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MR imaging provides means for discriminating different patterns of Hypoxic-ischemic encephalopathy (HIE) and may distinguish most severe cases from less severe but is unable to predict long-term outcome. Diffusion tensor imaging (DTI) offers information for a more complete characterization of HIE. The purpose of this study is to compare the modifications of DTI parameters in newborns one week and six months following total-body cooling to healthy controls. Forty-seven cooled newborns were studied with MRI, 20 underwent follow-up at 6 months. 12 healthy newborns and nine children at 6 months were enrolled as control groups (HC). Inferior Longitudinal Fasciculus (ILF), Corpus Callosum Fasciculus (CCF), Corticospinal Tract (CST), Optical Tract (OT), Optic Radiation (OR) were generated in all subjects. DTI parameters were evaluated in basal ganglia (BG), thalamus (TH) and tracks. Statistical analysis was performed with MANOVA. In newborns HIE versus HC, there were significantly lower fractional anisotropy (FA) on OR and CST and higher axial diffusivity (AD), apparent diffusion coefficient (ADC) and radial diffusivity (RD) values on CST, BG and TH in HIE-N. At 6 months there were no significant grouping effects. The analysis showed a significant increase of FA, decrease of ADC, AD, RD after 6 months for HIE and HC. We observed modifications of parameter values in HIE newborns vs HC; however normalization of values at 6 months suggests that changes of parameters cannot be considered early biomarkers for evaluation of therapeutic hypothermia in newborns with moderate HIE and normal conventional MRI. [ABSTRACT FROM AUTHOR]

Aim of this work was the implementation and validation, for the Discovery-ST PET/CT (GE Medical Systems) system, of the acquisition-specific noise equivalent counts (AS-NEC) method to establish the amount of tracer to be injected in 3D [sup.18]F-FDG whole body (WB) PET studies to achieve the peak of the NEC (NEC-p) at the acquisition time. The AS-NEC method uses prompts, delayed events and detector dead-time of a single reference PET scan to calculate the full shape of the NEC curve. The method was implemented using a 3D decay series of the 70 cm NEMA 2001 (line source in a 20 cm diameter solid polyethylene cylinder) phantom and validated with the cylindrical NEMA 1994 (diameter, 20 cm; length, 20 cm) and NEMA 2001 IEC body phantoms. The NEC curves generated by the single frames of the phantom series, using the AS-NEC method, well correlated with the experimental NEC curves proving the validity of the method and the possible application to clinical studies. The AS-NEC model was then retrospectively applied on 40 3D [sup.18]F-FDG WB studies in a range of body mass index (BMI) between 16 and 30 (kg/[m.sup.2]) (6 under-weight (uw), 18 normal-weight (nw), 16 over-weight (ow)). For each acquisition frame of each patient study, the activity at the acquisition time, corresponding to the NEC-p was identified on the NEC curves. Furthermore, as the NEC curves show a region around the NEC-p with small variations (nearly a plateau), the values of radioactivity corresponding to a reduction of 1%, 3% and 5% with respect to NEC-p were also calculated to assess a possible reduction of the doses to be injected in clinical studies. The results show that the average activities at the acquisition time corresponding to the NEC-p were comparable for the three BMI classes: 336.7 MBq (sd = 22.2), 329.3 MBq (sd = 33.3), 344.1 MBq (sd = 48.1) for uw, nw and ow, respectively. Therefore, the total average NEC-p activity for the three BMI classes was 336.7 MBq (sd = 40.7). The mean values of the radioactivity at a reduction of 1%, 3 % and 5 % with respect to the NEC-p were: 284.9 MBq (sd = 40.7), 247.9 MBq (sd = 33.3) and 225.7 MBq (sd = 29.6) respectively. These results indicate the possibility to use, for the Discovery-ST, a single injection protocol of 448 MBq (for the range of BMI here considered) to have an activity at the acquisition time (after 45 min of uptake) of 336.7 MBq (NEC-p). Nevertheless, the plateau near the NEC-p suggests the possibility to reduce significantly the dose to be injected in clinical studies down to about 330 MBq, while preserving suitable NEC performance (-3%) with respect to the NEC-p. This result was supported by image quality assessment performed on reconstructed images of the NEMA 2001 IEC body phantom. Index Terms--Data processing, image analysis, position emission tomography.