Spinal Cord Imaging & More
Neuro Wednesday, 19 May 2021

Oral Session - Spinal Cord Imaging & More
Neuro
Wednesday, 19 May 2021 18:00 - 20:00
  • Variations of quantitative MRI metrics along the cervical spinal cord: multi-vendor, multi-center, multi-subject study
    Jan Valošek1,2 and Julien Cohen-Adad2,3
    1Department of Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic, 2NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada, 3Functional Neuroimaging Unit, CRIUGM, University of Montreal, Montreal, QC, Canada
    We established normative qMRI metrics along C2-C5 cervical spinal cord levels for different regions-of-interest (spinal cord, white and gray matter, white matter columns) for 3 major MRI vendors (Siemens, Philips, GE) in ~250 healthy subjects. 
    Figure 1: (a) Example of used vertebral levels from C2 to C5 on structural T1-w image and (b) example of FA map from C3 level with illustration of individual regions-of-interest defined based on probabilistic PAM50 atlas. Light blue - spinal cord (SC), red/light blue - gray matter (GM) and white matter (WM), yellow - ventral columns, light blue - lateral columns, green - dorsal columns.
    Figure 2: Variations of individual qMRI metrics across vertebral levels from C2 to C5 for 6 different regions-of-interest (spinal cord, white matter, gray matter, dorsal columns, lateral columns, ventral columns). Mean and standard deviation values are shown.
  • Exploring diffusion modeling for the human cervical spinal cord: an evaluation of 480 multicompartment models
    Kurt G Schilling1, Qi Yang2, Vishwesh Nath3, Rutger Fick4, Kristin P O'Grady1, Adam W Anderson2, Bennett A Landman1, and Seth A Smith1
    1Vanderbilt University Medical Center, Nashville, TN, United States, 2Vanderbilt University, Nashville, TN, United States, 3NVIDIA, Bethesda, MD, United States, 4TheraPanacea, Paris, France
    We used extensive diffusion datasets to evaluate a large number of biophysical models (N=480) in the in vivo human spinal cord and found that certain compartments, and various constraints, are necessary to model diffusion in the cord and fully capture the changes in the diffusion MRI signal. 
    Figure 1. Data and regions of interest (ROIs). Data consisted of 2 subjects scanned with a 26-shell protocol (35 DWIs + 1 b0 per shell), resulting in 936 image volumes per subject. This covers a range of q-space, including multiple diffusion times, b-values, and angular directions. 16 ROIs were automatically extracted based on registration to the spinal cord atlas, and are shown overlaid on the structural image, the b0 image, and the mean diffusion weighted image.
    Figure 2. Multi-compartment models. Models consist of some combination of restricted cylinder compartments (C1-C4), Gaussian compartment (G1-G2), Restricted sphere compartments (S1-S3), and CSF compartments, with 8 different types of constraints used in the modeling process. This results in 480 different possible multi-compartment biophysical models of spinal cord microstructure.
  • The good, the bad and the ugly : a retrospective study of image quality in human cervical spinal cord MRI at 7T
    Guillaume Frebourg1,2, Aurélien Massire1,2, Lauriane Pini1,2, Maxime Guye1,2, Bertrand Audoin2,3, Annie Veschueren2,4, Pierre-Hugues Roche5, and Virginie Callot1,2
    1Aix-Marseille University, CNRS, CRMBM, Marseille, France, 2AP-HM, Hôpital de la Timone, CEMEREM, Marseille, France, 3AP-HM, Hôpital de la Timone, Neurology Dept., Marseille, France, 4AP-HM, Hôpital de la Timone, Neuromuscular Disease Dept., Marseille, France, 5AP-HM, Hôpital Nord, Neurosurgery Dept., Marseille, France
    A retrospective evaluation of SC image quality from 66 subjects was performed. MP2RAGE and DTI provided the best image quality, hence opening great perspectives for clinical or multi-centric transfer. New RF coils and pTx should help mitigating identified penalizing factors. 
    Fig.5 – 7T MRI offers new perspectives for SC characterization. Some atypical presentations, with details not seen on 3T scanners are presented here. (a, b) reference HC, (c) MS lesion in posterior funiculi with atypical ventral gray horn shape, (d) strong vascular hyposignal, (e) central canal dilatation, (f) MS patient presenting with several lesions (blue *not seen at 3T), (g) ALS patient presenting with strong degeneration of lateral funiculi, (h) MND patient presenting with strong hypersignal in GM (snake eyes), (i) MND patient with severe atrophy of the central GM commissure.
    Fig. 1 – Anatomical and structural native image quality assessment of 4 MR sequences (TSE, MP2RAGE, MGE, DTI) along the whole volume or for each slice from C1 to C7, using scoring between 0 and 4. Average scores and success rate were calculated for each modality and cohort. Images with a score ≥ 2 were qualified as "GOOD” and considered for the success rate calculation. B1+ and B0 inhomogeneities were evaluated as well using relative variations in %. BMI: body mass index (kg/m2).
  • Detection of resting state correlations between white matter tracts in spinal cord using BOLD fMRI and their changes with injury
    Anirban Sengupta1, Arabinda Mishra1, Feng Wang1, Li Min Chen1, and John C. Gore1
    1Vanderbilt University Medical Center, Nashville, TN, United States
    Stimulus evoked BOLD fluctuations and correlated resting state BOLD signal was detected robustly in spinal cord WM. Resting state WM correlations followed a trend which mimicked spinal cord functional recovery after an injury. (33 words)  
    Figure4: (A) Connectivity matrix (absolute values) averaged over 15 runs of 5 monkeys at different time points (Pre-SCI, Post-SCI Stage1 (2 weeks), Post-SCI Stage2 (7-8 weeks) and Post-SCI Stage3 (16-22 weeks). (B) Box-plot of the connectivity values at different time points . The dotted line joins the median of the box-plots. Significantly different box-plots using Wilcoxon non-parametric test are denoted by * (p<0.05) and ** (p<0.01) .
    Figure 5: (A) Mean +/- SD of power spectra (0.01-0.1Hz) of all ICs (averaged over 15 runs of 5 monkeys ) at pre-and post-SCI stage 1. The shaded bar denotes the region where the drop in connectivity is conspicuously observed.(B) Mean of all IC’s power spectra at different time points i.e. pre- and post SCI stage1-3. (C) Box plot of averaged (0.01-0.1 Hz) spectral power for all ICs at different time points. The dotted line joins the median of the box-plots. Statistically significant difference using Wilcoxon non-parametric test are denoted by * (p <.05) and ** (p<.01).
  • Correlating advanced MRI and histopathological measurements of axons and myelin in human traumatic spinal cord injury
    Sarah Rosemary Morris1,2,3, Andrew Yung1,2,4, Valentin Prevost1,2,4, Shana George1, Andrew Bauman1,2,4, Piotr Kozlowski1,2,3,4, Farah Samadi1,5, Caron Fournier1,5, Lisa Parker6, Kevin Dong1, Femke Streijger1, Veronica Hirsch-Reinshagen1,5,6, G.R. Wayne Moore1,5,6, Brian K Kwon1,7, and Cornelia Laule1,2,3,5
    1International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada, 2Radiology, University of British Columbia, Vancouver, BC, Canada, 3Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada, 4UBC MRI Research Centre, Vancouver, BC, Canada, 5Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, 6Vancouver General Hospital, Vancouver, BC, Canada, 7Vancouver Spine Surgery Institute, Vancouver, BC, Canada
    Myelin and axon-sensitive MRI metrics were quantitatively correlated with histology for myelin and axons in human spinal cord injury tissue. Myelin MRI metrics correlated with myelin staining, but axon MRI and staining metrics did not correlate.
    Figure 1: MRI and histology data for patients from the International Spinal Cord Injury Biobank included in this study. Advanced MRI was collected 9mm above and 9mm below injury epicentre. IDI: injury-death interval; ihMT: inhomogeneous magnetization transfer; MWF: myelin water fraction; DTI: diffusion tensor imaging; RD: radial diffusivity; LFB: Luxol fast blue; FA: fractional anisotropy; AD: axial diffusivity; DBSI: diffusion basis spectrum imaging; FF: fibre fraction; pNF: phosphorylated neurofilament.
    Figure 4: Spearman correlations between Luxol fast blue (LFB) staining for myelin phospholipids and three myelin-sensitive MRI metrics (radial diffusivity (RD), myelin water fraction (MWF), inhomogeneous magnetization transfer (ihMT)). All three metrics had significant, moderately strong correlations with LFB. MWF had the strongest correlation, RD the weakest. T1D filtering slightly increased the strength of the correlation with ihMT.
  • Variability of the hemodynamic response function in the healthy human cervical spinal cord at 3 Tesla
    D Rangaprakash1 and Robert L Barry1
    1Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
    Functional MRI is confounded by the HRF, but the nature of this confound in the spinal cord is not well understood. We observed cervical cord HRF to have 6–9% within- and between-subjects variability in the gray matter and 3–5% in the white matter.
    Figure-4. Percentage of HRF variability in the gray matter. In both the runs, RH consistently showed about 6% variability across quadrants, spinal levels (=slices) and subjects. TTP showed higher variability than RH (7–9%) but seemed less consistent across runs. This lesser consistency could perhaps be due to the poorer temporal resolution of our data (VAT=2.08s) (this is also a limitation of the study), as TTP estimates are quantified in units of VAT.
    Figure-3. Simple statistics of response height (RH), time-to-peak (TTP) and full-width at half max (FWHM) in the cervical spinal cord. Mean ± standard deviation of HRF parameters aggregated across all quadrants, levels and subjects is shown for both runs. The last column comparing runs 1 and 2 shows that aggregated HRF parameters are consistent across runs. The last row comparing gray (GM) and white matter (WM) shows that RH and TTP are significantly higher in the GM.
  • Associations between cervical cord sodium concentration, neuronal density and macromolecular tissue volume in spinal cord injury
    Bhavana S Solanky1, Ferran Prados1,2, Francesco Grussu1,3, Marco Battiston1, Jon Stutters1, Selma Al-Ahmad4, Baris Kanber2, David Choi4, Jalesh Panicker5, and Claudia AM Gandini Wheeler-Kingshott1,6,7
    1NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London (UCL), London, United Kingdom, 2Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London (UCL), London, United Kingdom, 3Radiomics Group, Vall d’Hebron Institute of Oncology, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain, 4National Hospital For Neurology and Neurosurgery, London, United Kingdom, 5Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Queen Square Institute of Neurology, London, United Kingdom, 6Department of Brain & Behavioural Sciences, University of Pavia, Pavia, Italy, 7Brain Connectivity Centre Research Department, IRCCS Mondino Foundation, Pavia, Italy
    Spinal cord total sodium concentration (TSC) correlates significantly with cohort in cervical myelopathy patients and healthy controls. Trend of increased intraneurite and extracellular fractions with higher TSC in patients.

    Figure 1

    a) 2D-T2w gradient echo image with the corresponding 23Na MRS voxel (SV) positioning in the cervical spinal cord in yellow, b) representative 23Na spectra from in vivo and phantom scans, used to quantify total sodium concentration. Example of multi-shell diffusion NODDI maps for c) fiso (fraction of free protons) and d) ficvf (fraction of restricted protons) for extracellular and intraneurite space evaluation, d) macromolecular tissue volume (MTV) map to quantify MTV in the spinal cord.

    Figure 2.

    Results for total sodium concentration adjusted for gender in the cervical spinal cord (aTSC), in both healthy controls (HC) and cervical myelopathy patients (CM). a) boxplots for HC and CM aTSC (* p<0.05).

    Regression variable plots for aTSC in HC (blue) and CM (red) groups. aTSC correlations to b) ficvf (fraction of restricted protons, an indication of intracellular space) c) fiso (fraction of free protons, a measure of extracellular space) and d) macromolecular tissue volume (MTV).

  • Atlas-based Quantification of DTI measures in Typically Developing Pediatric Spinal Cord
    Shiva Shahrampour1, Benjamin De Leener2, Mahdi Alizadeh1, Devon Middleton1, Laura Krisa1, Adam Flanders1, Scott Faro1, Julien Cohen-Adad2, and Feroze Mohamed1
    1Thomas Jefferson University, Philadelphia, PA, United States, 2Polytechnique Montreal, Montreal, QC, Canada
    We were able to automatically delineate various white matter tracts of the healthy pediatric spinal cord. The normative DTI indices associated with those tracts were quantified. The effect of age on the maturation of the tracts was studied and showed significant difference using MD, RD and AD.
    Figure 1. Overview of template registration pipeline. Initially, T2-weighted scans are registered to the template (top row). DTI data acquired during the same scan session are then registered to the anatomical data and PAM 50 objects are warped to diffusion data (bottom row) to generate the pediatric WM spine atlas.
    Figure 3. Spinal cord WM atlas: A. An atlas of spinal white matter tracts derived from the Gray’s Anatomy atlas B. Generated white matter atlas of pediatric spinal cord overlaid on a b0 image. The selected tracts are labeled with multiple colors. C. The C3 level is marked in green color on the sagittal T2-weighted scan.
  • Detection of fine-scale functional networks in spinal cord and the effects of injury on intra- and inter-segmental networks
    Anirban Sengupta1, Arabinda Mishra1, Feng Wang1, Li Min Chen1, and John C. Gore1
    1Vanderbilt University Medical Center, Nashville, TN, United States
    Robust BOLD fMRI fluctuations were detected at the bilateral intermediate region and gray-commissure region of spinal cord. Selective disruption of dorsal column white matter tract damages the inter-segmental connectivity more than the intra-segmental connectivity.
    Figure 4. (A) Connectivity matrix at different time-points arranged such that the connectivities from same community are next to each other. Red boxes on the matrix highlight the communities formed using graph theory principles. (B) The resulting communities are shown in different colors overlaid on a grid matrix. The columns of grid matrix represent the seven ROI and the rows represent the five slices/segments. No IR component was observed from slice 2 and kept white in color. Note community structures change and hence their number and colors don’t match across time points.
    Figure 3: (A) Connectivity matrix averaged over 14 runs of 5 monkeys at different time points with intra-slice and neighboring inter-slice connectivities highlighted in black triangles and black box respectively. Box-plot of (B) intra-slice connectivities and (C) neighboring inter-slice connectivities at different time points. Box-plots for intra-slice and neighboring inter-slice are computed from their corresponding significant connectivity measures. Significantly different box-plots (Wilcoxon non-parametric test) are denoted by * (p<0.05) and * * (p<0.01) . .
  • Visualization technique for assessment of spinal cord fMRI data quality
    Kimberly J Hemmerling1,2 and Molly G Bright1,2
    1Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States, 2Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
    Spinal cord imaging data can be simply visualized during an fMRI processing pipeline as a 2D signal intensity heatmap. Different anatomical organizations of the heatmap show how the interpretation of structured variations in the data are affected.
    (A) Heatmap organized by tissue type and (B) by vertebral level (C3-C7) in a BH scan. Two structures of motion are notable in these plots: a more prolonged movement indicated by the bracket that appears predominantly in the Rz and Ty motion traces, and a brief movement indicated by the arrows that is most pronounced in Rx, Rz, and Ty. The prolonged movement is discernible in GM and in WM tissues. The brief movement appears to have a more continuous gradation along the y-axis when organized by vertebral level, and the signal increases in magnitude from C3 to C7.
    Three heatmaps of a BH scan organized first by (A) vertebral level (C3-C7). Red arrows indicate the location of BHs which coincide with the PETCO2 and HR traces above the heatmap. (B) Heatmap reorganized by GLM derived t-statistics for HR. (C) Heatmap reorganized by GLM derived t-statistics for PETCO2. Motion regressors were also included in the GLM but are not shown here. For simplicity of the color scale, the absolute values of the t-statistics are shown. Though the organization is changed, the structured variation from the BH paradigm is visible in all three heatmap variations.
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Digital Poster Session - Spine & Nervous System Imaging
Neuro
Wednesday, 19 May 2021 19:00 - 20:00
  • Application of QSM in SPIO - labeled stem cell transplantation in Beagles with acute spinal cord injury
    Junting Zou1, Jilei Zhang2, Zhao Xiance2, Yuanyuan Xie1, Bing Zhang1, and Xiaoli Mai1
    1Nanjing Drum Tower Hospital, Nanjing, China, 2Philips Healthcare, Shanghai, China
    The SPIO-huc-MSCs are traced in vivo for 28 days by T2*WI. By quantifying iron concentration, QSM technology can be used to dynamically trace SPIO labeled stem cells in vivo.
    FIG. 4. QSM image of SPIO.Mag: Amplitude map, in which nano-iron oxide is black; QSM: The post-processed susceptibility distribution diagram, in which nano-iron oxide is white. We observed characteristic SPIO signals in the T2* hypointense signal region.
    FIG. 5. Trend graphs of T2* values and susceptibility values changing over time.The susceptibility values per unit pixel decrease with time, and the total volume of iron increases with time. The T2* values also show a trend of increasing with time.
  • Neurometabolic Analysis in Amyotrophic Lateral Sclerosis: A 1H-[13C]-NMR investigation
    Dipak Roy1 and Anant Bahadur Patel1
    1NMR Microimaging and Spectroscopy Facility, Centre for Cellular and Molecular Biology, Hyderabad, India
    In this study, we investigated the neurometabolic and astroglial activity in the SOD1G37R mouse model of ALS. Our findings suggest reduced neuronal and increased astroglial activity in the spinal cord. However, the activities of astroglia and neurons were elevated in the cerebral cortex.
    Figure 3: Cerebral Metabolic rates of glucose oxidation (CMRGlc(Ox)) in A. Cerebral cortex and B. Spinal cord. The bar graph represents the mean±SD of the group.
    Figure 4: Cerebral Metabolic rates of acetate oxidation (CMRAce(Ox)) in A. Cerebral cortex and B. Spinal cord. The bar graph represents the mean±SD of the group.
  • 3D-MP2RAGE T1 mapping to characterize regional cervical spinal cord impairments in  ALS and MS patients.
    Samira Mchinda1,2, Sarah Demortière3, Henitsoa Rasoanandrianina4, Claire Costes1,2, Jean Pelletier2,5, Shahram Attarian6, Aude-Marie Grapperon6, Bertrand Audoin2,5, Annie Vershueren6, and Virginie Callot1,2
    1Aix-Marseille Univ, CNRS, CRMBM, Marseille, France, 2APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France, 3APHM, Hôpital Universitaire Timone, Neurology Department, Marseille, France, 4Departement of Research and Innovation, Olea Medical, La Ciotat, France, 5. APHM, Hôpital Universitaire Timone, Neurology Department, Marseille, France, 6APHM, Hôpital Universitaire Timone, Reference Center for Neuromuscular Disorders and ALS, Marseille, France
    A 3D-MP2RAGE sequence previously optimized for 3T cervical cord imaging was applied for the first time to patients with MS and ALS, and their controls. Robust, allowing for cord CSA measurements, and potential specificity to disease, the MP2RAGE may be a technique of choice for clinical studies.
    Fig.5: Mean normal appearing T1-MP2RAGE map calculated over all MS patients (B) (after lesion filling) and age matched HC (A) in the PAM50 space and lesion distribution map (C). T1 values in NA tissues were statistically higher in MS patients (NAWM= 969±64/NAGM=970±47ms) as compared to HC_MS (902±22 and 939±21). Impairments were more particularly marked in NAaiGM in the upper cervical levels and in the whole WM, especially in CST/LST (p<0.0001).
    Fig.2: Representative T1-MP2RAGE maps obtained on HC (A), MS (B) and ALS (C) and the selected ROIs. For the MS patient, red arrows point on GM/WM lesions
  • Interpreting a machine learning model: radiomics in cervical spondylotic myelopathy postoperative recovery prediction
    Mengze Zhang1, Hanqiang Ouyang1, Dan Jing1, Jiangfang Liu1, Chunjie Wang1, Huishu Yuan1, and Liang Jiang1
    1Peking University Third Hospital, Beijing, China
    Radiomics features are potential indicators for predicting CSM patients’ postoperative recovery. The run variance was the most important feature in the radiomic-feature-based model.
    Fig 1. The pipeline of segment, normalization, scaling, feature extraction, feature selection, and model building.
    Fig 4. The partial dependence plots, the local dependence plots, and the accumulated dependence plots for each feature.
  • Characterizing 1-Year Development of Cervical Cord Atrophy Across Different MS Phenotypes: A Voxel-Wise, Multicenter Analysis
    Paola Valsasina1, Maria A. Rocca1,2,3, Claudio Gobbi4,5, Chiara Zecca4,5, Alex Rovira6, Xavier Montalban7, Hugh Kearney8, Olga Ciccarelli8, Lucy Matthews9, Jacqueline Palace9, Antonio Gallo10, Alvino Bisecco10, Achim Gass11, Philipp Eisele11, and Massimo Filippi1,2,3,12,13
    1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy, 2Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy, 3Vita-Salute San Raffaele University, Milan, Italy, 4Multiple Sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Civic Hospital, Lugano, Switzerland, 5Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland, 6Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain, 7Department of Neurology/Neuroimmunology, Multiple Sclerosis Center of Catalonia, Hospital Universitari Vall d’Hebron, Barcelona, Spain, 8NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, United Kingdom, 9Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom, 10Department of Advanced Medical and Surgical Sciences, and 3T MRI Center, University of Campania “Luigi Vanvitelli”, Naples, Italy, 11Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany, 12Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy, 13Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
    Longitudinal, voxel-wise analysis of patients with multiple sclerosis showed that cervical cord atrophy progressed at 1-year follow-up, was more widespread in relapsing-remitting MS than in other phenotypes and predicted 1-year clinical disability.
    Figure 2. Sagittal and axial views at various cervical cord levels showing clusters of significant cord atrophy progression at 1-year follow-up (color-coded for t-values, p<0.001 for display purposes) in: A) multiple sclerosis (MS) patients, considered as a whole; B) relapsing-remitting (RR) MS patients; and C) progressive (P) MS patients. Red boxes indicate clusters of cord atrophy progression significant at the time x group interaction vs HC. Abbreviations: L=left; R=right; A=anterior; P=posterior.
    Figure 1. Sagittal and axial views at various cervical cord levels showing clusters of significant cord atrophy differences (color-coded for t-values, p<0.001 for display purposes) in: A) multiple sclerosis (MS) patients, considered as a whole, vs healthy controls (HC); B) clinically isolated syndrome (CIS) patients vs HC; C) relapsing-remitting (RR) MS vs CIS patients; and D) progressive (P) MS vs RRMS patients. Abbreviations: L=left; R=right; A=anterior; P=posterior.
  • Free Water Eliminated White Matter Tract Integrity of Spinal Cord in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder
    Masaaki Hori1,2, Kouhei Kamiya1,2, Akifumi Hagiwara2,3, Kazumasa Yokoyama4, Issei Fukunaga5, Katsuhiro Sano2, Koji Kamagata2, Katsutoshi Murata6, Shohei Fujita2, Christina Andica2, Akihiko Wada2, Julien Cohen-Adad7, and Shigeki Aoki2
    1Radiology, Toho University Omori Medical Center, Tokyo, Japan, 2Radiology, Juntendo University School of Medicine, Tokyo, Japan, 3Radiology, David Geffen School of Medicine, Los Angeles, CA, United States, 4Neurology, Juntendo University School of Medicine, Tokyo, Japan, 5Juntendo University School of Medicine, Tokyo, Japan, 6Siemens Japan K.K, Tokyo, Japan, 7NeuroPoly Lab, Polytechnique Montreal, Montréal, QC, Canada
    Fractional anisotropy was significant higher in spinal cord white matter in multiple sclerosis patients, compared with Neuromyelitis optica patients using free water eliminated kurtosis-based white matter tract integrity.
    Figure1. Representative metric maps of a case with multiple sclerosis (41-year-old woman) and analysis process.
    Figure 2. The results of all metrics values of white matter of spinal cords at each spinal level in patients with MS and NMOSD.
  • Spinal cord neurodegeneration rostral and caudal to a degenerative cervical myelopathy (DCM): a quantitative MRI study
    Kevin Vallotton1, Gergely David1, Armin Curt1, Michael Fehlings2, Claudia A. M. Gandini Wheeler-Kingshott3,4,5, Rebecca S. Samson6, Julien Cohen-Adad7, Muhammad Ali Akbar2, Patrick Freund1,8,9, and Maryam Seif1
    1Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, Zuerich, Switzerland, 2University of Toronto Spine Program and Toronto Western Hospital, Toronto, Ontario, Canada, Toronto, ON, Canada, 3NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London (UCL), London, United Kingdom, 4Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy, Pavia, Italy, 5Brain Connectivity Center Research Department, IRCCS Mondino Foundation, Pavia, Italy, 6Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, London, United Kingdom, London, United Kingdom, 7Functional Neuroimaging Unit, CRIUGM, University of Montreal, Montreal, QC, Canada, Montreal, QC, Canada, 8Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, 9Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom
    Based on T2*- and DTI-weighted MRI, similar structural changes were observed in cervical and lumbar cord of degenerative cervical myelopathy (DCM) patients. The extent of cervical and lumbar cord atrophy is associated between each other in individual DCM patients.
    Figure 1. MRI protocol including T2*-weighted images and Diffusion Tensor-derived maps as conducted at the lumbar enlargement level (T11-L1).
    Figure 2. Box plots of cross-sectional areas of total spinal cord, grey and white matter areas in the cervical cord (at C2/3 level) and in the lumbar enlargement (at level T11-L2) of both DCM patients and healthy controls. ***p<0.001, *p<0.05.
  • Feasibility of cervical spinal cord cross-sectional measurements from 3D T1w sagittal head MRI at 7T
    Vanessa Wiggermann1, Henrik Lundell1, Mads Alexander Just Madsen1, Christopher Fugl Madelung1, and Hartwig Roman Siebner1,2,3
    1Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark, 2Dept. of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark, 3Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
    We showed that automated spinal cord measurements in healthy controls, multiple sclerosis and Parkinson’s patients at 7T are consistent between segmentation tools and with 3T data, if images with similar voxel sizes are used. At higher spatial resolution, smaller area estimates are obtained.
    Figure 2: Comparison of average CSA measurements at the C1/C2 level using SCT and the in-house technique (LT). Although SCT generally obtained lower CSA measurements, the relative reproducibility of CSA was very high, both on an individual level (see left regression of individual data) and on a group level (compare middle and right). Statistical analysis involved a non-parametric Kruskal-Wallis test with post-hoc multiple comparison correction by Tukey-Kramer. P-values are uncorrected for testing both SCT and LT.
    Figure 1: Example spinal cord segmentations at the C1/C2 level, SCT (left), LT (right). MPRAGE images without overlaid segmentation are shown for reference in the center. For display purposes, the SCT segmentations were upsampled to the LT standard and slices were visually matched. Arrows point toward partial segmentation of spinal nerve roots. For subject 1, (top row, female, RRMS, 33 years), mean SCT-CSA was 65.04 mm2, compared to LT-CSA=74.03 mm2. For subject 2, (bottom row, female, HC, 42 years), mean SCT-CSA was 53.49 mm2, compared to LT-CSA=61.26 mm2.
  • Quantitative Magnetic Resonance Imaging Assessment of Cervical Spinal Cord Injury in Rats
    Seung Yi Lee1, Shekar Kurpad2, and Matthew Budde2
    1Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States, 2Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
    The association of chronic motor function with the extent of edema, hemorrhage and axonal injury was investigated.  Filtered-DWI improved axonal damage presentation and a rat-specific MRI template was constructed for inter-subject/modality registration. 

    Figure 1 Multi-contrast MRI in acute cervical cord contusion

    The extent of the cord damage is captured in different modalities in both unilateral- and bilateral contusion injury. Edema (hyperintensity, T2w), hemorrhage (hypointensity, T2*w), vasogenic edema (blue, black triangle), and cytotoxic edema (red, white triangle) are evident in their respective contrasts. fDWI images clearly delineates focal axonal damage compared to T2w, T2*w and DTI.

    Figure 2 Inter-subject registration pipeline

    A histologic spinal cord atlas was digitized across all spinal cord levels to generate a template with pseudo T2-weighted contrast used for MRI registration. Manually marked spinal cord level aided initial z-level alignment and straightening followed by x-y plane registration to the template. Registered single subject images were averaged and registered iteratively across all subjects with the group mean image showing clear spinal cord anatomy.

  • Increased Dorsal Network Functional Connectivity is Associated with DTI Indices in the Cervical Spinal Cord in Relapsing-Remitting MS
    Anna JE Combes1,2, Kristin P O'Grady1,2, Baxter P Rogers1,2, Kurt G Schilling1,2, Richard D Lawless2,3, Mereze Visagie2, Delaney Houston2, Colin D McKnight1, Francesca R Bagnato4, John C Gore1,2,3,4, and Seth A Smith1,2,3
    1Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 2Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, 3Biomedical Engineering, Vanderbilt University, Nashville, TN, United States, 4Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
    DTI and resting-state fMRI were acquired in the cervical cord in a relapsing-remitting MS group with low disability. Higher functional connectivity (FC) in the dorsal network was correlated with DTI markers of tissue damage, suggesting increased FC may be a pathological feature in this group.
    Figure 2. Example slices for a control (M, 35 years old) and a participant with MS (F, 42 years old, EDSS 1.5). Left to right: anatomical T2*-weighted mFFE for segmentation; grey matter horns regions of interest overlaid on average functional run; FA and RD diffusion maps. FA = Fractional Anisotropy. GM = Grey Matter. RD = Radial Diffusivity.
    Figure 4. Ventral and dorsal network z-scores by subgroups: healthy controls (HC), MS with low FA/RD, MS with high FA/RD. FA = Fractional Anisotropy. RD = Radial Diffusivity. NS = Non Significant. *Significant at p<.05.
  • Preoperative Spinal Cord Perfusion has the ability to predict the postoperative prognosis for Patients with Cervical Spondylotic Myelopathy
    Chunyao Wang1, Xiao Han2, Wen Jiang2, Guangqi Li1, Jinchao Wang2, Donghang Li2, Hua Guo1, and Huijun Chen1
    1Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China, 2Jishuitan hospital, Beijing, China
    CSM is a chronic progressive disorder of spinal cord with a relatively ill-defined onset of pathogenesis. This study investigated the potential of preoperative blood supply condition measured by DSC MRI with a nonparametric model in prediction of postoperative prognosis for patients with CSM
    Fig 3. t-test results of 5 parameters between poor & good recovery groups. Results show that patients in poor-recovery group have significant lower rEnhance, slope1, but possess increased FWHM
    Table 2. Univariate/multivariate Logistic Regression for prediction of poor postoperative recovery (mJOA≤15)
  • Analysis of signal and contrast in a multi-echo gradient-echo sequence of the lumbosacral cord: recommendations for number of echoes and averages
    Silvan Büeler1, Patrick Freund2,3,4,5, Martina Liechti1, and Gergely David1,2
    1Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland, 2Spinal Cord Injury Center, Balgrist University Hospital Zurich, University of Zurich, Zurich, Switzerland, 3Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom, 4Department of Neurophysics, , Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, 5Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom
    When imaging the lumbosacral cord with a multi-echo gradient-echo sequence, we recommend a minimum of 3 and maximum of 4 echoes as an optimal trade-off between segmentability and artifact level, and 6 signal averages (or measurements) for robust segmentations of gray and white matter.
    Fig. 1: A: T2-weighted sagittal turbo spin echo image of the lower spine used for slice positioning. The 20 axial-oblique slices are positioned individually in each subject to encompass the lumbar enlargement and the conus medullaris. B: Corresponding axial slices from caudal (slice 1) to rostral (slice 20) direction. C: In each slice (here: slice 14 is shown), spinal cord and gray matter (GM) are segmented manually and a cerebrospinal fluid (CSF) mask is defined anterior to the spinal cord. The white matter (WM) mask is obtained by subtracting SC and GM masks.
    Fig. 3: Dependency of signal-to-noise ratio (SNR) of gray matter (GM) (blue curve) and white matter (WM) (orange curve) on the number of echoes. The two curves run largely similar, increasing from 1 to 2 echoes and minimally decreasing afterwards. B: Dependency of contrast-to-noise ratio (CNR) between GM/WM (blue curve) and WM/CSF (orange curve) on the number of echoes. While WM/CSF CNR steadily increases with more echoes, the WM/CSF contrast exhibits a very flat peak at 3-4 echoes. In both subplots, error bars represent standard deviation across subjects (n=10).
  • Lumbar disc degeneration changes in sedentary and prolonged-standing population assessed by T1ρ and T2 mapping Magnetic Resonance Imaging
    Zeng qi1, Zhang ziwei1, Nie lisha2, Zhu xia1, Huang zaoshu1, and Song lingling1
    1The affiliated hospital of Guizhou mdeical university, Guizhou guiyang, China, 2GE Healthcare,MR Resertch China, Beijing, China
     We found that prolonged-standing is more likely to affect the L1 / 2 level discs, while sedentary is more likely to affect the lower segment discs (L4 / 5 and L5/S1).
    Figure2. Two 29-year-old men, prolonged-standing affected L1/2 disc, sedentary affected L5/S1 disc, the nucleus pulposus was poorly demarcated from the annulus fibrosus
    Figure 1. L4/L5、L5/S1 NP values were negatively correlated with age
  • Spinal Cord Compression is Associated with Brain Plasticity in Degenerative Cervical Myelopathy
    Alicia Cronin1,2, Sarah Detombe3, Camille Duggal2, Neil Duggal3, and Robert Bartha1,2
    1Medical Biophysics, University of Western Ontario, London, ON, Canada, 2Centre for Functional and Metabolic Mapping, Robarts Research Institute, London, ON, Canada, 3Clinical Neurological Sciences, University Hospital, London Health Sciences Centre, London, ON, Canada
    This study found that degenerative cervical myelopathy (DCM) patients with severe spinal cord compression also demonstrated larger regions of cortical activation in the primary motor cortex during a controlled finger-tapping task.
    Figure 1: T2-weighted image of the cervical spinal cord of a DCM patient showing the segmented cord in red and the compression site displayed on the inset.

    Figure 2: A: % BOLD signal correlation with spinal cord compression volume when tapping with left hand. B: % BOLD signal correlation with spinal cord compression volume when tapping with right hand.

  • An optimized MP2RAGE sequence for studying both brain and cervical spinal cord
    Arash Forodighasemabadi1,2,3,4, Henitsoa Rasoanandrianina1,2,3,4, Mohamed Mounir El Mendili1,2, Maxime Guye1,2, and Virginie Callot1,2,4
    1Aix-Marseille Univ, CNRS, CRMBM, Marseille, France, 2APHM, Hopital Universitaire Timone, CEMEREM, Marseille, France, 3Aix-Marseille Univ, Université Gustave Eiffel, LBA, Marseille, France, 4iLab-Spine International Associated Laboratory, Montreal, Canada, Marseille, France
    This work proposes an optimized MP2RAGE protocol and postprocessing pipeline for simultaneous brain and cervical spinal cord (BCSC) T1 mapping at 3T, providing large spatial coverage, high CNR, low B1+ sensitivity, and short acquisition time, while benefiting from high reproducibility.
    Figure 1: Relationships between UNI signal and estimated T1 value. (a) The protocol Pr0, provides the highest CNR at the expense of acquisition time. (b) The protocol Pr1 provides a high CNR, while allowing to cover brain and CSC in less than 8 minutes. It should be noted that a ±20% B1+ variation for a T1 of 1350 (brain GM) for instance, leads to an estimation error of 8.7%, showing the necessity for B1+ correction. Protocols previously optimized for (c) studying brain2,14, and (d) SC7, independently. (e) Derivative of the UNI signal, providing an indication on tissue discrimination.
    Figure 3 : A representation of the UNI-denoised image (no unit) for Pr1 and 3 on brain and Pr1 and 2 along the cervical SC. In the bottom-right image we can see a zoomed-out section of spine, which shows the need for sub-millimetric resolution for imaging SC. We can observe a nice delineation between different structures of brain and SC, with a higher signal difference (contrast) between GM and WM for the optimized protocol 1 (arrows).
  • Single-Shot Inner-Field-of-View Fast Spin Echo Imaging with MAVRIC: Access to the Spinal Cord Close to Metallic Implants
    Caspar Florin1 and Jürgen Finsterbusch1
    11Department of Systems Neuroscience, University Medical Center Hamburg–Eppendorf, Hamburg, Germany
    Single-shot inner-field-of-view fast spin-echo imaging with MAVRIC is more robust close to metallic implants than EPI and could be used for DWI of the spinal cord.
    (a) Localizer of a volunteer with metallic implants and measured slice stack highlighted in orange. (b) 30 1x1x4mm³ transversal ZOOM EPI acquisitions (c) 30 1x1x4mm³ transversal ZOOM MAVRIC FSE acquisitions with a frequency increment of 500 Hz and 9 steps. The spinal cord is highlighted by red dotted ellipsoids.
    (a) Localizer of water phantom with a diameter of 2.8 cm, surrounded by 4 aluminum screws, with 2.9 cm and 3.3 cm to each other. (b) 7 out of 20 inner FOV FSE MAVRIC acquisitions with a resolution of 1x1x4mm³ (c) 7 out of 20 inner FOV FSE MAVRIC acquisitions with a resolution of 1x1x4mm³ and 81 MAVRIC frequency steps of Δω 500 Hz
  • Impact of manual segmentation on the non-linear registration of a spinal cord atlas to functional space
    Mark A Hoggarth1, Max C Wang2, Kimberly J Hemmerling1,2, Zachary A Smith3, Kenneth A Weber II4, and Molly G Bright1,2
    1Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States, 2Biomedical Engineering, Northwestern University, Evanston, IL, United States, 3Neurosurgery, Oklahoma University, Oklahoma City, OK, United States, 4Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
    Performing non-linear registration of fMRI improved DSC and agreement at the edges of the spinal cord between an expert rater and 8 raters with varied levels of experience.
    Outline of data processing, starting with temporal mean of fMRI time series, manually drawn spinal cord masks and comparison; then non-linear registration using the Spinal Cord Toolbox; then the post-registration segmentations and comparison.
    Illustration of edge masks and box plots of percent of voxels in agreement along the edges in input masks and registered segmentations across all raters and participants. Edge masks were created by a 2-pixel erosion subtracted from 2-pixel dilation of the expert mask. Bar in box plot equates significance (p < 0.01).
  • Quantitative Evaluation of Normal Lumbosacral Plexus Nerve Using Diffusion Tensor Imaging with Multiband SENSE
    Nan Zhang1, Qingwei Song2, Ailian Liu2, Renwang Pu2, Haonan Zhang2, Jiazheng Wang3, and Liangjie Lin3
    1The First Affilliated Hospital of Dalian Medical University, Dalian, China, 2The First Affiliated Hospital of Dalian Medical University, Dalian, China, 3Philips Healthcare, Beijing, China, Beijing, China
    This study indicated that MB SENSE=2 was recommended for DTI on normal lumbosacral plexus nerve, which facilitated a 50% reduction in scan time than conventional SENSE accelerated DTI.  
    Figure1 Upper row:b=0s/mm2,b=800s/mm2,mean diffusivity(MD),and fraction anisotropy(FA)map.Bottom row:Fiber tractography(FT)results of the iumbosacral nerves,a maximal intensity projection(MIP),FT and T2WI FFE combined,and disply of the segments at each level region of interest(ROI) placement.Dates obained by using diffusion tensor imaging based on SENSE1.6.
    Figure2 Upper row:b=0s/mm2,b=800s/mm2,mean diffusivity(MD),and fraction anisotropy(FA)map.Bottom row:Fiber tractography(FT)results of the iumbosacral nerves,a maximal intensity projection(MIP),FT and T2WI FFE combined,and disply of the segments at each level region of interest(ROI) placement.Dates obained by using diffusion tensor imaging based on mutiband SENSE 2.
  • Clinical Feasibility Study of Accelerated 2D Magnetic Resonance Spinal Imaging Using Compressed Sensing Algorithm
    Jianxing Qiu1, Jing Liu1, Qingping Gu2, Peng Sun2, and Naishan Qin1
    1Peking University First Hospital, Beijing, China, 2Philips Healthcare, Beijing, China, Beijing, China
    CS-MRI was valuable for improving the overall workflow of 2D spinal MRI with scanning time saved and image quality improved.
    Image quality comparisons of cervical MRI between Con-MRI and CS-MRI.A-C: Con-MRI. D-F: CS-MRI.
    Image quality comparisons of thoracic MRI between Con-MRI and CS-MRI.A-C: Con-MRI. D-F: CS-MRI
  • Multi-parameter model proposes a comprehensive imaging index for degenerative cervical myelopathy diagnosis: a preliminary study
    Yuancheng Jiang1, Xiao Han2, Jinchao Wang2, Sisi Li3, Ke Wang4, Yandong Liu5, Wei Liang5, Wen Jiang5, and Hua Guo3
    1Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, 2Department of spine surgery, Beijing Jishuitan Hospital, Beijing, China, 3Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, 4Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, United States, 5Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
    We find that study for metrics in different ROIs is necessary. By designing a multi-parameter model, we aim to propose a comprehensive imaging index that correlates well with mJOA.
     
    Fig. 2 Calculated DTI and MTR metrics for the non-compressed slice (No. 1) and the compressed slice (No. 2).
    Fig. 3 Spearman correlation between mJOA and FA (left), mJOA, and MTR (middle). Both 2 metrics are extracted from DC at C2 level. The direct correlation between FA and MTR is also significant (right).
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Digital Poster Session - Spine Imaging/Nervous System & More
Neuro
Wednesday, 19 May 2021 19:00 - 20:00
  • High-resolution anatomical and diffusion-weighted imaging in peripheral nerves at 7 Tesla using quantitative Double-Echo in Steady-State
    Bragi Sveinsson1,2, Robert L Barry1,2,3, Olivia Rowe1,2, Jason Stockmann1,2, Daniel J Park1, Peter J Lally4, Matthew S Rosen1,2,5, and Reza Sadjadi6
    1Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States, 2Radiology, Harvard Medical School, Boston, MA, United States, 3Harvard-Massachusetts Institute of Technology Health Sciences and Technology, Cambridge, MA, United States, 4Brain Sciences, Imperial College London, London, United Kingdom, 5Physics, Harvard University, Cambridge, MA, United States, 6Neurology, Massachusetts General Hospital, Boston, MA, United States
    Quantitative Double-Echo in Steady-State imaging at 7 Tesla with a 28-channel QED coil enables sub-150 μm anatomical and diffusion-weighted imaging of individual peripheral nerve fascicles.
    Figure 3: Anatomical comparison of a healthy subject scanned (a) at 3T with a 4-channel coil that wrapped around the thigh and (b) at 7T with a 28-channel QED coil. The individual fascicles of the sciatic nerves are clearly visible in the 7T image, but are more difficult to make out in the 3T image.
    Figure 4: (a) A 7T image of a subject with peripheral neuropathy and (b) a DESS ADC map computed in the framed section of panel a. (c) A conventional EPI DWI diffusion map for comparison. The EPI map not only has worse resolution but also has severe distortion.
  • Spinal cord perfusion mapping using Intra-Voxel Incoherent Motion at 3T in healthy individuals and Degenerative Cervical Myelopathy patients
    Simon Lévy1,2,3, Patrick Freund4,5,6, Virginie Callot1,2,3, and Maryam Seif4,5
    1CRMBM, Aix-Marseille University, CNRS, Marseille, France, 2CEMEREM, APHM, Hopital Universitaire Timone, Marseille, France, 3iLab-Spine International Research Laboratory, Marseille-Montreal, France, 4Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, 5Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, 6Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom
    The Intra-Voxel Incoherent Motion technique at 3T has the ability to map spinal cord perfusion and depict gray matter, even on a single-subject basis, with sensitivity to capillary network orientations and fair inter-slice reproducibility. More patients data are needed and will be acquired.

    Fig. 2: Mean IVIM parameters maps across HCs (N=11) at mid C1, C2, C3 levels in the template space (0.5mm isotropic, average of 15 slices) for each diffusion-encoding direction (A-P: anteroposterior, R-L: right-left, I-S: inferosuperior) and averaged across directions. The mean MEDIC image across subjects helps visualize GM and evaluate the quality of the template registration. Below, the mean signal profile is shown for each direction. The linear fit on high b-values helps visualize the deviation from the diffusion-only signal decay, illustrating the challenge along the I-S axis.

    Fig. 3: Slice-wise fIVIM and D* maps in a representative healthy volunteer (30 years old man) for diffusion encoding in the transverse plane (⊥, mean across maps with A-P and R-L diffusion encoding) and along the I-S axis. The mean maps across slices (after registration based on the MEDIC middle slice image) are shown at the bottom. The slices position is displayed on the sagittal anatomic image (T2-weighted turbo spin-echo, 0.3×0.3mm2 in-plane resolution, 2.75mm slice thickness). The MEDIC image resliced to the IVIM data resolution helps visualize the GM shape along with the IVIM maps.
  • A Simulation Study on the Difference of PNS with Magnetic Fields and Electric Fields in an Arm Model
    Yihe Hua1, Desmond TB Yeo1, and Thomas K Foo1
    1GE Global Research, Niskayuna, NY, United States
    For ES by electrodes, high field intensity distributed in local places that surround the electrodes due to the low electric conductivity of the skin. For the MS stimulation, the electric field distribution is more even. The chronaxie values with MRG model are at the same order for ES and MS cases.
    Fig.1 Different Views of Electric Stimulation(Case1 Red, Case2 Green) and Magnetic Stimulation(Blue). The electrodes in Case2 is 1.3cm more distal than Case 1 and the distal side electrode is closer to the nerve below it than Case 1)
    PNS response by (a)ES and (b)MS. In(b), refence magnetic field=0.0825mT/A is at 1.2cm above the center of the coil
  • Patch2Self denoising of diffusion MRI in the cervical spinal cord improves repeatability and feature conspicuity
    Kurt G. Schilling1,2, Shreyas Fadnavis3, Mereze Visagie2, Eleftherios Garyfallidis3, Bennett A. Landman2,4, Seth A. Smith1,2, and Kristin P. O'Grady1,2
    1Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 2Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, 3Intelligent Systems Engineering, Indiana University Bloomington, Bloomington, IN, United States, 4Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, United States
    We used Patch2Self to denoise spinal cord diffusion MRI data which is inherently limited in SNR with few gradient directions. Using self-supervised machine learning, we improved inter- and intra-session repeatability and conspicuity of pathology.
    Figure 5: Two representative MS patients: Patient A (25yr female, EDSS=0) and Patient B (38yr female, EDSS=1) without (top) and with (bottom) Patch2Self denoising applied to the dMRI data. Lesions in the lateral columns (white outlines) of both patients are more conspicuous in the denoised diffusion volumes, including one lesioned area (dashed outline) that is not apparent in the corresponding mFFE anatomical image for Patient A.
    Figure 1: Flow diagram of pre-processing steps for Patch2Self denoising of spinal cord diffusion MRI data.
  • Spaceflight Associated Neuro-Ocular Syndrome: Quantitative MRI Evaluation of Lower Body Negative Pressure as a Potential Countermeasure
    Larry A. Kramer1, Khader M. Hasan1, Brandon R. Macias2, Karina J. Marshall-Goebel3, Steven S. Laurie3, Refaat E. Gabr1, Leela Chaudhary1, and Alan R. Hargens4
    1Diagnostic Imaging, UTHSC-Houston, Houston, TX, United States, 2NASA, Houston, TX, United States, 3KBR, Houston, TX, United States, 4Orthopedic Surgery, UCSD, La Jolla, CA, United States
    The application of lower body negative pressure in the supine position simulates physiology that is associated with upright posture thereby supporting its use as a potential countermeasure to the development of optic disc edema in astronauts exposed to long-duration spaceflight.
    Bar graph with included standard deviation bars comparing volumetric blood flow of the internal carotid and vertebral arteries with and without LBNP. Note the drop in volumetric blood flow after the application of LBNP (p=.007).
    Bar graph with included standard deviation bars comparing internal jugular vein cross-sectional area with and without LBNP. Note the drop in cross-sectional area after the application of LBNP (p=.03).
  • Assessment of Spinal Cord Diffusivity in Degenerative Cervical Myelopathy after Spinal Fusion Decompression
    Kevin M Koch1, V. Emre Arpinar1, and Matthew Budde2
    1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, 2Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
    Diffusion-weighted imaging of instrumented spinal levels of cervical spondylotic myelopathy subjects was performed using MAVRIC DWI metal artifact-reduction methods, identifying a substantial reduction of diffusivity at the instrumented levels in the cord.
    Figure 3: Exemplary MAVRIC DW ADC maps of the cord in a CSM subject at the indicated levels (A), which are (B) unfused (above the hardware) and (C) fused by the hardware construct. The clear reduction in ADC in this subject at the fused levels is readily visible.
    Figure 1: A) Sagittal plane of isotropic T2w MAVRIC SL acquisition indicating fusion hardware and the location of displayed axial sections. B) Axial reformat of MAVRIC acquisition at C5 level indicating proximity of hardware to spinal cord. C) Conventional FOCUS (reduced field-of-view EPI) DWI b=0 image is non-diagnostic and completely disrupted due to hardware presence. D) MAVRIC DWI b=0 image allows for diffusion-weighted analysis of cord, even in near vicinity of hardware.
  • Quantitative Multimodal Magnetic Resonance Imaging for the Evaluation of Dysthyroid Optic Neuropathy
    Mengsha Zou1, Hongzhang Zhu1, Yunzhu Wu2, and Zhiyun Yang1
    1Radiology, The first affiliated hospital of Sun Yet-sen University, Guangzhou, China, 2MR Sicentific Marketing, Siemens Healthineers, Shanghai, China
    Dysthyroid optic neuropathy (DON) is one of the most severe types of Graves orbitopathy (GO) and frequently difficult to diagnose clinically in its early stages. In our study, we evaluate orbital condition of DON patients by using quantitative multimodal MRI.
    FIG.1.Methods for measurement of mMI and mean T2 value in a 53-year-old patient with bilateral DON (top row) and a 50-year-old GO patient without DON(bottom row). Axial fat-suppressed T2-weighted images in orbit with DON(A) and without DON(B). Oblique coronal T2WI of Dixon show mMI at 21mm with DON(C) and without DON(D) [mMI was the maximum value between (a+b)/c and (d+e)/f)]. E.F Coronal T1WI was presented as anatomical reference. T2 value of optic nerve of the eye with DON was 207.3ms(G) and the eye without DON was 105.5ms(H) respectively.
    FIG.2. MRI indicators for prediction of DON.Receiver operating characteristic curve analysis(A) and decision curve analysis (B) showed that combination of mMI at 21mm and optic nerve mean T2 value demonstrated optimal diagnostic efficiency for DON.
  • Partial Simultaneous Multi-Slice Acquisition of Combined T2*-Weighted Imaging of the Human Brain and Cervical Spinal Cord
    Ying Chu1 and Jürgen Finsterbusch1
    1Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
    Partial-SMS acceleration of combined fMRI acquisitions of the brain and cervical spinal cord is feasible with a loss in image quality or SNR but can reduce the acquisition time considerably.
    Figure 1: (a) Localizers showing the typical geometric setup for cortico-spinal fMRI: the brain (orange) and spinal cord (blue) volumes and the isocenter (red cross). (b, c) in vivo EPI example images of the (b) brain (16 of 60 slices), and (c) spinal cord (6 of 12 slices) using SMS acceleration with a factor of 3 for the brain volume only.
    Figure 3: Results of SNR measurements on an in vivo volunteer covering a brain volume only and combined brain and spinal cord volumes in the same acquisition: (a) spinal cord without simultaneous multi-slice imaging (SMS) and (b-d) brain volume (b) without SMS acceleration and (c,d) with SMS acceleration factors of 2 and 3, respectively.
  • A robust framework for characterising diffusion metrics of peripheral nerves: exploiting state of the art tracking methods
    Arkiev D'Souza1, Chenyu Wang1,2, Sicong Tu1,2, Dominic Soligo3, Matthew Kiernan1,2,4, Michael Barnett1,4, and Fernando Calamante1,5,6
    1Brain and Mind Centre, The University of Sydney, Sydney, Australia, 2Central Clinical School, The University of Sydney, Sydney, Australia, 3I-MED Radiology Network, Camperdown, Australia, 4Department of Neurology, Royal Prince Alfred Hospital, Camperdown, Australia, 5School of Biomedical Engineering, The University of Sydney, Sydney, Australia, 6Sydney Imaging, The University of Sydney, Sydney, Australia
    A sample size of 22 would be sufficient to detect 10% difference in track-weighted metrics studied. A sample size of 20 would be large enough to detect within-subject differences as small as 3% and between-subject differences as small as 4%. 
    Figure 1: (A) schematic of framework methods. Axial image of the forearm from (B) T1-weighted anatomical image, (C) FA map, (D) DEC-TDI. In B-D, the axis is centred at the same location. (E) shows a three-dimensional reconstruction of the ulnar nerve generated by volume rendering the nerve DEC-TDI image and overlaying on semi-opaque T1 volume render. In D and E, the colours indicate directionality (red for left-right, blue for proximal-distal, and green for anterior-posterior).
    Figure 2: Measurements of (A) track-weighted fibre orientation distribution, (B) track-weighted apparent diffusion coefficient, (C) track-weighed fractional anisotropy, (D) track-weighted axial diffusivity and (E) track-weighted radial diffusivity. Profiles have been realigned such that a displacement of 0 mm roughly corresponds with the head of the radial bone, shown as vertical black line in (F). Individual subject test and re-test measurements are colour matched, and are shown with solid and dashed lines, respectively. Average test and average re-test are shown in black.
  • Investigating layer specific MR properties in the superior colliculus ex vivo at 14.1T
    Ju Young Lee1, Andreas Mack2, Thomas Shiozawa-Bayer2, Marc Himmelbach3, Gisela Hagberg1,4, and Klaus Scheffler1,4
    1Max Planck Institute for Biological Cybernetics, Tübingen, Germany, 2Eberhard Karls University Tuebingen, Tübingen, Germany, 3Hertie-Institue for Clinical Brain Research, Tübingen, Germany, 4University Hospital Tübingen, Tübingen, Germany
    The present study investigates layer specific MR properties in superior colliculus using post mortem sample at 14.1T. We observed R2* maximum that likely corresponds to layer III, and high R2* and R1 in an area likely corresponding to layer VII.
    Figure 1. R2* map of sample 4. The left figure is a sagittal plane of the sample. Slides within the red lines were selected for superior colliculus depth analysis. The right figure is an axial plane of the sample. Red dash line is the second order polynomial fit to the boundary between periaqueductal gray and superior colliculus. The solid lines in different colors are the orthogonal vectors that were used for the depth analysis.
    Figure 3. R2* depth profile along the superior colliculus layers. The green region indicates the intermediate layers and the purple region indicates the deepest layer. Solid black lines plot the mean R2* of all vectors in all selected axial planes (95 % confidence interval in shaded grey). Dashed black lines indicates the starting point of the periaqueductal gray. Samples 3 and 4 show one peak in the intermediate layer and another peak in the deep layer. Sample 1and 2 shows similar trend. PAG : periaqueductal gray
  • Visible “Butterfly” of the Cervical Spinal Cord: A Pilot study using high-resolution Phase-Sensitive and multiple Fast Field Echo MR imaging
    bingbing gao1, Yanwei Miao1, Qingwei Song1, Ailian Liu1, and Jiazheng Wang2
    1the First Affiliated hospital of Dalian Medical university, Dalian, China, 2Philips Healthcare, BeiJing, China
    The present study aims to visualize the cervical spinal marrow with high resolution axial phase-sensitive inversion recovery (PSIR) and multiple Fast Field Echo (FFE) images, and further to detect the image quality differentially on gray and white matters. 
    Table 3. comparison of GM to WM signal intensity measured from the high resolution PSIR and FFE
    Figure1 Axial cervical spinal cord PSIR (a) and multiple FFE (b) images
  • Design and Construction of an Interchangeable RF Coil System for Rodent Spinal Cord MR Imaging
    Ming Lu1,2,3, Gary Drake1,2, Feng Wang1,2, Chaoqi Mu1,4, Limin Chen1,2, John C. Gore1,2,4, and Xinqiang Yan1,2
    1Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, 2Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 3College of nuclear equipment and nuclear engineering, Yantai University, Yantai, China, 4Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States
     We developed an interchangeable RF coil system for a 9.4T small animal MRI scanner, allowing for optimal coil selection for different experiments. Compared to a general-purpose commercial coil, up to 2.4-fold SNR improvement was obtained by using an optimal coil.
    Figure 4 A and B: Measured SNR on the phantom and a live rat (male Sprague-Dawley rat, 350 g) using Varian single loop coil and optimal quadrature coil specialized to L1-L2 spinal cord imaging. SNR maps were calculated from GRE images with the following parameters: phantom (FOV = 45 × 45 mm2, TR/TE = 1000/4 ms, FA = 20 degree, Matrix = 192 × 192, Bandwidth = 260.4 Hz/pixel), in vivo (FOV = 45 x 45 mm2, TR/TE = 200/2.874 ms, FA = 40 degree, Matrix = 128 x 128, bandwidth 390.6 Hz/pixel). C and D: One-dimensional profiles of the measured SNR along the dotted white line in Figures 4A and B.
    Figure 2 CAD drawing and constructed including animal management device (left) and coil management device (right). These devices were designed in SolidWorks (SolidWorks Corp., Santa Monica, CA) and printed (except the long tubes) by a ProJet 3D printer (HD 3500 Plus, 3D Systems, USA).
  • Diffusion features in white and gray matter of healthy cervical spinal cord using PSIR imaging
    Yunan Cui1, Yanwei Miao1, Ailian Liu1, Zhiwei Shen2, and Jiazheng Wang2
    1THE FIRST AFFILIATED HOSPITAL OF DALIAN MEDICAL UNIVERSITY, DALIAN, China, 2Philips Healthcare, BEIJING, China
    This study reports that there are diffusion differences in bilateral and ipsilateral gray and white matter of healthy spinal cords. 
    Table 1 Basic Information Of Volunteers
    Fig 1 MRI of a 34-year-old women with C3/4 horizontal cervical spinal cord.A(PSIR imaging),B(DTI and PSIR blending images),C(ROIs)
  • Morphological Assessment of the Instrumented Spinal Cord using Isotropic 3D-MSI MRI
    Kevin M Koch1 and Andrew S Nencka1
    1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
    Technical methods are described and demonstrated that allow for automated advanced morphological analysis of the spinal cord in the presence of stabilization instrumentation.  
    Figure 4. Example results of the described pipeline. A) and B) provide reformats of the T2w 3D-MSI, while C-D) provide views of the automatically segmented cord performed using the workflow outlined in Figure 3. E-F) provide maps of CSF z-score analysis, whereby the mean T2w signal of the CSF (corrected for signal shading an bias within the cord) is used to identify regions of low CSF (blue areas in the map). The blue arrows highlight a region of missing CSF (cord impingement), which is accurately reflected by the sharp blue region in the z-score map.
    Figure 2: Example T1 (A,B) and T2 (C,D) weighted 1.2 mm isotropic acquisitions in orthogonal reformatted (sagittal, A,C – axial, B,D) view planes. The isotropic acquisitions required 5 minutes each and were designed for morphological cord analysis rather than conventional planar diagnostics.
  • Optimization of Compressed SENSE accelerated Brachial Plexus MRI: Quality and Efficiency
    Renwang PU1, Qingwei SONG1, Ailian LIU1, Zijing ZHANG1, Nan ZHANG1, Haonan ZHANG1, Bingbing GAO1, Lihua CHEN1, and Liangjie LIN2
    1the First Affiliated Hospital of Dalian Medical Universityrsity, Dalian, China, 2Philips Healthcare, BEIJING, China
    3D-NerveVIEW scan with a CSAF of 4 is recommended for brachial plexus imaging with significantly reduced scan time (381s vs 821s, 54%) and comparable image quality compared to the reference scan.
    a.Coronal image of brachial plexus.The area of interest(ROI) in the nerve and muscle;b-e.Mip images of brachial plexus of sense2,cs2,cs4,cs6,respectively;the scores of image quality are 4 for b-e.
    a-e:Boxplot depiction of CNR,signal of nerves,image noise and image quality,respectively.
  • Application of 3D-FFE Based on Compressed Sensing for Lumbosacral Plexus Imaging: A Preliminary Study
    Jian Wang1, Yanjun Chen1, Yingjie Mei2, Jialing Chen1, and Xiaodong Zhang1
    1Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China, 2China International Center, Philips Healthcare, Guangzhou, China
    Compressed sensing technology can greatly improve scanning speed at the small expense of a small SNR with unchanged CNR, morphological measurements and subjective images evaluation score on lumbosacral plexus MR imaging.
    Figure 3. Comparison of the conventional FFE with the FFE-CS. LSP magnetic resonance neurography images of a 26-year-old woman without lower back pain. The coronal conventional 3D FFE (a) serves as a reference for the FFE-CS with factor CS2(b) and CS3(c). No difference can be observed among the three types of FFE, all sequences showing compromised image quality. A general noise enhancement could be observed in the FFE sequences with compressed sense. The subjective image quality score for LSP given by the two radiologists was both 3 in the conventional and compressed sensing sequences.
  • Banding artifacts reduction for lumbosacral plexus imaging with balanced FFE (b-FFE)
    Geli Hu1, Jiazheng Wang1, Qingping Gu1, Yang Zhang1, and Jianxia Cao1
    1Philips Healthcare, Beijing, China
    Our results demonstrated the potential clinical application of the proposed RF phase cycling scheme for lumbosacral plexus imaging, which yielded improved image quality and reduced banding artifacts when compared to the traditional b-FFE technique.

    Figure 1.A healthy volunteer, 56-year-old male.

    Left: Coronal B-FFE-XD image of the lumbosacral plexus. Right: Coronal B-FFE image of the lumbosacral plexus

  • Diffusion Tensor Imaging of the Roots of the Brachial Plexus: A Systematic Review and Meta-Analysis of Normative Values
    Ryckie George Wade1, Alexander Whittam2, Irvin Teh1, Gustav Andersson3, Fang-Cheng Yeh 4, Mikael Wiberg 3, and Grainne Bourke 1
    1University of Leeds, Leeds, United Kingdom, 2Sheffield Teaching Hospitals, Sheffield, United Kingdom, 3Umeå University, Umeå, Sweden, 4University of Pittsburgh, Pittsburgh, PA, United States
    In this systematic review and meta-analysis of the normal diffusion tensor imaging values for spinal roots of the brachial plexus, we show that the pooled mean FA of the roots was 0.36 (95% CI 0.34, 0.38) and the pooled mean MD of the roots was 1.51 x10-3 mm2/s (95% CI 1.45, 1.56).
    Figure 1. The roots of the brachial plexus emerging from the intervertebral foramina (upper left image) and their relationship to the scalene muscles and vasculature of the upper limb (upper right image). The lower image is a simplified schematic of the brachial plexus highlighting (in purple) the spinal roots. Reproduced with permission from Mr Donald Sammut.
    Figure 3. A scatterplot showing the negative association between the mean diffusivity of the roots of the brachial plexus and the mean age of adults in the included studies.
  • the value of preoperative MRI measurements of Meckel cavity volume in percutaneous balloon compression of the trigeminal nerve
    Junjiao Hu1, Kai Deng1, Weijun Situ1, and Huiting Zhang2
    1Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, China, 2MR Scientific Marketing, Siemens Healthcare Ltd., Wuhan, China
    3D SPACE sequence is helpful in preoperative measurements of Meckel cavity volume to guide percutaneous balloon compression of the trigeminal nerve.

    Figure 1. female, 48-year-old, trigeminal neuralgia. X-ray image and ROI measurement of left Meckel cavity in transverse, sagittal and coronal position in MRI images.

    Table 1. Comparison between the average values of ROI measurement and balloon filling volume of Meckel cavity