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BACKGROUND: Hoarding disorder (HD) is characterized by cognitive control impairments and abnormal brain activity in the insula and anterior cingulate cortex (ACC) during disposal of personal items or certain executive function tasks. However, whether there are any changes in resting-state functional connectivity of the insula and ACC remains unclear. METHODS: A total of 55 subjects, including 24 patients with HD and 31 healthy controls (HCs), participated in the study. We acquired resting-state functional magnetic resonance imaging data and examined group differences in functional connectivity from the insula and ACC in whole-brain voxels. RESULTS: In patients with HD, functional connectivity was significantly lower between the right insula and right inferior frontal gyrus (IFG) and left superior temporal gyrus (STG) compared to HCs. There was no correlation between these connectivities and HD symptoms. CONCLUSIONS: Although the clinical implication is uncertain, our results suggest that patients with HD have resting-state functional alterations between the insula and IFG and STG, corresponding with the results of previous fMRI studies. These findings provide new insight into the neurobiological basis of HD.

DOI： 10.3389/fpsyt.2024.1399062

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DOI： 10.1039/d3sc06957e

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Language：English   Publisher：(一社)日本神経学会  

Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Abstract

Magnetic resonance imaging of spinal dural arteriovenous fistula (SDAVF) shows longitudinally extensive spinal cord lesions mimicking neoplastic or inflammatory myelopathy. On positron emission tomography/computed tomography (PET/CT), we report two patients who showed focal ¹⁸F‐fluorodeoxyglucose (FDG) uptake in longitudinally extensive spinal cord lesions. These lesions were indistinguishable from tumors or myelitis but were finally diagnosed as SDAVF. Although PET/CT availability may be limited, in cases of myelopathy with diagnostic challenges, it is important to recognize that focal FDG uptake can be observed in SDAVF.

DOI： 10.1111/ncn3.12794

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Blood blister-like aneurysms (BBAs) are rare and challenging intracranial aneurysms. They pose significant diagnostic and surgical risks due to their delicate walls. Accounting for a small percentage of intracranial aneurysms, BBAs are pathologically pseudoaneurysms, often resulting from arterial dissection, with a high tendency to rupture. This report underscores the critical nature of BBAs by reviewing a case in which subarachnoid hemorrhage caused by a BBA rupture was difficult to diagnose with conventional imaging. We highlight the efficacy of three-dimensional (3D) high-resolution vessel wall imaging (VWI) in discerning the subtle vascular abnormality of BBAs. The integration of the black-blood imaging technique within VWI provides superior contrast between the aneurysm and surrounding tissues, facilitating clearer visualization of the aneurysmal wall. The use of 3D T1-weighted imaging provides intricate details of the vessel wall including its contrast enhancement, which is crucial for a comprehensive assessment of a ruptured aneurysm. This case is consistent with the existing literature, supporting the role of VWI in the identification of ruptured BBAs, an area with limited but growing information on its diagnostic value. VWI is precise and accurate in the preoperative diagnosis of BBAs, emphasizing its potential to improve patient management and outcomes, especially in conditions with high risks of morbidity and mortality.

DOI： 10.7759/cureus.58376

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Moyamoya disease (MMD) is characterized by progressive arterial occlusion, causing chronic hemodynamic impairment, which can reduce brain volume. A novel quantitative technique, synthetic magnetic resonance imaging (SyMRI), can evaluate brain volume. This study aimed to investigate whether brain volume measured with SyMRI correlated with cerebral blood flow (CBF) and brain function in adult MMD. In this retrospective study, 18 adult patients with MMD were included. CBF was measured using iodine-123-N-isopropyl-p-iodoamphetamine single photon emission computed tomography. Cerebrovascular reactivity (CVR) to acetazolamide challenge was also evaluated. Brain function was measured using the Wechsler Adult Intelligence Scales (WAIS)-III/IV and the WAIS-R tests. Gray matter (GM), white matter, and myelin-correlated volumes were evaluated in six areas. Resting CBF was positively correlated with GM fractions in the right anterior cerebral arterial and right middle cerebral arterial (MCA) territories. CVR was positively correlated with GM fraction in the right posterior cerebral arterial (PCA) territory. Full-Scale Intelligence Quotient and Verbal Comprehension Index scores were marginally positively correlated with GM fractions in the left PCA territory. Processing Speed Index score was marginally positively correlated with GM fraction in the right MCA territory. The SyMRI-measured territorial GM fraction correlated with CBF and brain function in patients with MMD.

DOI： 10.1038/s41598-024-56210-2

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DOI： 10.1016/j.bios.2023.115862

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DOI： 10.1016/j.pediatrneurol.2023.12.011

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PURPOSE: This study aimed to compare assessments by radiologists, artificial intelligence (AI), and quantitative measurement using synthetic MRI (SyMRI) for differential diagnosis between astrocytoma, IDH-mutant and oligodendroglioma, and IDH-mutant and 1p/19q-codeleted and to identify the superior method. METHODS: Thirty-three cases (men, 14; women, 19) comprising 19 astrocytomas and 14 oligodendrogliomas were evaluated. Four radiologists independently evaluated the presence of the T2-FLAIR mismatch sign. A 3D convolutional neural network (CNN) model was trained using 50 patients outside the test group (28 astrocytomas and 22 oligodendrogliomas) and transferred to evaluate the T2-FLAIR mismatch lesions in the test group. If the CNN labeled more than 50% of the T2-prolonged lesion area, the result was considered positive. The T1/T2-relaxation times and proton density (PD) derived from SyMRI were measured in both gliomas. Each quantitative parameter (T1, T2, and PD) was compared between gliomas using the Mann-Whitney U-test. Receiver-operating characteristic analysis was used to evaluate the diagnostic performance. RESULTS: The mean sensitivity, specificity, and area under the curve (AUC) of radiologists vs. AI were 76.3% vs. 94.7%; 100% vs. 92.9%; and 0.880 vs. 0.938, respectively. The two types of diffuse gliomas could be differentiated using a cutoff value of 2290/128 ms for a combined 90th percentile of T1 and 10th percentile of T2 relaxation times with 94.4/100% sensitivity/specificity with an AUC of 0.981. CONCLUSION: Compared to the radiologists' assessment using the T2-FLAIR mismatch sign, the AI and the SyMRI assessments increased both sensitivity and objectivity, resulting in improved diagnostic performance in differentiating gliomas.

DOI： 10.1007/s00234-024-03288-0

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Publisher：学研メディカル秀潤社  

DOI： 10.15105/gz.0000005316

CiNii Research

Language：Japanese   Publisher：(株)Gakken  

本稿では,ASLの原理と臨床応用について概説する.ASLは,動脈血を内因性トレーサーとして使用して脳灌流を画像化する非侵襲的手法であり,脳虚血,脳腫瘍,急性脳炎,脳症など様々な疾患の診断に有用である.また,脳血流量などの脳循環指標の定量化を行うことも可能である他,MRA技術として用いることもできる.

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Language：Japanese   Publisher：(株)Gakken  

本稿では,ASLの原理と臨床応用について概説する.ASLは,動脈血を内因性トレーサーとして使用して脳灌流を画像化する非侵襲的手法であり,脳虚血,脳腫瘍,急性脳炎,脳症など様々な疾患の診断に有用である.また,脳血流量などの脳循環指標の定量化を行うことも可能である他,MRA技術として用いることもできる.

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00235&link_issn=&doc_id=20240301020020&doc_link_id=10.15105%2FGZ.0000005316&url=https%3A%2F%2Fdoi.org%2F10.15105%2FGZ.0000005316&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(公社)日本医学放射線学会  

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PURPOSE: The cortical high-flow sign with the non-enhancing area was reportedly found to be more frequent with oligodendroglioma, IDH-mutant and 1p/19q codeleted (ODG IDHm-codel) than with IDH-wildtype or astrocytoma, IDH-mutant on arterial spin labeling (ASL) in diffuse gliomas. This study aimed to compare the identification rate of the cortical high-flow sign on ASL in patients with ODG IDHm-codel to that on dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI). METHODS: Participants consisted of 32 adult ODG IDHm-codel patients with pathologically confirmed. Subtraction images were generated from paired control and label images on ASL. For DSC, dynamic T2*-weighted perfusion weighted images were obtained after pre-bolus of gadolinium-based contrast agent. Regional cerebral blood flow/volume maps were generated based on the concentration-time curve and arterial input function. Tumor-affecting cortices without contrast enhancement on conventional MR imaging were targeted. The identification rate of the cortical high-flow sign was compared between ASL and DSC using the Pearson's Chi-Square test. RESULTS: Frequency of the cortical high-flow sign was significantly higher on ASL (18/32, 56.3%; p < 0.001) than on DSC (5/32, 15.6%). All cases with the positive cortical high-flow sign on DSC were identified on ASL. CONCLUSION: ASL effectively identifies the cortical high-flow sign in ODG IDHm-codel, surpassing DSC in identification rates.

DOI： 10.1007/s00234-023-03267-x

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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DOI： 10.1039/d3sc04953a

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DOI： 10.3233/SHTI230977

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Hypomyelination of early myelinating structures (HEMS) has recently been defined as a new genetic disorder accompanied by clinical and MR imaging characteristics. However, no studies have focused on diffusion-weighted imaging (DWI) findings of HEMS. We would like to propose a "sheep sign," which is formed by DWI hyperintensity in the medial medullary lamina along with alternating high-low-high (HLH) intensity stripes in the posterior limb of the internal capsule. We believe the presence of the "sheep sign" on DWI in combination with alternating HLH intensity stripes may be a valuable tool for diagnosing HEMS.

DOI： 10.1177/19714009231224419

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DOI： 10.1111/mec.17216

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PURPOSE: To assess the reproducibility of ADC, T1, T2, and proton density (PD) measurements on the cortex across the entire brain using high-resolution pseudo-3D diffusion-weighted imaging using echo-planar imaging with compressed SENSE (EPICS-DWI) and 3D quantification with an interleaved Look-Locker acquisition sequence with T2 preparation pulse (3D-QALAS) in normal healthy adults. METHODS: Twelve healthy participants (median age, 33 years; range, 28-51 years) were recruited to evaluate the reproducibility of whole-brain EPICS-DWI and synthetic MRI. EPICS-DWI utilizes a compressed SENSE reconstruction framework while maintaining the EPI sampling pattern. The 3D-QALAS sequence is based on multi-acquisition 3D gradient echo, with five acquisitions equally spaced in time, interleaved with a T2 preparation pulse and an inversion pulse. EPICS-DWI (b values, 0 and 1000 s/mm2) and 3D-QALAS sequence with identical voxel size on a 3.0-T MR system were performed twice (for test-retest scan). Intraclass correlation coefficients (ICCs) for ADC, T1, T2, and PD for all parcellated volume of interest (VOI) per subject on scan-rescan tests were calculated to assess reproducibility. Bland-Altman plots were used to investigate discrepancies in ADCs, T1s, T2s, and PDs obtained from the two MR scans. RESULTS: The ICC of ADCs was 0.785, indicating "good" reproducibility. The ICCs of T1s, T2s, and PDs were 0.986, 0.978, and 0.968, indicating "excellent" reproducibility. CONCLUSION: The combination of EPICS-DWI and 3D-QALAS sequences with identical voxel size could reproducible ADC, T1, T2, and PD measurements for the cortex across the entire brain in healthy adults.

DOI： 10.1016/j.ejro.2023.100516

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Language：Japanese   Publisher：(株)インナービジョン  

2021年に,WHO中枢神経系腫瘍分類第5版が出版された。最大の特徴として,組織学的所見と比べた分子遺伝学的情報の診断への寄与度が,2016年出版の改訂第4版以上に顕著となっており,腫瘍型分類にも反映されている。これは,主に分子遺伝学的所見による分類が,生命予後や治療反応性と相関することがエビデンスとして示されたことによる。画像診断学は病理組織所見との対比により発展してきたが,今回の腫瘍型分類改訂に伴い,従来の方法では術前の腫瘍型推定が困難な症例にも直面している。それでも,WHO中枢神経系腫瘍分類第5版では,発生部位,組織学的グレーディングおよび分子遺伝学的所見の組み合わせによる統合診断・層別化が重視されており,信号パターン以外にも,局在や広がりが非侵襲的に評価できる画像情報が術前診断に果たす役割は大きい。本稿では,腫瘍の縦緩和時間(T1値),横緩和時間(T2値),プロトン密度(PD)を同時取得する手法として,synthetic MRIの二次元Quantification of Relaxation Times and Proton Density by Multi-Echo acquisition of a saturation-recovery using Turbo spin-Echo Read-out(2D-QRAPMASTER)および3D-quantification using an interleaved Look-Locker acquisition sequence with a T2 preparation pulse(3D-QALAS)法について概説し,pseudo-3D DWI using echo planar imaging with compressed SENSE(EPICS-DWI)を用いたapparent diffusion coefficient(ADC)定量法,最後に,MR spectroscopy(MRS)を用いた分子遺伝学的所見検出の可能性について紹介する。(著者抄録)

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Language：Japanese   Publisher：(株)日本臨床社  

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DOI： 10.1038/s42004-023-01054-6

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Arterial spin labeling (ASL) is a noninvasive imaging technique that labels the proton spins in arterial blood and uses them as endogenous tracers. Brain perfusion imaging with ASL is becoming increasingly common in clinical practice, and clinical applications of ASL for intracranial magnetic resonance angiography (MRA) have also been demonstrated. Unlike computed tomography (CT) angiography and cerebral angiography, ASL-based MRA does not require contrast agents. ASL-based MRA overcomes most of the disadvantages of time-of-flight (TOF) MRA. Several schemes have been developed for ASL-based MRA; the most common method has been pulsed ASL, but more recently pseudo-continuous ASL, which provides a higher signal-to-noise ratio (SNR), has been used more frequently. New methods that have been developed include direct intracranial labeling methods such as velocity-selective ASL and acceleration-selective ASL. MRA using an extremely short echo time (eg, silent MRA) or ultrashort echo-time (TE) MRA can suppress metal susceptibility artifacts and is ideal for patients with a metallic device implanted in a cerebral vessel. Vessel-selective 4D ASL MRA can provide digital subtraction angiography (DSA)-like images. This review highlights the principles, clinical applications, and characteristics of various ASL-based MRA techniques. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.

DOI： 10.1002/jmri.29119

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DOI： 10.1007/s00234-023-03228-4

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Language：English   Publisher：Journal of Physiological Anthropology  

Background: Alexithymia, a personality trait characterized by difficulties in identifying and expressing their emotions despite having a range of emotional experiences, can impact individuals’ stress coping mechanisms. While many studies have investigated brain functions associated with specific tasks in relation to emotion processing, research focusing on resting-state brain functions has been limited. Thus, the aim of this study was to investigate the relationship between alexithymia and brain function by analyzing arterial spin labeling (ASL) data obtained during the resting state. Methods: A brain structural and functional imaging study was conducted on 42 healthy adult men and women using ASL and the 20-item Toronto Alexithymia Scale (TAS-20) questionnaire survey. Cerebral blood flow and functional connectivity values were calculated for regions of interest in the default mode network, saliency network, and central executive network from the ASL data. Correlation analysis was performed with TAS20 scores, and partial correlation analysis was conducted to control for anxiety and depression. Results: The functional connectivity analysis revealed a negative correlation between the functional connectivity of the right insular cortex and left anterior cingulate cortex and the total score of TAS, as well as difficulty identifying feelings and difficulty describing feeling subscores, indicating that the higher the scores, the weaker the functional connectivity between these regions (T = -3.830, p = 0.0013, R = -0.5180). This correlation remained significant even after controlling for anxiety and depression using partial correlation analysis. Conclusion: The present study revealed differences in the activity of the Saliency Network at rest as measured by ASL, which were independent of anxiety and depression, and varied depending on the severity of alexithymia. This functional change may underlie the neural basis of decreased emotional processing observed in alexithymia. These findings may contribute to the elucidation of the neural mechanisms of alexithymia, which can lead to social impairments, and suggest the usefulness of ASL measurement as a biomarker of alexithymia.

DOI： 10.1186/s40101-023-00336-1

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This study aimed to investigate whether arterial spin labeling (ASL) features allow differentiation of oligodendroglioma, IDH-mutant and 1p/19q-codeleted (IDHm-codel) from diffuse glioma with IDH-wildtype (IDHw) or astrocytoma, IDH-mutant (IDHm-noncodel). Participants comprised 71 adult patients with pathologically confirmed diffuse glioma, classified as IDHw, IDHm-noncodel, or IDHm-codel. Subtraction images were generated from paired-control/label images on ASL and used to assess the presence of a cortical high-flow sign. The cortical high-flow sign was defined as increased ASL signal intensity within the tumor-affecting cerebral cortex compared with normal-appearing cortex. Regions without contrast enhancement on conventional MR imaging were targeted. The frequency of the cortical high-flow sign on ASL was compared among IDHw, IDHm-noncodel, and IDHm-codel. As a result, the frequency of the cortical high-flow sign was significantly higher for IDHm-codel than for IDHw or IDHm-noncodel. In conclusion, the cortical high-flow sign could represent a hallmark of oligodendroglioma, IDH-mutant, and 1p/19q-codeleted without intense contrast enhancement.

DOI： 10.1007/s00234-023-03186-x

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Language：English   Publisher：(一社)日本生理人類学会  

失感情症と脳機能の関係について安静時に取得した動脈スピンラベリング(ASL)データの解析による検討を行った。健常成人42人(男性14人、女性28人、平均31.2±9.5歳)を対象として、ASLと20-item Toronto Alexithymia Scale(TAS-20)アンケート調査を用いて脳の構造及び機能イメージング研究を行った。ASLデータから、デフォルトモードネットワーク、salience network及びセントラルエグゼクティブネットワークにおける関心領域に対する脳血流及び機能的結合の値を算出した。機能的結合分析により、右島皮質及び左前帯状皮質の機能的結合と、TAS-20のトータルスコア、感情を特定することの困難さ、感情を語ることの困難さのサブスコアに負の相関がみられた。これらのスコアが高いほどこれらの領域間の機能的結合は弱くなった。この相関は偏相関分析を用いて不安及び抑鬱を調整した後でも有意であった。

Publisher：学研メディカル秀潤社  

DOI： 10.15105/gz.0000004785

CiNii Research

Publisher：学研メディカル秀潤社  

DOI： 10.15105/gz.0000004788

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Isocitrate dehydrogenase (IDH)-wildtype diffuse astrocytic glioma with telomerase reverse transcriptase (TERT) promoter mutation is defined as glioblastoma by the WHO 2021 criteria, revealing that TERT promotor mutation is highly associated with tumor aggressiveness. The aim of this study was to identify features from MR spectroscopy (MRS) and multi-exponential models of DWI distinguishing wild-type TERT (TERTw) from TERT promoter mutation (TERTm) in IDH-wildtype diffuse astrocytic glioma. METHODS: Participants comprised 25 adult patients with IDH-wildtype diffuse astrocytic glioma. Participants were classified into TERTw and TERTm groups. Point-resolved spectroscopy sequences were used for MRS data acquisition. DWI was performed with 13 different b-factors. Peak height ratios of NAA/Cr and Cho/Cr were calculated from MRS data. Mean apparent diffusion coefficient (ADC), perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient (D*), distributed diffusion coefficient (DDC), and heterogeneity index (α) were obtained using multi-exponential models from DWI data. Each parameter was compared between TERTw and TERTm using the Mann-Whitney U test. Correlations between parameters derived from MRS and DWI were also evaluated. RESULTS: NAA/Cr and Cho/Cr were both higher for TERTw than for TERTm. The α of TERTw was smaller than that of TERTm, while the f of TERTw was higher than that of TERTm. NAA/Cr correlated negatively with α, but not with other DWI parameters. Cho/Cr did not show significant correlations with any DWI parameters. CONCLUSION: The combination of NAA/Cr and α may have merit in clinical situation to predict the TERT mutation status of IDH-wildtype diffuse astrocytic glioma without intense enhancement.

DOI： 10.1007/s00234-023-03177-y

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Language：English   Publisher：(一社)日本脳神経外科学会  

膠芽腫患者を対象とした後ろ向き研究を実施し、FLAIR病変切除率を評価することで、supramaximal resection(SMR)の臨床効果について検討した。2006年12月～2018年8月に神経膠腫と診断された成人患者のうち、肉眼的全切除(GTR)が施行された成人33例(年齢中央値64歳、男性19例)を対象とした。評価項目は腫瘍切除率(手術前後のFLAIRおよびガドリニウム強調T1強調画像の腫瘍体積を3D画像体積分析装置により測定)、SMR率(0%から10%刻み)などとした。腫瘍を皮質灰白質との接触により、皮質群23例(SMR 8例、GTR 15例)、深在性群10例(SMR 4例、全切除6例)に分けて検討した。その結果、SMR閾値が30%以上の場合に全生存期間の改善が観察された。皮質群ではGTRと比較してSMRで全生存期間が延長する傾向が認められた(69.6ヵ月対22.1ヵ月)。一方、深在群ではGTRと比較してSMRで全生存期間が有意に短縮していた(10.2ヵ月対27.9ヵ月、p=0.0221)。以上から、FLAIR病変のsupramaximal resectionは神経膠腫患者の生存期間を延長可能であることが示された。

Language：Japanese   Publisher：(株)Gakken  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Japan Neurosurgical Society  

<p>We aimed to retrospectively determine the resection rate of fluid-attenuated inversion recovery (FLAIR) lesions to evaluate the clinical effects of supramaximal resection (SMR) on the survival of patients with glioblastoma (GBM). Thirty-three adults with newly diagnosed GBM who underwent gross total tumor resection were enrolled. The tumors were classified into cortical and deep-seated groups according to their contact with the cortical gray matter. Pre- and postoperative FLAIR and gadolinium-enhanced T1-weighted imaging tumor volumes were measured using a three-dimensional imaging volume analyzer, and the resection rate was calculated. To evaluate the association between SMR rate and outcome, we subdivided patients whose tumors were totally resected into the SMR and non-SMR groups by moving the threshold value of SMR in 10% increments from 0% and compared their overall survival (OS) change. An improvement in OS was observed when the threshold value of SMR was 30% or more. In the cortical group (n = 23), SMR (n = 8) tended to prolong OS compared with gross total resection (GTR) (n = 15), with the median OS of 69.6 and 22.1 months, respectively (p = 0.0945). Contrastingly, in the deep-seated group (n = 10), SMR (n = 4) significantly shortened OS compared with GTR (n = 6), with median OS of 10.2 and 27.9 months, respectively (p = 0.0221). SMR could help prolong OS in patients with cortical GBM when 30% or more volume reduction is achieved in FLAIR lesions, although the impact of SMR for deep-seated GBM must be validated in larger cohorts.</p>

DOI： 10.2176/jns-nmc.2022-0351

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We present a case of the T2-FLAIR mismatch sign in glioblastoma, isocitrate dehydrogenase (IDH)-wild type. The T2-FLAIR mismatch sign is known as a highly specific imaging finding of astrocytoma, IDH-mutant. Meanwhile, IDH-wildtype diffuse astrocytic gliomas with telomerase reverse transcriptase (TERT) promoter mutation in adults are defined as glioblastoma in the 2021 World Health Organization Classification of Tumors of the Central Nervous System, fifth edition (2021 WHO classification), which underscores the importance of molecular information in central nervous system tumors. This indicates even glioblastoma, IDH-wild type may be masquerading as lower-grade glioma in histology. The reasons for the discrepancy between tumors with less aggressive histology and poor prognosis caused by telomerase reverse transcriptase promoter mutation of IDH-wildtype diffuse glioma remain unclear. However, glioblastoma, IDH-wildtype should be considered as a potential differential diagnosis even in patients with the T2-FLAIR mismatch sign in diffuse gliomas.

DOI： 10.1177/20584601231184565

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DOI： 10.1038/s43856-023-00314-9

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DOI： 10.3389/fpubh.2023.1224093

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DOI： 10.1039/d3sc00724c

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DOI： 10.1021/acs.analchem.3c00163

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DOI： 10.1186/s12916-023-02862-2

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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DOI： 10.2320/matertrans.M-M2023810

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DOI： 10.15105/gz.0000004316

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: We evaluated the usefulness of three-dimensional (3D) chemical exchange saturation transfer (CEST) imaging with compressed sensing and sensitivity encoding (CS-SENSE) for differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs). METHODS: We evaluated 28 patients (mean age 51.0 ± 13.9 years, 13 males, 15 females) including 12 with LGGs and 16 with HGGs, all acquired using a 3 T magnetic resonance (MR) scanner. Nine slices were acquired for 3D CEST imaging, and one slice was acquired for two-dimensional (2D) CEST imaging. Two radiological technologists each drew a region of interest (ROI) surrounding the high-signal-intensity area(s) on the fluid-attenuated inversion recovery image of each patient. We compared the magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm in the tumors among the (i) single-slice 2D CEST imaging ("2D"), (ii) all tumor slices of the 3D CEST imaging (3Dall), and (iii) a representative tumor slice of 3D CEST imaging (maximum signal intensity [3Dmax]). The relationship between the MTRasym at 3.5 ppm values measured by these three methods and the Ki-67 labeling index (LI) of the tumors was assessed. Diagnostic performance was evaluated with a receiver operating characteristic analysis. The Ki-67LI and MTRasym at 3.5 ppm values were compared between the LGGs and HGGs. RESULTS: A moderate positive correlation between the MTRasym at 3.5 ppm and the Ki-67LI was observed with all three methods. All methods proved a significantly larger MTRasym at 3.5 ppm for the HGGs compared to the LGGs. All methods showed equivalent diagnostic performance. The signal intensity varied depending on the slice position in each case. CONCLUSIONS: The 3D CEST imaging provided the MTRasym at 3.5 ppm for each slice cross-section; its diagnostic performance was also equivalent to that of 2D CEST imaging.

DOI： 10.1016/j.ejrad.2022.110654

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DOI： 10.2196/41586

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PubMed

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Accurate assessment of cerebral perfusion in moyamoya disease is necessary to determine the indication for treatment. We aimed to investigate the usefulness of dynamic PCASL using a variable TR scheme with optimized background suppression in the evaluation of cerebral perfusion in moyamoya disease. METHODS: We retrospectively analyzed the images of 24 patients (6 men and 18 women, mean age 31.4 ± 18.2 years) with moyamoya disease; each of whom was imaged with both dynamic PCASL using the variable-TR scheme and 123IMP SPECT with acetazolamide challenge. ASL dynamic data at 10 phases are acquired by changing the LD and PLD. The background suppression timing was optimized for each phase. CBF and ATT were measured with ASL, and CBF and CVR to an acetazolamide challenge were measured with SPECT. RESULTS: A significant moderate correlation was found between the CBF measured by dynamic PCASL and that by SPECT (r = 0.53, P < 0.001). The CBF measured by dynamic PCASL (52.5 ± 13.3 ml/100 mg/min) was significantly higher than that measured by SPECT (43.0 ± 12.6 ml/100 mg/min, P < 0.001). The ATT measured by dynamic PCASL showed a significant correlation with the CVR measured by SPECT (r = 0.44, P < 0.001). ATT was significantly longer in areas where the CVR was impaired (CVR < 18.4%, ATT = 1812 ± 353 ms) than in areas where it was preserved (CVR > 18.4%, ATT = 1301 ± 437 ms, P < 0.001). The ROC analysis showed a moderate accuracy (AUC = 0.807, sensitivity = 87.7%, specificity = 70.4%) when the cutoff value of ATT was set at 1518 ms. CONCLUSION: Dynamic PCASL using this scheme was found to be useful for assessing cerebral perfusion in moyamoya disease.

DOI： 10.1007/s00234-022-03095-5

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DOI： 10.1371/journal.pone.0274610

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Language：English  

DOI： 10.1111/jop.13336

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Language：Japanese   Publisher：断層映像研究会  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(株)インナービジョン  

arterial spin labeling(以下、ASL)は動脈血中のプロトンのスピンをラベルし、それを内因性トレーサーとして画像化に利用する非侵襲的手法である。近年、臨床現場では、pseudo-continuous ASL(以下、pCASL)の導入により、ASLを用いた脳灌流画像の使用が普及しつつある。臨床で用いられるASLは、通常1つのlabel duration(以下、LD)と1つのpost-labeling delay(以下、PLD)の組み合わせによる1時相での撮像であるが、ラベルされた血液がラベル面から脳組織に到達するまでの時間(arterial transit time:ATT)が長く、ラベルされた血液が到達していない場合には、正しく脳血流量(cerebral blood flow:CBF)を評価することができない。最近では、多時相撮像を行うことでATTの影響を考慮したCBFの定量化が行われるようになってきている。また、ASLは脳灌流画像のみでなく、MR angiography(以下、MRA)にも応用することができる。臨床で用いられるtime of flight(以下、TOF)-MRAは撮像スラブへのinflow効果に依存しているため、上方向以外の血流、乱流、遅い血流などの描出は不良であることや、時間情報を持っていないという欠点がある。ASLによる4D-MRAは、TOF-MRAの弱点を克服しつつ時間情報を有する画像法である。さらに、血管選択的画像も取得することができ、選択的digital subtraction angiography(以下、DSA)の代替となるような画像も得られる。本稿では、多時相ASL灌流画像とASLを用いた4D-MRAの開発の最近の動向と、それらの臨床的有用性を概説する。(著者抄録)

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DOI： 10.3233/SHTI220700

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Language：English  

DOI： 10.3233/SHTI220053

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

This study aimed to determine whether quantitative relaxometry using synthetic magnetic resonance imaging (SyMRI) could differentiate between two diffuse glioma groups with isocitrate dehydrogenase (IDH)-mutant tumors, achieving an increased sensitivity compared to the qualitative T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign. Between May 2019 and May 2020, thirteen patients with IDH-mutant diffuse gliomas, including seven with astrocytomas and six with oligodendrogliomas, were evaluated. Five neuroradiologists independently evaluated the presence of the qualitative T2-FLAIR mismatch sign. Interrater agreement on the presence of the T2-FLAIR mismatch sign was calculated using the Fleiss kappa coefficient. SyMRI parameters (T1 and T2 relaxation times and proton density) were measured in the gliomas and compared by the Mann–Whitney U test. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance. The sensitivity, specificity, and kappa coefficient were 57.1%, 100%, and 0.60, respectively, for the qualitative T2-FLAIR mismatch sign. The two types of diffuse gliomas could be differentiated using a cutoff value of 178 ms for the T2 relaxation time parameter with 100% sensitivity, specificity, accuracy, and positive and negative predictive values, with an area under the curve (AUC) of 1.00. Quantitative relaxometry using SyMRI could differentiate astrocytomas from oligodendrogliomas, achieving an increased sensitivity and objectivity compared to the qualitative T2-FLAIR mismatch sign.

DOI： 10.1038/s41598-022-13036-0

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DOI： 10.1002/epi4.12616

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Language：Others   Publishing type：Research paper (scientific journal)  

DOI： 10.1259/bjr.20210392

Language：English   Publishing type：Research paper (scientific journal)  

Objectives: To develop an automated model to detect brain metastases using a convolutional neural network (CNN) and volume isotropic simultaneous interleaved bright-blood and black-blood examination (VISIBLE) and to compare its diagnostic performance with the observer test. Methods: This retrospective study included patients with clinical suspicion of brain metastases imaged with VISIBLE from March 2016 to July 2019 to create a model. Images with and without blood vessel suppression were used for training an existing CNN (DeepMedic). Diagnostic performance was evaluated using sensitivity and false-positive results per case (FPs/case). We compared the diagnostic performance of the CNN model with that of the twelve radiologists. Results: Fifty patients (30 males and 20 females; age range 29–86 years; mean 63.3 ± 12.8 years; a total of 165 metastases) who were clinically diagnosed with brain metastasis on follow-up were used for the training. The sensitivity of our model was 91.7%, which was higher than that of the observer test (mean ± standard deviation; 88.7 ± 3.7%). The number of FPs/case in our model was 1.5, which was greater than that by the observer test (0.17 ± 0.09). Conclusions: Compared to radiologists, our model created by VISIBLE and CNN to diagnose brain metastases showed higher sensitivity. The number of FPs/case by our model was greater than that by the observer test of radiologists; however, it was less than that in most of the previous studies with deep learning. Key Points: • Our convolutional neural network based on bright-blood and black-blood examination to diagnose brain metastases showed a higher sensitivity than that by the observer test. • The number of false-positives/case by our model was greater than that by the previous observer test; however, it was less than those from most previous studies. • In our model, false-positives were found in the vessels, choroid plexus, and image noise or unknown causes.

DOI： 10.1007/s00330-021-08427-2

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Language：Japanese   Publisher：(株)日本臨床社  

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DOI： 10.1002/smll.202106401

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Language：English  

DOI： 10.1111/1346-8138.16293

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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Language：Japanese   Publisher：(株)日本臨床社  

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Language：Japanese   Publisher：(公社)日本医学放射線学会  

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DOI： 10.1016/j.cmpbup.2022.100061

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DOI： 10.1371/journal.pone.0266141

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DOI： 10.1177/20584601211030661

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DOI： 10.1007/s00330-020-07389-1

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DOI： 10.1371/journal.pone.0237358

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DOI： 10.1371/journal.pone.0236512

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DOI： 10.1007/s00234-020-02456-2

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DOI： 10.1007/s00330-020-07057-4

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DOI： 10.1016/j.crad.2019.06.017

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DOI： 10.1016/j.diii.2019.02.010

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DOI： 10.2463/mrms.tn.2018-0068

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DOI： 10.1016/j.mri.2018.09.025

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DOI： 10.1371/journal.pone.0209796

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DOI： 10.1007/s00405-018-5101-6

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DOI： 10.1007/s00330-018-5404-4

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DOI： 10.3174/ajnr.A5657

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DOI： 10.1016/j.diii.2018.02.007

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DOI： 10.1007/s00062-016-0556-6

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DOI： 10.1007/s00234-018-1991-7

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DOI： 10.1148/radiol.2017162279

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DOI： 10.1007/s00330-017-4995-5

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DOI： 10.1155/2018/3141789

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DOI： 10.1259/bjr.20170912

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DOI： 10.1007/s11060-017-2604-8

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DOI： 10.1177/0284185116687172

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DOI： 10.1016/j.ejrad.2017.05.031

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DOI： 10.1002/mrm.26322

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DOI： 10.1002/jmri.25489

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DOI： 10.1007/s00330-016-4406-3

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DOI： 10.1007/s00330-016-4328-0

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DOI： 10.1259/bjrcr.20150497

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DOI： 10.1016/j.jstrokecerebrovasdis.2016.08.040

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DOI： 10.1002/jmri.25261

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DOI： 10.1016/j.neurad.2016.01.147

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DOI： 10.1097/RCT.0000000000000396

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DOI： 10.1093/neuonc/nov147

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DOI： 10.2463/mrms.mp.2015-0140

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DOI： 10.1259/bjr.20160074

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DOI： 10.1002/brb3.282

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DOI： 10.2463/mrms.2013-0065

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DOI： 10.1007/s00405-014-2933-6

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DOI： 10.3174/ajnr.A3620

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DOI： 10.1007/s11604-014-0342-9

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DOI： 10.1016/j.ejrad.2013.04.018

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DOI： 10.4329/wjr.v5.i8.325

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DOI： 10.1007/s00234-012-1089-6

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DOI： 10.1007/s00234-011-0977-5

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DOI： 10.1007/s11604-010-0495-0

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DOI： 10.1002/jnr.21868

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Language：Japanese   Publisher：(株)Gakken  

J-GLOBAL

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Language：Japanese   Publisher：(株)Gakken  

Language：Japanese   Publisher：(株)インナービジョン  

arterial spin labeling(以下、ASL)は動脈血中のプロトンのスピンをラベルし、それを内因性トレーサーとして画像化に利用する非侵襲的手法である。近年、臨床現場では、pseudo-continuous ASL(以下、pCASL)の導入により、ASLを用いた脳灌流画像の使用が普及しつつある。臨床で用いられるASLは、通常1つのlabel duration(以下、LD)と1つのpost-labeling delay(以下、PLD)の組み合わせによる1時相での撮像であるが、ラベルされた血液がラベル面から脳組織に到達するまでの時間(arterial transit time:ATT)が長く、ラベルされた血液が到達していない場合には、正しく脳血流量(cerebral blood flow:CBF)を評価することができない。最近では、多時相撮像を行うことでATTの影響を考慮したCBFの定量化が行われるようになってきている。また、ASLは脳灌流画像のみでなく、MR angiography(以下、MRA)にも応用することができる。臨床で用いられるtime of flight(以下、TOF)-MRAは撮像スラブへのinflow効果に依存しているため、上方向以外の血流、乱流、遅い血流などの描出は不良であることや、時間情報を持っていないという欠点がある。ASLによる4D-MRAは、TOF-MRAの弱点を克服しつつ時間情報を有する画像法である。さらに、血管選択的画像も取得することができ、選択的digital subtraction angiography(以下、DSA)の代替となるような画像も得られる。本稿では、多時相ASL灌流画像とASLを用いた4D-MRAの開発の最近の動向と、それらの臨床的有用性を概説する。(著者抄録)

Language：Japanese   Publisher：(株)日本臨床社  

Language：Japanese   Publisher：(株)日本臨床社  

Language：Japanese