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Biomedical subjects

Guido Gerig

Publications and source records attributed to Guido Gerig.

At least 19 recordsLinked to original sources

Fiber tract-oriented statistics for quantitative diffusion tensor MRI analysis.

Quantitative diffusion tensor imaging (DTI) has become the major imaging modality to study properties of white matter and the geometry of fiber tracts of the human brain. Clinical studies mostly focus on regional statistics of fractional anisotropy (FA) and mean diffusivity (MD) derived from tensors. Existing analysis techniques do not sufficiently take into account that the measurements are tensors, and thus require proper interpolation and statistics of tensors, and that regions of interest are fiber tracts with complex spatial geometry. We propose a new framework for quantitative tract-oriented DTI analysis that systematically includes tensor interpolation and averaging, using nonlinear Riemannian symmetric space. A new measure of tensor anisotropy, called geodesic anisotropy (GA) is applied and compared with FA. As a result, tracts of interest are represented by the geometry of the medial spine attributed with tensor statistics (average and variance) calculated within cross-sections. Feasibility of our approach is demonstrated on various fiber tracts of a single data set. A validation study, based on six repeated scans of the same subject, assesses the reproducibility of this new DTI data analysis framework.

Algorithms↗

User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability.

Active contour segmentation and its robust implementation using level set methods are well-established theoretical approaches that have been studied thoroughly in the image analysis literature. Despite the existence of these powerful segmentation methods, the needs of clinical research continue to be fulfilled, to a large extent, using slice-by-slice manual tracing. To bridge the gap between methodological advances and clinical routine, we developed an open source application called ITK-SNAP, which is intended to make level set segmentation easily accessible to a wide range of users, including those with little or no mathematical expertise. This paper describes the methods and software engineering philosophy behind this new tool and provides the results of validation experiments performed in the context of an ongoing child autism neuroimaging study. The validation establishes SNAP intrarater and interrater reliability and overlap error statistics for the caudate nucleus and finds that SNAP is a highly reliable and efficient alternative to manual tracing. Analogous results for lateral ventricle segmentation are provided.

Brain↗

Multi-modal image set registration and atlas formation.

In this paper, we present a Bayesian framework for both generating inter-subject large deformation transformations between two multi-modal image sets of the brain and for forming multi-class brain atlases. In this framework, the estimated transformations are generated using maximal information about the underlying neuroanatomy present in each of the different modalities. This modality independent registration framework is achieved by jointly estimating the posterior probabilities associated with the multi-modal image sets and the high-dimensional registration transformations mapping these posteriors. To maximally use the information present in all the modalities for registration, Kullback-Leibler divergence between the estimated posteriors is minimized. Registration results for image sets composed of multi-modal MR images of healthy adult human brains are presented. Atlas formation results are presented for a population of five infant human brains.

Algorithms↗

Reduced relationship to cortical white matter volume revealed by tractography-based segmentation of the corpus callosum in young children with developmental delay.

OBJECTIVE: The corpus callosum is the primary anatomical substrate for interhemispheric communication, which is important for a range of adaptive and cognitive behaviors in early development. Previous studies that have measured the corpus callosum in developmental populations have been limited by the use of rather arbitrary methods of subdividing the corpus callosum. The purpose of this study was to measure the corpus callosum in a clinical group of developmentally delayed children using a subdivision that more accurately reflected the anatomical properties of the corpus callosum. METHOD: The authors applied tractography to subdivide the corpus callosum into regions corresponding to the cortical regions to and from which its fibers travel in a clinical group of very young children with developmental delay, a precursor to general mental retardation, in comparison with typically developing children. RESULTS: The data demonstrate that the midsagittal area of the entire corpus callosum is reduced in children presenting with developmental delay, reflected in the smaller area of each of the fiber-based callosal subdivisions. In addition, while the area of each subdivision was strongly and significantly correlated with the corresponding cortical white matter volume in comparison subjects, this correlation was prominently absent in the developmentally delayed group. CONCLUSIONS: A fiber-based subdivision successfully separates lobar regions of the corpus callosum, and the areas of these regions distinguish a developmentally delayed clinical group from the comparison group. This distinction was evident both in the area measurements themselves and in their correlation to the white matter volumes of the corresponding cortical lobes.

Atrophy↗

Aggression and quantitative MRI measures of caudate in patients with chronic schizophrenia or schizoaffective disorder.

Caudate dysfunction is implicated in schizophrenia. However, little is known about the relationship between aggression and caudate volumes. Forty-nine patients received magnetic resonance imaging scanning in a double-blind treatment study in which aggression was measured. Caudate volumes were computed using a semiautomated method. The authors measured aggression with the Overt Aggression Scale and the Positive and Negative Syndrome Scale. Larger caudate volumes were associated with greater levels of aggression. The relationship between aggression and caudate volumes may be related to the iatrogenic effects of long-term treatment with typical antipsychotic agents or to a direct effect of schizophrenic processes on the caudate.

Adult↗

Quantitative MRI measures of orbitofrontal cortex in patients with chronic schizophrenia or schizoaffective disorder.

The relationship between orbitofrontal cortex (OFC) volumes and functional domains in treatment-resistant patients with schizophrenia or schizoaffective disorder is poorly understood. OFC dysfunction is implicated in several of the behaviors that are abnormal in schizophrenia. However, little is known about the relationship between these behaviors and OFC volumes. Forty-nine patients received magnetic resonance imaging scanning as part of a double-blind treatment study in which psychiatric symptomatology, neuropsychological function, and aggression were measured. OFC volumes were manually traced on anatomical images. Psychiatric symptomatology was measured with the Positive and Negative Syndrome Scale (PANSS). Aggression was measured with the Overt Aggression Scale (OAS) and with the PANSS. Neuropsychological function was assessed using a comprehensive test battery. Larger right OFC volumes were associated with poorer neuropsychological function. Larger left OFC gray matter volumes and larger OFC white matter volumes bilaterally were associated with greater levels of aggression. These findings are discussed in the context of potential iatrogenic effects.

Adult↗

Cortical gray and white brain tissue volume in adolescents and adults with autism.

BACKGROUND: A number of studies have found brain enlargement in autism, but there is disagreement as to whether this enlargement is limited to early development or continues into adulthood. In this study, cortical gray and white tissue volumes were examined in a sample of adolescents and adults with autism who had demonstrated total brain enlargement in a previous magnetic resonance imaging (MRI) study. METHODS: An automated tissue segmentation program was applied to structural MRI scans to obtain volumes of gray, white, and cerebrospinal fluid (CSF) tissue on a sample of adolescent and adult males ages 13-29 with autism (n = 23) and controls (n = 15). Regional differences for brain lobes and brain hemispheres were also examined. RESULTS: Significant enlargement in gray matter volume was found for the individuals with autism, with a disproportionate increase in left-sided gray matter volume. Lobe volume enlargements were detected for frontal and temporal, but not parietal or occipital lobes, in the subjects with autism. Age and nonverbal IQ effects on tissue volume were also observed. CONCLUSIONS: These findings give evidence for left-lateralized gray tissue enlargement in adolescents and adults with autism, and demonstrate a regional pattern of cortical lobe volumes underlying this effect.

Adolescent↗

Morphometric analysis of lateral ventricles in schizophrenia and healthy controls regarding genetic and disease-specific factors.

The structural variability of lateral ventricles is poorly understood notwithstanding that enlarged size has been identified as an unspecific marker for psychiatric illness, including schizophrenia. This paper explores the effects of heritability and genetic risk for schizophrenia reflected in ventricular size and structure. We examined ventricular size and shape in the MRI studies of monozygotic (MZ) twin pairs discordant for schizophrenia (DS), healthy MZ twin pairs, healthy dizygotic twin pairs, and healthy nonrelated subject pairs. Heritability and effect due to disease were analyzed in two tests. First, heritability was examined by ventricle similarity between pairs of co-twins. Results show that co-twin ventricle shape similarity decreases with decreasing genetic identity, an effect not seen in the volume analysis. Co-twin shape similarity of healthy MZ twins did not differ from DS MZ twins. Second, the disease effect was examined through the ventricular differences of DS subjects to a template shape representing healthy subjects. Affected DS twins showed shape differences from healthy subjects on the left and right sides. Interestingly, unaffected DS twins also showed significant shape differences from healthy subjects for both sides. Volume comparisons did not show differences between these groups. Locality of shape difference suggests that the ventricular shape of the anterior and posterior regions is under genetic influence in both healthy controls and schizophrenia patients. Affected and unaffected groups demonstrate main shape differences, compared with healthy controls, only in the posterior region. Our results suggest that genetics have a stronger influence on the shape of lateral ventricles than do the disease-related changes in schizophrenia.

Adult↗

Magnetic resonance imaging and head circumference study of brain size in autism: birth through age 2 years.

CONTEXT: While the neuroanatomical basis of autism is not yet known, evidence suggests that brain enlargement may be characteristic of this disorder. Inferences about the timing of brain enlargement have recently come from studies of head circumference (HC). OBJECTIVES: To examine brain volume and HC in individuals with autism as compared with control individuals. DESIGN: A cross-sectional study of brain volume was conducted at the first time point in an ongoing longitudinal magnetic resonance imaging study of brain development in autism. Retrospective longitudinal HC measurements were gathered from medical records on a larger sample of individuals with autism and local control individuals. SETTING: Clinical research center. PARTICIPANTS: The magnetic resonance imaging study included 51 children with autism and 25 control children between 18 and 35 months of age (the latter included both developmentally delayed and typically developing children). Retrospective, longitudinal HC data were examined from birth to age 3 years in 113 children with autism and 189 local control children. MAIN OUTCOME MEASURES: Cerebral cortical (including cortical lobes) and cerebellar gray and white matter magnetic resonance imaging brain volumes as well as retrospective HC data from medical records were studied. RESULTS: Significant enlargement was detected in cerebral cortical volumes but not cerebellar volumes in individuals with autism. Enlargement was present in both white and gray matter, and it was generalized throughout the cerebral cortex. Head circumference appears normal at birth, with a significantly increased rate of HC growth appearing to begin around 12 months of age. CONCLUSIONS: Generalized enlargement of gray and white matter cerebral volumes, but not cerebellar volumes, are present at 2 years of age in autism. Indirect evidence suggests that this increased rate of brain growth in autism may have its onset postnatally in the latter part of the first year of life.

Age Factors↗

Fiber tract-oriented statistics for quantitative diffusion tensor MRI analysis.

Diffusion tensor imaging (DTI) has become the major modality to study properties of white matter and the geometry of fiber tracts of the human brain. Clinical studies mostly focus on regional statistics of fractional anisotropy (FA) and mean diffusivity (MD) derived from tensors. Existing analysis techniques do not sufficiently take into account that the measurements are tensors, and thus require proper interpolation and statistics based on tensors, and that regions of interest are fiber tracts with complex spatial geometry. We propose a new framework for quantitative tract-oriented DTI analysis that includes tensor interpolation and averaging, using nonlinear Riemannian symmetric space. As a result, tracts of interest are represented by the geometry of the medial spine attributed with tensor statistics calculated within cross-sections. Examples from a clinical neuroimaging study of the early developing brain illustrate the potential of this new method to assess white matter fiber maturation and integrity.

Algorithms↗

Synthetic ground truth for validation of brain tumor MRI segmentation.

Validation and method of comparison for segmentation of magnetic resonance images (MRI) presenting pathology is a challenging task due to the lack of reliable ground truth. We propose a new method for generating synthetic multi-modal 3D brain MRI with tumor and edema, along with the ground truth. Tumor mass effect is modeled using a biomechanical model, while tumor and edema infiltration is modeled as a reaction-diffusion process that is guided by a modified diffusion tensor MRI. We propose the use of warping and geodesic interpolation on the diffusion tensors to simulate the displacement and the destruction of the white matter fibers. We also model the process where the contrast agent tends to accumulate in cortical csf regions and active tumor regions to obtain contrast enhanced T1w MR image that appear realistic. The result is simulated multi-modal MRI with ground truth available as sets of probability maps. The system will be able to generate large sets of simulation images with tumors of varying size, shape and location, and will additionally generate infiltrated and deformed healthy tissue probabilities.

Algorithms↗

Effects of healthy aging measured by intracranial compartment volumes using a designed MR brain database.

A publicly available database of high-quality, multi-modal MR brain images of carefully screened healthy subjects, equally divided by sex, and with an equal number of subjects per age decade, would be of high value to investigators interested in the statistical study of disease. This report describes initial use of an accumulating healthy database currently comprising 50 subjects aged 20-72. We examine changes by age and sex to the volumes of gray matter, white matter and cerebrospinal fluid for subjects within the database. We conclude that traditional views of healthy aging should be revised. Significant atrophy does not appear in healthy subjects 60 or 70 years old. Gray matter loss is not restricted to senility, but begins in early adulthood and is progressive. The percentage of white matter increases with age. A carefully-designed healthy database should be useful in the statistical analysis of many age- and non-age-related diseases.

Adult↗

Vessel tortuosity and brain tumor malignancy: a blinded study.

RATIONALE AND OBJECTIVES: Malignancy provokes regional changes to vessel shape. Characteristic vessel tortuosity abnormalities appear early during tumor development, affect initially healthy vessels, spread beyond the confines of tumor margins, and do not simply mirror tissue perfusion. The ability to detect and quantify tortuosity abnormalities on high-resolution magnetic resonance angiography (MRA) images offers a new approach to the noninvasive diagnosis of malignancy. This report evaluates a computerized, statistical method of analyzing the shapes of vessels extracted from MRA in diagnosing cancer. MATERIALS AND METHODS: The regional vasculature of 34 healthy subjects was compared with the tumor-associated vasculature of 30 brain tumors before surgical resection. The operator performing the analysis was blinded to the diagnosis. Vessels were segmented from an MRA of each subject, a region of interest was defined in each tumor patient and was mapped to all healthy controls, and a statistical analysis of vessel shape measures was then performed over the region of interest. Many difficult cases were included, such as pinpoint, hemorrhagic, and irradiated tumors, as were hypervascular benign tumors. Tumors were identified as benign or malignant on the basis of histological evaluation. RESULTS: A discriminant analysis performed at the study's conclusion successfully classified all but one of the 30 tumors as benign or malignant on the basis of vessel tortuosity. CONCLUSIONS: Quantitative, statistical measures of vessel shape offer a new approach to the diagnosis and staging of disease. Although the methods developed under the current report must be tested against a new series of cases, initial results are promising.

Adult↗

Assessment of mandibular growth and response to orthopedic treatment with 3-dimensional magnetic resonance images.

INTRODUCTION: Three-dimensional (3D) craniofacial images are commonly used in clinical studies in orthodontics to study developmental and morphologic relationships. METHODS: We used 3D magnetic resonance imaging to study relationships among craniofacial components during the pubertal growth spurt and in response to Fränkel appliance therapy. The sample for this prospective study was 156 high-resolution magnetic resonance images with 1 mm isotropic voxel resolution of 78 subjects taken initially (T1) and 18 +/- 1 months (T2) after treatment or an observation period. The subjects were Brazilian children; 28 were treated and 25 were untreated for Class II malocclusion, and 25 were untreated with normal occlusions. A Procrustes geometric transformation of 3D skeletal landmarks was used to assess growth or treatment alterations from T1 to T2. The landmarks were located on the mandibular rami and the other craniofacial parts specifically related to the mandibular growth (the middle cranial fossae and the posterior part of the bilateral nasomaxilla). This allowed visualization of the entire volumetric dataset with an interactive 3D display. RESULTS: Statistically significant differences were found in the relative 3D skeletal growth directions from T1 to T2 for treated vs untreated Class II children (Bonferroni-adjusted P < .001) and for treated Class II vs normal-occlusion subjects ( P < .001). The major differences in the treated group were increased mandibular rami vertical dimensions and more forward rami relative to the posterior nasomaxilla and the middle cranial fossae. Principal component analysis made it possible to show individual variability and group differences in the principal dimensions of skeletal change. CONCLUSIONS: These methods are generalizable to other imaging techniques and 3D samples, and significantly enhance the potential of systematically controlled data collection and analysis of bony structures in 3 dimensions for quantitative assessment of patient parameters in craniofacial biology.

Cephalometry↗

Comparison of relative mandibular growth vectors with high-resolution 3-dimensional imaging.

INTRODUCTION: The mandibular rami and their endochondrally growing condyles develop in many directions relative to the variable anatomic patterns of the nasomaxilla and middle cranial fossae during growth and response to orthopedic treatment. METHODS: High-resolution magnetic resonance images were used to compare 3-dimensional (3D) growth vectors of skeletal displacement and bone remodeling in 25 untreated subjects with Class II malocclusions, 28 subjects with Class II malocclusions who were treated with Fränkel appliance therapy, and 25 subjects with normal occlusions. Marked differences were noted over an 18-month observation period. The 3D coordinates of anatomic landmarks were registered by Procrustes fit to control for rotation, translation, and scale differences. RESULTS: Compared with untreated Class II and normal-occlusion subjects, the treated group showed highly significant differences in the 3D displacement/remodeling vectors of gonion and pterygomaxillary fissure relative to condylion and middle cranial fossae bilateral skeletal landmarks, by using both permutation tests ( P < .001) and a general linear multivariate model ( P < .0001). CONCLUSIONS: In a prospective and systematically controlled study, we quantitatively described significant 3D rami skeletal compensations in the structural assembly of facial morphogenesis at the beginning of the adolescent growth spurt using novel modeling techniques. These techniques have facilitated quantification of relative 3D growth vectors to illustrate skeletal changes with Fränkel appliance therapy. Future studies are required to assess the long-term clinical significance of our findings.

Bone Remodeling↗

Automatic segmentation of MR images of the developing newborn brain.

This paper describes an automatic tissue segmentation method for newborn brains from magnetic resonance images (MRI). The analysis and study of newborn brain MRI is of great interest due to its potential for studying early growth patterns and morphological changes in neurodevelopmental disorders. Automatic segmentation of newborn MRI is a challenging task mainly due to the low intensity contrast and the growth process of the white matter tissue. Newborn white matter tissue undergoes a rapid myelination process, where the nerves are covered in myelin sheathes. It is necessary to identify the white matter tissue as myelinated or non-myelinated regions. The degree of myelination is a fractional voxel property that represents regional changes of white matter as a function of age. Our method makes use of a registered probabilistic brain atlas. The method first uses robust graph clustering and parameter estimation to find the initial intensity distributions. The distribution estimates are then used together with the spatial priors to perform bias correction. Finally, the method refines the segmentation using training sample pruning and non-parametric kernel density estimation. Our results demonstrate that the method is able to segment the brain tissue and identify myelinated and non-myelinated white matter regions.

Aging↗