Publications by Year: 2007

Studies of myocardial motion using magnetic resonance imaging usually require multiple breath holds and several methods have been proposed in order to reduce the scan time. Rapid imaging using k-t BLAST has gained much attention with its high reduction factors and image quality. Temporal smoothing, however, may reduce the accuracy when assessing cardiac function. In the present work, a modified reconstruction filter is proposed, that preserves more of the high temporal frequencies. Artificial decimation of a fully sampled data set was used to evaluate the reconstruction filter. Compared to the conventional k-t BLAST reconstruction, the modified filter produced images with sharper temporal delineation of the myocardial walls. Quantitative analysis by means of regional velocity estimation showed that the modified reconstruction filter produced more accurate velocity estimations.

System development for image-guided therapy (IGT), or image-guided interventions (IGI), continues to be an area of active interest across academic and industry groups. This is an emerging field that is growing rapidly: major academic institutions and medical device manufacturers have produced IGT technologies that are in routine clinical use, dozens of high-impact publications are published in well regarded journals each year, and several small companies have successfully commercialized sophisticated IGT systems. In meetings between IGT investigators over the last two years, a consensus has emerged that several key areas must be addressed collaboratively by the community to reach the next level of impact and efficiency in IGT research and development to improve patient care. These meetings culminated in a two-day workshop that brought together several academic and industrial leaders in the field today. The goals of the workshop were to identify gaps in the engineering infrastructure available to IGT researchers, develop the role of research funding agencies and the recently established US-based National Center for Image Guided Therapy (NCIGT), and ultimately to facilitate the transfer of technology among research centers that are sponsored by the National Institutes of Health (NIH). Workshop discussions spanned many of the current challenges in the development and deployment of new IGT systems. Key challenges were identified in a number of areas, including: validation standards; workflows, use-cases, and application requirements; component reusability; and device interface standards. This report elaborates on these key points and proposes research challenges that are to be addressed by a joint effort between academic, industry, and NIH participants.

Organ motion compensation in image-guided therapy is an active area of research. However, there has been little research on motion tracking and compensation in magnetic resonance imaging (MRI)-guided therapy. In this paper, we present a method to track a moving organ in MRI and control an active mechanical device for motion compensation. The method proposed is based on MRI navigator echo tracking enhanced by Kalman filtering for noise robustness. We also developed an extrapolation scheme to resolve any discrepancies between tracking and device control sampling rates. The algorithm was tested in a simulation study using a phantom and an active mechanical tool holder. We found that the method is feasible to use in a clinical MRI scanner with sufficient accuracy (0.36 mm to 1.51 mm depending on the range of phantom motion) and is robust to noise. The method proposed may be useful in MRI-guided targeted therapy, such as focused ultrasound therapy for a moving organ.

CONTEXT: Progressive brain abnormalities in schizophrenia remain controversial. Evidence of interrelated progressive functional impairment would buttress the case for structural progression. Mismatch negativity (MMN) is reduced in chronic but not first-hospitalized schizophrenia and may index progressive structural changes. OBJECTIVE: To determine whether MMN shows associations with underlying auditory cortex gray matter at first hospitalization and progressive reduction longitudinally. DESIGN: Cross-sectional (first hospitalization) and longitudinal (1.5-year follow-up). SETTING: A private psychiatric hospital. PARTICIPANTS: Protocol entrance: MMN and magnetic resonance imaging at first hospitalization in 20 subjects with schizophrenia, 21 subjects with bipolar disorder with psychosis, and 32 control subjects. Longitudinal electrophysiologic testing: MMN in 16 subjects with schizophrenia, 17 subjects with bipolar disorder, and 20 control subjects. Longitudinal electrophysiologic testing and magnetic resonance imaging: MMN and magnetic resonance imaging in 11 subjects with schizophrenia, 13 subjects with bipolar disorder, and 13 control subjects. At each time point, reported samples were group matched for age, handedness, and parental socioeconomic status. INTERVENTIONS: Electrophysiologic testing and high-resolution structural magnetic resonance imaging. MAIN OUTCOME MEASURES: Mismatch negativity amplitude and Heschl gyrus and planum temporale gray matter volumes.

RATIONALE AND OBJECTIVES: To perform a retrospective, quantitative assessment of the anatomic relationship between intra-axial, supratentorial, primary brain tumors, and adjacent white matter fiber tracts based on anatomic and diffusion tensor magnetic resonance imaging (MRI). We hypothesized that white matter infiltration may be common among different types of tumor. MATERIAL AND METHODS: Preoperative, anatomic (T1- and T2-weighted), and LINESCAN diffusion tensor MRI were obtained in 12 patients harboring supratentorial gliomas (World Health Organization [WHO] Grades II and III). The two imaging modalities were rigidly registered. The tumors were manually segmented from the T1- and T2-weighted MRI, and their volume calculated. A three-dimensional tractography was performed in each case. A second segmentation and volume measurement was performed on the tumor regions intersecting adjacent white matter fiber tracts. Statistical methods included summary statistics to examine the fraction of tumor volume infiltrating adjacent white matter. RESULTS: There were five patients with low-grade oligodendroglioma (WHO Grade II), one with low-grade mixed oligoastrocytoma (WHO Grade II), one with ganglioglioma, two with low-grade astrocytoma (WHO Grade II), and three with anaplastic astrocytoma (WHO Grade III). We identified white matter tracts infiltrated by tumor in all 12 cases. The median tumor volume (+/- standard deviation) in our patient population was 42.5 +/- 28.9 mL. The median tumor volume (+/- standard deviation) infiltrating white matter fiber tracts was 5.2 +/- 9.9 mL. The median percentage of tumor volume infiltrating white matter fiber tracts was 21.4% +/- 9.7%. CONCLUSIONS: The information provided by diffusion tensor imaging combined with anatomic MRI might be useful for neurosurgical planning and intraoperative guidance. Our results confirm previous reports that extensive white matter infiltration by primary brain tumors is a common occurrence. However, prospective, large population studies are required to definitively clarify this issue, and how infiltration relates to histologic tumor type, tumor size, and location.

The accuracy of q-space measurements was evaluated at a 3.0-T clinical magnetic resonance imaging (MRI) scanner, as compared with a 4.7-T nuclear magnetic resonance (NMR) spectrometer. Measurements were performed using a stimulated-echo pulse-sequence on n-decane as well as on polyethylene glycol (PEG) mixed with different concentrations of water, in order to obtain bi-exponential signal decay curves. The diffusion coefficients as well as the modelled diffusional kurtosis K(fit) were obtained from the signal decay curve, while the full-width at half-maximum (FWHM) and the diffusional kurtosis K were obtained from the displacement distribution. Simulations of restricted diffusion, under conditions similar to those obtainable with a clinical MRI scanner, were carried out assuming various degrees of violation of the short gradient pulse (SGP) condition and of the long diffusion time limit. The results indicated that an MRI system can not be used for quantification of structural sizes less than about 10 microm by means of FWHM since the parameter underestimates the confinements due to violation of the SGP condition. However, FWHM can still be used as an important contrast parameter. The obtained kurtosis values were lower than expected from theory and the results showed that care must be taken when interpreting a kurtosis estimate deviating from zero.

We present software engineering methods to provide free open-source software for MR-guided therapy. We report that graphical representation of the surgical tools, interconnectively with the tracking device, patient-to-image registration, and MRI-based thermal mapping are crucial components of MR-guided therapy in sharing such software. Software process includes a network-based distribution mechanism by multi-platform compiling tool CMake, CVS, quality assurance software DART. We developed six procedures in four separate clinical sites using proposed software engineering and process, and found the proposed method is feasible to facilitate multicenter clinical trial of MR-guided therapies. Our future studies include use of the software in non-MR-guided therapies.

The integration of medical devices with software applications is crucial for image-guided medical applications. This work describes a general device interface that has been designed for high-frequency streaming of multi-modal events, thus providing maximum performance and flexibility for such applications. Several sample applications and performance tests are provided to demonstrate the usability of the concept.

A group of 44 patients with schizophrenia and 43 age-matched controls completed psychometrically-matched tasks of recall and recognition. The patients showed similarly depressed scores across both recall and recognition matched tasks, independent of their reduced IQ and executive functioning scores. In addition, reduced memory scores correlated in the expected direction with magnetic resonance imaging (MRI) of the hippocampus and diffusion tension imaging (DTI) of the fornix for subsets of both patients and controls that had available these structural imaging measures. Reduced executive functioning also correlated with lower fornix integrity for the patient subset. However, increased hippocampal volume correlated, in the negative direction, with lower scores for executive functioning and IQ in the control subset. Implications of these results are discussed.

The aim of the study was to retrospectively determine the potential for radiation dose reduction at multidetector computed tomography (CT) of the paranasal sinus by using computer simulation of the effect of low-radiation dose acquisition on diagnostic image quality. This HIPAA compliant study was approved by the institutional human research committee. The need for informed patient consent was waived. Twenty patients underwent four-section CT at 120 kV, 170 mAs, and 4 x 1-mm collimation. Artificial image noise was added to the CT raw data by using a dedicated software platform. Acquisitions with effective tube currents of 134, 100, 67, and 33 mAs were simulated. Each raw data set was reconstructed with bone and soft-tissue algorithms, and two radiologists independently rated the images in blinded fashion. A two-sided paired Student t test was used for statistical analysis. The lowest radiation dose that still provided diagnostic quality was