Biomedical subjects

L L Wald

Publications and source records attributed to L L Wald.

25 records · Page 2Linked to original sources

PubMed1997

High-resolution surface-coil MR of cortical lesions in medically refractory epilepsy: a prospective study.

PURPOSE: To determine the role of surface-coil MR imaging in evaluating medically refractory neocortical partial epilepsy. METHODS: A prospective study of 25 patients with medically refractory neocortical partial epilepsy was performed. Head- and surface-coil images were reviewed by two neuroradiologists to determine the clarity with which cortical lesions were depicted. The ability of imaging, combined with surface electroencephalography (EEG), to locate the suspected epileptogenic zone was evaluated. RESULTS: Compared with head-coil studies, surface-coil studies showed four more lesions, caused the most probable diagnosis to be altered in five patients, and better defined the lesions in four patients. Of 11 patients with lobar EEG abnormalities, imaging showed focal cortical abnormalities within the same or adjacent lobe in five and multifocal abnormalities in two. Of six patients with EEG abnormalities restricted to two adjacent lobes, imaging showed focal cortical abnormalities in one of these lobes in five patients and multifocal abnormalities in one patient. Of eight patients with a nonfocal EEG, imaging showed focal cortical abnormalities in five and multifocal cortical abnormalities in one. In two of 13 patients, video/EEG telemetry improved seizure location whereas surface-coil imaging showed focal cortical lesions in six and provided relevant prognostic information in five. CONCLUSION: Compared with head-coil studies, surface-coil imaging of the cerebral cortex improved detection and differentiation of focal cortical lesions in 64% of patients. Video/EEG telemetry improved location in 15% of patients, and surface-coil imaging combined with EEG results provided improved location of the suspected epileptogenic zone or relevant prognostic information in 85%.

Adolescent↗

PubMed1996

A technique for detecting GABA in the human brain with PRESS localization and optimized refocusing spectral editing radiofrequency pulses.

A proton magnetic resonance spectral editing technique is presented that uses PRESS excitation to achieve spatially localized measurements of brain gamma-aminobutyric acid (GABA). The homonuclear difference spectroscopy technique employs a frequency selective inversion pulse to suppress the creatine resonance at 3.0 ppm. The timing of this pulse is optimized to maximize the suppression of creatine by minimizing the effect of the editing pulse on the 3.0 ppm resonances. The PRESS excitation achieves three dimensional spatial localization in a single acquisition making it less sensitive to patient motion than multiple acquisition techniques. The performance and utility of this technique were evaluated by phantom experiments and by in vivo measurements of brain GABA concentration in 10 normal subjects.

Brain↗

PubMed1995

Phased array detectors and an automated intensity-correction algorithm for high-resolution MR imaging of the human brain.

Two- and four-coil phased array detectors were developed to increase the sensitivity and resolution of MR imaging of the human brain cortex, especially for detecting cortical dysplasias in pediatric epilepsy patients. An automated intensity correction algorithm based on an edge-completed, low-pass filtered image was used to correct the image intensity for the inhomogenous reception profile of the coils. Seven phased array coils were constructed and tested. The sensitivity of these coils was up to 600% higher at the surface of the cortex than that achieved with a conventional head coil and up to 30% greater at the center of the head. The sensitivity obtained was comparable with that of a conventional small surface coil, but extended over the larger dimensions of the array and previously inaccessible areas such as the top of the head. The advantages of the improved sensitivity are demonstrated with high resolution images of the brain.

Adult↗

PubMed1995

Proton spectroscopic imaging of the human brain using phased array detectors.

Two and four-coil phased array detectors have been developed to increase the sensitivity of proton spectroscopic imaging of the human brain. These include a quadrature figure-8 coil for the study of the vertex, several arrays of 2-4 small overlapping (6-8 cm diameter) circular coils and a combination figure-8 coil plus circular coil. These were constructed in our laboratory and tested to assess their utility for brain spectroscopy. Methods for optimally combining the data from the independent receivers based on the analytical coil maps or measured signal to noise ratios (SNRs) of the data were investigated. High spatial resolution (0.2-0.4 cm3 voxel size) two- or three-dimensional chemical shift images of normal brain were obtained in 17-minute acquisitions. These spatial resolutions are comparable to those previously obtained with conventional small surface coils, but the specialized detectors allow this sensitivity to be achieved for a larger region or for previously inaccessible areas such as the top of the head. The coverage and SNR increases demonstrated are similar to those obtained in magnetic resonance phased array imaging.

Brain↗

PubMedDate not supplied

High resolution T2-weighted imaging of the human brain using surface coils and an analytical reception profile correction.

High spatial resolution T2-weighted MR images of the human brain were obtained at 1.5 T. An optimized fast spin-echo (FSE) sequence and 1.5 g/cm gradients were used to obtain T2-weighted images in 4 to 9 minutes with an in-plane resolution of .27 mm and slice thicknesses from 1.5 to 3 mm. Phased arrays of surface coils were used as receivers, providing increased sensitivity but image intensities dependent on the reception profile of the coils. This image nonuniformity was removed by analyzing the data with a theoretical intensity correction algorithm developed in this laboratory. The FSE sequences, the specialized phased arrays of surface coils, and the intensity correction algorithm allowed improved visualization of nerves within the inner auditory canals and surface anatomy of the cerebral cortex. It is expected that this technique will be useful for clinical applications that require high resolution imaging of small, superficial structures of the brain.

Algorithms↗

PubMedDate not supplied

Volume MRI and MRSI techniques for the quantitation of treatment response in brain tumors: presentation of a detailed case study.

Patients with primary brain tumors may be considered for several different treatments during the course of their disease. Assessments of disease progression and response to therapy are typically performed by visual interpretation of serial MRI examinations. Although such examinations provide useful morphologic information, they are unable to reliably distinguish active tumor from radiation necrosis. This poses a particular problem in the assessment of response to localized radiation therapies such as gamma knife radiosurgery. In this paper, we present methodology for evaluating changes in tissue morphology and metabolism based on serial volumetric MRI and magnetic resonance spectroscopic imaging (MRSI) examinations. Registration and quantitative analysis of these data provide measurements of the temporal and spatial distributions of gadolinium enhancement and of N-acetylasparate, choline, creatine, and lactate/lipid. The key features of this approach and the potential clinical benefits are illustrated by a detailed analysis of six serial MRI/MRSI examinations and three serial 1-[F-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) studies on a patient with a recurrent anaplastic astrocytoma.

Adult↗

PubMedDate not supplied

Alignment of volume MR images and high resolution [18F]fluorodeoxyglucose PET images for the evaluation of patients with brain tumors.

PURPOSE: The goal of the study was to investigate the use of automated registration techniques for interpretation of volume MR and high resolution FDG-PET images that were obtained from patients with brain tumors. METHOD: Twenty-one patients with brain tumors were studied on one or more occasions using MRI and high resolution FDG-PET. The data were aligned using automated volume- and surface-matching algorithms. Composite images comprising the resliced pre- and postgadolinium spoiled GRE, T2-weighted SE, and PET data were constructed to correlate intensities of regions on the PET images with regions that corresponded to normal gray matter, white matter, and gadolinium enhancement. RESULTS: The accuracy of registration between the MR and PET images was estimated to be within 1-2 mm based upon the distance between surfaces of the outside of the head. In 12 of the 24 examinations, there were diagnoses of recurrent tumor, with only 5 of these exhibiting regions of higher FDG uptake than normal gray matter. For 19 of the 24 studies, the anatomic context provided by the registered MR images was found to be important in distinguishing recurrent tumor from necrosis based upon FDG uptake. CONCLUSION: The automated alignment was found to be an important factor in interpreting the high resolution PET images. This was particularly true for small lesions close to the cortex and for situations where FDG uptake had been reduced by prior treatment with radiation therapy.

Adult↗