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Bangalore Yogananda CG, Wagner BC, Truong NCD, Holcomb JM, Reddy DD, Saadat N, Hatanpaa KJ, Patel TR, Fei B, Lee MD, Jain R, Bruce RJ, Pinho MC, Madhuranthakam AJ, Maldjian JA. MRI-Based Deep Learning Method for Classification of IDH Mutation Status. Bioengineering (Basel) 2023; 10:1045. [PMID: 37760146 PMCID: PMC10525372 DOI: 10.3390/bioengineering10091045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Isocitrate dehydrogenase (IDH) mutation status has emerged as an important prognostic marker in gliomas. This study sought to develop deep learning networks for non-invasive IDH classification using T2w MR images while comparing their performance to a multi-contrast network. Methods: Multi-contrast brain tumor MRI and genomic data were obtained from The Cancer Imaging Archive (TCIA) and The Erasmus Glioma Database (EGD). Two separate 2D networks were developed using nnU-Net, a T2w-image-only network (T2-net) and a multi-contrast network (MC-net). Each network was separately trained using TCIA (227 subjects) or TCIA + EGD data (683 subjects combined). The networks were trained to classify IDH mutation status and implement single-label tumor segmentation simultaneously. The trained networks were tested on over 1100 held-out datasets including 360 cases from UT Southwestern Medical Center, 136 cases from New York University, 175 cases from the University of Wisconsin-Madison, 456 cases from EGD (for the TCIA-trained network), and 495 cases from the University of California, San Francisco public database. A receiver operating characteristic curve (ROC) was drawn to calculate the AUC value to determine classifier performance. Results: T2-net trained on TCIA and TCIA + EGD datasets achieved an overall accuracy of 85.4% and 87.6% with AUCs of 0.86 and 0.89, respectively. MC-net trained on TCIA and TCIA + EGD datasets achieved an overall accuracy of 91.0% and 92.8% with AUCs of 0.94 and 0.96, respectively. We developed reliable, high-performing deep learning algorithms for IDH classification using both a T2-image-only and a multi-contrast approach. The networks were tested on more than 1100 subjects from diverse databases, making this the largest study on image-based IDH classification to date.
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Affiliation(s)
- Chandan Ganesh Bangalore Yogananda
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Benjamin C. Wagner
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Nghi C. D. Truong
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - James M. Holcomb
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Divya D. Reddy
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Niloufar Saadat
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Kimmo J. Hatanpaa
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Toral R. Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Baowei Fei
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Matthew D. Lee
- Department of Radiology, NYU Grossman School of Medicine, New York, NY 10016, USA; (M.D.L.); (R.J.)
| | - Rajan Jain
- Department of Radiology, NYU Grossman School of Medicine, New York, NY 10016, USA; (M.D.L.); (R.J.)
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Richard J. Bruce
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
| | - Marco C. Pinho
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Ananth J. Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
| | - Joseph A. Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (B.C.W.); (N.C.D.T.); (J.M.H.); (D.D.R.); (N.S.); (B.F.); (M.C.P.); (A.J.M.); (J.A.M.)
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Grimbergen G, Eijkelenkamp H, van Vulpen JK, van de Ven S, Raaymakers BW, Intven MP, Meijer GJ. Feasibility of online radial magnetic resonance imaging for adaptive radiotherapy of pancreatic tumors. Phys Imaging Radiat Oncol 2023; 26:100434. [PMID: 37034029 PMCID: PMC10074242 DOI: 10.1016/j.phro.2023.100434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Background and purpose Online adaptive magnetic resonance (MR)-guided treatment planning for pancreatic tumors on 1.5T systems typically employs Cartesian 3D T 2w magnetic resonance imaging (MRI). The main disadvantage of this sequence is that respiratory motion results in substantial blurring in the abdomen, which can hamper delineation accuracy. This study investigated the use of two motion-robust radial MRI sequences as main delineation scan for pancreatic MR-guided radiotherapy. Materials and methods Twelve patients with pancreatic tumors were imaged with a 3D T 2w scan, a Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) scan (partially overlapping strips), and a 3D Vane scan (stack-of-stars), on a 1.5T MR-Linac under abdominal compression. The scans were assessed by three radiation oncologists for their suitability for online adaptive delineation. A quantitative comparison was made for gradient entropy and the effect of motion on apparent target position. Results The PROPELLER scans were selected as first preference in 56% of the cases, the 3D T 2w in 42% and the 3D Vane in 3%. PROPELLER scans sometimes contained a large interslice variation which would have compromised delineation. Gradient entropy was significantly higher in 3D T 2w patient scans. The apparent target position was more sensitive to motion amplitude in the PROPELLER scans, but substantial offsets did not occur under 10 mm peak-to-peak. Conclusion PROPELLER MRI may be a superior imaging sequence for pancreatic MRgRT compared to standard Cartesian sequences. The large interslice variation should be mitigated through further sequence optimization before PROPELLER can be adopted for online treatment adaptation.
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Kohli A, Pilkinton DT, Xi Y, Cho G, Moore D, Mohammadi D, Chhabra A. Image quality improvement and motion degradation reduction in shoulder MR imaging: comparison of BLADE and rectilinear techniques at 3-Tesla scanning. Skeletal Radiol 2022; 51:2291-2297. [PMID: 35751690 DOI: 10.1007/s00256-022-04085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE MR imaging of joints, particularly shoulder, requires a high degree of spatial resolution to ascertain anatomy and pathology. Unfortunately, motion artifacts can reduce the clinical quality of the examinations. BLADE sequence reduces motion degradation improving overall diagnostic imaging quality. The objective was to compare standard, rectilinear k-space coverage turbo spin echo (TSE), and BLADE sequences. MATERIAL AND METHODS Over a 4-month period, fifty-seven consecutive patients (22 males, 35 females; mean age: 48.5 years, range: 23-64 years) were scanned using traditional intermediate-weighted spin echo and BLADE sequences. Qualitative evaluation was performed by three musculoskeletal fellowship trained radiologists, each with more than 5 years of experience. Image sequences were evaluated using a Likert scale for each of the following five categories: motion degradation, ghosting/phase misregistration artifacts, star/radial encoding artifacts, fat suppression quality, and overall diagnostic quality. Additionally, image sequences were evaluated for signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) using manually drawn regions of interest (ROI) analysis. RESULTS Ghosting and phase artifacts were lower within BLADE sequence while streak artifacts were higher (p < 0.001). Image fat suppression, tendon and labral appearances, and the overall SNR and CNR were comparable on both sequences (p > 0.05). CONCLUSION Addition of BLADE reduces motion degradation and improves overall diagnostic imaging quality. Application of BLADE in patient scans suspected of motion artifacts can reduce the frequency of repeat imaging in patients with claustrophobia or those where motion is a concern. By reducing overall imaging time and call backs, it could reduce the cost burden to patients and healthcare system.
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Affiliation(s)
- Ajay Kohli
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA.,Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - David T Pilkinton
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Yin Xi
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Gina Cho
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Daniel Moore
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Daniel Mohammadi
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, 75022, USA. .,Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
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Sartoretti E, Sartoretti-Schefer S, van Smoorenburg L, Binkert CA, Gutzeit A, Wyss M, Sartoretti T. Spiral 2D T2-Weighted TSE Brain MR Imaging: Initial Clinical Experience. AJNR Am J Neuroradiol 2021; 42:1962-1967. [PMID: 34674994 DOI: 10.3174/ajnr.a7299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 07/23/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Spiral MR imaging may enable improved image quality and higher scan speeds than Cartesian trajectories. We sought to compare a novel spiral 2D T2-weighted TSE sequence with a conventional Cartesian and an artifact-robust, non-Cartesian sequence named MultiVane for routine clinical brain MR imaging. MATERIALS AND METHODS Thirty-one patients were scanned with all 3 sequences (Cartesian, 4 minutes 14 seconds; MultiVane, 2 minutes 49 seconds; spiral, 2 minutes 12 seconds) on a standard clinical 1.5T MR scanner. Three readers described the presence and location of abnormalities and lesions and graded images qualitatively in terms of overall image quality, the presence of motion and pulsation artifacts, gray-white matter differentiation, lesion conspicuity, and subjective preference. Image quality was objectivized by measuring the SNR and the coefficients of variation for CSF, GM, and WM. RESULTS Spiral achieved a scan time reduction of 51.9% and 21.9% compared with Cartesian and MultiVane, respectively. The number and location of lesions were identical among all sequences. As for the qualitative analysis, interreader agreement was high (Krippendorff α > .75). Spiral and MultiVane both outperformed the Cartesian sequence in terms of overall image quality, the presence of motion artifacts, and subjective preference (P < .001). In terms of the presence of pulsation artifacts, gray-white matter differentiation, and lesion conspicuity, all 3 sequences performed similarly well (P > .15). Spiral and MultiVane outperformed the Cartesian sequence in coefficient of variation WM and SNR (P < .01). CONCLUSIONS Spiral 2D T2WI TSE is feasible for routine structural brain MR imaging and offers high-quality, artifact-robust brain imaging in short scan times.
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Affiliation(s)
- E Sartoretti
- From the Institute of Radiology (E.S., S.S.-S., L.v.S., C.A.B., T.S.), Kantonsspital Winterthur, Winterthur, Switzerland.,Faculty of Medicine (E.S., T.S.), University of Zürich, Zürich, Switzerland
| | - S Sartoretti-Schefer
- From the Institute of Radiology (E.S., S.S.-S., L.v.S., C.A.B., T.S.), Kantonsspital Winterthur, Winterthur, Switzerland
| | - L van Smoorenburg
- From the Institute of Radiology (E.S., S.S.-S., L.v.S., C.A.B., T.S.), Kantonsspital Winterthur, Winterthur, Switzerland
| | - C A Binkert
- From the Institute of Radiology (E.S., S.S.-S., L.v.S., C.A.B., T.S.), Kantonsspital Winterthur, Winterthur, Switzerland
| | - A Gutzeit
- Department of Radiology (A.G.), Paracelsus Medical University, Salzburg, Austria
| | - M Wyss
- Philips Healthcare (M.W.), Zürich, Switzerland
| | - T Sartoretti
- From the Institute of Radiology (E.S., S.S.-S., L.v.S., C.A.B., T.S.), Kantonsspital Winterthur, Winterthur, Switzerland.,Faculty of Medicine (E.S., T.S.), University of Zürich, Zürich, Switzerland.,Department of Radiology and Nuclear Medicine (T.S.), Maastricht University Medical Center, Maastricht University, Maastricht, the Netherlands
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Sartoretti E, Wyss M, Eichenberger B, van Smoorenburg L, Binkert CA, Sartoretti-Schefer S, Sartoretti T. Rapid T2-weighted turbo spin echo MultiVane brain MRI using compressed SENSE: a qualitative analysis. Clin Radiol 2021; 76:786.e15-786.e22. [PMID: 34272060 DOI: 10.1016/j.crad.2021.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022]
Affiliation(s)
- E Sartoretti
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland; University of Zürich, Faculty of Medicine, Zürich, Switzerland
| | - M Wyss
- Philips Healthsystems, Zürich, Switzerland
| | - B Eichenberger
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - L van Smoorenburg
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland; University of Zürich, Faculty of Medicine, Zürich, Switzerland
| | - C A Binkert
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - S Sartoretti-Schefer
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - T Sartoretti
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland; University of Zürich, Faculty of Medicine, Zürich, Switzerland; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.
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Duan Y. Editorial for "Diagnostic Performance of Single-Shot FLAIR With Wide Inversion Recovery Pulse Designed to Reduce Cerebrospinal Fluid and Motion Artifacts for Evaluation of Uncooperative Patients in Acute Stroke Protocol". J Magn Reson Imaging 2021; 53:1839-1840. [PMID: 33900650 DOI: 10.1002/jmri.27640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yang Duan
- Department of Radiology, Center for Neuroimaging, The Northern Theater General Hospital, Shenyang, China
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Kubota Y, Yokota H, Sakai T, Yoneyama M, Ohira K, Uno T. Clinical feasibility of single-shot fluid-attenuated inversion recovery with wide inversion recovery pulse designed to reduce cerebrospinal fluid and motion artifacts for evaluation of uncooperative patients in acute stroke protocol. J Magn Reson Imaging 2020; 53:1833-1838. [PMID: 33368729 DOI: 10.1002/jmri.27483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 11/06/2022] Open
Abstract
Fluid-attenuated inversion recovery (FLAIR) imaging is a key sequence for stroke assessment. Motion artifact reduction with short acquisition time is still challenging, but necessary in the magnetic resonance (MR) stroke protocol, especially for uncooperative patients suspected of stroke. The aim of this study is to investigate the feasibility of modified single-shot FLAIR with wide inversion recovery pulses for use in stroke patients. This is a prospective study, which included 30 patients clinically suspected of stroke who were examined by MR stroke protocol from January 2018 to September 2018. A 1.5 T, multi-shot-turbo spin-echo (TSE) conventional FLAIR, and single-shot-TSE-FLAIR with wide inversion recovery pulse were used. Modified single-shot FLAIR was obtained for 30 patients with suspected stroke who moved during conventional FLAIR scan. Motion artifacts were randomly and independently scored using a 5-grade scale by three radiologists in blinded fashion. Whether the FLAIR vessel hyperintensity sign was present was visually evaluated. Statistical tests included Wilcoxon-signed rank test and weighted Cohen's kappa statistics. The motion artifact score was significantly lower in single-shot FLAIR than in conventional FLAIR (0.37 ± 0.56 vs. 1.83 ± 1.18; p < 0.05. The vessel hyperintensity sign was visualized in 6 and 5 patients on single-shot and conventional FLAIR images, respectively. This study demonstrates the value of single-shot FLAIR for stroke assessment. Single-shot FLAIR reduced motion artifact and visualized vessel hyperintensity sign more than conventional FLAIR. LEVEL OF EVIDENCE: 2. TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Yoshihiro Kubota
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Hajime Yokota
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Sakai
- Department of Radiology, Eastern Chiba Medical Center, Chiba, Japan
| | | | - Kenji Ohira
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Takashi Uno
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Bangalore Yogananda CG, Shah BR, Vejdani-Jahromi M, Nalawade SS, Murugesan GK, Yu FF, Pinho MC, Wagner BC, Mickey B, Patel TR, Fei B, Madhuranthakam AJ, Maldjian JA. A novel fully automated MRI-based deep-learning method for classification of IDH mutation status in brain gliomas. Neuro Oncol 2020; 22:402-411. [PMID: 31637430 PMCID: PMC7442388 DOI: 10.1093/neuonc/noz199] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/16/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH) mutation status has emerged as an important prognostic marker in gliomas. Currently, reliable IDH mutation determination requires invasive surgical procedures. The purpose of this study was to develop a highly accurate, MRI-based, voxelwise deep-learning IDH classification network using T2-weighted (T2w) MR images and compare its performance to a multicontrast network. METHODS Multiparametric brain MRI data and corresponding genomic information were obtained for 214 subjects (94 IDH-mutated, 120 IDH wild-type) from The Cancer Imaging Archive and The Cancer Genome Atlas. Two separate networks were developed, including a T2w image-only network (T2-net) and a multicontrast (T2w, fluid attenuated inversion recovery, and T1 postcontrast) network (TS-net) to perform IDH classification and simultaneous single label tumor segmentation. The networks were trained using 3D Dense-UNets. Three-fold cross-validation was performed to generalize the networks' performance. Receiver operating characteristic analysis was also performed. Dice scores were computed to determine tumor segmentation accuracy. RESULTS T2-net demonstrated a mean cross-validation accuracy of 97.14% ± 0.04 in predicting IDH mutation status, with a sensitivity of 0.97 ± 0.03, specificity of 0.98 ± 0.01, and an area under the curve (AUC) of 0.98 ± 0.01. TS-net achieved a mean cross-validation accuracy of 97.12% ± 0.09, with a sensitivity of 0.98 ± 0.02, specificity of 0.97 ± 0.001, and an AUC of 0.99 ± 0.01. The mean whole tumor segmentation Dice scores were 0.85 ± 0.009 for T2-net and 0.89 ± 0.006 for TS-net. CONCLUSION We demonstrate high IDH classification accuracy using only T2-weighted MR images. This represents an important milestone toward clinical translation.
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Affiliation(s)
| | - Bhavya R Shah
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Sahil S Nalawade
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Gowtham K Murugesan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Frank F Yu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marco C Pinho
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Benjamin C Wagner
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bruce Mickey
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Toral R Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Baowei Fei
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas
| | - Ananth J Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas,Corresponding Author: Joseph A. Maldjian, MD, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390–9178 ()
| | - Joseph A Maldjian
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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Heida EJ, Lunsing RJ, Brouwer OF, Meiners LC. Melatonin in neuropaediatric MRI: a retrospective study of efficacy in a general hospital setting. Eur J Paediatr Neurol 2020; 25:172-180. [PMID: 31753707 DOI: 10.1016/j.ejpn.2019.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/21/2019] [Accepted: 10/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Melatonin may offer a safe and cheap alternative to general anaesthesia and sedatives in neuropaediatric MRI. The purpose of our study was to evaluate its efficacy during a daily scanning programme and to assess its financial benefit. METHODS Neuro-MRI scans, performed in a general hospital setting after administration of melatonin in 64 children aged 10 months-5 years, were retrospectively reassessed by an experienced paediatric neuroradiologist, rating them as diagnostically contributing or as failed. The financial benefit was calculated. RESULTS 49/64 scans (77%) were diagnostically contributing, in 11 (22%) no movement artefact was seen in any sequence; 15/64 scans failed (23%), in 3/15 because of serious movement artefacts, in 12/15 the scan was not started. Repeat scans under general anaesthesia were performed in 17 cases (27%): in the 15 failed cases and in 2 cases initially assessed as failed, but were considered diagnostically contributing in the present study. The financial benefit at the time the scans were made was approximately 13,360 Euro. CONCLUSIONS In this retrospective study, the use of melatonin in neuropaediatric MRI, made during a daily scanning programme with a remote waiting room, was associated with a high success rate in infants and young children. A minority of scans had no movement artefacts, indicating most children were not asleep. The sleep-inducing effect of melatonin could therefore not be proven, but the high success rate may be attributed to the sedative and/or anxiolytic effect of melatonin. Only a minority of scans had to be repeated under general anesthesia, leading to a reduction of scan related costs.
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Affiliation(s)
- Elebarta Je Heida
- University of Groningen, University Medical Centre Groningen, Department of Neurology, Groningen, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of Radiology, Groningen, the Netherlands
| | - Roelineke J Lunsing
- University of Groningen, University Medical Centre Groningen, Department of Neurology, Groningen, the Netherlands
| | - Oebele F Brouwer
- University of Groningen, University Medical Centre Groningen, Department of Neurology, Groningen, the Netherlands
| | - Linda C Meiners
- University of Groningen, University Medical Centre Groningen, Department of Radiology, Groningen, the Netherlands.
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Hu HH, McAllister AS, Jin N, Lubeley LJ, Selvaraj B, Smith M, Krishnamurthy R, Zhou K. Comparison of 2D BLADE Turbo Gradient- and Spin-Echo and 2D Spin-Echo Echo-Planar Diffusion-Weighted Brain MRI at 3 T: Preliminary Experience in Children. Acad Radiol 2019; 26:1597-1604. [PMID: 30777649 DOI: 10.1016/j.acra.2019.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/27/2019] [Accepted: 02/04/2019] [Indexed: 12/28/2022]
Abstract
RATIONALE AND OBJECTIVES We describe our preliminary experience using a 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with non-Cartesian BLADE trajectory at 3 T in pediatric patients. We compared the TGSE BLADE to conventional DW spin-echo echo-planar imaging (SE-EPI) in pediatric brain imaging, assessing the presence of artifacts from signal pile-ups, geometric distortion, motion, susceptibility from air-tissue interface, shunts and orthodontia, and diagnostic image quality. MATERIALS AND METHODS Data were acquired in 53 patients (10.4 ± 7.9 years). All DW imaging data were acquired precontrast, with SE-EPI first. A four-point scale for rating was used-1 (best) and 4 (worst). A neuroradiologist scored the two sequences and further noted whether the TGSE BLADE approach or SE-EPI was preferred in each case. Apparent diffusion coefficients were compared quantitatively between the two sequences in a subset of 16 patients, in 41 separate regions of interests including caudate nucleus, putamen, globus pallidus, thalamus, and pathological areas. RESULTS In 43.4% of the cases, TGSE BLADE was preferred; in 49.1% of the cases, both sequences were preferred equally. Average scores for SE-EPI were 2.2 ± 0.8 versus TGSE's 1.2 ± 0.4 in assessing diagnostic quality (p < 0.05). Motion artifacts were minimal on both sequences in 92.5% of the cases. In the TGSE BLADE scores, no case received a "4" for significant artifacts with marginally acceptable image quality. Apparent diffusion coefficients values between the two sequences were statistically similar, with a linear regression slope of 0.92 (r2 = 0.97). CONCLUSION TGSE BLADE DW imaging exhibited less geometric distortion in the brain and reduced signal pile-ups in areas of high susceptibility than conventional SE-EPI.
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Jiang H, Wang S, Xian J, Chen Q, Wei W. Efficacy of PROPELLER in reducing ocular motion artefacts and improving image quality of orbital MRI at 3 T using an eye surface coil. Clin Radiol 2019; 74:734.e7-734.e12. [DOI: 10.1016/j.crad.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/20/2019] [Indexed: 12/21/2022]
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Hu HH, Benkert T, Jones JY, McAllister AS, Rusin JA, Krishnamurthy R, Block KT. 3D T1-weighted contrast-enhanced brain MRI in children using a fat-suppressed golden angle radial acquisition: an alternative to Cartesian inversion-recovery imaging. Clin Imaging 2019; 55:112-118. [DOI: 10.1016/j.clinimag.2019.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/18/2018] [Accepted: 02/08/2019] [Indexed: 02/07/2023]
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Park JE, Choi YH, Cheon J, Kim WS, Kim I, Ryu YJ, Paek M. Three-Dimensional Radial VIBE Sequence for Contrast-Enhanced Brain Imaging: An Alternative for Reducing Motion Artifacts in Restless Children. AJR Am J Roentgenol 2018; 210:876-82. [DOI: 10.2214/ajr.17.18490] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Meier-Schroers M, Marx C, Schmeel FC, Wolter K, Gieseke J, Block W, Sprinkart AM, Traeber F, Willinek W, Schild HH, Kukuk GM. Revised PROPELLER for T2-weighted imaging of the prostate at 3 Tesla: impact on lesion detection and PI-RADS classification. Eur Radiol 2017; 28:24-30. [DOI: 10.1007/s00330-017-4949-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/18/2017] [Accepted: 06/15/2017] [Indexed: 12/20/2022]
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Mavroidis P, Giankou E, Tsikrika A, Kapsalaki E, Chatzigeorgiou V, Batsikas G, Zaimis G, Kostopoulos S, Glotsos D, Ninos K, Georgountzos V, Kavouras D, Lavdas E. Brain imaging: Comparison of T1W FLAIR BLADE with conventional T1W SE. Magn Reson Imaging 2017; 37:234-42. [DOI: 10.1016/j.mri.2016.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 12/02/2016] [Accepted: 12/03/2016] [Indexed: 11/17/2022]
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Nagatomo K, Yabuuchi H, Yamasaki Y, Narita H, Kumazawa S, Kojima T, Sakai N, Masaki M, Kimura H. Efficacy of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) for shoulder magnetic resonance (MR) imaging. Eur J Radiol 2016; 85:1735-1743. [PMID: 27666610 DOI: 10.1016/j.ejrad.2016.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 06/05/2016] [Accepted: 07/14/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To elucidate the utility of PROPELLER for motion artefact reduction on shoulder MRI and to examine the influence of streak artefacts on diagnosis of clinical images. METHODS 15 healthy volunteers and 48 patients underwent shoulder MRI with/without PROPELLER (coronal oblique proton density-fast spin echo [PD-FSE], sagittal oblique T2-FSE). In a volunteer study, all sequences were performed in both static and exercise-loaded conditions. Two radiologists graded artefacts and delineation of various anatomical structures in the volunteer study and motion and streak artefacts in the clinical study. Mean scores were compared between sequences with/without PROPELLER. In the clinical study, mean scores of motion artefacts were compared with mean scores of streak artefacts. Wilcoxon signed-rank test was used for all comparisons. RESULTS In both studies, PROPELLER significantly reduced motion artefacts (P<0.05). In the volunteer study, it significantly improved delineations in sagittal oblique images in the exercise-loaded condition (P<0.05). In the clinical study, streak artefacts appeared dominantly on images with PROPELLER (P<0.05), but influenced diagnosis to a lesser extent than motion artefacts. CONCLUSION PROPELLER can reduce motion artefacts in shoulder MRI. While it does cause streak artefacts, it affects diagnosis to a lesser extent.
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Affiliation(s)
- Kazuya Nagatomo
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Hidetake Yabuuchi
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Yuzo Yamasaki
- Department of Clinical Radiology, Graduate of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Hiroshi Narita
- Hitachi Medical Corporation, 3-26-29 Hakataekimae, Hakata-ku, Fukuoka 812-0011, Japan.
| | - Seiji Kumazawa
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Tsukasa Kojima
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Noriyuki Sakai
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Masahumi Masaki
- Department of Radiology, Kimura Hospital, 2-13-19 Chiyo, Hakata-ku, Fukuoka 812-0044, Japan.
| | - Hiroshi Kimura
- Department of Surgery, Kimura Hospital, 2-13-19 Chiyo, Hakata-ku, Fukuoka 812-0044, Japan.
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Kojima T, Yabuuchi H, Narita H, Kumazawa S, Yamasaki Y, Yano Y, Sakai N, Kurihara Y, Hisada K, Masaki M, Kimura H. Efficacy of the radial acquisition regime (RADAR) for acquiring head and neck MR images. Br J Radiol 2016; 89:20160007. [PMID: 27635791 DOI: 10.1259/bjr.20160007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the efficacy of the radial acquisition regime (RADAR) for acquiring head and neck MR images. METHODS 15 healthy volunteers underwent imaging with 4 sequences [fast spin echo T2 weighted imaging (FSE-T2WI), RADAR T2 weighted imaging (RADAR-T2WI), single-shot echo planar imaging diffusion-weighted imaging (SS-EPI-DWI) and RADAR diffusion-weighted imaging (RADAR-DWI)]. Both standard images and images during periodic mouth motion were acquired. Two radiologists scored the overall image artefacts and detectability of several anatomical structures without knowledge of sequence type. For each sequence, image distortion was quantitatively compared by the anteroposterior to right-left ratio of several anatomical structures. The mean scores of artefacts and distortion of several anatomical structures were compared using the multiple comparison test. The detectabilities were compared using the Wilcoxon signed-rank test. RESULTS Regardless of mouth motion, RADAR-T2WI was significantly superior to FSE-T2WI in artefacts and oral-area detectability (p < 0.01), and RADAR-DWI was significantly superior to SS-EPI-DWI in terms of artefacts (p < 0.01). In terms of image distortion, RADAR-DWI was significantly superior to SS-EPI-DWI (p < 0.01). CONCLUSION RADAR-T2WI could replace FSE-T2WI as a conventional T2WI protocol for the head and neck. For the RADAR-DWI sequence, validation studies are needed. Advances in knowledge: RADAR-T2WI was superior to FSE-T2WI with regard to artefacts and detectability, and RADAR-DWI was superior in terms of artefacts compared with SS-EPI-DWI.
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Affiliation(s)
- Tsukasa Kojima
- 1 Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidetake Yabuuchi
- 1 Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Seiji Kumazawa
- 1 Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuzo Yamasaki
- 3 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuki Yano
- 1 Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriyuki Sakai
- 1 Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Kiyoshi Hisada
- 4 Department of Radiology, Kimura Hospital, Fukuoka, Japan
| | | | - Hiroshi Kimura
- 5 Department of Surgery, Kimura Hospital, Fukuoka, Japan
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Mavroidis P, Roka V, Kostopoulos S, Batsikas G, Lavdas E. Arachnoid cysts: the role of the BLADE technique. Hippokratia 2016; 20:244-248. [PMID: 29097895 PMCID: PMC5654446] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND This study aims at demonstrating the ability of BLADE sequences to reduce or even eliminate all the image artifacts as well as verifying the significance of using this technique in certain pathological conditions. MATERIAL AND METHODS This study involved fourteen consecutive patients (5 females, 9 males), who routinely underwent magnetic resonance imaging (MRI) brain examination, between 2010-2014. The applied routine protocol for brain MRI examination included the following sequences: i) T2-weighted (W) fluid-attenuated inversion recovery (FLAIR) axial; ii) T2-W turbo spin echo (TSE) axial; iii) T2*-W axial, iv) T1-W TSE sagittal; v) Diffusion-weighted (DWI) axial; vi) T1-W TSE axial; vii) T1-W TSE axial+contrast. Additionally, the T2-W FLAIR BLADE sequence was added to the protocol in cases of cystic tumors. Two radiologists independently evaluated all the images at two separate settings, which were performed 3 weeks apart. The presence of image artifacts such as motion, flow, chemical shift and Gibbs ringing artifacts, were also evaluated by the radiologists. In the measurements of the cysts, the extent of the divergence by the two MRI techniques (conventional and BLADE) was used by the two radiologists to evaluate the accuracy of the two techniques to determine the size of the cysts. RESULTS BLADE sequences were found to be more reliable than the conventional ones regarding the estimation of the cyst size. The qualitative analysis showed that the T2 FLAIR BLADE sequences were superior to the conventional T2 FLAIR with statistical significance (p <0.001) in the following fields: i) overall image quality, ii) cerebrospinal fluid (CSF) nulling; iii) contrast between pathology and its surrounding; iv) borders of the pathology; v) motion artifacts; vi) flow artifacts; vii) chemical shift artifacts and viii) Gibbs ringing artifacts. CONCLUSIONS BLADE sequence was found to decrease both flow artifacts in the temporal lobes and motion artifacts from the orbits. Additionally, it was shown to improve flow artifacts and image quality in cystic pathologies such as arachnoid cysts. Hippokratia 2016, 20(3): 244-248.
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Affiliation(s)
- P Mavroidis
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA
- Department of Medical Physics, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| | - V Roka
- Health Center of Farkadona, Trikala, Greece
| | - S Kostopoulos
- Department of Medical Instruments Technology, Technological Education Institute of Athens, Athens, Greece
| | - G Batsikas
- Department of Medical Imaging, IASO Thessalias Hospital, Larissa, Greece
| | - E Lavdas
- Department of Medical Radiological Technologists, Technological Education Institute of Athens, Athens, Greece
- Department of Medical Imaging, Animus kyanoys Larissa Hospital, Larissa, Larissa, Greece
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Meier-Schroers M, Kukuk G, Homsi R, Skowasch D, Schild HH, Thomas D. MRI of the lung using the PROPELLER technique: Artifact reduction, better image quality and improved nodule detection. Eur J Radiol 2015; 85:707-13. [PMID: 26971412 DOI: 10.1016/j.ejrad.2015.12.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the benefit of the PROPELLER technique (Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction, MultiVane, MV) for MR imaging of the lung. MATERIALS AND METHODS 30 Participants of a lung cancer screening program were recruited for the comparison of T2-MV and T2-Fast Spin Echo (FSE) sequences at 1.5T. Two readers evaluated artifacts, image quality, and pulmonary lesions. Artifacts and image quality were rated using a four-point scale. Lesion detection was correlated to low-dose computed tomography (CT). Wilcoxon rank-test for ratings of artifacts and image quality, sensitivity and specificity values for lesion detection, and Cohen's kappa for inter-rater agreement were used. RESULTS The MV sequence showed less pulsation and motion artifacts, and higher image quality (p=0.001 for R1, p=0.002 for R2) than FSE (p<0.001 for both readers, R1 and R2). Inter-rater agreement was excellent for lesion detection (0.84-0.95) and good to excellent for artifacts and image quality (0.66-0.84). 17 patients had lesions <8mm, and 7 had lesions >8mm as seen on CT. For R1 and R2, the MV sequence allowed for higher detection rates of pulmonary lesions <8mm with a sensitivity of 56% (R1) and 59% (R2); the FSE sequence achieved 50% (R1) and 53% (R2). Specificity was also higher for MV with 94% (R1) and 83% (R2) compared to 78% (R1) and 76% (R2). Lesions >8mm were detected with a sensitivity of 100% by both readers on both MV and FSE images. For both readers, specificity for larger lesions was higher on MV images with 100% compared to 96%. CONCLUSION The superior image quality and the very robust artifact reduction make MV a promising technique for MRI of the lung compared to FSE, especially since it is not requiring breathholds. Moreover, MV allows for improved lesion detection.
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Affiliation(s)
| | - Guido Kukuk
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
| | - Rami Homsi
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
| | - Dirk Skowasch
- Department of Internal Medicine II, Cardiology, Pneumology and Angiology, University of Bonn, Germany.
| | - Hans Heinz Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany.
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Affiliation(s)
- Joanna M Wardlaw
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
| | - Maria C Valdés Hernández
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
| | - Susana Muñoz-Maniega
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
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Abstract
Magnetic resonance imaging (MRI) evaluation of the developing brain has dramatically increased over the last decade. Faster acquisitions and the development of advanced MRI sequences, such as magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), perfusion imaging, functional MR imaging (fMRI), and susceptibility-weighted imaging (SWI), as well as the use of higher magnetic field strengths has made MRI an invaluable tool for detailed evaluation of the developing brain. This article will provide an overview of the use and challenges associated with 1.5-T and 3-T static magnetic fields for evaluation of the developing brain. This review will also summarize the advantages, clinical challenges, and safety concerns specifically related to MRI in the fetus and newborn, including the implications of increased magnetic field strength, logistics related to transporting and monitoring of neonates during scanning, and sedation considerations, and a discussion of current technologies such as MRI conditional neonatal incubators and dedicated small-foot print neonatal intensive care unit (NICU) scanners.
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Affiliation(s)
- Shannon Tocchio
- Pediatric Imaging Research Center, Department of Radiology Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Beth Kline-Fath
- Department of Radiology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Emanuel Kanal
- Director, Magnetic Resonance Services; Professor of Neuroradiology; Department of Radiology, University of Pittsburgh Medical Center (UPMC)
| | - Vincent J. Schmithorst
- Pediatric Imaging Research Center, Department of Radiology Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ashok Panigrahy
- Pediatric Imaging Research Center, Department of Radiology Children׳s Hospital of Pittsburgh of UPMC, University of Pittsburgh Medical Center, Pittsburgh, PA.
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Wellmer J, Quesada CM, Rothe L, Elger CE, Bien CG, Urbach H. Proposal for a magnetic resonance imaging protocol for the detection of epileptogenic lesions at early outpatient stages. Epilepsia 2013; 54:1977-87. [DOI: 10.1111/epi.12375] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2013] [Indexed: 01/04/2023]
Affiliation(s)
- Jörg Wellmer
- Ruhr-Epileptology; Department of Neurology; University Hospital Knappschaftskrankenhaus; Bochum Germany
| | - Carlos M. Quesada
- Department of Epileptology & Life and Brain Institute; University Hospital Bonn; Bonn Germany
| | - Lars Rothe
- Ruhr-Epileptology; Department of Neurology; University Hospital Knappschaftskrankenhaus; Bochum Germany
| | - Christian E. Elger
- Department of Epileptology & Life and Brain Institute; University Hospital Bonn; Bonn Germany
| | | | - Horst Urbach
- Department of Neuroradiology; University Hospital Freiburg; Freiburg Germany
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Lavdas E, Mavroidis P, Kostopoulos S, Glotsos D, Roka V, Topalzikis T, Bakas A, Oikonomou G, Papanikolaou N, Batsikas G, Kaffes I, Kechagias D. Improvement of image quality using BLADE sequences in brain MR imaging. Magn Reson Imaging 2013; 31:189-200. [DOI: 10.1016/j.mri.2012.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 08/06/2012] [Accepted: 08/06/2012] [Indexed: 10/27/2022]
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Madai VI, von Samson-Himmelstjerna FC, Bauer M, Stengl KL, Mutke MA, Tovar-Martinez E, Wuerfel J, Endres M, Niendorf T, Sobesky J. Ultrahigh-field MRI in human ischemic stroke--a 7 tesla study. PLoS One 2012; 7:e37631. [PMID: 22701525 PMCID: PMC3365122 DOI: 10.1371/journal.pone.0037631] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 04/27/2012] [Indexed: 11/27/2022] Open
Abstract
Introduction Magnetic resonance imaging (MRI) using field strengths up to 3 Tesla (T) has proven to be a powerful tool for stroke diagnosis. Recently, ultrahigh-field (UHF) MRI at 7 T has shown relevant diagnostic benefits in imaging of neurological diseases, but its value for stroke imaging has not been investigated yet. We present the first evaluation of a clinically feasible stroke imaging protocol at 7 T. For comparison an established stroke imaging protocol was applied at 3 T. Methods In a prospective imaging study seven patients with subacute and chronic stroke were included. Imaging at 3 T was immediately followed by 7 T imaging. Both protocols included T1-weighted 3D Magnetization-Prepared Rapid-Acquired Gradient-Echo (3D-MPRAGE), T2-weighted 2D Fluid Attenuated Inversion Recovery (2D-FLAIR), T2-weighted 2D Fluid Attenuated Inversion Recovery (2D-T2-TSE), T2* weighted 2D Fast Low Angle Shot Gradient Echo (2D-HemoFLASH) and 3D Time-of-Flight angiography (3D-TOF). Results The diagnostic information relevant for clinical stroke imaging obtained at 3 T was equally available at 7 T. Higher spatial resolution at 7 T revealed more anatomical details precisely depicting ischemic lesions and periinfarct alterations. A clear benefit in anatomical resolution was also demonstrated for vessel imaging at 7 T. RF power deposition constraints induced scan time prolongation and reduced brain coverage for 2D-FLAIR, 2D-T2-TSE and 3D-TOF at 7 T versus 3 T. Conclusions The potential of 7 T MRI for human stroke imaging is shown. Our pilot study encourages a further evaluation of the diagnostic benefit of stroke imaging at 7 T in a larger study.
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Affiliation(s)
- Vince I. Madai
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
| | - Federico C. von Samson-Himmelstjerna
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
- Berlin Ultra-High Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
| | - Miriam Bauer
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
| | - Katharina L. Stengl
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
| | - Matthias A. Mutke
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
| | - Elena Tovar-Martinez
- Berlin Ultra-High Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
| | - Jens Wuerfel
- Berlin Ultra-High Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Berlin, Germany
- Institute of Neuroradiology, University Luebeck, Luebeck, Germany
| | - Matthias Endres
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
- Excellence Cluster Neurocure, Charité-Universitätsmedizin, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultra-High Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- Experimental and Clinical Research Center (ECRC), Charité-Universitätsmedizin and Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
| | - Jan Sobesky
- Department of Neurology and Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany
- Experimental and Clinical Research Center (ECRC), Charité-Universitätsmedizin and Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- * E-mail:
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