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Biomedical subjects

Peter Boesiger

Publications and source records attributed to Peter Boesiger.

At least 19 recordsLinked to original sources

Safety evaluation of large external fixation clamps and frames in a magnetic resonance environment.

Large orthopedic external fixation clamps and related components were evaluated for force, torque, and heating response when subjected to the strong electromagnetic fields of magnetic-resonance (MR) imaging devices. Forces induced by a 3-Tesla (T) MR scanner were compiled for newly designed nonmagnetic clamps and older clamps that contained ferromagnetic components. Heating trials were performed in a 1.5 and in a 3 T MR scanner with two assembled external fixation frames. Forces of the newly designed clamps were more than a factor 2 lower as the gravitational force on the device whereas, magnetic forces on the older devices showed over 10 times the force induced by earth acceleration of gravity. No torque effects could be found for the newly designed clamps. Temperature measurements at the tips of Schanz screws in the 1.5 T MR scanner showed a rise of 0.7 degrees C for a pelvic frame and of 2.1 degrees C for a diamond knee bridge frame when normalized to a specific absorption rate (SAR) of 2 W/kg. The normalized temperature increases in the 3 T MR scanner were 0.9 degrees C for the pelvic frame and 1.1 degrees C for the knee bridge frame. Large external fixation frames assembled with the newly designed clamps (390 Series Clamps), carbon fiber reinforced rods, and implant quality 316L stainless steel Schanz screws met prevailing force and torque limits when tested in a 3-T field, and demonstrated temperature increase that met IEC-60601 guidelines for extremities. The influence of frame-induced eddy currents on the risk of peripheral nerve stimulation was not investigated.

External Fixators↗

Better memory and neural efficiency in young apolipoprotein E epsilon4 carriers.

The apolipoprotein E (APOE) epsilon4 allele is the major genetic risk factor for Alzheimer's disease, but an APOE effect on memory performance and memory-related neurophysiology in young, healthy subjects is unknown. We found an association of APOE epsilon4 with better episodic memory compared with APOE epsilon2 and epsilon3 in 340 young, healthy persons. Neuroimaging was performed in a subset of 34 memory-matched individuals to study genetic effects on memory-related brain activity independently of differential performance. E4 carriers decreased brain activity over 3 learning runs, whereas epsilon2 and epsilon3 carriers increased activity. This smaller neural investment of epsilon4 carriers into learning reappeared during retrieval: epsilon4 carriers exhibited reduced retrieval-related activity with equal retrieval performance. APOE isoforms had no differential effects on cognitive measures other than memory, brain volumes, and brain activity related to working memory. We suggest that APOE epsilon4 is associated with good episodic memory and an economic use of memory-related neural resources in young, healthy humans.

Adult↗

Enhanced brain activity may precede the diagnosis of Alzheimer's disease by 30 years.

Presenilin 1 (PSEN1) mutations cause autosomal dominant familial Alzheimer's disease (FAD). PSEN1 mutation carriers undergo the course of cognitive deterioration, which is typical for sporadic Alzheimer's disease but disease onset is earlier and disease progression is faster. Here, we sought to detect signs of FAD in presymptomatic carriers of the PSEN1 mutation (C410Y) by use of a neuropsychological examination, functional MRI during learning and memory tasks and MRI volumetry. We examined five non-demented members of a FAD family and 21 non-related controls. Two of the five family members were carrying the mutation; one was 20 years old and the other 45 years old. The age of clinical manifestation of FAD in the family studied here is approximately 48 years. Neuropsychological assessments suggested subtle problems with episodic memory in the 20-year-old mutation carrier. The middle-aged mutation carrier fulfilled criteria for amnestic mild cognitive impairment. The 20-year-old mutation carrier exhibited increased, while the middle-aged mutation carrier exhibited decreased brain activity compared to controls within memory-related neural networks during episodic learning and retrieval, but not during a working-memory task. The increased memory-related brain activity in the young mutation carrier might reflect a compensatory effort to overcome preclinical neural dysfunction caused by first pathological changes. The activity reductions in the middle-aged mutation carrier might reflect gross neural dysfunction in a more advanced stage of neuropathology. These data suggest that functional neuroimaging along with tasks that challenge specifically those brain areas which are initial targets of Alzheimer's disease pathology may reveal activity alterations on a single-subject level decades before the clinical manifestation of Alzheimer's disease.

Adult↗

The effect of macronutrients on gastric volume responses and gastric emptying in humans: A magnetic resonance imaging study.

The effects of macronutrients on gastric volume changes, emptying, and gastrointestinal symptoms are incompletely understood. Three liquid meals of 500 ml (fat emulsion, 375 kcal; protein solution, 375 kcal; glucose solution, 400 kcal) were infused into the stomach of 12 healthy volunteers on three occasions. Studies were performed in seated body position using an open-configuration magnetic resonance imaging (MRI) system. MRI imaging sequences, assessing stomach and meal volumes, were performed prior to and at times t = 0, 3, 6, 9, 12, 15, 25, 35, 45, 60, 75, and 90 min after meal administration. Areas under the curve for the early emptying phase (0-15 and 0-45 min) were calculated, and characteristics of the volume curves were analyzed by a gastric emptying model. Gastrointestinal symptoms were assessed by a self-report scale. Initial (t = 0 min) and early postprandial gastric volumes were highest for glucose because of lower initial emptying. However, in the early emptying phase the characteristics of the volume curves for stomach and meal were uniform for all macronutrients. Perceptions of fullness and satiety were linearly associated with postprandial gastric volumes, but not with macronutrient composition. Isovolumic macronutrient meals modulate gastric volume response by initial meal emptying patterns. Macronutrient specific accommodation responses, as shown in barostat studies, are not reflected as gastric volume responses under noninvasive conditions.

Adult↗

Cerebral metabolic alterations in McLeod syndrome.

The X-linked McLeod neuroacanthocytosis syndrome is a multisystem disorder with central nervous system manifestations resembling Huntington's disease. We examined 5 McLeod patients and 5 asymptomatic heterozygous females with fast multiple spin-echo spectroscopic imaging. Three patients with pronounced psychiatric or cognitive manifestations had pathological N-acetyl aspartate/(creatine + choline) ratios in frontal, temporal, and insular areas, with an individual pattern. Two patients with a severe choreatic movement disorder had unilateral thalamic alterations. One patient with moderate movement disorder and personality disorder had bilateral occipital alterations. One female heterozygote had unilateral insular metabolic alterations, possibly indicating subclinical cerebral involvement. Although the prominent psychiatric and cognitive manifestations in McLeod patients suggest significant and widespread cortical abnormalities, previous neuroradiological and histopathological data had not revealed definite extrastriatal pathology. Our findings demonstrating metabolic abnormalities in different brain regions of McLeod patients might either reflect neuronal dysfunction due to impaired basal ganglia-thalamo-cortical circuits or subtle structural alterations in the particular cerebral areas.

Adult↗

Computational investigation of subject-specific cerebrospinal fluid flow in the third ventricle and aqueduct of Sylvius.

The cerebrospinal fluid flow in the third ventricle of the brain and the aqueduct of Sylvius was studied using computational fluid dynamics (CFD) based on subject-specific boundary conditions derived from magnetic resonance imaging (MRI) scans. The flow domain geometry was reconstructed from anatomical MRI scans by manual image segmentation. The movement of the domain boundary was derived from MRI brain motion scans. Velocimetric MRI scans were used to reconstruct the velocity field at the inferior end of the aqueduct of Sylvius based on the theory of pulsatile flow in pipes. A constant pressure boundary condition was assigned at the foramina of Monro. Three main flow features were observed: a fluid jet emerging from the aqueduct of Sylvius, a moderately mobile recirculation zone above the jet and a mobile recirculation below the jet. The flow in the entire domain was laminar with a maximum Reynolds number of 340 in the aqueduct. The findings demonstrate that by combining MRI scans and CFD simulations, subject-specific detailed quantitative information of the flow field in the third ventricle and the aqueduct of Sylvius can be obtained.

Adult↗

Three-dimensional fiber architecture of the nonpregnant human uterus determined ex vivo using magnetic resonance diffusion tensor imaging.

The global muscle and collagen fiber orientation in the human uterus has been analyzed hitherto by various standard microscopic techniques. However, no widely accepted model of the fiber architecture of the myometrium could be acquired. The purpose of the present study was to investigate the uterus by magnetic resonance (MR) diffusion tensor imaging (DTI) in a 3D macroscopic approach. Ex vivo MR DTI measurements were performed on five uteri from nonpregnant patients. The main diffusion directions reflecting the orientation of directional structures in the examined tissues were determined from diffusion-weighted spin-echo measurements. A fiber tracking algorithm was used to extrapolate the fiber architecture. The method was validated against histological slides and indirectly through the analysis of leiomyomas, which exhibit less anisotropy than normal myometrium. Significant anisotropy was found in most regions of all examined nonpregnant human uteri. But only two systems of fibers were found running circularly along the intramural part of the uterine tubes. They merged caudally and built a close fitting envelope of circular layers around the uterine cavity. On the cervix, circular fibers were observed in the outer part as well as mostly longitudinal fibers in the inner part. These results confirm the existence of directional structures in the complex fiber architecture of the human uterus. They also indicate that MR DTI is a beneficial and complementary tool to standard microscopic techniques to determine the intrinsic fiber architecture in human organs.

Adult↗

Affective judgment and beneficial decision making: ventromedial prefrontal activity correlates with performance in the Iowa Gambling Task.

Damasio proposes in his somatic marker theory that not only cognitive but also affective components are critical for decision making. Since affective judgment requires an interplay between affective and cognitive components, it might be considered a key process in decision making that has been linked to neural activity in ventromedial prefrontal cortex (VMPFC). Using functional magnetic resonance imaging (fMRI), we examined the relationship between VMPFC, emotionally (unexpected)- and cognitively (expected)-accentuated affective judgment, and beneficial decision making (Iowa Gambling Task; IGT) in healthy subjects. Neuronal activity in the VMPFC during unexpected affective judgment significantly correlated with both global and final performance in the IGT task. These findings suggest that the degree to which subjects recruit the VMPFC during affective judgment is related to beneficial performance in decision making in gambling.

Adult↗

Gastric motor function and emptying in the right decubitus and seated body position as assessed by magnetic resonance imaging.

PURPOSE: To determine the effect of the right decubitus lying body position (RP) on relevant parameters of human gastric motor function in healthy volunteers. MATERIALS AND METHODS: Postprandial gastric function after ingestion of a solid/liquid meal (150 g/150 mL) was assessed over 90 minutes in volunteers in the RP and seated position (SP). Ten healthy volunteers were imaged using two MRI systems that differed in architecture and field strength. Stomach and intragastric air volume, intragastric meal distribution, gastric emptying, and gastric peristalsis were compared between the RP and SP. RESULTS: Body position did not affect gastric relaxation (RP, 372 mL vs. SP, 384 mL) and initial gastric volumes (stomach: RP, 458 mL vs. SP, 462 mL; meal: RP, 377 mL vs. SP, 399 mL; intragastric air: RP, 110 mL vs. SP, 98 mL). Postprandial stomach volume and gastric activity (RP and SP, 3.1 minute(-1)) were also similar. Meal emptying showed different characteristics, resulting in a significant but small difference in meal volume of -43 mL at t = 90 minutes (P < 0.05). CONCLUSION: Gastric MRI in RP is feasible for clinical research assessing gastric motor function. The subtle difference in meal emptying may be induced by posture-dependent vagal activity. This study confirms that MRI is a highly sensitive imaging technique for assessing gastrointestinal function in humans.

Adult↗

Assessing arterial blood flow and vessel area variations using real-time zonal phase-contrast MRI.

PURPOSE: To measure peripheral artery function using a real-time phase-contrast (PC)-MRI sequence with tailored image-processing algorithms for flow computation. MATERIALS AND METHODS: An approach to real-time flow measurements was developed based on two-dimensional spatially selective excitation pulses and consecutive tailored processing of the data to derive blood flow and vessel area variations. The data acquisition strategy allows for flow measurements at high spatial and temporal resolutions of 1 mm(2) and 50 msec, respectively. In postprocessing the vessel area is automatically extracted using correlation measures in conjunction with morphological image operators. By means of in vitro and in vivo validations, it is shown that the current methods provide accurate and reproducible measurements of flow and vessel area variations. RESULTS: In vitro the comparison between the lumen area measured with the presented method and the values obtained by caliper gauge measurement showed a difference of 3.4% +/- 3.4% (mean +/- 2 SD). Similarly, the comparison between the stroke volumes determined with the presented method and by stopwatch and bucket measurements yielded a difference of 6.1% +/- 2.1%. In vivo the results from the real-time measurements for lumen area and stroke volume were compared with those from a gated PC-MRI technique with differences of 4.8% +/- 14% and 3.0% +/- 24.7%, respectively. CONCLUSION: The presented method constitutes a reliable tool set for quantifying the variations of blood flow and lumen area in the superficial femoral artery during reactive hyperemia and for studying their correlation with cardiovascular risk factors.

Algorithms↗

Quantification of distal antral contractile motility in healthy human stomach with magnetic resonance imaging.

PURPOSE: To quantify healthy postprandial: 1) propagation, periodicity, geometry, and percentage occlusion by distal antral contraction waves (ACWs); and 2) changes in ACW activity in relationship to gastric emptying (GE). MATERIALS AND METHODS: Using 1.5-T MR scanner, nine healthy fasted volunteers were examined in the right decubitus position after ingestion of 500 mL of 10% glucose (200 kcal) with 500 microM Gd-DOTA. Total gastric (TGV) and meal volumes (MV) were assessed every five minutes for 90 minutes, in and interspersed with dynamic scan sequences (duration: 2.78 minutes) providing detailed images of distal ACWs. RESULTS: TGV increased by 738+/-38 mL after ingestion (t0), subsequently decreasing in parallel to GE. The mean GE rate and half-emptying time were 24+/-3 mL/5 minutes and 71+/-6 minutes, respectively. Accompanying ACWs reached a periodicity of 23+/-2 seconds at t35 and propagated at an unvarying speed of 0.27+/-0.01 cm/second. Their amplitude of 0.70+/-0.08 cm was constant, but the width decreased along the antral wall by 6+/-2%/cm (P=0.003). ACWs were nonocclusive (percentage occlusion 58.1+/-5.9%, t0 at the pylorus) with a reduction in occlusion away from the pylorus (P<0.001). No propagation and geometry characteristics of ACWs correlated with the changes of MV (mL/5 minutes; R2<0.05). CONCLUSION: Our results indicate that ACWs are not imperative for emptying of liquids. This study provides a detailed quantitative reference for MRI inquiries into pharmacologically- and pathologically-altered gastric motility.

Adult↗

Lattice permutation for reducing motion artifacts in radial and spiral dynamic imaging.

Radial and spiral trajectories exhibit favorable characteristics for dynamic imaging. Nevertheless, changes in image contents during acquisition lead to inconsistencies in the k-space data, which are manifested as streaks or spiral artifacts, respectively. This work proposes the concept of lattice permutation to reorder the data segments for artifact suppression. This acts to reshuffle the alias pattern along the temporal frequency axis. The proposed approach is well suited to sliding window reconstruction, although more sophisticated methods are also possible. For typical image series where the signal energies are concentrated in the low temporal frequencies, the permutation displaces most of the aliased signals from the low temporal frequencies to the high temporal frequencies, where they are attenuated by sliding window reconstruction, while the signals in the low temporal frequencies are mostly contaminated by aliasing from the much weaker signals in the higher temporal frequencies. This results in considerably reduced artifacts without any increase in scan time. In practice, lattice permutation achieves similar artifact suppression as the bit-reversed order, but with a less stringent restriction on the number of segments. At the same time, it provides a more powerful approach to controlling the alias pattern exactly. Results from real-time cardiac imaging are demonstrated.

Artifacts↗

Minimum-norm reconstruction for sensitivity-encoded magnetic resonance spectroscopic imaging.

In this work we propose minimum-norm reconstruction as a means to enhance the spatial response behavior in parallel spectroscopic MRI. By directly optimizing the shape of the spatial response function (SRF), the new method accounts for coil sensitivity variation across individual voxels and their side lobes. In this fashion, it mitigates the signal contamination and side-lobe aliasing, to which previous techniques are susceptible at low resolution. Although the computational burden is higher, minimum-norm reconstruction is shown to be feasible using an iterative algorithm. Benefits in terms of SRF shape and artifact suppression are demonstrated.

Algorithms↗

Coil setup optimization for 2D-SENSE whole-heart coronary imaging.

Accelerated "whole-heart" coronary imaging with sensitivity encoding applied in both phase encoding directions (2D-SENSE) was investigated. In order to maximize the signal-to-noise ratio (SNR), coil configuration optimization was performed. To this end, 10 practical coil configurations each consisting of six standard coil elements were investigated and the local SNR was assessed by means of phantom experiments. Based on the experimental data, a symmetric configuration was found to yield the highest SNR. In a volunteer study, 2D-SENSE coronary images were obtained with total reduction factors of 3 and 4. Excellent depiction of the right and left coronary systems was possible in all cases.

Adolescent↗

Prostate spectroscopy at 3 Tesla using two-dimensional S-PRESS.

Two-dimensional (2D) strong-coupling point-resolved spectroscopy (S-PRESS) is introduced as a novel approach to (1)H MR spectroscopy (MRS) in the prostate. The technique provides full spectral information and allows for an accurate characterization of the citrate (Cit) signal. The method is based on acquiring a series of PRESS spectra with constant total echo time (TE). The indirect dimension is encoded by varying the relative lengths of the first and second TEs (TE(1) + TE(2) = TE). In the resulting 2D spectra, only the signal of strongly coupled spin systems is spread into the second dimension, which leads to more clearly arranged spectra. Furthermore, the spectral parameters of Cit (coupling constant J and chemical shift difference delta of the AB spin system) can be determined with high accuracy in vivo. The sequence is analytically optimized for maximal "strong coupling peaks" of Cit at 3T. 2D S-PRESS spectra are compared with JPRESS spectra in vitro as well as in vivo.

Algorithms↗

ProFit: two-dimensional prior-knowledge fitting of J-resolved spectra.

A two-dimensional fitting procedure is introduced, capable of extracting the full amount of information from 2D J-resolved magnetic resonance spectroscopic data. The fitting procedure uses a linear combination of 2D model spectra. For reducing the degrees of freedom and increasing robustness, it is divided into a non-linear outer loop and an inner linear least-squares fit for the concentrations. In vitro and in vivo experiments on a whole-body 3 T MR scanner show the detectability of a wide range of metabolites in the human brain, namely total creatine, N-acetylaspartate, N-acetylaspartylglutamate, choline-containing compounds, glutamate, myo-inositol, glutathione, scyllo-inositol, gamma-aminobutyric acid, alanine and ascorbic acid.

Adult↗

Improved two-dimensional J-resolved spectroscopy.

Localised two-dimensional J-resolved spectroscopy (JPRESS) is optimised for the in vivo detection of J-coupled metabolites using magnetic resonance spectroscopy at 3 T. The acquisition of echo signals starts as early as possible (i.e. maximum-echo sampling). This sampling scheme increases sensitivity and decreases overlap of peak tails, hence alleviating baseline problems. Reconstruction issues are discussed and the sensitivity is compared analytically with that of 1D PRESS. The qualitative behaviour of eddy currents in JPRESS is outlined and a 2D eddy current correction procedure based on the 1D phase deconvolution method is proposed.

Adult↗

Effects of posture on the physiology of gastric emptying: a magnetic resonance imaging study.

OBJECTIVE: Gastric contents empty from the stomach despite frequent changes in body position. The mechanism that maintains gastric emptying independent of position is poorly understood. The aim of this study was to determine the effects of body position on gastric emptying and motor function. MATERIAL AND METHODS: Twelve volunteers were investigated in seated position (SP) and upside-down position (UDP) after ingestion of 300 ml water. Magnetic resonance imaging provided a non-invasive assessment of gastric emptying and volumes, intragastric distribution and peristaltic function. RESULTS: A marked difference in distal/proximal intragastric distribution between UDP and SP was present (7% versus 40%; p < 0.01). Gastric-emptying time was similar but emptying pattern was linear in UDP and exponential in SP. Peristalsis was slower in UDP than SP (2.75 versus 2.96 min-1; p < 0.01), but no correlation was found between peristaltic frequency and the rate of gastric emptying in either position. Postprandial volume response (gastric relaxation) was greater in UDP than SP (280 versus 250 ml; p < 0.05). A correlation was found between gastric relaxation and gastric-emptying time in SP (r2=0.46) but not in UDP. CONCLUSIONS: The stomach maintains the rate of gastric emptying despite radical changes in body position and intragastric distribution of gastric contents. In SP, hydrostatic pressure (modulated by gastric tone) dictates the gastric emptying. In UDP, gastric emptying also appears to be mediated by continuous adaptation of gastric tone. These findings provide support for the hypothesis that the mechanism of gastric emptying resembles a "pressure pump" rather than a "peristaltic pump".

Adult↗