BOLD MRI of human tumor oxygenation during carbogen breathing

An MRI method is described for demonstrating improved oxygenation of human tumors and normal tissues during carbogen inhalation (95% O2, 5% CO2). T2*-weighted gradient-echo imaging was performed before, during, and after carbogen breathing in 47 tumor patients and 13 male volunteers. Analysis of artifacts and signal intensity was performed. Thirty-six successful tumor examinations were obtained. Twenty showed significant whole-tumor signal increases (mean 21.0%, range 6.5-82.4%), and one decreased (-26.5 +/- 8.0%). Patterns of signal change were heterogeneous in responding tumors. Five of 13 normal prostate glands (four volunteers and nine patients with nonprostatic tumors) showed significant enhancement (mean 11.4%, range 8.4-14.0%). An increase in brain signal was seen in 11 of 13 assessable patients (mean 8.0 +/- 3.7%, range 5.0-11.7%). T2*-weighted tumor MRI during carbogen breathing is possible in humans. High failure rates occurred due to respiratory distress. Significant enhancement was seen in 56%, suggesting improved tissue oxygenation and blood flow, which could identify these patients as more likely to benefit from carbogen radiosensitization.     

Diffusion tensor magnetic resonance imaging of prostate cancer

PURPOSE: To explore the feasibility of 3T magnetic resonance (MR) diffusion tensor imaging (DTI) and fiber tracking (FT) in patients with prostate cancer. MATERIALS AND METHODS: Thirty consecutive patients (mean age, 62.5 years) with biopsy proven prostate cancer underwent 3T-MR imaging (MRI) and DTI using a 6-channel external phased-array coil before radical prostatectomy. Regions of interest of 14 pixels were defined in tumors and nonaffected areas in the peripheral zone (PZ) and central gland (CG), according to histopatology after radical prostatectomy. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were determined. Differences in mean ADC and FA values among prostate cancer, normal PZ and CG were compared by 2-sided Student t test. The predominant diffusion direction of the prostate anisotropy was color coded on a directionally encoded color (DEC) map. A 3D reconstruction of fiber tract orientations of the whole prostate was determined using the continuous tracking method. The overall image quality for tumor localization and local staging was assessed in retrospective matching with whole-mount section histopathology images. Nodules detected at MRI were classified as matched lesions if tumor presence and extension were evidenced at histopathology. RESULTS: For all the patients, the DTI sequence images were suitable for the evaluation of the zonal anatomy of the prostate gland and the tumor localization. Quantitative evaluation of the regions of interest (ROIs) showed a mean ADC value significantly lower in the peripheral neoplastic area (1.06 +/- 0.37 x 10(-3) mm2/s) than in the normal peripheral portion (1.95 +/- 0.38 x 10(-3) mm2/s) (P < 0.05). The mean FA values calculated in the normal peripheral (0.47 +/- 0.04) and central area (0.41 +/- 0.08) were very similar (P > 0.05). The mean FA values in the neoplastic lesion (0.27 +/- 0.05) were significantly lower (P < 0.05) than in the normal peripheral area and in the normal central and adenomyomatous area. DEC map showed a top-bottom type preferential direction in the peripheral but not in the central area, with the tumor lesions reducing the diffusion coding direction represented as color zones tending toward gray. Tractographic analysis permitted good delineation of the prostate anatomy (capsule outline, peripheral and central area borders) and neoplastic lesion extension and capsule infiltration compared with histopathology. CONCLUSIONS: Three Tesla DTI of the prostate gland is feasible and has the potential for providing improved diagnostic information.     

Combined magnetic resonance imaging and spectroscopic imaging approach to molecular imaging of prostate cancer

Magnetic resonance spectroscopic imaging (MRSI) provides a noninvasive method of detecting small molecular markers (historically the metabolites choline and citrate) within the cytosol and extracellular spaces of the prostate, and is performed in conjunction with high-resolution anatomic imaging. Recent studies in pre-prostatectomy patients have indicated that the metabolic information provided by MRSI combined with the anatomical information provided by MRI can significantly improve the assessment of cancer location and extent within the prostate, extracapsular spread, and cancer aggressiveness. Additionally, pre- and post-therapy studies have demonstrated the potential of MRI/MRSI to provide a direct measure of the presence and spatial extent of prostate cancer after therapy, a measure of the time course of response, and information concerning the mechanism of therapeutic response. In addition to detecting metabolic biomarkers of disease behavior and therapeutic response, MRI/MRSI guidance can improve tissue selection for ex vivo analysis. High-resolution magic angle spinning ((1)H HR-MAS) spectroscopy provides a full chemical analysis of MRI/MRSI-targeted tissues prior to pathologic and immunohistochemical analyses of the same tissue. Preliminary (1)H HR-MAS spectroscopy studies have already identified unique spectral patterns for healthy glandular and stromal tissues and prostate cancer, determined the composition of the composite in vivo choline peak, and identified the polyamine spermine as a new metabolic marker of prostate cancer. The addition of imaging sequences that provide other functional information within the same exam (dynamic contrast uptake imaging and diffusion-weighted imaging) have also demonstrated the potential to further increase the accuracy of prostate cancer detection and characterization.     

Role of diffusion-weighted magnetic resonance imaging in prostate cancer evaluation

Purpose

The authors analysed the role of diffusion-weighted imaging (DWI) as an additional tool in magnetic resonance (MR) evaluation of prostate cancer.

Materials and methods

Forty-one patients with suspected prostate cancer underwent MR imaging (1.5 Tesla). A DWI sequence was added to the standard morphological protocol, with a maximum b value of 1,000 s/mm². Diffusion maps were obtained, and the apparent diffusion coefficient (ADC) was calculated by drawing a region of interest (ROI) over healthy tissue and areas suspicious for malignancy. Histology was considered the gold standard.

Results

The areas correctly classified by MR imaging (42/51) had a low signal intensity on T2-weighted imaging and low ADC value (0.99±0.15 mm²/s; p<0.01) compared with the healthy peripheral zone (PZ) (1.73±0.27 mm²/s; p<0.01). Nine areas classified as suspicious for malignancy on T2-weighted sequences showed high ADC (1.44±0.06 mm²/s; p<0.01) and were confirmed to be disease free by subsequent histological examination. The accuracy of morphofunctional MR imaging was 81.6% compared with 73.7% of the morphological analysis alone.

Conclusions

The addition of DWI to the standard protocol increases the overall diagnostic performance of MR imaging in detecting prostatic cancer. Thus, DWI can help the clinician determine the most appropriate management strategy for the patient.     

Functional magnetic resonance imaging and dementia

Zusammenfassung In der zerebralen Bildgebung werden heute verschiedene Methoden zu einzelnen Fragestellungen in der Demenzdiagnostik mit unterschiedlichem Stellenwert eingesetzt. Bei Patienten mit manifester Alzheimer-Demenz wurde eine Verminderung der kortikalen Durchblutung bzw. des zerebralen Glukoseumsatzes in temporalen Strukturen und im temporoparietalen Übergang im Vergleich zu Gesunden unter verschiedenen Gedächtnisaufgaben nachgewiesen. Da unterschiedliche Testleistungen und unterschiedliche Ausprägungen der kortikalen Atrophie die funktionellen Befunde wesentlich beeinflussen, wird das Verständnis der normalen Alterungsprozesse als Voraussetzung für neuere Studien mittels funktioneller Bildgebung angesehen. Die Integration der Kenntnisse über neuropsychologische und neurobiologische Veränderungen gesunden Alterns erlaubt Hypothesen zur Differenzierung pathologischer Alterungsprozesse. Dabei nehmen heute die nichtinvasiven Verfahren wie fMRT und ASL einen zunehmenden Stellenwert ein.

---

     

肾的血氧水平依赖功能磁共振成像

肾实质不同区域解剖和生理过程之间存在明显差异,使得肾髓质在低氧环境下发挥功能,对血流的进一步降低和氧消耗的增加非常敏感[1]。以往对肾内氧分压的测量多利用微电极等有创性手段进行,但不能用于人类研究。血氧水平依赖磁共振成像(BOLD MRI)是目前唯一能无创性绘制肾内氧分布的技术,与微电极测量数据之间具有良好的一致性[2-8]。本文综述肾的BOLD MRI的理论基础、技术、临床应用以及与其他技术相比的优劣势。1肾BOLD MRI的理论基础BOLD是基于血红蛋白氧饱和水平的改变而成像的。氧合血红蛋白具有抗磁性,而脱氧血红蛋白具有顺磁…     

Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer

Dynamic contrast-enhanced MRI enables noninvasive analysis of prostate vascularization as well as tumour angiogenesis and capillary permeability characteristics in prostate cancers. Pharmacokinetic models summarizing the complex information provided by signal intensity-time curves for a few quantitative pharmacokinetic parameters are increasingly being used in the routine clinical setting. This review consists of two parts. The first part discusses the advantages and disadvantages of the MR pulse sequences that can be used for performing DCE-MRI and also of the most widely used pharmacokinetic parameters and models and the parameters they describe. The second part outlines the range of current and potential future clinical applications of DCE-MRI and pharmacokinetic parametric maps in patients with prostate cancer, with reference to the current scientific literature on the topic. The potential clinical applications of DCE-MRI for prostate cancer include detection, localization, and staging, differentiation of recurrent cancer and estimation of the patient's prognosis, as well as monitoring of treatment response.     

Functional magnetic resonance imaging of muscle

Muscle functional magnetic resonance imaging (MRI) is used to compare the relative involvement of different muscles recruited during exercise. The method relies on the activity-induced increase in the nuclear magnetic resonance transverse relaxation time (T2) of muscle water, which is caused by osmotically driven shifts of fluid into the myofibrillar space. In addition to imaging of whole muscle recruitment, muscle MRI may reveal changes in motor unit organization during disease.     

Functional magnetic resonance imaging using PROPELLER-EPI

Periodically rotated overlapping parallel lines with enhanced reconstruction-echo-planar imaging (PROPELLER-EPI) is a multishot technique that samples k-space by acquisition of narrow blades, which are subsequently rotated until the entire k-space is filled. It has the unique advantage that the center of k-space, and thus the area containing the majority of functional MRI signal changes, is sampled with each shot. This continuous refreshing of the k-space center by each acquired blade enables not only sliding-window but also keyhole reconstruction. Combining PROPELLER-EPI with a fast gradient-echo readout scheme allows for high spatial resolutions to be achieved while maintaining a temporal resolution, which is suitable for functional MRI experiments. Functional data acquired with a novel interlaced sequence that samples both single-shot EPI and blades in an alternating fashion suggest that PROPELLER-EPI can achieve comparable functional MRI results. PROPELLER-EPI, however, features different spatiotemporal characteristics than single-shot EPI, which not only enables keyhole reconstruction but also makes it an interesting alternative for many functional MRI applications.     

Computed diffusion-weighted imaging using 3-T magnetic resonance imaging for prostate cancer diagnosis

Objective

To assess the efficacy of computed diffusion-weighted images (cDWIs) of b?=?2000 s/mm² (cDWI₂₀₀₀) generated from DWIs of b?=?0 and 1000 for prostate cancer (PCa) diagnosis in comparison with that of measured original DWIs of b?=?1000 (mDWI₁₀₀₀) and b?=?2000(mDWI₂₀₀₀) using 3-T MRI.

Methods

Eighty patients who underwent a preoperative MRI examination, including T2WI and DWI (b?=?0, 1000, 2000 s/mm²), were enrolled in this study. Four combinations of images, protocol A (T2WI alone), B (T2WI + mDWI₁₀₀₀), C (T2WI + mDWI₂₀₀₀) and D (T2WI + cDWI₂₀₀₀), were assessed for their diagnostic capability. Areas under the receiver operating characteristic curve (Az) and diagnostic performance were evaluated, as well as contrast ratios (CR) between cancerous and non-cancerous lesions for each DWI.

Results

The highest CR was obtained with cDWI₂₀₀₀ (0.29?±?0.16). Sensitivity, specificity, accuracy, and Az of the protocols were: A: 66.3 %, 59.4 %, 63.0 %, 0.67; B: 82.6 %, 62.0 %, 72.5 %, 0.80; C: 84.1 %, 66.5 %, 75.5 %, 0.86; D: 83.2 %, 70.0 %, 76.6 %, and 0.84, respectively The specificities and accuracies of protocol C and D were significantly higher than those of protocol B (P?<?0.05).

Conclusion

cDWI₂₀₀₀ appears to be more effective than mDWI₁₀₀₀, and at least as effective as mDWI₂₀₀₀ for PCa diagnosis.

Key Points

? Computed diffusion-weighted MRI with over b1000s/mm ² is useful for prostate cancer detection. ? Computed DWI produces any b-value images with two different b-value images. ? DWI with computed b2000s/mm ² is as valuable as DWI with measured b2000 s/mm ² .     

In vivo monitoring of hepatic oxygenation changes in chronically ethanol-treated rats by functional magnetic resonance imaging.

In this study, functional magnetic resonance imaging (fMRI) was used to evaluate in vivo hepatic oxygenation changes in chronically ethanol (CE)-treated and pair-fed (PF) control rats. Male Wistar rats were pair-fed an all-liquid diet containing 36% of total calories as either ethanol or dextrin-maltose for 8 weeks. The rats were initially examined under normoxic conditions, and then subjected to 100% oxygen (hyperoxia), 10% oxygen (hypoxia), 5% carbon dioxide (hypercapnia), or an acute dose of ethanol (1.4 g/kg bw intraperitoneally). A T(2)-weighted spin-echo sequence, which may be more selective for sinusoidal (capillary bed) changes, was performed before, during, and after the four challenges. During hyperoxia, both the CE and PF rats showed a statistically significant increase in signal intensity (22% +/- 5% and 48% +/- 6%, respectively, P < 0.05) relative to normoxia, while hypoxic challenge decreased the signal intensity (9% +/- 4%, p>0.05 and 15% +/- 3%, P < 0.05, respectively). The hypercapnic challenge, which causes vasodilation, resulted in a small increase in signal intensity in CE-fed rats (5% +/- 3%, P > 0.05) and a significant increase in the PF rats (15% +/- 4%, P < 0.05), again consistent with expected changes in deoxyhemoglobin. With all three physiological challenges, the degree of change was less in CE rats compared to PF controls. An acute dose of ethanol that causes vasodilation also increased signal intensity, with no significant difference between the two groups. The signal intensity changes seen with fMRI were highly correlated with pulse oximeter readings (r(2) = 0.95; P < 0.05). In conclusion, fMRI was shown to be a good noninvasive indicator of tissue deoxyhemoglobin changes in the liver. In addition, fMRI was able to detect subtle, early effects of CE administration (manifested as an impaired ability of the liver to respond adequately to oxygenation challenges), consistent with microvascular dysfunction.     

Myocardial intensity changes associated with flow stimulation in blood oxygenation sensitive magnetic resonance imaging

Functional magnetic resonance imaging exploits deoxygenated blood as an endogeneous source for contrast in assessing local changes in tissue perfusion. Intrinsic changes in myocardial signal intensity were measured during dipyridamole induced coronary vasodilatation with T₂*-weighted echo planar MRI in healthy volunteers. Concurrently, changes in flow velocity in the left anterior descending coronary artery were measured using a time-of-flight method. Dipyridamole infusion produced 14 ± 6% increase in myocardial signal intensity (n = 7). Temporal profile of the myocardial signal intensity changes correlated well with the augmentation of coronary flow velocity. The data are consistent with the concept that changes in myocardial deoxyhemoglobin content due to altered flow result in changes in magnetic susceptibility that can be detected on T₂*-weighted MR images.     

Functional magnetic resonance imaging of methamphetamine craving

The study aimed to explore the abnormal activation of special brain areas associated with methamphetamine craving using functional magnetic resonance imaging (fMRI) and to reveal the neurobiological basis of addiction. Twenty-six methamphetamine addicts and 26 healthy subjects were scanned by brain fMRI while watching pictures of happy, sad, or methamphetamine to acquire resource data. SPM5 was used to analyze fMRI data to get related brain activation map, and it was found that methamphetamine addicts had high brain activation in cingulate and low activation in frontal lobe when watching methamphetamine-cue pictures. This study demonstrated that methamphetamine addicts had emotion-related brain activation abnormalities.     

Functional magnetic resonance imaging based on changes in vascular space occupancy.

During brain activation, local control of oxygen delivery is facilitated through microvascular dilatation and constriction. A new functional MRI (fMRI) methodology is reported that is sensitive to these microvascular adjustments. This contrast is accomplished by eliminating the blood signal in a manner that is independent of blood oxygenation and flow. As a consequence, changes in cerebral blood volume (CBV) can be assessed through changes in the remaining extravascular water signal (i.e., that of parenchymal tissue) without need for exogenous contrast agents or any other invasive procedures. The feasibility of this vascular space occupancy (VASO)-dependent functional MRI (fMRI) approach is demonstrated for visual stimulation, breath-hold (hypercapnia), and hyperventilation (hypocapnia). During visual stimulation and breath-hold, the VASO signal shows an inverse correlation with the stimulus paradigm, consistent with local vasodilatation. This effect is reversed during hyperventilation. Comparison of the hemodynamic responses of VASO-fMRI, cerebral blood flow (CBF)-based fMRI, and blood oxygenation level-dependent (BOLD) fMRI indicates both arteriolar and venular temporal characteristics in VASO. The effect of changes in water exchange rate and partial volume contamination with CSF were calculated to be negligible. At the commonly-used fMRI resolution of 3.75 x 3.75 x 5 mm(3), the contrast-to-noise-ratio (CNR) of VASO-fMRI was comparable to that of CBF-based fMRI, but a factor of 3 lower than for BOLD-fMRI. Arguments supporting a better gray matter localization for the VASO-fMRI approach compared to BOLD are provided.     

Local staging of prostate cancer using magnetic resonance imaging: a meta-analysis

Our objective was to determine the influence of patient-, study design-, and imaging protocol characteristics on staging performance of MR imaging in prostate cancer. In an electronic literature search and review of bibliographies (January 1984 to May 2000) the articles selected included data on sensitivity and specificity for local staging. Subgroup analyses examined the influence of age, prostate specific antigen, tumor grade, hormonal pre-treatment, stage distribution, publication year, department of origin, verification bias, time between biopsy and MR imaging; consensus reading, study design, consecutive patients, sample size, histology preparation, imaging planes, fast spin echo, fat suppression, endorectal coil, field strength, resolution, glucagon, contrast agents, MR spectroscopy, and dynamic contrast-enhanced MRI. Seventy-one articles and five abstracts were included, yielding 146 studies. Missing values were highly prevalent for patient characteristics and study design. Publication year, sample size, histologic gold standard, number of imaging planes, turbo spin echo, endorectal coil, and contrast agents influenced staging performance ( p=0.05). Due to poor reporting it was not possible to fully explain the heterogeneity of performance presented in the literature. Our results suggest that turbo spin echo, endorectal coil, and multiple imaging planes improve staging performance. Studies with small sample sizes may result in higher staging performance.