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Zhang YQ, Wu HH, Shu W, Li Y, Yu CD, Li T, Huang GM, Hou DQ, Chen FF, Liu JT, Li SL, Zong XN. [Current status of pubertal sexual characteristics development of 2 704 girls aged 6-18 years in Tongzhou District of Beijing]. Zhonghua Er Ke Za Zhi 2024; 62:430-437. [PMID: 38623010 DOI: 10.3760/cma.j.cn112140-20240104-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Objective: To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese. Methods: A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ2 test was applied to compare the counting data between two or multiple groups. Results: A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95%CI 8.9-9.1), 10.5 (95%CI 10.4-10.6), and 11.4 (95%CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95%CI 4.6-4.8) years, between P2 and P5 was 4.5 (95%CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95%CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95%CI 9.5-10.6), 9.3 (95%CI 9.2-9.4), and 8.6 (95%CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95%CI 12.4-13.7), 11.6 (95%CI 11.4-11.7), and 11.1 (95%CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in normal group and thin group was 4.7 and 4.5 years, 4.6 and 4.7 years, respectively. Conclusions: The ages of sexual characteristics development and menarche tend in Tongzhou District of Beijing to be earlier than that being reported of Beijing's survey 20 years ago. Girls characterized as overweight and obese not only start puberty at an earlier age than girls of normal weight, but also have a shorter developmental process.
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Affiliation(s)
- Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - W Shu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - C D Yu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - T Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - G M Huang
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - D Q Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - F F Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China
| | - J T Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - S L Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - X N Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
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Zhong X, Nickel MD, Kannengiesser SAR, Dale BM, Han F, Gao C, Shih SF, Dai Q, Curiel O, Tsao TC, Wu HH, Deshpande V. Accelerated free-breathing liver fat and R 2 * quantification using multi-echo stack-of-radial MRI with motion-resolved multidimensional regularized reconstruction: Initial retrospective evaluation. Magn Reson Med 2024. [PMID: 38650444 DOI: 10.1002/mrm.30117] [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: 03/28/2023] [Revised: 02/25/2024] [Accepted: 04/01/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE To improve image quality, mitigate quantification biases and variations for free-breathing liver proton density fat fraction (PDFF) andR 2 * $$ {\mathrm{R}}_2^{\ast } $$ quantification accelerated by radial k-space undersampling. METHODS A free-breathing multi-echo stack-of-radial MRI method was developed with compressed sensing with multidimensional regularization. It was validated in motion phantoms with reference acquisitions without motion and in 11 subjects (6 patients with nonalcoholic fatty liver disease) with reference breath-hold Cartesian acquisitions. Images, PDFF, andR 2 * $$ {\mathrm{R}}_2^{\ast } $$ maps were reconstructed using different radial view k-space sampling factors and reconstruction settings. Results were compared with reference-standard results using Bland-Altman analysis. Using linear mixed-effects model fitting (p < 0.05 considered significant), mean and SD were evaluated for biases and variations of PDFF andR 2 * $$ {\mathrm{R}}_2^{\ast } $$ , respectively, and coefficient of variation on the first echo image was evaluated as a surrogate for image quality. RESULTS Using the empirically determined optimal sampling factor of 0.25 in the accelerated in vivo protocols, mean differences and limits of agreement for the proposed method were [-0.5; -33.6, 32.7] s-1 forR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and [-1.0%; -5.8%, 3.8%] for PDFF, close to those of a previous self-gating method using fully sampled radial views: [-0.1; -27.1, 27.0] s-1 forR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and [-0.4%; -4.5%, 3.7%] for PDFF. The proposed method had significantly lower coefficient of variation than other methods (p < 0.001). Effective acquisition time of 64 s or 59 s was achieved, compared with 171 s or 153 s for two baseline protocols with different radial views corresponding to sampling factor of 1.0. CONCLUSION This proposed method may allow accelerated free-breathing liver PDFF andR 2 * $$ {\mathrm{R}}_2^{\ast } $$ mapping with reduced biases and variations.
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Affiliation(s)
- Xiaodong Zhong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Samueli School of Engineering, University of California Los Angeles, Los Angeles, California, USA
| | - Marcel D Nickel
- MR Application Predevelopment, Siemens Healthineers AG, Erlangen, Germany
| | | | - Brian M Dale
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Cary, North Carolina, USA
| | - Fei Han
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Los Angeles, California, USA
| | - Chang Gao
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Los Angeles, California, USA
| | - Shu-Fu Shih
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Samueli School of Engineering, University of California Los Angeles, Los Angeles, California, USA
| | - Qing Dai
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Samueli School of Engineering, University of California Los Angeles, Los Angeles, California, USA
| | - Omar Curiel
- Department of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Tsu-Chin Tsao
- Department of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, Samueli School of Engineering, University of California Los Angeles, Los Angeles, California, USA
| | - Vibhas Deshpande
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Austin, Texas, USA
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Ming Z, Pogosyan A, Gao C, Colbert CM, Wu HH, Finn JP, Ruan D, Hu P, Christodoulou AG, Nguyen KL. ECG-free cine MRI with data-driven clustering of cardiac motion for quantification of ventricular function. NMR Biomed 2024; 37:e5091. [PMID: 38196195 PMCID: PMC10947936 DOI: 10.1002/nbm.5091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Despite the widespread use of cine MRI for evaluation of cardiac function, existing real-time methods do not easily enable quantification of ventricular function. Moreover, segmented cine MRI assumes periodicity of cardiac motion. We aim to develop a self-gated, cine MRI acquisition scheme with data-driven cluster-based binning of cardiac motion. METHODS A Cartesian golden-step balanced steady-state free precession sequence with sorted k-space ordering was designed. Image data were acquired with breath-holding. Principal component analysis and k-means clustering were used for binning of cardiac phases. Cluster compactness in the time dimension was assessed using temporal variability, and dispersion in the spatial dimension was assessed using the Caliński-Harabasz index. The proposed and the reference electrocardiogram (ECG)-gated cine methods were compared using a four-point image quality score, SNR and CNR values, and Bland-Altman analyses of ventricular function. RESULTS A total of 10 subjects with sinus rhythm and 8 subjects with arrhythmias underwent cardiac MRI at 3.0 T. The temporal variability was 45.6 ms (cluster) versus 24.6 ms (ECG-based) (p < 0.001), and the Caliński-Harabasz index was 59.1 ± 9.1 (cluster) versus 22.0 ± 7.1 (ECG based) (p < 0.001). In subjects with sinus rhythm, 100% of the end-systolic and end-diastolic images from both the cluster and reference approach received the highest image quality score of 4. Relative to the reference cine images, the cluster-based multiphase (cine) image quality consistently received a one-point lower score (p < 0.05), whereas the SNR and CNR values were not significantly different (p = 0.20). In cases with arrhythmias, 97.9% of the end-systolic and end-diastolic images from the cluster approach received an image quality score of 3 or more. The mean bias values for biventricular ejection fraction and volumes derived from the cluster approach versus reference cine were negligible. CONCLUSION ECG-free cine cardiac MRI with data-driven clustering for binning of cardiac motion is feasible and enables quantification of cardiac function.
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Affiliation(s)
- Zhengyang Ming
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Arutyun Pogosyan
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Chang Gao
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Caroline M Colbert
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Holden H Wu
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - J Paul Finn
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Dan Ruan
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Peng Hu
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Anthony G Christodoulou
- Department of Bioengineering, University of California, Los Angeles, California, USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Kim-Lien Nguyen
- Physics and Biology in Medicine Graduate Program, University of California, Los Angeles, California, USA
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
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Zhou W, Li X, Zabihollahy F, Lu DS, Wu HH. Deep learning-based automatic pipeline for 3D needle localization on intra-procedural 3D MRI. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03077-3. [PMID: 38520646 DOI: 10.1007/s11548-024-03077-3] [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: 10/19/2023] [Accepted: 02/09/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Accurate and rapid needle localization on 3D magnetic resonance imaging (MRI) is critical for MRI-guided percutaneous interventions. The current workflow requires manual needle localization on 3D MRI, which is time-consuming and cumbersome. Automatic methods using 2D deep learning networks for needle segmentation require manual image plane localization, while 3D networks are challenged by the need for sufficient training datasets. This work aimed to develop an automatic deep learning-based pipeline for accurate and rapid 3D needle localization on in vivo intra-procedural 3D MRI using a limited training dataset. METHODS The proposed automatic pipeline adopted Shifted Window (Swin) Transformers and employed a coarse-to-fine segmentation strategy: (1) initial 3D needle feature segmentation with 3D Swin UNEt TRansfomer (UNETR); (2) generation of a 2D reformatted image containing the needle feature; (3) fine 2D needle feature segmentation with 2D Swin Transformer and calculation of 3D needle tip position and axis orientation. Pre-training and data augmentation were performed to improve network training. The pipeline was evaluated via cross-validation with 49 in vivo intra-procedural 3D MR images from preclinical pig experiments. The needle tip and axis localization errors were compared with human intra-reader variation using the Wilcoxon signed rank test, with p < 0.05 considered significant. RESULTS The average end-to-end computational time for the pipeline was 6 s per 3D volume. The median Dice scores of the 3D Swin UNETR and 2D Swin Transformer in the pipeline were 0.80 and 0.93, respectively. The median 3D needle tip and axis localization errors were 1.48 mm (1.09 pixels) and 0.98°, respectively. Needle tip localization errors were significantly smaller than human intra-reader variation (median 1.70 mm; p < 0.01). CONCLUSION The proposed automatic pipeline achieved rapid pixel-level 3D needle localization on intra-procedural 3D MRI without requiring a large 3D training dataset and has the potential to assist MRI-guided percutaneous interventions.
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Affiliation(s)
- Wenqi Zhou
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Xinzhou Li
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Fatemeh Zabihollahy
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Joint Department of Medical Imaging, Sinai Health System and University of Toronto, Toronto, Canada
| | - David S Lu
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.
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Zhang Z, Aygun E, Shih SF, Raman SS, Sung K, Wu HH. High-resolution prostate diffusion MRI using eddy current-nulled convex optimized diffusion encoding and random matrix theory-based denoising. MAGMA 2024:10.1007/s10334-024-01147-w. [PMID: 38349453 DOI: 10.1007/s10334-024-01147-w] [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] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To develop and evaluate a technique combining eddy current-nulled convex optimized diffusion encoding (ENCODE) with random matrix theory (RMT)-based denoising to accelerate and improve the apparent signal-to-noise ratio (aSNR) and apparent diffusion coefficient (ADC) mapping in high-resolution prostate diffusion-weighted MRI (DWI). MATERIALS AND METHODS: Eleven subjects with clinical suspicion of prostate cancer were scanned at 3T with high-resolution (HR) (in-plane: 1.0 × 1.0 mm2) ENCODE and standard-resolution (1.6 × 2.2 mm2) bipolar DWI sequences (both had 7 repetitions for averaging, acquisition time [TA] of 5 min 50 s). HR-ENCODE was retrospectively analyzed using three repetitions (accelerated effective TA of 2 min 30 s). The RMT-based denoising pipeline utilized complex DWI signals and Marchenko-Pastur distribution-based principal component analysis to remove additive Gaussian noise in images from multiple coils, b-values, diffusion encoding directions, and repetitions. HR-ENCODE with RMT-based denoising (HR-ENCODE-RMT) was compared with HR-ENCODE in terms of aSNR in prostate peripheral zone (PZ) and transition zone (TZ). Precision and accuracy of ADC were evaluated by the coefficient of variation (CoV) between repeated measurements and mean difference (MD) compared to the bipolar ADC reference, respectively. Differences were compared using two-sided Wilcoxon signed-rank tests (P < 0.05 considered significant). RESULTS HR-ENCODE-RMT yielded 62% and 56% higher median aSNR than HR-ENCODE (b = 800 s/mm2) in PZ and TZ, respectively (P < 0.001). HR-ENCODE-RMT achieved 63% and 70% lower ADC-CoV than HR-ENCODE in PZ and TZ, respectively (P < 0.001). HR-ENCODE-RMT ADC and bipolar ADC had low MD of 22.7 × 10-6 mm2/s in PZ and low MD of 90.5 × 10-6 mm2/s in TZ. CONCLUSIONS HR-ENCODE-RMT can shorten the acquisition time and improve the aSNR of high-resolution prostate DWI and achieve accurate and precise ADC measurements in the prostate.
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Affiliation(s)
- Zhaohuan Zhang
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Elif Aygun
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Shu-Fu Shih
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven S Raman
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - Kyunghyun Sung
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.
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Kafali SG, Shih SF, Li X, Kim GHJ, Kelly T, Chowdhury S, Loong S, Moretz J, Barnes SR, Li Z, Wu HH. Automated abdominal adipose tissue segmentation and volume quantification on longitudinal MRI using 3D convolutional neural networks with multi-contrast inputs. MAGMA 2024:10.1007/s10334-023-01146-3. [PMID: 38300360 DOI: 10.1007/s10334-023-01146-3] [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] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/18/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVE Increased subcutaneous and visceral adipose tissue (SAT/VAT) volume is associated with risk for cardiometabolic diseases. This work aimed to develop and evaluate automated abdominal SAT/VAT segmentation on longitudinal MRI in adults with overweight/obesity using attention-based competitive dense (ACD) 3D U-Net and 3D nnU-Net with full field-of-view volumetric multi-contrast inputs. MATERIALS AND METHODS 920 adults with overweight/obesity were scanned twice at multiple 3 T MRI scanners and institutions. The first scan was divided into training/validation/testing sets (n = 646/92/182). The second scan from the subjects in the testing set was used to evaluate the generalizability for longitudinal analysis. Segmentation performance was assessed by measuring Dice scores (DICE-SAT, DICE-VAT), false negatives (FN), and false positives (FP). Volume agreement was assessed using the intraclass correlation coefficient (ICC). RESULTS ACD 3D U-Net achieved rapid (< 4.8 s/subject) segmentation with high DICE-SAT (median ≥ 0.994) and DICE-VAT (median ≥ 0.976), small FN (median ≤ 0.7%), and FP (median ≤ 1.1%). 3D nnU-Net yielded rapid (< 2.5 s/subject) segmentation with similar DICE-SAT (median ≥ 0.992), DICE-VAT (median ≥ 0.979), FN (median ≤ 1.1%) and FP (median ≤ 1.2%). Both models yielded excellent agreement in SAT/VAT volume versus reference measurements (ICC > 0.997) in longitudinal analysis. DISCUSSION ACD 3D U-Net and 3D nnU-Net can be automated tools to quantify abdominal SAT/VAT volume rapidly, accurately, and longitudinally in adults with overweight/obesity.
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Affiliation(s)
- Sevgi Gokce Kafali
- Department of Radiological Sciences, University of California, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Shu-Fu Shih
- Department of Radiological Sciences, University of California, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Xinzhou Li
- Department of Radiological Sciences, University of California, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - Grace Hyun J Kim
- Department of Radiological Sciences, University of California, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - Tristan Kelly
- Department of Physiological Science, University of California, Los Angeles, CA, USA
| | - Shilpy Chowdhury
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Spencer Loong
- Department of Psychology, Loma Linda University School of Behavioral Health, Loma Linda, CA, USA
| | - Jeremy Moretz
- Department of Neuroradiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Samuel R Barnes
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Zhaoping Li
- Department of Medicine, University of California, Los Angeles, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, University of California, Los Angeles, CA, USA.
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Zong XN, Li H, Zhang YQ, Wu HH. [Updated growth standards for Chinese children under 7 years of age]. Zhonghua Er Ke Za Zhi 2023; 61:1103-1108. [PMID: 37989521 DOI: 10.3760/cma.j.cn112140-20230925-00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Objective: To construct growth standards for Chinese children under 7 years of age. Methods: Cross-sectional study design based on national representative data on children's growth and development in 2015 was used. Stratified cluster sampling method was used. A total of 83 628 healthy children aged 0-<7 years from 9 cities, including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, and Kunming, were investigated from June to November 2015, excluding those with adverse conditions that may impact the establishment of the growth standards. Weight, length (height) and head circumference were measured using unified measurement tools and measurement methods. The Lambda-Mu-Sigma method was employed to establish percentile and standard deviation score reference values of weight-for-age, length (height)-for-age, head circumference-for-age, weight-for-length (height) and body mass index (BMI)-for-age of the study population. The standard deviation score curves of the new-established growth standards were compared with the 2009 reference standards. Results: Reference values of percentile (P3, P10, P25, P50, P75, P90, P97) and standard deviation score (-3, -2, -1, 0,+1,+2,+3) of weight-for-age, length (height)-for-age, head circumference-for-age, weight-for-length (height) and BMI-for-age were obtained. Compared with the 2009 growth standards, the difference of weight at P50 was -0.1-0.4 kg, the difference of length (height) at P50 was 0.1-1.3 cm, the difference of head circumference at P50 was -0.2-0.2 cm, the difference of weight for length (height) at P50 was -0.2-0.5 kg, and the difference of BMI at P50 was -0.2-0.2 kg/m2. The main differences were as follows: weight for girls aged 5.0-<7.0 years was 0.4-0.6 kg higher at +2 s, height for boys and girls aged 2.0-<7.0 years was 0.4-1.4 cm higher at -2 s, and BMI for boys and girls aged 5.0-<7.0 years was 0.1-0.3 kg/m2 higher at +2 s than the 2009 reference standards. Conclusion: The newly established growth standards for Chinese children under 7 years of age that have achieved a minor revision to the 2009 reference standards, are recommended for nationwide use in growth monitoring and nutritional assessment.
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Affiliation(s)
- X N Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
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Zhang GQ, Wu HH, Sha L. [Clinical characteristics of COVID-19 Omicron variant infection in children with allergic diseases]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1373-1379. [PMID: 37743297 DOI: 10.3760/cma.j.cn112150-20230419-00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective: To analyze the clinical characteristics of infection of COVID-19 Omicron variants in children with allergic diseases. Methods: This was a cross-sectional retrospective study. A total of 657 pediatric patients with allergic diseases aged between 0-17 years confirmed with COVID-19 infection were enrolled from the Children's Hospital affiliated to Capital Institute of Pediatrics from January to March 2023. The median age was 6.6(4.7,9.9) years, with 443 males (67.4%) and 214 females (32.6%). Demographic data, vaccination status, clinical manifestations, therapeutic drugs, and other data were collected. The patients were then divided into different groups according to the age, type of allergic diseases and vaccination status, and their clinical characteristics were compared. Results: A total of 657 children with allergic diseases were included in this study, among them 568 with asthma. Fever is the most common symptoms after COVID-19 infection (627/657, 95.4%), and 509 children (77.5%) with high fever. Cough was observed in 446 (67.9%) and fatigue in 167 (25.4%) cases.10 cases (1.5%) were diagnosed as pneumonia. The proportion of pharyngalgia(22%,84/382, χ2=19.847, P<0.01), fatigue (31.7%, 121/382,χ2=23.831, P<0.01), headache(34.6%, 132/382,χ2=57.598, P<0.01), muscle joint pain(16.0%, 61/382,χ2=22.289, P<0.01) and vomiting(11.0%, 42/382,χ2=12.756, P<0.01) were highest in the>6 years group. Children younger than 3 years had the lowest proportion of runny nose(8.8%, 5/57,χ2=8.411, P<0.01), cough(45.6%, 26/57,χ2=6.287, P<0.05) and expectoration(7.0%, 4/57,χ2=5.950, P<0.05). 62.8%(137/218) of the patients in 3-6 year group had the highest rate of cough(χ2=6.287, P<0.05), with a higher proportion of wheezing (10.1%, 22/218). Cough and/or wheezing symptoms were most quickly relieved in the 6 year old group, who had a highest proportion of 68.8%(260/382) in duration of respiratory symptoms within 1 week compared with 52.2% (114/218)of 3-6 years group and 41.2% (22/57)of<3 year group, respectively(χ2=23.166, P<0.01). The asthma group had a significant higher proportion of cough(59.7% vs 41.6%, χ2=10.310, P<0.01), wheezing (8.5% vs 0.0%, χ2=8.114, P<0.01) and expectoration (19.2% vs 7.9%, χ2=10.310, P<0.01) than that of non-asthma group. Besides, patients with cough and/or wheezing in the asthma group had more impact on exercise and sleep (16.1% vs 0, χ2=5.436, P<0.05) and a longer duration over 4 weeks (25.1% vs 3.7%, χ2=6.244, P<0.05). Conclusions: The most common symptoms in children with allergy infected with COVID-19 Omicron variant were fever and cough. Children under 3 years of age had relatively fewer respiratory symptoms while those with asthma or aged 3-6 years were more likely to have cough and wheezing and longer duration of symptoms. The data suggested that the prevention and management of COVID-19 should be strengthened in children with allergy.
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Affiliation(s)
- G Q Zhang
- Department of Respiratory,Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - L Sha
- Department of Allergy,Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
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Lin J, Miao QI, Surawech C, Raman SS, Zhao K, Wu HH, Sung K. High-Resolution 3D MRI With Deep Generative Networks via Novel Slice-Profile Transformation Super-Resolution. IEEE Access 2023; 11:95022-95036. [PMID: 37711392 PMCID: PMC10501177 DOI: 10.1109/access.2023.3307577] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
High-resolution magnetic resonance imaging (MRI) sequences, such as 3D turbo or fast spin-echo (TSE/FSE) imaging, are clinically desirable but suffer from long scanning time-related blurring when reformatted into preferred orientations. Instead, multi-slice two-dimensional (2D) TSE imaging is commonly used because of its high in-plane resolution but is limited clinically by poor through-plane resolution due to elongated voxels and the inability to generate multi-planar reformations due to staircase artifacts. Therefore, multiple 2D TSE scans are acquired in various orthogonal imaging planes, increasing the overall MRI scan time. In this study, we propose a novel slice-profile transformation super-resolution (SPTSR) framework with deep generative learning for through-plane super-resolution (SR) of multi-slice 2D TSE imaging. The deep generative networks were trained by synthesized low-resolution training input via slice-profile downsampling (SP-DS), and the trained networks inferred on the slice profile convolved (SP-conv) testing input for 5.5x through-plane SR. The network output was further slice-profile deconvolved (SP-deconv) to achieve an isotropic super-resolution. Compared to SMORE SR method and the networks trained by conventional downsampling, our SPTSR framework demonstrated the best overall image quality from 50 testing cases, evaluated by two abdominal radiologists. The quantitative analysis cross-validated the expert reader study results. 3D simulation experiments confirmed the quantitative improvement of the proposed SPTSR and the effectiveness of the SP-deconv step, compared to 3D ground-truths. Ablation studies were conducted on the individual contributions of SP-DS and SP-conv, networks structure, training dataset size, and different slice profiles.
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Affiliation(s)
- Jiahao Lin
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Department of Electrical and Computer Engineering, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Q I Miao
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Chuthaporn Surawech
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Division of Diagnostic Radiology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Steven S Raman
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Kai Zhao
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Kyunghyun Sung
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
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Cheng CH, Su T, Wang J, Zhu QL, Wu HH, Wang ZJ, Han F, Chen R. [Alertness and task processing speed impairment status and influencing factors of young-middle aged men with obstructive sleep apnea hypopnea syndrome]. Zhonghua Yi Xue Za Zhi 2023; 103:1685-1691. [PMID: 37302859 DOI: 10.3760/cma.j.cn112137-20220909-01910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To investigate the alertness and task processing speed impairment status in young-mild aged men with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze its influencing factors. Methods: This prospective study recruited 251 snoring patients aged 18 to 59 (38.9±7.6) years in the Sleep Center of the Second Affiliated Hospital of Soochow University from July 2020 to September 2021 and all patients were diagnosed by polysomnography (PSG). Clinical information, Epworth Sleepiness Scale (ESS) and PSG date were collected. All patients were assessed with the Montreal Cognitive Assessment (MoCA) questionnaires, Mini-mental State Examination (MMSE) and Computerized Neurocognitive Assessment System which includes the reaction time of Motor Screening Task (MOT) for alertness, the reaction time of pattern recognition memory (PRM), spatial span (SSP) and spatial working memory (SWM) for task processing speed. Based on AHI tertiles, all patients were divided into Q1 group (AHI<15 times/h, n=79), Q2 group (15 times/h≤AHI<45 times/h, n=88), and Q3 group (AHI≥45 times/h, n=84). The characteristics of clinical information, ESS, PSG parameters and cognitive scores among three groups were compared. Multiple linear stepwise regression was conducted to analyze the influencing factors of cognitive impairment. Results: There were no statistically significant differences in age, years of education, history of smoking and drinking, and past disease history (except for the prevalence of hypertension) among the 3 groups (P>0.05). There were statistically significant among-group differences in the body mass index (BMI), ESS, prevalence of hypertension and complaints of daytime sleepiness (P<0.05). Compared with Q1 and Q2 group, the arousal index (ArI), oxygen desaturation index (ODI),the proportion of non-rapid eye movement phase 1 and 2 (N1+N2) and percentage of total sleep time with oxygen saturation level<90% (TS90) of Q3 group were higher (all P<0.05). In the cognitive assessment, there was no statistically significant difference in the MoCA total and individual scores and MMSE scores among the three groups (P>0.05). Compared with the Q1 group, the task processing speed and alertness were worse in Q3 group, as shown by slower PRM immediate and delayed reaction time, SSP reaction time and MOT reaction time (all P<0.05). The total time of SWM in Q2 group was slower than that in Q1 group (P<0.05). Multiple linear stepwise regression showed that years of education (β=-40.182, 95%CI:-69.847--10.517), ODI (β=3.539, 95%CI: 0.600-6.478) were the risk factors of PRM immediate reaction time. Age(β=13.303,95%CI: 2.487-24.119), years of education(β=-32.329, 95%CI:-63.162--1.497), ODI (β=4.515, 95%CI: 1.623-7.407) were the risk factors of PRM delayed reaction time. ODI was the risk factor of SSP reaction time (β=1.258, 95%CI: 0.379-2.137). TS90 was the risk factor of MOT reaction time (β=1.796, 95%CI: 0.664-2.928). Conclusions: The early cognitive impairment in young-mild aged OSAHS patients was manifested in decreased alertness and task processing speed, and intermittent nocturnal hypoxia was its influencing factor in addition to age and years of education.
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Affiliation(s)
- C H Cheng
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - T Su
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Q L Zhu
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H H Wu
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Z J Wang
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - F Han
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Chen
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Zong XN, Li H, Zhang YQ, Wu HH. [Reference values and growth curves of length for weight and head circumference for weight among Chinese newborns]. Zhonghua Er Ke Za Zhi 2023; 61:425-433. [PMID: 37096262 DOI: 10.3760/cma.j.cn112140-20221116-00972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Objective: To establish the reference values and growth curves of length for weight and head circumference for weight among Chinese newborns in order to provide a reference for the assessment of body proportionality at birth. Methods: A cross-sectional design was applied. A total of 24 375 singleton live birth newborns with gestational ages at birth of 24+0 to 42+6 weeks were recruited from June 2015 to November 2018 from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen, excluding those with maternal or newborn conditions that may impact the establishment of the reference values. The generalized additive model for location, scale, and shape was employed to establish reference values in terms of percentile and growth curves of length for weight and head circumference for weight for male and female newborns. The random forest machine learning method was employed to analyze the importance of variables between the established reference values in this study and the previous published weight/length, body mass index (BMI), ponderal index (PI), weight/head circumference, length/head circumference in the assessment of symmetrical and asymmetrical small for gestational age (SGA) newborns. Results: A total of 24 375 newborns with 13 197 male infants (preterm birth 7 042 infants and term birth 6 155 infants) and 11 178 female infants (preterm birth 5 222 infants and term birth 5 956 infants) were included in this study. The reference values in terms of percentile (P3, P10, P25, P50, P75, P90, P97) and growth curves of length for weight and head circumference for weight were obtained for male and female newborns with gestational ages of 24+0 to 42+6 weeks. The median birth lengths corresponding to the birth weights of 1 500, 2 500, 3 000, and 4 000 g were 40.4, 47.0, 49.3 and 52.1 cm for males and 40.4, 47.0, 49.2, and 51.8 cm for females, respectively; the median birth head circumferences were 28.4, 32.0, 33.2 and 35.2 cm for males and 28.4, 32.0, 33.1, and 35.1 cm for females, respectively. The differences of length for weight between males and females were minimum, with the difference range of -0.3 to 0.3 cm at P50; the differences of head circumference for weight between males and females were minimum, with the difference range of 0 to 0.2 cm at P50. Based on the match between birth length and birth weight for classifying symmetrical and asymmetrical SGA, length for weight and PI contributed the most, accounting for 0.32 and 0.25, respectively; based on the match between birth head circumference and birth weight, head circumference for weight and weight/head circumference contributed the most, accounting for 0.55 and 0.12, respectively; based on the match between birth length or head circumference with birth weight, head circumference for weight and length for weight contributed the most, accounting for 0.26 and 0.21, respectively. Conclusion: The establishment of the new standardized growth reference values and growth curves of length for weight and head circumference for weight among Chinese newborns are useful for clinical practice and scientific research.
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Affiliation(s)
- X N Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
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Shih SF, Kafali SG, Calkins KL, Wu HH. Uncertainty-aware physics-driven deep learning network for free-breathing liver fat and R 2 * quantification using self-gated stack-of-radial MRI. Magn Reson Med 2023; 89:1567-1585. [PMID: 36426730 PMCID: PMC9892263 DOI: 10.1002/mrm.29525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/02/2022] [Accepted: 10/25/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To develop a deep learning-based method for rapid liver proton-density fat fraction (PDFF) and R2 * quantification with built-in uncertainty estimation using self-gated free-breathing stack-of-radial MRI. METHODS This work developed an uncertainty-aware physics-driven deep learning network (UP-Net) to (1) suppress radial streaking artifacts because of undersampling after self-gating, (2) calculate accurate quantitative maps, and (3) provide pixel-wise uncertainty maps. UP-Net incorporated a phase augmentation strategy, generative adversarial network architecture, and an MRI physics loss term based on a fat-water and R2 * signal model. UP-Net was trained and tested using free-breathing multi-echo stack-of-radial MRI data from 105 subjects. UP-Net uncertainty scores were calibrated in a validation dataset and used to predict quantification errors for liver PDFF and R2 * in a testing dataset. RESULTS Compared with images reconstructed using compressed sensing (CS), UP-Net achieved structural similarity index >0.87 and normalized root mean squared error <0.18. Compared with reference quantitative maps generated using CS and graph-cut (GC) algorithms, UP-Net achieved low mean differences (MD) for liver PDFF (-0.36%) and R2 * (-0.37 s-1 ). Compared with breath-holding Cartesian MRI results, UP-Net achieved low MD for liver PDFF (0.53%) and R2 * (6.75 s-1 ). UP-Net uncertainty scores predicted absolute liver PDFF and R2 * errors with low MD of 0.27% and 0.12 s-1 compared to CS + GC results. The computational time for UP-Net was 79 ms/slice, whereas CS + GC required 3.2 min/slice. CONCLUSION UP-Net rapidly calculates accurate liver PDFF and R2 * maps from self-gated free-breathing stack-of-radial MRI. The pixel-wise uncertainty maps from UP-Net predict quantification errors in the liver.
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Affiliation(s)
- Shu-Fu Shih
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Sevgi Gokce Kafali
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Kara L. Calkins
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H. Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
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Story JD, Ghahremani S, Kafali SG, Shih SF, Kuwahara KJ, Calkins KL, Wu HH. Using Free-Breathing MRI to Quantify Pancreatic Fat and Investigate Spatial Heterogeneity in Children. J Magn Reson Imaging 2023; 57:508-518. [PMID: 35778376 PMCID: PMC9805469 DOI: 10.1002/jmri.28337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND MRI acquisition for pediatric pancreatic fat quantification is limited by breath-holds (BH). Full segmentation (FS) or small region of interest (ROI) analysis methods may not account for pancreatic fat spatial heterogeneity, which may limit accuracy. PURPOSE To improve MRI acquisition and analysis for quantifying pancreatic proton-density fat fraction (pPDFF) in children by investigating free-breathing (FB)-MRI, characterizing pPDFF spatial heterogeneity, and relating pPDFF to clinical markers. STUDY TYPE Prospective. POPULATION A total of 34 children, including healthy (N = 16, 8 female) and overweight (N = 18, 5 female) subjects. FIELD STRENGTH AND SEQUENCES 3 T; multiecho gradient-echo three-dimensional (3D) stack-of-stars FB-MRI, multiecho gradient-echo 3D Cartesian BH-MRI. ASSESSMENT A radiologist measured FS- and ROI-based pPDFF on FB-MRI and BH-MRI PDFF maps, with anatomical images as references. Regional pPDFF in the pancreatic head, body, and tail were measured on FB-MRI. FS-pPDFF, ROI-pPDFF, and regional pPDFF were compared, and related to clinical markers, including hemoglobin A1c. STATISTICAL TESTS T-test, Bland-Altman analysis, Lin's concordance correlation coefficient (CCC), one-way analysis of variance, and Spearman's rank correlation coefficient were used. P < 0.05 was considered significant. RESULTS FS-pPDFF and ROI-pPDFF from FB-MRI and BH-MRI had mean difference = 0.4%; CCC was 0.95 for FS-pPDFF and 0.62 for ROI-pPDFF. FS-pPDFF was higher than ROI-pPDFF (10.4% ± 6.4% vs. 4.2% ± 2.8%). Tail-pPDFF (11.6% ± 8.1%) was higher than body-pPDFF (8.9% ± 6.3%) and head-pPDFF (8.7% ± 5.2%). Head-pPDFF and body-pPDFF positively correlated with hemoglobin A1c. DATA CONCLUSION FB-MRI pPDFF is comparable to BH-MRI. Spatial heterogeneity affects pPDFF quantification. Regional measurements of pPDFF in the head and body were correlated with hemoglobin A1c, a marker of insulin sensitivity. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jacob D. Story
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Shahnaz Ghahremani
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Sevgi Gokce Kafali
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - Shu-Fu Shih
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - Kelsey J. Kuwahara
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Kara L. Calkins
- Department of Pediatrics, Division of Neonatology and Developmental Biology, and the UCLA Children’s Discovery and Innovation Institute, University of California Los Angeles, Los Angeles, CA, United States
| | - Holden H. Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
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Gao C, Ghodrati V, Shih SF, Wu HH, Liu Y, Nickel MD, Vahle T, Dale B, Sai V, Felker E, Surawech C, Miao Q, Finn JP, Zhong X, Hu P. Undersampling artifact reduction for free-breathing 3D stack-of-radial MRI based on a deep adversarial learning network. Magn Reson Imaging 2023; 95:70-79. [PMID: 36270417 PMCID: PMC10163826 DOI: 10.1016/j.mri.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/06/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Stack-of-radial MRI allows free-breathing abdominal scans, however, it requires relatively long acquisition time. Undersampling reduces scan time but can cause streaking artifacts and degrade image quality. This study developed deep learning networks with adversarial loss and evaluated the performance of reducing streaking artifacts and preserving perceptual image sharpness. METHODS A 3D generative adversarial network (GAN) was developed for reducing streaking artifacts in stack-of-radial abdominal scans. Training and validation datasets were self-gated to 5 respiratory states to reduce motion artifacts and to effectively augment the data. The network used a combination of three loss functions to constrain the anatomy and preserve image quality: adversarial loss, mean-squared-error loss and structural similarity index loss. The performance of the network was investigated for 3-5 times undersampled data from 2 institutions. The performance of the GAN for 5 times accelerated images was compared with a 3D U-Net and evaluated using quantitative NMSE, SSIM and region of interest (ROI) measurements as well as qualitative scores of radiologists. RESULTS The 3D GAN showed similar NMSE (0.0657 vs. 0.0559, p = 0.5217) and significantly higher SSIM (0.841 vs. 0.798, p < 0.0001) compared to U-Net. ROI analysis showed GAN removed streaks in both the background air and the tissue and was not significantly different from the reference mean and variations. Radiologists' scores showed GAN had a significant improvement of 1.6 point (p = 0.004) on a 4-point scale in streaking score while no significant difference in sharpness score compared to the input. CONCLUSION 3D GAN removes streaking artifacts and preserves perceptual image details.
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Affiliation(s)
- Chang Gao
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Inter-Departmental Graduate Program of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Vahid Ghodrati
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Inter-Departmental Graduate Program of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Shu-Fu Shih
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Inter-Departmental Graduate Program of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - Yongkai Liu
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Inter-Departmental Graduate Program of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | | | - Thomas Vahle
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Brian Dale
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Cary, NC, United States
| | - Victor Sai
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Ely Felker
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Chuthaporn Surawech
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Department of Radiology, Division of Diagnostic Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Qi Miao
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - J Paul Finn
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Inter-Departmental Graduate Program of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Los Angeles, CA, United States
| | - Peng Hu
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; Inter-Departmental Graduate Program of Physics and Biology in Medicine, University of California Los Angeles, Los Angeles, CA, United States.
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Strobel KM, Kafali SG, Shih SF, Artura AM, Masamed R, Elashoff D, Wu HH, Calkins KL. Pregnancies complicated by gestational diabetes and fetal growth restriction: an analysis of maternal and fetal body composition using magnetic resonance imaging. J Perinatol 2023; 43:44-51. [PMID: 36319757 PMCID: PMC9840659 DOI: 10.1038/s41372-022-01549-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Maternal body composition may influence fetal body composition. OBJECTIVE The objective of this pilot study was to investigate the relationship between maternal and fetal body composition. METHODS Three pregnant women cohorts were studied: healthy, gestational diabetes (GDM), and fetal growth restriction (FGR). Maternal body composition (visceral adipose tissue volume (VAT), subcutaneous adipose tissue volume (SAT), pancreatic and hepatic proton-density fat fraction (PDFF) and fetal body composition (abdominal SAT and hepatic PDFF) were measured using MRI between 30 to 36 weeks gestation. RESULTS Compared to healthy and FGR fetuses, GDM fetuses had greater hepatic PDFF (5.2 [4.2, 5.5]% vs. 3.2 [3, 3.3]% vs. 1.9 [1.4, 3.7]%, p = 0.004). Fetal hepatic PDFF was associated with maternal SAT (r = 0.47, p = 0.02), VAT (r = 0.62, p = 0.002), and pancreatic PDFF (r = 0.54, p = 0.008). When controlling for maternal SAT, GDM increased fetal hepatic PDFF by 0.9 ([0.51, 1.3], p = 0.001). CONCLUSION In this study, maternal SAT, VAT, and GDM status were positively associated with fetal hepatic PDFF.
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Affiliation(s)
- Katie M. Strobel
- Department of Pediatrics, Division of Neonatology & Developmental Biology, University of California Los Angeles, Los Angeles, CA, USA
| | - Sevgi Gokce Kafali
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Shu-Fu Shih
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Rinat Masamed
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David Elashoff
- University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H. Wu
- Department of Medicine, Biostatistics and Computational Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Kara L. Calkins
- Department of Pediatrics, Division of Neonatology & Developmental Biology, University of California Los Angeles, Los Angeles, CA, USA
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16
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Wang ZJ, Wu HH, Shen JC, Wang J, Wang QJ, Han F, Gui H, Chen R. [Clinical characteristics of patients with obstructive sleep apnea hypopnea syndrome combined with alveolar hypoventilation]. Zhonghua Yi Xue Za Zhi 2022; 102:555-562. [PMID: 35196777 DOI: 10.3760/cma.j.cn112137-20210630-01476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To evaluate the clinical characteristics of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) combined with alveolar hypoventilation. Methods: This retrospective study included patients who were diagnosed as OSAHS by polysomnography (PSG) and underwent daytime awake transcutaneous carbon dioxide (PtcCO2) monitoring from November 2019 to February 2021 at the Sleep Center of the Second Affiliated Hospital of Soochow University. A total of 177 patients were enrolled in the analysis, including 167 males and 10 females, aged (40±8) years old. Patients with daytime awake PtcCO2>45 mmHg (1 mmHg=0.133 kPa) were diagnosed as daytime alveolar hypoventilation, with which participants were divided into the daytime alveolar hypoventilation group and non-daytime alveolar hypoventilation group. Body mass index (BMI) cut-off value predicting daytime alveolar hypoventilation was calculated and the patients were divided into the high BMI group and low BMI group. The continuous nocturnal PtcCO2 data was available for a subset of 128 patients, and the patients were divided into two groups according the daytime alveolar hypoventilation or not. Across-group differences were compared, respectively. Results: Compared with the non-daytime alveolar hypoventilation group (n=125), the BMI [27.57 (26.55, 30.33) vs 26.60 (25.06, 28.09) kg/m2], Epworth sleepiness score(ESS) score [9.50 (6.25, 12.00) vs 7.00 (4.00, 10.75)], higher oxygen desaturation index (ODI) [38.00 (15.23, 64.93) vs 26.80 (11.30, 44.30) events/h] and percentage of total time with oxygen saturation level<90% (TS90%) [11.24% (1.88%, 32.44%) vs 4.35% (0.72%, 9.87%)] of the daytime alveolar hypoventilation group(n=52) were significantly higher (P<0.05), and lowest arterial oxygen saturation (LSaO2) [74.50% (60.25%, 82.00%) vs 79.00% (73.00%, 84.50%)], mean arterial oxygen saturation (MSaO2) [94.00% (91.00%, 95.00%) vs 95.00% (94.00%, 96.00%)] were significantly lower (P<0.05). The BMI cut-off value for predicting daytime alveolar hypoventilation was 27.04 kg/m2. Of the 177 enrolled patients, 90 were in the high BMI group and 87 were in low group. Compared with the low BMI group, the proportion of daytime sleepiness, the ESS score, the prevalence of hypertension, AHI and daytime awake PtcCO2 in the high BMI group were significantly higher (P<0.05). Among the subset of 128 patients with nocturnal PtcCO2 data available, the BMI, daytime PtcCO2 level, the nocturnal CO2 level and the prevalence of sleep related alveolar hypoventilation in the daytime alveolar hypoventilation group (n=40) were significantly higher than those in the non-daytime alveolar hypoventilation group (n=88) (P<0.05). Conclusions: The OSAHS patients with alveolar hypoventilation have higher BMI and more severe nocturnal hypoxia. OSAHS patients with BMI>27.04 kg/m2 are more likely to develop sleep related alveolar hypoventilation disorder.
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Affiliation(s)
- Z J Wang
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H H Wu
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J C Shen
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Wang
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Q J Wang
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - F Han
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H Gui
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Chen
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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17
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Wu HH. [Focus on the importance of classification of hyperglycemia in pregnancy and diagnostic criteria for gestational diabetes mellitus]. Zhonghua Yi Xue Za Zhi 2022; 102:389-392. [PMID: 35144336 DOI: 10.3760/cma.j.cn112137-20210730-01694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hyperglycemia in pregnancy (HIP) is the most common pathological obstetric disease. However, there is no uniform standard in the world for classification of HIP and diagnosis of gestational diabetes mellitus(GDM). This article will analyze this issue and support the International association of diabetes and pregnancy study group(IADPSG) criteria as a global standard for diagnosing GDM,also support HIP should be divided into four categories: PGDM, ODM, GDM and prediabetes, so as to refine clinical management.
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Affiliation(s)
- H H Wu
- Endocrinology Department of Peking University First Hospital, Beijing 100034, China
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18
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Geoghegan R, Zhang L, Priester A, Wu HH, Marks L, Natarajan S. Interstitial Optical Monitoring of Focal Laser Ablation. IEEE Trans Biomed Eng 2022; 69:2545-2556. [PMID: 35148260 PMCID: PMC9371599 DOI: 10.1109/tbme.2022.3150279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Focal laser ablation is a minimally invasive method of treating cancerous lesions in organs such as prostate, liver and brain. Oncologic control is achieved by inducing hyperthermia throughout the target while minimizing damage to surrounding tissue. Consequently, successful clinical outcomes are contingent upon achieving desired ablation volumes. Magnetic resonance thermometry is frequently used to monitor the formation of the induced thermal damage zone and inform the decision to terminate energy delivery. However, due to the associated cost and complexity there is growing interest in the development of alternative approaches. Here we investigate the utility of real-time interstitial interrogation of laser-tissue interaction as an inexpensive alternative monitoring modality that provides direct assessment of tissue coagulation without the need for organ specific calibration. The optical contrast mechanism was determined using a Monte Carlo model. Subsequently, four interstitial probe designs were manufactured and assessed in a tissue mimicking phantom under simultaneous magnetic resonance imaging. Finally, the optimal probe design was evaluated in ex vivo bovine muscle. It was found to be capable of providing sufficient feedback to achieve pre-defined ablation radii in the range 4-7mm with a mean absolute error of 0.3mm. This approach provides an inexpensive monitoring modality that may facilitate widespread adoption of focal laser ablation.
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Kafali SG, Armstrong T, Shih SF, Kim GJ, Holtrop JL, Venick RS, Ghahremani S, Bolster BD, Hillenbrand CM, Calkins KL, Wu HH. Free-breathing radial magnetic resonance elastography of the liver in children at 3 T: a pilot study. Pediatr Radiol 2022; 52:1314-1325. [PMID: 35366073 PMCID: PMC9192470 DOI: 10.1007/s00247-022-05297-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/02/2021] [Accepted: 01/20/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Magnetic resonance (MR) elastography of the liver measures hepatic stiffness, which correlates with the histopathological staging of liver fibrosis. Conventional Cartesian gradient-echo (GRE) MR elastography requires breath-holding, which is challenging for children. Non-Cartesian radial free-breathing MR elastography is a potential solution to this problem. OBJECTIVE To investigate radial free-breathing MR elastography for measuring hepatic stiffness in children. MATERIALS AND METHODS In this prospective pilot study, 14 healthy children and 9 children with liver disease were scanned at 3 T using 2-D Cartesian GRE breath-hold MR elastography (22 s/slice) and 2-D radial GRE free-breathing MR elastography (163 s/slice). Each sequence was acquired twice. Agreement in the stiffness measurements was evaluated using Lin's concordance correlation coefficient (CCC) and within-subject mean difference. The repeatability was assessed using the within-subject coefficient of variation and intraclass correlation coefficient (ICC). RESULTS Fourteen healthy children and seven children with liver disease completed the study. Median (±interquartile range) normalized measurable liver areas were 62.6% (±26.4%) and 44.1% (±39.6%) for scan 1, and 60.3% (±21.8%) and 43.9% (±44.2%) for scan 2, for Cartesian and radial techniques, respectively. Hepatic stiffness from the Cartesian and radial techniques had close agreement with CCC of 0.89 and 0.94, and mean difference of 0.03 kPa and -0.01 kPa, for scans 1 and 2. Cartesian and radial techniques achieved similar repeatability with within-subject coefficient of variation=1.9% and 3.4%, and ICC=0.93 and 0.92, respectively. CONCLUSION In this pilot study, radial free-breathing MR elastography was repeatable and in agreement with Cartesian breath-hold MR elastography in children.
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Affiliation(s)
- Sevgi Gokce Kafali
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095 USA ,Department of Bioengineering, University of California Los Angeles, Los Angeles, CA USA
| | - Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095 USA
| | - Shu-Fu Shih
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095 USA ,Department of Bioengineering, University of California Los Angeles, Los Angeles, CA USA
| | - Grace J. Kim
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095 USA
| | - Joseph L. Holtrop
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - Robert S. Venick
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA
| | - Shahnaz Ghahremani
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095 USA
| | | | - Claudia M. Hillenbrand
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN USA ,Research Imaging NSW, University of New South Wales, Sydney, Australia
| | - Kara L. Calkins
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA
| | - Holden H. Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095 USA ,Department of Bioengineering, University of California Los Angeles, Los Angeles, CA USA
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Kafali SG, Shih SF, Li X, Chowdhury S, Loong S, Barnes S, Li Z, Wu HH. 3D Neural Networks for Visceral and Subcutaneous Adipose Tissue Segmentation using Volumetric Multi-Contrast MRI. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3933-3937. [PMID: 34892092 PMCID: PMC8758404 DOI: 10.1109/embc46164.2021.9630110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Individuals with obesity have larger amounts of visceral (VAT) and subcutaneous adipose tissue (SAT) in their body, increasing the risk for cardiometabolic diseases. The reference standard to quantify SAT and VAT uses manual annotations of magnetic resonance images (MRI), which requires expert knowledge and is time-consuming. Although there have been studies investigating deep learning-based methods for automated SAT and VAT segmentation, the performance for VAT remains suboptimal (Dice scores of 0.43 to 0.89). Previous work had key limitations of not fully considering the multi-contrast information from MRI and the 3D anatomical context, which are critical for addressing the complex spatially varying structure of VAT. An additional challenge is the imbalance between the number and distribution of pixels representing SAT/VAT. This work proposes a network based on 3D U-Net that utilizes the full field-of-view volumetric T1-weighted, water, and fat images from dual-echo Dixon MRI as the multi-channel input to automatically segment SAT and VAT in adults with overweight/obesity. In addition, this work extends the 3D U-Net to a new Attention-based Competitive Dense 3D U-Net (ACD 3D U-Net) trained with a class frequency-balancing Dice loss (FBDL). In an initial testing dataset, the proposed 3D U-Net and ACD 3D U-Net with FBDL achieved 3D Dice scores of (mean ± standard deviation) 0.99 ±0.01 and 0.99±0.01 for SAT, and 0.95±0.04 and 0.96 ±0.04 for VAT, respectively, compared to manual annotations. The proposed 3D networks had rapid inference time (<60 ms/slice) and can enable automated segmentation of SAT and VAT.Clinical relevance- This work developed 3D neural networks to automatically, accurately, and rapidly segment visceral and subcutaneous adipose tissue on MRI, which can help to characterize the risk for cardiometabolic diseases such as diabetes, elevated glucose levels, and hypertension.
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Affiliation(s)
- Sevgi Gokce Kafali
- Departments of Radiological Sciences and Bioengineering, University of California, Los Angeles, CA, USA
| | - Shu-Fu Shih
- Departments of Radiological Sciences and Bioengineering, University of California, Los Angeles, CA, USA
| | - Xinzhou Li
- Departments of Radiological Sciences and Bioengineering, University of California, Los Angeles, CA, USA
| | - Shilpy Chowdhury
- Department of Radiology, Loma Linda University Medical Center, CA, USA
| | - Spencer Loong
- Department of Psychology, Loma Linda University School of Behavioral Health, CA, USA
| | - Samuel Barnes
- Department of Radiology, Loma Linda University Medical Center, CA, USA
| | - Zhaoping Li
- Department of Medicine, University of California, Los Angeles, CA, USA
| | - Holden H. Wu
- Departments of Radiological Sciences and Bioengineering, University of California, Los Angeles, CA, USA
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21
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Armstrong T, Zhong X, Shih SF, Felker E, Lu DS, Dale BM, Wu HH. Free-breathing 3D stack-of-radial MRI quantification of liver fat and R 2* in adults with fatty liver disease. Magn Reson Imaging 2021; 85:141-152. [PMID: 34662702 DOI: 10.1016/j.mri.2021.10.016] [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: 04/16/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the agreement, intra-session repeatability, and inter-reader agreement of liver proton-density fat fraction (PDFF) and R2* quantification using free-breathing 3D stack-of-radial MRI, with and without self-gated motion compensation, compared to reference breath-hold techniques in subjects with fatty liver disease (FLD). METHODS In this institutional review board-approved prospective study, thirty-eight adults with FLD and/or iron overload (24 male, 58 ± 12 years) were imaged at 3T using free-breathing stack-of-radial MRI, breath-hold 3D Cartesian MRI, and breath-hold single-voxel MR spectroscopy (SVS). Each sequence was acquired twice in random order. To assess agreement compared to reference breath-hold techniques, the dependency of liver PDFF and/or R2* quantification on the sequence, radial sampling factor, and radial self-gating temporal resolution was assessed by calculating the Bayesian mean difference (MDB) of the posteriors. Intra-session repeatability and inter-reader agreement (two independent readers) were assessed by the coefficient of repeatability (CR) and intraclass correlation coefficient (ICC), respectively. RESULTS Thirty-five participants (21 male, 57 ± 12 years) were included for analysis. Both free-breathing radial MRI techniques (with and without self-gating) achieved ICC ≥ 0.92 for quantifying PDFF and R2*, and quantified PDFF with MDB < 1.2% compared to breath-hold techniques. Free-breathing radial MRI required self-gating to accurately quantify R2* (MDB < 10s-1 with self-gating; MDB < 50s-1 without self-gating). The radial sampling factor affected PDFF and R2* quantification while the radial self-gating temporal resolution only affected R2* quantification. Repeated self-gated free-breathing radial MRI scans achieved CR < 3% and CR < 27 s-1 for PDFF and R2*, respectively. CONCLUSION A free-breathing stack-of-radial MRI technique with self-gating demonstrated agreement, repeatability, and inter-reader agreement compared to reference breath-hold techniques for quantification of liver PDFF and R2* in adults with FLD.
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Affiliation(s)
- Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Xiaodong Zhong
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Los Angeles, CA, United States
| | - Shu-Fu Shih
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - Ely Felker
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - David S Lu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Brian M Dale
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Cary, NC, United States
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States.
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22
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Wu HH, Wang ZJ, Cheng CH, Wang J, Wang QJ, Chen R. [Effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome]. Zhonghua Jie He He Hu Xi Za Zhi 2021; 44:873-879. [PMID: 34565113 DOI: 10.3760/cma.j.cn112147-20210210-00105] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This prospective study recruited patients complaining of snoring and diagnosed with OSAHS at the Sleep Center of the Second Affiliated Hospital of Soochow University from January to November 2020. Patients were assessed clinically and scored for their memory function. All patients underwent daytime transcutaneous carbon dioxide (PtcCO2) test, and overnight polysomnography (PSG). Logical memory was scored using the Logical Memory Test (LMT), while working memory was evaluated by Digit Span Test (DST) and Cambridge Neuropsychological Test Automated Battery (CANTAB) which included Pattern Recognition Memory (PRM), Spatial Span (SSP), and Spatial Working Memory (SWM). Patients were divided into the normocapnic group and the hypercapnic group using the daytime PtcCO2 test. The clinical and PSG parameters and the memory test scores between the two groups were compared. Binary logistic stepwise regression was conducted to identify risk factors of memory impairment in OSAHS patients. Results: Among the 123 enrolled OSAHS patients, 79 were normocapnic and 44 were hypercapnic. There was no significant difference in the general clinical parameters between the two groups. The snoring history in years in the hypercapnic group was longer than that in the normocapnic group (P<0.05). Compared with the normocapnic group, the apnea-hyponea index (AHI), oxygen desaturation index (ODI) and percentage of total sleep time with oxygen saturation level<90% (TS90) of the hypercapnic group were higher (all P<0.05), while other PSG parameters exhibited no statistically significant differences. There was no statistically significant difference in the immediate logical memory and PRM immediate accuracy rate between the two groups, while the delayed logical memory, verbal and spatial working memory, and executive function were worse in the hypercapnic group, as shown by lower total LMT scores, lower DST, lower SSP scores (all P<0.05), and higher between errors and strategy scores (P<0.01) of SWM in the hypercapnic group. Binary logistic stepwise regression showed that PtcCO2 ≥45 mmHg (1 mmHg=0.133 kPa, OR=3.055, 95%CI 1.359-6.868, P=0.007) and higher body mass index (BMI) (OR=1.132, 95%CI 1.005-1.275, P=0.041) were risk factors for poor performance in Digit Span Backwards Test. Therefore, PtcCO2 ≥45 mmHg was an independent risk factors for poor performance in delayed LMT, SSP, and between errors and strategy scores in SWM (OR=3.109, 3.941, 3.238 and 2.785, respectively, all P<0.05). Conclusion: Hypercapnia had negative impacts on logical memory and working memory of OSAHS patients, especially on the delayed logical memory, verbal working memory and spatial working memory impairment.
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Affiliation(s)
- H H Wu
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Z J Wang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - C H Cheng
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Q J Wang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Chen
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Deng T, Zhang L, Li X, Zink JI, Wu HH. Responsive Nanoparticles to Enable a Focused Ultrasound-Stimulated Magnetic Resonance Imaging Spotlight. ACS Nano 2021; 15:14618-14630. [PMID: 34519214 DOI: 10.1021/acsnano.1c04339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Magnetic resonance imaging (MRI)-guided high-intensity focused ultrasound (HIFU) has been applied as a therapeutic tool in the clinic, and enhanced MRI contrast for depiction of target tissues will improve the precision and applicability of HIFU therapy. This work presents a "spotlight MRI" contrast enhancement technique, which combines four essential components: periodic HIFU stimulation, strong modulation of T1 caused by HIFU, rapid MRI signal collection, and spotlight MRI spectral signal processing. The T1 modulation is enabled by a HIFU-responsive nanomaterial based on mesoporous silica nanoparticles with Pluronic polymers (Poloxamers) and MRI contrast agents attached. With periodic HIFU stimulation in a precisely defined region containing the nanomaterial, strong periodic MRI T1-weighted signal changes are generated. Rapid MRI signal collection of the periodic signal changes is realized by a rapid dynamic 3D MRI technique, and spotlight MRI spectral signal processing creates modulation enhancement maps (MEM) that suppress background signal and spotlight the spatial location with nanomaterials experiencing HIFU stimulation. In particular, a framework is presented to analyze the trade-offs between different parameter choices for the signal processing method. The optimal parameter choices under a specific experimental setting achieved MRI contrast enhancement of more than 2 orders of magnitude at the HIFU focal point, compared to controls.
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Affiliation(s)
- Tian Deng
- Department of Chemistry and Biochemistry, University of California, Los Angeles, California 90095, United States
- California Nano Systems Institute (CNSI), University of California, Los Angeles, California 90095, United States
| | - Le Zhang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California 90095, United States
| | - Xinzhou Li
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California 90095, United States
- Department of Bioengineering, University of California, Los Angeles, California 90095, United States
| | - Jeffrey I Zink
- Department of Chemistry and Biochemistry, University of California, Los Angeles, California 90095, United States
- California Nano Systems Institute (CNSI), University of California, Los Angeles, California 90095, United States
| | - Holden H Wu
- California Nano Systems Institute (CNSI), University of California, Los Angeles, California 90095, United States
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California 90095, United States
- Department of Bioengineering, University of California, Los Angeles, California 90095, United States
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Chao JY, Xiong KP, Zhuang S, Zhang JR, Huang JY, Li J, Mao CJ, Wu HH, Wang JY, Liu CF. [Relationship between emotional apathy and motor symptoms, sleep and cognitive function in patients with early Parkinson's disease]. Zhonghua Yi Xue Za Zhi 2021; 101:2792-2797. [PMID: 34551496 DOI: 10.3760/cma.j.cn112137-20210130-00286] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the relationship between emotional apathy and motor symptoms, sleep, and cognitive function in patients with early Parkinson's disease (PD). Methods: One hundred and twenty-nine early PD patients who were treated in the Second Affiliated Hospital of Soochow University from June to October 2020 were included, including 82 male and 47 female patients. The emotional apathy was assessed by modified apathy rating scale (MAES). The above 129 patients were divided into 67 patients in the PD with emotional apathy group (MAES>14 points) and 62 patients in the PD without emotional apathy group (MAES≤ 14 points). Age, gender, course of disease and levodopa equivalent dose were also collected. Hoehn-Yahr stage and unified Parkinson's disease rating scale PartⅢ(UPDRS-Ⅲ), Pittsburgh Sleep Quality Index (PSQI), polysomnography, and Montreal Cognitive Assessment Scale (MoCA) were used to evaluate the motor symptoms, sleep and cognitive functions of patients with early PD, and the clinical characteristics of patients with early PD with apathywere determined. Results: Compared with PD patients without apathy, those with apathy had longer disease duration [M(Q1,Q3)][5.0 (3.0, 7.0) years vs 3.0 (2.0, 5.0) years, P=0.006] and severer motor symptoms [20.0 (10.0, 28.0) vs 14.0 (8.5, 23.0), P=0.047]. There was no significant difference in PSQI score between the two groups. Among the 33 patients who completed polysomnography, compared with PD patients without apathy (n=16), those with apathy (n=17) had a longer rapid eye movement (REM) sleep latency [150 (124, 184) min vs 87 (57, 133) min, P=0.035)] and more frequent periodic limb movements in the REM phase(P=0.042).The REM sleep ratio (r=0.373, P=0.042), apnea-hypopena index (AHI)(r=0.374, P=0.046) and oxygen deficit index (r=0.409, P=0.025) were positively correlated with the degree of apathy in PD patients. PD patients with apathy had relatively poorer performance in cognition assessment than those without apathy and total MoCA score was inversely correlated with the degree of apathy (r=-0.231, P=0.017). Conclusion: Early PD patients with apathy have objective sleep disorders dominated by REM sleep disorders, which can have a negative impact on cognitive function.
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Affiliation(s)
- J Y Chao
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - K P Xiong
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - S Zhuang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J R Zhang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Y Huang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Li
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - C J Mao
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H H Wu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Y Wang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - C F Liu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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25
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Zhong X, Armstrong T, Gao C, Nickel MD, Han F, Dale BM, Li X, Kafali SG, Hu P, Wu HH, Deshpande V. Accelerated k-space shift calibration for free-breathing stack-of-radial MRI quantification of liver fat and R 2 ∗. Magn Reson Med 2021; 87:281-291. [PMID: 34412158 DOI: 10.1002/mrm.28981] [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: 02/06/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE To develop an accelerated k-space shift calibration method for free-breathing 3D stack-of-radial MRI quantification of liver proton-density fat fraction (PDFF) and R 2 ∗ . METHODS Accelerated k-space shift calibration was developed to partially skip acquisition of k-space shift data in the through-plane direction then interpolate in processing, as well as to reduce the in-plane averages. A multi-echo stack-of-radial sequence with the baseline calibration was evaluated on a phantom versus vendor-provided reference-standard PDFF and R 2 ∗ values at 1.5T, and in 13 healthy subjects and 5 clinical subjects at 3T with respect to reference-standard breath-hold Cartesian acquisitions. PDFF and R 2 ∗ maps were calculated with different calibration acceleration factors offline and compared to reference-standard values using Bland-Altman analysis. Bias and uncertainty were evaluated using normal distribution and Bayesian probability of difference (P < .05 considered significant). RESULTS Bland-Altman plots of phantom and in vivo data showed that substantial acceleration was highly feasible in both through-plane and in-plane directions. Compared to the baseline calibration without acceleration, Bayesian analysis revealed no significant differences on biases and uncertainties of PDFF and R 2 ∗ measurements with all acceleration methods in this study, except the method with through-plane acceleration equaling slices and averages equaling 20 for PDFF and R 2 ∗ (both P < .001) for the phantom. A six-fold reduction in equivalent calibration acquisition time (time saving ≥25 s and ≥80.7%) was achieved using recommended acceleration factors for the in vivo protocols in this study. CONCLUSION This proposed method may allow accelerated calibration for free-breathing stack-of-radial MRI PDFF and R 2 ∗ mapping.
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Affiliation(s)
- Xiaodong Zhong
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Los Angeles, California, USA
| | - Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Chang Gao
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Marcel D Nickel
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Fei Han
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Los Angeles, California, USA
| | - Brian M Dale
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Cary, North Carolina, USA
| | - Xinzhou Li
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA
| | - Sevgi G Kafali
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA
| | - Peng Hu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California, USA
| | - Vibhas Deshpande
- MR R&D Collaborations, Siemens Medical Solutions USA, Inc, Austin, Texas, USA
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Liu ZQ, Maforo NG, Renella P, Halnon N, Wu HH, Ennis DB. Reproducibility of Left Ventricular CINE DENSE Strain in Pediatric Subjects with Duchenne Muscular Dystrophy. Funct Imaging Model Heart 2021; 12738:232-241. [PMID: 36939420 PMCID: PMC10022706 DOI: 10.1007/978-3-030-78710-3_23] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cardiomyopathy is the leading cause of mortality in boys with Duchenne muscular dystrophy (DMD). Left ventricular (LV) peak mid-wall circumferential strain (Ecc) is a sensitive early biomarker for evaluating both the subtle and variable onset and the progression of cardiomyopathy in pediatric subjects with DMD. Cine Displacement Encoding with Stimulated Echoes (DENSE) has proven sensitive to changes in Ecc, but its reproducibility has not been reported in a pediatric cohort or a DMD cohort. The objective was to quantify the intra-observer repeatability, and intra-exam and inter-observer reproducibility of global and regional Ecc derived from cine DENSE in DMD patients (N = 10) and age-and sex-matched controls (N = 10). Global and regional Ecc measures were considered reproducible in the intra-exam, intra-observer, and inter-observer comparisons. Intra-observer repeatability was highest, followed by intra-exam reproducibility and then inter-observer reproducibility. The smallest detectable change in Ecc was 0.01 for the intra-observer comparison, which is below the previously reported yearly decrease of 0.013 ± 0.015 in Ecc in DMD patients.
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Affiliation(s)
- Zhan-Qiu Liu
- Department of Radiology, Stanford University, Palo Alto, CA, USA
| | - Nyasha G Maforo
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | - Pierangelo Renella
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
- Department of Medicine (Pediatric Cardiology), Children's Hospital, Orange, CA, USA
| | - Nancy Halnon
- Department of Pediatrics, University of California, Los Angeles, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Palo Alto, CA, USA
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27
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Dual SA, Maforo NG, McElhinney DB, Prosper A, Wu HH, Maskatia S, Renella P, Halnon N, Ennis DB. Right Ventricular Function and T1-Mapping in Boys With Duchenne Muscular Dystrophy. J Magn Reson Imaging 2021; 54:1503-1513. [PMID: 34037289 DOI: 10.1002/jmri.27729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Clinical management of boys with Duchenne muscular dystrophy (DMD) relies on in-depth understanding of cardiac involvement, but right ventricular (RV) structural and functional remodeling remains understudied. PURPOSE To evaluate several analysis methods and identify the most reliable one to measure RV pre- and postcontrast T1 (RV-T1) and to characterize myocardial remodeling in the RV of boys with DMD. STUDY TYPE Prospective. POPULATION Boys with DMD (N = 27) and age-/sex-matched healthy controls (N = 17) from two sites. FIELD STRENGTH/SEQUENCE 3.0 T using balanced steady state free precession, motion-corrected phase sensitive inversion recovery and modified Look-Locker inversion recovery sequences. ASSESSMENT Biventricular mass (Mi), end-diastolic volume (EDVi) and ejection fraction (EF) assessment, tricuspid annular excursion (TAE), late gadolinium enhancement (LGE), pre- and postcontrast myocardial T1 maps. The RV-T1 reliability was assessed by three observers in four different RV regions of interest (ROI) using intraclass correlation (ICC). STATISTICAL TESTS The Wilcoxon rank sum test was used to compare RV-T1 differences between DMD boys with negative LGE(-) or positive LGE(+) and healthy controls. Additionally, correlation of precontrast RV-T1 with functional measures was performed. A P-value <0.05 was considered statistically significant. RESULTS A 1-pixel thick RV circumferential ROI proved most reliable (ICC > 0.91) for assessing RV-T1. Precontrast RV-T1 was significantly higher in boys with DMD compared to controls. Both LGE(-) and LGE(+) boys had significantly elevated precontrast RV-T1 compared to controls (1543 [1489-1597] msec and 1550 [1402-1699] msec vs. 1436 [1399-1473] msec, respectively). Compared to healthy controls, boys with DMD had preserved RVEF (51.8 [9.9]% vs. 54.2 [7.2]%, P = 0.31) and significantly reduced RVMi (29.8 [9.7] g vs. 48.0 [15.7] g), RVEDVi (69.8 [29.7] mL/m2 vs. 89.1 [21.9] mL/m2 ), and TAE (22.0 [3.2] cm vs. 26.0 [4.7] cm). Significant correlations were found between precontrast RV-T1 and RVEF (β = -0.48%/msec) and between LV-T1 and LVEF (β = -0.51%/msec). DATA CONCLUSION Precontrast RV-T1 is elevated in boys with DMD compared to healthy controls and is negatively correlated with RVEF. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Seraina A Dual
- Department of Radiology, Stanford University, Palo Alto, California, USA.,Department of Cardiothoracic Surgery, Stanford University, Palo Alto, California, USA.,Cardiovascular Institute, Stanford University, Palo Alto, California, USA
| | - Nyasha G Maforo
- Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, California, USA.,Department of Radiological Sciences, University of California, Los Angeles, California, USA
| | - Doff B McElhinney
- Department of Cardiothoracic Surgery, Stanford University, Palo Alto, California, USA
| | - Ashley Prosper
- Department of Radiological Sciences, University of California, Los Angeles, California, USA
| | - Holden H Wu
- Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, California, USA.,Department of Radiological Sciences, University of California, Los Angeles, California, USA
| | - Shiraz Maskatia
- Department of Pediatrics, Stanford University, Palo Alto, California, USA.,Maternal & Child Health Research Institute, Stanford University, Palo Alto, California, USA
| | - Pierangelo Renella
- Department of Radiological Sciences, University of California, Los Angeles, California, USA.,Children's hospital Orange County, University of California, Irvine, California, USA
| | - Nancy Halnon
- Department of Medicine (Cardiology), University of California, Los Angeles, California, USA
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Palo Alto, California, USA.,Cardiovascular Institute, Stanford University, Palo Alto, California, USA.,Maternal & Child Health Research Institute, Stanford University, Palo Alto, California, USA
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Shih SF, Kafali SG, Armstrong T, Zhong X, Calkins KL, Wu HH. Deep Learning-Based Parameter Mapping with Uncertainty Estimation for Fat Quantification using Accelerated Free-Breathing Radial MRI. Proc IEEE Int Symp Biomed Imaging 2021; 2021:433-437. [PMID: 35024087 PMCID: PMC8745355 DOI: 10.1109/isbi48211.2021.9433938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Deep learning has been applied to remove artifacts from undersampled MRI and to replace time-consuming signal fitting in quantitative MRI, but these have usually been treated as separate tasks, which does not fully exploit the shared information. This work proposes a new two-stage framework that completes these two tasks in a concerted approach and also estimates the pixel-wise uncertainty levels. Results from accelerated free-breathing radial MRI for liver fat quantification demonstrate that the proposed framework can achieve high image quality from undersampled radial data, high accuracy for liver fat quantification, and detect uncertainty caused by noisy input data. The proposed framework achieved 3-fold acceleration to <1 min scan time and reduced the computational time for signal fitting to <100 ms/slice in free-breathing liver fat quantification.
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Affiliation(s)
- Shu-Fu Shih
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Sevgi Gokce Kafali
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Tess Armstrong
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Xiaodong Zhong
- Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Kara L Calkins
- Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H Wu
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
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29
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Shih SF, Kafali SG, Armstrong T, Zhong X, Calkins KL, Wu HH. Deep Learning-Based Parameter Mapping with Uncertainty Estimation for Fat Quantification using Accelerated Free-Breathing Radial MRI. Proc IEEE Int Symp Biomed Imaging 2021; 2021:433-437. [PMID: 35024087] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Deep learning has been applied to remove artifacts from undersampled MRI and to replace time-consuming signal fitting in quantitative MRI, but these have usually been treated as separate tasks, which does not fully exploit the shared information. This work proposes a new two-stage framework that completes these two tasks in a concerted approach and also estimates the pixel-wise uncertainty levels. Results from accelerated free-breathing radial MRI for liver fat quantification demonstrate that the proposed framework can achieve high image quality from undersampled radial data, high accuracy for liver fat quantification, and detect uncertainty caused by noisy input data. The proposed framework achieved 3-fold acceleration to <1 min scan time and reduced the computational time for signal fitting to <100 ms/slice in free-breathing liver fat quantification.
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Affiliation(s)
- Shu-Fu Shih
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Sevgi Gokce Kafali
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Tess Armstrong
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Xiaodong Zhong
- Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Kara L Calkins
- Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H Wu
- Radiological Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
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30
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Zong XN, Li H, Zhang YQ, Wu HH. [Reference values and growth curves of weight/length, body mass index, and ponderal index of Chinese newborns of different gestational ages]. Zhonghua Er Ke Za Zhi 2021; 59:181-188. [PMID: 33657691 DOI: 10.3760/cma.j.cn112140-20201130-01063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To establish the reference values and growth curves of weight/length, body mass index, and ponderal index for Chinese newborns with gestational ages of 24 to 42 weeks, in order to provide a reference for the assessment of body proportionality and nutritional status at birth. Methods: Cross-sectional study design was applied. From June 2015 to November 2018, a total of 24 375 singleton live birth newborns with gestational ages of 24 to 42 weeks from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen were selected, excluding those impacting the establishment of the reference values. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile (P3, P10, P25, P50, P75, P90, P97) reference values and growth curves of weight/length, body mass index, and ponderal index for male and female newborns with gestational ages of 24 to 42 weeks. The established growth standards in this study were compared with the standards from the 1988 Chinese data, the INTERGROWTH project, and the USA reference values. Results: A total of 24 375 newborns with 12 264 preterm newborns (7 042 males and 5 222 females) and 12 111 full-term newborns (6 155 males and 5 956 females) were included in this study. The percentile reference values and growth curves of weight/length, body mass index, and ponderal index were obtained for male and female newborns with gestational ages of 24 to 42 weeks. Weight/length of males in all gestational ages at P10, P50 and P90 was 0 to 0.2 kg/m higher than that of females, and body mass index of males in all gestational ages at the P10, P50 and P90 was 0.1 to 0.3 kg/m2 higher than that of females. The established growth curves of weight/length and body mass index at the upper percentile and ponderal index at both upper and lower percentiles were greatly different from those of the 1988 Chinese data, which, for example, reported the difference ranges at P90 as -1.09 to 0.40 kg/m for weight/length, -1.19 to 0.92 kg/m2 for body mass index, and -0.64 to 0.81 kg/m3 for ponderal index. The established weight/length curves were generally consistent with the reference values from the INTERGROWTH project with a difference of -0.17 to 0.20 kg/m at P50, while being 0.02 to 0.40 kg/m lower at P90 and 0.13 to 0.41 kg/m higher at P10 than that of the INTERGROWTH reference values at gestational ages of ≤32 weeks. The established body mass index curves differed from that of the USA reference values with a difference of -0.47 to 0.17 kg/m2 at P50, while being 0.53 to 1.10 kg/m2 lower at gestational ages of ≥37 weeks but 0.17 to 0.45 kg/m2 higher at gestational ages of ≤28 weeks than that of the USA reference values at P90. Conclusion: The establishment of the new standardized growth reference values of weight/length, body mass index, and ponderal index for Chinese newborns by different gestational ages are useful for clinical practice and scientific research.
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Affiliation(s)
- X N Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
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31
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Maforo NG, Magrath P, Moulin K, Shao J, Kim GH, Prosper A, Renella P, Wu HH, Halnon N, Ennis DB. T 1-Mapping and extracellular volume estimates in pediatric subjects with Duchenne muscular dystrophy and healthy controls at 3T. J Cardiovasc Magn Reson 2020; 22:85. [PMID: 33302967 PMCID: PMC7731511 DOI: 10.1186/s12968-020-00687-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cardiovascular disease is the leading cause of death in patients with Duchenne muscular dystrophy (DMD)-a fatal X-linked genetic disorder. Late gadolinium enhancement (LGE) imaging is the current gold standard for detecting myocardial tissue remodeling, but it is often a late finding. Current research aims to investigate cardiovascular magnetic resonance (CMR) biomarkers, including native (pre-contrast) T1 and extracellular volume (ECV) to evaluate the early on-set of microstructural remodeling and to grade disease severity. To date, native T1 measurements in DMD have been reported predominantly at 1.5T. This study uses 3T CMR: (1) to characterize global and regional myocardial pre-contrast T1 differences between healthy controls and LGE + and LGE- boys with DMD; and (2) to report global and regional myocardial post-contrast T1 values and myocardial ECV estimates in boys with DMD, and (3) to identify left ventricular (LV) T1-mapping biomarkers capable of distinguishing between healthy controls and boys with DMD and detecting LGE status in DMD. METHODS Boys with DMD (N = 28, 13.2 ± 3.1 years) and healthy age-matched boys (N = 20, 13.4 ± 3.1 years) were prospectively enrolled and underwent a 3T CMR exam including standard functional imaging and T1 mapping using a modified Look-Locker inversion recovery (MOLLI) sequence. Pre-contrast T1 mapping was performed on all boys, but contrast was administered only to boys with DMD for post-contrast T1 and ECV mapping. Global and segmental myocardial regions of interest were contoured on mid LV T1 and ECV maps. ROI measurements were compared for pre-contrast myocardial T1 between boys with DMD and healthy controls, and for post-contrast myocardial T1 and ECV between LGE + and LGE- boys with DMD using a Wilcoxon rank-sum test. Results are reported as median and interquartile range (IQR). p-Values < 0.05 were considered significant. Receiver Operating Characteristic analysis was used to evaluate a binomial logistic classifier incorporating T1 mapping and LV function parameters in the tasks of distinguishing between healthy controls and boys with DMD, and detecting LGE status in DMD. The area under the curve is reported. RESULTS Boys with DMD had significantly increased global native T1 [1332 (60) ms vs. 1289 (56) ms; p = 0.004] and increased within-slice standard deviation (SD) [100 (57) ms vs. 74 (27) ms; p = 0.001] compared to healthy controls. LGE- boys with DMD also demonstrated significantly increased lateral wall native T1 [1322 (68) ms vs. 1277 (58) ms; p = 0.001] compared to healthy controls. LGE + boys with DMD had decreased global myocardial post-contrast T1 [565 (113) ms vs 635 (126) ms; p = 0.04] and increased global myocardial ECV [32 (8) % vs. 28 (4) %; p = 0.02] compared to LGE- boys. In all classification tasks, T1-mapping biomarkers outperformed a conventional biomarker, LV ejection fraction. ECV was the best performing biomarker in the task of predicting LGE status (AUC = 0.95). CONCLUSIONS Boys with DMD exhibit elevated native T1 compared to healthy, sex- and age-matched controls, even in the absence of LGE. Post-contrast T1 and ECV estimates from 3T CMR are also reported here for pediatric patients with DMD for the first time and can distinguish between LGE + from LGE- boys. In all classification tasks, T1-mapping biomarkers outperform a conventional biomarker, LVEF.
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Affiliation(s)
- Nyasha G Maforo
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
- Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Patrick Magrath
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Kévin Moulin
- Department of Radiology, Stanford University, 1201 Welch Road, Room P264, Stanford, CA, 94305-5488, USA
| | - Jiaxin Shao
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | - Grace Hyun Kim
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
- Department of Biostatistics, University of California, Los Angeles, CA, USA
| | - Ashley Prosper
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | - Pierangelo Renella
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of Pediatric Cardiology, CHOC Children's Hospital, Orange, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
- Physics and Biology in Medicine Interdepartmental Program, University of California, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Nancy Halnon
- Department of Pediatrics (Cardiology), University of California, Los Angeles, CA, USA
| | - Daniel B Ennis
- Department of Radiology, Stanford University, 1201 Welch Road, Room P264, Stanford, CA, 94305-5488, USA.
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32
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Cheng CA, Chen W, Zhang L, Wu HH, Zink JI. Magnetic resonance imaging of high-intensity focused ultrasound-stimulated drug release from a self-reporting core@shell nanoparticle platform. Chem Commun (Camb) 2020; 56:10297-10300. [PMID: 32756711 DOI: 10.1039/d0cc03179h] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We developed a theranostic approach exemplifying a concept called an "exchange method" that controls and "images" drug release from nanoparticles using magnetic resonance imaging-guided high-intensity focused ultrasound. The controllable amount of released drug and therapeutic efficacy can be self-reported by associated MRI contrast changes in solution and in cells.
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Affiliation(s)
- Chi-An Cheng
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California 90095, USA.
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Singhrao K, Fu J, Gao Y, Wu HH, Yang Y, Hu P, Lewis JH. A generalized system of tissue-mimicking materials for computed tomography and magnetic resonance imaging. ACTA ACUST UNITED AC 2020; 65:13NT01. [DOI: 10.1088/1361-6560/ab86d4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Li X, Young AS, Raman SS, Lu DS, Lee YH, Tsao TC, Wu HH. Automatic needle tracking using Mask R-CNN for MRI-guided percutaneous interventions. Int J Comput Assist Radiol Surg 2020; 15:1673-1684. [PMID: 32676870 DOI: 10.1007/s11548-020-02226-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 07/03/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Accurate needle tracking provides essential information for MRI-guided percutaneous interventions. Passive needle tracking using MR images is challenged by variations of the needle-induced signal void feature in different situations. This work aimed to develop an automatic needle tracking algorithm for MRI-guided interventions based on the Mask Region Proposal-Based Convolutional Neural Network (R-CNN). METHODS Mask R-CNN was adapted and trained to segment the needle feature using 250 intra-procedural images from 85 MRI-guided prostate biopsy cases and 180 real-time images from MRI-guided needle insertion in ex vivo tissue. The segmentation masks were passed into the needle feature localization algorithm to extract the needle feature tip location and axis orientation. The proposed algorithm was tested using 208 intra-procedural images from 40 MRI-guided prostate biopsy cases, and 3 real-time MRI datasets in ex vivo tissue. The algorithm results were compared with human-annotated references. RESULTS In prostate datasets, the proposed algorithm achieved needle feature tip localization error with median Euclidean distance (dxy) of 0.71 mm and median difference in axis orientation angle (dθ) of 1.28°, respectively. In 3 real-time MRI datasets, the proposed algorithm achieved consistent dynamic needle feature tracking performance with processing time of 75 ms/image: (a) median dxy = 0.90 mm, median dθ = 1.53°; (b) median dxy = 1.31 mm, median dθ = 1.9°; (c) median dxy = 1.09 mm, median dθ = 0.91°. CONCLUSIONS The proposed algorithm using Mask R-CNN can accurately track the needle feature tip and axis on MR images from in vivo intra-procedural prostate biopsy cases and ex vivo real-time MRI experiments with a range of different conditions. The algorithm achieved pixel-level tracking accuracy in real time and has potential to assist MRI-guided percutaneous interventions.
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Affiliation(s)
- Xinzhou Li
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Adam S Young
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - Steven S Raman
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - David S Lu
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA
| | - Yu-Hsiu Lee
- Department of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Tsu-Chin Tsao
- Department of Mechanical and Aerospace Engineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA.
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Zhang Z, Wu HH, Priester A, Magyar C, Afshari Mirak S, Shakeri S, Mohammadian Bajgiran A, Hosseiny M, Azadikhah A, Sung K, Reiter RE, Sisk AE, Raman S, Enzmann DR. Prostate Microstructure in Prostate Cancer Using 3-T MRI with Diffusion-Relaxation Correlation Spectrum Imaging: Validation with Whole-Mount Digital Histopathology. Radiology 2020; 296:348-355. [PMID: 32515678 DOI: 10.1148/radiol.2020192330] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Microstructural MRI has the potential to improve diagnosis and characterization of prostate cancer (PCa), but validation with histopathology is lacking. Purpose To validate ex vivo diffusion-relaxation correlation spectrum imaging (DR-CSI) in the characterization of microstructural tissue compartments in prostate specimens from men with PCa by using registered whole-mount digital histopathology (WMHP) as the reference standard. Materials and Methods Men with PCa who underwent 3-T MRI and robotic-assisted radical prostatectomy between June 2018 and January 2019 were prospectively studied. After prostatectomy, the fresh whole prostate specimens were imaged in patient-specific three-dimensionally printed molds by using 3-T MRI with DR-CSI and were then sliced to create coregistered WMHP slides. The DR-CSI spectral signal component fractions (fA, fB, fC) were compared with epithelial, stromal, and luminal area fractions (fepithelium, fstroma, flumen) quantified in PCa and benign tissue regions. A linear mixed-effects model assessed the correlations between (fA, fB, fC) and (fepithelium, fstroma, flumen), and the strength of correlations was evaluated by using Spearman correlation coefficients. Differences between PCa and benign tissues in terms of DR-CSI signal components and microscopic tissue compartments were assessed using two-sided t tests. Results Prostate specimens from nine men (mean age, 65 years ± 7 [standard deviation]) were evaluated; 20 regions from 17 PCas, along with 20 benign tissue regions of interest, were analyzed. Three DR-CSI spectral signal components (spectral peaks) were consistently identified. The fA, fB, and fC were correlated with fepithelium, fstroma, and flumen (all P < .001), with Spearman correlation coefficients of 0.74 (95% confidence interval [CI]: 0.62, 0.83), 0.80 (95% CI: 0.66, 0.89), and 0.67 (95% CI: 0.51, 0.81), respectively. PCa exhibited differences compared with benign tissues in terms of increased fA (PCa vs benign, 0.37 ± 0.05 vs 0.27 ± 0.06; P < .001), decreased fC (PCa vs benign, 0.18 ± 0.06 vs 0.31 ± 0.13; P = .01), increased fepithelium (PCa vs benign, 0.44 ± 0.13 vs 0.26 ± 0.16; P < .001), and decreased flumen (PCa vs benign, 0.14 ± 0.08 vs 0.27 ± 0.18; P = .004). Conclusion Diffusion-relaxation correlation spectrum imaging signal components correlate with microscopic tissue compartments in the prostate and differ between cancer and benign tissue. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Lee and Hectors in this issue.
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Affiliation(s)
- Zhaohuan Zhang
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Holden H Wu
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Alan Priester
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Clara Magyar
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Sohrab Afshari Mirak
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Sepideh Shakeri
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Amirhossein Mohammadian Bajgiran
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Melina Hosseiny
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Afshin Azadikhah
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Kyunghyun Sung
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Robert E Reiter
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Anthony E Sisk
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Steven Raman
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
| | - Dieter R Enzmann
- From the Department of Radiological Sciences, David Geffen School of Medicine (Z.Z., H.H.W., S.A.M., S.S., A.M.B., M.H., A.A., K.S., S.R., D.R.E.), Department of Bioengineering (Z.Z., H.H.W.), Department of Urology (A.P., R.E.R.), and Department of Pathology and Laboratory Medicine (C.M., A.E.S.), University of California, Los Angeles, 300 UCLA Medical Plaza, Suite B119, Los Angeles, CA 90095
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Zhong X, Hu HH, Armstrong T, Li X, Lee Y, Tsao T, Nickel MD, Kannengiesser SA, Dale BM, Deshpande V, Kiefer B, Wu HH. Free‐Breathing Volumetric Liver and Proton Density Fat Fraction Quantification in Pediatric Patients Using Stack‐of‐Radial
MRI
With Self‐Gating Motion Compensation. J Magn Reson Imaging 2020; 53:118-129. [DOI: 10.1002/jmri.27205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 01/28/2023] Open
Affiliation(s)
- Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare Los Angeles California USA
| | - Houchun H. Hu
- Department of Radiology Nationwide Children's Hospital Columbus Ohio USA
- Clinical Science, Hyperfine Guilford Connecticut USA
| | - Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine University of California Los Angeles Los Angeles California USA
| | - Xinzhou Li
- Department of Radiological Sciences, David Geffen School of Medicine University of California Los Angeles Los Angeles California USA
- Department of Bioengineering University of California Los Angeles Los Angeles California USA
| | - Yu‐Hsiu Lee
- Department of Mechanical and Aerospace Engineering University of California Los Angeles Los Angeles California USA
| | - Tsu‐Chin Tsao
- Department of Mechanical and Aerospace Engineering University of California Los Angeles Los Angeles California USA
| | - Marcel D. Nickel
- MR Application Development, Siemens Healthcare GmbH Erlangen Germany
| | | | - Brian M. Dale
- MR R&D Collaborations, Siemens Healthcare Cary North Carolina USA
| | | | - Berthold Kiefer
- MR Application Development, Siemens Healthcare GmbH Erlangen Germany
| | - Holden H. Wu
- Department of Radiological Sciences, David Geffen School of Medicine University of California Los Angeles Los Angeles California USA
- Department of Bioengineering University of California Los Angeles Los Angeles California USA
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Zhang YQ, Li H, Wu HH, Zong XN. [Timing of permanent tooth emergence and its association with physical growth among children aged from four to seven years in nine cities of China]. Zhonghua Er Ke Za Zhi 2020; 58:206-212. [PMID: 32135592 DOI: 10.3760/cma.j.issn.0578-1310.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective: To investigate the timing of permanent tooth emergence and its association with physical growth among children aged 4-7 years in 9 cities of China, and to analyze the trend of permanent teeth development. Methods: According to a stratified cluster sampling design, a cross-sectional survey on the timing of permanent tooth emergence children aged 4-7 years was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. A total of 37 973 children (19 035 boys and 18 938 girls) were recruited and were divided into different age groups (4.0-<4.5, 4.5-5.0, 5.0-5.5 and 6.0-<7.0 years of age). The situation of the exfoliation of primary teeth and the eruption of permanent teeth were investigated. Height and weight were measured using the standardized methods. Z-scores of physical growth indicators were calculated using the growth standards for Chinese children in 2009. Probit regression analysis was used to determine the median and percentile age of transition from deciduous to permanent teeth. Chi-square test was used for comparison of categorical data and t test was used for comparison of measurement data between boys and girls, urban and suburban as well as among different ages and regions. Meanwhile, the data from the national survey on physical growth and development of children under 7 years of age in 9 cities of China in 1995 were used to analyze the trends of the permanent teeth development. Results: The rate of transition from deciduous to permanent teeth in 37 973 children aged 4-7 years was higher with age, which was 0.6% (42/7 568) in 4.0-<4.5 years of age group, 30.3% (2 295/7 583) in 5.5-<6.0 years of age group, and 74.5% (5 680/7 627) in 6.0-<7.0 years of age group. The rates of transition from deciduous to permanent teeth in boys were all lower than those of girls except for children aged 4.0-<4.5 years (all P<0.01). The rate of transition from deciduous to permanent teeth in urban children was higher than that in suburban children for older than 5.5-6.0 years of age group in boys and older than 4.5-5.0 years of age group in girls, which was 74.2% (1 427/1 924) in urban boys aged 6.0-<7.0 years and 69.2% (1 305/1 885) in suburban boys aged 6.0-<7.0 years (χ(2)=11.446, P<0.01). The age of transition from deciduous to permanent teeth was 6.00 (95%CI: 5.98-6.01) years and the range of the 3-97 percentile was 4.88-7.11 years of age. The median permanent tooth emergence age of girls was lower than that of boys (5.94 vs. 6.06 years) and the median age of urban children was lower than that of suburban children (5.94 vs. 6.05 years). The median permanent tooth emergence age of southern Chinese children (6.05 years) was higher than that of northern (5.97 years) and central Chinese children (5.97 years). The weight for age Z-scores (WAZ), height for age Z-scores (HAZ) and body mass index for age Z-scores (BMIZ) of children with transition from deciduous to permanent teeth (0.35±1.17, 0.32±1.00, 0.23±1.16) were significantly higher than those of children without transition from deciduous to permanent teeth (0.03±1.13, 0.03±1.02, 0.04±1.13, t=20.81,21.67,12.09, all P<0.05). In comparison with the data in 1995, data in 2015 showed that the rate of transition from deciduous to permanent teeth was higher, for example, the rate of urban boys aged 6.0-<7.0 years group was 63.8% (1 146/1 796) in 1995, and increased to 74.2% (1 427/1 924) in 2015 (χ(2)=46.748, P<0.01). The median permanent tooth emergence age decreased by 0.24 years in 2015 as compared with that in 1995. Conclusions: The development of permanent teeth is earlier in girls than in boys, earlier in urban children than in suburban children and slightly delay in southern children than in central and northern Chinese children. In addition, the development of permanent teeth, which is related to the physical growth, slightly accelerate in China during the past 20 years.
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Affiliation(s)
- Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - X N Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
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Zhang YQ, Li H, Wu HH, Zong XN, Li YC, Li J, Xiang XM, Zhang J, Tong ML, Cao ZZ, Lin SF, Chen W, Zhu K. [Survey on the stunting of children under seven years of age in nine cities of China]. Zhonghua Er Ke Za Zhi 2020; 58:194-200. [PMID: 32135590 DOI: 10.3760/cma.j.issn.0578-1310.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting. Methods: According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions. Results: Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ(2)=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ(2)=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ(2)=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ(2)=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ(2)=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ(2)=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ(2)=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499). Conclusions: The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.
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Affiliation(s)
- Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H Li
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - H H Wu
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - X N Zong
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y C Li
- Department of Child Health Care, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - J Li
- Department of Child Health Care, Harbin Maternal and Child Health Care Hospital, Harbin 150010, China
| | - X M Xiang
- Department of Primary Child Health Care, Xi'an Maternal and Child Health Care Hospital, Xi'an 710002, China
| | - J Zhang
- Department of Child Health Care, Shanghai Maternal and Child Health Care Center, Shanghai 200062, China
| | - M L Tong
- Department of Child Health Care, Women's Hospital of Nanjing Medical University, Nanjing 210004, China
| | - Z Z Cao
- Department of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430015, China
| | - S F Lin
- Department of Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
| | - W Chen
- Department of Child Health Care, Fuzhou Maternal and Child Health Care Hospital, Fuzhou 350005, China
| | - K Zhu
- Department of Child Health Care, Kunming City Maternal and Child Health Hospital (Kunming Municipal Service Center for Maternal and Child Health and Family Planning), Kunming 650000, China
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Singhrao K, Fu J, Wu HH, Hu P, Kishan AU, Chin RK, Lewis JH. A novel anthropomorphic multimodality phantom for MRI‐based radiotherapy quality assurance testing. Med Phys 2020; 47:1443-1451. [DOI: 10.1002/mp.14027] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Kamal Singhrao
- Department of Radiation Oncology University of California Los Angeles Los Angeles CA 90095USA
| | - Jie Fu
- Department of Radiation Oncology University of California Los Angeles Los Angeles CA 90095USA
| | - Holden H. Wu
- Department of Radiology University of California Los Angeles Los Angeles CA 90095USA
| | - Peng Hu
- Department of Radiology University of California Los Angeles Los Angeles CA 90095USA
| | - Amar U. Kishan
- Department of Radiation Oncology University of California Los Angeles Los Angeles CA 90095USA
| | - Robert K. Chin
- Department of Radiation Oncology University of California Los Angeles Los Angeles CA 90095USA
| | - John H. Lewis
- Department of Radiation Oncology Cedars‐Sinai Medical Center Los Angeles CA 90048USA
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Li W, Zhang JF, Wu F, Shi L, Xiong CR, Yao YY, Zhao S, Liu L, Feng Y, Hang DR, Hong QB, Huang YX, Liang YS, Ge J, Wu HH, Yang HT, Yang K. [Progress of interruption of schistosomiasis transmission in Jiangsu Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 31:583-590. [PMID: 32064799 DOI: 10.16250/j.32.1374.2019184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Schistosomiasis was once heavily endemic in Jiangsu Province. Following the control efforts for several decades, schistosomiasis was almost eradicated in all endemic counties in Jiangsu Province in 1980, and transmission control was achieved in the province in 2011. According to the principle of "implementing the control measures with adaptation to local circumstances and guiding the control programs with classified interventions", an integrated strategy with emphasis on the management of both infectious sources and snails has been recently employed for schitsosomiasis control in Jiangsu Province. In addition, a sensitive and highly effective surveillance system has been built and the application of novel techniques and information construction has been intensified to effectively interrupt the transmission of schistosomiasis in the Province. Transmission interruption of schistosomiasis was achieved in all endemic counties in Jiangsu Province. The paper summarizes the endemic situation of schistosomiasis, progress of schistosomiasis control, and major schistosomiasis control measures implemented during the stage of transmission interruption in Jiangsu Province.
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Affiliation(s)
- W Li
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - J F Zhang
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - F Wu
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - L Shi
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - C R Xiong
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - Y Y Yao
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - S Zhao
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - L Liu
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - Y Feng
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - D R Hang
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - Q B Hong
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - Y X Huang
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - Y S Liang
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - J Ge
- Office of the Leading Group for Schistosomiasis and other Endemic Diseases Control, Jiangsu Provincial People's Government, China
| | - H H Wu
- Office of the Leading Group for Schistosomiasis and other Endemic Diseases Control, Jiangsu Provincial People's Government, China
| | - H T Yang
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
| | - K Yang
- Jiangsu Institute of Parasitic Diseases, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Wuxi 214064, China
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Koulakis JP, Rouch J, Huynh N, Wu HH, Dunn JCY, Putterman S. Tumescent Injections in Subcutaneous Pig Tissue Disperse Fluids Volumetrically and Maintain Elevated Local Concentrations of Additives for Several Hours, Suggesting a Treatment for Drug Resistant Wounds. Pharm Res 2020; 37:51. [PMID: 32043171 PMCID: PMC7010616 DOI: 10.1007/s11095-020-2769-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/23/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE Bolus injection of fluid into subcutaneous tissue results in accumulation of fluid at the injection site. The fluid does not form a pool. Rather, the injection pressure forces the interstitial matrix to expand to accommodate the excess fluid in its volume, and the fluid becomes bound similar to that in a hydrogel. We seek to understand the properties and dynamics of externally tumesced (swollen) subcutaneous tissue as a first step in assessing whether tumescent antibiotic injections into wounds may provide a novel method of treatment. METHODS Subcutaneous injections of saline are performed in live and dead pigs and the physical properties (volume, expansion ratio, residence time, apparent diffusion constant) of the resulting fluid deposits are observed with diffusion-weighted magnetic resonance imaging, computed tomography, and 3D scanning. RESULTS Subcutaneous tissue can expand to a few times its initial volume to accommodate the injected fluid, which is dispersed thoroughly throughout the tumescent volume. The fluid spreads to peripheral unexpanded regions over the course of a few minutes, after which it remains in place for several hours. Eventually the circulation absorbs the excess fluid and the tissue returns to its original state. CONCLUSIONS Given the evidence for dense fluid dispersal and several-hour residence time, a procedure is proposed whereby tumescent antibiotic injections are used to treat drug-resistant skin infections and chronic wounds that extend into the subcutaneous tissue. The procedure has the potential to effectively treat otherwise untreatable wounds by keeping drug concentrations above minimum inhibitory levels for extended lengths of time.
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Affiliation(s)
- John P Koulakis
- Department of Physics and Astronomy, University of California Los Angeles, California, Los Angeles, 90095, USA.
| | - Joshua Rouch
- Department of Surgery, Division of Pediatric Surgery, University of California Los Angeles, California, Los Angeles, 90095, USA
| | - Nhan Huynh
- Department of Surgery, Division of Pediatric Surgery, University of California Los Angeles, California, Los Angeles, 90095, USA
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, California, Los Angeles, 90095, USA
| | - James C Y Dunn
- Department of Surgery. Division of Pediatric Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Alway M116, Stanford, CA, 94305, USA
| | - Seth Putterman
- Department of Physics and Astronomy, University of California Los Angeles, California, Los Angeles, 90095, USA
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Mikaiel S, Simonelli J, Li X, Lee Y, Lee YS, Sung K, Lu DS, Tsao T, Wu HH. MRI‐guided targeted needle placement during motion using hydrostatic actuators. Int J Med Robot 2020; 16:e2041. [DOI: 10.1002/rcs.2041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 01/17/2023]
Affiliation(s)
- Samantha Mikaiel
- Department of Radiological Sciences University of California Los Angeles Los Angeles California
- Physics and Biology in Medicine Program University of California Los Angeles Los Angeles California
| | - James Simonelli
- Department of Mechanical and Aerospace Engineering University of California Los Angeles Los Angeles California
| | - Xinzhou Li
- Department of Radiological Sciences University of California Los Angeles Los Angeles California
- Department of Bioengineering University of California Los Angeles Los Angeles California
| | - Yu‐Hsiu Lee
- Department of Mechanical and Aerospace Engineering University of California Los Angeles Los Angeles California
| | - Yong Seok Lee
- Department of Radiological Sciences University of California Los Angeles Los Angeles California
- Department of Radiology Dongguk University Ilsan Hospital Republic of Korea
| | - Kyunghyun Sung
- Department of Radiological Sciences University of California Los Angeles Los Angeles California
- Physics and Biology in Medicine Program University of California Los Angeles Los Angeles California
- Department of Bioengineering University of California Los Angeles Los Angeles California
| | - David S. Lu
- Department of Radiological Sciences University of California Los Angeles Los Angeles California
| | - Tsu‐Chin Tsao
- Department of Mechanical and Aerospace Engineering University of California Los Angeles Los Angeles California
| | - Holden H. Wu
- Department of Radiological Sciences University of California Los Angeles Los Angeles California
- Physics and Biology in Medicine Program University of California Los Angeles Los Angeles California
- Department of Bioengineering University of California Los Angeles Los Angeles California
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Tsai HY, Wu HH, Chou BC, Li CS, Gau BZ, Lin ZY, Fuh CB. A magneto-microfluidic platform for fluorescence immunosensing using quantum dot nanoparticles. Nanotechnology 2019; 30:505101. [PMID: 31557130 DOI: 10.1088/1361-6528/ab423d] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study reports the online fluorescent detection of carcinoembryonic antigen (CEA) and α-fetoprotein (AFP) biomarker proteins in microfluidic channels using functional nanoparticles. Functional magnetic nanoparticles labeled with two antibodies were predeposited on separated microfluidic channels. Antigens were passed through each microfluidic channel to react with the respective antibodies. Two types of fluorescent nanoparticles labeled with antibodies were then used to detect and confirm antigens in the immunocomplex. Results indicate that online fluorescent detection of proteins can provide advantages for real-time monitoring and diagnostic applications. The running time was less than 20 min for each trial. The detection limits of CEA and AFP were found to be 0.6 and 0.2 pg ml-1. These detection limits are lower than those of ELISA. The linear ranges of CEA and AFP detection were from 1.8 pg ml-1 to 1.8 ng ml-1 and from 0.68 pg ml-1 to 0.68 ng ml-1 for two deposition zones in a magnetic sandwich immunoassay. The linear ranges of this method are wider than those of ELISA and those of most other methods. The measurements of CEA and AFP in serum samples from this method differed from ELISA results by 11% and 9.4%, respectively. The detection limit of online detection has achieved the same range as those of previous offline detection. This method has a good potential for automation and multichannel analysis to increase the throughput with some modifications in the future. The proposed method can provide simple, fast, and sensitive online detection for biomarkers.
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Affiliation(s)
- H Y Tsai
- School of Medical Applied Chemistry, Chung Shan Medical University, Taichung 402, Taiwan. Department of Medical Education, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
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Hu HH, Branca RT, Hernando D, Karampinos DC, Machann J, McKenzie CA, Wu HH, Yokoo T, Velan SS. Magnetic resonance imaging of obesity and metabolic disorders: Summary from the 2019 ISMRM Workshop. Magn Reson Med 2019; 83:1565-1576. [PMID: 31782551 DOI: 10.1002/mrm.28103] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/02/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023]
Abstract
More than 100 attendees from Australia, Austria, Belgium, Canada, China, Germany, Hong Kong, Indonesia, Japan, Malaysia, the Netherlands, the Philippines, Republic of Korea, Singapore, Sweden, Switzerland, the United Kingdom, and the United States convened in Singapore for the 2019 ISMRM-sponsored workshop on MRI of Obesity and Metabolic Disorders. The scientific program brought together a multidisciplinary group of researchers, trainees, and clinicians and included sessions in diabetes and insulin resistance; an update on recent advances in water-fat MRI acquisition and reconstruction methods; with applications in skeletal muscle, bone marrow, and adipose tissue quantification; a summary of recent findings in brown adipose tissue; new developments in imaging fat in the fetus, placenta, and neonates; the utility of liver elastography in obesity studies; and the emerging role of radiomics in population-based "big data" studies. The workshop featured keynote presentations on nutrition, epidemiology, genetics, and exercise physiology. Forty-four proffered scientific abstracts were also presented, covering the topics of brown adipose tissue, quantitative liver analysis from multiparametric data, disease prevalence and population health, technical and methodological developments in data acquisition and reconstruction, newfound applications of machine learning and neural networks, standardization of proton density fat fraction measurements, and X-nuclei applications. The purpose of this article is to summarize the scientific highlights from the workshop and identify future directions of work.
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Affiliation(s)
- Houchun H Hu
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio
| | - Rosa Tamara Branca
- Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Diego Hernando
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research, Tübingen, Germany.,Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Charles A McKenzie
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Holden H Wu
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California
| | - Takeshi Yokoo
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Singapore BioImaging Consortium, Agency for Science Technology and Research, Singapore
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Zhong X, Armstrong T, Nickel MD, Kannengiesser SAR, Pan L, Dale BM, Deshpande V, Kiefer B, Wu HH. Effect of respiratory motion on free-breathing 3D stack-of-radial liver R 2 ∗ relaxometry and improved quantification accuracy using self-gating. Magn Reson Med 2019; 83:1964-1978. [PMID: 31682016 DOI: 10.1002/mrm.28052] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 03/24/2019] [Revised: 09/12/2019] [Accepted: 10/05/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To develop an accurate free-breathing 3D liver R 2 ∗ mapping approach and to evaluate it in vivo. METHODS A free-breathing multi-echo stack-of-radial sequence was applied in 5 normal subjects and 6 patients at 3 Tesla. Respiratory motion compensation was implemented using the inherent self-gating signal. A breath-hold Cartesian acquisition was the reference standard. Proton density fat fraction and R 2 ∗ were measured and compared between radial and Cartesian methods using Bland-Altman plots. The normal subject results were fitted to a linear mixed model (P < .05 considered significant). RESULTS Free-breathing stack-of-radial without self-gating exhibited signal attenuation in echo images and artifactually elevated apparent R 2 ∗ values. In the Bland-Altman plots of normal subjects, compared to breath-hold Cartesian, free-breathing stack-of-radial acquisitions of 22, 30, 36, and 44 slices, had mean R 2 ∗ differences of 27.4, 19.4, 10.9, and 14.7 s-1 with 800 radial views, and they had 18.4, 11.9, 9.7, and 27.7 s-1 with 404 views, which were reduced to 0.4, 0.9, -0.2, and -0.7 s-1 and to -1.7, -1.9, -2.1, and 0.5 s-1 with self-gating, respectively. No substantial proton density fat fraction differences were found. The linear mixed model showed free-breathing radial R 2 ∗ results without self-gating were significantly biased by 17.2 s-1 averagely (P = .002), which was eliminated with self-gating (P = .930). Proton density fat fraction results were not different (P > .234). For patients, Bland-Altman plots exhibited mean R 2 ∗ differences of 14.4 and 0.1 s-1 for free-breathing stack-of-radial without self-gating and with self-gating, respectively, but no substantial proton density fat fraction differences. CONCLUSION The proposed self-gating method corrects the respiratory motion bias and enables accurate free-breathing stack-of-radial quantification of liver R 2 ∗ .
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Affiliation(s)
- Xiaodong Zhong
- MR R&D Collaborations, Siemens Healthcare, Los Angeles, California
| | - Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Marcel D Nickel
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | | | - Li Pan
- MR R&D Collaborations, Siemens Healthcare, Baltimore, Maryland
| | - Brian M Dale
- MR R&D Collaborations, Siemens Healthcare, Cary, North Carolina
| | | | - Berthold Kiefer
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Physics and Biology in Medicine Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Cheng CA, Chen W, Zhang L, Wu HH, Zink JI. A Responsive Mesoporous Silica Nanoparticle Platform for Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound-Stimulated Cargo Delivery with Controllable Location, Time, and Dose. J Am Chem Soc 2019; 141:17670-17684. [PMID: 31604010 DOI: 10.1021/jacs.9b07591] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Magnetic resonance imaging (MRI) is an essential modality for clinical diagnosis, and MRI-guided high-intensity focused ultrasound (MRgHIFU) is a powerful technology for targeted therapy. Clinical applications of MRgHIFU primarily utilize hyperthermia and ablation to treat cancerous tissue, but for drug delivery applications thermal damage is undesirable. A biofriendly MRgHIFU-responsive mesoporous silica nanoparticle (MSN) platform that is stimulated within a physiological safe temperature range has been developed, reducing the possibility of thermal damage to the surrounding healthy tissues. Biocompatible polyethylene glycol (PEG) was employed to cap the pores of MSNs, and the release of cargo molecules by HIFU occurs without substantial temperature increase (∼4 °C). To visualize by MRI and measure the stimulated delivery in situ, a U.S. Food and Drug Administration (FDA)-approved gadolinium-based contrast agent, gadopentetate dimeglumine (Gd(DTPA)2-), was used as the imageable cargo. Taking advantage of the three-dimensional (3-D) imaging and targeting capabilities of MRgHIFU, the release of Gd(DTPA)2- stimulated by HIFU was pinpointed at the HIFU focal point in 3-D space in a tissue-mimicking gel phantom. The amount of Gd(DTPA)2- released was controlled by HIFU stimulation times and power levels. A positive correlation between the amount of Gd(DTPA)2- released and T1 was found. The MRgHIFU-stimulated cargo release was further imaged in a sample of ex vivo animal tissue. With this technology, the biodistribution of the nanocarriers can be tracked and the MRgHIFU-stimulated cargo release can be pinpointed, opening up an opportunity for future image-guided theranostic applications.
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Affiliation(s)
- Chi-An Cheng
- Department of Bioengineering , University of California Los Angeles , Los Angeles , California 90095 , United States.,California NanoSystems Institute , University of California Los Angeles , Los Angeles 90095 , California , United States
| | - Wei Chen
- Department of Chemistry & Biochemistry , University of California Los Angeles , Los Angeles , California 90095 , United States.,California NanoSystems Institute , University of California Los Angeles , Los Angeles 90095 , California , United States
| | - Le Zhang
- Department of Radiological Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California 90095 , United States
| | - Holden H Wu
- Department of Bioengineering , University of California Los Angeles , Los Angeles , California 90095 , United States.,Department of Radiological Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California 90095 , United States
| | - Jeffrey I Zink
- Department of Chemistry & Biochemistry , University of California Los Angeles , Los Angeles , California 90095 , United States.,California NanoSystems Institute , University of California Los Angeles , Los Angeles 90095 , California , United States
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Zhang Z, Moulin K, Aliotta E, Shakeri S, Afshari Mirak S, Hosseiny M, Raman S, Ennis DB, Wu HH. Prostate diffusion MRI with minimal echo time using eddy current nulled convex optimized diffusion encoding. J Magn Reson Imaging 2019; 51:1526-1539. [PMID: 31625663 DOI: 10.1002/jmri.26960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/25/2019] [Accepted: 09/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prostate diffusion-weighted imaging (DWI) using monopolar encoding is sensitive to eddy-current-induced distortion artifacts. Twice-refocused bipolar encoding suppresses eddy current artifacts, but increases echo time (TE), leading to lower signal-to-noise ratio (SNR). Optimization of the diffusion encoding might improve prostate DWI. PURPOSE To evaluate eddy current nulled convex optimized diffusion encoding (ENCODE) for prostate DWI with minimal TE. STUDY TYPE Prospective cohort study. POPULATION A diffusion phantom, an ex vivo prostate specimen, 10 healthy male subjects (27 ± 3 years old), and five prostate cancer patients (62 ± 7 years old). FIELD STRENGTH/SEQUENCE 3T; single-shot spin-echo echoplanar DWI. ASSESSMENT Eddy-current artifacts, TE, SNR, apparent diffusion coefficient (ADC), and image quality scores from three independent readers were compared between monopolar, bipolar, and ENCODE prostate DWI for standard-resolution (1.6 × 1.6 mm2 , partial Fourier factor [pF] = 6/8) and higher-resolution protocols (1.6 × 1.6 mm2 , pF = off; 1.0 × 1.0 mm2 , pF = 6/8). STATISTICAL TESTING SNR and ADC differences between techniques were tested with Kruskal-Wallis and Wilcoxon signed-rank tests (P < 0.05 considered significant). RESULTS Eddy current suppression with ENCODE was comparable to bipolar encoding (mean coefficient of variation across three diffusion directions of 9.4% and 9%). For a standard-resolution protocol, ENCODE achieved similar TE as monopolar and reduced TE by 14 msec compared to bipolar, resulting in 27% and 29% higher mean SNR in prostate transition zone (TZ) and peripheral zone (PZ) (P < 0.05) compared to bipolar, respectively. For higher-resolution protocols, ENCODE achieved the shortest TE (67 msec), with 17-21% and 58-70% higher mean SNR compared to monopolar (TE = 77 msec) and bipolar (TE = 102 msec) in PZ and TZ (P < 0.05). No significant differences were found in mean TZ (P = 0.91) and PZ ADC (P = 0.94) between the three techniques. ENCODE achieved similar or higher image quality scores than bipolar DWI in patients, with mean intraclass correlation coefficient of 0.77 for overall quality between three independent readers. DATA CONCLUSION ENCODE minimizes TE (improves SNR) and reduces eddy-current distortion for prostate DWI compared to monopolar and bipolar encoding. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1526-1539.
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Affiliation(s)
- Zhaohuan Zhang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Kevin Moulin
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Eric Aliotta
- Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA
| | - Sepideh Shakeri
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Sohrab Afshari Mirak
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Melina Hosseiny
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Steven Raman
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
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Affiliation(s)
- H H Wu
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
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Zhang YQ, Li Y, Li H, Wu HH, Zong XN. [Development of primary teeth among infants and toddlers in nine cities of China in 2015]. Zhonghua Er Ke Za Zhi 2019; 57:680-685. [PMID: 31530353 DOI: 10.3760/cma.j.issn.0578-1310.2019.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the status of the development of primary teeth and to identify the development patterns among infants and toddlers in nine cities of China in 2015. Methods: Healthy children aged 1-<36 months were investigated by across-sectional survey and retrospective studies, which was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. Subjects (n=103 995) were divided into 14 age groups (1-<2, 2-<3, 3-<4, 4-<5, 5-<6, 6-<8, 8-<10, 10-<12, 12-<15, 15-<18, 18-<21, 21-<24, 24-<30, 30-<36 months). There were 150-200 boys and girls respectively in each group of urban and suburb areas in each city. The eruption status and the number of primary teeth were examined by the trained child health care physician or pediatrician on the spot. The timing of primary teeth eruption of children was retrospectively surveyed using a questionnaire. The prevalence of primary teeth was calculated and χ(2) test was used for comparison of categorical data. Probit regression analysis was used to determine the median and percentile age of eruption of primary teeth. Results: Totally 103 995 children aged 1-<36 months were investigated. There were 52 346 children in urban areas (boys 26 228, girls 26 118) and 51 649 children in suburb areas (boys 25 912, girls 25 737). The eruption rate of primary teeth in children under 2 years became higher with age and the difference among each age group was statistically significant (χ(2)=85 913.868, P<0.01), which was 0.3% (22/7 450) in 3-<4 months group, 43.0% (3 227/7 503) in 6-<8 months group and 99.9% (7 441/7 446) in 15-<18 months group. The eruption age of primary teeth was 6.6 months (95%CI: 6.5-6.7 months), and the range of the 3rd to 97th percentile was 4.1-10.6 months. The eruption ages of primary teeth in urban and suburb areas children were 6.6 months (95%CI: 6.5-6.7 months) and 6.6 months (95%CI: 6.5-6.7 months) respectively. The eruption age of primary teeth was earlier in boys (6.4 months, 95%CI: 6.3-6.5 months) than that in girls (6.7 months, 95%CI: 6.6-6.8 months). The median eruption age of primary teeth was earlier in northern China (6.2 months) than that in central (6.7 months) and southern China (6.9 months). The eruption rate of primary teeth became higher with age, showing that the median number of primary teeth was 2 in 8-<10 months group, 8 in 12-<15 months group and 20 in 30-<36 months group. Conclusions: The timing of eruption of primary teeth was similar between urban and suburb areas children and that of the boys was slightly earlier than that of the girls. There were slight differences among different regions in the eruption timing of primary teeth. The range of the 3rd to 97th percentile in the eruption age of primary teeth was 4.1-10.6 months and the number of primary teeth followed the regular development pattern with age.
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Affiliation(s)
- Y Q Zhang
- Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China
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Zhang L, Armstrong T, Li X, Wu HH. A variable flip angle golden-angle-ordered 3D stack-of-radial MRI technique for simultaneous proton resonant frequency shift and T 1 -based thermometry. Magn Reson Med 2019; 82:2062-2076. [PMID: 31257639 DOI: 10.1002/mrm.27883] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 03/18/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop and evaluate a variable-flip-angle golden-angle-ordered 3D stack-of-radial MRI technique for simultaneous proton resonance frequency shift (PRF) and T1 -based thermometry in aqueous and adipose tissues, respectively. METHODS The proposed technique acquires multiecho radial k-space data in segments with alternating flip angles to measure 3D temperature maps dynamically on the basis of PRF and T1 . A sliding-window k-space weighted image contrast filter is used to increase temporal resolution. PRF is measured in aqueous tissues and T1 in adipose tissues using fat/water masks. The accuracy for T1 quantification was evaluated in a reference T1 /T2 phantom. In vivo nonheating experiments were conducted in healthy subjects to evaluate the stability of PRF and T1 in the brain, prostate, and breast. The proposed technique was used to monitor high-intensity focused ultrasound (HIFU) ablation in ex vivo porcine fat/muscle tissues and compared to temperature probe readings. RESULTS The proposed technique achieved 3D coverage with 1.1-mm to 1.3-mm in-plane resolution and 2-s to 5-s temporal resolution. During 20 to 30 min of nonheating in vivo scans, the temporal coefficient of variation for T1 was <5% in the brain, prostate, and breast fatty tissues, while the standard deviation of relative PRF temperature change was within 3°C in aqueous tissues. During ex vivo HIFU ablation, the temperatures measured by PRF and T1 were consistent with temperature probe readings, with an absolute mean difference within 2°C. CONCLUSION The proposed technique achieves simultaneous PRF and T1 -based dynamic 3D MR temperature mapping in aqueous and adipose tissues. It may be used to improve MRI-guided thermal procedures.
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Affiliation(s)
- Le Zhang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Tess Armstrong
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Physics in Biology and Medicine Interdepartmental Graduate Program, University of California Los Angeles, Los Angeles, California
| | - Xinzhou Li
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California
| | - Holden H Wu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Physics in Biology and Medicine Interdepartmental Graduate Program, University of California Los Angeles, Los Angeles, California.,Department of Bioengineering, University of California Los Angeles, Los Angeles, California
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