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Andrew L Alexander

Publications and source records attributed to Andrew L Alexander.

33 records · Page 2Linked to original sources

Diffusion tensor eigenvector directional color imaging patterns in the evaluation of cerebral white matter tracts altered by tumor.

PURPOSE: To categorize the varied appearances of tumor-altered white matter (WM) tracts on diffusion tensor eigenvector directional color maps. MATERIALS AND METHODS: Diffusion tensor imaging (DTI) was obtained preoperatively in 13 patients with brain tumors ranging from benign to high-grade malignant, including primary and metastatic lesions, and maps of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and major eigenvector direction were generated. Regions of interest (ROIs) were drawn within identifiable WM tracts affected by tumor, avoiding grossly cystic and necrotic regions, known fiber crossings, and gray matter. Patterns of WM tract alteration were categorized on the basis of qualitative analysis of directional color maps and correlation analysis of ADC and FA. RESULTS: Four basic patterns of WM alteration were identified: 1) normal or nearly normal FA and ADC, with abnormal tract location or tensor directions attributable to bulk mass displacement, 2) moderately decreased FA and increased ADC with normal tract locations and tensor directions, 3) moderately decreased FA and increased ADC with abnormal tensor directions, and 4) near isotropy. FA and ADC were inversely correlated for Patterns 1-3 but did not discriminate edema from infiltrating tumor. However, in the absence of mass displacement, infiltrating tumor was found to produce tensor directional changes that were not observed with vasogenic edema, suggesting the possibility of discrimination on the basis of directional statistics. CONCLUSION: Tumor alteration of WM tracts tends to produce one of four patterns on FA and directional color maps. Clinical application of these patterns must await further study.

Adult↗

Does fractional anisotropy have better noise immunity characteristics than relative anisotropy in diffusion tensor MRI? An analytical approach.

Fractional anisotropy (FA) and relative anisotropy (RA) are the two most commonly used scalar measures of anisotropy in diffusion tensor (DT) MRI. While a few published studies have shown that FA has superior noise immunity relative to RA, no theoretical basis has been proposed to explain this behavior. In the current study, the diffusion tensor invariants were used to derive a simple analytical expression that directly relates RA and FA. An analysis based on that analytical expression demonstrated that the FA images have a higher signal-to-noise ratio (SNR) than RA for any value of tensor anisotropy RA or FA > 0. This theoretical behavior was verified using both Monte Carlo simulations and bootstrap analysis of DT-MRI data acquired in a spherical water phantom and normal human subjects.

Anisotropy↗

Quantitative analysis of diffusion tensor orientation: theoretical framework.

Diffusion-tensor MRI (DT-MRI) yields information about the magnitude, anisotropy, and orientation of water diffusion of brain tissues. Although white matter tractography and eigenvector color maps provide visually appealing displays of white matter tract organization, they do not easily lend themselves to quantitative and statistical analysis. In this study, a set of visual and quantitative tools for the investigation of tensor orientations in the human brain was developed. Visual tools included rose diagrams, which are spherical coordinate histograms of the major eigenvector directions, and 3D scatterplots of the major eigenvector angles. A scatter matrix of major eigenvector directions was used to describe the distribution of major eigenvectors in a defined anatomic region. A measure of eigenvector dispersion was developed to describe the degree of eigenvector coherence in the selected region. These tools were used to evaluate directional organization and the interhemispheric symmetry of DT-MRI data in five healthy human brains and two patients with infiltrative diseases of the white matter tracts. In normal anatomical white matter tracts, a high degree of directional coherence and interhemispheric symmetry was observed. The infiltrative diseases appeared to alter the eigenvector properties of affected white matter tracts, showing decreased eigenvector coherence and interhemispheric symmetry. This novel approach distills the rich, 3D information available from the diffusion tensor into a form that lends itself to quantitative analysis and statistical hypothesis testing.

Adolescent↗

Less white matter concentration in autism: 2D voxel-based morphometry.

Autism is a neurodevelopmental disorder affecting behavioral and social cognition, but there is little understanding about the link between the functional deficit and its underlying neuroanatomy. We applied a 2D version of voxel-based morphometry (VBM) in differentiating the white matter concentration of the corpus callosum for the group of 16 high functioning autistic and 12 normal subjects. Using the white matter density as an index for neural connectivity, autism is shown to exhibit less white matter concentration in the region of the genu, rostrum, and splenium removing the effect of age based on the general linear model (GLM) framework. Further, it is shown that the less white matter concentration in the corpus callosum in autism is due to hypoplasia rather than atrophy.

Adolescent↗

Diffusion tensor imaging in cerebral tumor diagnosis and therapy.

Diffusion-weighted MR images and their analysis using the tensor model open up many new possibilities for tissue characterization, surgical planning, and treatment follow-up in patients with cerebral neoplasms. These possibilities are only just beginning to be fully explored. This article reviews the physical principles underlying diffusion tensor imaging (DTI); the various postprocessing methods available for DTI data in the context of tumor imaging; the commonly encountered patterns of tumor-related alteration to cerebral white matter, as depicted by directionally encoded color maps; and the current state of the art in DTI-based tumor diagnosis and treatment planning.

Anisotropy↗

Contextual modulation of amygdala responsivity to surprised faces.

We recently demonstrated a functional relationship between fMRI responses within the amygdala and the medial prefrontal cortex based upon whether subjects interpreted surprised facial expressions positively or negatively. In the present fMRI study, we sought to assess amygdala-medial prefrontal cortex responsivity when the interpretations of surprised faces were determined by contextual experimental stimuli, rather than subjective judgment. Subjects passively viewed individual presentations of surprised faces preceded by either a negatively or positively valenced contextual sentence (e. g., She just found $500 vs. She just lost $500). Negative and positive sentences were carefully matched in terms of length, situations described, and arousal level. Negatively cued surprised faces produced greater ventral amygdala activation compared to positively cued surprised faces. Responses to negative versus positive sentences were greater within the ventrolateral prefrontal cortex, whereas responses to positive versus negative sentences were greater within the ventromedial prefrontal cortex. The present study demonstrates that amygdala response to surprised facial expressions can be modulated by negatively versus positively valenced verbal contextual information. Connectivity analyses identified candidate cortical-subcortical systems subserving this modulation.

Adult↗

Inverse amygdala and medial prefrontal cortex responses to surprised faces.

Here we show inverse fMRI activation patterns in amygdala and medial prefrontal cortex (mPFC) depending upon whether subjects interpreted surprised facial expressions positively or negatively. More negative interpretations of surprised faces were associated with greater signal changes in the right ventral amygdala, while more positive interpretations were associated with greater signal changes in the ventral mPFC. Accordingly, signal change within these two areas was inversely correlated. Thus, individual differences in the judgment of surprised faces are related to a systematic inverse relationship between amygdala and mPFC activity, a circuitry that the animal literature suggests is critical to the assessment of stimuli that predict potential positive vs negative outcomes.

Adult↗

White matter tractography using diffusion tensor deflection.

Diffusion tensor MRI provides unique directional diffusion information that can be used to estimate the patterns of white matter connectivity in the human brain. In this study, the behavior of an algorithm for white matter tractography is examined. The algorithm, called TEND, uses the entire diffusion tensor to deflect the estimated fiber trajectory. Simulations and imaging experiments on in vivo human brains were performed to investigate the behavior of the tractography algorithm. The simulations show that the deflection term is less sensitive than the major eigenvector to image noise. In the human brain imaging experiments, estimated tracts were generated in corpus callosum, corticospinal tract, internal capsule, corona radiata, superior longitudinal fasciculus, inferior longitudinal fasciculus, fronto-occipital fasciculus, and uncinate fasciculus. This approach is promising for mapping the organizational patterns of white matter in the human brain as well as mapping the relationship between major fiber trajectories and the location and extent of brain lesions.

Algorithms↗

An error analysis of white matter tractography methods: synthetic diffusion tensor field simulations.

White matter tractography using diffusion tensor MR images is a promising method for estimating the pathways of white matter tracts in the human brain. The success of this method ultimately depends upon the accuracy of the white matter tractography algorithms. In this study, a Monte Carlo simulation was used to investigate the impact of SNR, tensor anisotropy, and diffusion tensor encoding directions on the accuracy of six tractography algorithms. The accuracy was assessed in straight and curved tracts and tract geometries with divergence properties. In general, the tract dispersion increased with distance and decreased with SNR and anisotropy. The tract orientation with respect to the encoding scheme also influenced tract dispersion. Divergent tract geometries increased tract dispersion, whereas convergent tract geometries reduced dispersion. Analytic models of tract dispersion were constructed as a function of the tract distance, SNR, eigenvalues of the tracts, voxel size, and the relationship between the tract direction and the diffusion tensor encoding directions. In certain cases, the mean tract trajectory was found to deviate from the ideal pathway for curved trajectories. Analytical models of mean displacement were constructed as a function of the curvature, tract distance, step size, and tensor eigenvalues. These models may be used in future studies to assess the level of confidence associated with a tractography result.

Algorithms↗

Diffusion tensor imaging in an infant with traumatic brain swelling.

We present the case of a 14-month-old male infant who underwent diffusion tensor imaging within 24 hours of traumatic brain injury. Although conventional MR findings that included those of diffusion-weighted imaging were unremarkable, full-tensor diffusion imaging revealed striking abnormalities in regions of brain that subsequently developed overt swelling. This case engenders important hypotheses regarding mechanisms of traumatic brain swelling and anisotropic diffusion of water in pathologic tissues.

Brain Edema↗

Correction of slab boundary artifact using histogram matching.

PURPOSE: To improve the imaging efficiency of multi-slab three-dimensional acquisitions by decreasing slab overlap and the number of blanked slices. MATERIALS AND METHODS: Application of the histogram matching technique for correction of the slab boundary artifact (SBA) due to non-ideal radiofrequency pulse profiles has been proposed. The technique was validated by studying its effectiveness in reducing the SBA in phantom images, as well as in proton density- and T2-weighted brain images. RESULTS: The correction algorithm considerably decreases the disruption of image volume continuity due to the SBA, and improves slice-to-slice intensity continuity. CONCLUSION: The proposed technique can greatly reduce the SBA when the SBA can be described as a global intensity variation along the slab. The technique may be used to improve imaging efficiency of the multi-slab three-dimensional fast spin-echo sequences by decreasing the amount of required slab overlap.

Algorithms↗

UNFOLD using a temporal subtraction and spectral energy comparison technique.

In dynamic MRI, several methods have been demonstrated to increase acquisition speed by decreasing the number of sequential phase encodings. The UNFOLD technique interleaves the measurements of k-space, reconstructs aliased images from each k-space interleaf, and applies a temporal low-pass filter to obtain the nonaliased images. However, low-pass filter resolution of the nonaliased images fails if there is overlap between the spatially aliased temporal spectra. In this study a subtraction method was used to remove the static portion of the image. The aliased and nonaliased dynamic portions are then resolved by comparing the temporal energy of bands in the power spectrum. This method was combined with the 3D 2 x 2 UNFOLD (a factor of 2 interleaves in two directions) technique. The combination resulted in a factor of 4 improvement in acquisition speed. Application of this method to a time-resolved, contrast-enhanced flow phantom study is presented.

Algorithms↗

Diffusion-tensor imaging of white matter tracts in patients with cerebral neoplasm.

OBJECT: Preserving vital cerebral function while maximizing tumor resection is a principal goal in surgical neurooncology. Although functional magnetic resonance imaging has been useful in the localization of eloquent cerebral cortex, this method does not provide information about the white matter tracts that may be involved in invasive, intrinsic brain tumors. Recently, diffusion-tensor (DT) imaging techniques have been used to map white matter tracts in the normal brain. The aim of this study was to demonstrate the role of DT imaging in preoperative mapping of white matter tracts in relation to cerebral neoplasms. METHODS: Nine patients with brain malignancies (one pilocytic astrocytoma, five oligodendrogliomas, one low-grade oligoastrocytoma, one Grade 4 astrocytoma, and one metastatic adenocarcinoma) underwent DT imaging examinations prior to tumor excision. Anatomical information about white matter tract location, orientation, and projections was obtained in every patient. Depending on the tumor type and location, evidence of white matter tract edema (two patients), infiltration (two patients), displacement (five patients), and disruption (two patients) could be assessed with the aid of DT imaging in each case. CONCLUSIONS: Diffusion-tensor imaging allowed for visualization of white matter tracts and was found to be beneficial in the surgical planning for patients with intrinsic brain tumors. The authors' experience with DT imaging indicates that anatomically intact fibers may be present in abnormal-appearing areas of the brain. Whether resection of these involved fibers results in subtle postoperative neurological deficits requires further systematic study.

Adenocarcinoma↗

Myelin water fraction in human cervical spinal cord in vivo.

The noninvasive discrimination of myelin disease from axonal loss and other pathologic confounds remains an unsolved problem in multiple sclerosis but may be possible through magnetic resonance quantitation of the intramyelinic water compartment. Technical challenges have limited the study of this approach in the spinal cord, a common site of involvement in multiple sclerosis. This technical note reports the test-retest reproducibility of a short T2-based estimate of myelin content in human spinal cord in vivo.

Algorithms↗