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Children who have experienced deprivation as a result of orphanage care during early development are at increased risk for a number of cognitive, emotional, and social difficulties (MacLean, 2003). This study examined the neuropsychological and behavioral profile of internationally adopted children with language difficulties, one of the most common cognitive challenges (Behen et al., 2008). In addition to neuropsychological testing, fMRI was utilized to examine activation patterns during expressive fluency and receptive language tasks. In comparison to internationally adopted children without language difficulties and nonadopted controls, participants with language difficulty had worse performance on tasks of verbal memory and reasoning, academic skills, and working memory. Behaviorally, all internationally adopted participants, regardless of language ability, had more parent-reported hyperactivity and impulsivity compared with controls. The fMRI tasks revealed reduced activation in traditional language areas in participants with language difficulty. The impact of early adverse experience on later development is discussed. [ABSTRACT FROM PUBLISHER]

Objectives: This study aims to determine the feasibility and utility of functional imaging of copper metabolism imbalance in Atp7b (-/-) knockout mouse model of Wilson's disease (WD) with positron emission tomography-computed tomography (PET-CT) using orally administered copper-64 chloride ((64)CuCl(2)) as a tracer.Procedures: Atp7b (-/-) KO mice (N = 5) were subjected to PET scanning using a hybrid PET-CT scanner, after oral administration of (64)CuCl(2) as a tracer. Time-dependent PET quantitative analysis was performed to assess gastrointestinal absorption and biodistribution of (64)Cu radioactivity in the Atp7b (-/-) KO mice, using C57BL wild-type (WT) mice (N = 5) as a normal control. Estimates of human radiation dosimetry were calculated based on biodistribution of (64)Cu radioactivity in live animals.Results: PET-CT analysis demonstrated higher (64)Cu radioactivity in the liver of Atp7b (-/-) knockout mice compared with that in the control C57BL WT mice (p < 0.001), following oral administration of (64)CuCl(2) as a tracer. In addition, (64)Cu radioactivity in the lungs of the Atp7b (-/-) knockout mice was slightly higher than those in the control C57BL WT mice (p = 0.01). Despite initially higher renal clearance of (64)Cu, there was no significant difference of (64)Cu radioactivity in the kidneys of the Atp7b (-/-) KO mice and the control C57BL WT mice at 24 h post-oral administration of (64)CuCl(2) (p = 0.16). There was no significant difference in low (64)Cu radioactivity in the blood, brain, heart, and muscles between the Atp7b (-/-) knockout mice and control C57BL WT mice (p > 0.05). Based on the biodistribution of (64)Cu radioactivity in C57BL WT mice, radiation dosimetry estimates of (64)Cu in normal human subjects were obtained. An effective dose (ED) of 42.4 μSv/MBq (weighted dose over 22 organs) was calculated and the lower large intestines were identified as the critical organ for radiation exposure (120 μGy/MBq for males and 135 μGy/MBq for females). Radiation dosimetry estimates for patients with WD, derived from the biodistribution of (64)Cu in Atp7b (-/-) KO mice, showed a slightly lower ED of 37.5 μSv/MBq, with the lower large intestines as the critical organ for radiation exposure (83 μSv/MBq for male and 95 μSv/MBq for female).Conclusions: PET-CT quantitative analysis demonstrated an increased level of (64)Cu radioactivity in the liver of Atp7b (-/-) KO mice compared with that in the control C57BL WT mice, following oral administration of (64)CuCl(2) as a tracer. The results of this study suggest the feasibility and utility of PET-CT using orally administered (64)CuCl(2) as a tracer ((64)CuCl(2)-PET/CT) for functional imaging of copper metabolism imbalance in WD. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to determine feasibility and utility of copper-64(II) chloride (⁶⁴CuCl₂) as a tracer for positron emission tomography (PET) of copper metabolism imbalance in human Wilson's disease (WD).Procedures: Atp7b⁻/⁻ mice, a mouse model of human WD, were injected with ⁶⁴CuCl₂ intravenously and subjected to PET scanning using a hybrid PET-CT (computerized tomography) scanner, with the wild-type C57BL mice as a normal control. Quantitative PET analysis was performed to determine biodistribution of ⁶⁴Cu radioactivity and radiation dosimetry estimates of ⁶⁴Cu were calculated for PET of copper metabolism in humans.Results: Dynamic PET analysis revealed increased accumulation and markedly reduced clearance of ⁶⁴Cu from the liver of the Atp7b⁻/⁻ mice, compared to hepatic uptake and clearance of ⁶⁴Cu in the wild-type C57BL mice. Kinetics of copper clearance and retention was also altered for kidneys, heart, and lungs in the Atp7b/⁻ mice. Based on biodistribution of ⁶⁴Cu in wild-type C57BL mice, radiation dosimetry estimates of ⁶⁴Cu in normal human subjects were obtained, showing an effective dose (ED) of 32.2 μ (micro)Sv/MBq (weighted dose over 22 organs) and the small intestine as the critical organ for radiation dose (61 μGy/MBq for males and 69 μGy/MBq for females). Radiation dosimetry estimates for the patients with WD, based on biodistribution of ⁶⁴Cu in the Atp7b⁻/⁻ mice, showed a similar ED of 32.8 μ (micro)Sv/MBq (p = 0.53), with the liver as the critical organ for radiation dose (120 μSv/MBq for male and 161 μSv/MBq for female).Conclusions: Quantitative PET analysis demonstrates abnormal copper metabolism in the mouse model of WD with improved time-resolution. Human radiation dosimetry estimates obtained in this preclinical study encourage direct radiation dosimetry of ⁶⁴CuCl₂ in human subjects. The results suggest feasibility of utilizing ⁶⁴CuCl₂ as a tracer for noninvasive assessment of copper metabolism in WD with PET. [ABSTRACT FROM AUTHOR]

Abstract: Background: The natural course of Sturge-Weber syndrome (SWS) is poorly understood, although neurological symptoms are often progressive. Aims: To track longitudinal changes in brain glucose metabolism measured with positron emission tomography (PET) and their relation to clinical changes during the early course of SWS. Methods: Fourteen children (age 3 months to 3.9 years at enrollment) with SWS and unilateral leptomeningeal angioma underwent two consecutive glucose metabolism PET scans with a mean follow-up time of 1.2 years. Longitudinal changes of the extent of cortical glucose hypometabolism on the angioma side were measured and correlated with age, clinical seizure frequency and hemiparesis. Results: An increase in the size of the hypometabolic cortex was seen in 6 children, coinciding with an age-related increase in cortical glucose metabolism measured in unaffected contralateral cortex. These 6 patients were younger both at the initial (mean age 0.75 vs. 2.8 years; p<0.001) and the second scan (mean age 1.8 vs. 4.2 years; p=0.001) than those with no change in the extent of hypometabolic cortex (n=6). The area of cortical hypometabolism decreased in the two remaining children, and this was associated with resolution of an initial hemiparesis in one of them. Seizure frequency between the two scans was higher in children who showed progressive enlargement of cortical hypometabolism, as compared to those with no progression (p=0.008). Conclusions: In SWS, detrimental metabolic changes occur before 3 years of age coinciding with a sharp increase of developmentally regulated cerebral metabolic demand. Progressive hypometabolism is associated with high seizure frequency in these children. However, metabolic abnormalities may remain limited or even partially recover later in some children with well-controlled seizures. Metabolic recovery accompanied by neurological improvement suggests a window for therapeutic intervention in children with unilateral SWS. [Copyright &y& Elsevier]

Background: Experimental studies have shown that positron emission tomography (PET) with 13N-labeled ammonia provides accurate quantification of regional myocardial blood flow (MBF) under rest and stress conditions. To establish the clinical utility of this method, the interobserver variability and the temporal variability of serial measurements of blood flow and coronary flow reserve (CFR) must be known. This study investigated the interobserver and temporal reproducibility of 13N-labeled PET for measurement of MBF and CFR.Methods and Results: Initial and follow-up 13N-labeled ammonia PET studies were performed at rest and during adenosine infusion in six normal volunteers and six patients with stable coronary artery disease. Two investigators analyzed dynamically acquired data from the initial studies and one investigator analyzed the follow-up studies. Time-activity curves of tissue tracer activity were derived by a semiautomated sampling routine. A three-compartment model and curve-fitting algorithm were used to determine estimates of MBF in five myocardial regions. The interobserver correlations for MBF and CFR were excellent (r = 0.96 and 0.93, respectively). The interstudy correlation was good for rest and stress MBF (r = 0.87). The estimates of CFR on the initial and follow-up studies demonstrated a fair correlation (r = 0.72). For individual myocardial regions, there was considerable interstudy variability of stress MBF and CFR, with a mean percent difference for CFR of 19% +/- 19% in normal volunteers and 38% +/- 16% in patients with coronary disease. In normal subjects, regional CFR was highly reproducible (95%) when the values were defined as either normal (> or = 2.5) or reduced (< 2.5).Conclusions: The interobserver of reproducibility of 13N-labeled ammonia PET estimates of regional MBF was excellent. The temporal reproducibility of MBF and CFR was fair, with individual regions demonstrating substantial interstudy variability. [ABSTRACT FROM AUTHOR]

Background: Recent reports on 13N-labeled ammonia (13N-ammonia) positron emission tomographic (PET) imaging have suggested a relative reduction of measured tracer activity in the posterolateral wall. Such inhomogeneity of tracer distribution could potentially affect accuracy for detection of disease. The aim of this study was to compare the regional distribution of 13N-ammonia with 82Rb and 62Cu-labeled PTSM (62Cu-PTSM) to identify tracer-specific patterns that may be important in the clinical interpretation of cardiac flow studies.Methods and Results: Twenty-eight healthy volunteers underwent PET imaging at rest with either 13N-ammonia (n = 14), 82Rb (n = 8), or 62Cu-PTSM (n = 6). Eight subjects given 13N-ammonia also underwent imaging after adenosine. Activity measured in the posterolateral wall on transaxial images was significantly lower than in the septum for 13N-ammonia, both at rest (p < 0.005) and after adenosine (p < 0.05). No differences were detected for 82Rb or 62Cu-PTSM. The septum/posterolateral wall activity ratios for 13N-ammonia, 82Rb, and 62Cu-PTSM were 1.15 +/- 0.07, 1.00 +/- 0.06, and 0.97 +/- 0.08, respectively (p < 0.001). Regional analysis of image data showed the percent of maximal activity data for 13N-ammonia in the lateral wall to be less than that of other regions (p < 0.001) and in the inferior wall to be greater than in the anterior and lateral walls (p < 0.001). For 62Cu-PTSM, activity in the inferior wall was greater than that in other regions (p < 0.005). No regional differences were detected for 82Rb.Conclusions: The relatively increased wall activity with 13N-ammonia and 62Cu-PTSM is most likely due to cross-contamination of activity from the liver. The significant reduction in activity in the lateral wall with 13N-ammonia, which persists after adenosine, is most likely related to regional heterogeneity in 13N-ammonia retention and may reflect regional differences in metabolic-trapping mechanisms for 13N-ammonia. Further investigation is required to elucidate the underlying mechanism of this phenomenon. Reduced tracer retention in the lateral wall segment as a normal variant must be considered when evaluating clinical 13N-ammonia PET studies. [ABSTRACT FROM AUTHOR]

Abstract Background We studied the distribution and expression of translocator protein in the human brain using 11C-[R]-PK-11195 positron emission tomography (PK11195 PET) and evaluated age-related changes. Methods A dynamic PK11195 PET scan was performed in 15 normal healthy adults (mean age: 29 ±8.5 years (range: 20 to 49); 7 males) and 10 children (mean age: 8.8 ±5.2 years (range: 1.2 to 17); 5 males), who were studied for potential neuroinflammation but showed no focally increased PK11195 binding. The PET images were evaluated by calculating standard uptake values and regional binding potential, based on a simplified reference region model, as well as with a voxel-wise analysis using statistical parametric mapping. Results PK11195 uptake in the brain is relatively low, compared with the subcortical structures, and symmetrical. The overall pattern of PK11195 distribution in the brain does not change with age. PK11195 uptake was lowest in the frontal-parietal-temporal cortex and highest in the pituitary gland, midbrain, thalamus, basal ganglia, occipital cortex, hippocampus and cerebellum, in descending order. White matter showed negligible PK11195 uptake. Overall, brain PK11195 uptake increased with age, with midbrain and thalamus showing relatively higher increases with age compared with other brain regions. Conclusions The brain shows low PK11195 uptake, which is lower in the cortex and cerebellum compared with subcortical structures, suggesting a low level of translocator protein expression. There is no hemispheric asymmetry in PK11195 uptake and the overall pattern of PK11195 distribution in the brain does not change with age. However, brain PK11195 uptake increases with age, with the thalamus and midbrain showing relatively higher increases compared with other brain regions. This increase in uptake suggests an age-related increase in translocator protein expression or the number of cells expressing these receptors or both.

This study assessed the safety and efficacy of intravenous adenosine used as a coronary vasodilator in 18 pediatric patients with aortic valve disease or Kawasaki disease. Adenosine infusion effectively produced coronary vasodilation and was well tolerated. [ABSTRACT FROM AUTHOR]

The macrophage colony-stimulating factor 1 receptor (CSF1R) is almost exclusively expressed in microglia, representing a biomarker target for imaging of microglia availability. [ 11 C]CPPC has specific binding affinity to CSF1R and suitable kinetic properties for in vivo PET imaging of microglia. However, previous studies reported a low radiochemical yield, motivating additional research to optimize [ 11 C]CPPC radiochemistry. In this work, we report an automated radiosynthesis of [ 11 C]CPPC on a Synthra MeIPlus module with improved radiochemical yield. The final [ 11 C]CPPC product was obtained with excellent chemical/radiochemical purities and molecular activity, facilitating high-quality in-human PET imaging applications., Competing Interests: None., (AJNMMI Copyright © 2024.)

Purpose: Preclinical studies showed the tryptophan analog PET radiotracer 1-(2- 18 F-fluoroethyl)-L-tryptophan ( 18 F-FETrp) to accumulate in various tumors, including gliomas, and being metabolized via the immunosuppressive kynurenine pathway. In this first-in-human study, we tested the use 18 F-FETrp-PET in patients with neuroendocrine and brain tumors., Procedures: We applied dynamic brain imaging in patients with gliomas (n = 2) and multi-pass 3D whole-body PET scans in patients with neuroendocrine tumors (n =4). Semiquantitative analysis of organ and tumor tracer uptake was performed using standardized uptake values (SUVs). In addition, organ dosimetry was performed based on extracted time-activity curves and the OLINDA software., Results: Neuroendocrine tumors showed an early peak (10-min post-injection) followed by washout. Both gliomas showed prolonged 18 F-FETrp accumulation plateauing around 40 min and showing heterogeneous uptake including non-enhancing tumor regions. Biodistribution showed moderate liver uptake and fast clearance of radioactivity into the urinary bladder; the estimated effective doses were similar to other 18 F-labeled radioligands., Conclusions: The study provides proof-of-principle data for the safety and potential clinical value of 18 F-FETrp-PET for molecular imaging of human gliomas., (© 2023. The Author(s), under exclusive licence to World Molecular Imaging Society.)

The human brain is a prediction device, a view widely accepted in neuroscience. Prediction is a rational and efficient response that relies on the brain's ability to create and employ generative models to optimize actions over unpredictable time horizons. We argue that extant predictive frameworks while compelling, have not explicitly accounted for the following: (a) The brain's generative models must incorporate predictive depth (i.e., rely on degrees of abstraction to enable predictions over different time horizons); (b) The brain's implementation scheme to account for varying predictive depth relies on dynamic predictive hierarchies formed using the brain's functional networks. We show that these hierarchies incorporate the ascending processes (driven by reaction), and the descending processes (related to prediction), eventually driving action. Because they are dynamically formed, predictive hierarchies allow the brain to address predictive challenges in virtually any domain. By way of application, we explain how this framework can be applied to heretofore poorly understood processes of human behavioral thermoregulation. Although mammalian thermoregulation has been closely tied to deep brain structures engaged in autonomic control such as the hypothalamus, this narrow conception does not translate well to humans. In addition to profound differences in evolutionary history, the human brain is bestowed with substantially increased functional complexity (that itself emerged from evolutionary differences). We argue that behavioral thermoregulation in humans is possible because, (a) ascending signals shaped by homeostatic sub-networks, interject with (b) descending signals related to prediction (implemented in interoceptive and executive sub-networks) and action (implemented in executive sub-networks). These sub-networks cumulatively form a predictive hierarchy for human thermoregulation, potentiating a range of viable responses to known and unknown thermoregulatory challenges. We suggest that our proposed extensions to the predictive framework provide a set of generalizable principles that can further illuminate the many facets of the predictive brain. This article is categorized under: Neuroscience > Behavior Philosophy > Action Psychology > Prediction., (© 2023 Wiley Periodicals LLC.)

The cannabinoid subtype 1 receptor (CB1R) is highly expressed in the central nervous system and abnormalities in regional CB1R density are associated with neurodegenerative disorders. The PET tracer [ 18 F]FMPEP- d 2 is an inverse CB1R agonist which was shown to be suitable for non-invasive PET imaging. In this work, we reported the fully automated radiosynthesis of [ 18 F]FMPEP- d 2 on a Synthra RNplus research module. In a total synthesis time of 70 min, [ 18 F]FMPEP- d 2 was obtained in 2.2 ± 0.1 GBq (n = 3) with excellent radiochemical and chemical purity. Quality control test showed that [ 18 F]FMPEP- d 2 product meets all the release criteria for clinical patient use., Competing Interests: None., (AJNMMI Copyright © 2023.)

We introduce the Fast Algorithm for Motion Correction (FALCON) software, which allows correction of both rigid and nonlinear motion artifacts in dynamic whole-body (WB) images, irrespective of the PET/CT system or the tracer. Methods: Motion was corrected using affine alignment followed by a diffeomorphic approach to account for nonrigid deformations. In both steps, images were registered using multiscale image alignment. Moreover, the frames suited to successful motion correction were automatically estimated by calculating the initial normalized cross-correlation metric between the reference frame and the other moving frames. To evaluate motion correction performance, WB dynamic image sequences from 3 different PET/CT systems (Biograph mCT, Biograph Vision 600, and uEXPLORER) using 6 different tracers ( 18 F-FDG, 18 F-fluciclovine, 68 Ga-PSMA, 68 Ga-DOTATATE, 11 C-Pittsburgh compound B, and 82 Rb) were considered. Motion correction accuracy was assessed using 4 different measures: change in volume mismatch between individual WB image volumes to assess gross body motion, change in displacement of a large organ (liver dome) within the torso due to respiration, change in intensity in small tumor nodules due to motion blur, and constancy of activity concentration levels. Results: Motion correction decreased gross body motion artifacts and reduced volume mismatch across dynamic frames by about 50%. Moreover, large-organ motion correction was assessed on the basis of correction of liver dome motion, which was removed entirely in about 70% of all cases. Motion correction also improved tumor intensity, resulting in an average increase in tumor SUVs by 15%. Large deformations seen in gated cardiac 82 Rb images were managed without leading to anomalous distortions or substantial intensity changes in the resulting images. Finally, the constancy of activity concentration levels was reasonably preserved (<2% change) in large organs before and after motion correction. Conclusion: FALCON allows fast and accurate correction of rigid and nonrigid WB motion artifacts while being insensitive to scanner hardware or tracer distribution, making it applicable to a wide range of PET imaging scenarios., (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)

The radiotracer 1-(2-[ 18 F]fluoroethyl)-L-tryptophan (L-[ 18 F]FETrp or [ 18 F]FETrp) is a substrate of indoleamine 2,3-dioxygenase, the initial and key enzyme of the kynurenine pathway associated with tumoral immune resistance. In preclinical positron emission tomography studies, [ 18 F]FETrp is highly accumulated in a wide range of primary and metastatic cancers, such as lung cancer, prostate cancer, and gliomas. However, the clinical translation of this radiotracer into the first-in-human trial has not been reported, partially due to its racemization during radiofluorination which renders the purification of the final product challenging. However, efficient purification is essential for human studies in order to assure radiochemical and enantiomeric purity. In this work, we report a fully automated radiosynthesis of [ 18 F]FETrp on a Synthra RNPlus research module, including a one-pot two steps radiosynthesis, dual independent chiral and reverse-phase semipreparative high-performance liquid chromatography purifications, and solid-phase extraction-assisted formulation. The presented approach has led to its Investigational New Drug application and approval that allows the testing of this tracer in humans., (© 2023 John Wiley & Sons Ltd.)

The aim of the study was to evaluate the effect of reduced injected [18F]FDG activity levels on the quantitative and diagnostic accuracy of PET images of patients with non-lesional epilepsy (NLE).Nine healthy volunteers and nine patients with NLE underwent 60-min dynamic list-mode (LM) scans on a fully-integrated PET/MRI system. Injected FDG activity levels were reduced virtually by randomly removing counts from the last 10-min of the LM data, so as to simulate the following activity levels: 50 %, 35 %, 20 %, and 10 % of the original activity. Four image reconstructions were evaluated: standard OSEM, OSEM with resolution recovery (PSF), the A-MAP, and the Asymmetrical Bowsher (AsymBowsher) algorithms. For the A-MAP algorithms, two weights were selected (low and high). Image contrast and noise levels were evaluated for all subjects while the lesion-to-background ratio (L/B) was only evaluated for patients. Patient images were scored by a Nuclear Medicine physician on a 5-point scale to assess clinical impression associated with the various reconstruction algorithms.The image contrast and L/B ratio characterizing all four reconstruction algorithms were similar, except for reconstructions based on only 10 % of total counts. Based on clinical impression, images with diagnostic quality can be achieved with as low as 35 % of the standard injected activity. The selection of algorithms utilizing an anatomical prior did not provide a significant advantage for clinical readings, despite a small improvement in L/B (< 5 %) using the A-MAP and AsymBowsher reconstruction algorithms.In patients with NLE who are undergoing [18F]FDG-PET/MR imaging, the injected [18F]FDG activity can be reduced to 35 % of the original dose levels without compromising., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose: Pretreatment predictions of absorbed doses can be especially valuable for patient selection and dosimetry-guided individualization of radiopharmaceutical therapy. Our goal was to build regression models using pretherapy 68Ga-DOTATATE PET uptake data and other baseline clinical factors/biomarkers to predict renal absorbed dose delivered by 177Lu-DOTATATE peptide receptor radionuclide therapy (177Lu-PRRT) for neuroendocrine tumors. We explore the combination of biomarkers and 68Ga PET uptake metrics, hypothesizing that they will improve predictive power over univariable regression., Patients and Methods: Pretherapy 68Ga-DOTATATE PET/CTs were analyzed for 25 patients (50 kidneys) who also underwent quantitative 177Lu SPECT/CT imaging at approximately 4, 24, 96, and 168 hours after cycle 1 of 177Lu-PRRT. Kidneys were contoured on the CT of the PET/CT and SPECT/CT using validated deep learning-based tools. Dosimetry was performed by coupling the multi-time point SPECT/CT images with an in-house Monte Carlo code. Pretherapy renal PET SUV metrics, activity concentration per injected activity (Bq/mL/MBq), and other baseline clinical factors/biomarkers were investigated as predictors of the 177Lu SPECT/CT-derived mean absorbed dose per injected activity to the kidneys using univariable and bivariable models. Leave-one-out cross-validation (LOOCV) was used to estimate model performance using root mean squared error and absolute percent error in predicted renal absorbed dose including mean absolute percent error (MAPE) and associated standard deviation (SD)., Results: The median therapy-delivered renal dose was 0.5 Gy/GBq (range, 0.2-1.0 Gy/GBq). In LOOCV of univariable models, PET uptake (Bq/mL/MBq) performs best with MAPE of 18.0% (SD = 13.3%), and estimated glomerular filtration rate (eGFR) gives an MAPE of 28.5% (SD = 19.2%). Bivariable regression with both PET uptake and eGFR gives LOOCV MAPE of 17.3% (SD = 11.8%), indicating minimal improvement over univariable models., Conclusions: Pretherapy 68Ga-DOTATATE PET renal uptake can be used to predict post-177Lu-PRRT SPECT-derived mean absorbed dose to the kidneys with accuracy within 18%, on average. Compared with PET uptake alone, including eGFR in the same model to account for patient-specific kinetics did not improve predictive power. Following further validation of these preliminary findings in an independent cohort, predictions using renal PET uptake can be used in the clinic for patient selection and individualization of treatment before initiating the first cycle of PRRT., Competing Interests: Conflicts of interest and sources of funding: The authors declare that they have no conflicts of interest. This work was supported by grants R01CA240706 and P30CA046592 from the National Cancer Institute., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

We introduce multiple-organ objective segmentation (MOOSE) software that generates subject-specific, multiorgan segmentation using data-centric artificial intelligence principles to facilitate high-throughput systemic investigations of the human body via whole-body PET imaging. Methods: Image data from 2 PET/CT systems were used in training MOOSE. For noncerebral structures, 50 whole-body CT images were used, 30 of which were acquired from healthy controls (14 men and 16 women), and 20 datasets were acquired from oncology patients (14 men and 6 women). Noncerebral tissues consisted of 13 abdominal organs, 20 bone segments, subcutaneous fat, visceral fat, psoas muscle, and skeletal muscle. An expert panel manually segmented all noncerebral structures except for subcutaneous fat, visceral fat, and skeletal muscle, which were semiautomatically segmented using thresholding. A majority-voting algorithm was used to generate a reference-standard segmentation. From the 50 CT datasets, 40 were used for training and 10 for testing. For cerebral structures, 34 18 F-FDG PET/MRI brain image volumes were used from 10 healthy controls (5 men and 5 women imaged twice) and 14 nonlesional epilepsy patients (7 men and 7 women). Only 18 F-FDG PET images were considered for training: 24 and 10 of 34 volumes were used for training and testing, respectively. The Dice score coefficient (DSC) was used as the primary metric, and the average symmetric surface distance as a secondary metric, to evaluate the automated segmentation performance. Results: An excellent overlap between the reference labels and MOOSE-derived organ segmentations was observed: 92% of noncerebral tissues showed DSCs of more than 0.90, whereas a few organs exhibited lower DSCs (e.g., adrenal glands [0.72], pancreas [0.85], and bladder [0.86]). The median DSCs of brain subregions derived from PET images were lower. Only 29% of the brain segments had a median DSC of more than 0.90, whereas segmentation of 60% of regions yielded a median DSC of 0.80-0.89. The results of the average symmetric surface distance analysis demonstrated that the average distance between the reference standard and the automatically segmented tissue surfaces (organs, bones, and brain regions) lies within the size of image voxels (2 mm). Conclusion: The proposed segmentation pipeline allows automatic segmentation of 120 unique tissues from whole-body 18 F-FDG PET/CT images with high accuracy., (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)

Homeostatic centers in the mammalian brainstem are critical in responding to thermal challenges. These centers play a prominent role in human thermoregulation, but humans also respond to thermal challenges through behavior modification. Behavioral modifications are presumably sub served by interactions between the brainstem and interoceptive, cognitive and affective elements in human brain networks. Prior evidence suggests that interoceptive regions such as the insula, and cognitive/affective regions such as the orbitofrontal cortex and anterior cingulate cortex are crucial. Here we used dynamic causal modeling (DCM) to discover likely generative network architectures and estimate changes in the effective connectivity between nodes in a hierarchically organized thermoregulatory network (homeostatic-interoceptive-cognitive/affective). fMRI data were acquired while participants (N = 20) were subjected to a controlled whole body thermal challenge that alternatingly evoked sympathetic and parasympathetic responses. Using a competitive modeling framework (ten competing modeling architectures), we demonstrated that sympathetic responses (evoked by whole-body cooling) resulted in more complex network interactions along two ascending pathways: (i) homeostatic interoceptive and (ii) homeostatic cognitive/affective. Analyses of estimated connectivity coefficients demonstrated that sympathetic responses evoked greater network connectivity in key pathways compared to parasympathetic responses. These results reveal putative mechanisms by which human thermoregulatory networks evince a high degree of contextual sensitivity to thermoregulatory challenges. The patterns of the discovered interactions also reveal how information propagation from homeostatic regions to both interoceptive and cognitive/affective regions sub serves the behavioral repertoire that is an important aspect of thermoregulatory defense in humans., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This work set out to develop a motion-correction approach aided by conditional generative adversarial network (cGAN) methodology that allows reliable, data-driven determination of involuntary subject motion during dynamic 18 F-FDG brain studies. Methods: Ten healthy volunteers (5 men/5 women; mean age ± SD, 27 ± 7 y; weight, 70 ± 10 kg) underwent a test-retest 18 F-FDG PET/MRI examination of the brain ( n = 20). The imaging protocol consisted of a 60-min PET list-mode acquisition contemporaneously acquired with MRI, including MR navigators and a 3-dimensional time-of-flight MR angiography sequence. Arterial blood samples were collected as a reference standard representing the arterial input function (AIF). Training of the cGAN was performed using 70% of the total datasets ( n = 16, randomly chosen), which was corrected for motion using MR navigators. The resulting cGAN mappings (between individual frames and the reference frame [55-60 min after injection]) were then applied to the test dataset (remaining 30%, n = 6), producing artificially generated low-noise images from early high-noise PET frames. These low-noise images were then coregistered to the reference frame, yielding 3-dimensional motion vectors. Performance of cGAN-aided motion correction was assessed by comparing the image-derived input function (IDIF) extracted from a cGAN-aided motion-corrected dynamic sequence with the AIF based on the areas under the curves (AUCs). Moreover, clinical relevance was assessed through direct comparison of the average cerebral metabolic rates of glucose (CMRGlc) values in gray matter calculated using the AIF and the IDIF. Results: The absolute percentage difference between AUCs derived using the motion-corrected IDIF and the AIF was (1.2% + 0.9%). The gray matter CMRGlc values determined using these 2 input functions differed by less than 5% (2.4% + 1.7%). Conclusion: A fully automated data-driven motion-compensation approach was established and tested for 18 F-FDG PET brain imaging. cGAN-aided motion correction enables the translation of noninvasive clinical absolute quantification from PET/MR to PET/CT by allowing the accurate determination of motion vectors from the PET data itself., (© 2021 by the Society of Nuclear Medicine and Molecular Imaging.)