Susceptibility Signal Research Articles

Prediction of MRI relaxometry in the presence of hepatic steatosis by Monte Carlo simulations.

To develop Monte Carlo simulations to predict the relationship of with liver fat content at 1.5T and 3.0T. For various fat fractions (FFs) from 1% to 25%, four types of virtual liver models were developed by incorporating the size and spatial distribution of fat droplets. Magnetic fields were then generated under different fat susceptibilities at 1.5T and 3.0T, and proton movement was simulated for phase accrual and MRI signal synthesis. The synthesized signal was fit to single-peak and multi-peak fat signal models for and proton density fat fraction (PDFF) predictions. In addition, the relationships between and PDFF predictions were compared with in vivo calibrations and Bland-Altman analysis was performed to quantitatively evaluate the effects of these components (type of virtual liver model, fat susceptibility, and fat signal model) on predictions. A virtual liver model with realistic morphology of fat droplets was demonstrated, and and PDFF values were predicted by Monte Carlo simulations at 1.5T and 3.0T. predictions were linearly correlated with PDFF, while the slope was unaffected by the type of virtual liver model and increased as fat susceptibility increased. Compared with in vivo calibrations, the multi-peak fat signal model showed superior performance to the single-peak fat signal model, which yielded an underestimation of liver fat. The -PDFF relationships by simulations with fat susceptibility of 0.6ppm and the multi-peak fat signal model were ( , ) at 1.5T and ( , ) at 3.0T. Monte Carlo simulations provide a new means for -PDFF prediction, which is primarily determined by fat susceptibility, fat signal model, and magnetic field strength. Accurate -PDFF calibration has the potential to correct the effect of fat on quantification, and may be helpful for accurate measurements in liver iron overload. In this study, a Monte Carlo simulation of hepatic steatosis was developed to predict the relationship between and PDFF. Furthermore, the effects of fat droplet morphology, fat susceptibility, fat signal model, and magnetic field strength were evaluated for the -PDFF calibration. Our results suggest that Monte Carlo simulations provide a new means for -PDFF prediction and this means can be easily generated for various regimes, such as simulations with higher fields and different echo times, as well as correction of magnetic susceptibility measurements for liver iron quantification.

Quantifying Remyelination Using χ-Separation in White Matter and Cortical Multiple Sclerosis Lesions.

Myelin and iron play essential roles in remyelination processes of multiple sclerosis (MS) lesions. χ-separation, a novel biophysical model applied to multiecho T2*-data and T2-data, estimates the contribution of myelin and iron to the obtained susceptibility signal. We used this method to investigate myelin and iron levels in lesion and nonlesion brain areas in patients with MS and healthy individuals. This prospective MS cohort study included patients with MS fulfilling the McDonald Criteria 2017 and healthy individuals, aged 18 years or older, with no other neurologic comorbidities. Participants underwent MRI at baseline and after 2 years, including multiecho GRE-(T2*) and FAST-(T2) sequences. Using χ-separation, we generated myelin-sensitive and iron-sensitive susceptibility maps. White matter lesions (WMLs), cortical lesions (CLs), surrounding normal-appearing white matter (NAWM), and normal-appearing gray matter were segmented on fluid-attenuated inversion recovery and magnetization-prepared 2 rapid gradient echo images, respectively. Cross-sectional group comparisons used Wilcoxon rank-sum tests, longitudinal analyses applied Wilcoxon signed-rank tests. Associations with clinical outcomes (disease phenotype, age, sex, disease duration, disability measured by Expanded Disability Status Scale [EDSS], neurofilament light chain levels, and T2-lesion number and volume) were assessed using linear regression models. Of 168 patients with MS (median [interquartile range (IQR)] age 47.0 [21.7] years; 101 women; 6,898 WMLs, 775 CLs) and 103 healthy individuals (age 33.0 [10.5] years, 57 women), 108 and 62 were followed for a median of 2 years, respectively (IQR 0.1; 5,030 WMLs, 485 CLs). At baseline, WMLs had lower myelin (median 0.025 [IQR 0.015] parts per million [ppm]) and iron (0.017 [0.015] ppm) than the corresponding NAWM (myelin 0.030 [0.012]; iron 0.019 [0.011] ppm; both p < 0.001). After 2 years, both myelin (0.027 [0.014] ppm) and iron had increased (0.018 [0.015] ppm; both p < 0.001). Younger age (p < 0.001, b = -5.111 × 10-5), lower disability (p = 0.04, b = -2.352 × 10-5), and relapsing-remitting phenotype (RRMS, 0.003 [0.01] vs primary progressive 0.002 [IQR 0.01], p < 0.001; vs secondary progressive 0.0004 [IQR 0.01], p < 0.001) at baseline were associated with remyelination. Increment of myelin correlated with clinical improvement measured by EDSS (p = 0.015, b = -6.686 × 10-4). χ-separation, a novel mathematical model applied to multiecho T2*-images and T2-images shows that young RRMS patients with low disability exhibit higher remyelination capacity, which correlated with clinical disability over a 2-year follow-up.

The usefulness of the magnetic susceptibility of loess paleosol sequences for paleoclimate and stratigraphic studies: The case of the Quaternary Palouse loess, northwestern United States

Worldwide, Quaternary loess-paleosol sequences archive terrestrial paleoenvironmental information. The Palouse loess in the northwestern USA is one such deposit representing at least a million years of sediment accumulation. Loess paleosol sequences are often studied via the magnetic susceptibility of sediments and the changes in susceptibility with depth. However, since variations in magnetic susceptibility can have different underlying causes, the interpretation of the magnetic susceptibility of loess depends on factors specific to each major loess region. We measured the magnetic susceptibility of sediments along depth profiles in a well-studied exposure of the Palouse loess in eastern Washington, USA (the “CLY-2 site,” 46.3131° N, 118.4874° W, WGS84). Our measurements show that the magnetic susceptibility of sediments in the Palouse loess varies systematically and predictably with depth and can be correlated with other magnetic susceptibility profiles at the outcrop scale and at the regional scale. We also measured changes in grain size, elemental abundance, mineralogy, and other magnetic properties to determine the most likely cause of the magnetic susceptibility signal. Based on these results, variations in magnetic susceptibility in the Palouse are likely driven mostly by changes in coarse sediment supply and accumulation of tephra rather than changes in weathering. Magnetic susceptibility is useful as an inexpensive, non-destructive tool for stratigraphic correlation of Quaternary loess deposits in the Palouse, especially in combination with paleosol stratigraphic markers and known tephra deposits.

DIPG-54. PREDICTING EARLY DEATH IN DIFFUSE MIDLINE GLIOMA

Abstract BACKGROUND Diffuse midline glioma (DMG) is an invariably fatal diagnosis with a median survival of 9-11 months. While early death is uncommon, such cases do exist. Identification of children at risk of short-term survival can support clinicians to provide informed counselling to families regarding important treatment decisions. METHODS We identified patients with a radiological diagnosis of DMG at the Royal Children’s Hospital (Melbourne) and the Women’s and Children’s Hospital (Adelaide) between 2001-2023. Clinical, imaging, and histopathological data were abstracted and compared between short-term survivors (STSs) and longer survivors (LSs). RESULTS Among 89 patients included, 21 (24%) had an overall survival (OS) of &amp;lt; 6 months of which 7 (8%) had an OS &amp;lt; 3 months. 5 of these cases had dramatic early death with &amp;lt; 1 month since diagnosis. While neither the pattern nor presence of contrast enhancement were predictive of poor survival, STSs were found to have a larger volume of contrast enhancement on T1-weighted imaging compared to LSs (1.3 cm3 vs 0.2 cm3, p &amp;lt; 0.01). Evaluation of the presence and extent of intratumoural susceptibility signals (ITSS) on susceptibility weighted imaging (SWI) demonstrated higher grades of ITSS (&amp;gt; 5 foci) were strongly associated with poor survival (p = 0.01, median OS = 5.5 months). Furthermore, 50% (6/12) of STSs had ≥ 11 dot-like or fine linear ITSSs in a maximum tumour cross section. From a treatment standpoint, as expected, patients who did not receive upfront radiotherapy experienced significantly worse OS (3.4 months vs 10.4 months, p &amp;lt; 0.01). Notably, a number of STSs did not receive palliative therapy in the context of their rapid and unforeseen disease progression. CONCLUSIONS The preliminary findings from this multi-centre study provide the foundation for future exploratory analysis alongside international collaborators at the DMG/DIPG registry to improve prognostication for patients with high-risk features of early death.

Comparison between R2'-based and R2*-based χ-separation methods: A clinical evaluation in individuals with multiple sclerosis.

Susceptibility source separation, or χ-separation, estimates diamagnetic (χdia) and paramagnetic susceptibility (χpara) signals in the brain using local field and R2' (= R2* - R2) maps. Recently proposed R2*-based χ-separation methods allow for χ-separation using only multi-echo gradient echo (ME-GRE) data, eliminating the need for additional data acquisition for R2 mapping. Although this approach reduces scan time and enhances clinical utility, the impact of missing R2 information remains a subject of exploration. In this study, we evaluate the viability of two previously proposed R2*-based χ-separation methods as alternatives to their R2'-based counterparts: model-based R2*-χ-separation versus χ-separation and deep learning-based χ-sepnet-R2* versus χ-sepnet-R2'. Their performances are assessed in individuals with multiple sclerosis (MS), comparing them with their corresponding R2'-based counterparts (i.e., R2*-χ-separation vs. χ-separation and χ-sepnet-R2* vs. χ-sepnet-R2'). The evaluations encompass qualitative visual assessments by experienced neuroradiologists and quantitative analyses, including region of interest analyses and linear regression analyses. Qualitatively, R2*-χ-separation tends to report higher χpara and χdia values compared with χ-separation, leading to less distinct lesion contrasts, while χ-sepnet-R2* closely aligns with χ-sepnet-R2'. Quantitative analysis reveals a robust correlation between both R2*-based methods and their R2'-based counterparts (r ≥ 0.88). Specifically, in the whole-brain voxels, χ-sepnet-R2* exhibits higher correlation and better linearity than R2*-χ-separation (χdia/χpara from R2*-χ-separation: r = 0.88/0.90, slope = 0.79/0.86; χdia/χpara from χ-sepnet-R2*: r = 0.90/0.92, slope = 0.99/0.97). In MS lesions, both R2*-based methods display comparable correlation and linearity (χdia/χpara from R2*-χ-separation: r = 0.90/0.91, slope = 0.98/0.91; χdia/χpara from χ-sepnet-R2*: r = 0.88/0.88, slope = 0.91/0.95). Notably, χ-sepnet-R2* demonstrates negligible offsets, whereas R2*-χ-separation exhibits relatively large offsets (0.02 ppm in the whole brain and 0.01 ppm in the MS lesions), potentially indicating the false presence of myelin or iron in MS lesions. Overall, both R2*-based χ-separation methods demonstrated their viability as alternatives to their R2'-based counterparts. χ-sepnet-R2* showed better alignment with its R2'-based counterpart with minimal susceptibility offsets, compared with R2*-χ-separation that reported higher χpara and χdia values compared with R2'-based χ-separation.

An update on susceptibility-weighted imaging in brain gliomas.

Susceptibility-weighted imaging (SWI) has become a standard component of most brain MRI protocols. While traditionally used for detecting and characterising brain hemorrhages typically associated with stroke or trauma, SWI has also shown promising results in glioma assessment. Numerous studies have highlighted SWI's role in differentiating gliomas from other brain lesions, such as primary central nervous system lymphomas or metastases. Additionally, SWI aids radiologists in non-invasively grading gliomas and predicting their phenotypic profiles. Various researchers have suggested incorporating SWI as an adjunct sequence for predicting treatment response and for post-treatment monitoring. A significant focus of these studies is on the detection of intratumoural susceptibility signals (ITSSs) in gliomas, which are indicative of microhemorrhages and vessels within the tumour. The quantity, distribution, and characteristics of these ITSSs can provide radiologists with more precise information for evaluating and characterising gliomas. Furthermore, the potential benefits and added value of performing SWI after the administration of gadolinium-based contrast agents (GBCAs) have been explored. This review offers a comprehensive, educational, and practical overview of the potential applications and future directions of SWI in the context of glioma assessment. CLINICAL RELEVANCE STATEMENT: SWI has proven effective in evaluating gliomas, especially through assessing intratumoural susceptibility signal changes, and is becoming a promising, easily integrated tool in MRI protocols for both pre- and post-treatment assessments. KEY POINTS: • Susceptibility-weighted imaging is the most sensitive sequence for detecting blood and calcium inside brain lesions. • This sequence, acquired with and without gadolinium, helps with glioma diagnosis, characterisation, and grading through the detection of intratumoural susceptibility signals. • There are ongoing challenges that must be faced to clarify the role of susceptibility-weighted imaging for glioma assessment.

Multi-Echo Complex Quantitative Susceptibility Mapping and Quantitative Blood Oxygen Level-Dependent Magnitude (mcQSM + qBOLD or mcQQ) for Oxygen Extraction Fraction (OEF) Mapping.

Oxygen extraction fraction (OEF), the fraction of oxygen that tissue extracts from blood, is an essential biomarker used to directly assess tissue viability and function in neurologic disorders. In ischemic stroke, for example, increased OEF can indicate the presence of penumbra-tissue with low perfusion yet intact cellular integrity-making it a primary therapeutic target. However, practical OEF mapping methods are not currently available in clinical settings, owing to the impractical data acquisitions in positron emission tomography (PET) and the limitations of existing MRI techniques. Recently, a novel MRI-based OEF mapping technique, termed QQ, was proposed. It shows high potential for clinical use by utilizing a routine sequence and removing the need for impractical multiple gas inhalations. However, QQ relies on the assumptions of Gaussian noise in susceptibility and multi-echo gradient echo (mGRE) magnitude signals for OEF estimation. This assumption is unreliable in low signal-to-noise ratio (SNR) regions like disease-related lesions, risking inaccurate OEF estimation and potentially impacting clinical decisions. Addressing this, our study presents a novel multi-echo complex QQ (mcQQ) that models realistic Gaussian noise in mGRE complex signals. We implemented mcQQ using a deep learning framework (mcQQ-NET) and compared it with the existing QQ-NET in simulations, ischemic stroke patients, and healthy subjects, using identical training and testing datasets and schemes. In simulations, mcQQ-NET provided more accurate OEF than QQ-NET. In the subacute stroke patients, mcQQ-NET showed a lower average OEF ratio in lesions relative to unaffected contralateral normal tissue than QQ-NET. In the healthy subjects, mcQQ-NET provided uniform OEF maps, similar to QQ-NET, but without unrealistically high OEF outliers in areas of low SNR, such as SNR ≤ 15 (dB). Therefore, mcQQ-NET improves OEF accuracy by more accurately reflecting realistic Gaussian noise in complex mGRE signals. Its enhanced sensitivity to OEF abnormalities, based on more realistic biophysics modeling, suggests that mcQQ-NET has potential for investigating tissue variability in neurologic disorders.

Direct comparison between 18F-Flortaucipir tau PET and quantitative susceptibility mapping in progressive supranuclear palsy

PurposeThe pattern of flortaucipir tau PET uptake is topographically similar to the pattern of magnetic susceptibility in progressive supranuclear palsy (PSP); both with increased signal in subcortical structures such as the basal ganglia and midbrain, suggesting that they may be closely related. However, their relationship remains unknown since no studies have directly compared these two modalities in the same PSP cohort. We hypothesized that some flortaucipir uptake in PSP is associated with magnetic susceptibility, and hence iron deposition. The aim of this study was to evaluate the regional relationship between flortaucipir uptake and magnetic susceptibility and to examine the effects of susceptibility on flortaucipir uptake in PSP. MethodsFifty PSP patients and 67 cognitively normal controls were prospectively recruited and underwent three Tesla MRI and flortaucipir tau PET scans. Quantitative susceptibility maps were reconstructed from multi-echo gradient-echo MRI images. Region of interest (ROI) analysis was performed to obtain flortaucipir and susceptibility values in the subcortical regions. Relationships between flortaucipir and susceptibility signals were evaluated using partial correlation analysis in the subcortical ROIs and voxel-based analysis in the whole brain. The effects of susceptibility on flortaucipir uptake were examined by using the framework of mediation analysis. ResultsBoth flortaucipir and susceptibility were greater in PSP compared to controls in the putamen, pallidum, subthalamic nucleus, red nucleus, and cerebellar dentate (p<0.05). The ROI-based and voxel-based analyses showed that these two signals were positively correlated in these five regions (r = 0.36–0.59, p<0.05). Mediation analysis showed that greater flortaucipir uptake was partially explained by susceptibility in the putamen, pallidum, subthalamic nucleus, and red nucleus, and fully explained in the cerebellar dentate. ConclusionsThese results suggest that some of the flortaucipir uptake in subcortical regions in PSP is related to iron deposition. These findings will contribute to our understanding of the mechanisms underlying flortaucipir tau PET findings in PSP and other neurodegenerative diseases.

Intensity and lifetime ratiometric luminescent thermometer based on a Tb(III) coordination polymer.

A three-dimensional terbium(III) coordination polymer of formula [Tb(bttb)0.5(2,5-pzdc)0.5]n (1) [H4bttb = 1,2,4,5-tetrakis(4'-carboxyphenyl)benzene and H2-2,5-pzdc = 2,5-pyrazinedicarboxylic acid] was obtained under hydrothermal conditions. The bttb4- tetraanion in 1 adopts the bridging and chelating-bridging pseudo-oxo coordination modes while the 2,5-pzdc2- dianion exhibits a rather unusual bis-bidentate bridging pseudo-oxo coordination mode, both ligands being responsible for the stiffness of the resulting 3D structure. Solid-state photoluminescent measurements illustrate that 1 exhibits remarkable green luminescence emission, the most intense band occurring in the region of 550 nm (5D4 → 7F5) with lifetimes at the millisecond scale. Thermometric performances of 1 reveal a maximum relative sensitivity (Sm) of 0.76% K-1 at 295 K (δT = 0.05 K), constituting a TbIII ratiometric solid luminescent thermometer over the physiological temperature range. Variable-temperature static (dc) magnetic susceptibility measurements for 1 in the temperature range 2.0-300 K show the expected behavior for the depopulation of the splitted mJ levels of the 7F7 ground state of the magnetically anisotropic terbium(III) ion plus a weak antiferromagnetic interaction through the carboxylate bridges. No significant out-of-phase magnetic susceptibility signals were observed for 1 in the temperature range 2.0-10.0 K, either in the absence or presence of a static dc magnetic field.

Intravoxel incoherent motion and enhanced T2*-weighted angiography for preoperative prediction of microvascular invasion in hepatocellular carcinoma.

To investigate the value of the combined application of intravoxel incoherent motion (IVIM) and enhanced T2*-weighted angiography (ESWAN) for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). 76 patients with pathologically confirmed HCC were retrospectively enrolled and divided into the MVI-positive group (n=26) and MVI-negative group (n=50). Conventional MRI, IVIM, and ESWAN sequences were performed. Three region of interests (ROIs) were placed on the maximum axial slice of the lesion on D, D*, and f maps derived from IVIM sequence, and R2* map derived from ESWAN sequence, and intratumoral susceptibility signal (ITSS) from the phase map derived from ESWAN sequence was also automatically measured. Receiver operating characteristic (ROC) curves were drawn to evaluate the ability for predicting MVI. Univariate and multivariate logistic regression were used to screen independent risk predictors in clinical and imaging information. The Delong's test was used to compare the differences between the area under curves (AUCs). The D and D* values of MVI-negative group were significantly higher than those of MVI-positive group (P=0.038, and P=0.023), which in MVI-negative group were 0.892×10-3 (0.760×10-3, 1.303×10-3) mm2/s and 0.055 (0.025, 0.100) mm2/s, and in MVI-positive group were 0.591×10-3 (0.372×10-3, 0.824×10-3) mm2/s and 0.028 (0.006, 0.050)mm2/s, respectively. The R2* and ITSS values of MVI-negative group were significantly lower than those of MVI-positive group (P=0.034, and P=0.005), which in MVI-negative group were 29.290 (23.117, 35.228) Hz and 0.146 (0.086, 0.236), and in MVI-positive group were 43.696 (34.914, 58.083) Hz and 0.199 (0.155, 0.245), respectively. After univariate and multivariate analyses, only AFP (odds ratio, 0.183; 95% CI, 0.041-0.823; P = 0.027) was the independent risk factor for predicting the status of MVI. The AUCs of AFP, D, D*, R2*, and ITSS for prediction of MVI were 0.652, 0.739, 0.707, 0.798, and 0.657, respectively. The AUCs of IVIM (D+D*), ESWAN (R2*+ITSS), and combination (D+D*+R2*+ITSS) for predicting MVI were 0.772, 0.800, and, 0.855, respectively. When IVIM combined with ESWAN, the performance was improved with a sensitivity of 73.1% and a specificity of 92.0% (cut-off value: 0.502) and the AUC was significantly higher than AFP (P=0.001), D (P=0.038), D* (P=0.023), R2* (P=0.034), and ITSS (P=0.005). The IVIM and ESWAN parameters showed good efficacy in prediction of MVI in patients with HCC. The combination of IVIM and ESWAN may be useful for noninvasive prediction of MVI before clinical operation.

Peranan Sekuen Susceptibility Weight Imaging (SWI) Pada Pemeriksaan MRI Brain Pada Kasus Tumor

The aim of the research is to find out the role of the transverse suspectibility weighted imaging (SWI) sequence in brain MRI examination techniques in tumor cases. The research method used in this research is a qualitative descriptive study that uses a literature study approach to explore, analyze and identify information about how the Susceptibility Weighted Imaging (SWI) sequence plays a role in the Brain MRI examination process in patients who have tumors. The results and discussion of the literature review show: 1) Susceptibility-Weighted Imaging (SWI) on MRI brain has an important role in detecting blood degradation products, calcification and iron accumulation in glioblastoma. SWI allows visualization of small blood vessels, detection of iron, as well as identification of areas of calcification within the tumor, providing a more detailed picture of the nature and malignancy of glioblastoma. The Intratumoral Susceptibility Signal (ITSS) on SWI images is a visual marker associated with microhemorrhage, neoangiogenesis, and calcification, enabling tumor grading based on the frequency and distribution of these signals. In addition, Intralesional Susceptibility Signal (ILSS) also has an important role in differentiating glioblastoma from abscesses and metastases, with high levels of ILSS tending to be associated with tumor severity. Thus, the integration of SWI and ITSS and ILSS analysis can make a significant contribution to the characterization and assessment of the level of malignancy. 2) Susceptibility-Weighted Imaging (SWI) in the diagnosis of glioblastoma has the advantage of providing internal visualization of the tumor with high resolution. SWI is highly sensitive to differences in tissue susceptibility, allows the detection of neovascularization, hemorrhage, and calcification within glioblastoma, and provides detailed information about cerebral vascular anatomy. The advantages of SWI include its ability to image the Intratumoral Susceptibility Signal (ITSS) and Intralesional Susceptibility Signal (ILSS) and increase the visibility of low signal intensity structures. However, its shortcomings, namely sensitivity to artifacts, dependence on susceptibility phenomena, and subjective interpretation are aspects that need to be considered.

FRI647 Hemiballismus - A Rare Presentation Of Uncontrolled Diabetes Mellitus Type 2

Abstract Disclosure: C.L. Macrohon: None. M.L. Kanapi: None. Background: Diabetic Striatopathy is a rare disease with a prevalence of 1 in 100,000 and is more commonly seen in elderly women with poor glycemic control. It is an acute movement disorder characterized by sudden, non-purposeful jerking movements secondary to non-ketotic hyperglycemia. This is associated with high-intensity signals on T1-weighted magnetic resonance imaging of the brain noted at the basal ganglia. Case: We have a case of an 80-year old female who came in due to a four-day history of persistent involuntary, non-purposeful jerking of her right upper extremity accompanied by episodes of agitation and visual hallucinations. She has Diabetes Mellitus Type 2 for the past 20 years on Glibenclamide and Metformin. However, self-monitoring of blood glucose revealed fasting glucose levels as high as 300mg/dl. She was asymptomatic hence did not have regular follow-up with her primary care physician. She had no history of previous cerebrovascular disease. Family history was unremarkable. Upon examination, she was disoriented to place but answers appropriately to questions and did not have any speech abnormalities. On inspection it was noted that she had high amplitude involuntary flailing of the right upper extremity accompanied by non-purposeful jerking of her right lower extremity. Initial blood glucose level was 354mg/dl with an Hba1c of 13.7%. Serum ketones was within normal limits with a value of 0.1mmol/L. A plain Magnetic Resonance Imaging of the brain was done which showed a region of T1 weighted hyperintensity with no corresponding abnormal restricted diffusion nor increased susceptibility signals involving the left lentiform nucleus with no evidence of acute infarction nor intracranial hemorrhage noted. At this time, patient was co-managed by Endocrinology and Neurology service with an impression of a Diabetic Striatopathy. For the hemiballism and other neurologic manifestations such as agitation, visual hallucinations and disorientation patient was given risperidone and clonazepam. Blood glucose was then managed through cautious insulin therapy as well as hydration. On the third hospital day, there was noted resolution of right-sided hemiballismus and at this time glycemic control was improved. Conclusion: Proper identification and diagnosis is essential in managing Diabetic striatopathy. Although this may be a rare presentation of uncontrolled diabetes mellitus, clinicians should be aware of the possibility of an acute movement disorder as an unveiling symptom. This shows the importance of prompt blood glucose measurement in these acute cases. Once identified, adequate glycemic control through insulin therapy remains to be the center and most effective therapeutic management for the resolution of these hyperkinetic symptoms. Presentation: Friday, June 16, 2023

Probe Screening Techniques for Rapid, High-Resolution Core Analysis and Their Potential Usefulness for Energy Transition Applications

Core analysis techniques have traditionally been used mainly for hydrocarbon reservoir applications. However, the same techniques are equally applicable to reservoir issues associated with energy transition, such as geothermal prospects, carbon geosequestration, and hydrogen storage. Traditionally, much core analysis has been performed successfully using core plugs. However, this approach has certain drawbacks: (1) the selected plugs may not necessarily be representative of the full range of lithologies, (2) key features (e.g., thin naturally cemented or fractured zones) may be missed, (3) high-resolution detail at the lamina scale may be missed, (4) depth shifting to well logs may not be sufficiently accurate, and (5) this strategy may be more sensitive to missing core. In this paper, we highlight the usefulness of probe core analysis techniques on slabbed core and powdered samples. For many reservoirs relevant to energy transition, it is crucial to have a high-resolution continuous record of petrophysical properties so that key features are not missed. Probe measurements are less destructive, without the need to cut core plugs, and provide: (1) high-resolution data at the lamina scale so that key features and small-scale heterogeneities can be identified, (2) improved depth matching to well-log data, and (3) rapid, cost-effective data. We describe examples highlighting some different probe techniques. While some techniques are well known, such as probe permeability, others, such as probe acoustics, probe luminance (from linear X-ray measurements), and probe magnetics, are less familiar to core analysts but are well suited for analyzing cores from reservoirs associated with energy transition as well as hydrocarbons. For example, potential geothermal prospects involve studying igneous and metamorphic samples (where the main radiogenic heat sources reside) as well as sedimentary samples, and differences in the magnetic susceptibility signals using a small, portable magnetic probe can quickly differentiate the different rock types. Probe acoustics can be used to (1) rapidly identify anisotropy by orienting the acoustic transmitter-receiver bracket in different directions, (2) identify open microfractures via longer transit times, and (3) produce high-resolution porosity profiles after correlation of transit times with some representative plug or well-log porosity data. Probe luminance and associated linear X-ray images, which are related to density, can indicate small-scale heterogeneities that may impact permeability variation and anisotropy and may not be seen from mere visual observations of the slabbed core surface.

Chiral Zn3Ln3 Hexanuclear Clusters of an Achiral Flexible Ligand.

Multifunctional single-molecule magnets (SMMs) have sparked great interest, but chiral SMMs obtained via spontaneous resolution are rarely reported. We synthesized a series of chiral trinuclear hepta-coordinate lanthanide complexes [ZnII3LnIII3] (1 for Dy, 2 for Tb, 3 for Gd, and 4 for Dy0.07Y0.93) using the achiral flexible ligand H2L (2,2'-[1,2-ethanediylbis[(ethylimino)methylene]]bis[3,5-dimethylphenol]). The complexes crystallize in the chiral P63 group space, and two enantiomers of different chirality are spontaneously resolved. Three [Zn(L)Cl]- anions utilize the two phenoxy oxygen atoms of each L2- to coordinate with three lanthanide ions, respectively, and the three hepta-coordinate D5h lanthanide ions are arranged in a triangle. The chirality comes from the propeller arrangement of the peripheral three bidentate chelate L2- ligands like octahedral [M(AA)3]n+/- (M = transition metal ions; AA = bidentate chelate ligands, e.g., 2,2'-bipyridine, 1,10-phenathroline, ethylenediamine, acac- or oxalate). Complex 1 exhibits an AC susceptibility signal and is frequency-dependent, which is typical of SMMs. Complex 4, doped with a large amount of diamagnetic Y(III) in Dy(III), exhibits Ueff = 48.3 K and τ0 = 4.4 × 10-8 s in experiments. Complex 2 shows circularly polarized luminescence and apparent photoluminescence, typical of the f-f transitions of Tb(III).

Structural and magnetic anisotropy in YBa$_2$Cu$_3$O$_7$/La$_{0.67}$Sr$_{0.33}$MnO$_3$ bilayer on SrTiO$_3$ substrate

We study the magnetic properties and emergence of superconductivity in YBa_22Cu_33O_77 (YBCO)/ La_{0.67}0.67Sr_{0.33}0.33MnO_33 (LSMO) heterostructures. Bilayer films of superconducting layer, YBCO, and ferromagnetic layer, LSMO were grown on SrTiO_{3}3 (STO) (001) substrate using ultrahigh vacuum Pulsed Laser Deposition system. Magnetization data at 100 K as a function of applied magnetic field shows ferromagnetic behaviour due to the LSMO layer. Cooling below 100 K leads to superconductivity in this material; the onset of superconductivity occurs at a temperature, T_{c,SC},Tc,SC, of 86 K for H_{ext}\perp cHext⊥c (in-plane) &amp; 84 K for H_{ext}||cHext||c (out-of-plane) under 100 Oe applied field. In-plane magnetic measurements show significant suppression of diamagnetic behaviour as compared to the out-of-plane measurements. The susceptibility signals are higher for out-of-plane direction. Such strong anisotropy in magnetism and the transition temperatures reveal complex interplay of magnetism and superconductivity in this system and calls for further study in this direction.

Analysis of epigenetic mediators for the effect of Polyunsaturated fatty acids Omega6/3 ratio on cognitive function and progression to dementia

AbstractBackgroundPrevious research reported the association between circulating Omega‐3 polyunsaturated fatty acids (PUFA) in blood and the risk of dementia and Alzheimer’s disease (AD). However, a large intervention study supplementing Omega‐3 reported that this supplementation has only a marginal effect on improvement of cognitive performance after the supplementation. Since PUFA metabolism shared the processing enzymes, we explored whether the relationship between two main families of PUFA, i.e., Omega‐3 and Omega‐6, might associate with cognitive performance. Hence, we observed that the ratio Omega‐6/Omega‐3 in blood is associated with cognitive decline and dementia. To follow up on this finding, we sought to explore whether modulation of immune response and inflammation may underlie these effects.MethodThree independent cohort were used for this study: i) the observational memory‐clinic‐based cohort DELCODE (n = 1036); ii) the primary care‐derived cohort AgeCoDe (n = 1252); iii) the Multidomain Alzheimer Preventive Trial (MAPT study) cohort (n = 1679). Omega‐3 and PUFA levels were quantified specifically in plasma from each cohort. COX regressions and linear mixed models were applied to evaluate PUFA ratio effect on cognitive performance and progression to dementia. Genomic and epigenomic modulators for the observed effects were further explored using the previously published tool (MetaMeth). Results were confirmed using our pipeline for epigenome‐wide association study (EWAS).ResultOmega‐6/Omega‐3 ratio is associated with cognitive performance and risk of progressing to AD in DELCODE and AgeCoDe. In MAPT, the improvement of this ratio is associated with improvement on cognitive performance. Moreover, levels of Omega‐3 in blood modulate methylation of genes coding for key enzymes of PUFA metabolism. Our data showed that the biological effect for some genetic susceptibility signals for AD is mediated by changes in DNA methylation, including immune‐related genes like MS4A and TREM2.ConclusionOur data suggests that balance between PUFA is relevant on cognitive decline and dementia. In addition, the genetic effect of risk variants located at the AD risk loci containing the MS4A gene cluster and TREM2 are mediated by changes in methylation. To provide a connection between PUFA and neuroinflammation in the context of AD, we are currently exploring the effect of PUFA levels on DNA methylation at MS4A and TREM2 loci.

Magnetic resonance imaging-derived parameters to predict response to regorafenib in recurrent glioblastoma.

Regorafenib is a multikinase inhibitor, approved as a preferred regimen for recurrent glioblastoma (rGB). Although its effects on prolonging survival could seem modest, it is still unclear whether a subset of patients, potentially identifiable by imaging biomarkers, might experience a more substantial positive effect. Our aim was to evaluate the potential value of magnetic resonance imaging-derived parameters as non-invasive biomarkers to predict response to regorafenib in patients with rGB. 20 patients with rGB underwent conventional and advanced MRI at diagnosis (before surgery), at recurrence and at first follow-up (3months) during regorafenib. Maximum relative cerebral blood volume (rCBVmax) value, intra-tumoral susceptibility signals (ITSS), apparent diffusion coefficient (ADC) values, and contrast-enhancing tumor volumes were tested for correlation with response to treatment, progression-free survival (PFS), and overall survival (OS). Response at first follow-up was assessed according to Response Assessment in Neuro-Oncology (RANO) criteria. 8/20 patients showed stable disease at first follow-up. rCBVmax values of the primary glioblastoma (before surgery) significantly correlated to treatment response; specifically, patients with stable disease displayed higher rCBVmax compared to progressive disease (p = 0.04, 2-group t test). Moreover, patients with stable disease showed longer PFS (p = 0.02, 2-group t test) and OS (p = 0.04, 2-group t test). ITSS, ADC values, and contrast-enhancing tumor volumes showed no correlation with treatment response, PFS nor OS. Our results suggest that rCBVmax of the glioblastoma at diagnosis could serve as a non-invasive biomarker of treatment response to regorafenib in patients with rGB.

Remotely Sensed Data, Morpho-Metric Analysis, and Integrated Method Approach for Flood Risk Assessment: Case Study of Wadi Al-Arish Landscape, Sinai, Egypt

Evaluating and predicting the occurrence and spatial remarks of climate and rainfall-related destructive hazards is a big challenge. Periodically, Sinai Peninsula is suffering from natural risks that enthuse researchers to provide the area more attention and scientific investigation. Extracted information from the morpho-metric indices aids in understanding the flood potentiality over various sizes of drainage catchments. In this work, the morpho-metric analysis has been used in order to model the relative signals of flood vulnerability of 16 catchments in northern Sinai. The geospatial technique has been applied to process the digital elevation models (DEMs) in order to produce different analysis maps. Basic geometries, in addition to several morpho-metric indices, were extracted and analyzed by investigating the digital elevation models. Three different effective methods were applied separately to build up three models of flood susceptibility behaviors. Finally, two flood susceptibility signals were defined: the integration method and accurate pixel level conditions models. The integrated method analysis indicates that the western half of the study landscape, including catchments (12, 13, and 14), presents high levels of flood susceptibility in addition to catchment 9 in the eastern half, whereas the other catchments were found to provide moderate levels. The integrated flood susceptibility final map overlaid one of the most effective topographic indices (topographic position index, TPI). The integrated results aided in understanding the link of the general catchments morphometry to the in situ topography for mapping the different flood susceptibility locations over the entire study landscape. Therefore, this can be used for investigating the surface-specific reduction strategy against the impacts of flood hazards in the proposed landscape.

Prediction of Ki-67 labeling index, ATRX mutation, and MGMT promoter methylation status in IDH-mutant astrocytoma by morphological MRI, SWI, DWI, and DSC-PWI.

Noninvasive detection of molecular status of astrocytoma is of great clinical significance for predicting therapeutic response and prognosis. We aimed to evaluate whether morphological MRI (mMRI), SWI, DWI, and DSC-PWI could predict Ki-67 labeling index (LI), ATRX mutation, and MGMT promoter methylation status in IDH mutant (IDH-mut) astrocytoma. We retrospectively analyzed mMRI, SWI, DWI, and DSC-PWI in 136 patients with IDH-mut astrocytoma.The features of mMRI and intratumoral susceptibility signals (ITSS) were compared using Fisher exact test or chi-square tests. Wilcoxon rank sum test was used to compare the minimum ADC (ADCmin), and minimum relative ADC (rADCmin) of IDH-mut astrocytoma in different molecular markers status. Mann-Whitney U test was used to compare the rCBVmax of IDH-mut astrocytoma with different molecular markers status. Receiver operating characteristic curves was performed to evaluate their diagnostic performances. ITSS, ADCmin, rADCmin, and rCBVmax were significantly different between high and low Ki-67 LI groups. ITSS, ADCmin, and rADCmin were significantly different between ATRX mutant and wild-type groups. Necrosis, edema, enhancement, and margin pattern were significantly different between low and high Ki-67 LI groups. Peritumoral edema was significantly different between ATRX mutant and wild-type groups. Grade 3 IDH-mut astrocytoma with unmethylated MGMT promoter was more likely to show enhancement compared to the methylated group. mMRI, SWI, DWI, and DSC-PWI were shown to have the potential to predict Ki-67 LI and ATRX mutation status in IDH-mut astrocytoma. A combination of mMRI and SWI may improve diagnostic performance for predicting Ki-67 LI and ATRX mutation status. Conventional MRI and functional MRI (SWI, DWI, and DSC-PWI) can predict Ki-67 expression and ATRX mutation status of IDH mutant astrocytoma, which may help clinicians determine personalized treatment plans and predict patient outcomes. • A combination of multimodal MRI may improve the diagnostic performance to predict Ki-67 LI and ATRX mutation status. • Compared with IDH-mutant astrocytoma with low Ki-67 LI, IDH-mutant astrocytoma with high Ki-67 LI was more likely to show necrosis, edema, enhancement, poorly defined margin, higher ITSS levels, lower ADC, and higher rCBV. • ATRX wild-type IDH-mutant astrocytoma was more likely to show edema, higher ITSS levels, and lower ADC compared to ATRX mutant IDH-mutant astrocytoma.

Quantitative susceptibility mapping evaluation of glioma.

To comprehensively evaluate the glioma using quantitative susceptibility mapping (QSM). Forty-two patients (18 women; mean age, 45years) with pathologically confirmed gliomas were retrospectively included. All the patients underwent conventional and advanced MRI examinations (QSM, DWI, MRS, etc.). Five patients underwent paired QSM (pre- and post-enhancement). Four Visually Accessible Rembrandt Image (VASARI) features and intratumoural susceptibility signal (ITSS) were observed. Three ROIs each were manually drawn separately in the tumour parenchyma with relatively high and low magnetic susceptibility. The association between the tumour's magnetic susceptibility and other MRI parameters was also analysed. Morphologically, gliomas with heterogeneous ITSS were more similar to high-grade gliomas (p = 0.006, AUC: 0.72, sensitivity: 70%, and specificity: 73%). Heterogeneous ITSS was significantly associated with tumour haemorrhage, necrosis, diffusion restriction, and avid enhancement but did not change between pre- and post-enhanced QSM. Quantitatively, tumour parenchyma magnetic susceptibility had limited value in grading gliomas and identifying IDH mutation status, whereas the relatively low magnetic susceptibility of the tumour parenchyma helped identify oligodendrogliomas in IDH mutated gliomas (AUC = 0.78) with high specificity (100%). The relatively high tumour magnetic susceptibility significantly increased after enhancement (p = 0.039). Additionally, we found that the magnetic susceptibility of the tumour parenchyma was significantly correlated with ADC (r = 0.61) and Cho/NAA (r = 0.40). QSM is a promising candidate for the comprehensive evaluation of gliomas, except for IDH mutation status. The magnetic susceptibility of tumour parenchyma may be affected by tumour cell proliferation. • Morphologically, gliomas with a heterogeneous intratumoural susceptibility signal (ITSS) are more similar to high-grade gliomas (p = 0.006; AUC, 0.72; sensitivity, 70%; and specificity, 73%). Heterogeneous ITSS was significantly associated with tumour haemorrhage, necrosis, diffusion restriction, and avid enhancement but did not change between pre- and post-enhanced QSM. • Tumour parenchyma's relatively low magnetic susceptibility helped identify oligodendroglioma with high specificity. • Tumour parenchyma magnetic susceptibility was significantly correlated with ADC (r = 0.61) and Cho/NAA (r = 0.40).