Multimodal Multimodal Magnetic Resonance Imaging Research Articles

Brain tumor segmentation by combining MultiEncoder UNet with wavelet fusion.

Accurate segmentation of brain tumors from multimodal magnetic resonance imaging (MRI) holds significant importance in clinical diagnosis and surgical intervention, while current deep learning methods cope with situations of multimodal MRI by an early fusion strategy that implicitly assumes that the modal relationships are linear, which tends to ignore the complementary information between modalities, negatively impacting the model's performance. Meanwhile, long-range relationships between voxels cannot be captured due to the localized character of the convolution procedure. Aiming at this problem, we propose a multimodal segmentation network based on a late fusion strategy that employs multiple encoders and a decoder for the segmentation of brain tumors. Each encoder is specialized for processing distinct modalities. Notably, our framework includes a feature fusion module based on a 3D discrete wavelet transform aimed at extracting complementary features among the encoders. Additionally, a 3D global context-aware module was introduced to capture the long-range dependencies of tumor voxels at a high level of features. The decoder combines fused and global features to enhance the network's segmentation performance. Our proposed model is experimented on the publicly available BraTS2018 and BraTS2021 datasets. The experimental results show competitiveness with state-of-the-art methods. The results demonstrate that our approach applies a novel concept for multimodal fusion within deep neural networks and delivers more accurate and promising brain tumor segmentation, with the potential to assist physicians in diagnosis.

Deep unfolding network with spatial alignment for multi-modal MRI reconstruction

Multi-modal Magnetic Resonance Imaging (MRI) offers complementary diagnostic information, but some modalities are limited by the long scanning time. To accelerate the whole acquisition process, MRI reconstruction of one modality from highly under-sampled k-space data with another fully-sampled reference modality is an efficient solution. However, the misalignment between modalities, which is common in clinic practice, can negatively affect reconstruction quality. Existing deep learning-based methods that account for inter-modality misalignment perform better, but still share two main common limitations: (1) The spatial alignment task is not adaptively integrated with the reconstruction process, resulting in insufficient complementarity between the two tasks; (2) the entire framework has weak interpretability. In this paper, we construct a novel Deep Unfolding Network with Spatial Alignment, termed DUN-SA, to appropriately embed the spatial alignment task into the reconstruction process. Concretely, we derive a novel joint alignment-reconstruction model with a specially designed aligned cross-modal prior term. By relaxing the model into cross-modal spatial alignment and multi-modal reconstruction tasks, we propose an effective algorithm to solve this model alternatively. Then, we unfold the iterative stages of the proposed algorithm and design corresponding network modules to build DUN-SA with interpretability. Through end-to-end training, we effectively compensate for spatial misalignment using only reconstruction loss, and utilize the progressively aligned reference modality to provide inter-modality prior to improve the reconstruction of the target modality. Comprehensive experiments on four real datasets demonstrate that our method exhibits superior reconstruction performance compared to state-of-the-art methods.

Recent deep learning-based brain tumor segmentation models using multi-modality magnetic resonance imaging: a prospective survey.

Radiologists encounter significant challenges when segmenting and determining brain tumors in patients because this information assists in treatment planning. The utilization of artificial intelligence (AI), especially deep learning (DL), has emerged as a useful tool in healthcare, aiding radiologists in their diagnostic processes. This empowers radiologists to understand the biology of tumors better and provide personalized care to patients with brain tumors. The segmentation of brain tumors using multi-modal magnetic resonance imaging (MRI) images has received considerable attention. In this survey, we first discuss multi-modal and available magnetic resonance imaging modalities and their properties. Subsequently, we discuss the most recent DL-based models for brain tumor segmentation using multi-modal MRI. We divide this section into three parts based on the architecture: the first is for models that use the backbone of convolutional neural networks (CNN), the second is for vision transformer-based models, and the third is for hybrid models that use both convolutional neural networks and transformer in the architecture. In addition, in-depth statistical analysis is performed of the recent publication, frequently used datasets, and evaluation metrics for segmentation tasks. Finally, open research challenges are identified and suggested promising future directions for brain tumor segmentation to improve diagnostic accuracy and treatment outcomes for patients with brain tumors. This aligns with public health goals to use health technologies for better healthcare delivery and population health management.

Multimodal imaging evaluation of early neurological deterioration following acute ischemic stroke.

Early neurologic deterioration occurs in up to one-third of patients with acute ischemic stroke (IS), often leading to poor functional outcomes. At present, few studies have applied amide proton transfer (APT) imaging to the evaluation of early neurological deterioration (END). This study analyzed the value of computed tomography perfusion (CTP) combined with multimodal magnetic resonance imaging (MRI) in patients with acute IS with END. This retrospective study included patients with acute IS who were admitted to the neurology inpatient department in a tertiary hospital from October 2021 to June 2023. Patients with acute IS underwent CTP within 24 hours of stroke onset and MRI [arterial spin labeling (ASL), susceptibility-weighted imaging (SWI), and APT] within 7 days. END was defined as an elevation of ≥2 points on the National Institute of Health Stroke Scale (NIHSS) within 7 days of stroke onset. Univariable and multivariable analyses were used to compare clinical and imaging biomarkers in patients with acute IS with and without END. The performance of potential biomarkers in distinguishing between the two groups was evaluated using receiver operating characteristic (ROC) curve analysis. Among the 70 patients with acute IS, 20 (29%) had END. After conducting univariable analysis, variables were selected for entry into a binary logistic regression analysis based on our univariable analysis results, previous research findings, clinical experience, and methodological standards. The results indicated that relative cerebral blood volume (CBV) on CTP, relative cerebral blood flow (CBF) on ASL, and relative signal intensity on amide proton transfer-weighted (APTw) imaging were independent risk factors for END. The areas under the ROC curves for these risk factors were 0.710 [95% confidence interval (CI): 0.559-0.861, P=0.006], 0.839 (95% CI: 0.744-0.933, P<0.001), and 0.804 (95% CI: 0.676-0.932, P<0.001), respectively. The combined area under the curve (AUC), sensitivity, and specificity of the four indices (0.941, 100%, and 78%, respectively) were higher than those of the four indices alone. CTP combined with multi-modal MRI better evaluated hemodynamics, tissue metabolism, and other relevant patient information, providing an objective basis for the clinical assessment of patients with acute IS with END and facilitating the development of accurate and personalized treatment plans.

A comprehensive approach for evaluating lymphovascular invasion in invasive breast cancer: Leveraging multimodal MRI findings, radiomics, and deep learning analysis of intra- and peritumoral regions

PurposeTo evaluate lymphovascular invasion (LVI) in breast cancer by comparing the diagnostic performance of preoperative multimodal magnetic resonance imaging (MRI)-based radiomics and deep-learning (DL) models. MethodsThis retrospective study included 262 patients with breast cancer—183 in the training cohort (144 LVI-negative and 39 LVI-positive cases) and 79 in the validation cohort (59 LVI-negative and 20 LVI-positive cases). Radiomics features were extracted from the intra- and peritumoral breast regions using multimodal MRI to generate gross tumor volume (GTV)_radiomics and gross tumor volume plus peritumoral volume (GPTV)_radiomics. Subsequently, DL models (GTV_DL and GPTV_DL) were constructed based on the GTV and GPTV to determine the LVI status. Finally, the most effective radiomics and DL models were integrated with imaging findings to establish a hybrid model, which was converted into a nomogram to quantify the LVI risk. ResultsThe diagnostic efficiency of GPTV_DL was superior to that of GTV_DL (areas under the curve [AUCs], 0.771 and 0.720, respectively). Similarly, GPTV_radiomics outperformed GTV_radiomics (AUC, 0.685 and 0.636, respectively). Univariate and multivariate logistic regression analyses revealed an association between imaging findings, such as MRI-axillary lymph nodes and peritumoral edema (AUC, 0.665). The hybrid model achieved the highest accuracy by combining GPTV_DL, GPTV_radiomics, and imaging findings (AUC, 0.872). ConclusionThe diagnostic efficiency of the GPTV-derived radiomics and DL models surpassed that of the GTV-derived models. Furthermore, the hybrid model, which incorporated GPTV_DL, GPTV_radiomics, and imaging findings, demonstrated the effective determination of LVI status prior to surgery in patients with breast cancer.

Automated Segmentation of Brain Gliomas in Multimodal MRI Data

ABSTRACTBrain gliomas, common in adults, pose significant diagnostic challenges. Accurate segmentation from multimodal magnetic resonance imaging (MRI) scans is critical for effective treatment planning. Traditional manual segmentation methods, labor‐intensive and error‐prone, often lead to inconsistent diagnoses. To overcome these limitations, our study presents a sophisticated framework for the automated segmentation of brain gliomas from multimodal MRI images. This framework consists of three integral components: a 3D UNet, a classifier, and a Classifier Weight Transformer (CWT). The 3D UNet, acting as both an encoder and decoder, is instrumental in extracting comprehensive features from MRI scans. The classifier, employing a streamlined 1 × 1 convolutional architecture, performs detailed pixel‐wise classification. The CWT integrates self‐attention mechanisms through three linear layers, a multihead attention module, and layer normalization, dynamically refining the classifier's parameters based on the features extracted by the 3D UNet, thereby improving segmentation accuracy. Our model underwent a two‐stage training process for maximum efficiency: in the first stage, supervised learning was used to pre‐train the encoder and decoder, focusing on robust feature representation. In the second stage, meta‐training was applied to the classifier, with the encoder and decoder remaining unchanged, ensuring precise fine‐tuning based on the initially developed features. Extensive evaluation of datasets such as BraTS2019, BraTS2020, BraTS2021, and a specialized private dataset (ZZU) underscored the robustness and clinical potential of our framework, highlighting its superiority and competitive advantage over several state‐of‐the‐art approaches across various segmentation metrics in training and validation sets.

Analysis of the Value of Quantitative Features in Multimodal MRI Images to Construct a Radio-Omics Model for Breast Cancer Diagnosis.

To analyze the diagnostic value of quantitative features in multimodal magnetic resonance imaging (MRI) images to construct a radio-omics model for breast cancer. Ninety-five patients with breast-related diseases from January 2020 to January 2021 were grouped into the benign group (n=57) and malignant group (n=38) according to the pathological findings. All cases were randomized as the training group (n=66) and validation group (n=29) in a 7:3 ratio based on the examination time. All subjects were examined by T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), dynamic contrast enhancement (DCE), and apparent diffusion coefficient (ADC) multimodality MRI. The MRI findings were analyzed against pathological findings. A diagnostic breast cancer radiomics model was constructed. The diagnostic efficacy of the model in the validation group was analyzed, and the diagnostic efficacy was analyzed via the ROC curve. Fibroadenoma accounted for 49.12% of benign breast diseases, and invasive ductal carcinoma accounted for 73.68% of malignant breast diseases. The sensitivity of T1WI, T2WI, DWI, ADC, and DCE in diagnosing breast cancer was 61.14%, 66.67%, 73.30%, 78.95%, and 85.96%, using the four-fold table method. The area under the curves (AUCs) of T1WI, T2WI, DWI, ADC, and DCE for diagnosing breast cancer were 0.715, 0.769, 0.785, 0.835, and 0.792, respectively. The AUCs of plain scan, diffuse, enhanced, plain scan + diffuse, plain scan + enhanced, enhanced + diffuse, and plain scan + enhanced + diffuse for diagnosing breast cancer were 0.746, 0.798, 0.816, 0.839, 0.890, 0.906, and 0.927, respectively. The construction of a radio-omics model by quantitative features in multimodal MRI images was valuable in the diagnosis of breast cancer. The value of radio-omics models such as plain scan + enhanced + diffuse was higher than the other models in diagnosing breast cancer and could be widely applied in clinical practice.

Preoperative Grading of Brain Gliomas Using 3D-ResNet18 Based on Multimodal MRI and Attention Mechanism

In response to the prevalent challenge of imprecise preoperative glioma grading prediction, a multimodal Magnetic Resonance Imaging (MRI) image with attention mechanism prediction model based on Residual Network (ResNet) is proposed for accurate prediction. To achieve this, publicly accessible datasets from BraTS 2019 and BraTS 2020 were employed. MRI images across three modalities underwent preprocessing, cropping, and subsequent stacking to generate comprehensive multimodal representations. Meanwhile, An Efficient Channel Attention (ECA) mechanism based on 3D data (3D-ECA) is proposed and introduced to reduce the problem of slow network convergence and overfitting. Notably, experiments demonstrate that the 3D-ECA attention mechanism added to the model improves the network training speed and the classification accuracy of the model, and the classification accuracy reached 88.1%, with an impressive area under the subject working characteristic curve of 0.918. Therefore, the 3D-ResNet18 deep learning model, incorporating multimodal MRI and 3D-ECA attention mechanisms, demonstrates high accuracy and robustness in distinguishing between high-grade and low-grade gliomas. Thus, showcasing significant clinical potential for glioma classification and diagnosis.

Misalignment-Resistant Deep Unfolding Network for multi-modal MRI super-resolution and reconstruction

Multi-modal Magnetic Resonance Imaging (MRI) super-resolution (SR) and reconstruction aims to obtain a high-quality target image from corresponding sparsely sampled signals under the guidance of a reference image. However, existing techniques typically assume that the input multi-modal MR images are well aligned, which is challenging to achieve in clinical practice. This naive assumption has made their algorithms vulnerable to misalignment scenarios. Moreover, they often neglect many non-local common characteristics within and between modalities. In this work, we proposed a MisAlignment-Resistant Deep Unfolding Network (MAR-DUN) embedded in the tailored gradient descent module (GDM) and proximal mapping module (PMM) for multi-modal MRI SR and reconstruction. In the GDM, we employ an adaptive step-size sub-network (ASS-Net) to enhance the texture representation capacity of the proposed MAR-DUN. Furthermore, in the PMM, we propose a cross-modality non-local module (CNLM) featuring the inverse deformation layer (IDL). The IDL aligns features between the target and reference images by adaptively learning their spatial transformations, thus enhancing the robustness of the proposed network and allowing the CNLM to further explore the cross-modality non-local characteristics. On the other hand, the proposed CNLM aims to establish both the intra-modality and inter-modality non-local dependencies for fully exploiting the correlations between the target and reference images. Extensive experimental results show that our proposed method consistently achieves state-of-the-art reconstruction performance in alignment and misalignment scenarios, demonstrating its significant promise for real-world applications.

GAN-MAT: Generative adversarial network-based microstructural profile covariance analysis toolbox

Multimodal magnetic resonance imaging (MRI) provides complementary information for investigating brain structure and function; for example, an in vivo microstructure-sensitive proxy can be estimated using the ratio between T1- and T2-weighted structural MRI. However, acquiring multiple imaging modalities is challenging in patients with inattentive disorders. In this study, we proposed a comprehensive framework to provide multiple imaging features related to the brain microstructure using only T1-weighted MRI. Our toolbox consists of (i) synthesizing T2-weighted MRI from T1-weighted MRI using a conditional generative adversarial network; (ii) estimating microstructural features, including intracortical covariance and moment features of cortical layer-wise microstructural profiles; and (iii) generating a microstructural gradient, which is a low-dimensional representation of the intracortical microstructure profile. We trained and tested our toolbox using T1- and T2-weighted MRI scans of 1,104 healthy young adults obtained from the Human Connectome Project database. We found that the synthesized T2-weighted MRI was very similar to the actual image and that the synthesized data successfully reproduced the microstructural features. The toolbox was validated using an independent dataset containing healthy controls and patients with episodic migraine as well as the atypical developmental condition of autism spectrum disorder. Our toolbox may provide a new paradigm for analyzing multimodal structural MRI in the neuroscience community and is openly accessible at https://github.com/CAMIN-neuro/GAN-MAT.

Contralateral acupuncture for migraine without aura: a randomized trial protocol with multimodal MRI.

Migraine is a common clinical disorder, ranks as the second most disabling disease worldwide, and often manifests with unilateral onset. Contralateral acupuncture (CAT), as a classical acupuncture method, has been proven to be effective in the treatment of migraine without aura (MWoA). However, its neural mechanisms have not been investigated using multimodal magnetic resonance imaging (MRI). In this multimodal neuroimaging randomized trial, a total of 96 female MWoA participants and 30 female healthy controls (HCs) will be recruited. The 96 female MWoA participants will be randomized into three groups: Group A (CAT group), Group B [ipsilateral acupuncture (IAT) group], and Group C (sham CAT group) in a 1:1:1 allocation ratio. Each group will receive 30 min of treatment every other day, three times a week, for 8 weeks, followed by an 8-week follow-up period. The primary outcome is the intensity of the migraine attack. Data will be collected at baseline (week 0), at the end of the 8-week treatment period (weeks 1-8), and during the 8-week follow-up (weeks 9-16). Adverse events will be recorded. Multimodal MRI scans will be conducted at baseline and after 8-week treatment. This study hypothesized that CAT may treat MWoA by restoring pathological alterations in brain neural activity, particularly by restoring cross-integrated functional connectivity with periaqueductal gray (PAG) as the core pathological brain region. The findings will provide scientific evidence for CAT in the treatment of MWoA. The Medical Ethics Committee of the Second Affiliated Hospital of Yunnan University of Chinese Medicine has given study approval (approval no. 2022-006). This trial has been registered with the Chinese Clinical Trials Registry (registration no. ChiCTR2300069456). Peer-reviewed papers will be used to publicize the trial's findings. https://clinicaltrials.gov/, identifier ChiCTR2300069456.

Enhancing Acute Bilirubin Encephalopathy Diagnosis with Multi-Modal MRI: A Deep Learning Approach

Background: Acute Bilirubin Encephalopathy (ABE) is a major cause of infant mortality and disability, making early detection and treatment essential to prevent further progression and complications. Methods: To enhance the diagnostic capabilities of multi-modal Magnetic Resonance Imaging (MRI) for ABE, we proposed a deep learning model integrating an attention module (AM) with a central network (CentralNet). This model was tested on MRI data from 145 newborns diagnosed with ABE and 140 non-ABE newborns, utilizing both T1-weighted and T2-weighted images. Results: The findings indicated the following: (1) In single-modality experiments, the inclusion of AM significantly improved all the performance metrics compared to the models without AM. Specifically, for T1-weighted MRI, the accuracy was 0.639 ± 0.04, AUC was 0.682 ± 0.037, and sensitivity was 0.688 ± 0.09. For the T2-weighted images, the accuracy was 0.738 ± 0.039 and the AUC was 0.796 ± 0.025. (2) In multi-modal experiments, using T1 + T2 images, our model achieved the best accuracy of 0.845 ± 0.018, AUC of 0.913 ± 0.02, and sensitivity of 0.954 ± 0.069, compared to models without an AM and CentralNet. The specificity remained relatively stable, while the precision and F1 scores significantly increased, reaching 0.792 ± 0.048 and 0.862 ± 0.017, respectively. Conclusions: This study emphasizes the effectiveness of combining attention modules with CentralNet, significantly enhancing the accuracy of multi-modal MRI in classifying ABE. It presents a new perspective and possibility for the clinical application of multi-modal MRI imaging in the diagnosis of ABE.

Combined radiomics-clinical model to predict platinum-sensitivity in advanced high-grade serous ovarian carcinoma using multimodal MRI.

We aimed to predict platinum sensitivity using routine baseline multimodal magnetic resonance imaging (MRI) and established clinical data in a radiomics framework. We evaluated 96 patients with ovarian cancer who underwent multimodal MRI and routine laboratory tests between January 2016 and December 2020. The patients underwent diffusion-weighted, contrast-enhanced T1-weighted, and T2-weighted MRI. Subsequently, 293 radiomic features were extracted by manually identifying tumor regions of interest. The features were subjected to the least absolute shrinkage and selection operators, leaving only a few selected features. We built the first prediction model with a tree-based classifier using selected radiomics features. A second prediction model was built by combining the selected radiomic features with four established clinical factors: age, disease stage, initial tumor marker level, and treatment course. Both models were built and tested using a five-fold cross-validation. Our radiomics model predicted platinum sensitivity with an AUC of 0.65 using a few radiomics features related to heterogeneity. The second combined model had an AUC of 0.77, confirming the incremental benefits of the radiomics model in addition to models using established clinical factors. Our combined radiomics-clinical data model was effective in predicting platinum sensitivity in patients with advanced ovarian cancer.

A multimodal MRI study of XNKQ acupuncture for limb dysfunction after ischemic stroke: a randomized controlled study protocol.

Limb motor dysfunction is one of the challenges in rehabilitation after cerebral ischemic stroke (CIS) and greatly affects the quality of life of patients. This study aims to investigate the central mechanisms of the curative effect with multimodal magnetic resonance imaging (MRI), which will provide additional evidence to support the application of Xingnao Kaiqiao (XNKQ) acupuncture. This trial is a randomized controlled trial. Patients who meet the criteria will be recruited and randomly divided into 2 groups. One group will receive acupuncture treatment and another group will not receive acupuncture treatment. Both groups will receive conventional treatment. In addition, 20 healthy individuals will be recruited who will not receive any treatment. The total course of treatment is 14 days. The primary outcome is multimodal MRI analysis. For safety assessment, adverse events will be observed and recorded. The study involving human subjects was reviewed and approved by the Ethics Committee of IRB of The First Teaching Hospital of Tianjin University of TCM (TYLL2023[K]031). This study complied with the Declaration of Helsinki. Written informed consent about this study was provided by the participants. The results of this study will be published in a peer-reviewed journal. Chinese Clinical Trial Registration Center (ChiCTR2300078315) https://www.chictr.org.cn/.

Multimodal Transformer of Incomplete MRI Data for Brain Tumor Segmentation.

Accurate segmentation of brain tumors plays an important role for clinical diagnosis and treatment. Multimodal magnetic resonance imaging (MRI) can provide rich and complementary information for accurate brain tumor segmentation. However, some modalities may be absent in clinical practice. It is still challenging to integrate the incomplete multimodal MRI data for accurate segmentation of brain tumors. In this paper, we propose a brain tumor segmentation method based on multimodal transformer network with incomplete multimodal MRI data. The network is based on U-Net architecture consisting of modality specific encoders, multimodal transformer and multimodal shared-weight decoder. First, a convolutional encoder is built to extract the specific features of each modality. Then, a multimodal transformer is proposed to model the correlations of multimodal features and learn the features of missing modalities. Finally, a multimodal shared-weight decoder is proposed to progressively aggregate the multimodal and multi-level features with spatial and channel self-attention modules for brain tumor segmentation. A missing-full complementary learning strategy is used to explore the latent correlation between the missing and full modalities for feature compensation. For evaluation, our method is tested on the multimodal MRI data from BraTS 2018, BraTS 2019 and BraTS 2020 datasets. The extensive results demonstrate that our method outperforms the state-of-the-art methods for brain tumor segmentation on most subsets of missing modalities.

An attention-based multi-modal MRI fusion model for major depressive disorder diagnosis

Objective. Major depressive disorder (MDD) is one of the biggest threats to human mental health. MDD is characterized by aberrant changes in both structure and function of the brain. Although recent studies have developed some deep learning models based on multi-modal magnetic resonance imaging (MRI) for MDD diagnosis, the latent associations between deep features derived from different modalities were largely unexplored by previous studies, which we hypothesized may have potential benefits in improving the diagnostic accuracy of MDD. Approach. In this study, we proposed a novel deep learning model that fused both structural MRI (sMRI) and resting-state MRI (rs-fMRI) data to enhance the diagnosis of MDD by capturing the interactions between deep features extracted from different modalities. Specifically, we first employed a brain function encoder (BFE) and a brain structure encoder (BSE) to extract the deep features from fMRI and sMRI, respectively. Then, we designed a function and structure co-attention fusion (FSCF) module that captured inter-modal interactions and adaptively fused multi-modal deep features for MDD diagnosis. Main results. This model was evaluated on a large cohort and achieved a high classification accuracy of 75.2% for MDD diagnosis. Moreover, the attention distribution of the FSCF module assigned higher attention weights to structural features than functional features for diagnosing MDD. Significance. The high classification accuracy highlights the effectiveness and potential clinical of the proposed model.

Aerobic exercise and metformin on intermuscular adipose tissue (IMAT): insights from multimodal MRI and histological changes in prediabetic rats

BackgroundPhysical exercise is the first-line intervention for prediabetes, and metformin is the most widely used oral insulin-sensitizing agent. Moreover, intermuscular adipose tissue (IMAT) directly affects insulin resistance by helping maintain glucose homeostasis. Here, we evaluated the effects of moderate aerobic exercise and/or metformin on histological IMAT parameters in non-streptozotocin-induced prediabetes.MethodsMale Wistar rats with prediabetes fed a high-fat diet and high-sugar drinks were randomly assigned to high-fat diet (PRE), metformin (MET), moderate aerobic exercise (EXE), combined therapy (EMC), or EMC + compound-c (EMA) groups for 4 weeks. Multimodal magnetic resonance imaging (MRI) was then performed, and tissue-specific inflammation and energy and lipid metabolism were evaluated in IMAT.ResultsThe EXE group had lower inflammatory factor levels, lipid metabolism, and mitochondrial oxidative stress, and shorter IMAT adipocyte diameters than the MET group. The MET group exhibited lower IL-1β and Plin5 expression than the PRE group. Furthermore, the IMAT of the EMC group had lower TNF-α and phosphorylated NF-κB levels and higher GLUT1 and GLUT4 expression than the PRE group. Multimodal MRI revealed significant changes in transverse-relaxation time 2, apparent diffusion coefficient, and fractional anisotropy values in the IMAT and muscles, as well as lower IMAT% values in the EXE and EMC groups than in the MET and PRE groups.ConclusionModerate aerobic exercise training can effectively improve IMAT function and structure via the AMP-activated protein kinase pathway in prediabetes. Combining metformin with moderate aerobic exercise might elicit modest synergy, and metformin does not counterbalance the beneficial effects of exercise.

Multimodal Transformer for Accelerated MR Imaging.

Accelerated multi-modal magnetic resonance (MR) imaging is a new and effective solution for fast MR imaging, providing superior performance in restoring the target modality from its undersampled counterpart with guidance from an auxiliary modality. However, existing works simply combine the auxiliary modality as prior information, lacking in-depth investigations on the potential mechanisms for fusing different modalities. Further, they usually rely on the convolutional neural networks (CNNs), which is limited by the intrinsic locality in capturing the long-distance dependency. To this end, we propose a multi-modal transformer (MTrans), which is capable of transferring multi-scale features from the target modality to the auxiliary modality, for accelerated MR imaging. To capture deep multi-modal information, our MTrans utilizes an improved multi-head attention mechanism, named cross attention module, which absorbs features from the auxiliary modality that contribute to the target modality. Our framework provides three appealing benefits: (i) Our MTrans use an improved transformers for multi-modal MR imaging, affording more global information compared with existing CNN-based methods. (ii) A new cross attention module is proposed to exploit the useful information in each modality at different scales. The small patch in the target modality aims to keep more fine details, the large patch in the auxiliary modality aims to obtain high-level context features from the larger region and supplement the target modality effectively. (iii) We evaluate MTrans with various accelerated multi-modal MR imaging tasks, e.g., MR image reconstruction and super-resolution, where MTrans outperforms state-of-the-art methods on fastMRI and real-world clinical datasets.

Application of Multimodal MRI in the Early Diagnosis of Autism Spectrum Disorders: A Review.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder in children. Early diagnosis and intervention can remodel the neural structure of the brain and improve quality of life but may be inaccurate if based solely on clinical symptoms and assessment scales. Therefore, we aimed to analyze multimodal magnetic resonance imaging (MRI) data from the existing literature and review the abnormal changes in brain structural-functional networks, perfusion, neuronal metabolism, and the glymphatic system in children with ASD, which could help in early diagnosis and precise intervention. Structural MRI revealed morphological differences, abnormal developmental trajectories, and network connectivity changes in the brain at different ages. Functional MRI revealed disruption of functional networks, abnormal perfusion, and neurovascular decoupling associated with core ASD symptoms. Proton magnetic resonance spectroscopy revealed abnormal changes in the neuronal metabolites during different periods. Decreased diffusion tensor imaging signals along the perivascular space index reflected impaired glymphatic system function in children with ASD. Differences in age, subtype, degree of brain damage, and remodeling in children with ASD led to heterogeneity in research results. Multimodal MRI is expected to further assist in early and accurate clinical diagnosis of ASD through deep learning combined with genomics and artificial intelligence.

The value of multimodal functional magnetic resonance imaging in differentiating p53abn from p53wt endometrial carcinoma.

Endometrial carcinoma (EC) is the sixth most common cancer in women. P53 gene expression in patients with endometrial cancer can predict the efficacy and prognosis of patients with neoadjuvant therapy. To explore the value of multimodal magnetic resonance imaging (MRI) in differentiating p53 abnormal (p53abn) from p53 wild-type (p53wt) EC. Data from 47 EC patients, including 14 p53abn cases and 33 p53wt cases, were retrospectively analyzed. The preoperative MRI sequences included amide proton transfer weighted (APTw) imaging, T2 mapping, mDIXON-Quant imaging and diffusion-weighted imaging (DWI). After post-processing, APT, T2, transverse relaxation rate (R2*), fat fraction (FF) and apparent diffusion coefficient (ADC) maps were obtained. The APT, T2, R2*, FF and ADC values for lesions of the two groups of cases were measured by two observers who were blind to the pathological data. The APT value and R2* value in the p53abn group were higher than those in the p53wt group, while the ADC value was lower (all P < 0.05). There was no statistically significant difference in T2 value and FF value between the two groups (all P > 0.05). The area under curve of APT, R2*, ADC and combined APT + R2*+ADC values for identification of p53abn and p53wt EC were 0.739, 0.689, 0.718 and 0.820, respectively (all P > 0.05). APTw, mDIXON-Quant and DWI techniques can be usedfor quantitative identification of p53abn and p53wt EC. The multimodal MRI provides a new way for preoperative quantitative evaluation of EC molecular typing, which has certain clinical application value.