Diffusion MRI allows us not only voxelized diffusion characteristics but also the potential to delineate neuronal fiber path through tractography. There is a dearth of flexible open source tractography software programs for visualizing these complicated 3D structures. Moreover, rendering these structures using various shading, lighting, and representations will result in vastly different graphical feel. In addition, the ability to output these objects in various formats increases the utility of this platform. We have created TractRender that leverages openGL features through Matlab, allowing for maximum ease of use but still maintain the flexibility of custom scene rendering.
ApoliopoproteinE Ɛ4 (ApoE-Ɛ4) polymorphism is the most well known genetic risk factor for developing Alzheimers Disease. The exact mechanism through which ApoE 4 increases AD risk is not fully known, but may be related to decreased clearance and increased oligomerization of Aβ. By making measurements of white matter integrity via diffusion MR and correlating the metrics in a voxel-based statistical analysis with ApoE-Ɛ4 genotype (whilst controlling for vascular risk factor, gender, cognitive status and age) we are able to identify changes in white matter associated with carrying an ApoE Ɛ4 allele. We found potentially significant regions (Puncorrected < 0:05) near the hippocampus and the posterior cingulum that were independent of voxels that correlated with age or clinical dementia rating (CDR) status suggesting that ApoE may affect cognitive decline via a pathway in dependent of normal aging and acute insults that can be measured by CDR and Framingham Coronary Risk Score (FCRS).
Most white matter related neurological disease exhibit a large number of White Matter Hyperintensities (WMHs) on FLAIR MRI images. However, these lesions are not well understood. At the same time, Diffusion MRI has been gaining popularity as a powerful method of characterizing White Matter (WM) integrity. This work aims to study the behavior of the diffusion signal within the WMH voxels. The goal is to develop hybrid MR metrics that leverage information from multiple MR acquisitions to solve clinical problems. In our case, we are trying to address the WMH penumbra (as defined by Maillard et al 20112) where WMH delineates a foci that is more widespread than the actual damage area presumably due to acute inflammation. Our results show that diffusion MR metrics may be able to better delineate tissue that is inflamed versus scar tissue but may be less specific to lesions than FLAIR. Therefore, a hybrid metric that encodes information from both FLAIR and Diffusion MR may yield new and novel imaging information about the progression of white matter disease progression. We hope that this work also demonstrates how future PACS systems could have image fusion capabilities that would be able to leverage information from multiple imaging series to yield new and novel imaging contrast.
Mild traumatic brain injury (MTBI) or concussive injury affects 1.7 million Americans annually, of which 300,000 are due to recreational activities and contact sports, such as football, rugby, and boxing[1]. Finding the neuroanatomical correlates of brain TBI non-invasively and precisely is crucial for diagnosis and prognosis. Several studies have shown the in influence of traumatic brain injury (TBI) on the integrity of brain WM [2-4]. The vast majority of these works focus on athletes with diagnosed concussions. However, in contact sports, athletes are subjected to repeated hits to the head throughout the season, and we hypothesize that these have an influence on white matter integrity. In particular, the corpus callosum (CC), as a small structure connecting the brain hemispheres, may be particularly affected by torques generated by collisions, even in the absence of full blown concussions. Here, we use a combined surface-based morphometry and relative pose analyses, applying on the point distribution model (PDM) of the CC, to investigate TBI related brain structural changes between 9 pre-season and 9 post-season contact sport athlete MRIs. All the data are fed into surface based morphometry analysis and relative pose analysis. The former looks at surface area and thickness changes between the two groups, while the latter consists of detecting the relative translation, rotation and scale between them.
Prediction of Alzheimers disease (AD) progression based on baseline measures allows us to understand disease progression and has implications in decisions concerning treatment strategy. To this end we combine a predictive multi-task machine learning method1 with novel MR-based multivariate morphometric surface map of the hippocampus2 to predict future cognitive scores of patients. Previous work by Zhou et al.1 has shown that a multi-task learning framework that performs prediction of all future time points (or tasks) simultaneously can be used to encode both sparsity as well as temporal smoothness. They showed that this can be used in predicting cognitive outcomes of Alzheimers Disease Neuroimaging Initiative (ADNI) subjects based on FreeSurfer-based baseline MRI features, MMSE score demographic information and ApoE status. Whilst volumetric information may hold generalized information on brain status, we hypothesized that hippocampus specific information may be more useful in predictive modeling of AD. To this end, we applied Shi et al.2s recently developed multivariate tensor-based (mTBM) parametric surface analysis method to extract features from the hippocampal surface. We show that by combining the power of the multi-task framework with the sensitivity of mTBM features of the hippocampus surface, we are able to improve significantly improve predictive performance of ADAS cognitive scores 6, 12, 24, 36 and 48 months from baseline.
The factors behind the neural mechanisms that motivate food choice and obesity are not well known. Furthermore,
it is not known when these neural mechanisms develop and how they are influenced by both genetic
and environmental factors. This study uses fMRI together with clinical data to shed light on the aforementioned
questions by investigating how appetite-related activation in the brain changes with low versus high caloric foods
in pre-pubescent girls. Previous studies have shown that obese adults have less striatal D2 receptors and thus
reduced Dopamine (DA) signaling leading to the reward-deficit theory of obesity. However, overeating in itself
reduces D2 receptor density, D2 sensitivity and thus reward sensitivity. The results of this study will show how
early these neural mechanisms develop and what effect the drastic endocrinological changes during puberty has
on these mechanisms. Our preliminary results showed increased activations in the Putamen, Insula, Thalamus
and Hippocampus when looking at activations where High Calorie > Low Calorie. When comparing High Calorie
> Control and Low Calorie > Control, the High > Control test showed increased significant activation in the
frontal lobe. The Low > Control also yielded significant activation in the Left and Right Fusiform Gyrus, which
did not appear in the High > Control test. These results indicate that the reward pathway activations previously
shown in post-puberty and adults are present in pre-pubescent teens. These results may suggest that some of
the preferential neural mechanisms of reward are already present pre-puberty.
KEYWORDS: Glucose, Functional magnetic resonance imaging, Brain, Head, Magnetic resonance imaging, Data acquisition, Scanners, Amygdala, Blood oxygen saturation, Signal detection
A novel MRI protocol has been developed to investigate the differential effects of glucose or fructose consumption
on whole-brain functional brain connectivity. A previous study has reported a decrease in the fMRI blood oxygen
level dependent (BOLD) signal of the hypothalamus following glucose ingestion, but due to technical limitations,
was restricted to a single slice covering the hypothalamus, and thus unable to detect whole-brain connectivity.
In another previous study, a protocol was devised to acquire whole-brain fMRI data following food intake, but
only after restricting image acquisition to an MR sampling or repetition time (TR) of 20s, making the protocol
unsuitable to detect functional connectivity above 0.025Hz. We have successfully implemented a continuous
36-min, 40 contiguous slices, whole-brain BOLD acquisition protocol on a 3T scanner with TR=4.5s to ensure
detection of up to 0.1Hz frequencies for whole-brain functional connectivity analysis. Human data were acquired
first with ingestion of water only, followed by a glucose or fructose drink within the scanner, without interrupting
the scanning. Whole-brain connectivity was analyzed using standard correlation methodology in the 0.01-0.1
Hz range. The correlation coefficient differences between fructose and glucose ingestion among targeted regions
were converted to t-scores using the water-only correlation coefficients as a null condition. Results show a
dramatic increase in the hypothalamic connectivity to the hippocampus, amygdala, insula, caudate and the
nucleus accumben for fructose over glucose. As these regions are known to be key components of the feeding
and reward brain circuits, these results suggest a preference for fructose ingestion.
The Digital Hand Atlas in Assessment of Skeletal Development is a large-scale Computer Aided Diagnosis (CAD)
project for automating the process of grading Skeletal Development of children from 0-18 years of age. It includes a
complete collection of 1,400 normal hand X-rays of children between the ages of 0-18 years of age. Bone Age
Assessment is used as an index of skeletal development for detection of growth pathologies that can be related to
endocrine, malnutrition and other disease types. Previous work at the Image Processing and Informatics Lab (IPILab)
allowed the bone age CAD algorithm to accurately assess bone age of children from 1 to 16 (male) or 14 (female) years
of age using the Phalanges as well as the Carpal Bones. At the older ages (16(male) or 14(female) -19 years of age) the
Phalanges as well as the Carpal Bones are fully developed and do not provide well-defined features for accurate bone
age assessment. Therefore integration of the Radius Bone as a region of interest (ROI) is greatly needed and will
significantly improve the ability to accurately assess the bone age of older children. Preliminary studies show that an
integrated Bone Age CAD that utilizes the Phalanges, Carpal Bones and Radius forms a robust method for automatic
bone age assessment throughout the entire age range (1-19 years of age).
Bone age assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology
to evaluate the stage of skeletal maturation based on a left hand and wrist radiograph. The most commonly
used standard: Greulich and Pyle (G&P) Hand Atlas was developed 50 years ago and exclusively based on
Caucasian population. Moreover, inter- & intra-observer discrepancies using this method create a need of
an objective and automatic BAA method. A digital hand atlas (DHA) has been collected with 1,400 hand
images of normal children from Asian, African American, Caucasian and Hispanic descends. Based on
DHA, a fully automatic, objective computer-aided-diagnosis (CAD) method was developed and it was
adapted to specific population. To bring DHA and CAD method to the clinical environment as a useful tool
in assisting radiologist to achieve higher accuracy in BAA, a web-based system with direct connection to a
clinical site is designed as a novel clinical implementation approach for online and real time BAA. The
core of the system, a CAD server receives the image from clinical site, processes it by the CAD method and
finally, generates report. A web service publishes the results and radiologists at the clinical site can review
it online within minutes. This prototype can be easily extended to multiple clinical sites and will provide
the foundation for broader use of the CAD system for BAA.
KEYWORDS: Radiology, Picture Archiving and Communication System, Databases, Data mining, Image retrieval, Information science, Medicine, Magnetic resonance imaging, Classification systems, Speaker recognition
Radiology Information Systems (RIS) contain a wealth of information that can be used for research, education, and
practice management. However, the sheer amount of information available makes querying specific data difficult and
time consuming. Previous work has shown that a clinical RIS database and its RIS text reports can be extracted,
duplicated and indexed for searches while complying with HIPAA and IRB requirements. This project's intent is to
provide a software tool, the RadSearch Toolkit, to allow intelligent indexing and parsing of RIS reports for easy yet
powerful searches. In addition, the project aims to seamlessly query and retrieve associated images from the Picture
Archiving and Communication System (PACS) in situations where an integrated RIS/PACS is in place - even
subselecting individual series, such as in an MRI study. RadSearch's application of simple text parsing techniques to
index text-based radiology reports will allow the search engine to quickly return relevant results. This powerful
combination will be useful in both private practice and academic settings; administrators can easily obtain complex
practice management information such as referral patterns; researchers can conduct retrospective studies with specific,
multiple criteria; teaching institutions can quickly and effectively create thorough teaching files.
KEYWORDS: Bone, Statistical analysis, Radiography, Digital imaging, Image processing, Picture Archiving and Communication System, Radiology, Medicine, Diagnostics, Data processing
Bone age assessment is most commonly performed with the use of the Greulich and Pyle (G&P)
book atlas, which was developed in the 1950s. The population of theUnited States is not as
homogenous as the Caucasian population in the Greulich and Pyle in the 1950s, especially in the
Los Angeles, California area. A digital hand atlas (DHA) based on 1,390 hand images of children
of different racial backgrounds (Caucasian, African American, Hispanic, and Asian) aged 0-18
years was collected from Children's Hospital Los Angeles. Statistical analysis discovered
significant discrepancies exist between Hispanic and the G&P atlas standard. To validate the usage
of DHA as a clinical standard, diagnostic radiologists performed reads on Hispanic pediatric hand
and wrist computed radiography images using either the G&P pediatric radiographic atlas or the
Children's Hospital Los Angeles Digital Hand Atlas (DHA) as reference. The order in which the
atlas is used (G&P followed by DHA or vice versa) for each image was prepared before actual
reading begins. Statistical analysis of the results was then performed to determine if a discrepancy
exists between the two readings.
The most commonly used method for bone age assessment in clinical practice is the book atlas matching method
developed by Greulich and Pyle in the 1950s. Due to changes in both population diversity and nutrition in the United
States, this atlas may no longer be a good reference. An updated data set becomes crucial to improve the bone age
assessment process. Therefore, a digital hand atlas was built with 1,100 children hand images, along with patient
information and radiologists' readings, of normal Caucasian (CAU), African American (BLK), Hispanic (HIS), and
Asian (ASI) males (M) and females (F) with ages ranging from 0 - 18 years. This data was collected from Childrens'
Hospital Los Angeles. A computer-aided-diagnosis (CAD) method has been developed based on features extracted from
phalangeal regions of interest (ROIs) and carpal bone ROIs from this digital hand atlas. Using the data collected along
with the Greulich and Pyle Atlas-based readings and CAD results, this paper addresses this question: "Do different
ethnicities and gender have different bone growth patterns?" To help with data analysis, a novel web-based visualization
tool was developed to demonstrate bone growth diversity amongst differing gender and ethnic groups using data
collected from the Digital Atlas. The application effectively demonstrates a discrepancy of bone growth pattern amongst
different populations based on race and gender. It also has the capability of helping a radiologist determine the
normality of skeletal development of a particular patient by visualizing his or her chronological age, radiologist reading,
and CAD assessed bone age relative to the accuracy of the P&G method.
KEYWORDS: Picture Archiving and Communication System, Diffractive optical elements, Medicine, Telecommunications, Personal digital assistants, Cell phones, Wireless communications, C++, Wireless broadband, Data communications
Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to
wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and
Communications System) data. SMS is a flexible and mobile method for real-time access and control of
Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike
conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or
any other localized signal. It provides a simple, reliable yet flexible method to communicate with an
information system. In addition, SMS services are widely available for low costs from cellular phone
service providers and allows for more mobility than other services such as wireless internet. This paper
aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote
access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and
streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort
to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.
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