3D cerebrovascular segmentation combining fuzzy vessel enhancement and level-sets with anisotropic energy weights

The aim of this work is to present and evaluate a level-set segmentation approach with vesselness-dependent anisotropic energy weights, which focuses on the exact segmentation of malformed as well as small vessels from time-of-flight (TOF) magnetic resonance angiography (MRA) datasets.     

Carotid plaque high-resolution MRI at 3 T: evaluation of a new imaging score for symptomatic plaque assessment

Purpose

To assess the sensitivity and specificity of intra-plaque hemorrhage (IPH), large lipid-rich necrotic core (LR-NC) and ulceration or cap rupture (UCR) for symptomatic carotid plaque characterization and to evaluate a new imaging score [Hemorrhage, Ulceration or cap rupture, Lipid-rich necrotic Core (HULC) score based on the sum of presence/absence of IPH, UCR and LR-NC; range 0–3] for assessment of recently symptomatic carotid plaques.

Material and methods

Twenty-seven recently symptomatic (< 8 weeks) and 36 asymptomatic patients with a carotid plaque thicker than 2 mm were prospectively imaged on a 3-T magnetic resonance (MR) system using high-resolution, multi-contrast MR sequences. Prior to analysis, all images were reviewed to assess image quality of each sequence. Sensitivity and specificity of IPH, LR-NC, UCR and HULC scores were calculated.

Results

Fifty-one patients were analyzed (26 symptomatic carotids and 67 asymptomatic carotids) after exclusion of studies with poor image quality. Sensitivity and specificity for symptomatic carotid plaque was, respectively, 46.1% and 97% for IPH, 84.6% and 73.1% for UCR and 80.7% and 76.1% for LR-NC. A HULC score of 2 or more showed a sensitivity of 73% and a specificity of 92.5%.

Conclusion

At 3 T, intra-plaque hemorrhage is the most specific criterion to characterize symptomatic carotid plaque. The HULC score offers the best compromise between sensitivity and specificity.     

A quantitative comparison of two methods to correct eddy current-induced distortions in DT-MRI

Eddy current-induced geometric distortions of single-shot, diffusion-weighted, echo-planar (DW-EP) images are a major confounding factor to the accurate determination of water diffusion parameters in diffusion tensor MRI (DT-MRI). Previously, it has been suggested that these geometric distortions can be removed from brain DW-EP images using affine transformations determined from phantom calibration experiments using iterative cross-correlation (ICC). Since this approach was first described, a number of image-based registration methods have become available that can also correct eddy current-induced distortions in DW-EP images. However, as yet no study has investigated whether separate eddy current calibration or image-based registration provides the most accurate way of removing these artefacts from DT-MRI data. Here we compare how ICC phantom calibration and affine FLIRT (http://www.fmrib.ox.ac.uk), a popular image-based multi-modal registration method that can correct both eddy current-induced distortions and bulk subject motion, perform when registering DW-EP images acquired with different slice thicknesses (2.8 and 5 mm) and b-values (1000 and 3000 s/mm(2)). With the use of consistency testing, it was found that ICC was a more robust algorithm for correcting eddy current-induced distortions than affine FLIRT, especially at high b-value and small slice thickness. In addition, principal component analysis demonstrated that the combination of ICC phantom calibration (to remove eddy current-induced distortions) with rigid body FLIRT (to remove bulk subject motion) provided a more accurate registration of DT-MRI data than that achieved by affine FLIRT.     

A model for quantitative changes in the magnetic resonance parameters of muscle in children after therapeutic irradiation

Purpose/ObjectiveThis study aimed to develop objective models of radiation effects on musculature in children with soft tissue sarcoma using treatment dosimetry and clinical and quantitative magnetic resonance imaging (MRI) parameters that may be used to guide treatment planning or predict side effects.MethodsIn the initial 13 patients undergoing external beam radiation therapy (RT) on a Phase II study of conformal or intensity-modulated RT for the treatment of soft tissue sarcoma approved by an Institutional Review Board, we evaluated quantitative MRI changes in the musculature to assess radiation-related treatment effects. Patients with soft tissue sarcoma, including Ewing's sarcoma, had quantitative T₁, T₂ and dynamic enhanced MRI (DEMRI) performed before, during (Week 4) and after RT (Week 12). Regions of interest were selected in consistent locations within and outside the high-dose regions (on ipsilateral and contralateral sides when available). Mean RT dose, T₁, T₂ and DEMRI parameters were calculated and modeled using a mixed random coefficient dose model.ResultsThe mean doses to the high- and low-dose regions were 56.4 Gy (41.8–75.3 Gy) and 13.0 Gy (0.1–37.5 Gy), respectively. Compared with tissues distant from the tumor bed, maximal enhancement was significantly increased in tissues adjacent to the tumor/tumor bed prior to RT (60.6 vs. 44.2, P=.045) and remained elevated after 12 weeks. T₁ was significantly elevated in tissues adjacent to the tumor bed prior to RT (942.4 vs. 759.0, P=.0078). The slope of longitudinal change in T₁ was greater for tissues that received low-dose irradiation than those that received high-dose irradiation (P=.0488). The effect of dose on the slope of T₂ was different (P=.0333) when younger and older patients are compared.ConclusionsAcute affects of irradiation in muscle are quantifiable via MRI. These models provide evidence that quantifiable MRI parameters may be correlated with patient parameters of radiation dose and clinical factors including patient age. Long-term follow-up will be required to determine if acute changes correlate with clinically significant late effects.     

MRI allows for longitudinal quantitative analysis of body fat composition in rats: An analysis of sibutramine-associated changes at the group level

Purpose

Body fat distribution changes are associated with multiple alterations in metabolism. Therefore, the assessment of body fat compartments by MRI in animal models is a promising approach to obesity research. Standard T1-weighted (T1w) whole body MRI was used here to quantify different effects in the subcutaneous and visceral fat compartments in rats under treatment with an anorexiant.

Materials and methods

Twenty rats on a high caloric diet were investigated by the identical MRI protocol at baseline and after seven weeks. Ten rats received a treatment with sibutramine, 10 rats served as vehicle control group. To longitudinally assess body fat components, MRI analysis was used with two approaches: 2D slicewise graphic analysis (SGA) was compared with an automated 3D analysis algorithm (3DA).

Results

At the group level, fat volume differences showed a longitudinal increase of subcutaneous and visceral fat volumes for the control group, whereas the sibutramine group showed stable subcutaneous fat volumes and decrease in visceral fat volumes. SGA and 3DA volume determination showed significant correlations for subcutaneous fat volume (C = 0.85, p < 0.001), visceral fat volume (C = 0.87, p < 0.001), and total fat volume (C = 0.90, p < 0.001).

Conclusion

It could be demonstrated that computer-based analysis of T1w MRI could be used to longitudinally assess changes in body fat compartments in rats at the group level. In detail, it was possible to investigate the effect of sibutramine separate on the fat compartments in rats.     

Denoising 3D MR images by the enhanced non-local means filter for Rician noise

The non-local means (NLM) filter removes noise by calculating the weighted average of the pixels in the global area and shows superiority over existing local filter methods that only consider local neighbor pixels. This filter has been successfully extended from 2D images to 3D images and has been applied to denoising 3D magnetic resonance (MR) images. In this article, a novel filter based on the NLM filter is proposed to improve the denoising effect. Considering the characteristics of Rician noise in the MR images, denoising by the NLM filter is first performed on the squared magnitude images. Then, unbiased correcting is carried out to eliminate the biased deviation. When performing the NLM filter, the weight is calculated based on the Gaussian-filtered image to reduce the disturbance of the noise. The performance of this filter is evaluated by carrying out a qualitative and quantitative comparison of this method with three other filters, namely, the original NLM filter, the unbiased NLM (UNLM) filter and the Rician NLM (RNLM) filter. Experimental results demonstrate that the proposed filter achieves better denoising performance over the other filters being compared.     

Optimal techniques for magnetic resonance imaging of the liver using a respiratory navigator-gated three-dimensional spoiled gradient-recalled echo sequence

Purpose

To optimize the navigator-gating technique for the acquisition of high-quality three-dimensional spoiled gradient-recalled echo (3D SPGR) images of the liver during free breathing.

Materials and methods

Ten healthy volunteers underwent 3D SPGR magnetic resonance imaging of the liver using a conventional navigator-gated 3D SPGR (cNAV-3D-SPGR) sequence or an enhanced navigator-gated 3D SPGR (eNAV-3D-SPGR) sequence. No exogenous contrast agent was used. A 20-ms wait period was inserted between the 3D SPGR acquisition component and navigator component of the eNAV-3D-SPGR sequence to allow T1 recovery. Visual evaluation and calculation of the signal-to-noise ratio were performed to compare image quality between the imaging techniques.

Result

The eNAV-3D-SPGR sequence provided better noise properties than the cNAV-3D-SPGR sequence visually and quantitatively. Navigator gating with an acceptance window of 2 mm effectively inhibited respiratory motion artifacts. The widening of the window to 6 mm shortened the acquisition time but increased motion artifacts, resulting in degradation of overall image quality. Neither slice tracking nor incorporation of short breath holding successfully compensated for the widening of the window.

Conclusion

The eNAV-3D-SPGR sequence with an acceptance window of 2 mm provides high-quality 3D SPGR images of the liver.     

The physiology and metabolism of neuronal activation: in vivo studies by NMR and other methods

In this article, a review is made of the current knowledge concerning the physiology and metabolism of neuronal activity, as provided by the application of NMR approaches in vivo. The evidence furnished by other functional spectroscopic and imaging techniques, such as PET and optical methods, are also discussed. In spite of considerable amounts of studies presented in the literature, several controversies concerning the mechanisms underlying brain function still remain, mainly due to the difficult assessment of the single vascular and metabolic dynamics which generally influence the functional signals. In this framework, methodological and technical improvements are required to provide new and reliable experimental elements, which can support or eventually modify the current models of activation.     

Evaluation of MRI issues at 3-Tesla for a hospital identification (ID) wristband

Background and Purpose

A recent report suggested that a serious burn injury was due to the presence of the identification (ID) wristband. As such, in lieu of removing or padding hospital ID wristbands in all patients prior to magnetic resonance imaging (MRI), testing may be performed to characterize risks for ID wristbands. Therefore, the purpose of this investigation was to evaluate the magnetic field interactions, heating and artifacts at 3 T for a hospital ID wristband.

Materials and Methods

Standardized test methods were used to evaluate magnetic field interactions, MRI-related heating, and artifacts at 3 T for a hospital ID wristband.

Results

There were no magnetic field interactions. MRI-related heating evaluated at a relatively high, MR system-reported, whole body-averaged specific absorption rate (2.9 W/kg) did not increase above the background level. The artifacts related to the ink used for printing were “small” for one toner and “large” for the other in relation to the dimensions of the printing.

Conclusions

Based on the tests performed, this particular hospital ID wristband is considered MR safe and will not pose a hazard to a patient undergoing an MRI examination. Importantly, it is not necessary to remove this item for a patient referred for MRI.     

Novel methodology for 3D reconstruction of carotid arteries and plaque characterization based upon magnetic resonance imaging carotid angiography data

In this study, we present a novel methodology that allows reliable segmentation of the magnetic resonance images (MRIs) for accurate fully automated three-dimensional (3D) reconstruction of the carotid arteries and semiautomated characterization of plaque type. Our approach uses active contours to detect the luminal borders in the time-of-flight images and the outer vessel wall borders in the T(1)-weighted images. The methodology incorporates the connecting components theory for the automated identification of the bifurcation region and a knowledge-based algorithm for the accurate characterization of the plaque components. The proposed segmentation method was validated in randomly selected MRI frames analyzed offline by two expert observers. The interobserver variability of the method for the lumen and outer vessel wall was -1.60%±6.70% and 0.56%±6.28%, respectively, while the Williams Index for all metrics was close to unity. The methodology implemented to identify the composition of the plaque was also validated in 591 images acquired from 24 patients. The obtained Cohen's k was 0.68 (0.60-0.76) for lipid plaques, while the time needed to process an MRI sequence for 3D reconstruction was only 30 s. The obtained results indicate that the proposed methodology allows reliable and automated detection of the luminal and vessel wall borders and fast and accurate characterization of plaque type in carotid MRI sequences. These features render the currently presented methodology a useful tool in the clinical and research arena.     

Moderating registration misalignment in voxelwise comparisons of DTI data: a performance evaluation of skeleton projection

An evaluative methodology and five accompanying performance measures were developed to quantitatively assess the performance of the skeleton projection algorithm constituting the heart of tract-based spatial statistics (TBSS). The performance measures were designed to quantify the accuracy of skeleton projection in its indented task of alleviating any residual misalignment that may remain after image registration. A ground truth fractional anisotropy (FA) image was slightly warped using a realistic warp field that served to model post-registration residual misalignment of varying magnitudes. Skeleton projection was then used to register the warped FA image to the ground truth. Performing skeleton projection was found to yield up to 50% better correspondence between the values of FA compared to smoothing, despite the fact that less than 10% of post-registration misalignment was corrected. The align-max-with-max strategy underlying TBSS was posited as a potential explanation for this high correspondence in the values of FA, at the expense of lesser alignment between anatomically concordant voxels.     

Automatic segmentation of cerebral white matter hyperintensities using only 3D FLAIR images

Magnetic Resonance (MR) white matter hyperintensities have been shown to predict an increased risk of developing cognitive decline. However, their actual role in the conversion to dementia is still not fully understood. Automatic segmentation methods can help in the screening and monitoring of Mild Cognitive Impairment patients who take part in large population-based studies. Most existing segmentation approaches use multimodal MR images. However, multiple acquisitions represent a limitation in terms of both patient comfort and computational complexity of the algorithms. In this work, we propose an automatic lesion segmentation method that uses only three-dimensional fluid-attenuation inversion recovery (FLAIR) images. We use a modified context-sensitive Gaussian mixture model to determine voxel class probabilities, followed by correction of FLAIR artifacts. We evaluate the method against the manual segmentation performed by an experienced neuroradiologist and compare the results with other unimodal segmentation approaches. Finally, we apply our method to the segmentation of multiple sclerosis lesions by using a publicly available benchmark dataset. Results show a similar performance to other state-of-the-art multimodal methods, as well as to the human rater.     

Technical evaluation of in vivo abdominal fat and IMCL quantification using MRI and MRSI at 3 T

OBJECTIVES: The objectives of this study were to develop protocols that measure abdominal fat and calf muscle lipids with magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS), respectively, at 3 T and to examine the correlation between these parameters and insulin sensitivity. MATERIALS AND METHODS: Ten nondiabetic subjects [five insulin-sensitive (IS) subjects and five insulin-resistant (IR) subjects] were scanned at 3 T. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were segmented semiautomatically from abdominal imaging. Intramyocellular lipids (IMCL) in calf muscles were quantified with single-voxel MRS in both soleus and tibialis anterior muscles and with magnetic resonance spectroscopic imaging (MRSI). RESULTS: The average coefficient of variation (CV) of VAT/(VAT+SAT) was 5.2%. The interoperator CV was 1.1% and 5.3% for SAT and VAT estimates, respectively. The CV of IMCL was 13.7% in soleus, 11.9% in tibialis anterior and 2.9% with MRSI. IMCL based on MRSI (3.8+/-1.2%) were significantly inversely correlated with glucose disposal rate, as measured by a hyperinsulinemic-euglycemic clamp. VAT volume correlated significantly with IMCL. IMCL based on MRSI for IR subjects was significantly greater than that for IS subjects (4.5+/-0.9% vs. 2.8+/-0.5%, P=.02). CONCLUSION: MRI and MRS techniques provide a robust noninvasive measurement of abdominal fat and muscle IMCL, which are correlated with insulin action in humans.     

A new perceptual difference model for diagnostically relevant quantitative image quality evaluation: A preliminary study

Purpose

Most objective image quality metrics average over a wide range of image degradations. However, human clinicians demonstrate bias toward different types of artifacts. Here, we aim to create a perceptual difference model based on Case-PDM that mimics the preference of human observers toward different artifacts.

Method

We measured artifact disturbance to observers and calibrated the novel perceptual difference model (PDM). To tune the new model, which we call Artifact-PDM, degradations were synthetically added to three healthy brain MR data sets. Four types of artifacts (noise, blur, aliasing or “oil painting” which shows up as flattened, over-smoothened regions) of standard compressed sensing (CS) reconstruction, within a reasonable range of artifact severity, as measured by both PDM and visual inspection, were considered. After the model parameters were tuned by each synthetic image, we used a functional measurement theory pair-comparison experiment to measure the disturbance of each artifact to human observers and determine the weights of each artifact's PDM score. To validate Artifact-PDM, human ratings obtained from a Double Stimulus Continuous Quality Scale experiment were compared to the model for noise, blur, aliasing, oil painting and overall qualities using a large set of CS-reconstructed MR images of varying quality. Finally, we used this new approach to compare CS to GRAPPA, a parallel MRI reconstruction algorithm.

Results

We found that, for the same Artifact-PDM score, the human observer found incoherent aliasing to be the most disturbing and noise the least. Artifact-PDM results were highly correlated to human observers in both experiments. Optimized CS reconstruction quality compared favorably to GRAPPA's for the same sampling ratio.

Conclusions

We conclude our novel metric can faithfully represent human observer artifact evaluation and can be useful in evaluating CS and GRAPPA reconstruction algorithms, especially in studying artifact trade-offs.     

Evaluation of MRI artifacts at 3 Tesla for 38 commonly used cosmetics

Purpose

To evaluate MRI artifacts at 3-Tesla for 38 commonly used cosmetics.

Materials and Methods

Thirty-eight cosmetics (16, nail polishes; 5, eyeliners; 3, mascaras; 10, eye shadows; 1, lip gloss; 1, body lotion; 1, body glitter, and 1, hair loss concealer) underwent evaluation for MRI artifacts at 3-Tesla. The cosmetics were applied a copper-sulfate-filled, phantom and initially assessed using a “screening” gradient echo (GRE) pulse sequence. Of the 38 different cosmetics, 14 (37%) exhibited artifacts. For these 14 cosmetics, additional characterization of artifacts was performed using a GRE pulse sequence. A qualitative scale was applied to characterize the artifact size.

Results

Artifacts were observed, as follows: 2, nail polishes; 5, eyeliners; 3, mascaras; 3, eye shadows; 1, hair loss concealer. Artifact size ranged from small (eye shadow) to very large (hair loss concealer) and tended to be associated with the presence of iron oxide or other metal-based ingredient.

Conclusions

Commonly used cosmetics caused artifacts that may create issues if the area of interest is the same as where the cosmetic was applied or if its presence was unknown, thus, potentially causing it to be construed as pathology. Therefore, these findings have important implications for patients referred for MRI examinations.     

Intersubject variability in the analysis of diffusion tensor images at the group level: fractional anisotropy mapping and fiber tracking techniques

Introduction

Diffusion tensor imaging (DTI) provides comprehensive information about quantitative diffusion and connectivity in the human brain. Transformation into stereotactic standard space is a prerequisite for group studies and requires thorough data processing to preserve directional inter-dependencies. The objective of the present study was to optimize technical approaches for this preservation of quantitative and directional information during spatial normalization in data analyses at the group level.

Methods

Different averaging methods for mean diffusion-weighted images containing DTI information were compared, i.e., region of interest-based fractional anisotropy (FA) mapping, fiber tracking (FT) and corresponding tractwise FA statistics (TFAS). The novel technique of intersubject FT that takes into account directional information of single data sets during the FT process was compared to standard FT techniques. Application of the methods was shown in the comparison of normal subjects and subjects with defined white matter pathology (alterations of the corpus callosum).

Results

Fiber tracking was applied to averaged data sets and showed similar results compared with FT on single subject data. The application of TFAS to averaged data showed averaged FA values around 0.4 for normal controls. The values were in the range of the standard deviation for averaged FA values for TFAS applied to single subject data. These results were independent of the applied averaging technique. A significant reduction of the averaged FA values was found in comparison to TFAS applied to data from subjects with defined white matter pathology (FA around 0.2).

Conclusion

The applicability of FT techniques in the analysis of different subjects at the group level was demonstrated. Group comparisons as well as FT on group averaged data were shown to be feasible. The objective of this work was to identify the most appropriate method for intersubject averaging and group comparison which incorporates intersubject variability of the directional information.     

Synthesis of Fe3O4 magnetic fluid used for magnetic resonance imaging and hyperthermia

Fe₃O₄ magnetic nanoparticles were prepared by co-precipitation from FeSO₄·7H₂O and FeCl₃·6H₂O aqueous solutions using NaOH as precipitating reagent. The nanoparticles have an average size of 12 nm and exhibit superparamagnetism at room temperature. The nanoparticles were used to prepare a water-based magnetic fluid using oleic acid and Tween 80 as surfactants. The stability and magnetic properties of the magnetic fluid were characterized by Gouy magnetic balance. The experimental results imply that the hydrophilic block of Tween 80 can make the Fe₃O₄ nanoparticles suspending in water stable even after dilution and autoclaving. The magnetic fluid demonstrates excellent stability and fast magneto-temperature response, which can be used both in magnetic resonance imaging and magnetic fluid hyperthermia.     

Two-dimensional spectroscopic imaging for pretreatment evaluation of prostate cancer: comparison with the step-section histology after radical prostatectomy

Purpose

To minimize user and vendor dependence of the spectrum processing of prostate spectra, to measure the ratio of choline (Cho) plus creatine (Cr) to citrate (Cit) in the prostate tissue of normal volunteers and cancer patients, and to compare the results with pathologic findings after radical prostatectomy.

Materials and methods

Four healthy volunteers and 13 patients with prostate cancer were measured. Measurements were performed using two-dimensional magnetic resonance spectroscopic imaging (MRSI) and endorectal coil. A standard vendor's spectrum processing approach has been modified. An original feature of this methodology was the combination of vendor-optimized and user-independent spectrum preprocessing in the scanner and user-independent quantitation in the environment of an MRUI software package. (Cho+Cr)/Cit ratio was used for the classification of prostate tissue. Results were compared with histopathology after radical prostatectomy.

Results

Eight of 13 cancer patients were classified as suspicious or very suspicious for cancer at spectroscopy, three were ambiguous for cancer and two patients were evaluated as false negative. A considerable overlap of metabolite ratios at various Gleason score was found.

Conclusion

The proposed spectrum processing has the potential to improve the accuracy and user independency of the (Cho+Cr)/Cit quantitation. This study confirmed the previous results that a considerable overlap of (Cho+Cr)/Cit ratios exists at various Gleason score levels.     

Preoperative demonstration of neurovascular relationship in trigeminal neuralgia by using 3D FIESTA sequence

Purpose

The purpose of the study was to evaluate the value of high-resolution three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) imaging in the visualization of neurovascular relationship in patients with trigeminal neuralgia (TN).

Methods

Thirty-seven patients with unilateral typical TN underwent 3D FIESTA imaging. Neurovascular relationship at the trigeminal root entry zone was reviewed by an experienced neuroradiologist, who was blinded to the clinical details. The imaging results were compared with the operative findings in all patients.

Results

In 37 patients with TN, 3D FIESTA imaging identified surgically verified neurovascular contact in 35 of 36 symptomatic nerves. Based on surgical findings, the sensitivity and specificity of magnetic resonance (MR) imaging were 97.2% and 100%, respectively. Agreement between the position (medial, lateral, superior and inferior) of the compressing vessel relative to the trigeminal nerve identified by MR imaging and surgery was excellent (K=0.81; 95% confidence interval, 0.56–1.00). A statistically significant difference was found between the site of neurovascular contact and the clinical symptom related to the trigeminal branch (Fisher's Exact Test, P<.001).

Conclusions

Use of 3D FIESTA sequence enables accurate visualization of neurovascular contact in patients with TN. Anatomic relationships defined by this method can be useful in surgical planning and predicting surgical findings.