Standard Clinical Magnetic Resonance Imaging Research Articles

Microelectrode Recordings Validate the Clinical Visualization of Subthalamic-Nucleus Based on 7T Magnetic Resonance Imaging and Machine Learning for Deep Brain Stimulation Surgery.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a proven and effective therapy for the management of the motor symptoms of Parkinson's disease (PD). While accurate positioning of the stimulating electrode is critical for success of this therapy, precise identification of the STN based on imaging can be challenging. We developed a method to accurately visualize the STN on a standard clinical magnetic resonance imaging (MRI). The method incorporates a database of 7-Tesla (T) MRIs of PD patients together with machine-learning methods (hereafter 7 T-ML). To validate the clinical application accuracy of the 7 T-ML method by comparing it with identification of the STN based on intraoperative microelectrode recordings. Sixteen PD patients who underwent microelectrode-recordings guided STN DBS were included in this study (30 implanted leads and electrode trajectories). The length of the STN along the electrode trajectory and the position of its contacts to dorsal, inside, or ventral to the STN were compared using microelectrode-recordings and the 7 T-ML method computed based on the patient's clinical 3T MRI. All 30 electrode trajectories that intersected the STN based on microelectrode-recordings, also intersected it when visualized with the 7 T-ML method. STN trajectory average length was 6.2±0.7mm based on microelectrode recordings and 5.8±0.9mm for the 7 T-ML method. We observed a 93% agreement regarding contact location between the microelectrode-recordings and the 7 T-ML method. The 7 T-ML method is highly consistent with microelectrode-recordings data. This method provides a reliable and accurate patient-specific prediction for targeting the STN.

Brain lesion scores obtained using a simple semi-quantitative scale from MR imaging are associated with motor function, communication and cognition in dyskinetic cerebral palsy.

PurposeTo characterise brain lesions in dyskinetic cerebral palsy (DCP) using the semi-quantitative scale for structural MRI (sqMRI) and to investigate their relationship with motor, communication and cognitive function.Materials and methodsThirty-nine participants (19 females, median age 21y) with DCP were assessed in terms of motor function, communication and a variety of cognitive domains. Whole-head magnetic resonance imaging (MRI) was performed including T1-MPRAGE, T2 turbo spin echo (axial plane), and fluid attenuated inversion recovery images (FLAIR). A child neurologist visually assessed images for brain lesions and scored these using the sqMRI. Ordinal, Poisson and binomial negative regression models identified which brain lesions accounted for clinical outcomes.ResultsBrain lesions were most frequently located in the ventral posterior lateral thalamus and the frontal lobe. Gross (B = 0.180, p < .001; B = 0.658, p < .001) and fine (B = 0.136, p = .003; B = 0.540, p < .001) motor function were associated with global sqMRI score and parietal involvement. Communication functioning was associated with putamen involvement (B = 0.747, p < .028). Intellectual functioning was associated with global sqMRI score and posterior thalamus involvement (B = −0.018, p < .001; B = −0.192, p < .001). Selective attention was associated with global sqMRI score (B = −0.035, p < .001), parietal (B = −0.063, p = .023), and corpus callosum involvement (B = −0.448, p < .001). Visuospatial and visuoperceptive abilities were associated with global sqMRI score (B = −0.078, p = .007) and medial dorsal thalamus involvement (B = −0.139, p < .012), respectively.ConclusionsKey clinical outcomes in DCP are associated with specific observable brain lesions as indexed by a simple lesion scoring system that relies only on standard clinical MRI.

Quantitative texture analysis in the prediction of IDH status in low-grade gliomas

ObjectivesMolecular markers provide valuable information about treatment response and prognosis in patients with low-grade gliomas (LGG). In order to make this important information available prior to surgery the aim of this study was to explore if molecular status in LGG can be discriminated by preoperative magnetic resonance imaging (MRI). Patients and methodsAll patients with histopathologically confirmed LGG with available molecular status who had undergone a preoperative standard clinical MRI protocol using a 3T Siemens Skyra scanner during 2008–2015 were retrospectively identified. Based on Haralick texture parameters and the segmented LGG FLAIR volume we explored if it was possible to predict molecular status. ResultsIn total 25 patients (nine women, average age 44) fulfilled the inclusion parameters. The textural parameter homogeneity could discriminate between LGG patients with IDH mutation (0.12, IQR 0.10-0.15) and IDH wild type (0.07, IQR 0.06-0.09, p=0.005). None of the other four analyzed texture parameters (energy, entropy, correlation and inertia) were associated with molecular status. Using ROC curves, the area under curve for predicting IDH mutation was 0.905 for homogeneity, 0.840 for tumor volume and 0.940 for the combined parameters of tumor volume and homogeneity. We could not predict molecular status using the four other chosen texture parameters (energy, entropy, correlation and inertia). Further, we could not separate LGG with IDH mutation with or without 1p19q codeletion. ConclusionsIn this preliminary study using Haralick texture parameters based on preoperative clinical FLAIR sequence, the homogeneity parameter could separate IDH mutated LGG from IDH wild type LGG. Combined with tumor volume, these diagnostic properties seem promising.

MRI-based electric properties tomography with a quasi-Newton approach

Magnetic resonance electric properties tomography is a non-destructive imaging modality that maps the spatial distribution of the electrical conductivity and permittivity of the human body using standard clinical magnetic resonance imaging systems. From the magnetic field maps and the local form of the Maxwell equations, several schemes have been derived to provide direct approximated formulas but they suffer from instabilities. In this paper, we propose to address it as an inverse problem solved by a constrained optimization algorithm where we exploit the weak formulation of the electric Helmholtz equation and a Lagrangian approach. We derive the associated adjoint field equation and employ a quasi-Newton minimization scheme. We also take advantage of a regularisation strategy based on geometrical a priori information for defining large zones into which the electric parameters are known to be piece-wise constant.

A Planning and Guidance Platform for Cardiac Resynchronization Therapy.

Patients with drug-refractory heart failure can greatly benefit from cardiac resynchronization therapy (CRT). A CRT device can resynchronize the contractions of the left ventricle (LV) leading to reduced mortality. Unfortunately, 30%-50% of patients do not respond to treatment when assessed by objective criteria such as cardiac remodeling. A significant contributing factor is the suboptimal placement of the LV lead. It has been shown that placing this lead away from scar and at the point of latest mechanical activation can improve response rates. This paper presents a comprehensive and highly automated system that uses scar and mechanical activation to plan and guide CRT procedures. Standard clinical preoperative magnetic resonance imaging is used to extract scar and mechanical activation information. The data are registered to a single 3-D coordinate system and visualized in novel 2-D and 3-D American Heart Association plots enabling the clinician to select target segments. During the procedure, the planning information is overlaid onto live fluoroscopic images to guide lead deployment. The proposed platform has been used during 14 CRT procedures and validated on synthetic, phantom, volunteer, and patient data.

Abstract TP57: Altered Functional Connectivity in Transient Ischemic Attack Patients

Introduction: The pathophysiology and sequelae of transient ischaemic attacks (TIA) merit further study,. Particular challenges arise from the on-going debate on diagnostic criteria and the fact that few studies use the modern tissue-based definition. Differences in functional connectivity have previously been identified in a number of conditions, including stroke, have been implicated in the symptom profile and are known to vary during recovery. In this pilot study we investigate whether there were functional connectivity differences between TIA patients and healthy controls. Methods: Patients were referred for a standard clinical magnetic resonance imaging (MRI) neurovascular protocol, with the addition of a resting state functional MRI (fMRI) sequence. Eight patients diagnosed with a TIA (4 women, 57±9) were recruited, along with eight healthy controls (4 women, 30±5). Independent component analysis was used to isolate the networks before performing non-parametric two-sample t-test using both threshold-free cluster enhancement (TFCE) and voxel-wise statistics. Results: Significant differences (p&lt;0.05, FWE-corrected) emerged using TFCE, in particular increased connectivity was noted in the mid-cingulate area with contrasting decreases in the cerebellum within the sensorimotor network. Additionally clusters of decreased connectivity were noted in the right insula in an attentional component, the pre-cuneus within the default mode network and the supplementary motor area in a visual component. No significant differences between the TIA and control group were above the threshold using voxel-wise statistics. Conclusion: In line with previous research in groups of stroke patients, this study has identified evidence of differences in neural connectivity associated with TIA, which cannot be explained by age. Differences in the sensorimotor network may be linked to the symptoms experienced by patients, with the mid-cingluate area being implicated in memory and learning. Alterations in functional connectivity may be relevant for recovery, including the on-going cognitive deficits reported in TIA patients. These findings suggest an important area for further research with a larger cohort.

Prospective Longitudinal Analysis of 2-Hydroxyglutarate Magnetic Resonance Spectroscopy Identifies Broad Clinical Utility for the Management of Patients With IDH-Mutant Glioma.

Purpose Proton magnetic resonance spectroscopy (MRS) of the brain can detect 2-hydroxyglutarate (2HG), the oncometabolite produced in neoplasms harboring a mutation in the gene coding for isocitrate dehydrogenase ( IDH). We conducted a prospective longitudinal imaging study to determine whether quantitative assessment of 2HG by MRS could serve as a noninvasive clinical imaging biomarker for IDH-mutated gliomas. Patients and Methods 2HG MRS was performed in 136 patients using point-resolved spectroscopy at 3 T in parallel with standard clinical magnetic resonance imaging and assessment. Data were analyzed in patient cohorts representing the major phases of the glioma clinical course and were further subgrouped by histology and treatment type to evaluate 2HG. Histologic correlations were performed. Results Quantitative 2HG MRS was technically and biologically reproducible. 2HG concentration > 1 mM could be reliably detected with high confidence. During the period of indolent disease, 2HG concentration varied by less than ± 1 mM, and it increased sharply with tumor progression. 2HG concentration was positively correlated with tumor cellularity and significantly differed between high- and lower-grade gliomas. In response to cytotoxic therapy, 2HG concentration decreased rapidly in 1p/19q codeleted oligodendrogliomas and with a slower time course in astrocytomas and mixed gliomas. The magnitude and time course of the decrease in 2HG concentration and magnitude of the decrease in tumor volume did not differ between oligodendrogliomas treated with temozolomide or carmustine. Criteria for 2HG MRS were established to make a presumptive molecular diagnosis of an IDH mutation in gliomas technically unable to undergo a surgical procedure. Conclusion 2HG concentration as measured by MRS was reproducible and reliably reflected the disease state. These data provide a basis for incorporating 2HG MRS into clinical management of IDH-mutated gliomas.

Identification of Reliable Sulcal Patterns of the Human Rolandic Region.

A major feature of the human cortex is its huge morphological variability. Although a comprehensive literature about the sulco-gyral pattern of the central region is available from post-mortem data, a reliable and reproducible characterization from in vivo data is still lacking. The aim of this study is to test the reliability of morphological criteria of the central region sulci used in post-mortem data, when applied to in vivo magnetic resonance imaging (MRI) data. Thirty right-handed healthy individuals were included in the study. Automated segmentation and three dimensional (3D) surface-based rendering were obtained from clinical 3D T1-weighted MRI. Two senior radiologists labeled the three sulci composing the central region (precentral [PreCS], central [CS] and postcentral [PostCS]) and analyzed their morphological variations using 47 standard criteria derived from Ono’s atlas based on post-mortem data. For each criterion, inter-rater concordance and comparison with the occurrence frequency provided in Ono’s atlas were estimated. Overall, the sulcal pattern criteria derived from MRI data were highly reproducible between the raters with a high mean inter-rater concordance in the three sulci (CS: κ = 0.92 in left hemisphere/κ = 0.91 in right hemisphere; PreCS: κ = 0.91/κ = 0.93; PostCS: κ = 0.84/0.79). Only a very limited number of sulcal criteria significantly differed between the in vivo and the post-mortem data (CS: 2 criteria in the left hemisphere/3 criteria in the right hemisphere; PreCS: 3 in the left and right hemispheres; PostCS: 3 in the left hemisphere and 5 in the right hemisphere). Our study provides a comprehensive description of qualitative sulcal patterns in the central region from in vivo clinical MRI with high agreement with previous post-mortem data. Such identification of reliable sulcal patterns of the central region visible with standard clinical MRI data paves the way for the detection of subtle variations of the central sulcation associated with variations of normal or pathological functioning.

Design and Construction of a Heteronuclear 1H and 31P Double Tuned Coil for Breast Imaging and Spectroscopy.

Magnetic resonance imaging (MRI) is a noninvasive imaging modality that uses radio frequency (RF) energy to excite nuclei in the presence of a strong magnetic field and linear spatially encoding magnetic field gradients. Clinically, MRI takes advantage of the spin properties of hydrogen (1H) nuclei due to the high concentration and relative abundance in tissue water and fats. However, other nuclei having the quantum mechanical property of spin can also be probed. One of the most common is phosphorous (31P), which has 100% natural abundance and reasonable in vivo concentrations that are measurable at clinical MRI field strengths. Phosphorous measurements can provide an understanding of important metabolic pathways within tissues, which ultimately can help in better understanding disease and treatment. However, clinical MRIs do not routinely come with the ability to assess non-1H nuclei. Hence, hardware and pulse sequences need development, while considering the need to easily interface with standard clinical MRI hardware and protocols. This review describes the motivation for and development of MRI RF hardware designs for a human breast imaging system that can acquire 31P data from a clinically approved breast MR imaging and biopsy table.

MRI-based analysis of patellofemoral cartilage contact, thickness, and alignment in extension, and during moderate and deep flexion

BackgroundSeveral factors are believed to contribute to patellofemoral joint function throughout knee flexion including patellofemoral (PF) kinematics, contact, and bone morphology. However, data evaluating the PF joint in this highly flexed state have been limited. Therefore, the purpose of this study was to evaluate patellofemoral contact and alignment in low (0°), moderate (60°), and deep (140°) knee flexion, and then correlate these parameters to each other, as well as to femoral morphology. MethodsSagittal magnetic resonance images were acquired on 14 healthy female adult knees (RSRB approved) using a 1.5T scanner with the knee in full extension, mid-flexion, and deep flexion. The patellofemoral cartilage contact area, lateral contact displacement (LCD), cartilage thickness, and lateral patellar displacement (LPD) throughout flexion were defined. Intra- and inter-rater repeatability measures were determined. Correlations between patellofemoral contact parameters, alignment, and sulcus morphology were calculated. ResultsMeasurement repeatability ICCs ranged from 0.94 to 0.99. Patellofemoral cartilage contact area and thickness, LCD, and LPD were statistically different throughout all levels of flexion (p<0.001). The cartilage contact area was correlated to LPD, cartilage thickness, sulcus angle, and epicondylar width (r=0.47–0.72, p<0.05). DiscussionThis study provides a comprehensive analysis of the patellofemoral joint throughout its range of motion. ConclusionsThis study agrees with past studies that investigated patellofemoral measures at a single flexion angle, and provides new insights into the relationship between patellofemoral contact and alignment at multiple flexion angles. Clinical RelevanceThe study provides a detailed analysis of the patellofemoral joint in vivo, and demonstrates the feasibility of using standard clinical magnetic resonance imaging scanners to image the knee joint in deep flexion.

Interpolation-based super-resolution reconstruction: effects of slice thickness.

Standard clinical magnetic resonance imaging (MRI) is acquired in two-dimensions where the in-plane resolution is higher than the slice select direction. These acquisitions include axial, coronal, and sagittal planes. To date, there have been few attempts to combine the information of these three orthogonal orientations. This paper aims to take advantage of the different in-plane resolution acquired from each plane orientation and combine them into one volume in order to attain a higher resolution image. This combination of MRI data will allow the detection of smaller areas that would otherwise be missed using only one slice orientation. A comparison of slice thicknesses along with image registration is performed. The mean-squared error and peak signal-to-noise were computed for quantitative assessment. MRI and phantom scans and joint histograms were used for qualitative assessment.

Parallel imaging-based reduction of acoustic noise for clinical magnetic resonance imaging.

The objective of this study was to demonstrate the feasibility of improving perceived acoustic comfort for a standard clinical magnetic resonance imaging protocol via gradient wave form optimization and validate parallel imaging as a means to achieve a further reduction of acoustic noise. The gradient wave forms of a standard T2 axial turbo spin-echo (TSE) sequence in head examinations were modified for acoustic performance while attempting to keep the total acquisition and inter-echo spacing the same. Parallel imaging was then used to double the inter-echo spacing and allow further wave form optimization. Along with comparative acoustic noise measurements, a statistical analysis of radiologist scoring was conducted on volumes from standard and modified sequences acquired from 10 patients after informed consent was obtained. Compared with TSE, significant improvement of acoustic comfort was measured for modified-sequences quiet TSE and quiet TSE with generalized autocalibrating partially parallel acquisitions (P = 0.0034 and P = 0.0003, respectively), and no statistically significant difference in diagnostic quality was observed without the use of parallel imaging. Standard clinical magnetic resonance imaging protocols can be made quieter through adequate gradient wave form optimization. In scans with high signal-to-noise ratio, parallel imaging can be used to further reduce acoustic noise.

Imaging intracranial vessel wall pathology with magnetic resonance imaging: current prospects and future directions.

To date, the probable cause of ischemic stroke is often inferred from the size and location of the infarct, in combination with an evaluation of the heart and the presence of extracranial arterial occlusion or high-grade stenosis.1 Currently used conventional lumenography-based methods such as digital subtraction angiography, computed tomography angiography, and magnetic resonance (MR) angiography are used to determine the presence of such an acute occlusion or high-grade arterial stenosis. From extracranial studies, it is known that luminal narrowing may be absent in patients with severe atherosclerosis owing to arterial remodeling.2–4 Therefore, these methods do not provide information about the underlying pathological processes, which most often involve the vessel wall.5 Vessel wall changes such as vessel wall thickening, enhancement, or the presence of vulnerable atherosclerotic plaques without luminal stenosis are therefore often missed but might be of importance for a better understanding of ischemic stroke.6 Furthermore, intracranial atherosclerosis is an important cause of ischemic stroke7 and often involves the vessel wall. Patients with intracranial atherosclerosis have high recurrent stroke rates,8 and increasingly more attention is being directed to the assessment of the intracranial vessel wall, necessitating an imaging technique directly assessing the intracranial vessel wall. MR imaging (MRI) seems the most promising technique to reliably image intracranial vessel wall pathologies because of its superior soft tissue contrast. Recent advances in MRI9 have made it possible to obtain information about these abnormalities within the intracranial vessel wall, which provides an imaging tool to investigate the role of intracranial vessel wall abnormalities in the diagnosis of stroke. In this review, we discuss the current status of intracranial vessel wall MRI and its potential to identify different intracranial vessel wall pathologies. First, we present the state-of-the-art MRI methods to visualize the intracranial vessel wall …

Functional and structural brain changes in anti–N‐methyl‐D‐aspartate receptor encephalitis

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis with a characteristic neuropsychiatric syndrome and severe and prolonged clinical courses. In contrast, standard clinical magnetic resonance imaging (MRI) remains normal in the majority of patients. Here, we investigated structural and functional brain changes in a cohort of patients with anti-NMDAR encephalitis. Twenty-four patients with established diagnosis of anti-NMDAR encephalitis and age- and gender-matched controls underwent neuropsychological testing and multimodal MRI, including T1w/T2w structural imaging, analysis of resting state functional connectivity, analysis of white matter using diffusion tensor imaging, and analysis of gray matter using voxel-based morphometry. Patients showed significantly reduced functional connectivity of the left and right hippocampus with the anterior default mode network. Connectivity of both hippocampi predicted memory performance in patients. Diffusion tensor imaging revealed extensive white matter changes, which were most prominent in the cingulum and which correlated with disease severity. In contrast, no differences in T1w/T2w structural imaging and gray matter morphology were observed between patients and controls. Anti-NMDAR encephalitis is associated with characteristic alterations of functional connectivity and widespread changes of white matter integrity despite normal findings in routine clinical MRI. These results may help to explain the clinicoradiological paradox in anti-NMDAR encephalitis and advance the pathophysiological understanding of the disease. Correlation of imaging abnormalities with disease symptoms and severity suggests that these changes play an important role in the symptomatology of anti-NMDAR encephalitis.

Simultaneous Imaging of Lung Structure and Function with Triple-Nuclear Hybrid MR Imaging

To re-engineer a standard clinical magnetic resonance (MR) imaging system to enable the acquisition, in the same breath hold, of lung images from two hyperpolarized gases (helium 3 [(3)He] and xenon 129 [(129)Xe]) with simultaneous registered anatomic proton (hydrogen 1 [(1)H]) MR images of lung structure. Studies with (3)He and (129)Xe were performed with National Research Ethics Committee approval, with informed consent from the volunteer. (1)H-(3)He-(129)Xe MR imaging was achieved in the same breath by using mutually decoupled nested radiofrequency coil hardware capable of transmit and receive on each respective nucleus without power cross talk. MR pulse sequences were also developed for rapid switching between each nucleus. The system is demonstrated with triple-nuclear lung images in a healthy individual following inhalation of a mixture of (3)He and (129)Xe gases. Spatially and temporally registered images of all three nuclei were obtained with high signal to noise ratio and high spatial resolution in the same breath. The multinuclear technique is capable of providing registered lung images with mutually complementary functional and structural spatial information.

Renal diffusion tensor imaging: is it possible to define the tubular pathway? A case report

The authors report a case of unilateral xanthogranulomatous pyelonephritis, associated with chronic lithiasis studied by standard clinical magnetic resonance imaging protocol and diffusion tensor imaging (DTI). Maps of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) and tractography were reconstructed on both healthy and pathologic kidney. ADC and FA values are in agreement with the literature. Tractography reconstruction of tubular renal architecture was confirmed by histology. This result suggests the potential ability of DTI to detect structural alterations in the architecture of the kidney, as noninvasive tool, preceding the onset of clinical-laboratory alterations.

Microgel Iron Oxide Nanoparticles for Tracking Human Fetal Mesenchymal Stem Cells Through Magnetic Resonance Imaging

Stem cell transplantation for regenerative medicine has made significant progress in various injury models, with the development of modalities to track stem cell fate and migration post-transplantation being currently pursued rigorously. Magnetic resonance imaging (MRI) allows serial high-resolution in vivo detection of transplanted stem cells labeled with iron oxide particles, but has been hampered by low labeling efficiencies. Here, we describe the use of microgel iron oxide (MGIO) particles of diameters spanning 100-750 nm for labeling human fetal mesenchymal stem cells (hfMSCs) for MRI tracking. We found that MGIO particle uptake by hfMSCs was size dependent, with 600-nm MGIO (M600) particles demonstrating three- to sixfold higher iron loading than the clinical particle ferucarbotran (33-263 versus 9.6-42.0 pg iron/hfMSC; p < .001). Cell labeling with either M600 particles or ferucarbotran did not affect either cellular proliferation or tri-lineage differentiation into osteoblasts, adipocytes, and chondrocytes, despite differences in gene expression on a genome-wide microarray analysis. Cell tracking in a rat photothrombotic stroke model using a clinical 1.5-T MRI scanner demonstrated the migration of labeled hfMSCs from the contralateral cortex to the stroke injury, with M600 particles achieving a five- to sevenfold higher sensitivity for MRI detection than ferucarbotran (p < .05). However, model-related cellular necrosis and acute inflammation limited the survival of hfMSCs beyond 5-12 days. The use of M600 particles allowed high detection sensitivity with low cellular toxicity to be achieved through a simple incubation protocol, and may thus be useful for cellular tracking using standard clinical MRI scanners.

TU‐A‐351‐01: Small Animal Magnetic Resonance Imaging: Current Trends, Challenges and Perspectives for Pathological Imaging

The utilization of magnetic resonance imaging (MRI) in the study of animal models of human pathology began more than 30 years ago. The continual advancement of imaging technology along with the increasing demand for tools to non‐invasively and serially assess disease progression and/or regression in small animals has driven this field forward since its inception. Standard clinical MRI scans primarily focus on disease detection and are based on anatomical and morphological abnormalities, whereas small animal MRI studies center on the serial characterization of the morphological, functional and molecular properties of diseased tissue. Small animal MRI studies often employ novel contrast mechanisms and exogenous chemical reagents, higher magnetic field strengths, higher spatial resolution and multi‐modality imaging but are complicated by issues such as low signal‐to‐noise ratios, enhanced sensitivity to respiratory and susceptibility artifacts, anesthesia‐induced alterations of disease physiology and demanding data processing requirements.This lecture will provide an overview of the role of small animal MRI in studying human disease, the technical and experimental challenges of such studies and how it could be used in the future to impact clinical treatment planning.Educational Objectives:1. Understand the role small animal MRI plays in understanding human disease and its impact on the development and validation of novel therapeutic strategies.2. Understand the issues and challenges related to a small animal MRI experiment including design, data acquisition and processing.3. Understand the future directions and potential advancements currently being pursued in small animal MRI.

A computer-assisted protocol for endovascular target interventions using a clinical MRI system for controlling untethered microdevices and future nanorobots

The possibility of automatically navigating untethered microdevices or future nanorobots to conduct target endovascular interventions has been demonstrated by our group with the computer-controlled displacement of a magnetic sphere along a pre-planned path inside the carotid artery of a living swine. However, although the feasibility of propelling, tracking and performing real-time closed-loop control of an untethered ferromagnetic object inside a living animal model with a relatively close similarity to human anatomical conditions has been validated using a standard clinical Magnetic Resonance Imaging (MRI) system, little information has been published so far concerning the medical and technical protocol used. In fact, such a protocol developed within technological and physiological constraints was a key element in the success of the experiment. More precisely, special software modules were developed within the MRI software environment to offer an effective tool for experimenters interested in conducting such novel interventions. These additional software modules were also designed to assist an interventional radiologist in all critical real-time aspects that are executed at a speed beyond human capability, and include tracking, propulsion, event timing and closed-loop position control. These real-time tasks were necessary to avoid a loss of navigation control that could result in serious injury to the patient. Here, additional simulation and experimental results for microdevices designed to be targeted more towards the microvasculature have also been considered in the identification, validation and description of a specific sequence of events defining a new computer-assisted interventional protocol that provides the framework for future target interventions conducted in humans.

Patellar cartilage lesions: comparison of magnetic resonance imaging and T2 relaxation-time mapping

To evaluate the detection and the size of focal patellar cartilage lesions in T2 mapping as compared to standard clinical magnetic resonance imaging (MRI) at 1.5T. Fifty-five consecutive clinical patients referred to knee MRI were imaged both with a standard knee MRI protocol (proton-density-weighted sagittal and axial series, T2-weighted sagittal and coronal series, and T1-weighted coronal series) and with an axial multislice multi-echo spin-echo measurement to determine the T2 relaxation time of the patellar cartilage. MR images and T2 maps of patellar cartilage were evaluated for focal lesions. The lesions were evaluated for lesion width (mm), lesion depth (1/3, 2/3, or 3/3 of cartilage thickness), and T2 value (20-40 ms, 40-60 ms, or 60-80 ms) based on visual evaluation. Altogether, 36 focal patellar cartilage lesions were detected from 20 human subjects (11 male, nine female, mean age 40+/-15 years). Twenty-eight lesions were detected both on MRI and T2 maps, while eight lesions were only visible on T2 maps. Cartilage lesions were significantly wider (P = 0.001) and thicker (P<0.001) on T2 maps as compared to standard knee MRI. Most lesions 27 had moderately (T2 40-60 ms) increased T2 values, while two lesions had slightly (T2 20-40 ms) and seven lesions remarkably (T2 60-80 ms) increased T2 relaxation times. T2 mapping of articular cartilage is feasible in the clinical setting and may reveal early cartilage lesions not visible with standard clinical MRI.