Comparative Lateralizing Ability of Multimodality MRI in Temporal Lobe Epilepsy.

Purpose. The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy. Methods. We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel 1H MR spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects. Results. Individual volumetric measurements provided accurate lateralization in 85% of the patients, spectroscopy in 57%, and DTI in 57%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85%), spectroscopy-DTI (85%), and volumetry-DTI (100%). Significantly decreased NAA/(Cho+Cr) ratios (p = 0.002) and increased FA (p = 0.001) values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (p = 0.016, r = -0.847). The history of febrile convulsion associated with ipsilateral increased ADC values (p = 0.015, r = 0.851) and reduced NAA/(Cho+Cr) ratios (p = 0.047, r = -761). Conclusion. Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy

Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease

Background And Purpose: Extracranial superficial temporal artery (STA) calcification is an unusual finding seen in Patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in Patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Materials And Methods: Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 Patients with a discharge diagnosis of end-stage renal disease (ESRD). CT head examinations were reviewed to identify and associate STA calcification with 1) risk factors for the vascular calcification, 2) intracranial artery calcification, and 3) cerebral ischemia (white matter and/or cortical ischemic changes). Results: STA calcification was present in 9.9% (45/453) of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45) in Patients with STA calcification and 9.3% (38/408) in Patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208, P=0.037) was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221). Conclusion: The presence of diabetes mellitus is important in describing the risk of STA calcification in Patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus

Comparative Lateralizing Ability of Multimodality MRI in Temporal Lobe Epilepsy

Purpose. The objective is to compare lateralizing ability of three quantitative MR (qMRI) modalities to depict changes of hippocampal architecture with clinical entities in temporal lobe epilepsy. Methods. We evaluated 14 patients with clinical and EEG proven diagnosis of unilateral TLE and 15 healthy volunteers. T1-weighted 3D dataset for volumetry, single-voxel (HMR)-H-1 spectroscopy (MRS), and diffusion tensor imaging (DTI) were performed for bilateral hippocampi of all subjects. Results. Individual volumetric measurements provided accurate lateralization in 85\% of the patients, spectroscopy in 57\%, and DTI in 57\%. Higher lateralization ratios were acquired combining volumetry-spectroscopy (85\%), spectroscopy-DTI (85\%), and volumetry-DTI (100\%). Significantly decreased NAA/(Cho+Cr)ratios (p = 0.002) and increased FA (p = 0.001) values were obtained in ipsilateral to epileptogenic hippocampus. Duration of epilepsy and FA values showed a significant negative correlation (p = 0.016,r = -0.847). The history of febrile convulsion associated with ipsilateral increased ADC values (p = 0.015,r = 0.851) and reduced NAA/(Cho+Cr) ratios (p = 0.047,r = -761). Conclusion. Volumetry, MRS, and DTI studies provide complementary information of hippocampal pathology. For lateralization of epileptogenic focus and preoperative examination, volumetry-DTI combination may be indicative of diagnostic accuracy

Eye Movements Quantitative Analysis of the Displacement of the Anterior Visual Pathway by Pituitary Lesions and the Associated Visual Field Loss

PURPOSE. To evaluate quantitatively the relationship between the displacement of anterior visual pathway structures by pituitary tumors and visual field damage with the goal of improving diagnosis and management. METHODS. Subjects had pituitary macroadenomas and both magnetic resonance imaging (MRI) and static perimetry. Neuroradiologists measured the displacement of anterior visual pathway structures and right-left tumor asymmetry. To quantify the degree and laterality of visual field loss, we used algorithms from the neurologic hemifield test to analyze each right-left pair of visual fields with respect to temporal asymmetry, the proportion of loss that was temporal, total asymmetry, and total damage. We compared these metrics with the displacement of anterior visual pathway structures and tumor asymmetry. RESULTS. Of 114 subjects, 64 (56%) were male and the median age was 57 years (range, 14-88). The summation of vision loss in both eyes and the proportion of temporal loss were statistically significantly related to the maximum displacement of the anterior visual pathway (both P < 0.001 for fit of linear regression). The relationship between the asymmetry of visual field loss in the two eyes and the subjective assignment of tumor asymmetry on MRI did not achieve statistical significance (P ¼ 0.06 by analysis of variance). CONCLUSIONS. Displacement of the anterior visual pathway by pituitary tumors is associated with both the total amount of visual field loss and the proportion of temporal visual field loss. Although there was right-left asymmetry of vision loss in some subjects, it was not related to the subjective assessment of tumor asymmetry

Time-dependent diffusivity and kurtosis in phantoms and patients with head and neck cancer

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/175204/1/mrm29457.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/175204/2/mrm29457_am.pd

Gallium-68-labeled fibroblast activation protein inhibitor-46 PET in patients with resectable or borderline resectable pancreatic ductal adenocarcinoma: A phase 2, multicenter, single arm, open label non-randomized study protocol.

BackgroundPancreatic ductal adenocarcinoma (PDAC) is a lethal disease prone to widespread metastatic dissemination and characterized by a desmoplastic stroma that contributes to poor outcomes. Fibroblast activation protein (FAP)-expressing Cancer-Associated Fibroblasts (CAFs) are crucial components of the tumor stroma, influencing carcinogenesis, fibrosis, tumor growth, metastases, and treatment resistance. Non-invasive tools to profile CAF identity and function are essential for overcoming CAF-mediated therapy resistance, developing innovative targeted therapies, and improved patient outcomes. We present the design of a multicenter phase 2 study (clinicaltrials.gov identifier NCT05262855) of [68Ga]FAPI-46 PET to image FAP-expressing CAFs in resectable or borderline resectable PDAC.MethodsWe will enroll up to 60 adult treatment-naïve patients with confirmed PDAC. These patients will be eligible for curative surgical resection, either without prior treatment (Cohort 1) or after neoadjuvant therapy (NAT) (Cohort 2). A baseline PET scan will be conducted from the vertex to mid-thighs approximately 15 minutes after administering 5 mCi (±2) of [68Ga]FAPI-46 intravenously. Cohort 2 patients will undergo an additional PET after completing NAT but before surgery. Histopathology and FAP immunohistochemistry (IHC) of initial diagnostic biopsy and resected tumor samples will serve as the truth standards. Primary objective is to assess the sensitivity, specificity, and accuracy of [68Ga]FAPI-46 PET for detecting FAP-expressing CAFs. Secondary objectives will assess predictive values and safety profile validation. Exploratory objectives are comparison of diagnostic performance of [68Ga]FAPI-46 PET to standard-of-care imaging, and comparison of pre- versus post-NAT [68Ga]FAPI-46 PET in Cohort 2.ConclusionTo facilitate the clinical translation of [68Ga]FAPI-46 in PDAC, the current study seeks to implement a coherent strategy to mitigate risks and increase the probability of meeting FDA requirements and stakeholder expectations. The findings from this study could potentially serve as a foundation for a New Drug Application to the FDA.Trial [email protected] identifier NCT05262855

Summary of prior patient preparation and scanning procedure.

Summary of prior patient preparation and scanning procedure.</p