). CONCLUSIONS IVIM parameters (bval, fp, D) provide quantitative information and correlate with PET parameters (MTV, TLG) and staging. IVIM might be a useful tool for additional characterization of gastro-esophageal cancer.
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Affiliation(s)
- Khoschy Schawkat
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland - .,University of Zurich, Zurich, Switzerland -
| | - Bert-Ram Sah
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Edwin E Ter Voert
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Gaspar Delso
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Moritz Wurnig
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Anton S Becker
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Sebastian Leibl
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Paul M Schneider
- Center for Visceral, Thoracic and Specialized Tumor Surgery, Hirslanden Medical Center, Zurich, Switzerland
| | - Cäcilia S Reiner
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Veit-Haibach
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Toronto, Toronto, ON, Canada.,Toronto Joint Department of Medical Imaging, University Hospital of Zurich, Toronto General Hospital, Zurich, Switzerland
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Lima Cardoso P, Fischmeister FPS, Dymerska B, Geißler A, Wurnig M, Trattnig S, Beisteiner R, Robinson SD. Robust presurgical functional MRI at 7 T using response consistency. Hum Brain Mapp 2017; 38:3163-3174. [PMID: 28321965 PMCID: PMC5434844 DOI: 10.1002/hbm.23582] [Citation(s) in RCA: 5] [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: 06/01/2016] [Revised: 03/07/2017] [Accepted: 03/11/2017] [Indexed: 12/31/2022] Open
Abstract
Functional MRI is valuable in presurgical planning due to its non-invasive nature, repeatability, and broad availability. Using ultra-high field MRI increases the specificity and sensitivity, increasing the localization reliability and reducing scan time. Ideally, fMRI analysis for this application should identify unreliable runs and work even if the patient deviates from the prescribed task timing or if there are changes to the hemodynamic response due to pathology. In this study, a model-free analysis method-UNBIASED-based on the consistency of fMRI responses over runs was applied, to ultra-high field fMRI localizations of the hand area. Ten patients with brain tumors and epilepsy underwent 7 Tesla fMRI with multiple runs of a hand motor task in a block design. FMRI data were analyzed with the proposed approach (UNBIASED) and the conventional General Linear Model (GLM) approach. UNBIASED correctly identified and excluded fMRI runs that contained little or no activation. Generally, less motion artifact contamination was present in UNBIASED than in GLM results. Some cortical regions were identified as activated in UNBIASED but not GLM results. These were confirmed to show reproducible delayed or transient activation, which was time-locked to the task. UNBIASED is a robust approach to generating activation maps without the need for assumptions about response timing or shape. In presurgical planning, UNBIASED can complement model-based methods to aid surgeons in making prudent choices about optimal surgical access and resection margins for each patient, even if the hemodynamic response is modified by pathology. Hum Brain Mapp 38:3163-3174, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Pedro Lima Cardoso
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
| | - Florian Ph. S. Fischmeister
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Barbara Dymerska
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
| | - Alexander Geißler
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Moritz Wurnig
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Siegfried Trattnig
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
| | - Roland Beisteiner
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Simon Daniel Robinson
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
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Cardoso PL, Fischmeister FPS, Dymerska B, Geißler A, Wurnig M, Trattnig S, Beisteiner R, Robinson SD. Improving the clinical potential of ultra-high field fMRI using a model-free analysis method based on response consistency. MAGMA 2016; 29:435-49. [PMID: 26965512 PMCID: PMC4891377 DOI: 10.1007/s10334-016-0533-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/19/2016] [Accepted: 02/06/2016] [Indexed: 12/16/2022]
Abstract
Objective To develop an analysis method that is sensitive to non-model-conform responses often encountered in ultra-high field presurgical planning fMRI. Using the consistency of time courses over a number of experiment repetitions, it should exclude low quality runs and generate activation maps that reflect the reliability of responses. Materials and methods 7 T fMRI data were acquired from six healthy volunteers: three performing purely motor tasks and three a visuomotor task. These were analysed with the proposed approach (UNBIASED) and the GLM. Results UNBIASED results were generally less affected by false positive results than the GLM. Runs that were identified as being of low quality were confirmed to contain little or no activation. In two cases, regions were identified as activated in UNBIASED but not GLM results. Signal changes in these areas were time-locked to the task, but were delayed or transient. Conclusion UNBIASED is shown to be a reliable means of identifying consistent task-related signal changes regardless of response timing. In presurgical planning, UNBIASED could be used to rapidly generate reliable maps of the consistency with which eloquent brain regions are activated without recourse to task timing and despite modified hemodynamics. Electronic supplementary material The online version of this article (doi:10.1007/s10334-016-0533-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro Lima Cardoso
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
| | - Florian Ph. S. Fischmeister
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Barbara Dymerska
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
| | - Alexander Geißler
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Moritz Wurnig
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Siegfried Trattnig
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
| | - Roland Beisteiner
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Simon Daniel Robinson
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
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Rath J, Wurnig M, Fischmeister F, Klinger N, Höllinger I, Geißler A, Aichhorn M, Foki T, Kronbichler M, Nickel J, Siedentopf C, Staffen W, Verius M, Golaszewski S, Koppelstaetter F, Auff E, Felber S, Seitz RJ, Beisteiner R. Between- and within-site variability of fMRI localizations. Hum Brain Mapp 2016; 37:2151-60. [PMID: 26955899 DOI: 10.1002/hbm.23162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/12/2015] [Accepted: 02/17/2016] [Indexed: 11/11/2022] Open
Abstract
This study provides first data about the spatial variability of fMRI sensorimotor localizations when investigating the same subjects at different fMRI sites. Results are comparable to a previous patient study. We found a median between-site variability of about 6 mm independent of task (motor or sensory) and experimental standardization (high or low). An intraclass correlation coefficient analysis using data quality measures indicated a major influence of the fMRI site on variability. In accordance with this, within-site localization variability was considerably lower (about 3 mm). We conclude that the fMRI site is a considerable confound for localization of brain activity. However, when performed by experienced clinical fMRI experts, brain pathology does not seem to have a relevant impact on the reliability of fMRI localizations. Hum Brain Mapp 37:2151-2160, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jakob Rath
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Moritz Wurnig
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Florian Fischmeister
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Nicolaus Klinger
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Ilse Höllinger
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Alexander Geißler
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Markus Aichhorn
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Thomas Foki
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
| | - Martin Kronbichler
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.,Neuroscience Institute, Christian-Doppler-Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Janpeter Nickel
- Department of Neurology, University Hospital Düsseldorf, Germany
| | | | - Wolfgang Staffen
- Department of Neurology, Christian-Doppler-Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Michael Verius
- Department of Radiology, Medical University of Innsbruck, Austria
| | - Stefan Golaszewski
- Department of Neurology, Christian-Doppler-Clinic, Paracelsus Medical University, Salzburg, Austria
| | | | - Eduard Auff
- Department of Neurology, Medical University of Vienna, Austria
| | - Stephan Felber
- Institute for Diagnostic Radiology, Stiftungsklinikum Mittelrhein, Koblenz, Germany
| | - Rüdiger J Seitz
- Department of Neurology, University Hospital Düsseldorf, Germany.,Centre of Neurology and Neuropsychiatry, Heinrich-Heine-University Düsseldorf, LVR-Klinikum Düsseldorf, Germany
| | - Roland Beisteiner
- Department of Neurology and MR Center of Excellence, Medical University of Vienna, Austria
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Kenkel D, Wurnig M, Filli L, Ulbrich E, Runge V, Beck T, Boss A. Whole-Body Diffusion Imaging Applying Simultaneous Multi-Slice Excitation. ROFO-FORTSCHR RONTG 2016; 188:E1. [DOI: 10.1055/s-0035-1567082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- D. Kenkel
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - M. Wurnig
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - L. Filli
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - E. Ulbrich
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | - V. Runge
- Department of Neuroradiology, University Hospital Zurich, Switzerland
| | - T. Beck
- Siemens Healthcare GmbH, Erlangen, Germany
| | - A. Boss
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
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Meier A, Wurnig M, Desbiolles L, Leschka S, Frauenfelder T, Alkadhi H. Advanced virtual monoenergetic images: improving the contrast of dual-energy CT pulmonary angiography. Clin Radiol 2015; 70:1244-51. [DOI: 10.1016/j.crad.2015.06.094] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/15/2015] [Accepted: 06/25/2015] [Indexed: 11/25/2022]
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Foki T, Pirker W, Geißler A, Haubenberger D, Hilbert M, Hoellinger I, Wurnig M, Rath J, Lehrner J, Matt E, Fischmeister F, Trattnig S, Auff E, Beisteiner R. Finger dexterity deficits in Parkinson's disease and somatosensory cortical dysfunction. Parkinsonism Relat Disord 2015; 21:259-65. [DOI: 10.1016/j.parkreldis.2014.12.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/22/2014] [Accepted: 12/27/2014] [Indexed: 01/17/2023]
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Geißler A, Matt E, Fischmeister F, Wurnig M, Dymerska B, Knosp E, Feucht M, Trattnig S, Auff E, Fitch WT, Robinson S, Beisteiner R. Differential functional benefits of ultra highfield MR systems within the language network. Neuroimage 2014; 103:163-170. [PMID: 25255049 PMCID: PMC4263528 DOI: 10.1016/j.neuroimage.2014.09.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/03/2014] [Accepted: 09/15/2014] [Indexed: 11/16/2022] Open
Abstract
Several investigations have shown limitations of fMRI reliability with the current standard field strengths. Improvement is expected from ultra highfield systems but studies on possible benefits for cognitive networks are lacking. Here we provide an initial investigation on a prominent and clinically highly-relevant cognitive function: language processing in individual brains. 26 patients evaluated for presurgical language localization were investigated with a standardized overt language fMRI paradigm on both 3T and 7T MR scanners. During data acquisition and analysis we made particular efforts to minimize effects not related to static magnetic field strength differences. Six measures relevant for functional activation showed a large dissociation between essential language network nodes: although in Wernicke's area 5/6 measures indicated a benefit of ultra highfield, in Broca's area no comparison was significant. The most important reason for this discrepancy was identified as being an increase in susceptibility-related artifacts in inferior frontal brain areas at ultra high field. We conclude that functional UHF benefits are evident, however these depend crucially on the brain region investigated and the ability to control local artifacts.
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Affiliation(s)
- A Geißler
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria; High Field MR Center, Medical University of Vienna, Austria; Department of Neurology, Medical University of Vienna, Austria
| | - E Matt
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria; High Field MR Center, Medical University of Vienna, Austria; Department of Neurology, Medical University of Vienna, Austria
| | - F Fischmeister
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria; High Field MR Center, Medical University of Vienna, Austria; Department of Neurology, Medical University of Vienna, Austria
| | - M Wurnig
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria; High Field MR Center, Medical University of Vienna, Austria; Department of Neurology, Medical University of Vienna, Austria
| | - B Dymerska
- High Field MR Center, Medical University of Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - E Knosp
- Department of Neurosurgery, Medical University of Vienna, Austria
| | - M Feucht
- Department of Pediatrics, Medical University of Vienna, Austria
| | - S Trattnig
- High Field MR Center, Medical University of Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - E Auff
- Department of Neurology, Medical University of Vienna, Austria
| | - W T Fitch
- Department of Cognitive Biology, University of Vienna, Vienna, Austria
| | - S Robinson
- High Field MR Center, Medical University of Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - R Beisteiner
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria; High Field MR Center, Medical University of Vienna, Austria; Department of Neurology, Medical University of Vienna, Austria.
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Hugelshofer M, Keller A, Wurnig M, Regli L, Aguzzi A. The Role of Microglia in Prevention of Hemorrhagic Transformation and Blood Flow Regulation after Ischemic Stroke. J Neurol Surg A Cent Eur Neurosurg 2014. [DOI: 10.1055/s-0034-1383758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Bickelhaupt S, Wurnig M, Boss A, Patak MA. Correlation between morphological expansion and impairment of intra- and prelesionary motility in inflammatory small bowel lesions in patients with Crohn's disease - preliminary data. Eur J Radiol 2014; 83:1044-1050. [PMID: 24794863 DOI: 10.1016/j.ejrad.2014.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 03/02/2014] [Accepted: 03/11/2014] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study is to investigate if alterations of intra- and prelesionary motility in inflamed small-bowel segments correlate with length, wall-thickness and prelesionary dilatation of inflammatory small bowel lesions in patients suffering from Crohn's disease assessed with MRI. METHODS AND MATERIALS This retrospective IRB approved study included 25 patients (12 males, 18-77y) with inflammatory lesions examined using (MRE) magnetic resonance imaging enterography. Cine MRE was performed using a coronal 2D steady-state free precession sequence (TR 2.9, TE 1.25) on a 1.5T MRI scanner. Small bowel motility was examined using a dedicated MR-motility assessment software (Motasso, Vers. 1.0, Sohard AG, Bern, Switzerland). Motility patterns (contraction frequency, relative occlusion rate and mean diameter) were assessed in correlation to wall thickness, length and prelesionary dilatation of the lesions. Statistical analysis was performed by calculation of the Pearson's-Correlation coefficient. RESULTS The length of the inflammatory segments, the wall thickening and prelesionary dilatation did not correlate with the frequency of the contractions (r=0.17, p=0.477; r=0.316, p=0.123; r=0.161, p=0.441) or the impairment of luminal occlusion (r=0.274, p=0.184; r=0.199, p=.0339; r=0.015, p=0.945) and only the prelesionary dilatation (r=0.410, p=0.042) correlated to the mean luminal diameter of the segment. CONCLUSION The degree of motility impairment within inflammatory small bowel lesions does not significantly correlate with the extent of the lesion but with the motility measured in prelesionary, non-affected segments, suggesting an interdependent functional aspect of inflammation even in morphologically non-affected small bowel segments.
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Affiliation(s)
- Sebastian Bickelhaupt
- University Hospital Zürich, Department of Radiology, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Moritz Wurnig
- University Hospital Zürich, Department of Radiology, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Andreas Boss
- University Hospital Zürich, Department of Radiology, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Michael A Patak
- University Hospital Zürich, Department of Radiology, Rämistrasse 100, 8091 Zürich, Switzerland; Hirslanden Clinic, Radiology, Witellikerstrasse 40, 8032 Zürich, Switzerland.
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Foki T, Pirker W, Geissler A, Haubenberger D, Hilbert M, Hoellinger I, Wurnig M, Rath J, Lehrner J, Trattnig S, Auff E, Beisteiner R. Impaired activation of somatosensory cortex as FMRI correlate of reduced dexterity in PD. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Beisteiner R, Wurnig M, Fischmeister F, Matt E, Knosp E, Feucht M, Auff E, Trattnig S, Robinson S, Geissler A. Are there benefits of ultra-high field MR for clinical language localization? J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Robinson SD, Schöpf V, Cardoso P, Geissler A, Fischmeister FPS, Wurnig M, Trattnig S, Beisteiner R. Applying independent component analysis to clinical FMRI at 7 t. Front Hum Neurosci 2013; 7:496. [PMID: 24032007 PMCID: PMC3759034 DOI: 10.3389/fnhum.2013.00496] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 01/30/2013] [Accepted: 08/05/2013] [Indexed: 11/24/2022] Open
Abstract
Increased BOLD sensitivity at 7 T offers the possibility to increase the reliability of fMRI, but ultra-high field is also associated with an increase in artifacts related to head motion, Nyquist ghosting, and parallel imaging reconstruction errors. In this study, the ability of independent component analysis (ICA) to separate activation from these artifacts was assessed in a 7 T study of neurological patients performing chin and hand motor tasks. ICA was able to isolate primary motor activation with negligible contamination by motion effects. The results of General Linear Model (GLM) analysis of these data were, in contrast, heavily contaminated by motion. Secondary motor areas, basal ganglia, and thalamus involvement were apparent in ICA results, but there was low capability to isolate activation in the same brain regions in the GLM analysis, indicating that ICA was more sensitive as well as more specific. A method was developed to simplify the assessment of the large number of independent components. Task-related activation components could be automatically identified via these intuitive and effective features. These findings demonstrate that ICA is a practical and sensitive analysis approach in high field fMRI studies, particularly where motion is evoked. Promising applications of ICA in clinical fMRI include presurgical planning and the study of pathologies affecting subcortical brain areas.
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Affiliation(s)
- Simon Daniel Robinson
- High Field Magnetic Resonance Imaging Centre of Excellence, Medical University of Vienna , Vienna , Austria ; Department of Radiology, Medical University of Vienna , Vienna , Austria
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15
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Geißler A, Fischmeister FPS, Grabner G, Wurnig M, Rath J, Foki T, Matt E, Trattnig S, Beisteiner R, Robinson SD. Comparing the Microvascular Specificity of the 3- and 7-T BOLD Response Using ICA and Susceptibility-Weighted Imaging. Front Hum Neurosci 2013; 7:474. [PMID: 23950744 PMCID: PMC3739379 DOI: 10.3389/fnhum.2013.00474] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 07/29/2013] [Indexed: 11/28/2022] Open
Abstract
In functional MRI it is desirable for the blood-oxygenation level dependent (BOLD) signal to be localized to the tissue containing activated neurons rather than the veins draining that tissue. This study addresses the dependence of the specificity of the BOLD signal – the relative contribution of the BOLD signal arising from tissue compared to venous vessels – on magnetic field strength. To date, studies of specificity have been based on models or indirect measures of BOLD sensitivity such as signal to noise ratio and relaxation rates, and assessment has been made in isolated vein and tissue voxels. The consensus has been that ultra-high field systems not only significantly increase BOLD sensitivity but also specificity, that is, there is a proportionately reduced signal contribution from draining veins. Specificity was not quantified in prior studies, however, due to the difficulty of establishing a reliable network of veins in the activated volume. In this study we use a map of venous vessel networks extracted from 7 T high resolution Susceptibility-Weighted Images to quantify the relative contributions of micro- and macro-vasculature to functional MRI results obtained at 3 and 7 T. High resolution measurements made here minimize the contribution of physiological noise and Independent Component Analysis (ICA) is used to separate activation from technical, physiological, and motion artifacts. ICA also avoids the possibility of timing-dependent bias from different micro- and macro-vasculature responses. We find a significant increase in the number of activated voxels at 7 T in both the veins and the microvasculature – a BOLD sensitivity increase – with the increase in the microvasculature being higher. However, the small increase in sensitivity at 7 T was not significant. For the experimental conditions of this study, our findings do not support the hypothesis of an increased specificity of the BOLD response at ultra-high field.
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Affiliation(s)
- Alexander Geißler
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna , Vienna , Austria ; High Field Magnetic Resonance Imaging Center of Excellence, Medical University of Vienna , Vienna , Austria
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16
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Tsushima Y, Wurnig M, Jang JJ, Boss A, Weder W, Jungraithmayr W. P-218ASSESSMENT OF ISCHAEMIA REPERFUSION INJURY BY MICRO-COMPUTED TOMOGRAPHY AND ULTRA-SHORT ECHO-TIME MAGNETIC RESONANCE IMAGING AFTER MOUSE LUNG TRANSPLANTATION. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Beisteiner R, Robinson S, Wurnig M, Hilbert M, Merksa K, Rath J, Höllinger I, Klinger N, Marosi C, Trattnig S, Geißler A. Clinical fMRI: evidence for a 7T benefit over 3T. Neuroimage 2011; 57:1015-21. [PMID: 21620980 PMCID: PMC3134943 DOI: 10.1016/j.neuroimage.2011.05.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 05/02/2011] [Accepted: 05/03/2011] [Indexed: 11/17/2022] Open
Abstract
Despite there being an increasing number of installations of ultra high field MR systems (>3T) in clinical environments, no functional patient investigations have yet examined possible benefits for functional diagnostics. Here we performed presurgical localization of the primary motor hand area on 3T and 7T Siemens scanners with identical investigational procedures and comparable system specific sequence optimizations. Results from 17 patients showed significantly higher functional sensitivity of the 7T system measured via percent signal change, mean t-values, number of suprathreshold voxels and contrast to noise ratio. On the other hand, 7T data suffered from a significant increase of artifacts (ghosting, head motion). We conclude that ultra high field systems provide a clinically relevant increase of functional sensitivity for patient investigations.
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Affiliation(s)
- R. Beisteiner
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Corresponding author at: Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Fax: + 43 1 40400 3459.
| | - S. Robinson
- Department of Radiology, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - M. Wurnig
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - M. Hilbert
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - K. Merksa
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - J. Rath
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - I. Höllinger
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - N. Klinger
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Ch. Marosi
- Department of Medicine I, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - S. Trattnig
- Department of Radiology, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - A. Geißler
- Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Austria
- MR Center of Excellence, Medical University of Vienna, Austria, Währinger Gürtel 18-20, 1090 Vienna, Austria
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18
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Rath J, Klinger N, Geissler A, Höllinger I, Gruber S, Wurnig M, Hausner T, Auff E, Schmidhammer R, Beisteiner R. An fMRI marker for peripheral nerve regeneration. Neurorehabil Neural Repair 2011; 25:577-9. [PMID: 21436389 DOI: 10.1177/1545968310397552] [Citation(s) in RCA: 7] [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] [Indexed: 11/17/2022]
Abstract
Final outcome after surgical repair of peripheral nerve transections varies. Here, we present the first longitudinal functional magnetic resonance imaging (fMRI) observation of cortical somatosensory reorganization patterns after surgery. A 43-year-old man presented with isolated complete transection of the right median nerve and underwent immediate epineural end-to-end coaptation. Applying standardized vibrotactile median nerve stimulation, 3 T brain activation maps were evaluated at 1, 7, 15 weeks and 1 year after surgery. Initially, the affected hemisphere showed no primary activation but increased frontoparietal activity. After 1 year, primary activation had recovered, and frontoparietal activity was decreased relative to the nonaffected hemisphere. Based on these longitudinal fMRI patterns, we propose a new marker for restoration of somatosensory function, which may not be provided by electrophysiological methods.
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Affiliation(s)
- Jakob Rath
- Medical University of Vienna, Vienna, Austria
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