119 research outputs found

    A medical device-grade T1 and ECV phantom for global T1 mapping quality assurance - the T1_1 Mapping and ECV Standardization in cardiovascular magnetic resonance (T1MES) program

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    Background:\textbf{Background:} T1_1 mapping and extracellular volume (ECV) have the potential to guide patient care and serve as surrogate end-points in clinical trials, but measurements differ between cardiovascular magnetic resonance (CMR) scanners and pulse sequences. To help deliver T1_1 mapping to global clinical care, we developed a phantom-based quality assurance (QA) system for verification of measurement stability over time at individual sites, with further aims of generalization of results across sites, vendor systems, software versions and imaging sequences. We thus created T1MES: The T1 Mapping and ECV Standardization Program. Methods:\textbf{Methods:} A design collaboration consisting of a specialist MRI small-medium enterprise, clinicians, physicists and national metrology institutes was formed. A phantom was designed covering clinically relevant ranges of T1_1 and T2_2 in blood and myocardium, pre and post-contrast, for 1.5 T and 3 T. Reproducible mass manufacture was established. The device received regulatory clearance by the Food and Drug Administration (FDA) and Conformité Européene (CE) marking. Results:\textbf{Results:} The T1MES phantom is an agarose gel-based phantom using nickel chloride as the paramagnetic relaxation modifier. It was reproducibly specified and mass-produced with a rigorously repeatable process. Each phantom contains nine differently-doped agarose gel tubes embedded in a gel/beads matrix. Phantoms were free of air bubbles and susceptibility artifacts at both field strengths and T1_1 maps were free from off-resonance artifacts. The incorporation of high-density polyethylene beads in the main gel fill was effective at flattening the B1B_1 field. T1_1 and T2_2 values measured in T1MES showed coefficients of variation of 1 % or less between repeat scans indicating good short-term reproducibility. Temperature dependency experiments confirmed that over the range 15-30 °C the short-T1_1 tubes were more stable with temperature than the long-T1_1 tubes. A batch of 69 phantoms was mass-produced with random sampling of ten of these showing coefficients of variations for T1_1 of 0.64 ± 0.45 % and 0.49 ± 0.34 % at 1.5 T and 3 T respectively. Conclusion:\textbf{Conclusion:} The T1MES program has developed a T1_1 mapping phantom to CE/FDA manufacturing standards. An initial 69 phantoms with a multi-vendor user manual are now being scanned fortnightly in centers worldwide. Future results will explore T1_1 mapping sequences, platform performance, stability and the potential for standardization.This project has been funded by a European Association of Cardiovascular Imaging (EACVI part of the ESC) Imaging Research Grant, a UK National Institute of Health Research (NIHR) Biomedical Research Center (BRC) Cardiometabolic Research Grant at University College London (UCL, #BRC/ 199/JM/101320), and a Barts Charity Research Grant (#1107/2356/MRC0140). G.C. is supported by the National Institute for Health Research Rare Diseases Translational Research Collaboration (NIHR RD-TRC) and by the NIHR UCL Hospitals Biomedical Research Center. J.C.M. is directly and indirectly supported by the UCL Hospitals NIHR BRC and Biomedical Research Unit at Barts Hospital respectively. This work was in part supported by an NIHR BRC award to Cambridge University Hospitals NHS Foundation Trust and NIHR Cardiovascular Biomedical Research Unit support at Royal Brompton Hospital London UK

    Influence of microenvironment on engraftment of transplanted β-cells

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    Pancreatic islet transplantation into the liver provides a possibility to treat selected patients with brittle type 1 diabetes mellitus. However, massive early β-cell death increases the number of islets needed to restore glucose homeostasis. Moreover, late dysfunction and death contribute to the poor long-term results of islet transplantation on insulin independence. Studies in recent years have identified early and late challenges for transplanted pancreatic islets, including an instant blood-mediated inflammatory reaction when exposing human islets to the blood microenvironment in the portal vein and the low oxygenated milieu of islets transplanted into the liver. Poor revascularization of remaining intact islets combined with severe changes in the gene expression of islets transplanted into the liver contributes to late dysfunction. Strategies to overcome these hurdles have been developed, and some of these interventions are now even tested in clinical trials providing a hope to improve results in clinical islet transplantation. In parallel, experimental and clinical studies have, based on the identified problems with the liver site, evaluated the possibility of change of implantation organ in order to improve the results. Site-specific differences clearly exist in the engraftment of transplanted islets, and a more thorough characterization of alternative locations is needed. New strategies with modifications of islet microenvironment with cells and growth factors adhered to the islet surface or in a surrounding matrix could be designed to intervene with site-specific hurdles and provide possibilities to improve future results of islet transplantation

    State-of-the-art microscopy to understand islets of Langerhans:what to expect next?

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    The discovery of Langerhans and microscopic description of islets in the pancreas were crucial steps in the discovery of insulin. Over the past 150 years, many discoveries in islet biology and type 1 diabetes have been made using powerful microscopic techniques. In the past decade, combination of new probes, animal and tissue models, application of new biosensors and automation of light and electron microscopic methods and other (sub)cellular imaging modalities have proven their potential in understanding the beta cell under (patho)physiological conditions. The imaging evolution, from fluorescent jellyfish to real-time intravital functional imaging, the revolution in automation and data handling and the increased resolving power of analytical imaging techniques are now converging. Here, we review innovative approaches that address islet biology from new angles by studying cells and molecules at high spatiotemporal resolution and in live models. Broad implementation of these cellular imaging techniques will shed new light on cause/consequence of (mal)function in islets of Langerhans in the years to come

    A stochastic multidimensional scaling vector threshold model for the spatial representation of “pick any/ n ” data

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    This paper presents a new stochastic multidimensional scaling vector threshold model designed to analyze “pick any/ n ” choice data (e.g., consumers rendering buy/no buy decisions concerning a number of actual products). A maximum likelihood procedure is formulated to estimate a joint space of both individuals (represented as vectors) and stimuli (represented as points). The relevant psychometric literature concerning the spatial treatment of such binary choice data is reviewed. The nonlinear probit type model is described, as well as the conjugate gradient procedure used to estimate parameters. Results of Monte Carlo analyses investigating the performance of this methodology with synthetic choice data sets are presented. An application concerning consumer choices for eleven competitive brands of soft drinks is discussed. Finally, directions for future research are presented in terms of further applications and generalizing the model to accommodate three-way choice data.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45743/1/11336_2005_Article_BF02294452.pd

    A stochastic multidimensional scaling procedure for the spatial representation of three-mode, three-way pick any/ J data

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    This paper presents a new stochastic multidimensional scaling procedure for the analysis of three-mode, three-way pick any/ J data. The method provides either a vector or ideal-point model to represent the structure in such data, as well as “floating” model specifications (e.g., different vectors or ideal points for different choice settings), and various reparameterization options that allow the coordinates of ideal points, vectors, or stimuli to be functions of specified background variables. A maximum likelihood procedure is utilized to estimate a joint space of row and column objects, as well as a set of weights depicting the third mode of the data. An algorithm using a conjugate gradient method with automatic restarts is developed to estimate the parameters of the models. A series of Monte Carlo analyses are carried out to investigate the performance of the algorithm under diverse data and model specification conditions, examine the statistical properties of the associated test statistic, and test the robustness of the procedure to departures from the independence assumptions. Finally, a consumer psychology application assessing the impact of situational influences on consumers' choice behavior is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45749/1/11336_2005_Article_BF02294486.pd
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