Kinetic Modeling of Contrast-Enhanced MRI: An Automated Technique for Assessing Inflammation in the Rheumatoid Arthritis Wrist

In recent years, development of rheumatoid arthritis (RA) drug therapy has been more directly targeted to counteract specific mechanisms of inflammation, and it is now believed that early aggressive treatment with disease modifying drugs is important to inhibit future structural joint damage. The development of these new treatments has increased the need for methodologies to assess disease activity in RA and monitor the effectiveness of drug therapy. Unlike X-ray, which shows only structural bone damage, magnetic resonance imaging (MRI) can depict soft tissue damage and synovitis, the primary pathology of RA. Recent studies have also indicated that MRI is sensitive to pathophysiologic changes that may predate radiographic erosions and may predict future joint damage. In this study, we have developed a computer automated analysis technique for MR wrist images that provides an objective measure of RA synovitis. This method applies a two-compartment pharmacokinetic model to every voxel of a dynamic contrast-enhanced MRI (DCE-MRI) dataset and outputs resulting parametric images. The aim of this technique is to not only objectively quantify the severity of rheumatoid synovitis, but to also locally determine where areas of serious disease activity are situated through kinetic modeling of blood-tissue exchange. Preliminary results show good correlation to early enhancement rate, which has previously been shown to be a useful clinical marker of RA activity. However, the use of tracer kinetic modeling methods potentially provides more specific information regarding underlying RA physiology. This approach could provide a useful new tool in RA patient management and could substantially improve RA therapeutic studies by calculating objective biomarkers of the disease state.     

Hardware assessment using the multi-module, multi-resolution system (M3R): a signal-detection study

The multi-module, multi-resolution system (M3R) is used for hardware assessment in objective, task-based signal detection studies in projection data. A phantom capable of generating multiple realizations of a random textured background is introduced. Measured backgrounds from this phantom are used along with simulated lumpy and uniform backgrounds to investigate signal-to-noise ratio as a function of exposure time. Results are shown to agree with theoretical predictions, exhibiting a power-law like dependence previously seen for studies performed either in simulation or without an imaging system, and help validate the use of simulated lumpy backgrounds in observer studies. A second study looks at signal-detection performance, measured by AUC (area under the receiver operating characteristic curve), in lumpy backgrounds for 20 M3R aperture combinations as a function of lump size and signal size. Observer performance reveals an improvement in AUC for certain ranges of signal and lump combinations through the use of multiplexed, multiple-pinhole apertures, indicating a need for task-specific aperture optimization. The channelized Hotelling observer is used with Laguerre-Gauss channels for both observer studies. Methods for selection of number of channels and channel width are discussed.     

The multi-module, multi-resolution system (M3R): a novel small-animal SPECT system

We have designed and built an inexpensive, high-resolution, tomographic imaging system, dubbed the multi-module, multi-resolution system, or M3R. Slots machined into the system shielding allow for the interchange of pinhole plates, enabling the system to operate over a wide range of magnifications and with virtually any desired pinhole configuration. The flexibility of the system allows system optimization for specific imaging tasks and also allows for modifications necessary due to improved detectors, electronics, and knowledge of system construction (e.g., system sensitivity optimization). We provide an overview of M3R, focusing primarily on system design and construction, aperture construction, and calibration methods. Reconstruction algorithms will be described and reconstructed images presented.     

Cellular learning theory: theoretical comment on Cole and McNally (2007)

The idea that learning proceeds as a function of the discrepancy (or error) between expected and obtained outcomes is central to many theories of associative learning. However, remarkably little is known about the neurobiological mechanisms that underlie this learning of predictive errors in fear conditioning, a widely used preparation in studies of cellular and molecular mechanisms of memory. In this issue of Behavioral Neuroscience, S. Cole and G. P. McNally demonstrate an important dissociation between the establishment and regulation of predictive error at the cellular level. Their findings have added a level of complexity to currently established views of the function of NMDA and opioid receptors in learning and memory. This commentary discusses some of the implications of these findings for theoretical and neurobiological approaches to memory, as well as current thinking about the cellular circuitry involved in reward learning and drug abuse.     

Canalicular adenoma arising in the esophagus

Canalicular adenomas are benign neoplasms that arise from salivary glands and often present as painless enlarging nodules. They have a predilection for upper lip but can be found throughout the oropharynx. To our knowledge, canalicular adenoma arising in the esophagus has never been described in the English literature. Here we report a canalicular adenoma occurring in the esophagus.     

Kimura disease

Kimura disease is a benign rare chronic inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous tissue of the head and neck regions. Elevated serum immunoglobulin E levels and peripheral blood eosinophilia are also common. This disease is most common in middle-aged Asian men. Although the etiology is unknown, it most probably represents an aberrant chronic immune response. Treatment for Kimura disease includes surgical resection and regional or systemic steroid therapy. Cytotoxic therapy and radiation have also been utilized. The disease has an excellent prognosis, although it may recur locally.     

Peptide hormone modulation of a neuronally modulated motor circuit

Rhythmically active motor circuits are influenced by neuronally released and circulating hormone modulators, but there are few systems in which the influence of a peptide hormone modulator on a neuronally modulated motor circuit has been determined. We performed such an analysis in the isolated crab stomatogastric nervous system by assessing the influence of the hormone crustacean cardioactive peptide (CCAP) on the gastric mill (chewing) rhythm elicited by identified modulatory projection neurons. The gastric mill circuit is located in the stomatogastric ganglion. In situ, this ganglion is located within the ophthalmic artery and thus is in the path of circulating hormones such as CCAP. Focally-applied CCAP directly excited some gastric mill neurons, including the gastric mill central pattern generator neurons LG and Int1, but it did not elicit a sustained gastric mill rhythm. At concentrations as low as 10(-10) M, however, CCAP did influence gastric mill rhythms elicited by coactivating the projection neurons MCN1 and CPN2 and by selectively stimulating MCN1. In both cases, CCAP slowed this rhythm by selectively prolonging the protraction phase, although its influence on the MCN1-elicited rhythm was limited to those with relatively brief cycle periods. Interestingly, CCAP also reduced the threshold MCN1 firing frequency for activating the gastric mill rhythm. Last, the gastric mill neurons that exhibited altered activity during these CCAP-influenced rhythms did not correspond completely to the set of CCAP-responsive neurons. These results highlight the ability of hormonal modulation to enhance the flexibility provided by the neuronal modulation of rhythmically active motor circuits.