Search PubMed⌕ Search

Biomedical subjects

Joel P Felmlee

Publications and source records attributed to Joel P Felmlee.

At least 19 recordsLinked to original sources
PubMed2007

Anatomic compartments of the foot: a 3-Tesla magnetic resonance imaging study.

There is neither consensus on the number nor agreement on the location of the anatomic compartments of the foot. This project utilized high-resolution magnetic resonance imaging (MRI) to identify foot compartments. The purpose of this study was to devise a new system using 3-Tesla (3T) MRI that assessed the number and location of these compartments. Six feet from healthy volunteers were imaged. From these, 10 compartments were described: (1) medial, (2) calcaneal, (3) lateral, (4) central superficial, (5) central deep (adductor), (6-9) interossei, and (10) skin. The 3T MRI and foot/ankle coil allowed us to assess the number and location of foot compartments.

Compartment Syndromes↗
PubMed2006

Fiducial markers for MR histological correlation in ex vivo or short-term in vivo animal experiments: a screening study.

PURPOSE: To test injectable fiducial markers for magnetic resonance (MR) histological correlation in ex vivo or in vivo animal experiments. MATERIALS AND METHODS: A total of 35 potential markers were tested ex vivo in pork muscle. The end-points were: 1) visibility, size, and shape on MR images and at macroscopic examination; 2) 24-hour stability; and 3) microscopic appearance. Selected markers were injected in vivo (rabbit's muscle and breast tumor tissue) to test their three-hour in vivo stability and their potential toxicity. Finally, different dilutions of the two best markers were assessed again through the same screening tests to determine whether their size on MR images could be customized by dilution. RESULTS: Two fluid acrylic paints containing inorganic pigments were found to be potentially interesting markers. On MR images, they created well-defined susceptibility artifacts. The markers made with iridescent bronze paint (iron oxide coated mica particles) were readily visible on microscopy and their size on MR images could be customized by dilution. The iridescent stainless steel paint (iron, chromium, nickel) created ex vivo the smallest markers in tissue but needed colloidal iron staining to be visible on microscopy and could not be easily diluted. CONCLUSION: Fluid acrylic paints are potentially interesting markers for MR histological correlation. Further studies are needed to assess their long-term properties.

Acrylates↗
PubMed2006

MR histological correlation: a method for cutting specimens along the imaging plane in animal or ex vivo experiments.

PURPOSE: To assess a method aimed at cutting histological specimens along the magnetic resonance (MR) imaging plane. MATERIAL AND METHODS: The method is performed in two steps: the imaging plane (defined by three acrylic paint markers) is made horizontal under MR guidance by using a mobile platform that can be rotated in three directions (PlaneFinder device [PFD]); then, the specimen is embedded in wax and cut horizontally. Three-dimensional images parallel to the markers' plane were obtained on 31 pork muscles containing a central hole with a pyramidal shape, with a technique of reference (RT images) and with PFD (PF images), before and after fixation. The last 17 fixed specimens were cut in the markers' plane (tissue section [TS] images). The central hole area (CHA) in the markers' plane was used to compare RT, PF, and TS images. Using a workstation, PF images were rotated and translated to estimate the shift along each direction that could explain the entire CHA difference between RT, PF, and TS images (maximum error, worst-case scenario). RESULTS: Excellent correlation was found between RT and PF images (r = 0.989, slope = 1.0175), PF and TS images (r = 0.991, slope = 1.0058), and RT images on fresh specimens and TS images (r = 0.979, slope = 1.0732). For each step, the maximum angle error was < or = 3 degrees in 88-95% of the specimens. CONCLUSION: Our methodology can be used to cut specimens along the imaging plane with high accuracy.

Acrylates↗
PubMed2006

MR angiography fusion technique for treatment planning of intracranial arteriovenous malformations.

PURPOSE: To develop an image fusion technique using elliptical centric contrast-enhanced (CE) MR angiography (MRA) and three-dimensional (3D) time-of-flight (TOF) acquisitions for radiosurgery treatment planning of arteriovenous malformations (AVMs). MATERIALS AND METHODS: CE and 3D-TOF MR angiograms with disparate in-plane fields of view (FOVs) were acquired, followed by k-space reformatting to provide equal voxel dimensions. Spatial domain addition was performed to provide a third, fused data volume. Spatial distortion was evaluated on an MRA phantom and provided slice-dependent and global distortion along the three physical dimensions of the MR scanner. In vivo validation was performed on 10 patients with intracranial AVMs prior to their conventional angiogram on the day of gamma knife radiosurgery. RESULTS: Spatial distortion in the phantom within a volume of 14 x 14 x 3.2 cm(3) was less than +/-1 mm (+/-1 standard deviation (SD)) for CE and 3D-TOF data sets. Fused data volumes were successfully generated for all 10 patients. CONCLUSION: Image fusion can be used to obtain high-resolution CE-MRA images of intracranial AVMs while keeping the fiducial markers needed for gamma knife radiosurgery planning. The spatial fidelity of these data is within the tolerance acceptable for daily quality control (QC) purposes and gamma knife treatment planning.

Adult↗
PubMed2006

Stiffness-weighted magnetic resonance imaging.

An imaging method is introduced in which the signal in MR images is affected by the stiffness distribution in the object being imaged. Intravoxel phase dispersion (IVPD) that occurs during MR elastography (MRE) acquisitions decreases the signal in soft regions more than in stiff regions due to changes in shear wave amplitude and wavelength. The IVPD effect is enhanced by lowpass filtering the MR k-space data with a circular Gaussian lowpass filter. A processing method is introduced to take the time series of MRE magnitude images with IVPD and produce a final stiffness-weighted image (SWI) by calculating the minimum signal at each pixel from a small number of temporal samples. The SWI technique is demonstrated in phantom studies as well as in the case of a preserved postmortem breast tissue specimen with a stiff lesion created by focused ultrasound ablation to mimic a breast cancer. When free of significant sources of depth-dependent wave attenuation, interference, and boundary effects, SWI is a simple, fast, qualitative technique that does not require the use of phase unwrapping or inversion algorithms for localizing stiff regions in an object.

Algorithms↗
PubMed2006

Feasibility of simultaneous temperature and tissue stiffness detection by MRE.

Temperature and tissue stiffness are two indices that can be used to monitor MRI-guided focused ultrasound thermal therapy. It would be beneficial to have both measures available to monitor treatment progression during thermal therapy. MR Elastography (MRE) has already been shown to provide tissue stiffness information; the purpose of this work is to demonstrate how temperature can be derived from the same MRE data acquisition. MRE data were acquired from 1.5% agarose phantoms and ex vivo porcine muscle tissue (from a grocery store) while they were heated slowly. The temperatures were measured using a fluorescent thermometer. The phase average from the MRE acquisition was used to calculate the phase shift induced by the proton resonance frequency shift associated with the temperature change. The results show that the phase shift due to temperature extracted from MRE data correlate well with the temperature change recorded by thermometer, yielding a temperature coefficient of -0.0096 ppm/ degrees C for the agarose phantom, and -0.0103 ppm/ degrees C for the ex vivo porcine tissue. These results indicate that it is possible to simultaneously measure both temperature and tissue shear stiffness using a new method of MRE data reconstruction.

Animals↗
PubMed2006

Rapid MR elastography using selective excitations.

Rapid MR elastography (MRE) techniques using spatially-selective excitations to reduce acquisition times to a few seconds or less were devised and tested. The techniques included reduced field of view (rFOV) MRE and 1D MRE (beam MRE) using 2D spatially selective RF excitations for gradient-echo (GRE) applications and intersecting 90 degrees and 180 degrees slice-selective excitations for spin-echo (SE) applications. It was shown that scan times could be reduced by a factor of 8 using rFOV MRE, and by 64 using beam MRE, while still obtaining stiffness estimates comparable to full-FOV MRE. Results were shown in gel phantom experiments as well as in the case of a preserved postmortem breast tissue specimen with a stiff lesion. These methods can be used to more rapidly interrogate regions of interest (ROIs) in tissue to quickly obtain information about the viscoelastic properties of that tissue.

Algorithms↗
PubMed2006

Noninvasive treatment of uterine fibroids: early Mayo Clinic experience with magnetic resonance imaging-guided focused ultrasound.

Uterine fibroids often cause symptoms of pelvic pain, pressure, and bleeding. Traditional therapies have included medical (eg, hormonal therapy) and surgical (eg, myomectomy, hysterectomy) options. Recently, uterine artery embolization was added to the treatment armamentarium. We describe an exciting new non-invasive treatment option using focused ultrasound with magnetic resonance imaging and summarize the early experience at the Mayo Clinic in Rochester, Minn, during the initial research studies of this new technology.

Female↗
PubMed2005

Safety evaluation of titanium middle ear prostheses at 3.0 tesla.

OBJECTIVE: To assess the magnetic resonance imaging (MRI) safety of titanium middle ear prostheses at 3.0 tesla (T). STUDY DESIGN AND SETTING: Titanium middle ear prostheses from 3 commercial vendors were examined for magnetic field interactions at 3 T. Initially, ex vivo studies were performed to test for rotational motion and forward displacement (translational motion) of the prostheses in a static magnetic field. If movement was observed during this screening study, then the prosthesis was tested to determine the translational or rotational force acting upon the prosthesis. In addition to testing for prosthesis displacement, temperature changes of the prostheses were measured to assess for radiofrequency heating during imaging. RESULTS: Twenty-one of the 24 titanium prostheses tested revealed no movement when tested in the 3 T static magnetic field. Three prostheses revealed minimal movement during the screening study. A translational force test (string test) was performed upon these 3 prostheses, and the measured angle of displacement was used to determine the force. This calculated force acting upon each prosthesis was essentially zero. Therefore, we conclude that the magnetic field interaction is negligible. A positive control with a ferromagnetic stainless steel prosthesis demonstrated obvious displacement during the screening study, as well as deflection of the prosthesis by 90 degrees in the translational force test. Last, heating of the titanium prostheses did not occur in the 7 models tested. CONCLUSIONS: Middle ear prostheses made from titanium are safe, neither deflecting nor heating during magnetic resonance examinations conducted at 3 T. EBM RATING: C-1.

Equipment Failure Analysis↗
PubMed2005

CT fluoroscopy-guided biopsy of the lung or upper abdomen with a breath-hold monitoring and feedback system: a prospective randomized controlled clinical trial.

PURPOSE: To prospectively determine the clinical effectiveness of a breath-hold monitoring and feedback system in computed tomographic (CT) fluoroscopy-guided biopsies in which respiratory motion is a problem. MATERIALS AND METHODS: Institutional review board approval and oral and written informed consent were obtained. This study was HIPAA compliant. A bellows-based system was used to monitor respiration and provide patient feedback. A randomized controlled clinical trial compared intermittent mode CT fluoroscopy-guided biopsies of the lung or upper abdomen performed with (n = 56) and without (n = 57) the bellows system. Inclusion criteria for 113 patients were lesions 6 cm or smaller in maximum dimension that were not affixed to the chest or abdominal wall. Primary outcome measurements were CT fluoroscopy exposure time and patient dose. Wilcoxon rank sum, chi(2), and Fisher exact tests were used for statistical analysis. RESULTS: Median CT fluoroscopy exposure time was 12.6 seconds (range, 2.4-44.4 seconds) for the bellows group and 18.0 seconds (range, 6.0-118.0 seconds) for the nonbellows group (P = .004). Patient dose was decreased in the bellows group (median dose, 29.5 mGy; range, 4.7-135.8 mGy) versus the nonbellows group (median, 41.3 mGy; range, 11.8-155.9 mGy) (P = .01). Lesions were accessed successfully with one needle puncture attempt in 43 of 56 patients (77%) in the bellows group and 30 of 57 patients (53%) in the nonbellows group (P = .007). Pneumothorax developed in 11 of 50 patients (22%) in the bellows group who underwent lung biopsy compared with 16 of 50 (32%) patients in the nonbellows group. CONCLUSION: A breath-hold monitoring and feedback system allows depiction of mobile target lesions throughout CT fluoroscopy-guided biopsy of the lung and upper abdomen.

Abdomen↗
PubMed2004

Self-navigated motion correction using moments of spatial projections in radial MRI.

Interest in radial MRI (also known as projection reconstruction (PR) MRI) has increased recently for uses such as fast scanning and undersampled acquisitions. Additionally, PR acquisitions offer intrinsic advantages over standard two-dimensional Fourier transform (2DFT) imaging with respect to motion of the imaged object. It is well known that aligning each spatial domain projection's center of mass (calculated using the 0th and 1st moments) to the center of the field of view (FOV) corrects shifts caused by in-plane translation. In this work, a previously unrealized ability to determine the in-plane rotational motion of an imaged object using the 2nd moments of the spatial domain projections in conjunction with a specific projection angle acquisition time order is reported. We performed the correction using only the PR data itself acquired with the newly proposed projection angle acquisition time order. With the proposed view angle acquisition order, the acquisition is "self-navigating" with respect to both in-plane translation and rotation. We reconstructed the images using the aligned projections and detected acquisition angles to significantly reduce image artifacts due to such motion. The theory of the correction technique is described, and its effectiveness is demonstrated in phantom and in vivo experiments.

Algorithms↗
PubMed2004

Safety and MRI artifact evaluation at 1.5 T of metallic mounting sheath of a marking clip inadvertently deployed at stereotactic biopsy.

OBJECTIVE: The purpose of our study was to assess the MRI risk factors for the patient after an unusual case of inadvertent deployment of the mounting sheath of a metallic clip used at stereotactic breast biopsy. MATERIALS AND METHODS: We evaluated the materials for ferromagnetic properties, heating, and artifacts. RESULTS: Our analysis showed significant deflection and prominent susceptibility artifacts of the sheath at 1.5 T, although the clip itself showed no deflection and only minimal artifact. Our study shows that a device and its delivery apparatus may have significantly different ferromagnetic properties. CONCLUSION: In case of inadvertent deployment of the sheath, a delay of 6-8 weeks before MRI is recommended as a conservative approach to ensure tissue ingrowth and to minimize the chance of harm to the patient. In the case of metallic clips used for breast biopsy, caution is warranted when a portion of the device unintended for placement is introduced into the breast.

Artifacts↗
PubMed2003

Shear stiffness estimation using intravoxel phase dispersion in magnetic resonance elastography.

Dynamic MR elastography (MRE) is a phase-contrast technique in which the periodic shear motion of an object is encoded as variations in the phase of the reconstructed images. An alternative MRE method is presented whereby waves are depicted as intensity variations in the magnitude images due to intravoxel phase dispersion (IVPD). A theoretical framework is developed to model how the IVPD magnitude data are related to the underlying shear wave motion, and how they can be used to estimate shear stiffness. The results are shown in a series of phantom experiments to demonstrate that IVPD MRE complements phase-contrast MRE.

Agar↗
PubMed2003

Magnetic resonance measurements of renal blood flow as a marker of disease severity in autosomal-dominant polycystic kidney disease.

BACKGROUND: Autosomal-dominant polycystic kidney disease (ADPKD) is an inherited disorder characterized by renal cyst growth, early development of hypertension, and late occurrence of renal insufficiency. Despite evidence for the importance of nephroangiosclerosis in the progression of renal insufficiency in ADPKD, evaluation of renal blood flow (RBF) as a surrogate marker of disease severity has received little attention. METHODS: Flow phantoms and repeat RBF measurements assessed accuracy and reproducibility. One hundred twenty-seven ADPKD subjects with creatinine clearances >70 mL/min underwent measurements of RBF, total, and cyst renal volumes, and % cyst volumes by magnetic resonance (MR) and of glomerular filtration rate (GFR). Renal vascular resistance (RVR) was calculated. MR blood flow sequences utilized a two-dimensional cine phase-contrast breath-hold pulse sequence perpendicular to the renal arteries. Flow rates were calculated utilizing FLOW software. Volumetric analysis was performed using stereology and region-based thresholding. RESULTS: Excellent accuracy and intraobserver and interobserver reproducibility were demonstrated. Anatomic (total kidney volume, total cyst volume, and % cyst volume), hemodynamic (RBF and RVR), and functional (GFR) parameters were strongly correlated. Left polycystic kidneys were larger and had more severe disease. Regression analysis showed that age, diagnosis of hypertension, anatomic parameters and hemodynamic parameters were significant predictors of GFR. Multiple linear regression analysis identified age and hemodynamic parameters only as separate predictors of GFR. Anatomic, hemodynamic, and functional parameters discriminated between normotensive and hypertensive subjects despite antihypertensive treatments. CONCLUSION: Renal hemodynamic parameters measured by MR correlate with anatomic and functional indices of disease severity, are the strongest predictors of renal function, and deserve further consideration as an outcome measure in clinical trials to guide therapy in ADPKD.

Adult↗
PubMed2003

Intermittent-mode CT fluoroscopy-guided biopsy of the lung or upper abdomen with breath-hold monitoring and feedback: system development and feasibility.

A bellows-based breath-hold monitoring and feedback system was developed and evaluated for use in intermittent-mode computed tomographic (CT) fluoroscopy-guided biopsy procedures in the lung or upper abdomen. The bellows system is described, and its feasibility is demonstrated in studies with a respiratory phantom and human volunteers. Results are reported for seven patients who underwent bellows-assisted biopsy. Breath-hold monitoring and feedback with the bellows system allow the patient to perform reliable breath holding at a preselected level. This optimizes intermittent-mode CT fluoroscopy-guided biopsies by allowing consistent visualization of the target lesion throughout the procedure.

Abdomen↗
PubMed2002

Hybrid phased array for improved internal auditory canal imaging at 3.0-T MR.

PURPOSE: To develop and evaluate a hybrid phased array for internal auditory canal (IAC) imaging at 3.0 T. MATERIALS AND METHODS: A hybrid phased array was designed and built as two circular surface receive-only coils combined with a volume transmit-receive birdcage head coil for simultaneous image acquisition. Phantom and volunteer images were obtained to assess the coil performance. RESULTS: The phantom data show that significant signal-to-noise ratio (SNR) improvement was achieved in the region corresponding to the inner ear, i.e., by a factor of 2.5 compared to the standard head coil data. Volunteer IAC image quality was deemed superior as compared to images acquired at 3.0 T using a standard head coil. CONCLUSION: This hybrid array combined with three-dimensional fast spin-echo (FSE) acquisition resulted in improved high spatial resolution IAC imaging.

Ear, Inner↗