Magnetic Resonance Imaging Scans Research Articles

Three-dimensional source position verification in image-guided high-dose-rate brachytherapy using an XCT-based gel dosimeter.

Comprehensive quality assurance (QA) for a seamless workflow of high-dose-rate brachytherapy, from imaging to planning and irradiation, is uncommon, and QA of the source dwell position is performed in one- or two-dimensions. Gel dosimetry using magnetic resonance imaging (MRI) is effective in verifying the three-dimensional distribution of doses for image-guided brachytherapy (IGBT). However, MRI scanners are not readily accessible, and MRI scanning is time-consuming. Nevertheless, X-ray computed tomography (XCT) is available for IGBT planning. In this study, we designed and developed an efficient method for QA for a seamless workflow of IGBT with a new commercially available XCT-based polymer gel dosimeter. To enable direct insertion of brachytherapy applicators, the gelatinizing agent of the dosimeter was modified. A cylindrical polyvinyl chloride jar was filled with the modified gel dosimeter, which was subsequently used to determine the reproducibility of source dwell positions, detectability of source positional errors from intentionally introduced catheter length offsets, effect of looped source transfer tubes on the average displacement, extent of inter-observer variation, and gel robustness following multiple needle-insertions. Three ProGuide sharp needles were inserted into the jar. The dwell time at each point was determined to identify the irradiated volume with a diameter of approximately 10mm on XCT images. All the times were the same. The plan was delivered using an afterloader with an Ir-192 radioactive source, and the irradiated gel dosimeter was scanned using an XCT scanner. The subtracted images were generated from pre- and post-irradiated images. Volumes with incremented Hounsfield units were manually identified and contoured. The centroid of the volume was defined as the measured source dwell position. Subsequently, planned source dwell positions were extracted from the DICOM file of the plan. Finally, the source dwell positions in plan and irradiated gel were compared in three axes. The hardness of the dosimeter was 1250% greater than that of the previously reported gel dosimeter. Source dwell positions were visually identified in the XCT image. Testing of CT acquisition, planning, irradiation, and analysis was completed in approximately 1h. In the reproducibility test of source dwell positions, created by inserting three needles (each with three source dwell positions), the average displacements of the source positions from the first source dwell position were within 0.5mm in all three directions. In the detectability test, displacements were less than 1mm in the x-y plane but greater than 1mm in the z-axis, which was the source path direction. When errors of 1-3mm were intentionally introduced, the measured displacement was within 0.7mm of the median (range: 0.21-1.65mm) of intentional errors. When the transfer tube was looped, the source dwell position displaced by approximately 1mm. After 20 needle-insertions, the source dwell position displacement was within 1mm. The maximum inter-observer variation of contouring was 0.57mm. The XCT-based gel dosimeter enabled verification of three-dimensional source dwell positions for a seamless workflow of IGBT with high precision and efficiency.

Using U-Net models in deep learning for brain tumor detection from MRI scans

Tumor diseases in the nervous system are both dangerous and complex. Magnetic Resonance Imaging (MRI) is crucial for detecting brain disease; however, identifying the presence of tumors from these is time-consuming and requires a professional doctor. Utilizing deep learning for tumor detection in MRI images can reduce waiting times and enhance detection accuracy. We propose a method employing two U-Net models: ResNeXt-50 and EfficientNet architectures, integrated with a Feature Pyramid Network (FPN) for segmenting brain tumor. The models were trained on the BraTS 2021 dataset, consisting of 3,929 MRI scan images with 3,929 corresponding masks, divided into training, testing, and evaluation sets in a 70:15:15 ratio. The results indicate that the hybrid model, which combines EfficientNet and FPN, delivers superior performance, with an average Intersection over Union (IoU) accuracy of 0.90 on the test set compared to 0.50 for ResNeXt-50, and Dice accuracy of 0.92 compared to 0.66 for ResNeXt-50. Furthermore, we developed a web application that implements the EfficientNet with FPN model, facilitating convenient tumor detection from uploaded MRI images for doctors.

Magnetic Resonance Imaging Parameters in the Subacute Phase after Traumatic Cervical Spinal Cord Injury: A Prospective, Observational Longitudinal Study. Part 1: Conventional Imaging Characteristics.

Magnetic resonance imaging (MRI) remains the gold standard for evaluating spinal cord tissue damage after spinal cord injury (SCI). Several MRI findings may have some prognostic potential, but their evolution over time, especially from the subacute to the chronic phase has not been studied extensively. We performed a prospective observational longitudinal study exploring the evolution of MRI parameters from the subacute to chronic phase after human traumatic cervical SCI. The study, conducted between 2016 and 2021, involved standardized neurological examinations and MRI scans 1 month, 3 months, and 1 year after SCI. The study cohort comprises 52 patients with cervical SCI. Patients were classified into AIS grades (American Spinal Injury Association Impairment Scale), and neurological recovery was assessed using the Integrated Neurological Change Score. The MRI protocol included various routine sequences, allowing the evaluation of established parameters such as intramedullary hemorrhage, lesion dimensions, maximum spinal cord compression, and various grading scales. The persistence of intramedullary hemorrhage one month after injury was associated with worse lower extremity motor scores and pinprick values after 3 months, and also in the chronic phase. In addition, dorsal column T2-weighted hyperintensities detected 3 months post-injury and in the chronic phase were related to lower pinprick sensory scores. The basic score and Sagittal Grade at 1 month were predictive for motor function 3 months after SCI and for neurological recovery between 1 and 3 months after injury. The study contributes valuable insights into the utility of routine MRI sequences for evaluating traumatic cervical SCI during the subacute to chronic phase. The identified MRI parameters and scores offer prognostic information and could support clinical decision-making.

Magnetic resonance imaging quantitative assessment of corticospinal tract damage in basal ganglia infarction.

To retrospectively explore the role of magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) in analyzing the corticospinal tract injury in acute cerebral anterior circulation infarction in the basal ganglia region and the correlation between DTI parameters and neurological function scores, patients with acute cerebral infarction and stroke had undergone plain MRI and DTI sequence scanning were enrolled. Diffusion tensor tractography was used to perform 3-dimensional reconstruction of bilateral corticospinal tracts (CST). The image data were processed to obtain fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values, and the correlation between the DTI parameters and neurological function scores of National Institutes of Health Stroke Scale (NIHSS) was evaluated. A total of thirty-two patients with acute ischemic cerebral infarction were retrospectively enrolled, including 19 males and 13 females with a mean age 63.22 ± 7.78 years. The CST score was 0 in 2 (6.25%) patients, 1 in 9 (28.13%), 2 in 9 (28.13%), 3 in 7 (21.88%), and 4 in 5 (15.63%). The FA value significantly (P = .01) decreased (0.52 ± 0.03 vs 0.62 ± 0.04) on the ischemic side compared with that on the normal side. A significant (P < .05) difference was detected in the number of nerve fibers (223.3 ± 110.0 vs 246.7 ± 104.4) rather than in the ADC values (0.86 ± 0.06 vs 0.84 ± 0.06) between the ischemic and healthy sides. The FA and ADC values were not significantly (P > .05) different according to the CST scores 0, 1, 2, 3, or 4 between the ischemic and healthy sides. There was a significant (P < .05) negative correlation between the FA value on the infarcted side and the NIHSS score. In conclusion, with the DTI technology, varying degrees of damage to the corticospinal tract at the infarcted side can be detected and important clinical information can be provided for the diagnosis and prognosis of acute cerebral infarction by evaluating the degree of corticospinal tract injury.

Correlation between magnetic resonance imaging and arthroscopic findings in superior labral from anterior to posterior injuries of shoulder joint

Background: The aim of our study was to identify the accuracy of the magnetic resonance imaging (MRI) in detecting superior labral from anterior to posterior (SLAP) lesions when compared to arthroscopic findings, considering arthroscopy as the gold standard. Methods: This is a retrospective study conducted between January 2015 to July 2021 that focuses on SLAP lesions to evaluate the accuracy of its magnetic resonance imaging (MRI) reporting. All patients who had shoulder arthroscopy were included, and their intra-operative pathology was recorded and compared to their pre-operative MRI reports. Accuracy was assessed by calculating the sensitivity and specificity of MRI in comparison to the standard shoulder arthroscopy. Results: 60 patients were included in the study. In diagnosing SLAP lesions this study showed that MRI was 54% sensitivity, 67% specificity with 79% positive predictive value and 39% negative predictive value. Accuracy was found to be 55%. Conclusions: In this study, the MRI did not detect SLAP lesions at a rate as high as arthroscopy, which is considered the gold standard. When performing arthroscopy, it is important to be diligent in detecting actual SLAP lesions that may not have been identified by traditional MRI scans.

Improving Prostate Image Segmentation Based on Equilibrium Optimizer and Cross-Entropy

Over the past decade, the development of computer-aided detection tools for medical image analysis has seen significant advancements. However, tasks such as the automatic differentiation of tissues or regions in medical images remain challenging. Magnetic resonance imaging (MRI) has proven valuable for early diagnosis, particularly in conditions like prostate cancer, yet it often struggles to produce high-resolution images with clearly defined boundaries. In this article, we propose a novel segmentation approach based on minimum cross-entropy thresholding using the equilibrium optimizer (MCE-EO) to enhance the visual differentiation of tissues in prostate MRI scans. To validate our method, we conducted two experiments. The first evaluated the overall performance of MCE-EO using standard grayscale benchmark images, while the second focused on a set of transaxial-cut prostate MRI scans. MCE-EO’s performance was compared against six stochastic optimization techniques. Statistical analysis of the results demonstrates that MCE-EO offers superior performance for prostate MRI segmentation, providing a more effective tool for distinguishing between various tissue types.

A rare occurrence of enchondroma with pathological fracture of proximal femur in an adult female: A case report

Enchondroma occurrence in the proximal femur is a very uncommon condition. We report a 40-year-old female with a history of accidental slip and fall, sustained injury to her left lower limb, and was unable to bear weight on the injured leg since the fall. Anteroposterior radiograph of the pelvis with bilateral hips shows a well-defined lytic lesion in the neck of the femur with some calcified matrix and no periosteal reaction with the left femoral subtrochanteric fracture. Magnetic resonance imaging scan revealed hypointense signals on T1 and hyperintense signals on T2 sequence over the proximal femur as well as left subtrochanteric femur fracture. After preanesthetic evaluation, bone curettage with excision biopsy with open reduction and internal fixation with long proximal femoral nail and bolts and iliac crest bone graft was done. A biopsy sample sent for histopathological examination reveals enchondroma. Complete weight bearing was started after four months. No recurrence was noted on follow up.

Structural Covariance Networks in the Fetal Brain Reveal Altered Neurodevelopment for Specific Subtypes of Congenital Heart Disease.

Altered structural brain development has been identified in fetuses with congenital heart disease (CHD), suggesting that the neurodevelopmental impairment observed later in life might originate in utero. There are many interacting factors that may perturb neurodevelopment during the fetal period and manifest as structural brain alterations, such as altered cerebral substrate delivery and aberrant fetal hemodynamics. We extracted structural covariance networks from the log Jacobian determinants of 435 in utero T2 weighted image magnetic resonance imaging scans, (n=67 controls, 368 with CHD) acquired during the third trimester. We fit general linear models to test whether age, sex, expected cerebral substrate delivery, and CHD diagnosis were significant predictors of structural covariance. We identified significant effects of age, sex, cerebral substrate delivery, and specific CHD diagnosis across a variety of structural covariance networks, including primary motor and sensory cortices, cerebellar regions, frontal cortex, extra-axial cerebrospinal fluid, thalamus, brainstem, and insula, consistent with widespread coordinated aberrant maturation of specific brain regions over the third trimester. Structural covariance networks offer a sensitive, data-driven approach to explore whole-brain structural changes without anatomical priors. We used them to stratify a heterogenous patient cohort with CHD, highlighting similarities and differences between diagnoses during fetal neurodevelopment. Although there was a clear effect of abnormal fetal hemodynamics on structural brain maturation, our results suggest that this alone does not explain all the variation in brain development between individuals with CHD.

A Comprehensive Review of the Recent Advancements in Imaging Segmentation and Registration Techniques for Glioblastoma and Focusing on the Utilization of Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scans.

The most common primary malignant brain tumor is glioblastoma. Glioblastoma Multiforme (GBM) diagnosis is difficult. However, image segmentation and registration methods may simplify and automate Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scan analysis. Medical practitioners and researchers can better identify and characterize glioblastoma tumors using this technology. Many segmentation and registration approaches have been proposed recently. Note that these approaches are not fully compiled. This review efficiently and critically evaluates the state-of-the-art segmentation and registration techniques for MRI and CT GBM images, providing researchers, medical professionals, and students with a wealth of knowledge to advance GBM imaging and inform decision-making. GBM's origins and development have been examined, along with medical imaging methods used to diagnose tumors. Image segmentation and registration were examined, showing their importance in this difficult task. Frequently encountered glioblastoma segmentation and registration issues were examined. Based on these theoretical foundations, recent image segmentation and registration advances were critically analyzed. Additionally, evaluation measures for analytical efforts were thoroughly reviewed.

Lateral femoral impaction fractures during an ACL tear extend posteriorly on the weight-bearing area of the tibiofemoral joint.

Posterior elongation of the physiological terminal sulcus (TS) due to lateral femoral condyle impaction fracture (LFC-IF) after an anterior cruciate ligament (ACL) tear could potentially decrease the weight-bearing area of the tibiofemoral joint, decrease the tension on lateral meniscus and cause flattening of the LFC which would influence rotational knee motion and cause anisometry of the lateral and anterolateral stabilizers. Therefore, the purpose of the study was to assess if the LFC-IF elongates the physiological TS posteriorly. One hundred patients magnetic resonance images (MRIs) (75 males, 25 females, mean age 32.2 years, SD = 8.2) were included with a 1:1 ratio between the full-thickness ACL tear group and the control group (patients with knee MRI performed due to other reasons, with no tear of ACL on MRI and negative clinical tests). Two independent raters evaluated the sagittal T1-weighted preselected MRI scans. The principal measurement of interest was the distance from the intersection of the Blumensaat line with subchondral bone to the posterior border of the TS/LFC-IF. The median distance from the Blumensaat line to the posterior border of the TS/LFC-IF was significantly higher in the ACL tear group: 14.3 mm, interquartile range (IQR) = 11.6-16.4 mm versus control group: 12.8 mm, IQR = 9.0-15.0 mm, p = 0.038. Intrarater and inter-rater reliabilities were >0.90. LFC-IF after full-thickness ACL tear significantly elongates the physiological TS in the posterior direction. Level III.

Variable Presence of an Evolutionarily New Brain Structure is Related to Trait Impulsivity.

Impulsivity is a multidimensional construct reflecting poor constraint over one's behaviors. Clinical psychology research identifies separable impulsivity dimensions that are each unique transdiagnostic indicators for psychopathology. Yet, despite this apparent clinical importance, the shared and unique neuroanatomical correlates of these factors remain largely unknown. Concomitantly, neuroimaging research identifies variably present human brain structures implicated in cognition and disorder: the folds (sulci) of the cerebral cortex located in the latest developing and most evolutionarily expanded hominoid-specific association cortices. We tethered these two fields to test whether variability in one such structure in anterior cingulate cortex (ACC)-the paracingulate sulcus (PCGS)-was related to individual differences in trait impulsivity. 120 adult participants with internalizing or externalizing psychopathology completed a magnetic resonance imaging scan and the Three-Factor Impulsivity Index. Using precision imaging techniques, we manually identified the PCGS, when present, and acquired quantitative folding metrics (PCGS length and ACC local gyrification index). Neuroanatomical-behavioral analyses revealed that participants with leftward or symmetrical PCGS patterns had greater severity of Lack of Follow Through (LFT)-which captures inattention and lack of perseverance-than those with rightward asymmetry. Neuroanatomical-functional analyses identified that the PCGS co-localized with a focal locus found in a neuroimaging meta-analysis on a feature underlying LFT. Both quantitative folding metrics did not relate to any impulsivity dimension. This study advances understanding of the neuroanatomical correlates of impulsivity and establishes the notion that the topographical organization of distinct, hominoid-specific cortical expanses underlie separable impulsivity dimensions with robust, transdiagnostic implications for psychopathology.

The mediation role of gray matter volume in the relationship between childhood maltreatment and psychological resilience in adolescents with first-episode major depressive disorder

Previous studies have revealed morphologic alterations in patients with major depressive disorder (MDD) with experiences of childhood trauma. However, the underlying neural mechanisms remain largely unknown. This study aims to explore the brain structural changes and their possible mediation role in the relationship between childhood maltreatment and psychological resilience in drug-naïve adolescents with first-episode MDD. A total of 57 adolescents with first-episode MDD and 36 healthy controls (HCs) completed the T1-weighted magnetic resonance imaging scan. The adverse childhood experiences and current psychological resilience were assessed using the Childhood Trauma Questionnaire-Short Form and the Connor Davidson Resilience Scale, respectively. The voxel-based morphometry approach was applied to examine changes in the gray matter volume (GMV). Compared with the HCs, adolescents with MDD had significantly reduced GMV volumes in the left fusiform gyrus, right orbitofrontal gyrus, right superior temporal gyrus, right calcarine cortex, right middle frontal gyrus, left angular gyrus, right precuneus, right posterior cingulate gyrus, and right posterior central gyrus, as well as significantly increased GMV volumes in the left lenticular putamen and right lenticular pallidum. The GMV of the right calcarine cortex was found to be negatively correlated with the severity of emotional abuse and positively correlated with the level of psychological resilience. Moreover, the GMV of the right calcarine cortex might partially mediate the relationship between childhood maltreatment and psychological resilience. The present study provided further evidence for structural impairments in adolescents with MDD. Our findings also confirmed the important role of depression-related GMV changes in childhood growth experiences and psychological resilience characteristics during adolescent brain maturation.

Reversal of Denervation Changes in Infraspinatus Muscle After Operative Management of Paralabral Cysts: An MRI-Based Study.

Paralabral cysts at the spinoglenoid notch are rare disorders that can potentially lead to compressive suprascapular neuropathy. Given their infrequency, a standard treatment protocol has not yet been established. This study aimed to assess changes in the infraspinatus muscle using magnetic resonance imaging (MRI) and to compare the outcomes of 2 different surgical methods. It was hypothesized that surgical intervention could alleviate compressive neuropathy, with comparable outcomes between the 2 surgical approaches. Cohort study; Level of evidence, 3. This retrospective review encompassed 43 patients undergoing arthroscopic labral repair for a paralabral cyst at the spinoglenoid notch, with cyst decompression (27 patients; labral repair with cyst decompression [LRCD] group) or without cyst decompression (16 patients; labral repair only [LRO] group). Preoperative MRI focused on evaluating the condition of the infraspinatus and teres minor muscles. Electromyography (EMG) was conducted on 36 patients (21 in LRCD and 15 in LRO) to assess suprascapular nerve function. Postoperative evaluations were performed in 35 patients at postoperative 1 year, excluding those lost to follow-up. Postoperative MRI findings (24 patients in LRCD and 11 patients in LRO) and functional outcome scores including recovery of external rotation power were compared with preoperative status in both groups. Preoperative MRI revealed denervation changes or atrophy of the infraspinatus in 26 of the 43 patients (60.4%). Among the 36 patients who underwent preoperative EMG, 21 patients (58.3%; 13 patients in LRCD and 8 patients in LRO) showed evidence of suprascapular neuropathy. A discrepancy between EMG and MRI findings was noted in 10 patients, with 5 patients showing suprascapular neuropathy according to EMG despite normal muscle status on MRI scans, and the remaining 5 vice versa. Notable atrophy of the infraspinatus was seen in 6 patients and teres minor hypertrophy in 5 patients, all of whom exhibited concurrent infraspinatus atrophy. Postoperatively, cyst disappearance was observed in all cases in both LRCD (24 patients) and LRO (11 patients) groups. Denervation changes in the infraspinatus were resolved in all patients. In patients with infraspinatus atrophy, some improvement was noted. Teres minor hypertrophy persisted in 2 of 4 patients. Improvements were similar in both groups (all P > .05). External rotation power improved postoperatively in both groups (from 39.1 ± 18.6 to 50.6 ± 17.7 N in LRCD, P < .001; from 45.1 ± 16.0 to 54.2 ± 10.7 N in LRO, P = .025). Both LRCD and LRO surgical approaches appear to be effective for paralabral cysts at the spinoglenoid notch. Suprascapular neuropathy can be successfully addressed by both methods. However, conditions with severe infraspinatus atrophy and teres minor hypertrophy warrant further investigation in larger series.

Effects of a 6-month aerobic exercise intervention on brain morphology in women with breast cancer receiving aromatase inhibitor therapy: a sub-study of the EPICC trial.

Physical exercise may increase brain volume and cortical thickness in late adulthood. However, few studies have examined the possibility for exercise to influence brain morphology in women treated for breast cancer. We conducted a nested sub-study within a randomized clinical trial to examine whether 6 months of moderate-intensity aerobic exercise in postmenopausal women with early-stage breast cancer influences brain morphology. We included twenty-eight postmenopausal women newly diagnosed with Stage 0-IIIa breast cancer (M age = 62.96 ± 5.40) who were randomized to either 45-60 min of supervised aerobic exercise 3 days/week (n = 16) or usual care (n = 12). Before beginning aromatase inhibitor aromatase inhibitor therapy, and the exercise intervention, and again at 6-month follow-up, volumetric and cortical thickness measures were derived from magnetic resonance imaging scans. There were no significant intervention effects on brain volume and cortical thickness. However, greater average exercise intensity (%) during the intervention was associated with greater post-intervention cortical volume, mean cortical thickness, precentral gyrus thickness, and superior parietal thickness (all p < 0.05). Finally, total supervised exercise time was associated with higher precentral gyrus thickness after the intervention (p = 0.042, R 2 = 0.263). The exercise intervention did not significantly affect brain volumes and cortical thickness compared to the control group. However, positive associations were found between exercise intensity and brain morphology changes after the 6-month intervention, indicating that exercise may reduce the vulnerability of the brain to the deleterious effects of breast cancer and its treatment.

Feasibility of knee magnetic resonance imaging protocol using artificial intelligence-assisted iterative algorithm protocols: comparison with standard MRI protocols.

To evaluate the image quality and diagnostic performance of AI-assisted iterative algorithm protocols (AIIA) in accelerated fast spin-echo magnetic resonance imaging (MRI) versus standard (SD) fast spin-echo MRI for clinical 3.0 T rapid knee scans. The accelerated sequence, which includes fat-suppression proton density-weighted imaging (FS-PDWI), T2-weighted imaging (T2WI), and T1-weighted imaging (T1WI), was used in conjunction with the SD sequence in 61 patients who underwent MRI scans. SD images were processed using standard reconstruction techniques, while accelerated images utilized AIIA reconstruction. Quantitative assessments of image quality were conducted, measuring noise levels, signal-to-noise ratio (SNR) and contrast signal-to-noise ratio (CNR). Additionally, subjective evaluations were performed using a Likert five-point scale to assess image quality. The SD group completed the entire knee scan in 466 s, while the AIIA group completed the scan in 312 s. Compared to the SD group, the AIIA group had a noticeably higher SNR of T1WI in the femur and subpatellar fat pad (p = 0.04, 0.001). On the other hand, T2WI femur SNR was noticeably higher in the SD group (p = 0.004). Measurements of SNR, CNR and other noise levels showed no statistically significant changes. Compared to the SD group, the AIIA group had significantly higher subjective image quality scores for every sequence (p < 0.05). There was a modest to large intraclass correlation value (ICC = 0.65-0.90) for the anomalies that were examined among readers. Both the AIIA and SD procedures were shown to have comparable diagnostic performance for meniscal and cruciate ligament rupture (p > 0.05). Images processed using AIIA reconstruction were acquired faster while maintaining comparable image quality and diagnostic capability, meeting the requirements for clinical diagnosis.

Pain resilience dimensions and regional gray matter volume as risk factors for poor outcomes of chronic pain: a prospective cohort study.

Pain resilience and regional gray matter volume (rGMV) are established correlates of adaptation to chronic pain within cross-sectional studies. Extending such work, this prospective cohort study tested the status of baseline pain resilience dimension scores and rGMV as risk factors for subsequent exacerbations in chronic pain disability and intensity. 142 adults with chronic musculoskeletal pain completed an initial assessment comprising a structural magnetic resonance imaging scan and self-report measures of cognitive/affective positivity and behavioral perseverance pain resilience dimensions, disability, pain intensity, and demographics. Disability and pain intensity were outcomes re-assessed at a 6-month follow-up. The impact of pain resilience dimension scores and identified rGMV sites on follow-up outcomes was examined after controlling for other baseline correlates of outcomes. Mediating effects of identified rGMV sites on pain resilience dimension-follow-up outcome relations were also evaluated. Aside from the significant multivariate effect of lower behavioral perseverance and cognitive/affective positivity scores, augmented left precuneus, temporal pole, superior temporal gyrus (STG), and precentral gyrus rGMV combined to predict higher follow-up disability levels, independent of covariates. Higher left fusiform gyrus rGMV levels predicted follow-up exacerbations in pain intensity, but pain resilience dimension scores did not. Finally, left precuneus and left temporal pole STG rGMV partially mediated cognitive/affective positivity-follow-up disability relations. Findings underscore deficits in pain resilience and increased rGMV as potential risk factors for poorer subsequent outcomes of chronic musculoskeletal pain and provide foundations for further prospective extensions as well as targeted intervention research.

The Critical Shoulder Angle as a Highly Specific Predictor of a Full-Thickness Rotator Cuff Tear: A Case-Control Study

Background: The critical shoulder angle (CSA) has become an important topic of study in patients with rotator cuff tears (RCTs). However, there are conflicting data on whether the CSA can differentiate between patients with normal shoulder pathology and full-thickness RCTs on shoulder radiographs. Purpose/Hypothesis: The purpose of this study was to define the relationship between full-thickness RCTs and the CSA. It was hypothesized that patients with full-thickness RCTs would have an increased CSA compared with matched controls. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This retrospective case-control study identified patients with magnetic resonance imaging scans showing full-thickness RCTs between 2009 and 2019. A 1 to 1 propensity score match was performed to identify a control group with normal rotator cuffs while controlling for baseline participant characteristics—including age, sex, body mass index, and tobacco use. A total cohort of 532 was identified, with 266 cases and 266 controls. Two independent observers measured CSAs on true anteroposterior shoulder radiographs. Results: There was no difference in baseline participant characteristics between the RCT and the non-RCT groups (P > .05). The mean CSA for the entire cohort was 33.6°± 4.2°. The CSA did not significantly vary by sex (P = .088) or tobacco usage (P = .16). The mean CSA for the RCT case group, 36.2°± 3.3°, was significantly different from the mean CSA for the control group, 30.9°± 3.3° (P < .0001). The receiver operating characteristic curve analysis produced an area under the curve of 0.88 (P < .0001). At CSAs ≥35°, there was a 67.7% sensitivity and 89.4% specificity for having a full-thickness RCT. Last, each degree of increase in the CSA increased the risk of having an associated RCT by 1.7 times (OR, 1.7 [95% CI, 1.551-1.852]; P < .0001). Conclusion: Patients with RCTs had significantly higher CSAs compared with matched controls. Increased CSA was an independent risk factor for RCTs, with an odds ratio of 1.7 per degree. The CSA is an accurate test (area under the curve, 0.88) with good sensitivity (67.7%) and specificity (89.4%) at values ≥35°. The CSA is a simple, reproducible measurement that can assist in clinical decision-making regarding full-thickness RCTs.

Multiparametric quantitative MRI of healthy adult pancreas: correlations with gender and age

BackgroundThe pancreas plays an important role in the nutrition and metabolism of the whole body. Many disease processes including obesity, diabetes mellitus (DM), acute or chronic pancreatitis, and pancreatic carcinoma result in abnormality of pancreas morphology and function. Magnetic resonance imaging (MRI) provides quantitative parameters including T1, T2, and apparent diffusion coefficient (ADC) values for evaluating normal and abnormal pancreas. Based on the normal range of these quantitative parameters, pancreatic abnormality could be detected early. However, the range and the relationship of T1, T2, and ADC values with gender and age groups using the same dataset have not been explored.PurposeTo establish the ranges of MRI tissue and functional parameters, including T1, T2, and ADC values, in healthy adult pancreas and their correlations with gender, subregion, and age.Materials and methodsThe T1, T2, and ADC values of healthy pancreas in 86 adults were measured using a 3.0-T MRI scanner. The average T1, T2, and ADC values were obtained in the whole pancreas and subregions (head, neck, body, and tail). Their correlations with gender and age were investigated.ResultsThe T1, T2, and ADC values of the whole pancreas from all subjects were 870.07 ± 61.86 ms, 44.07 ± 6.14 ms, and 1.072 ± 0.212 × 10−3 mm2/s, respectively. T2 values were significantly different between genders (P &amp;lt; 0.05). No significant differences were found between subregions. The T1, T2, and ADC values differed significantly among the age groups (P &amp;lt; 0.05). The T1 value revealed a moderately positive correlation, while the T2 and ADC values displayed negative correlations with age (r = 0.31, −0.45, and −0.39, respectively). The combination of T1, T2, and ADC values achieved the highest AUC value and showed a significant difference compared to T1, T2, and ADC values alone in predicting age older than 45 years.ConclusionThis study established the normal ranges of T1, T2, and ADC. We found that T2 is different between men and women, and T1, T2, and ADC are age-dependent. These results could be useful for quantitative MRI of pancreatic disease.

Perceptual super-resolution in multiple sclerosis MRI.

Magnetic resonance imaging (MRI) is crucial for diagnosing and monitoring of multiple sclerosis (MS) as it is used to assess lesions in the brain and spinal cord. However, in real-world clinical settings, MRI scans are often acquired with thick slices, limiting their utility for automated quantitative analyses. This work presents a single-image super-resolution (SR) reconstruction framework that leverages SR convolutional neural networks (CNN) to enhance the through-plane resolution of structural MRI in people with MS (PwMS). Our strategy involves the supervised fine-tuning of CNN architectures, guided by a content loss function that promotes perceptual quality, as well as reconstruction accuracy, to recover high-level image features. Extensive evaluation with MRI data of PwMS shows that our SR strategy leads to more accurate MRI reconstructions than competing methods. Furthermore, it improves lesion segmentation on low-resolution MRI, approaching the performance achievable with high-resolution images. Results demonstrate the potential of our SR framework to facilitate the use of low-resolution retrospective MRI from real-world clinical settings to investigate quantitative image-based biomarkers of MS.

Arthroscopy has a higher discriminative capacity than MRI in detecting mild cartilage lesions.

To determine whether current magnetic resonance imaging (MRI) could detect superficial cartilage lesions that are observed during diagnostic arthroscopy in patients with knee pain who have not been diagnosed with joint disease. Adult patients with knee pain of unclear origin lasting more than three months, scheduled for a therapeutic/diagnostic arthroscopy were recruited. Demographic and clinical data, pain assessment, MRI imaging, and observations of cartilage damage in the medial femoral condyle during arthroscopic procedure were documented. Patients were categorized based on the presence of cartilage damage assessed via MRI and/or direct visualization. Concordance between these assessments and its variation with age and patient-reported pain were examined. Out of the 95 patients recruited, 48 exhibited lesions in the medial femoral condyle (MFC) during arthroscopic examination, while only 24 of them showed lesions on the MRI scans. The thickness of the cartilage in the MFC was significantly lower in patients with cartilage damage detected by MRI compared with those without. Among patients with cartilage lesions identified during arthroscopy, those also showing lesions on the MRI had lower cartilage thickness and higher Outerbridge score than those without lesions on the MRI. Patients with detectable cartilage damage on the MRI were significantly older and reported higher levels of pain than those with damage detected only by arthroscopic examination. Despite significant technological advancements in MRI, arthroscopy still proves superior in identifying mild structural cartilage lesions that are not identifiable by this technique.