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Gagoski B, Xu J, Wighton P, Tisdall MD, Frost R, Lo WC, Golland P, van der Kouwe A, Adalsteinsson E, Grant PE. Automated detection and reacquisition of motion-degraded images in fetal HASTE imaging at 3 T. Magn Reson Med 2021; 87:1914-1922. [PMID: 34888942 DOI: 10.1002/mrm.29106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE Fetal brain Magnetic Resonance Imaging suffers from unpredictable and unconstrained fetal motion that causes severe image artifacts even with half-Fourier single-shot fast spin echo (HASTE) readouts. This work presents the implementation of a closed-loop pipeline that automatically detects and reacquires HASTE images that were degraded by fetal motion without any human interaction. METHODS A convolutional neural network that performs automatic image quality assessment (IQA) was run on an external GPU-equipped computer that was connected to the internal network of the MRI scanner. The modified HASTE pulse sequence sent each image to the external computer, where the IQA convolutional neural network evaluated it, and then the IQA score was sent back to the sequence. At the end of the HASTE stack, the IQA scores from all the slices were sorted, and only slices with the lowest scores (corresponding to the slices with worst image quality) were reacquired. RESULTS The closed-loop HASTE acquisition framework was tested on 10 pregnant mothers, for a total of 73 acquisitions of our modified HASTE sequence. The IQA convolutional neural network, which was successfully employed by our modified sequence in real time, achieved an accuracy of 85.2% and area under the receiver operator characteristic of 0.899. CONCLUSION The proposed acquisition/reconstruction pipeline was shown to successfully identify and automatically reacquire only the motion degraded fetal brain HASTE slices in the prescribed stack. This minimizes the overall time spent on HASTE acquisitions by avoiding the need to repeat the entire stack if only few slices in the stack are motion-degraded.
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Affiliation(s)
- Borjan Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Junshen Xu
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Paul Wighton
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - M Dylan Tisdall
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert Frost
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Wei-Ching Lo
- Siemens Medical Solutions USA, Inc, Charlestown, Massachusetts, USA
| | - Polina Golland
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.,Computer Science and Artificial Intelligence Laboratory (CSAIL), Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Andre van der Kouwe
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Elfar Adalsteinsson
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - P Ellen Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
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Tan E, Zhou JC, Mahmood O, Ong CL, Ng CH. MRI signs of intrauterine fetal demise. Abdom Radiol (NY) 2021; 46:3365-3377. [PMID: 33715028 DOI: 10.1007/s00261-021-03031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/24/2021] [Accepted: 02/27/2021] [Indexed: 11/26/2022]
Abstract
Intrauterine fetal demise (IUFD) is an uncommon but serious event that may occasionally be encountered on fetal MRI. Compared to the more florid signs of fetal demise which has occurred some time ago, recent IUFD is associated with more subtle findings that may be missed or misinterpreted. The two main MRI sequences used in imaging the fetus are T2-like two-dimensional balanced steady-state free-precession (SSFP), a white blood sequence, or T2-weighted single-shot fast spin-echo (SSFSE), a black blood sequence. The most reliable and specific signs of a recent IUFD are a constricted heart with poorly delineated cardiac chambers and signal abnormality in the heart and aorta, which will have different features depending on the MRI sequence used. Secondary signs of IUFD include global brain ischemia, abnormal globes, effusions, body wall edema and umbilical cord thrombosis. Unlike fetal ultrasound examinations where cardiac activity is routinely assessed, fetal MRI requires careful scrutiny of the fetal heart for assessment of fetal life.
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Affiliation(s)
- Eelin Tan
- Department of Diagnostic and Interventional Imaging, KK Womens' and Childrens' Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Joel Cheng'en Zhou
- Department of Diagnostic and Interventional Imaging, KK Womens' and Childrens' Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Omar Mahmood
- Department of Diagnostic and Interventional Imaging, KK Womens' and Childrens' Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Chiou Li Ong
- Department of Diagnostic and Interventional Imaging, KK Womens' and Childrens' Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Chee Hui Ng
- Department of Diagnostic and Interventional Imaging, KK Womens' and Childrens' Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
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Oishi K, Chang L, Huang H. Baby brain atlases. Neuroimage 2018; 185:865-880. [PMID: 29625234 DOI: 10.1016/j.neuroimage.2018.04.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 02/27/2018] [Accepted: 04/02/2018] [Indexed: 01/23/2023] Open
Abstract
The baby brain is constantly changing due to its active neurodevelopment, and research into the baby brain is one of the frontiers in neuroscience. To help guide neuroscientists and clinicians in their investigation of this frontier, maps of the baby brain, which contain a priori knowledge about neurodevelopment and anatomy, are essential. "Brain atlas" in this review refers to a 3D-brain image with a set of reference labels, such as a parcellation map, as the anatomical reference that guides the mapping of the brain. Recent advancements in scanners, sequences, and motion control methodologies enable the creation of various types of high-resolution baby brain atlases. What is becoming clear is that one atlas is not sufficient to characterize the existing knowledge about the anatomical variations, disease-related anatomical alterations, and the variations in time-dependent changes. In this review, the types and roles of the human baby brain MRI atlases that are currently available are described and discussed, and future directions in the field of developmental neuroscience and its clinical applications are proposed. The potential use of disease-based atlases to characterize clinically relevant information, such as clinical labels, in addition to conventional anatomical labels, is also discussed.
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Affiliation(s)
- Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Linda Chang
- Departments of Diagnostic Radiology and Nuclear Medicine, and Neurology, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Hao Huang
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Absent cavum septum pellucidum: a review with emphasis on associated commissural abnormalities. Pediatr Radiol 2015; 45:950-64. [PMID: 26123886 DOI: 10.1007/s00247-015-3318-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 12/06/2014] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
The cavum septum pellucidum (CSP) is an important fetal midline forebrain landmark, and its absence often signifies additional underlying malformations. Frequently detected by prenatal sonography, absence of the CSP requires further imaging with pre- or postnatal MRI to characterize the accompanying abnormalities. This article reviews the developmental anatomy of the CSP and the pivotal role of commissurization in normal development. An understanding of the patterns of commissural abnormalities associated with absence of the CSP can lead to improved characterization of the underlying spectrum of pathology.
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Gholipour A, Estroff JA, Barnewolt CE, Robertson RL, Grant PE, Gagoski B, Warfield SK, Afacan O, Connolly SA, Neil JJ, Wolfberg A, Mulkern RV. Fetal MRI: A Technical Update with Educational Aspirations. CONCEPTS IN MAGNETIC RESONANCE. PART A, BRIDGING EDUCATION AND RESEARCH 2014; 43:237-266. [PMID: 26225129 PMCID: PMC4515352 DOI: 10.1002/cmr.a.21321] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Fetal magnetic resonance imaging (MRI) examinations have become well-established procedures at many institutions and can serve as useful adjuncts to ultrasound (US) exams when diagnostic doubts remain after US. Due to fetal motion, however, fetal MRI exams are challenging and require the MR scanner to be used in a somewhat different mode than that employed for more routine clinical studies. Herein we review the techniques most commonly used, and those that are available, for fetal MRI with an emphasis on the physics of the techniques and how to deploy them to improve success rates for fetal MRI exams. By far the most common technique employed is single-shot T2-weighted imaging due to its excellent tissue contrast and relative immunity to fetal motion. Despite the significant challenges involved, however, many of the other techniques commonly employed in conventional neuro- and body MRI such as T1 and T2*-weighted imaging, diffusion and perfusion weighted imaging, as well as spectroscopic methods remain of interest for fetal MR applications. An effort to understand the strengths and limitations of these basic methods within the context of fetal MRI is made in order to optimize their use and facilitate implementation of technical improvements for the further development of fetal MR imaging, both in acquisition and post-processing strategies.
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Affiliation(s)
- Ali Gholipour
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Judith A Estroff
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Carol E Barnewolt
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Richard L Robertson
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - P Ellen Grant
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Borjan Gagoski
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Simon K Warfield
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Onur Afacan
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Susan A Connolly
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jeffrey J Neil
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Adam Wolfberg
- Boston Maternal Fetal Medicine, Boston, Massachusetts, USA
| | - Robert V Mulkern
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
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Abstract
Magnetic resonance imaging has become an important noninvasive technique to gain insight into fetal brain development. Its capabilities go beyond ultrasound when diagnosing high-risk pregnancies. To summarize observations across a population in magnetic resonance imaging studies, reference systems such as atlases that establish correspondences across a cohort are key. In this article, we review the evolution of atlas-building methods in light of their relevance, limitations, and benefits for the modeling of human brain development. Starting with single anatomical templates to which brain scans where mapped to such as Talairach and Montreal Neurological Institute space, we explore the uses of atlases as a means to establish correspondences across a cohort and as a model that captures the population characteristics of the cases the atlas is built from. We discuss methods that capture features of increasingly heterogeneous populations and approaches that are able to generalize with only minimal annotation. The main focus of this review are methods that explicitly model the variability in the population with regard to time, such as in the modeling of disease progression and brain development. We highlight the applicability and limitations of state-of-the art approaches, how insights from the study of disease progression are helpful in developmental studies, and point to the directions of future research that is still necessary.
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Abstract
Magnetic resonance imaging (MRI) has been used to image the in utero fetus for the past 3 decades. Although not as commonplace as other patient-oriented MRI, it is a growing field and demonstrating a role in the clinical care of the fetus. Indeed, the body of literature involving fetal MRI exceeds 3000 published articles. Indeed, there is interest in accessing even the healthy fetus with MRI to further understand the development of humans during the fetal stage. On the horizon is fetal imaging using 3.0-T clinical systems. Although a clear path is not necessarily determined, experiments, theoretical calculations, advances in pulse sequence design, new hardware, and experience from imaging at 1.5 T help define the path.
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Affiliation(s)
- Robert C Welsh
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109-5667, USA.
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Vossough A, Limperopoulos C, Putt ME, du Plessis AJ, Schwab PJ, Wu J, Gee JC, Licht DJ. Development and validation of a semiquantitative brain maturation score on fetal MR images: initial results. Radiology 2013; 268:200-7. [PMID: 23440324 DOI: 10.1148/radiol.13111715] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To develop a valid, reliable, and simple-to-use semiquantitative visual scale of fetal brain maturation for use in clinical fetal MR imaging assessment and interpretation. MATERIALS AND METHODS This is a retrospective assessment of data from a previous study that was prospective, institutional review board approved, and HIPAA compliant. Forty-eight normal pregnancies with a gestational age (GA) of 25 to 35 weeks were studied. A fetal total maturation score (fTMS) was developed by utilizing six subscores that evaluated cortical sulcation, myelination, and the germinal matrix and provided a single combined numerical value to be evaluated as a marker of brain maturity. The fTMS was correlated with GA and segmented brain volume. A regression model that associated GA based on the visual fTMS scoring was determined. The model was validated with a leave-one-out cross validation procedure. RESULTS Mean GA was 29.3 weeks ± 2.9 (standard deviation) (range, 25.2-35.3 weeks) and mean fTMS was 8.6 ± 3.7 (range, 4-16). The intraclass correlation coefficient between the three readers (independent and blinded) was 0.948 (P < .001). The correlations were as follows: GA and brain volume, r = 0.964 (P < .001); fTMS and brain volume, r = 0.970 (P < .001); and GA and fTMS, r = 0.975 (P < .001). A regression model to calculate GA based on fTMS yielded the following equation: calculated GA (weeks) = 22.86 + 0.748 fTMS (P < .001; adjusted R(2) = 0.946). The standard error of the model for calculation of fetal GA from the visual fTMS scale was ± 4.8 days. CONCLUSION If validated further, the fTMS scale might be used to assess morphologic brain maturity of fetuses between 25 and 35 weeks GA on a single-case basis in a clinical setting.
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Affiliation(s)
- Arastoo Vossough
- Department of Radiology, Children's Hospital of Philadelphia, 324 S 34th St, Wood 2115, Philadelphia, PA 19004, USA.
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Hallowell SG, Spatz DL. The relationship of brain development and breastfeeding in the late-preterm infant. J Pediatr Nurs 2012; 27:154-62. [PMID: 22341194 DOI: 10.1016/j.pedn.2010.12.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 12/16/2010] [Accepted: 12/27/2010] [Indexed: 11/30/2022]
Abstract
Late-preterm infants (34 0/7-36 6/7 weeks gestation) are physiologically and developmentally immature at birth. The relationship between brain development and feeding is important since adequate oral intake is imperative to prevent feeding-related morbidity and mortality associated with being late preterm. One third of brain growth occurs in the last 6-8 weeks of gestation. The ontogeny of coordinated oral feeding appears to follow a chronological, predictable pattern in preterm neonates. This suggests that neurodevelopmental maturation, rather than experience or learned behavior, is largely responsible for feeding behaviors. The aim of this article is to provide a review of the literature that establishes the relationship between brain development and feeding in the late-preterm infant.
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Affiliation(s)
- Sunny G Hallowell
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, PA, USA.
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