Simultaneous EEG and functional MRI: A noninvasive tool in the presurgical evaluation of focal epilepsy

Verdaasdonk, R.M. [Promotor]Boon, P.A.J.M. [Promotor]Ossenblok, P.P.W. [Copromotor]Munck, J.C. de [Copromotor

Longitudinal correlations between intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) MRI during radiotherapy in prostate cancer patients

Purpose: Intravoxel incoherent motion (IVIM) is a promising technique that can acquire perfusion information without the use of contrast agent, contrary to the more established dynamic contrast-enhanced (DCE) technique. This is of interest for treatment response monitoring, where patients can be imaged on each treatment fraction. In this study, longitudinal correlations between IVIM- and DCE parameters were assessed in prostate cancer patients receiving radiation treatment.Materials and Methods: 20 prostate cancer patients were treated on a 1.5 T MR-linac with 20 x 3 or 3.1 Gy. Weekly IVIM and DCE scans were acquired. Tumors, the peripheral zone (PZ), and the transition zone (TZ) were delineated on a T2-weighted scan acquired on the first fraction. IVIM and DCE scans were registered to this scan and the delineations were propagated. Median values from these delineations were used for further analysis. The IVIM parameters D, f, D* and the product fD* were calculated. The Tofts model was used to calculate the DCE parameters Ktrans, kep and ve. Pearson correlations were calculated for the IVIM and DCE parameters on values from the first fraction for each region of interest (ROI). For longitudinal analysis, the repeated measures correlation coefficient was used to determine correlations between IVIM and DCE parameters in each ROI.Results: When averaging over patients, an increase during treatment in all IVIM and DCE parameters was observed in all ROIs, except for D in the PZ and TZ. No significant Pearson correlations were found between any pair of IVIM and DCE parameters measured on the first fraction. Significant but low longitudinal correlations were found for some combinations of IVIM and DCE parameters in the PZ and TZ, while no significant longitudinal correlations were found in the tumor. Notably in the TZ, for both f and fD*, significant longitudinal correlations with all DCE parameters were found.Conclusions: The increase in IVIM- and DCE parameters when averaging over patients indicates a measurable response to radiation treatment with both techniques. Although low, significant longitudinal correlations were found which suggests that IVIM could potentially be used as an alternative to DCE for treatment response monitoring.</p

Daily Intravoxel Incoherent Motion (IVIM) in prostate cancer patients during MR-guided radiotherapy: a multicenter study

Biological, physical and clinical aspects of cancer treatment with ionising radiatio

ADC measurements on the Unity MR-linac - A recommendation on behalf of the Elekta Unity MR-linac consortium

Background and purpose: Diffusion-weighted imaging (DWI) for treatment response monitoring is feasibleon hybrid magnetic resonance linear accelerator (MR-linac) systems. The MRI scanner of the ElektaUnity system has an adjusted design compared to diagnostic scanners. We investigated its impact onmeasuring the DWI-derived apparent diffusion coefficient (ADC) regarding three aspects: the choice ofb-values, the spatial variation of the ADC, and scanning during radiation treatment. The aim of this studyis to give recommendations for accurate ADC measurements on Unity systems.Materials and methods: Signal-to-noise ratio (SNR) measurements with increasing b-values were done todetermine the highest bvalue that can be measured reliably. The spatial variation of the ADC wasassessed on six Unity systems with a cylindrical phantom of 40 cm diameter. The influence of gantry rotationand irradiation was investigated by acquiring DWI images before and during treatment of 11 prostatecancer patients.Results: On the Unity system, a maximum b-value of 500 s/mm2 should be used for ADC quantification, asa trade-off between SNR and diffusion weighting. Accurate ADC values were obtained within 7 cm fromthe iso-center, while outside this region ADC values deviated more than 5%. The ADC was not influencedby the rotating linac or irradiation during treatment.Conclusion: We provide Unity system specific recommendations for measuring the ADC. This willincrease the consistency of ADC values acquired in different centers on the Unity system, enabling largecohort studies for biomarker discovery and treatment response monitoring.Biological, physical and clinical aspects of cancer treatment with ionising radiatio

A community-endorsed open-source lexicon for contrast agent–based perfusion MRI: a consensus guidelines report from the ISMRM Open Science Initiative for Perfusion Imaging (OSIPI)

This manuscript describes the ISMRM OSIPI (Open Science Initiative for Perfusion Imaging) lexicon for dynamic contrast-enhanced and dynamic susceptibility-contrast MRI. The lexicon was developed by Taskforce 4.2 of OSIPI to provide standardized definitions of commonly used quantities, models, and analysis processes with the aim of reducing reporting variability. The taskforce was established in February 2020 and consists of medical physicists, engineers, clinicians, data and computer scientists, and DICOM (Digital Imaging and Communications in Medicine) standard experts. Members of the taskforce collaborated via a slack channel and quarterly virtual meetings. Members participated by defining lexicon items and reporting formats that were reviewed by at least two other members of the taskforce. Version 1.0.0 of the lexicon was subject to open review from the wider perfusion imaging community between January and March 2022, and endorsed by the Perfusion Study Group of the ISMRM in the summer of 2022. The initial scope of the lexicon was set by the taskforce and defined such that it contained a basic set of quantities, processes, and models to enable users to report an end-to-end analysis pipeline including kinetic model fitting. We also provide guidance on how to easily incorporate lexicon items and definitions into free-text descriptions (e.g., in manuscripts and other documentation) and introduce an XML-based pipeline encoding format to encode analyses using lexicon definitions in standardized and extensible machine-readable code. The lexicon is designed to be open-source and extendable, enabling ongoing expansion of its content. We hope that widespread adoption of lexicon terminology and reporting formats described herein will increase reproducibility within the field

Detection and localization of early- and late-stage cancers using platelet RNA

Cancer patients benefit from early tumor detection since treatment outcomes are more favorable for less advanced cancers. Platelets are involved in cancer progression and are considered a promising biosource for cancer detection, as they alter their RNA content upon local and systemic cues. We show that tumor-educated platelet (TEP) RNA-based blood tests enable the detection of 18 cancer types. With 99% specificity in asymptomatic controls, thromboSeq correctly detected the presence of cancer in two-thirds of 1,096 blood samples from stage I–IV cancer patients and in half of 352 stage I–III tumors. Symptomatic controls, including inflammatory and cardiovascular diseases, and benign tumors had increased false-positive test results with an average specificity of 78%. Moreover, thromboSeq determined the tumor site of origin in five different tumor types correctly in over 80% of the cancer patients. These results highlight the potential properties of TEP-derived RNA panels to supplement current approaches for blood-based cancer screening

Network analysis of generalized spike-and-wave discharges occurring in both animal models as well as in children

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A semi-automatic method to determine electrode positions and labels from gel artifacts in EEG/fMRI-studies

The analysis of simultaneous EEG and fMRI data is generally based on the extraction of regressors of interest from the EEG, which are correlated to the fMRI data in a general linear model setting. In more advanced approaches, the spatial information of EEG is also exploited by assuming underlying dipole models. In this study, we present a semi automatic and efficient method to determine electrode positions from electrode gel artifacts, facilitating the integration of EEG and fMRI in future EEG/fMRI data models. In order to visualize all electrode artifacts simultaneously in a single view, a surface rendering of the structural MRI is made using a skin triangular mesh model as reference surface, which is expanded to a "pancake view". Then the electrodes are determined with a simple mouse click for each electrode. Using the geometry of the skin surface and its transformation to the pancake view, the 3D coordinates of the electrodes are reconstructed in the MRI coordinate frame. The electrode labels are attached to the electrode positions by fitting a template grid of the electrode cap in which the labels are known. The correspondence problem between template and sample electrodes is solved by minimizing a cost function over rotations, shifts and scalings of the template grid. The crucial step here is to use the solution of the so-called "Hungarian algorithm" as a cost function, which makes it possible to identify the electrode artifacts in arbitrary order. The template electrode grid has to be constructed only once for each cap configuration. In our implementation of this method, the whole procedure can be performed within 15 min including import of MRI, surface reconstruction and transformation, electrode identification and fitting to template. The method is robust in the sense that an electrode template created for one subject can be used without identification errors for another subject for whom the same EEG cap was used. Furthermore, the method appears to be robust against spurious or missing artifacts. We therefore consider the proposed method as a useful and reliable tool within the larger toolbox required for the analysis of co-registered EEG/fMRI data. © 2011 Elsevier Inc