Registration of functional and anatomical MRI: accuracy assessment and application in navigated neurosurgery.

OBJECTIVE: A procedure for acquisition, automated registration, and fusion of functional and anatomical magnetic resonance images is presented. Its accuracy is quantitatively assessed using a publicly available gold standard. A patient case is used to illustrate the technique's clinical usefulness in image-guided neurosurgery. MATERIALS AND METHODS: Before and after functional MRI (fMRI) acquisition, additional anatomical images were acquired at spatial locations identical to those of the functional images (5-10 slices) for the purpose of voxel-based image registration. Registration accuracy of the anatomical volumes and high-resolution 3D MRI volumes (MP-RAGE imaging) was quantified using adapted data (8 patients) originating from the Vanderbilt Retrospective Registration Evaluation Project (NIH project 1 R01 NS33926-02). Selecting three subsets of slices from that data (5 slices/6 mm slice distance, 10 slices/3 mm distance, and 10 slices/6 mm distance), the small number of images available from fMRI acquisition was taken into account. Accuracies in registering these sparse data sets were then compared to the accuracy achieved using complete data. For clinical patient data (16 patients), fMRI images were fused with MP-RAGE images, thereby integrating anatomical images with information about the locations of functional areas. The resulting images were used for planning and navigation during tumor resections using an operating microscope (MKM, Zeiss). RESULTS: Quantitative analysis showed no loss of registration accuracy due to a reduced number of slices, regardless of whether 5 or 10 slices were used. For small-volume coverage in the anatomical images (thickness 24 mm), registration of one patient failed, and this could easily be identified by visual inspection. No failures were experienced when 54 mm was covered. In the clinical environment, all 16 interventions using fused fMRI and MRI data were successful. CONCLUSIONS: Automatic registration of functional and high-resolution anatomical MRI was found to be sufficiently accurate and reliable for use in stereotactic neurosurgery.     

Perforation holes in ventricular catheters—is less more?

Objective  

Obstruction is a common cause of cerebrospinal fluid (CSF) shunt failure. Risk factors for proximal obstructive malfunction are suboptimal ventricular catheter positioning and slit-like ventricles. A new ventricular catheter design to decrease risk of obstruction was evaluated.     

Gene expression signatures separate B-cell chronic lymphocytic leukaemia prognostic subgroups defined by ZAP-70 and CD38 expression status.

B-cell chronic lymphocytic leukaemia (B-CLL) is a heterogenous disease with a highly variable clinical course and analysis of zeta-associated protein 70 (ZAP-70) and CD38 expression on B-CLL cells allowed for identification of patients with good (ZAP-70-CD38-) and poor (ZAP-70+CD38+) prognosis. DNA microarray technology was employed to compare eight ZAP-70+CD38+ with eight ZAP-70-CD38- B-CLL cases. The expression of 358 genes differed significantly between the two subgroups, including genes involved in B-cell receptor signaling, angiogenesis and lymphomagenesis. Three of these genes, that is, immune receptor translocation-associated protein 4 (IRTA4)/Fc receptor homologue 2 (FcRH2), angiopoietin 2 (ANGPT2) and Pim2 were selected for further validating studies in a cohort of 94 B-CLL patients. IRTA4/FcRH2 expression as detected by flow cytometry was significantly lower in the poor prognosis subgroup as compared to ZAP-70-CD38- B-CLL cells. In healthy individuals, IRTA4/FcRH2 protein expression was associated with a CD19+CD27+ memory cell phenotype. ANGPT2 plasma concentrations were twofold higher in the poor prognosis subgroup (P<0.05). Pim2 was significantly overexpressed in poor prognosis cases and Binet stage C. Disease progression may be related to proangiogenic processes and strong Pim2 expression.     

模拟肺癌外周血微转移癌细胞富集检测方法的建立

目的 制备特异的纳米免疫磁性微球,结合免疫细胞化学技术研制肺癌细胞富集检测试剂盒,探讨在肺癌患者外周血中微转移癌细胞检测的可行性及灵敏度.方法 用反相微乳法制备纳米磁性微球,然后以碳二亚胺为交联剂将抗体与微球连接,制备纳米免疫磁性微球;将人肺腺癌细胞(A549)与PBMC及全血混匀建立癌细胞微转移模型,经纳米免疫磁性微球吸附和磁性分离后进行肺癌细胞的免疫细胞化学鉴定,检测此方法的特异性及灵敏度,建立癌细胞富集检测方法.结果 制备的纳米免疫磁性微球能够特异地与A549细胞结合并能将细胞磁性分离,当PBMC与A549比为5×106:1时可检测到癌细胞,并且能检测出1 ml外周血中1个癌细胞,未有假阳性.结论 制备的肺癌细胞富集检测试剂能有效的从外周血中分离和鉴定出微转移的癌细胞,具有较高的灵敏度,为临床提供了一种简便、快速、敏感的肿瘤微转移病灶检测技术,可提高肺癌转移及复发的诊断率. 匀建立癌细胞微转移模型,经纳米免疫磁性微球吸附和磁性分离后进行肺癌细胞的免疫细胞化学鉴定,检测此方法的特异性及灵敏度,建立癌细胞富集检测方法.结果 制备的纳米免疫磁性微球能够特异地与A549细胞结合并能将细胞磁性分离,当PBMC与A 49比为5×106:1时可检测到癌细胞,并且能检测出1 ml外周血中1个癌细胞,未有假阳性.结论 制备的肺癌细胞富集检测试剂能有效的从外周血中分离和鉴定出微转移的癌细胞,具有较高的灵敏度,为临床提供了一种简便、快速、敏感的肿瘤微转移病灶检测技术,可提高肺癌转移及复发的诊断率. 匀建立癌细胞微转移模型,经纳米免疫磁性微球吸附和磁性分离后进行肺癌细胞的免疫细胞化学鉴定,检测此方法的特异性及灵敏度,建立癌细胞富集检测方法.结果 制备的纳米免疫磁性     

Visualization of rat pial microcirculation using the novel orthogonal polarized spectral (OPS) imaging after brain injury.

Recently, the novel optical system, orthogonal polarized spectral (OPS) imaging was developed to visualize microcirculation. Investigation of changes in microcirculation is essential for physiological, pathophysiological, and pharmacological studies. In the present study applicability of OPS imaging was assessed to study pial microcirculation in normal and traumatized rat brain. High quality images of rat pial microcirculation in normal and traumatized rats were generated with the OPS imaging, allowing to easily differentiate arterioles and venules with the dura remaining intact. In non-traumatized rats, mean vessel diameter of arterioles and venules of five different cortical regions was 19.1+/-2.7 and 22.2+/-1.4 microm, respectively. In the early phase following focal cortical contusion vessel diameter was significantly decreased in arterioles by 28% while diameter in venules was significantly increased by 27%. For technical reasons velocity in arterioles was not measurable. In venules, mean flow velocity of 0.68+/-0.08 mm/s was significantly decreased by 50% at 30 min after trauma. OPS imaging is an easy to use optical system allowing to generate high quality images and to reliably investigate pial microcirculation without having to remove the dura. This technique opens the possibility to perform longitudinal studies investigating changes in pial microcirculation.     

Management of pineal region tumors in a pediatric case series

Neurosurgical Review - Pineal region tumors commonly present with non-communicating hydrocephalus. These heterogeneous histological entities require different therapeutic regimens. We evaluated our...