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We aimed to assess the correlation of cardiovascular magnetic resonance (CMR)-derived epicardial adipose tissue (EAT) with infarct size (IS) and residual systolic function in ST-segment elevation myocardial infarction (STEMI). We enrolled patients discharged for a first anterior reperfused STEMI submitted to undergo CMR. EAT, left ventricular (LV) ejection fraction (LVEF), and IS were quantified at the 1-week (n = 221) and at 6-month CMR (n = 167). At 1-week CMR, mean EAT was 31 ± 13 mL/m2. Patients with high EAT volume (n = 72) showed larger 1-week IS. After adjustment, EAT extent was independently related to 1-week IS. In patients with large IS at 1 week (>30% of LV mass, n = 88), those with high EAT showed more preserved 6-month LVEF. This association persisted after adjustment and in a 1:1 propensity score-matched patient subset. Overall, EAT decreased at 6 months. In patients with large IS, a greater reduction of EAT was associated with more preserved 6-month LVEF. In STEMI, a higher presence of EAT was associated with a larger IS. Nevertheless, in patients with large infarctions, high EAT and greater subsequent EAT reduction were linked to more preserved LVEF in the chronic phase. This dual and paradoxical effect of EAT fuels the need for further research in this field. [ABSTRACT FROM AUTHOR]

Aim: To describe the clinical outcomes for a group of complex regional pain syndrome patients using infrared thermography as an intraprocedural support tool when undertaking fluoroscopy‐guided lumbar sympathetic blocks. Subjects: 27 patients with lower limb complex regional pain syndrome accompanied by severe pain and persistent functional impairment. Methods: A series of three fluoroscopic‐guided lumbar sympathetic blocks with local anesthetic and corticoids using infrared thermography as an intraprocedural support tool were performed. Clinical variables were collected at baseline, prior to each block, and one, three, and six months after blocks in a standardized checklist assessing each of the clinical categories of complex regional pain syndrome stipulated in the Budapest criteria. Results: 23.75% of the blocks required more than one chance to achieve the desired thermal pattern and therefore to be considered as successful. A decrease in pain measured on a visual analogic scale was observed at all time points compared to pre‐blockade data, but only 37% of the cases were categorized as responders, representing a ≥ 30% decrease in VAS, with the disappearance of pain at rest. An improvement of most of the clinical variables recorded was observed, such as tingling, edema, perception of thermal asymmetry, difference in coloring and sweating. There was a significant decrease of neuropathic pain and improvement of functional limitation. Logistic regression analysis showed the main variable to explain the probability of being a responder was immobilization time (odds ratio of 0.89). Conclusion: A series of fluoroscopy‐guided lumbar sympathetic blocks controlled by infrared thermography in the treatment of lower limb CRPS showed a responder rate of 37%. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol dependence is characterized by a gradual reduction in cognitive control and inflexibility to contingency changes. The neuroadaptations underlying this aberrant behavior are poorly understood. Using an animal model of alcohol use disorders (AUD) and complementing diffusion-weighted (dw)-MRI with quantitative immunohistochemistry and electrophysiological recordings, we provide causal evidence that chronic intermittent alcohol exposure affects the microstructural integrity of the fimbria/fornix, decreasing myelin basic protein content, and reducing the effective communication from the hippocampus (HC) to the prefrontal cortex (PFC). Using a simple quantitative neural network model, we show how disturbed HC-PFC communication may impede the extinction of maladaptive memories, decreasing flexibility. Finally, combining dw-MRI and psychometric data in AUD patients, we discovered an association between the magnitude of microstructural alteration in the fimbria/fornix and the reduction in cognitive flexibility. Overall, these findings highlight the vulnerability of the fimbria/fornix microstructure in AUD and its potential contribution to alcohol pathophysiology. Summary: Fimbria vulnerability to alcohol underlies hippocampal-prefrontal cortex dysfunction and correlates with cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Stress cardiac MRI permits comprehensive evaluation of patients with known or suspected chronic coronary syndromes (CCS). The impact of sex on the use of invasive cardiac angiography (ICA) after vasodilator stress cardiac MRI is unclear. Purpose: To evaluate the impact of sex on ICA use after vasodilator stress cardiac MRI. Study type: Retrospective. Population: A total of 6229 consecutive patients (age [mean ± standard deviation] 65.2 ± 11.5 years, 38.1% women). Field Strength/Sequence: A 5‐T; a steady‐state free‐precession cine sequence; stress first‐pass perfusion imaging; late enhancement imaging. Assessment: Patients underwent vasodilator stress cardiac MRI for known or suspected CCS. The ischemic burden (at stress first‐pass perfusion imaging) was computed (17‐segment model). Statistical Tests: Multivariate logistic regression was used to evaluate the potential differential association between ischemic burden and use of cardiac MRI‐related ICA across sex. Results: A total of 1109 (17.8%) patients were referred to ICA, among which there were significantly more men (762, 19.7%) than women (347, 14.6%). Overall, after multivariate adjustment, female sex was not associated with lower use of ICA (odds ratio [OR] = 0.99; confidence interval [CI] 95%: 0.84–1.18, P = 0.934). However, significant sex differences were detected across ischemic burden. Whereas women with nonischemic vasodilator stress cardiac MRI (0 ischemic segments) were less commonly submitted to ICA (OR = 0.49; CI 95%: 0.35–0.69) in patients with ischemia (>1 ischemic segment), adjusted use of ICA was more frequent in women than men (OR = 1.27; CI 95%: 1.1–1.5). Data Conclusions: In patients with known or suspected CCS submitted to undergo vasodilator stress cardiac MRI, cardiac MRI‐related ICA may be overused in men without ischemia. Furthermore, ICA referral in patients with negative ischemia resulted in greater odds of revascularization in men. Evidence Level: 3 Technical Efficacy: Stage 5 [ABSTRACT FROM AUTHOR]

Background older patients with ST-segment elevation myocardial infarction (STEMI) represent a very high-risk population. Data on the prognostic value of cardiac magnetic resonance (CMR) in this scenario are scarce. Methods the registry comprised 247 STEMI patients over 70 years of age treated with percutaneous intervention and included in a multicenter registry. Baseline characteristics, echocardiographic parameters and CMR-derived left ventricular ejection fraction (LVEF, %), infarct size (% of left ventricular mass) and microvascular obstruction (MVO, number of segments) were prospectively collected. The additional prognostic power of CMR was assessed using adjusted C-statistic, net reclassification index (NRI) and integrated discrimination improvement index (IDI). Results during a 4.8-year mean follow-up, the number of first major adverse cardiac events (MACE) was 66 (26.7%): 27 all-cause deaths and 39 re-admissions for acute heart failure. Predictors of MACE were GRACE score (HR 1.03 [1.02–1.04], P  < 0.001), CMR–LVEF (HR 0.97 [0.95–0.99] per percent increase, P  = 0.006) and MVO (HR 1.24 [1.09–1.4] per segment, P  = 0.001). Adding CMR data significantly improved MACE prediction compared to the model with baseline and echocardiographic characteristics (C-statistic 0.759 [0.694–0.824] vs. 0.685 [0.613–0.756], NRI = 0.6, IDI = 0.08, P  < 0.001). The best cut-offs for independent variables were GRACE score > 155, LVEF < 40% and MVO ≥ 2 segments. A simple score (0, 1, 2, 3) based on the number of altered factors accurately predicted the MACE per 100 person-years: 0.78, 5.53, 11.51 and 78.79, respectively (P  < 0.001). Conclusions CMR data contribute valuable prognostic information in older patients submitted to undergo CMR soon after STEMI. The Older-STEMI–CMR score should be externally validated. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) is the most accurate imaging technique for left ventricular ejection fraction (LVEF) quantification, but as yet the prognostic value of LVEF assessment at any time after ST‐segment elevation myocardial infarction (STEMI) for subsequent major adverse cardiac event (MACE) prediction is uncertain. Purpose: To explore the prognostic impact of MRI‐derived LVEF at any time post‐STEMI to predict subsequent MACE (cardiovascular death or re‐admission for acute heart failure). Study Type: Prospective. Population: One thousand thirteen STEMI patients were included in a multicenter registry. Field Strength/Sequence: 1.5‐T. Balanced steady‐state free precession (cine imaging) and segmented inversion recovery steady‐state free precession (late gadolinium enhancement) sequences. Assessment: Post‐infarction MRI‐derived LVEF (reduced [r]: <40%; mid‐range [mr]: 40%–49%; preserved [p]: ≥50%) was sequentially quantified at 1 week and after >3 months of follow‐up. Statistical Tests: Multi‐state Markov model to determine the prognostic value of each LVEF state (r‐, mr‐ or p‐) at any time point assessed to predict subsequent MACE. A P‐value <0.05 was considered to be statistically significant. Results: During a 6.2‐year median follow‐up, 105 MACE (10%) were registered. Transitions toward improved LVEF predominated and only r‐LVEF (at any time assessed) was significantly related to a higher incidence of subsequent MACE. The observed transitions from r‐LVEF, mr‐LVEF, and p‐LVEF states to MACE were: 15.3%, 6%, and 6.7%, respectively. Regarding the adjusted transition intensity ratios, patients in r‐LVEF state were 4.52‐fold more likely than those in mr‐LVEF state and 5.01‐fold more likely than those in p‐LVEF state to move to MACE state. Nevertheless, no significant differences were found in transitions from mr‐LVEF and p‐LVEF states to MACE state (P‐value = 0.6). Data Conclusion: LVEF is an important MRI index for simple and dynamic post‐STEMI risk stratification. Detection of r‐LVEF by MRI at any time during follow‐up identifies a subset of patients at high risk of subsequent events. Level of Evidence: 2 Technical Efficacy Stage: 2 [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) causes complex alterations in the brain that are poorly understood. The heterogeneity of drinking patterns and the high incidence of comorbid factors compromise mechanistic investigations in AUD patients. Here we used male Marchigian Sardinian alcohol-preferring (msP) rats, a well established animal model of chronic alcohol drinking, and a combination of longitudinal resting-state fMRI and manganese-enhanced MRI to provide objective measurements of brain connectivity and activity, respectively. We found that 1month of chronic alcohol drinking changed the correlation between resting-state networks. The change was not homogeneous, resulting in the reorganization of pairwise interactions and a shift in the equilibrium of functional connections. We identified two fundamentally different forms of network reorganization. First is functional dedifferentiation, which is defined as a regional increase in neuronal activity and overall correlation, with a concomitant decrease in preferential connectivity between specific networks. Through this mechanism, occipital cortical areas lost their specific interaction with sensory-insular cortex, striatal, and sensorimotor networks. Second is functional narrowing, which is defined as an increase in neuronal activity and preferential connectivity between specific brain networks. Functional narrowing strengthened the interaction between striatal and prefrontocortical networks, involving the anterior insular, cingulate, orbitofrontal, prelimbic, and infralimbic cortices. Importantly, these two types of alterations persisted after alcohol discontinuation, suggesting that dedifferentiation and functional narrowing rendered persistent network states. Our results support the idea that chronic alcohol drinking, albeit at moderate intoxicating levels, induces an allostatic change in the brain functional connectivity that propagates into early abstinence. [ABSTRACT FROM AUTHOR]

Wireless electrophysiology opens important possibilities for neuroscience, especially for recording brain activity in more natural contexts, where exploration and interaction are not restricted by the usual tethered devices. The limiting factor is transmission power and, by extension, battery life required for acquiring large amounts of neural electrophysiological data. We present a digital compression algorithm capable of reducing electrophysiological data to less than 65.5% of its original size without distorting the signals, which we tested in vivo in experimental animals. The algorithm is based on a combination of delta compression and Huffman codes with optimizations for neural signals, which allow it to run in small, low-power Field-Programmable Gate Arrays (FPGAs), requiring few hardware resources. With this algorithm, a hardware prototype was created for wireless data transmission using commercially available devices. The power required by the algorithm itself was less than 3 mW, negligible compared to the power saved by reducing the transmission bandwidth requirements. The compression algorithm and its implementation were designed to be device-agnostic. These developments can be used to create a variety of wired and wireless neural electrophysiology acquisition systems with low power and space requirements without the need for complex or expensive specialized hardware. [ABSTRACT FROM AUTHOR]

Abnormal resting‐state functional connectivity, as measured by functional magnetic resonance imaging (MRI), has been reported in alcohol use disorders (AUD), but findings are so far inconsistent. Here, we exploited recent developments in graph‐theoretical analyses, enabling improved resolution and fine‐grained representation of brain networks, to investigate functional connectivity in 35 recently detoxified alcohol dependent patients versus 34 healthy controls. Specifically, we focused on the modular organization, that is, the presence of tightly connected substructures within a network, and on the identification of brain regions responsible for network integration using an unbiased approach based on a large‐scale network composed of more than 600 a priori defined nodes. We found significant reductions in global connectivity and region‐specific disruption in the network topology in patients compared with controls. Specifically, the basal brain and the insular–supramarginal cortices, which form tightly coupled modules in healthy subjects, were fragmented in patients. Further, patients showed a strong increase in the centrality of the anterior insula, which exhibited stronger connectivity to distal cortical regions and weaker connectivity to the posterior insula. Anterior insula centrality, a measure of the integrative role of a region, was significantly associated with increased risk of relapse. Exploratory analysis suggests partial recovery of modular structure and insular connectivity in patients after 2 weeks. These findings support the hypothesis that, at least during the early stages of abstinence, the anterior insula may drive exaggerated integration of interoceptive states in AUD patients with possible consequences for decision making and emotional states and that functional connectivity is dynamically changing during treatment. [ABSTRACT FROM AUTHOR]

Purpose: In ST-segment elevation myocardial infarction (STEMI) patients, longitudinal strain (LS) in remote non-infarcted myocardium (RNM) has not yet been characterized by tissue tracking (TT) cardiovascular magnetic resonance (CMR). In STEMI patients, we aimed to characterize RNM-LS by TT-CMR and to assess both its dynamics and its structural and prognostic implications.Methods: We recruited 271 patients with a first STEMI studied with TT-CMR 1 week after infarction. Of these patients, 145 underwent 1-week and 6-month TT-CMR and were used to characterize both the dynamics and the short-term and long-term structural implications of RNM-LS. Based on previously validated data, RNM areas were defined depending on the culprit coronary artery.Results: Reduced RNM-LS at 1 week (n = 70, 48%) was associated with larger infarct size and more depressed left ventricular ejection fraction (LVEF) at both the 1-week and 6-month TT-CMR (p value < 0.001). Late normalization of RNM-LS was frequent (28/70, 40%) and independently related to late recovery of LVEF (p value = 0.002). Patients with reduced RNM-LS at 1-week TT-CMR had more major adverse cardiac events (death, heart failure or re-infarction) in both the 271 patients included in the study group (26% vs. 11%, p value = 0.002) and in an external validation cohort made up of 177 STEMI patients (57% vs. 13%, p value < 0.001).Conclusion: After STEMI, reduced RNM-LS by TT-CMR is common and is associated with more severe short- and long-term structural damage. There is a beneficial tendency towards recovery of RNM-LS that parallels late recovery of LVEF. More events occur in patients with reduced RNM-LS. [ABSTRACT FROM AUTHOR]

Background The respiratory epithelium is frequently infected by the respiratory syncytial virus, resulting in inflammation, a reduction in cilia activity and an increase in the production of mucus. Methods In this study, an automatic method has been proposed to characterize the ciliary motility from cell cultures by means of a motility index using a dense optical flow algorithm. This method allows us to determine the ciliary beat frequency (CBF) together with a ciliary motility index of the cells in the cultures. The object of this analysis is to automatically distinguish between normal and infected cells in a culture. Results The method was applied in 2 stages. It was concluded from the first stage that the CBF is not a good enough indicator to discriminate between the control and infected cultures. However, the ciliary motility index does succeed in discriminating between the control and infected cultures using the t test with a value t = 6.46 and P < .001. In the second stage, it has been shown that the ciliary motility index did not differ significantly between patients, and the analysis of variance test gives α = 0.05, F = 1.61, P = .20. A threshold for this index has been determined using a receiver operating characteristics analysis that gives an area under the curve of 0.93. Conclusions We have obtained a ciliary motility index that is able to discriminate between control and infected cultures after the eighth postinfection day. After infection, there is a rapid cilia loss of the cells and the measured CBF corresponds to the remaining noninfected cells. This is why the CBF does not discriminate between the control and the infected cells. [ABSTRACT FROM AUTHOR]

Objective: To examine the capability of MRI texture analysis to differentiate the primary site of origin of brain metastases following a radiomics approach.Methods: Sixty-seven untreated brain metastases (BM) were found in 3D T1-weighted MRI of 38 patients with cancer: 27 from lung cancer, 23 from melanoma and 17 from breast cancer. These lesions were segmented in 2D and 3D to compare the discriminative power of 2D and 3D texture features. The images were quantized using different number of gray-levels to test the influence of quantization. Forty-three rotation-invariant texture features were examined. Feature selection and random forest classification were implemented within a nested cross-validation structure. Classification was evaluated with the area under receiver operating characteristic curve (AUC) considering two strategies: multiclass and one-versus-one.Results: In the multiclass approach, 3D texture features were more discriminative than 2D features. The best results were achieved for images quantized with 32 gray-levels (AUC = 0.873 ± 0.064) using the top four features provided by the feature selection method based on the p-value. In the one-versus-one approach, high accuracy was obtained when differentiating lung cancer BM from breast cancer BM (four features, AUC = 0.963 ± 0.054) and melanoma BM (eight features, AUC = 0.936 ± 0.070) using the optimal dataset (3D features, 32 gray-levels). Classification of breast cancer and melanoma BM was unsatisfactory (AUC = 0.607 ± 0.180).Conclusion: Volumetric MRI texture features can be useful to differentiate brain metastases from different primary cancers after quantizing the images with the proper number of gray-levels.Key Points: • Texture analysis is a promising source of biomarkers for classifying brain neoplasms. • MRI texture features of brain metastases could help identifying the primary cancer. • Volumetric texture features are more discriminative than traditional 2D texture features. [ABSTRACT FROM AUTHOR]

Objective: To find structural differences between brain metastases of lung and breast cancer, computing their heterogeneity parameters by means of both 2D and 3D texture analysis (TA).Materials and methods: Patients with 58 brain metastases from breast (26) and lung cancer (32) were examined by MR imaging. Brain lesions were manually delineated by 2D ROIs on the slices of contrast-enhanced T1-weighted (CET1) images, and local binary patterns (LBP) maps were created from each region. Histogram-based (minimum, maximum, mean, standard deviation, and variance), and co-occurrence matrix-based (contrast, correlation, energy, entropy, and homogeneity) 2D, weighted average of the 2D slices, and true 3D TA were obtained on the CET1 images and LBP maps.Results: For LBP maps and 2D TA contrast, correlation, energy, and homogeneity were identified as statistically different heterogeneity parameters (SDHPs) between lung and breast metastasis. The weighted 3D TA identified entropy as an additional SDHP. Only two texture indexes (TI) were significantly different with true 3D TA: entropy and energy. All these TIs discriminated between the two tumor types significantly by ROC analysis. For the CET1 images there was no SDHP at all by 3D TA.Conclusion: Our results indicate that the used textural analysis methods may help with discriminating between brain metastases of different primary tumors. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the ability of texture analysis to differentiate between infarcted nonviable, viable, and remote segments on cardiac cine magnetic resonance imaging (MRI). Methods: This retrospective study included 50 patients suffering chronic myocardial infarction. The data were randomly split into training (30 patients) and testing (20 patients) sets. The left ventricular myocardium was segmented according to the 17‐segment model in both cine and late gadolinium enhancement (LGE) MRI. Infarcted myocardium regions were identified on LGE in short‐axis views. Nonviable segments were identified as those showing LGE ≥ 50%, and viable segments those showing 0 < LGE < 50% transmural extension. Features derived from five texture analysis methods were extracted from the segments on cine images. A support vector machine (SVM) classifier was trained with different combination of texture features to obtain a model that provided optimal classification performance. Results: The best classification on testing set was achieved with local binary patterns features using a 2D + t approach, in which the features are computed by including information of the time dimension available in cine sequences. The best overall area under the receiver operating characteristic curve (AUC) were: 0.849, sensitivity of 92% to detect nonviable segments, 72% to detect viable segments, and 85% to detect remote segments. Conclusion: Nonviable segments can be detected on cine MRI using texture analysis and this may be used as hypothesis for future research aiming to detect the infarcted myocardium by means of a gadolinium‐free approach. [ABSTRACT FROM AUTHOR]

Purpose The development of automatic and reliable algorithms for the detection and segmentation of the vertebrae are of great importance prior to any diagnostic task. However, an important problem found to accurately segment the vertebrae is the presence of the ribs in the thoracic region. To overcome this problem, a probabilistic atlas of the spine has been developed dealing with the proximity of other structures, with a special focus on ribs suppression. Methods The data sets used consist of Computed Tomography images corresponding to 21 patients suffering from spinal metastases. Two methods have been combined to obtain the final result: firstly, an initial segmentation is performed using a fully automatic level-set method; secondly, to refine the initial segmentation, a 3D volume indicating the probability of each voxel of belonging to the spine has been developed. In this way, a probability map is generated and deformed to be adapted to each testing case. Results To validate the improvement obtained after applying the atlas, the Dice coefficient ( DSC), the Hausdorff distance ( HD), and the mean surface-to-surface distance ( MSD) were used. The results showed up an average of 10 mm of improvement accuracy in terms of HD, obtaining an overall final average of 15.51 ± 2.74 mm. Also, a global value of 91.01 ± 3.18% in terms of DSC and a MSD of 0.66 ± 0.25 mm were obtained. The major improvement using the atlas was achieved in the thoracic region, as ribs were almost perfectly suppressed. Conclusion The study demonstrated that the atlas is able to detect and appropriately eliminate the ribs while improving the segmentation accuracy. [ABSTRACT FROM AUTHOR]

Robust neuroimaging markers of neuropsychiatric disorders have proven difficult to obtain. In alcohol use disorders, profound brain structural deficits can be found in severe alcoholic patients, but the heterogeneity of unimodal MRI measurements has so far precluded the identification of selective biomarkers, especially for early diagnosis. In the present work we used a combination of multiple MRI modalities to provide comprehensive and insightful descriptions of brain tissue microstructure. We performed a longitudinal experiment using Marchigian-Sardinian (msP) rats, an established model of chronic excessive alcohol consumption, and acquired multi-modal images before and after 1 month of alcohol consumption (6.8 ± 1.4 g/kg/day, mean ± SD), as well as after 1 week of abstinence with or without concomitant treatment with the antirelapse opioid antagonist naltrexone (2.5 mg/kg/day). We found remarkable sensitivity and selectivity to accurately classify brains affected by alcohol even after the relative short exposure period. One month drinking was enough to imprint a highly specific signature of alcohol consumption. Brain alterations were regionally specific and affected both gray and white matter and persisted into the early abstinence state without any detectable recovery. Interestingly, naltrexone treatment during early abstinence resulted in subtle brain changes that could be distinguished from non-treated abstinent brains, suggesting the existence of an intermediate state associated with brain recovery from alcohol exposure induced by medication. The presented framework is a promising tool for the development of biomarkers for clinical diagnosis of alcohol use disorders, with capacity to further inform about its progression and response to treatment. [ABSTRACT FROM AUTHOR]

Summary: Feasibility evaluation of early detection of osteoporosis in oncologic patients by bone mineral density (BMD) on abdominal computed tomography (CT) scans performed for other clinical indications, by using dual-energy X-ray absorptiometry (DXA) as reference. Abdominal CT images can identify patients with osteoporosis BMD without additional radiation exposure or cost. Introduction: The purpose of the study is to evaluate the feasibility of early detection of osteoporosis by bone mineral density (BMD) on abdominal computed tomography (CT) scans performed in oncologic patients, comparing calibrated and uncalibrated measurements by using dual-energy X-ray absorptiometry (DXA) as reference. We also performed an external validation of a threshold of 160 Hounsfield units (HU), proposed as highly sensitive. Methods: Cohort comprised CT-DXA pairs within a 6-month period performed for any indication on 326 consecutive adults, aged 62.4 ± 12.38 years (mean ± standard deviation). CT attenuation of trabecular bone in HU was measured at the axial cross sections of L1, L2, L3, and L4 vertebrae. Vertebral compression fractures were assessed by sagittal reconstruction view. Diagnostic performance measures and the area under the receiver operator characteristic curve (AUC) for diagnosing osteoporosis were calculated. Results: BMD values were statistical significantly lower at any vertebral level from L1 to L4 for patients with osteoporosis defined by DXA ( p < 0.001). Calibrated and uncalibrated BMD values were significantly correlated ( R = 0.833, p < 0.01). An uncalibrated L1 CT attenuation threshold of 160 HU was more than 90 % sensitive, and a threshold of 73 HU was more than 90 % specific for distinguishing osteoporosis BMD. Fifty-nine percent of patients with vertebral compression fracture had non-osteoporotic DXA T-scores. Conclusions: Abdominal CT images obtained for other reasons can identify patients with osteoporosis BMD without additional radiation exposure or cost. Uncalibrated values at L1 can detect more osteoporosis patients with spinal compression fractures than DXA in oncologic patients. [ABSTRACT FROM AUTHOR]

Purpose: To develop and evaluate a method for an automatic detection of brain metastases in MR images.Materials and Methods: Nineteen patients were scanned using a 1.5 Tesla MR scanner. Two radiologists and a radiation oncologist marked the location of the brain metastases. The training group consisted of eight patients harboring 20 metastases. First, three-dimensional (3D) tumor-appearance templates were cross-correlated with MR brain images to evaluate their similarity, and a correlation threshold was established for metastasis candidates. Afterward, a method to reduce false positive rate (FPR) was applied: each detected object was segmented and its degree of anisotropy (DA) was obtained, removing the elongated structures with a DA above the optimal value from the receiver operating characteristic curve. Finally, the method was statistically validated in two groups: 11 patients with 42 brain metastases and 11 patients without metastases.Results: The method led to a sensitivity of 80% and an FPR per slice of 0.023 and 2.75 per patient in the training group. In the first validation group, a sensitivity of 88.10% and an FPR per slice of 0.05 corresponding to 6.91 false positives per patient were obtained. DA implementation decreased 3.5 times FPR compared with templates alone. It improved the radiologist's performance in metastases less than 10 mm from 89-93% to 100%. In the second validation group the FPR was 0.04 per slice and 5.18 per patient.Conclusion: This method demonstrates that 3D template matching applying DA technique has high sensitivity and low FPR for detecting brain metastases in MR images. J. Magn. Reson. Imaging 2016;44:642-652. [ABSTRACT FROM AUTHOR]

Early detection of brain metastases increases survival in patients with cancer, since image-guided radiosurgery is the most widely used treatment. As support for the qualitative diagnosis made by radiologists, Computer Assisted Diagnosis provides a quantitative and reproducible analysis. This article reviews the methods for an automatic detection of brain metastases in contrast-enhanced T1-weighted magnetic resonance imaging. Model-based methods detect metastases due to their high degree of similarity with models representing their morphology, mainly templates. On the other hand, methods based on brain symmetry and intensity search intensity differences between both brain hemispheres with respect to the symmetry axis. Model-based methods are more commonly used because they allow the detection of metastases of a wider range of measures. [ABSTRACT FROM PUBLISHER]

Purpose: To develop a classification model using texture features and support vector machine in contrast-enhanced T1-weighted images to differentiate between brain metastasis and radiation necrosis.Methods: Texture features were extracted from 115 lesions: 32 of them previously diagnosed as radiation necrosis, 23 as radiation-treated metastasis and 60 untreated metastases; including a total of 179 features derived from six texture analysis methods. A feature selection technique based on support vector machine was used to obtain a subset of features that provide optimal performance.Results: The highest classification accuracy evaluated over test sets was achieved with a subset of ten features when the untreated metastases were not considered; and with a subset of seven features when the classifier was trained with untreated metastases and tested on treated ones. Receiver operating characteristic curves provided area-under-the-curve (mean ± standard deviation) of 0.94 ± 0.07 in the first case, and 0.93 ± 0.02 in the second.Conclusion: High classification accuracy (AUC > 0.9) was obtained using texture features and a support vector machine classifier in an approach based on conventional MRI to differentiate between brain metastasis and radiation necrosis. [ABSTRACT FROM AUTHOR]

Alzheimer disease (AD) is the most common type of dementia and mild cognitive impairment (MCI) is a syndrome with an increased risk of developing dementia. As neuroimaging is relevant in their diagnosis, the purpose of this paper is to develop an automatic classification methodology of AD, MCI and control patients. A total of 83 subjects provided by ADNI (Alzheimer's Disease Neuroimaging Initiative) were studied (26 controls, 24 MCI and 33 AD patients) to develop an automatic method. It allows voxel-based morphometry (VBM) optimized by Dartel coregistration and complemented with a volumetric quantification subalgorithm. The developed algorithm implements VBM automatically and segments the three main brain tissues accurately. Difference between controls and AD increased during follow-up (Anova, p = 0,001). Finally statistical parametric maps were created from output images, where morphometric and volumetric differences can be appreciated. This algorithm automates brain imaging volumetry in cognitive impaired patients and control subjects. Even with the described limitations, the developed methodology is fast and user independent and it improves the traditional voxel-based morphometry algorithm. [ABSTRACT FROM PUBLISHER]

Anisotropy is one of the most meaningful determinants of biomechanical behaviour. This study employs micro-computed tomography (μCT) and image techniques for analysing the anisotropy of regenerative medicine polymer scaffolds. For this purpose, three three-dimensional anisotropy evaluation image methods were used: ellipsoid of inertia (EI), mean intercept length (MIL) and tensor scale (t-scale). These were applied to three patterns (a sphere, a cube and a right prism) and to two polymer scaffold topologies (cylindrical orthogonal pore mesh and spherical pores). For the patterns, the three methods provided good results. Regarding the scaffolds, EI mistook both topologies (0.0158, [ − 0.5683; 0.6001]; mean difference and 95% confidence interval), and MIL showed no significant differences (0.3509, [0.0656; 0.6362]). T-scale is the preferable method because it gave the best capability (0.3441, [0.1779; 0.5102]) to differentiate both topologies. This methodology results in the development of non-destructive tools to engineer biomimetic scaffolds, incorporating anisotropy as a fundamental property to be mimicked from the original tissue and permitting its assessment by means of μCT image analysis. [ABSTRACT FROM PUBLISHER]

This work presents a Positron Emission Tomography (PET) image analysis tool and its application to the study of rat brain glucose consumption (PETra comes from PET+rat). The described methodology has four steps: a preprocessing of PET images, a coregistration of these images with an atlas, a semiautomatic segmentation of the regions of interest in the rat brain and a 3D reconstruction of these regions to obtain the volumes of interest. Brain glucose uptake was quantified as Standardized Uptake Value (SUV). This tool was applied to nine Wistar rats, young (4-7 months) and old (22-24 months) groups, to study the effect of aging on brain glucose consumption and the difference between sexes. Results showed a lower glucose uptake in old rats than in young rats, regardless gender; while young female rats showed higher glucose consumption than young male rats, whereas these differences disappeared with aging. The developed tool allows the quantification of glucose in rat brain. Results show the accuracy of the tool to define ranges of variation in a population of young and old rats, showing a decrease in glucose consumption in aging. [ABSTRACT FROM PUBLISHER]

Purpose The aim of this study was to establish reference values for segmental myocardial strain measured by magnetic resonance (MR) cardiac tagging in order to characterize the regional function of the heart. Material and Methods We characterized the left ventricular (LV) systolic deformation in 39 subjects (26 women and 13 men, age 58.8 ± 11.6 years) whose cardiological study had not revealed any significant abnormality. The deformation was measured from MR-tagged (Siemens 1.5T MR) images using an algorithm based on sine wave modeling. Circumferential and radial peak systolic strain values along with the torsion angle and circumferential-longitudinal (CL) shear were determined in 16 LV segments in order to settle the reference values for these parameters. Results Circumferential strain was highest at the anterior and lateral walls (−20.2 ± 4.0% and −21.8 ± 4.3%, respectively; P < 0.05) and was lowest at the base level (−17.2 ± 3.1% vs. −20.1 ± 3.1% 'mid level,' P < 0.05; −17.2 ± 3.1% vs. −20.3 ± 3.0% 'apical level,' P < 0.05). Radial strain highest values were from inferior and lateral walls (13.7 ± 7.4% and 12.8 ± 7.8%, respectively; P < 0.05) and it was lowest medially (9.4 ± 4.1% vs. 13.1 ± 4.1% 'base level,' P < 0.05; 9.4 ± 4.1% vs. 12.1 ± 4.4% 'apical level,' P < 0.05). Torsion angle (counterclockwise when viewed from the apex) increased with the distance from the base (7.9 ± 2.4° vs. 16.8 ± 4.4°, P < 0.05), and the highest and lowest values were found at lateral (medial lateral: 12.0 ± 4.4°, apical lateral: 25.1 ± 6.4°, P < 0.05) and septal wall (medial septal: 3.6 ± 2.1°, apical septal: 8.3 ± 5.3°, P < 0.05), respectively. These differences were found again in CL shear values, around the LV circumference. However, CL shear remained constant with increasing distance from the base (9.1 ± 2.6°, medium and 9.8 ± 2.4°, apex). Conclusion In summary, this study provides reference values for the assessment of regional myocardial function by MR cardiac tagging. Comparison of patient deformation parameters with normal deformation patterns may permit early detection of regional systolic dysfunction. J. Magn. Reson. Imaging 2015;41:83-92. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Polylaminin (polyLM) is a non-covalent acid-induced nano- and micro-structured polymer of the protein laminin displaying distinguished biological properties. Polylaminin stimulates neuritogenesis beyond the levels achieved by ordinary laminin and has been shown to promote axonal regeneration in animal models of spinal cord injury. Here we used confocal fluorescence microscopy (CFM), scanning electron microscopy (SEM) and atomic force microscopy (AFM) to characterize its three-dimensional structure. Renderization of confocal optical slices of immunostained polyLM revealed the aspect of a loose flocculated meshwork, which was homogeneously stained by the antibody. On the other hand, an ordinary matrix obtained upon adsorption of laminin in neutral pH (LM) was constituted of bulky protein aggregates whose interior was not accessible to the same anti-laminin antibody. SEM and AFM analyses revealed that the seed unit of polyLM was a flat polygon formed in solution whereas the seed structure of LM was highly heterogeneous, intercalating rod-like, spherical and thin spread lamellar deposits. As polyLM was visualized at progressively increasing magnifications, we observed that the morphology of the polymer was alike independently of the magnification used for the observation. A search for the Hausdorff dimension in images of the two matrices showed that polyLM, but not LM, presented fractal dimensions of 1.55, 1.62 and 1.70 after 1, 8 and 12 hours of adsorption, respectively. Data in the present work suggest that the intrinsic fractal nature of polymerized laminin can be the structural basis for the fractal-like organization of basement membranes in the neurogenic niches of the central nervous system. [ABSTRACT FROM AUTHOR]

Infarct size (IS) at 1 week after ST-elevation myocardial infarction (MI) diminishes during the first months. The incremental prognostic value of IS regression and of scar size (SS) at 6 months is unknown. We compared cardiovascular magnetic resonance (CMR)-derived IS at 1 week and SS at 6 months after MI for predicting late major adverse cardiac events (MACE). 250 patients underwent CMR at 1 week and 6 months after MI. IS and SS were determined as the extent of transmural late enhancement (in >50 % of wall thickness, ETLE). During 163 weeks, 23 late MACE (cardiac death, MI or readmission for heart failure after the 6 months CMR) occurred. Patients with MACE had a larger IS at 1 week (6 [4-9] vs. 3 [1-5], p < .0001) and a larger SS at 6 months (5 [2-6] vs. 3 [1-5], p = .005) than those without MACE. Late MACE rates in IS >median were higher at 1 week (14 vs. 4 %, p = .007) and in SS >median at 6 months (12 vs. 5 %, p = .053). The C-statistic for predicting late MACE of CMR at 1 week and 6 months was comparable (.720 vs. .746, p = .1). Only ETLE at 1 week (HR 1.31 95 % CI [1.14-1.52], p < .0001, per segment) independently predicted late MACE. CMR-derived SS at 6 months does not offer prognostic value beyond IS at 1 week after MI. The strongest predictor of late MACE is ETLE at 1 week. [ABSTRACT FROM AUTHOR]

Fibronectin (FN) assembles into fibrillar networks by cells through an integrin-dependent mechanism. We have recently shown that simple FN adsorption onto poly(ethyl acrylate) surfaces (PEA), but not control polymer (poly(methyl acrylate), PMA), also triggered FN organization into a physiological fibrillar network. FN fibrils exhibited enhanced biological activities in terms of myogenic differentiation compared to individual FN molecules. In the present study, we investigate the influence of topological cues on the material-driven FN assembly and the myogenic differentiation process. Aligned and random electrospun fibers were prepared. While FN fibrils assembled on the PEA fibers as they do on the smooth surface, the characteristic distribution of globular FN molecules observed on flat PMA transformed into non-connected FN fibrils on electrospun PMA, which significantly enhanced cell differentiation. The direct relationship between the fibrillar organization of FN at the material interface and the myogenic process was further assessed by preparing FN gradients on smooth PEA and PMA films. Isolated FN molecules observed at one edge of the substrate gradually interconnected with each other, eventually forming a fully developed network of FN fibrils on PEA. In contrast, FN adopted a globular-like conformation along the entire length of the PMA surface, and the FN gradient consisted only of increased density of adsorbed FN. Correspondingly, the percentage of differentiated cells increased monotonically along the FN gradient on PEA but not on PMA. This work demonstrates an interplay between material chemistry and topology in modulating material-driven FN fibrillogenesis and cell differentiation. [ABSTRACT FROM AUTHOR]

To develop a method for segmenting cerebrospinal fluid (CSF) regions with complex, inhomogeneous pulsatile patterns in phase contrast magnetic resonance imaging (PC-MRI) sequences. Our approach used various temporal features of flow behavior as input attributes in an unsupervised k-means classification algorithm. CSF flow parameters for the cervical subarachnoid spaces and the pontine cistern were calculated in 26 healthy volunteers. Background and aliasing corrections were applied automatically. The algorithm's reproducibility was determined by calculating two parameters (area and stroke volume) while varying the initially selected seed point. The influence of background correction on these parameters was also assessed. The method was highly reproducible, with coefficients of variation of 3 and 4% for the cervical stroke volume and area, respectively. In an analysis of variance, background correction did not have a statistically significant effect on either the stroke volume ( p = 0.32) or the CSF net mean flow ( p = 0.69) at the C2C3 level. The method presented here enables rapid, reproducible, quantitative analysis of CSF flow in complex regions such as the C2C3 subarachnoid spaces and the pontine cistern. © 2011 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 21, 290-297, 2011; [ABSTRACT FROM AUTHOR]

Background: The cell-material interaction is a complex bi-directional and dynamic process that mimics to a certain extent the natural interactions of cells with the extracellular matrix. Cells tend to adhere and rearrange adsorbed extracellular matrix (ECM) proteins on the material surface in a fibril-like pattern. Afterwards, the ECM undergoes proteolytic degradation, which is a mechanism for the removal of the excess ECM usually approximated with remodeling. ECM remodeling is a dynamic process that consists of two opposite events: assembly and degradation. Methodology/Principal Findings: This work investigates matrix protein dynamics on mixed self-assembled monolayers (SAMs) of -OH and -CH3 terminated alkanethiols. SAMs assembled on gold are highly ordered organic surfaces able to provide different chemical functionalities and well-controlled surface properties. Fibronectin (FN) was adsorbed on the different surfaces and quantified in terms of the adsorbed surface density, distribution and conformation. Initial cell adhesion and signaling on FN-coated SAMs were characterized via the formation of focal adhesions, integrin expression and phosphorylation of FAKs. Afterwards, the reorganization and secretion of FN was assessed. Finally, matrix degradation was followed via the expression of matrix metalloproteinases MMP2 and MMP9 and correlated with Runx2 levels. We show that matrix degradation at the cell material interface depends on surface chemistry in MMP-dependent way. Conclusions/Significance: This work provides a broad overview of matrix remodeling at the cell-material interface, establishing correlations between surface chemistry, FN adsorption, cell adhesion and signaling, matrix reorganization and degradation. The reported findings improve our understanding of the role of surface chemistry as a key parameter in the design of new biomaterials. It demonstrates the ability of surface chemistry to direct proteolytic routes at the cell-material interface, which gains a distinct bioengineering interest as a new tool to trigger matrix degradation in different biomedical applications. [ABSTRACT FROM AUTHOR]