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Sample records for fluid-attenuated whole-brain imaging

  1. Rapid hybrid encoding for high-resolution whole-brain fluid-attenuated imaging.

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    Lee, Hoonjae; Sohn, Chul-Ho; Park, Jaeseok

    2013-12-01

    Single-slab three-dimensional (3D) turbo spin-echo (TSE) imaging combined with inversion recovery (IR), which employs short, spatially non-selective refocusing pulses and signal prescription based variable refocusing flip angles (VFA) to increase imaging efficiency, was recently introduced to produce fluid-attenuated brain images for lesion detection. Despite the advantages, the imaging efficiency in this approach still remains limited because a substantially long time of inversion is needed to selectively suppress the signal intensity of cerebrospinal fluid (CSF) while fully recovering that of brain tissues. The purpose of this work is to develop a novel, rapid hybrid encoding method for highly efficient whole-brain fluid-attenuated imaging. In each time of repetition, volumetric data are continuously encoded using the hybrid modular acquisition in a sequential fashion even during IR signal transition, wherein reversed fast imaging with steady-state free precession (PSIF) is employed to encode intermediate-to-high spatial frequency signals prior to CSF nulling, while VFA-TSE is used to collect low-to-intermediate spatial frequency signals afterwards. Gradient-induced spin de-phasing between a pair of neighboring radio-frequency (RF) pulses in both PSIF and TSE modules is kept identical to avoid the occurrence of multiple echoes in a single acquisition window. Additionally, a two-step, alternate RF phase-cycling scheme is employed in the low spatial frequency region to eliminate free induction decay induced edge artifacts. Numerical simulations of the Bloch equations were performed to evaluate signal evolution of brain tissues along the echo train while optimizing imaging parameters. In vivo studies demonstrate that the proposed technique produces high-resolution isotropic fluid-attenuated whole-brain images in a clinically acceptable imaging time with substantially high signal-to-noise ratio for white matter while retaining lesion conspicuity.

  2. Whole-brain dynamic CT angiography and perfusion imaging

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    Orrison, W.W. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Department of Medical Education, University of Nevada School of Medicine, Reno, NV (United States); Snyder, K.V.; Hopkins, L.N. [Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Buffalo, NY (United States); Roach, C.J. [School of Life Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Ringdahl, E.N. [Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV (United States); Nazir, R. [Shifa International Hospital, Islamabad (Pakistan); Hanson, E.H., E-mail: eric.hanson@amigenics.co [College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States)

    2011-06-15

    The availability of whole brain computed tomography (CT) perfusion has expanded the opportunities for analysing the haemodynamic parameters associated with varied neurological conditions. Examples demonstrating the clinical utility of whole-brain CT perfusion imaging in selected acute and chronic ischaemic arterial neurovascular conditions are presented. Whole-brain CT perfusion enables the detection and focused haemodynamic analyses of acute and chronic arterial conditions in the central nervous system without the limitation of partial anatomical coverage of the brain.

  3. Whole brain imaging with Serial Two-Photon Tomography

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    Stephen P Amato

    2016-03-01

    Full Text Available Imaging entire mouse brains at submicron resolution has historically been a challenging undertaking and largely confined to the province of dedicated atlasing initiatives. The has limited systematic investigations into important areas of neuroscience, such as neural circuits, brain mapping and neurodegeneration. In this paper, we describe in detail Serial Two-Photon (STP tomography, a robust, reliable method for imaging entire brains with histological detail. We provide examples of how the basic methodology can be extended to other imaging modalities, such as optical coherence tomography, in order to provide unique contrast mechanisms. Furthermore we provide a survey of the research that STP tomography has enabled in the field of neuroscience, provide examples of how this technology enables quantitative whole brain studies, and discuss the current limitations of STP tomography-based approaches

  4. Whole Brain Magnetic Resonance Image Atlases: A Systematic Review of Existing Atlases and Caveats for Use in Population Imaging

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    Dickie, David Alexander; Shenkin, Susan D.; Anblagan, Devasuda; Lee, Juyoung; Blesa Cabez, Manuel; Rodriguez, David; Boardman, James P.; Waldman, Adam; Job, Dominic E.; Wardlaw, Joanna M.

    2017-01-01

    Brain MRI atlases may be used to characterize brain structural changes across the life course. Atlases have important applications in research, e.g., as registration and segmentation targets to underpin image analysis in population imaging studies, and potentially in future in clinical practice, e.g., as templates for identifying brain structural changes out with normal limits, and increasingly for use in surgical planning. However, there are several caveats and limitations which must be considered before successfully applying brain MRI atlases to research and clinical problems. For example, the influential Talairach and Tournoux atlas was derived from a single fixed cadaveric brain from an elderly female with limited clinical information, yet is the basis of many modern atlases and is often used to report locations of functional activation. We systematically review currently available whole brain structural MRI atlases with particular reference to the implications for population imaging through to emerging clinical practice. We found 66 whole brain structural MRI atlases world-wide. The vast majority were based on T1, T2, and/or proton density (PD) structural sequences, had been derived using parametric statistics (inappropriate for brain volume distributions), had limited supporting clinical or cognitive data, and included few younger (>5 and 60 years) subjects. To successfully characterize brain structural features and their changes across different stages of life, we conclude that whole brain structural MRI atlases should include: more subjects at the upper and lower extremes of age; additional structural sequences, including fluid attenuation inversion recovery (FLAIR) and T2* sequences; a range of appropriate statistics, e.g., rank-based or non-parametric; and detailed cognitive and clinical profiles of the included subjects in order to increase the relevance and utility of these atlases. PMID:28154532

  5. Protoneus-sequence: extended fluid-attenuated inversion recovery MR imaging without and with contrast enhancement

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    Nasel, Christian [Division of Neuroradiology, Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)]. E-mail: christian.nasel@perfusion.at

    2005-08-01

    Fluid-attenuated inversion recovery imaging (=flair imaging) is widely used as primary screening sequence in various investigation protocols, due to its high lesion contrast and sensitivity in detection of parenchymatous and leptomeningeal disease. An additional increase of sensitivity for detection of lesions may be achieved by contrast-enhanced flair imaging. Based on flair imaging a dual-echo inversion recovery imaging sequence (=proton echo usage [=protoneus] - sequence) was developed, which could significantly extend the possibilities of conventional flair imaging.

  6. Whole brain myelin mapping using T1- and T2-weighted MR imaging data

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    Marco eGanzetti

    2014-09-01

    Full Text Available Despite recent advancements in MR imaging, non-invasive mapping of myelin in the brain still remains an open issue. Here we attempted to provide a potential solution. Specifically, we developed a processing workflow based on T1-w and T2-w MR data to generate an optimized myelin enhanced contrast image. The workflow allows whole brain mapping using the T1-w/T2-w technique, which was originally introduced as a non-invasive method for assessing cortical myelin content. The hallmark of our approach is a retrospective calibration algorithm, applied to bias-corrected T1-w and T2-w images, that relies on image intensities outside the brain. This permits standardizing the intensity histogram of the ratio image, thereby allowing for across-subject statistical analyses. Quantitative comparisons of image histograms within and across different datasets confirmed the effectiveness of our normalization procedure. Not only did the calibrated T1-w/T2-w images exhibit a comparable intensity range, but also the shape of the intensity histograms was largely corresponding. We also assessed the reliability and specificity of the ratio image compared to other MR-based techniques, such as magnetization transfer ratio, fractional anisotropy and fluid-attenuated inversion recovery. With respect to these other techniques, T1-w/T2-w had consistently high values, as well as low inter-subject variability, in brain structures where myelin is most abundant. Overall, our results suggested that the T1-w/T2-w technique may be a valid tool supporting the non-invasive mapping of myelin in the brain. Therefore, it might find important applications in the study of brain development, aging and disease.

  7. MR fluid-attenuated inversion recovery imaging as routine brain T2-weighted imaging

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    Arakia, Yutaka; Ashikaga, Ryuichiro; Fujii, Koichi; Nishimura, Yasumasa; Ueda, Jun; Fujita, Norihiko

    1999-11-01

    We tried to investigate if magnetic resonance (MR) fluid-attenuated inversion recovery (FLAIR) imaging can be used as a routine brain screening examination instead of spin-echo T2-weighted imaging. Three hundred and ninety-four patients with clinically suspected brain diseases were randomly selected and examined with both brain MR FLAIR and T2-weighted imaging on the axial plane. These two imaging techniques were evaluated by two neuroradiologists as to which imaging was better for routine brain T2-weighted imaging. In 123 of 394 cases (31%), FLAIR imaging was superior to spin-echo T2-weighted imaging. Especially in cases with inflammatory diseases, traumatic diseases and demyelinating diseases, FLAIR imaging was particularly useful. Small lesions bordering cerebrospinal fluid (CSF) are often detected only by FLAIR imaging. In 259 cases (66%), including 147 normal cases (37%), they were equally evaluated. Only in 12 cases (3%) was conventional T2-weighted imaging superior to FLAIR imaging. Cerebrovascular lesions like cerebral aneurysm and Moyamoya disease could not be detected on FLAIR images because these structures were obscured by a low signal from the CSF. Also, because old infarctions tend to appear as low signal intensity on FLAIR images, the condition was sometimes hard to detect. Finally, FLAIR imaging could be used as routine brain T2-weighted imaging instead of conventional spin-echo T2-weighted imaging if these vascular lesions were watched.

  8. SU-E-J-171: Surface Imaging Based Intrafraction Motion Assessments for Whole Brain Radiotherapy

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    Wiant, D; Vanderstraeten, C; Maurer, J; Pursley, J; Terrell, J; Sintay, B [Cone Health Cancer Center, Greensboro, NC (United States)

    2014-06-01

    Purpose: To quantify and characterize intrafraction motion for whole brain radiotherapy treatments in open face masks using 3D surface imaging. Methods: Fifteen whole brain patients were monitored with 3D surface imaging over a total of 202 monitoring sessions. Mean translations and rotations were calculated over each minute, each session, and over all sessions combined. The percentage of each session that the root mean square (RMS) of the linear translations were outside of 2 mm, 3 mm, 4 mm, and 5 mm were determined for each patient. Correlations between mean translations per minute and time and between standard deviation per minute and time were evaluated using Pearson's r value. Results: The mean RMS translation averaged over all patients was 1.45 mm +/− 1.52 mm. The patients spent an average of 18%, 10%, 6%, and 3% of the monitoring time outside of 2 mm, 3 mm, 4 mm, and 5 mm RMS tolerances, respectively. The RMS values averaged over all patients were 1.31 mm +/− 0.98 mm, 1.52 +/- 1.04, and 1.30 mm +/− 0.71 mm over the 1th, 5th, and 10th minutes of monitoring, respectively. Neither, the RMS values (p = 0.15) or the standard deviations of the RMS values (p = 0.16) showed significant correlations with time. Conclusion: The patients were positioned within 2 mm of isocenter, which was the initial set-up tolerance, for the majority of their treatments. The average position changed by < 0.3 mm over 10 minutes of monitoring. Short term movements, reflected by the standard deviations, where on the order of 1 mm. This immobilization system provides adequate immobilization over a course of treatment for whole brain radiotherapy. This system may also be suitable for head and neck or stereotactic radiosurgery treatments as well.

  9. Whole-brain perfusion imaging with balanced steady-state free precession arterial spin labeling.

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    Han, Paul Kyu; Ye, Jong Chul; Kim, Eung Yeop; Choi, Seung Hong; Park, Sung-Hong

    2016-03-01

    Recently, balanced steady-state free precession (bSSFP) readout has been proposed for arterial spin labeling (ASL) perfusion imaging to reduce susceptibility artifacts at a relatively high spatial resolution and signal-to-noise ratio (SNR). However, the main limitation of bSSFP-ASL is the low spatial coverage. In this work, methods to increase the spatial coverage of bSSFP-ASL are proposed for distortion-free, high-resolution, whole-brain perfusion imaging. Three strategies of (i) segmentation, (ii) compressed sensing (CS) and (iii) a hybrid approach combining the two methods were tested to increase the spatial coverage of pseudo-continuous ASL (pCASL) with three-dimensional bSSFP readout. The spatial coverage was increased by factors of two, four and six using each of the three approaches, whilst maintaining the same total scan time (5.3 min). The number of segments and/or CS acceleration rate (R) correspondingly increased to maintain the same bSSFP readout time (1.2 s). The segmentation approach allowed whole-brain perfusion imaging for pCASL-bSSFP with no penalty in SNR and/or total scan time. The CS approach increased the spatial coverage of pCASL-bSSFP whilst maintaining the temporal resolution, with minimal impact on the image quality. The hybrid approach provided compromised effects between the two methods. Balanced SSFP-based ASL allows the acquisition of perfusion images with wide spatial coverage, high spatial resolution and SNR, and reduced susceptibility artifacts, and thus may become a good choice for clinical and neurological studies. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Diffusion-weighted imaging and fluid attenuated inversion recovery imaging in the evaluation of primitive neuroectodermal tumors

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    Erdem, E.; Zimmerman, R.A.; Haselgrove, J.C.; Bilaniuk, L.T.; Hunter, J.V. [Hospital of the Univ. of Pennsylvania (HUP), Philadelphia (United States). Dept. of Radiology

    2001-11-01

    The aim of our study was to determine whether fluid-attenuated inversion recovery (FLAIR) imaging and diffusion-weighted imaging (DWI) would be helpful in characterizing primitive neuroectodermal tumors (PNET) from other pediatric brain tumors. We expected that the compact cellular nature and the relatively small extracellular space of this tumor would affect the signal intensity on both pulse sequences relative to the more sparsely cellular glial tumors that have larger extracellular spaces. Eighteen pediatric patients with PNET were examined on a 1.5 T MRI with routine imaging plus FLAIR and compared with 28 patients with non-PNET. DWI was also performed in 7 PNET and 18 non-PNET. Seventy-eight percent of PNET were isointense to gray matter on FLAIR while 82 % of non-PNET were hyperintense and only one was isointense (3 %). Diffusion was abnormally restricted in all 7 PNET examined (100 %) but was restricted in non-PNET in only 1 out of 18 (6 %) patients who had DWI. The differences in the histologic architecture between PNET and non-PNET are reflected in both FLAIR imaging and in DWI. (orig.)

  11. Single shot whole brain imaging using spherical stack of spirals trajectories.

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    Assländer, Jakob; Zahneisen, Benjamin; Hugger, Thimo; Reisert, Marco; Lee, Hsu-Lei; LeVan, Pierre; Hennig, Jürgen

    2013-06-01

    MR-encephalography allows the observation of functional signal in the brain at a frequency of 10 Hz, permitting filtering of physiological "noise" and the detection of single event activations. High temporal resolution is achieved by the use of undersampled non-Cartesian trajectories, parallel imaging and regularized image reconstruction. MR-encephalography is based on 3D-encoding, allowing undersampling in two dimensions and providing advantages in terms of signal to noise ratio. Long readout times, which are necessary for single shot whole brain imaging (up to 75 ms), cause off-resonance artifacts. To meet this issue, a spherical stack of spirals trajectory is proposed in this work. By examining the trajectories in local k-space, it is shown that in areas of strong susceptibility gradients spatial information is fundamentally lost, making a meaningful image reconstruction impossible in the affected areas. It is shown that the loss of spatial information is reduced when using a stack of spirals trajectory compared to concentric shells.

  12. Whole-brain calcium imaging with cellular resolution in freely behaving Caenorhabditis elegans.

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    Nguyen, Jeffrey P; Shipley, Frederick B; Linder, Ashley N; Plummer, George S; Liu, Mochi; Setru, Sagar U; Shaevitz, Joshua W; Leifer, Andrew M

    2016-02-23

    The ability to acquire large-scale recordings of neuronal activity in awake and unrestrained animals is needed to provide new insights into how populations of neurons generate animal behavior. We present an instrument capable of recording intracellular calcium transients from the majority of neurons in the head of a freely behaving Caenorhabditis elegans with cellular resolution while simultaneously recording the animal's position, posture, and locomotion. This instrument provides whole-brain imaging with cellular resolution in an unrestrained and behaving animal. We use spinning-disk confocal microscopy to capture 3D volumetric fluorescent images of neurons expressing the calcium indicator GCaMP6s at 6 head-volumes/s. A suite of three cameras monitor neuronal fluorescence and the animal's position and orientation. Custom software tracks the 3D position of the animal's head in real time and two feedback loops adjust a motorized stage and objective to keep the animal's head within the field of view as the animal roams freely. We observe calcium transients from up to 77 neurons for over 4 min and correlate this activity with the animal's behavior. We characterize noise in the system due to animal motion and show that, across worms, multiple neurons show significant correlations with modes of behavior corresponding to forward, backward, and turning locomotion.

  13. Problems with diagnosis by fluid-attenuated inversion recovery magnetic resonance imaging in patients with acute aneurysmal subarachnoid hemorrhage.

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    Shimoda, Masami; Hoshikawa, Kaori; Shiramizu, Hideki; Oda, Shinri; Matsumae, Mitsunori

    2010-01-01

    The diagnostic efficacy of fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging and computed tomography (CT) for acute subarachnoid hemorrhage (SAH) were compared and the problems with diagnosis were investigated in 81 patients with aneurysmal SAH within 24 hours after onset who underwent FLAIR imaging and CT on admission. The number of hematomas in the cisterns and ventricles were evaluated by clot scores. In addition, the frequency of undetected hematomas was calculated for the cisterns and ventricles. Clot scores were significantly higher for FLAIR imaging than for CT in the lateral sylvian, quadrigeminal, and convexity cisterns. On the other hand, clot scores were significantly higher for CT than for FLAIR imaging in the interhemispheric and medial sylvian cisterns. The overall frequency of undetected SAH was 2% for FLAIR imaging and 14% for CT. With the exception of the interhemispheric and medial sylvian cisterns, the frequency of undetected SAH was higher for CT than for FLAIR imaging. In this study, FLAIR imaging was more sensitive than CT for the detection of acute SAH within 24 hours after onset. However, the diagnostic efficacy of FLAIR imaging was reduced in comparatively tight cisterns.

  14. Leptomeningeal high signal intensity (ivy sign) on fluid-attenuated inversion-recovery (FLAIR) MR images in moyamoya disease

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    Fujiwara, Hirokazu [Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo 1608582 (Japan)]. E-mail: hirokazu_fujiwara@ybb.ne.jp; Momoshima, Suketaka [Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo 1608582 (Japan); Kuribayashi, Sachio [Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo 1608582 (Japan)

    2005-08-01

    Purpose: There are a few reports on leptomeningeal high signal intensity (LMHI: ivy sign) on fluid-attenuated inversion-recovery (FLAIR) images in moyamoya disease, but the feature of this finding has not been completely understood. The purpose of this study was to characterize LMHI on FLAIR images in moyamoya disease and to assess usefulness of this finding in the diagnosis of moyamoya disease in conventional MR imaging. Material and methods: MR imaging of 28 patients with moyamoya disease was retrospectively reviewed. The grade of LMHI on FLAIR images was classified as 'absent,' 'minimal,' 'moderate' and 'marked.' Fifty-four hemispheres of 28 patients (2 patients had unilateral disease) were assessed for the frequency of visualization and distribution of LMHI. The correlations between LMHI on FLAIR images, moyamoya vessels on T1- and T2-weighted images and MR angiography findings were also analyzed. Results: Moderate and marked LMHI was seen in 31 out of 54 hemispheres (57%). LMHI was seen more prominently in the frontal and parietal lobes than in the temporal and occipital lobes. Although there was a tendency for LMHI on FLAIR images to be prominent in groups with moderate and marked moyamoya vessels on T1- and T2-weighted images, there was no significant correlation. More prominent LMHI was observed in the hemispheres in which cortical branches of the middle cerebral arteries were poorly visualized on MR angiography. Conclusion: Leptomeningeal high signal intensity (ivy sign) on FLAIR images is predominantly seen in the frontal and parietal lobes. Because this sign can be seen in patients with unremarkable moyamoya vessels, LMHI is a useful sign in conventional MR imaging for the diagnosis of moyamoya disease.

  15. Application of variable threshold intensity to segmentation for white matter hyperintensities in fluid attenuated inversion recovery magnetic resonance images

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    Yoo, Byung Il; Han, Ji Won; Oh, San Yeo Wool; Kim, Tae Hui [Seoul National University Bundang Hospital, Department of Neuropsychiatry, Seongnam, Gyeonggi-do (Korea, Republic of); Lee, Jung Jae; Lee, Eun Young [Kyungbook National University Chilgok Hospital, Department of Psychiatry, Buk-gu, Daegu (Korea, Republic of); MacFall, James R. [Duke University Medical Center, Neuropsychiatric Imaging Research Laboratory, Durham, NC (United States); Duke University Medical Center, Department of Radiology, Durham, NC (United States); Payne, Martha E. [Duke University Medical Center, Neuropsychiatric Imaging Research Laboratory, Durham, NC (United States); Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC (United States); Kim, Jae Hyoung [Seoul National University Bundang Hospital, Department of Radiology, Seongnam, Gyeonggi-do (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Kim, Ki Woong [Seoul National University Bundang Hospital, Department of Neuropsychiatry, Seongnam, Gyeonggi-do (Korea, Republic of); Seoul National University College of Medicine, Department of Psychiatry, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Natural Sciences, Department of Brain and Cognitive Science, Gwanak-gu, Seoul (Korea, Republic of)

    2014-04-15

    White matter hyperintensities (WMHs) are regions of abnormally high intensity on T2-weighted or fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI). Accurate and reproducible automatic segmentation of WMHs is important since WMHs are often seen in the elderly and are associated with various geriatric and psychiatric disorders. We developed a fully automated monospectral segmentation method for WMHs using FLAIR MRIs. Through this method, we introduce an optimal threshold intensity (I{sub O}) for segmenting WMHs, which varies with WMHs volume (V{sub WMH}), and we establish the I{sub O} -V{sub WMH} relationship. Our method showed accurate validations in volumetric and spatial agreements of automatically segmented WMHs compared with manually segmented WMHs for 32 confirmatory images. Bland-Altman values of volumetric agreement were 0.96 ± 8.311 ml (bias and 95 % confidence interval), and the similarity index of spatial agreement was 0.762 ± 0.127 (mean ± standard deviation). Furthermore, similar validation accuracies were obtained in the images acquired from different scanners. The proposed segmentation method uses only FLAIR MRIs, has the potential to be accurate with images obtained from different scanners, and can be implemented with a fully automated procedure. In our study, validation results were obtained with FLAIR MRIs from only two scanner types. The design of the method may allow its use in large multicenter studies with correct efficiency. (orig.)

  16. Clinical implications of sulcal enhancement on postcontrast fluid attenuated inversion recovery images in patients with acute stroke symptoms

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    Lee, Hyuk Joon; Kim, Eun Hee; Lee, Kyung Mi; Kim, Jae Hyoung; Bae, Yun Jung; Choi, Byoung Se; Jung, Cheol Kyu [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-08-15

    Hyperintense acute reperfusion marker (HARM) without diffusion abnormalities is occasionally found in patients with an acute stroke. This study was to determine the prevalence and clinical implications of HARM without diffusion abnormalities. There was a retrospective review of magnetic resonance images 578 patients with acute strokes and identified those who did not have acute infarction lesions, as mapped by diffusion-weighted imaging (DWI). These patients were classified into an imaging-negative stroke and HARM without diffusion abnormalities groups, based on the DWI findings and postcontrast fluid attenuated inversion recovery images. The National Institutes of Health Stroke Scale (NIHSS) scores at admission, 1 day, and 7 days after the event, as well as clinical data and risk factors, were compared between the imaging-negative stroke and HARM without diffusion abnormalities groups. Seventy-seven acute stroke patients without any DWI abnormalities were found. There were 63 patients with an imaging-negative stroke (accounting for 10.9% of 578) and 13 patients with HARM without diffusion abnormalities (accounting for 2.4% of 578). The NIHSS scores at admission were higher in HARM without diffusion abnormalities group than in the imaging-negative stroke group (median, 4.5 vs. 1.0; p < 0.001), but the scores at 7 days after the event were not significantly different between the two groups (median, 0 vs. 0; p = 1). The patients with HARM without diffusion abnormalities were significantly older, compared with patients with an imaging-negative stroke (mean, 73.1 years vs. 55.9 years; p < 0.001). Patients with HARM without diffusion abnormalities are older and have similarly favorable short-term neurological outcomes, compared with the patients with imaging-negative stroke.

  17. Evolution of Volume and Signal Intensity on Fluid-attenuated Inversion Recovery MR Images after Endovascular Stroke Therapy.

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    Federau, Christian; Mlynash, Michael; Christensen, Soren; Zaharchuk, Greg; Cha, Brannon; Lansberg, Maarten G; Wintermark, Max; Albers, Gregory W

    2016-07-01

    Purpose To analyze both volume and signal evolution on magnetic resonance (MR) fluid-attenuated inversion recovery (FLAIR) images between the images after endovascular therapy and day 5 (which was the prespecified end point for infarct volume in the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution [DEFUSE 2] trial) in a subset of patients enrolled in the DEFUSE 2 study. Materials and Methods This study was approved by the local ethics committee at all participating sites. Informed written consent was obtained from all patients. In this post hoc analysis of the DEFUSE 2 study, 35 patients with FLAIR images acquired both after endovascular therapy (median time after symptom onset, 12 hours) and at day 5 were identified. Patients were separated into two groups based on the degree of reperfusion achieved on time to maximum greater than 6-second perfusion imaging (≥90% vs <90%). After coregistration and signal normalization, lesion volumes and signal intensity were assessed by using FLAIR imaging for the initial lesion (ie, visible after endovascular therapy) and the recruited lesion (the additional lesion visible on day 5, but not visible after endovascular therapy). Statistical significance was assessed by using Wilcoxon signed-rank, Mann-Whitney U, and Fisher exact tests. Results All 35 patients had FLAIR lesion growth between the after-revascularization examination and day 5. Median lesion growth was significantly larger in patients with <90% reperfusion (27.85 mL) compared with ≥90% (8.12 mL; P = .003). In the initial lesion, normalized signal did not change between after endovascular therapy (median, 1.60) and day 5 (median, 1.58) in the ≥90% reperfusion group (P = .97), but increased in the <90% reperfusion group (from 1.60 to 1.73; P = .01). In the recruited lesion, median normalized signal increased significantly in both groups between after endovascular therapy and day 5 (after endovascular therapy, from 1.19 to 1.56, P

  18. Image analysis of intracranial high perfusion lesion by whole brain one-stop imaging technique with 320 detector rows CT

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    Fei-zhou DU

    2014-03-01

    Full Text Available Objective  The perfusion and vascular architecture features were investigated and evaluated by use of one-stop imaging technique with 320 rows CT for exploring the clinical value of one-stop imaging technique in the diagnosis of intracranial lesions. Methods  The perfusion parameters and vascular architecture of intracranial high perfusion lesions of 52 patients were collected in General Hospital of Chengdu Command from Oct. 2010 to Apr. 2013, who were examined by one-stop imaging technique with 320 rows CT, were retrospectively analyzed. The perfusion values of normal contralateral cerebral tissue were used as control to analyze the perfusion and vascular architecture features of injured parts. Results  Of the 52 patients, there were 16 cases of subacute cerebral infarction, 9 cases of arteriovenous malformation, 7 cases of hemangioma, 12 cases of meningioma, and 8 cases of glioma. All the patients showed elevated CBV and/or CBF and different changes in mean transit time (MTT, time to peak (TTP and delay time (Delay. In the cases of subacute cerebral infarction, the parameters of MTT, TTP and Delay increased. In the cases of arteriovenous malformation, all the parameters decreased. In the cases of hemangioma, the MTT decreased, while TTP and Delay increased. In the cases of glioma, the TTP and Delay increased, while the change of MTT varied. Meanwhile, abnormality of vascular structures was found in all the cases by CT angiography. Conclusion  With whole brain perfusion and one-stop vascular imaging with 320 rows CT, the perfusion characteristics of intracranial lesions can be revealed completely, including blood supply and microcirculation changes in the lesions, and it may be of benefit in guiding the clinical diagnosis and treatment. DOI: 10.11855/j.issn.0577-7402.2014.03.10

  19. Clinical characteristics of unknown symptom onset stroke patients with and without diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch

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    Thomalla, Götz; Boutitie, Florent; Fiebach, Jochen B.

    2017-01-01

    Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI...... onset. Clinical characteristics were compared between patients with and without DWI-FLAIR mismatch. Results Of 699 patients included, 418 (59.8%) presented with DWI-FLAIR mismatch. A shorter delay between last seen well and symptom recognition (p = 0.0063), a shorter delay between symptom recognition...

  20. Total Bolus Extraction Method Improves Arterial Image Quality in Dynamic CTAs Derived from Whole-Brain CTP Data

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    Elyas Ghariq

    2014-01-01

    Full Text Available Background and Purposes. The 320-detector row CT scanner enables visualization of whole-brain hemodynamic information (dynamic CT angiography (CTA derived from CT perfusion scans. However, arterial image quality in dynamic CTA (dCTA is inferior to arterial image quality in standard CTA. This study evaluates whether the arterial image quality can be improved by using a total bolus extraction (ToBE method. Materials and Methods. DCTAs of 15 patients, who presented with signs of acute cerebral ischemia, were derived from 320-slice CT perfusion scans using both the standard subtraction method and the proposed ToBE method. Two neurointerventionalists blinded to the scan type scored the arterial image quality on a 5-point scale in the 4D dCTAs in consensus. Arteries were divided into four categories: (I large extradural, (II intradural (large, medium, and small, (III communicating arteries, and (IV cerebellar and ophthalmic arteries. Results. Quality of extradural and intradural arteries was significantly higher in the ToBE dCTAs than in the standard dCTAs (extradural P=0.001, large intradural P<0.001, medium intradural P<0.001, and small intradural P<0.001. Conclusion. The 4D dCTAs derived with the total bolus extraction (ToBE method provide hemodynamic information combined with improved arterial image quality as compared to standard 4D dCTAs.

  1. Evaluation of Possible Prognostic Factors of Fulminant Acute Disseminated Encephalomyelitis (ADEM) on Magnetic Resonance Imaging with Fluid-Attenuated Inversion Recovery (FLAIR) and Diffusion-Weighted Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Donmez, F.Y.; Aslan, H.; Coskun, M. (Dept. of Radiology, Faculty of Medicine, Baskent Univ., Ankara (Turkey))

    2009-04-15

    Background: Acute disseminated encephalomyelitis (ADEM) may be a rapidly progressive disease with different clinical outcomes. Purpose: To investigate the radiological findings of fulminant ADEM on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) images, and to correlate these findings with clinical outcome. Material and Methods: Initial and follow-up magnetic resonance imaging (MRI) scans in eight patients were retrospectively evaluated for distribution of lesions on FLAIR images and presence of hemorrhage or contrast enhancement. DWI of the patients was evaluated as to cytotoxic versus vasogenic edema. The clinical records were analyzed, and MRI results and clinical outcome were correlated. Results: Four of the eight patients died, three had full recovery, and one had residual cortical blindness. The distribution of the hyperintense lesions on FLAIR sequence was as follows: frontal (37.5%), parietal (50%), temporal (37.5%), occipital (62.5%), basal ganglia (50%), pons (37.5%), mesencephalon (37.5%), and cerebellum (50%). Three of the patients who died had brainstem involvement. Two patients had a cytotoxic edema, one of whom died, and the other developed cortical blindness. Six patients had vasogenic edema: three of these patients had a rapid progression to coma and died; three of them recovered. Conclusion: DWI is not always helpful for evaluating the evolution or predicting the outcome of ADEM. However, extension of the lesions, particularly brainstem involvement, may have an influence on the prognosis.

  2. The hyperintense acute reperfusion marker on fluid-attenuated inversion recovery magnetic resonance imaging is caused by gadolinium in the cerebrospinal fluid.

    Science.gov (United States)

    Köhrmann, Martin; Struffert, Tobias; Frenzel, Thomas; Schwab, Stefan; Doerfler, Arnd

    2012-01-01

    The hyperintense acute reperfusion marker (HARM) on fluid-attenuated inversion recovery MRI is believed to be caused by gadolinium-based contrast agents crossing a disrupted blood-brain barrier. However, this hypothesis has never been directly verified in humans. In this study, we analyzed cerebrospinal fluid samples of patients with HARM on imaging regarding the presence and concentration of gadolinium-based contrast agents. Gadobutrol was found in concentrations of approximately 50 μmol/L. Using phantom MRI experiments, we demonstrate that the detected concentrations are consistent with the observed HARM imaging pattern. Our study yields first direct evidence in humans that the imaging phenomenon HARM is indeed caused by leakage of gadolinium-based contrast agents into the cerebrospinal fluid.

  3. Medical Image Processing for Fully Integrated Subject Specific Whole Brain Mesh Generation

    Directory of Open Access Journals (Sweden)

    Chih-Yang Hsu

    2015-05-01

    Full Text Available Currently, anatomically consistent segmentation of vascular trees acquired with magnetic resonance imaging requires the use of multiple image processing steps, which, in turn, depend on manual intervention. In effect, segmentation of vascular trees from medical images is time consuming and error prone due to the tortuous geometry and weak signal in small blood vessels. To overcome errors and accelerate the image processing time, we introduce an automatic image processing pipeline for constructing subject specific computational meshes for entire cerebral vasculature, including segmentation of ancillary structures; the grey and white matter, cerebrospinal fluid space, skull, and scalp. To demonstrate the validity of the new pipeline, we segmented the entire intracranial compartment with special attention of the angioarchitecture from magnetic resonance imaging acquired for two healthy volunteers. The raw images were processed through our pipeline for automatic segmentation and mesh generation. Due to partial volume effect and finite resolution, the computational meshes intersect with each other at respective interfaces. To eliminate anatomically inconsistent overlap, we utilized morphological operations to separate the structures with a physiologically sound gap spaces. The resulting meshes exhibit anatomically correct spatial extent and relative positions without intersections. For validation, we computed critical biometrics of the angioarchitecture, the cortical surfaces, ventricular system, and cerebrospinal fluid (CSF spaces and compared against literature values. Volumina and surface areas of the computational mesh were found to be in physiological ranges. In conclusion, we present an automatic image processing pipeline to automate the segmentation of the main intracranial compartments including a subject-specific vascular trees. These computational meshes can be used in 3D immersive visualization for diagnosis, surgery planning with haptics

  4. Comparison of accelerated T1-weighted whole-brain structural-imaging protocols.

    Science.gov (United States)

    Falkovskiy, Pavel; Brenner, Daniel; Feiweier, Thorsten; Kannengiesser, Stephan; Maréchal, Bénédicte; Kober, Tobias; Roche, Alexis; Thostenson, Kaely; Meuli, Reto; Reyes, Denise; Stoecker, Tony; Bernstein, Matt A; Thiran, Jean-Philippe; Krueger, Gunnar

    2016-01-01

    Imaging in neuroscience, clinical research and pharmaceutical trials often employs the 3D magnetisation-prepared rapid gradient-echo (MPRAGE) sequence to obtain structural T1-weighted images with high spatial resolution of the human brain. Typical research and clinical routine MPRAGE protocols with ~1mm isotropic resolution require data acquisition time in the range of 5-10min and often use only moderate two-fold acceleration factor for parallel imaging. Recent advances in MRI hardware and acquisition methodology promise improved leverage of the MR signal and more benign artefact properties in particular when employing increased acceleration factors in clinical routine and research. In this study, we examined four variants of a four-fold-accelerated MPRAGE protocol (2D-GRAPPA, CAIPIRINHA, CAIPIRINHA elliptical, and segmented MPRAGE) and compared clinical readings, basic image quality metrics (SNR, CNR), and automated brain tissue segmentation for morphological assessments of brain structures. The results were benchmarked against a widely-used two-fold-accelerated 3T ADNI MPRAGE protocol that served as reference in this study. 22 healthy subjects (age=20-44yrs.) were imaged with all MPRAGE variants in a single session. An experienced reader rated all images of clinically useful image quality. CAIPIRINHA MPRAGE scans were perceived on average to be of identical value for reading as the reference ADNI-2 protocol. SNR and CNR measurements exhibited the theoretically expected performance at the four-fold acceleration. The results of this study demonstrate that the four-fold accelerated protocols introduce systematic biases in the segmentation results of some brain structures compared to the reference ADNI-2 protocol. Furthermore, results suggest that the increased noise levels in the accelerated protocols play an important role in introducing these biases, at least under the present study conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Motor-related circuit dysfunction in MSA-P: Usefulness of combined whole-brain imaging analysis.

    Science.gov (United States)

    Tir, Mélissa; Delmaire, Christine; le Thuc, Vianney; Duhamel, Alain; Destée, Alain; Pruvo, Jean-Pierre; Defebvre, Luc

    2009-04-30

    The aim of this study was to evaluate in vivo changes in the brain's macro- and microstructure (notably in the motor system) in the parkinsonian variant of multiple system atrophy (MSA-P) and in Parkinson's disease (PD) and to characterize the cerebral anatomical differences between the two conditions. We used a combination of voxel-based morphometry (VBM) and whole-brain, voxel-based diffusion tensor imaging analysis (VB-DTI). Forty-seven right-handed subjects (14 MSA-P patients, 19 PD patients, and 14 controls) were evaluated using VBM and VB-DTI in an analysis of covariance (ANCOVA) with a significance threshold set to P MSA-P patients, VBM analysis revealed a lower density of grey matter (GM) in a motor-related circuit (especially in the left primary motor cortex, PMC), relative to PD patients, and in the left supplementary motor area (SMA), relative to controls). Diffusion tensor imaging analysis revealed lower fractional anisotropy (FA) values in the left PMC and the right cerebellum in MSA-P patients, compared with controls. Using a volumetric diffusion technique, our study revealed selective tissue degeneration in motor circuits, regardless of the volume loss detected in VBM and in agreement with pathology reports and clinical motor characteristics. Our findings suggest that MSA-P is characterized by both macro- and microstructural changes in the sensorimotor circuit.

  6. Nonparametric Bayesian Clustering of Structural Whole Brain Connectivity in Full Image Resolution

    DEFF Research Database (Denmark)

    Ambrosen, Karen Marie Sandø; Albers, Kristoffer Jon; Dyrby, Tim B.

    2014-01-01

    Diffusion magnetic resonance imaging enables measuring the structural connectivity of the human brain at a high spatial resolution. Local noisy connectivity estimates can be derived using tractography approaches and statistical models are necessary to quantify the brain’s salient structural...... organization. However, statistically modeling these massive structural connectivity datasets is a computational challenging task. We develop a high-performance inference procedure for the infinite relational model (a prominent non-parametric Bayesian model for clustering networks into structurally similar...... groups) that defines structural units at the resolution of statistical support. We apply the model to a network of structural brain connectivity in full image resolution with more than one hundred thousand regions (voxels in the gray-white matter boundary) and around one hundred million connections...

  7. Whole-brain calcium imaging with cellular resolution in freely behaving Caenorhabditis elegans

    Science.gov (United States)

    Nguyen, Jeffrey; Shipley, Frederick; Linder, Ashley; Plummer, George; Liu, Mochi; Setru, Sagar; Shaevitz, Joshua; Leifer, Andrew

    The ability to acquire large-scale recordings of neuronal activity in awake and unrestrained animals is needed to provide new insights into how populations of neurons generate animal behavior. Acquiring this data, however, is challenging because it is difficult to track and image individual neurons as an animal deforms its posture and moves many body lengths. Here, we present an instrument capable of recording intracellular calcium transients from the majority of neurons in the head of a freely behaving Caenorhabditis elegans with cellular resolution while simultaneously recording the animal's position, posture, and locomotion. 3D volumetric fluorescent images of neurons expressing the calcium indicator GCaMP6s are recorded at 6 head-volumes/s using spinning disk confocal microscopy. At the same time, we record low magnification images of the animal to measure the animals behavior and track its head as it moves. We develop a time independent neuronal matching algorithm that uses non-rigid point set registration and machine learning to correctly match neurons across time. Using this method, we are able to observe calcium transients from up to 90 neurons for over 4 min and correlate the neural activity with the animal's behavior.

  8. Tracing Activity across the Whole Brain Neural Network with Optogenetic Functional Magnetic Resonance Imaging (ofMRI

    Directory of Open Access Journals (Sweden)

    Jin Hyung eLee

    2011-10-01

    Full Text Available Despite the overwhelming need, there has been a relatively large gap in our ability to trace network level activity across the brain. The complex dense wiring of the brain makes it extremely challenging to understand a specific set of neuron’s activity and their communication beyond a few synapses. Recent development of the optogenetic functional magnetic resonance imaging (ofMRI provides a new impetus for the study of the brain circuit by enabling causal tracing of the brain circuit activity across the whole brain. Brain circuit elements can be selectively triggered based on their genetic identity, cell body location, and/or their axonal projection target with temporal precision while the resulting network response is monitored non-invasively with unprecedented spatial and temporal accuracy. With further studies including technological innovations to bring ofMRI to its full potential, ofMRI is expected to play an important role in our system-level understanding of the brain circuit mechanism.

  9. Microstructural changes of whole brain in patients with comitant strabismus: evidence from a diffusion tensor imaging study

    Directory of Open Access Journals (Sweden)

    Huang X

    2016-08-01

    Full Text Available Xin Huang,1,2,* Hai-Jun Li,3,* Ying Zhang,1 De-Chang Peng,3 Pei-Hong Hu,1 Yu-Lin Zhong,1 Fu-Qing Zhou,3 Yi Shao1 1Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, 2Department of Ophthalmology, The First People’s Hospital of Jiujiang City, Jiujiang, 3Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China*These authors contributed equally to this work Objective: The aim of this study was to investigate the fractional anisotropy (FA and mean diffusivity (MD using a diffusion tensor imaging technique and whole-brain voxel-based analysis in patients with comitant strabismus.Patients and methods: A total of 19 (nine males and ten females patients with comitant strabismus and 19 age-, sex-, and education-matched healthy controls (HCs underwent magnetic resonance imaging examination. Imaging data were analyzed using two-sample t-tests to identify group differences in FA and MD values. Patients with comitant strabismus were distinguishable from HCs by receiver operating characteristic curves.Results: Compared with HCs, patients with comitant strabismus exhibited significantly decreased FA values in the brain regions of the left superior temporal gyrus and increased values in the bilateral medial frontal gyrus, right globus pallidus/brainstem, and bilateral precuneus. Meanwhile, MD value was significantly reduced in the brain regions of the bilateral cerebellum posterior lobe and left middle frontal gyrus but increased in the brain regions of the right middle frontal gyrus and left anterior cingulate.Conclusion: These results suggest significant brain abnormalities in comitant strabismus, which may underlie the pathologic mechanisms of fusion defects and ocular motility disorders in patients with comitant strabismus. Keywords: comitant strabismus, diffusion tensor imaging, mean diffusivity, fractional anisotropy, resting state

  10. Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, M.; Sakuma, H.; Takeda, K. [Dept. of Radiology, Mie Univ. School of Medicine, Mie (Japan); Yagishita, A. [Dept. of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Tokyo (Japan); Yamamoto, T. [Dept. of Radiology, Obama Municipal Hospital, Fukui (Japan)

    2003-12-01

    A variety of central nervous system (CNS) diseases are associated with abnormal hyperintensity within the subarachnoid space (SAS) by fluid-attenuated inversion-recovery (FLAIR) MR imaging. Careful attention to the SAS can provide additional useful information that may not be available with conventional MR sequences. The purpose of this article is to provide a pictorial essay about CNS diseases and FLAIR images with abnormal hyperintensity within the SAS. We present several CNS diseases including subarachnoid hemorrhage, meningitis, leptomeningeal metastases, acute infarction, and severe arterial occlusive diseases such as moya-moya disease. We also review miscellaneous diseases or normal conditions that may exhibit cerebrospinal fluid hyperintensity on FLAIR images. Although the detection of abnormal hyperintensity suggests the underlying CNS diseases and narrows differential diagnoses, FLAIR imaging sometimes presents artifactual hyperintensity within the SAS that can cause the misinterpretation of normal SAS as pathologic conditions; therefore, radiologists should be familiar with such artifactual conditions as well as pathologic conditions shown as hyperintensity by FLAIR images. This knowledge is helpful in establishing the correct diagnosis. (orig.)

  11. A comparison of inner ear imaging features at different time points of sudden sensorineural hearing loss with three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging.

    Science.gov (United States)

    Zhu, Honglei; Ou, Yongkang; Fu, Jia; Zhang, Ya; Xiong, Hao; Xu, Yaodong

    2015-10-01

    It has been reported that about half of patients with sudden sensorineural hearing loss (SSNHL) show high signals in the affected inner ear on three-dimensional, fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI). These signals may reflect minor hemorrhage or an increased concentration of protein in the inner ear, which has passed through blood vessels with increased permeability. Our objective was to compare the positive ratio of the high signal in affected inner ears at different time points to determine the suitable imaging time point for 3D-FLAIR MRI in SSNHL. 3D-FLAIR MRI images were taken at three times, precontrast and approximately 10 min and 4 h after intravenous injection of a single dose of gadodiamide (Gd) (0.1 mmol/kg), in 46 patients with SNHL. We compared the positive findings of the high signals in the inner ear of patients with SNHL as well as the signal intensity ratio (SIR) between the affected cochleae and unaffected cochleae at three time points. The positive ratios of the high signals in the affected inner ear at the time points of precontrast and 10 min and 4 h after the intravenous Gd injection were 26.1, 32.6, and 41.3%, respectively. The high signal intensity ratios of affected inner ears at the three time points were 1.28, 1.31, and 1.48, respectively. The difference between the positive ratios precontrast and at 10 min after the intravenous Gd injection was statistically significant (P = 0.006); the differences between the positive ratios at 4 h after the intravenous Gd injection and precontrast and between the ratios at 4 h and 10 min after the intravenous Gd injection were not statistically significant. The time effects of the median value of SIR were not significant (P = 0.064). We do not recommend 4 h after intravenous Gd injection as a time point to image the inner ear in SNHL. We believe that imaging precontrast and at 10 min after the intravenous Gd injection are suitable time points.

  12. Diffusion-weighted imaging-fluid-attenuated inversion recovery mismatch is associated with better neurologic response to intravenous thrombolytic therapy in acute ischemic stroke patients.

    Science.gov (United States)

    Jeong, Jong Yeong; Han, Sang Kuk; Shin, Dong Hyuk; Na, Ji Ung; Lee, Hyun Jung; Choi, Pil Cho; Lee, Jeong Hun

    2015-03-01

    To investigate differences in the effect of intravenous (IV) thrombolysis regarding the mismatch of diffusion-weighted imaging-fluid-attenuated inversion recovery (DWI-FLAIR) among acute ischemic stroke patients who visited the emergency department (ED) within 3 hours from the onset of symptoms. Among ED patients presenting with an acute ischemic stroke between January 2011 and May 2013 at a tertiary hospital, those who underwent magnetic resonance imaging before IV thrombolytic therapy were included in this retrospective study. Patients were divided into DWI-FLAIR mismatch and match groups. National Institutes of Health Stroke Scale (NIHSS) scores obtained initially, 24 hours after thrombolytic therapy, and on discharge, and early neurologic improvement (ENI) and major neurologic improvement (MNI) were compared. During the study period, 50 of the 213 acute ischemic stroke patients who presented to the ED were included. The DWI-FLAIR mismatch group showed a statistically significantly greater reduction in NIHSS both at 24 hours after thrombolytic therapy and upon discharge than did the match group (5.5 vs. 1.2, PIV thrombolytic therapy than did the DWI-FLAIR match group in terms of neurologic outcome.

  13. Comparison of T1-weighted fast spin-echo and T1-weighted fluid-attenuated inversion recovery images of the lumbar spine at 3.0 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Lavdas, Eleftherios; Vlychou, Marianna; Arikidis, Nikos; Kapsalaki, Eftychia; Roka, Violetta; Fezoulidis, Ioannis V. (Dept. of Radiology, Univ. Hospital of Larissa, Medical School of Thessaly, Mezourlo (Greece)), e-mail: mvlychou@med.uth.gr

    2010-04-15

    Background: T1-weighted fluid-attenuated inversion recovery (FLAIR) sequence has been reported to provide improved contrast between lesions and normal anatomical structures compared to T1-weighted fast spin-echo (FSE) imaging at 1.5T regarding imaging of the lumbar spine. Purpose: To compare T1-weighted FSE and fast T1-weighted FLAIR imaging in normal anatomic structures and degenerative and metastatic lesions of the lumbar spine at 3.0T. Material and Methods: Thirty-two consecutive patients (19 females, 13 males; mean age 44 years, range 30-67 years) with lesions of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted FSE and fast T1-weighted FLAIR sequences. Both qualitative and quantitative analyses measuring the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and relative contrast (ReCon) between degenerative and metastatic lesions and normal anatomic structures were conducted, comparing these sequences. Results: On quantitative evaluation, SNRs of cerebrospinal fluid (CSF), nerve root, and fat around the root of fast T1-weighted FLAIR imaging were significantly lower than those of T1-weighted FSE images (P<0.001). CNRs of normal spinal cord/CSF and disc herniation/ CSF for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted FSE images (P<0.001). ReCon of normal spinal cord/CSF, disc herniation/CSF, and vertebral lesions/CSF for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted FSE images (P<0.001). On qualitative evaluation, it was found that CSF nulling and contrast at the spinal cord (cauda equina)/CSF interface for T1-weighted FLAIR images were significantly superior compared to those for T1-weighted FSE images (P<0.001), and the disc/spinal cord (cauda equina) interface was better for T1-weighted FLAIR images (P<0.05). Conclusion: The T1-weighted FLAIR sequence may be considered as the preferred lumbar spine imaging

  14. Quantification of traumatic meningeal injury using dynamic contrast enhanced (DCE) fluid-attenuated inversion recovery (FLAIR) imaging

    Science.gov (United States)

    Castro, Marcelo A.; Williford, Joshua P.; Cota, Martin R.; MacLaren, Judy M.; Dardzinski, Bernard J.; Latour, Lawrence L.; Pham, Dzung L.; Butman, John A.

    2016-03-01

    Traumatic meningeal injury is a novel imaging marker of traumatic brain injury, which appears as enhancement of the dura on post-contrast T2-weighted FLAIR images, and is likely associated with inflammation of the meninges. Dynamic Contrast Enhanced MRI provides a better discrimination of abnormally perfused regions. A method to properly identify those regions is presented. Images of seventeen patients scanned within 96 hours of head injury with positive traumatic meningeal injury were normalized and aligned. The difference between the pre- and last post-contrast acquisitions was segmented and voxels in the higher class were spatially clustered. Spatial and morphological descriptors were used to identify the regions of enhancement: a) centroid; b) distance to the brain mask from external voxels; c) distance from internal voxels; d) size; e) shape. The method properly identified thirteen regions among all patients. The method failed in one case due to the presence of a large brain lesion that altered the mask boundaries. Most false detections were correctly rejected resulting in a sensitivity and specificity of 92.9% and 93.6%, respectively.

  15. Improved delineation of short cortical association fibers and gray/white matter boundary using whole-brain three-dimensional diffusion tensor imaging at submillimeter spatial resolution.

    Science.gov (United States)

    Song, Allen W; Chang, Hing-Chiu; Petty, Christopher; Guidon, Arnaud; Chen, Nan-Kuei

    2014-11-01

    Recent emergence of human connectome imaging has led to a high demand on angular and spatial resolutions for diffusion magnetic resonance imaging (MRI). While there have been significant growths in high angular resolution diffusion imaging, the improvement in spatial resolution is still limited due to a number of technical challenges, such as the low signal-to-noise ratio and high motion artifacts. As a result, the benefit of a high spatial resolution in the whole-brain connectome imaging has not been fully evaluated in vivo. In this brief report, the impact of spatial resolution was assessed in a newly acquired whole-brain three-dimensional diffusion tensor imaging data set with an isotropic spatial resolution of 0.85 mm. It was found that the delineation of short cortical association fibers is drastically improved as well as the definition of fiber pathway endings into the gray/white matter boundary-both of which will help construct a more accurate structural map of the human brain connectome.

  16. A combined solenoid-surface RF coil for high-resolution whole-brain rat imaging on a 3.0 Tesla clinical MR scanner.

    Science.gov (United States)

    Underhill, Hunter R; Yuan, Chun; Hayes, Cecil E

    2010-09-01

    Rat brain models effectively simulate a multitude of human neurological disorders. Improvements in coil design have facilitated the wider utilization of rat brain models by enabling the utilization of clinical MR scanners for image acquisition. In this study, a novel coil design, subsequently referred to as the rat brain coil, is described that exploits and combines the strengths of both solenoids and surface coils into a simple, multichannel, receive-only coil dedicated to whole-brain rat imaging on a 3.0 T clinical MR scanner. Compared with a multiturn solenoid mouse body coil, a 3-cm surface coil, a modified Helmholtz coil, and a phased-array surface coil, the rat brain coil improved signal-to-noise ratio by approximately 72, 61, 78, and 242%, respectively. Effects of the rat brain coil on amplitudes of static field and radiofrequency field uniformity were similar to each of the other coils. In vivo, whole-brain images of an adult male rat were acquired with a T(2)-weighted spin-echo sequence using an isotropic acquisition resolution of 0.25 x 0.25 x 0.25 mm(3) in 60.6 min. Multiplanar images of the in vivo rat brain with identification of anatomic structures are presented. Improvement in signal-to-noise ratio afforded by the rat brain coil may broaden experiments that utilize clinical MR scanners for in vivo image acquisition.

  17. Feasibility of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging as a prognostic factor in patients with sudden hearing loss.

    Science.gov (United States)

    Lee, Ho Yun; Jung, Su Young; Park, Moon Suh; Yeo, Seung Geun; Lee, So Yoon; Lee, Sun Kyu

    2012-08-01

    The aim of this study was to confirm the feasibility of high signal on three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D FLAIR MRI) as one of the prognostic factors in recovery of sudden idiopathic hearing loss. A retrospective study was conducted using patients who were diagnosed with unilateral sudden idiopathic hearing loss from January 2008 to December 2010. A total of 120 patients were enrolled in for this study. High-intensity signal in the inner ear on precontrast 3D FLAIR MRI was observed in 31 patients (25.8%; FHS) and labyrinthine enhancement was not observed in another 89 patients (FNS; 74.2%). There was no significant difference in patients' characteristics between two groups except final hearing. Final puretone average of the FHS group was 49.4 dB, significantly worse than FNS group's 36.7 dB (p = 0.037 hearing was related to initial hearing, accompanying dizziness, and abnormal auditory brainstem response result by multiple regression analysis. However, presence of high-intensity signal on precontrast 3D FLAIR MRI did not affect final hearing significantly. Significant difference due to the presence of dizziness in final hearing was observed in whole patients and in the FHS group, whereas no significant difference in final hearing was observed in FNS group. (p = 0.063 > 0.05). From these findings, the presence of high-intensity signal on 3D FLAIR MRI is a subfactor related to dizziness rather than a single poor prognostic factor and the absence of high-intensity signal on 3D FLAIR MRI can possibly imply relative good prognosis.

  18. Whole-brain three-dimensional T2-weighted BOLD functional magnetic resonance imaging at 7 Tesla.

    Science.gov (United States)

    Hua, Jun; Qin, Qin; van Zijl, Peter C M; Pekar, James J; Jones, Craig K

    2014-12-01

    A new acquisition scheme for T2-weighted spin-echo BOLD fMRI is introduced. It uses a T2-preparation module to induce blood-oxygenation-level-dependent (BOLD) contrast, followed by a single-shot three-dimensional (3D) fast gradient-echo readout with short echo time (TE). It differs from most spin-echo BOLD sequences in that BOLD contrast is generated before the readout, which eliminates the "dead time" due to long TE required for T2 contrast, and substantially improves acquisition efficiency. This approach, termed "3D T2prep-GRE," was implemented at 7 Tesla (T) with a typical spatial (2.5 × 2.5 × 2.5 mm(3) ) and temporal (TR = 2.3 s) resolution for functional MRI (fMRI) and whole-brain coverage (55 slices), and compared with the widely used 2D spin-echo EPI sequence. In fMRI experiments of simultaneous visual/motor activities, 3D T2prep-GRE showed minimal distortion and little signal dropout across the whole brain. Its lower power deposition allowed greater spatial coverage (55 versus 17 slices with identical TR, resolution and power level), temporal SNR (60% higher) and CNR (35% higher) efficiency than 2D spin-echo EPI. It also showed smaller T2* contamination. This approach is expected to be useful for ultra-high field fMRI, especially for regions near air cavities. The concept of using T2-preparation to generate BOLD contrast can be combined with many other sequences at any field strength. © 2013 Wiley Periodicals, Inc.

  19. Image quality, radiation dose and diagnostic accuracy of 70 kVp whole brain volumetric CT perfusion imaging: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Xiao Kun; Ni, Qian Qian; Zhou, Chang Sheng; Chen, Guo Zhong; Luo, Song; Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Ashley River Tower, Division of Cardiovascular Imaging, Charleston, SC (United States); Fuller, Stephen R.; De Cecco, Carlo N. [Medical University of South Carolina, Ashley River Tower, Division of Cardiovascular Imaging, Charleston, SC (United States)

    2016-11-15

    To evaluate image quality and diagnostic accuracy for acute infarct detection and radiation dose of 70 kVp whole brain CT perfusion (CTP) and CT angiography (CTA) reconstructed from CTP source data. Patients were divided into three groups (n = 50 each): group A, 80 kVp, 21 scanning time points; groups B, 70 kVp, 21 scanning time points; group C, 70 kVp, 17 scanning time points. Objective and subjective image quality of CTP and CTA were compared. Diagnostic accuracy for detecting acute infarct and cerebral artery stenosis ≥ 50 % was calculated for CTP and CTA with diffusion weighted imaging and digital subtraction angiography as reference standards. Effective radiation dose was compared. There were no differences in any perfusion parameter value between three groups (P > 0.05). No difference was found in subjective image quality between three groups (P > 0.05). Diagnostic accuracy for detecting acute infarct and vascular stenosis showed no difference between three groups (P > 0.05). Compared with group A, radiation doses of groups B and C were decreased by 28 % and 37 % (both P < 0.001), respectively. Compared with 80 kVp protocol, 70 kVp brain CTP allows comparable vascular and perfusion assessment and lower radiation dose while maintaining high diagnostic accuracy in detecting acute infarct. (orig.)

  20. Mapping whole-brain activity with cellular resolution by light-sheet microscopy and high-throughput image analysis (Conference Presentation)

    Science.gov (United States)

    Silvestri, Ludovico; Rudinskiy, Nikita; Paciscopi, Marco; Müllenbroich, Marie Caroline; Costantini, Irene; Sacconi, Leonardo; Frasconi, Paolo; Hyman, Bradley T.; Pavone, Francesco S.

    2016-03-01

    Mapping neuronal activity patterns across the whole brain with cellular resolution is a challenging task for state-of-the-art imaging methods. Indeed, despite a number of technological efforts, quantitative cellular-resolution activation maps of the whole brain have not yet been obtained. Many techniques are limited by coarse resolution or by a narrow field of view. High-throughput imaging methods, such as light sheet microscopy, can be used to image large specimens with high resolution and in reasonable times. However, the bottleneck is then moved from image acquisition to image analysis, since many TeraBytes of data have to be processed to extract meaningful information. Here, we present a full experimental pipeline to quantify neuronal activity in the entire mouse brain with cellular resolution, based on a combination of genetics, optics and computer science. We used a transgenic mouse strain (Arc-dVenus mouse) in which neurons which have been active in the last hours before brain fixation are fluorescently labelled. Samples were cleared with CLARITY and imaged with a custom-made confocal light sheet microscope. To perform an automatic localization of fluorescent cells on the large images produced, we used a novel computational approach called semantic deconvolution. The combined approach presented here allows quantifying the amount of Arc-expressing neurons throughout the whole mouse brain. When applied to cohorts of mice subject to different stimuli and/or environmental conditions, this method helps finding correlations in activity between different neuronal populations, opening the possibility to infer a sort of brain-wide 'functional connectivity' with cellular resolution.

  1. In vivo quantitative whole-brain diffusion tensor imaging analysis of APP/PS1 transgenic mice using voxel-based and atlas-based methods

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Yuan-Yuan [Huazhong University of Science and Technology, Department of Radiology, Tongji Hospital, Tongji Medical College, Wuhan (China); The Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Li, Mu-Wei; Oishi, Kenichi [The Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Zhang, Shun; Zhang, Yan; Zhao, Ling-Yun; Zhu, Wen-Zhen [Huazhong University of Science and Technology, Department of Radiology, Tongji Hospital, Tongji Medical College, Wuhan (China); Lei, Hao [Chinese Academy of Sciences, Wuhan Center for Magnetic Resonance, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Wuhan (China)

    2013-08-15

    Diffusion tensor imaging (DTI) has been applied to characterize the pathological features of Alzheimer's disease (AD) in a mouse model, although little is known about whether these features are structure specific. Voxel-based analysis (VBA) and atlas-based analysis (ABA) are good complementary tools for whole-brain DTI analysis. The purpose of this study was to identify the spatial localization of disease-related pathology in an AD mouse model. VBA and ABA quantification were used for the whole-brain DTI analysis of nine APP/PS1 mice and wild-type (WT) controls. Multiple scalar measurements, including fractional anisotropy (FA), trace, axial diffusivity (DA), and radial diffusivity (DR), were investigated to capture the various types of pathology. The accuracy of the image transformation applied for VBA and ABA was evaluated by comparing manual and atlas-based structure delineation using kappa statistics. Following the MR examination, the brains of the animals were analyzed for microscopy. Extensive anatomical alterations were identified in APP/PS1 mice, in both the gray matter areas (neocortex, hippocampus, caudate putamen, thalamus, hypothalamus, claustrum, amygdala, and piriform cortex) and the white matter areas (corpus callosum/external capsule, cingulum, septum, internal capsule, fimbria, and optic tract), evidenced by an increase in FA or DA, or both, compared to WT mice (p < 0.05, corrected). The average kappa value between manual and atlas-based structure delineation was approximately 0.8, and there was no significant difference between APP/PS1 and WT mice (p > 0.05). The histopathological changes in the gray matter areas were confirmed by microscopy studies. DTI did, however, demonstrate significant changes in white matter areas, where the difference was not apparent by qualitative observation of a single-slice histological specimen. This study demonstrated the structure-specific nature of pathological changes in APP/PS1 mouse, and also showed the

  2. Whole-brain diffusion tensor imaging in correlation to visual-evoked potentials in multiple sclerosis: a tract-based spatial statistics analysis.

    Science.gov (United States)

    Lobsien, D; Ettrich, B; Sotiriou, K; Classen, J; Then Bergh, F; Hoffmann, K-T

    2014-01-01

    Functional correlates of microstructural damage of the brain affected by MS are incompletely understood. The purpose of this study was to evaluate correlations of visual-evoked potentials with microstructural brain changes as determined by DTI in patients with demyelinating central nervous disease. Sixty-one patients with clinically isolated syndrome or MS were prospectively recruited. The mean P100 visual-evoked potential latencies of the right and left eyes of each patient were calculated and used for the analysis. For DTI acquisition, a single-shot echo-planar imaging pulse sequence with 80 diffusion directions was performed at 3T. Fractional anisotropy, radial diffusivity, and axial diffusivity were calculated and correlated with mean P100 visual-evoked potentials by tract-based spatial statistics. Significant negative correlations between mean P100 visual-evoked potentials and fractional anisotropy and significant positive correlations between mean P100 visual-evoked potentials and radial diffusivity were found widespread over the whole brain. The highest significance was found in the optic radiation, frontoparietal white matter, and corpus callosum. Significant positive correlations between mean P100 visual-evoked potentials and axial diffusivity were less widespread, notably sparing the optic radiation. Microstructural changes of the whole brain correlated significantly with mean P100 visual-evoked potentials. The distribution of the correlations showed clear differences among axial diffusivity, fractional anisotropy, and radial diffusivity, notably in the optic radiation. This finding suggests a stronger correlation of mean P100 visual-evoked potentials to demyelination than to axonal damage. © 2014 by American Journal of Neuroradiology.

  3. Manganese-enhanced magnetic resonance imaging for mapping of whole brain activity patterns associated with the intake of snack food in ad libitum fed rats.

    Science.gov (United States)

    Hoch, Tobias; Kreitz, Silke; Gaffling, Simone; Pischetsrieder, Monika; Hess, Andreas

    2013-01-01

    Non-homeostatic hyperphagia, which is a major contributor to obesity-related hyperalimentation, is associated with the diet's molecular composition influencing, for example, the energy content. Thus, specific food items such as snack food may induce food intake independent from the state of satiety. To elucidate mechanisms how snack food may induce non-homeostatic food intake, it was tested if manganese-enhanced magnetic resonance imaging (MEMRI) was suitable for mapping the whole brain activity related to standard and snack food intake under normal behavioral situation. Application of the MnCl2 solution by osmotic pumps ensured that food intake was not significantly affected by the treatment. After z-score normalization and a non-affine three-dimensional registration to a rat brain atlas, significantly different grey values of 80 predefined brain structures were recorded in ad libitum fed rats after the intake of potato chips compared to standard chow at the group level. Ten of these areas had previously been connected to food intake, in particular to hyperphagia (e.g., dorsomedial hypothalamus or the anterior paraventricular thalamic nucleus) or to the satiety system (e.g., arcuate hypothalamic nucleus or solitary tract); 27 areas were related to reward/addiction including the core and shell of the nucleus accumbens, the ventral pallidum and the ventral striatum (caudate and putamen). Eleven areas associated to sleep displayed significantly reduced Mn2+ -accumulation and six areas related to locomotor activity showed significantly increased Mn2+ -accumulation after the intake of potato chips. The latter changes were associated with an observed significantly higher locomotor activity. Osmotic pump-assisted MEMRI proved to be a promising technique for functional mapping of whole brain activity patterns associated to nutritional intake under normal behavior.

  4. Manganese-enhanced magnetic resonance imaging for mapping of whole brain activity patterns associated with the intake of snack food in ad libitum fed rats.

    Directory of Open Access Journals (Sweden)

    Tobias Hoch

    Full Text Available Non-homeostatic hyperphagia, which is a major contributor to obesity-related hyperalimentation, is associated with the diet's molecular composition influencing, for example, the energy content. Thus, specific food items such as snack food may induce food intake independent from the state of satiety. To elucidate mechanisms how snack food may induce non-homeostatic food intake, it was tested if manganese-enhanced magnetic resonance imaging (MEMRI was suitable for mapping the whole brain activity related to standard and snack food intake under normal behavioral situation. Application of the MnCl2 solution by osmotic pumps ensured that food intake was not significantly affected by the treatment. After z-score normalization and a non-affine three-dimensional registration to a rat brain atlas, significantly different grey values of 80 predefined brain structures were recorded in ad libitum fed rats after the intake of potato chips compared to standard chow at the group level. Ten of these areas had previously been connected to food intake, in particular to hyperphagia (e.g., dorsomedial hypothalamus or the anterior paraventricular thalamic nucleus or to the satiety system (e.g., arcuate hypothalamic nucleus or solitary tract; 27 areas were related to reward/addiction including the core and shell of the nucleus accumbens, the ventral pallidum and the ventral striatum (caudate and putamen. Eleven areas associated to sleep displayed significantly reduced Mn2+ -accumulation and six areas related to locomotor activity showed significantly increased Mn2+ -accumulation after the intake of potato chips. The latter changes were associated with an observed significantly higher locomotor activity. Osmotic pump-assisted MEMRI proved to be a promising technique for functional mapping of whole brain activity patterns associated to nutritional intake under normal behavior.

  5. Color-coded perfused blood volume imaging using multidetector CT: initial results of whole-brain perfusion analysis in acute cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kloska, Stephan P.; Fischer, Tobias; Fischbach, Roman; Heindel, Walter [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Nabavi, Darius G.; Dittrich, Ralf; Ringelstein, E.B. [University of Muenster, Department of Neurology, Muenster (Germany); Ditt, Hendrik; Klotz, Ernst [Siemens AG, Medical Solutions, Forchheim (Germany)

    2007-09-15

    Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively. The detection rate of ischemic changes in the PBV images was compared with NECT. The volume of ischemic changes in PBV was correlated with the infarct volume on follow-up examination taking potential vessel recanalization into account. PBV demonstrated ischemic changes in 12/12 patients with proven infarction and was superior to NECT (8/12) in the detection of early ischemia. Moreover, PBV demonstrated the best correlation coefficient with the follow-up infarct volume (Pearson's R = 0.957; P = 0.003) for patients with proven recanalization of initially occluded cerebral arteries. In summary, PBV appears to be more accurate in the detection of early infarction compared to NECT and mainly visualizes the irreversibly damaged ischemic tissue. (orig.)

  6. High-fidelity functional and structural whole-brain imaging with Bessel-beam light-sheet microscopy (Conference Presentation)

    Science.gov (United States)

    Müllenbroich, Marie Caroline; Silvestri, Ludovico; Turrini, Lapo; Di Giovanna, Antonino Paolo; Alterini, Tommaso; Gheisari, Ali; Ricci, Pietro; Sacconi, Leonardo; Vanzi, Francesco; Pavone, Francesco S.

    2017-02-01

    Light-sheet microscopy (LSM) has proven a useful tool in neuroscience and is particularly well suited to image the entire brain with high frame rates at single cell resolution. On the one hand, LSM is employed in combination with tissue clearing methods like CLARITY which allows for the reconstruction of neuronal or vascular anatomy over cm-sized samples. On the other hand, LSM has been paired with intrinsically transparent samples for real-time recording of neuronal activity with single cell resolution across the entire brain, using calcium indicators like GCaMP6. Despite its intrinsic advantages in terms of high imaging speed and reduced photobleaching, LSM is very sensitive to residual opaque objects present in the sample, which cause dark horizontal stripes in the collected images. In the best case, these artefacts obscure the features of interest in structural imaging; in the worst case, dynamic shadowing introduced by red blood cells significantly alters the fluorescence signal variations related to neuronal activity. We show how the use of Bessel beams in LSM can dramatically reduce such artefacts even in conventional one-sided illumination schemes, thanks to their "self-healing" properties. On the functional side, Bessel-beam LSM allows recording neuronal activity traces without any disturbing flickering caused by the movement of red blood cells. On the structural side, our proposed method is capable of obtaining anatomical information across the entire volume of whole mouse brains allowing tracing blood vessels and neuronal projections also in poorly cleared specimens.

  7. Metastatic brain cancer: prediction of response to whole-brain helical tomotherapy with simultaneous intralesional boost for metastatic disease using quantitative MR imaging features

    Science.gov (United States)

    Sharma, Harish; Bauman, Glenn; Rodrigues, George; Bartha, Robert; Ward, Aaron

    2014-03-01

    The sequential application of whole brain radiotherapy (WBRT) and more targeted stereotactic radiosurgery (SRS) is frequently used to treat metastatic brain tumors. However, SRS has side effects related to necrosis and edema, and requires separate and relatively invasive localization procedures. Helical tomotherapy (HT) allows for a SRS-type simultaneous infield boost (SIB) of multiple brain metastases, synchronously with WBRT and without separate stereotactic procedures. However, some patients' tumors may not respond to HT+SIB, and would be more appropriately treated with radiosurgery or conventional surgery despite the additional risks and side effects. As a first step toward a broader objective of developing a means for response prediction to HT+SIB, the goal of this study was to investigate whether quantitative measurements of tumor size and appearance (including first- and second-order texture features) on a magnetic resonance imaging (MRI) scan acquired prior to treatment could be used to differentiate responder and nonresponder patient groups after HT+SIB treatment of metastatic disease of the brain. Our results demonstrated that smaller lesions may respond better to this form of therapy; measures of appearance provided limited added value over measures of size for response prediction. With further validation on a larger data set, this approach may lead to a means for prediction of individual patient response based on pre-treatment MRI, supporting appropriate therapy selection for patients with metastatic brain cancer.

  8. Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Ming-Xiong Huang

    2014-01-01

    Full Text Available Traumatic brain injury (TBI is a leading cause of sustained impairment in military and civilian populations. However, mild TBI (mTBI can be difficult to detect using conventional MRI or CT. Injured brain tissues in mTBI patients generate abnormal slow-waves (1–4 Hz that can be measured and localized by resting-state magnetoencephalography (MEG. In this study, we develop a voxel-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mTBI on a single-subject basis. A normative database of resting-state MEG source magnitude images (1–4 Hz from 79 healthy control subjects was established for all brain voxels. The high-resolution MEG source magnitude images were obtained by our recent Fast-VESTAL method. In 84 mTBI patients with persistent post-concussive symptoms (36 from blasts, and 48 from non-blast causes, our method detected abnormalities at the positive detection rates of 84.5%, 86.1%, and 83.3% for the combined (blast-induced plus with non-blast causes, blast, and non-blast mTBI groups, respectively. We found that prefrontal, posterior parietal, inferior temporal, hippocampus, and cerebella areas were particularly vulnerable to head trauma. The result also showed that MEG slow-wave generation in prefrontal areas positively correlated with personality change, trouble concentrating, affective lability, and depression symptoms. Discussion is provided regarding the neuronal mechanisms of MEG slow-wave generation due to deafferentation caused by axonal injury and/or blockages/limitations of cholinergic transmission in TBI. This study provides an effective way for using MEG slow-wave source imaging to localize affected areas and supports MEG as a tool for assisting the diagnosis of mTBI.

  9. Whole-brain proton MR spectroscopic imaging of mild-to-moderate traumatic brain injury and correlation with neuropsychological deficits.

    Science.gov (United States)

    Govind, Varan; Gold, Stuart; Kaliannan, Krithica; Saigal, Gaurav; Falcone, Steven; Arheart, Kristopher L; Harris, Leo; Jagid, Jonathan; Maudsley, Andrew A

    2010-03-01

    Changes in the distribution of the magnetic resonance (MR)-observable brain metabolites N-acetyl aspartate (NAA), total choline (Cho), and total creatine (Cre), following mild-to-moderate closed-head traumatic brain injury (mTBI) were evaluated using volumetric proton MR spectroscopic imaging (MRSI). Studies were carried out during the subacute time period following injury, and associations of metabolite indices with neuropsychological test (NPT) results were evaluated. Twenty-nine subjects with mTBI and Glasgow Coma Scale (GCS) scores of 10-15 were included. Differences in individual metabolite and metabolite ratio distributions relative to those of age-matched control subjects were evaluated, as well as analyses by hemispheric lobes and tissue types. Primary findings included a widespread decrease of NAA and NAA/Cre, and increases of Cho and Cho/NAA, within all lobes of the TBI subject group, and with the largest differences seen in white matter. Examination of the association between all of the metabolite measures and the NPT scores found the strongest negative correlations to occur in the frontal lobe and for Cho/NAA. No significant correlations were found between any of the MRSI or NPT measures and the GCS. These results demonstrate that significant and widespread alterations of brain metabolites occur as a result of mild-to-moderate TBI, and that these measures correlate with measures of cognitive performance.

  10. Three-dimensional whole-brain perfused blood volume imaging with multimodal CT for evaluation of acute ischaemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Lu, J.; Zhang, M.; Cao, Y. [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing (China); Ma, Q. [Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing (China); Chen, J. [Healthcare, Siemens Ltd. China, Beijing (China); Ji, X. [Department of Neurosurgery Xuanwu Hospital, Capital Medical University, Beijing (China); Li, K., E-mail: imaging@yeah.ne [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing (China)

    2011-06-15

    Aim: To determine the diagnostic value of integrating three-dimensional perfused blood volume (3D PBV) with multimodal computed tomography (CT) [non-enhanced CT (NECT), CT perfusion (CTP), and CT angiography (CTA)] in acute ischaemic stroke. Materials and methods: NECT, CTP, and CTA were performed in 25 acute ischaemic stroke patients. The ischaemia detection rate of 3D PBV was compared with the results of baseline NECT and CTP. The correlation of ischaemic lesion volume between 3D PBV, CTP images, and follow-up NECT were analysed. Results: NECT demonstrated ischaemic signs in 12 of 25 patients with proven infarction. CTP maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) all demonstrated perfusion deficits in 21 of 25 patients. However, 3D PBV demonstrated perfusion deficits in all of the 25 patients. Among the 25 patients, a strong correlation was found between PBV and the follow-up NECT infarct (r = 0.858). The correlation between CTP and the follow-up NECT infarct as following: CBF (r = 0.718), CBV (r = 0.785), and TTP (r = 0.569). In 14 thrombolytic patients, strong correlation was found between the ischaemic volume on 3D PBV and follow-up NECT (r = 0.798). Conclusion: In acute stroke patients, the combination of 3D PBV and multimodal CT (NECT, CTP, and CTA) can improve the detection rate of ischaemia and enable assessment of the full extent of ischaemia, which correlates well with follow-up NECT.

  11. [Three-dimensional fluid attenuated inversion recovery imaging at 3T MRI in sudden deafness: its findings and relationship with the prognosis].

    Science.gov (United States)

    Qian, Yin-feng; Wu, Ji-chun; Zhang, Cheng; Yu, Yong-qiang

    2011-10-01

    To investigate inner ear of patients with sudden deafness with three-dimensional fluid attenuated inversion recovery (3D FLAIR) MRI, and the relationship between the results of 3D FLAIR and the prognosis. Twenty-three patients with sudden deafness received 3D FLAIR at 3T MRI, and the signals of inner ear were recorded. Hearing levels were evaluated at initial visit and after treatment. The relationship between 3D FLAIR findings and hearing prognosis was evaluated. Eight patients with sudden deafness showed high signals in the affected cochlea on 3D FLAIR, the others of affected cochlea and all of contralateral cochlea showed no signal on 3D FLAIR. The age, sex, affected side, period to initial visit and initial audiogram had no difference between cochlea no signal group and high signal group. The average auditory threshold (x±s) in cochlea high signal group (90±21) dB HL was significant higher than that in cochlea no signal group (60±28) dB HL, Psudden deafness showed high signal in affected side vestibule on 3D FLAIR, and the hearing of whom had no change after treatment. 3D FLAIR can show high signal in affected inner ear in sudden deafness patients, and which is related to a poor hearing prognosis.

  12. Degenerative disc disease of the lumbar spine: a prospective comparison of fast T1-weighted fluid-attenuated inversion recovery and T1-weighted turbo spin echo MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, L. Oktay [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)]. E-mail: sunarerdem@yahoo.com; Erdem, C. Zuhal [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey); Acikgoz, Bektas [Department of Neurosurgery, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Gundogdu, Sadi [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)

    2005-08-01

    Objective: To compare fast T1-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted turbo spin-echo (TSE) imaging of the degenerative disc disease of the lumbar spine. Materials and methods: Thirty-five consecutive patients (19 females, 16 males; mean age 41 years, range 31-67 years) with suspected degenerative disc disease of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted TSE and fast T1-weighted FLAIR sequences. Two radiologists compared these sequences both qualitatively and quantitatively. Results: On qualitative evaluation, CSF nulling, contrast at the disc-CSF interface, the disc-spinal cord (cauda equina) interface, and the spinal cord (cauda equina)-CSF interface of fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.001). On quantitative evaluation of the first 15 patients, signal-to-noise ratios of cerebrospinal fluid of fast T1-weighted FLAIR imaging were significantly lower than those for T1-weighted TSE images (P < 0.05). Contrast-to-noise ratios of spinal cord/CSF and normal bone marrow/disc for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.05). Conclusion: Results in our study have shown that fast T1-weighted FLAIR imaging may be a valuable imaging modality in the armamentarium of lumbar spinal T1-weighted MR imaging, because the former technique has definite superior advantages such as CSF nulling, conspicuousness of the normal anatomic structures and changes in the lumbar spinal discogenic disease and image contrast and also almost equally acquisition times.

  13. Voxel-based analysis of whole-brain effects of age and gender on dopamine transporter SPECT imaging in healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Eusebio, Alexandre; Azulay, Jean-Philippe [APHM, Hopital de la Timone, Service de Neurologie et Pathologie du Mouvement, Marseille (France); CNRS, Aix-Marseille Univ, Institut de Neurosciences de la Timone, Marseille (France); Ceccaldi, Mathieu [APHM, Hopital de la Timone, Service de Neurologie et de Neuropsychologie, Marseille (France); Aix-Marseille Univ, UMR Inserm 1106, Institut de Neurosciences des Systemes, Marseille (France); Girard, Nadine [APHM, Hopital de la Timone, Service de Neuroradiologie diagnostique et interventionnelle, Marseille (France); Mundler, Olivier [APHM, Hopital de la Timone, Service Central de Biophysique et Medecine Nucleaire, Marseille (France); Aix-Marseille Univ, CERIMED, Marseille (France); Guedj, Eric [CNRS, Aix-Marseille Univ, Institut de Neurosciences de la Timone, Marseille (France); APHM, Hopital de la Timone, Service Central de Biophysique et Medecine Nucleaire, Marseille (France); Aix-Marseille Univ, CERIMED, Marseille (France)

    2012-11-15

    Several studies have shown age- and gender-related differences in striatal dopamine transporter (DaT) binding. These studies were based on a striatal region on interest approach that may have underestimated these effects and could not evaluate extrastriatal regions. Our aim was to determine the effects at the voxel level of age and gender on whole-brain DaT distribution using [{sup 123}I]FP-CIT SPECT in healthy subjects. We performed a whole-brain [{sup 123}I]FP-CIT SPECT voxel-based analysis using SPM8 and a standardized normalization template (p < 0.05, corrected using the false discovery rate method) in 51 healthy subjects aged from 21 to 79 years. We found an age-related DaT binding decrease in the striatum, anterior cingulate/medial frontal cortices and insulo-opercular cortices. Also DaT binding ratios were higher in women than men in the striatum and opercular cortices. This study showed both striatal and extrastriatal age-related and gender-related differences in DaT binding in healthy subjects using a whole-brain voxel-based non-a priori approach. These differences highlight the need for careful age and gender matching in DaT analyses of neuropsychiatric disorders. (orig.)

  14. Signal intensity change of the labyrinth in patients with surgically confirmed or radiologically diagnosed vestibular schwannoma on isotropic 3D fluid-attenuated inversion recovery MR imaging at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Ho; Kim, Hyung-Jin; Kim, Eunhee; Moon, Jung Won; Kim, Sung Tae; Kim, Keon Ha; Jeon, Pyoung; Byun, Hong Sik [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea); Chung, Won Ho [Sungkyunkwan University School of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Seoul (Korea)

    2010-04-15

    The purpose of this study was to evaluate the signal intensity (SI) change of the labyrinth in patients with vestibular schwannoma on isotropic 3D fluid-attenuated inversion recovery (FLAIR) imaging at 3 T. Thirty-four patients with surgically confirmed or radiologically diagnosed vestibular schwannoma were included in this study. Retrospectively, we visually and quantitatively compared the SIs of the cochlea and vestibule on the affected side with those on the unaffected side. We also investigated whether there was correlation between the SI ratios (SIRs) of the labyrinth and the audiometric findings. On 3D FLAIR images, the SI of the cochlea and vestibule on the affected side was significantly increased in 97% (33/34) and 91% (31/34), respectively. While the SI of the cochlea was diffusely increased, that of the vestibule was only partially increased. Quantitative study also revealed statistically significantly higher SIRs of the cochlea (0.99 {+-} 0.29) and vestibule (0.73 {+-} 0.31) on the affected side, compared with the cochlea (0.47 {+-} 0.20) and vestibule (0.19 {+-} 0.10) on the unaffected side. There was no significant correlation of the SIRs of the labyrinth with the degree of hearing loss. In patients with vestibular schwannoma, isotropic 3D FLAIR imaging is a useful method for the evaluation of the SI changes of the labyrinth. (orig.)

  15. The usefulness of diffusion-weighted/fluid-attenuated inversion recovery imaging in the diagnostics and timing of lacunar and nonlacunar stroke

    Energy Technology Data Exchange (ETDEWEB)

    Witkowski, Grzegorz; Sienkiewicz-Jarosz, Halina [Institute of Psychiatry and Neurology, 1st Department of Neurology, Warsaw (Poland); Piliszek, Agnieszka; Ryglewicz, Danuta [Central Clinical Hospital of the Ministry of Interior, Department of Radiology, Warsaw (Poland); Skierczynska, Agnieszka; Poniatowska, Renata [Institute of Psychiatry and Neurology, Department of Radiology, Warsaw (Poland); Dorobek, Malgorzata; Filipek-Gliszczynska, Anna [Central Clinical Hospital of the Ministry of Interior, Department of Neurology, Warsaw (Poland); Walecki, Jerzy [Polish Academy of Science, Mossakowski Medical Research Centre, Warsaw (Poland)

    2014-10-15

    The DWI/FLAIR mismatch is a potential radiological marker for the timing of stroke onset. The aim of the study was to assess if the DWI/FLAIR mismatch can help to identify patients with both lacunar and nonlacunar acute ischemic stroke within 4.5 h of onset. A retrospective study was performed in which the authors analysed data from 86 ischemic lacunar and nonlacunar stroke patients with a known time of symptom onset, imaged within the first 24 h from stroke onset (36 patients <4.5 h, 14 patients 4.5-6 h, 15 patients 6-12 h, and 21 patients 12-24 h). Patients underwent the admission CT and MR scan. The presence of lesions was assessed in correlation with the duration of the stroke. The time from stroke onset to neuroimaging was significantly shorter in patients with an ischemic lesion visible only in the DWI (mean 2.78 h, n = 24) as compared to patients with signs of ischemia also in other modalities (mean 8.6 h, n = 62) (p = 0.0001, Kruskal-Wallis ANOVA). The DWI/FLAIR mismatch was characterised by a global sensitivity of 58 %, specificity 94 %, PPV 87.5 %, and NPV 76 % in identifying patients in the 4.5 h thrombolysis time window. For lacunar strokes (n = 20), these parameters were as follows: sensitivity 50 %, specificity 92.8 %, PPV 75 %, and NPV 81.2 %. The presence of acute ischemic lesions only in DWI can help to identify both lacunar and nonlacunar stroke patients who are in the 4.5 h time window for intravenous thrombolysis with high specificity. (orig.)

  16. Evaluation of 2D multiband EPI imaging for high-resolution, whole-brain, task-based fMRI studies at 3T: Sensitivity and slice leakage artifacts.

    Science.gov (United States)

    Todd, Nick; Moeller, Steen; Auerbach, Edward J; Yacoub, Essa; Flandin, Guillaume; Weiskopf, Nikolaus

    2016-01-01

    Functional magnetic resonance imaging (fMRI) studies that require high-resolution whole-brain coverage have long scan times that are primarily driven by the large number of thin slices acquired. Two-dimensional multiband echo-planar imaging (EPI) sequences accelerate the data acquisition along the slice direction and therefore represent an attractive approach to such studies by improving the temporal resolution without sacrificing spatial resolution. In this work, a 2D multiband EPI sequence was optimized for 1.5mm isotropic whole-brain acquisitions at 3T with 10 healthy volunteers imaged while performing simultaneous visual and motor tasks. The performance of the sequence was evaluated in terms of BOLD sensitivity and false-positive activation at multiband (MB) factors of 1, 2, 4, and 6, combined with in-plane GRAPPA acceleration of 2× (GRAPPA 2), and the two reconstruction approaches of Slice-GRAPPA and Split Slice-GRAPPA. Sensitivity results demonstrate significant gains in temporal signal-to-noise ratio (tSNR) and t-score statistics for MB 2, 4, and 6 compared to MB 1. The MB factor for optimal sensitivity varied depending on anatomical location and reconstruction method. When using Slice-GRAPPA reconstruction, evidence of false-positive activation due to signal leakage between simultaneously excited slices was seen in one instance, 35 instances, and 70 instances over the ten volunteers for the respective accelerations of MB 2×GRAPPA 2, MB 4×GRAPPA 2, and MB 6×GRAPPA 2. The use of Split Slice-GRAPPA reconstruction suppressed the prevalence of false positives significantly, to 1 instance, 5 instances, and 5 instances for the same respective acceleration factors. Imaging protocols using an acceleration factor of MB 2×GRAPPA 2 can be confidently used for high-resolution whole-brain imaging to improve BOLD sensitivity with very low probability for false-positive activation due to slice leakage. Imaging protocols using higher acceleration factors (MB 3 or MB 4

  17. Altered whole-brain connectivity in albinism.

    Science.gov (United States)

    Welton, Thomas; Ather, Sarim; Proudlock, Frank A; Gottlob, Irene; Dineen, Robert A

    2017-02-01

    Albinism is a group of congenital disorders of the melanin synthesis pathway. Multiple ocular, white matter and cortical abnormalities occur in albinism, including a greater decussation of nerve fibres at the optic chiasm, foveal hypoplasia and nystagmus. Despite this, visual perception is largely preserved. It was proposed that this may be attributable to reorganisation among cerebral networks, including an increased interhemispheric connectivity of the primary visual areas. A graph-theoretic model was applied to explore brain connectivity networks derived from resting-state functional and diffusion-tensor magnetic resonance imaging data in 23 people with albinism and 20 controls. They tested for group differences in connectivity between primary visual areas and in summary network organisation descriptors. Main findings were supplemented with analyses of control regions, brain volumes and white matter microstructure. Significant functional interhemispheric hyperconnectivity of the primary visual areas in the albinism group were found (P = 0.012). Tests of interhemispheric connectivity based on the diffusion-tensor data showed no significant group difference (P = 0.713). Second, it was found that a range of functional whole-brain network metrics were abnormal in people with albinism, including the clustering coefficient (P = 0.005), although this may have been driven partly by overall differences in connectivity, rather than reorganisation. Based on the results, it was suggested that changes occur in albinism at the whole-brain level, and not just within the visual processing pathways. It was proposed that their findings may reflect compensatory adaptations to increased chiasmic decussation, foveal hypoplasia and nystagmus. Hum Brain Mapp 38:740-752, 2017. © 2016 Wiley Periodicals, Inc.

  18. 全脑CT灌注成像在短暂性脑缺血发作中的初步应用%Primary application of whole-brain CT perfusion imaging in patients with transient ischemic attack

    Institute of Scientific and Technical Information of China (English)

    陈婷; 郭大静; 赵建农; 方正

    2011-01-01

    目的 评价全脑CT灌注(CT perfusion,CTP)成像在短暂性脑缺血发作(transient ischemic attack,TIA)的临床应用价值.方法 对40例临床诊断为TIA的患者行全脑CTP,CTP检查获得达峰时间(TTP)、平均通过时间(MTT)、脑血流量(CBF)、脑血容量(CBV)等参数,同时获得动态CT血管成像(4D-CTA)图像,分析TIA患者的CTP和CT血管造影(CTA)表现.结果 40例TIA患者有36例发现与临床症状相对应的58处异常灌注区.异常灌注区表现为TTP和MTT明显延长,CBF有轻度降低,CBV轻度增高或基本正常.异常灌注区和健侧镜像区TTP值、MTT值和CBF值比较差异均有统计学意义(P<0.05),CBV值比较差异无统计学意义(P>0.05).4D-CTA显示责任血管不同程度的狭窄或闭塞,40例TIA患者有32例发现有血管狭窄,2例闭塞,6例正常.结论 全脑CTP可以实现对TIA的全面评价,在TIA的诊断及严重程度判断中具有重要价值.%Objective To explore the value of whole-brain CT perfusion (CTP) imaging in patients with transient ischemic attack (TIA). Methods Whole-brain CTP was performed in 40 patients with clinically diagnosed TIA. The parameter maps of time to peak (TTP), mean transit time (MTT), cerebral blood flow (CBF) , and cerebral blood volume (CBV) were analyzed. Dynamic CT angiography (4D-CTA) images were also obtained. Results Fifty-eight areas of abnormal perfusion changes corresponding to clinical symptoms were found in 36 of the 40 patients with CTP. Prolonged TTP and MTT, decreased CBF and increased or non-changed CBV were detected in the abnormal perfusion areas. The differences of TTP, MTT and CBF of the affected side compared with those of the contralateral side were significant (P 0.05). 4D-CTA showed responsible vascular stenosis or occlusion in varying degrees. In the 40 patients, vascular stenosis was found in 32 patients, occlusion in 2 patients and normal in 6 patients. Conclusion Overall assessment of TIA can be achieved by whole-brain

  19. Fast whole-brain optical tomography capable of automated slice-collection (Conference Presentation)

    Science.gov (United States)

    Yuan, Jing; Jiang, Tao; Deng, Lei; Long, Beng; Peng, Jie; Luo, Qingming; Gong, Hui

    2016-03-01

    Acquiring brain-wide composite information of neuroanatomical and molecular phenotyping is crucial to understand brain functions. However, current whole-brain imaging methods based on mechnical sectioning haven't achieved brain-wide acquisition of both neuroanatomical and molecular phenotyping due to the lack of appropriate whole-brain immunostaining of embedded samples. Here, we present a novel strategy of acquiring brain-wide structural and molecular maps in the same brain, combining whole-brain imaging and subsequent immunostaining of automated-collected slices. We developed a whole-brain imaging system capable of automatically imaging and then collecting imaged tissue slices in order. The system contains three parts: structured illumination microscopy for high-throughput optical sectioning, vibratome for high-precision sectioning and slice-collection device for automated collecting of tissue slices. Through our system, we could acquire a whole-brain dataset of agarose-embedded mouse brain at lateral resolution of 0.33 µm with z-interval sampling of 100 µm in 9 h, and automatically collect the imaged slices in sequence. Subsequently, we performed immunohistochemistry of the collected slices in the routine way. We acquired mouse whole-brain imaging datasets of multiple specific types of neurons, proteins and gene expression profiles. We believe our method could accelerate systematic analysis of brain anatomical structure with specific proteins or genes expression information and understanding how the brain processes information and generates behavior.

  20. Simultaneous multi-slice Turbo-FLASH imaging with CAIPIRINHA for whole brain distortion-free pseudo-continuous arterial spin labeling at 3 and 7 T.

    Science.gov (United States)

    Wang, Yi; Moeller, Steen; Li, Xiufeng; Vu, An T; Krasileva, Kate; Ugurbil, Kamil; Yacoub, Essa; Wang, Danny J J

    2015-06-01

    Simultaneous multi-slice (SMS) or multiband (MB) imaging has recently been attempted for arterial spin labeled (ASL) perfusion MRI in conjunction with echo-planar imaging (EPI) readout. It was found that SMS-EPI can reduce the T1 relaxation effect of the label and improve image coverage and resolution with little penalty in signal-to-noise ratio (SNR). However, EPI still suffers from geometric distortion and signal dropout from field inhomogeneity effects especially at high and ultrahigh magnetic fields. Here we present a novel scheme for achieving high fidelity distortion-free quantitative perfusion imaging by combining pseudo-continuous ASL (pCASL) with SMS Turbo-FLASH (TFL) readout at both 3 and 7 T. Bloch equation simulation was performed to characterize and optimize the TFL-based pCASL perfusion signal. Two MB factors (3 and 5) were implemented in SMS-TFL pCASL and compared with standard 2D TFL and EPI pCASL sequences. The temporal SNR of SMS-TFL pCASL relative to that of standard TFL pCASL was 0.76 ± 0.10 and 0.74 ± 0.11 at 7 T and 0.70 ± 0.05 and 0.65 ± 0.05 at 3T for MB factor of 3 and 5, respectively. By implementing background suppression in conjunction with SMS-TFL at 3T, the relative temporal SNR improved to 0.84 ± 0.09 and 0.79 ± 0.10 for MB factor of 3 and 5, respectively. Compared to EPI pCASL, significantly increased temporal SNR (pbrain distortion-free quantitative mapping of cerebral blood flow at high and ultrahigh magnetic fields.

  1. Mapping inter-regional connectivity of the entire cortex to characterize major depressive disorder: a whole-brain diffusion tensor imaging tractography study.

    Science.gov (United States)

    Korgaonkar, Mayuresh S; Cooper, Nicholas J; Williams, Leanne M; Grieve, Stuart M

    2012-06-20

    Diffusion tensor imaging (DTI) can be used to study the organization of brain white matter noninvasively. The aim of this study was to present a proof of concept for integrating DTI with high-resolution anatomical (T1) images to map and assess inter-regional connectivity across the entire cortex in a cohort of healthy participants and compared with patients with major depressive disorder. We used MRI data of 23 patients and 23 matched controls, assessed as part of baseline testing in the International Study to Predict Optimized Treatment in Depression (iSPOT-D). Freesurfer was used to analyze the T1 images to automatically label 35 gyral-based areas for each hemisphere. DTI tractography was performed to parcellate intercortical tracts using each of these areas in seed-target combinations. We quantified fractional anisotropy, number-of-fiber connections, and fiber path length for each DTI connection, with the goal of identifying the best measure or combination of measures to characterize major depression. The best classification accuracy for the individual measures was achieved using the number-of-fibers data, whereas the combination model provided a slight improvement. The most discriminant features between the two groups were for white matter associated with the limbic, frontal, and thalamic projection fibers and as part of cortical connections between the left inferior temporal and the postcentral cortex; the left parstriangularis and the left superior frontal; the left cuneus and the corpus callosum; the left lingual and the right lateral occipital, the right superior parietal and the right superior temporal cortices; and the right inferior parietal and the right insula and postcentral cortices.

  2. Evaluation of 128-slice spiral CT whole brain perfusion imaging in grading infiltrating astrocytomas%128层螺旋CT全脑灌注对浸润性星形细胞瘤的分级评估

    Institute of Scientific and Technical Information of China (English)

    曾文兵; 王毅; 汪明全; 吴炅; 刘兴华; 罗江平; 温云

    2011-01-01

    目的:评价128层螺旋CT全脑灌注(CTP)对浸润性星形细胞瘤分级定性诊断的价值.方法:选择我院90例脑肿瘤患者进行CTP检查,经手术和病理学证实为浸润性星形细胞瘤(Ⅱ~Ⅳ级)者46例纳入本研究对象.CTP采用SOMATOM Definition AS型128层螺旋CT机进行灌注扫描,应用后处理工作站对原始数据进行后处理.获得时间-密度曲线(TDC).测定肿瘤区和对侧正常组织的脑血流量(CBF)、脑血容量(CBV)、毛细血管表面通透性(PS)及对比剂达峰值时间(TTP),并对灌注参数进行统计学分析.结果:在所有病例中,全脑灌注图像平均视觉评价分数明显高于传统灌注图(P<0 01).且对病变定位更为精确.星形细胞肿瘤高级别组的CBF、CBV和PS值均显著高于低级别组(P<0.01).而TTP值的差异无统计学意义(P>0.05).ROC曲线分析表明,CBF、CBV和PS值对鉴别高、低级别星形细胞肿瘤的ROC曲线下面积分别为0.925、0.897和0.954.采用CBF≥72.052ml/min/100g,CBV≥4.293ml/100g和PS≥6.337ml/min/100g作为分界点对鉴别高低级别星形细胞肿瘤的敏感性均为87.2%,特异性分别是83.5%、83.5%和93.0%.结论:128层螺旋CT全脑灌注有利于脑肿瘤的术前整体评估和精确定位;CTP参数CBF、CBV及PS值及TDC曲线对鉴别高、低级别星形细胞肿瘤具有较高的敏感性和特异性.%Objective:To evaluate the value of 128-slicc spiral CT whole brain perfusion (CTP) imaging in grading infil-traiing astrocytomas. Methods: Ninety patients with brain rumors underwent CTP examination and forty-six of them with astrocytic tumors (Ⅱ -Ⅳ) confirmed by operation and pathology were selected as the object of this study. 128-slice helical CT whole brain perfusion imaging was performed in the 46 patients, and the data were analyzed by the software. Cerebral blood flow (CBF). Cerebral blood volume (CBV). Time to peak (TTP) and permeability surface (PS> on the maximum perfusion area

  3. Restoring susceptibility induced MRI signal loss in rat brain at 9.4 T: A step towards whole brain functional connectivity imaging.

    Directory of Open Access Journals (Sweden)

    Rupeng Li

    Full Text Available The aural cavity magnetic susceptibility artifact leads to significant echo planar imaging (EPI signal dropout in rat deep brain that limits acquisition of functional connectivity fcMRI data. In this study, we provide a method that recovers much of the EPI signal in deep brain. Needle puncture introduction of a liquid-phase fluorocarbon into the middle ear allows acquisition of rat fcMRI data without signal dropout. We demonstrate that with seeds chosen from previously unavailable areas, including the amygdala and the insular cortex, we are able to acquire large scale networks, including the limbic system. This tool allows EPI-based neuroscience and pharmaceutical research in rat brain using fcMRI that was previously not feasible.

  4. Feasibility of simultaneous whole-brain imaging on an integrated PET-MRI system using an enhanced 2-point Dixon attenuation correction method.

    Directory of Open Access Journals (Sweden)

    Udunna C Anazodo

    2015-01-01

    Full Text Available Purpose: To evaluate a potential approach for improved attenuation correction (AC of PET in simultaneous PET and MRI brain imaging, a straightforward approach that adds bone information missing on Dixon AC was explored. Methods: Bone information derived from individual T1-weighted MRI data using segmentation tools in SPM8, were added to the standard Dixon AC map. Percent relative difference between PET reconstructed with Dixon+bone and with Dixon AC maps were compared across brain regions of 13 oncology patients. The clinical potential of the improved Dixon AC was investigated by comparing relative perfusion (rCBF measured with arterial spin labeling to relative glucose uptake (rPETdxbone measured simultaneously with 18F-flurodexoyglucose in several regions across the brain. Results: A gradual increase in PET signal from center to the edge of the brain was observed in PET reconstructed with Dixon+bone. A 5-20% reduction in regional PET signals were observed in data corrected with standard Dixon AC maps. These regional underestimations of PET were either reduced or removed when Dixon+bone AC was applied. The mean relative correlation coefficient between rCBF and rPETdxbone was r = 0.53 (p<0.001. Marked regional variations in rCBF-to-rPET correlation were observed, with the highest associations in the caudate and cingulate and the lowest in limbic structures. All findings were well matched to observations from previous studies conducted with PET data reconstructed with computed tomography derived AC maps. Conclusion: Adding bone information derived from T1-weighted MRI to Dixon AC maps can improve underestimation of PET activity in hybrid PET-MRI neuroimaging.

  5. Deep Mining and Analysis for Massive Data of Whole Brain Magnetic Resonance Imaging%海量磁共振全脑影像数据的深度挖掘分析

    Institute of Scientific and Technical Information of China (English)

    王征

    2016-01-01

    Magnetic resonance imaging is one of the most important modern brain imaging methods to carry out biomedicine research. Recently in several national level brain research projects such as the Human Connectome Project and the BRAIN Initiative, magnetic resonance imaging technique has been widely used to acquire whole-brain structure and function maps of network connections. These brain-mapping studies, generally through statistical group comparison between healthy subjects and clinical patients, allow to seek signiifcant pathological differences for providing better guidance for the diagnosis and treatment of mental diseases. However, high-resolution magnetic resonance imaging of the whole brain often produce a large amount of structural and functional connectomics data, demanding effective computing technology to optimize this procedure. We plan first to collect cross-species magnetic resonance imaging data in both human and monkey brains, to develop novel machine learning algorithms for neural information analysis, and to combine evidence of animal models and human clinical trials for better understanding of the pathological mechanisms and for the development of effective therapeutic interventions.%磁共振成像是开展脑科学研究最重要的现代影像方法之一。随着近几年各国脑计划的陆续展开如美国人类连接组计划(Human Connectome Project)和2013年美国奥巴马政府制定的“脑计划”(BRAIN Initiative),磁共振技术已被广泛应用于探索大脑结构和功能网络连接图谱。使用脑网络联接图谱研究情绪障碍类疾病,一般是通过统计性比较正常人和病患的脑网络,寻找有意义的差异特征,为疾病的诊断和治疗提供指导。但是,高分辨的全脑磁共振成像经常产生大量的结构和功能联接图谱数据,因此需要非常有效的计算技术来实现这一过程。我们计划首先建立人-猴相对应的脑疾病影像数据集合,发展适

  6. Initial experience of whole-brain perfusion imaging performed with 256-slice CT%256层螺旋CT全脑灌注成像的初步研究

    Institute of Scientific and Technical Information of China (English)

    唐健; 姜建威; 常军; 侯海燕; 姜旭栋; 堵红群

    2011-01-01

    目的:初步评价256层螺旋CT全脑灌注成像对正常脑血流动力学测定的可行性和价值.方法:从拟诊缺血性脑病行头颅平扫、头颅灌注成像及头颈部血管成像的114例患者中选取检查结果正常者35例,记录头颅灌注成像的辐射剂量,由两名高年资神经放射科医生分别对灌注图像进行分析,选择基底节层面和侧脑室体部层面的两侧大脑中动脉供血区的颞叶皮质进行测定,通过手动勾画选定层面的感兴趣区,CT灌注软件自动生成感兴趣区的脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTr)、达峰时间(TTP)值,测得的灌注参数均值进行单因素方差分析.结果:35例正常人的辐射剂量为(2.307±0.008)mSv.2名分析者所测得侧脑室体部层面和基底节层面的颞叶灰质的CBF、CBV、MTr、TTP值之间无明显统计学差异(P>0.05).2名分析者测得的两个层面的颞叶灰质的CBV、CBF值之间均有统计学差异(P<0.05).结论:256层螺旋CT全脑灌注成像辐射剂量低,脑灌注参数稳定,能够更真实的反应全脑血流动力学改变.%Objective;To preliminarily evaluate the feasibility and potential values of whole-brain perfusion imaging performed with 256-slice CT to assess normal adult cerebral hemodynamics. Methods; Thirty-five normal results were selected from one hundred and fourteen patients who underwent brain CT unenhanced scan.CT perfusion imaging and CT angiography in head and neck for suspicion of ischemic cerebrovascular disease. The radiation dosage of CT perfusion imaging was recorded. Two senior neuroradiologic doctors independently analyzed the CT perfusion maps. Region of interest (ROI) was placed on bilateral temporal gray matter of two slices (the basal ganglia slice and body of lateral cerebral ventricle slice) supplied by middle cerebral artery,and the cerebral blood flow(CBF),cerebral blood volume(CBV),mean transiting time(MTT), and time to peak(TTP) values of ROI

  7. Quantitative comparison of functional contrast from BOLD-weighted spin-echo and gradient-echo echoplanar imaging at 1.5 Tesla and H2 15O PET in the whole brain.

    Science.gov (United States)

    Lowe, M J; Lurito, J T; Mathews, V P; Phillips, M D; Hutchins, G D

    2000-09-01

    Spin-echo and gradient-echo echoplanar functional magnetic resonance imaging (fMRI) studies at 1.5 Tesla (T) were used to obtain blood oxygenation level-dependent (BOLD) contrast images of the whole brain in seven strongly right-handed women during execution of a complex motor task. Five subjects underwent subsequent H215O positron emission tomography (PET) studies while performing the same task. Group-averaged results for changes in the MRI relaxation rates R2* and R2 at 1.5T in response to neuronal activation in nine cortical, subcortical, and cerebellar motor regions are reported. Results for each method are grouped according to tissue type-cerebral cortex (precentral gyrus and supplementary motor area), subcortical regions (thalamus and putamen), and cerebellar cortex (superior lobule). The observed changes in R2* from activation-induced oxygenation changes were more variable across brain regions with different tissue characteristics than observed changes in R2. The ratio of deltaR2* to deltaR2 was 3.3 +/- 0.9 for cerebral cortex and 2.0 +/- 0.6 for subcortical tissue. deltaR2*, deltaR2, and relative blood flow changes were deltaR2* = -0.201 +/- 0.040 (s-1), deltaR2 = -0.064 +/- 0.011 s(-1), and deltaf/f = 16.7 +/- 0.8% in the cerebral cortex; deltaR2* = -0.100 +/- 0.026 s(-1), deltaR2 = -0.049 +/- 0.009 s(-1), and deltaf/f = 9.4 +/- 0.7% in the subcortical regions; and deltaR2* = -0.215 +/- 0.093 s(-1), deltaR2 = -0.069 +/- 0.012 s(-1), and deltaf/f = 16.2 +/- 1.2% in the cerebellar cortex.

  8. Whole Brain Size and General Mental Ability: A Review

    OpenAIRE

    2009-01-01

    We review the literature on the relation between whole brain size and general mental ability (GMA) both within and between species. Among humans, in 28 samples using brain imaging techniques, the mean brain size/GMA correlation is 0.40 (N = 1,389; p < 10−10); in 59 samples using external head size measures it is 0.20 (N = 63,405; p < 10−10). In 6 samples using the method of correlated vectors to distill g, the general factor of mental ability, the mean r is 0.63. We also describe the brain si...

  9. Optimizing the scan protocol in whole-brain perfusion imaging with 320-MDCT%320排容积CT全脑灌注成像扫描协议优化研究

    Institute of Scientific and Technical Information of China (English)

    曹国全; 许化致; 潘克华; 陈伟建; 郭翔

    2014-01-01

    目的 探讨320排容积CT全脑灌注成像扫描协议优化的可行性.方法 20名健康志愿者按随机数字表法分为对照组和试验组,对照组7例,选择标准灌注扫描协议(19圈容积采集);试验组13例,通过合理改变采集间隔,减少扫描期相,采用一组新的灌注扫描协议(11圈容积采集).图像分析感兴趣区(ROI)设为两侧额叶白质、顶叶白质、半卵圆区、基底节区、枕叶、小脑,大小约(20±2)mm2.计算得到各感兴趣区的灌注参数值,包括脑血容量(rCBV)、达峰时间(TTP)、脑血流量(rCBF)、平均通过时间(MTT)及延迟时间(DT).结果 试验组剂量长度乘积(DLP)和有效剂量(E)较对照组降低了42.02%.两组不同层面左右两侧ROI区的各灌注参数的差异无统计学意义.两组组间上述各个对应部位的ROI区各灌注参数无明显差别.结论 优化后的扫描协议得到了与厂家推荐的标准协议无差异的全脑灌注参数值且降低了辐射剂量,推荐常规使用.%Objective To evaluate the feasibility of optimized scan protocol in whole-brain perfusion imaging with 320-MDCT scanner.Methods Twenty healthy volunteers were randomly divided into control group (13 patients) and test group (7 patients).The standard perfusion scan protocol (collecting 19 volumes)was applied in control group.The optimized perfusion CT scan protocol(collecting ll volumes)formulated by reducing scanning phases reasonably and changing the collection intervals was applied in test group.The regions of interest(ROI) with area of(20 ± 2)mm2 were located in the bilateral frontal white matter,parietal white matter,centrum semiovate,basal ganglia,occipital lobe and cerebellum.Bilateral perfusion values from ROI were measured,including cerebral blood volume(CBV),mean transit time (TTP),cerebral blood flow (CBF),mean transit time (MTT) and delay time (DT).Results Dose length product (DLP)and effective dose (ED)in optimized protocol were decreased 42.02

  10. 急性脑梗死320排 CT 脑灌注成像分析%The analysis of whole-brain CT perfusion imaging with 320-detector row CT in acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    阮志兵; 段庆红

    2014-01-01

    Objective To explore the clinical value of whole-brain CT perfusion imaging with 320-detector row CT in early acute cerebral infarction.Methods The CTP parameters(CBF,CBV,MTT,TTP)and its pseudo color map of 25 patients with early acute cerebral infarction were retrospectively analysed and compared between infarction area,ischemic penumbra (IP)and the con-tralateral normal region.Results The abnormal perfusion area were found on CTP in 25 patients with early acute cerebral infarction. CTP showed cerebral blood flow (CBF)and cerebral blood volume (CBV)decreased significantly,mean transit time (MTT)short-ened significantly,time to peak (TTP)was significantly longer than those of the contralateral normal region in 7 cases of acute cere-bral infarct core.18 cases of IP lesions showed CBF decreased slightly,CBV increased slightly or maintain normal,MTT and TTP extension compared with contralateral.CBF,CBV,MTT,TTP values had significantly differences between infarct region and the contralateral corresponding normal region,between the infarct core area and IP of acute cerebral infarction (P 0.05)between IP region and the contralateral corresponding normal region,but showed a downward trend in blood flow.Parameter color maps of CTP could di-rectly,clearly and sensitively show abnormal changes region about cerebral blood flow.In particular,MTT and TTP maps shows ab-normal region clearer and sensitively.Follow-up 18 cases of IP,active lesions deduced in 6 cases,the lesions disappeared in 5 pa-tients (CT/ MRI showed no abnormal,and the clinical symptoms disappeared)after thrombolytic therapy,7 cases of MRI and CT scans confirmed infarction stove.Conclusion Whole-brain CTP with 320-detector row CT can early show the acute cerebral infarc-tion and its ischemic penumbra,it has significant important clinical value for early acute cerebral infarction.%目的:探讨320排 CT 全脑灌注成像(CTP)在早期急性脑梗死中的临床应用价值。方法回顾性分析25

  11. A Thomistic defense of whole-brain death

    OpenAIRE

    Eberl, Jason T.

    2015-01-01

    Michel Accad critiques the currently accepted whole-brain criterion for determining the death of a human being from a Thomistic metaphysical perspective and, in so doing, raises objections to a particular argument defending the whole-brain criterion by Patrick Lee and Germain Grisez. In this paper, I will respond to Accad's critique of the whole-brain criterion and defend its continued validity as a criterion for determining when a human being's death has occurred in accord with Thomistic met...

  12. Regional Fluid-Attenuated Inversion Recovery (FLAIR at 7 Tesla correlates with Amyloid beta in Hippocampus and Brainstem of cognitively normal elderly subjects.

    Directory of Open Access Journals (Sweden)

    Simon J Schreiner

    2014-09-01

    Full Text Available Background: Accumulation of amyloid beta (Aβ may occur during healthy aging and is a risk factor for Alzheimer Disease (AD. While individual Aβ-accumulation can be measured non-invasively using Pittsburgh compound-B positron-emission-tomography (PiB-PET, Fluid-Attenuated Inversion Recovery (FLAIR is a Magnetic Resonance Imaging (MRI sequence, capable of indicating heterogeneous age-related brain pathologies associated with tissue-edema. In the current study cognitively normal elderly subjects were investigated for regional correlation of PiB- and FLAIR- intensity. Methods: 14 healthy elderly subjects without known history of cognitive impairment received 11C-PiB-PET for estimation of regional Aβ-load. In addition, whole brain T1-MPRAGE and FLAIR-MRI sequences were acquired at high field strength of 7 Tesla (7T. Volume-normalized intensities of brain regions were assessed by applying an automated subcortical segmentation algorithm for spatial definition of brain structures. Statistical dependence between FLAIR- and PiB-PET intensities was tested using Spearman's rank correlation coefficient (rho, followed by Holm-Bonferroni correction for multiple testing. Results: Neuropsychological testing revealed normal cognitive performance levels in all participants. Mean regional PiB-PET and FLAIR intensities were normally distributed and independent. Significant correlation between volume-normalized PiB-PET signals and FLAIR intensities resulted for Hippocampus (right:rho=0.86; left:rho=0.84, Brainstem (rho=0.85 and left Basal Ganglia vessel region (rho=0.82. Conclusions: Our finding of a significant relationship between PiB- and FLAIR-intensity mainly observable in the Hippocampus and Brainstem, indicates regional Aβ associated tissue-edema in cognitively normal elderly subjects. Further studies including clinical populations are necessary to clarify the relevance of our findings for estimating individual risk for age-related neurodegenerative

  13. Regional Fluid-Attenuated Inversion Recovery (FLAIR) at 7 Tesla correlates with amyloid beta in hippocampus and brainstem of cognitively normal elderly subjects

    Science.gov (United States)

    Schreiner, Simon J.; Liu, Xinyang; Gietl, Anton F.; Wyss, Michael; Steininger, Stefanie C.; Gruber, Esmeralda; Treyer, Valerie; Meier, Irene B.; Kälin, Andrea M.; Leh, Sandra E.; Buck, Alfred; Nitsch, Roger M.; Pruessmann, Klaas P.; Hock, Christoph; Unschuld, Paul G.

    2014-01-01

    Background: Accumulation of amyloid beta (Aβ) may occur during healthy aging and is a risk factor for Alzheimer Disease (AD). While individual Aβ-accumulation can be measured non-invasively using Pittsburgh Compund-B positron emission tomography (PiB-PET), Fluid-attenuated inversion recovery (FLAIR) is a Magnetic Resonance Imaging (MRI) sequence, capable of indicating heterogeneous age-related brain pathologies associated with tissue-edema. In the current study cognitively normal elderly subjects were investigated for regional correlation of PiB- and FLAIR intensity. Methods: Fourteen healthy elderly subjects without known history of cognitive impairment received 11C-PiB-PET for estimation of regional Aβ-load. In addition, whole brain T1-MPRAGE and FLAIR-MRI sequences were acquired at high field strength of 7 Tesla (7T). Volume-normalized intensities of brain regions were assessed by applying an automated subcortical segmentation algorithm for spatial definition of brain structures. Statistical dependence between FLAIR- and PiB-PET intensities was tested using Spearman's rank correlation coefficient (rho), followed by Holm–Bonferroni correction for multiple testing. Results: Neuropsychological testing revealed normal cognitive performance levels in all participants. Mean regional PiB-PET and FLAIR intensities were normally distributed and independent. Significant correlation between volume-normalized PiB-PET signals and FLAIR intensities resulted for Hippocampus (right: rho = 0.86; left: rho = 0.84), Brainstem (rho = 0.85) and left Basal Ganglia vessel region (rho = 0.82). Conclusions: Our finding of a significant relationship between PiB- and FLAIR intensity mainly observable in the Hippocampus and Brainstem, indicates regional Aβ associated tissue-edema in cognitively normal elderly subjects. Further studies including clinical populations are necessary to clarify the relevance of our findings for estimating individual risk for age-related neurodegenerative

  14. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study; Anormalidade de sinal na imagem por RM do polo temporal na epilepsia do lobo temporal com esclerose hipocampal: um estudo pela sequencia inversao recuperacao com supressao da agua livre (FLAIR)

    Energy Technology Data Exchange (ETDEWEB)

    Carrete Junior, Henrique; Abdala, Nitamar; Szjenfeld, Jacob; Nogueira, Roberto Gomes [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem; Lin, Katia; Caboclo, Luis Otavio; Centeno, Ricardo Silva; Sakamoto, Americo Ceiki; Yacubian, Elza Marcia Targas [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Neurologia e Neurocirurgia

    2007-09-15

    Objective: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. Method: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. Results: Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, {chi}{sup 2} test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. Conclusion: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved. (author)

  15. Hypothalamic dysfunction following whole-brain irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Mechanick, J.I.; Hochberg, F.H.; LaRocque, A.

    1986-10-01

    The authors describe 15 cases with evidence of hypothalamic dysfunction 2 to 9 years following megavoltage whole-brain x-irradiation for primary glial neoplasm. The patients received 4000 to 5000 rads in 180- to 200-rad fractions. Dysfunction occurred in the absence of computerized tomography-delineated radiation necrosis or hypothalamic invasion by tumor, and antedated the onset of dementia. Fourteen patients displayed symptoms reflecting disturbances of personality, libido, thirst, appetite, or sleep. Hyperprolactinemia (with prolactin levels up to 70 ng/ml) was present in all of the nine patients so tested. Of seven patients tested with thyrotropin-releasing hormone, one demonstrated an abnormal pituitary gland response consistent with a hypothalamic disorder. Seven patients developed cognitive abnormalities. Computerized tomography scans performed a median of 4 years after tumor diagnosis revealed no hypothalamic tumor or diminished density of the hypothalamus. Cortical atrophy was present in 50% of cases and third ventricular dilatation in 58%. Hypothalamic dysfunction, heralded by endocrine, behavioral, and cognitive impairment, represents a common, subtle form of radiation damage.

  16. A Thomistic defense of whole-brain death.

    Science.gov (United States)

    Eberl, Jason T

    2015-08-01

    Michel Accad critiques the currently accepted whole-brain criterion for determining the death of a human being from a Thomistic metaphysical perspective and, in so doing, raises objections to a particular argument defending the whole-brain criterion by Patrick Lee and Germain Grisez. In this paper, I will respond to Accad's critique of the whole-brain criterion and defend its continued validity as a criterion for determining when a human being's death has occurred in accord with Thomistic metaphysical principles. I will, however, join Accad in criticizing Lee and Grisez's proposed defense of the whole-brain criterion as potentially leading to erroneous conclusions regarding the determination of human death. Lay summary: Catholic physicians and bioethicists currently debate the legally accepted clinical standard for determining when a human being has died-known as the "wholebrain criterion"-which has also been morally affirmed by the Magisterium. This paper responds to physician Michel Accad's critique of the whole-brain criterion based upon St. Thomas Aquinas's metaphysical account of human nature as a union of a rational soul and a material body. I defend the whole-brain criterion from the same Thomistic philosophical perspective, while agreeing with Accad's objection to an alternative Thomistic defense of whole-brain death by philosophers Patrick Lee and Germain Grisez.

  17. Whole brain CT perfusion on a 320-slice CT scanner

    Directory of Open Access Journals (Sweden)

    Jai Jai Shiva Shankar

    2011-01-01

    Full Text Available Computed tomography perfusion (CTP has been criticized for limited brain coverage. This may result in inadequate coverage of the lesion, inadequate arterial input function, or omission of the lesion within the target perfusion volume. The availability of 320-slice CT scanners offers whole brain coverage. This minimizes the chances of misregistration of lesions regardless of location, and makes the selection of the arterial input function easy. We present different clinical scenarios in which whole brain CTP is especially useful.

  18. Automatic planning on hippocampal avoidance whole-brain radiotherapy.

    Science.gov (United States)

    Wang, Shuo; Zheng, Dandan; Zhang, Chi; Ma, Rongtao; Bennion, Nathan R; Lei, Yu; Zhu, Xiaofeng; Enke, Charles A; Zhou, Sumin

    2017-01-01

    Mounting evidence suggests that radiation-induced damage to the hippocampus plays a role in neurocognitive decline for patients receiving whole-brain radiotherapy (WBRT). Hippocampal avoidance whole-brain radiotherapy (HA-WBRT) has been proposed to reduce the putative neurocognitive deficits by limiting the dose to the hippocampus. However, urgency of palliation for patients as well as the complexities of the treatment planning may be barriers to protocol enrollment to accumulate further clinical evidence. This warrants expedited quality planning of HA-WBRT. Pinnacle(3) Automatic treatment planning was designed to increase planning efficiency while maintaining or improving plan quality and consistency. The aim of the present study is to evaluate the performance of the Pinnacle(3) Auto-Planning on HA-WBRT treatment planning. Ten patients previously treated for brain metastases were selected. Hippocampal volumes were contoured on T1 magnetic resonance (MR) images, and planning target volumes (PTVs) were generated based on RTOG0933. The following 2 types of plans were generated by Pinnacle(3) Auto-Planning: the one with 2 coplanar volumetric modulated arc therapy (VMAT) arcs and the other with 9-field noncoplanar intensity-modulated radiation therapy (IMRT). D2% and D98% of PTV were used to calculate homogeneity index (HI). HI and Paddick Conformity index (CI) of PTV as well as D100% and Dmax of the hippocampus were used to evaluate the plan quality. All the auto-plans met the dose coverage and constraint objectives based on RTOG0933. The auto-plans eliminated the necessity of generating pseudostructures by the planners, and it required little manual intervention which expedited the planning process. IMRT quality assurance (QA) results also suggest that all the auto-plans are practically acceptable on delivery. Pinnacle(3) Auto-Planning generates acceptable plans by RTOG0933 criteria without time-consuming planning process. The expedited quality planning achieved by

  19. Whole-brain atrophy differences between progressive supranuclear palsy and idiopathic Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Carlos Guevara

    2016-09-01

    Full Text Available Background: The absence of markers for ante-mortem diagnosis of progressive supranuclear palsy (PSP results in this disorder’s being commonly mistaken for other conditions, such as idiopathic Parkinson's disease (IPD. Such mistakes occur particularly in the initial stages, when ‘plus syndrome’ has not yet clinically emerged.Objective. To investigate global brain volume and tissue loss in patients with PSP relative to patients with IPD and healthy controls and correlations between clinical parameters and magnetic resonance imaging (MRI-derived brain volume estimates.Methods: T1-weighted images were obtained from three groups of Chilean Latin American adults: 21 patients with IPD, 18 patients with PSP and 14 healthy controls. We used Structural Imaging Evaluation with Normalization of Atrophy (SIENAX to assess white matter, gray matter and whole-brain volumes (normalized to cranial volume. Imaging data were used to analyze putative correlations with the clinical status of PSP and IPD patients using the Unified Parkinson’s Disease Rating Scale Part III, Hoehn and Yahr, the Clinical Global Impression for Disease Severity Scale and the Frontal Assessment Battery.Results: PSP patients had significantly lower whole brain volume than both IPD patients and controls. Whole brain volume reduction in PSP patients was primarily attributable to gray matter volume reduction. We found a significant correlation between brain volume reduction and clinical status in the PSP group.Conclusions: At the group level, whole brain and gray matter volumes differentiated patients with PSP from patients with IPD. There was also significant clinical-imaging correlations with motor disturbances in PSP.

  20. Whole-Brain Atrophy Differences between Progressive Supranuclear Palsy and Idiopathic Parkinson’s Disease

    Science.gov (United States)

    Guevara, Carlos; Bulatova, Katherina; Barker, Gareth J.; Gonzalez, Guido; Crossley, Nicolas A.; Kempton, Matthew J.

    2016-01-01

    Background: The absence of markers for ante-mortem diagnosis of progressive supranuclear palsy (PSP), results in this disorder being commonly mistaken for other conditions, such as idiopathic Parkinson’s disease (IPD). Such mistakes occur particularly in the initial stages, when “plus syndrome” has not yet clinically emerged. Objective: To investigate the global brain volume and tissue loss in patients with PSP relative to patients with IPD and healthy controls and correlations between clinical parameters and magnetic resonance imaging (MRI)-derived brain volume estimates. Methods: T1-weighted images were obtained from three groups of Chilean Latin American adults: 21 patients with IPD, 18 patients with PSP and 14 healthy controls. We used Structural Imaging Evaluation with Normalization of Atrophy (SIENAX) to assess white matter, gray matter and whole-brain volumes (normalized to cranial volume). Imaging data were used to analyze putative correlations with the clinical status of PSP and IPD patients using the Unified Parkinson’s Disease Rating Scale Part III (UPDRS III), Hoehn and Yahr (H&Y), the Clinical Global Impression for Disease Severity Scale (CGI-S) and the Frontal Assessment Battery (FAB). Results: PSP patients had significantly lower whole brain volume than both IPD patients and controls. Whole brain volume reduction in PSP patients was primarily attributable to gray matter volume reduction. We found a significant correlation between brain volume reduction and clinical status in the PSP group. Conclusions: At the group level, the whole brain and gray matter volumes differentiated patients with PSP from patients with IPD. There was also significant clinical-imaging correlations with motor disturbances in PSP. PMID:27679572

  1. Simultaneous Whole-Brain Segmentation and White Matter Lesion Detection Using Contrast-Adaptive Probabilistic Models

    DEFF Research Database (Denmark)

    Puonti, Oula; Van Leemput, Koen

    2016-01-01

    In this paper we propose a new generative model for simultaneous brain parcellation and white matter lesion segmentation from multi-contrast magnetic resonance images. The method combines an existing whole-brain segmentation technique with a novel spatial lesion model based on a convolutional...... restricted Boltzmann machine. Unlike current state-of-the-art lesion detection techniques based on discriminative modeling, the proposed method is not tuned to one specific scanner or imaging protocol, and simultaneously segments dozens of neuroanatomical structures. Experiments on a public benchmark dataset...... in multiple sclerosis indicate that the method’s lesion segmentation accuracy compares well to that of the current state-of-the-art in the field, while additionally providing robust whole-brain segmentations....

  2. Developmental venous anomalies: appearance on whole-brain CT digital subtraction angiography and CT perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, Eric H. [Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); University of Nevada Las Vegas, Department of Health Physics and Diagnostic Sciences, 4505 Maryland Parkway, Box 453037, Las Vegas, NV (United States); Amigenics, Inc, Las Vegas, NV (United States); Roach, Cayce J. [Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); University of Nevada Las Vegas, School of Life Sciences, Las Vegas, NV (United States); Ringdahl, Erik N. [University of Nevada Las Vegas, Department of Psychology, Las Vegas, NV (United States); Wynn, Brad L. [Family Medicine Spokane, Spokane, WA (United States); DeChancie, Sean M.; Mann, Nathan D. [Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); Diamond, Alan S. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); Orrison, William W. [Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); University of Nevada Las Vegas, Department of Health Physics and Diagnostic Sciences, 4505 Maryland Parkway, Box 453037, Las Vegas, NV (United States); CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); University of Nevada School of Medicine, Department of Medical Education, Reno, NV (United States)

    2011-05-15

    Developmental venous anomalies (DVA) consist of dilated intramedullary veins that converge into a large collecting vein. The appearance of these anomalies was evaluated on whole-brain computed tomography (CT) digital subtraction angiography (DSA) and CT perfusion (CTP) studies. CT data sets of ten anonymized patients were retrospectively analyzed. Five patients had evidence of DVA and five age- and sex-matched controls were without known neurovascular abnormalities. CT angiograms, CT arterial-venous views, 4-D CT DSA and CTP maps were acquired on a dynamic volume imaging protocol on a 320-detector row CT scanner. Whole-brain CTP parameters were evaluated for cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and delay. DSA was utilized to visualize DVA anatomy. Radiation dose was recorded from the scanner console. Increased CTP values were present in the DVA relative to the unaffected contralateral hemisphere of 48%, 32%, and 26%; and for the control group with matched hemispheric comparisons of 2%, -10%, and 9% for CBF, CBV, and MTT, respectively. Average effective radiation dose was 4.4 mSv. Whole-brain DSA and CTP imaging can demonstrate a characteristic appearance of altered DVA hemodynamic parameters and capture the anomalies in superior cortices of the cerebrum and the cerebellum. Future research may identify the rare subsets of patients at increased risk of adverse outcomes secondary to the altered hemodynamics to facilitate tailored imaging surveillance and application of appropriate preventive therapeutic measures. (orig.)

  3. Whole brain CT perfusion in acute anterior circulation ischemia: coverage size matters

    Energy Technology Data Exchange (ETDEWEB)

    Emmer, B.J. [Erasmus Medical Centre, Department of Radiology, Postbus 2040, Rotterdam (Netherlands); Rijkee, M.; Walderveen, M.A.A. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Niesten, J.M.; Velthuis, B.K. [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Wermer, M.J.H. [Leiden University Medical Centre, Department of Neurology, Leiden (Netherlands)

    2014-12-15

    Our aim was to compare infarct core volume on whole brain CT perfusion (CTP) with several limited coverage sizes (i.e., 3, 4, 6, and 8 cm), as currently used in routine clinical practice. In total, 40 acute ischemic stroke patients with non-contrast CT (NCCT) and CTP imaging of anterior circulation ischemia were included. Imaging was performed using a 320-multislice CT. Average volumes of infarct core of all simulated partial coverage sizes were calculated. Infarct core volume of each partial brain coverage was compared with infarct core volume of whole brain coverage and expressed using a percentage. To determine the optimal starting position for each simulated CTP coverage, the percentage of infarct coverage was calculated for every possible starting position of the simulated partial coverage in relation to Alberta Stroke Program Early CT Score in Acute Stroke Triage (ASPECTS 1) level. Whole brain CTP coverage further increased the percentage of infarct core volume depicted by 10 % as compared to the 8-cm coverage when the bottom slice was positioned at the ASPECTS 1 level. Optimization of the position of the region of interest (ROI) in 3 cm, 4 cm, and 8 cm improved the percentage of infarct depicted by 4 % for the 8-cm, 7 % for the 4-cm, and 13 % for the 3-cm coverage size. This study shows that whole brain CTP is the optimal coverage for CTP with a substantial improvement in accuracy in quantifying infarct core size. In addition, our results suggest that the optimal position of the ROI in limited coverage depends on the size of the coverage. (orig.)

  4. Whole brain susceptibility mapping using compressed sensing.

    Science.gov (United States)

    Wu, Bing; Li, Wei; Guidon, Arnaud; Liu, Chunlei

    2012-01-01

    The derivation of susceptibility from image phase is hampered by the ill-conditioned filter inversion in certain k-space regions. In this article, compressed sensing is used to compensate for the k-space regions where direct filter inversion is unstable. A significantly lower level of streaking artifacts is produced in the resulting susceptibility maps for both simulated and in vivo data sets compared to outcomes obtained using the direct threshold method. It is also demonstrated that the compressed sensing based method outperforms regularization based methods. The key difference between the regularized inversions and compressed sensing compensated inversions is that, in the former case, the entire k-space spectrum estimation is affected by the ill-conditioned filter inversion in certain k-space regions, whereas in the compressed sensing based method only the ill-conditioned k-space regions are estimated. In the susceptibility map calculated from the phase measurement obtained using a 3T scanner, not only are the iron-rich regions well depicted, but good contrast between white and gray matter interfaces that feature a low level of susceptibility variations are also obtained. The correlation between the iron content and the susceptibility levels in iron-rich deep nucleus regions is studied, and strong linear relationships are observed which agree with previous findings.

  5. Hippocampal-sparing whole-brain radiotherapy using Elekta equipment.

    Science.gov (United States)

    Nevelsky, Alexander; Ieumwananonthachai, Nantakan; Kaidar-Person, Orit; Bar-Deroma, Raquel; Nasrallah, Haitam; Ben-Yosef, Rahamim; Kuten, Abraham

    2013-05-06

    The purpose of this study was to evaluate the feasibility of hippocampal-sparing whole-brain radiotherapy (HS WBRT) using the Elekta Infinity linear accelerator and Monaco treatment planning system (TPS). Ten treatment plans were created for HS-WBRT to a dose of 30 Gy (10 fractions). RTOG 0933 recommendations were applied for treatment planning. Intensity-modulated radiotherapy (IMRT) plans for the Elekta Infinity linear accelerator were created using Monaco 3.1 TPS-based on a nine-field arrangement and step-and-shoot delivery method. Plan evaluation was performed using D2% and D98% for the whole-brain PTV (defined as whole brain excluding hippocampus avoidance region), D100% and maximum dose to the hippocampus, and maximum dose to optic nerves and chiasm. Homogeneity index (HI) defined as (D2%-D98%)/Dmedian was used to quantify dose homogeneity in the PTV. The whole-brain PTV D2% mean value was 37.28 Gy (range 36.95-37.49Gy), and D98% mean value was 25.37 Gy (range 25.40-25.89 Gy). The hippocampus D100% mean value was 8.37 Gy (range 7.48-8.97 Gy) and the hippocampus maximum dose mean value was 14.35 Gy (range 13.48-15.40 Gy). The maximum dose to optic nerves and optic chiasm for all patients did not exceed 37.50 Gy. HI mean value was 0.36 (range 0.34-0.37). Mean number of segments was 105 (range 88-122) and mean number of monitor units was 1724 (range 1622-1914). Gamma evaluation showed that all plans passed 3%, 3 mm criteria with more than 99% of the measured points. These results indicate that Elekta equipment (Elekta Infinity linac and Monaco TPS) can be used for HS WBRT planning according to compliance criteria defined by the RTOG 0933 protocol.

  6. Whole Brain Thinking : An Educational Alternative for Language Instructors

    OpenAIRE

    Ogawa, Ruby Toshimi

    2008-01-01

    Whole brain thinking offers new potentials in providing an educational alternative in teaching English as a Second Language (ESL). Prevailing research has shown that the right and the left sides of the brain function and process information differently according to Nobel Prize Winner Roger Sperry in his split-brain research on epileptics. While acknowledging these physical neurological differences, current research suggesting that in view of traditional teaching methods that rely on left-brai...

  7. Whole brain white matter changes revealed by multiple diffusion metrics in multiple sclerosis: A TBSS study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yaou, E-mail: asiaeurope80@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Duan, Yunyun, E-mail: xiaoyun81.love@163.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); He, Yong, E-mail: yong.h.he@gmail.com [State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875 (China); Yu, Chunshui, E-mail: csyuster@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Wang, Jun, E-mail: jun_wang@bnu.edu.cn [State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875 (China); Huang, Jing, E-mail: sainthj@126.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Ye, Jing, E-mail: jingye.2007@yahoo.com.cn [Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Parizel, Paul M., E-mail: paul.parizel@ua.ac.be [Department of Radiology, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, 2650 Edegem, 8 Belgium (Belgium); Li, Kuncheng, E-mail: kunchengli55@gmail.com [Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053 (China); Shu, Ni, E-mail: nshu55@gmail.com [State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875 (China)

    2012-10-15

    Objective: To investigate whole brain white matter changes in multiple sclerosis (MS) by multiple diffusion indices, we examined patients with diffusion tensor imaging and utilized tract-based spatial statistics (TBSS) method to analyze the data. Methods: Forty-one relapsing-remitting multiple sclerosis (RRMS) patients and 41 age- and gender-matched normal controls were included in this study. Diffusion weighted images were acquired by employing a single-shot echo planar imaging sequence on a 1.5 T MR scanner. Voxel-wise analyses of multiple diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were performed with TBSS. Results: The MS patients had significantly decreased FA (9.11%), increased MD (8.26%), AD (3.48%) and RD (13.17%) in their white matter skeletons compared with the controls. Through TBSS analyses, we found abnormal diffusion changes in widespread white matter regions in MS patients. Specifically, decreased FA, increased MD and increased RD were involved in whole-brain white matter, while several regions exhibited increased AD. Furthermore, white matter regions with significant correlations between the diffusion metrics and the clinical variables (the EDSS scores, disease durations and white matter lesion loads) in MS patients were identified. Conclusion: Widespread white matter abnormalities were observed in MS patients revealed by multiple diffusion metrics. The diffusion changes and correlations with clinical variables were mainly attributed to increased RD, implying the predominant role of RD in reflecting the subtle pathological changes in MS.

  8. Whole-brain circuit dissection in free-moving animals reveals cell-specific mesocorticolimbic networks

    Science.gov (United States)

    Michaelides, Michael; Anderson, Sarah Ann R.; Ananth, Mala; Smirnov, Denis; Thanos, Panayotis K.; Neumaier, John F.; Wang, Gene-Jack; Volkow, Nora D.; Hurd, Yasmin L.

    2013-01-01

    The ability to map the functional connectivity of discrete cell types in the intact mammalian brain during behavior is crucial for advancing our understanding of brain function in normal and disease states. We combined designer receptor exclusively activated by designer drug (DREADD) technology and behavioral imaging with μPET and [18F]fluorodeoxyglucose (FDG) to generate whole-brain metabolic maps of cell-specific functional circuits during the awake, freely moving state. We have termed this approach DREADD-assisted metabolic mapping (DREAMM) and documented its ability in rats to map whole-brain functional anatomy. We applied this strategy to evaluating changes in the brain associated with inhibition of prodynorphin-expressing (Pdyn-expressing) and of proenkephalin-expressing (Penk-expressing) medium spiny neurons (MSNs) of the nucleus accumbens shell (NAcSh), which have been implicated in neuropsychiatric disorders. DREAMM revealed discrete behavioral manifestations and concurrent engagement of distinct corticolimbic networks associated with dysregulation of Pdyn and Penk in MSNs of the NAcSh. Furthermore, distinct neuronal networks were recruited in awake versus anesthetized conditions. These data demonstrate that DREAMM is a highly sensitive, molecular, high-resolution quantitative imaging approach. PMID:24231358

  9. Automated diagnosis of Alzheimer's disease with multi-atlas based whole brain segmentations

    Science.gov (United States)

    Luo, Yuan; Tang, Xiaoying

    2017-03-01

    Voxel-based analysis is widely used in quantitative analysis of structural brain magnetic resonance imaging (MRI) and automated disease detection, such as Alzheimer's disease (AD). However, noise at the voxel level may cause low sensitivity to AD-induced structural abnormalities. This can be addressed with the use of a whole brain structural segmentation approach which greatly reduces the dimension of features (the number of voxels). In this paper, we propose an automatic AD diagnosis system that combines such whole brain segmen- tations with advanced machine learning methods. We used a multi-atlas segmentation technique to parcellate T1-weighted images into 54 distinct brain regions and extract their structural volumes to serve as the features for principal-component-analysis-based dimension reduction and support-vector-machine-based classification. The relationship between the number of retained principal components (PCs) and the diagnosis accuracy was systematically evaluated, in a leave-one-out fashion, based on 28 AD subjects and 23 age-matched healthy subjects. Our approach yielded pretty good classification results with 96.08% overall accuracy being achieved using the three foremost PCs. In addition, our approach yielded 96.43% specificity, 100% sensitivity, and 0.9891 area under the receiver operating characteristic curve.

  10. Diagnosis of retrodiscal tissue in painful temporomandibular joint (TMJ) by fluid-attenuated inversion recovery (FLAIR) signal intensity.

    Science.gov (United States)

    Kuroda, Migiwa; Otonari-Yamamoto, Mika; Sano, Tsukasa; Fujikura, Mamiko; Wakoh, Mamoru

    2015-10-01

    The purpose of the present study is to analyze the fluid-attenuated inversion recovery (FLAIR) signal intensity of the retrodiscal tissue in a painful temporomandibular joint (TMJ), and to develop a diagnostic system based on FLAIR data. The study was based on 33 joints of 17 patients referred for MR imaging of the TMJ. Regions of interest were placed over retrodiscal tissue and gray matter (GM) on FLAIR images. Using signal intensities of GM as reference points, signal intensity ratios (SIR) of retrodiscal tissue were calculated. SIRs in painful TMJ were compared with those in painless TMJ. Wilcoxon's Rank Sum Test was used to analyze the difference in SIRs between the painful and painless groups (Pjoints than in painless joints. FLAIR sequences provide a high signal in patients having painful TMJ, and it suggests that retrodiscal tissue in painful TMJ contains elements such as protein.

  11. One-Stop Dynamic Whole Brain CTA-CTP Imaging in the Diagnosis of Ischemic Cerebrovascular Disease%一站式全脑动态容积CTA-CTP成像在缺血性脑血管病诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    陈涓; 刘银红; 郭锬; 吴国庚; 王妍焱; 王志; 周诚; 陈敏

    2012-01-01

    目的 探讨一站式全脑动态容积CTA-CTP成像在缺血性脑血管病诊断的优越性.方法 31例缺血性脑血管病患者接受了一站式全脑动态容积CTA-CTP成像,其中23例行MRI,包括DWI.21例在最初检查后的20~40天行CT或MRI随诊.将CTA-CTP结果与DWI及随访的影像结果进行比较.结果 31例中CTA-CTP成像阴性者3例,其中短暂性脑缺血发作(TIA)2例,桥脑梗死1例.CTA-CTP成像阳性者28例,其中2例为先天性血管变异,其余26例为急性或亚急性期缺血性脑卒中患者,表现为不同程度的灌注参数异常.缺血病灶位于幕下及枕叶3例,位于半卵圆中心以上平面3例,位于基底节区至侧脑室层面7例,大面积缺血累及一侧半球13例.脑灌注显示脑血容量(CBV)升高7例,其中6例为亚急性期缺血患者,1例为急性期缺血患者.26例卒中患者动态CTA显示相应责任血管闭塞或狭窄20例,其中5例患侧可见血流缓慢,排空延迟及侧支血管形成;CTA阴性6例.结论 一站式全脑动态容积CTA-CTP成像能够准确判断缺血发生后不同时期脑组织的血液动力学改变,较以往CT灌注显示缺血病灶更全面,结合动态CTA可以显示病变区的血流情况,为临床提供更准确的影像学依据.%Objective To explore the superiority of one-stop dynamic whole brain CTA-CTP imaging in the diagnosis of ischemic cerebrovascular disease. Methods Thirty one patients with ischemic cerebrovascular disease underwent one-stop whole brain CTA-CTP examination. 28 of them underwent MR imaging including DWI examination. 21 patients had follow up CT or MR scan at 20 - 40 days after initial scan. CTA-CTP results were compared with DWI and follow-up imaging re sults. Results Among 31 patients, CTA-CTP results were negative in 3 patients. 2 of them were TIA, and the other one had infarct lesion at the pons. CTA-CTP results were positive in 28 cases. 2 of them had congenital vascular variation, and the remaining 26 cases

  12. Whole-brain perfusion imaging and angiography performed with 256-slice CTin evaluation of cerebrovascular reserve capacity in unilateral carotid artery stenosis%256层CT全脑灌注成像联合CTA评估单侧颈动脉狭窄的脑血管储备能力的价值

    Institute of Scientific and Technical Information of China (English)

    唐健; 常军; 侯海燕; 姜旭栋; 堵红群; 姜建威

    2012-01-01

    Objective To assess the value of combination of whole-brain perfusion imaging and CTA in evaluating cerebrovascular reserve capacity in unilateral carotid artery stenosis. Methods Twenty-seven patients with unilateral carotid artery stenosis of ≥50% were divided into 2 groups according to CTA results: carotid moderate stenosis groupfcarotid stenosis of 50%-69%, group A) and carotid severe stenosis or occlusion group(carotid stenosis of ≥70% , group B). The relative cerebral blood volume(rCBV) , the relative cerebral blood folw(rCBF) , the difference in mean transit time(dMTT) and the difference in time to peak(dTTP) in bilateral temporal white matter and gray matter supplied by middle cerebral artery were measured and calculated. CTA was used to assess the configuration of the circle of Willis and if primary collaterals were patent. Differences in perfusion parameters between group A and group B, and between patients with patent primary collaterals or not were determined by using one way ANOVA test. Results There were statistical differences in rCBV, rCBF, dMTT and dTTP between two groups in white matter. Statistical difference of dMTT and dTTP was found between two groups in gray matter. There was significant increase in dTTP in the group B of the patients without patent primary collaterals. Conclusion Combined whole-brain perfusion imaging and CTA is a good way to evaluate cerebrovascular reserve capacity in unilateral carotid artery stenosis, and to provide a reliable method for choice of clinic treatments.%目的 探讨256层CT全脑灌注成像联合CTA评估单侧颈动脉狭窄的脑血管储备能力的价值.方法 单侧颈动脉狭窄≥50%的患者27例,根据CTA结果 按颈动脉狭窄程度划分为第一组中度狭窄组(血管阻塞50%~69%)和第二组重度狭窄或闭塞组(血管阻塞≥70%).测量并计算2组大脑中动脉供血区的白质和灰质的相对脑血容量(relative cerebral blood volume,r

  13. Hippocampal-Sparing Whole-Brain Radiotherapy for Lung Cancer.

    Science.gov (United States)

    Zhao, Ren; Kong, Wei; Shang, Jun; Zhe, Hong; Wang, Yan-Yang

    2017-03-01

    Brain metastases occur in 20% to 40% of lung cancer patients. Whole-brain radiotherapy (WBRT) has long been considered the treatment of choice for many patients with lung cancer, because of its wide availability, ease of delivery, and effectiveness in prolonging survival. However, WBRT is also associated with several side effects, such as decline in memory and other cognitive functions. There exists significant preclinical and clinical evidence that radiation-induced injury to the hippocampus correlates with neurocognitive decline of patients who receive WBRT. Technological advances in treatment planning and delivery facilitate the use of hippocampal-sparing (HS) WBRT as prophylactic cranial irradiation or the primary treatment modality for lung cancer patients with brain metastases. In this review, we provide a detailed and comprehensive discussion of the safety profile, techniques for hippocampus-sparing, and the clinical evidence of HS-WBRT for lung cancer patients.

  14. Hippocampus sparing in whole-brain radiotherapy. A review

    Energy Technology Data Exchange (ETDEWEB)

    Oskan, F. [University of Munich, Department of Radiation Oncology and CCC Neuro-Oncology, Munich (Germany); Saarland University Medical Center, Department of Radiation Oncology, Homburg/Saar (Germany); Ganswindt, U.; Schwarz, S.B.; Manapov, F.; Belka, C.; Niyazi, M. [University of Munich, Department of Radiation Oncology and CCC Neuro-Oncology, Munich (Germany)

    2014-04-15

    Radiation treatment techniques for whole-brain radiation therapy (WBRT) have not changed significantly since development of the procedure. However, the recent development of novel techniques such as intensity-modulated radiation therapy (IMRT), volumetric-modulated arc therapy (VMAT) and helical tomotherapy, as well as an increasing body of evidence concerning neural stem cells (NSCs) have altered the conventional WBRT treatment paradigm. In this regard, hippocampus-sparing WBRT is a novel technique that aims to spare critical hippocampus regions without compromising tumour control. Published data on this new technique are limited to planning and feasibility studies; data on patient outcome are still lacking. However, several prospective trials to analyse the feasibility of this technique and to document clinical outcome in terms of reduced neurotoxicity are ongoing. (orig.) [German] Die Technik der Ganzhirnbestrahlung (''whole-brain radiation therapy'', WBRT) hat sich seit der Entwicklung nicht wesentlich veraendert. Allerdings stellten die Neuentwicklung von Techniken wie die intensitaetsmodulierte Strahlentherapie (IMRT), die volumenmodulierte Arc-Therapie (VMAT) oder die helikale Tomotherapie sowie immer groesseres Wissen ueber das neurale Stammzellkompartiment (NSCs) das herkoemmliche Ganzhirn-Paradigma in Frage. Die hippocampusschonende Ganzhirnbestrahlung ist eine neuartige Technik, welche die kritische Region des Hippocampus schont, ohne die Tumorkontrolle zu gefaehrden. Ueber diese Technik gibt es bisher nur eine begrenzte Datenlage im Sinne von Planungs- und Machbarkeitsstudien. Klinische Daten bzgl. der Behandlungsergebnisse fehlen nach wie vor, aber einige prospektive Studien sind im Gange, um nicht nur die Machbarkeit zu belegen, sondern auch das klinische Outcome im Sinne einer verringerten Neurotoxizitaet nachzuweisen. (orig.)

  15. Retrieving binary answers using whole-brain activity pattern classification

    Directory of Open Access Journals (Sweden)

    Norberto Eiji Nawa

    2015-12-01

    Full Text Available Multivariate pattern analysis (MVPA has been successfully employed to advance our understanding of where and how information regarding different mental states is represented in the human brain, bringing new insights into how these states come to fruition, and providing a promising complement to the mass-univariate approach. Here, we employed MVPA to classify whole-brain activity patterns occurring in single fMRI scans, in order to retrieve binary answers from experiment participants. Five healthy volunteers performed two types of mental task while in the MRI scanner: counting down numbers and recalling positive autobiographical events. Data from these runs were used to train individual machine learning based classifiers that predicted which mental task was being performed based on the voxel-based brain activity patterns. On a different day, the same volunteers reentered the scanner and listened to six statements (e.g., the month you were born is an odd number, and were told to countdown numbers if the statement was true (yes or recall positive events otherwise (no. The previously trained classifiers were then used to assign labels (yes/no to the scans collected during the 24-second response periods following each one of the statements. Mean classification accuracies at the single scan level were in the range of 73.6% to 80.8%, significantly above chance for all participants. When applying a majority vote on the scans within each response period, i.e., the most frequent label (yes/no in the response period becomes the answer to the previous statement, 5.0 to 5.8 sentences, out of 6, were correctly classified in each one of the runs, on average. These results indicate that binary answers can be retrieved from whole-brain activity patterns, suggesting that MVPA provides an alternative way to establish basic communication with unresponsive patients when other techniques are not successful.

  16. 突发性聋患者内耳三维液体衰减反转恢复成像在预后评估中的价值%Three-dimensional fluid attenuated inversion recovery imaging at 3T MRI in sudden deafness: its findings and relationship with the prognosis

    Institute of Scientific and Technical Information of China (English)

    钱银锋; 吴继春; 张诚; 余永强

    2011-01-01

    目的 探讨突发性聋患者内耳在三维液体衰减反转恢复(fluid attenuated inversion recovery,FLAIR)成像上的表现及其与疗效间关系.方法 23例突发性聋患者行三维FLAIR成像,观察内耳在FLAIR上的表现,并测定入院和治疗后的平均听阈,分析内耳信号与治疗结果之间关系.结果23例患者中8例患侧耳蜗在FLAIR上呈高信号,15例患侧及全部健侧耳蜗无信号.就诊时患侧耳蜗无信号组患者平均((x)±s,下同)听阈(听力级,下同)为(80±24) dB,耳蜗高信号组平均听阈为(92±18)dB,差异无统计学意义(t=1.245,P>0.05);治疗后两组的平均听阈分别为(60±28)dB和(90±21)dB,有效率分别为60.0%和12.5%,差异均有统计学意义(P值均<0.05).7例伴有眩晕患者中5例患侧半规管在FLAIR上呈高信号,此5例均治疗无效.结论三维FLAIR可显示突发性聋患者内耳淋巴液改变,呈高信号时疗效及预后差.%Objective To investigate inner ear of patients with sudden deafness with threedimensional fluid attenuated inversion recovery(3 D FLAIR) MRI,and the relationship between the results of 3D FLAIR and the prognosis.Methods Twenty-three patients with sudden deafness received 3D FLAIR at 3T MRI,and the signals of inner ear were recorded.Hearing levels were evaluated at initial visit and after treatment.The relationship between 3D FLAIR findings and hearing prognosis was evaluated.Results Eight patients with sudden deafness showed high signals in the affected cochlea on 3D FLAIR,the others of affected cochlea and all of contralateral cochlea showed no signal on 3D FLAIR.The age,sex,affected side,period to initial visit and initial audiogram had no difference between cochlea no signal group and high signal group.The average auditory threshold (~ ± s) in cochlea high signal group (90 ± 21 ) dB HL was significant higher than that in cochlea no signal group (60 ±28) dB HL,P <0.05 at patients' discharge.After treatment,in cochlea no

  17. A neuromarker of sustained attention from whole-brain functional connectivity.

    Science.gov (United States)

    Rosenberg, Monica D; Finn, Emily S; Scheinost, Dustin; Papademetris, Xenophon; Shen, Xilin; Constable, R Todd; Chun, Marvin M

    2016-01-01

    Although attention plays a ubiquitous role in perception and cognition, researchers lack a simple way to measure a person's overall attentional abilities. Because behavioral measures are diverse and difficult to standardize, we pursued a neuromarker of an important aspect of attention, sustained attention, using functional magnetic resonance imaging. To this end, we identified functional brain networks whose strength during a sustained attention task predicted individual differences in performance. Models based on these networks generalized to previously unseen individuals, even predicting performance from resting-state connectivity alone. Furthermore, these same models predicted a clinical measure of attention--symptoms of attention deficit hyperactivity disorder--from resting-state connectivity in an independent sample of children and adolescents. These results demonstrate that whole-brain functional network strength provides a broadly applicable neuromarker of sustained attention.

  18. The Current Role of Whole Brain Radiation Therapy in Non-Small Cell Lung Cancer Patients.

    Science.gov (United States)

    Loganadane, Gokoulakrichenane; Hendriks, Lizza; Le Péchoux, Cécile; Levy, Antonin

    2017-10-01

    The incidence of brain metastases has increased in patients with NSCLC as a result of better systemic disease control and advances in imaging modalities. Whole brain radiotherapy (WBRT) has been the mainstay treatment of multiple symptomatic brain metastases for years. A number of recent publications have questioned its place in the absence of a survival and quality of life benefit and the possible risk for long-term neurotoxicity. Omission or deferral of WBRT and strategies consisting of stereotactic radiosurgery or delivery of systemic therapies alone are being proposed more and more. However, critical analysis of the literature shows that WBRT still has relevant indications in well-selected patients. Within this review, we discuss the place of WBRT in the modern management of patients with NSCLC. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  19. Whole-brain activity maps reveal stereotyped, distributed networks for visuomotor behavior.

    Science.gov (United States)

    Portugues, Ruben; Feierstein, Claudia E; Engert, Florian; Orger, Michael B

    2014-03-19

    Most behaviors, even simple innate reflexes, are mediated by circuits of neurons spanning areas throughout the brain. However, in most cases, the distribution and dynamics of firing patterns of these neurons during behavior are not known. We imaged activity, with cellular resolution, throughout the whole brains of zebrafish performing the optokinetic response. We found a sparse, broadly distributed network that has an elaborate but ordered pattern, with a bilaterally symmetrical organization. Activity patterns fell into distinct clusters reflecting sensory and motor processing. By correlating neuronal responses with an array of sensory and motor variables, we find that the network can be clearly divided into distinct functional modules. Comparing aligned data from multiple fish, we find that the spatiotemporal activity dynamics and functional organization are highly stereotyped across individuals. These experiments systematically reveal the functional architecture of neural circuits underlying a sensorimotor behavior in a vertebrate brain.

  20. Defining acute ischemic stroke tissue pathophysiology with whole brain CT perfusion.

    Science.gov (United States)

    Bivard, A; Levi, C; Krishnamurthy, V; Hislop-Jambrich, J; Salazar, P; Jackson, B; Davis, S; Parsons, M

    2014-12-01

    This study aimed to identify and validate whole brain perfusion computed tomography (CTP) thresholds for ischemic core and salvageable penumbra in acute stroke patients and develop a probability based model to increase the accuracy of tissue pathophysiology measurements. One hundred and eighty-three patients underwent multimodal stroke CT using a 320-slice scanner within 6hours of acute stroke onset, followed by 24hour MRI that included diffusion weighted imaging (DWI) and dynamic susceptibility weighted perfusion imaging (PWI). Coregistered acute CTP and 24hour DWI was used to identify the optimum single perfusion parameter thresholds to define penumbra (in patients without reperfusion), and ischemic core (in patients with reperfusion), using a pixel based receiver operator curve analysis. Then, these results were used to develop a sigma curve fitted probability based model incorporating multiple perfusion parameter thresholds. For single perfusion thresholds, a time to peak (TTP) of +5seconds best defined the penumbra (area under the curve, AUC 0.79 CI 0.74-0.83) while a cerebral blood flow (CBF) of acute ischemic core (AUC 0.73, CI 0.69-0.77). The probability model was more accurate at detecting the ischemic core (AUC 0.80 SD 0.75-0.83) and penumbra (0.85 SD 0.83-0.87) and was significantly closer in volume to the corresponding reference DWI (P=0.031). Whole brain CTP can accurately identify penumbra and ischemic core using similar thresholds to previously validated 16 or 64 slice CTP. Additionally, a novel probability based model was closer to defining the ischemic core and penumbra than single thresholds. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study Anormalidade de sinal na imagem por RM do pólo temporal na epilepsia do lobo temporal com esclerose hipocampal: um estudo pela seqüência inversão recuperação com supressão da água livre (FLAIR

    Directory of Open Access Journals (Sweden)

    Henrique Carrete Junior

    2007-09-01

    Full Text Available OBJECTIVE: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA in patients with hippocampal sclerosis (HS using fluid-attenuated inversion-recovery (FLAIR MR imaging, and to correlate this feature with history. METHOD: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. RESULTS: Ninety (75% of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, chi2 test. The anteromedial zone of temporal pole was affected in 27 (30% out of 90 patients. In 63 (70% patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018, but without association with duration of epilepsy. CONCLUSION: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved.OBJETIVO: Determinar a freqüência e o envolvimento regional da anormalidade de sinal do pólo temporal (APT em pacientes com esclerose hipocampal (EH utilizando seqüência inversão recuperação com supressão da água (FLAIR por RM, e correlacioná-la com a história. MÉTODO: Foram analisadas as imagens coronais FLAIR dos pólos temporais de 120 pacientes com EH e de 30 indivíduos normais, para avaliar a demarcação entre substâncias branca e cinzenta. RESULTADOS: Noventa (75% dos 120 pacientes tinham APT associada. Houve prevalência do lado esquerdo (p=0.04, chi2 teste na relação entre APT e o lado da EH. A zona ântero-medial estava acometida em 27 (30% destes pacientes. Em 63 (70% pacientes também a zona lateral estava acometida. Pacientes com APT apresentaram início da epilepsia quando mais jovens (p=0.018, porém sem associação com a sua duração. CONCLUSÃO: A seqüência FLAIR mostra haver ATP em 3/4 dos pacientes com EH

  2. Whole-brain activity mapping onto a zebrafish brain atlas.

    Science.gov (United States)

    Randlett, Owen; Wee, Caroline L; Naumann, Eva A; Nnaemeka, Onyeka; Schoppik, David; Fitzgerald, James E; Portugues, Ruben; Lacoste, Alix M B; Riegler, Clemens; Engert, Florian; Schier, Alexander F

    2015-11-01

    In order to localize the neural circuits involved in generating behaviors, it is necessary to assign activity onto anatomical maps of the nervous system. Using brain registration across hundreds of larval zebrafish, we have built an expandable open-source atlas containing molecular labels and definitions of anatomical regions, the Z-Brain. Using this platform and immunohistochemical detection of phosphorylated extracellular signal–regulated kinase (ERK) as a readout of neural activity, we have developed a system to create and contextualize whole-brain maps of stimulus- and behavior-dependent neural activity. This mitogen-activated protein kinase (MAP)-mapping assay is technically simple, and data analysis is completely automated. Because MAP-mapping is performed on freely swimming fish, it is applicable to studies of nearly any stimulus or behavior. Here we demonstrate our high-throughput approach using pharmacological, visual and noxious stimuli, as well as hunting and feeding. The resultant maps outline hundreds of areas associated with behaviors.

  3. Whole brain radiotherapy with radiosensitizer for brain metastases

    Directory of Open Access Journals (Sweden)

    Viani Gustavo

    2009-01-01

    Full Text Available Abstract Purpose To study the efficacy of whole brain radiotherapy (WBRT with radiosensitizer in comparison with WBRT alone for patients with brain metastases in terms of overall survival, disease progression, response to treatment and adverse effects of treatment. Methods A meta-analysis of randomized controlled trials (RCT was performed in order to compare WBRT with radiosensitizer for brain metastases and WBRT alone. The MEDLINE, EMBASE, LILACS, and Cochrane Library databases, in addition to Trial registers, bibliographic databases, and recent issues of relevant journals were researched. Significant reports were reviewed by two reviewers independently. Results A total of 8 RCTs, yielding 2317 patients were analyzed. Pooled results from this 8 RCTs of WBRT with radiosensitizer have not shown a meaningful improvement on overall survival compared to WBRT alone OR = 1.03 (95% CI0.84–1.25, p = 0.77. Also, there was no difference in local brain tumor response OR = 0.8(95% CI 0.5 – 1.03 and brain tumor progression (OR = 1.11, 95% CI 0.9 – 1.3 when the two arms were compared. Conclusion Our data show that WBRT with the following radiosentizers (ionidamine, metronidazole, misonodazole, motexafin gadolinium, BUdr, efaproxiral, thalidomide, have not improved significatively the overall survival, local control and tumor response compared to WBRT alone for brain metastases. However, 2 of them, motexafin- gadolinium and efaproxiral have been shown in recent publications (lung and breast to have positive action in lung and breast carcinoma brain metastases in association with WBRT.

  4. Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study.

    Science.gov (United States)

    Kazda, Tomas; Vrzal, Miroslav; Prochazka, Tomas; Dvoracek, Petr; Burkon, Petr; Pospisil, Petr; Dziacky, Adam; Nikl, Tomas; Jancalek, Radim; Slampa, Pavel; Lakomy, Radek

    2017-07-20

    Unilateral sparing of the dominant (left) hippocampus during whole brain radiotherapy (WBRT) could mitigate cognitive decline, especially verbal memory, similar to the widely investigated bilateral hippocampus avoidance (HA-WBRT). The aim of this planning study is dosimetrical comparison of HA-WBRT with only left hippocampus sparing (LHA-WBRT) plans. HA-WBRT plans for 10 patients were prepared in accordance with RTOG 0933 trial and served as baseline for comparisons with several LHA-WBRT plans prepared with an effort: 1) to maintain the same left hippocampus dosimetry ("BEST PTV") and 2) to maintain same dosimetry in planning target volume as in HA-WBRT ("BEST LH"). All HA-WBRT plans met RTOG 0933 protocol criteria with a mean Conformity index 1.09 and mean Homogeneity index (HI) 0.21. Mean right and left hippocampal D100 % was 7.8 Gy and 8.5 Gy and mean Dmax 14.0 Gy and 13.8 Gy, respectively. "BEST PTV" plans reduced HI by 31.2 % (P=0.005) which is mirrored by lower PTV_D2% (-0.8 Gy, P=0.005) and higher PTV_D98% (+1.3 Gy, P=0.005) as well as decreased optic pathway's Dmax by 1 Gy. In "BEST LH", mean D100% and Dmax for the left hippocampus were significantly reduced by 11.2 % (P=0.005) and 10.9 % (P=0.005) respectively. LHA-WBRT could improve target coverage and/or further decrease in dose to spared hippocampus. Future clinical trials must confirm whether statistically significant reduction in left hippocampal dose is also clinically significant.

  5. Outcome of whole-brain irradiation for breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Roar (Dept. of Cancer Research and Molecular Medicine, Norwegian Univ. of Science and Technology (NTNU), Trondheim (Norway)); Lundgren, Steinar; Westin, Andreas A. (Dept. of Oncology, St. Olav University Hospital, Trondheim (Norway)); Bofin, Anna M. (Dept. of Pathology and Medical genetics, St. Olavs University Hospital, Trondheim (Norway))

    2008-02-15

    Purpose. To determine the overall survival (OS) of breast cancer patients treated by Whole Brain Radiation Therapy (WBRT) and possible important prognostic factors for OS. Material and methods. The study population comprised 99 patients with brain metastases (BM) treated with WBRT in the period 1988 to 2004 at St. Olavs University Hospital, Trondheim, Norway. Prognostic factors as age, performance status, axillary lymph node involvement and extent of BM were evaluated. Results. Median survival (range) of the total population from start of irradiation was 5.3 (0.3-157) months. For patients >60 years, 40-60 years and <40 years median survival (range) were 4.5 (0.3-92), 6.8 (0.3-157) and 8.5 (0.8-11) months, respectively (NS, p=0.5), and for Karnofsky performance status (KPS) < or >70, were 3.7 (0.3-92) and 6.8 (1.0-157) months, respectively (NS, p=0.17). One,three, 12 and 24 month survival rate were 90, 64, 29 and 11%, respectively. Grouping patients according to Recursive Partitioning Analyses (RPA) classes, the median survival (range) were 8.0 (1.0-157), 6.5 (1.3-92) and 3.5 (0.3-92) months for RPA class 1, 2 and 3, respectively (NS, p=0.6). Conclusion. KPS and in particular the extent of BM were the most important prognostic factors. Grouping patients into RPA classes may be important when deciding whether breast cancer patients should be aggressively treated for their BM

  6. Whole-brain serial-section electron microscopy in larval zebrafish

    Science.gov (United States)

    Hildebrand, David Grant Colburn; Cicconet, Marcelo; Torres, Russel Miguel; Choi, Woohyuk; Quan, Tran Minh; Moon, Jungmin; Wetzel, Arthur Willis; Scott Champion, Andrew; Graham, Brett Jesse; Randlett, Owen; Plummer, George Scott; Portugues, Ruben; Bianco, Isaac Henry; Saalfeld, Stephan; Baden, Alexander David; Lillaney, Kunal; Burns, Randal; Vogelstein, Joshua Tzvi; Schier, Alexander Franz; Lee, Wei-Chung Allen; Jeong, Won-Ki; Lichtman, Jeff William; Engert, Florian

    2017-05-01

    High-resolution serial-section electron microscopy (ssEM) makes it possible to investigate the dense meshwork of axons, dendrites, and synapses that form neuronal circuits. However, the imaging scale required to comprehensively reconstruct these structures is more than ten orders of magnitude smaller than the spatial extents occupied by networks of interconnected neurons, some of which span nearly the entire brain. Difficulties in generating and handling data for large volumes at nanoscale resolution have thus restricted vertebrate studies to fragments of circuits. These efforts were recently transformed by advances in computing, sample handling, and imaging techniques, but high-resolution examination of entire brains remains a challenge. Here, we present ssEM data for the complete brain of a larval zebrafish (Danio rerio) at 5.5 days post-fertilization. Our approach utilizes multiple rounds of targeted imaging at different scales to reduce acquisition time and data management requirements. The resulting dataset can be analysed to reconstruct neuronal processes, permitting us to survey all myelinated axons (the projectome). These reconstructions enable precise investigations of neuronal morphology, which reveal remarkable bilateral symmetry in myelinated reticulospinal and lateral line afferent axons. We further set the stage for whole-brain structure-function comparisons by co-registering functional reference atlases and in vivo two-photon fluorescence microscopy data from the same specimen. All obtained images and reconstructions are provided as an open-access resource.

  7. Whole brain magnetization transfer histogram analysis of pediatric acute lymphoblastic leukemia patients receiving intrathecal methotrexate therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Akira [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507 (Japan)]. E-mail: yakira@kuhp.kyoto-u.ac.jp; Miki, Yukio [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507 (Japan)]. E-mail: mikiy@kuhp.kyoto-u.ac.jp; Adachi, Souichi [Department of Pediatrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507 (Japan)]. E-mail: sadachi@kuhp.kyoto-u.ac.jp (and others)

    2006-03-15

    Background and purpose: The purpose of this prospective study was to evaluate the hypothesis that magnetization transfer ratio (MTR) histogram analysis of the whole brain could detect early and subtle brain changes nonapparent on conventional magnetic resonance imaging (MRI) in children with acute lymphoblastic leukemia (ALL) receiving methotrexate (MTX) therapy. Materials and methods: Subjects in this prospective study comprised 10 children with ALL (mean age, 6 years; range, 0-16 years). In addition to conventional MRI, magnetization transfer images were obtained before and after intrathecal and intravenous MTX therapy. MTR values were calculated and plotted as a histogram, and peak height and location were calculated. Differences in peak height and location between pre- and post-MTX therapy scans were statistically analyzed. Conventional MRI was evaluated for abnormal signal area in white matter. Results: MTR peak height was significantly lower on post-MTX therapy scans than on pre-MTX therapy scans (p = 0.002). No significant differences in peak location were identified between pre- and post-chemotherapy imaging. No abnormal signals were noted in white matter on either pre- or post-MTX therapy conventional MRI. Conclusions: This study demonstrates that MTR histogram analysis allows better detection of early and subtle brain changes in ALL patients who receive MTX therapy than conventional MRI.

  8. Application feasibility of double-low dose combined with iterative reconstruction technique in the whole brain perfusion imaging%双低剂量联合迭代重建技术在急性脑梗死容积 CT 全脑灌注成像中的可行性应用

    Institute of Scientific and Technical Information of China (English)

    王涛; 师毅冰; 华荣; 张青山; 徐凯

    2015-01-01

    目的:探讨低浓度对比剂、低管电压联合迭代重建技术在急性脑梗死患者全脑灌注成像(CTP)中的可行性应用。方法:选取2014年9月-2015年3月在徐州医学院徐州临床学院行全脑 CTP 检查、临床拟诊为急性脑梗死患者59例,随机分为 A、B 两组,A 组28例[管电压100 kV,对比剂为碘海醇(350 mg I/mL),滤波反投影重建法(FBP)重建];B组31例[管电压80 kV,对比剂为碘克沙醇(270 mg I/mL),迭代重建算法(ART)重建]。测量并计算 A、B 两组的大脑中动脉 CT 值、信噪比(SNR)、对比噪声比(CNR)、剂量长度乘积(DLP)、有效辐射剂量(ED)及碘摄入量,并对两组间上述指标进行统计学分析;2名医师对两组图像质量评价的一致性采用 kappa 分析;两组间图像质量主观评价差异采用χ2检验。结果:A、B 两组间的 CT 值、SNR、CNR、CTP 及 CTA 的图像主观质量评价差异均无统计学意义(P 均>0.05);两组间梗死灶的检出率无统计学差异;而 B 组(双低剂量组)的 ED、碘摄入量较 A 组低。结论:联合低管电压和迭代重建技术时,使用低浓度对比剂(270 mg I/mL)进行全脑 CTP 检查,在不降低图像质量的同时,还能减少 ED 及碘摄入量,从而降低对比剂肾病(CIN)的风险。%Objective:To evaluate the influence of low tube voltage and low iodine-concentration contrast material on the image quality,the degree of blood vessels enhancement and radiation dose in the whole brain perfusion imaging (CTP). Methods:From September 2014 to March 2015,59 patients with clinical suspicion of acute cerebral infarction were enrolled in our center.They were randomly divided into two groups,and they all underwent CTP.Twenty-eight patients (group A) underwent examination with 100kV,350mg I/mL contrast medium and filter back-projection (FBP)reconstruction.Thirty-one patients (group B

  9. SU-E-QI-12: Morphometry Based Measurements of the Structural Response to Whole Brain Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Fuentes, D; Castillo, R; Castillo, E; Guerrero, T [UT MD Anderson Cancer Center, Houston, TX (United States)

    2014-06-15

    Purpose: Although state of the art radiation therapy techniques for treating intracranial malignancies have eliminated acute brain injury, cognitive impairment occurs in 50–90% of patients who survive >6mo post irradiation. Quantitative characterization of therapy response is needed to facilitate therapeutic strategies to minimize radiation induced cognitive impairment [1]. Deformation based morphometry techniques [2, 3] are presented as a quantitative imaging biomarker of therapy response in patients receiving whole brain radiation for treating medulloblastoma. Methods: Post-irradiation magnetic resonance imaging (MRI) data sets were retrospectively analyzed in N=15 patients, >60 MR image datasets. As seen in Fig 1(a), volume changes at multiple time points post-irradiation were quantitatively measured in the cerebrum and ventricles with respect to pre-irradiation MRI. A high resolution image Template, was registered to the pre-irradiation MRI of each patient to create a brain atlas for the cerebrum, cerebellum, and ventricles. Skull stripped images for each patient were registered to the initial pre-treatment scan. Average volume changes in the labeled regions were measured using the determinant of the displacement field Jacobian. Results: Longitudinal measurements, Fig 1(b-c), show a negative correlation p=.06, of the cerebral volume change with the time interval from irradiation. A corresponding positive correlation, p=.01, between ventricular volume change and time interval from irradiation is seen. One sample t-test for correlations were computed using a Spearman method. An average decrease in cerebral volume, p=.08, and increase in ventricular volume, p<.001, was observed. The radiation dose was seen directly proportional to the induced volume changes in the cerebrum, r=−.44, p<.001, Fig 1(d). Conclusion: Results indicate that morphometric monitoring of brain tissue volume changes may potentially be used to quantitatively assess toxicity and response to

  10. Whole-brain quantitative mapping of metabolites using short echo 3D-proton- MRSI

    Science.gov (United States)

    Lecocq, Angèle; Le Fur, Yann; Maudsley, Andrew A; Le Troter, Arnaud; Sheriff, Sulaiman; Sabati, Mohamad; Donnadieu, Maxime; Confort-Gouny, Sylviane; Cozzone, Patrick J.; Guye, Maxime; Ranjeva, Jean-Philippe

    2014-01-01

    Purpose To improve the extent over which whole brain quantitative 3D-MRSI maps can be obtained and be used to explore brain metabolism in a population of healthy volunteers. Materials and Methods Two short TE (20 ms) acquisitions of 3D Echo Planar Spectroscopic Imaging at two orientations, one in the anterior commissure – posterior commissure (AC-PC) plane and the second tilted in the AC-PC +15° plane were obtained at 3T in a group of ten healthy volunteers. B1+, B1−, and B0 correction procedures and normalization of metabolite signals with quantitative water proton density measurements were performed. A combination of the two spatially normalized 3D-MRSI, using a weighted mean based on the pixel wise standard deviation metabolic maps of each orientation obtained from the whole group, provided metabolite maps for each subject allowing regional metabolic profiles of all parcels of the automated anatomical labeling (AAL) atlas to be obtained. Results The combined metabolite maps derived from the two acquisitions reduced the regional inter-subject variance. The numbers of AAL regions showing NAA SD/Mean ratios lower than 30% increased from 17 in the AC-PC orientation and 41 in the AC-PC+15° orientation, to a value of 76 regions out of 116 for the combined NAA maps. Quantitatively, regional differences in absolute metabolite concentrations (mM) over the whole brain were depicted such as in the GM of frontal lobes (cNAA=10.03+1.71, cCho=1.78±0.55, cCr=7.29±1.69; cmIns=5.30±2.67) and in cerebellum (cNAA=5.28±1.77, cCho=1.60±0.41, cCr=6.95±2.15; cmIns=3.60±0.74). Conclusion A double-angulation acquisition enables improved metabolic characterization over a wide volume of the brain. PMID:25431032

  11. 基于静息态功能磁共振成像的慢性嗜酒者双侧杏仁核全脑功能连接研究%Whole brain functional connectivity of the bilateral amygdaloid in chronic alcoholics: a resting-state functional magnetic resonance imaging study

    Institute of Scientific and Technical Information of China (English)

    赵益林; 陈军; 刘金欢; 林雪; 吴汉斌; 徐良洲; 许启仲; 刘昌盛; 邱丽

    2015-01-01

    Objective To explore the conditions of whole brain functional connectivity (FC) of the bilateral amygdaloid in resting state in chronic alcoholics.Methods Thirty-three chronic alcoholics and 36 healthy control subjects matched in gender,age,education and handedness,admitted to our hospital from October 2011 to October 2012,were enrolled as chronic alcoholics group and control group,respectively.All subjects were asked to perform both Michigan alcohol screening scale (MAST) and alcohol addiction scale (ADS) to ensure that the alcohol dependent individuals enrolled in this study reached moderate alcohol dependent.All subjects were performed MR imaging;DPARSF software was used to perform data processing which was based on MATLABE,SPM and REST operating environment.REST software was made use of the left amygdala activity peak voxel (-24,0,-16) and right amygdala peak voxel (24,0,16) as seeded region of interest to get the whole brain FC mapping.Rest Slice Viewer software within REST software package was used to view statistical results.Each time series of brain regions were extracted,and correlation analysis of MAST scores with ADS scores was performed and the corresponding correlation coefficient values were recorded.Results Finally,57 subjects (28 in chronic alcoholics group and 29 in control group) were enrolled after screening.As compared with that in the healthy controls,the FC of left pars opercularis gyri frontalis inferiorista,bilateral supramarginal gyrus,left thalamus,bilateral paracentral lobule,left precentral gyrus,right pars orbitalis gyri frontalis inferiois and right superior temporal gyrus was significantly increased in the left amygdaloid,and that of left middle occipital gyrus,left cerebellar peduncle,left orbitofrontal region,left entorhinal cortex,right cerebellum inferior semi-Lunar lobule,right cerebellar parietal and superior frontal gyrus was significantly decreased in resting state in chronic alcoholism (P<0.05);as compared with that in the

  12. Aging Effects on Whole-Brain Functional Connectivity in Adults Free of Cognitive and Psychiatric Disorders.

    Science.gov (United States)

    Ferreira, Luiz Kobuti; Regina, Ana Carolina Brocanello; Kovacevic, Natasa; Martin, Maria da Graça Morais; Santos, Pedro Paim; Carneiro, Camila de Godoi; Kerr, Daniel Shikanai; Amaro, Edson; McIntosh, Anthony Randal; Busatto, Geraldo F

    2016-09-01

    Aging is associated with decreased resting-state functional connectivity (RSFC) within the default mode network (DMN), but most functional imaging studies have restricted the analysis to specific brain regions or networks, a strategy not appropriate to describe system-wide changes. Moreover, few investigations have employed operational psychiatric interviewing procedures to select participants; this is an important limitation since mental disorders are prevalent and underdiagnosed and can be associated with RSFC abnormalities. In this study, resting-state fMRI was acquired from 59 adults free of cognitive and psychiatric disorders according to standardized criteria and based on extensive neuropsychological and clinical assessments. We tested for associations between age and whole-brain RSFC using Partial Least Squares, a multivariate technique. We found that normal aging is not only characterized by decreased RSFC within the DMN but also by ubiquitous increases in internetwork positive correlations and focal internetwork losses of anticorrelations (involving mainly connections between the DMN and the attentional networks). Our results reinforce the notion that the aging brain undergoes a dedifferentiation processes with loss of functional diversity. These findings advance the characterization of healthy aging effects on RSFC and highlight the importance of adopting a broad, system-wide perspective to analyze brain connectivity.

  13. Whole brain N-acetylaspartate concentration is conserved throughout normal aging.

    Science.gov (United States)

    Wu, William E; Gass, Achim; Glodzik, Lidia; Babb, James S; Hirsch, Jochen; Sollberger, Marc; Achtnichts, Lutz; Amann, Michael; Monsch, Andreas U; Gonen, Oded

    2012-10-01

    We hypothesize that normal aging implies neuronal durability, reflected by age-independent concentrations of their marker--the amino acid derivative N-acetylaspartate (NAA). To test this, we obtained the whole-brain and whole-head N-acetylaspartate concentrations (WBNAA and WHNAA) with proton magnetic resonance (MR) spectroscopy; and the fractional brain parenchyma volume (fBPV)--a metric of atrophy, by segmenting the magnetic resonance image (MRI) from 42 (18 male) healthy young (31.9 ± 5.8 years old) and 100 (64 male, 72.6 ± 7.3 years old) cognitively normal elderly. The 12.8 ± 1.9 mM WBNAA of the young was not significantly different from the 13.1 ± 3.1 mM in the elderly (p > 0.05). In contrast, both fBPV (87.3 ± 4.7% vs. 74.8 ± 4.8%) and WHNAA (11.1 ± 1.7 mM vs. 9.8 ± 2.4 mM) were significantly higher in the young (approximately 14%; p normal aging apart suggests that neuronal integrity is maintained across the lifespan. Clinically, WBNAA could be used as a marker for normal (hence, also abnormal) brain aging. In contrast, WHNAA and fBPV seem age-related suggesting that brain atrophy may occur without compromising the remaining tissue.

  14. Changes in whole-brain functional networks and memory performance in aging.

    Science.gov (United States)

    Sala-Llonch, Roser; Junqué, Carme; Arenaza-Urquijo, Eider M; Vidal-Piñeiro, Dídac; Valls-Pedret, Cinta; Palacios, Eva M; Domènech, Sara; Salvà, Antoni; Bargalló, Nuria; Bartrés-Faz, David

    2014-10-01

    We used resting-functional magnetic resonance imaging data from 98 healthy older adults to analyze how local and global measures of functional brain connectivity are affected by age, and whether they are related to differences in memory performance. Whole-brain networks were created individually by parcellating the brain into 90 cerebral regions and obtaining pairwise connectivity. First, we studied age-associations in interregional connectivity and their relationship with the length of the connections. Aging was associated with less connectivity in the long-range connections of fronto-parietal and fronto-occipital systems and with higher connectivity of the short-range connections within frontal, parietal, and occipital lobes. We also used the graph theory to measure functional integration and segregation. The pattern of the overall age-related correlations presented positive correlations of average minimum path length (r = 0.380, p = 0.008) and of global clustering coefficients (r = 0.454, p < 0.001), leading to less integrated and more segregated global networks. Main correlations in clustering coefficients were located in the frontal and parietal lobes. Higher clustering coefficients of some areas were related to lower performance in verbal and visual memory functions. In conclusion, we found that older participants showed lower connectivity of long-range connections together with higher functional segregation of these same connections, which appeared to indicate a more local clustering of information processing. Higher local clustering in older participants was negatively related to memory performance.

  15. Temporal dynamics and determinants of whole brain tissue volume changes during recovery from alcohol dependence.

    Science.gov (United States)

    Gazdzinski, Stefan; Durazzo, Timothy C; Meyerhoff, Dieter J

    2005-06-01

    Brain shrinkage and its partial reversibility with abstinence is a common neuroimaging finding in alcohol dependent individuals. We used an automated three-dimensional whole brain magnetic resonance imaging method (boundary shift integral) in 23 alcohol dependent individuals to measure the temporal dynamics of cerebral tissue and spinal fluid volume changes over a 12-month interval and to examine the major determinants of brain tissue change rates during abstinence and non-abstinence. We found more rapid brain tissue gain during the first month of sobriety than in the following months. The most rapid volume recovery was observed in abstinent individuals with the greatest baseline brain shrinkage and drinking severity. The rapid reversal of brain volume gains in non-abstinent individuals and tissue volume changes are modulated by duration of abstinence and non-abstinence periods, as well as recency of non-abstinence. Age, family history density of alcoholism, relapse severity, and duration or age of onset of heavy drinking were not major determinants of brain shrinkage and brain volume recovery rates. Treatment providers may use this tangible information to reinforce the biomedical benefits of sobriety. Previous quantitative measurements of brain volumes in alcohol dependent individuals performed after several weeks of abstinence likely underestimated the full extent of chronic alcohol-associated brain shrinkage.

  16. 基于体素的遗忘型轻度认知障碍和轻度阿尔茨海默病全脑白质MR扩散张量成像分析%MR diffusion tensor imaging voxel-based analysis of whole brain white matter in patients with amnestic-type mild cognitive impairment and mild Alzheimer disease

    Institute of Scientific and Technical Information of China (English)

    李亚迪; 冯晓源; 何慧瑾; 丁玎; 汤伟军; 赵倩华

    2011-01-01

    (MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.

  17. Robust whole-brain segmentation: application to traumatic brain injury.

    Science.gov (United States)

    Ledig, Christian; Heckemann, Rolf A; Hammers, Alexander; Lopez, Juan Carlos; Newcombe, Virginia F J; Makropoulos, Antonios; Lötjönen, Jyrki; Menon, David K; Rueckert, Daniel

    2015-04-01

    We propose a framework for the robust and fully-automatic segmentation of magnetic resonance (MR) brain images called "Multi-Atlas Label Propagation with Expectation-Maximisation based refinement" (MALP-EM). The presented approach is based on a robust registration approach (MAPER), highly performant label fusion (joint label fusion) and intensity-based label refinement using EM. We further adapt this framework to be applicable for the segmentation of brain images with gross changes in anatomy. We propose to account for consistent registration errors by relaxing anatomical priors obtained by multi-atlas propagation and a weighting scheme to locally combine anatomical atlas priors and intensity-refined posterior probabilities. The method is evaluated on a benchmark dataset used in a recent MICCAI segmentation challenge. In this context we show that MALP-EM is competitive for the segmentation of MR brain scans of healthy adults when compared to state-of-the-art automatic labelling techniques. To demonstrate the versatility of the proposed approach, we employed MALP-EM to segment 125 MR brain images into 134 regions from subjects who had sustained traumatic brain injury (TBI). We employ a protocol to assess segmentation quality if no manual reference labels are available. Based on this protocol, three independent, blinded raters confirmed on 13 MR brain scans with pathology that MALP-EM is superior to established label fusion techniques. We visually confirm the robustness of our segmentation approach on the full cohort and investigate the potential of derived symmetry-based imaging biomarkers that correlate with and predict clinically relevant variables in TBI such as the Marshall Classification (MC) or Glasgow Outcome Score (GOS). Specifically, we show that we are able to stratify TBI patients with favourable outcomes from non-favourable outcomes with 64.7% accuracy using acute-phase MR images and 66.8% accuracy using follow-up MR images. Furthermore, we are able to

  18. Whole brain radiation-induced cognitive impairment: pathophysiological mechanisms and therapeutic targets.

    Science.gov (United States)

    Lee, Yong Woo; Cho, Hyung Joon; Lee, Won Hee; Sonntag, William E

    2012-07-01

    Radiation therapy, the most commonly used for the treatment of brain tumors, has been shown to be of major significance in tu-mor control and survival rate of brain tumor patients. About 200,000 patients with brain tumor are treated with either partial large field or whole brain radiation every year in the United States. The use of radiation therapy for treatment of brain tumors, however, may lead to devastating functional deficits in brain several months to years after treatment. In particular, whole brain radiation therapy results in a significant reduction in learning and memory in brain tumor patients as long-term consequences of treatment. Although a number of in vitro and in vivo studies have demonstrated the pathogenesis of radiation-mediated brain injury, the cel-lular and molecular mechanisms by which radiation induces damage to normal tissue in brain remain largely unknown. Therefore, this review focuses on the pathophysiological mechanisms of whole brain radiation-induced cognitive impairment and the iden-tification of novel therapeutic targets. Specifically, we review the current knowledge about the effects of whole brain radiation on pro-oxidative and pro-inflammatory pathways, matrix metalloproteinases (MMPs)/tissue inhibitors of metalloproteinases (TIMPs) system and extracellular matrix (ECM), and physiological angiogenesis in brain. These studies may provide a foundation for defin-ing a new cellular and molecular basis related to the etiology of cognitive impairment that occurs among patients in response to whole brain radiation therapy. It may also lead to new opportunities for therapeutic interventions for brain tumor patients who are undergoing whole brain radiation therapy.

  19. Relationship between the Whole Brain Creativity Model and Kolb’s Experiential Learning Model

    Directory of Open Access Journals (Sweden)

    E Potgieter

    1999-09-01

    Full Text Available The aim of this article is to illustrate the relation between the cognitive styles in Kolb’s experiential learning model and dominance in brain functioning. A descriptive analytical study of the literature on creativity and the development of creative thinking, explored various theories and definitions of creativity, and the nature of creative learning. Congruences between cognitive styles and the four quadrants of the Whole Brain Model were detected. This article focuses specifically on Kolb’s cognitive styles in relation to the Whole Brain Model and the implications thereof for nursing education.

  20. Incidence of Leukoencephalopathy After Whole-Brain Radiation Therapy for Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ebi, Junko, E-mail: junkoe@fmu.ac.jp [Department of Radiology, Fukushima Medical University, Fukushima (Japan); Sato, Hisashi; Nakajima, Masaru; Shishido, Fumio [Department of Radiology, Fukushima Medical University, Fukushima (Japan)

    2013-04-01

    Purpose: To evaluate the incidence of leukoencephalopathy after whole-brain radiation therapy (WBRT) in patients with brain metastases. Methods and Materials: We retrospectively reviewed 111 patients who underwent WBRT for brain metastases from April 2001 through March 2008 and had evaluable computed tomography (CT) and/or magnetic resonance imaging (MRI) at least 1 month after completion of WBRT. We evaluated the leukoencephalopathy according to the Common Terminology Criteria for Adverse Events, version 3.0. The patients who had brain tumor recurrence after WBRT were censored at the last follow-up CT or MRI without recurrence. To evaluate the risk factors for leukoencephalopathy, bivariate analysis was performed using a logistic regression analysis adjusted for follow-up time. Factors included in the analysis were age, gender, dose fractionation, 5-fluorouracil, methotrexate, cisplatin, and other chemotherapeutic agents. Results: The median age of the 111 patients was 60.0 years (range, 23-89 years). The median follow-up was 3.8 months (range, 1.0-38.1 months). Leukoencephalopathy developed in 23 of the 111 patients. Grades 1, 2, and 3 were observed in 8, 7, and 8 patients, respectively. The incidence was 34.4% (11 of 32), 42.9% (6 of 14), 66.7% (2 of 3), and 100% (2 of 2) of the patients who were followed up for ≥6, ≥12, ≥24, and ≥36 months, respectively. In the bivariate analysis, older age (≥65 years) was significantly correlated with higher risk of leukoencephalopathy (odds ratio 3.31; 95% confidence interval 1.15-9.50; P=.03). Conclusions: The incidence of leukoencephalopathy after WBRT was 34.4% with ≥6 months follow-up, and increased with longer follow-up. Older age was a significant risk factor. The schedule of WBRT for patients with brain metastases should be carefully determined, especially for favorable patients.

  1. Aberrant whole-brain functional connectivity and intelligence structure in children with primary nocturnal enuresis.

    Directory of Open Access Journals (Sweden)

    Bing Yu

    Full Text Available AIM: To assess the potential relationship between intelligence structure abnormalities and whole-brain functional connectivity in children with primary nocturnal enuresis (PNE with resting-state functional magnetic resonance imaging (fMRI to provide insights into the association between these two seemingly unrelated conditions. METHODS: Intelligence testing and fMRI data were obtained from 133 right-handed children, including 67 PNE children (M/F, 39:28; age, 10.5 ± 1.2 y and 66 age-matched healthy controls (M/F, 37:29; age, 10.1 ± 1.1 y. All intelligence tests were performed using the China-Wechsler Intelligence Scale for Children (C-WISC. Each subject's full intelligence quotient (FIQ, verbal IQ (VIQ, performance IQ (PIQ, and memory/caution (M/C factor was measured and recorded. Resting state fMRI scans were performed on a 3.0-T MR scanner and post-processed using REST software. Comparisons of z-score correlation coefficients between distinct cerebral regions were used to identify altered functional connectivity in PNE children. RESULTS: The PNE group had normal FIQ, VIQ, and PIQ values, indicating no significant variation from the control group. However, the M/C factor was significantly lower in the PNE group. Compared to the control group, PNE children exhibited overall lower levels of functional connectivity that were most apparent in the cerebello-thalamo-frontal pathway. The M/C factor significantly correlated with z-scores representing connectivity between Cerebellum_Crus1_L and Frontal_Mid_R. CONCLUSION: PNE children exhibit intelligence structure imbalance and attention deficits. Our findings suggest that cerebello-thalamo-frontal circuit abnormalities are likely to be involved in the onset and progression of attention impairment in PNE children.

  2. Aberrant whole-brain functional connectivity and intelligence structure in children with primary nocturnal enuresis.

    Science.gov (United States)

    Yu, Bing; Sun, Hongbin; Ma, Hongwei; Peng, Miao; Kong, Fanxing; Meng, Fanxing; Liu, Na; Guo, Qiyong

    2013-01-01

    To assess the potential relationship between intelligence structure abnormalities and whole-brain functional connectivity in children with primary nocturnal enuresis (PNE) with resting-state functional magnetic resonance imaging (fMRI) to provide insights into the association between these two seemingly unrelated conditions. Intelligence testing and fMRI data were obtained from 133 right-handed children, including 67 PNE children (M/F, 39:28; age, 10.5 ± 1.2 y) and 66 age-matched healthy controls (M/F, 37:29; age, 10.1 ± 1.1 y). All intelligence tests were performed using the China-Wechsler Intelligence Scale for Children (C-WISC). Each subject's full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ), and memory/caution (M/C) factor was measured and recorded. Resting state fMRI scans were performed on a 3.0-T MR scanner and post-processed using REST software. Comparisons of z-score correlation coefficients between distinct cerebral regions were used to identify altered functional connectivity in PNE children. The PNE group had normal FIQ, VIQ, and PIQ values, indicating no significant variation from the control group. However, the M/C factor was significantly lower in the PNE group. Compared to the control group, PNE children exhibited overall lower levels of functional connectivity that were most apparent in the cerebello-thalamo-frontal pathway. The M/C factor significantly correlated with z-scores representing connectivity between Cerebellum_Crus1_L and Frontal_Mid_R. PNE children exhibit intelligence structure imbalance and attention deficits. Our findings suggest that cerebello-thalamo-frontal circuit abnormalities are likely to be involved in the onset and progression of attention impairment in PNE children.

  3. Novel whole brain segmentation and volume estimation using quantitative MRI

    Energy Technology Data Exchange (ETDEWEB)

    West, J. [Linkoeping University, Radiation Physics, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); SyntheticMR AB, Linkoeping (Sweden); Warntjes, J.B.M. [Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); SyntheticMR AB, Linkoeping (Sweden); Linkoeping University and Department of Clinical Physiology UHL, County Council of Oestergoetland, Clinical Physiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Lundberg, P. [Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); Linkoeping University and Department of Radiation Physics UHL, County Council of Oestergoetland, Radiation Physics, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Linkoeping University and Department of Radiology UHL, County Council of Oestergoetland, Radiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden)

    2012-05-15

    Brain segmentation and volume estimation of grey matter (GM), white matter (WM) and cerebro-spinal fluid (CSF) are important for many neurological applications. Volumetric changes are observed in multiple sclerosis (MS), Alzheimer's disease and dementia, and in normal aging. A novel method is presented to segment brain tissue based on quantitative magnetic resonance imaging (qMRI) of the longitudinal relaxation rate R{sub 1}, the transverse relaxation rate R{sub 2} and the proton density, PD. Previously reported qMRI values for WM, GM and CSF were used to define tissues and a Bloch simulation performed to investigate R{sub 1}, R{sub 2} and PD for tissue mixtures in the presence of noise. Based on the simulations a lookup grid was constructed to relate tissue partial volume to the R{sub 1}-R{sub 2}-PD space. The method was validated in 10 healthy subjects. MRI data were acquired using six resolutions and three geometries. Repeatability for different resolutions was 3.2% for WM, 3.2% for GM, 1.0% for CSF and 2.2% for total brain volume. Repeatability for different geometries was 8.5% for WM, 9.4% for GM, 2.4% for CSF and 2.4% for total brain volume. We propose a new robust qMRI-based approach which we demonstrate in a patient with MS. (orig.)

  4. Improving the Students' Spiritual Intelligence in English Writing through Whole Brain Learning

    Science.gov (United States)

    Santoso, Didik

    2016-01-01

    The objective of this research was to improve the students' spiritual intelligence in English writing through Whole Brain Learning strategy. Therefore, this study was conducted as a classroom action research. The research pocedure followed the cyclonic process of planning, action, observation, and reflection. This process was preceeded by…

  5. Early diagnosis of dementia based on intersubject whole-brain dissimilarities

    DEFF Research Database (Denmark)

    Klein, S.; Loog, M.; Lijn, F. van der;

    2010-01-01

    . A kNN classifier was trained on the dissimilarity matrix and the performance was tested in a leave-one-out experiment. A classification accuracy of 81% was attained (spec. 83%, sens. 79%). This demonstrates the potential of whole-brain intersubject dissimilarities to aid in early diagnosis of dementia....

  6. Abnormal whole-brain functional networks in homogeneous acute mild traumatic brain injury.

    NARCIS (Netherlands)

    Shumskaya, E.; Andriessen, T.; Norris, D.G.; Vos, P.E.

    2012-01-01

    Objectives: To evaluate the whole-brain resting-state networks in a homogeneous group of patients with acute mild traumatic brain injury (MTBI) and to identify alterations in functional connectivity induced by MTBI. Methods: Thirty-five patients with acute MTBI and 35 healthy control subjects, mat

  7. Value of Whole Brain Computed Tomography Perfusion for Predicting Outcome after TIA or Minor Ischemic Stroke

    NARCIS (Netherlands)

    Van Den Wijngaard, Ido R.; Algra, Ale; Lycklama À Nijeholt, Geert J.; Boiten, Jelis; Wermer, Marieke J H; Van Walderveen, Marianne A A

    2015-01-01

    Introduction About 15% of patients with transient ischemic attack (TIA) or minor ischemic stroke have functional impairment after 3 months. We studied the role of whole brain computed tomography perfusion (WB-CTP) in the emergency diagnosis of TIA or minor stroke in predicting disability at 3 months

  8. The Effect of Herrmann Whole Brain Teaching Method on Students' Understanding of Simple Electric Circuits

    Science.gov (United States)

    Bawaneh, Ali Khalid Ali; Nurulazam Md Zain, Ahmad; Salmiza, Saleh

    2011-01-01

    The purpose of this study was to investigate the effect of Herrmann Whole Brain Teaching Method over conventional teaching method on eight graders in their understanding of simple electric circuits in Jordan. Participants (N = 273 students; M = 139, F = 134) were randomly selected from Bani Kenanah region-North of Jordan and randomly assigned to…

  9. Abnormal whole-brain functional networks in homogeneous acute mild traumatic brain injury.

    NARCIS (Netherlands)

    Shumskaya, A.N.; Andriessen, T.M.J.C.; Norris, D.G.; Vos, P.E.

    2012-01-01

    OBJECTIVES: To evaluate the whole-brain resting-state networks in a homogeneous group of patients with acute mild traumatic brain injury (MTBI) and to identify alterations in functional connectivity induced by MTBI. METHODS: Thirty-five patients with acute MTBI and 35 healthy control subjects, match

  10. Parameterization of the Age-Dependent Whole Brain Apparent Diffusion Coefficient Histogram

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    Uwe Klose

    2015-01-01

    Full Text Available Purpose. The distribution of apparent diffusion coefficient (ADC values in the brain can be used to characterize age effects and pathological changes of the brain tissue. The aim of this study was the parameterization of the whole brain ADC histogram by an advanced model with influence of age considered. Methods. Whole brain ADC histograms were calculated for all data and for seven age groups between 10 and 80 years. Modeling of the histograms was performed for two parts of the histogram separately: the brain tissue part was modeled by two Gaussian curves, while the remaining part was fitted by the sum of a Gaussian curve, a biexponential decay, and a straight line. Results. A consistent fitting of the histograms of all age groups was possible with the proposed model. Conclusions. This study confirms the strong dependence of the whole brain ADC histograms on the age of the examined subjects. The proposed model can be used to characterize changes of the whole brain ADC histogram in certain diseases under consideration of age effects.

  11. Whole-brain functional networks in cognitively normal, mild cognitive impairment, and Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Eun Hyun Seo

    Full Text Available The conceptual significance of understanding functional brain alterations and cognitive deficits associated with Alzheimer's disease (AD process has been widely established. However, the whole-brain functional networks of AD and its prodromal stage, mild cognitive impairment (MCI, are not well clarified yet. In this study, we compared the characteristics of the whole-brain functional networks among cognitively normal (CN, MCI, and AD individuals by applying graph theoretical analyses to [(18F] fluorodeoxyglucose positron emission tomography (FDG-PET data. Ninety-four CN elderly, 183 with MCI, and 216 with AD underwent clinical evaluation and FDG-PET scan. The overall small-world property as seen in the CN whole-brain network was preserved in MCI and AD. In contrast, individual parameters of the network were altered with the following patterns of changes: local clustering of networks was lower in both MCI and AD compared to CN, while path length was not different among the three groups. Then, MCI had a lower level of local clustering than AD. Subgroup analyses for AD also revealed that very mild AD had lower local clustering and shorter path length compared to mild AD. Regarding the local properties of the whole-brain networks, MCI and AD had significantly decreased normalized betweenness centrality in several hubs regionally associated with the default mode network compared to CN. Our results suggest that the functional integration in whole-brain network progressively declines due to the AD process. On the other hand, functional relatedness between neighboring brain regions may not gradually decrease, but be the most severely altered in MCI stage and gradually re-increase in clinical AD stages.

  12. Whole-Brain CT Perfusion to Quantify Acute Ischemic Penumbra and Core.

    Science.gov (United States)

    Lin, Longting; Bivard, Andrew; Krishnamurthy, Venkatesh; Levi, Christopher R; Parsons, Mark W

    2016-06-01

    Purpose To validate the use of perfusion computed tomography (CT) with whole-brain coverage to measure the ischemic penumbra and core and to compare its performance to that of limited-coverage perfusion CT. Materials and Methods Institutional ethics committee approval and informed consent were obtained. Patients (n = 296) who underwent 320-detector CT perfusion within 6 hours of the onset of ischemic stroke were studied. First, the ischemic volume at CT perfusion was compared with the penumbra and core reference values at magnetic resonance (MR) imaging to derive CT perfusion penumbra and core thresholds. Second, the thresholds were tested in a different group of patients to predict the final infarction at diffusion-weighted imaging 24 hours after CT perfusion. Third, the change in ischemic volume delineated by the optimal penumbra and core threshold was determined as the brain coverage was gradually reduced from 160 mm to 20 mm. The Wilcoxon signed-rank test, concordance correlation coefficient (CCC), and analysis of variance were used for the first, second, and third steps, respectively. Results CT perfusion at penumbra and core thresholds resulted in the least volumetric difference from MR imaging reference values with delay times greater than 3 seconds and delay-corrected cerebral blood flow of less than 30% (P = .34 and .33, respectively). When the thresholds were applied to the new group of patients, prediction of the final infarction was allowed with delay times greater than 3 seconds in patients with no recanalization of the occluded artery (CCC, 0.96 [95% confidence interval: 0.92, 0.98]) and with delay-corrected cerebral blood flow less than 30% in patients with complete recanalization (CCC, 0.91 [95% confidence interval: 0.83, 0.95]). However, the ischemic volume with a delay time greater than 3 seconds was underestimated when the brain coverage was reduced to 80 mm (P = .04) and the core volume measured as cerebral blood flow less than 30% was

  13. Great expectations: using whole-brain computational connectomics for understanding neuropsychiatric disorders.

    Science.gov (United States)

    Deco, Gustavo; Kringelbach, Morten L

    2014-12-01

    The study of human brain networks with in vivo neuroimaging has given rise to the field of connectomics, furthered by advances in network science and graph theory informing our understanding of the topology and function of the healthy brain. Here our focus is on the disruption in neuropsychiatric disorders (pathoconnectomics) and how whole-brain computational models can help generate and predict the dynamical interactions and consequences of brain networks over many timescales. We review methods and emerging results that exhibit remarkable accuracy in mapping and predicting both spontaneous and task-based healthy network dynamics. This raises great expectations that whole-brain modeling and computational connectomics may provide an entry point for understanding brain disorders at a causal mechanistic level, and that computational neuropsychiatry can ultimately be leveraged to provide novel, more effective therapeutic interventions, e.g., through drug discovery and new targets for deep brain stimulation.

  14. Whole-brain voxel-based morphometry of white matter in medial temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Yu Aihong [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China); Li Kuncheng [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China)], E-mail: Likuncheng@vip.sina.com; Li Lin; Shan Baoci [Institute of High Energy Physics, Chinese Academy of Sciences (China); Wang Yuping; Xue Sufang [Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences (China)

    2008-01-15

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in medial temporal lobe epilepsy (MTLE). Materials and methods: We studied 23 patients with MTLE and 13 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The seizure focus was right sided in 11 patients and left sided in 12. The data were collected on a 1.5 T MR system and analyzed by SPM 99 to generate white matter density maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MTLE prominently including bilateral frontal lobes, bilateral temporal lobes and corpus callosum. White matter reduction was also found in the bilateral cerebellar hemispheres in the left MTLE group. Conclusion: VBM is a simple and automated approach that is able to identify diffuse whole-brain white matter reduction in MTLE.

  15. Optimizing patient positioning for intensity modulated radiation therapy in hippocampal-sparing whole brain radiation therapy.

    Science.gov (United States)

    Siglin, Joshua; Champ, Colin E; Vakhnenko, Yelena; Witek, Matthew E; Peng, Cheng; Zaorsky, Nicholas G; Harrison, Amy S; Shi, Wenyin

    2014-01-01

    Sparing the hippocampus during whole brain radiation therapy (WBRT) offers potential neurocognitive benefits. However, previously reported intensity modulated radiation therapy (IMRT) plans use multiple noncoplanar beams for treatment delivery. An optimized coplanar IMRT template for hippocampal-sparing WBRT would assist in clinical workflow and minimize resource utilization. In this study, we sought to determine the optimal patient position to facilitate coplanar treatment planning and delivery of hippocampal-sparing WBRT using IMRT. A variable angle, inclined board was utilized for patient positioning. An anthropomorphic phantom underwent computed tomography simulation at various head angles. The IMRT goals were designed to achieve target coverage of the brain while maintaining hippocampal dose-volume constraints designed to conform to the Radiation Therapy Oncology Group 0933 protocol. Optimal head angle was then verified using data from 8 patients comparing coplanar and noncoplanar WBRT IMRT plans. Hippocampal, hippocampal avoidance region, and whole brain mean volumes were 1.1 cm(3), 12.5 cm(3), and 1185.1 cm(3), respectively. The hippocampal avoidance region occupied 1.1% of the whole brain planning volume. For the 30-degree head angle, a 7-field coplanar IMRT plan was generated, sparing the hippocampus to a maximum dose of 14.7 Gy; D100% of the hippocampus was 7.4 Gy and mean hippocampal dose was 9.3 Gy. In comparison, for flat head positioning the hippocampal Dmax was 22.9 Gy with a D100% of 9.2 Gy and mean dose of 11.7 Gy. Target coverage and dose homogeneity was comparable with previously published noncoplanar IMRT plans. Compared with conventional supine positioning, an inclined head board at 30 degrees optimizes coplanar whole brain IMRT treatment planning. Clinically acceptable hippocampal-sparing WBRT dosimetry can be obtained using a simplified coplanar plan at a 30-degree head angle, thus obviating the need for complex and time consuming noncoplanar

  16. Structural brain network: What is the effect of LiFE optimization of whole brain tractography?

    Directory of Open Access Journals (Sweden)

    Shouliang eQi

    2016-02-01

    Full Text Available Structural brain networks constructed based on diffusion-weighted MRI (dMRI have provided a systems perspective to explore the organization of the human brain. Some redundant and nonexistent fibers, however, are inevitably generated in whole brain tractography. We propose to add one critical step while constructing the networks to remove these fibers using the linear fascicle evaluation (LiFE method, and study the differences between the networks with and without LiFE optimization. For a cohort of 9 healthy adults and for 9 out of the 35 subjects from Human Connectome Project, the T1-weighted images and dMRI data are analyzed. Each brain is parcellated into 90 regions-of-interest, whilst a probabilistic tractography algorithm is applied to generate the original connectome. The elimination of redundant and nonexistent fibers from the original connectome by LiFE creates the optimized connectome, and the random selection of the same number of fibers as the optimized connectome creates the non-optimized connectome. The combination of parcellations and these connectomes leads to the optimized and non-optimized networks, respectively. The optimized networks are constructed with six weighting schemes, and the correlations of different weighting methods are analyzed. The fiber length distributions of the non-optimized and optimized connectomes are compared. The optimized and non-optimized networks are compared with regard to edges, nodes and networks, within a sparsity range of 0.75-0.95. It has been found that relatively more short fibers exist in the optimized connectome. About 24.0% edges of the optimized network are significantly different from those in the non-optimized network at a sparsity of 0.75. About 13.2% of edges are classified as false positives or the possible missing edges. The strength and betweenness centrality of some nodes are significantly different for the non-optimized and optimized networks, but not the node efficiency. The

  17. Sparse representation of whole-brain fMRI signals for identification of functional networks.

    Science.gov (United States)

    Lv, Jinglei; Jiang, Xi; Li, Xiang; Zhu, Dajiang; Chen, Hanbo; Zhang, Tuo; Zhang, Shu; Hu, Xintao; Han, Junwei; Huang, Heng; Zhang, Jing; Guo, Lei; Liu, Tianming

    2015-02-01

    There have been several recent studies that used sparse representation for fMRI signal analysis and activation detection based on the assumption that each voxel's fMRI signal is linearly composed of sparse components. Previous studies have employed sparse coding to model functional networks in various modalities and scales. These prior contributions inspired the exploration of whether/how sparse representation can be used to identify functional networks in a voxel-wise way and on the whole brain scale. This paper presents a novel, alternative methodology of identifying multiple functional networks via sparse representation of whole-brain task-based fMRI signals. Our basic idea is that all fMRI signals within the whole brain of one subject are aggregated into a big data matrix, which is then factorized into an over-complete dictionary basis matrix and a reference weight matrix via an effective online dictionary learning algorithm. Our extensive experimental results have shown that this novel methodology can uncover multiple functional networks that can be well characterized and interpreted in spatial, temporal and frequency domains based on current brain science knowledge. Importantly, these well-characterized functional network components are quite reproducible in different brains. In general, our methods offer a novel, effective and unified solution to multiple fMRI data analysis tasks including activation detection, de-activation detection, and functional network identification. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. An In vivo Multi-Modal Structural Template for Neonatal Piglets Using High Angular Resolution and Population-Based Whole-Brain Tractography.

    Science.gov (United States)

    Zhong, Jidan; Chen, David Q; Walker, Matthew; Waspe, Adam; Looi, Thomas; Piorkowska, Karolina; Drake, James M; Hodaie, Mojgan

    2016-01-01

    An increasing number of applications use the postnatal piglet model in neuroimaging studies, however, these are based primarily on T1 weighted image templates. There is a growing need for a multimodal structural brain template for a comprehensive depiction of the piglet brain, particularly given the growing applications of diffusion weighted imaging for characterizing tissue microstructures and white matter organization. In this study, we present the first multimodal piglet structural brain template which includes a T1 weighted image with tissue segmentation probability maps, diffusion weighted metric templates with multiple diffusivity maps, and population-based whole-brain fiber tracts for postnatal piglets. These maps provide information about the integrity of white matter that is not available in T1 images alone. The availability of this diffusion weighted metric template will contribute to the structural imaging analysis of the postnatal piglet brain, especially models that are designed for the study of white matter diseases. Furthermore, the population-based whole-brain fiber tracts permit researchers to visualize the white matter connections in the piglet brain across subjects, guiding the delineation of a specific white matter region for structural analysis where current diffusion data is lacking. Researchers are able to augment the tracts by merging tracts from their own data to the population-based fiber tracts and thus improve the confidence of the population-wise fiber distribution.

  19. An In vivo Multi-Modal Structural Template for Neonatal Piglets Using High Angular Resolution and Population-Based Whole-Brain Tractography

    Science.gov (United States)

    Zhong, Jidan; Chen, David Q.; Walker, Matthew; Waspe, Adam; Looi, Thomas; Piorkowska, Karolina; Drake, James M.; Hodaie, Mojgan

    2016-01-01

    An increasing number of applications use the postnatal piglet model in neuroimaging studies, however, these are based primarily on T1 weighted image templates. There is a growing need for a multimodal structural brain template for a comprehensive depiction of the piglet brain, particularly given the growing applications of diffusion weighted imaging for characterizing tissue microstructures and white matter organization. In this study, we present the first multimodal piglet structural brain template which includes a T1 weighted image with tissue segmentation probability maps, diffusion weighted metric templates with multiple diffusivity maps, and population-based whole-brain fiber tracts for postnatal piglets. These maps provide information about the integrity of white matter that is not available in T1 images alone. The availability of this diffusion weighted metric template will contribute to the structural imaging analysis of the postnatal piglet brain, especially models that are designed for the study of white matter diseases. Furthermore, the population-based whole-brain fiber tracts permit researchers to visualize the white matter connections in the piglet brain across subjects, guiding the delineation of a specific white matter region for structural analysis where current diffusion data is lacking. Researchers are able to augment the tracts by merging tracts from their own data to the population-based fiber tracts and thus improve the confidence of the population-wise fiber distribution. PMID:27729850

  20. Whole-brain CT perfusion and CT angiography assessment of Moyamoya disease before and after surgical revascularization: preliminary study with 256-slice CT.

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    Jun Zhang

    Full Text Available BACKGROUND/AIMS: The 256-slice CT enables the entire brain to be scanned in a single examination. We evaluated the application of 256-slice whole-brain CT perfusion (CTP in determining graft patency as well as investigating cerebral hemodynamic changes in Moyamoya disease before and after surgical revascularization. METHODS: Thirty-nine cases of Moyamoya disease were evaluated before and after surgical revascularization with 256-slice CT. Whole-brain perfusion images and dynamic 3D CT angiographic images generated from perfusion source data were obtained in all patients. Cerebral blood flow (CBF, cerebral blood volume (CBV, time to peak (TTP and mean transit time (MTT of one hemisphere in the region of middle cerebral artery (MCA distribution and contralateral mirroring areas were measured. Relative CTP values (rCBF, rCBV, rTTP, rMTT were also obtained. Differences in pre- and post- operation perfusion CT values were assessed with paired t test or matched-pairs signed-ranks test. RESULTS: Preoperative CBF, MTT and TTP of potential surgical side were significantly different from those of contralateral side (P<0.01 for all. All graft patencies were displayed using the 3D-CTA images. Postoperative CBF, rCBF and rCBV values of surgical side in the region of MCA were significantly higher than those before operation (P<0.01 for all. Postoperative MTT, TTP, rMTT and rTTP values of the surgical side in the region of MCA were significantly lower than those before operation (P<0.05 for all. CONCLUSION: The 256-slice whole-brain CTP can be used to evaluate cerebral hemodynamic changes in Moyamoya disease before and after surgery and the 3D-CTA is useful for assessing the abnormalities of intracranial arteries and graft patencies.

  1. Supervised, Multivariate, Whole-brain Reduction Did Not Help to Achieve High Classification Performance in Schizophrenia Research

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    Eva Janousova

    2016-08-01

    Full Text Available We examined how penalized linear discriminant analysis with resampling, which is a supervised, multivariate, whole-brain reduction technique, can help schizophrenia diagnostics and research. In an experiment with magnetic resonance brain images of 52 first-episode schizophrenia patients and 52 healthy controls, this method allowed us to select brain areas relevant to schizophrenia, such as the left prefrontal cortex, the anterior cingulum, the right anterior insula, the thalamus and the hippocampus. Nevertheless, the classification performance based on such reduced data was not significantly better than the classification of data reduced by mass univariate selection using a t-test or unsupervised multivariate reduction using principal component analysis. Moreover, we found no important influence of the type of imaging features, namely local deformations or grey matter volumes, and the classification method, specifically linear discriminant analysis or linear support vector machines, on the classification results. However, we ascertained significant effect of a cross-validation setting on classification performance as classification results were overestimated even though the resampling was performed during the selection of brain imaging features. Therefore, it is critically important to perform cross-validation in all steps of the analysis (not only during classification in case there is no external validation set to avoid optimistically biasing the results of classification studies.

  2. Three-dimensional fluid-attenuated inversion recovery sequence for visualisation of subthalamic nucleus for deep brain stimulation in Parkinson's disease

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    Heo, Young Jin [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology, Research Institute of Radiology, Seoul (Korea, Republic of); Inje University, Department of Radiology, Busan Paik Hospital, Busan (Korea, Republic of); Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Chai [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology, Research Institute of Radiology, Seoul (Korea, Republic of); Lee, Jung Kyo [University of Ulsan College of Medicine, Asan Medical Center, Department of Neurosurgery, Seoul (Korea, Republic of); Lee, Chong Sik; Chung, Sun J. [University of Ulsan College of Medicine, Asan Medical Center, Department of Neurology, Seoul (Korea, Republic of); Cho, So Hyun [Department of Radiology, Busan (Korea, Republic of); Lee, Gyoung Ro [Philips HealthCare Korea, Seoul (Korea, Republic of)

    2015-09-15

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted treatment for advanced Parkinson's disease (PD). However, targeting the STN is difficult due to its relatively small size and variable location. The purpose of this study was to assess which of the following sequences obtained with the 3.0 T MR system can accurately delineate the STN: coronal 3D fluid-attenuated inversion recovery (FLAIR), 2D T2*-weighted fast-field echo (T2*-FFE) and 2D T2-weighted turbo spin-echo (TSE) sequences. We included 20 consecutive patients with PD who underwent 3.0 T MR for DBS targeting. 3D FLAIR, 2D T2*-FFE and T2-TSE images were obtained for all study patients. Image quality and demarcation of the STN were analysed using 4-point scales, and contrast ratio (CR) of the STN and normal white matter was calculated. The Friedman test was used to compare the three sequences. In qualitative analysis, the 2D T2*-FFE image showed more artefacts than 3D FLAIR or 2D T2-TSE, but the difference did not reach statistical significance. 3D FLAIR images showed significantly superior demarcation of the STN compared with 2D T2*-FFE and T2-TSE images (P < 0.001, respectively). The CR of 3D FLAIR was significantly higher than that of 2D T2*-FFE or T2-TSE images in multiple comparison correction (P < 0.001), but there was no significant difference in the CR between 2D T2*-FFE and T2-TSE images. Coronal 3D FLAIR images showed the most accurate demarcation of the STN for DBS targeting among coronal 3D FLAIR, 2D T2*-FFE and T2-TSE images. (orig.)

  3. The balance between cognitive reserve and brain imaging biomarkers of cerebrovascular and Alzheimer's diseases.

    Science.gov (United States)

    Murray, Alison D; Staff, Roger T; McNeil, Christopher J; Salarirad, Sima; Ahearn, Trevor S; Mustafa, Nazahah; Whalley, Lawrence J

    2011-12-01

    The cognitive reserve hypothesis explains the disparity between clinical and pathological phenotypes and why, in two individuals with the same extent of neuropathology, one may be demented while the other remains cognitively intact. We examined the balance between brain magnetic resonance imaging measures of the two most common pathologies associated with brain ageing, cerebrovascular disease and Alzheimer's disease, and parameters of cerebral reserve in well-characterized participants born in 1936, for whom childhood intelligence is known. Brain magnetic resonance imaging was carried out at 1.5T using fluid attenuation inversion recovery and T(1)-weighted volumetric sequences in 249 participants. Cerebrovascular disease was quantified by measuring brain white matter hyperintensities on fluid attenuation inversion recovery images using Scheltens' scale and Alzheimer's disease was measured from volumetric data using FreeSurfer to extract whole brain volume and hippocampal volumes in turn. The effect of these measures of brain burden on life-long cognitive ageing from the age of 11 to 68 years was compared with the effect of educational attainment and occupational grade using structural equation modelling. Complete brain burden and reserve data were available in 224 participants. We found that educational attainment, but not occupation, has a measurable and positive effect, with a standardized regression weight of +0.23, on late life cognitive ability in people without cognitive impairment aged 68 years, allowing for the influence of childhood intelligence and the two most common subclinical brain pathological burdens in the ageing brain. In addition, we demonstrate that the magnitude of the contribution of education is greater than the negative impact of either neuropathological burden alone, with standardized regression weights of -0.14 for white matter hyperintensities and -0.20 for hippocampal atrophy. This study illustrates how education counteracts the

  4. Disease-Specific Regions Outperform Whole-Brain Approaches in Identifying Progressive Supranuclear Palsy: A Multicentric MRI Study

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    Mueller, Karsten; Jech, Robert; Bonnet, Cecilia; Tintěra, Jaroslav; Hanuška, Jaromir; Möller, Harald E.; Fassbender, Klaus; Ludolph, Albert; Kassubek, Jan; Otto, Markus; Růžička, Evžen; Schroeter, Matthias L.

    2017-01-01

    To identify progressive supranuclear palsy (PSP), we combined voxel-based morphometry (VBM) and support vector machine (SVM) classification using disease-specific features in multicentric magnetic resonance imaging (MRI) data. Structural brain differences were investigated at four centers between 20 patients with PSP and 20 age-matched healthy controls with T1-weighted MRI at 3T. To pave the way for future application in personalized medicine, we applied SVM classification to identify PSP on an individual level besides group analyses based on VBM. We found a major decline in gray matter density in the brainstem, insula, and striatum, and also in frontomedian regions, which is in line with current literature. Moreover, SVM classification yielded high accuracy rates above 80% for disease identification in imaging data. Focusing analyses on disease-specific regions-of-interest (ROI) led to higher accuracy rates compared to a whole-brain approach. Using a polynomial kernel (instead of a linear kernel) led to an increased sensitivity and a higher specificity of disease detection. Our study supports the application of MRI for individual diagnosis of PSP, if combined with SVM approaches. We demonstrate that SVM classification provides high accuracy rates in multicentric data—a prerequisite for potential application in diagnostic routine. PMID:28326008

  5. Whole-brain grey matter density predicts balance stability irrespective of age and protects older adults from falling.

    Science.gov (United States)

    Boisgontier, Matthieu P; Cheval, Boris; van Ruitenbeek, Peter; Levin, Oron; Renaud, Olivier; Chanal, Julien; Swinnen, Stephan P

    2016-03-01

    Functional and structural imaging studies have demonstrated the involvement of the brain in balance control. Nevertheless, how decisive grey matter density and white matter microstructural organisation are in predicting balance stability, and especially when linked to the effects of ageing, remains unclear. Standing balance was tested on a platform moving at different frequencies and amplitudes in 30 young and 30 older adults, with eyes open and with eyes closed. Centre of pressure variance was used as an indicator of balance instability. The mean density of grey matter and mean white matter microstructural organisation were measured using voxel-based morphometry and diffusion tensor imaging, respectively. Mixed-effects models were built to analyse the extent to which age, grey matter density, and white matter microstructural organisation predicted balance instability. Results showed that both grey matter density and age independently predicted balance instability. These predictions were reinforced when the level of difficulty of the conditions increased. Furthermore, grey matter predicted balance instability beyond age and at least as consistently as age across conditions. In other words, for balance stability, the level of whole-brain grey matter density is at least as decisive as being young or old. Finally, brain grey matter appeared to be protective against falls in older adults as age increased the probability of losing balance in older adults with low, but not moderate or high grey matter density. No such results were observed for white matter microstructural organisation, thereby reinforcing the specificity of our grey matter findings.

  6. Examination of the role of magnetic resonance imaging in multiple sclerosis: A problem-orientated approach

    Directory of Open Access Journals (Sweden)

    McFarland Henry

    2009-01-01

    Full Text Available Magnetic Resonance Imaging (MRI has brought in several benefits to the study of Multiple Sclerosis (MS. It provides accurate measurement of disease activity, facilitates precise diagnosis, and aid in the assessment of newer therapies. The imaging guidelines for MS are broadly divided in to approaches for imaging patients with suspected MS or clinically isolated syndromes (CIS or for monitoring patients with established MS. In this review, the technical aspects of MR imaging for MS are briefly discussed. The imaging process need to capture the twin aspects of acute MS viz. the autoimmune acute inflammatory process and the neurodegenerative process. Gadolinium enhanced MRI can identify acute inflammatory lesions precisely. The commonly applied MRI marker of disease progression is brain atrophy. Whole brain magnetization Transfer Ratio (MTR and Magnetic Resonance Spectroscopy (MRS are two other techniques use to monitor disease progression. A variety of imaging techniques such as Double Inversion Recovery (DIR, Spoiled Gradient Recalled (SPGR acquisition, and Fluid Attenuated Inversion Recovery (FLAIR have been utilized to study the cortical changes in MS. MRI is now extensively used in the Phase I, II and III clinical trials of new therapies. As the technical aspects of MRI advance rapidly, and higher field strengths become available, it is hoped that the impact of MRI on our understanding of MS will be even more profound in the next decade.

  7. Real-time, whole-brain, temporally resolved pressure responses in translational head impact.

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    Zhao, Wei; Ji, Songbai

    2016-02-01

    Theoretical debate still exists on the role of linear acceleration ( a lin) on the risk of brain injury. Recent injury metrics only consider head rotational acceleration ( a rot) but not a lin, despite that real-world on-field head impacts suggesting a lin significantly improves a concussion risk function. These controversial findings suggest a practical challenge in integrating theory and real-world experiment. Focusing on tissue-level mechanical responses estimated from finite-element (FE) models of the human head, rather than impact kinematics alone, may help address this debate. However, the substantial computational cost incurred (runtime and hardware) poses a significant barrier for their practical use. In this study, we established a real-time technique to estimate whole-brain a lin-induced pressures. Three hydrostatic atlas pressures corresponding to translational impacts (referred to as 'brain print') along the three major axes were pre-computed. For an arbitrary a lin profile at any instance in time, the atlas pressures were linearly scaled and then superimposed to estimate whole-brain responses. Using 12 publically available, independently measured or reconstructed real-world a lin profiles representative of a range of impact/injury scenarios, the technique was successfully validated (except for one case with an extremely short impulse of approx. 1 ms). The computational cost to estimate whole-brain pressure responses for an entire a lin profile was less than 0.1 s on a laptop versus typically hours on a high-end multicore computer. These findings suggest the potential of the simple, yet effective technique to enable future studies to focus on tissue-level brain responses, rather than solely relying on global head impact kinematics that have plagued early and contemporary brain injury research to date.

  8. From hippocampus to whole-brain: The role of integrative processing in episodic memory retrieval.

    Science.gov (United States)

    Geib, Benjamin R; Stanley, Matthew L; Dennis, Nancy A; Woldorff, Marty G; Cabeza, Roberto

    2017-01-23

    Multivariate functional connectivity analyses of neuroimaging data have revealed the importance of complex, distributed interactions between disparate yet interdependent brain regions. Recent work has shown that topological properties of functional brain networks are associated with individual and group differences in cognitive performance, including in episodic memory. After constructing functional whole-brain networks derived from an event-related fMRI study of memory retrieval, we examined differences in functional brain network architecture between forgotten and remembered words. This study yielded three main findings. First, graph theory analyses showed that successfully remembering compared to forgetting was associated with significant changes in the connectivity profile of the left hippocampus and a corresponding increase in efficient communication with the rest of the brain. Second, bivariate functional connectivity analyses indicated stronger interactions between the left hippocampus and a retrieval assembly for remembered versus forgotten items. This assembly included the left precuneus, left caudate, bilateral supramarginal gyrus, and the bilateral dorsolateral superior frontal gyrus. Integrative properties of the retrieval assembly were greater for remembered than forgotten items. Third, whole-brain modularity analyses revealed that successful memory retrieval was marginally significantly associated with a less segregated modular architecture in the network. The magnitude of the decreases in modularity between remembered and forgotten conditions was related to memory performance. These findings indicate that increases in integrative properties at the nodal, retrieval assembly, and whole-brain topological levels facilitate memory retrieval, while also underscoring the potential of multivariate brain connectivity approaches for providing valuable new insights into the neural bases of memory processes. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  9. Disruption of functional networks in dyslexia: A whole-brain, data-driven analysis of connectivity

    Science.gov (United States)

    Finn, Emily S.; Shen, Xilin; Holahan, John M.; Scheinost, Dustin; Lacadie, Cheryl; Papademetris, Xenophon; Shaywitz, Sally E.; Shaywitz, Bennett A.; Constable, R. Todd

    2013-01-01

    Background Functional connectivity analyses of fMRI data are a powerful tool for characterizing brain networks and how they are disrupted in neural disorders. However, many such analyses examine only one or a small number of a priori seed regions. Studies that consider the whole brain frequently rely on anatomic atlases to define network nodes, which may result in mixing distinct activation timecourses within a single node. Here, we improve upon previous methods by using a data-driven brain parcellation to compare connectivity profiles of dyslexic (DYS) versus non-impaired (NI) readers in the first whole-brain functional connectivity analysis of dyslexia. Methods Whole-brain connectivity was assessed in children (n = 75; 43 NI, 32 DYS) and adult (n = 104; 64 NI, 40 DYS) readers. Results Compared to NI readers, DYS readers showed divergent connectivity within the visual pathway and between visual association areas and prefrontal attention areas; increased right-hemisphere connectivity; reduced connectivity in the visual word-form area (part of the left fusiform gyrus specialized for printed words); and persistent connectivity to anterior language regions around the inferior frontal gyrus. Conclusions Together, findings suggest that NI readers are better able to integrate visual information and modulate their attention to visual stimuli, allowing them to recognize words based on their visual properties, while DYS readers recruit altered reading circuits and rely on laborious phonology-based “sounding out” strategies into adulthood. These results deepen our understanding of the neural basis of dyslexia and highlight the importance of synchrony between diverse brain regions for successful reading. PMID:24124929

  10. Relating resting-state fMRI and EEG whole-brain connectomes across frequency bands

    Science.gov (United States)

    Deligianni, Fani; Centeno, Maria; Carmichael, David W.; Clayden, Jonathan D.

    2014-01-01

    Whole brain functional connectomes hold promise for understanding human brain activity across a range of cognitive, developmental and pathological states. So called resting-state (rs) functional MRI studies have contributed to the brain being considered at a macroscopic scale as a set of interacting regions. Interactions are defined as correlation-based signal measurements driven by blood oxygenation level dependent (BOLD) contrast. Understanding the neurophysiological basis of these measurements is important in conveying useful information about brain function. Local coupling between BOLD fMRI and neurophysiological measurements is relatively well defined, with evidence that gamma (range) frequency EEG signals are the closest correlate of BOLD fMRI changes during cognitive processing. However, it is less clear how whole-brain network interactions relate during rest where lower frequency signals have been suggested to play a key role. Simultaneous EEG-fMRI offers the opportunity to observe brain network dynamics with high spatio-temporal resolution. We utilize these measurements to compare the connectomes derived from rs-fMRI and EEG band limited power (BLP). Merging this multi-modal information requires the development of an appropriate statistical framework. We relate the covariance matrices of the Hilbert envelope of the source localized EEG signal across bands to the covariance matrices derived from rs-fMRI with the means of statistical prediction based on sparse Canonical Correlation Analysis (sCCA). Subsequently, we identify the most prominent connections that contribute to this relationship. We compare whole-brain functional connectomes based on their geodesic distance to reliably estimate the performance of the prediction. The performance of predicting fMRI from EEG connectomes is considerably better than predicting EEG from fMRI across all bands, whereas the connectomes derived in low frequency EEG bands resemble best rs-fMRI connectivity. PMID:25221467

  11. Relating resting-state fMRI and EEG whole-brain connectomes across frequency bands

    Directory of Open Access Journals (Sweden)

    Fani eDeligianni

    2014-08-01

    Full Text Available Whole brain functional connectomes hold promise for understanding human brain activity across a range of cognitive, developmental and pathological states. So called ‘resting-state’ (rs functional MRI studies have contributed to the brain being considered at a macroscopic scale as a set of interacting regions. Interactions are defined as correlation-based signal measurements driven by blood oxygenation level dependent (BOLD contrast. Understanding the neurophysiological basis of these measurements is important in conveying useful information about brain function. Local coupling between BOLD fMRI and neurophysiological measurements is relatively well defined, with evidence that gamma (range frequency EEG signals are the closest correlate of BOLD fMRI changes during cognitive processing. However, it is less clear how whole-brain network interactions relate during rest where lower frequency signals have been suggested to play a key role. Simultaneous EEG-fMRI offers the opportunity to observe brain network dynamics with high spatio-temporal resolution. We utilize these measurements to compare the connectomes derived from rs-fMRI and EEG band limited power (BLP. Merging this multi-modal information requires the development of an appropriate statistical framework. We relate the covariance matrices of the Hilbert envelope of the source localised EEG signal across bands to the covariance matrices derived from rs-fMRI with the means of statistical prediction based on sparse Canonical Correlation Analysis (sCCA. Subsequently, we identify the most prominent connections that contribute to this relationship. We compare whole-brain functional connectomes based on their geodesic distance to reliably estimate the performance of the prediction. The performance of predicting fMRI from EEG connectomes is considerably better than predicting EEG from fMRI across all bands, whereas the connectomes derived in low frequency EEG bands resemble best rs

  12. Clinical application of RapidArc volumetric modulated arc therapy as a component in whole brain radiation therapy for poor prognostic, four or more multiple brain metastases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Heon; Lee, Kyu Chan; Choi, Jin Ho; Kim, Hye Young; Lee, Seok Ho; Sung, Ki Hoon; Kim, Yun Mi [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2012-06-15

    To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. Nine patients with multiple ({>=}4) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10- 12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. The median biologically effective dose to metastatic tumors was 68.1 Gy10 and 67.2 Gy10 and the median brain volume irradiated more than 100 Gy3 were 1.9% (24 cm3) and 0.8% (13 cm3) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.

  13. Field in field technique in two-dimensional planning for whole brain irradiation; Tecnica field in field em planejamentos bidimensionais para irradiacao de cerebro total

    Energy Technology Data Exchange (ETDEWEB)

    Castro, A.L.S.; Campos, T.P.R., E-mail: radioterapia.andre@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (Brazil). Departamento de Engenharia Nuclear

    2016-11-01

    Radiotherapy is the most used clinical method used for brain metastases treatment, the most frequent secondary tumors provided by breast, lung and melanomas as primary origin. The protocols often use high daily doses and, depending on the irradiation technique there is high probability of complications in health tissues. In order to minimize adverse effects, it is important the dosimetric analysis of three-dimensional radiotherapy planning through tomographic images or, concerning to the 2D simulations, by the application of techniques that optimize dose distribution by increasing the homogeneity. The study aimed to compare the 2D and 3D conformal planning for total brain irradiation in a individual equivalent situation and evaluate the progress of these planning applying the field in field technique. The methodology consisted of simulating a two-dimensional planning, reproduce it on a set of tomographic images and compare it with the conformal plan for two fields and four fields (field in field). The results showed no significant difference between 2D and 3D planning for whole brain irradiation, and the field in field technique significantly improved the dose distribution in brain volume compared with two fields for the proposal situation. As conclusion, the two-dimensional plane for the four fields described was viable for whole brain irradiation in the treatment of brain metastases at the proposal situation. (author)

  14. Understanding principles of integration and segregation using whole-brain computational connectomics: implications for neuropsychiatric disorders.

    Science.gov (United States)

    Lord, Louis-David; Stevner, Angus B; Deco, Gustavo; Kringelbach, Morten L

    2017-06-28

    To survive in an ever-changing environment, the brain must seamlessly integrate a rich stream of incoming information into coherent internal representations that can then be used to efficiently plan for action. The brain must, however, balance its ability to integrate information from various sources with a complementary capacity to segregate information into modules which perform specialized computations in local circuits. Importantly, evidence suggests that imbalances in the brain's ability to bind together and/or segregate information over both space and time is a common feature of several neuropsychiatric disorders. Most studies have, however, until recently strictly attempted to characterize the principles of integration and segregation in static (i.e. time-invariant) representations of human brain networks, hence disregarding the complex spatio-temporal nature of these processes. In the present Review, we describe how the emerging discipline of whole-brain computational connectomics may be used to study the causal mechanisms of the integration and segregation of information on behaviourally relevant timescales. We emphasize how novel methods from network science and whole-brain computational modelling can expand beyond traditional neuroimaging paradigms and help to uncover the neurobiological determinants of the abnormal integration and segregation of information in neuropsychiatric disorders.This article is part of the themed issue 'Mathematical methods in medicine: neuroscience, cardiology and pathology'. © 2017 The Author(s).

  15. Whole-brain structural topology in adult attention-deficit/hyperactivity disorder: Preserved global – disturbed local network organization

    Directory of Open Access Journals (Sweden)

    Justina Sidlauskaite

    2015-01-01

    Full Text Available Prior studies demonstrate altered organization of functional brain networks in attention-deficit/hyperactivity disorder (ADHD. However, the structural underpinnings of these functional disturbances are poorly understood. In the current study, we applied a graph-theoretic approach to whole-brain diffusion magnetic resonance imaging data to investigate the organization of structural brain networks in adults with ADHD and unaffected controls using deterministic fiber tractography. Groups did not differ in terms of global network metrics — small-worldness, global efficiency and clustering coefficient. However, there were widespread ADHD-related effects at the nodal level in relation to local efficiency and clustering. The affected nodes included superior occipital, supramarginal, superior temporal, inferior parietal, angular and inferior frontal gyri, as well as putamen, thalamus and posterior cerebellum. Lower local efficiency of left superior temporal and supramarginal gyri was associated with higher ADHD symptom scores. Also greater local clustering of right putamen and lower local clustering of left supramarginal gyrus correlated with ADHD symptom severity. Overall, the findings indicate preserved global but altered local network organization in adult ADHD implicating regions underpinning putative ADHD-related neuropsychological deficits.

  16. Whole-brain in-vivo measurements of the axonal g-ratio in a group of 37 healthy volunteers

    Directory of Open Access Journals (Sweden)

    Siawoosh eMohammadi

    2015-11-01

    Full Text Available The g-ratio, quantifying the ratio between the inner and outer diameters of a fiber, is an important microstructural characteristic of fiber pathways and is functionally related to conduction velocity. We introduce a novel method for estimating the MR g-ratio non-invasively across the whole brain using high-fidelity magnetization transfer (MT imaging and single-shell diffusion MRI. These methods enabled us to map the MR g-ratio in vivo across the brain’s prominent fiber pathways in a group of 37 healthy volunteers and to estimate the inter-subject variability. Effective correction of susceptibility-related distortion artifacts was essential before combining the MT and diffusion data, in order to reduce partial volume and edge artifacts. The MR g-ratio is in good qualitative agreement with histological findings despite the different resolution and spatial coverage of MRI and histology. The MR g-ratio holds promise as an important non-invasive biomarker due to its microstructural and functional relevance in neurodegeneration.

  17. Salvinorin A and derivatives: protection from metabolism does not prolong short-term, whole-brain residence.

    Science.gov (United States)

    Hooker, Jacob M; Munro, Thomas A; Béguin, Cécile; Alexoff, David; Shea, Colleen; Xu, Youwen; Cohen, Bruce M

    2009-09-01

    Salvinorin A (SA) is a potent kappa opioid agonist with a brief duration of action. Consistent with this, our previous positron emission tomography (PET) studies of carbon-11 labeled SA showed that brain levels decrease rapidly after intravenous administration. SA is rapidly metabolized, giving the much less potent salvinorin B (SB), which is presumed to be responsible in part for SA's brief duration of action. To test this, we labeled the metabolically stable methyl ester of SA and SB with carbon-11 and compared their pharmacokinetics by PET imaging after intravenous administration to baboons. Labeling of salvinorin B ethoxymethyl ether (EOM-SB), a derivative with greater potency and resistance to metabolism, provided an additional test of the role of metabolism in brain efflux. Plasma analysis confirmed that SB and EOM-SB exhibited greater metabolic stability than SA. However, the three compounds exhibited very similar pharmacokinetics in brain, entering and exiting rapidly. This suggests that metabolism is not solely responsible for the brief brain residence time of SA. We determined that whole-brain concentrations of EOM-SB declined more slowly than SA after intraperitoneal administration in rodents. This is likely due to a combination in EOM-SB's increased metabolic stability and its decreased plasma protein affinity. Our results suggest that protecting salvinorin A derivatives from metabolism will prolong duration of action, but only when administered by routes giving slow absorption.

  18. Is Karnofsky Performance Status Correlate with Better Overall Survival in Palliative Conformal Whole Brain Radiotherapy? Our Experience

    Science.gov (United States)

    Reali, Alessia; Allis, Simona; Girardi, Andrea; Verna, Roberta; Bianco, Lavinia; Redda, Maria Grazia Ruo

    2015-01-01

    Aim: Brain metastases (BMs) are a common event in the progression of many human cancers. The aim of this study was to evaluate the potential prognostic factors for the clinical identification of a subgroup of patients that could benefit from whole brain conformal radiotherapy (WBRT). Materials and Methods: From January 2010 to February 2014, 80 patients with a diagnosis of BMs underwent WBRT at our Radiation Oncology Department, San Luigi Hospital, Italy. Among them, 36 medical records were retrospective reviewed. Gender, age, Karnofsky performance status (KPS), number of BMs on computed tomography and/or magnetic resonance images, presence or absence of perilesional edema, presence or absence of necrosis pattern, and histology of primary tumor were analyzed. Univariate and multivariate analyses were performed. Results: In our cohort of patients, significant prognostic factors for 20 months overall survival was KPS> 70, while a statistical trend (P = 0.098) was registered regarding primary breast. Conclusion: WBRT can be still considered a standard and effective treatment in patients with BMs. High KPS and breast cancer primary tumor seem to be useful parameters for characterize a subgroup of patients with more favorable prognosis. PMID:26600700

  19. Whole-Brain Monosynaptic Afferent Inputs to Basal Forebrain Cholinergic System

    Science.gov (United States)

    Hu, Rongfeng; Jin, Sen; He, Xiaobin; Xu, Fuqiang; Hu, Ji

    2016-01-01

    The basal forebrain cholinergic system (BFCS) robustly modulates many important behaviors, such as arousal, attention, learning and memory, through heavy projections to cortex and hippocampus. However, the presynaptic partners governing BFCS activity still remain poorly understood. Here, we utilized a recently developed rabies virus-based cell-type-specific retrograde tracing system to map the whole-brain afferent inputs of the BFCS. We found that the BFCS receives inputs from multiple cortical areas, such as orbital frontal cortex, motor cortex, and insular cortex, and that the BFCS also receives dense inputs from several subcortical nuclei related to motivation and stress, including lateral septum, central amygdala, paraventricular nucleus of hypothalamus, dorsal raphe, and parabrachial nucleus. Interestingly, we found that the BFCS receives inputs from the olfactory areas and the entorhinal–hippocampal system. These results greatly expand our knowledge about the connectivity of the mouse BFCS and provided important preliminary indications for future exploration of circuit function. PMID:27777554

  20. Dose planning management of patients undergoing salvage whole brain radiation therapy after radiosurgery.

    Science.gov (United States)

    Saw, Cheng B; Battin, Frank; McKeague, Janice; Haggerty, Meghan; Baikadi, Madhava; Peters, Christopher

    2016-01-01

    Dose or treatment planning management is necessary for the re-irradiation of intracranial relapses after focal irradiation, radiosurgery, or stereotactic radiotherapy. The current clinical guidelines for metastatic brain tumors are the use of focal irradiation if the patient presents with 4 lesions or less. Salvage treatments with the use of whole brain radiation therapy (WBRT) can then be used to limit disease progression if there is an intracranial relapse. However, salvage WBRT poses a number of challenges in dose planning to limit disease progression and preserve neurocognitive function. This work presents the dose planning management that addresses a method of delineating previously treated volumes, dose level matching, and the dose delivery techniques for WBRT. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  1. Physics strategies for sparing neural stem cells during whole-brain radiation treatments

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, Neil; Chuang, Cynthia; Pouliot, Jean; Hwang, Andrew; Barani, Igor J. [Department of Radiation Oncology, University of California San Francisco, San Francisco, California 94143-1708 (United States)

    2011-10-15

    Purpose: Currently, there are no successful long-term treatments or preventive strategies for radiation-induced cognitive impairments, and only a few possibilities have been suggested. One such approach involves reducing the dose to neural stem cell compartments (within and outside of the hippocampus) during whole-brain radiation treatments for brain metastases. This study investigates the fundamental physics issues associated with the sparing of neural stem cells during photon radiotherapy for brain metastases. Methods: Several factors influence the stem cell dose: intracranial scattering, collimator leakage, beam energy, and total number of beams. The relative importance of these factors is investigated through a set of radiation therapy plans, which are all variations of an initial 6 MV intensity-modulated radiation therapy (IMRT) plan designed to simultaneously deliver a whole-brain dose of 30 Gy and maximally reduce stem cell compartment dose. Additionally, an in-house leaf segmentation algorithm was developed that utilizes jaw motion to minimize the collimator leakage. Results: The plans are all normalized such that 50% of the PTV receives 30 Gy. For the initial 6 MV IMRT plan, 50% of the stem cells receive a dose greater than 6.3 Gy. Calculations indicate that 3.6 Gy of this dose originates from intracranial scattering. The jaw-tracking segmentation algorithm, used in conjunction with direct machine parameter optimization, reduces the 50% stem cell dose to 4.3 and 3.7 Gy for 6 and 10 MV treatment beams, respectively. Conclusions: Intracranial scattering alone is responsible for a large dose contribution to the stem cell compartment. It is, therefore, important to minimize other contributing factors, particularly the collimator leakage, to maximally reduce dose to these critical structures. The use of collimator jaw tracking in conjunction with modern collimators can minimize this leakage.

  2. Oatp-associated uptake and toxicity of microcystins in primary murine whole brain cells.

    Science.gov (United States)

    Feurstein, D; Holst, K; Fischer, A; Dietrich, D R

    2009-01-15

    Microcystins (MCs) are naturally occurring cyclic heptapeptides that exhibit hepato-, nephro- and possibly neurotoxic effects in mammals. Organic anion transporting polypeptides (rodent Oatp/human OATP) appear to be specifically required for active uptake of MCs into hepatocytes and kidney epithelial cells. Based on symptoms of neurotoxicity in MC-intoxicated patients and the presence of Oatp/OATP at the blood-brain-barrier (BBB) and blood-cerebrospinal-fluid-barrier (BCFB) it is hypothesized that MCs can be transported across the BBB/BCFB in an Oatp/OATP-dependent manner and can induce toxicity in brain cells via inhibition of protein phosphatase (PP). To test these hypotheses, the presence of murine Oatp (mOatp) in primary murine whole brain cells (mWBC) was investigated at the mRNA and protein level. MC transport was tested by exposing mWBCs to three different MC-congeners (MC-LR, -LW, -LF) with/without co-incubation with the OATP/Oatp-substrates taurocholate (TC) and bromosulfophthalein (BSP). Uptake of MCs and cytotoxicity was demonstrated via MC-Western blot analysis, immunocytochemistry, cell viability and PP inhibition assays. All MC congeners bound covalently and inhibited mWBC PP. MC-LF was the most cytotoxic congener followed by -LW and -LR. The lowest toxin concentration significantly reducing mWBC viability after 48 h exposure was 400 nM (MC-LF). Uptake of MCs into mWBCs was inhibited via co-incubation with excess TC (50 and 500 microM) and BSP (50 microM). MC-Western blot analysis demonstrated a concentration-dependent accumulation of MCs. In conclusion, the in vitro data support the assumed MC-congener-dependent uptake in a mOatp-associated manner and cytotoxicity of MCs in primary murine whole brain cells.

  3. Comprehensive evaluation of corticospinal tract metabolites in amyotrophic lateral sclerosis using whole-brain 1H MR spectroscopy.

    Directory of Open Access Journals (Sweden)

    Varan Govind

    Full Text Available Changes in the distribution of the proton magnetic resonance spectroscopy (MRS observed metabolites N-acetyl aspartate (NAA, total-choline (Cho, and total-creatine (Cre in the entire intracranial corticospinal tract (CST including the primary motor cortex were evaluated in patients with amyotrophic lateral sclerosis (ALS. The study included 38 sporadic definite-ALS subjects and 70 age-matched control subjects. All received whole-brain MR imaging and spectroscopic imaging scans at 3T and clinical neurological assessments including percentage maximum forced vital capacity (FVC and upper motor neuron (UMN function. Differences in each individual metabolite and its ratio distributions were evaluated in the entire intracranial CST and in five segments along the length of the CST (at the levels of precentral gyrus (PCG, centrum semiovale (CS, corona radiata (CR, posterior limb of internal capsule (PLIC and cerebral peduncle (CP. Major findings included significantly decreased NAA and increased Cho and Cho/NAA in the entire intracranial CST, with the largest differences for Cho/NAA in all the groups. Significant correlations between Cho/NAA in the entire intracranial CST and the right finger tap rate were noted. Of the ten bilateral CST segments, significantly decreased NAA in 4 segments, increased Cho in 5 segments and increased Cho/NAA in all the segments were found. Significant left versus right CST asymmetries were found only in ALS for Cho/NAA in the CS. Among the significant correlations found between Cho/NAA and the clinical assessments included the left-PCG versus FVC and right finger tap rate, left -CR versus FVC and right finger tap rate, and left PLIC versus FVC and right foot tap rate. These results demonstrate that a significant and bilaterally asymmetric alteration of metabolites occurs along the length of the entire intracranial CST in ALS, and the MRS metrics in the segments correlate with measures of disease severity and UMN function.

  4. Fluid-Attenuated Inversion Recovery Hypointensity of the Pulvinar Nucleus of Patients with Alzheimer Disease: Its Possible Association with Iron Accumulation as Evidenced by the T2 Map

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Won Jin; Roh, Hong Gee; Choi, Jin Woo [Dept. of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of); Kim, Hee Jin [Dept. of Neurology, Hanyang University Medical Center, Hanyang University School of Medicine, Seoul (Korea, Republic of); Han, Seol Heui [Center for Geriatric Neuroscience Research, Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2012-11-15

    We hypothesized that prominent pulvinar hypointensity in brain MRI represents the disease process due to iron accumulation in Alzheimer disease (AD). We aimed to determine whether or not the pulvinar signal intensity (SI) on the fluid-attenuated inversion recovery (FLAIR) sequences at 3.0T MRI differs between AD patients and normal subjects, and also whether the pulvinar SI is correlated with the T2 map, an imaging marker for tissue iron, and a cognitive scale. Twenty one consecutive patients with AD and 21 age-matched control subjects were prospectively included in this study. The pulvinar SI was assessed on the FLAIR image. We measured the relative SI ratio of the pulvinar to the corpus callosum. The T2 values were calculated from the T2 relaxometry map. The differences between the two groups were analyzed, by using a Student t test. The correlation between the measurements was assessed by the Pearson's correlation test. As compared to the normal white matter, the FLAIR signal intensity of the pulvinar nucleus was significantly more hypointense in the AD patients than in the control subjects (p < 0.01). The pulvinar T2 was shorter in the AD patients than in the control subjects (51.5 {+-} 4.95 ms vs. 56.5 {+-} 5.49 ms, respectively, p = 0.003). The pulvinar SI ratio was strongly correlated with the pulvinar T2 (r = 0.745, p < 0.001). When controlling for age, only the pulvinar-to-CC SI ratio was positively correlated with that of the Mini-Mental State Examination (MMSE) score (r = 0.303, p < 0.050). Conversely, the pulvinar T2 was not correlated with the MMSE score (r = 0.277, p = 0.080). The FLAIR hypointensity of the pulvinar nucleus represents an abnormal iron accumulation in AD and may be used as an adjunctive finding for evaluating AD.

  5. Slow cortical rhythms: from single-neuron electrophysiology to whole-brain imaging in vivo

    NARCIS (Netherlands)

    Olcese, U.; Faraguna, U.

    2015-01-01

    The slow cortical oscillation is the major brain rhythm occurring during sleep, and has been the object of thorough investigation for over thirty years. Despite all these efforts, the function and the neuronal mechanisms behind slow cortical rhythms remain only partially understood. In this review

  6. Slow cortical rhythms: from single-neuron electrophysiology to whole-brain imaging in vivo

    NARCIS (Netherlands)

    U. Olcese; U. Faraguna

    2015-01-01

    The slow cortical oscillation is the major brain rhythm occurring during sleep, and has been the object of thorough investigation for over thirty years. Despite all these efforts, the function and the neuronal mechanisms behind slow cortical rhythms remain only partially understood. In this review w

  7. Exploration of whole brain networks modulated by acupuncture at analgesia acupoint ST36 using scale-specific wavelet correlation analysis

    Institute of Scientific and Technical Information of China (English)

    CHENG Hao; YAN Hao; BAI Li-jun; WANG Bao-guo

    2013-01-01

    Background Previous studies have demonstrated that acupuncture could modulate various brain systems in the resting brain networks.Graph theoretical analysis offers a novel way to investigate the functional organization of the large-scale cortical networks modulated by acupuncture at whole brain level.In this study,we used wavelets correlation analysis to estimate the pairwise correlations between 90 cortical and subcortical human brain regions in normal human volunteers scanned during the post-stimulus resting state.Methods Thirty-two college students,all right-handed and acupuncture na(i)ve,participated in this study.Every participant received only one acupoint stimulation,resulting in 16 subjects in one group.Both structural functional magnetic resonance imaging (fMRI) data (3D sequence with a voxel size of 1 mm3 for anatomical localization) and functional fMRI data (TR=1500 ms,TE=30 ms,flip angle=90°) were collected for each subject.After thresholding the resulting scale-specific wavelet correlation matrices to generate undirected binary graphs,we compared graph metrics of brain organization following verum manual acupuncture (ACU) and sham acupuncture (SHAM) groups.Results The topological parameters of the large-scale brain networks in ACU group were different from those of the SHAM group at multiple scales.There existed distinct modularity functional brain networks during the post-stimulus resting state following ACU and SHAM at multiple scales.Conclusions The distinct modulation patterns of the resting brain attributed to the specific effects evoked by acupuncture.In addition,we also identified that there existed frequency-specific modulation in the post-stimulus resting brain following ACU and SHAM.The modulation may be related to the effects of verum acupuncture on modulating special disorder treatment.This preliminary finding may provide a new clue to understand the relatively functionoriented specificity of acupuncture effects.

  8. Effect of whole-brain irradiation on the specific brain regions in a rat model: Metabolic and histopathological changes.

    Science.gov (United States)

    Bálentová, Soňa; Hnilicová, Petra; Kalenská, Dagmar; Murín, Peter; Hajtmanová, Eva; Lehotský, Ján; Adamkov, Marian

    2017-05-01

    Effect of ionizing radiation on the brain affects neuronal, glial, and endothelial cell population and lead to significant morphological, metabolic, and functional deficits. In the present study we investigated a dose- and time-dependent correlation between radiation-induced metabolic and histopathological changes. Adult male Wistar rats received a total dose of 35Gy delivered in 7 fractions (dose 5Gy per fraction) once per week in the same weekday during 7 consecutive weeks. Proton magnetic resonance spectroscopy ((1)H MRS), histochemistry, immunohistochemistry and confocal microscopy were used to determine whether radiation-induced alteration of the brain metabolites correlates with appropriate histopathological changes of neurogenesis and glial cell response in 2 neurogenic regions: the hippocampal dentate gyrus (DG) and the subventricular zone-olfactory bulb axis (SVZ-OB axis). Evaluation of the brain metabolites 18-19 weeks after irradiation performed by (1)H MRS revealed a significant decrease in the total N-acetylaspartate to total creatine (tNAA/tCr) ratio in the striatum and OB. A significant decline of gamma-aminobutyric acid to tCr (GABA/tCr) ratio was seen in the OB and hippocampus. MR revealed absence of gross inflammatory or necrotic lesions in these regions. Image analysis of the brain sections 18-21 weeks after the exposure showed a radiation-induced increase of neurodegeneration, inhibition of neurogenesis and strong resemblance to the reactive astrogliosis. Results showed that fractionated whole-brain irradiation led to the changes in neurotransmission and to the loss of neuronal viability in vivo. Metabolic changes were closely associated with histopathological findings, i.e. initiation of neuronal cell death, inhibition of neurogenesis and strong response of astrocytes indicated development of late radiation-induced changes. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Efficiency and prognosis of whole brain irradiation combined with precise radiotherapy on triple-negative breast cancer

    Directory of Open Access Journals (Sweden)

    Xinhong Wu

    2013-01-01

    Conclusion: After whole brain irradiation followed by IMRT or 3DCRT treatment, TN phenotype breast cancer patients with intracranial metastasis had high objective response rates but shorter survival time. With respect to survival in breast cancer patients with intracranial metastasis, the TN phenotype represents a significant adverse prognostic factor.

  10. Repeat Whole Brain Radiation Therapy with a Simultaneous Infield Boost: A Novel Technique for Reirradiation

    Directory of Open Access Journals (Sweden)

    William A. Hall

    2014-01-01

    Full Text Available The treatment of patients who experience intracranial progression after whole brain radiation therapy (WBRT is a clinical challenge. Novel radiation therapy delivery technologies are being applied with the objective of improving tumor and symptom control in these patients. The purpose of this study is to describe the clinical outcomes of the application of a novel technology to deliver repeat WBRT with volume modulated arc therapy (VMAT and a simultaneous infield boost (WB-SIB to gross disease. A total of 16 patients were initially treated with WBRT between 2000 and 2008 and then experienced intracranial progression, were treated using repeat WB-SIB, and were analyzed. The median dose for the first course of WBRT was 35 Gy (range: 30–50.4 Gy. Median time between the initial course of WBRT and repeat WB-SIB was 11.3 months. The median dose at reirradiation was 20 Gy to the whole brain with a median boost dose of 30 Gy to gross disease. A total of 2 patients demonstrated radiographic disease progression after treatment. The median overall survival (OS time from initial diagnosis of brain metastases was 18.9 months (range: 7.1–66.6 (95% CI: 0.8–36.9. The median OS time after initiation of reirradiation for all patients was 2.7 months (range: 0.46–14.46 (95% CI: 1.3–8.7. Only 3 patients experienced CTCAE grade 3 fatigue. No other patients experienced any ≥ CTCAE grade 3 toxicity. This analysis reports the result of a novel RT delivery technique for the treatment of patients with recurrent brain metastases. Side effects were manageable and comparable to other conventional repeat WBRT series. Repeat WB-SIB using the VMAT RT delivery technology is feasible and appears to have acceptable short-term acute toxicity. These results may provide a foundation for further exploration of the WB-SIB technique for repeat WBRT in future prospective clinical trials.

  11. Distinct Expression of Various Angiogenesis Factors in Mice Brain After Whole-Brain Irradiation by X-ray.

    Science.gov (United States)

    Deng, Zhezhi; Huang, Haiwei; Wu, Xiaohong; Wu, Mengmeng; He, Guoyong; Guo, Junjie

    2017-02-01

    Radiation-induced brain injury (RBI) is the most serious complication after radiotherapy. However, the etiology of RBI remains elusive. In order to evaluate the effect of X-rays on normal brain tissue, adult male BALB/C mice were subjected to whole-brain exposure with a single dose of 10 Gy or sham radiation. The structure and number of mice brain vessels were investigated 1, 7, 30, 90 and 180 days after irradiation by H&E staining and immune-fluorescence staining. Compared with sham control mice, in addition to morphological changes, a significant reduction of microvascular density was detected in irradiated mice brains. Whole-brain irradiation also caused damage in tight junction (TJ). Increased expression of glial fibrillary acidic protein (GFAP) and vascular endothelial growth factor (VEGF) was observed in irradiated mouse brains showed by Western Blot. Immune-fluorescence staining results also verified the co-labeling of GFAP and VEGF after whole-brain irradiation. Furthermore, the protein expression levels of other angiogenesis factors, angiopoietin-1 (Ang-1), endothelial-specific receptor tyrosine kinase (Tie-2), and angiopoietin-2 (Ang-2) in brain were determined by Western Blot. Increased expression of Ang-2 was shown in irradiated mouse brains. In contrast, whole-brain irradiation significantly decreased Ang-1 and Tie-2 expression. Our data indicated that X-rays induced time-dependent microvascular injury and activation of astrocytes after whole-brain irradiation in mouse brain. Distinct regulation of VEGF/Ang2 and Ang-1/Tie-2 are closely associated with RBI, suggesting that angiogenesis interventions might be beneficial for patients with RBI.

  12. Detection of Low-Signal Pulvinar Areas Using Diffusion-Weighted Imaging in Patients with Dementia Experiencing Visual Hallucinations

    Science.gov (United States)

    Sugiura, Mayuko; Satoh, Masayuki; Tabei, Ken-ichi; Saito, Tomoki; Mori, Mutsuki; Abe, Makiko; Kida, Hirotaka; Maeda, Masayuki; Sakuma, Hajime; Tomimoto, Hidekazu

    2016-01-01

    Background Little research has been conducted regarding the role of pulvinar nuclei in the pathogenesis of visual hallucinations due to the difficulty of assessing abnormalities in this region using conventional magnetic resonance imaging (MRI). The present study aimed to retrospectively investigate the relative abilities of diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR), and susceptibility-weighted imaging (SWI) to visualize the pulvinar and to ascertain the relationship between pulvinar visualization and visual hallucinations. Methods A retrospective analysis of 3T MRIs from 73 patients (31 males, 42 females; mean age 73.5 ± 12.7 years) of the Memory Clinic of Mie University Hospital was conducted. Correlations between pulvinar visualization and the following were analyzed: age, sex, education, hypertension, hyperlipidemia, diabetes mellitus, Mini-Mental State Examination score, Evans index, and visual hallucinations. Results DWI detected low-signal pulvinar areas in approximately half of the patients (52.1%). Participants with pulvinar visualization were significantly older, and the pulvinar was more frequently visualized in patients who had experienced visual hallucinations compared to those who had not. No significant association was observed between whole brain atrophy and pulvinar visualization. Conclusions The results of the present study indicate that diffusion-weighted 3T MRI is the most suitable method for the detection of pulvinar nuclei in patients with dementia experiencing visual hallucinations.

  13. 三维适形放疗配合全脑照射治疗脑转移瘤的疗效观察%The effects of three-dimensional conformal radiotherapy combined with whole brain irradiation on brain metastases

    Institute of Scientific and Technical Information of China (English)

    Jin Hu; Yeqing Zhou; Mi Liu

    2009-01-01

    Objective: To observe the recently therapeutic effects and toxicity of three-dimensional conformal radiotherapy combined with whole brain irradiation for patients with brain metastasis. Methods: 33 cases were treated by whole brain irradiation at first, the dose of which was 36-40 Gy (18-20 f). Then three-dimensional conformal radiotherapy was added to the focus with a total dose of 20-25 Gy, whose fractionated dose was 2-5 Gy/time, 5 times/week or 3 times/week. Results: Within 1 month after radiotherapy, according to imaging of the brain, the CR of all patients was 45.5%, PR 36.4%, NC 15.1%, and PD 3%. For the 32 cases with neural symptoms before radiation, the CR of the symptoms was 40.6% and PR 59.4%. All patients gained different increases in KPS grade. By the end of the follow-up period, there were 22 deaths with the mean survival time up to 9.3 months. Conclusion: Three-dimensional conformal radiotherapy combined with whole brain irradiation can not only effectively control brain metastases and improve life quality, but also tends to prolong survival time.

  14. Acute promyelocytic leukemia after whole brain irradiation of primary brain lymphomainan HIV-infected patient

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    Boban A

    2009-01-01

    Full Text Available Abstract The occurrence of acute promyelocytic leukemia (APL in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here, we report a case of an HIV-patient who developed APL and upon treatment entered a complete remission. A 25-years old male patient was diagnosed with HIV-infection in 1996, but remained untreated. In 2004, the patient was diagnosed with primary central nervous system lymphoma. We treated the patient with antiretroviral therapy and whole-brain irradiation, resulting in complete remission of the lymphoma. In 2006, prompted by a sudden neutropenia, we carried out a set of diagnostic procedures, revealing APL. Induction therapy consisted of standard treatment with all-trans-retinoic-acid (ATRA and idarubicin. Subsequent cytological and molecular analysis of bone marrow demonstrated complete hematological and molecular remission. Due to the poor general condition, consolidation treatment with ATRA was given in March and April 2007. The last follow-up 14 months later, showed sustained molecular APL remission. In conclusion, we demonstrated that a complete molecular APL remission in an HIV-patient was achieved by using reduced-intensity treatment.

  15. A Whole-Brain Investigation of White Matter Microstructure in Adolescents with Conduct Disorder.

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    Sagari Sarkar

    Full Text Available The biological basis of severe antisocial behaviour in adolescents is poorly understood. We recently reported that adolescents with conduct disorder (CD have significantly increased fractional anisotropy (FA of the uncinate fasciculus (a white matter (WM tract that connects the amygdala to the frontal lobe compared to their non-CD peers. However, the extent of WM abnormality in other brain regions is currently unclear.We used tract-based spatial statistics to investigate whole brain WM microstructural organisation in 27 adolescent males with CD, and 21 non-CD controls. We also examined relationships between FA and behavioural measures. Groups did not differ significantly in age, ethnicity, or substance use history.The CD group, compared to controls, had clusters of significantly greater FA in 7 brain regions corresponding to: 1 the bilateral inferior and superior cerebellar peduncles, corticopontocerebellar tract, posterior limb of internal capsule, and corticospinal tract; 2 right superior longitudinal fasciculus; and 3 left cerebellar WM. Severity of antisocial behavior and callous-unemotional symptoms were significantly correlated with FA in several of these regions across the total sample, but not in the CD or control groups alone.Adolescents with CD have significantly greater FA than controls in WM regions corresponding predominantly to the fronto-cerebellar circuit. There is preliminary evidence that variation in WM microstructure may be dimensionally related to behaviour problems in youngsters. These findings are consistent with the hypothesis that antisocial behaviour in some young people is associated with abnormalities in WM 'connectivity'.

  16. Whole-brain mapping of neuronal activity in the learned helplessness model of depression

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    Yongsoo eKim

    2016-02-01

    Full Text Available Some individuals are resilient, whereas others succumb to despair in repeated stressful situations. The neurobiological mechanisms underlying such divergent behavioral responses remain unclear. Here, we employed an automated method for mapping neuronal activity in search of signatures of stress responses in the entire mouse brain. We used serial two-photon tomography to detect expression of c-FosGFP – a marker of neuronal activation – in c-fosGFP transgenic mice subjected to the learned helplessness (LH procedure, a widely used model of stress-induced depression-like phenotype in laboratory animals. We found that mice showing helpless behavior had an overall brain-wide reduction in the level of neuronal activation compared with mice showing resilient behavior, with the exception of a few brain areas, including the locus coeruleus, that were more activated in the helpless mice. In addition, the helpless mice showed a strong trend of having higher similarity in whole brain activity profile among individuals, suggesting that helplessness is represented by a more stereotypic brain-wide activation pattern. This latter effect was confirmed in rats subjected to the LH procedure, using 2-deoxy-2[18F]fluoro-D-glucose positron emission tomography to assess neural activity. Our findings reveal distinct brain activity markings that correlate with adaptive and maladaptive behavioral responses to stress, and provide a framework for further studies investigating the contribution of specific brain regions to maladaptive stress responses.

  17. Neurocognitive function impairment after whole brain radiotherapy for brain metastases: actual assessment

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    Tallet Agnes V

    2012-05-01

    Full Text Available Abstract Whole brain radiation therapy (WBRT is an effective treatment in brain metastases and, when combined with local treatments such as surgery and stereotactic radiosurgery, gives the best brain control. Nonetheless, WBRT is often omitted after local treatment due to its potential late neurocognitive effects. Publications on radiation-induced neurotoxicity have used different assessment methods, time to assessment, and definition of impairment, thus making it difficult to accurately assess the rate and magnitude of the neurocognitive decline that can be expected. In this context, and to help therapeutic decision making, we have conducted this literature review, with the aim of providing an average incidence, magnitude and time to occurrence of radio-induced neurocognitive decline. We reviewed all English language published articles on neurocognitive effects of WBRT for newly diagnosed brain metastases or with a preventive goal in adult patients, with any methodology (MMSE, battery of neurcognitive tests with which baseline status was provided. We concluded that neurocognitive decline is predominant at 4 months, strongly dependant on brain metastases control, partially solved at later time, graded 1 on a SOMA-LENT scale (only 8% of grade 2 and more, insufficiently assessed in long-term survivors, thus justifying all efforts to reduce it through irradiation modulation.

  18. Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors

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    Gani, C.; Mueller, A.C.; Eckert, F.; Schroeder, C.; Bamberg, M.; Berger, B. [Univ. of Tuebingen (Germany). Dept. of Radiation Oncology; Bender, B. [Univ. of Tuebingen (Germany). Dept. of Diagnostics and Interventional Neuroradiology; Pantazis, G. [Univ. of Tuebingen (Germany). Dept. of Neuropathology

    2012-02-15

    The purpose of the present study was to investigate outcome after whole brain radiotherapy (WBRT) alone as a palliative treatment without concomitant chemotherapy for intracranial leptomeningeal carcinomatosis (LMC). Overall survival and treatment response were retrospectively analyzed in 27 consecutive patients with LMC from breast and lung cancer. All patients had evidence of intracranial manifestations of LMC. Seven potential prognostic factors were evaluated. Median overall survival (OS) for the entire group was 8.1 weeks. OS rates after 6 and 12 months were 26% and 15%, respectively. Improvement of neurological deficits was observed in 3 patients. In 3 of 4 patients with follow-up MRI studies, a decreased size of contrast-enhanced lesions was observed. Prognostic factors for improved OS on univariate analysis were absence of cranial nerve dysfunction, Karnofsky Performance Score (KPS) > 60%, and time interval > 35 months between the initial diagnosis of malignant disease and development of LMC. On multivariate analysis, absence of cranial nerve dysfunction remained the only significant prognosticator for OS (median 3.7 vs. 19.4 weeks, p < 0.001). WBRT alone is an effective palliative treatment for patients unfit/unsuitable for chemotherapy and low performance status suffering from intracranial LMC. However, prognostic factors should be considered in order to identify patients who are likely to benefit from WBRT. (orig.)

  19. A Whole-Brain Investigation of White Matter Microstructure in Adolescents with Conduct Disorder.

    Science.gov (United States)

    Sarkar, Sagari; Dell'Acqua, Flavio; Froudist Walsh, Seán; Blackwood, Nigel; Scott, Stephen; Craig, Michael C; Deeley, Quinton; Murphy, Declan G M

    2016-01-01

    The biological basis of severe antisocial behaviour in adolescents is poorly understood. We recently reported that adolescents with conduct disorder (CD) have significantly increased fractional anisotropy (FA) of the uncinate fasciculus (a white matter (WM) tract that connects the amygdala to the frontal lobe) compared to their non-CD peers. However, the extent of WM abnormality in other brain regions is currently unclear. We used tract-based spatial statistics to investigate whole brain WM microstructural organisation in 27 adolescent males with CD, and 21 non-CD controls. We also examined relationships between FA and behavioural measures. Groups did not differ significantly in age, ethnicity, or substance use history. The CD group, compared to controls, had clusters of significantly greater FA in 7 brain regions corresponding to: 1) the bilateral inferior and superior cerebellar peduncles, corticopontocerebellar tract, posterior limb of internal capsule, and corticospinal tract; 2) right superior longitudinal fasciculus; and 3) left cerebellar WM. Severity of antisocial behavior and callous-unemotional symptoms were significantly correlated with FA in several of these regions across the total sample, but not in the CD or control groups alone. Adolescents with CD have significantly greater FA than controls in WM regions corresponding predominantly to the fronto-cerebellar circuit. There is preliminary evidence that variation in WM microstructure may be dimensionally related to behaviour problems in youngsters. These findings are consistent with the hypothesis that antisocial behaviour in some young people is associated with abnormalities in WM 'connectivity'.

  20. Cognitive dysfunction and histological findings in adult rats one year after whole brain irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Akiyama, Katsuhiko; Tanaka, Ryuichi; Sato, Mitsuya; Takeda, Norio [Niigata Univ. (Japan). Brain Research Inst.

    2001-12-01

    Cognitive dysfunction and histological changes in the brain were investigated following irradiation in 20 Fischer 344 rats aged 6 months treated with whole brain irradiation (WBR) (25 Gy/single dose), and compared with the same number of sham-irradiated rats as controls. Performance of the Morris water maze task and the passive avoidance task were examined one year after WBR. Finally, histological and immunohistochemical examinations using antibodies to myelin basic protein (MBP), glial fibrillary acidic protein (GFAP), and neurofilament (NF) were performed of the rat brains. The irradiated rats continued to gain weight 7 months after WBR whereas the control rats stopped gaining weight. Cognitive functions in both the water maze task and the passive avoidance task were lower in the irradiated rats than in the control rats. Brain damage consisting of demyelination only or with necrosis was found mainly in the body of the corpus callosum and the parietal white matter near the corpus callosum in the irradiated rats. Immunohistochemical examination of the brains without necrosis found MBP-positive fibers were markedly decreased in the affected areas by irradiation; NF-positive fibers were moderately decreased and irregularly dispersed in various shapes in the affected areas; and GFAP-positive fibers were increased, with gliosis in those areas. These findings are similar to those in clinically accelerated brain aging in conditions such as Alzheimer's disease, Binswanger's disease, and multiple sclerosis. (author)

  1. Overall Survival After Whole-Brain Radiation Therapy for Intracerebral Metastases from Testicular Cancer.

    Science.gov (United States)

    Rades, Dirk; Dziggel, Liesa; Veninga, Theo; Bajrovic, Amira; Schild, Steven E

    2016-09-01

    To identify predictors and develop a score for overall survival of patients with intracerebral metastasis from testicular cancer. Whole-brain radiation therapy program, age, Karnofsky performance score (KPS), number of intracerebral metastases, number of other metastatic sites and time between testicular cancer diagnosis and radiation therapy were analyzed for their association with overall survival in eight patients. KPS of 80-90% was significantly associated with better overall survival (p=0.006), one or no other metastatic sites showed a trend for a better outcome (p=0.10). The following scores were assigned: KPS 60-70%=0 points, KPS 80-90%=1 point, ≥2 other metastatic sites=0 points, 0-1 other metastatic sites=1 point. Two groups, with 0 and with 1-2 points, were formed. Overall survival rates were 33% vs. 100% at 6 months and 0% vs. 100% at 12 months (p=0.006), respectively. A simple instrument enabling physicians to judge the overall survival of patients with intracerebral metastasis from testicular cancer is provided. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Prognostic factors affecting survival after whole brain radiotherapy in patients with brain metastasized lung cancer.

    Science.gov (United States)

    Tsakonas, Georgios; Hellman, Fatou; Gubanski, Michael; Friesland, Signe; Tendler, Salomon; Lewensohn, Rolf; Ekman, Simon; de Petris, Luigi

    2017-10-06

    Whole-brain radiotherapy (WBRT) has been the standard of care for multiple NSCLC brain metastases but due to its toxicity and lack of survival benefit, its use in the palliative setting is being questioned. This was a single institution cohort study including brain metastasized lung cancer patients who received WBRT at Karolinska University Hospital. Information about Recursive Partitioning Analysis (RPA) and Graded Prognostic Assessment (GPA) scores, demographics, histopathological results and received oncological therapy were collected. Predictors of overall survival (OS) from the time of received WBRT were identified by Cox regression analyses. OS between GPA and RPA classes were compared by pairwise log rank test. A subgroup OS analysis was performed stratified by RPA class. The cohort consisted of 280 patients. RPA 1 and 2 classes had better OS compared to class 3, patients with GPA 70 years was associated with worse OS (p70. In RPA 2 patients with age ≤70 years and GPA <1.5 points WBRT could be a reasonable option.

  3. A Whole-Brain Investigation of White Matter Microstructure in Adolescents with Conduct Disorder

    Science.gov (United States)

    Sarkar, Sagari; Dell’Acqua, Flavio; Froudist Walsh, Seán; Blackwood, Nigel; Scott, Stephen; Craig, Michael C.

    2016-01-01

    Background The biological basis of severe antisocial behaviour in adolescents is poorly understood. We recently reported that adolescents with conduct disorder (CD) have significantly increased fractional anisotropy (FA) of the uncinate fasciculus (a white matter (WM) tract that connects the amygdala to the frontal lobe) compared to their non-CD peers. However, the extent of WM abnormality in other brain regions is currently unclear. Methods We used tract-based spatial statistics to investigate whole brain WM microstructural organisation in 27 adolescent males with CD, and 21 non-CD controls. We also examined relationships between FA and behavioural measures. Groups did not differ significantly in age, ethnicity, or substance use history. Results The CD group, compared to controls, had clusters of significantly greater FA in 7 brain regions corresponding to: 1) the bilateral inferior and superior cerebellar peduncles, corticopontocerebellar tract, posterior limb of internal capsule, and corticospinal tract; 2) right superior longitudinal fasciculus; and 3) left cerebellar WM. Severity of antisocial behavior and callous-unemotional symptoms were significantly correlated with FA in several of these regions across the total sample, but not in the CD or control groups alone. Conclusions Adolescents with CD have significantly greater FA than controls in WM regions corresponding predominantly to the fronto-cerebellar circuit. There is preliminary evidence that variation in WM microstructure may be dimensionally related to behaviour problems in youngsters. These findings are consistent with the hypothesis that antisocial behaviour in some young people is associated with abnormalities in WM ‘connectivity’. PMID:27271503

  4. Penumbra pattern assessment in acute stroke patients: comparison of quantitative and non-quantitative methods in whole brain CT perfusion.

    Directory of Open Access Journals (Sweden)

    Kolja M Thierfelder

    Full Text Available BACKGROUND AND PURPOSE: While penumbra assessment has become an important part of the clinical decision making for acute stroke patients, there is a lack of studies measuring the reliability and reproducibility of defined assessment techniques in the clinical setting. Our aim was to determine reliability and reproducibility of different types of three-dimensional penumbra assessment methods in stroke patients who underwent whole brain CT perfusion imaging (WB-CTP. MATERIALS AND METHODS: We included 29 patients with a confirmed MCA infarction who underwent initial WB-CTP with a scan coverage of 100 mm in the z-axis. Two blinded and experienced readers assessed the flow-volume-mismatch twice and in two quantitative ways: Performing a volumetric mismatch analysis using OsiriX imaging software (MM(VOL and visual estimation of mismatch (MM(EST. Complementarily, the semiquantitative Alberta Stroke Programme Early CT Score for CT perfusion was used to define mismatch (MM(ASPECTS. A favorable penumbral pattern was defined by a mismatch of ≥ 30% in combination with a cerebral blood flow deficit of ≤ 90 ml and an MM(ASPECTS score of ≥ 1, respectively. Inter- and intrareader agreement was determined by Kappa-values and ICCs. RESULTS: Overall, MM(VOL showed considerably higher inter-/intrareader agreement (ICCs: 0.751/0.843 compared to MM(EST (0.292/0.749. In the subgroup of large (≥ 50 mL perfusion deficits, inter- and intrareader agreement of MM(VOL was excellent (ICCs: 0.961/0.942, while MM(EST interreader agreement was poor (0.415 and intrareader agreement was good (0.919. With respect to penumbra classification, MM(VOL showed the highest agreement (interreader agreement: 25 agreements/4 non-agreements/κ: 0.595; intrareader agreement 27/2/0.833, followed by MM(EST (22/7/0.471; 23/6/0.577, and MM(ASPECTS (18/11/0.133; 21/8/0.340. CONCLUSION: The evaluated approach of volumetric mismatch assessment is superior to pure visual and ASPECTS penumbra

  5. Examination of the predictive factors of the response to whole brain radiotherapy for brain metastases from lung cancer using MRI.

    Science.gov (United States)

    Aoki, Shuri; Kanda, Tomonori; Matsutani, Noriyuki; Seki, Nobuhiko; Kawamura, Masafumi; Furui, Shigeru; Yamashita, Hideomi

    2017-07-01

    Previous studies have been conducted on the prognostic factors for overall survival in patients with brain metastases (BMs) following whole brain radiotherapy (WBRT). However, there have been a small number of studies regarding the prognostic factors for the response of tumor to WBRT. The aim of the present study was to identify the predictive factors for the response to WBRT from the point of view of reduction of tumor using magnetic resonance imaging. A retrospective analysis of 62 patients with BMs from primary lung cancer treated with WBRT was undertaken. The effects of the following factors on the response to WBRT were evaluated: Age; sex; performance status; lactate dehydrogenase; pathology; existence of extracranial metastases; activity of extracranial disease; chemo-history; chest radiotherapy history; treatment term; γ-knife radiotherapy; diffusion weighted image signal intensity; tumor diameter; extent of edema and the edema/tumor (E/T) ratio. The association between the reduction of tumors and clinical factors was evaluated using logistic regression analysis. P<0.05 was considered to indicate a statistically significant difference. The overall response ratio of this cohort was 54.8%. In the univariate analysis, the response of tumors was associated with the presence of small cell lung carcinoma (SCLC; P=0.0007), an E/T ratio of ≥1.5 (P=0.048), and a median tumor diameter of <20 mm (P=0.014). In the multivariate analysis, the presence of SCLC [P=0.001; odds ratio (OR), 17.152), an E/T ratio of ≥1.5 (P=0.019; OR, 9.526), and the presence of extracranial metastases (P=0.031; OR, 4.875) were revealed to be independent predictive factors for the reduction of tumor. The following 3 factors were significantly associated with the response of tumors to WBRT: The presence of SCLC; an E/T ratio of ≥1.5; and the presence of extracranial metastases. The E/T ratio is a novel index that provides a simple and easy predictive method for use in a clinical setting.

  6. Dosimetric Evaluation of Intensity-Modulated Radiotherapy, Volumetric Modulated Arc Therapy, and Helical Tomotherapy for Hippocampal-Avoidance Whole Brain Radiotherapy

    Science.gov (United States)

    Rong, Yi; Evans, Josh; Xu-Welliver, Meng; Pickett, Cadron; Jia, Guang; Chen, Quan; Zuo, Li

    2015-01-01

    Background Whole brain radiotherapy (WBRT) is a vital tool in radiation oncology and beyond, but it can result in adverse health effects such as neurocognitive decline. Hippocampal Avoidance WBRT (HA-WBRT) is a strategy that aims to mitigate the neuro-cognitive side effects of whole brain radiotherapy treatment by sparing the hippocampi while delivering the prescribed dose to the rest of the brain. Several competing modalities capable of delivering HA-WBRT, include: Philips Pinnacle step-and-shoot intensity modulated radiotherapy (IMRT), Varian RapidArc volumetric modulated arc therapy (RapidArc), and helical TomoTherapy (TomoTherapy). Methods In this study we compared these methods using 10 patient datasets. Anonymized planning CT (computerized tomography) scans and contour data based on fused MRI images were collected. Three independent planners generated treatment plans for the patients using three modalities, respectively. All treatment plans met the RTOG 0933 criteria for HA-WBRT treatment. Results In dosimetric comparisons between the three modalities, TomoTherapy has a significantly superior homogeneity index of 0.15 ± 0.03 compared to the other two modalities (0.28 ± .04, p delivery time of 2.5 min compared to the other modalities (15 min for IMRT and 18 min for TomoTherapy). Conclusion TomoTherapy is considered to be the preferred modality for HA-WBRT due to its superior dose distribution. When TomoTherapy is not available or treatment time is a concern, RapidArc can provide sufficient dose distribution meeting RTOG criteria and efficient treatment delivery. PMID:25894615

  7. Whole-brain mapping of inputs to projection neurons and cholinergic interneurons in the dorsal striatum.

    Science.gov (United States)

    Guo, Qingchun; Wang, Daqing; He, Xiaobin; Feng, Qiru; Lin, Rui; Xu, Fuqiang; Fu, Ling; Luo, Minmin

    2015-01-01

    The dorsal striatum integrates inputs from multiple brain areas to coordinate voluntary movements, associative plasticity, and reinforcement learning. Its projection neurons consist of the GABAergic medium spiny neurons (MSNs) that express dopamine receptor type 1 (D1) or dopamine receptor type 2 (D2). Cholinergic interneurons account for a small portion of striatal neuron populations, but they play important roles in striatal functions by synapsing onto the MSNs and other local interneurons. By combining the modified rabies virus with specific Cre- mouse lines, a recent study mapped the monosynaptic input patterns to MSNs. Because only a small number of extrastriatal neurons were labeled in the prior study, it is important to reexamine the input patterns of MSNs with higher labeling efficiency. Additionally, the whole-brain innervation pattern of cholinergic interneurons remains unknown. Using the rabies virus-based transsynaptic tracing method in this study, we comprehensively charted the brain areas that provide direct inputs to D1-MSNs, D2-MSNs, and cholinergic interneurons in the dorsal striatum. We found that both types of projection neurons and the cholinergic interneurons receive extensive inputs from discrete brain areas in the cortex, thalamus, amygdala, and other subcortical areas, several of which were not reported in the previous study. The MSNs and cholinergic interneurons share largely common inputs from areas outside the striatum. However, innervations within the dorsal striatum represent a significantly larger proportion of total inputs for cholinergic interneurons than for the MSNs. The comprehensive maps of direct inputs to striatal MSNs and cholinergic interneurons shall assist future functional dissection of the striatal circuits.

  8. Diagnostic accuracy of whole-brain CT perfusion in the detection of acute infratentorial infarctions

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    Bollwein, Christine; Sommer, Wieland H.; Thierfelder, Kolja M.; Reiser, Maximilian F. [Ludwig-Maximilians-University Hospital of Munich, Institute for Clinical Radiology, Munich (Germany); Plate, Annika; Straube, Andreas; Baumgarten, Louisa von [Ludwig-Maximilians-University Hospital of Munich, Department of Neurology, Munich (Germany); Janssen, Hendrik [South Nuremberg Hospital, Department of Neuroradiology, Nuremberg (Germany)

    2016-11-15

    Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes. Two blinded readers evaluated NECT and four different CTP maps independently for the presence and location of infratentorial ischemic perfusion deficits. The study was designed as a retrospective case-control study and included 280 patients (cases/controls = 1/3). WB-CTP revealed a greater diagnostic sensitivity than NECT (41.4 vs. 17.1 %, P = 0.003). The specificity, however, was comparable (93.3 vs. 95.0 %). Mean transit time (MTT) and time to drain (TTD) were the most sensitive (41.4 and 40.0 %) and cerebral blood volume (CBV) the most specific (99.5 %) perfusion maps. Infarctions detected using WB-CTP were significantly larger than those not detected (15.0 vs. 2.2 ml; P = 0.0007); infarct location, however, did not influence the detection rate. The detection of infratentorial infarctions can be improved by assessing WB-CTP as part of the multimodal stroke workup. However, it remains a diagnostic challenge, especially small volume infarctions in the brainstem are likely to be missed. (orig.)

  9. Shorter-Course Whole-Brain Radiotherapy for Brain Metastases in Elderly Patients

    Energy Technology Data Exchange (ETDEWEB)

    Rades, Dirk, E-mail: rades.dirk@gmx.net [Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lubeck (Germany); Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg (Germany); Evers, Jasmin N. [Department of Radiation Oncology, University Hospital Schleswig-Holstein, Lubeck (Germany); Veninga, Theo [Department of Radiotherapy, Dr. Bernard Verbeeten Institute, Tilburg (Netherlands); Stalpers, Lukas J.A. [Department of Radiotherapy, Academic Medical Center, Amsterdam (Netherlands); Lohynska, Radka [Department of Radiation Oncology, University Hospital, Prague (Czech Republic); Schild, Steven E. [Department of Radiation Oncology, Mayo Clinic Scottsdale, Arizona (United States)

    2011-11-15

    Purpose: Many patients with brain metastases receive whole-brain radiotherapy (WBRT) alone. Using 10 Multiplication-Sign 3 Gy in 2 weeks is the standard regimen in most centers. Regarding the extraordinarily poor survival prognosis of elderly patients with multiple brain metastases, a shorter WBRT regimen would be preferable. This study compared 10 Multiplication-Sign 3 Gy with 5 Multiplication-Sign 4 Gy in elderly patients ({>=}65 years). Methods and Materials: Data from 455 elderly patients who received WBRT alone for brain metastases were retrospectively analyzed. Survival and local (= intracerebral) control of 293 patients receiving 10 Multiplication-Sign 3 Gy were compared with 162 patients receiving 5 Multiplication-Sign 4 Gy. Eight additional potential prognostic factors were investigated including age, gender, Karnofsky performance score (KPS), primary tumor, number of brain metastases, interval from tumor diagnosis to WBRT, extracerebral metastases, and recursive partitioning analysis (RPA) class. Results: The 6-month overall survival rates were 29% after 5 Multiplication-Sign 4 Gy and 21% after 10 Multiplication-Sign 3 Gy (p = 0.020). The 6-month local control rates were 12% and 10%, respectively (p = 0.32). On multivariate analysis, improved overall survival was associated with KPS {>=} 70 (p < 0.001), only one to three brain metastases (p = 0.029), no extracerebral metastasis (p = 0.012), and lower RPA class (p < 0.001). Improved local control was associated with KPS {>=} 70 (p < 0.001), breast cancer (p = 0.029), and lower RPA class (p < 0.001). Conclusions: Shorter-course WBRT with 5 Multiplication-Sign 4 Gy was not inferior to 10 Multiplication-Sign 3 Gy with respect to overall survival or local control in elderly patients. 5 Multiplication-Sign 4 Gy appears preferable for the majority of these patients.

  10. Whole brain resting-state analysis reveals decreased functional connectivity in major depression

    Directory of Open Access Journals (Sweden)

    Ilya M. Veer

    2010-09-01

    Full Text Available Recently, both increases and decreases in resting-state functional connectivity have been found in major depression. However, these studies only assessed functional connectivity within a specific network or between a few regions of interest, while comorbidity and use of medication was not always controlled for. Therefore, the aim of the current study was to investigate whole-brain functional connectivity, unbiased by a priori definition of regions or networks of interest, in medication-free depressive patients without comorbidity. We analyzed resting-state fMRI data of 19 medication-free patients with a recent diagnosis of major depression (within six months before inclusion and no comorbidity, and 19 age- and gender-matched controls. Independent component analysis was employed on the concatenated data sets of all participants. Thirteen functionally relevant networks were identified, describing the entire study sample. Next, individual representations of the networks were created using a dual regression method. Statistical inference was subsequently done on these spatial maps using voxelwise permutation tests. Abnormal functional connectivity was found within three resting-state networks in depression: 1 decreased bilateral amygdala and left anterior insula connectivity in an affective network, 2 reduced connectivity of the left frontal pole in a network associated with attention and working memory, and 3 decreased bilateral lingual gyrus connectivity within ventromedial visual regions. None of these effects were associated with symptom severity or grey matter density. We found abnormal resting-state functional connectivity not previously associated with major depression, which might relate to abnormal affect regulation and mild cognitive deficits, both associated with the symptomatology of the disorder.

  11. Marked response of gliomatosis cerebri to temozolomide and whole brain radiotherapy.

    Science.gov (United States)

    Mattox, Austin K; Lark, Amy L; Adamson, D Cory

    2012-05-01

    Gliomatosis cerebri (GC) represents an unfortunate, rare variant of glioma with a very poor prognosis. Given this lesion's rarity, little information exists on appropriate treatment options. The diffuse, infiltrative nature of GC precludes any surgical resection and limits therapy. Because of the improved survival seen with the use of temozolomide (TMZ) in malignant glioma, a rigorous systematic review of the published literature was performed to ascertain the benefit of TMZ in GC. We identified all GC cases in the literature where there was enough information to ascertain a clear response to a specific chemoradiotherapeutic treatment. In addition to our experience with a recent case, we have identified 61 patients with GC in the published literature who demonstrated a positive radiographic or clinic response after treatment. Statistical analysis of survival was performed by Kaplan-Meier analysis. A positive radiographic and clinical response was seen in patients ranging in age from 4 to 84 years. Overall median survival in patients diagnosed with GC who demonstrated a response after treatment was 25 months, with 1- and 2-year survival rates of 89% and 55%, respectively. The most common treatment regimens for responders included TMZ alone (26.2%), external whole-brain radiotherapy (WBRT) (26.2%), and concomitant TMZ and WBRT (20%). Our patient was treated with concomitant TMZ (150 mg/m(2)/day over 5 days) and WBRT (50 Gy) and has remained with a complete radiographic response after 36 months. In conclusion, patients with GC confirmed by surgical biopsy should be aggressively treated with concomitant TMZ and WBRT, as marked responses have been seen, and this appears to offer overall survival benefit.

  12. Cerebral white matter injury and damage to myelin sheath following whole-brain ischemia.

    Science.gov (United States)

    Chen, Yingzhu; Yi, Qiong; Liu, Gang; Shen, Xue; Xuan, Lihui; Tian, Ye

    2013-02-01

    Myelin sheath, either in white matter or in other regions of brain, is vulnerable to ischemia. The specific events involved in the progression of ischemia in white matter have not yet been elucidated. The aim of this study was to determine histopathological alterations in cerebral white matter and levels of myelin basic protein (MBP) in ischemia-injured brain tissue during the acute and subacute phases of central nervous injury following whole-brain ischemia. The whole cerebral ischemia model (four-vessel occlusion (4-VO)) was established in adult Sprague-Dawley rats and MBP gene expression and protein levels in the brain tissue were measured using reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA) at 2 days, 4 days, 7 days, 14 days, and 28 days following ischemia. Demyelination was determined by Luxol fast blue myelin staining, routine histopathological staining, and electron microscopy in injured brain tissue. Results showed that edema, vascular dilation, focal necrosis, demyelination, adjacent reactive gliosis and inflammation occurred 7 days after ischemia in HE staining and recovered to control levels at 28 days. The absence of Luxol fast blue staining and vacuolation was clearly visible at 7 days, 14 days, and 28 days. Semiquantitative analysis showed that the transparency of myelin had decreased significantly by 7 days, 14 days, and 28 days. Demyelination and ultrastructual changes were detected 7 days after ischemia. The relative levels of MBP mRNA decreased 2 days after ischemia and this trend continued throughout the remaining four points in time. The MBP levels measured using ELISA also decreased significantly at 2 days and 4 days, but they recovered by 7 days and returned to control levels by 14 days. These results suggest that the impact of ischemia on cerebral white matter is time-sensitive and that different effects may follow different courses over time.

  13. Dose escalation in patients receiving whole-brain radiotherapy for brain metastases from colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Heisterkamp, Christine; Rades, Dirk [Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Luebeck (Germany); Haatanen, Tiina [Dept. of Radiation Oncology, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany); Schild, Steven E. [Dept. of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States)

    2010-02-15

    Background and Purpose: Whole-brain radiotherapy (WBRT) alone is the most common treatment for brain metastases from colorectal cancer, as most patients are not candidates for more aggressive therapies such as resection or radiosurgery. The standard WBRT regimen, 30 Gy in ten fractions (10 x 3 Gy), has generally resulted in poor outcomes. This study investigated whether an escalation of the WBRT dose improves these results. Patients and Methods: Data from 53 patients receiving WBRT alone for brain metastases from colorectal cancer were retrospectively analyzed. 10 x 3 Gy (n = 35) was compared to higher doses (40 Gy/20 fractions or 45 Gy/15 fractions; n = 18) for overall survival (OS) and local control (LC). Additional factors evaluated for prognostic importance included age, gender, performance status, number of metastases, and extracerebral metastases. Results: The OS rates at 6 months were 17% after 10 x 3 Gy and 50% after 20 x 2 Gy/15 x 3 Gy (p = 0.014). On multivariate analysis, improved OS was significantly associated with higher WBRT dose (p = 0.047), Karnofsky Performance Score (KPS) {>=} 70 (p = 0.034), less than four brain metastases (p = 0.036), and lack of extracerebral metastases (p = 0.010). The LC rates at 6 months were 17% after 10 x 3 Gy and 50% after higher doses (p = 0.018). On multivariate analysis of LC, higher WBRT dose was significant (p = 0.028). A trend was observed for KPS {>=} 70 (p = 0.08) and less than four brain metastases (p = 0.06). Conclusion: These data suggest that patients with brain metastases from colorectal cancer treated with WBRT alone appeared to benefit from escalation of the radiation dose beyond 10 x 3 Gy in terms of improved OS and LC. (orig.)

  14. Monte Carlo simulation of contrast-enhanced whole brain radiotherapy on a CT scanner.

    Science.gov (United States)

    Schultz, Bernd-Joachim; Wust, Peter; Lüdemann, Lutz; Jost, Gregor; Pietsch, Hubertus

    2011-08-01

    To perform a feasibility study of contrast-enhanced whole brain radiotherapy for treating patients with multiple brain metastasis using a conventional computed tomography (CT) scanner. The treatment dose was optimized to be applied in a single run using a maximum tube power of 5200 kWs at 140 kV. CT scans of a large and a small head were used as reference. Irradiation geometry, shielding, axial beam collimation, radial beam collimation, gantry tilt, and tube current for beam modulation were optimized using a Monte Carlo simulation and a contrast agent concentration of 5 mg/ml iodine in the tumor. The statistical uncertainty of the Monte Carlo simulation was corrected using back convolution. Using a CT tube with a beam collimation of 28.8 mm, a mean tumor dose of 1.76 +/- 0.13 Gy was achieved, while the head bone dose was 2.61 +/- 0.18 Gy with a normal brain dose of 0.98 +/- 0.06 Gy, eye dose of 0.19 +/- 0.05 Gy, and lens dose of 0.15 +/- 0.03 Gy, respectively. Using a CT tube with dose modulation and a beam collimation of 40.0 mm, the mean tumor dose was 2.00 +/- 0.11 Gy with a head bone dose of 1.96 +/- 0.14 Gy, normal brain dose of 1.13 +/- 0.08 Gy, eye dose of 0.21 +/- 0.05 Gy, and lens dose of 0.16 +/- 0.02 Gy, respectively. Thus a standard CT scanner enables an effective tumor dose of 37.0 Gy to be administered in 13 fractions, while exposing healthy brain to an effective dose of 17.2 Gy and head bone to 69.3 Gy. Additional radial collimation implemented in the hardware improves the therapeutic tumor dose by 25.2% in relation to the bone dose. Contrast-enhanced total brain radiotherapy is feasible using a conventional CT tube with optimized dose application.

  15. SU-D-BRD-06: Automated Population-Based Planning for Whole Brain Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schreibmann, E; Fox, T; Crocker, I; Shu, H [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA (United States)

    2014-06-01

    Purpose: Treatment planning for whole brain radiation treatment is technically a simple process but in practice it takes valuable clinical time of repetitive and tedious tasks. This report presents a method that automatically segments the relevant target and normal tissues and creates a treatment plan in only a few minutes after patient simulation. Methods: Segmentation is performed automatically through morphological operations on the soft tissue. The treatment plan is generated by searching a database of previous cases for patients with similar anatomy. In this search, each database case is ranked in terms of similarity using a customized metric designed for sensitivity by including only geometrical changes that affect the dose distribution. The database case with the best match is automatically modified to replace relevant patient info and isocenter position while maintaining original beam and MLC settings. Results: Fifteen patients were used to validate the method. In each of these cases the anatomy was accurately segmented to mean Dice coefficients of 0.970 ± 0.008 for the brain, 0.846 ± 0.009 for the eyes and 0.672 ± 0.111 for the lens as compared to clinical segmentations. Each case was then subsequently matched against a database of 70 validated treatment plans and the best matching plan (termed auto-planned), was compared retrospectively with the clinical plans in terms of brain coverage and maximum doses to critical structures. Maximum doses were reduced by a maximum of 20.809 Gy for the left eye (mean 3.533), by 13.352 (1.311) for the right eye, and by 27.471 (4.856), 25.218 (6.315) for the left and right lens. Time from simulation to auto-plan was 3-4 minutes. Conclusion: Automated database- based matching is an alternative to classical treatment planning that improves quality while providing a cost—effective solution to planning through modifying previous validated plans to match a current patient's anatomy.

  16. Risk of dry eye syndrome in patients treated with whole-brain radiotherapy.

    Science.gov (United States)

    Nanda, Tavish; Wu, Cheng-Chia; Campbell, Ashley A; Bathras, Ryan M; Jani, Ashish; Kazim, Michael; Wang, Tony J C

    2017-08-04

    With improvements in systemic therapy, patients with cancer treated with whole-brain radiotherapy (WBRT) are living long enough to develop late toxicities, including dry eye syndrome. In general practice, dose to the lacrimal gland (LG) is not constrained (maximum constraint <40 Gy) in WBRT. The purpose of this study was to measure dose to the LG in WBRT and determine methods for reducing radiation exposure. We conducted a retrospective review of 70 3-dimensional (3D) conformal plans; thirty-six plans with a radiation prescription of 30 Gy in 10 fractions and 34 plans with a prescription of 37.5 Gy in 15 fractions. LGs were contoured in accordance with Freedman and Sidani (2015). Biological effective dose (BED)3 maximum constraints were calculated from 40 Gy and 20 Gy to be 32.17 Gy (30 Gy) and 36.70 Gy (37.5 Gy). Both regimens demonstrated supraorbital blocking by 3 methods: T1, bordering the supraorbital ridge; T2, no contact with supraorbital ridge; and T3, coverage of the supraorbital ridge. Mean dose for the plans with a 30-Gy prescription and the plans with a 37.5-Gy prescription was 27.5 Gy and 35.2 Gy, respectively (p ≤ 0.0001). BED3 maximum constraint (Dmax) was violated 16 of 26 (61.5%) in T1 (average Dmax: 32.2 Gy), 13 of 28 (46.4%) in T2 (average Dmax: 32.1 Gy), and 5 of 18 (27.8%) in T3 (average Dmax: 31.8 Gy) for the 30-Gy prescription. Dmax was violated in 32 of 32 (100%) in T1 (average Dmax: 40.1 Gy), 22 of 22 (100%) in T2 (average Dmax: 40.3 Gy), and 14 of 14 (100%) in T3 (average Dmax: 39.4) for the 37.5 Gy prescription. Average Dmax for the 37.5-Gy prescription was highly significant in favor of T3 (p = 0.0098). Patients who receive WBRT may develop dry eye syndrome as a late toxicity. Constraints are commonly violated with a prescription of 37.5 Gy. Methods to reduce dose include T3 supraorbital blocking, an easily implementable change that may dramatically improve patient quality of life. Copyright © 2017

  17. A placebo-controlled, randomized phase II study of maintenance enzastaurin following whole brain radiation therapy in the treatment of brain metastases from lung cancer

    DEFF Research Database (Denmark)

    Grønberg, Bjørn H; Ciuleanu, Tudor; Fløtten, Øystein;

    2012-01-01

    Enzastaurin is a protein kinase C inhibitor with anti-tumor activity. This study was designed to determine if maintenance enzastaurin improved the outcome of whole brain radiotherapy (WBRT) in lung cancer (LC) patients with brain metastases (BMs).......Enzastaurin is a protein kinase C inhibitor with anti-tumor activity. This study was designed to determine if maintenance enzastaurin improved the outcome of whole brain radiotherapy (WBRT) in lung cancer (LC) patients with brain metastases (BMs)....

  18. Targeted Therapy as an Alternative to Whole-Brain Radiotherapy in EGFR-Mutant or ALK-Positive Non-Small-Cell Lung Cancer With Brain Metastases.

    Science.gov (United States)

    Martínez, Pablo; Mak, Raymond H; Oxnard, Geoffrey R

    2017-09-01

    Is up-front whole-brain radiotherapy required to treat multiple brain metastases from non-small-cell lung cancer when highly active targeted therapies are available? Patients with EGFR-mutant or ALK-positive non-small-cell lung cancer with brain metastases now have the potential to achieve a prolonged survival. Through use of highly active targeted therapies, whole-brain radiotherapy can be safely postponed, diminishing toxic effects that could impair quality of life.

  19. Low-Dose Whole Brain Radiotherapy with Tumor Bed Boost after Methotrexate-Based Chemotherapy for Primary Central Nervous System Lymphoma

    OpenAIRE

    Kim, Byoung Hyuck; Kim, Il Han; Park, Sung-Hye; Park, Chul Kee; Jung, Hee Won; Kim, Tae Min; Lee, Se-Hoon; Heo, Dae Seog

    2014-01-01

    Purpose The purpose of this study is to evaluate the outcome of low-dose whole brain radiotherapy (WBRT) with tumor bed boost after methotrexate-based chemotherapy in the management of primary central nervous system lymphoma (PCNSL). Materials and Methods We retrospectively analyzed 64 patients with pathologically proven PCNSL between 2000 and 2011. Methotrexate-based chemotherapy with a median of five cycles was followed by radiotherapy to the whole brain and to the initial tumor bed. The me...

  20. Whole-brain hippocampal sparing radiation therapy: Volume-modulated arc therapy vs intensity-modulated radiation therapy case study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Katrina, E-mail: Trinabena23@gmail.com; Lenards, Nishele; Holson, Janice

    2016-04-01

    The hippocampus is responsible for memory and cognitive function. An ongoing phase II clinical trial suggests that sparing dose to the hippocampus during whole-brain radiation therapy can help preserve a patient's neurocognitive function. Progressive research and advancements in treatment techniques have made treatment planning more sophisticated but beneficial for patients undergoing treatment. The aim of this study is to evaluate and compare hippocampal sparing whole-brain (HS-WB) radiation therapy treatment planning techniques using volume-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). We randomly selected 3 patients to compare different treatment techniques that could be used for reducing dose to the hippocampal region. We created 2 treatment plans, a VMAT and an IMRT, from each patient's data set and planned on the Eclipse 11.0 treatment planning system (TPS). A total of 6 plans (3 IMRT and 3 VMAT) were created and evaluated for this case study. The physician contoured the hippocampus as per the Radiation Therapy Oncology Group (RTOG) 0933 protocol atlas. The organs at risk (OR) were contoured and evaluated for the plan comparison, which included the spinal cord, optic chiasm, the right and left eyes, lenses, and optic nerves. Both treatment plans produced adequate coverage on the planning target volume (PTV) while significantly reducing dose to the hippocampal region. The VMAT treatment plans produced a more homogenous dose distribution throughout the PTV while decreasing the maximum point dose to the target. However, both treatment techniques demonstrated hippocampal sparing when irradiating the whole brain.

  1. Whole-brain, time-locked activation with simple tasks revealed using massive averaging and model-free analysis

    Science.gov (United States)

    Gonzalez-Castillo, Javier; Saad, Ziad S.; Handwerker, Daniel A.; Inati, Souheil J.; Brenowitz, Noah; Bandettini, Peter A.

    2012-01-01

    The brain is the body's largest energy consumer, even in the absence of demanding tasks. Electrophysiologists report on-going neuronal firing during stimulation or task in regions beyond those of primary relationship to the perturbation. Although the biological origin of consciousness remains elusive, it is argued that it emerges from complex, continuous whole-brain neuronal collaboration. Despite converging evidence suggesting the whole brain is continuously working and adapting to anticipate and actuate in response to the environment, over the last 20 y, task-based functional MRI (fMRI) have emphasized a localizationist view of brain function, with fMRI showing only a handful of activated regions in response to task/stimulation. Here, we challenge that view with evidence that under optimal noise conditions, fMRI activations extend well beyond areas of primary relationship to the task; and blood-oxygen level-dependent signal changes correlated with task-timing appear in over 95% of the brain for a simple visual stimulation plus attention control task. Moreover, we show that response shape varies substantially across regions, and that whole-brain parcellations based on those differences produce distributed clusters that are anatomically and functionally meaningful, symmetrical across hemispheres, and reproducible across subjects. These findings highlight the exquisite detail lying in fMRI signals beyond what is normally examined, and emphasize both the pervasiveness of false negatives, and how the sparseness of fMRI maps is not a result of localized brain function, but a consequence of high noise and overly strict predictive response models. PMID:22431587

  2. Spatial patterns of whole brain grey and white matter injury in patients with occult spastic diplegic cerebral palsy.

    Science.gov (United States)

    Mu, Xuetao; Nie, Binbin; Wang, Hong; Duan, Shaofeng; Zhang, Zan; Dai, Guanghui; Ma, Qiaozhi; Shan, Baoci; Ma, Lin

    2014-01-01

    Spastic diplegic cerebral palsy (SDCP) is a common type of cerebral palsy (CP), which presents as a group of motor-impairment syndromes. Previous conventional MRI studies have reported abnormal structural changes in SDCP, such as periventricular leucomalacia. However, there are roughly 27.8% SDCP patients presenting normal appearance in conventional MRI, which were considered as occult SDCP. In this study, sixteen patients with occult SDCP and 16 age- and sex-matched healthy control subjects were collected and the data were acquired on a 3T MR system. We applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis to investigate whole brain grey and white matter injury in occult SDCP. By using VBM method, the grey matter volume reduction was revealed in the bilateral basal ganglia regions, thalamus, insula, and left cerebral peduncle, whereas the white matter atrophy was found to be located in the posterior part of corpus callosum and right posterior corona radiata in the occult SDCP patients. By using TBSS, reduced fractional anisotropy (FA) values were detected in multiple white matter regions, including bilateral white matter tracts in prefrontal lobe, temporal lobe, internal and external capsule, corpus callosum, cingulum, thalamus, brainstem and cerebellum. Additionally, several regions of white matter tracts injury were found to be significantly correlated with motor dysfunction. These results collectively revealed the spatial patterns of whole brain grey and white matter injury in occult SDCP.

  3. A Phase I trial of dose escalation of topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Ge; Wenyan Zhao; Xiaocang Ren; Yongqiang Wang; Zhigang Li; Yanqi Li; Yuee Liu; Qiang Lin

    2012-01-01

    Objective: The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer. Methods: Patients with brain metastasis of lung cancer received conventional fractionation radiotherapy, with 5 daily fractions of 2 Gy per week, the total radiation dose was 40 Gy, while the larger lesions were boosted to 50-60 Gy. The initial dose of topotecan was 1.0 mg/m2. Escalation dose was 0.25 mg/m2. Every cohort contained at least 3 patients.If no dose-limiting toxicity (DLT) was observed,the next dose level was opened for entry. These courses were repeated until DLT appeared. MTD was declared as one dose level below which DLT appeared. Results: Eighteen patients were recruited. Two cases of grade 3 leucopenia/neutropenia was observed as DLT at the level of topotecan 2.0 mg/m2. MTD of topotecan was defined as 1.75 mg/m2.The major side effects were leucopenia/neutropenia, nausea and vomiting. Conclusion: Topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer is well tolerated. Maximum-tolerated dose of topotecan is 1.75 mg/m2, once a week of a total of four.

  4. White matter microstructural characteristics in newly diagnosed Parkinson’s disease: An unbiased whole-brain study

    Science.gov (United States)

    Wen, Ming-Ching; Heng, Hannah S. E.; Ng, Samuel Y. E.; Tan, Louis C. S.; Chan, Ling Ling; Tan, Eng King

    2016-01-01

    Parkinson’s disease (PD) is a debilitating neurodegenerative disorder. Findings on specific white matter (WM) alterations in PD have been inconsistent. We hypothesized that WM changes occur in early PD patients and unbiased whole-brain analysis may provide additional evidence of pathological WM changes in PD. In this study, we examined various indexes of WM microstructure in newly diagnosed PD patients at the whole-brain level. 64 PDs with Hoehn & Yahr stage 1 (HY1PDs), 87 PDs with Hoehn & Yahr stage 2 (HYPD2s), and 60 controls (HCs) were recruited. Tract-based spatial statistics (TBSS) and diffusion connectometry were used to identify changes of WM pathways associated with PD. There were no significant differences in axial diffusivity, but HY1PDs exhibited greater fractional anisotropy (FA) and decreased mean and radial diffusivities (MD and RD) in callosal, projection, and association fibres than HCs and HY2PDs. Motor severity was inversely correlated with FA, but positively correlated with MD and RD in PD patients. Connectometry analysis also revealed increased WM density in the aforementioned tracts in PD patients, compared with HCs. Our study reveals WM enhancement, suggesting neural compensations in early PD. Longitudinal follow-up studies are warranted to identify the trajectory of WM changes alongside the progression of PD. PMID:27762307

  5. 320-Multidetector row whole-head dynamic subtracted CT angiography and whole-brain CT perfusion before and after carotid artery stenting: Technical note

    Energy Technology Data Exchange (ETDEWEB)

    San Millan Ruiz, Diego, E-mail: dsanmil1@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Murphy, Kieran, E-mail: KMURPHY@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Gailloud, Philippe, E-mail: pgailloud@cerebrovascular.ne [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States)

    2010-06-15

    Introduction: Multidetector CT (MDCT) is increasingly used for the investigation of neurovascular disorders, but restricted z-axis coverage (3.2 cm for 64-MDCT) currently limits perfusion to a small portion of the brain close to the circle of Willis, and precludes dynamic angiographic appreciation of the entire brain circulation. We illustrate the clinical potential of recently developed 320-MDCT extending the z-axis coverage to 16 cm in a patient with symptomatic carotid artery stenosis. Methods: In a 74-year-old patient presenting with critical symptomatic stenosis of the left CCA, pre- and post-carotid artery stenting whole-head subtracted dynamic MDCT angiography and perfusion were obtained in addition to CT angiography of the supra-aortic trunks. Both whole-head subtracted MDCT angiography and perfusion demonstrated delayed left ICA circulation, which normalized after carotid stenting. Discussion: 320-MDCT offers unprecedented z-axis coverage allowing for whole-brain perfusion and subtracted dynamic angiography of the entire intracranial circulation. These innovations can consolidate the role of MDCT as a first intention imaging technique for cerebrovascular disorders, in particular for the acute management of stroke.

  6. Whole brain volume changes and its correlation with clinical symptom severity in patients with schizophrenia: A DARTEL-based VBM study.

    Science.gov (United States)

    Kim, Gwang-Won; Kim, Yun-Hyeon; Jeong, Gwang-Woo

    2017-01-01

    The purpose of this study was to evaluate gray matter (GM) and white matter (WM) volume alterations in whole-brain structures in patients with schizophrenia and healthy controls using voxel-based morphometry (VBM), and further to assess the correlation between GM and WM volume variations and symptom severity in schizophrenia. A total of 22 patients with schizophrenia and 22 age-matched healthy controls participated. Magnetic resonance image data were processed using SPM8 software with diffeomorphic anatomical registration via an exponentiated Lie algebra (DARTEL) algorithm. Patients with schizophrenia exhibited significantly decreased GM volumes of the insula, superior temporal gyrus (STG), gyrus rectus, and anterior cingulate cortex (ACC) compared with healthy controls. The GM volumes of the STG and gyrus rectus were negatively correlated with the positive scales on the Positive and Negative Syndrome Scale (PANSS) and those of the STG and ACC were negatively correlated with the negative scales. The durations of illness in schizophrenia were negatively correlated with the GM volumes of the insula, STG, and ACC. Patients with schizophrenia exhibited significantly decreased WM volumes of the superior frontal gyrus, inferior temporal gyrus, and STG. The WM volumes of the STG were negatively correlated with the duration of illness. Our findings suggest that GM and WM volume abnormalities in the STG are associated with the psychopathology of schizophrenia.

  7. Increased brain iron deposition is a risk factor for brain atrophy in patients with haemodialysis: a combined study of quantitative susceptibility mapping and whole brain volume analysis.

    Science.gov (United States)

    Chai, Chao; Zhang, Mengjie; Long, Miaomiao; Chu, Zhiqiang; Wang, Tong; Wang, Lijun; Guo, Yu; Yan, Shuo; Haacke, E Mark; Shen, Wen; Xia, Shuang

    2015-08-01

    To explore the correlation between increased brain iron deposition and brain atrophy in patients with haemodialysis and their correlation with clinical biomarkers and neuropsychological test. Forty two patients with haemodialysis and forty one age- and gender-matched healthy controls were recruited in this prospective study. 3D whole brain high resolution T1WI and susceptibility weighted imaging were scanned on a 3 T MRI system. The brain volume was analyzed using voxel-based morphometry (VBM) in patients and to compare with that of healthy controls. Quantitative susceptibility mapping was used to measure and compare the susceptibility of different structures between patients and healthy controls. Correlation analysis was used to investigate the relationship between the brain volume, iron deposition and neuropsychological scores. Stepwise multiple regression analysis was used to explore the effect of clinical biomarkers on the brain volumes in patients. Compared with healthy controls, patients with haemodialysis showed decreased volume of bilateral putamen and left insular lobe (All P putamen, substantia nigra, red nucleus and dentate nucleus were significantly higher (All P putamen (P putamen (P < 0.05). Our study indicated increased brain iron deposition and dialysis duration was risk factors for brain atrophy in patients with haemodialysis. The decreased gray matter volume of the left insular lobe was correlated with neurocognitive impairment.

  8. Effects of hormone replacement therapy on magnetic resonance imaging of brain parenchyma hyperintensities in postmenopausal women

    Institute of Scientific and Technical Information of China (English)

    Yan-yong LIU; Qin-sheng GE; Ping-ping ZUO; Ling HU; Chao JI; Dong-wen CHEN; Xi SHEN; Nan YANG; Yun YUE; Jing-mei JIANG; Xia HONG

    2009-01-01

    Aim:To apply 3.0 magnetic resonance imaging (MRI) to study the effects of long-term,low dose hormone replacement therapy (HRT) on the brain parenchyma of postmenopausal women.Methods:A total of 155 postmenopausal healthy female medical staff members from Peking Union Medical College Hospital were enrolled.The HRT group was composed of 71 subjects who had been given a low dose of HRT for over 4 years,while 84 women who had never been given HRT were enrolled in the control group.The Mini-Mental State Examination (MMSE) was used to evaluate mental state,and an Enzyme-Linked ImmunoSorbent Assay (ELISA) was used to detect plasma levels of sex hormones.In addition,all participants were subjected to an MRI,including axial T2 weighted imaging (T2WI),fluid-attenuated inversion recovery (FLAIR),T1 weighted imaging (TIWI,oblique coronal,vertical to the hippocampus,slice thickness 3 mm without gaps),and a 3D image of the whole brain.Results:The ELISA showed that the plasma level of estradiol in the HRT group was significantly higher than that in the control group (P

  9. Correlating Whole Brain Neural Activity with Behavior in Head-Fixed Larval Zebrafish.

    Science.gov (United States)

    Orger, Michael B; Portugues, Ruben

    2016-01-01

    We present a protocol to combine behavioral recording and imaging using 2-photon laser-scanning microscopy in head-fixed larval zebrafish that express a genetically encoded calcium indicator. The steps involve restraining the larva in agarose, setting up optics that allow projection of a visual stimulus and infrared illumination to monitor behavior, and analysis of the neuronal and behavioral data.

  10. Altered whole-brain white matter networks in preclinical Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Florian Udo Fischer

    2015-01-01

    Our results suggest an impairment of WM networks in preclinical AD that is detectable while other structural imaging markers do not yet indicate incipient neurodegeneration. Moreover, these findings are specific to WM networks and cannot be explained by other surrogates of global WM integrity.

  11. Whole Brain Irradiation and Hypo-fractionation Radiotherapy for the Metastases in Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Xingting GU

    2016-04-01

    Full Text Available Up to 40% non-small cell lung cancer patients developed brain metastasis during progression. Multiple brain metastases are common in non-small cell lung cancer. The prognosis of brain metastasis is poor with median survival of less than 1 year. Radio therapy for brain metastases has gradually developed from whole brain radiotherapy (WBRT to various radiation strategies. WBRT, surgery+WBRT, stereotactic radiotherapy+WBRT or WBRT with simultaneous integrated boost (SIB, etc. have better overall survival than those untreated patients. The damage of the cognitive function from WBRT has been realized recently, however, options of radiation strategies for long expected survival patients remain controversial. This paper will discuss different WBRT strategies and treatment side effects of non-small cell lung cancer with brain metastases.

  12. Rationale for the Use of Upfront Whole Brain Irradiation in Patients with Brain Metastases from Breast Cancer

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    Agnes V. Tallet

    2014-05-01

    Full Text Available Breast cancer is the second most common cause of brain metastases and deserves particular attention in relation to current prolonged survival of patients with metastatic disease. Advances in both systemic therapies and brain local treatments (surgery and stereotactic radiosurgery have led to a reappraisal of brain metastases management. With respect to this, the literature review presented here was conducted in an attempt to collect medical evidence-based data on the use of whole-brain radiotherapy for the treatment of brain metastases from breast cancer. In addition, this study discusses here the potential differences in outcomes between patients with brain metastases from breast cancer and those with brain metastases from other primary malignancies and the potential implications within a treatment strategy.

  13. Early whole-brain CT perfusion for detection of patients at risk for delayed cerebral ischemia after subarachnoid hemorrhage.

    Science.gov (United States)

    Malinova, Vesna; Dolatowski, Karoline; Schramm, Peter; Moerer, Onnen; Rohde, Veit; Mielke, Dorothee

    2016-07-01

    OBJECT This prospective study investigated the role of whole-brain CT perfusion (CTP) studies in the identification of patients at risk for delayed ischemic neurological deficits (DIND) and of tissue at risk for delayed cerebral infarction (DCI). METHODS Forty-three patients with aneurysmal subarachnoid hemorrhage (aSAH) were included in this study. A CTP study was routinely performed in the early phase (Day 3). The CTP study was repeated in cases of transcranial Doppler sonography (TCD)-measured blood flow velocity (BFV) increase of > 50 cm/sec within 24 hours and/or on Day 7 in patients who were intubated/sedated. RESULTS Early CTP studies revealed perfusion deficits in 14 patients, of whom 10 patients (72%) developed DIND, and 6 of these 10 patients (60%) had DCI. Three of the 14 patients (21%) with early perfusion deficits developed DCI without having had DIND, and the remaining patient (7%) had neither DIND nor DCI. There was a statistically significant correlation between early perfusion deficits and occurrence of DIND and DCI (p 50 cm/sec within 24 hours, revealing a perfusion deficit in 3 of them (38%). Two of the 3 patients (67%) developed DCI without preceding DIND and 1 patient (33%) had DIND without DCI. In 4 of the 7 patients (57%) who were sedated and/or comatose, additional CTP studies on Day 7 showed perfusion deficits. All 4 patients developed DCI. CONCLUSIONS Whole-brain CTP on Day 3 after aSAH allows early and reliable identification of patients at risk for DIND and tissue at risk for DCI. Additional CTP investigations, guided by TCD-measured BFV increase or persisting coma, do not contribute to information gain.

  14. Treatment planning and 3D dose verification of whole brain radiation therapy with hippocampal avoidance in rats

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    Yoon, S. W.; Miles, D.; Cramer, C.; Reinsvold, M.; Kirsch, D.; Oldham, M.

    2017-05-01

    Despite increasing use of stereotactic radiosurgery, whole brain radiotherapy (WBRT) continues to have a therapeutic role in a selected subset of patients. Selectively avoiding the hippocampus during such treatment (HA-WBRT) emerged as a strategy to reduce the cognitive morbidity associated with WBRT and gave rise to a recently published the phase II trial (RTOG 0933) and now multiple ongoing clinical trials. While conceptually hippocampal avoidance is supported by pre-clinical evidence showing that the hippocampus plays a vital role in memory, there is minimal pre-clinic data showing that selectively avoiding the hippocampus will reduce radiation-induced cognitive decline. Largely the lack of pre-clinical evidence can be attributed to the technical hurdles associated with delivering precise conformal treatment the rat brain. In this work we develop a novel conformal HA-WBRT technique for Wistar rats, utilizing a 225kVp micro-irradiator with precise 3D-printed radiation blocks designed to spare hippocampus while delivering whole brain dose. The technique was verified on rodent-morphic Presage® 3D dosimeters created from micro-CT scans of Wistar rats with Duke Large Field-of-View Optical Scanner (DLOS) at 1mm isotropic voxel resolution. A 4-field box with parallel opposed AP-PA and two lateral opposed fields was explored with conformal hippocampal sparing aided by 3D-printed radiation blocks. The measured DVH aligned reasonably well with that calculated from SmART Plan Monte Carlo simulations with simulated blocks for 4-field HA-WBRT with both demonstrating hippocampal sparing of 20% volume receiving less than 30% the prescription dose.

  15. Treatment of brain metastases of renal cell cancer with combined hypofractionated stereotactic radiotherapy and whole brain radiotherapy with hippocampal sparing.

    Science.gov (United States)

    Vrána, David; Študentová, Hana; Matzenauer, Marcel; Vlachová, Zuzana; Cwiertka, Karel; Gremlica, David; Kalita, Ondřej

    2016-06-01

    Renal cell cancer patients with brain metastatic disease generally have poor prognosis. Treatment options include surgery, radiotherapy, targeted therapy or best supportive care with respect to disease burden, patient preference and performance status. In the present case report the radiotherapy technique combining whole brain radiotherapy with hippocampal sparing (hippocampal avoidance whole brain radiotherapy HA-WBRT) and hypofractionated stereotactic radiotherapy (SRT) of the brain metastases is performed in a patient with metastatic renal cell carcinoma. HA-WBRT was administered to 30 Gy in 10 fractions with sparing of the hippocampal structures and SRT of 21 Gy in 3 fractions to brain metastases which has preceded the HA-WBRT. Two single arc volumetric modulated arc radiotherapy (VMAT) plans were prepared using Monaco planning software. The HA-WBRT treatment plan achieved the following results: D2=33.91 Gy, D98=25.20 Gy, D100=14.18 Gy, D50=31.26 Gy. The homogeneity index was calculated as a deduction of the minimum dose in 2% and 98% of the planning target volume (PTV), divided by the minimum dose in 50% of the PTV. The maximum dose to the hippocampus was 17.50 Gy and mean dose was 11.59 Gy. The following doses to organs at risk (OAR) were achieved: Right opticus Dmax, 31.96 Gy; left opticus Dmax, 30.96 Gy; chiasma D max, 32,76 Gy. The volume of PTV for stereotactic radiotherapy was 3,736 cm3, with coverage D100=20.95 Gy and with only 0.11% of the PTV being irradiated to dose below the prescribed dose. HA-WBRT with SRT represents a feasible technique for radiotherapy of brain metastatic disease, however this technique is considerably demanding on departmental equipment and staff time/experience.

  16. Whole-brain mapping of afferent projections to the bed nucleus of the stria terminalis in tree shrews.

    Science.gov (United States)

    Ni, Rong-Jun; Luo, Peng-Hao; Shu, Yu-Mian; Chen, Ju-Tao; Zhou, Jiang-Ning

    2016-10-01

    The bed nucleus of the stria terminalis (BST) plays an important role in integrating and relaying input information to other brain regions in response to stress. The cytoarchitecture of the BST in tree shrews (Tupaia belangeri chinensis) has been comprehensively described in our previous publications. However, the inputs to the BST have not been described in previous reports. The aim of the present study was to investigate the sources of afferent projections to the BST throughout the brain of tree shrews using the retrograde tracer Fluoro-Gold (FG). The present results provide the first detailed whole-brain mapping of BST-projecting neurons in the tree shrew brain. The BST was densely innervated by the prefrontal cortex, entorhinal cortex, ventral subiculum, amygdala, ventral tegmental area, and parabrachial nucleus. Moreover, moderate projections to the BST originated from the medial preoptic area, supramammillary nucleus, paraventricular thalamic nucleus, pedunculopontine tegmental nucleus, dorsal raphe nucleus, locus coeruleus, and nucleus of the solitary tract. Afferent projections to the BST are identified in the ventral pallidum, nucleus of the diagonal band, ventral posteromedial thalamic nucleus, posterior complex of the thalamus, interfascicular nucleus, retrorubral field, rhabdoid nucleus, intermediate reticular nucleus, and parvicellular reticular nucleus. In addition, the different densities of BST-projecting neurons in various regions were analyzed in the tree shrew brains. In summary, whole-brain mapping of direct inputs to the BST is delineated in tree shrews. These brain circuits are implicated in the regulation of numerous physiological and behavioral processes including stress, reward, food intake, and arousal.

  17. Potential for reduced radiation-induced toxicity using intensity-modulated arc therapy for whole-brain radiotherapy with hippocampal sparing.

    Science.gov (United States)

    Pokhrel, Damodar; Sood, Sumit; Lominska, Christopher; Kumar, Pravesh; Badkul, Rajeev; Jiang, Hongyu; Wang, Fen

    2015-09-08

    The purpose of this study was to retrospectively investigate the accuracy, plan quality, and efficiency of using intensity-modulated arc therapy (IMAT) for whole brain radiotherapy (WBRT) patients with sparing not only the hippocampus (following RTOG 0933 compliance criteria) but also other organs at risk (OARs). A total of 10 patients previously treated with nonconformal opposed laterals whole-brain radiotherapy (NC-WBRT) were retrospectively replanned for hippocampal sparing using IMAT treatment planning. The hippocampus was volumetrically contoured on fused diagnostic T1-weighted MRI with planning CT images and hippocampus avoidance zone (HAZ) was generated using a 5 mm uniform margin around the hippocampus. Both hippocampi were defined as one paired organ. Whole brain tissue minus HAZ was defined as the whole-brain planning target volume (WB-PTV). Highly conformal IMAT plans were generated in the Eclipse treatment planning system for Novalis TX linear accelerator consisting of high-definition multileaf collimators (HD-MLCs: 2.5 mm leaf width at isocenter) and 6 MV beam for a prescription dose of 30 Gy in 10 fractions following RTOG 0933 dosimetric criteria. Two full coplanar arcs with orbits avoidance sectors were used. In addition to RTOG criteria, doses to other organs at risk (OARs), such as parotid glands, cochlea, external/middle ear canals, skin, scalp, optic pathways, brainstem, and eyes/lens, were also evaluated. Subsequently, dose delivery efficiency and accuracy of each IMAT plan was assessed by delivering quality assurance (QA) plans with a MapCHECK device, recording actual beam-on time and measuring planed vs. measured dose agreement using a gamma index. On IMAT plans, following RTOG 0933 dosimetric criteria, the maximum dose to WB-PTV, mean WB-PTV D2%, and mean WB-PTV D98% were 34.9 ± 0.3 Gy, 33.2 ± 0.4 Gy, and 26.0± 0.4Gy, respectively. Accordingly, WB-PTV received the prescription dose of 30Gy and mean V30 was 90.5% ± 0.5%. The D100%, and

  18. Gamma knife stereotactic radiosurgery as salvage therapy after failure of whole-brain radiotherapy in patients with small-cell lung cancer.

    Science.gov (United States)

    Harris, Sunit; Chan, Michael D; Lovato, James F; Ellis, Thomas L; Tatter, Stephen B; Bourland, J Daniel; Munley, Michael T; deGuzman, Allan F; Shaw, Edward G; Urbanic, James J; McMullen, Kevin P

    2012-05-01

    Radiosurgery has been successfully used in selected cases to avoid repeat whole-brain irradiation (WBI) in patients with multiple brain metastases of most solid tumor histological findings. Few data are available for the use of radiosurgery for small-cell lung cancer (SCLC). Between November 1999 and June 2009, 51 patients with SCLC and previous WBI and new brain metastases were treated with GammaKnife stereotactic radiosurgery (GKSRS). A median dose of 18 Gy (range, 10-24 Gy) was prescribed to the margin of each metastasis. Patients were followed with serial imaging. Patient electronic records were reviewed to determine disease-related factors and clinical outcomes after GKSRS. Local and distant brain failure rates, overall survival, and likelihood of neurologic death were determined based on imaging results. The Kaplan-Meier method was used to determine survival and local and distant brain control. Cox proportional hazard regression was performed to determine strength of association between disease-related factors and survival. Median survival time for the entire cohort was 5.9 months. Local control rates at 1 and 2 years were 57% and 34%, respectively. Distant brain failure rates at 1 and 2 years were 58% and 75%, respectively. Fifty-three percent of patients ultimately died of neurologic death. On multivariate analysis, patients with stable (hazard ratio [HR] = 2.89) or progressive (HR = 6.98) extracranial disease (ECD) had worse overall survival than patients without evidence of ECD (p = 0.00002). Concurrent chemotherapy improved local control (HR = 89; p = 0.006). GKSRS represents a feasible salvage option in patients with SCLC and brain metastases for whom previous WBI has failed. The status of patients' ECD is a dominant factor predictive of overall survival. Local control may be inferior to that seen with other cancer histological results, although the use of concurrent chemotherapy may help to improve this. Copyright © 2012 Elsevier Inc. All rights

  19. Gamma Knife Stereotactic Radiosurgery as Salvage Therapy After Failure of Whole-Brain Radiotherapy in Patients With Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Sunit [Department of Radiation Oncology, Wake Forest University, Winston-Salem, North Carolina (United States); Chan, Michael D., E-mail: mchan@wfubmc.edu [Department of Radiation Oncology, Wake Forest University, Winston-Salem, North Carolina (United States); Lovato, James F. [Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina (United States); Ellis, Thomas L.; Tatter, Stephen B. [Department of Neurosurgery, Wake Forest University, Winston-Salem, North Carolina (United States); Bourland, J. Daniel; Munley, Michael T.; Guzman, Allan F. de; Shaw, Edward G.; Urbanic, James J.; McMullen, Kevin P. [Department of Radiation Oncology, Wake Forest University, Winston-Salem, North Carolina (United States)

    2012-05-01

    Purpose: Radiosurgery has been successfully used in selected cases to avoid repeat whole-brain irradiation (WBI) in patients with multiple brain metastases of most solid tumor histological findings. Few data are available for the use of radiosurgery for small-cell lung cancer (SCLC). Methods and Materials: Between November 1999 and June 2009, 51 patients with SCLC and previous WBI and new brain metastases were treated with GammaKnife stereotactic radiosurgery (GKSRS). A median dose of 18 Gy (range, 10-24 Gy) was prescribed to the margin of each metastasis. Patients were followed with serial imaging. Patient electronic records were reviewed to determine disease-related factors and clinical outcomes after GKSRS. Local and distant brain failure rates, overall survival, and likelihood of neurologic death were determined based on imaging results. The Kaplan-Meier method was used to determine survival and local and distant brain control. Cox proportional hazard regression was performed to determine strength of association between disease-related factors and survival. Results: Median survival time for the entire cohort was 5.9 months. Local control rates at 1 and 2 years were 57% and 34%, respectively. Distant brain failure rates at 1 and 2 years were 58% and 75%, respectively. Fifty-three percent of patients ultimately died of neurologic death. On multivariate analysis, patients with stable (hazard ratio [HR] = 2.89) or progressive (HR = 6.98) extracranial disease (ECD) had worse overall survival than patients without evidence of ECD (p = 0.00002). Concurrent chemotherapy improved local control (HR = 89; p = 0.006). Conclusions: GKSRS represents a feasible salvage option in patients with SCLC and brain metastases for whom previous WBI has failed. The status of patients' ECD is a dominant factor predictive of overall survival. Local control may be inferior to that seen with other cancer histological results, although the use of concurrent chemotherapy may help to

  20. Comparison of inter subject variability and reproducibility of whole brain proton spectroscopy.

    Science.gov (United States)

    Veenith, Tonny V; Mada, Marius; Carter, Eleanor; Grossac, Julia; Newcombe, Virginia; Outtrim, Joanne; Lupson, Victoria; Nallapareddy, Sridhar; Williams, Guy B; Sheriff, Sulaiman; Menon, David K; Maudsley, Andrew A; Coles, Jonathan P

    2014-01-01

    The aim of these studies was to provide reference data on intersubject variability and reproducibility of metabolite ratios for Choline/Creatine (Cho/Cr), N-acetyl aspartate/Choline (NAA/Cho) and N-acetyl aspartate/Creatine (NAA/Cr), and individual signal-intensity normalised metabolite concentrations of NAA, Cho and Cr. Healthy volunteers underwent imaging on two occasions using the same 3T Siemens Verio magnetic resonance scanner. At each session two identical Metabolic Imaging and Data Acquisition Software (MIDAS) sequences were obtained along with standard structural imaging. Metabolite maps were created and regions of interest applied in normalised space. The baseline data from all 32 volunteers were used to calculate the intersubject variability, while within session and between session reproducibility were calculated from all the available data. The reproducibility of measurements were used to calculate the overall and within session 95% prediction interval for zero change. The within and between session reproducibility data were lower than the values for intersubject variability, and were variable across the different brain regions. The within and between session reproducibility measurements were similar for Cho/Cr, NAA/Choline, Cho and Cr (11.8%, 11.4%, 14.3 and 10.6% vs. 11.9%, 11.4%, 13.5% and 10.5% respectively), but for NAA/Creatine and NAA between session reproducibility was lower (9.3% and 9.1% vs. 10.1% and 9.9%; p <0.05). This study provides additional reference data that can be utilised in interventional studies to quantify change within a single imaging session, or to assess the significance of change in longitudinal studies of brain injury and disease.

  1. Visualizing whole-brain DTI tractography with GPU-based Tuboids and LoD management.

    Science.gov (United States)

    Petrovic, Vid; Fallon, James; Kuester, Falko

    2007-01-01

    Diffusion Tensor Imaging (DTI) of the human brain, coupled with tractography techniques, enable the extraction of large-collections of three-dimensional tract pathways per subject. These pathways and pathway bundles represent the connectivity between different brain regions and are critical for the understanding of brain related diseases. A flexible and efficient GPU-based rendering technique for DTI tractography data is presented that addresses common performance bottlenecks and image-quality issues, allowing interactive render rates to be achieved on commodity hardware. An occlusion query-based pathway LoD management system for streamlines/streamtubes/tuboids is introduced that optimizes input geometry, vertex processing, and fragment processing loads, and helps reduce overdraw. The tuboid, a fully-shaded streamtube impostor constructed entirely on the GPU from streamline vertices, is also introduced. Unlike full streamtubes and other impostor constructs, tuboids require little to no preprocessing or extra space over the original streamline data. The supported fragment processing levels of detail range from texture-based draft shading to full raycast normal computation, Phong shading, environment mapping, and curvature-correct text labeling. The presented text labeling technique for tuboids provides adaptive, aesthetically pleasing labels that appear attached to the surface of the tubes. Furthermore, an occlusion query aggregating and scheduling scheme for tuboids is described that reduces the query overhead. Results for a tractography dataset are presented, and demonstrate that LoD-managed tuboids offer benefits over traditional streamtubes both in performance and appearance.

  2. Topology of whole-brain functional MRI networks: Improving the truncated scale-free model

    Science.gov (United States)

    Ruiz Vargas, E.; Mitchell, D. G. V.; Greening, S. G.; Wahl, L. M.

    2014-07-01

    Networks of connections within the human brain have been the subject of intense recent research, yet their topology is still only partially understood. We analyze weighted networks calculated from functional magnetic resonance imaging (fMRI) data acquired during task performance. Expanding previous work in the area, our analysis retains all of the connections between all of the voxels in the full brain fMRI data, computing correlations between approximately 200,000 voxels per subject for 10 subjects. We evaluate the extent to which this rich dataset can be described by existing models of scale-free or exponentially truncated scale-free topology, comparing results across a large number of more complex topological models as well. Our results suggest that the novel “log quadratic” model presented in this paper offers a significantly better fit to networks of functional connections at the voxel level in the human brain.

  3. Infinite von Mises-Fisher Mixture Modeling of Whole Brain fMRI Data

    DEFF Research Database (Denmark)

    Røge, Rasmus; Madsen, Kristoffer Hougaard; Schmidt, Mikkel Nørgaard

    2017-01-01

    spherical manifold are rarely analyzed, in part due to the computational challenges imposed by directional statistics. In this letter, we discuss a Bayesian von Mises-Fisher (vMF) mixture model for data on the unit hypersphere and present an efficient inference procedure based on collapsed Markov chain...... Monte Carlo sampling. Comparing the vMF and gaussian mixture models on synthetic data, we demonstrate that the vMF model has a slight advantage inferring the true underlying clustering when compared to gaussian-based models on data generated from both a mixture of vMFs and a mixture of gaussians......Cluster analysis of functional magnetic resonance imaging (fMRI) data is often performed using gaussian mixture models, but when the time series are standardized such that the data reside on a hypersphere, this modeling assumption is questionable. The consequences of ignoring the underlying...

  4. Phase II trial of temozolomide plus concurrent whole-brain radiation followed by TNV regimen as adjuvant therapy for patients with newly diagnosed primary CNS lymphoma

    Directory of Open Access Journals (Sweden)

    Yong Wang

    2013-01-01

    Full Text Available Background: Primary central nervous system lymphoma (PCNSL is an aggressive extranodal non-Hodgkin′s lymphoma limited to the CNS. Treatment of PCNSL with high-dose methotrexate (HD-MTX-based chemotherapy and whole-brain radiotherapy (WBRT is associated with high rates of relapse and severe treatment-related neurotoxicity. Aim: To report our experience of treating newly diagnosed PCNSL with temozolomide, nedaplatin, and vincristine (TNV, as the replacement of HD-MTX, in combination with concurrent chemoradiotherapy. Materials and Methods: Newly diagnosed PCNSL patients were given concurrent temozolomide (75 mg/m 2 , orally daily during WBRT. Then, the TNV regimen was given after four weeks. The TNV regimen consisted of temozolomide (200 mg/m 2 orally: Days 1-5, nedaplatin (80 mg/m 2 intravenous: Day 1, and vincristine (1.4 mg/m 2 intravenous: Day 1. Each cycle was of a duration of four weeks and a maximum of six cycles were applied. The primary end point was response to treatment obtained by magnetic resonance imaging (MRI. Secondary end points were progression-free survival (PFS and fewer toxic effects. Results: The study subjects included 14 patients (median age: 53.5, median Karnofsky Performance Scale (KPS: 75. The median number of TNV cycles given was five. Response to treatment: Complete response in 12 (85.7% patients, partial response in 2 (14.3% patients, and none with progressive disease. The objective response rate was 100%, and median PFS was 21.4 months. Toxicity was relatively mild, which mainly included nausea in six and fatigue in five, grade 3-4 hematotoxicity in one, and abnormal liver functions in five patients. No neurotoxicity has been observed till date. Conclusion: The efficacy outcomes in this study are comparable to other reported HD-MTX-based regimens plus WBRT, with an added favorable toxicity profile. Prospective, randomized controlled trials are warranted to confirm such results.

  5. Whole Mouse Brain Image Reconstruction from Serial Coronal Sections Using FIJI (ImageJ).

    Science.gov (United States)

    Paletzki, Ronald; Gerfen, Charles R

    2015-10-01

    Whole-brain reconstruction of the mouse enables comprehensive analysis of the distribution of neurochemical markers, the distribution of anterogradely labeled axonal projections or retrogradely labeled neurons projecting to a specific brain site, or the distribution of neurons displaying activity-related markers in behavioral paradigms. This unit describes a method to produce whole-brain reconstruction image sets from coronal brain sections with up to four fluorescent markers using the freely available image-processing program FIJI (ImageJ).

  6. Functional connectivity analysis using whole brain and regional network metrics in MS patients.

    Science.gov (United States)

    Chirumamilla, V C; Fleischer, V; Droby, A; Anjum, T; Muthuraman, M; Zipp, F; Groppa, S

    2016-08-01

    In the present study we investigated brain network connectivity differences between patients with relapsing-remitting multiple sclerosis (RRMS) and healthy controls (HC) as derived from functional resonance magnetic imaging (fMRI) using graph theory. Resting state fMRI data of 18 RRMS patients (12 female, mean age ± SD: 42 ± 12.06 years) and 25 HC (8 female, 29.2 ± 5.38 years) were analyzed. In order to obtain information of differences in entire brain network, we focused on both, local and global network connectivity parameters. And the regional connectivity differences were assessed using regional network parameters. RRMS patients presented a significant increase of modularity in comparison to HC, pointing towards a network structure with densely interconnected nodes within one module, while the number of connections with other modules outside decreases. This higher decomposable network favours cost-efficient local information processing and promotes long-range disconnection. In addition, at the regional anatomical level, the network parameters clustering coefficient and local efficiency were increased in the insula, the superior parietal gyrus and the temporal pole. Our study indicates that modularity as derived from fMRI can be seen as a characteristic connectivity feature that is increased in MS patients compared to HC. Furthermore, specific anatomical regions linked to perception, motor function and cognition were mainly involved in the enhanced local information processing.

  7. Rey's Auditory Verbal Learning Test scores can be predicted from whole brain MRI in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Elaheh Moradi

    2017-01-01

    Full Text Available Rey's Auditory Verbal Learning Test (RAVLT is a powerful neuropsychological tool for testing episodic memory, which is widely used for the cognitive assessment in dementia and pre-dementia conditions. Several studies have shown that an impairment in RAVLT scores reflect well the underlying pathology caused by Alzheimer's disease (AD, thus making RAVLT an effective early marker to detect AD in persons with memory complaints. We investigated the association between RAVLT scores (RAVLT Immediate and RAVLT Percent Forgetting and the structural brain atrophy caused by AD. The aim was to comprehensively study to what extent the RAVLT scores are predictable based on structural magnetic resonance imaging (MRI data using machine learning approaches as well as to find the most important brain regions for the estimation of RAVLT scores. For this, we built a predictive model to estimate RAVLT scores from gray matter density via elastic net penalized linear regression model. The proposed approach provided highly significant cross-validated correlation between the estimated and observed RAVLT Immediate (R = 0.50 and RAVLT Percent Forgetting (R = 0.43 in a dataset consisting of 806 AD, mild cognitive impairment (MCI or healthy subjects. In addition, the selected machine learning method provided more accurate estimates of RAVLT scores than the relevance vector regression used earlier for the estimation of RAVLT based on MRI data. The top predictors were medial temporal lobe structures and amygdala for the estimation of RAVLT Immediate and angular gyrus, hippocampus and amygdala for the estimation of RAVLT Percent Forgetting. Further, the conversion of MCI subjects to AD in 3-years could be predicted based on either observed or estimated RAVLT scores with an accuracy comparable to MRI-based biomarkers.

  8. A machine learning system for automated whole-brain seizure detection

    Directory of Open Access Journals (Sweden)

    P. Fergus

    2016-01-01

    Full Text Available Epilepsy is a chronic neurological condition that affects approximately 70 million people worldwide. Characterised by sudden bursts of excess electricity in the brain, manifesting as seizures, epilepsy is still not well understood when compared with other neurological disorders. Seizures often happen unexpectedly and attempting to predict them has been a research topic for the last 30 years. Electroencephalograms have been integral to these studies, as the recordings that they produce can capture the brain’s electrical signals. The diagnosis of epilepsy is usually made by a neurologist, but can be difficult to make in the early stages. Supporting para-clinical evidence obtained from magnetic resonance imaging and electroencephalography may enable clinicians to make a diagnosis of epilepsy and instigate treatment earlier. However, electroencephalogram capture and interpretation is time consuming and can be expensive due to the need for trained specialists to perform the interpretation. Automated detection of correlates of seizure activity generalised across different regions of the brain and across multiple subjects may be a solution. This paper explores this idea further and presents a supervised machine learning approach that classifies seizure and non-seizure records using an open dataset containing 342 records (171 seizures and 171 non-seizures. Our approach posits a new method for generalising seizure detection across different subjects without prior knowledge about the focal point of seizures. Our results show an improvement on existing studies with 88% for sensitivity, 88% for specificity and 93% for the area under the curve, with a 12% global error, using the k-NN classifier.

  9. Influence of Circulating Endothelin-1 and Asymmetric Dimethylarginine on Whole Brain Circulation Time in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Lucia Monti

    2017-06-01

    Full Text Available Blood-brain barrier (BBB breakdown, inflammatory and immune cell activation, and chronic cerebral hypoperfusion are features of multiple sclerosis (MS. The aim is to determine the influence of endothelin-1 (ET1 and asymmetric dimethylarginine (ADMA on cerebral circulation time (CCT in patients with MS. In all, 64 patients with MS (39 relapsing-remitting [RR]-MS; 25 secondary progressive [SP]-MS subtype and 37 controls (C were studied. Cerebral circulation time was obtained by angiography. Plasmatic ET1 and ADMA were measured by enzyme-linked immunosorbent assay. Lesion load (LL and brain volume (BV were obtained by magnetic resonance imaging. Cerebral circulation time was correlated to ET1, ADMA, LL, BV, disease duration (DD, and Expanded Disability Status Scale (EDSS. In MS, both ET1 and ADMA were significantly higher than C ( P  < .0001; CCT was approximately 2 times lower than C ( P  < .0001 and significantly slower in SP than in RR-MS ( P  = .0215. Cerebral circulation time significantly correlated with ET1 in SP-MS ( r  = 0.38, whereas in RR-MS CCT significantly correlated with DD ( r  = 0.75. The LL, BV, and EDSS did not correlate with CCT. Endothelin-1 significantly influences CCT delay in SP-MS. Diversely, CCT in RR-MS is independent of ET1 and correlates significantly with DD. We conclude that in RR-MS, DD responds to neurovascular damage accumulation. It is supposed that high ET1 and ADMA levels stem from a protective response to early insults, aimed at opposing nitric oxide overproduction, whereas persistent pathological ET1 and ADMA levels translate into detrimental long-term effects, due to increased brain micro-vessel resistance.

  10. Rey's Auditory Verbal Learning Test scores can be predicted from whole brain MRI in Alzheimer's disease.

    Science.gov (United States)

    Moradi, Elaheh; Hallikainen, Ilona; Hänninen, Tuomo; Tohka, Jussi

    2017-01-01

    Rey's Auditory Verbal Learning Test (RAVLT) is a powerful neuropsychological tool for testing episodic memory, which is widely used for the cognitive assessment in dementia and pre-dementia conditions. Several studies have shown that an impairment in RAVLT scores reflect well the underlying pathology caused by Alzheimer's disease (AD), thus making RAVLT an effective early marker to detect AD in persons with memory complaints. We investigated the association between RAVLT scores (RAVLT Immediate and RAVLT Percent Forgetting) and the structural brain atrophy caused by AD. The aim was to comprehensively study to what extent the RAVLT scores are predictable based on structural magnetic resonance imaging (MRI) data using machine learning approaches as well as to find the most important brain regions for the estimation of RAVLT scores. For this, we built a predictive model to estimate RAVLT scores from gray matter density via elastic net penalized linear regression model. The proposed approach provided highly significant cross-validated correlation between the estimated and observed RAVLT Immediate (R = 0.50) and RAVLT Percent Forgetting (R = 0.43) in a dataset consisting of 806 AD, mild cognitive impairment (MCI) or healthy subjects. In addition, the selected machine learning method provided more accurate estimates of RAVLT scores than the relevance vector regression used earlier for the estimation of RAVLT based on MRI data. The top predictors were medial temporal lobe structures and amygdala for the estimation of RAVLT Immediate and angular gyrus, hippocampus and amygdala for the estimation of RAVLT Percent Forgetting. Further, the conversion of MCI subjects to AD in 3-years could be predicted based on either observed or estimated RAVLT scores with an accuracy comparable to MRI-based biomarkers.

  11. Experimental Study Comparing a Traditional Approach to Performance Appraisal Training to a Whole-Brain Training Method at C.B. Fleet Laboratories

    Science.gov (United States)

    Selden, Sally; Sherrier, Tom; Wooters, Robert

    2012-01-01

    The purpose of this study is to examine the effects of a new approach to performance appraisal training. Motivated by split-brain theory and existing studies of cognitive information processing and performance appraisals, this exploratory study examined the effects of a whole-brain approach to training managers for implementing performance…

  12. An efficient Volumetric Arc Therapy treatment planning approach for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT)

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Jin [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States); Bender, Edward [Department of Medical Physics, University of Wisconsin, Madison, WI (United States); Yaparpalvi, Ravindra; Kuo, Hsiang-Chi; Basavatia, Amar; Hong, Linda; Bodner, William; Garg, Madhur K.; Kalnicki, Shalom [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States); Tomé, Wolfgang A., E-mail: wtome@montefiore.org [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States); Department of Medical Physics, University of Wisconsin, Madison, WI (United States)

    2015-10-01

    An efficient and simple class solution is proposed for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT) planning using the Volumetric Arc Therapy (VMAT) delivery technique following the NRG Oncology protocol NRG-CC001 treatment planning guidelines. The whole-brain planning target volume (PTV) was subdivided into subplanning volumes that lie in plane and out of plane with the hippocampal-avoidance volume. To further improve VMAT treatment plans, a partial-field dual-arc technique was developed. Both the arcs were allowed to overlap on the in-plane subtarget volume, and in addition, one arc covered the superior out-of-plane sub-PTV, while the other covered the inferior out-of-plane subtarget volume. For all plans (n = 20), the NRG-CC001 protocol dose-volume criteria were met. Mean values of volumes for the hippocampus and the hippocampal-avoidance volume were 4.1 cm{sup 3} ± 1.0 cm{sup 3} and 28.52 cm{sup 3} ± 3.22 cm{sup 3}, respectively. For the PTV, the average values of D{sub 2%} and D{sub 98%} were 36.1 Gy ± 0.8 Gy and 26.2 Gy ± 0.6 Gy, respectively. The hippocampus D{sub 100%} mean value was 8.5 Gy ± 0.2 Gy and the maximum dose was 15.7 Gy ± 0.3 Gy. The corresponding plan quality indices were 0.30 ± 0.01 (homogeneity index), 0.94 ± 0.01 (target conformality), and 0.75 ± 0.02 (confirmation number). The median total monitor unit (MU) per fraction was 806 MU (interquartile range [IQR]: 792 to 818 MU) and the average beam total delivery time was 121.2 seconds (IQR: 120.6 to 121.35 seconds). All plans passed the gamma evaluation using the 5-mm, 4% criteria, with γ > 1 of not more than 9.1% data points for all fields. An efficient and simple planning class solution for HA-WBRT using VMAT has been developed that allows all protocol constraints of NRG-CC001 to be met.

  13. A precision 3D conformal treatment technique in rats: application to whole brain radiotherapy with hippocampal avoidance.

    Science.gov (United States)

    Yoon, Suk W; Cramer, Christina K; Miles, Devin A; Reinsvold, Michael H; Joo, Kyeung M; Kirsch, David G; Oldham, Mark

    2017-08-24

    To develop and validate 3D conformal hippocampal sparing whole-brain radiation therapy (HA-WBRT) for Wistar rats utilizing precision 3D printed immobilization and micro-blocks. This technique paves the way for future pre-clinical studies investigating brain treatments that reduce neurotoxicity. A novel pre-clinical treatment planning and delivery process was developed to enable precision 3D conformal treatment and hippocampal avoidance capability for the Xrad 225cx small animal irradiator. A range of conformal avoidance plans were evaluated consisting of equi-angularly spaced co-planar axial beams, with plans containing 2, 4, 7, and 8 fields. The hippocampal sparing and coverage of these plans were investigated through Monte Carlo dose calculation (SmART-Plan Xrad 225cx planning system). Treatment delivery was implemented through a novel process where hippocampal block shapes were computer-generated from an MRI rat atlas which was registered to on-board cone-beam-CT of the rat in treatment position. The blocks were 3D-printed with a tungsten-doped filament at lateral resolution of 80μm. Precision immobilization was achieved utilizing a 3D-printed support system which enabled angled positioning of the rat head in supine position and bite-block to improve coverage of the central diencephalon. Treatment delivery was verified on rodent-morphic Presage(®) 3D dosimeters optically scanned at 0.2mm isotropic resolution. Biological verification of hippocampal avoidance was performed with immunohistologic staining. All simulated plans spared the hippocampus while delivering high dose to the brain (22.5-26.2Gy mean dose to brain at mean hippocampal dose of 7Gy). No significant improvement in hippocampal sparing was observed by adding beams beyond 4 fields. Dosimetric sparing of hippocampal region of the 4-field plan was verified with the Presage(®) dosimeter (mean dose = 9.6Gy, D100% = 7.1Gy). Simulation and dosimeter match at distance-to-agreement of 2mm and dose

  14. Clinical features of brain metastases in breast cancer: an implication for hippocampal-sparing whole-brain radiation therapy

    Directory of Open Access Journals (Sweden)

    Wu S

    2016-12-01

    Full Text Available San-Gang Wu,1,* Jia-Yuan Sun,2,* Qin Tong,3 Feng-Yan Li,2 Zhen-Yu He2 1Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, 2Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 3Department of Radiation Oncology, The First Affiliated Hospital of University of South China, Hengyang, People’s Republic of China *These authors contributed equally to this work Objective: The objectives of this study were to describe the distribution of brain metastases (BM in breast cancer patients and investigate the risk factors for perihippocampal metastases (PHM. Patients and methods: Retrospective analysis of the clinicopathological characteristics and patterns of BM was performed. Associations between clinicopathological characteristics and PHM (the hippocampus plus 5 mm margin were evaluated using logistic regression analyses. Results: A total of 1,356 brain metastatic lesions were identified in 192 patients. Patients with 1–3 BM, 4–9 BM, and ≥10 BM accounted for 63.0%, 18.8%, and 18.2%, respectively. There were only 7 (3.6% patients with hippocampal metastases (HM and 14 (7.3% patients with PHM. On logistic regression, the number of BM was an independent risk factor for PHM. Patients with ≥10 BM had a significantly higher risk of PHM compared with those with <10 BM. Breast cancer subtype (BCS was not associated with PHM. The number of BM was significantly correlated with various BCSs. Patients with hormone receptor (HR+/human epidermal growth factor receptor 2 (HER2+, HR-/HER2+, and HR-/HER2- subtypes had a higher probability of ≥10 BM, relative to patients with an HR+/HER2- subtype. Conclusion: Our study suggests that a low incidence of PHM may be acceptable to perform hippocampal-sparing whole-brain radiation therapy for breast cancer patients

  15. Diagnostic value of contrast-enhanced fluid-attenuated inversion-recovery MRI for intracranial tumors in comparison with post-contrast T1W spin-echo MRI

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Contrast-enhanced fluid-attenuated inversion-recovery (FLAIR) magnetic resonance imaging (MRI) has been reported to have higher sensitivity for detecting leptomeningeal disease compared with contrast- enhanced T1-weighted MRI (CE T1WI). However, currently there are no studies showing the potential value of clinical applications of contrast-enhanced FLAIR (CE FLAIR) sequence in diagnosing intracranial tumors in a larger group of patients. The purpose of this study was to evaluate the diagnostic value of CE FLAIR in comparison with CE T1WI for intracranial tumors and to provide more information for clinical diagnosis and therapy.Methods One hundred and four consecutive cases of intracranial tumors referred for CE brain MRI were analyzed with regard to FLAIR and T1WI pre- and post-administration of Gd-DTPA. The CE FLAIR and CE T1WI were evaluated independently by two radiologists for the number of examinations with one or more enhanced lesions, the number and location of enhanced lesions per examination, signal-to-noise ratio (SNR) and contrast-enhancement ratio (CER) of lesions, as well as the size and extent of the enhanced lesions. Results In 98 of 104 cases, enhanced lesions were seen both on the FLAIR and T1W images. More lesions were seen on CE T1WI (n=120) than those on CE FLAIR sequence (n=117), but no differences of statistical significance were found between the two sequences (P>0.05). Four lesions were revealed only on the CE FLAIR images whereas 7 lesions were only found on CE T1WI. Enhanced lesions located in the cerebral hemisphere or the forth ventricle were revealed much more on CE T1WI than on CE FLAIR images. However, CE FLAIR images may be useful in showing superficial abnormalities and those located in the sulcus or lateral ventricle. The CER and contrast-to-noise ratio (CNR) on CE T1WI was significantly higher (t=7.10,P=0.00;t=9.67,P=0.00, respectively), but grey matter/white matter contrast was lower (t=2.46,P=0.02) than those on CE

  16. Crizotinib Treatment Combined with Resection and Whole-brain Radiation Therapy 
in A ROS1 Rearranged Lung Adenocarcinoma with Brain Metastasis: 
Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Min ZHANG

    2016-08-01

    Full Text Available Background and objective Lung cancer with brain metastasis had poor prognosis. Crizotinib had been confirmed to be used in ROS1 (C-ros oncogene 1 receptor tyrosine kinase rearranged lung adenocarcinoma, but its efficacy in lung cancer with brain metastasis was poor due to the blood brain barrier. In the present study, we reported one case of ROS1 fusion lung adenocarcinoma with symptomatic brain matastasis, who was treated with brain metastases resection, crizotinib, and whole brain radiotherapy plus boost to residual brain metastasis. The safety and efficacy was summarized. Methods At first, surgical resection was used to relive mass effect and to biopsy. Then crizotinib (250 mg, bid was chosen for the existence of ROS1 fusion gene. Whole brain radiotherapy plus boost to residual brain metastasis were used after surgery. Objective response was evaluated by Response Evaluation Criteriation in Solid Tumours (RECIST v1.1 and brain metastasis were evaluated by computer tomography (CT/magnetic resonance imaging (MRI image. Adverse events were evaluated according to Common Terminology Criteria for Adverse Events (CTC AE v4.0. Results After taking crizotinib for 3 months, the lung lesions were close to complete response (CR, the brain metastasis were partial response (PR, the abdomen metastasis were CR and the symptom of blurred vision relieved. Conclusion Crizotinib combined with palliative operation and radiation therapy (WBRT plus boost to residual brain metastasis in the treatment of ROS1 fusion gene positive lung adenocarcinoma with symptomatic brain metastases, can effectively control intracranial lesions with good tolerance.

  17. Positive selection in ASPM is correlated with cerebral cortex evolution across primates but not with whole-brain size.

    Science.gov (United States)

    Ali, Farhan; Meier, Rudolf

    2008-11-01

    The rapid increase of brain size is a key event in human evolution. Abnormal spindle-like microcephaly associated (ASPM) is discussed as a major candidate gene for explaining the exceptionally large brain in humans but ASPM's role remains controversial. Here we use codon-specific models and a comparative approach to test this candidate gene that was initially identified in Homo-chimp comparisons. We demonstrate that accelerated evolution of ASPM (omega = 4.7) at 16 amino acid sites occurred in 9 primate lineages with major changes in relative cerebral cortex size. However, ASPM's evolution is not correlated with major changes in relative whole-brain or cerebellum sizes. Our results suggest that a single candidate gene such as ASPM can influence a specific component of the brain across large clades through changes in a few amino acid sites. We furthermore illustrate the power of using continuous phenotypic variability across primates to rigorously test candidate genes that have been implicated in the evolution of key human traits.

  18. Concomitant treatment of brain metastasis with Whole Brain Radiotherapy [WBRT] and Temozolomide [TMZ] is active and improves Quality of Life

    Directory of Open Access Journals (Sweden)

    Montella Liliana

    2007-01-01

    Full Text Available Abstract Background Brain metastases (BM represent one of the most frequent complications related to cancer, and their treatment continues to evolve. We have evaluated the activity, toxicity and the impact on Quality of Life (QoL of a concomitant treatment with whole brain radiotherapy (WBRT and Temozolomide (TMZ in patients with brain metastases from solid tumors in a prospective Simon two stage study. Methods Fifty-nine patients were enrolled and received 30 Gy WBRT with concomitant TMZ (75 mg/m2/day for ten days, and subsequently TMZ (150 mg/m2/day for up to six cycles. The primary end points were clinical symptoms and radiologic response. Results Five patients had a complete response, 21 patients had a partial response, while 18 patients had stable disease. The overall response rate (45% exceeded the target activity per study design. The median time to progression was 9 months. Median overall survival was 13 months. The most frequent toxicities included grade 3 neutropenia (15% and anemia (13%, and only one patient developed a grade 4 thrombocytopenia. Age, Karnofsky performance status, presence of extracranial metastases and the recursive partitioning analysis (RPA were found to be predictive factors for response in patients. Overall survival (OS and progression-free survival (PFS were dependent on age and on the RPA class. Conclusion We conclude that this treatment is well tolerated, with an encouraging objective response rate, and a significant improvement in quality of life (p

  19. A Case of Brain Metastases from Breast Cancer Treated with Whole-Brain Radiotherapy and Eribulin Mesylate

    Directory of Open Access Journals (Sweden)

    Carsten Nieder

    2012-01-01

    Full Text Available Patients with triple receptor-negative breast cancer often develop aggressive metastatic disease, which also might involve the brain. In many cases, systemic and local treatment is needed. It is important to consider the toxicity of chemo- and radiotherapy, especially when newly approved drugs become available. Randomised studies leading to drug approval often exclude patients with newly diagnosed brain metastases. Here we report our initial experience with eribulin mesylate and whole-brain radiotherapy (WBRT in a heavily pretreated patient with multiple brain, lung, and bone metastases from triple receptor-negative breast cancer. Eribulin mesylate was given after 4 previous lines for metastatic disease. Two weeks after the initial dose, that is, during the first cycle, the patient was diagnosed with 5 brain metastases with a maximum size of approximately 4.5 cm. She continued chemotherapy and received concomitant WBRT with 10 fractions of 3 Gy. After 3 cycles of eribulin mesylate, treatment was discontinued because of newly diagnosed liver metastases and progression in the lungs. No unexpected acute toxicity was observed. The only relevant adverse reactions were haematological events after the third cycle (haemoglobin 9.5 g/dL, leukocytes 3.1×109/L. The patient died from respiratory failure 18.5 months from diagnosis of metastatic disease, and 2.7 months from diagnosis of brain metastases. To the best of our knowledge, this is the first report on combined WBRT and eribulin mesylate.

  20. Whole brain analysis of postmortem density changes of grey and white matter on computed tomography by statistical parametric mapping

    Energy Technology Data Exchange (ETDEWEB)

    Nishiyama, Yuichi; Mori, Hiroshi; Katsube, Takashi; Kitagaki, Hajime [Shimane University Faculty of Medicine, Department of Radiology, Izumo-shi, Shimane (Japan); Kanayama, Hidekazu; Tada, Keiji; Yamamoto, Yasushi [Shimane University Hospital, Department of Radiology, Izumo-shi, Shimane (Japan); Takeshita, Haruo [Shimane University Faculty of Medicine, Department of Legal Medicine, Izumo-shi, Shimane (Japan); Kawakami, Kazunori [Fujifilm RI Pharma, Co., Ltd., Tokyo (Japan)

    2017-06-15

    This study examined the usefulness of statistical parametric mapping (SPM) for investigating postmortem changes on brain computed tomography (CT). This retrospective study included 128 patients (23 - 100 years old) without cerebral abnormalities who underwent unenhanced brain CT before and after death. The antemortem CT (AMCT) scans and postmortem CT (PMCT) scans were spatially normalized using our original brain CT template, and postmortem changes of CT values (in Hounsfield units; HU) were analysed by the SPM technique. Compared with AMCT scans, 58.6 % and 98.4 % of PMCT scans showed loss of the cerebral sulci and an unclear grey matter (GM)-white matter (WM) interface, respectively. SPM analysis revealed a significant decrease in cortical GM density within 70 min after death on PMCT scans, suggesting cytotoxic brain oedema. Furthermore, there was a significant increase in the density of the WM, lenticular nucleus and thalamus more than 120 min after death. The SPM technique demonstrated typical postmortem changes on brain CT scans, and revealed that the unclear GM-WM interface on early PMCT scans is caused by a rapid decrease in cortical GM density combined with a delayed increase in WM density. SPM may be useful for assessment of whole brain postmortem changes. (orig.)

  1. A whole brain volumetric approach in overweight/obese children: Examining the association with different physical fitness components and academic performance. The ActiveBrains project.

    Science.gov (United States)

    Esteban-Cornejo, Irene; Cadenas-Sanchez, Cristina; Contreras-Rodriguez, Oren; Verdejo-Roman, Juan; Mora-Gonzalez, Jose; Migueles, Jairo H; Henriksson, Pontus; Davis, Catherine L; Verdejo-Garcia, Antonio; Catena, Andrés; Ortega, Francisco B

    2017-08-05

    Obesity, as compared to normal weight, is associated with detectable structural differences in the brain. To the best of our knowledge, no previous study has examined the association of physical fitness with gray matter volume in overweight/obese children using whole brain analyses. Thus, the aim of this study was to examine the association between the key components of physical fitness (i.e. cardiorespiratory fitness, speed-agility and muscular fitness) and brain structural volume, and to assess whether fitness-related changes in brain volumes are related to academic performance in overweight/obese children. A total of 101 overweight/obese children aged 8-11 years were recruited from Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 T S Magnetom Tim Trio system. Gray matter tissue was calculated using Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra (DARTEL). Academic performance was assessed by the Batería III Woodcock-Muñoz Tests of Achievement. All analyses were controlled for sex, peak high velocity offset, parent education, body mass index and total brain volume. The statistical threshold was calculated with AlphaSim and further Hayasaka adjusted to account for the non-isotropic smoothness of structural images. The main results showed that higher cardiorespiratory fitness was related to greater gray matter volumes (P superior temporal gyrus) with β ranging from 0.564 to 0.611. Both clusters were related to better academic performance (β ranging from 0.217 to 0.296; both P < 0.05). Muscular fitness was not independently associated with greater gray matter volume in any brain region. Furthermore, there were no statistically significant negative association between any component of physical fitness and gray matter volume in any region of the brain. In conclusion, cardiorespiratory fitness and speed-agility, but not

  2. Whole-brain gray matter volume abnormalities in patients with generalized anxiety disorder: voxel-based morphometry.

    Science.gov (United States)

    Moon, Chung-Man; Kim, Gwang-Won; Jeong, Gwang-Woo

    2014-02-12

    Patients with generalized anxiety disorder (GAD) experience psychological distress because of excessive and uncontrollable anxiety in everyday life. Only a few morphological studies have so far focused on specific brain regions of interest as well as the gray matter volume changes in GAD patients. This study evaluated gray matter volume alterations in whole-brain areas between GAD patients and healthy controls, and sex differences between the specific brain areas with significant volume changes in GAD patients using voxel-based morphometry. Twenty-two patients with GAD (13 men and nine women), who were diagnosed using the DSM-IV-TR, and 22 age-matched healthy controls (13 men and nine women) participated in this study. The high-resolution MRI data were processed using voxel-based morphometry analysis on the basis of diffeomorphic anatomical registration through an exponentiated Lie algebra algorithm in Statistical Parametric Mapping 8. There was no significant difference in the total intracranial volume between GAD patients and controls, but a significant difference was observed between sexes (Psuperior temporal gyrus compared with the controls. As for the sex comparison, female patients showed a significant increase in the volume of the dorsolateral prefrontal cortex relative to male patients. Also, the volume of the dorsolateral prefrontal cortex in female patients was correlated positively with the Hamilton Anxiety Rating Scale score (γ=0.68, P=0.04). The specific morphological variations in patient with GAD will be helpful to understand the neural mechanism associated with a symptom of GAD. Furthermore, the findings would be valuable for the diagnostic accuracy of GAD using morphometric MRI analysis.

  3. Prognostic Factors for Survival in Patients Treated With Stereotactic Radiosurgery for Recurrent Brain Metastases After Prior Whole Brain Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Caballero, Jorge A. [Stanford University School of Medicine, Stanford, CA (United States); Sneed, Penny K., E-mail: psneed@radonc.ucsf.edu [Department of Radiation Oncology, University of California, San Francisco, CA (United States); Lamborn, Kathleen R. [Department of Neurological Surgery, University of California, San Francisco, CA (United States); Ma, Lijun [Department of Radiation Oncology, University of California, San Francisco, CA (United States); Denduluri, Sandeep [Department of Radiology, Tulane School of Medicine, New Orleans, LA (United States); Nakamura, Jean L.; Barani, Igor J. [Department of Radiation Oncology, University of California, San Francisco, CA (United States); McDermott, Michael W. [Department of Radiation Oncology, University of California, San Francisco, CA (United States); Department of Neurological Surgery, University of California, San Francisco, CA (United States)

    2012-05-01

    Purpose: To evaluate prognostic factors for survival after stereotactic radiosurgery (SRS) for new, progressive, or recurrent brain metastases (BM) after prior whole brain radiotherapy (WBRT). Methods and Materials: Patients treated between 1991 and 2007 with Gamma Knife SRS for BM after prior WBRT were retrospectively reviewed. Potential prognostic factors were analyzed overall and by primary site using univariate and stepwise multivariate analyses and recursive partitioning analysis, including age, Karnofsky performance status (KPS), primary tumor control, extracranial metastases, number of BM treated, total SRS target volume, and interval from WBRT to SRS. Results: A total of 310 patients were analyzed, including 90 breast, 113 non-small-cell lung, 31 small-cell lung, 42 melanoma, and 34 miscellaneous patients. The median age was 56, KPS 80, number of BM treated 3, and interval from WBRT to SRS 8.1 months; 76% had controlled primary tumor and 60% had extracranial metastases. The median survival was 8.4 months overall and 12.0 vs. 7.9 months for single vs. multiple BM treated (p = 0.001). There was no relationship between number of BM and survival after excluding single-BM patients. On multivariate analysis, favorable prognostic factors included age <50, smaller total target volume, and longer interval from WBRT to SRS in breast cancer patients; smaller number of BM, KPS >60, and controlled primary in non-small-cell lung cancer patients; and smaller total target volume in melanoma patients. Conclusions: Among patients treated with salvage SRS for BM after prior WBRT, prognostic factors appeared to vary by primary site. Although survival time was significantly longer for patients with a single BM, the median survival time of 7.9 months for patients with multiple BM seems sufficiently long for salvage SRS to appear to be worthwhile, and no evidence was found to support the use of a cutoff for number of BM appropriate for salvage SRS.

  4. Regionally distinct responses of microglia and glial progenitor cells to whole brain irradiation in adult and aging rats.

    Science.gov (United States)

    Hua, Kun; Schindler, Matthew K; McQuail, Joseph A; Forbes, M Elizabeth; Riddle, David R

    2012-01-01

    Radiation therapy has proven efficacy for treating brain tumors and metastases. Higher doses and larger treatment fields increase the probability of eliminating neoplasms and preventing reoccurrence, but dose and field are limited by damage to normal tissues. Normal tissue injury is greatest during development and in populations of proliferating cells but also occurs in adults and older individuals and in non-proliferative cell populations. To better understand radiation-induced normal tissue injury and how it may be affected by aging, we exposed young adult, middle-aged, and old rats to 10 Gy of whole brain irradiation and assessed in gray- and white matter the responses of microglia, the primary cellular mediators of radiation-induced neuroinflammation, and oligodendrocyte precursor cells, the largest population of proliferating cells in the adult brain. We found that aging and/or irradiation caused only a few microglia to transition to the classically "activated" phenotype, e.g., enlarged cell body, few processes, and markers of phagocytosis, that is seen following more damaging neural insults. Microglial changes in response to aging and irradiation were relatively modest and three markers of reactivity - morphology, proliferation, and expression of the lysosomal marker CD68- were regulated largely independently within individual cells. Proliferation of oligodendrocyte precursors did not appear to be altered during normal aging but increased following irradiation. The impacts of irradiation and aging on both microglia and oligodendrocyte precursors were heterogeneous between white- and gray matter and among regions of gray matter, indicating that there are regional regulators of the neural response to brain irradiation. By several measures, the CA3 region of the hippocampus appeared to be differentially sensitive to effects of aging and irradiation. The changes assessed here likely contribute to injury following inflammatory challenges like brain irradiation and

  5. Regionally distinct responses of microglia and glial progenitor cells to whole brain irradiation in adult and aging rats.

    Directory of Open Access Journals (Sweden)

    Kun Hua

    Full Text Available Radiation therapy has proven efficacy for treating brain tumors and metastases. Higher doses and larger treatment fields increase the probability of eliminating neoplasms and preventing reoccurrence, but dose and field are limited by damage to normal tissues. Normal tissue injury is greatest during development and in populations of proliferating cells but also occurs in adults and older individuals and in non-proliferative cell populations. To better understand radiation-induced normal tissue injury and how it may be affected by aging, we exposed young adult, middle-aged, and old rats to 10 Gy of whole brain irradiation and assessed in gray- and white matter the responses of microglia, the primary cellular mediators of radiation-induced neuroinflammation, and oligodendrocyte precursor cells, the largest population of proliferating cells in the adult brain. We found that aging and/or irradiation caused only a few microglia to transition to the classically "activated" phenotype, e.g., enlarged cell body, few processes, and markers of phagocytosis, that is seen following more damaging neural insults. Microglial changes in response to aging and irradiation were relatively modest and three markers of reactivity - morphology, proliferation, and expression of the lysosomal marker CD68- were regulated largely independently within individual cells. Proliferation of oligodendrocyte precursors did not appear to be altered during normal aging but increased following irradiation. The impacts of irradiation and aging on both microglia and oligodendrocyte precursors were heterogeneous between white- and gray matter and among regions of gray matter, indicating that there are regional regulators of the neural response to brain irradiation. By several measures, the CA3 region of the hippocampus appeared to be differentially sensitive to effects of aging and irradiation. The changes assessed here likely contribute to injury following inflammatory challenges like

  6. Postoperative Stereotactic Radiosurgery Without Whole-Brain Radiation Therapy for Brain Metastases: Potential Role of Preoperative Tumor Size

    Energy Technology Data Exchange (ETDEWEB)

    Hartford, Alan C., E-mail: Alan.C.Hartford@Hitchcock.org [Section of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Paravati, Anthony J. [Section of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Spire, William J. [Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Li, Zhongze [Biostatistics Shared Resource, Norris Cotton Cancer Center, Lebanon, New Hampshire (United States); Jarvis, Lesley A. [Section of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Fadul, Camilo E. [Section of Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Rhodes, C. Harker [Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Erkmen, Kadir [Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Friedman, Jonathan [Department of Surgery, Texas A and M College of Medicine, College Station, Texas (United States); Gladstone, David J. [Section of Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States); Hug, Eugen B. [ProCure, New York, New York (United States); Roberts, David W.; Simmons, Nathan E. [Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (United States)

    2013-03-01

    Purpose: Radiation therapy following resection of a brain metastasis increases the probability of disease control at the surgical site. We analyzed our experience with postoperative stereotactic radiosurgery (SRS) as an alternative to whole-brain radiotherapy (WBRT), with an emphasis on identifying factors that might predict intracranial disease control and overall survival (OS). Methods and Materials: We retrospectively reviewed all patients through December 2008, who, after surgical resection, underwent SRS to the tumor bed, deferring WBRT. Multiple factors were analyzed for time to intracranial recurrence (ICR), whether local recurrence (LR) at the surgical bed or “distant” recurrence (DR) in the brain, for time to WBRT, and for OS. Results: A total of 49 lesions in 47 patients were treated with postoperative SRS. With median follow-up of 9.3 months (range, 1.1-61.4 months), local control rates at the resection cavity were 85.5% at 1 year and 66.9% at 2 years. OS rates at 1 and 2 years were 52.5% and 31.7%, respectively. On univariate analysis (preoperative) tumors larger than 3.0 cm exhibited a significantly shorter time to LR. At a cutoff of 2.0 cm, larger tumors resulted in significantly shorter times not only for LR but also for DR, ICR, and salvage WBRT. While multivariate Cox regressions showed preoperative size to be significant for times to DR, ICR, and WBRT, in similar multivariate analysis for OS, only the graded prognostic assessment proved to be significant. However, the number of intracranial metastases at presentation was not significantly associated with OS nor with other outcome variables. Conclusions: Larger tumor size was associated with shorter time to recurrence and with shorter time to salvage WBRT; however, larger tumors were not associated with decrements in OS, suggesting successful salvage. SRS to the tumor bed without WBRT is an effective treatment for resected brain metastases, achieving local control particularly for tumors up to

  7. Gamma knife radiosurgery for multiple brain metastases from non-small cell lung cancer. Comparison with whole brain radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Serizawa, Toru; Ono, Junichi [Chiba Cardiovascular Center (Japan); Iuchi, Toshihiko; Osato, Katsunobu

    2001-04-01

    The purpose of this retrospective study is to compare the effectiveness of gamma knife radiosurgery (GKS) with that of whole-brain radiation therapy (WBRT) for multiple cerebral metastases from non-small cell lung cancer. Among 302 cases with cerebral metastases from non-small cell lung cancer treated at the Chiba Cardiovascular Center and Chiba Cancer Center between 1990 and 1999, 100 consecutive patients filling the following 4 entry criteria were analyzed in this study: Up to 10 multiple brain lesions at initial MRI study; No surgically inaccessible tumors with more than 30 mm in diameter; No carcinomatous meningitis; More than 3 months of life expectancy. The patients were divided into two groups: the GKS group (66 patients) and the WBRT group (34 patients). In the GKS group, large lesions ({>=}30mm) were removed microsurgically and all other small lesions (<30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was administered according to the primary physician's protocol. The two groups did not differ in terms of age, gender, initial Karnofsky Performance Scale (KPS) score, pathology of lung caner, number, and size of brain lesion, systemic control, and chemotherapy. Overall survival (OS), neurological survival (NS) and qualitative survival (QS) of the GKS group were longer than those of the WBRT group according to Kaplan-Meier's method. In a multivariate analysis the WBRT group also had significant poor prognostic factors for OS, NS and QS. GKS without prophylactic WBRT could be a primary choice of treatment method for patients with as many as 10 cerebral metastases from non-small cell lung cancer. (author)

  8. Treatment of small cell carcinoma of lung with combined high dose mediastinal irradiation, whole brain prophylaxis and chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shank, B.; Natale, R.B.; Hilaris, B.S.; Wittes, R.E.

    1981-04-01

    Survival of patients with small cell carcinoma of lung, treated on a new combined radiotherapy-chemotherapy protocol, compares favorably with other regimens in the literature and our own previous combined approaches. Radiation, given after induction chemotherapy, consisted of whole brain prophylaxis in all 44 evaluable patients. Patients with limited disease were also treated to the primary and mediastinum to a high dose (5000 rad equivalent) using multiple fields. The new chemotherapy regimen consisted of induction with cyclophosphamide, doxorubicin, and vincristine alternated with cis-platinum and VP-16 (an epipodophyllotoxin) for two cycles, followed by consolidation with low dose cyclophosphamide and vincristine concurrent with irradiation. Patients with limited disease who achieved less than complete response, and all patients with extensive disease were not continued on maintenance chemotherapy. Out of 24 evaluable patients with limited disease, there was 73% survival at 1 year by life-table analysis, measured from treatment initiation. After induction, 16/24 of these limited disease patients were CR (complete responders): 20/24 were CR at completion of their irradiation. Out of 20 evaluable patients with extensive disease, there was 59% survival at 1 year by life-table analysis. Only 4/44 (9%) brain parenchymal relapses occurred, one at 3 months and one at 6 months after local failure and two in patients who did not become CRs, implicating a possible re-seeding mechanism. Five patients had central nervous system relapses outside of brain parenchyma (spinal epidural and leptomeningeal); in three patients this was the initial site of failure. Significant complications included leukopenia (50%) and thrombocytopenia (24%) primarily during induction, and chronic pulmonary fibrosis (25%), possibly contributing to two deaths.

  9. Whole brain radiotherapy in management of non-small-cell lung carcinoma associated leptomeningeal carcinomatosis: evaluation of prognostic factors.

    Science.gov (United States)

    Ozdemir, Yurday; Yildirim, Berna Akkus; Topkan, Erkan

    2016-09-01

    To assess the efficacy of whole-brain radiotherapy (WBRT) and prognostic factors in leptomeningeal carcinomatosis (LMC) of non-small-cell lung cancer (NSCLC) patients. WBRT records of 51 LMC patients confined to brain were reviewed. Eligible patients had squamous-cell carcinoma (SCC) or adenocarcinoma, and Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-3. The WBRT was either 20 or 30 Gray. The primary and secondary objectives were to determine overall survival (OS) and prognostic factors for improved treatment response, respectively. Median age was 53 years (range 39-68), 58.8 % had SCC, 74.5 % had ECOG PS 1-2, and 70.6 % had LMC accompanied by parenchymal brain metastases (BM). The median follow-up was 4.1 months (range 0.7-14.4); all patients died due to disease progression. Median OS was 3.9 months (95 % CI 3.3-4.5) with 6 and 12 month estimates of 19.6 and 5.9 %, respectively. Evaluation of prognostic factors revealed that patients with ECOG 1, longer time to LMC (TT-LMC) from NSCLC diagnosis (>11.3 months), and absence of parenchymal BM had significantly superior OS than those patients with ECOG 2 (p = 0.01) or 3 (p  11.3 months, and no BM as independent prognosticators for better response to WBRT in NSCLC patients with LMC.

  10. Whole-brain structural connectivity in dyskinetic cerebral palsy and its association with motor and cognitive function.

    Science.gov (United States)

    Ballester-Plané, Júlia; Schmidt, Ruben; Laporta-Hoyos, Olga; Junqué, Carme; Vázquez, Élida; Delgado, Ignacio; Zubiaurre-Elorza, Leire; Macaya, Alfons; Póo, Pilar; Toro, Esther; de Reus, Marcel A; van den Heuvel, Martijn P; Pueyo, Roser

    2017-09-01

    Dyskinetic cerebral palsy (CP) has long been associated with basal ganglia and thalamus lesions. Recent evidence further points at white matter (WM) damage. This study aims to identify altered WM pathways in dyskinetic CP from a standardized, connectome-based approach, and to assess structure-function relationship in WM pathways for clinical outcomes. Individual connectome maps of 25 subjects with dyskinetic CP and 24 healthy controls were obtained combining a structural parcellation scheme with whole-brain deterministic tractography. Graph theoretical metrics and the network-based statistic were applied to compare groups and to correlate WM state with motor and cognitive performance. Results showed a widespread reduction of WM volume in CP subjects compared to controls and a more localized decrease in degree (number of links per node) and fractional anisotropy (FA), comprising parieto-occipital regions and the hippocampus. However, supramarginal gyrus showed a significantly higher degree. At the network level, CP subjects showed a bilateral pathway with reduced FA, comprising sensorimotor, intraparietal and fronto-parietal connections. Gross and fine motor functions correlated with FA in a pathway comprising the sensorimotor system, but gross motor also correlated with prefrontal, temporal and occipital connections. Intelligence correlated with FA in a network with fronto-striatal and parieto-frontal connections, and visuoperception was related to right occipital connections. These findings demonstrate a disruption in structural brain connectivity in dyskinetic CP, revealing general involvement of posterior brain regions with relative preservation of prefrontal areas. We identified pathways in which WM integrity is related to clinical features, including but not limited to the sensorimotor system. Hum Brain Mapp 38:4594-4612, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Voluntary running prevents progressive memory decline and increases adult hippocampal neurogenesis and growth factor expression after whole-brain irradiation.

    Science.gov (United States)

    Wong-Goodrich, Sarah J E; Pfau, Madeline L; Flores, Catherine T; Fraser, Jennifer A; Williams, Christina L; Jones, Lee W

    2010-11-15

    Whole-brain irradiation (WBI) therapy produces progressive learning and memory deficits in patients with primary or secondary brain tumors. Exercise enhances memory and adult hippocampal neurogenesis in the intact brain, so we hypothesized that exercise may be an effective treatment to alleviate consequences of WBI. Previous studies using animal models to address this issue have yielded mixed results and have not examined potential molecular mechanisms. We investigated the short- and long-term effects of WBI on spatial learning and memory retention and determined whether voluntary running after WBI aids recovery of brain and cognitive function. Forty adult female C57Bl/6 mice given a single dose of 5 Gy or sham WBI were trained 2.5 weeks and up to 4 months after WBI in a Barnes maze. Half of the mice received daily voluntary wheel access starting 1 month after sham or WBI. Daily running following WBI prevented the marked decline in spatial memory retention observed months after irradiation. Bromodeoxyuridine (BrdUrd) immunolabeling and enzyme-linked immunosorbent assay indicated that this behavioral rescue was accompanied by a partial restoration of newborn BrdUrd+/NeuN+ neurons in the dentate gyrus and increased hippocampal expression of brain-derived vascular endothelial growth factor and insulin-like growth factor-1, and occurred despite irradiation-induced elevations in hippocampal proinflammatory cytokines. WBI in adult mice produced a progressive memory decline consistent with what has been reported in cancer patients receiving WBI therapy. Our findings show that running can abrogate this memory decline and aid recovery of adult hippocampal plasticity, thus highlighting exercise as a potential therapeutic intervention.

  12. Repeat Courses of Stereotactic Radiosurgery (SRS), Deferring Whole-Brain Irradiation, for New Brain Metastases After Initial SRS

    Energy Technology Data Exchange (ETDEWEB)

    Shultz, David B.; Modlin, Leslie A.; Jayachandran, Priya; Von Eyben, Rie; Gibbs, Iris C. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Choi, Clara Y.H. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Department of Radiation Oncology, Santa Clara Valley Medical Center, San Jose, California (United States); Chang, Steven D.; Harsh, Griffith R.; Li, Gordon; Adler, John R. [Department of Neurosurgery, Stanford University School of Medicine, Stanford, California (United States); Hancock, Steven L. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Soltys, Scott G., E-mail: sgsoltys@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States)

    2015-08-01

    Purpose: To report the outcomes of repeat stereotactic radiosurgery (SRS), deferring whole-brain radiation therapy (WBRT), for distant intracranial recurrences and identify factors associated with prolonged overall survival (OS). Patients and Methods: We retrospectively identified 652 metastases in 95 patients treated with 2 or more courses of SRS for brain metastases, deferring WBRT. Cox regression analyzed factors predictive for OS. Results: Patients had a median of 2 metastases (range, 1-14) treated per course, with a median of 2 courses (range, 2-14) of SRS per patient. With a median follow-up after first SRS of 15 months (range, 3-98 months), the median OS from the time of the first and second course of SRS was 18 (95% confidence interval [CI] 15-24) and 11 months (95% CI 6-17), respectively. On multivariate analysis, histology, graded prognostic assessment score, aggregate tumor volume (but not number of metastases), and performance status correlated with OS. The 1-year cumulative incidence, with death as a competing risk, of local failure was 5% (95% CI 4-8%). Eighteen (24%) of 75 deaths were from neurologic causes. Nineteen patients (20%) eventually received WBRT. Adverse radiation events developed in 2% of SRS sites. Conclusion: Multiple courses of SRS, deferring WBRT, for distant brain metastases after initial SRS, seem to be a safe and effective approach. The graded prognostic assessment score, updated at each course, and aggregate tumor volume may help select patients in whom the deferral of WBRT might be most beneficial.

  13. Diagnostic performance of whole brain volume perfusion CT in intra-axial brain tumors: Preoperative classification accuracy and histopathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Xyda, Argyro, E-mail: argyro.xyda@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Department of Radialogy, University Hospital of Heraklion, Voutes, 71110 Heraklion, Crete (Greece); Haberland, Ulrike, E-mail: ulrike.haberland@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Klotz, Ernst, E-mail: ernst.klotz@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Jung, Klaus, E-mail: kjung1@uni-goettingen.de [Department of Medical Statistics, Georg-August University, Humboldtallee 32, 37073 Goettingen (Germany); Bock, Hans Christoph, E-mail: cbock@gmx.de [Department of Neurosurgery, Johannes Gutenberg University Hospital of Mainz, Langenbeckstraße 1, 55101 Mainz (Germany); Schramm, Ramona, E-mail: ramona.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Knauth, Michael, E-mail: michael.knauth@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Schramm, Peter, E-mail: p.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany)

    2012-12-15

    Background: To evaluate the preoperative diagnostic power and classification accuracy of perfusion parameters derived from whole brain volume perfusion CT (VPCT) in patients with cerebral tumors. Methods: Sixty-three patients (31 male, 32 female; mean age 55.6 ± 13.9 years), with MRI findings suspected of cerebral lesions, underwent VPCT. Two readers independently evaluated VPCT data. Volumes of interest (VOIs) were marked circumscript around the tumor according to maximum intensity projection volumes, and then mapped automatically onto the cerebral blood volume (CBV), flow (CBF) and permeability Ktrans perfusion datasets. A second VOI was placed in the contra lateral cortex, as control. Correlations among perfusion values, tumor grade, cerebral hemisphere and VOIs were evaluated. Moreover, the diagnostic power of VPCT parameters, by means of positive and negative predictive value, was analyzed. Results: Our cohort included 32 high-grade gliomas WHO III/IV, 18 low-grade I/II, 6 primary cerebral lymphomas, 4 metastases and 3 tumor-like lesions. Ktrans demonstrated the highest sensitivity, specificity and positive predictive value, with a cut-off point of 2.21 mL/100 mL/min, for both the comparisons between high-grade versus low-grade and low-grade versus primary cerebral lymphomas. However, for the differentiation between high-grade and primary cerebral lymphomas, CBF and CBV proved to have 100% specificity and 100% positive predictive value, identifying preoperatively all the histopathologically proven high-grade gliomas. Conclusion: Volumetric perfusion data enable the hemodynamic assessment of the entire tumor extent and provide a method of preoperative differentiation among intra-axial cerebral tumors with promising diagnostic accuracy.

  14. Survival and level of care among breast cancer patients with brain metastases treated with whole brain radiotherapy.

    Science.gov (United States)

    Frisk, Gabriella; Tinge, Beatrice; Ekberg, Sara; Eloranta, Sandra; Bäcklund, L Magnus; Lidbrink, Elisabet; Smedby, Karin E

    2017-08-22

    The benefit of whole brain radiotherapy (WBRT) for late stage breast cancer patients with brain metastases has been questioned. In this study we evaluated survival and level of care (hospital or home) following WBRT in a population-based cohort by personal and tumor characteristics. We identified 241 consecutive patients with breast cancer and brain metastases receiving WBRT in Stockholm, Sweden, 1999-2012. Through review of medical records, we collected data on prognostic determinants including level of care before and after WBRT. Survival was estimated using Cox regression, and odds ratios (OR) of not coming home using logistic regression. Median age at WBRT was 58 years (range 30---88 years). Most patients (n = 212, 88%) were treated with 4 Gray × 5. Median survival following WBRT was 2.9 months (interquartile range 1.1-6.6 months), and 57 patients (24%) were never discharged from hospital. Poor performance status and triple-negative tumors were associated with short survival (WHO 3-4 median survival 0.9 months, HR = 5.96 (3.88-9.17) versus WHO 0-1; triple-negative tumors median survival 2.0 months, HR = 1.87 (1.23-2.84) versus Luminal A). Poor performance status and being hospitalized before WBRT were associated with increased ORs of not coming home whereas cohabitation with children at home was protective. Survival was short following WBRT, and one in four breast cancer patients with brain metastases could never be discharged from hospital. When deciding about WBRT, WHO score, level of care before WBRT, and the patient's choice of level of care in the end-of-life period should be considered.

  15. Clinical Features of Brain Metastases in Small Cell Lung Cancer: an Implication for Hippocampal Sparing Whole Brain Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Wen-Long Guo

    2017-02-01

    Full Text Available PURPOSE: To assess the clinical features and distribution of brain metastases (BMs of small cell lung cancer (SCLC in the hippocampal and perihippocampal region, with the purpose of exploring the viability of hippocampal-sparing whole-brain radiation therapy (HS-WBRT on reducing neurocognitive deficits. METHODS: This was a retrospective analysis of the clinical characteristics and patterns of BMs in patients with SCLC. Associations between the clinical characteristics and hippocampal metastases (HMs/perihippocampal metastases (PHMs were evaluated in univariate and multivariate regression analyses. RESULTS: A total of 1594 brain metastatic lesions were identified in 180 patients. Thirty-two (17.8% patients were diagnosed with BMs at the time of primary SCLC diagnosis. The median interval between diagnosis of primary SCLC and BMs was 9.3 months. There were 9 (5.0% and 22 (12.2% patients with HMs and PHMs (patients with BMs located in or within 5 mm around the hippocampus, respectively. In the univariate and multivariate analysis, the number of BMs was the risk factor for HMs and PHMs. Patients with BMs ≥ 5 had significantly higher risk of HMs (odds ratio [OR] 7.892, 95% confidence interval [CI] 1.469-42.404, P = .016, and patients with BMs ≥ 7 had significantly higher risk of PHMs (OR 5.162, 95% CI 2.017-13.213, P = .001. Patients with extracranial metastases are also associated with HMs. CONCLUSIONS: Our results indicate that patients with nonoligometastatic disease are significantly associated with HMs and PHMs. The incidence of PHMs may be acceptably low enough to perform HS-WBRT for SCLC. Our findings provide valuable clinical data to assess the benefit of HS-WBRT in SCLC patients with BMs.

  16. Alteration of Selected Neurotrophic Factors and their Receptor Expression in Mouse Brain Response to Whole-Brain Irradiation.

    Science.gov (United States)

    Pius-Sadowska, Ewa; Kawa, Miłosz Piotr; Kłos, Patrycja; Rogińska, Dorota; Rudnicki, Michał; Boehlke, Marek; Waloszczyk, Piotr; Machaliński, Bogusław

    2016-11-01

    Ionizing radiation can significantly affect brain function in children and young adults, particularly in the hippocampus where neurogenic niches are located. Injury to normal tissue is a major concern when whole-brain irradiation (WBI) is used to treat central nervous system (CNS) tumors, and the pathogenesis of this injury remains poorly understood. We assessed the expression of selected neurotrophins (NTs) and NT receptors (NTRs) in brains of young mice after a single 10 Gy gamma-ray exposure using morphological and molecular analyses [qRT-PCR, Western blot, immunohistochemistry (IHC)] to evaluate WBI-induced injury in its acute phase. Activity of the NT-NTR axes was examined by analysis of ERK and Akt phosphorylation. Using Nissl staining of hippocampus slices to visualize morphological changes, and TUNEL assay and active caspase-3 detection to assess apoptotic cell death, we found evidence of apoptosis and degenerative changes in hippocampal tissue after WBI. Shortly after WBI, we also observed significant overexpression of several NTs (BDNF, NT-3, NGF and GDNF) and NTRs (TrkA, TrkB, TrkC, GFRα-1, and p75NTR) compared to control animals. The upregulated NT and NTR proteins, in part, originated from two analyzed neurogenic areas: the subgranular zone of the hippocampal dentate gyrus and the subventricular zone, as confirmed by IHC. Finally, components of intracellular signaling pathways, including Akt and MAPK, were activated in acute phase after WBI. Given the role of NTs in diverse biological mechanisms, including maintenance and growth of neurons in the adult brain, our findings of altered expression of neurotrophins and their receptors in brain tissue shortly after irradiation suggest that these molecules play a vital role in the pathophysiology of the acute phase of WBI-induced injury.

  17. Bilateral mesial temporal sclerosis: MRI with high-resolution fast spin-echo and fluid-attenuated inversion-recovery sequences

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheim, C.; Dormont, D.; Lehericy, S.; Marsault, C. [Dept. of Neuroradiology, Groupe Hospitalier Pite-Salpetriere, Paris (France); Hasboun, D. [Dept. of Neuroradiology, Groupe Hospitalier Pite-Salpetriere, Paris (France)]|[Dept. of Neurology, Paris VI Univ. (France); Bazin, B.; Samson, S.; Baulac, M. [Dept. of Neurology, Paris VI Univ. (France)

    1999-07-01

    We report a retrospective analysis of MRI in 206 patients with intractable seizures and describe the findings in bilateral mesial temporal sclerosis (MTS) on fast spin-echo (FSE) and fast fluid-attenuated inversion-recovery (fFLAIR) sequences. Criteria for MTS were atrophy, signal change and loss of the digitations of the head of the hippocampus. In patients with bilateral MRI signs of MTS, correlation with clinical electro, volumetric MRI data and neuropsychological tests, when available, was performed. Bilateral MTS was observed in seven patients. Bilateral loss of the digitations and signal change of fFLAIR was seen in all seven. In three, bilateral atrophy was obvious. In two patients, mild bilateral atrophy was observed and in two others, the hippocampi were: asymmetrical, with obvious atrophy on only one side. Volumetric data confirmed bilateral symmetrical atrophy in five patients, and volumes were at the lowest of the normal range in other two. The EEG showed temporal abnormalities in all patients, unilateral in five and bilateral in two. All patients had memory impairment and neuropsychological data confirmed visual and verbal memory deficits; two patients failed the Wada test on both sides. High-resolution T2-weighted FSE and fFLAIR sequences allow diagnosis of bilateral MTS, which has important therapeutic and prognostic implications. (orig.)

  18. A Phase I Study of Short-Course Accelerated Whole Brain Radiation Therapy for Multiple Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Caravatta, Luciana; Deodato, Francesco; Ferro, Marica [Department of Radiation Oncology, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Macchia, Gabriella, E-mail: gmacchia@rm.unicatt.it [Department of Radiation Oncology, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Massaccesi, Mariangela [Department of Radiation Oncology, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Cilla, Savino [Medical Physics Unit, Fondazione di Ricerca e Cura ' Giovanni Paolo II,' Universita Cattolica del S. Cuore, Campobasso (Italy); Padula, Gilbert D.A. [Department of Radiation Oncology, The Lacks Cancer Center Saint Mary' s Health Care, Grand Rapids, Michigan (United States); Mignogna, Samantha; Tambaro, Rosa [Department of Palliative Therapies, Fondazione di Ricerca e Cura ' Giovanni Paolo II' , Universita Cattolica del S. Cuore, Campobasso (Italy); Carrozza, Francesco [Department of Oncology, A. Cardarelli Hospital, Campobasso (Italy); Flocco, Mariano [Madre Teresa di Calcutta Hospice, Larino (Italy); Cantore, Giampaolo [Department of Neurological Sciences, Istituto Neurologico Mediterraneo Neuromed, Istituto di Ricovero e Cura a Carattere Scientifico, Pozzilli (Italy); Scapati, Andrea [Department of Radiation Oncology, ' San Francesco' Hospital, Nuoro (Italy); Buwenge, Milly [Department of Radiotherapy, Mulago Hospital, Kampala (Uganda); and others

    2012-11-15

    Purpose: To define the maximum tolerated dose (MTD) of a SHort-course Accelerated whole brain RadiatiON therapy (SHARON) in the treatment of patients with multiple brain metastases. Methods and Materials: A phase 1 trial in 4 dose-escalation steps was designed: 12 Gy (3 Gy per fraction), 14 Gy (3.5 Gy per fraction), 16 Gy (4 Gy per fraction), and 18 Gy (4.5 Gy per fraction). Eligibility criteria included patients with unfavorable recursive partitioning analysis (RPA) class > or =2 with at least 3 brain metastases or metastatic disease in more than 3 organ systems, and Eastern Cooperative Oncology Group (ECOG) performance status {<=}3. Treatment was delivered in 2 days with twice-daily fractionation. Patients were treated in cohorts of 6-12 to define the MTD. The dose-limiting toxicity (DLT) was defined as any acute toxicity {>=}grade 3, according to the Radiation Therapy Oncology Group scale. Information on the status of the main neurologic symptoms and quality of life were recorded. Results: Characteristics of the 49 enrolled patients were as follows: male/female, 30/19; median age, 66 years (range, 23-83 years). ECOG performance status was <3 in 46 patients (94%). Fourteen patients (29%) were considered to be in recursive partitioning analysis (RPA) class 3. Grade 1-2 acute neurologic (26.4%) and skin (18.3%) toxicities were recorded. Only 1 patient experienced DLT (neurologic grade 3 acute toxicity). With a median follow-up time of 5 months (range, 1-23 months), no late toxicities have been observed. Three weeks after treatment, 16 of 21 symptomatic patients showed an improvement or resolution of presenting symptoms (overall symptom response rate, 76.2%; confidence interval 0.95: 60.3-95.9%). Conclusions: Short-course accelerated radiation therapy in twice-daily fractions for 2 consecutive days is tolerated up to a total dose of 18 Gy. A phase 2 study has been planned to evaluate the efficacy on overall survival, symptom control, and quality of life indices.

  19. Patients with brain metastases from gastrointestinal tract cancer treated with whole brain radiation therapy:Prognostic factors and survival

    Institute of Scientific and Technical Information of China (English)

    Susanne Bartelt; Felix Momm; Christian Weissenberger; Johannes Lutterbach

    2004-01-01

    AIM: To identify the prognostic factors with regard to survival for patients with brain metastasis from primary tumors of the gastrointestinal tract.METHODS: Nine hundred and sixteen patients with brain metastases, treated with whole brain radiation therapy (WBRT) between January 1985 and December 2000 at the Department of Radiation Oncology, University Hospital Freiburg, were analyzed retrospectively.RESULTS: Fifty-seven patients presented with a primary tumor of the gastrointestinal tract (esophagus: n = 0, stomach:n = 10, colorectal: n = 47). Twenty-six patients had a solitary brain metastasis, 31 patients presented with multiple brain metastases. Surgical resection was performed in 25 patients.WBRTwas applied with daily fractions of 2 Gray (Gy) or 3 Gy to a total dose of 50 Gy or 30 Gy, respectively. The interval between diagnoses of the primary tumors and brain metastases was 22.6 mo vs8.0 mo for patients with primary tumors of the colon/rectum vs other primary tumors,respectively (P<0.01, log-rank). Median overall survival for all patients with brain metastases (n = 916) was 3.4 mo and 3.2 mo for patients with gastrointestinal neoplasms.Patients with gastrointestinal primary tumors presented significantly more often with a solitary brain metastasis than patients with other primary tumors (P<0.05, log-rank). In patients with gastrointestinal neoplasms (n = 57), the median overall survival was 5.8 mo for patients with solitary brain metastasis vs 2.7 mo for patients with multiple brain metastases (P<0.01, log-rank). The median overall survival for patients with a Karnofsky performance status (KPS) ≥70was 5.5 mo vs2.1 mo for patients with KPS <70 (P<0.01,log-rank). At multivariate analysis (Cox Model) the performance status and the number of brain metastases were identified as independent prognostic factors for overall survival.CONCLUSION: Brain metastases occur late in the course of gastrointestinal tumors. Pretherapeutic variables like KPS and the

  20. Whole brain radiotherapy after local treatment of brain metastases in melanoma patients - a randomised phase III trial

    Directory of Open Access Journals (Sweden)

    Forder Peta M

    2011-04-01

    Full Text Available Abstract Background Cerebral metastases are a common cause of death in patients with melanoma. Systemic drug treatment of these metastases is rarely effective, and where possible surgical resection and/or stereotactic radiosurgery (SRS are the preferred treatment options. Treatment with adjuvant whole brain radiotherapy (WBRT following neurosurgery and/or SRS is controversial. Proponents of WBRT report prolongation of intracranial control with reduced neurological events and better palliation. Opponents state melanoma is radioresistant; that WBRT yields no survival benefit and may impair neurocognitive function. These opinions are based largely on studies in other tumour types in which assessment of neurocognitive function has been incomplete. Methods/Design This trial is an international, prospective multi-centre, open-label, phase III randomised controlled trial comparing WBRT to observation following local treatment of intracranial melanoma metastases with surgery and/or SRS. Patients aged 18 years or older with 1-3 brain metastases excised and/or stereotactically irradiated and an ECOG status of 0-2 are eligible. Patients with leptomeningeal disease, or who have had previous WBRT or localised treatment for brain metastases are ineligible. WBRT prescription is at least 30 Gy in 10 fractions commenced within 8 weeks of surgery and/or SRS. Randomisation is stratified by the number of cerebral metastases, presence or absence of extracranial disease, treatment centre, sex, radiotherapy dose and patient age. The primary endpoint is the proportion of patients with distant intracranial failure as determined by MRI assessment at 12 months. Secondary end points include: survival, quality of life, performance status and neurocognitive function. Discussion Accrual to previous trials for patients with brain metastases has been difficult, mainly due to referral bias for or against WBRT. This trial should provide the evidence that is currently lacking in

  1. Deep neural network with weight sparsity control and pre-training extracts hierarchical features and enhances classification performance: Evidence from whole-brain resting-state functional connectivity patterns of schizophrenia.

    Science.gov (United States)

    Kim, Junghoe; Calhoun, Vince D; Shim, Eunsoo; Lee, Jong-Hwan

    2016-01-01

    Functional connectivity (FC) patterns obtained from resting-state functional magnetic resonance imaging data are commonly employed to study neuropsychiatric conditions by using pattern classifiers such as the support vector machine (SVM). Meanwhile, a deep neural network (DNN) with multiple hidden layers has shown its ability to systematically extract lower-to-higher level information of image and speech data from lower-to-higher hidden layers, markedly enhancing classification accuracy. The objective of this study was to adopt the DNN for whole-brain resting-state FC pattern classification of schizophrenia (SZ) patients vs. healthy controls (HCs) and identification of aberrant FC patterns associated with SZ. We hypothesized that the lower-to-higher level features learned via the DNN would significantly enhance the classification accuracy, and proposed an adaptive learning algorithm to explicitly control the weight sparsity in each hidden layer via L1-norm regularization. Furthermore, the weights were initialized via stacked autoencoder based pre-training to further improve the classification performance. Classification accuracy was systematically evaluated as a function of (1) the number of hidden layers/nodes, (2) the use of L1-norm regularization, (3) the use of the pre-training, (4) the use of framewise displacement (FD) removal, and (5) the use of anatomical/functional parcellation. Using FC patterns from anatomically parcellated regions without FD removal, an error rate of 14.2% was achieved by employing three hidden layers and 50 hidden nodes with both L1-norm regularization and pre-training, which was substantially lower than the error rate from the SVM (22.3%). Moreover, the trained DNN weights (i.e., the learned features) were found to represent the hierarchical organization of aberrant FC patterns in SZ compared with HC. Specifically, pairs of nodes extracted from the lower hidden layer represented sparse FC patterns implicated in SZ, which was

  2. Whole brain irradiation with hippocampal sparing and dose escalation on multiple brain metastases. Local tumour control and survival

    Energy Technology Data Exchange (ETDEWEB)

    Oehlke, Oliver; Wucherpfennig, David; Prokic, Vesna [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); Fels, Franziska [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); St. Josefs Hospital, Department of Radiation Oncology, Offenburg (Germany); Frings, Lars [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); University Hospital Freiburg, Department of Geriatrics and Gerontology, Freiburg (Germany); University Medical Center Freiburg, Department of Nuclear Medicine, Freiburg (Germany); Egger, Karl [University Medical Center Freiburg, Department of Neuroradiology, Freiburg (Germany); Weyerbrock, Astrid [University Medical Center Freiburg, Department of Neurosurgery, Freiburg (Germany); Nieder, Carsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Grosu, Anca-Ligia [University Medical Center Freiburg, Department of Radiation Oncology, Freiburg (Germany); German Cancer Consortium (DKTK), Freiburg (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany)

    2015-01-16

    Hippocampal-avoidance whole brain radiotherapy (HA-WBRT) for multiple brain metastases may prevent treatment-related cognitive decline, compared to standard WBRT. Additionally, simultaneous integrated boost (SIB) on individual metastases may further improve the outcome. Here, we present initial data concerning local tumour control (LTC), intracranial progression-free survival (PFS), overall survival (OS), toxicity and safety for this new irradiation technique. Twenty patients, enrolled between 2011 and 2013, were treated with HA-WBRT (30 Gy in 12 fractions, D{sub 98} {sub %} to hippocampus ≤ 9 Gy) and a SIB (51 Gy) on multiple (2-13) metastases using a volumetric modulated arc therapy (VMAT) approach based on 2-4 arcs. Metastases were evaluated bidimensionally along the two largest diameters in contrast-enhanced three-dimensional T1-weighed MRI. Median follow-up was 40 weeks. The median time to progression of boosted metastases has not been reached yet, corresponding to a LTC rate of 73 %. Median intracranial PFS was 40 weeks, corresponding to a 1-year PFS of 45.3 %. Median OS was 71.5 weeks, corresponding to a 1-year OS of 60 %. No obvious acute or late toxicities grade > 2 (NCI CTCAE v4.03) were observed. D{sub mean} to the bilateral hippocampi was 6.585 Gy ± 0.847 (α/β = 2 Gy). Two patients developed a new metastasis in the area of hippocampal avoidance. HA-WBRT (simultaneous integrated protection, SIP) with SIB to metastases is a safe and tolerable regime that shows favorable LTC for patients with multiple brain metastases, while it has the potential to minimize the side-effect of cognitive deterioration. (orig.) [German] Die Hippocampus-schonende Ganzhirnbestrahlung (HS-GHB) kann im Vergleich zur Standard-GHB die Verschlechterung der neurokognitiven Funktion verhindern. Zusaetzlich vermag ein simultan integrierter Boost (SIB) auf die Metastasen die Prognose der betroffenen Patienten weiter zu verbessern. In dieser Studie praesentieren wir erste Ergebnisse

  3. Outcome and prognostic factors in patients with brain metastases from small-cell lung cancer treated with whole brain radiotherapy.

    Science.gov (United States)

    Bernhardt, Denise; Adeberg, Sebastian; Bozorgmehr, Farastuk; Opfermann, Nils; Hoerner-Rieber, Juliane; König, Laila; Kappes, Jutta; Thomas, Michael; Herth, Felix; Heußel, Claus Peter; Warth, Arne; Debus, Jürgen; Steins, Martin; Rieken, Stefan

    2017-08-01

    The purpose of this study was to evaluate prognostic factors associated with overall survival (OS) and neurological progression free survival (nPFS) in small-cell lung cancer (SCLC) patients with brain metastases who received whole-brain radiotherapy (WBRT). From 2003 to 2015, 229 SCLC patients diagnosed with brain metastases who received WBRT were analyzed retrospectively. In this cohort 219 patients (95%) received a total photon dose of 30 Gy in 10 fractions. The prognostic factors evaluated for OS and nPFS were: age, Karnofsky Performance Status (KPS), number of brain metastases, synchronous versus metachronous disease, initial response to chemotherapy, the Radiation Therapy Oncology Group recursive partitioning analysis (RPA) class and thoracic radiation. Median OS after WBRT was 6 months and the median nPFS after WBRT was 11 months. Patients with synchronous cerebral metastases had a significantly better median OS with 8 months compared to patients with metachronous metastases with a median survival of 3 months (p < 0.0001; HR 0.46; 95% CI 0.31-0.67). Based on RPA classification median survival after WBRT was 17 months in RPA class I, 7 months in class II and 3 months in class III (p < 0.0001). Karnofsky performance status scale (KPS < 70%) was significantly associated with OS in both univariate (HR 2.84; p < 0.001) and multivariate analyses (HR 2.56; p = 0.011). Further, metachronous brain metastases (HR 1.8; p < 0.001), initial response to first-line chemotherapy (HR 0.51, p < 0.001) and RPA class III (HR 2.74; p < 0.001) were significantly associated with OS in univariate analysis. In multivariate analysis metachronous disease (HR 1.89; p < 0.001) and initial response to chemotherapy (HR 0.61; p < 0.001) were further identified as significant prognostic factors. NPFS was negatively significantly influenced by poor KPS (HR 2.56; p = 0.011), higher number of brain metastases (HR 1.97; p = 0.02), and

  4. Comparison of whole brain radiation therapy and locally limited radiation therapy in the treatment of solitary brain metastases from non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ueki, Keisuke; Matsutani, Masao; Nakamura, Osamu; Tanaka, Yoshiaki [Tokyo Metropolitan Komagome Hospital (Japan)

    1996-06-01

    The benefit and risk of whole brain radiation therapy (WBRT) compared to locally limited radiation therapy was assessed in 61 patients with solitary brain metastases from non-small cell lung cancer without an unresectable active primary lesion or systemic dissemination in the other organs. Twenty-three patients received local irradiation (Group A), and 38 patients received whole brain irradiation with or without local irradiation (Group B). The survival was significantly better in Group A than in Group B (p<0.05), with median survivals of 83.1 and 30.7 weeks, respectively. One-year local recurrence rates were 7% in Group A and 21% in Group B, but the difference was not statistically significant. The 1-year distant recurrence rate was similar at 18%. Radiation-induced dementia occurred in two patients in Group A (8.7%) and seven in Group B (18.4%), but was not statistically significant (p=0.30). There is no obvious benefit and possible disadvantages of WBRT compared to local irradiation for the population of patients investigated in this study. Intraoperative radiation therapy or stereotactic radiosurgery without WBRT should be considered in the patients with solitary brain metastases. (author)

  5. Report of whole-brain radiation therapy in a patient with an implanted deep brain stimulator: important neurosurgical considerations and radiotherapy practice principles.

    Science.gov (United States)

    Kotecha, Rupesh; Berriochoa, Camille A; Murphy, Erin S; Machado, Andre G; Chao, Samuel T; Suh, John H; Stephans, Kevin L

    2016-04-01

    Patients with implanted neuromodulation devices present potential challenges for radiation therapy treatment planning and delivery. Although guidelines exist regarding the irradiation of cardiac pacemakers and defibrillators, fewer data and less clinical experience exist regarding the effects of radiation therapy on less frequently used devices, such as deep brain stimulators. A 79-year-old woman with a history of coarse tremors effectively managed with deep brain stimulation presented with multiple intracranial metastases from a newly diagnosed lung cancer and was referred for whole-brain radiation therapy. She was treated with a German helmet technique to a total dose of 30 Gy in 10 fractions using 6 MV photons via opposed lateral fields with the neurostimulator turned off prior to delivery of each fraction. The patient tolerated the treatment well with no acute complications and no apparent change in the functionality of her neurostimulator device or effect on her underlying neuromuscular disorder. This represents the first reported case of the safe delivery of whole-brain radiation therapy in a patient with an implanted neurostimulator device. In cases such as this, neurosurgeons and radiation oncologists should have discussions with patients about the risks of brain injury, device malfunction or failure of the device, and plans for rigorous testing of the device before and after radiation therapy.

  6. Unusual acute and delayed skin reactions during and after whole-brain radiotherapy in combination with the BRAF inhibitor vemurafenib. Two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, B.; Roedel, C.; Weiss, C. [Johann Wolfgang Goethe-University Hospital, Department of Radiation Oncology, Frankfurt am Main (Germany); Meissner, M.; Wolter, M. [Johann Wolfgang Goethe-University Hospital, Department of Dermatology, Frankfurt am Main (Germany)

    2014-02-15

    Besides radiotherapy (RT) and surgery, the introduction of BRAF inhibitors like vemurafenib has provided new opportunities for treatment of patients with metastasized malignant melanomas. RT and vemurafenib are being increasingly used concurrently, although little is known about the potential side effects of this combination. Vemurafenib is known to cause severe cutaneous skin reactions such as phototoxicity and evidence is accumulating that RT may further enhance these side effects. We report two cases of unusual skin reactions occurring during and after treatment with a combination of vemurafenib and whole-brain irradiation in patients with cerebral metastases arising from malignant melanomas. One case report describes excessive acute radiodermatitis which arose during whole-brain irradiation in combination with vemurafenib. The second describes a late skin reaction occurring approximately 30 days after completion of RT. These two case reports show that combination of both treatment modalities is possible, but requires close monitoring of patients and good interdisciplinary collaboration. (orig.) [German] Neben der Strahlentherapie und Chirurgie stellt die Einfuehrung von BRAF-Inhibitoren wie Vemurafenib eine neue Moeglichkeit zur Behandlung von metastasierten malignen Melanomen dar und immer haeufiger kommt eine Kombination aus Strahlentherapie und Vemurafenib zum Einsatz. Bislang ist wenig bekannt ueber potentielle Nebenwirkungen, die sich aus einer Kombination beider Therapieoptionen ergeben koennen. Vemurafenib kann zu schweren kutanen Nebenwirkungen wie z. B. Phototoxizitaet fuehren und es haeufen sich Hinweise, dass die Strahlentherapie diese Nebenwirkungen verstaerken kann. Wir berichten ueber zwei Faelle ungewoehnlicher Hautreaktionen waehrend und nach einer Ganzhirnbestrahlung in Kombination mit Vemurafenib. Ein Fall beschreibt eine akute und ueberschiessende Radiodermatitis unter fortlaufender Radiotherapie und der andere Fall beschreibt eine spaete

  7. A matter of respect: a defense of the dead donor rule and of a "whole-brain" criterion for determination of death.

    Science.gov (United States)

    Khushf, George

    2010-06-01

    Many accounts of the historical development of neurological criteria for determination of death insufficiently distinguish between two strands of interpretation advanced by advocates of a "whole-brain" criterion. One strand focuses on the brain as the organ of integration. Another provides a far more complex and nuanced account, both of death and of a policy on the determination of death. Current criticisms of the whole-brain criterion are effective in refuting the first interpretation, but not the second, which is advanced in the 2008 President's Council report on the determination of death. In this essay, I seek to further develop this second strand of interpretation. I argue that policy on determination of death aligns moral, biological, and ontological death concepts. Morally, death marks the stage when respect is no longer owed. Biologically, death concerns integrated functioning of an organism as a whole. But the biological concepts are underdetermined. The moral concerns lead to selection of strong individuality concepts rather than weak ones. They also push criteria to the "far side" of the dying process. There is a countervailing consideration associated with optimizing the number of available organs, and this pushes to the "near side" of death. Policy is governed by a conviction that it is possible to align these moral and biological death concepts, but this conviction simply lays out an agenda. There is also a prescription-integral to the dead donor rule-that lexically prioritizes the deontic concerns and that seeks to balance the countervailing tendencies by using science-based refinements to make the line between life and death more precise. After showing how these concerns have been effectively aligned in the current policy, I present a modified variant of a "division" scenario and show how an "inverse decapitation problem" leads to a conclusive refutation of the nonbrain account of death.

  8. Total target volume is a better predictor of whole brain dose from gamma stereotactic radiosurgery than the number, shape, or location of the lesions.

    Science.gov (United States)

    Narayanasamy, Ganesh; Smith, Adam; Van Meter, Emily; McGarry, Ronald; Molloy, Janelle A

    2013-09-01

    To assess the hypothesis that the volume of whole brain that receives a certain dose level is primarily dependent on the treated volume rather than on the number, shape, or location of the lesions. This would help a physician validate the suitability of GammaKnife(®) based stereotactic radiosurgery (GKSR) prior to treatment. Simulation studies were performed to establish the hypothesis for both oblong and spherical shaped lesions of various numbers and sizes. Forty patients who underwent GKSR [mean age of 54 years (range 7-80), mean number of lesions of 2.5 (range 1-6), and mean lesion volume of 4.4 cm(3) (range 0.02-22.2 cm(3))] were also studied retrospectively. Following recommendations of QUANTEC, the volume of brain irradiated by the 12 Gy (VB12) isodose line was measured and a power-law based relation is proposed here for estimating VB12 from the known tumor volume and the prescription dose. In the simulation study on oblong, spherical, and multiple lesions, the volume of brain irradiated by 50%, 10%, and 1% of maximum dose was found to have linear, linear, and exponentially increasing dependence on the volume of the treated region, respectively. In the retrospective study on 40 GKSR patients, a similar relationship was found to predict the brain dose with a Spearman correlation coefficient >0.9. In both the studies, the volume of brain irradiated by a certain dose level does not have a statistically significant relationship (p ≥ 0.05) with the number, shape, or position of the lesions. The measured VB12 agrees with calculation to within 1.7%. The results from the simulation and the retrospective clinical studies indicate that the volume of whole brain that receives a certain percentage of the maximum dose is primarily dependent on the treated volume and less on the number, shape, and location of the lesions.

  9. Effects of 1-3-n-Butylphthalide on the blood-brain barrier following whole brain irradiation in rats%丁苯酞对放射性脑损伤大鼠血脑屏障的影响

    Institute of Scientific and Technical Information of China (English)

    陈应柱; 张娴娴; 肖璐; 戚艳红; 杨璞; 田野; 包仕尧

    2012-01-01

    endothelial cells (CECs) isolated from right ventricular blood were counted.MRI was evaluated with the T1-weighted images,T2-weighted images and MRI enhancement images induced by Gd-DTPA.The data were compared among the groups through Student-Newman-Keuls test.Results Compared with the sham-irradiation group,the EB content,the expression of VEGF in the brain tissue and the CECs were significantly increased in the irradiation group (2.81∶ 7.82,P =0.002;5.83∶ 10.26,P=0.003;3.16∶6.14,P =0.002).The signal intensity of T1-weighted images was significantly decreased while T2-weighted images and the enhancement rate significantly increased in the irradiation group (P =0.004 -0.018 ).Compared with irradiation group,the EB content,the expression of VEGF and the CECs were decreased significantly in the irradiation plus 1-3-n-Butylphthalide group ( 7.80∶ 3.86,P =0.007 ; 10.83 ∶ 5.26,P =0.008 ;6.36∶ 3.64,P =0.009 ).However,the changes in the MRI were significantly attenuated ( P =0.008-0.026,and 0.006 -0.038,respectively).Conclusions Following whole brain irradiation,1-3-n-Butylphthalide can decrease the permeability of the BBB in rats via decreasing VEGF expression and decreasing the CECs.

  10. Task-Driven Activity Reduces the Cortical Activity Space of the Brain: Experiment and Whole-Brain Modeling.

    Science.gov (United States)

    Ponce-Alvarez, Adrián; He, Biyu J; Hagmann, Patric; Deco, Gustavo

    2015-08-01

    How a stimulus or a task alters the spontaneous dynamics of the brain remains a fundamental open question in neuroscience. One of the most robust hallmarks of task/stimulus-driven brain dynamics is the decrease of variability with respect to the spontaneous level, an effect seen across multiple experimental conditions and in brain signals observed at different spatiotemporal scales. Recently, it was observed that the trial-to-trial variability and temporal variance of functional magnetic resonance imaging (fMRI) signals decrease in the task-driven activity. Here we examined the dynamics of a large-scale model of the human cortex to provide a mechanistic understanding of these observations. The model allows computing the statistics of synaptic activity in the spontaneous condition and in putative tasks determined by external inputs to a given subset of brain regions. We demonstrated that external inputs decrease the variance, increase the covariances, and decrease the autocovariance of synaptic activity as a consequence of single node and large-scale network dynamics. Altogether, these changes in network statistics imply a reduction of entropy, meaning that the spontaneous synaptic activity outlines a larger multidimensional activity space than does the task-driven activity. We tested this model's prediction on fMRI signals from healthy humans acquired during rest and task conditions and found a significant decrease of entropy in the stimulus-driven activity. Altogether, our study proposes a mechanism for increasing the information capacity of brain networks by enlarging the volume of possible activity configurations at rest and reliably settling into a confined stimulus-driven state to allow better transmission of stimulus-related information.

  11. Task-Driven Activity Reduces the Cortical Activity Space of the Brain: Experiment and Whole-Brain Modeling.

    Directory of Open Access Journals (Sweden)

    Adrián Ponce-Alvarez

    2015-08-01

    Full Text Available How a stimulus or a task alters the spontaneous dynamics of the brain remains a fundamental open question in neuroscience. One of the most robust hallmarks of task/stimulus-driven brain dynamics is the decrease of variability with respect to the spontaneous level, an effect seen across multiple experimental conditions and in brain signals observed at different spatiotemporal scales. Recently, it was observed that the trial-to-trial variability and temporal variance of functional magnetic resonance imaging (fMRI signals decrease in the task-driven activity. Here we examined the dynamics of a large-scale model of the human cortex to provide a mechanistic understanding of these observations. The model allows computing the statistics of synaptic activity in the spontaneous condition and in putative tasks determined by external inputs to a given subset of brain regions. We demonstrated that external inputs decrease the variance, increase the covariances, and decrease the autocovariance of synaptic activity as a consequence of single node and large-scale network dynamics. Altogether, these changes in network statistics imply a reduction of entropy, meaning that the spontaneous synaptic activity outlines a larger multidimensional activity space than does the task-driven activity. We tested this model's prediction on fMRI signals from healthy humans acquired during rest and task conditions and found a significant decrease of entropy in the stimulus-driven activity. Altogether, our study proposes a mechanism for increasing the information capacity of brain networks by enlarging the volume of possible activity configurations at rest and reliably settling into a confined stimulus-driven state to allow better transmission of stimulus-related information.

  12. Loss of entorhinal cortex and hippocampal volumes compared to whole brain volume in normal aging: the SMART-Medea study.

    Science.gov (United States)

    Knoops, Arnoud J G; Gerritsen, Lotte; van der Graaf, Yolanda; Mali, Willem P T M; Geerlings, Mirjam I

    2012-07-30

    In non-demented elderly age-related decline in hippocampal volume has often been observed, but it is not clear if this loss is disproportionate relative to other brain tissue. Few studies examined age-related volume loss of the entorhinal cortex. We investigated the association of age with hippocampal and entorhinal cortex (ERC) volumes in a large sample of middle-aged and older persons without dementia. Within the SMART-Medea study, cross-sectional analyses were performed in 453 non-demented subjects (mean age 62±9 years, 81% male) with a history of arterial disease. Hippocampal and ERC volumes were assessed by manual segmentation on three-dimensional fast field-echo sequence T1-weighted magnetic resonance images. Automated segmentation was used to quantify volumes of BV and ICV. Hippocampal and ERC volumes were divided by intracranial volume (ICV) as well as total brain volume (BV) to determine whether age-related differences were disproportionate relative to other brain tissue. Total crude hippocampal volume was 5.96±0.7 ml and total crude ERC volume was 0.34±0.06 ml. Linear regression analyses adjusted for sex showed that with increasing age, hippocampal volume divided by ICV decreased (B per year older=-0.01 ml; 95% CI -0.02 to -0.004). However, no age-related decline in hippocampal volume relative to BV was observed (B per year older=0.005 ml; 95% CI -0.002 to 0.01). No age-related decline in ERC volume relative to ICV or BV was observed. In this population of nondemented patients with a history of vascular disease no age-related decline in entorhinal cortex volume was observed and although hippocampal volume decreased with age, it was not disproportionate relative to total brain volume. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Whole-brain 320-detector row dynamic volume CT perfusion detected crossed cerebellar diaschisis after spontaneous intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Jun; Chen, Wei-jian; Wang, Mei-hao; Li, Jian-ce; Zhang, Qian; Xia, Neng-zhi; Yang, Yun-jun [Wenzhou Medical University, Department of Radiology, First Affiliated Hospital, Wenzhou (China); Wu, Gui-yun [Cleveland Clinics Foundation, Department of Nuclear Medicine, Imaging Institute, Cleveland, OH (United States); Cheng, Jing-liang; Zhang, Yong [Zhengzhou University, Department of Radiology, First Affiliated Hospital, Zhengzhou (China); Zhuge, Qichuan [Wenzhou Medical University, Department of Neurosurgery, First Affiliated Hospital, Wenzhou (China)

    2014-11-09

    The purpose of this study was to evaluate the value of 320-detector row CT used to detect crossed cerebellar diaschisis (CCD) in patients with unilateral supratentorial spontaneous intracerebral hemorrhage (SICH). We investigated 62 of 156 patients with unilateral supratentorial SICH using 320-detector row CT scanning. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), and time to peak (rTTP) levels were measured in different regions of interest (ROIs) that were manually outlined on computed tomography perfusion (CTP) for the cerebrum, including normal-appearing brain tissue that surrounded the perilesional low-density area (NA) and the perihematomal low-density area (PA) in all patients and the cerebellum (ipsilateral and contralateral) in CCD-positive patients. Of 62 cases, a total of 14 met the criteria for CCD due to cerebellar perfusion asymmetry on CTP maps. In the quantitative analysis, significant differences were found in the perfusion parameters between the contralateral and ipsilateral cerebellum in CCD-positive cases. No significant differences were found between the CCD-positive group and the CCD-negative group according to the hematoma volume, NIHSS scores, and cerebral perfusion abnormality (each P > 0.05). The correlation analysis of the degree of NA, PA perfusion abnormality, and the degree of CCD severity showed negative and significant linear correlations (R, -0.66∝-0.56; P < 0.05). 320-detector row CT is a robust and practicable method for the comprehensive primary imaging work-up of CCD in unilateral supratentorial SICH patients. (orig.)

  14. Treatment of brain metastases of small-cell lung cancer : Comparing teniposide and teniposide with whole-brain radiotherapy - A phase III study of the European Organization for the Research and Treatment of Cancer Lung Cancer Cooperative Group

    NARCIS (Netherlands)

    Postmus, PE; Haaxma-Reiche, H; Smit, EF; Groen, HJM; Karnicka, H; Lewinski, T; van Meerbeeck, J; Clerico, M; Gregor, A; Curran, D; Sahmoud, T; Kirkpatrick, A; Giaccone, G

    2000-01-01

    Purpose: Approximately 60% of patients with small-cell lung cancer (SCLC) develop brain metastases, Whole-brain radiotherapy (WBRT) gives symptomatic improvement in more than 50% of these patients. Because brain metastases are a sign of systemic progression, and chemotherapy was found to be

  15. Whole Brain Radiotherapy and RRx-001: Two Partial Responses in Radioresistant Melanoma Brain Metastases from a Phase I/II Clinical Trial

    Directory of Open Access Journals (Sweden)

    Michelle M. Kim

    2016-04-01

    Full Text Available BACKGROUND: Kim et al. report two patients with melanoma metastases to the brain that responded to treatment with RRx-001 and whole brain radiotherapy (WBRT without neurologic or systemic toxicity in the context of a phase I/II clinical trial. RRx-001 is an reactive oxygen and reactive nitrogen species (ROS/RNS-dependent systemically nontoxic hypoxic cell radiosensitizer with vascular normalizing properties under investigation in patients with various solid tumors including those with brain metastases. SIGNIFICANCE: Metastatic melanoma to the brain is historically associated with poor outcomes and a median survival of 4 to 5 months. WBRT is a mainstay of treatment for patients with multiple brain metastases, but no significant therapeutic advances for these patients have been described in the literature. To date, candidate radiosensitizing agents have failed to demonstrate a survival benefit in patients with brain metastases, and in particular, no agent has demonstrated improved outcome in patients with metastatic melanoma. Kim et al. report two patients with melanoma metastases to the brain that responded to treatment with novel radiosensitizing agent RRx-001 and WBRT without neurologic or systemic toxicity in the context of a phase I/II clinical trial.

  16. Decreased cerebellar-orbitofrontal connectivity correlates with stuttering severity: Whole-brain functional and structural connectivity associations with persistent developmental stuttering

    Directory of Open Access Journals (Sweden)

    Kevin Richard Sitek

    2016-05-01

    Full Text Available Persistent developmental stuttering is characterized by speech production disfluency and affects 1% of adults. The degree of impairment varies widely across individuals and the neural mechanisms underlying the disorder and this variability remain poorly understood. Here, we elucidate compensatory mechanisms related to this variability in impairment using whole-brain functional and white matter connectivity analyses in persistent developmental stuttering. We found that people who stutter had stronger functional connectivity between cerebellum and thalamus than people with fluent speech, while stutterers with the least severe symptoms had greater functional connectivity between left cerebellum and left orbitofrontal cortex. Additionally, people who stutter had decreased functional and white matter connectivity among the perisylvian auditory, motor, and speech planning regions compared to typical speakers, but greater functional connectivity between the right basal ganglia and bilateral temporal auditory regions. Structurally, disfluency ratings were negatively correlated with white matter connections to left perisylvian regions and to the brain stem. Overall, we found increased connectivity among subcortical and reward network structures in people who stutter compared to controls. These connections were negatively correlated with stuttering severity, suggesting the involvement of cerebellum and orbitofrontal cortex may underlie successful compensatory mechanisms by more fluent stutterers.

  17. Results of the whole-brain radiotherapy for patients with brain metastases from lung cancer: The RTOG RPA intra-classes analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kepka, Lucyna; Bujko, Krzysztof; Fijuth, Jacek; Wierzchowski, Marek [Memorial M. Sklodowska-Curie Cancer Center and Inst., Warsaw (Poland). Dept. of Radiation Oncology; Cieslak, Ewa [Public Hospital of Pneumology and Oncology, Olsztyn (Poland)

    2005-06-01

    We evaluated the overall survival with respect to prognostic factors in patients with brain metastases (BM) from lung cancer in order to assess the RTOG RPA (Recursive Partitioning Analysis) classification value and to perform intra-classes analyses including pretreatment and treatment-related variables. Between 1986 and 1997, 322 consecutive patients with BM from lung cancer were treated with whole-brain radiotherapy. Patients' distribution according to the RTOG RPA classes was: Class 1 - 13%, Class 2 - 67% and Class 3 - 20%. Prognostic value of the following variables was tested: RTOG RPA classes, performance status, age, extracranial metastases, control of the primary tumour, gender, histology, number of BM and interval from diagnosis to the development of BM. Intra-classes analyses were performed including radiation dose and surgery of BM. Median survival was 4.0 months. Median survival for RTOG RPA classes 1, 2 and 3 were 5.2, 4.0 and 2.5 months, respectively (p=0.003). Extracranial metastases, performance status, control of the primary and RTOG RPA classes were prognostic for survival. Within class 2 higher radiation dose, female, no extracranial metastases and surgery of BM were related to the improved survival. RTOG RPA classes maintain their prognostic significance for patients with BM from lung cancer not participating in clinical trials.

  18. Radiolabeled cetuximab plus whole-brain irradiation (WBI) for the treatment of brain metastases from non-small cell lung cancer (NSCLC)

    Energy Technology Data Exchange (ETDEWEB)

    Rades, Dirk; Nadrowitz, Roger [Dept. of Radiation Oncology, Univ. of Luebeck (Germany); Buchmann, Inga; Meller, Birgit [Section of Nuclear Medicine, Univ. of Luebeck (Germany); Hunold, Peter [Dept. of Radiology, Univ. of Luebeck (Germany); Noack, Frank [Inst. of Pathology, Univ. of Luebeck (Germany); Schild, Steven E. [Dept. of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States)

    2010-08-15

    Background and Purpose: The addition of systemic drugs to whole-brain irradiation has not improved the survival of patients with multiple brain metastases, most likely because the agents did not readily cross the blood-brain barrier (BBB). Radiolabeling of cetuximab was performed to investigate whether this antibody crosses the BBB. Case Report: A patient with multiple brain lesions from non-small cell lung cancer was investigated. The largest metastasis (40 x 33 x 27 mm) was selected the reference lesion. On day 1, 200 mg/m{sup 2} cetuximab (0.25% hot and 99.75% cold antibody) were given. On day 3, 200 mg/m{sup 2} cetuximab (cold antibody) were given. Weekly doses of 250 mg/m{sup 2} cetuximab were administered for 3 months. Results: The reference lesion showed enhancement of radiolabeled cetuximab ({sup 123}I-Erbi) on scintigraphy; {sup 123}I-Erbi crossed the BBB and accumulated in the lesion. The reference lesion measured 31 x 22 x 21 mm at 4 months. Enhancement of contrast medium was less pronounced. Conclusion: This is the first demonstration of cetuximab crossing the BBB and accumulating in brain metastasis. (orig.)

  19. Forced running exercise attenuates hippocampal neurogenesis impairment and the neurocognitive deficits induced by whole-brain irradiation via the BDNF-mediated pathway

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Jian-feng; Ji, Sheng-jun; Sun, Rui; Li, Kun; Zhang, Yuan; Zhang, Li-yuan; Tian, Ye, E-mail: dryetian@hotmail.com

    2014-01-10

    Highlights: •Forced exercise can ameliorate WBI induced cognitive impairment in our rat model. •Mature BDNF plays an important role in the effects of forced exercise. •Exercise may be a possible treatment of the radiation-induced cognitive impairment. -- Abstract: Cranial radiotherapy induces progressive and debilitating cognitive deficits, particularly in long-term cancer survivors, which may in part be caused by the reduction of hippocampal neurogenesis. Previous studies suggested that voluntary exercise can reduce the cognitive impairment caused by radiation therapy. However, there is no study on the effect of forced wheel exercise and little is known about the molecular mechanisms mediating the effect of exercise. In the present study, we investigated whether the forced running exercise after irradiation had the protective effects of the radiation-induced cognitive impairment. Sixty-four Male Sprague–Dawley rats received a single dose of 20 Gy or sham whole-brain irradiation (WBI), behavioral test was evaluated using open field test and Morris water maze at 2 months after irradiation. Half of the rats accepted a 3-week forced running exercise before the behavior detection. Immunofluorescence was used to evaluate the changes in hippocampal neurogenesis and Western blotting was used to assess changes in the levels of mature brain-derived neurotrophic factor (BDNF), phosphorylated tyrosine receptor kinase B (TrkB) receptor, protein kinase B (Akt), extracellular signal-regulated kinase (ERK), calcium-calmodulin dependent kinase (CaMKII), cAMP-calcium response element binding protein (CREB) in the BDNF–pCREB signaling. We found forced running exercise significantly prevented radiation-induced cognitive deficits, ameliorated the impairment of hippocampal neurogenesis and attenuated the down-regulation of these proteins. Moreover, exercise also increased behavioral performance, hippocampal neurogenesis and elevated BDNF–pCREB signaling in non

  20. Whole brain radiotherapy plus concurrent chemotherapy in non-small cell lung cancer patients with brain metastases: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Hong Qin

    Full Text Available The aim of the present meta-analysis is to evaluate the response rate, median survival time (MST and toxicity in patients with brain metastases (BM originating from non-small cell lung cancer (NSCLC and who were treated using either whole brain radiotherapy (WBRT plus concurrent chemotherapy or WBRT alone.PubMed, EMBASE, Web of Science, The Cochrane Library, clinical trials and current controlled trials were searched to identify any relevant publications. After screening the literature and undertaking quality assessment and data extraction, the meta-analysis was performed using Stata11.0 software.In total, six randomized controlled trials (RCT involving 910 participants were included in the meta-analysis. The results of the analysis indicate that WBRT plus concurrent chemotherapy was more effective at improving response rate (RR = 2.06, 95% CI [1.13, 3.77]; P = 0.019 than WBRT alone. However, WBRT plus concurrent chemotherapy did not improve median survival time (MST (HR = 1.09, 95%CI [0.94, 1.26]; P = 0.233 or time of neurological progression (CNS-TTP (HR = 0.93, 95%CI [0.75, 1.16]; P = 0.543, and increased adverse events (Grade≥3 (RR = 2.59, 95% CI [1.88, 3.58]; P = 0.000. There were no significant differences in Grade 3-5 neurological or hematological toxicity between two patient groups (RR = 1.08, 95%CI [0.23, 5.1]; P = 0.92.The combination of chemotherapy plus WBRT in patients with BM originating from NSCLC may increase treatment response rates of brain metastases with limited toxicity. Although the therapy schedule did not prolong MST or CNS-TTP, further assessment is warranted.

  1. Forced running exercise attenuates hippocampal neurogenesis impairment and the neurocognitive deficits induced by whole-brain irradiation via the BDNF-mediated pathway.

    Science.gov (United States)

    Ji, Jian-feng; Ji, Sheng-jun; Sun, Rui; Li, Kun; Zhang, Yuan; Zhang, Li-yuan; Tian, Ye

    2014-01-10

    Cranial radiotherapy induces progressive and debilitating cognitive deficits, particularly in long-term cancer survivors, which may in part be caused by the reduction of hippocampal neurogenesis. Previous studies suggested that voluntary exercise can reduce the cognitive impairment caused by radiation therapy. However, there is no study on the effect of forced wheel exercise and little is known about the molecular mechanisms mediating the effect of exercise. In the present study, we investigated whether the forced running exercise after irradiation had the protective effects of the radiation-induced cognitive impairment. Sixty-four Male Sprague-Dawley rats received a single dose of 20Gy or sham whole-brain irradiation (WBI), behavioral test was evaluated using open field test and Morris water maze at 2months after irradiation. Half of the rats accepted a 3-week forced running exercise before the behavior detection. Immunofluorescence was used to evaluate the changes in hippocampal neurogenesis and Western blotting was used to assess changes in the levels of mature brain-derived neurotrophic factor (BDNF), phosphorylated tyrosine receptor kinase B (TrkB) receptor, protein kinase B (Akt), extracellular signal-regulated kinase (ERK), calcium-calmodulin dependent kinase (CaMKII), cAMP-calcium response element binding protein (CREB) in the BDNF-pCREB signaling. We found forced running exercise significantly prevented radiation-induced cognitive deficits, ameliorated the impairment of hippocampal neurogenesis and attenuated the down-regulation of these proteins. Moreover, exercise also increased behavioral performance, hippocampal neurogenesis and elevated BDNF-pCREB signaling in non-irradiation group. These results suggest that forced running exercise offers a potentially effective treatment for radiation-induced cognitive deficits.

  2. Whole-brain Mapping of the Direct Inputs and Axonal Projections of Pro-opiomelanocortin(POMC and Agouti-related peptide(AgRP Neurons

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    Daqing ewang

    2015-03-01

    Full Text Available Pro-opiomelanocortin (POMC neurons in the arcuate nucleus (ARC of the hypothalamus and nucleus tractus solitarius (NTS of the brainstem play important roles in suppressing food intake and maintaining energy homeostasis. Previous tract-tracing studies have revealed the axonal connection patterns of these two brain areas, but the intermingling of POMC neurons with other neuron types has made it challenging to precisely identify the inputs and outputs of POMC neurons. In this study, we used the modified rabies virus to map the brain areas that provide direct inputs to the POMC neurons in the ARC and NTS as well as the inputs to the ARC AgRP neurons for comparison. ARC POMC neurons receive inputs from dozens of discrete structures throughout the forebrain and brainstem. The brain areas containing the presynaptic partners of ARC POMC neurons largely overlap with those of ARC AgRP neurons, although POMC neurons receive relatively broader, denser inputs. Furthermore, POMC neurons in the NTS receive direct inputs predominantly from the brainstem and show very different innervation patterns for POMC neurons in the ARC. By selectively expressing fluorescent markers in the ARC and NTS POMC neurons, we found that almost all of their major presynaptic partners are innervated by POMC neurons in the two areas, suggesting that there are strong reciprocal projections among the major POMC neural pathways. By comprehensively chartering the whole-brain connections of the central melanocortin system in a cell-type-specific manner, this study lays the foundation for dissecting the roles and underlying circuit mechanisms of specific neural pathways in regulating energy homeostasis.

  3. Predictors for long-term survival free from whole brain radiation therapy in patients treated with radiosurgery for limited brain metastases

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    Daniel eGorovets

    2015-05-01

    Full Text Available Purpose: To identify predictors for prolonged survival free from salvage whole brain radiation therapy (WBRT in patients with brain metastases treated with stereotactic radiosurgery (SRS as their initial radiotherapy approach. Material and Methods: Patients with brain metastases treated with SRS from 2001-2013 at our institution were identified. SRS without WBRT was typically offered to patients with 1-4 brain metastases, Karnofsky Performance Status ≥70, and life expectancy ≥3 mo. Three hundred and eight patients met inclusion criteria for analysis. Medical records were reviewed for patient, disease, and treatment information. Two comparison groups were identified: those with ≥1-yr WBRT-free survival (N=104, and those who died or required salvage WBRT within 3 mo of SRS (N=56. Differences between these groups were assessed by univariate and multivariate analyses.Results: Median survival for all patients was 11 mo. Among patients with ≥1-yr WBRT-free survival, median survival was 33 mo [12-107 mo] with only 21% requiring salvage WBRT. Factors significantly associated with prolonged WBRT-free survival on univariate analysis (p<0.05 included younger age, asymptomatic presentation, RTOG RPA class I, fewer brain metastases, surgical resection, breast primary, new or controlled primary, absence of extracranial metastatic disease, and oligometastatic disease burden (≤5 metastatic lesions. After controlling for covariates, asymptomatic presentation, breast primary, single brain metastasis, absence of extracranial metastases, and oligometastatic disease burden remained independent predictors for favorable WBRT-free survival.Conclusions: A subset of patients with brain metastases can achieve long-term survival after upfront SRS without the need for salvage WBRT. Predictors identified in this study can help select patients that might benefit most from a treatment strategy of SRS alone.

  4. Combining Whole-Brain Radiotherapy with Gefitinib/Erlotinib for Brain Metastases from Non-Small-Cell Lung Cancer: A Meta-Analysis

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    Mao-hua Zheng

    2016-01-01

    Full Text Available Background. To comprehensively assess the efficacy and safety of whole-brain radiotherapy (WBRT combined with gefitinib/erlotinib for treatment of brain metastases (BM from non-small-cell lung cancer (NSCLC. Methods. Databases including PubMed, EMBASE.com, Web of Science, and Cochrane Library were searched from inception to April 12, 2015. Studies on randomized controlled trials (RCTs and case-control trials comparing WBRT combined with gefitinib/erlotinib versus WBRT alone for BM from NSCLC were included. Literature selection, data extraction, and quality assessment were performed independently by two trained reviewers. RevMan 5.3 software was used to analyze data. Results. A total of 7 trials involving 622 patients were included. Compared with WBRT alone or WBRT plus chemotherapy, WBRT plus gefitinib/erlotinib could significantly improve response rate (OR = 2.16, 95% CI: 1.35–3.47; P=0.001, remission rate of central nervous system (OR = 6.06, 95% CI: 2.57–14.29; P<0.0001, disease control rate (OR = 3.34, 95% CI: 1.84–6.07; P<0.0001, overall survival (HR = 0.72, 95% CI: 0.58–0.89; P=0.002, and 1-year survival rate (OR = 2.43, 95% CI: 1.51–3.91; P=0.0002. In adverse events (III-IV, statistically significant differences were not found, except for rash (OR = 7.96, 95% CI: 2.02–31.34; P=0.003 and myelosuppression (OR = 0.19, 95% CI: 0.07–0.51; P=0.0010. Conclusions. WBRT plus gefitinib/erlotinib was superior to WBRT alone and well tolerated in patients with BM from NSCLC.

  5. Karnofsky Performance Status and Lactate Dehydrogenase Predict the Benefit of Palliative Whole-Brain Irradiation in Patients With Advanced Intra- and Extracranial Metastases From Malignant Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Partl, Richard, E-mail: richard.partl@medunigraz.at [Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz (Austria); Richtig, Erika [Department of Dermatology, Medical University of Graz, Graz (Austria); Avian, Alexander; Berghold, Andrea [Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz (Austria); Kapp, Karin S. [Department of Therapeutic Radiology and Oncology, Medical University of Graz, Graz (Austria)

    2013-03-01

    Purpose: To determine prognostic factors that allow the selection of melanoma patients with advanced intra- and extracerebral metastatic disease for palliative whole-brain radiation therapy (WBRT) or best supportive care. Methods and Materials: This was a retrospective study of 87 patients who underwent palliative WBRT between 1988 and 2009 for progressive or multiple cerebral metastases at presentation. Uni- and multivariate analysis took into account the following patient- and tumor-associated factors: gender and age, Karnofsky performance status (KPS), neurologic symptoms, serum lactate dehydrogenase (LDH) level, number of intracranial metastases, previous resection or stereotactic radiosurgery of brain metastases, number of extracranial metastasis sites, and local recurrences as well as regional lymph node metastases at the time of WBRT. Results: In univariate analysis, KPS, LDH, number of intracranial metastases, and neurologic symptoms had a significant influence on overall survival. In multivariate survival analysis, KPS and LDH remained as significant prognostic factors, with hazard ratios of 3.3 (95% confidence interval [CI] 1.6-6.5) and 2.8 (95% CI 1.6-4.9), respectively. Patients with KPS ≥70 and LDH ≤240 U/L had a median survival of 191 days; patients with KPS ≥70 and LDH >240 U/L, 96 days; patients with KPS <70 and LDH ≤240 U/L, 47 days; and patients with KPS <70 and LDH >240 U/L, only 34 days. Conclusions: Karnofsky performance status and serum LDH values indicate whether patients with advanced intra- and extracranial tumor manifestations are candidates for palliative WBRT or best supportive care.

  6. Differences in Parotid Dosimetry and Expected Normal Tissue Complication Probabilities in Whole Brain Radiation Plans Covering C1 Versus C2.

    Science.gov (United States)

    Orton, Andrew; Gordon, John; Vigh, Tyler; Tonkin, Allison; Cannon, George

    2017-05-03

    There is no consensus standard regarding the placement of the inferior field border in whole brain radiation therapy (WBRT) plans, with most providers choosing to cover the first versus (vs.) second cervical vertebrae (C1 vs. C2). We hypothesize that extending coverage to C2 may increase predicted rates of xerostomia. Fifteen patients underwent computed tomography (CT) simulation; two WBRT plans were then produced, one covering C2 and the other covering C1. The plans were otherwise standard, and patients were prescribed doses of 25, 30 and 37.5 gray (Gy). Dose-volume statistics were obtained and normal tissue complication probabilities (NTCPs) were estimated using the Lyman-Burman-Kutcher model. Mean parotid dose and predicted xerostomia rates were compared for plans covering C2 vs. C1 using a two-sided patient-matched t-test. Plans were also evaluated to determine whether extending the lower field border to cover C2 would result in a violation of commonly accepted dosimetric planning constraints. The mean dose to both parotid glands was significantly higher in WBRT plans covering C2 compared to plans covering C1 for all dose prescriptions (pplans covering C2 vs. plans covering C1 (pPlans covering C2 were unable to constrain at least one parotid to plans vs. 9% of plans when C1 was covered. A total parotid dose constraint of plans covering C2 vs. 0% of plans covering C1. Coverage of C2 significantly increases the mean parotid dose and predicted NTCPs and results in more frequent violation of commonly accepted dosimetric planning constraints.

  7. Effect of chronic aluminum exposure on the levels of conjugated dienes and enzymatic antioxidants in hippocampus and whole brain of rat

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A.; Shukla, G.S. [Industrial Toxicology Research Centre, Lucknow (India)

    1995-11-01

    The reported association between elevated tissue levels of aluminum (Al) and certain human neurological disorders have evoked increasing attention on the neurotoxic effects of aluminum. High levels of Al have been reported in hippocampal neurons comprising neurofibrillary tangles in senile dementia of Alzheimer`s type, amyotropic lateral sclerosis and Parkinsonian dementia of Guam. Aluminum is considered to be the causal factor for a high incidence of dialysis encephalopathy. It has been shown that the incidence of Alzheimer`s disease was higher in places with a high Al content in drinking water compared to low level areas. Varied uses of Al in pharmaceutical preparations, foods, water purification and many house-hold items have increased the risk of its exposure to general population. The exposure may be as high as 500 mg/kg/day in children with uremia who are treated with Al containing phosphate binding gels. Aluminum ingestion in humans and experimental animals have been reported to produce behavioural dysfunctions. The mechanism of al neurotoxicity is not understood at present. Attempts made in this direction have reported its interaction with blood-brain barrier function, decreased membrane fluidity, glutathione depletion and increased brain lipid peroxidation. These studies indicate the possibility that oxidative stress may be one of the possible mechanisms of Al-induced neurotoxicity. Since Al has been reported to be in high concentrations in hippocampal neurons in certain neurological diseases and there is wealth of evidence implicating hippocampal impairment and memory dysfunction, we attempted to investigate the effect of chronic Al intoxication on the status of enzymatic antioxidants and the extent of peroxidative damage in hippocampus and whole brain of rat. 16 refs., 4 figs., 1 tab.

  8. Radiotherapy for brain metastases from renal cell cancer. Should whole-brain radiotherapy be added to stereotactic radiosurgery? Analysis of 88 patients

    Energy Technology Data Exchange (ETDEWEB)

    Fokas, Emmanouil; Henzel, Martin; Engenhart-Cabillic, Rita [Dept. of Radiotherapy and Radiation Oncology, Philipps Univ. Marburg (Germany); Hamm, Klaus; Surber, Gunnar; Kleinert, Gabriele [Dept. for Stereotactic Neurosurgery and Radiosurgery, HELIOS Klinikum Erfurt (Germany)

    2010-04-15

    Purpose: To evaluate the role of stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) for the treatment of brain metastases in patients with renal cell cancer (RCC). Patients and methods: 88 patients were treated with either SRS (n = 51) or SRS + WBRT (n = 17) for one to three lesions, or with WBRT (n = 20) for more than three brain metastases. Overall survival (OS), intracerebral control (IC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Results: The median times for OS, IC, and LC from the time of diagnosis were 11, 9, and 10 months. The median OS times for SRS, SRS + WBRT, and WBRT were 12, 16, and 2 months. Addition of WBRT to the SRS improved IC (p = 0.032) but not OS (p = 0.703). On multivariate analyses, improved OS was associated with the absence of extracerebral metastases (p < 0.001) and RPA class (p = 0.04), and IC with treatment (p = 0.019). SRS provided a 1-year, 2-year, and 3-year LC probability of 81%, 78%, and 55%, respectively. No association between LC and any of the potential prognostic factors was observed. The results of the subgroup analyses, regarding treatment modality, were similar to the entire cohort, particularly for RPA class I patients. Conclusion: Addition of WBRT to SRS offers better IC and should be considered for RCC patients with one to three brain metastases, especially in RPA class I group. SRS offers excellent LC rates, while WBRT should be reserved for patients with multiple metastases and poor prognosis. (orig.)

  9. Timing of Whole Brain Radiotherapy on Survival of Patients with EGFR-mutated 
Non-small Cell Lung Cancer and Brain Metastases

    Directory of Open Access Journals (Sweden)

    Guimei LIU

    2016-08-01

    Full Text Available Background and objective There is no high-level evidence for the time of whole brain radiotherapy (WBRT for patients with epidermal growth factor receptor (EGFR-mutated non-small cell lung cancer (NSCLC and brain metastases. The aim of this study is to assess the appropriate timing of WBRT for patients with EGFR-mutated NSCLC and brain metastases (BM. Methods There were 78 patients diagnosed with EGFR-mutated NSCLC and BM in Beijing Chest Hospital between August 2009 and May 2015. 48 untreated patients who received both WBRT and EGFR-tyrosine kinase inhibitors (TKIs therapy. Prognostic factors of intracranial progression-free survival (PFS and overall survival (OS were identified by Cox proportional hazards modeling. Results Intracranial objective response rate was 81.3% and disease control rate was 93.8%. Median intracranial PFS was 10 months. Median OS was 18 months. Multivariate analysis of intracranial PFS revealed that Eastern Cooperative Oncology Group (ECOG performance status (PS 0-1 (HR=30.436, 95%CI: 4.721-196.211, P<0.001 and early WBRT (HR=3.663, 95%CI: 1.657-8.098, P=0.001 had a better intracranial PFS. Multivariate analysis of OS revealed that PS 0-1 (HR=57.607, 95%CI: 6.135-540.953, P<0.001, early WBRT (HR=2.757, 95%CI: 1.140-6.669, P=0.024, and stereotactic radiosurgery (HR=5.964, 95%CI: 1.895-18.767, P=0.002 were independent prognostic factors of OS. Conclusion Early WBRT combined with EGFR-TKIs can improve outcomes of patients with EGFR-mutated NSCLC and BM, but it needs to be confirmed by large-sample-size and multicenter prospective clinical trials.

  10. Shielding in whole brain irradiation in the multileaf collimator era: Dosimetric evaluation of coverage using SFOP guidelines against in-house guidelines

    Directory of Open Access Journals (Sweden)

    Patil Vijay

    2010-01-01

    Full Text Available Aim : Compare the planning target volume (PTV coverage in three different shielding techniques in cranial irradiation. Settings and Design : Tertiary care center, prospective study. Materials and Methods : The whole brain and meninges were contoured in ten planning CT scans, and expanded by 5 mm for the PTV. Shielding was designed using the French Society of Pediatric Oncology (SFOP guidelines (SFOP plan, in-house recommendation (with 1 cm margin from the orbital roof and sphenoid wing on a igitally Reconstructed Radiograph (DRR and a third plan was generated using a 3D conformal radiation technique (3DCRT. The coverage of the PTV was noted using the isodose covering 95% of the PTV(D95, minimum dose within the PTV(D min , and maximum dose within the PTV(D max . The location of PTV not covered by the 95% isodose curve was noted. The median dose and maximum dose (D max to both eyes and maximum dose D max for the lens were noted. Statistical Analysis : General linear model method repeated the measure of analysis of variance test (ANOVA. Results : PTV coverage was significantly poorer in the SFOP and in-house plans as compared to 3DCRT plan (P=0.04. Median volume of PTV not covered by 95% isodose curve was 4.18 cc, 1.01 cc, and 0 cc in SFOP, in-house, and 3DCRT plan, respectively. Conclusions : In the absence of volumetric planning techniques, SFOP guidelines lead to inadequate coverage and the in-house method is recommended.

  11. 脑转移癌全脑放疗相关认知功能损害%Cognitive impairment associated with whole brain radiotherapy for brain metastases

    Institute of Scientific and Technical Information of China (English)

    董标; 李薇; 王尚虎; 程怀东; 解佳奇; 陈振东

    2014-01-01

    目的探讨脑转移癌( BM)患者全脑放疗( WBRT)后认知功能的改变。方法以41例接受WBRT的BM患者为研究对象,以简易精神状态量表( MMSE)作为认知评估工具,对其放疗前1周、放疗后1周、1~6个月进行总体认知评估,并观察有无神经系统症状的BM患者(各12例)放疗前后的总体认知功能的改变。结果41例患者放疗前与放疗后1周比较差异有统计学意义(28.146±0.528 vs 27.585±0.290,P=0.006);放疗前无神经系统症状组,放疗后4个月MMSE减低最明显,其后有所提高,放疗后4个月与放疗前患者的 MMSE 成绩(29.125±0.579 vs 26.500±0.524)比较,差异有统计学意义( P<0.01);而有神经系统症状组放疗后4个月MMSE成绩提高,与放疗前(25.000±0.524 vs S27.500±0.370)比较,差异有统计学意义(P=0.001)。结论 WBRT对认知功能有损害,放疗后约4个月认知功能损害最明显,其后有所恢复。且放疗前有无神经系统症状与其放疗后的认知功能改变存在单分离。%Objective To investigate the change of cognitive function associated with whole brain radiotherapy for brain metastases after treatment. Methods The study was based on patients (n=41) of brain metastases who re-ceived whole brain radiotherapy, and MMSE was used as a cognitive assessment tool. Cognitive assessments were taken for the patients the week before radiotherapy, one week after radiotherapy and monthly after that, until 6 months later, to observe overall cognitive changes. And in which the change of cognitive function of the patients be-fore and after treatment with and without neurological symptoms group (12cases per group) was observed. Results there was significafint difference between Baseline MMSE score and the score one week after radiotherapy in the 41 patients (28. 146±0.528 vs 27.585±0.290, P=0.006). In no-neurological symptoms group(n=12 ),cog-nitive decline was predominant in the fourth month, but improved subsequently, baseline

  12. Helical tomotherapy for whole-brain irradiation with integrated boost to multiple brain metastases: evaluation of dose distribution characteristics and comparison with alternative techniques.

    Science.gov (United States)

    Levegrün, Sabine; Pöttgen, Christoph; Wittig, Andrea; Lübcke, Wolfgang; Abu Jawad, Jehad; Stuschke, Martin

    2013-07-15

    To quantitatively evaluate dose distribution characteristics achieved with helical tomotherapy (HT) for whole-brain irradiation (WBRT) with integrated boost (IB) to multiple brain metastases in comparison with alternative techniques. Dose distributions for 23 patients with 81 metastases treated with WBRT (30 Gy/10 fractions) and IB (50 Gy) were analyzed. The median number of metastases per patient (N(mets)) was 3 (range, 2-8). Mean values of the composite planning target volume of all metastases per patient (PTV(mets)) and of the individual metastasis planning target volume (PTV(ind met)) were 8.7 ± 8.9 cm(3) (range, 1.3-35.5 cm(3)) and 2.5 ± 4.5 cm(3) (range, 0.19-24.7 cm(3)), respectively. Dose distributions in PTV(mets) and PTV(ind met) were evaluated with respect to dose conformity (conformation number [CN], RTOG conformity index [PITV]), target coverage (TC), and homogeneity (homogeneity index [HI], ratio of maximum dose to prescription dose [MDPD]). The dependence of dose conformity on target size and N(mets) was investigated. The dose distribution characteristics were benchmarked against alternative irradiation techniques identified in a systematic literature review. Mean ± standard deviation of dose distribution characteristics derived for PTV(mets) amounted to CN = 0.790 ± 0.101, PITV = 1.161 ± 0.154, TC = 0.95 ± 0.01, HI = 0.142 ± 0.022, and MDPD = 1.147 ± 0.029, respectively, demonstrating high dose conformity with acceptable homogeneity. Corresponding numbers for PTV(ind met) were CN = 0.708 ± 0.128, PITV = 1.174 ± 0.237, TC = 0.90 ± 0.10, HI = 0.140 ± 0.027, and MDPD = 1.129 ± 0.030, respectively. The target size had a statistically significant influence on dose conformity to PTV(mets) (CN = 0.737 for PTV(mets) ≤4.32 cm(3) vs CN = 0.848 for PTV(mets) >4.32 cm(3), P=.006), in contrast to N(mets). The achieved dose conformity to PTV(mets), assessed by both CN and PITV, was in all investigated volume strata well within the best quartile of

  13. Whole brain radiotherapy with hippocampal avoidance and simultaneous integrated boost for brain metastases: a dosimetric volumetric-modulated arc therapy study.

    Science.gov (United States)

    Giaj Levra, Niccolò; Sicignano, Gianluisa; Fiorentino, Alba; Fersino, Sergio; Ricchetti, Francesco; Mazzola, Rosario; Naccarato, Stefania; Ruggieri, Ruggero; Alongi, Filippo

    2016-01-01

    To develop a feasible volumetric modulated arc therapy (VMAT) treatment in whole brain radiotherapy (WBRT) with a simultaneous integrated boost (SIB) and hippocampal (HP) sparing in 1-5 brain metastases (BMs). Ten patients with 20 BMs received a WBRT prescription of 20 Gy, SIB dose on BMs of 40 Gy/5 fractions. PTVWBRT was generated from brain minus BMs-PTVs (PTVSIB) and planning organ at risk volume to HP. All plans were evaluated in: homogeneity index (HI), target coverage (TC), maximum dose to prescription dose ratio (MDPD), prescription isodose to target volume ratio (PITV) and paddick conformity index (CI). We also evaluate D100%, mean and maximum doses to HP. Planning objectives were for PTVWBRT, D2% = 25 Gy with acceptable deviation of 26.7 Gy and D98% ≥ 16.7 Gy; for PTVSIB D95% ≥ 38 Gy; for HP, D100% = 6 Gy with acceptable deviation of 6.7 Gy, Dmax = 10.7 Gy with acceptable deviation of 11.3 Gy, a mean dose of 8 Gy. Mean number of BMs was 2 (range 1-5). Mean values for BMs were volume of PTVSIB = 5.1 ± 4.9 cc, dose to 95% of PTVSIB 39.3 ± 0.9 Gy, HI 0.083 ± 0.03, TC 0.96 ± 0.24, CI 0.78 ± 0.17. Mean MDPD was 1.06 ± 0.02 and PITV 0.96 ± 0.24. For WBRT, mean target volume was (13.46 ± 2)*10(2) cc, mean dose to 90% of PTVWBRT 19.8 ± 0.2 Gy, mean HI 0.42 ± 0.12 and TC 0.78 ± 0.11. Mean and maximum HP doses were 7.7 ± 0.3 Gy and 10.5 ± 0.5 Gy. Mean dose to 100% of HP volume (D100%) was 6.7 ± 0.3 Gy. WBRT plus SIB with HP avoidance with VMAT was feasible. All dosimetric parameters were satisfied for PTVWBRT and PTVSIB.

  14. Phase 3 Trials of Stereotactic Radiosurgery With or Without Whole-Brain Radiation Therapy for 1 to 4 Brain Metastases: Individual Patient Data Meta-Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Sahgal, Arjun, E-mail: arjun.sahgal@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Aoyama, Hidefumi [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata (Japan); Kocher, Martin [Department of Radiation Oncology, University of Cologne, Cologne (Germany); Neupane, Binod [Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Canada); Collette, Sandra [Statistics Department, European Organisation for Research and Treatment of Cancer, Brussels (Belgium); Tago, Masao [Department of Radiology, Teikyo University Mizonokuchi Hospital, Kanagawa (Japan); Shaw, Prakesh [Department of Pediatrics, Mount Sinai Hospital, Institute of Health Policy Management and Evaluation, University of Toronto, Ontario (Canada); Beyene, Joseph [Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Canada); Chang, Eric L. [Department of Radiation Oncology, University of Southern California, Los Angeles, California (United States); Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States)

    2015-03-15

    Purpose: To perform an individual patient data (IPD) meta-analysis of randomized controlled trials evaluating stereotactic radiosurgery (SRS) with or without whole-brain radiation therapy (WBRT) for patients presenting with 1 to 4 brain metastases. Method and Materials: Three trials were identified through a literature search, and IPD were obtained. Outcomes of interest were survival, local failure, and distant brain failure. The treatment effect was estimated after adjustments for age, recursive partitioning analysis (RPA) score, number of brain metastases, and treatment arm. Results: A total of 364 of the pooled 389 patients met eligibility criteria, of whom 51% were treated with SRS alone and 49% were treated with SRS plus WBRT. For survival, age was a significant effect modifier (P=.04) favoring SRS alone in patients ≤50 years of age, and no significant differences were observed in older patients. Hazard ratios (HRs) for patients 35, 40, 45, and 50 years of age were 0.46 (95% confidence interval [CI] = 0.24-0.90), 0.52 (95% CI = 0.29-0.92), 0.58 (95% CI = 0.35-0.95), and 0.64 (95% CI = 0.42-0.99), respectively. Patients with a single metastasis had significantly better survival than those who had 2 to 4 metastases. For distant brain failure, age was a significant effect modifier (P=.043), with similar rates in the 2 arms for patients ≤50 of age; otherwise, the risk was reduced with WBRT for patients >50 years of age. Patients with a single metastasis also had a significantly lower risk of distant brain failure than patients who had 2 to 4 metastases. Local control significantly favored additional WBRT in all age groups. Conclusions: For patients ≤50 years of age, SRS alone favored survival, in addition, the initial omission of WBRT did not impact distant brain relapse rates. SRS alone may be the preferred treatment for this age group.

  15. Whole-brain radiotherapy with 20 Gy in 5 fractions for brain metastases in patients with cancer of unknown primary (CUP)

    Energy Technology Data Exchange (ETDEWEB)

    Rades, D. [Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Luebeck (Germany); Dept. of Radiation Oncology, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany); Bohlen, G.; Dunst, J. [Dept. of Radiation Oncology, Univ. Hospital Schleswig-Holstein, Luebeck (Germany); Lohynska, R. [Dept. of Radiation Oncology, Univ. Hospital Prague (Czech Republic); Veninga, T. [Dept. of Radiotherapy, Dr. Bernard Verbeeten Inst., Tilburg (Netherlands); Stalpers, L.J.A. [Dept. of Radiotherapy, Academic Medical Center, Amsterdam (Netherlands); Schild, S.E. [Dept. of Radiation Oncology, Mayo Clinic Scottsdale, AZ (United States)

    2007-11-15

    Background: Whole brain radiotherapy (WBRT) is the most common treatment for brain metastases. Survival of patients with cancer of unknown primary (CUP) presenting with brain metastases is extremely poor. A radiation program with a short overall treatment time (short-course RT) would be preferable to longer programs if it provides similar outcomes. This study compares short-course RT with 20 Gy in 5 fractions (5 x 4 Gy) given over 5 days to longer programs in CUP patients. Patients and Methods: Data regarding 101 CUP patients who received either short course WBRT (n = 34) with 5 x 4 Gy or long-course WBRT (n = 67) with 10 x 3 Gy given over 2 weeks or 20 x 2 Gy given over 4 weeks for brain metastases were analyzed retrospectively. Six additional potential prognostic factors were investigated: age, gender, Karnofsky performance score (KPS), number of brain metastases, extracranial metastases, RPA-(Recursive Partitioning Analysis-)class. Results: On univariate analysis, the radiation program was not associated with survival (p = 0.88) nor intracerebral control (p = 0.36). Improved survival was associated with KPS {>=} 70 (p < 0.001), absence of extracranial metastases (p < 0.001), and RPA-class 1 (p < 0.001). On multivariate analyses, KPS (risk ratio [RR]: 4.55; p < 0.001), extracranial metastases (RR: 1.70; p = 0.018), and RPA-class (RR: 2.86; p < 0.001) maintained significance. On univariate analysis, KPS (p < 0.001) and RPA-class (p < 0.001) were significantly associated with intracerebral control. On multivariate analyses, KPS (RR: 2.72; p < 0.001) and RPA-class (RR: 2.09; p < 0.001) remained significant. Conclusion: Short-course WBRT with 5 x 4 Gy provided similar intracerebral control and survival as longer programs for the treatment of brain metastases in CUP patients. 5 x 4 Gy appears preferable because it is more convenient for patients. (orig.)

  16. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

  17. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L;

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion recov...

  18. Magnetic resonance imaging at 3.0 tesla detects more lesions in acute optic neuritis than at 1.5 tesla

    DEFF Research Database (Denmark)

    Nielsen, Kirsten; Rostrup, Egill; Frederiksen, Jette L.;

    2006-01-01

    OBJECTIVE:: We sought to assess whether magnetic resonance imaging (MRI) at 3.0 T detects more brain lesions in acute optic neuritis (ON) than MRI at 1.5 T. MATERIALS AND METHODS:: Twenty-eight patients with acute ON were scanned at both field-strengths using fast-fluid-attenuated inversion...

  19. 注意缺陷多动障碍儿童的右侧颞顶叶联合部全脑功能连接特征%Abnormal patterns of functional connectivity between right temporal parietal junction and whole brain in children with attention deficit hyperactivity disorder

    Institute of Scientific and Technical Information of China (English)

    王苏文; 邢伟; 陈杰; 王娜; 王苏弘

    2015-01-01

    目的 通过静息态功能连接磁共振成像(functional magnetic resonance imaging, fMRI)来研究注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)儿童右侧颞顶叶联合部(right temporal parietal junction,rTPJ)与全脑的功能连接特征,从功能网络角度分析ADHD儿童临床症状与神经网络之间的联系.方法 采集30名混合型ADHD儿童及33名正常对照(normal control,NC)儿童静息态下血氧依赖水平(blood oxygenation level dependent,BOLD) fMRI数据,选取rTPJ为感兴趣区,进行功能连接分析比较组内、组间差异及连接强度与注意缺陷评分和多动评分间的关系.结果 rTPJ与全脑功能连接显著区在两组儿童分布相似.与NC组比较,ADHD组rTPJ与全脑功能连接增高区域包括:左侧颞上回(MNI坐标:-33,6,-48)、右侧前扣带回(MNI坐标:6,39,-3)、右侧顶下小叶(MNI坐标:42,-33,30)、左额内侧回(MNI坐标:-3,63,-18);减低区域包括:右侧颞中回(MNI坐标:57,-33,-12)、右侧扣带回(MNI坐标:18,-21,36).相关性分析显示,ADHD组中,rTPJ与全脑功能连接强度的平均值与注意缺陷评分及多动评分呈正相关,而在NC组中,则呈负相关.rTPJ与上述6个脑区间功能连接强度与注意缺陷评分及多动评分存在相关性,但相关性无统计学意义.结论 rTPJ与全脑的异常功能连接可能与ADHD儿童注意力不集中这一临床症状有关.%Objective To investigate the pathophysiological distinction of the functional connectivity between right temporal parietal junction(rTPJ) and whole brain in children with attention-deficit/hyperactivity disorder(ADHD) on resting-state functional magnetic resonance imaging(fMRI) and explore the neurological mechanisms of ADHD at the point of functional connectivity.Methods Resting-state functional magnetic resonance imaging scans were obtained in 30 children with ADHD from The Third Affiliated Hospital of Soochow Univcrsity and another 33 with age and gender

  20. Switches for multiple behavioral states and a viral-based approach to non-invasive whole-brain cargo delivery (Conference Presentation)

    Science.gov (United States)

    Gradinaru, Viviana

    2017-05-01

    Over the past years we have worked on: (1) Viral-based approaches to non-invasive whole-brain cargo delivery: Genetically-encoded tools that can be used to visualize, monitor, and modulate mammalian neurons are revolutionizing neuroscience. These tools are particularly powerful in rodents and invertebrate models where intersectional transgenic strategies are available to restrict their expression to defined cell populations. However, use of genetic tools in non-transgenic animals is often hindered by the lack of vectors capable of safe, efficient, and specific delivery to the desired cellular targets. To begin to address these challenges, we have developed an in vivo Cre-based selection platform (CREATE) for identifying adeno-associated viruses (AAVs) that more efficiently transduce genetically defined cell populations. Our platform's novelty and power arises from the additional selective pressure imparted by a recovery step that amplifies only those capsid variants that have functionally transduced a genetically-defined, Cre-expressing target cell population. The Cre-dependent capsid recovery works within heterogeneous tissue samples without the need for additional steps such as selective capsid recovery approaches that require cell sorting or secondary adenovirus infection. As a first test of the CREATE platform, we selected for viruses that transduced the brain after intravascular delivery and found a novel vector, AAV-PHP.B, that is 40- to 90-fold more efficient at transducing the brain than the current standard, AAV9. AAV-PHP.B transduces most neuronal types and glia across the brain. We also demonstrate here how whole-body tissue clearing can facilitate transduction maps of systemically delivered genes. Since CNS disorders are notoriously challenging due to the restrictive nature of the blood brain barrier our discovery that recombinant vectors can be engineered to overcome this barrier is enabling for the whole field. With the exciting advances in gene

  1. Volumetric-modulated arc therapy (VMAT) for whole brain radiotherapy: not only for hippocampal sparing, but also for reduction of dose to organs at risk.

    Science.gov (United States)

    Sood, Sumit; Pokhrel, Damodar; McClinton, Christopher; Lominska, Christopher; Badkul, Rajeev; Jiang, Hongyu; Wang, Fen

    2017-08-16

    A prospective clinical trial, Radiation Therapy Oncology Group (RTOG) 0933, has demonstrated that whole brain radiotherapy (WBRT) using conformal radiation delivery technique with hippocampal avoidance is associated with less memory complications. Further sparing of other organs at risk (OARs) including the scalp, ear canals, cochleae, and parotid glands could be associated with reductions in additional toxicities for patients treated with WBRT. We investigated the feasibility of WBRT using volumetric-modulated arc therapy (VMAT) to spare the hippocampi and the aforementioned OARs. Ten patients previously treated with nonconformal WBRT (NC-WBRT) using opposed lateral beams were retrospectively re-planned using VMAT with hippocampal sparing according to the RTOG 0933 protocol. The OARs (scalp, auditory canals, cochleae, and parotid glands) were considered as dose-constrained structures. VMAT plans were generated for a prescription dose of 30 Gy in 10 fractions. Comparison of the dosimetric parameters achieved by VMAT and NC-WBRT plans was performed using paired t-tests using upper bound p-value of D100%) of 8.4 ± 0.3 Gy and maximum dose of 15.6 ± 0.4 Gy, respectively. A statistically significant dose reduction (p < 0.001) to all OARs was achieved. The mean and maximum scalp doses were reduced by an average of 9 Gy (32%) and 2 Gy (6%), respectively. The mean and maximum doses to the auditory canals were reduced from 29.5 ± 0.5 Gy and 31.0 ± 0.4 Gy with NC-WBRT, to 21.8 ± 1.6 Gy (26%) and 27.4 ± 1.4 Gy (12%) with VMAT. VMAT also reduced mean and maximum doses to the cochlea by an average of 4 Gy (13%) and 2 Gy (6%), respectively. The parotid glands mean and maximum doses with VMAT were 4.4 ± 1.9 Gy and 15.7 ± 5.0 Gy, compared to 12.8 ± 4.9 Gy and 30.6 ± 0.5 Gy with NC-WBRT, respectively. The average dose reduction of mean and maximum of parotid glands from VMAT were 65% and 50

  2. SU-E-T-493: Analysis of the Impact of Range and Setup Uncertainties On the Dose to Brain Stem and Whole Brain in the Passively Scattered Proton Therapy Plans

    Energy Technology Data Exchange (ETDEWEB)

    Sahoo, N; Zhu, X; Zhang, X; Poenisch, F; Li, H; Wu, R; Lii, M; Umfleet, W; Gillin, M; Mahajan, A; Grosshans, D [MD Anderson Cancer Ctr., Houston, TX (United States)

    2014-06-01

    Purpose: To quantify the impact of range and setup uncertainties on various dosimetric indices that are used to assess normal tissue toxicities of patients receiving passive scattering proton beam therapy (PSPBT). Methods: Robust analysis of sample treatment plans of six brain cancer patients treated with PSPBT at our facility for whom the maximum brain stem dose exceeded 5800 CcGE were performed. The DVH of each plan was calculated in an Eclipse treatment planning system (TPS) version 11 applying ±3.5% range uncertainty and ±3 mm shift of the isocenter in x, y and z directions to account for setup uncertainties. Worst-case dose indices for brain stem and whole brain were compared to their values in the nominal plan to determine the average change in their values. For the brain stem, maximum dose to 1 cc of volume, dose to 10%, 50%, 90% of volume (D10, D50, D90) and volume receiving 6000, 5400, 5000, 4500, 4000 CcGE (V60, V54, V50, V45, V40) were evaluated. For the whole brain, maximum dose to 1 cc of volume, and volume receiving 5400, 5000, 4500, 4000, 3000 CcGE (V54, V50, V45, V40 and V30) were assessed. Results: The average change in the values of these indices in the worst scenario cases from the nominal plan were as follows. Brain stem; Maximum dose to 1 cc of volume: 1.1%, D10: 1.4%, D50: 8.0%, D90:73.3%, V60:116.9%, V54:27.7%, V50: 21.2%, V45:16.2%, V40:13.6%,Whole brain; Maximum dose to 1 cc of volume: 0.3%, V54:11.4%, V50: 13.0%, V45:13.6%, V40:14.1%, V30:13.5%. Conclusion: Large to modest changes in the dosiemtric indices for brain stem and whole brain compared to nominal plan due to range and set up uncertainties were observed. Such potential changes should be taken into account while using any dosimetric parameters for outcome evaluation of patients receiving proton therapy.

  3. Functional Connectivity Magnetic Resonance Imaging Classification of Autism

    Science.gov (United States)

    Anderson, Jeffrey S.; Nielsen, Jared A.; Froehlich, Alyson L.; DuBray, Molly B.; Druzgal, T. Jason; Cariello, Annahir N.; Cooperrider, Jason R.; Zielinski, Brandon A.; Ravichandran, Caitlin; Fletcher, P. Thomas; Alexander, Andrew L.; Bigler, Erin D.; Lange, Nicholas; Lainhart, Janet E.

    2011-01-01

    Group differences in resting state functional magnetic resonance imaging connectivity between individuals with autism and typically developing controls have been widely replicated for a small number of discrete brain regions, yet the whole-brain distribution of connectivity abnormalities in autism is not well characterized. It is also unclear…

  4. Functional Connectivity Magnetic Resonance Imaging Classification of Autism

    Science.gov (United States)

    Anderson, Jeffrey S.; Nielsen, Jared A.; Froehlich, Alyson L.; DuBray, Molly B.; Druzgal, T. Jason; Cariello, Annahir N.; Cooperrider, Jason R.; Zielinski, Brandon A.; Ravichandran, Caitlin; Fletcher, P. Thomas; Alexander, Andrew L.; Bigler, Erin D.; Lange, Nicholas; Lainhart, Janet E.

    2011-01-01

    Group differences in resting state functional magnetic resonance imaging connectivity between individuals with autism and typically developing controls have been widely replicated for a small number of discrete brain regions, yet the whole-brain distribution of connectivity abnormalities in autism is not well characterized. It is also unclear…

  5. Assessing response to stroke thrombolysis: validation of 24-hour multimodal magnetic resonance imaging.

    Science.gov (United States)

    Campbell, Bruce C V; Tu, Hans T H; Christensen, Søren; Desmond, Patricia M; Levi, Christopher R; Bladin, Christopher F; Hjort, Niels; Ashkanian, Mahmoud; Sølling, Christine; Donnan, Geoffrey A; Davis, Stephen M; Ostergaard, Leif; Parsons, Mark W

    2012-01-01

    Imaging is used as a surrogate for clinical outcome in early-phase stroke trials. Assessment of infarct growth earlier than the standard 90 days used for clinical end points may be equally accurate and more practical. To compare assessment of the effect of reperfusion therapies using 24-hour vs day 90 magnetic resonance imaging. Infarct volume was assessed on diffusion-weighted imaging (DWI) at baseline and 24 hours after stroke onset and on fluid-attenuated inversion recovery images at day 90. The DWI and fluid-attenuated inversion recovery lesions were manually outlined by 2 independent raters, and the volumes were averaged. Interrater consistency was assessed using the median difference in lesion volume between raters. Referral center. Patients  Imaging data were available for 83 patients; 77 of these patients received thrombolysis. Infarct volume at 24 hours and 90 days. The 24-hour DWI infarct volume had a strong linear correlation with day 90 fluid-attenuated inversion recovery infarct volume (r = 0.98, 95% confidence interval, 0.97-0.99). Recanalization had a significant effect on infarct evolution between baseline and 24 hours but not between 24 hours and day 90. Infarct growth from baseline was significantly reduced by recanalization, whether assessed at 24 hours or day 90. Infarct volume at either time point predicted functional outcome independent of age and baseline stroke severity. Interrater agreement was better for DWI than fluid-attenuated inversion recovery (1.4 mL [8%] vs 1.8 mL [17%]; P = .002). Assessment of final infarct volume using DWI at 24 hours captures the effect of reperfusion therapies on infarct growth and predicts functional outcome similarly to imaging at day 90. This has the potential to reduce loss to follow-up in trials and may add early prognostic information in clinical practice.

  6. Morphometric changes of whole brain in patients with alcohol addiction: a voxel-based morphometry study%酒精成瘾者的体素全脑形态测量学分析

    Institute of Scientific and Technical Information of China (English)

    李金锋; 陈志晔; 马林

    2011-01-01

    目的:应用基于体素的形态测量学( VBM)方法分析酒精成瘾患者脑结构的变化。方法 采用3.0T超导MR系统,对15例酒精成瘾者(患者组)和15例年龄和性别与之相匹配的正常成年志愿者(对照组)行MR脑结构像扫描,并应用VBM方法对图像进行分析,全脑体积的比较采用成组t检验。结果 酒精成瘾者局部灰质体积明显萎缩脑区为左侧额中回、额上回、楔前回、直回及右侧额上回内侧、眶回。白质萎缩的区域为双侧额上回白质。全脑体积分析显示患者组脑白质体积[ (675.14±70.62) ml]及脑实质体积[(1578.8l±199.05) ml]较对照组脑白质体积[(841.33±177.35) ml]及脑实质体积[(1722.13±117.62) ml]明显减小(t值分别为11.37、5.764,P值均<0.05),患者组全脑灰质体积[(903.67±139.87) ml]较对照组[(880.79±157.10) ml]未见减小(t =0.177,P>0.05)。结论 酒精成瘾者脑部早期变化可表现为局部脑灰质、白质结构的萎缩,额叶灰质及白质是酒精性脑损伤相对特异的脑区。VBM对于评估酒精性成瘾者脑萎缩有一定的价值。%Objective To evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. Methods Fifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T1 structure images were normalized,segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age,body mass index ( BMI ), and education years as covariates because of exact sex match. A statistical threshold of P < 0. 01 (uncorrected) and more than continuous 50 voxels were determined as significant.Results Regional results showed there was a significant reduction of gray matter volume in left middle frontal gyrus, superior frontal gyrus

  7. Medical diagnosis imaging systems: image and signal processing applications aided by fuzzy logic

    Science.gov (United States)

    Hata, Yutaka

    2010-04-01

    First, we describe an automated procedure for segmenting an MR image of a human brain based on fuzzy logic for diagnosing Alzheimer's disease. The intensity thresholds for segmenting the whole brain of a subject are automatically determined by finding the peaks of the intensity histogram. After these thresholds are evaluated in a region growing, the whole brain can be identified. Next, we describe a procedure for decomposing the obtained whole brain into the left and right cerebral hemispheres, the cerebellum and the brain stem. Our method then identified the whole brain, the left cerebral hemisphere, the right cerebral hemisphere, the cerebellum and the brain stem. Secondly, we describe a transskull sonography system that can visualize the shape of the skull and brain surface from any point to examine skull fracture and some brain diseases. We employ fuzzy signal processing to determine the skull and brain surface. The phantom model, the animal model with soft tissue, the animal model with brain tissue, and a human subjects' forehead is applied in our system. The all shapes of the skin surface, skull surface, skull bottom, and brain tissue surface are successfully determined.

  8. Quantitation of regional cerebral blood flow by single photon emission computed tomography of CBF-tracer combined with whole-brain CBF; A comparison between [sup 123]I-IMP and [sup 99m]Tc-HMPAO in healthy volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Yoshinari; Imaizumi, Masatoshi; Ashida, Keiichi; Ohe, Yosuke; Okamoto, Masaya; Abe, Tohru; Tanaka, Seiji (Osaka National Hospital (Japan))

    1994-05-01

    A simple, noninvasive method of measuring cerebral blood flow (CBF) that uses single-photon emission computed tomography (SPECT) of CBF-tracer and whole brain CBF obtained by xenon-133 ([sup 133]Xe) clearance technique was developed. In nine healthy volunteers, SPECT data were normalized to the count density of [sup 123]I-IMP or [sup 99m]Tc-HMPAO uptake in the whole-brain, and then converted to the absolute units of CBF by multiplying average [sup 133]Xe-CBF in the whole brain. The CBF values measured by [sup 99m]Tc-HMPA CBF-SPECT was significantly lower in the high flow regions of cortical gray matter (bilateral frontal lobe; p<0.05 and right occipital lobe; p<0.05), and was significantly higher in the bilateral white matter (p<0.05 or 0.01) and the cerebellum (p<0.005) compared with the flow values measured by [sup 123]I-IMP CBF-SPECT. Whereas, the IMP-CBF values were significantly lower in the bilateral striatum (p<0.02 or 0.05) compared with the HMPAO-CBF values. Good correlations were found between IMP-CBF and the HMPAO-CBF values in the cortical gray matter (r[sub s]=0.761; p<0.001, n=108), the white matter (r[sub s]=0.739; p<0.001, n=18) and the cerebellum (r[sub s]=0.731; p<0.001, n=18). In the striatum (r[sub s]=0.58; p<0.05, n=18) and the thalamus (r[sub s]=0.628; p<0.05, n=18), the correlations between IMP-CBF and HMPAO-CBF values were inferior to those of the other three regions. The results indicated that the contrast between high and low CBF regions in the HMPAO CBF-SPECT was significantly less than that in the IMP CBF-SPECT. However, this assumption is not applicable in all of the cerebral regions. (author).

  9. Early Gray-Matter and White-Matter Concentration in Infancy Predict Later Language Skills: A Whole Brain Voxel-Based Morphometry Study

    Science.gov (United States)

    Can, Dilara Deniz; Richards, Todd; Kuhl, Patricia K.

    2013-01-01

    Magnetic Resonance Imaging (MRI) brain scans were obtained from 19 infants at 7 months. Expressive and receptive language performance was assessed at 12 months. Voxel-based morphometry (VBM) identified brain regions where gray-matter and white-matter concentrations at 7 months correlated significantly with children's language scores at 12 months.…

  10. Early Gray-Matter and White-Matter Concentration in Infancy Predict Later Language Skills: A Whole Brain Voxel-Based Morphometry Study

    Science.gov (United States)

    Can, Dilara Deniz; Richards, Todd; Kuhl, Patricia K.

    2013-01-01

    Magnetic Resonance Imaging (MRI) brain scans were obtained from 19 infants at 7 months. Expressive and receptive language performance was assessed at 12 months. Voxel-based morphometry (VBM) identified brain regions where gray-matter and white-matter concentrations at 7 months correlated significantly with children's language scores at 12 months.…

  11. Development and organization of the human brain tissue compartments across the lifespan using diffusion tensor imaging.

    Science.gov (United States)

    Hasan, Khader M; Sankar, Ambika; Halphen, Christopher; Kramer, Larry A; Brandt, Michael E; Juranek, Jenifer; Cirino, Paul T; Fletcher, Jack M; Papanicolaou, Andrew C; Ewing-Cobbs, Linda

    2007-10-29

    We used a diffusion tensor imaging-based whole-brain tissue segmentation to characterize age-related changes in (a) whole-brain grey matter, white matter, and cerebrospinal fluid relative to intracranial volume and (b) the corresponding brain tissue microstructure using measures of diffusion tensor anisotropy and mean diffusivity. The sample, a healthy cohort of 119 right-handed males and females aged 7-68 years. Our results demonstrate that white matter and grey matter volumes and their corresponding diffusion tensor anisotropy and mean diffusivity follow nonlinear trajectories with advancing age. In contrast, cerebrospinal fluid volume increases linearly with age.

  12. New Advance on Research of Brain Dominance in Neuropsychology from Herrmann Whole Brain Concept%赫曼全脑概念对神经心理侧化优势研究的新成果

    Institute of Scientific and Technical Information of China (English)

    郑林科

    2001-01-01

    神经心理侧化优势的研究经历了史培利的“二分脑模型”和麦春色连的“三分脑模型”阶段。现已发展到赫曼的“四分脑模型”新阶段,赫曼是风行世界的全脑技术的创始人,其代表作《The Creative Brain》轰动美国之后,又推出了《Whole Brain Technology》。他创立了“全脑概念”(Whole Brain Concept)的理论体系,其要旨是:“四分脑模型”是神经心理侧化优势的新概念和新成果;“四分脑模型”可通过“赫曼大脑优势量表”的技术来测量[1]。“全脑概念”的理论和技术已在美国和欧洲许多国家得到推广使用,但在我国赫曼全脑概念及其医学哲学的理论价值鲜为人知,因此,介绍赫曼全脑概念对神经心理侧化优势研究的新成果。有助于医学心理学基础理论研究的深化和神经心理临床技术的试用。

  13. Characteristics of the whole-brain white-matter structural network in 2 to 3-year-old children with autism spectrum disorder%2~3岁孤独谱系障碍儿童的全脑白质结构网络特征

    Institute of Scientific and Technical Information of China (English)

    钱璐; 钱龙; 邱婷; 肖运华; 李赟; 肖湘; 肖婷; 储康康; 方慧

    2015-01-01

    目的 研究2~3岁孤独谱系障碍(ASD)儿童全脑白质结构网络拓扑属性的特征.方法 对2~3岁的ASD儿童与年龄、性别及智商相匹配的发育迟缓(DD)儿童各45例进行扩散张量成像(DTI)扫描,在使用确定性纤维追踪技术构建脑结构网络的基础上采用基于图论的分析方法分析2组儿童的脑网络拓扑结构属性的特征,并进一步探讨ASD儿童脑网络拓扑结构属性的特征值与临床症状之间的相关性.结果 ASD组儿童脑结构网络的全局拓扑属性异常,表现为全局效率显著降低(P =0.006),最短路径长度显著增加(P=0.010);ASD儿童的脑结构网络共有11个核心节点,其中有9个与DD组相同,2个与DD组不同的核心节点为右侧颞中回及右侧背外侧额上回;与DD组相比,ASD组节点效率显著降低的区域为左侧眶部额下回、左侧内侧眶部额上回、右侧后扣带回、左侧枕下回、右侧楔前叶、左侧旁中央小叶、左侧尾状核、右侧尾状核和左侧颞上回颞极(P<0.001);显著升高的区域为左侧缘上回、右侧角回和左侧颞横回(P <0.001);ASD组儿童脑网络拓扑结构属性的特征值与临床症状之间的相关分析未显示显著相关.结论 幼儿期ASD儿童的全脑白质结构网络存在着小世界属性;与DD儿童相比,ASD儿童全脑信息传输慢且效率降低,但在不同脑区间的结构连接上同时存在降低与增强的现象.%Objective To investigate the topological property alterations of the whole-brain white-matter (WM) structural network between 2 to 3-year-old children with autism spectrum disorder (ASD) children.Methods This research used diffusion tensor imaging(DTI) tractography to construct the human brain WM networks of 45 ASD children ranging from 2 to 3-year-old and 45 age-and sex-matched DD controls,followed by a graph theoretical analysis to establish topological architecture of the cerebral anatomical network,so as to further show the

  14. 不同核型特纳综合征患儿认知及脑形态学研究%Wechsler intelligence test and a whole-brain matter analysis in children with Turner syndrome of different karyotypes

    Institute of Scientific and Technical Information of China (English)

    赵秋玲; 张知新; 谢晟; 程盼贵; 张嘉颖; 龚高浪

    2012-01-01

    Objective To detect the cognitive phenotype and structural changes of cerebral gray and white matter in children with Turner syndrome (TS) of different chromosome karyotype by using Wechsler intelligence test and voxel-based morphometry (VBM). Methods Nine 45X karyotype and 11 non 45X karyotype TS girls and 20 age-matched control girls were recruited. Wechsler intelligence scale for children was used to obtain their intelligence quotients (IQ). High-resolution magnetic MR imaging was performed in TS children and control girls to collect the whole brain structural data. The analysis of VBM was performed with SPM 8 to compare the volume of gray and white matter between the 45X karyotype and non 45X karyotype of TS children and normal controls by covariance analysis. Results Compared with normal controls, the statistical analysis revealed significant difference of IQ in TS group (P<0.05); significant difference was observed in 45X karyotype TS group in verbal comprehension, perceptual reasoning, working memory and processing speed; and there was significant difference in non 45X karyotype TS group in perceptual reasoning, processing speed (P<0.05). There was significant difference in verbal comprehension between TS groups (P<0.05). Compared with normal controls, 45X karyotype TS children showed significantly decreased volume (P<0.05) in the gray matter of the right superior parietal lobule, postcentral gyrus, precuneus lobule, calcarine, cuneus cortices, and the left middle and inferior occipital lobe. However, the volume of the bilateral supplemental motor area and the medial superior frontal lobes, the right middle cingulum, the left superior, middle, and inferior temporal gyri were increased in the TS children, compared to the controls. The left fusiform, the left parahippocampus, the left hippocampus and the left cerebellum were also significantly enlarged in TS children (P<0.05, FEW-corrected); non 45X karyotype TS children showed significantly decreased volume

  15. Only Three Fingers Write, but the Whole Brain Works: A High-Density EEG Study Showing Advantages of Drawing Over Typing for Learning.

    Science.gov (United States)

    van der Meer, Audrey L H; van der Weel, F R Ruud

    2017-01-01

    Are different parts of the brain active when we type on a keyboard as opposed to when we draw visual images on a tablet? Electroencephalogram (EEG) was used in young adults to study brain electrical activity as they were typing or describing in words visually presented Pictionary(TM) words using a keyboard, or as they were drawing pictures of the same words on a tablet using a stylus. Analyses of temporal spectral evolution (time-dependent amplitude changes) were performed on EEG data recorded with a 256-channel sensor array. We found that when drawing, brain areas in the parietal and occipital regions showed event related desynchronization activity in the theta/alpha range. Existing literature suggests that such oscillatory neuronal activity provides the brain with optimal conditions for learning. When describing the words using the keyboard, upper alpha/beta/gamma range activity in the central and frontal brain regions were observed, especially during the ideation phase. However, since this activity was highly synchronized, its relation to learning remains unclear. We concluded that because of the benefits for sensory-motor integration and learning, traditional handwritten notes are preferably combined with visualizations (e.g., small drawings, shapes, arrows, symbols) to facilitate and optimize learning.

  16. Whole brain radiation therapy with simultaneously integrated brain metastases boost a planning and effect study%脑转移癌螺旋断层放疗剂量学特点和近期疗效分析

    Institute of Scientific and Technical Information of China (English)

    路娜; 王雅棣; 姚波; 陈点点; 刘清智

    2014-01-01

    目的:探讨脑转移癌螺旋断层放射治疗(helical tomotherapy ,HT)行全脑放疗联合同步推量技术的剂量学特性及疗效。方法回顾性分析20例行螺旋断层放疗的脑转移患者资料,给予全脑(PT Vw b )40 Gy/20 F ,同时局部转移灶(pGTV)加量至60 Gy/20 F ,5次/周。分别对靶区的均匀性指数(HI)、不均匀性指数(heterogeneity index ,UI)和正常器官受照的最大剂量及平均剂量进行评价,并采用RTOG/EORTC标准评价急性反应,参照RECIST 1.0版实体瘤评价标准评价疗效。结果所有患者的Tomotherapy计划均有较好的靶区处方剂量分布、适形度和均匀性,危及器官受照射剂量均达到处方剂量要求。20例患者均顺利完成放疗,局部控制率95%,1 a生存率60%。放疗后K PS评分较放疗前明显提高,差异有统计学意义( P<0.05)。主要急性不良反应为脑水肿、乏力、脱发、听力下降、记忆力轻度减退,1例患者出现Ⅲ~Ⅳ级神经系统不良反应。结论螺旋断层放疗行全脑放疗联合同步推量技术临床可行,适用于脑转移癌放射治疗。%Objective To evaluate the dosimetric characteristics and the short term effect of Helical Tomotherapy for brain metastases by whole brain radiotherapy combined with simultaneous integrated boost.Methods 20 patients with brain metasta-ses were chosen for retrospective analysis.The prescribed whole brain (PTVwb) doses were 40 Gy in 20 fractions ,while doses to brain metastases(pGTV) were simultaneously boosted to 60 Gy.Plans were evaluated regarding the dose coverage of targets , dose volume histograph ,and other dosimetric index.Results The dose distribution ,conformity and uniformity of Tomotherapy plan were acceptable.The local control rates of brain metastases were 95% ,the one year survival rate was 60%.The KPS scores were significantly different from that of per-treatment.The main toxicity

  17. Application of Whole-brain Perfusion CT with 320-detector Row CT System in Staging of Cerebral Ischemic Penumbra%320排动态容积CT全脑灌注成像在脑梗死缺血半暗带分期中的应用

    Institute of Scientific and Technical Information of China (English)

    向永华; 王波; 金科; 杨伟; 汪春红

    2012-01-01

    Purpose To investigate the feasibility of staging cerebral ischemic penumbra using 320-detector row CT whole-brain perfusion imaging. Materials and Methods The values of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were measured in infarct core area, ischemic penumbra, and mirror area in 18 cases with ischemic penumbra. The staging of the ischemic penumbra was made according to the criteria of pre-infarction period staging. Results In 18 cases with ischemic penumbra, MTT and TTP were delayed; CBF was decreased; CBV was slightly decreased, normal or slightly increased. Compared with infarct core area, CBV and CBF were increased, MTT was delayed and TTP was shortened in ischemic penumbra (P 0.05). In 18 cases, three cases were in stage I 2, nine cases in stage Ⅱ1, six cases in stage Ⅱ2. Conclusion Application of whole-brain perfusion CT with 320-detector row CT system can identify the area of cerebral lesions and the existence of ischemic penumbra.%目的 应用320排动态容积CT全脑灌注成像探讨脑梗死缺血半暗带分期的可行性.资料与方法 测量18例存在缺血半暗带脑梗死患者的梗死核心区、缺血半暗带区及其镜像对侧脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)及达峰时间(TTP),按脑梗死前期分期标准对缺血半暗带进行分期.结果 18例缺血半暗带区表现为MTT、TTP延长,CBF降低,CBV轻度升高、正常或轻度降低.与梗死核心区比较,缺血半暗带区CBV、CBF升高,MTT延长,TTP缩短(P<0.05);与健侧对应区比较,CBF降低,MTT及TTP延长(P<0.05),而CBV无显著差异(P>0.05).缺血半暗带分期:Ⅰ2期3例,Ⅱ1期9例,Ⅱ2期6例.结论 应用320排动态容积CT全脑灌注成像可明确脑梗死患者的病变部位、范围以及有无缺血半暗带存在,并可对缺血半暗带进行分期.

  18. Comparison of Clinical Outcomes of Surgery Followed by Local Brain Radiotherapy and Surgery Followed by Whole Brain Radiotherapy in Patients With Single Brain Metastasis: Single-Center Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Kenji [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Narita, Yoshitaka, E-mail: yonarita@ncc.go.jp [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Miyakita, Yasuji; Ohno, Makoto [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Mayahara, Hiroshi [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Kayama, Takamasa; Shibui, Soichiro [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan)

    2011-11-15

    Purpose: Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited. Patients and Methods: A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital. Results: A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups. Conclusions: The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.

  19. Whole Brain Radiotherapy and RRx-001: Two Partial Responses in Radioresistant Melanoma Brain Metastases from a Phase I/II Clinical Trial: A TITE-CRM Phase I/II Clinical Trial.

    Science.gov (United States)

    Kim, Michelle M; Parmar, Hemant; Cao, Yue; Pramanik, Priyanka; Schipper, Matthew; Hayman, James; Junck, Larry; Mammoser, Aaron; Heth, Jason; Carter, Corey A; Oronsky, Arnold; Knox, Susan J; Caroen, Scott; Oronsky, Bryan; Scicinski, Jan; Lawrence, Theodore S; Lao, Christopher D

    2016-04-01

    Kim et al. report two patients with melanoma metastases to the brain that responded to treatment with RRx-001 and whole brain radiotherapy (WBRT) without neurologic or systemic toxicity in the context of a phase I/II clinical trial. RRx-001 is an reactive oxygen and reactive nitrogen species (ROS/RNS)-dependent systemically nontoxic hypoxic cell radiosensitizer with vascular normalizing properties under investigation in patients with various solid tumors including those with brain metastases. Metastatic melanoma to the brain is historically associated with poor outcomes and a median survival of 4 to 5 months. WBRT is a mainstay of treatment for patients with multiple brain metastases, but no significant therapeutic advances for these patients have been described in the literature. To date, candidate radiosensitizing agents have failed to demonstrate a survival benefit in patients with brain metastases, and in particular, no agent has demonstrated improved outcome in patients with metastatic melanoma. Kim et al. report two patients with melanoma metastases to the brain that responded to treatment with novel radiosensitizing agent RRx-001 and WBRT without neurologic or systemic toxicity in the context of a phase I/II clinical trial. Published by Elsevier Inc.

  20. Quantitative measurements of cerebral blood flow in volume imaging PET scanners

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.J.; Shao, L.; Freifelder, R.; Karp, J.S.; Ragland, J.D. [Univ. of Pennsylvania, Philadelphia, PA (United States)

    1995-08-01

    Quantitative measurements of Cerebral Blood Flow (CBF) are performed in a volume imaging PET Scanner by means of moderate activity infusions. In equilibrium infusions, activations are measured by scanning over 10 minutes with 16 minute activations. Typical measured whole brain CBF values are 37{+-}8 ml/min/100g, close to the value of 42 ml/min/100g reported by other groups using this method. For ramped infusions, scanning over 4 minutes with 5 minute activations results in whole brain CBFs of 49 {+-} 9 ml/min/100g, close to the Kety and Schmidt value of 50 ml/min/100g. Both equilibrium and ramped infusion methods have been used to study face and word memory in human subjects. Both methods were able to detect significant activations in regions implicated in human memory. The authors conclude that precise quantitation of regional CBF is achieved using both methods, and that ramped infusions also provide accurate measures of CBF. In addition a simplified protocol for ramped infusion studies has been developed. In this method the whole brain tissue time activity curve generated from dynamic scanning is replaced by an appropriately scaled camera coincidence countrate curve. The resulting whole brain CBF values are only 7% different from the dynamic scan and fit results. Regional CBFs (rCBF) may then be generated from the summed image (4.25 minutes) using a count density vs flow lookup table.

  1. Cerebral toxoplasmosis: case review and description of a new imaging sign

    Energy Technology Data Exchange (ETDEWEB)

    Masamed, R. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States)], E-mail: rmasamed@mednet.ucla.edu; Meleis, A. [Princeton University, New Jersey, CA (United States); Lee, E.W. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Hathout, G.M. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, Olive View UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, West L.A. VA Medical Center, Los Angeles, CA (United States)

    2009-05-15

    Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

  2. Novel diffusion-weighted magnetic resonance imaging findings in leptomeningeal carcinomatosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Y.F.; Chang, F.C.; Hu, H.H.; Hsu, L.C. [Taipei Veterans General Hospital, Taiwan (China). Depts. of Internal Medicine and Radiology, and Neurological Inst.

    2006-12-15

    This report presents a rare case of leptomeningeal carcinomatosis initially presenting with mental impairment and rapidly progressing to coma without any history of malignancy. In addition to highlighting the diagnostic difficulties, the linear high signal intensity along the cortex on the diffusion-weighted imaging (DWI) sequence of magnetic resonance (MR) imaging was identified accidentally. High signal change in the corresponding areas was also noted on unenhanced fluid-attenuated inversion recovery (FLAIR) MR imaging, which may be a novel method of diagnosing leptomeningeal carcinomatosis, which should be studied further.

  3. Whole Brain Networks for Treatment of Epilepsy

    Science.gov (United States)

    2013-07-01

    Sakaie, Ph.D. CONTRACTING ORGANIZATION: The Cleveland Clinic Foundation...2. REPORT TYPE Final 3. DATES COVERED 1 July 2011 – 30 June 2013 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0362...f DF(O , ) , mlm l l m c Y (14) where is the zenith angle, is the azimuth angle, ( , )mlY are the modified spherical

  4. Whole Brain Networks for Treatment for Epilepsy

    Science.gov (United States)

    2012-07-01

    connectivity. This result, presented at the 2012 scientific meeting of the American Society of Neuroradiology (3), indicates that the link between...scientific meeting of the American Society of Neuroradiology (3) CONCLUSION We have implemented a methodology for tractography that is fast and...Annual Meeting of the American Society for Neuroradiology ; 2012; New York. 4. Biswal B, Yetkin FZ, Haughton VM, Hyde JS (1995). Functional

  5. Putting Your Company's Whole Brain to Work.

    Science.gov (United States)

    Leonard, Dorothy; Straus, Susaan

    1997-01-01

    Managers who foster innovation succeed in getting different approaches to grate against one another in a productive process called creative abrasion. They nurture and know how to use a cognitively diverse environment. (JOW)

  6. Putting Your Company's Whole Brain to Work.

    Science.gov (United States)

    Leonard, Dorothy; Straus, Susaan

    1997-01-01

    Managers who foster innovation succeed in getting different approaches to grate against one another in a productive process called creative abrasion. They nurture and know how to use a cognitively diverse environment. (JOW)

  7. A Phase 3 Trial of Whole Brain Radiation Therapy and Stereotactic Radiosurgery Alone Versus WBRT and SRS With Temozolomide or Erlotinib for Non-Small Cell Lung Cancer and 1 to 3 Brain Metastases: Radiation Therapy Oncology Group 0320

    Energy Technology Data Exchange (ETDEWEB)

    Sperduto, Paul W., E-mail: psperduto@mropa.com [Metro MN CCOP, Minneapolis, Minnesota (United States); Wang, Meihua [RTOG Statistical Center, Philadelphia, Pennsylvania (United States); Robins, H. Ian [University of Wisconsin Medical School Cancer Center, Madison, Wisconsin (United States); Schell, Michael C. [Wilmot Cancer Center, University of Rochester, Rochester, New York (United States); Werner-Wasik, Maria [Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Komaki, Ritsuko [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Souhami, Luis [McGill University, Montreal, Quebec (Canada); Buyyounouski, Mark K. [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Khuntia, Deepak [University of Wisconsin Hospital, Madison, Wisconsin (United States); Demas, William [Akron City Hospital, Akron, Ohio (United States); Shah, Sunjay A. [Christiana Care Health Services, Inc, CCOP, Newark, Delaware (United States); Nedzi, Lucien A. [University of Texas Southwestern Medical School, Dallas, Texas (United States); Perry, Gad [The Ottawa Hospital Cancer Centre, Ottawa, Ontario (Canada); Suh, John H. [Cleveland Clinic Foundation, Cleveland, Ohio (United States); Mehta, Minesh P. [Northwestern Memorial Hospital, Chicago, Illinois (United States)

    2013-04-01

    Background: A phase 3 Radiation Therapy Oncology Group (RTOG) study subset analysis demonstrated improved overall survival (OS) with the addition of stereotactic radiosurgery (SRS) to whole brain radiation therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with 1 to 3 brain metastases. Because temozolomide (TMZ) and erlotinib (ETN) cross the blood-brain barrier and have documented activity in NSCLC, a phase 3 study was designed to test whether these drugs would improve the OS associated with WBRT + SRS. Methods and Materials: NSCLC patients with 1 to 3 brain metastases were randomized to receive WBRT (2.5 Gy × 15 to 37.5 Gy) and SRS alone, versus WBRT + SRS + TMZ (75 mg/m{sup 2}/day × 21 days) or ETN (150 mg/day). ETN (150 mg/day) or TMZ (150-200 mg/m{sup 2}/day × 5 days/month) could be continued for as long as 6 months after WBRT + SRS. The primary endpoint was OS. Results: After 126 patients were enrolled, the study closed because of accrual limitations. The median survival times (MST) for WBRT + SRS, WBRT + SRS + TMZ, and WBRT + SRS + ETN were qualitatively different (13.4, 6.3, and 6.1 months, respectively), although the differences were not statistically significant. Time to central nervous system progression and performance status at 6 months were better in the WBRT + SRS arm. Grade 3 to 5 toxicity was 11%, 41%, and 49% in arms 1, 2, and 3, respectively (P<.001). Conclusion: The addition of TMZ or ETN to WBRT + SRS in NSCLC patients with 1 to 3 brain metastases did not improve survival and possibly had a deleterious effect. Because the analysis is underpowered, these data suggest but do not prove that increased toxicity was the cause of inferior survival in the drug arms.

  8. Definitive Chemoradiation Therapy Following Surgical Resection or Radiosurgery Plus Whole-Brain Radiation Therapy in Non-Small Cell Lung Cancer Patients With Synchronous Solitary Brain Metastasis: A Curative Approach

    Energy Technology Data Exchange (ETDEWEB)

    Parlak, Cem, E-mail: cemparlak@gmail.com [Department of Radiation Oncology, Baskent University, Adana Medical Faculty, Adana (Turkey); Mertsoylu, Hüseyin [Department of Medical Oncology, Baskent University, Adana Medical Faculty, Adana (Turkey); Güler, Ozan Cem; Onal, Cem; Topkan, Erkan [Department of Radiation Oncology, Baskent University, Adana Medical Faculty, Adana (Turkey)

    2014-03-15

    Purpose/Objectives: The aim of this study was to evaluate the impact of definitive thoracic chemoradiation therapy following surgery or stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT) on the outcomes of patients with non-small cell lung cancer (NSCLC) with synchronous solitary brain metastasis (SSBM). Methods and Materials: A total of 63 NSCLC patients with SSBM were retrospectively evaluated. Patients were staged using positron emission tomography-computed tomography in addition to conventional staging tools. Thoracic radiation therapy (TRT) with a total dose of 66 Gy in 2 Gy fractions was delivered along with 2 cycles of cisplatin-based chemotherapy following either surgery plus 30 Gy of WBRT (n=33) or SRS plus 30 Gy of WBRT (n=30) for BM. Results: Overall, the treatment was well tolerated. All patients received planned TRT, and 57 patients (90.5%) were also able to receive 2 cycles of chemotherapy. At a median follow-up of 25.3 months (7.1-52.1 months), the median months of overall, locoregional progression-free, neurological progression-free, and progression-free survival were 28.6, 17.7, 26.4, and 14.6, respectively. Both univariate and multivariate analyses revealed that patients with a T1-T2 thoracic disease burden (P=.001), a nodal stage of N0-N1 (P=.003), and no weight loss (P=.008) exhibited superior survival. Conclusions: In the present series, surgical and radiosurgical treatments directed toward SSBM in NSCLC patients were equally effective. The similarities between the present survival outcomes and those reported in other studies for locally advanced NSCLC patients indicate the potentially curative role of definitive chemoradiation therapy for highly selected patients with SSBM.

  9. Images

    Data.gov (United States)

    National Aeronautics and Space Administration — Images for the website main pages and all configurations. The upload and access points for the other images are: Website Template RSW images BSCW Images HIRENASD...

  10. Hyperintense ipsilateral cortical sulci on FLAIR imaging in carotid stenosis: ivy sign equivalent from enlarged leptomeningeal collaterals.

    Science.gov (United States)

    Hacein-Bey, Lotfi; Mukundan, Govind; Shahi, Kavian; Chan, Hung; Tajlil, Ali T

    2014-01-01

    Fluid-attenuated inversion recovery (FLAIR) imaging provides high contrast between hyperintense lesions and normal tissue. Hyperintense structures in convexity sulci are commonly linked to abnormal cerebrospinal fluid composition, whether blood, protein, or infection. A patient with hemispheric transient ischemic attacks from severe carotid stenosis had hyperintense convexity sulci on FLAIR magnetic resonance imaging, interpreted as possible prior hemorrhage, making the patient ineligible for carotid stent reconstruction. Retrospective analysis revealed that hyperintense sulci were dilated leptomeningeal collaterals. In severe arterial disease causing cerebral hypoperfusion, dilated leptomeningeal vessels should be considered a cause for serpiginous hyperintense structures on FLAIR imaging, similar to the "ivy sign" described in moya-moya patients.

  11. Whole brain radiation with supplementary boost for patients for unique brain metastasis from a primitive lung cancer; Experience de l'irradiation encephalique totale avec escalade de dose focalisee pour le traitement des metastases cerebrales uniques d'un carcinome bronchopulmonaire

    Energy Technology Data Exchange (ETDEWEB)

    Levy, A.; Lamproglou, I. [Service de radiotherapie, groupe hospitalier Pitie-Salpetriere, 47-83, boulevard de l' Hopital, 75013 Paris (France); Chargari, C. [Service de radiotherapie, groupe hospitalier Pitie-Salpetriere, 47-83, boulevard de l' Hopital, 75013 Paris (France); Service de radiotherapie, hopital d' instruction des armees Val-de-Grace, 75005 Paris (France); Mazeron, J.J. [Service de radiotherapie, groupe hospitalier Pitie-Salpetriere, 47-83, boulevard de l' Hopital, 75013 Paris (France); Universite Pierre-et-Marie-Curie Paris 6, 4, place Jussieu, 75005 Paris (France); Krzisch, C. [Service de radiotherapie, CHU d' Amiens-Picardie, place Victor-Pauchet, 80054 Amiens cedex (France); Assouline, A. [Service de radiotherapie, groupe hospitalier Pitie-Salpetriere, 47-83, boulevard de l' Hopital, 75013 Paris (France); Universite Pierre-et-Marie-Curie Paris 6, 4, place Jussieu, 75005 Paris (France); Service de radiotherapie, CHU d' Amiens-Picardie, place Victor-Pauchet, 80054 Amiens cedex (France)

    2011-08-15

    Purpose. - To assess the potential benefit of a boost in patients treated with whole brain irradiation by a conventional linear accelerator for lung cancer solitary brain metastasis. Patients and methods. - From 2002 to 2006, a retrospective analysis was carried out from 64 unselected consecutive patients with secondary brain metastasis from lung cancer, treated with whole brain irradiation without surgical resection. Thirty patients (47%) received a boost in their brain metastases. Three potential prognostic factors were studied: sex, RPA score and improvement of neurological symptoms after radiotherapy. An analysis was conducted to determine whether an additional dose may improve survival in the absence of surgical resection. Results. - The mean follow-up was 4.9 months. The median overall survival was 8.5 months (6.4 to 10.7 months). The total dose of radiotherapy was the only significant prognostic factor for overall survival. The median overall survival was 6.2 months for patients without additional radiation versus 11.2 months for patients receiving a boost dose (p = 0.011). Sex, RPA score and improvement of neurological symptoms after radiotherapy were not found as prognostic factors for overall survival. Conclusions. - Boost delivered after whole brain radiation therapy by a conventional particle accelerator may provide a benefit in selected patients, especially for centres that do not have radiotherapy techniques in stereotactic conditions. This warrants further prospective assessment. (authors)

  12. Secondary analysis of RTOG 9508, a phase 3 randomized trial of whole-brain radiation therapy versus WBRT plus stereotactic radiosurgery in patients with 1-3 brain metastases; poststratified by the graded prognostic assessment (GPA).

    Science.gov (United States)

    Sperduto, Paul W; Shanley, Ryan; Luo, Xianghua; Andrews, David; Werner-Wasik, Maria; Valicenti, Richard; Bahary, Jean-Paul; Souhami, Luis; Won, Minhee; Mehta, Minesh

    2014-11-01

    Radiation Therapy Oncology Group (RTOG) 9508 showed a survival advantage for patients with 1 but not 2 or 3 brain metastasis (BM) treated with whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) versus WBRT alone. An improved prognostic index, the graded prognostic assessment (GPA) has been developed. Our hypothesis was that if the data from RTOG 9508 were poststratified by the GPA, the conclusions may vary. In this analysis, 252 of the 331 patients were evaluable by GPA. Of those, 211 had lung cancer. Breast cancer patients were excluded because the components of the breast GPA are not in the RTOG database. Multiple Cox regression was used to compare survival between treatment groups, adjusting for GPA. Treatment comparisons within subgroups were performed with the log-rank test. A free online tool (brainmetgpa.com) simplified GPA use. The fundamental conclusions of the primary analysis were confirmed in that there was no survival benefit overall for patients with 1 to 3 metastases; however, there was a benefit for the subset of patients with GPA 3.5 to 4.0 (median survival time [MST] for WBRT + SRS vs WBRT alone was 21.0 versus 10.3 months, P=.05) regardless of the number of metastases. Among patients with GPA 3.5 to 4.0 treated with WBRT and SRS, the MST for patients with 1 versus 2 to 3 metastases was 21 and 14.1 months, respectively. This secondary analysis of predominantly lung cancer patients, consistent with the original analysis, shows no survival advantage for the group overall when treated with WBRT and SRS; however, in patients with high GPA (3.5-4), there is a survival advantage regardless of whether they have 1, 2, or 3 BM. This benefit did not extend to patients with lower GPA. Prospective validation of this survival benefit for patients with multiple BM and high GPA when treated with WBRT and SRS is warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Competing Risk Analysis of Neurologic versus Nonneurologic Death in Patients Undergoing Radiosurgical Salvage After Whole-Brain Radiation Therapy Failure: Who Actually Dies of Their Brain Metastases?

    Energy Technology Data Exchange (ETDEWEB)

    Lucas, John T., E-mail: jolucas@wakehealth.edu [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Colmer, Hentry G.; White, Lance [Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Fitzgerald, Nora; Isom, Scott [Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Bourland, John D. [Department of Radiation Oncology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (United States); Laxton, Adrian W. [Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina (United States); Tatter, Stephen B. [Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Chan, Michael D. [Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina (United States)

    2015-08-01

    Purpose: To estimate the hazard for neurologic (central nervous system, CNS) and nonneurologic (non-CNS) death associated with patient, treatment, and systemic disease status in patients receiving stereotactic radiosurgery after whole-brain radiation therapy (WBRT) failure, using a competing risk model. Patients and Methods: Of 757 patients, 293 experienced recurrence or new metastasis following WBRT. Univariate Cox proportional hazards regression identified covariates for consideration in the multivariate model. Competing risks multivariable regression was performed to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for both CNS and non-CNS death after adjusting for patient, disease, and treatment factors. The resultant model was converted into an online calculator for ease of clinical use. Results: The cumulative incidence of CNS and non-CNS death at 6 and 12 months was 20.6% and 21.6%, and 34.4% and 35%, respectively. Patients with melanoma histology (relative to breast) (aHR 2.7, 95% CI 1.5-5.0), brainstem location (aHR 2.1, 95% CI 1.3-3.5), and number of metastases (aHR 1.09, 95% CI 1.04-1.2) had increased aHR for CNS death. Progressive systemic disease (aHR 0.55, 95% CI 0.4-0.8) and increasing lowest margin dose (aHR 0.97, 95% CI 0.9-0.99) were protective against CNS death. Patients with lung histology (aHR 1.3, 95% CI 1.1-1.9) and progressive systemic disease (aHR 2.14, 95% CI 1.5-3.0) had increased aHR for non-CNS death. Conclusion: Our nomogram provides individual estimates of neurologic death after salvage stereotactic radiosurgery for patients who have failed prior WBRT, based on histology, neuroanatomical location, age, lowest margin dose, and number of metastases after adjusting for their competing risk of death from other causes.

  14. Secondary Analysis of RTOG 9508, a Phase 3 Randomized Trial of Whole-Brain Radiation Therapy Versus WBRT Plus Stereotactic Radiosurgery in Patients With 1-3 Brain Metastases; Poststratified by the Graded Prognostic Assessment (GPA)

    Energy Technology Data Exchange (ETDEWEB)

    Sperduto, Paul W., E-mail: psperduto@mropa.com [Metro-Minnesota CCOP and Minneapolis Radiation Oncology, Minneapolis, Minnesota (United States); Shanley, Ryan [Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota (United States); Luo, Xianghua [Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota (United States); Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota (United States); Andrews, David [Thomas Jefferson University, Department of NeuroOncology, Philadelphia, Pennsylvania (United States); Werner-Wasik, Maria [Thomas Jefferson University, Department of Radiation Oncology, Philadelphia, Pennsylvania (United States); Valicenti, Richard [UC Davis Medical Center, Department of Radiation Oncology, Sacramento, California (United States); Bahary, Jean-Paul [CHUM Hospital Notre Dame, Quebec (Canada); Souhami, Luis [McGill University, Montreal, Quebec (Canada); Won, Minhee [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Mehta, Minesh [University of Maryland Medical System, Baltimore, Maryland (United States)

    2014-11-01

    Purpose: Radiation Therapy Oncology Group (RTOG) 9508 showed a survival advantage for patients with 1 but not 2 or 3 brain metastasis (BM) treated with whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) versus WBRT alone. An improved prognostic index, the graded prognostic assessment (GPA) has been developed. Our hypothesis was that if the data from RTOG 9508 were poststratified by the GPA, the conclusions may vary. Methods and Materials: In this analysis, 252 of the 331 patients were evaluable by GPA. Of those, 211 had lung cancer. Breast cancer patients were excluded because the components of the breast GPA are not in the RTOG database. Multiple Cox regression was used to compare survival between treatment groups, adjusting for GPA. Treatment comparisons within subgroups were performed with the log-rank test. A free online tool ( (brainmetgpa.com)) simplified GPA use. Results: The fundamental conclusions of the primary analysis were confirmed in that there was no survival benefit overall for patients with 1 to 3 metastases; however, there was a benefit for the subset of patients with GPA 3.5 to 4.0 (median survival time [MST] for WBRT + SRS vs WBRT alone was 21.0 versus 10.3 months, P=.05) regardless of the number of metastases. Among patients with GPA 3.5 to 4.0 treated with WBRT and SRS, the MST for patients with 1 versus 2 to 3 metastases was 21 and 14.1 months, respectively. Conclusions: This secondary analysis of predominantly lung cancer patients, consistent with the original analysis, shows no survival advantage for the group overall when treated with WBRT and SRS; however, in patients with high GPA (3.5-4), there is a survival advantage regardless of whether they have 1, 2, or 3 BM. This benefit did not extend to patients with lower GPA. Prospective validation of this survival benefit for patients with multiple BM and high GPA when treated with WBRT and SRS is warranted.

  15. Stereotactic Radiosurgery With or Without Whole-Brain Radiation Therapy for Limited Brain Metastases: A Secondary Analysis of the North Central Cancer Treatment Group N0574 (Alliance) Randomized Controlled Trial.

    Science.gov (United States)

    Churilla, Thomas M; Ballman, Karla V; Brown, Paul D; Twohy, Erin L; Jaeckle, Kurt; Farace, Elana; Cerhan, Jane H; Anderson, S Keith; Carrero, Xiomara W; Garces, Yolanda I; Barker, Fred G; Deming, Richard; Dixon, Jesse G; Burri, Stuart H; Chung, Caroline; Ménard, Cynthia; Stieber, Volker W; Pollock, Bruce E; Galanis, Evanthia; Buckner, Jan C; Asher, Anthony L

    2017-08-05

    To determine whether whole-brain radiation therapy (WBRT) is associated with improved overall survival among non-small cell lung cancer (NSCLC) patients with favorable prognoses at diagnosis. In the N0574 trial, patients with 1 to 3 brain metastases were randomized to receive stereotactic radiosurgery (SRS) or SRS plus WBRT (SRS + WBRT), with a primary endpoint of cognitive deterioration. We calculated diagnosis-specific graded prognostic assessment (DS-GPA) scores for NSCLC patients and evaluated overall survival according to receipt of WBRT and DS-GPA score using 2 separate cut-points (≥2.0 vs <2.0 and ≥2.5 vs <2.5). A total of 126 NSCLC patients were included for analysis, with median follow-up of 14.2 months. Data for DS-GPA calculation were available for 86.3% of all enrolled NSCLC patients. Overall, 50.0% of patients had DS-GPA score ≥2.0, and 23.0% of patients had DS-GPA scores ≥2.5. The SRS and SRS + WBRT groups were well balanced with regard to prognostic factors. The median survival according to receipt of WBRT was 11.3 months (+WBRT) and 17.9 months (-WBRT) for patients with DS-GPA ≥2.0 (favorable prognoses, P=.63; hazard ratio 0.86; 95% confidence interval 0.47-1.59). Median survival was 3.7 months (+WBRT) and 6.6 months (-WBRT) for patients with DS-GPA <2.0 patients (unfavorable prognoses, P=.85; hazard ratio 0.95; 95% confidence interval 0.56-1.62). Outcomes according to the receipt of WBRT and DS-GPA remained similar utilizing DS-GPA ≥2.5 as a cutoff for favorable prognoses. There was no interaction between the continuum of the DS-GPA groups and WBRT on overall survival (P=.53). We observed no significant differences in survival according to receipt of WBRT in favorable-prognosis NSCLC patients. This study further supports the approach of SRS alone in the majority of patients with limited brain metastases. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Whole-brain functional magnetic resonance imaging of human brain during voluntary movements of dominant and subdominant hands%利手和非利手随意运动的全脑功能磁共振成像

    Institute of Scientific and Technical Information of China (English)

    于薇; 林冲宇; 臧玉峰; 晏子旭; 马晓海; 张兆琪; 翁旭初

    2003-01-01

    目的利用全脑功能磁共振成像(fMRI)技术,探讨参与利手和非利手简单随意运动的关键脑结构.方法采用Siemens公司Sonata 1.5 T 磁共振成像系统,对7名健康右利手志愿者的利手或非利手食指按键运动进行了全脑扫描.数据经头动矫正、空间标准化、空间平滑等预处理后,通过互相关分析分别获得利手和非利手运动的脑激活统计参数图.结果利手运动主要激活对侧初级运动区(MI)、双侧辅助运动区(SMA)、双侧运动二区(MII)和同侧小脑,而非利手运动除以上区域外还激活了对侧前运动区(PMC),而且SMA和MII的激活体积大于利手运动.结论全脑fMRI研究表明,随意运动依赖于大脑皮质和小脑等许多脑结构的参与.与利手运动相比,非利手运动更依赖于SMA和PMC等高级运动控制区.

  17. Efifcacy of Gamma Knife Radiation Therapy in Lung Cancer Patients with Brain Metastasis Lesions and Whole Brain Radiation Therapy%肺癌脑转移病灶患者伽马刀放射治疗及全脑放射治疗的疗效

    Institute of Scientific and Technical Information of China (English)

    刘敬聘; 秦坤明; 王仁生; 阮林

    2015-01-01

    Objective: To investigate the efficacy analysis of lung lesions in patients with brain metastases Gamma Knife radiation therapy and whole brain radiation therapy.Methods:March 2002~ March 2013 in our hospital diagnosis and treatment of 500 cases of lung cancer patients with brain metastases as the research object. According to the specific circumstances of the patient decided to use the gamma knife radiation therapy or whole brain radiation therapy.Gamma Knife radiotherapy group and whole brain radiotherapy group in gender, age was not significantly different,P>0.05,comparable.Results:The Gamma Knife radiotherapy group and whole brain radiotherapy efficacy in the near future, with a median survival time and 1-year progression-free survival without brain lesions was no significant difference; 1-year survival rate was significantly higher than the gamma knife radiotherapy whole brain radiotherapy; adverse reaction rate of gamma knife radiotherapy group was significantly higher than the whole-brain radiotherapy.Conclusion:The adverse reaction rates using the gamma knife radiation is small, good effect, and thus overall due to the whole brain radiotherapy, but in clinical practice should also consider the specific circumstances of the patient treatment decisions for patients with larger tumors may be two were combined to achieve a more satisfactory outcome.%目的:探讨分析肺癌脑转移病灶患者伽马刀放射治疗(放疗)及全脑放射治疗的疗效。方法:选取2002年3月~2013年3月在我院接受诊断和治疗的500例肺癌脑转移患者作为研究对象。根据患者具体情况决定使用伽马刀放射治疗或全脑放射治疗。伽马刀放疗组和全脑放疗组患者在性别、年龄方面差异不明显,P>0.05,具有可比性。结果:伽马刀放疗组和全脑放疗组在近期疗效、中位生存期和1年无颅脑病灶进展生存率方面无明显差异;伽马刀放疗组的1年生存率明显高于全脑

  18. 轻微肝性脑病全脑功能连接的静息态功能MRI研究%Altered whole brain functional connectivity in patients with minimal hepatic encephalopathy: a resting-state functional MRI study

    Institute of Scientific and Technical Information of China (English)

    戚荣丰; 张龙江; 许强; 梁雪; 罗松; 张志强; 卢光明

    2014-01-01

    Objective To investigate the alteration of the whole brain functional connectivity in patients with minimal hepatic encephalopathy(MHE) by using resting-state functional MRI,and to explore its role in distinguishing the MHE from cirrhotic patients without MHE by using the receiver operator characteristic(ROC) curve.Methods Thirty cirrhotic patients with MHE,32 cirrhotic patients without MHE (non-MHE),and 49 healthy controls underwent standard resting-state functional MRI scan.Whole brain functional connectivities were compared with analysis of variance test to observe the difference among three groups,and then compared with Post-hoc test to investigate the changes between MHE and non-MHE groups.Results There were widespreadly different functional connectivities among three groups.All 115 functional conenctivities showed significant difference among three groups(all P<0.05).Compared with non-MHE patients,MHE patients showed 6 decreased functional connectivity in the following brain regions (P<0.05):between left supper temporal gyrus-right orbitofrontal cortex,left Heschl's gyrus-left Rolandic operculum,left Heschl's gyrus-right olfactory cortex,left hippocampus-right amygdala,left putamen-right putamen,and left temporal pole of supper temporal gyrus-right temporal pole of middle temporal gyrus (t=-4.41-3.82,P<0.01).ROC analysis demonstrated that the left hippocampus-right amygdala had the highest value for differentiating MHE from non-MHE group(AUC=0.78,95%CI 0.66-0.90) with a cutoff value=0.56,sensitivity=73% and specificity=81%).Conclusion Functional connectivity analysis can be used to observe the functional changes in MHE patient,and has a potential for the early diagnosis of MHE.%目的 利用静息态fMRI观察轻微肝性脑病(MHE)患者全脑功能连接的改变,并通过ROC曲线分析差异脑区连接在鉴别MHE和无MHE的肝硬化患者中的价值.方法 收集30例MHE患者(MHE组)、32例无MHE的肝硬化患者(无MHE组)和49名健

  19. THE EXPRESSION OF FOS IN THE WHOLE BRAIN OF RATS FOLLOWING COMPLEX DOUBLE ROTATION ON TWO AXES%围绕两轴进行复杂的旋转刺激后大鼠全脑内Fos的表达

    Institute of Scientific and Technical Information of China (English)

    葛顺楠; 董玉琳; 张富兴; 李金莲

    2007-01-01

    为了探讨旋转刺激与运动病发生的关系,本研究利用一种复杂的围绕两轴旋转的加速度刺激器刺激大鼠后,观察大鼠全脑内Fos蛋白的表达情况.动物被随机地分成四组,即正常对照组、两轴旋转刺激组、双侧迷路毁损组以及双侧迷路毁损后接受旋转刺激组.采用免疫组织化学染色方法观察全脑不同核团内Fos蛋白的表达情况.结果显示:(1)正常对照组和双侧迷路毁损组大鼠的脑内均未检测到Fos样免疫阳性产物;(2)两轴旋转刺激组的大鼠在给予复杂的围绕两轴旋转的加速度刺激后,在大鼠脑和脑干的多个核团内均可检测到Fos样免疫阳性神经元,其阳性产物主要表达于细胞核.其中在脑干内的前庭复合体的不同亚核(包括前庭内侧核、前庭上核和前庭下核),孤束核、蓝斑核、臂旁内侧核、臂旁外侧核,间脑的室旁核以及边缘系统的杏仁核等内均可观察到密集分布的Fos样免疫阳性神经元;(3)双侧迷路毁损组大鼠在接受复杂的围绕两轴旋转刺激后,在上述相应核团内均难以检测到Fos蛋白的表达.以上研究结果提示两轴旋转刺激可以有效地激活前庭神经元,而大鼠在接受前庭刺激后,脑和脑干的许多核团内大量的神经元可能通过与前庭核复合体发生直接或间接的纤维联系也被激活,这些被激活的神经元可能与运动病发生的复杂机制有关.%To investigate the relationship of the rotation stimulation with motion sickness, the expression of Fos protein in the whole brain of the rat stimulated by complex double rotation on two axes was observed in the present study. The rats were randomly divided into four groups: normal contral group; double-axes rotation stimulation group; the bilateral labyrinthectomy group; group of two-axes rotation stimulation after the bilateral labyrinthectomy. Immunohistochemical staining method was used to detect the expression of Fos

  20. 全脑照射后昆明鼠的学习、记忆力损伤及其变化规律%Dynamic changing of mouse learning and memory ability after whole brain irradiation

    Institute of Scientific and Technical Information of China (English)

    朱广迎; 梁克; 欧广飞; 李艳春; 蔡伟明

    2001-01-01

    目的探讨全脑照射后鼠的学习、记忆力损伤及其变化规律。方法硫喷妥钠麻醉后,采用直线加速器10 MeV电子线照射102只4~6周龄昆明鼠全脑;102只分为3组(每组34只),照射剂量分别为20、10、5 Gy。另设34只鼠为对照组(只麻醉不照射)。照射后第1、2、3、4、5天和第14、28、56、84天采用跳台法测定鼠的学习、记忆力。结果照射后第2、3、56天,20 Gy组鼠受电击次数分别为(1.0±0.9)次、(0.9±0.6)次和(1.4±1.0)次,与对照组的差异均有非常显著性(P<0.01)。照射后第2,3天20 Gy组受电击潜伏期分别为(64±87)s、(92±78)s,与对照组[(173±21)s,(175±16)s]的差异均有非常显著性(P<0.01);第56天为(164±88)s,与对照组[(261±79)s]的差异有显著性,P<0.05。照射后第2天20 Gy组受电击鼠的构成比为6/9,与对照组(11%)的差异有显著性(P<0.05)。20 Gy组学习、记忆力损伤最重,10 Gy组次之,5 Gy组与对照组的差异无显著性。照射后鼠学习、记忆力损伤的规律:照射后第2,3天学习、记忆力有明显损伤,第4~28天为暂时恢复期,第56天出现第2次损伤高峰,第84天后再次恢复。结论放射性脑损伤可使鼠的学习、记忆力明显下降,记忆力损伤程度及恢复快慢均与照射剂量相关。%Objective To study the regularity of the injury of the mose learning and memory ability, after the whole brain irradiation. Methods After anaesthetized with thiopentone, the whole brain of Kunming mice was irradiated with 10 MeV electronic ray. On the first, second, third, fourth, fifth,fourteenth, twenty-eighth, fifty-sixth and eighty-fourth day after the irradiation, the mouse learning and memory ability was measured with step down method. Results On the second,third and fifty-sixth day after the brain irradiation with 20 Gy electronic ray, the means of

  1. Three-dimensional SPACE fluid-attenuated inversion recovery at 3 T to improve subthalamic nucleus lead placement for deep brain stimulation in Parkinson's disease: from preclinical to clinical studies.

    Science.gov (United States)

    Senova, Suhan; Hosomi, Koichi; Gurruchaga, Jean-Marc; Gouello, Gaëtane; Ouerchefani, Naoufel; Beaugendre, Yara; Lepetit, Hélène; Lefaucheur, Jean-Pascal; Badin, Romina Aron; Dauguet, Julien; Jan, Caroline; Hantraye, Philippe; Brugières, Pierre; Palfi, Stéphane

    2016-08-01

    OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for motor symptoms in patients with pharmacoresistant Parkinson's disease (PD). However, the procedure, which requires multimodal perioperative exploration such as imaging, electrophysiology, or clinical examination during macrostimulation to secure lead positioning, remains challenging because the STN cannot be reliably visualized using the gold standard, T2-weighted imaging (T2WI) at 1.5 T. Thus, there is a need to improve imaging tools to better visualize the STN, optimize DBS lead implantation, and enlarge DBS diffusion. METHODS Gradient-echo sequences such as those used in T2WI suffer from higher distortions at higher magnetic fields than spin-echo sequences. First, a spin-echo 3D SPACE (sampling perfection with application-optimized contrasts using different flip angle evolutions) FLAIR sequence at 3 T was designed, validated histologically in 2 nonhuman primates, and applied to 10 patients with PD; their data were clinically compared in a double-blind manner with those of a control group of 10 other patients with PD in whom STN targeting was performed using T2WI. RESULTS Overlap between the nonhuman primate STNs segmented on 3D-histological and on 3D-SPACE-FLAIR volumes was high for the 3 most anterior quarters (mean [± SD] Dice scores 0.73 ± 0.11, 0.74 ± 0.06, and 0.60 ± 0.09). STN limits determined by the 3D-SPACE-FLAIR sequence were more consistent with electrophysiological edges than those determined by T2WI (0.9 vs 1.4 mm, respectively). The imaging contrast of the STN on the 3D-SPACE-FLAIR sequence was 4 times higher (p SPACE-FLAIR-guided implantation than for those in whom T2WI was used (62.2% vs 43.6%, respectively; p SPACE-FLAIR sequence (p SPACE-FLAIR sequences at 3 T improved STN lead placement under stereotactic conditions, improved the clinical outcome of patients with PD, and increased the benefit/risk ratio of STN-DBS surgery.

  2. Deformable image registration between pathological images and MR image via an optical macro image.

    Science.gov (United States)

    Ohnishi, Takashi; Nakamura, Yuka; Tanaka, Toru; Tanaka, Takuya; Hashimoto, Noriaki; Haneishi, Hideaki; Batchelor, Tracy T; Gerstner, Elizabeth R; Taylor, Jennie W; Snuderl, Matija; Yagi, Yukako

    2016-10-01

    Computed tomography (CT) and magnetic resonance (MR) imaging have been widely used for visualizing the inside of the human body. However, in many cases, pathological diagnosis is conducted through a biopsy or resection of an organ to evaluate the condition of tissues as definitive diagnosis. To provide more advanced information onto CT or MR image, it is necessary to reveal the relationship between tissue information and image signals. We propose a registration scheme for a set of PT images of divided specimens and a 3D-MR image by reference to an optical macro image (OM image) captured by an optical camera. We conducted a fundamental study using a resected human brain after the death of a brain cancer patient. We constructed two kinds of registration processes using the OM image as the base for both registrations to make conversion parameters between the PT and MR images. The aligned PT images had shapes similar to the OM image. On the other hand, the extracted cross-sectional MR image was similar to the OM image. From these resultant conversion parameters, the corresponding region on the PT image could be searched and displayed when an arbitrary pixel on the MR image was selected. The relationship between the PT and MR images of the whole brain can be analyzed using the proposed method. We confirmed that same regions between the PT and MR images could be searched and displayed using resultant information obtained by the proposed method. In terms of the accuracy of proposed method, the TREs were 0.56±0.39mm and 0.87±0.42mm. We can analyze the relationship between tissue information and MR signals using the proposed method.

  3. Brain oxygen saturation assessment in neonates using T2-prepared blood imaging of oxygen saturation and near-infrared spectroscopy

    DEFF Research Database (Denmark)

    Alderliesten, Thomas; De Vis, Jill B; Lemmers, Petra Ma

    2017-01-01

    sinus. A strong linear relation was found between the oxygen saturation measured by magnetic resonance imaging and the oxygen saturation measured by near-infrared spectroscopy (R(2 )= 0.64, p ..., and magnetic resonance imaging measures of frontal cerebral blood flow, whole brain cerebral blood flow and venous oxygen saturation in the sagittal sinus (R(2 )= 0.71, 0.50, 0.65; p ... saturation in the sagittal sinus (R(2 )= 0.49, p = 0.023), but no significant correlations could be demonstrated with frontal and whole brain cerebral blood flow. These results suggest that measuring oxygen saturation by T2-prepared blood imaging of oxygen saturation is feasible, even in neonates. Strong...

  4. Imaging of the epilepsies

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H. [University of Bonn Medical Center, Department of Radiology/Neuroradiology, Bonn (Germany)

    2005-03-01

    Imaging of epilepsy patients is challenging, since epileptogenic lesions (defined as structural lesions causally related to the epilepsy syndrome) may be small and often do not change during life. Prior clinical information about the epilepsy syndrome and the semiology of the seizures is needed in order to plan the examination properly. The effort to detect an epileptogenic lesion is directed to partial (focal) epilepsy syndromes whereas - by definition - no lesion is identified in idiopathic epilepsies. Most patients with partial epilepsies suffer from mesial temporal lobe epilepsies. In these patients, 2- to 3-mm-thick T2-weighted and fluid-attenuated inversion-recovery (FLAIR) fast spin echo slices along or perpendicular to the temporal lobe length axis have the highest diagnostic efficacy. In contrast, in patients with extratemporal lobe epilepsies perpendicular FLAIR slices through the anatomic region, from which, due to clinical and EEG criteria, the seizures are likely to originate, are preferred. The imaging features of common epileptogenic lesions (hippocampal sclerosis, long-term epilepsy-associated tumours, focal cortical dysplasias, vascular malformations, encephalitis including limbic and Rasmussen's encephalitis, gyral scarring including ulegyria) are detailed in the second section of this paper. (orig.)

  5. Discrimination between glioma grades II and III in suspected low-grade gliomas using dynamic contrast-enhanced and dynamic susceptibility contrast perfusion MR imaging

    DEFF Research Database (Denmark)

    Falk, Anna; Fahlström, Markus; Rostrup, Egill;

    2014-01-01

    INTRODUCTION: Perfusion magnetic resonance imaging (MRI) can be used in the pre-operative assessment of brain tumours. The aim of this prospective study was to identify the perfusion parameters from dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast (DSC) perfusion imaging...... that could best discriminate between grade II and III gliomas. METHODS: MRI (3 T) including morphological ((T2 fluid attenuated inversion recovery (FLAIR) and T1-weighted (T1W)+Gd)) and perfusion (DCE and DSC) sequences was performed in 39 patients with newly diagnosed suspected low-grade glioma after...

  6. Icotinib versus whole-brain irradiation in patients with EGFR-mutant non-small-cell lung cancer and multiple brain metastases (BRAIN): a multicentre, phase 3, open-label, parallel, randomised controlled trial.

    Science.gov (United States)

    Yang, Jin-Ji; Zhou, Caicun; Huang, Yisheng; Feng, Jifeng; Lu, Sun; Song, Yong; Huang, Cheng; Wu, Gang; Zhang, Li; Cheng, Ying; Hu, Chengping; Chen, Gongyan; Zhang, Li; Liu, Xiaoqing; Yan, Hong Hong; Tan, Fen Lai; Zhong, Wenzhao; Wu, Yi-Long

    2017-09-01

    For patients with non-small-cell lung cancer (NSCLC) and multiple brain metastases, whole-brain irradiation (WBI) is a standard-of-care treatment, but its effects on neurocognition are complex and concerning. We compared the efficacy of an epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), icotinib, versus WBI with or without chemotherapy in a phase 3 trial of patients with EGFR-mutant NSCLC and multiple brain metastases. We did a multicentre, open-label, parallel randomised controlled trial (BRAIN) at 17 hospitals in China. Eligible participants were patients with NSCLC with EGFR mutations, who were naive to treatment with EGFR-TKIs or radiotherapy, and had at least three metastatic brain lesions. We randomly assigned participants (1:1) to either icotinib 125 mg orally (three times per day) or WBI (30 Gy in ten fractions of 3 Gy) plus concurrent or sequential chemotherapy for 4-6 cycles, until unacceptable adverse events or intracranial disease progression occurred. The randomisation was done by the Chinese Thoracic Oncology Group with a web-based allocation system applying the Pocock and Simon minimisation method; groups were stratified by EGFR gene mutation status, treatment line (first line or second line), brain metastases only versus both intracranial and extracranial metastases, and presence or absence of symptoms of intracranial hypertension. Clinicians and patients were not masked to treatment assignment, but individuals involved in the data analysis did not participate in the treatments and were thus masked to allocation. Patients receiving icotinib who had intracranial progression only were switched to WBI plus either icotinib or chemotherapy until further progression; those receiving icotinib who had extracranial progression only were switched to icotinib plus chemotherapy. Patients receiving WBI who progressed were switched to icotinib until further progression. Icotinib could be continued beyond progression if a clinical benefit

  7. Random forest regression for magnetic resonance image synthesis.

    Science.gov (United States)

    Jog, Amod; Carass, Aaron; Roy, Snehashis; Pham, Dzung L; Prince, Jerry L

    2017-01-01

    By choosing different pulse sequences and their parameters, magnetic resonance imaging (MRI) can generate a large variety of tissue contrasts. This very flexibility, however, can yield inconsistencies with MRI acquisitions across datasets or scanning sessions that can in turn cause inconsistent automated image analysis. Although image synthesis of MR images has been shown to be helpful in addressing this problem, an inability to synthesize both T2-weighted brain images that include the skull and FLuid Attenuated Inversion Recovery (FLAIR) images has been reported. The method described herein, called REPLICA, addresses these limitations. REPLICA is a supervised random forest image synthesis approach that learns a nonlinear regression to predict intensities of alternate tissue contrasts given specific input tissue contrasts. Experimental results include direct image comparisons between synthetic and real images, results from image analysis tasks on both synthetic and real images, and comparison against other state-of-the-art image synthesis methods. REPLICA is computationally fast, and is shown to be comparable to other methods on tasks they are able to perform. Additionally REPLICA has the capability to synthesize both T2-weighted images of the full head and FLAIR images, and perform intensity standardization between different imaging datasets.

  8. Stereotactic radiation therapy combined with temozolomide in the treatmsct recurrent non-small cell lung cancer after whole brain radiotherapy%非小细胞肺癌全脑放疗复发后替莫唑胺联合立体定向放疗补救治疗临床观察

    Institute of Scientific and Technical Information of China (English)

    蔡勇; 王季颖

    2012-01-01

    目的 评价非小细胞肺癌(NSCLC)全脑放疗后颅内失败采用替莫唑胺联合立体定向治疗挽救的价值.方法 54例患者进入本次研究,所有全脑放疗后颅内复发转移的患者接受替莫唑胺化疗联合立体定向放疗,分析局控率,生存率情况,多因素分析确定和生存相关的预后因素.结果 随访率100%,中位随访时间为13个月.全组中位生存时间为11.7个月.独立递归分级指数(RPA)l,2,3级中位生存期分别为19,14,9个月.自脑转移开始患者的中位生存时间为15个月(6~22个月),立体定向治疗加替莫唑胺挽救治疗后6和12个月局部控制率分别为93%和65%.结论 联合治疗有较好的有效性和安全性,值得在NSCLC中颅内治疗失败后作为挽救治疗推广.%Purpose To observe the therapeutic effect and toxicity of stereotactic radiation therapy combined with temozolomide in treating recurrent non small cell lung cancer after whole brain radiotherapy. Methods 54 patients with recurrent non-small cell lung cancer after whole brain radiotherapy were treated by stereotactic radiation therapy combined with temozolomide. Results The follow-up rate was 100%. The median follow-up time was 12 months. The median over-up survival (OS) time was 11.7 months. The median OS time from the diagnosis of brain metastasis was 15 months. Local control at 6 and 12 months was 93% and 65%. Conclusion The therapy of stereotactic radiation therapy combined with temozolomide was safe and effective in the treatment of recurrent non small cell lung cancer after whole brain radiotherapy.

  9. [Imaging].

    Science.gov (United States)

    Chevrot, A; Drapé, J L; Godefroy, D; Dupont, A M; Pessis, E; Sarazin, L; Minoui, A

    1997-01-01

    The panoply of imaging techniques useful in podology is essentially limited to X-rays. Standard "standing" and "lying" X-rays furnish most of the required information. Arthrography is sometimes performed, in particular for trauma or tumour of the ankle. CT scan and MRI make a decisive contribution in difficult cases, notably in fractures and in small fractures without displacement. The two latter techniques are useful in tendon, ligament and muscular disorders, where echography is also informative. Rigorous analysis of radiographies and a good knowledge of foot disorders make these imaging techniques efficacious.

  10. Isolated fourth ventricular cysticercus cyst: MR imaging in 4 cases with short literature review

    Directory of Open Access Journals (Sweden)

    Singh S

    2003-07-01

    Full Text Available We describe the magnetic resonance imaging (MRI signal characteristics of isolated (solitary lesion intra fourth ventricular cysticercus cyst in 4 patients who clinically presented with obstructive hydrocephalus. All patients had routine MRI sequences (T1, T2, & proton density-weighted imaging, Fluid Attenuation Inversion Recovery (FLAIR, and post-gadolinium imaging followed by cerebrospinal fluid (CSF flow study. It revealed a CSF signal intensity (on all pulse sequences, intra fourth ventricular cyst with a nidus (scolex, and wall enhancement. On T1-weighted and FLAIR images, the cyst wall and nidus (scolex were seen in 3 cases, which were not seen in other routine sequences. The CSF flow study showed the intraluminal nature of the cyst. The MRI features suspected a cysticercus cyst, and per-operative findings and histopathological examination confirmed the diagnosis. The review of literature of the intra fourth ventricular cyst is briefly discussed.

  11. 应用基于体素的MR形态测量学分析抽动秽语综合征患儿脑灰质体积变化%Volume changes of whole brain gray matter in pediatric patients with Tourette syndrome: evidence from voxel-based morphometry

    Institute of Scientific and Technical Information of China (English)

    刘玥; 单保慈; 彭芸; 高培毅; 聂彬彬; 吕传凯; 张礼萍; 季之颖; 尹光恒; 于彤

    2012-01-01

    目的 应用优化的基于体素的形态测量学(VBM)技术,分析抽动秽语综合征(TS)患儿全脑灰质异常情况.方法 选取31例TS患儿(TS组)和与之年龄、性别匹配的50名正常儿童(正常对照组)进行3DT1WI.利用基于统计参数图(SPM)2软件的VBM 2工具箱对扫描获得的图像进行预处理,对TS患儿和正常儿童的全脑灰质体积采用t检验进行比较.将灰质体积差异区域的改变值提取出来,与临床耶鲁综合抽动严重程度评分量表(YGTSS)评分、病程进行多元线性分析.结果 应用VBM方法,发现TS组的左顶上小叶、右小脑半球、左海马旁回灰质体积较对照组增大,增加体积分别为4059、2126、84 mm3,其差异有统计学意义(t值分别为3.93、3.71、3.58,P值均<0.05).延髓和左桥脑体积较对照组减小,减小体积分别为213、117 mm3(t值分别为3.53、3.48,P值均<0.05).体积差异区域的体积改变值与临床YGTSS评分无相关性(P>0.05),左海马旁回灰质体积与患儿病程呈负相关(Beta=-0.391,P=0.039).结论 VBM能够显示常规MRI表现正常的TS患儿的灰质异常.颡顶叶和小脑体积增加可能是TS患儿的适应性反应,左海马旁回灰质体积可能是评价TS患者预后的一项客观指标.%Objectives To identify the related abnormalities of gray matter in pediatric patients with Tourette syndrome (TS) by using the optimized voxel-based morphometry (VBM).Methods Three dimensional T1WI was acquired in 31 TS children (28 boys,3 girts,mean age 8 years,range 4-15 years) and 50 age- and sex-matched controls on a 1.5 Tesla Philips scanner. Images were pre-processed and analyzed using a version of VBM 2 in SPM 2.The whole brain gray matter volume was compared between the study and control group by using t-test.Multivariate linear regression analysis was used for analyzing the correlation between the change of grey matter volume within each brain region (mm3 ) and YGTSS score and course of disease of

  12. Hybrid Method for 3D Segmentation of Magnetic Resonance Images

    Institute of Scientific and Technical Information of China (English)

    ZHANGXiang; ZHANGDazhi; TIANJinwen; LIUJian

    2003-01-01

    Segmentation of some complex images, especially in magnetic resonance brain images, is often difficult to perform satisfactory results using only single approach of image segmentation. An approach towards the integration of several techniques seems to be the best solution. In this paper a new hybrid method for 3-dimension segmentation of the whole brain is introduced, based on fuzzy region growing, edge detection and mathematical morphology, The gray-level threshold, controlling the process of region growing, is determined by fuzzy technique. The image gradient feature is obtained by the 3-dimension sobel operator considering a 3×3×3 data block with the voxel to be evaluated at the center, while the gradient magnitude threshold is defined by the gradient magnitude histogram of brain magnetic resonance volume. By the combined methods of edge detection and region growing, the white matter volume of human brain is segmented perfectly. By the post-processing using mathematical morphological techniques, the whole brain region is obtained. In order to investigate the validity of the hybrid method, two comparative experiments, the region growing method using only gray-level feature and the thresholding method by combining gray-level and gradient features, are carried out. Experimental results indicate that the proposed method provides much better results than the traditional method using a single technique in the 3-dimension segmentation of human brain magnetic resonance data sets.

  13. SPET imaging of central muscarinic receptors with (R,R)[{sup 123}I]-I-QNB: methodological considerations

    Energy Technology Data Exchange (ETDEWEB)

    Norbury, R. E-mail: r.norbury@iop.kcl.ac.uk; Travis, M.J.; Erlandsson, K.; Waddington, W.; Owens, J.; Ell, P.J.; Murphy, D.G

    2004-07-01

    Investigations on the effect of normal healthy ageing on the muscarinic system have shown conflicting results. Also, in vivo determination of muscarinic receptor binding has been hampered by a lack of subtype selective ligands and differences in methods used for quantification of receptor densities. Recent in vitro and in vivo work with the muscarinic antagonist (R,R)-I-QNB indicates this ligand has selectivity for m{sub 1} and m{sub 4} muscarinic receptor subtypes. Therefore, we used (R,R)[{sup 123}I]-I-QNB and single photon emission tomography to study brain m{sub 1} and m{sub 4} muscarinic receptors in 25 healthy female subjects (11 younger subjects, age range 26-32 years and 14 older subjects, age range 57-82 years). Our aims were to ascertain the viability of tracer administration and imaging within the same day, and to evaluate whether normalization to whole brain, compared to normalization to cerebellum, could alter the clinical interpretation of results. Images were analyzed using the simplified reference tissue model and by two ratio methods: normalization to whole brain and normalization to cerebellum. Significant correlations were observed between kinetic analysis and normalization to cerebellum, but not to whole brain. Both the kinetic analysis and normalization to cerebellum showed age-related reductions in muscarinic binding in frontal, orbitofrontal, and parietal regions. Normalization to whole brain, however, failed to detect age-related changes in any region. Here we show that, for this radiotracer, normalizing to a region of negligible specific binding (cerebellum) significantly improves sensitivity when compared to global normalization.

  14. 单体型特纳综合征患儿全脑灰、白质基于体素的形态学分析%A whole-brain gray and white matter analysis in children with 45XO karyotype Turner syndrome:voxel-based morphometry

    Institute of Scientific and Technical Information of China (English)

    赵秋玲; 谢晟; 张知新; 潘慧; 李康; 张嘉颖; 程盼贵; 龚高浪; 刘茜玮

    2013-01-01

    Objective To detect the structural changes of cerebral gray and white matter in children of monosomy Turner syndrome (TS) by using voxel-based morphometry (VBM).Methods Nine children 45XO karyotype TS and 20 age-matched control girls were recruited in this study.Wechsler intelligence scale for children was used to obtain their intelligence quotients (IQ).High-resolution magnetic MR imaging was performed in TS children and control girls to collect the whole brain structural data.The data were analyzed by VBM based on SPM 8 to compare the volume of gray and white matter between the TS children and normal controls by using covariance analysis.Results The IQ of TS children was 81 ± 13,and the IQ of the controls was 109 ± 16.Statistical analysis revealed significant difference of IQ between the two groups (t =-4.70,P < 0.05).Compared with normal controls,TS children showed significantly decreased volume (numbers of voxel in clusters were 631,525,520,t =3.95,3.50,3.36,P < 0.05,FWE-corrected) in the gray matter of the right superior parietal lobule,postcentral gyrus,precuneus lobule,calcarine,cuneus cortices,as well as the left middle and inferior occipital lobe.However,the volume of the bilateral supplemental motor area and the medial superior frontal lobes,the right middle cingulum,the left superior,middle,and inferior temporal gyri were increased in the TS children compared to the controls.The left fusiform,the left parahippocampus,the left hippocampus and the left cerebellum were also enlarged in TS children (numbers of voxel in clusters were 2082,974,1708,588,579,t =5.45,4.59,4.40,4.29,3.55,P <0.05,FWE-corrected).White matter regions in the left postcentral gyrus and inferior parietal lobule showed significantly reduced volume (voxel number 957,t =5.85,P < 0.05,FWE-corrected).Conclusion Children with monosomy TS show abnormal gray and white matter volumes in some brain regions,which may be involved in the neuropathology of Turner syndrome.%目的 利用

  15. Abnormalities on diffusion-weighted magnetic resonance imaging in patients with transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Tomomi; Shibagaki, Yasuro [Ushiku Aiwa General Hospital, Ibaraki (Japan); Uchiyama, Shinichiro; Iwata, Makoto [Tokyo Women' s Medical Coll. (Japan)

    2003-03-01

    We studied abnormalities on diffusion-weighted magnetic resonance imaging (DWI) in patients with transient ischemic attack (TIA). Out of 18 consecutive TIA patients, 9 patients had relevant focal abnormalities on DWI. Among TIA patients, six patients were associated with atrial fibrillation (Af), and all of these patients had focal abnormalities on DWI as well. TIA patients with Af had significantly more frequent focal abnormalities on DWI than those without Af (p=0.009; Fisher's exact probability test). In addition, the duration of TIA symptoms was not related to the presence of focal abnormalities on DWI. These results indicate that embolic mechanism may cause focal abnormalities on DWI. DWI was more sensitive to detect responsible ischemic lesions in these patients than T2-weighted image or fluid-attenuated inversion recovery image. (author)

  16. Magnetic Resonance Imaging in Breath-Hold Divers with Cerebral Decompression Sickness

    Directory of Open Access Journals (Sweden)

    Ryu Matsuo

    2014-01-01

    Full Text Available The mechanism of cerebral decompression sickness (DCS is still unclear. We report 2 cases of breath-hold divers with cerebral DCS in whom magnetic resonance imaging (MRI demonstrated distinctive characteristics. One case presented right hemiparesthesia, diplopia, and gait disturbance after breath-hold diving into the sea at a depth of 20 m. Brain MRI with fluid-attenuated inversion recovery (FLAIR sequence revealed multiple hyperintense lesions in the right frontal lobe, bilateral thalamus, pons, and right cerebellar hemisphere. The second case presented visual and gait disturbance after repetitive breath-hold diving into the sea. FLAIR imaging showed hyperintense areas in the bilateral occipito-parietal lobes. In both cases, diffusion-weighted imaging and apparent diffusion coefficient mapping revealed hyperintense areas in the lesions identified by FLAIR. Moreover, follow-up MRI showed attenuation of the FLAIR signal abnormalities. These findings are suggestive of transient hyperpermeability in the microvasculature as a possible cause of cerebral DCS.

  17. Alterations in Cortical Thickness and White Matter Integrity in Mild-to-Moderate Communicating Hydrocephalic School-Aged Children Measured by Whole-Brain Cortical Thickness Mapping and DTI

    Science.gov (United States)

    Ye, Xinjian; Bai, Guanghui; Fu, Yuchuan; Mao, Chuanwan; Wu, Aiqin

    2017-01-01

    Follow-up observation is required for mild-to-moderate hydrocephalic patients because of the potential damage to brain. However, effects of mild-to-moderate hydrocephalus on gray and white matter remain unclear in vivo. Using structural MRI and diffusion tensor imaging (DTI), current study compared the cortical thickness and white matter integrity between children with mild-to-moderate communicating hydrocephalus and healthy controls. The relationships between cortical changes and intelligence quota were also examined in patients. We found that cortical thickness in the left middle temporal and left rostral middle frontal gyrus was significantly lower in the hydrocephalus group compared with that of controls. Fractional anisotropy in the right corpus callosum body was significantly lower in the hydrocephalus group compared with that of controls. In addition, there was no association of cortical thinning or white matter fractional anisotropy with intelligence quota in either group. Thus, our findings provide clues to that mild-to-moderate hydrocephalus could lead to structural brain deficits especially in the middle temporal and middle frontal gyrus prior to the behavior changes.

  18. In vivo bioluminescence imaging of Ca signalling in the brain of Drosophila.

    Directory of Open Access Journals (Sweden)

    Jean-René Martin

    Full Text Available Many different cells' signalling pathways are universally regulated by Ca(2+ concentration [Ca(2+] rises that have highly variable amplitudes and kinetic properties. Optical imaging can provide the means to characterise both the temporal and spatial aspects of Ca(2+ signals involved in neurophysiological functions. New methods for in vivo imaging of Ca(2+ signalling in the brain of Drosophila are required for probing the different dynamic aspects of this system. In studies here, whole brain Ca(2+ imaging was performed on transgenic flies with targeted expression of the bioluminescent Ca(2+ reporter GFP-aequorin (GA in different neural structures. A photon counting based technique was used to undertake continuous recordings of cytosolic [Ca(2+] over hours. Time integrals for reconstructing images and analysis of the data were selected offline according to the signal intensity. This approach allowed a unique Ca(2+ response associated with cholinergic transmission to be identified by whole brain imaging of specific neural structures. Notably, [Ca(2+] transients in the Mushroom Bodies (MBs following nicotine stimulation were accompanied by a delayed secondary [Ca(2+] rise (up to 15 min. later in the MB lobes. The delayed response was sensitive to thapsigargin, suggesting a role for intra-cellular Ca(2+ stores. Moreover, it was reduced in dunce mutant flies, which are impaired in learning and memory. Bioluminescence imaging is therefore useful for studying Ca(2+ signalling pathways and for functional mapping of neurophysiological processes in the fly brain.

  19. In vivo bioluminescence imaging of Ca signalling in the brain of Drosophila.

    Science.gov (United States)

    Martin, Jean-René; Rogers, Kelly L; Chagneau, Carine; Brûlet, Philippe

    2007-03-07

    Many different cells' signalling pathways are universally regulated by Ca(2+) concentration [Ca(2+)] rises that have highly variable amplitudes and kinetic properties. Optical imaging can provide the means to characterise both the temporal and spatial aspects of Ca(2+) signals involved in neurophysiological functions. New methods for in vivo imaging of Ca(2+) signalling in the brain of Drosophila are required for probing the different dynamic aspects of this system. In studies here, whole brain Ca(2+) imaging was performed on transgenic flies with targeted expression of the bioluminescent Ca(2+) reporter GFP-aequorin (GA) in different neural structures. A photon counting based technique was used to undertake continuous recordings of cytosolic [Ca(2+)] over hours. Time integrals for reconstructing images and analysis of the data were selected offline according to the signal intensity. This approach allowed a unique Ca(2+) response associated with cholinergic transmission to be identified by whole brain imaging of specific neural structures. Notably, [Ca(2+)] transients in the Mushroom Bodies (MBs) following nicotine stimulation were accompanied by a delayed secondary [Ca(2+)] rise (up to 15 min. later) in the MB lobes. The delayed response was sensitive to thapsigargin, suggesting a role for intra-cellular Ca(2+) stores. Moreover, it was reduced in dunce mutant flies, which are impaired in learning and memory. Bioluminescence imaging is therefore useful for studying Ca(2+) signalling pathways and for functional mapping of neurophysiological processes in the fly brain.

  20. In vivo Bioluminescence Imaging of Ca2+ Signalling in the Brain of Drosophila

    Science.gov (United States)

    Chagneau, Carine; Brûlet, Philippe

    2007-01-01

    Many different cells' signalling pathways are universally regulated by Ca2+ concentration [Ca2+] rises that have highly variable amplitudes and kinetic properties. Optical imaging can provide the means to characterise both the temporal and spatial aspects of Ca2+ signals involved in neurophysiological functions. New methods for in vivo imaging of Ca2+ signalling in the brain of Drosophila are required for probing the different dynamic aspects of this system. In studies here, whole brain Ca2+ imaging was performed on transgenic flies with targeted expression of the bioluminescent Ca2+ reporter GFP-aequorin (GA) in different neural structures. A photon counting based technique was used to undertake continuous recordings of cytosolic [Ca2+] over hours. Time integrals for reconstructing images and analysis of the data were selected offline according to the signal intensity. This approach allowed a unique Ca2+ response associated with cholinergic transmission to be identified by whole brain imaging of specific neural structures. Notably, [Ca2+] transients in the Mushroom Bodies (MBs) following nicotine stimulation were accompanied by a delayed secondary [Ca2+] rise (up to 15 min. later) in the MB lobes. The delayed response was sensitive to thapsigargin, suggesting a role for intra-cellular Ca2+ stores. Moreover, it was reduced in dunce mutant flies, which are impaired in learning and memory. Bioluminescence imaging is therefore useful for studying Ca2+ signalling pathways and for functional mapping of neurophysiological processes in the fly brain. PMID:17342209

  1. Simultaneous Denoising, Deconvolution, and Demixing of Calcium Imaging Data.

    Science.gov (United States)

    Pnevmatikakis, Eftychios A; Soudry, Daniel; Gao, Yuanjun; Machado, Timothy A; Merel, Josh; Pfau, David; Reardon, Thomas; Mu, Yu; Lacefield, Clay; Yang, Weijian; Ahrens, Misha; Bruno, Randy; Jessell, Thomas M; Peterka, Darcy S; Yuste, Rafael; Paninski, Liam

    2016-01-20

    We present a modular approach for analyzing calcium imaging recordings of large neuronal ensembles. Our goal is to simultaneously identify the locations of the neurons, demix spatially overlapping components, and denoise and deconvolve the spiking activity from the slow dynamics of the calcium indicator. Our approach relies on a constrained nonnegative matrix factorization that expresses the spatiotemporal fluorescence activity as the product of a spatial matrix that encodes the spatial footprint of each neuron in the optical field and a temporal matrix that characterizes the calcium concentration of each neuron over time. This framework is combined with a novel constrained deconvolution approach that extracts estimates of neural activity from fluorescence traces, to create a spatiotemporal processing algorithm that requires minimal parameter tuning. We demonstrate the general applicability of our method by applying it to in vitro and in vivo multi-neuronal imaging data, whole-brain light-sheet imaging data, and dendritic imaging data.

  2. MR imaging of acute intermittent porphyria mimicking reversible posterior leukoencephalopathy syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Utz, N.; Kinkel, B.; Hedde, J.P.; Bewermeyer, H. [Staedtisches Krankenhaus Koeln-Merheim, Koeln (Germany). Neurologische Klinik

    2001-12-01

    Reversible posterior leukoencephalopathy syndrome (PLS) is characterized by headache, altered mental function, visual disturbances and seizures. Neuroimaging studies suggest a white-matter oedema, predominantly in the posterior parietal-temporal-occipital regions of the brain. We present the case of a 30-year-old woman who had suffered her first attack of acute intermittent porphyria (AIP). Following 1 week of abdominal pain she developed several generalized seizures, and hallucinations, and exhibited a progressive deterioration of the consciousness. T2-weighted images, especially fluid-attenuated inversion recovery (FLAIR) sequences showed bilateral lesions in the posterior frontal, parietal and occipital cortex and subcortical white matter. Following treatment with haematin and a high carbohydrate diet the patient's condition improved. Follow-up magnetic resonance imaging (MRI) revealed complete resolution of the lesions. To our knowledge, this is the first report concerning a completely reversible PLS in AIP. (orig.)

  3. Knife-edge scanning microscopy for in silico study of cerebral blood flow: From biological imaging data to flow simulations.

    Science.gov (United States)

    Nowak, Michael R; Lozovskiy, Alexander; Dobroskok, Dimitri; Yoonsuck Choe

    2016-08-01

    Knife-edge scanning microscopy provides the capability to image whole-brain cerebral microvasculature of small organisms, such as mice, at sub-micron resolution, providing a feasible foundation for the reconstruction of circulatory pathways from the systemic to cellular scale. In this paper, we illustrate the feasibility of using this data to model cerebral blood flow using numerical simulations. Starting with a small vascular element in microcirculation of interest, we present its segmentation from the imaging-data volume, construction of its triangular surface mesh, assembly of its tetrahedral volumetric mesh from the surface, and then conclude with Stokes flow simulation of plasma through the microvascular vessel.

  4. High-Resolution Longitudinal Screening with Magnetic Resonance Imaging in a Murine Brain Cancer Model

    Directory of Open Access Journals (Sweden)

    Nicholas A. Bock

    2003-11-01

    Full Text Available One of the main limitations of intracranial models of diseases is our present inability to monitor and evaluate the intracranial compartment noninvasively over time. Therefore, there is a growing need for imaging modalities that provide thorough neuropathological evaluations of xenograft and transgenic models of intracranial pathology. In this study, we have established protocols for multiple-mouse magnetic resonance imaging (MRI to follow the growth and behavior of intracranial xenografts of gliomas longitudinally. We successfully obtained weekly images on 16 mice for a total of 5 weeks on a 7-T multiple-mouse MRI. T2- and Ti-weighted imaging with gadolinium enhancement of vascularity was used to detect tumor margins, tumor size, and growth. These experiments, using 3D whole brain images obtained in four mice at once, demonstrate the feasibility of obtaining repeat radiological images in intracranial tumor models and suggest that MRI should be incorporated as a research modality for the investigation of intracranial pathobiology.

  5. The value of hyperintense vessel signs on fluid-attenuated inversion recovery imaging for assessing the patterns of collateral blood flow in adult moyamoya disease%液体衰减反转恢复成像-高信号血管征评估成年型烟雾病颅内侧支血流模式的价值

    Institute of Scientific and Technical Information of China (English)

    刘文华; 黄显军; 李永坤; 朱武生; 马敏敏; 徐格林; 刘新峰

    2012-01-01

    目的 探讨MRI-液体衰减反转恢复(FLAIR)序列-高信号血管征(hyperintense vessel signs,HVS)评估烟雾病患者颅内侧支血流模式的价值.方法 从南京卒中注册系统中提取2008年8月至2011年1月经脑血管造影诊断,且实施了MRI-FLAIR序列检查的41例非脑出血性成年型烟雾病患者临床资料.根据HVS在大脑中动脉供血区域分布部位的不同,将其分布模式分为0~3级:0 级是指缺乏HVS;l级是指HVS主要分布在颞叶脑沟和外侧裂区域;2级是指HVS主要分布在顶、额叶脑沟和外侧裂区域;3级是指HVS分布于1级和2级联合的区域.另外,依据脑血管造影结果,将继发于血管狭窄和闭塞的颅内侧支血流模式分为1~3型:第1型为通过病变血管或其周围的新生血管形成的顺向性残余血流;第2型为通过软膜血管形成的逆向性血流;第3型为第1和第2型联合组成的混合性血流.分析烟雾病患者颅内侧支血流模式与HVS分布之间的关系.结果 在41例非出血性成年型烟雾病患者中,3例为单侧病变,38例为双侧血管病变,故存在烟雾血管的半球数为79侧;因3例患者双侧大脑半球表现HVS缺如,故存在HVS的半球数为73侧,HVS阳性率达92.4%(73/79).重要的是,1级HVS对应的均是缓慢的顺向性血流(7/7);2级HVS主要对应的是缓慢的逆向性软脑膜血流(95.0%,19/20);3级主要对应的是缓慢的混合性血流(84.8%,39/46).且随着HVS分布从颞叶脑沟转移至额、顶叶脑沟,侧支血流的方向由顺向转变为逆向,此转变趋势有统计学意义.结论 不同分布部位的HVS反映了不同模式的侧支血流,HVS能无创评估成年型烟雾病患者颅内侧支血流方向.%Objective To investigate the value of hyperintense vessel signs (HVS) on fluidattenuated inversion recovery (FLAIR) sequence for assessing the patterns of collateral blood flow in adult moyamoya disease (MMD).Methods Forty-one adult patients with non-hemorrhagic MMD retrieved from Nanjing Stroke Registry Program between August 2008 and January 2011 were identified by digital cerebral angiography and performed the examination of FLAIR sequence in Jinling hospital.According to the different sites of HVS located in the territory of the middle cerebral artery,the patterns of HVS were classified into grades 0-3: Grade 0,absence of HVS ; Grade 1,HVS limited in the cerebral sulci of temporal lobe and Sylvian fissure ; Grade 2,HVS in the cerebral sulci of frontal and parietal lobe regions and Sylvian fissure;and Grade 3,HVS in the combined territories of Grade 1 and Grade 2.According to the intracerebral collateral blood flow,steno-occlusions of the arteries were classified into three types: Type 1,residual antegrade flow across steno-occlusive lesions; Type 2,retrograde flow via leptomeningeal vessels; Type 3,the combined collateral blood flow of Type 1 and Type 2.The relationship between the patterns of intracerebral collateral blood flow and the location of HVS was analyzed.Results Of 41 adult patients with non-hemorrhagic MMD,there were 3 patients presented with unilateral vascular lesions and 38 with bilateral vascular lesions,so the total number of vascular lesions of the cerebral hemispheres was 79.Because three patients showed the absence of HVS in bilateral hemispheres,the total number of the presence of HVS of the cerebral hemispheres was 73.Therefore,the percentage of the presence of HVS was 92.4% (73/79) in vascular lesions of the cerebral hemispheres.Importantly,the patterns of slow collateral blood flow corresponding to Grade 1 HVS were all antegrade (7/7) ; the collateral patterns corresponding to Grade 2 HVS were mainly retrograde leptomeningeal flow (95.0%,19/20) ; and the patterns corresponding to Grade 3 HVS were mainly slow combined collateral blood flow(84.8%,39/46).Furthermore,with the changing sites of HVS from the cerebral sulci of temporal lobe to the cerebral sulci of frontal and parietal lobe regions,the directions of collateral flow changed with a shift from antegrade to retrograde,which was statistically significant.Conclusion The different locations of HVS can reflect the different patterns of collateral blood flow,and the locations of HVS may predict the directions of intracerebral collateral blood flow in adult MMD patients.

  6. Neural interface of mirror therapy in chronic stroke patients: a functional magnetic resonance imaging study.

    Science.gov (United States)

    Bhasin, Ashu; Padma Srivastava, M V; Kumaran, Senthil S; Bhatia, Rohit; Mohanty, Sujata

    2012-01-01

    Recovery in stroke is mediated by neural plasticity. Neuro-restorative therapies improve recovery after stroke by promoting repair and function. Mirror neuron system (MNS) has been studied widely in humans in stroke and phantom sensations. Study subjects included 20 patients with chronic stroke and 10 healthy controls. Patients had clinical disease-severity scores, functional magnetic resonance imaging (fMRI) and diffuse tensor imaging (DTI) at baseline, 8 and at 24 weeks. Block design with alternate baseline and activation cycles was used with a total of 90 whole brain echo planar imaging (EPI) measurements (timed repetition (TR) = 4520 ms, timed echo (TE) = 44 ms, slices = 31, slice thickness = 4 mm, EPI factor 127, matrix = 128 × 128, FOV = 230 mm). Whole brain T1-weighted images were acquired using 3D sequence (MPRage) with 120 contiguous slices of 1.0 mm thickness. The mirror therapy was aimed via laptop system integrated with web camera, mirroring the movement of the unaffected hand. This therapy was administered for 5 days in a week for 60-90 min for 8 weeks. All the patients showed statistical significant improvement in Fugl Meyer and modified Barthel Index (P stroke. Therapy induced cortical reorganization was also observed from our study.

  7. The circuit architecture of whole brains at the mesoscopic scale.

    Science.gov (United States)

    Mitra, Partha P

    2014-09-17

    Vertebrate brains of even moderate size are composed of astronomically large numbers of neurons and show a great degree of individual variability at the microscopic scale. This variation is presumably the result of phenotypic plasticity and individual experience. At a larger scale, however, relatively stable species-typical spatial patterns are observed in neuronal architecture, e.g., the spatial distributions of somata and axonal projection patterns, probably the result of a genetically encoded developmental program. The mesoscopic scale of analysis of brain architecture is the transitional point between a microscopic scale where individual variation is prominent and the macroscopic level where a stable, species-typical neural architecture is observed. The empirical existence of this scale, implicit in neuroanatomical atlases, combined with advances in computational resources, makes studying the circuit architecture of entire brains a practical task. A methodology has previously been proposed that employs a shotgun-like grid-based approach to systematically cover entire brain volumes with injections of neuronal tracers. This methodology is being employed to obtain mesoscale circuit maps in mouse and should be applicable to other vertebrate taxa. The resulting large data sets raise issues of data representation, analysis, and interpretation, which must be resolved. Even for data representation the challenges are nontrivial: the conventional approach using regional connectivity matrices fails to capture the collateral branching patterns of projection neurons. Future success of this promising research enterprise depends on the integration of previous neuroanatomical knowledge, partly through the development of suitable computational tools that encapsulate such expertise.

  8. Mapping human whole-brain structural networks with diffusion MRI.

    Directory of Open Access Journals (Sweden)

    Patric Hagmann

    Full Text Available Understanding the large-scale structural network formed by neurons is a major challenge in system neuroscience. A detailed connectivity map covering the entire brain would therefore be of great value. Based on diffusion MRI, we propose an efficient methodology to generate large, comprehensive and individual white matter connectional datasets of the living or dead, human or animal brain. This non-invasive tool enables us to study the basic and potentially complex network properties of the entire brain. For two human subjects we find that their individual brain networks have an exponential node degree distribution and that their global organization is in the form of a small world.

  9. Can the whole brain be simpler than its "parts"?

    OpenAIRE

    Eliashberg, Victor

    2002-01-01

    This is the first in a series of connected papers discussing the problem of a dynamically reconfigurable universal learning neurocomputer that could serve as a computational model for the whole human brain. The whole series is entitled "The Brain Zero Project. My Brain as a Dynamically Reconfigurable Universal Learning Neurocomputer." (For more information visit the website www.brain0.com.) This introductory paper is concerned with general methodology. Its main goal is to explain why it is cr...

  10. Whole Brain Learning: The Fine Arts with Students at Risk

    Science.gov (United States)

    Respress, Trinetia; Lutfi, Ghazwan

    2006-01-01

    Schools are searching for more effective strategies that will enable all students to thrive and succeed. Evidence indicates that the fine arts can provide a unique avenue for reaching challenging students with principles of brain-based learning. This article describes HEARTS, an after-school fine arts program which taps and develops the talents of…

  11. MR Imaging in Spinocerebellar Ataxias: A Systematic Review.

    Science.gov (United States)

    Klaes, A; Reckziegel, E; Franca, M C; Rezende, T J R; Vedolin, L M; Jardim, L B; Saute, J A

    2016-08-01

    Polyglutamine expansion spinocerebellar ataxias are autosomal dominant slowly progressive neurodegenerative diseases with no current treatment. MR imaging is the best-studied surrogate biomarker candidate for polyglutamine expansion spinocerebellar ataxias, though with conflicting results. We aimed to review quantitative central nervous system MR imaging technique findings in patients with polyglutamine expansion spinocerebellar ataxias and correlations with well-established clinical and molecular disease markers. We searched MEDLINE, LILACS, and Cochrane data bases of clinical trials between January 1995 and January 2016, for quantitative MR imaging volumetric approaches, MR spectroscopy, diffusion tensor imaging, or other quantitative techniques, comparing patients with polyglutamine expansion spinocerebellar ataxias (SCAs) with controls. Pertinent details for each study regarding participants, imaging methods, and results were extracted. After reviewing the 706 results, 18 studies were suitable for inclusion: 2 studies in SCA1, 1 in SCA2, 15 in SCA3, 1 in SCA7, 1 in SCA1 and SCA6 presymptomatic carriers, and none in SCA17 and dentatorubropallidoluysian atrophy. Cerebellar hemispheres and vermis, whole brain stem, midbrain, pons, medulla oblongata, cervical spine, striatum, and thalamus presented significant atrophy in SCA3. The caudate, putamen and whole brain stem presented similar sensitivity to change compared with ataxia scales after 2 years of follow-up in a single prospective study in SCA3. MR spectroscopy and DTI showed abnormalities only in cross-sectional studies in SCA3. Results from single studies in other polyglutamine expansion spinocerebellar ataxias should be replicated in different cohorts. Additional cross-sectional and prospective volumetric analysis, MR spectroscopy, and DTI studies are necessary in polyglutamine expansion spinocerebellar ataxias. The properties of preclinical disease biomarkers (presymptomatic) of MR imaging should be

  12. Clinical application of CTA coupled with whole brain CT perfused blood flow after onset of aneurismal subarachnoid hemorrhage%CTA联合全脑血流灌注成像在蛛网膜下腔出血后的临床应用

    Institute of Scientific and Technical Information of China (English)

    李响; 李春志; 李松柏; 卑贵光; 蒋宝国; 徐克

    2011-01-01

    目的:探讨CTA联合全脑灌注成像在蛛网膜下腔出血(SAH)后的临床应用价值.方法:SAH病人29例,通过双源CT全脑血流灌注(PBV)检查,重建CTA图像和PBV图像,在检出动脉瘤等同时,以灌注参数评估SAH后脑血管痉挛及其所致的脑缺血改变情况.结果:29例病人中检出27例的28个动脉瘤.额、颞、顶、枕叶及小脑PBV值SAH组分别为11.17±3.13;10.92±2.91;11.08±2.53;9.88±3.01;19.83±5.12,对照组分别为17.10±3.60;15.98±5.03;15.84±3.53;16.14±1.86;23.54±4.64,额、顶、枕叶差异显著(P<0.05);存活组与死亡组各脑叶PBV值均未见显著性差异;优势出血侧和非优势出血侧低灌注出现情况无显著性差异.结论:CTA联合全脑PBV灌注成像能够在诊断SAH出血原因的同时显示脑血管痉挛引起的脑组织缺血改变.%Objective: To investigate the clinical application of CTA coupled with whole brain CT perfused blood flow after onset of aneurismal subarachnoid hemorrhage (SAH).Methods: Perfused blood volume (PBV) values were confirmed in 29 patients with SAH by dual source computed tomography.CTA maps and PBV maps were reconstructed.In the meantime we detectd the aneurysm, we evaluated the change of vasospasm and the cause of cerebral ischemia by the perfusion characteristics.Results: Twenty-eight aneurysms in 27 patients were detected.PBV value in the frontal, temporal, parietal, occipital lobe and cerebellum is 11.17±3.13; 10.92±2.91; 11.08±2.53; 9.88±3.01; 19.83±5.12 respectively in the SAH group, and 17.10±3.60; 15.98±5.03; 15.84±3.53; 16.14±1.86; 23.54±4.64 respectively in the control group.Significant difference was showed in the frontal, parietal and occipital lobes of the brain (P<0.05), but the PBV values had no significant difference in the survival group and the death group.It showed no significant difference of hypoperfusion between bleeding dominant hemisphere and the other one.Conclusions: The cause of the SAH could be

  13. Temozolomide combined with whole-brain radiotherapy in treatment of non-small cell lung cancer complicated with metastatic brain tumor%替莫唑胺联合全脑放疗治疗非小细胞肺癌脑转移瘤的近期临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨宏山; 瞿广桥

    2015-01-01

    Objective To observe the therapeutic effect and toxicity of temozolomide combined with whole-brain radiotherapy in the treatment of non-small cell lung cancer complicated with metastatic brain tumor.Methods 32 patients with non-small cell lung cancer who were diagnosed with brain metastases orally took temozolomide (75mg/m2·d) and received 40 Gy fractionated conventional external-beam radiotherapy (2 Gy per day,5 days per week) for 4 weeks.After radiotherapy,patients took temozolomide (200mg/m2·d) for 5 days every 4 weeks for 6 cycles.Progression-free survival curves and overall were estimated by Kaplan-Meier technique.Results All the 32 patients were evaluable for response with 5 cases of CR,19 PR,4 SD,and 4 PD.The overall response rate was 74.9% and the clinical benefit rate was 87.4%.The median progression-free survival time was 7.6 months.The main side effects were gastrointestinal reaction and myelosuppression,which were alleviated by symptomatic treatment.Conclusions Temozolomide combined with whole-brain radiotherapy is effective with mild toxicity for patients with non-small cell lung cancer who were diagnosed with brain metastases.%目的 观察替莫唑胺联合全脑放疗治疗非小细胞肺癌脑转移患者的临床疗效及安全性.方法 回顾分析了确诊非小细胞肺癌脑转移的患者32例,予以常规分割性全脑放疗,剂量DT 40 Gy (2Gy,1次/d,每周5d),放疗期间每日口服替莫唑胺75 mg,/(m2·d),放疗结束后每4周予以替莫唑胺200 mg/ (m2·d)口服5d方案化疗,共6周期.生存率使用Kaplan-Meier方法计算.结果 32例患者均可评价疗效,其中完全缓解5例(15.6%),部分缓解19例(59.3%),稳定4例(12.5%),进展4例(12.5%),近期治疗有效率74.9%,临床获益率87.4%,中位生存期7.6个月.治疗的不良反应主要表现为胃肠道症状、骨髓抑制,患者均可耐受.结论 替莫唑胺联合全脑放疗方案治疗非小细胞肺癌脑转移患者有较好的近期疗

  14. Aberrant topological properties of whole-brain functional network in chronic right-sided sensorineural hearing loss: a resting-state functional MRI study%慢性右侧感音神经性耳聋患者全脑功能网络静息态fMRI研究

    Institute of Scientific and Technical Information of China (English)

    张玲玲; 刘斌; 徐仰文; 杨明; 冯源; 黄亚青; 黄志纯; 侯召瑞

    2015-01-01

    目的 利用静息态功能磁共振成像(fMRI)数据探讨慢性单侧感音神经性耳聋(USNHL)患者全脑功能网络的改变情况.方法 收集2012年6月至2013年6月经东南大学附属中大医院耳鼻喉门诊接待或广告招募重度右侧USNHL患者19例及31例听力正常的志愿者的静息态磁共振BOLD数据,构建受试者的全脑功能网络,计算网络相关参数:全局效率(Eglobal)、局部效率(Elocal)、小世界属性(Cp、Lp、γ、λ、σ).比较组间参数差异,并将Eglobal、Lp与耳聋持续时间及严重程度进行偏相关分析.结果 在稀疏度阈值范围为0.1 ~0.2时,两组均符合小世界属性(σ>1);大部分阈值下耳聋组Lp、λ高于正常对照组,差异有统计学意义,Eglobal低于正常对照组,差异有统计学意义(P<0.05);而Cp、Elocal、γ、σ差异无统计学意义(P>0.05).Eglobal、Lp与耳聋持续时间及严重程度无相关性(P>0.05).结论 右侧USNHL患者脑功能网络虽仍具有小世界属性,但患者全脑功能网络的某些属性已发生改变,这些改变对于从大尺度脑网络角度研究USNHL病理机制具有重要意义.%Objective To investigate the topological properties of the functional brain network in unilateral sensorineural hearing loss patients.Methods In this study,we acquired resting-state BOLD-fMRI data from 19 right-sided SNHL patients and 31 healthy controls with normal hearing and constructed their whole brain functional networks.Two-sample two-tailed t-tests were performed to investigate group differences in topological parameters between the USNHL patients and the controls.Partial correlation analysis was conducted to determine the relationships between the network metrics and USNHL-related variables.Results Both USNHL patients and controls exhibited small-word architecture in their brain functional networks within the range 0.1-0.2 of sparsity.Compared to the controls,USNHL patients showed significant increase in

  15. Unraveling pathology in juvenile Alexander disease: serial quantitative MR imaging and spectroscopy of white matter

    Energy Technology Data Exchange (ETDEWEB)

    Voorn, J.P. van der [VU University Medical Center, Department of Child Neurology, Amsterdam (Netherlands); VU University Medical Center, Department of Pathology, Amsterdam (Netherlands); Pouwels, Petra J.W. [VU University Medical Center, Department of Physics and Medical Technology, Amsterdam (Netherlands); Salomons, Gajja S. [VU University Medical Center, Department of Clinical Chemistry (Metabolic Unit), Amsterdam (Netherlands); Barkhof, Frederik [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Knaap, Marjo S. van der [VU University Medical Center, Department of Child Neurology, Amsterdam (Netherlands)

    2009-10-15

    Alexander disease is a rare disorder of the central nervous system with characteristic symmetric white matter abnormalities with frontal predominance on magnetic resonance (MR) images. Histopathology shows a lack of myelin in the affected white matter, variably interpreted as hypomyelination or demyelination. To increase our insight into the nature of the pathology leading to the MR imaging findings in Alexander disease, we applied serial MR imaging, spectroscopy, magnetization transfer (MT) imaging (MTI), and diffusion tensor imaging (DTI) in six patients with juvenile Alexander disease. The MR imaging protocol comprised T1- and T2-weighted spin echo images and fluid-attenuated inversion recovery images. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), and MT ratio (MTR) maps were generated, and MR spectroscopy concentrations were quantified for several metabolites. MR imaging showed similar cerebral white matter abnormalities in all patients, with only minor increase on prolonged follow-up, despite sometimes serious clinical progression. MR spectroscopy showed highly elevated levels of myo-inositol, lactate, and choline-containing compounds and decreased total N-acetyl-aspartate and N-acetyl-aspartyl-glutamate levels in the abnormal white matter. High values of ADC were observed, and both FA and MTR were attenuated. The sequential MR imaging findings in Alexander disease provide strong evidence against active demyelination as sole explanation for the underlying pathology. An alternative explanation for our spectroscopic, DTI, and MTI findings - which would suggest demyelination - could be hyperplasia and hypertrophy of astrocytes, as seen in low grade gliomas. (orig.)

  16. A nested phosphorus and proton coil array for brain magnetic resonance imaging and spectroscopy.

    Science.gov (United States)

    Brown, Ryan; Lakshmanan, Karthik; Madelin, Guillaume; Parasoglou, Prodromos

    2016-01-01

    A dual-nuclei radiofrequency coil array was constructed for phosphorus and proton magnetic resonance imaging and spectroscopy of the human brain at 7T. An eight-channel transceive degenerate birdcage phosphorus module was implemented to provide whole-brain coverage and significant sensitivity improvement over a standard dual-tuned loop coil. A nested eight-channel proton module provided adequate sensitivity for anatomical localization without substantially sacrificing performance on the phosphorus module. The developed array enabled phosphorus spectroscopy, a saturation transfer technique to calculate the global creatine kinase forward reaction rate, and single-metabolite whole-brain imaging with 1.4cm nominal isotropic resolution in 15min (2.3cm actual resolution), while additionally enabling 1mm isotropic proton imaging. This study demonstrates that a multi-channel array can be utilized for phosphorus and proton applications with improved coverage and/or sensitivity over traditional single-channel coils. The efficient multi-channel coil array, time-efficient pulse sequences, and the enhanced signal strength available at ultra-high fields can be combined to allow volumetric assessment of the brain and could provide new insights into the underlying energy metabolism impairment in several neurodegenerative conditions, such as Alzheimer's and Parkinson's diseases, as well as mental disorders such as schizophrenia.

  17. Theory of mind associations with other cognitive functions and brain imaging in normal aging.

    Science.gov (United States)

    Charlton, Rebecca A; Barrick, Thomas R; Markus, Hugh S; Morris, Robin G

    2009-06-01

    The study investigated age-related differences in theory of mind and explored the relationship between this ability, other cognitive abilities, and structural brain measures. A cohort of 106 adults (ages 50-90 years) was recruited. Participants completed tests of theory of mind, verbal and performance intelligence, executive function, and information processing speed and underwent structural magnetic resonance imaging (measurement of whole brain volume, volume of white matter hyperintensities, and diffusion tensor imaging of white matter integrity). Theory of mind ability declined with increasing age, and the relationship between theory of mind and age was fully mediated by performance intelligence, executive function, and information processing speed and was partially mediated by verbal intelligence. Theory of mind performance correlated significantly with diffusion tensor imaging measures of white matter integrity but not with volume of white matter hyperintensities or whole-brain volume. Theory of mind age-related decline may not be independent of other cognitive functions; it may also be particularly susceptible to changes in white matter integrity. (c) 2009 APA, all rights reserved.

  18. 3D functional ultrasound imaging of the cerebral visual system in rodents.

    Science.gov (United States)

    Gesnik, Marc; Blaize, Kevin; Deffieux, Thomas; Gennisson, Jean-Luc; Sahel, José-Alain; Fink, Mathias; Picaud, Serge; Tanter, Mickaël

    2017-02-03

    3D functional imaging of the whole brain activity during visual task is a challenging task in rodents due to the complex tri-dimensional shape of involved brain regions and the fine spatial and temporal resolutions required to reveal the visual tract. By coupling functional ultrasound (fUS) imaging with a translational motorized stage and an episodic visual stimulation device, we managed to accurately map and to recover the activity of the visual cortices, the Superior Colliculus (SC) and the Lateral Geniculate Nuclei (LGN) in 3D. Cerebral Blood Volume (CBV) responses during visual stimuli were found to be highly correlated with the visual stimulus time profile in visual cortices (r=0.6), SC (r=0.7) and LGN (r=0.7). These responses were found dependent on flickering frequency and contrast, and optimal stimulus parameters for largest CBV increases were obtained. In particular, increasing the flickering frequency higher than 7Hz revealed a decrease of visual cortices response while the SC response was preserved. Finally, cross-correlation between CBV signals exhibited significant delays (d=0.35s +/-0.1s) between blood volume response in SC and visual cortices in response to our visual stimulus. These results emphasize the interest of fUS imaging as a whole brain neuroimaging modality for brain vision studies in rodent models.

  19. Intensity standardisation of 7T MR images for intensity-based segmentation of the human hypothalamus.

    Science.gov (United States)

    Schindler, Stephanie; Schreiber, Jan; Bazin, Pierre-Louis; Trampel, Robert; Anwander, Alfred; Geyer, Stefan; Schönknecht, Peter

    2017-01-01

    The high spatial resolution of 7T MRI enables us to identify subtle volume changes in brain structures, providing potential biomarkers of mental disorders. Most volumetric approaches require that similar intensity values represent similar tissue types across different persons. By applying colour-coding to T1-weighted MP2RAGE images, we found that the high measurement accuracy achieved by high-resolution imaging may be compromised by inter-individual variations in the image intensity. To address this issue, we analysed the performance of five intensity standardisation techniques in high-resolution T1-weighted MP2RAGE images. Twenty images with extreme intensities in the GM and WM were standardised to a representative reference image. We performed a multi-level evaluation with a focus on the hypothalamic region-analysing the intensity histograms as well as the actual MR images, and requiring that the correlation between the whole-brain tissue volumes and subject age be preserved during standardisation. The results were compared with T1 maps. Linear standardisation using subcortical ROIs of GM and WM provided good results for all evaluation criteria: it improved the histogram alignment within the ROIs and the average image intensity within the ROIs and the whole-brain GM and WM areas. This method reduced the inter-individual intensity variation of the hypothalamic boundary by more than half, outperforming all other methods, and kept the original correlation between the GM volume and subject age intact. Mixed results were obtained for the other four methods, which sometimes came at the expense of unwarranted changes in the age-related pattern of the GM volume. The mapping of the T1 relaxation time with the MP2RAGE sequence is advertised as being especially robust to bias field inhomogeneity. We found little evidence that substantiated the T1 map's theoretical superiority over the T1-weighted images regarding the inter-individual image intensity homogeneity.

  20. Intensity standardisation of 7T MR images for intensity-based segmentation of the human hypothalamus

    Science.gov (United States)

    Schreiber, Jan; Bazin, Pierre-Louis; Trampel, Robert; Anwander, Alfred; Geyer, Stefan; Schönknecht, Peter

    2017-01-01

    The high spatial resolution of 7T MRI enables us to identify subtle volume changes in brain structures, providing potential biomarkers of mental disorders. Most volumetric approaches require that similar intensity values represent similar tissue types across different persons. By applying colour-coding to T1-weighted MP2RAGE images, we found that the high measurement accuracy achieved by high-resolution imaging may be compromised by inter-individual variations in the image intensity. To address this issue, we analysed the performance of five intensity standardisation techniques in high-resolution T1-weighted MP2RAGE images. Twenty images with extreme intensities in the GM and WM were standardised to a representative reference image. We performed a multi-level evaluation with a focus on the hypothalamic region—analysing the intensity histograms as well as the actual MR images, and requiring that the correlation between the whole-brain tissue volumes and subject age be preserved during standardisation. The results were compared with T1 maps. Linear standardisation using subcortical ROIs of GM and WM provided good results for all evaluation criteria: it improved the histogram alignment within the ROIs and the average image intensity within the ROIs and the whole-brain GM and WM areas. This method reduced the inter-individual intensity variation of the hypothalamic boundary by more than half, outperforming all other methods, and kept the original correlation between the GM volume and subject age intact. Mixed results were obtained for the other four methods, which sometimes came at the expense of unwarranted changes in the age-related pattern of the GM volume. The mapping of the T1 relaxation time with the MP2RAGE sequence is advertised as being especially robust to bias field inhomogeneity. We found little evidence that substantiated the T1 map’s theoretical superiority over the T1-weighted images regarding the inter-individual image intensity homogeneity. PMID

  1. Three-dimensional reconstruction of functional brain images

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Masato; Shoji, Kazuhiko; Kojima, Hisayoshi; Hirano, Shigeru; Naito, Yasushi; Honjo, Iwao [Kyoto Univ. (Japan)

    1999-08-01

    We consider PET (positron emission tomography) measurement with SPM (Statistical Parametric Mapping) analysis to be one of the most useful methods to identify activated areas of the brain involved in language processing. SPM is an effective analytical method that detects markedly activated areas over the whole brain. However, with the conventional presentations of these functional brain images, such as horizontal slices, three directional projection, or brain surface coloring, makes understanding and interpreting the positional relationships among various brain areas difficult. Therefore, we developed three-dimensionally reconstructed images from these functional brain images to improve the interpretation. The subjects were 12 normal volunteers. The following three types of images were constructed: routine images by SPM, three-dimensional static images, and three-dimensional dynamic images, after PET images were analyzed by SPM during daily dialog listening. The creation of images of both the three-dimensional static and dynamic types employed the volume rendering method by VTK (The Visualization Toolkit). Since the functional brain images did not include original brain images, we synthesized SPM and MRI brain images by self-made C++ programs. The three-dimensional dynamic images were made by sequencing static images with available software. Images of both the three-dimensional static and dynamic types were processed by a personal computer system. Our newly created images showed clearer positional relationships among activated brain areas compared to the conventional method. To date, functional brain images have been employed in fields such as neurology or neurosurgery, however, these images may be useful even in the field of otorhinolaryngology, to assess hearing and speech. Exact three-dimensional images based on functional brain images are important for exact and intuitive interpretation, and may lead to new developments in brain science. Currently, the surface

  2. Diffusion Tensor Imaging of Pedophilia.

    Science.gov (United States)

    Cantor, James M; Lafaille, Sophie; Soh, Debra W; Moayedi, Massieh; Mikulis, David J; Girard, Todd A

    2015-11-01

    Pedophilia is a principal motivator of child molestation, incurring great emotional and financial burdens on victims and society. Even among pedophiles who never commit any offense,the condition requires lifelong suppression and control. Previous comparison using voxel-based morphometry (VBM)of MR images from a large sample of pedophiles and controls revealed group differences in white matter. The present study therefore sought to verify and characterize white matter involvement using diffusion tensor imaging (DTI), which better captures the microstructure of white matter than does VBM. Pedophilics ex offenders (n=24) were compared with healthy, age-matched controls with no criminal record and no indication of pedophilia (n=32). White matter microstructure was analyzed with Tract-Based Spatial Statistics, and the trajectories of implicated fiber bundles were identified by probabilistic tractography. Groups showed significant, highly focused differences in DTI parameters which related to participants’ genital responses to sexual depictions of children, but not to measures of psychopathy or to childhood histories of physical abuse, sexual abuse, or neglect. Some previously reported gray matter differences were suggested under highly liberal statistical conditions (p(uncorrected)<.005), but did not survive ordinary statistical correction (whole brain per voxel false discovery rate of 5%). These results confirm that pedophilia is characterized by neuroanatomical differences in white matter microstructure, over and above any neural characteristics attributable to psychopathy and childhood adversity, which show neuroanatomic footprints of their own. Although some gray matter structures were implicated previously, only few have emerged reliably.

  3. Connectome and Maturation Profiles of the Developing Mouse Brain Using Diffusion Tensor Imaging.

    Science.gov (United States)

    Ingalhalikar, Madhura; Parker, Drew; Ghanbari, Yasser; Smith, Alex; Hua, Kegang; Mori, Susumu; Abel, Ted; Davatzikos, Christos; Verma, Ragini

    2015-09-01

    This paper presents a comprehensive effort to establish a structural mouse connectome using diffusion tensor magnetic resonance imaging coupled with connectivity analysis tools. This work lays the foundation for imaging-based structural connectomics of the mouse brain, potentially facilitating a whole-brain network analysis to quantify brain changes in connectivity during development, as well as deviations from it related to genetic effects. A connectomic trajectory of maturation during postnatal ages 2-80 days is presented in the C57BL/6J mouse strain, using a whole-brain connectivity analysis, followed by investigations based on local and global network features. The global network measures of density, global efficiency, and modularity demonstrated a nonlinear relationship with age. The regional network metrics, namely degree and local efficiency, displayed a differential change in the major subcortical structures such as the thalamus and hippocampus, and cortical regions such as visual and motor cortex. Finally, the connectomes were used to derive an index of "brain connectivity index," which demonstrated a high correlation (r = 0.95) with the chronological age, indicating that brain connectivity is a good marker of normal age progression, hence valuable in detecting subtle deviations from normality caused by genetic, environmental, or pharmacological manipulations.

  4. Increased cortical-limbic anatomical network connectivity in major depression revealed by diffusion tensor imaging.

    Directory of Open Access Journals (Sweden)

    Peng Fang

    Full Text Available Magnetic resonance imaging studies have reported significant functional and structural differences between depressed patients and controls. Little attention has been given, however, to the abnormalities in anatomical connectivity in depressed patients. In the present study, we aim to investigate the alterations in connectivity of whole-brain anatomical networks in those suffering from major depression by using machine learning approaches. Brain anatomical networks were extracted from diffusion magnetic resonance images obtained from both 22 first-episode, treatment-naive adults with major depressive disorder and 26 matched healthy controls. Using machine learning approaches, we differentiated depressed patients from healthy controls based on their whole-brain anatomical connectivity patterns and identified the most discriminating features that represent between-group differences. Classification results showed that 91.7% (patients=86.4%, controls=96.2%; permutation test, p<0.0001 of subjects were correctly classified via leave-one-out cross-validation. Moreover, the strengths of all the most discriminating connections were increased in depressed patients relative to the controls, and these connections were primarily located within the cortical-limbic network, especially the frontal-limbic network. These results not only provide initial steps toward the development of neurobiological diagnostic markers for major depressive disorder, but also suggest that abnormal cortical-limbic anatomical networks may contribute to the anatomical basis of emotional dysregulation and cognitive impairments associated with this disease.

  5. Usefulness of combined fat- and fluid-suppressed SPIR-FLAIR images in optic neurits : Comparison with fat-suppressed SPIR or STIR images

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Yeon; Son, Seok Hyun; Eun, Choong Ki; Han, Sang Suk [Inje Univ., College of Medicine, Pusan (Korea, Republic of)

    2001-12-01

    To compare the usefulness of combined fat- and fluid-suppressed selective partial inversion recovery-fluid attenuated inversion recovery(SPIR-FLAIR) images in the detection of high signal intensity of the optic nerve in optic neuritis with that of fat-suppressed selective partial inversion recovery(SPIR) or short inversion time inversion recovery(STIR) images. Two radiologists independently analyzed randomly mixed MR images of 16 lesions in 14 patients (M:F=7:7; mean age, 40 years) in whom optic neuritis had been clinically diagnosed. All subjects underwent both SPIR-FLAIR and fat-suppressed SPIR or STIR imaging, in a blind fashion. In order to evaluate the optic nerve, coronal images perpendicular to its long axis were obtained. The detection rate of high signal intensity of the optic nerve, the radiologists preferred imaging sequences, and intersubject consistency of detection were evaluated. 'High signal intensity' was defined as the subjective visual evaluation of increased signal intensity compared with that of the contralateral optic nerve or that of white matter. The mean detection rate of high signal intensity of the optic nerve was 90% for combined fat- and fluid-suppressed SPIR-FLAIR images, and 59% for fat-suppressed SPIR or STIR images. In all cases in which the signal intensity observed on SPIR-FLAIR images was normal, that on fat-suppressed SPIR or STIR images was also normal. The radiologists preferred the contrast properties of SPIR-FLAIR to those of fat-suppressed SPIR or STIR images. In the diagnosis of optic neuritis using MRI, combined fat- and fluid-suppressed SPIR-FLAIR images were more useful for the detection of high signal intensity of the optic nerve than fat-suppressed SPIR or STIR images. For the evaluation of optic neuritis, combined fat- and fluid-suppressed SPIR-FLAIR imaging is superior to fat-suppressed SPIR or STIR imaging.

  6. False positives in imaging genetics.

    Science.gov (United States)

    Meyer-Lindenberg, Andreas; Nicodemus, Kristin K; Egan, Michael F; Callicott, Joseph H; Mattay, Venkata; Weinberger, Daniel R

    2008-04-01

    Imaging genetics provides an enormous amount of functional-structural data on gene effects in living brain, but the sheer quantity of potential phenotypes raises concerns about false discovery. Here, we provide the first empirical results on false positive rates in imaging genetics. We analyzed 720 frequent coding SNPs without significant association with schizophrenia and a subset of 492 of these without association with cognitive function. Effects on brain structure (using voxel-based morphometry, VBM) and brain function, using two archival imaging tasks, the n-back working memory task and an emotional face matching task, were studied in whole brain and regions of interest and corrected for multiple comparisons using standard neuroimaging procedures. Since these variants are unlikely to impact relevant brain function, positives obtained provide an upper empirical estimate of the false positive association rate. In a separate analysis, we randomly permuted genotype labels across subjects, removing any true genotype-phenotype association in the data, to derive a lower empirical estimate. At a set correction level of 0.05, in each region of interest and data set used, the rate of positive findings was well below 5% (0.2-4.1%). There was no relationship between the region of interest and the false positive rate. Permutation results were in the same range as empirically derived rates. The observed low rates of positives provide empirical evidence that the type I error rate is well controlled by current commonly used correction procedures in imaging genetics, at least in the context of the imaging paradigms we have used. In fact, our observations indicate that these statistical thresholds are conservative.

  7. 胶质瘤模型单剂量全脑放疗后血脑屏障开放的时间阈及紧密连接变化的研究%Study of Time-Domain of Blood-brain Barrier Opened and Tight Junction Changed in Glioma Models after Whole-brain Irradiated with Single Dose

    Institute of Scientific and Technical Information of China (English)

    李蓉; 刘国龙; 关明媚; 牛道立; 易炜; 孙健聪

    2012-01-01

    目的 观察C6脑胶质瘤15 Gy单次全脑放射线照射后血-脑屏障(blood-brain barrier,BBB)通透性的动态变化及紧密连接蛋白claudin-5的表达变化,观察大鼠血-脑屏障(BBB)开放的时间阈.方法 荷瘤鼠(建模后17天)60只,行15 Gy全脑放射线单次照射,并于照射后24h、3d、7d、14d、21d、28d各处死10只,各5只分别行硝酸镧(La+)透射电子显微镜示踪法观察肿瘤邻近处(brain adjacent to tumor,BAT)即距肿瘤边界2mm以内BBB通透性及免疫组织化学法测定紧密连接蛋白claudin-5的变化研究.结果 (1)照射后24h、3d硝酸镧渗出广泛,基底膜、血管腔外、脑组织间隙内及细胞内均可见;第7d为La3渗出减弱,基底膜及脑组织间隙内见细小的镧颗粒;第14d为La3+渗出至局部基底膜,较前减少;第21d、28d均为La3+无渗出.统计学分析硝酸镧渗出程度显示:24h和3d>7d>14d>21d和28d(P<0.05).(2)照射后24h、3d紧密连接蛋白claudin-5呈轻度表达,呈碎片状表达;照射后第7d为轻中度表达,血管扭曲、变形:照射后第14d为中度表达,血管扭曲、变形,但仍呈连续状态;照射后第21d、28d为中强度表达,出现连续与碎片表达并存.统计学分析claudin-5表达程度显示:24h和3d<7d<14d<21d和28d(P<0.05).结论 荷瘤鼠单次15 Gy照射后BBB开放,且2周后BBB通透性逐渐消失,表现出时间依赖性.%Objective To investigate the change in blood-brain barrier (BBB) permeability and ultrastruc-ture of microvessle in C6 glioma and the tight junction protein expression of claudin-5.which were whole-brain irradiated with 15 Gy,and to explore the time-domain of BBB opened. Methods Sixty tumor-bearing rats (17thday after inoculation) were whole-brain irradiated with 15 Gy,and 10 rats were severally sacrificed at 24 h,3 d,7 d,14 d,21 d and 28 d after irradiation,5 rats were using transmission electron microscopy of exogenous lanthanum nitrate (La3+ )-tracing to observe the

  8. Effect of CSF Suppression for Diffusional Kurtosis Imaging

    Science.gov (United States)

    Yang, Alicia W.; Jensen, Jens H.; Hu, Caixia C.; Tabesh, Ali; Falangola, Maria F.; Helpern, Joseph A.

    2012-01-01

    Purpose To evaluate the cerebrospinal fluid (CSF) partial volume effect on diffusional kurtosis imaging (DKI) metrics in white matter and cortical gray matter. Materials and Methods Four healthy volunteers participated in this study. Standard DKI and fluid-attenuated inversion recovery (FLAIR) DKI experiments were performed using a twice-refocused-spin-echo diffusion sequence. The conventional diffusional tensor imaging (DTI) metrics of fractional anisotropy (FA), mean, axial, and radial diffusivity (MD, D∥, D⊥) together with DKI metrics of mean, axial and radial kurtosis (MK, K∥, K⊥) were measured and compared. Single image slices located above the lateral ventricles, with similar anatomical features for each subject, were selected to minimize the effect of CSF from the ventricles. Results In white matter, differences of less than 10% were observed between diffusion metrics measured with standard DKI and FLAIR-DKI sequences, suggesting minimal CSF contamination. For gray matter, conventional DTI metrics differed by 19% to 52%, reflecting significant CSF partial volume effect. Kurtosis metrics, however, changed by 11% or less, indicating greater robustness with respect to CSF contamination. Conclusion Kurtosis metrics are less sensitive to CSF partial voluming in cortical gray matter than conventional diffusion metrics. The kurtosis metrics may then be more specific indicators of changes in tissue microstructure, provided the effect sizes for the changes are comparable. PMID:23034866

  9. Regional variability of imaging biomarkers in autosomal dominant Alzheimer's disease.

    Science.gov (United States)

    Benzinger, Tammie L S; Blazey, Tyler; Jack, Clifford R; Koeppe, Robert A; Su, Yi; Xiong, Chengjie; Raichle, Marcus E; Snyder, Abraham Z; Ances, Beau M; Bateman, Randall J; Cairns, Nigel J; Fagan, Anne M; Goate, Alison; Marcus, Daniel S; Aisen, Paul S; Christensen, Jon J; Ercole, Lindsay; Hornbeck, Russ C; Farrar, Angela M; Aldea, Patricia; Jasielec, Mateusz S; Owen, Christopher J; Xie, Xianyun; Mayeux, Richard; Brickman, Adam; McDade, Eric; Klunk, William; Mathis, Chester A; Ringman, John; Thompson, Paul M; Ghetti, Bernardino; Saykin, Andrew J; Sperling, Reisa A; Johnson, Keith A; Salloway, Stephen; Correia, Stephen; Schofield, Peter R; Masters, Colin L; Rowe, Christopher; Villemagne, Victor L; Martins, Ralph; Ourselin, Sebastien; Rossor, Martin N; Fox, Nick C; Cash, David M; Weiner, Michael W; Holtzman, David M; Buckles, Virginia D; Moulder, Krista; Morris, John C

    2013-11-19

    Major imaging biomarkers of Alzheimer's disease include amyloid deposition [imaged with [(11)C]Pittsburgh compound B (PiB) PET], altered glucose metabolism (imaged with [(18)F]fluro-deoxyglucose PET), and structural atrophy (imaged by MRI). Recently we published the initial subset of imaging findings for specific regions in a cohort of individuals with autosomal dominant Alzheimer's disease. We now extend this work to include a larger cohort, whole-brain analyses integrating all three imaging modalities, and longitudinal data to examine regional differences in imaging biomarker dynamics. The anatomical distribution of imaging biomarkers is described in relation to estimated years from symptom onset. Autosomal dominant Alzheimer's disease mutation carrier individuals have elevated PiB levels in nearly every cortical region 15 y before the estimated age of onset. Reduced cortical glucose metabolism and cortical thinning in the medial and lateral parietal lobe appeared 10 and 5 y, respectively, before estimated age of onset. Importantly, however, a divergent pattern was observed subcortically. All subcortical gray-matter regions exhibited elevated PiB uptake, but despite this, only the hippocampus showed reduced glucose metabolism. Similarly, atrophy was not observed in the caudate and pallidum despite marked amyloid accumulation. Finally, before hypometabolism, a hypermetabolic phase was identified for some cortical regions, including the precuneus and posterior cingulate. Additional analyses of individuals in which longitudinal data were available suggested that an accelerated appearance of volumetric declines approximately coincides with the onset of the symptomatic phase of the disease.

  10. Diffusion-weighted imaging and cognition in the leukoariosis and disability in the elderly study

    DEFF Research Database (Denmark)

    Schmidt, Reinhold; Ropele, Stefan; Ferro, José;

    2010-01-01

    BACKGROUND AND PURPOSE: The mechanisms by which leukoariosis impacts on clinical and cognitive functions are not yet fully understood. We hypothesized that ultrastructural abnormalities of the normal-appearing brain tissue (NABT) assessed by diffusion-weighted imaging played a major and independent...... without previous disability. WMH severity was rated according to the Fazekas score. Multivariate regression analysis served to assess correlations of histogram metrics of the apparent diffusion coefficient (ADC) of whole-brain tissue, NABT, and of the mean ADC of WMH with cognitive functions. RESULTS...... role. METHODS: In addition to a comprehensive clinical, neuropsychologic, and imaging work-up, diffusion-weighted imaging was performed in 340 participants of the multicenter leukoariosis and disability study examining the impact of white matter hyperintensities (WMH) on 65- to 85-year old individuals...

  11. Ribbon scanning confocal for high-speed high-resolution volume imaging of brain.

    Science.gov (United States)

    Watson, Alan M; Rose, Annika H; Gibson, Gregory A; Gardner, Christina L; Sun, Chengqun; Reed, Douglas S; Lam, L K Metthew; St Croix, Claudette M; Strick, Peter L; Klimstra, William B; Watkins, Simon C

    2017-01-01

    Whole-brain imaging is becoming a fundamental means of experimental insight; however, achieving subcellular resolution imagery in a reasonable time window has not been possible. We describe the first application of multicolor ribbon scanning confocal methods to collect high-resolution volume images of chemically cleared brains. We demonstrate that ribbon scanning collects images over ten times faster than conventional high speed confocal systems but with equivalent spectral and spatial resolution. Further, using this technology, we reconstruct large volumes of mouse brain infected with encephalitic alphaviruses and demonstrate that regions of the brain with abundant viral replication were inaccessible to vascular perfusion. This reveals that the destruction or collapse of large regions of brain micro vasculature may contribute to the severe disease caused by Venezuelan equine encephalitis virus. Visualization of this fundamental impact of infection would not be possible without sampling at subcellular resolution within large brain volumes.

  12. Reduction in camera-specific variability in [{sup 123}I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls

    Energy Technology Data Exchange (ETDEWEB)

    Buchert, Ralph; Lange, Catharina [Charite - Universitaetsmedizin Berlin, Department of Nuclear Medicine, Berlin (Germany); Kluge, Andreas; Bronzel, Marcus [ABX-CRO advanced pharmaceutical services Forschungsgesellschaft m.b.H., Dresden (Germany); Tossici-Bolt, Livia [University Hospital Southampton NHS Foundation Trust, Department of Medical Physics, Southampton (United Kingdom); Dickson, John [University College London Hospital NHS Foundation Trust, Institute of Nuclear Medicine, London (United Kingdom); Asenbaum, Susanne [Medical University of Vienna, Department of Nuclear Medicine, Vienna (Austria); Booij, Jan [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Centre, Amsterdam (Netherlands); Kapucu, L. Oezlem Atay [Gazi University, Department of Nuclear Medicine, Faculty of Medicine, Ankara (Turkey); Svarer, Claus [Rigshospitalet and University of Copenhagen, Neurobiology Research Unit, Copenhagen (Denmark); Koulibaly, Pierre-Malick [University of Nice-Sophia Antipolis, Nuclear Medicine Department, Centre Antoine Lacassagne, Nice (France); Nobili, Flavio [University of Genoa, Department of Neuroscience (DINOGMI), Clinical Neurology Unit, Genoa (Italy); Pagani, Marco [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Sabri, Osama [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Sera, Terez [University of Szeged, Department of Nuclear Medicine and Euromedic Szeged, Szeged (Hungary); Tatsch, Klaus [Municipal Hospital of Karlsruhe Inc, Department of Nuclear Medicine, Karlsruhe (Germany); Borght, Thierry vander [CHU Namur, IREC, Nuclear Medicine Division, Universite catholique de Louvain, Yvoir (Belgium); Laere, Koen van [University Hospital and K.U. Leuven, Nuclear Medicine, Leuven (Belgium); Varrone, Andrea [Karolinska University Hospital, Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm (Sweden); Iida, Hidehiro [National Cerebral and Cardiovascular Center - Research Institute, Osaka (Japan)

    2016-07-15

    Quantitative estimates of dopamine transporter availability, determined with [{sup 123}I]FP-CIT SPECT, depend on the SPECT equipment, including both hardware and (reconstruction) software, which limits their use in multicentre research and clinical routine. This study tested a dedicated reconstruction algorithm for its ability to reduce camera-specific intersubject variability in [{sup 123}I]FP-CIT SPECT. The secondary aim was to evaluate binding in whole brain (excluding striatum) as a reference for quantitative analysis. Of 73 healthy subjects from the European Normal Control Database of [{sup 123}I]FP-CIT recruited at six centres, 70 aged between 20 and 82 years were included. SPECT images were reconstructed using the QSPECT software package which provides fully automated detection of the outer contour of the head, camera-specific correction for scatter and septal penetration by transmission-dependent convolution subtraction, iterative OSEM reconstruction including attenuation correction, and camera-specific ''to kBq/ml'' calibration. LINK and HERMES reconstruction were used for head-to-head comparison. The specific striatal [{sup 123}I]FP-CIT binding ratio (SBR) was computed using the Southampton method with binding in the whole brain, occipital cortex or cerebellum as the reference. The correlation between SBR and age was used as the primary quality measure. The fraction of SBR variability explained by age was highest (1) with QSPECT, independently of the reference region, and (2) with whole brain as the reference, independently of the reconstruction algorithm. QSPECT reconstruction appears to be useful for reduction of camera-specific intersubject variability of [{sup 123}I]FP-CIT SPECT in multisite and single-site multicamera settings. Whole brain excluding striatal binding as the reference provides more stable quantitative estimates than occipital or cerebellar binding. (orig.)

  13. Combining functional magnetic resonance imaging with transcranial electrical stimulation

    Directory of Open Access Journals (Sweden)

    Catarina eSaiote

    2013-08-01

    Full Text Available Transcranial electrical stimulation (tES is a neuromodulatory method with promising potential for basic research and as a therapeutic tool. The most explored type of tES is transcranial direct current stimulation (tDCS, but also transcranial alternating current stimulation (tACS and transcranial random noise stimulation (tRNS have been shown to affect cortical excitability, behavioral performance and brain activity. Although providing indirect measure of brain activity, functional magnetic resonance imaging (fMRI can tell us more about the global effects of stimulation in the whole brain and what is more, on how it modulates functional interactions between brain regions, complementing what is known from electrophysiological methods such as measurement of motor evoked potentials. With this review, we aim to present the studies that have combined these techniques, the current approaches and discuss the results obtained so far.

  14. Uremic encephalopathy with isolated brainstem involvement revealed by magnetic resonance image: a case report.

    Science.gov (United States)

    Jia, Li-Jing; Qu, Zhen-Zhen; Zhang, Xue-Qian; Tian, Yu-Juan; Wang, Ying

    2017-08-08

    Uremic Encephalopathy (UE) is a neurological complication associated with acute or chronic renal failure. Imaging findings of UE may present involvement of the basal ganglia, cortical or subcortical regions, and white matter. We report a rare case of UE caused by neurogenic bladder with isolated brainstem involvement revealed by magnetic resonance imaging (MRI). Immediate therapy resulted in full recovery of neurological signs and changes on MRI. A 14-year-old Han Chinese woman with a history of chronic renal failure caused by neurogenic bladder. On admission, she was unconscious and her pupils presented different sizes, while her vital signs were normal. MRI showed high signal in the dorsal pontine base and in the mid brain on fluid-attenuated inversion-recovery (FLAIR) imaging and on T2-weighted imaging while the signal was normal on diffusion-weighted images (DWI). Blood analysis revealed renal failure and acidosis. After urinary retention treatment and acidosis correction, the patient soon recovered. Follow-up MRI 2 months after the discharge revealed complete resolution of UE in the brainstem. We reported a rare case of a patient with UE that had unusual imaging manifestations for whom timely diagnosis and treatment assured recovery.

  15. Computer aided detection of tumor and edema in brain FLAIR magnetic resonance image using ANN

    Science.gov (United States)

    Pradhan, Nandita; Sinha, A. K.

    2008-03-01

    This paper presents an efficient region based segmentation technique for detecting pathological tissues (Tumor & Edema) of brain using fluid attenuated inversion recovery (FLAIR) magnetic resonance (MR) images. This work segments FLAIR brain images for normal and pathological tissues based on statistical features and wavelet transform coefficients using k-means algorithm. The image is divided into small blocks of 4×4 pixels. The k-means algorithm is used to cluster the image based on the feature vectors of blocks forming different classes representing different regions in the whole image. With the knowledge of the feature vectors of different segmented regions, supervised technique is used to train Artificial Neural Network using fuzzy back propagation algorithm (FBPA). Segmentation for detecting healthy tissues and tumors has been reported by several researchers by using conventional MRI sequences like T1, T2 and PD weighted sequences. This work successfully presents segmentation of healthy and pathological tissues (both Tumors and Edema) using FLAIR images. At the end pseudo coloring of segmented and classified regions are done for better human visualization.

  16. Do brain image databanks support understanding of normal ageing brain structure? A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Dickie, David Alexander; Job, Dominic E.; Wardlaw, Joanna M. [University of Edinburgh, Division of Clinical Neurosciences, Western General Hospital, Brain Research Imaging Centre (BRIC), Edinburgh (United Kingdom); Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Edinburgh (United Kingdom); Poole, Ian [Toshiba Medical Visualisation Systems Europe, Ltd., Edinburgh (United Kingdom); Ahearn, Trevor S.; Staff, Roger T.; Murray, Alison D. [University of Aberdeen, Aberdeen Biomedical Imaging Centre, Aberdeen (United Kingdom); Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Edinburgh (United Kingdom)

    2012-07-15

    To document accessible magnetic resonance (MR) brain images, metadata and statistical results from normal older subjects that may be used to improve diagnoses of dementia. We systematically reviewed published brain image databanks (print literature and Internet) concerned with normal ageing brain structure. From nine eligible databanks, there appeared to be 944 normal subjects aged {>=}60 years. However, many subjects were in more than one databank and not all were fully representative of normal ageing clinical characteristics. Therefore, there were approximately 343 subjects aged {>=}60 years with metadata representative of normal ageing, but only 98 subjects were openly accessible. No databank had the range of MR image sequences, e.g. T2*, fluid-attenuated inversion recovery (FLAIR), required to effectively characterise the features of brain ageing. No databank supported random subject retrieval; therefore, manual selection bias and errors may occur in studies that use these subjects as controls. Finally, no databank stored results from statistical analyses of its brain image and metadata that may be validated with analyses of further data. Brain image databanks require open access, more subjects, metadata, MR image sequences, searchability and statistical results to improve understanding of normal ageing brain structure and diagnoses of dementia. (orig.)

  17. 小细胞肺癌脑转移全脑放疗失败后挽救性分次立体定向放疗疗效分析%Fractionated stereotactic radiotherapy for recurrent small cell lung cancer brain metastases after whole brain radiotherapy

    Institute of Scientific and Technical Information of China (English)

    李祥攀; 李晔雄; 肖建平; 陈秀军; 姜雪松; 张烨; 徐英杰; 郇福奎; 方浩; 万宝

    2012-01-01

    Objective Evaluation the Fractionated Stereotactic Radiotherapy (FSRT) for the patients with small-cell lung cancer (SCLC) after the whole brain radiotherapy (WBRT) failure.Methods We retrospectively analyzed 35 patients with brain metastases from small-cell lung cancer treated with linear accelerator FSRT after the WBRT failure. Multivariate analysis was used to determine significant prognostic factor related to survival.Results The following-up rate was 100%.The median following-up time was 11 months.The median over-all survival (OS) time was 10.3( 1 -30) months after FSRT.Controlled extra cranial disease was the only identified significant predictor of increased median OS time (χ2 =4.02,P =0.045 ).The median OS time from the diagnosis of brain metastasis was 22 (6 - 134 )months.14 patients died from brain metastasis,14 from extra-cranial progression,1 from leptomeningeal metastases,and 3 from other causes. Local control at 6 months and 12 months was 91% and 76%,respectively.No significant late complications.New brain metastases outside of the treated area developed in 17% of patients at a median time of 4(2 -20) months; all patients had received previous WBRT.Conclusions Fractionated stereotactic radiotherapy was safe and effective treatment for recurrent small-cell lung carcinoma brain metastases.%目的 评价小细胞肺癌( SCLC)全脑放疗(WBRT)后颅内失败分次立体定向放疗(FSRT)挽救的价值.方法 回顾分析WBRT失败后使用FSRT挽救的35例SCLC脑转移患者的生存情况,多因素分析确定和生存相关的预后因素.结果 随访率为100%,中位随访时间11个月.全组总中位生存期为10.3个月,多因素分析显示颅外疾病控制状态和患者的生存相关(χ2=4.02,P=0.045).自诊断脑转移开始中位生存期为22.0个月,未发现严重晚期不良反应.6、12个月局部控制率分别为91%、76%.6例局部未控患者中3例行二程FSRT挽救,挽救治疗后生存时间分别为3、9

  18. Post-contrast FLAIR MR imaging of the brain in children: normal and abnormal intracranial enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Choi, Choong-Gon [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul (Korea)

    2003-12-01

    To describe the normally enhancing intracranial structures on fluid-attenuated inversion recovery (FLAIR) MRI and evaluate the usefulness of postcontrast FLAIR images of the brain in the assessment of enhancing lesions by comparing postcontrast FLAIR imaging with postcontrast T1-weighted (T1-W) imaging in children. In 218 children, 249 pre- and postcontrast FLAIR MRI examinations of the brain were obtained consecutively between August 2001 and April 2002. The normally enhancing intracranial structures on FLAIR imaging were assessed in 77 MRI studies of 74 children who showed normal intracranial imaging findings. In 86 MRI studies in 68 children who showed enhancing intracranial lesions, lesion conspicuity on postcontrast FLAIR imaging was compared with that on postcontrast T1-W imaging for all lesions (n=107), intra-axial lesions (n=40), or extra-axial lesions (n=67). The normally enhancing intracranial structures on FLAIR MRI were the choroid plexus (99%, 76/77), pituitary stalk (84%, 65/77), pineal gland (71%, 55/77), dural sinuses (26%, 20/77), and cortical veins (9%, 7/77). Of all the enhancing lesions, lesion conspicuousness on postcontrast FLAIR imaging was better than postcontrast T1-weighted imaging in 42, equal in 28, and worse in 37. Of 40 intra-axial lesions, lesion conspicuousness on postcontrast FLAIR imaging was better in 6, equal in 10, and worse in 24. Of 67 extra-axial lesions, lesion conspicuity on postcontrast FLAIR imaging was better in 36, equal in 18, and worse in 13. Conspicuousness of extra-axial lesions was significantly better than that of intra-axial lesions on postcontrast FLAIR imaging (P<0.001). The choroid plexus, pituitary stalk, pineal gland, dural sinuses, and cortical veins show normal enhancement on postcontrast FLAIR MRI in children, and postcontrast FLAIR imaging appears better than postcontrast T1-W imaging in the assessment of extra-axial enhancing lesions in children. (orig.)

  19. IMAGES, IMAGES, IMAGES

    Energy Technology Data Exchange (ETDEWEB)

    Marcus, A.

    1980-07-01

    The role of images of information (charts, diagrams, maps, and symbols) for effective presentation of facts and concepts is expanding dramatically because of advances in computer graphics technology, increasingly hetero-lingual, hetero-cultural world target populations of information providers, the urgent need to convey more efficiently vast amounts of information, the broadening population of (non-expert) computer users, the decrease of available time for reading texts and for decision making, and the general level of literacy. A coalition of visual performance experts, human engineering specialists, computer scientists, and graphic designers/artists is required to resolve human factors aspects of images of information. The need for, nature of, and benefits of interdisciplinary effort are discussed. The results of an interdisciplinary collaboration are demonstrated in a product for visualizing complex information about global energy interdependence. An invited panel will respond to the presentation.

  20. Radiation-Induced Alterations in Mouse Brain Development Characterized by Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gazdzinski, Lisa M.; Cormier, Kyle [Mouse Imaging Centre, Hospital for Sick Children, Toronto (Canada); Lu, Fred G. [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto (Canada); Lerch, Jason P. [Mouse Imaging Centre, Hospital for Sick Children, Toronto (Canada); Department of Medical Biophysics, University of Toronto, Toronto (Canada); Wong, C. Shun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto (Canada); Department of Medical Biophysics, University of Toronto, Toronto (Canada); Department of Radiation Oncology, University of Toronto, Toronto (Canada); Nieman, Brian J., E-mail: bjnieman@phenogenomics.ca [Mouse Imaging Centre, Hospital for Sick Children, Toronto (Canada); Department of Medical Biophysics, University of Toronto, Toronto (Canada)

    2012-12-01

    Purpose: The purpose of this study was to identify regions of altered development in the mouse brain after cranial irradiation using longitudinal magnetic resonance imaging (MRI). Methods and Materials: Female C57Bl/6 mice received a whole-brain radiation dose of 7 Gy at an infant-equivalent age of 2.5 weeks. MRI was performed before irradiation and at 3 time points following irradiation. Deformation-based morphometry was used to quantify volume and growth rate changes following irradiation. Results: Widespread developmental deficits were observed in both white and gray matter regions following irradiation. Most of the affected brain regions suffered an initial volume deficit followed by growth at a normal rate, remaining smaller in irradiated brains compared with controls at all time points examined. The one exception was the olfactory bulb, which in addition to an early volume deficit, grew at a slower rate thereafter, resulting in a progressive volume deficit relative to controls. Immunohistochemical assessment revealed demyelination in white matter and loss of neural progenitor cells in the subgranular zone of the dentate gyrus and subventricular zone. Conclusions: MRI can detect regional differences in neuroanatomy and brain growth after whole-brain irradiation in the developing mouse. Developmental deficits in neuroanatomy persist, or even progress, and may serve as useful markers of late effects in mouse models. The high-throughput evaluation of brain development enabled by these methods may allow testing of strategies to mitigate late effects after pediatric cranial irradiation.

  1. White matter integrity in Asperger syndrome: a preliminary diffusion tensor magnetic resonance imaging study in adults.

    Science.gov (United States)

    Bloemen, Oswald J N; Deeley, Quinton; Sundram, Fred; Daly, Eileen M; Barker, Gareth J; Jones, Derek K; van Amelsvoort, Therese A M J; Schmitz, Nicole; Robertson, Dene; Murphy, Kieran C; Murphy, Declan G M

    2010-10-01

    Autistic Spectrum Disorder (ASD), including Asperger syndrome and autism, is a highly genetic neurodevelopmental disorder. There is a consensus that ASD has a biological basis, and it has been proposed that it is a "connectivity" disorder. Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) allows measurement of the microstructural integrity of white matter (a proxy measure of "connectivity"). However, nobody has investigated the microstructural integrity of whole brain white matter in people with Asperger syndrome. We measured the fractional anisotropy (FA), mean diffusivity (MD) and radial diffusivity (RD) of white matter, using DT-MRI, in 13 adults with Asperger syndrome and 13 controls. The groups did not differ significantly in overall intelligence and age. FA, MD and RD were assessed using whole brain voxel-based techniques. Adults with Asperger syndrome had a significantly lower FA than controls in 13 clusters. These were largely bilateral and included white matter in the internal capsule, frontal, temporal, parietal and occipital lobes, cingulum and corpus callosum. Adults with Asperger syndrome have widespread significant differences from controls in white matter microstructural integrity.

  2. Uremic Encephalopathy: MR Imaging Findings and Clinical Correlation.

    Science.gov (United States)

    Kim, D M; Lee, I H; Song, C J

    2016-09-01

    Uremic encephalopathy is a metabolic disorder in patients with renal failure. The purpose of this study was to describe the MR imaging findings of uremic encephalopathy. This study retrospectively reviewed MR imaging findings in 10 patients with clinically proved uremic encephalopathy between May 2005 and December 2014. Parameters evaluated were lesion location and appearance; MR signal intensity of the lesions on T1WI, T2WI, and T2 fluid-attenuated inversion recovery images; the presence or absence of restricted diffusion on diffusion-weighted images and apparent diffusion coefficient maps; and the reversibility of documented signal-intensity abnormalities on follow-up MR imaging. MR imaging abnormalities accompanying marked elevation of serum creatinine (range, 4.3-11.7 mg/dL) were evident in the 10 patients. Nine patients had a history of chronic renal failure with expansile bilateral basal ganglia lesions, and 1 patient with acute renal failure had reversible largely cortical lesions. Two of 6 patients with available arterial blood gas results had metabolic acidosis. All basal ganglia lesions showed expansile high signal intensity (lentiform fork sign) on T2WI. Varied levels of restricted diffusion and a range of signal intensities on DWI were evident and were not correlated with serum Cr levels. All cortical lesions demonstrated high signal intensity on T2WI. Four patients with follow-up MR imaging after hemodialysis showed complete resolution of all lesions. The lentiform fork sign is reliable in the early diagnosis of uremic encephalopathy, regardless of the presence of metabolic acidosis. Cytotoxic edema and/or vasogenic edema on DWI/ADC maps may be associated with uremic encephalopathy. © 2016 by American Journal of Neuroradiology.

  3. Magnetic Resonance Imaging in Marchiafava-Bignami Syndrome: A Cornerstone in Diagnosis and Prognosis

    Directory of Open Access Journals (Sweden)

    Kathyayini Paidipati Gopalkishna Murthy

    2014-01-01

    Full Text Available Marchiafava-Bignami syndrome is a rare condition. However, with the advent of MRI, more and more of these cases are being diagnosed. Thus, it becomes essential for a radiologist to be familiar with its imaging features as well as clinical presentation. A 50-year-old chronic alcoholic presented to the emergency room with history of 3 episodes of seizures 2 days earlier. The patient had gait disturbances for the last few days. On examination, the patient was in a state of stupor. No neck rigidity was elicited. On MRI, the corpus callosum appeared diffusely hypointense on T1 weighted images and hyperintense on T2 weighted sequences without any evident enhancement after intravenous administration of Gadolinium. On fluid attenuation and inversion recovery images, central hypointensity with surrounding hyperintense rim involving the genu, body, and splenium of corpus callosum was noted. Additionally, cortical-subcortical signal intensity changes were also noted predominantly involving the right frontal lobe. On diffusion weighted imaging, all the above mentioned lesions showed restriction of diffusion. I am presenting here a case of Marchiafava-Bignami syndrome highlighting the role of MR imaging in diagnosing, prognosticating as well as in understanding the underlying pathophysiology of this rare clinical entity.

  4. Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

    Energy Technology Data Exchange (ETDEWEB)

    Parmar, Hemant [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore) and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto (Canada)]. E-mail: parurad@hotmail.com; Sitoh, Y.-Y. [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore); Anand, Pooja [Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng (Singapore); Chua, Violet [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore); Hui, Francis [Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433 (Singapore)

    2006-04-15

    Purpose: The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis. Materials and methods: We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface. Results: Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively. Conclusion: Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis.

  5. Imaging findings of adiposis dolorosa vs. massive localized lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Petscavage-Thomas, Jonelle M.; Bernard, Stephanie A.; Bennett, Jennifer [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD (United States)

    2015-06-01

    Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa. A 10-year retrospective review of the picture archiving and communications system was performed. Two musculoskeletal radiologists reviewed images to confirm and document imaging features, location, size, and patient demographics. Medical records were reviewed to characterize patients into three groups: one group met at least three of the four criteria of Dercum's syndrome, the second group met less than three criteria, and the third group had clinical diagnosis of cellulitis of the lower extremity. Seventeen cases (25 masses) of adiposis dolorosa were found, nine cases of which met at least three criteria of Dercum's syndrome. All cases in the first two groups demonstrated skin thickening and lymphedema of subcutaneous fat, which was fluid attenuation on CT and low or intermediate T1-weighted and high STIR/T2-weighted MR signal. Two cases with pathology showed mild fatty infiltration with fibrous septa, and the third case showed massive localized lymphedema. The third group of ten cellulitis patients demonstrated non-mass-like subcutaneous edema with similar CT attenuation and MR signal characteristics to the first two groups, but differed by the presence of post-contrast enhancement and non-mass-like appearance in 90 %. Imaging findings of adiposis dolorosa and massive localized lymphedema overlap, as do the symptoms and pathological features. Due to the mass-like engorgement of the soft tissues and pain, patients will often undergo imaging to exclude neoplasm or infection. Knowledge of these

  6. Fast quantitative diffusion-tensor imaging of cerebral white matter from the neonatal period to adolescence

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, J.F.L.; Martin, E. [Department of Neuroradiology and Magnetic Resonance Imaging, University Children' s Hospital, Steinwiesstrasse 75, 8032, Zuerich (Switzerland); Il' yasov, K.A.; Hennig, J. [Department of Diagnostic Radiology, Section of Medical Physics, University Medical Centre, Hugstetter Strasse 55, 79106, Freiburg (Germany)

    2004-04-01

    We investigated the isotropic diffusion coefficient (D') and fractional anisotropy (FA) in white matter (WM) during brain development, using an optimised diffusion-tensor imaging (DTI) method with whole brain coverage in a clinically acceptable time. We images 52 children with no evident neurological abnormality (30 boys, 22 girls aged 1 day-16 years) using high-angle DTI with optimised temporal gradient performance. D' and FA were calculated in 10 regions of interest in white matter. We saw that the age-related reduction in D' and increase in FA follow a mono- or biexponential model in white matter, probably depending on the compactness and myelination rate of the fibre tracts. In contrast to other areas, in which adult values were reached during the third year, there is a trend to continuous increase in FA in all deep white-matter areas, suggesting continuing maturation and organisation of deep tracts not detected on conventional MRI. (orig.)

  7. Optimizing and extending light-sculpting microscopy for fast functional imaging in neuroscience

    CERN Document Server

    Rupprecht, Peter; Groessl, Florian; Haubensak, Wulf E; Vaziri, Alipasha

    2015-01-01

    A number of questions in systems biology such as understanding how dynamics of neuronal networks are related to brain function require the ability to capture the functional dynamics of large cellular populations at high speed. Recently, this has driven the development of a number of parallel and high speed imaging techniques such as light-sculpting microscopy, which has been used to capture neuronal dynamics at the whole brain and single cell level in small model organism. However, the broader applicability of light-sculpting microscopy is limited by the size of volumes for which high speed imaging can be obtained and scattering in brain tissue. Here, we present strategies for optimizing the present tradeoffs in light-sculpting microscopy. Various scanning modalities in light-sculpting microscopy are theoretically and experimentally evaluated, and strategies to maximize the obtainable volume speeds, and depth penetration in brain tissue using different laser systems are provided. Design-choices, important par...

  8. Magnetic Resonance Imaging of Cerebral Aspergillosis: Imaging and Pathological Correlations

    Science.gov (United States)

    Sabou, Marcela; Lannes, Béatrice; Cotton, François; Meyronet, David; Galanaud, Damien; Cottier, Jean-Philippe; Grand, Sylvie; Desal, Hubert; Kreutz, Julie; Schenck, Maleka; Meyer, Nicolas; Schneider, Francis; Dietemann, Jean-Louis; Koob, Meriam

    2016-01-01

    Cerebral aspergillosis is associated with a significant morbidity and mortality rate. The imaging data present different patterns and no full consensus exists on typical imaging characteristics of the cerebral lesions. We reviewed MRI findings in 21 patients with cerebral aspergillosis and correlated them to the immune status of the patients and to neuropathological findings when tissue was available. The lesions were characterized by their number, topography, and MRI signal. Dissemination to the brain resulted from direct spread from paranasal sinuses in 8 patients, 6 of them being immunocompetent. Hematogenous dissemination was observed in 13 patients, all were immunosuppressed. In this later group we identified a total of 329 parenchymal abscesses involving the whole brain with a predilection for the corticomedullary junction. More than half the patients had a corpus callosum lesion. Hemorrhagic lesions accounted for 13% and contrast enhancement was observed in 61% of the lesions. Patients with hematogenous dissemination were younger (p = 0.003), had more intracranial lesions (p = 0.0004) and had a higher 12-week mortality rate (p = 0.046) than patients with direct spread from paranasal sinuses. Analysis of 12 aneurysms allowed us to highlight two distinct situations. In case of direct spread from the paranasal sinuses, aneurysms are saccular and located on the proximal artery portions, while the hematogenous dissemination in immunocompromised patients is more frequently associated with distal and fusiform aneurysms. MRI is the exam of choice for cerebral aspergillosis. Number and type of lesions are different according to the mode of dissemination of the infection. PMID:27097323

  9. 全脑照射后血脑屏障改变对放射性脑损伤的影响%The study on the relationship between permeability alteration of blood brain barrier and radiation brain injury after whole brain irradiation in rats

    Institute of Scientific and Technical Information of China (English)

    阮林; 韦力; 廉春蓉; 张文佳; 莫立根; 李小妹

    2011-01-01

    目的 探讨全脑照射后血脑屏障通透性的改变对放射性脑损伤的影响.方法 80只昆明小鼠随机分对照组、5 Gy、15 Gy和30 Gy剂量组,每组20只,分别于照射后1周和4周,各组随机取出10只小鼠采用Morris水迷宫测试其空间记忆能力,行为测试结束后,随机抽取7只测量其脑内伊文思蓝的含量,3只在电镜下观察血脑屏障结构的改变.结果 照射后1周,15 Gy和30 Gy剂量组脑内依文思蓝明显升高;照射后4周,15 Gy剂量组恢复到对照组水平,而30 Gy剂量组仍未见恢复.照射后1周,15 Gy和30 Gy剂量组小鼠第1次穿