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Biomedical subjects

Guido Gerig

Publications and source records attributed to Guido Gerig.

30 records · Page 2Linked to original sources

Duration of illness and treatment effects on hippocampal volume in male patients with schizophrenia.

BACKGROUND: Reduced hippocampal volume is a consistently described structural abnormality in schizophrenia but its cause and timing are not known. AIMS: To examine the relationship of duration of schizophrenic illness and treatment effects with hippocampal volumes. METHOD: Quantitative 1.5 T magnetic resonance imaging brain scans of young male patients in the early stage of schizophrenic illness were compared with those of chronically ill older patients. Scans were also acquired for controls matched to both patient groups for age and handedness. Duration of illness was recorded and severity of symptoms assessed with the Positive and Negative Syndrome Scale. RESULTS: The patients with schizophrenia had smaller hippocampal volumes than the controls. The volume reduction was larger in older patients than in young, compared with age-matched controls. In the early illness group atypical antipsychotics rather than haloperidol were associated with larger hippocampal volumes even after controlling for differences in illness severity. CONCLUSIONS: The greater reduction of hippocampal volume in people with chronic v. early illness, after controlling for illness severity and age, supports the hypothesis of progressive hippocampal reduction in males with schizophrenia. Atypical antipsychotics early in illness may protect against this.

Adolescent↗

3 Tesla magnetic resonance imaging of the brain in newborns.

While it has been hypothesized that brain development is abnormal in schizophrenia and other neurodevelopmental disorders, there have been few attempts to study very early brain development in children. Twenty unsedated healthy newborns underwent 3 Tesla magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI). The left ventricle was significantly larger than the right; females had significantly larger ventricles than males. Fractional anisotropy (FA) increased significantly with gestational age in the genu and splenium of the corpus callosum. It is feasible to study brain development in unsedated newborns using 3 T MRI.

Brain↗

Boundary and medial shape analysis of the hippocampus in schizophrenia.

Statistical shape analysis has become of increasing interest to the neuroimaging community due to its potential to precisely locate morphological changes and thus potentially discriminate between healthy and pathological structures. This paper describes a combined boundary and medial shape analysis based on two different shape descriptions applied to a study of the hippocampus shape abnormalities in schizophrenia. The first shape description is the sampled boundary implied by the spherical harmonic SPHARM description. The second one is the medial shape description called M-rep. Both descriptions are sampled descriptions with inherent point correspondence. Their shape analysis is based on computing differences from an average template structure analyzed using standard group mean difference tests. The results of the global and local shape analysis in the presented hippocampus study exhibit the same patterns for the boundary and the medial analysis. The results strongly suggest that the normalized hippocampal shape of the schizophrenic group is different from the control group, most significantly as a deformation difference in the tail region.

Brain Mapping↗

A brain tumor segmentation framework based on outlier detection.

This paper describes a framework for automatic brain tumor segmentation from MR images. The detection of edema is done simultaneously with tumor segmentation, as the knowledge of the extent of edema is important for diagnosis, planning, and treatment. Whereas many other tumor segmentation methods rely on the intensity enhancement produced by the gadolinium contrast agent in the T1-weighted image, the method proposed here does not require contrast enhanced image channels. The only required input for the segmentation procedure is the T2 MR image channel, but it can make use of any additional non-enhanced image channels for improved tissue segmentation. The segmentation framework is composed of three stages. First, we detect abnormal regions using a registered brain atlas as a model for healthy brains. We then make use of the robust estimates of the location and dispersion of the normal brain tissue intensity clusters to determine the intensity properties of the different tissue types. In the second stage, we determine from the T2 image intensities whether edema appears together with tumor in the abnormal regions. Finally, we apply geometric and spatial constraints to the detected tumor and edema regions. The segmentation procedure has been applied to three real datasets, representing different tumor shapes, locations, sizes, image intensities, and enhancement.

Algorithms↗

Unbiased diffeomorphic atlas construction for computational anatomy.

Construction of population atlases is a key issue in medical image analysis, and particularly in brain mapping. Large sets of images are mapped into a common coordinate system to study intra-population variability and inter-population differences, to provide voxel-wise mapping of functional sites, and help tissue and object segmentation via registration of anatomical labels. Common techniques often include the choice of a template image, which inherently introduces a bias. This paper describes a new method for unbiased construction of atlases in the large deformation diffeomorphic setting. A child neuroimaging autism study serves as a driving application. There is lack of normative data that explains average brain shape and variability at this early stage of development. We present work in progress toward constructing an unbiased MRI atlas of 2 years of children and the building of a probabilistic atlas of anatomical structures, here the caudate nucleus. Further, we demonstrate the segmentation of new subjects via atlas mapping. Validation of the methodology is performed by comparing the deformed probabilistic atlas with existing manual segmentations.

Algorithms↗

Abnormal vessel tortuosity as a marker of treatment response of malignant gliomas: preliminary report.

Despite multiple advances in medical imaging, noninvasive monitoring of therapeutic efficacy for malignant gliomas remains problematic. An underutilized observation is that malignancy induces characteristic abnormalities of vessel shape. These characteristic shape abnormalities affect both capillaries and much larger vessels in the tumor vicinity, involve larger vessels prior to sprout formation, and are generally not present in hypervascular benign tumors. Vessel shape abnormalities associated with malignancy thus may appear independently of increase in vessel density. We hypothesize that an automated, computerized analysis of vessel shape as defined from high-resolution MRA can provide valuable information about tumor activity during the treatment of malignant gliomas. This report describes vessel shape properties in 10 malignant gliomas prior to treatment, in 2 patients in remission during treatment, and in 2 patients with recurrent disease. One subject was scanned multiple times. The method involves an automated, statistical analysis of vessel shape within a region of interest for each tumor, normalized by the values obtained from the vessels within the same region of interest of 34 healthy subjects. Results indicate that untreated tumors display statistically significant vessel tortuosity abnormalities. These abnormalities involve vessels not only within the tumor margins as defined from MR but also vessels in the surrounding tissue. The abnormalities resolve during effective treatment and recur with tumor recurrence. We conclude that vessel shape analysis could provide an important means of assessing tumor activity.

Cerebrovascular Circulation↗

Practical consideration for 3T imaging.

In the past 10 to 15 years, 1.5T has been one of the most commonly used field strengths for day-to-day clinical operations. However, recent advances in high field technology and the increased availability of high field (> 1.5T) human scanners have opened the doors for a variety of exciting improvements in clinical and research applications of MR imaging. In particular, 3T has continued to gain wide acceptance as one of the main field strengths for clinical and research studies. Therefore, in this article the authors focus on the pros and cons of 3T imaging and comparisons between results obtained at 3T and 1.5T.

Brain↗

Automatic brain tumor segmentation by subject specific modification of atlas priors.

RATIONALE AND OBJECTIVES: Manual segmentation of brain tumors from magnetic resonance images is a challenging and time-consuming task. An automated system has been developed for brain tumor segmentation that will provide objective, reproducible segmentations that are close to the manual results. Additionally, the method segments white matter, grey matter, cerebrospinal fluid, and edema. The segmentation of pathology and healthy structures is crucial for surgical planning and intervention. MATERIALS AND METHODS: The method performs the segmentation of a registered set of magnetic resonance images using an expectation-maximization scheme. The segmentation is guided by a spatial probabilistic atlas that contains expert prior knowledge about brain structures. This atlas is modified with the subject-specific brain tumor prior that is computed based on contrast enhancement. RESULTS: Five cases with different types of tumors are selected for evaluation. The results obtained from the automatic segmentation program are compared with results from manual and semi-automated methods. The automated method yields results that have surface distances at roughly 1-4 mm compared with the manual results. CONCLUSION: The automated method can be applied to different types of tumors. Although its performance is below that of the semi-automated method, it has the advantage of requiring no user supervision.

Automation↗

Structural and radiometric asymmetry in brain images.

This paper presents a general framework for analyzing structural and radiometric asymmetry in brain images. In a healthy brain, the left and right hemispheres are largely symmetric across the mid-sagittal plane. Brain tumors may belong to one or both of the following categories: mass-effect, in which the diseased tissue displaces healthy tissue; and infiltrating, in which healthy tissue has become diseased. Mass-effect brain tumors cause structural asymmetry by displacing healthy tissue, and may cause radiometric asymmetry in adjacent normal structures due to edema. Infiltrating tumors have a different radiometric response from healthy tissue. Thus, structural and radiometric asymmetries across the mid-sagittal plane in brain images provide important cues that tumors may be present. We have developed a framework that registers images with their reflections across the mid-sagittal plane. The registration process accounts for tissue displacement through large deformation image warping. Radiometric differences are taken into account through an additive intensity field. We present an efficient multi-scale algorithm for the joint estimation of structural and radiometric asymmetry. Results for nine MR images of patients with tumors and four normal control subjects are presented.

Algorithms↗

Measuring tortuosity of the intracerebral vasculature from MRA images.

The clinical recognition of abnormal vascular tortuosity, or excessive bending, twisting, and winding, is important to the diagnosis of many diseases. Automated detection and quantitation of abnormal vascular tortuosity from three-dimensional (3-D) medical image data would, therefore, be of value. However, previous research has centered primarily upon two-dimensional (2-D) analysis of the special subset of vessels whose paths are normally close to straight. This report provides the first 3-D tortuosity analysis of clusters of vessels within the normally tortuous intracerebral circulation. We define three different clinical patterns of abnormal tortuosity. We extend into 3-D two tortuosity metrics previously reported as useful in analyzing 2-D images and describe a new metric that incorporates counts of minima of total curvature. We extract vessels from MRA data, map corresponding anatomical regions between sets of normal patients and patients with known pathology, and evaluate the three tortuosity metrics for ability to detect each type of abnormality within the region of interest. We conclude that the new tortuosity metric appears to be the most effective in detecting several types of abnormalities. However, one of the other metrics, based on a sum of curvature magnitudes, may be more effective in recognizing tightly coiled, "corkscrew" vessels associated with malignant tumors.

Brain↗

Comparisons of regional white matter diffusion in healthy neonates and adults performed with a 3.0-T head-only MR imaging unit.

PURPOSE: To evaluate the normal brains of adults and neonates for regional and age-related differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA). MATERIALS AND METHODS: Eight healthy adults and 20 healthy neonates were examined with a 3.0-T head-only magnetic resonance (MR) imaging unit by using a single-shot diffusion-tensor sequence. Trace ADC maps, FA maps, directional maps of the putative directions of white matter (WM) tracts, and fiber-tracking maps were obtained. Regions of interest-eight in WM and one in gray matter (GM)-were predefined for the ADC and FA measurements. The Student t test was used to compare FA and ADC between adults and neonates, whereas the Tukey multiple-comparison test was used to compare FA and ADC in different brain regions in the adult and neonate groups. RESULTS: A global elevation in ADC (P <.001) in both GM and WM and a reduction in FA (P <.001) in WM were observed in neonates as compared with these values in adults. In addition, significant regional variations in FA and ADC were observed in both groups. Regional variations in FA and ADC were less remarkable in adults, whereas neonates had consistently higher FA values and lower ADC values in the central WM as compared with these values in the peripheral WM. Fiber tracking revealed only major WM tracts in the neonates but fibers extending to the peripheral WM in the adults. CONCLUSION: There were regional differences in FA and ADC values in the neonates; such variations were less remarkable in the adults.

Adult↗

Amygdala-hippocampal shape differences in schizophrenia: the application of 3D shape models to volumetric MR data.

Evidence suggests that some structural brain abnormalities in schizophrenia are neurodevelopmental in origin. There is also growing evidence to suggest that shape deformations in brain structure may reflect abnormalities in neurodevelopment. While many magnetic resonance (MR) imaging studies have investigated brain area and volume measures in schizophrenia, fewer have focused on shape deformations. In this MR study we used a 3D shape representation technique, based on spherical harmonic functions, to analyze left and right amygdala-hippocampus shapes in each of 15 patients with schizophrenia and 15 healthy controls matched for age, gender, handedness and parental socioeconomic status. Left/right asymmetry was also measured for both shape and volume differences. Additionally, shape and volume measurements were combined in a composite analysis. There were no differences between groups in overall volume or shape. Left/right amygdala-hippocampal asymmetry, however, was significantly larger in patients than controls for both relative volume and shape. The local brain regions responsible for the left/right asymmetry differences in patients with schizophrenia were in the tail of the hippocampus (including both the inferior aspect adjacent to parahippocampal gyrus and the superior aspect adjacent to the lateral geniculate nucleus and more anteriorly to the cerebral peduncles) and in portions of the amygdala body (including the anterior-superior aspect adjacent to the basal nucleus). Also, in patients, increased volumetric asymmetry tended to be correlated with increased left/right shape asymmetry. Furthermore, a combined analysis of volume and shape asymmetry resulted in improved differentiation between groups. Classification function analyses correctly classified 70% of cases using volume, 73.3% using shape, and 87% using combined volume and shape measures. These findings suggest that shape provides important new information toward characterizing the pathophysiology of schizophrenia, and that combining volume and shape measures provides improved group discrimination in studies investigating brain abnormalities in schizophrenia. An evaluation of shape deformations also suggests local abnormalities in the amygdala-hippocampal complex in schizophrenia.

Adult↗