Publications

2001
SS Yoo, CR Guttmann, and LP Panych. 2001. “Multiresolution data acquisition and detection in functional MRI.” Neuroimage, 14, 6, Pp. 1476-85.Abstract
In an investigation of a multiresolution and multistaged approach in functional MRI, the relationship between spatial resolution and detection of functional activation is examined. The difference between functional detection and mapping is defined, and a multiresolution approach to functional detection is analyzed by constructing simple theoretical and experimental models simulating variations of in-plane resolution. Experimentally measured blood oxygenation level-dependent (BOLD) signal changes as well as BOLD contrast-to-noise ratio (CNR) with respect to different spatial resolutions are compared with results from theoretical predictions and simulation. From both an experimental and a theoretical perspective, it is shown that BOLD CNR and, thus, the concomitant detection of the functional activation are maximized when the resolution matches the size of activation.
RA Sperling, CR Guttmann, MJ Hohol, SK Warfield, M Jakab, M Parente, EL Diamond, KR Daffner, MJ Olek, EJ Orav, R Kikinis, FA Jolesz, and HL Weiner. 2001. “Regional magnetic resonance imaging lesion burden and cognitive function in multiple sclerosis: a longitudinal study.” Arch Neurol, 58, 1, Pp. 115-21.Abstract
OBJECTIVE: To investigate the relationship between magnetic resonance imaging regional lesion burden and cognitive performance in multiple sclerosis (MS) over a 4-year follow-up period. DESIGN: Twenty-eight patients with MS underwent magnetic resonance imaging and took the Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis at baseline, 1-year, and 4-year follow-up. An automated 3-dimensional lesion detection method was used to identify MS lesions within anatomical regions on proton density T2-weighted images. The relationship between magnetic resonance imaging regional lesion volumes and the Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis results was examined using regression analyses. RESULTS: At all time points, frontal lesion volume represented the greatest proportion of total lesion volume, and the percentage of white matter classified as lesion was also highest in frontal and parietal regions. On neuropsychological testing, when compared with age- and educational level-matched control subjects, patients with MS showed significant impairment on tests of sustained attention, processing speed, and verbal memory (P<.001). Performance on these measures was negatively correlated with MS lesion volume in frontal and parietal regions at baseline, 1-year, and 4-year follow-up (R = -0.55 to -0.73, P<.001). CONCLUSIONS: Multiple sclerosis lesions show a propensity for frontal and parietal white matter. Lesion burden in these areas was strongly associated with performance on tasks requiring sustained complex attention and working verbal memory. This relationship was consistent over a 4-year period, suggesting that disruption of frontoparietal subcortical networks may underlie the pattern of neuropsychological impairment seen in many patients with MS.
2000
SJ Khoury, CR Guttmann, EJ Orav, R Kikinis, FA Jolesz, and HL Weiner. 2000. “Changes in activated T cells in the blood correlate with disease activity in multiple sclerosis.” Arch Neurol, 57, 8, Pp. 1183-9.Abstract
OBJECTIVE: To determine whether changes in activation markers on peripheral blood T cells correlate with disease activity in patients with multiple sclerosis. DESIGN: In a prospective longitudinal study during 1 year, we analyzed the change in percentage of activated T lymphocytes in the peripheral blood of 40 patients with multiple sclerosis in relation to clinical findings and changes on brain magnetic resonance imaging (MRI) scans. The patients underwent repeated imaging of the brain (mean number of MRIs for each patient, 22) at the time blood samples were obtained as well as at monthly neurological examinations, and at the time of scoring on the Kurtzke Expanded Disability Status Scale (EDSS) and ambulation index scale. RESULTS: A change in the percentage of cells expressing the activation markers interleukin 2 receptor (CD25), class II major histocompatibility complex (MHC) (I3) or surface dipeptidyl peptidase (CD26) correlated significantly with a change in lesion volume or a change in number of gadolinium-enhancing lesions as detected on MRI. Changes in CD25( +) cells and in CD4(+) cells expressing class II MHC also correlated with changes in disability as measured by EDSS in patients with relapsing-remitting disease, and changes in CD4(+)CD25(+) cells correlated with the occurrence of attacks in patients with relapsing-remitting disease. These correlations are dependent on measurement of changes between time points sampled at 1- or 2-week intervals. CONCLUSION: There is a linkage between peripheral T-lymphocyte activation as measured by cell surface markers and disease activity in patients with multiple sclerosis. Arch Neurol. 2000;57:1183-1189
G Gerig, D Welti, CR Guttmann, AC Colchester, and G Székely. 2000. “Exploring the discrimination power of the time domain for segmentation and characterization of active lesions in serial MR data.” Med Image Anal, 4, 1, Pp. 31-42.Abstract
This paper presents a new method for the automatic segmentation and characterization of object changes in time series of three-dimensional data sets. The technique was inspired by procedures developed for analysis of functional MRI data sets. After precise registration of serial volume data sets to 4-D data, we applied a time series analysis taking into account the characteristic time function of variable lesions. The images were preprocessed with a correction of image field inhomogeneities and a normalization of the brightness over the whole time series. Thus, static regions remain unchanged over time, whereas changes in tissue characteristics produce typical intensity variations in the voxel's time series. A set of features was derived from the time series, expressing probabilities for membership to the sought structures. These multiple sources of uncertain evidence were combined to a single evidence value using Dempster-Shafer's theory. The project was driven by the objective of improving the segmentation and characterization of white matter lesions in serial MR data of multiple sclerosis patients. Pharmaceutical research and patient follow-up requires efficient and robust methods with a high degree of automation. The new approach replaces conventional segmentation of series of 3-D data sets by a 1-D processing of the temporal change at each voxel in the 4-D image data set. The new method has been applied to a total of 11 time series from different patient studies, covering time resolutions of 12 and 24 data sets over a period of about 1 year. The results demonstrate that time evolution is a highly sensitive feature for detection of fluctuating structures.
RV Mulkern, HP Zengingonul, RL Robertson, P Bogner, KH Zou, H Gudbjartsson, CR Guttmann, D Holtzman, W Kyriakos, FA Jolesz, and SE Maier. 2000. “Multi-component apparent diffusion coefficients in human brain: relationship to spin-lattice relaxation.” Magn Reson Med, 44, 2, Pp. 292-300.Abstract
In vivo measurements of the human brain tissue water signal decay with b-factor over an extended b-factor range up to 6,000 s/mm(2) reveal a nonmonoexponential decay behavior for both gray and white matter. Biexponential parametrization of the decay curves from cortical gray (CG) and white matter voxels from the internal capsule (IC) of healthy adult volunteers describes the decay process and serves to differentiate between these two tissues. Inversion recovery experiments performed in conjunction with the extended b-factor signal decay measurements are used to make separate measurements of the spin-lattice relaxation times of the fast and slow apparent diffusion coefficient (ADC) components. Differences between the spin-lattice relaxation times of the fast and slow ADC components were not statistically significant in either the CG or IC voxels. It is possible that the two ADC components observed from the extended b-factor measurements arise from two distinct water compartments with different intrinsic diffusion coefficients. If so, then the relaxation results are consistent with two possibilities. Either the spin-lattice relaxation times within the compartments are similar or the rate of water exchange between compartments is "fast" enough to ensure volume averaged T(1) relaxation yet "slow" enough to allow for the observation of biexponential ADC decay curves over an extended b-factor range. Magn Reson Med 44:292-300, 2000.
JP Mugler, S Bao, RV Mulkern, CR Guttmann, RL Robertson, FA Jolesz, and JR Brookeman. 2000. “Optimized single-slab three-dimensional spin-echo MR imaging of the brain.” Radiology, 216, 3, Pp. 891-9.Abstract
The development and optimization of spin-echo-based, single-slab, three-dimensional techniques for magnetic resonance imaging of the whole brain are described. T1-weighted and T2-weighted image sets with a volume resolution of 1 mm(3) and fluid-attenuated inversion-recovery image sets with a volume resolution of 3 mm(3) were obtained in acquisition times of less than 10 minutes per image set.
HL Weiner, CR Guttmann, SJ Khoury, EJ Orav, MJ Hohol, R Kikinis, and FA Jolesz. 2000. “Serial magnetic resonance imaging in multiple sclerosis: correlation with attacks, disability, and disease stage.” J Neuroimmunol, 104, 2, Pp. 164-73.Abstract
Serial MRI and clinical testing was performed on 45 well-defined untreated multiple sclerosis patients in different categories of disease (relapsing-remitting, progressive, stable). Up to 24 MRIs were scheduled over a 1-year period for each patient. Clinical evaluation was performed monthly and at times of attacks using the Expanded Disability Status Scale (EDSS) and the Ambulation Index (AI). MRI scans were performed both with and without gadolinium enhancement. MRI lesion volume was determined by computerized analysis and gadolinium-enhancing lesions were counted by radiologists. We observed an increase in lesion volume over 1 year in all patient groups except those classified clinically as stable. In relapsing-remitting patients there were correlations between increases in the number of gadolinium enhancing lesions and increases in EDSS and the occurrence of attacks. In chronic progressive patients, increases in lesion volume were correlated with both increases in EDSS and AI. These results demonstrate a linkage between MRI and clinical disease that depends both on the stage of MS and the MRI measures used and support the use of MRI as a surrogate marker of clinical disability in the study of multiple sclerosis.
CR Guttmann, R Benson, SK Warfield, X Wei, MC Anderson, CB Hall, K Abu-Hasaballah, JP Mugler, and L Wolfson. 2000. “White matter abnormalities in mobility-impaired older persons.” Neurology, 54, 6, Pp. 1277-83.Abstract
OBJECTIVE: To investigate the relationship between white matter abnormalities and impairment of gait and balance in older persons. METHODS: Quantitative MRI was used to evaluate the brain tissue compartments of 28 older individuals separated into normal and impaired groups on the basis of mobility performance testing using the Short Physical Performance Battery. In addition, individuals were tested on six indices of gait and balance. For imaging data, segmentation of intracranial volume into four tissue classes was performed using template-driven segmentation, in which signal-intensity-based statistical tissue classification is refined using a digital brain atlas as anatomic template. RESULTS: Both decreased white matter volume, which was age-related, and increased white matter signal abnormalities, which were not age-related, were observed in the mobility-impaired group compared with the control subjects. The average volume of white matter signal abnormalities for impaired individuals was nearly double that of control subjects. CONCLUSIONS: This cross-sectional study suggests that decreased white matter volume is age-related, whereas increased white matter signal abnormalities are most likely to occur as a result of disease. Both of these changes are independently associated with impaired mobility in older persons and therefore likely to be additive factors of motor disability.
1999
SJ Khoury, EJ Orav, CR Guttmann, R Kikinis, FA Jolesz, and HL Weiner. 1999. “Changes in serum levels of ICAM and TNF-R correlate with disease activity in multiple sclerosis.” Neurology, 53, 4, Pp. 758-64.Abstract
OBJECTIVE: To study the change in serum levels of soluble intercellular adhesion molecule 1 (sICAM-1) and soluble tumor necrosis factor receptors (sTNF-Rs) in MS patients in relation to clinical disease activity and changes on brain MRI. BACKGROUND: Circulating forms of adhesion molecules or soluble receptors may be released from cells as a consequence of activation and may be useful markers for inflammation. METHODS: During a prospective longitudinal study over 1 year, 40 patients with MS underwent frequent imaging of the brain (22 MR images per patient) at the time of blood sampling as well as monthly neurologic examinations, and scoring on Kurtzke's Expanded Disability Status Scale (EDSS) and ambulation index (AI). RESULTS: Patients with relapsing-progressive disease had the highest levels of sICAM-1 whereas patients with progressive disease had the highest levels of sTNF-Rs. Fluctuations in sICAM-1 correlated with the occurrence of attacks in patients with relapsing and relapsing-progressive disease. In patients with relapsing-progressive MS, an increase in sICAM-1 level preceded the appearance of new gadolinium (Gd) enhancing lesions on MRI. In patients with progressive disease, an increase in sTNF-R p55 level preceded the appearance of new Gd enhancing lesions on MRI, whereas a decrease in sICAM-1 levels correlated with the appearance of new Gd enhancing lesions. CONCLUSIONS: These results demonstrate a linkage between sICAM-1 and sTNF-R levels and disease activity in MS. Furthermore, patients with progressive disease appear to have a different immunologic stage of disease in which immune changes are tightly linked with changes on MRI. The demonstration of a correlation in individual patients between immunologic events and changes in disease activity has implications for monitoring patients undergoing treatment and for monitoring disease progression.
SS Yoo, CR Guttmann, and LP Panych. 1999. “Functional magnetic resonance imaging using non-Fourier, spatially selective radiofrequency encoding.” Magn Reson Med, 41, 4, Pp. 759-66.Abstract
A new method for functional magnetic resonance imaging (fMRI) employing non-Fourier encoding using spatially selective radiofrequency (RF) excitation is presented. The method uses manipulation of spatially selective RF pulses to encode spins in the slice-select direction. The method has several advantages over standard multislice approaches. It provides a simple means for monitoring irregularly distributed sections throughout a volume without the need to encode the whole volume. It offers the potential for increased signal-to-noise ratio if an appropriate basis is used for encoding. With a unique design of excitation pulses, it also appears possible to significantly reduce in-flow effects. An interleaved echo-planar imaging (EPI) sequence was adapted for non-Fourier encoding in the slice-select direction and was implemented on a conventional 1.5-Telsa system. The method was then used for functional mapping of the visual and motor areas where significant reduction of in-flow effect was demonstrated. This approach can be adapted to other imaging sequences that are used for fMRI, such as single-shot EPI.
RV Mulkern, H Gudbjartsson, CF Westin, HP Zengingonul, W Gartner, CR Guttmann, RL Robertson, W Kyriakos, R Schwartz, D Holtzman, FA Jolesz, and SE Maier. 1999. “Multi-component apparent diffusion coefficients in human brain.” NMR Biomed, 12, 1, Pp. 51-62.Abstract
The signal decay with increasing b-factor at fixed echo time from brain tissue in vivo has been measured using a line scan Stejskal-Tanner spin echo diffusion approach in eight healthy adult volunteers. The use of a 175 ms echo time and maximum gradient strengths of 10 mT/m allowed 64 b-factors to be sampled, ranging from 5 to 6000 s/ mm2, a maximum some three times larger than that typically used for diffusion imaging. The signal decay with b-factor over this extended range showed a decidedly non-exponential behavior well-suited to biexponential modeling. Statistical analyses of the fitted biexponential parameters from over 125 brain voxels (15 x 15 x 1 mm3 volume) per volunteer yielded a mean volume fraction of 0.74 which decayed with a typical apparent diffusion coefficient around 1.4 microm2/ms. The remaining fraction had an apparent diffusion coefficient of approximately 0.25 microm2/ms. Simple models which might explain the non-exponential behavior, such as intra- and extracellular water compartmentation with slow exchange, appear inadequate for a complete description. For typical diffusion imaging with b-factors below 2000 s/mm2, the standard model of monoexponential signal decay with b-factor, apparent diffusion coefficient values around 0.7 microm2/ms, and a sensitivity to diffusion gradient direction may appear appropriate. Over a more extended but readily accessible b-factor range, however, the complexity of brain signal decay with b-factor increases, offering a greater parametrization of the water diffusion process for tissue characterization.
L Kappos, D Moeri, EW Radue, A Schoetzau, K Schweikert, F Barkhof, D Miller, CR Guttmann, HL Weiner, C Gasperini, and M Filippi. 1999. “Predictive value of gadolinium-enhanced magnetic resonance imaging for relapse rate and changes in disability or impairment in multiple sclerosis: a meta-analysis. Gadolinium MRI Meta-analysis Group.” Lancet, 353, 9157, Pp. 964-9.Abstract
BACKGROUND: Reliable prognostic factors are lacking for multiple sclerosis (MS). Gadolinium enhancement in magnetic resonance imaging (MRI) of the brain detects with high sensitivity disturbance of the blood-brain barrier, an early event in the development of inflammatory lesions in MS. To investigate the prognostic value of gadolinium-enhanced MRI, we did a meta-analysis of longitudinal MRI studies. METHODS: From the members of MAGNIMS (European Magnetic Resonance Network in Multiple Sclerosis) and additional centres in the USA, we collected data from five natural-course studies and four placebo groups of clinical trials completed between 1992 and 1995. We included a total of 307 patients, 237 with relapsing disease course and 70 with secondary progressive disease course. We investigated by regression analysis the relation between initial count of gadolinium-enhancing lesions and subsequent worsening of disability or impairment as measured by the expanded disability status scale (EDSS) and relapse rate. FINDINGS: The relapse rate in the first year was predicted with moderate ability by the mean number of gadolinium-enhancing lesions in monthly scans during the first 6 months (relative risk per five lesions 1.13, p=0.023). The predictive value of the number of gadolinium-enhancing lesions in one baseline scan was less strong. The best predictor for relapse rate was the variation (SD) of lesion counts in the first six monthly scans which allowed an estimate of relapse in the first year (relative risk 1.2, p=0.020) and in the second year (risk ratio=1.59, p=0.010). Neither the initial scan nor monthly scans over six months were predictive of change in the EDSS in the subsequent 12 months or 24 months. The mean of gadolinium-enhancing-lesion counts in the first six monthly scans was weakly predictive of EDSS change after 1 year (odds ratio=1.34, p=0.082) and 2 years (odds ratio=1.65, p=0.049). INTERPRETATION: Although disturbance of the blood-brain barrier as shown by gadolinium enhancement in MRI is a predictor of the occurrence of relapses, it is not a strong predictor of the development of cumulative impairment or disability. This discrepancy supports the idea that variant pathogenetic mechanisms are operative in the occurrence of relapses and in the development of long-term disability in MS.
L Kappos, D Moeri, EW Radue, A Schoetzau, K Schweikert, F Barkhof, D Miller, CR Guttmann, HL Weiner, C Gasperini, and M Filippi. 1999. “Predictive value of gadolinium-enhanced magnetic resonance imaging for relapse rate and changes in disability or impairment in multiple sclerosis: a meta-analysis. Gadolinium MRI Meta-analysis Group.” Lancet, 353, 9157, Pp. 964-9.Abstract
BACKGROUND: Reliable prognostic factors are lacking for multiple sclerosis (MS). Gadolinium enhancement in magnetic resonance imaging (MRI) of the brain detects with high sensitivity disturbance of the blood-brain barrier, an early event in the development of inflammatory lesions in MS. To investigate the prognostic value of gadolinium-enhanced MRI, we did a meta-analysis of longitudinal MRI studies. METHODS: From the members of MAGNIMS (European Magnetic Resonance Network in Multiple Sclerosis) and additional centres in the USA, we collected data from five natural-course studies and four placebo groups of clinical trials completed between 1992 and 1995. We included a total of 307 patients, 237 with relapsing disease course and 70 with secondary progressive disease course. We investigated by regression analysis the relation between initial count of gadolinium-enhancing lesions and subsequent worsening of disability or impairment as measured by the expanded disability status scale (EDSS) and relapse rate. FINDINGS: The relapse rate in the first year was predicted with moderate ability by the mean number of gadolinium-enhancing lesions in monthly scans during the first 6 months (relative risk per five lesions 1.13, p=0.023). The predictive value of the number of gadolinium-enhancing lesions in one baseline scan was less strong. The best predictor for relapse rate was the variation (SD) of lesion counts in the first six monthly scans which allowed an estimate of relapse in the first year (relative risk 1.2, p=0.020) and in the second year (risk ratio=1.59, p=0.010). Neither the initial scan nor monthly scans over six months were predictive of change in the EDSS in the subsequent 12 months or 24 months. The mean of gadolinium-enhancing-lesion counts in the first six monthly scans was weakly predictive of EDSS change after 1 year (odds ratio=1.34, p=0.082) and 2 years (odds ratio=1.65, p=0.049). INTERPRETATION: Although disturbance of the blood-brain barrier as shown by gadolinium enhancement in MRI is a predictor of the occurrence of relapses, it is not a strong predictor of the development of cumulative impairment or disability. This discrepancy supports the idea that variant pathogenetic mechanisms are operative in the occurrence of relapses and in the development of long-term disability in MS.
CR Guttmann, R Kikinis, MC Anderson, M Jakab, SK Warfield, RJ Killiany, HL Weiner, and FA Jolesz. 1999. “Quantitative follow-up of patients with multiple sclerosis using MRI: reproducibility.” J Magn Reson Imaging, 9, 4, Pp. 509-18.Abstract
The reproducibility of an automated method for estimating the volume of white matter abnormalities on brain magnetic resonance (MR) images of multiple sclerosis (MS) patients was evaluated. Twenty MS patients underwent MR imaging twice within 30 minutes. Measurement variability is introduced mainly by MRI acquisition and image registration procedures, which demonstrate significantly worse reproducibility than the image segmentation. The correction of partial volume artifacts is essential for sensitive measurements of overall lesion burden. The average lesion volume difference (bias) between two MR exams of the same MS patient (N = 20) was 0.05 cm3, with a 95% confidence interval between -0.17 and +0.28 cm3, suggesting that the proposed measurement system is suitable for clinical follow-up trials, even in relatively small patient cohorts. The limits of agreement for lesion volume were between -1.3 and +1.5 cm3, implying that in individual patients changes in lesion load need to be at least this large to be detected reliably. This automated method for estimating lesion burden is a reliable tool for the evaluation of MS progression and exacerbation in patient cohorts and potentially also in individual patients.
R Kikinis, CR Guttmann, D Metcalf, WM Wells, GJ Ettinger, HL Weiner, and FA Jolesz. 1999. “Quantitative follow-up of patients with multiple sclerosis using MRI: technical aspects.” J Magn Reson Imaging, 9, 4, Pp. 519-30.Abstract
A highly reproducible automated procedure for quantitative analysis of serial brain magnetic resonance (MR) images was developed for use in patients with multiple sclerosis (MS). The intracranial cavity (ICC) was identified on standard dual-echo spin-echo brain MR images using a supervised automated procedure. MR images obtained from one MS patient at 24 time points in the course of a 1-year follow-up were aligned with the images of one of the time points. Next, the contents of the ICC in each MR exam were segmented into four tissues, using a self-adaptive statistical algorithm. Misclassifications due to partial voluming were corrected using a combination of morphologic operators and connectivity criteria. Finally, a connectivity detection algorithm was used to separate the tissue classified as lesions into individual entities. Registration, classification of the contents of the ICC, and identification of individual lesions are fully automatic. Only identification of the ICC requires operator interaction. In each MR exam, the program estimated volumes for the ICC, gray matter (GM), white matter (WM), white matter lesions (WML), and cerebrospinal fluid (CSF). The reproducibility of the system was superior to that of supervised segmentation, as evidenced by the coefficient of variation: CSF supervised 45.9% vs. automated 7.7%, GM 16.0% vs. 1.4%, WM 15.7% vs. 1.3%, and WML 39.5% vs 52.0%. Our results demonstrate that this computerized procedure allows routine reproducible quantitative analysis of large serial MRI data sets.
R Kikinis, CR Guttmann, D Metcalf, WM Wells, GJ Ettinger, HL Weiner, and FA Jolesz. 1999. “Quantitative follow-up of patients with multiple sclerosis using MRI: technical aspects.” J Magn Reson Imaging, 9, 4, Pp. 519-30.Abstract
A highly reproducible automated procedure for quantitative analysis of serial brain magnetic resonance (MR) images was developed for use in patients with multiple sclerosis (MS). The intracranial cavity (ICC) was identified on standard dual-echo spin-echo brain MR images using a supervised automated procedure. MR images obtained from one MS patient at 24 time points in the course of a 1-year follow-up were aligned with the images of one of the time points. Next, the contents of the ICC in each MR exam were segmented into four tissues, using a self-adaptive statistical algorithm. Misclassifications due to partial voluming were corrected using a combination of morphologic operators and connectivity criteria. Finally, a connectivity detection algorithm was used to separate the tissue classified as lesions into individual entities. Registration, classification of the contents of the ICC, and identification of individual lesions are fully automatic. Only identification of the ICC requires operator interaction. In each MR exam, the program estimated volumes for the ICC, gray matter (GM), white matter (WM), white matter lesions (WML), and cerebrospinal fluid (CSF). The reproducibility of the system was superior to that of supervised segmentation, as evidenced by the coefficient of variation: CSF supervised 45.9% vs. automated 7.7%, GM 16.0% vs. 1.4%, WM 15.7% vs. 1.3%, and WML 39.5% vs 52.0%. Our results demonstrate that this computerized procedure allows routine reproducible quantitative analysis of large serial MRI data sets.
SS Yoo, CR Guttmann, L Zhao, and LP Panych. 1999. “Real-time adaptive functional MRI.” Neuroimage, 10, 5, Pp. 596-606.Abstract
Adaptively limiting image acquisition to areas of interest will allow more efficient data acquisition time for in-depth characterization of areas of brain activation. We designed and implemented an adaptive image acquisition scheme that uses a multiresolution-based strategy to zoom into the regions of cortical activity. Real-time pulse prescription and data processing capabilities were combined with spatially selective radiofrequency encoding. The method was successfully demonstrated in volunteers performing simple sensorimotor paradigms for simultaneous activation of primary motor and cerebellar areas. We believe that real-time adaptation of spatial and temporal sampling to task-related changes will increase the efficiency and flexibility of functional mapping experiments. Contrast-to-noise analysis in selected regions-of-interest was performed to quantitatively assess the multiresolution adaptive approach.
S Bao, CR Guttmann, JP Mugler, JR Brookeman, LP Panych, RA Kraft, K Oshio, D Jaramillo, FA Jolesz, DS Williamson, and RV Mulkern. 1999. “Spin-Echo planar spectroscopic imaging for fast lipid characterization in bone marrow.” Magn Reson Imaging, 17, 8, Pp. 1203-10.Abstract
Lipid characterization of bone marrow in vivo with proton magnetic resonance spectroscopy was performed using Spin-Echo Planar Spectroscopic Imaging sequences. The methods are shown capable of rapidly generating two-dimensional chemical shift imaging data sets suitable for measuring lipid indices that reflect unsaturation levels among triglycerides, as demonstrated in oil phantoms and bone marrow from a healthy volunteer. The volume coverage, spatial resolution, acquisition speed, and spectral characteristics of Spin-Echo Planar Spectroscopic Imaging should make it attractive for clinical studies of diseases affecting normal lipid chemical composition.
1998
RB Schwartz, L Hsu, DF Kacher, TZ Wong, E Alexander, S Okon, CR Guttmann, PM Black, RA Kelley, T Moriarty, C Martin, HG Isbister, CD Cahill, SA Spaulding, and FA Jolesz. 1998. “Intraoperative dynamic MRI: localization of sites of brain tumor recurrence after high-dose radiotherapy.” J Magn Reson Imaging, 8, 5, Pp. 1085-9.Abstract
In patients with malignant astrocytomas or metastatic brain disease treated with high-dose radiotherapy, conventional imaging methods may not adequately distinguish recurrent tumor from radiation change. We used a fast spoiled gradient refocusing technique in the open-configuration intraoperative MR system to assess the rate of regional enhancement of the treated tumor bed and to localize specific sites for pathologic sampling to determine whether gadolinium uptake correlated with histologic data. Twenty-four patients were studied. Fourteen of 15 patients with areas of early enhancement had recurrent tumor present in histologic samples, and 8 of the remaining 9 patients had only reactive changes. Dynamic MRI was predictive of recurrent tumor (P < .0005, Fisher exact test and P < .002, Student t test). We conclude that dynamic MRI in the open-bore magnet is a promising method for localizing potential sites of active tumor growth in patients treated for malignant astrocytomas and metastatic brain lesions.
CR Guttmann, FA Jolesz, R Kikinis, RJ Killiany, MB Moss, T Sandor, and MS Albert. 1998. “White matter changes with normal aging.” Neurology, 50, 4, Pp. 972-8.Abstract
We evaluated brain tissue compartments in 72 healthy volunteers between the ages of 18 and 81 years with quantitative MRI. The intracranial fraction of white matter was significantly lower in the age categories above 59 years. The CSF fraction increased significantly with age, consistent with previous reports. The intracranial percentage of gray matter decreased somewhat with age, but there was no significant difference between the youngest subjects and the subjects above 59. A covariance adjustment for the volume of hyperintensities did not alter the foregoing results. The intracranial percentage of white matter volume was strongly correlated with the percentage volume of CSF. The finding of a highly significant decrease with age in white matter, in the absence of a substantial decrease in gray matter, is consistent with recent neuropathologic reports in humans and nonhuman primates.

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