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Low-field (<1T) magnetic resonance imaging (MRI) scanners remain in widespread use in low- and middle-income countries (LMICs) and are commonly used for some applications in higher income countries e.g. for small child patients with obesity, claustrophobia, implants, or tattoos. However, low-field MR images commonly have lower resolution and poorer contrast than images from high field (1.5T, 3T, and above). Here, we present Image Quality Transfer (IQT) to enhance low-field structural MRI by estimating from a low-field image the image we would have obtained from the same subject at high field. Our approach uses (i) a stochastic low-field image simulator as the forward model to capture uncertainty and variation in the contrast of low-field images corresponding to a particular high-field image, and (ii) an anisotropic U-Net variant specifically designed for the IQT inverse problem. We evaluate the proposed algorithm both in simulation and using multi-contrast (T1-weighted, T2-weighted, and fluid attenuated inversion recovery (FLAIR)) clinical low-field MRI data from an LMIC hospital. We show the efficacy of IQT in improving contrast and resolution of low-field MR images. We demonstrate that IQT-enhanced images have potential for enhancing visualisation of anatomical structures and pathological lesions of clinical relevance from the perspective of radiologists. IQT is proved to have capability of boosting the diagnostic value of low-field MRI, especially in low-resource settings., Comment: Accepted in Medical Image Analysis

Seizure activity is a ubiquitous and pernicious pathophysiology that, in principle, should yield to mathematical treatments of (neuronal) ensemble dynamics - and therefore interventions on stochastic chaos. A seizure can be characterised as a deviation of neural activity from a stable dynamical regime, i.e. one in which signals fluctuate only within a limited range. In silico treatments of neural activity are an important tool for understanding how the brain can achieve stability, as well as how pathology can lead to seizures and potential strategies for mitigating instabilities, e.g. via external stimulation. Here, we demonstrate that the (neuronal) state equation used in Dynamic Causal Modelling generalises to a Fokker-Planck formalism when propagation of neuronal activity along structural connections is considered. Using the Jacobian of this generalised state equation, we show that an initially unstable system can be rendered stable via a reduction in diffusivity (i.e., connectivity that disperses neuronal fluctuations). We show, for neural systems prone to epileptic seizures, that such a reduction can be achieved via external stimulation. Specifically, we show that this stimulation should be applied in such a way as to temporarily mirror epileptic activity in the areas adjoining an affected brain region - thus 'fighting seizures with seizures'. We offer proof of principle using simulations based on functional neuroimaging data collected from patients with idiopathic generalised epilepsy, in which we successfully suppress pathological activity in a distinct sub-network. Our hope is that this technique can form the basis for real-time monitoring and intervention devices that are capable of suppressing or even preventing seizures in a non-invasive manner.

1.5T or 3T scanners are the current standard for clinical MRI, but low-field (<1T) scanners are still common in many lower- and middle-income countries for reasons of cost and robustness to power failures. Compared to modern high-field scanners, low-field scanners provide images with lower signal-to-noise ratio at equivalent resolution, leaving practitioners to compensate by using large slice thickness and incomplete spatial coverage. Furthermore, the contrast between different types of brain tissue may be substantially reduced even at equal signal-to-noise ratio, which limits diagnostic value. Recently the paradigm of Image Quality Transfer has been applied to enhance 0.36T structural images aiming to approximate the resolution, spatial coverage, and contrast of typical 1.5T or 3T images. A variant of the neural network U-Net was trained using low-field images simulated from the publicly available 3T Human Connectome Project dataset. Here we present qualitative results from real and simulated clinical low-field brain images showing the potential value of IQT to enhance the clinical utility of readily accessible low-field MRIs in the management of epilepsy., Comment: 6 pages, 3 figures, accepted at ICLR 2020 workshop on Artificial Intelligence for Affordable Healthcare

MR images scanned at low magnetic field ($<1$T) have lower resolution in the slice direction and lower contrast, due to a relatively small signal-to-noise ratio (SNR) than those from high field (typically 1.5T and 3T). We adapt the recent idea of Image Quality Transfer (IQT) to enhance very low-field structural images aiming to estimate the resolution, spatial coverage, and contrast of high-field images. Analogous to many learning-based image enhancement techniques, IQT generates training data from high-field scans alone by simulating low-field images through a pre-defined decimation model. However, the ground truth decimation model is not well-known in practice, and lack of its specification can bias the trained model, aggravating performance on the real low-field scans. In this paper we propose a probabilistic decimation simulator to improve robustness of model training. It is used to generate and augment various low-field images whose parameters are random variables and sampled from an empirical distribution related to tissue-specific SNR on a 0.36T scanner. The probabilistic decimation simulator is model-agnostic, that is, it can be used with any super-resolution networks. Furthermore we propose a variant of U-Net architecture to improve its learning performance. We show promising qualitative results from clinical low-field images confirming the strong efficacy of IQT in an important new application area: epilepsy diagnosis in sub-Saharan Africa where only low-field scanners are normally available.

Random Field Theory has been used in the fMRI literature to address the multiple comparisons problem. The method provides an analytical solution for the computation of precise p-values when its assumptions are met. When its assumptions are not met the thresholds generated by Random Field Theory can be more conservative than Bonferroni corrections, which are arguably too stringent for use in fMRI. As this has been well documented theoretically it is surprising that a majority of current studies (~80%) would not meet the assumptions of Random Field Theory and therefore would have reduced sensitivity. Specifically most data is not smooth enough to meet the good lattice assumption. Current studies smooth data on average by twice the voxel size which is rarely sufficient to meet the good lattice assumption. The amount of smoothing required for Random Field Theory to produce accurate p-values increases with image resolution and decreases with degrees of freedom. There is no rule of thumb that is valid for all study designs but for typical data (3mm resolution, and greater than 20 subjects) residual smoothness with FWHM = 4 times voxel size should produce valid results. However, it should be stressed that for higher spatial resolution and lower degrees of freedom the critical smoothness required will increase sharply. This implies that researchers should carefully choose appropriate smoothing kernels. This can be facilitated by the simulations we provide that identify the critical smoothness at which the application of RFT becomes appropriate. For some applications such as presurgical mapping or, imaging of small structures, probing the laminar/columnar structure of the cortex these smoothness requirements may be too great to preserve spatial structure. As such, this study suggests developments are needed in Random Field Theory to fully exploit the resolution of modern neuroimaging.