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Biomedical subjects

M D Robson

Publications and source records attributed to M D Robson.

18 recordsLinked to original sources

Between session reproducibility and between subject variability of diffusion MR and tractography measures.

As diffusion tractography is increasingly used to generate quantitative measures to address clinical questions, it is important to characterise the inter-session reproducibility and inter-subject variability of these measures. Here, we assess the reproducibility and variability of diffusion tractography measures using diffusion data from 8 subjects scanned 3 times. We used probabilistic tractography to define the cingulum bundle, pyramidal tracts, optic radiations and genu of the corpus callosum in each individual data set using three different methods of seed definition. Measures of mean fractional anisotropy (FA) and mean diffusivity (MD) along the tracts were more reproducible than measures of tract volume. Further, tracts defined using a two region of interest (ROI) approach were more reproducible than those defined using manually placed seed masks alone. For mean FA taken from tracts defined using the two ROI approach, inter-session coefficients of variation (CV) were all below 5% and inter-subject CVs were below 10%; for mean MD inter-session, CVs were all below 3% and inter-subject CVs were below 8%. We use the variability measures found here to calculate the sample sizes required to detect changes in FA, MD or tract volume of a given size, either between groups of subjects or within subjects over time. Finally, we compare tractography results using 60 diffusion encoding directions to those found using a subset of 12 directions; the number of diffusion directions did not have a significant effect on reproducibility, but tracts derived using fewer directions were consistently smaller than those derived using 60 direction data. We suggest that 12 direction data are sufficient for reproducibly defining the core of large bundles but may be less sensitive to smaller pathways.

Adult↗

Cardiovascular magnetic resonance imaging for non-invasive assessment of vascular function: validation against ultrasound.

Ultrasound is an established modality for quantification of vascular function in clinical studies of cardiovascular disease. We determined whether cardiovascular magnetic resonance imaging (CMR) can provide a comparable assessment of vascular function. In seventeen control subjects, we used CMR to quantify endothelium-dependent (flow mediated dilatation, FMD) and endothelium-independent dilatation of the brachial artery, brachial and carotid distensibility, aortic compliance, and pulse wave velocity. These were compared to brachial and carotid measurements obtained by established ultrasound protocols. Twelve of the volunteers then underwent repeated measurements with both modalities. There was good agreement between imaging modalities for measures of endothelial function and arterial structure in the same subjects (difference between CMR and ultrasound for FMD = 0.14 +/- 6.8%, and brachial artery area = - 0.7 +/- 2.2 mm2, correlation between modalities for FMD = 0.62, p = 0.01 and for area = 0.87, p = < 0.0001). Inter-study reproducibility was also similar (coefficient of variation (CV) for FMD: CMR = 0.3, ultrasound = 0.3, CV for brachial artery area: CMR = 0.1, ultrasound = 0.1). Comparability and reproducibility were not as strong for functional measures if repeated studies were several days apart (CV for FMD by ultrasound on the same day = 0.1 and several days apart = 0.4). CMR and ultrasound show good agreement for quantitative measures of vascular structure and function with good reproducibility for both modalities. The major advantage of CMR is that it allows one-stop integrated assessment of both peripheral and central measures of vascular function.

Adult↗

A consistent relationship between local white matter architecture and functional specialisation in medial frontal cortex.

Functionally significant landmarks in the brain do not necessarily align with local sulcal and gyral architecture in a manner that is consistent across individuals. However, the functional specialisation underlying these landmarks is strongly constrained by the connectional architecture of the region. Here, we explore this relationship in the supplementary motor area (SMA) and pre-SMA in the medial frontal cortex of the human brain. Using diffusion tensor, conventional and functional MR imaging, we find that the location of the functional boundary between SMA and preSMA is more consistent with respect to specific features of the local white matter as it approaches neocortex than with respect to the local gyral and sulcal anatomy in the region.

Adult↗

Changes in connectivity profiles define functionally distinct regions in human medial frontal cortex.

A fundamental issue in neuroscience is the relation between structure and function. However, gross landmarks do not correspond well to microstructural borders and cytoarchitecture cannot be visualized in a living brain used for functional studies. Here, we used diffusion-weighted and functional MRI to test structure-function relations directly. Distinct neocortical regions were defined as volumes having similar connectivity profiles and borders identified where connectivity changed. Without using prior information, we found an abrupt profile change where the border between supplementary motor area (SMA) and pre-SMA is expected. Consistent with this anatomical assignment, putative SMA and pre-SMA connected to motor and prefrontal regions, respectively. Excellent spatial correlations were found between volumes defined by using connectivity alone and volumes activated during tasks designed to involve SMA or pre-SMA selectively. This finding demonstrates a strong relationship between structure and function in medial frontal cortex and offers a strategy for testing such correspondences elsewhere in the brain.

Adult↗

Contrast enhancement of short T2 tissues using ultrashort TE (UTE) pulse sequences.

AIM: To review the effects of contrast administration on tissues with short T2s using a pulse ultrashort echo time (UTE) sequence. MATERIALS AND METHODS: Pulse sequences were implemented with echo times of 0.08 ms and three later gradient echoes. A fat-suppression option was used and later echo images were subtracted from the first echo image. Contrast enhancement with gadodiamide (0.3 mmol/kg) was used for serial studies in a volunteer. The images of 10 patients were reviewed for evidence of contrast enhancement in short T2 tissues. RESULTS: Contrast enhancement was seen in normal meninges, falx, tendons, ligaments, menisci, periosteum and cortical bone. In addition more extensive enhancement than with conventional pulse sequences was seen in meningeal disease, intervertebral disc disease, periligamentous scar tissue and periosteum after fracture. Subtraction of an image taken with a longer TE from the first image was of value in differentiating enhancement in short T2 tissues from that in long T2 tissues or blood. CONCLUSION: Contrast enhancement can be identified in tissues with short T2s using UTE pulse sequences in health and disease.

Connective Tissue↗

Magnetic resonance imaging of the Achilles tendon using ultrashort TE (UTE) pulse sequences.

AIM: To assess the potential value of imaging the Achilles tendon with ultrashort echo time (UTE) pulse sequences. MATERIALS AND METHODS: Four normal controls and four patients with chronic Achilles tendinopathy were examined in the sagittal and transverse planes. Three of the patients were examined before and after intravenous gadodiamide. RESULTS: The fascicular pattern was clearly demonstrated within the tendon and detail of the three distinct fibrocartilaginous components of an "enthesis organ" was well seen. T2* measurements showed two short T2* components. Increase in long T2 components with reduction in short T2 components was seen in tendinopathy. Contrast enhancement was much more extensive than with conventional sequences in two cases of tendinopathy but in a third case, there was a region of reduced enhancement. CONCLUSION: UTE pulse sequences provide anatomical detail not apparent with conventional sequences, demonstrate differences in T2* and show patterns of both increased and decreased enhancement in tendinopathy.

Achilles Tendon↗

MRI of the brain with ultra-short echo-time pulse sequences.

As well as the long-T2 relaxation components normally detected with conventional imaging techniques, the brain has short-T2 components. We wished to use ultra-short (0.08 ms) echo time (UTE) pulse sequences to assess the feasibility of imaging these in normal subjects and patients. UTE sequences were employed, with or without fat suppression, 90 degree long-T2 suppression pulses, and selective nulling of long-T2 components using an inversion pulse. Subtraction of later echoes from the first was also used to reduce the signal from long-T2 components. We studied dive normal subjects and 15 patients with various diseases. Short-T2 components were demonstrated in grey and white matter. Increased signal from these components was seen in meningeal disease, probable calcification, presumed cavernomas, melanoma metastases and probable gliosis. Reduced signal was seen in some tumours, infarcts, mild multifocal vascular disease and vasogenic oedema. Further development and evaluation of these pulse sequences is warranted.

Adult↗

Quantitative imaging of magnetization transfer using multiple selective pulses.

New spectroscopic and imaging methods have been developed for quantitatively measuring magnetization transfer (MT). These methods use trains of radiofrequency (rf) pulses with pulse separations much longer than 1/k(mf) and pulse durations much shorter than 1/k(mf), where k(mf) is the rate of MT from the immobile (macromolecular) protons to the mobile (free water) protons. Signal sensitivity to MT occurs when these pulses affect the mobile and immobile proton pools to different degrees. The signal from water may be quantitatively related to the macromolecular content of the sample using theory. The method has been used to make quantitative measurements of macromolecular content in cross-linked bovine serum albumin and employed in conjunction with echoplanar imaging to produce maps of the spatial distribution of the macromolecular content.

Algorithms↗

Measurements of the temporal fMRI response of the human auditory cortex to trains of tones.

Averaged single trials (AST) allowed the functional magnetic resonance imaging (fMRI) response to auditory stimuli to be measured at high temporal (1 s) and spatial (0.1 cm3) resolution. Using this paradigm we investigated the transient signal response to 100-ms tone bursts in trains of between 100 ms and 25.5 s in total duration. We have demonstrated that the fMRI response to such auditory stimuli is approximately linear for trains of 6 s and longer, but that shorter stimuli produce signals that are larger than might be expected from the response to the longer stimuli. This nonlinear behavior can be modeled if an adaptive response to each stimulus is assumed. A study using a novel paradigm was also performed in order to study the influence of scanner noise during fMRI experiments on the auditory system response to tones. This study demonstrated that the temporal response to 700-ms tone stimuli is modified when performed in the presence of scanner gradient noise, the modification being a small but significant increase (P < 0.05) in the magnitude of the response. Finally the ability to measure the onset of functional activation using the AST method was examined. It was found, with the aid of computer simulation that a sampling rate of one image per second is adequate to distinguish temporal responses. Using the data acquired in this study, onset times were calculated for the auditory cortex, and these results are consistent with current models of functional activation.

Adult↗

Diffusion-weighted multiple shot echo planar imaging of humans without navigation.

A new method is proposed for reducing the artifacts produced in diffusion-weighted imaging. When data are acquired using multiple shot echo planar acquisitions, conventional reconstruction methods produce artifactual images as a consequence of diffusion weighting and small amounts of bulk motion of the subject. If the amount of motion can be determined, it is possible to correct the data before reconstruction, which removes the artifact. A method for estimating the motion from the acquired data has been developed and evaluated. This method assumes that ghost image effects will be minimized when motion has been correctly compensated. By considering the amount of signal in the background of the image, appropriate corrections to the data can be made, and the accuracy of the motion compensation may be estimated. This technique has been evaluated by computer simulation, and its performance has been demonstrated in a phantom and humans with both two- and four-shot echo planar acquisitions and using both "mosaic" and "interleaved" sampling schemes.

Artifacts↗

Measurement of the point spread function in MRI using constant time imaging.

The point spread function is a fundamental property of magnetic resonance imaging methods that affects image quality and spatial resolution. The point spread function is difficult to measure precisely in magnetic resonance even with the use of carefully designed phantoms, and it is difficult to calculate this function for complex sequences such as echo-planar imaging. This report describes a method that measures the point spread function with high spatial resolution at each pixel in samples of uniform intensity distribution. This method uses additional phase encoding gradients before the echo-planar acquisition that are constant in length but vary in amplitude. The additional gradients are applied to image the contents within each individual voxel. This method has been used to measure the point spread function for echo-planar imaging to demonstrate the effects of limited k-space sampling and transverse relaxation, as well as the effects of object motion. By considering the displacement of the point spread function, local distortions due to susceptibility and chemical shift effects have been quantified and corrected. The method allows rapid assessment of the point spread function in echo-planar imaging, in vivo, and may also be applied to other rapid imaging sequences that can be modified to include these additional phase encoding gradients.

Brain↗

Three-dimensional strain-rate imaging.

Strain-rate imaging uses large velocity encoding gradients to obtain measurements of velocity that are extremely insensitive to the effects of random noise. The spatial differential of velocity yields the velocity gradient from which the strain-rate and twist-rate tensors can be determined. These tensors represent the distortion of the material and are of interest in the analysis of the dynamic behavior of living tissue (e.g., that of the myocardium). This work presents a new technique that uses the magnitude of the signal in the velocity encoded data to measure through-plane velocity variations at the resolution of the voxel size. The magnitude of the MR signal contains information about the range of phases present within a voxel. When the phase is dependent on the velocity (as in phase velocity imaging), the magnitude contains information about the range of velocities within a voxel. The method presented in this work uses unbalanced slice-refocusing gradients to sample the magnitude variation introduced by the interaction of velocity encoding gradients with spatially dependent velocities. The previously developed in-plane velocity gradient methods can be easily integrated with this new through-plane measurement to characterize the deformation of the myocardium in three spatial dimensions with high accuracy. The applicability of these methods is demonstrated theoretically, in phantoms and in vivo.

Echo-Planar Imaging↗

A combined analysis and magnetic resonance imaging technique for computerised automatic measurement of cartilage thickness in the distal interphalangeal joint.

It is well known that magnetic resonance imaging (MRI) contrast can be controlled, albeit sometimes at the expense of image resolution and signal-to-noise ratio, and most studies of articular joints have used a single MRI protocol, which is optimised for subjective image analysis. Inevitably that single protocol frequently compromises the detection of one or another of the boundaries between which any measurement must be made. This paper describes an alternative approach in which the criteria for computerised edge detection necessary for fully automated measurement of cartilage thickness are used to define the MRI acquisition parameters. This necessitates the combined use of two MRI sequences, one optimised for the cartilage-bone boundary, and the other for cartilage-synovial fluid. This provides a highly effective combination and its efficacy is demonstrated for the distal interphalangeal joint of a range of asymptomatic adults.

Adult↗

Effect of first and subsequent use of hemodialyzers on patient well-being: the rise and fall of a syndrome associated with new dialyzer use.

In a single large dialysis unit in which dialyzers are routinely subjected to multiple use, the incidence rates of intradialytic symptoms during first use and reuse were compared. Dialyses administered during two periods were analyzed: During the first (26,592 treatments), dialyzers were processed by a manual method before both first and subsequent use. During the second (12,395 treatments), dialyzers were processed by an automated machine method before first and subsequent use. During the first (manual processing) period, 12 symptoms were found to occur more frequently during first use than during reuse. The most striking findings related to chest pain (2.8 times more frequent with first use), back pain (6 times), and concurrent chest and back pain (42 times). Thus, a "first-use syndrome" characterized by chest and back pain was clearly evident. During the second (machine processing) period, the previously noted increased symptom incidence during first use was no longer present. In particular, the incidence of chest pain and back pain was no longer greater during first use than during reuse. Our results suggest that subjecting dialyzers to an automated reuse processing system before first use can markedly diminish the incidence of first-use syndrome.

Back Pain↗

Effect of first and subsequent use of hemodialyzers on patient well-being. Analysis of the incidence of symptoms and events and description of a syndrome associated with new dialyzer use.

To determine the effect of multiple dialyzer use on intradialytic symptoms, data from 26,592 successive dialyses on 147 patients were analyzed. Over the 26-month period of study 4,933 new dialyzers were used. All symptoms, considered together, occurred 1.3 times more frequently during the initial than during the subsequent use of the dialyzer. No symptom occurred more frequently in the second or subsequent use of the dialyzer. Concurrent chest and back pain were 41 times more frequent when the dialyzer was used for the first time. A syndrome associated with the first use of the dialyzer is described.

Back Pain↗

Comparison of intermittent with continuous peritoneal dialysis.

Our experience with 41 patients on CAPD is presented (127 patient months). Thirty-three patients were previously on intermittent peritoneal dialysis. We used 4 exchanges of 2 L each per 24 hours (8, 6, 6 and 4 hours dwell times). There was a dramatic fall in serum creatinine of 27%, BUN fell 22%, total CO2 rose 15%. Haemoglobin rose 10% and serum albumin fell by 5%. The incidence of peritonitis was one episode per 7.1 patient months. All patients noted an increase in well being. There were almost no dietary restrictions and patients gained real body weight. In most instances, their antihypertensive medication could be discontinued. This technique is superior to all the other forms of peritoneal dialysis.

Adult↗