In silico evaluation of the thermal stress induced by MRI switched gradient fields in patients with metallic hip implant

This work focuses on the in silico evaluation of the energy deposed by MRI switched gradient fields in bulk metallic implants and the consequent temperature increase in the surrounding tissues. An original computational strategy, based on the subdivision of the gradient coil switching sequences into sub-signals and on the time-harmonic electromagnetic field solution, allows to realistically simulate the evolution of the phenomena produced by the gradient coils fed according to any MRI sequence. Then, Pennes' bioheat equation is solved through a Douglas-Gunn time split scheme to compute the time-dependent temperature increase. The procedure is validated by comparison with laboratory results, using a component of a realistic hip implant embedded within a phantom, obtaining an agreement on the temperature increase better than 5%, lower than the overall measurement uncertainty. The heating generated inside the body of a patient with a unilateral hip implant when undergoing an Echo-Planar Imaging (EPI) MRI sequence is evaluated and the role of the parameters affecting the thermal results (body position, coil performing the frequency encoding, effects of thermoregulation) is discussed. The results show that the gradient coils can generate local increases of temperature up to some kelvin when acting without radiofrequency excitation. Hence, their contribution in general should not be disregarded when evaluating patients' safety

Image quality of standard and synthetic diffusion weighted magnetic resonance imaging in prostate cancer

The extension from Quantitative Magnetic Resonance Imaging to synthetic imaging has the clear advantage of being able to continually image the patient after the exam. MR techniques such as DWI are commonly used but have some clear disadvantages resulting from the use of echoplanar imaging. It should then be asked whether one imaging technique is objectively better. If one technique is better, the incorporation in clinical settings could produce better diagnostic rates, and save valuable time. In order to quantitatively assess the quality of these techniques, the SNR and CNR values of similar tissues were compared. The pre-analysis discussion concentrating on the spatial resolution and artifacts, supports that synthetic images have an advantage over DWI due to higher resolution and absence of artifacts. The SNR and CNR values were calculated for each patient and image type for the comparison, initially assuming that the synthetic images would have a higher mean SNR and CNR. In most cases the differences between scan types was found to not be statistically significant. In conclusion, this analysis could not support the initial theory that the synthetic images had a higher SNR or CNR. The research shows that they are more likely to be comparable. An investigation of the diagnostic power of the synthetic in comparison to standard DWI would give clinical relevance to these results

Cardiovascular physiology of the edible crab Cancer pagurus under Ocean Warming and Acidification

Rising atmospheric CO2 levels have caused warming of the atmosphere and oceans and reduced the seawater pH. Thermal tolerance of marine ectotherms was shown to be reduced in high-CO2 waters, limiting chances for survival under the combined effects of warming and acidification. An enhanced temperature sensitivity in a high-CO2 ocean has been confirmed by reduced O2 levels in the body fluids of large marine crustacea. The haemolymph O2 level is a function of oxygen supply and demand and largely influenced by the activities of ventilatory and circulatory systems. The present work highlights the impact of combined CO2 and temperature effects on the ventilatory and cardiovascular performance of the edible crab Cancer pagurus. It adds to previous mechanistic studies on the general synergistic effects of both drivers, revealing limitations in ventilatory performance and cardiac work. The relevance of these results is underlined by the non-invasive measurements on truly resting animals

Cardiovascular physiology of the edible crab Cancer pagurus under Ocean Warming and Acidification

Rising atmospheric CO2 levels have caused warming of the atmosphere and oceans and reduced the seawater pH. Thermal tolerance of marine ectotherms was shown to be reduced in high-CO2 waters, limiting chances for survival under the combined effects of warming and acidification. An enhanced temperature sensitivity in a high-CO2 ocean has been confirmed by reduced O2 levels in the body fluids of large marine crustacea. The haemolymph O2 level is a function of oxygen supply and demand and largely influenced by the activities of ventilatory and circulatory systems. The present work highlights the impact of combined CO2 and temperature effects on the ventilatory and cardiovascular performance of the edible crab Cancer pagurus. It adds to previous mechanistic studies on the general synergistic effects of both drivers, revealing limitations in ventilatory performance and cardiac work. The relevance of these results is underlined by the non-invasive measurements on truly resting animals

Techniques for Analysis and Motion Correction of Arterial Spin Labelling (ASL) Data from Dementia Group Studies

This investigation examines how Arterial Spin Labelling (ASL) Magnetic Resonance Imaging can be optimised to assist in the early diagnosis of diseases which cause dementia, by considering group study analysis and control of motion artefacts. ASL can produce quantitative cerebral blood flow maps noninvasively - without a radioactive or paramagnetic contrast agent being injected. ASL studies have already shown perfusion changes which correlate with the metabolic changes measured by Positron Emission Tomography in the early stages of dementia, before structural changes are evident. But the clinical use of ASL for dementia diagnosis is not yet widespread, due to a combination of a lack of protocol consistency, lack of accepted biomarkers, and sensitivity to motion artefacts. Applying ASL to improve early diagnosis of dementia may allow emerging treatments to be administered earlier, thus with greater effect. In this project, ASL data acquired from two separate patient cohorts ( (i) Young Onset Alzheimer’s Disease (YOAD) study, acquired at Queen Square; and (ii) Incidence and RISk of dementia (IRIS) study, acquired in Rotterdam) were analysed using a pipeline optimised for each acquisition protocol, with several statistical approaches considered including support-vector machine learning. Machine learning was also applied to improve the compatibility of the two studies, and to demonstrate a novel method to disentangle perfusion changes measured by ASL from grey matter atrophy. Also in this project, retrospective motion correction techniques for specific ASL sequences were developed, based on autofocusing and exploiting parallel imaging algorithms. These were tested using a specially developed simulation of the 3D GRASE ASL protocol, which is capable of modelling motion. The parallel imaging based approach was verified by performing a specifically designed MRI experiment involving deliberate motion, then applying the algorithm to demonstrably reduce motion artefacts retrospectively

The investigation of early MRI in diagnosis and prognosis in patients presenting with a clinically isolated syndrome characteristic of demyelination

This thesis explores the use of early MRI in prognosis and diagnosis in patients presenting with a clinically isolated syndrome (CIS) characteristic of demyelination. This has been investigated in a cohort recruited within 3 months of CIS onset between 1995 and 2004 and followed up clinically and with MRI (planned at 3 months, 1,3 and 5 years). Current MRI criteria are highly specific for the development of clinically definite multiple sclerosis (CDMS) but have limited sensitivity and are complex. Presented is the evaluation of simplified MRI criteria in my London CIS cohort and in a multicentre CIS cohort. Results from the presented studies show that the MRI criteria can be simplified (dissemination in space: 2 or more lesions in separate but characteristic locations, dissemination in time: an early new T2 lesion) and still maintain high specificity, with improved sensitivity and accuracy. The prognostic role of early MRI was investigated in the optic neuritis (ON) subgroup, as 80% of my cohort presented with ON and some studies have suggested that such a presentation is associated with more benign disease. Whereas baseline lesion number significantly predicted conversion to CDMS and increased disability at 5 years, other MRI parameters, namely baseline lesion location (periventricular lesions increasing the hazard of CDMS and spinal cord and infratentorial lesions increasing the odds of greater disability at 5 years) and lesion activity (new T2 lesion at 3 month follow-up), were stronger predictors. No non-conventional MRI parameters (spectroscopy, magnetisation transfer ratio or atrophy measures) had a significant prognostic role. Overall early MRI findings can aid diagnosis and help identify the CIS patients at greatest risk of conversion to CDMS and subsequent disability, which in turn can help direct treatment and clinical follow-up in specialist MS clinics

Double volumetric navigators for real-time simultaneous shim and motion measurement and correction in Glycogen Chemical Exchange Saturation Transfer (GlycoCEST) MRI

Glycogen is the primary glucose storage mechanism in in living systems and plays a central role in systemic glucose homeostasis. The study of muscle glycogen concentrations in vivo still largely relies on tissue sampling methods via needle biopsy. However, muscle biopsies are invasive and limit the frequency of measurements and the number of sites that can be assessed. Non-invasive methods for quantifying glycogen in vivo are therefore desirable in order to understand the pathophysiology of common diseases with dysregulated glycogen metabolism such as obesity, insulin resistance, and diabetes, as well as glycogen metabolism in sports physiology. Chemical Exchange Saturation Transfer (CEST) MRI has emerged as a non-invasive contrast enhancement technique that enables detection of molecules, like glycogen, whose concentrations are too low to impact the contrast of standard MR imaging. CEST imaging is performed by selectively saturating hydrogen nuclei of the metabolites that are in chemical exchange with those of water molecules and detecting a reduction in MRI signal in the water pool resulting from continuous chemical exchange. However, CEST signal can easily be compromised by artifacts. Since CEST is based on chemical shift, it is very sensitive to field inhomogeneity which may arise from poor initial shimming, subject respiration, heating of shim iron, mechanical vibrations or subject motion. This is a particular problem for molecules that resonate close to water, such as - OH protons in glycogen, where small variations in chemical shift cause misinterpretation of CEST data. The purpose of this thesis was to optimize the CEST MRI sequence for glycogen detection and implement a real-time simultaneous motion and shim correction and measurement method. First, analytical solution of the Bloch-McConnell equations was used to find optimal continuous wave RF pulse parameters for glycogen detection, and results were validated on a phantom with varying glycogen concentrations and in vivo on human calf muscle. Next, the CEST sequence was modified with double volumetric navigators (DvNavs) to measure pose changes and update field of view and zero- and first-order shim parameters. Finally, the impact of B0 field fluctuations on the scan-rescan reproducibility of CEST was evaluated in vivo in 9 volunteers across 10 different scans. Simulation results showed an optimal RF saturation power of 1.5µT and duration of 1s for glycoCEST. These parameters were validated experimentally in vivo and the ability to detect varying glycogen concentrations was demonstrated in a phantom. Phantom data showed that the DvNav-CEST sequence accurately estimates system frequency and linear shim gradient changes due to motion and corrects resulting image distortions. In addition, DvNav-CEST was shown to yield improved CEST quantification in vivo in the presence of motion and motion-induced field inhomogeneity. B0 field fluctuations were found to lower the reproducibility of CEST measures: the mean coefficient of variation (CoV) for repeated scans was 83.70 ± 70.79 % without shim correction. However, the DvNav-CEST sequence was able to measure and correct B0 variations, reducing the CoV to 2.6 ± 1.37 %. The study confirms the possibility of detecting glycogen using CEST MRI at 3 T and shows the potential of the real-time shim and motion navigated CEST sequence for producing repeatable results in vivo by reducing the effect of B0 field fluctuations