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Biomedical subjects

Hiroyuki Kabasawa

Publications and source records attributed to Hiroyuki Kabasawa.

At least 19 recordsLinked to original sources

Flexible ex vivo phantoms for validation of diffusion tensor tractography on a clinical scanner.

PURPOSE: The aim of this study was to develop ex vivo diffusion tensor (DT) flexible phantoms. MATERIALS AND METHODS: Materials were bundles of textile threads of cotton, monofilament nylon, rayon, and polyester bunched with spiral wrapping bands and immersed in water. DT images were acquired on a 1.5-Tesla clinical magnetic resonance scanner using echo planar imaging sequences with 15 motion probing gradient directions. DT tractography with seeding and a line-tracking method was carried out by software originally developed on a PC-based workstation. RESULTS: We observed relatively high fractional anisotropy on the polyester phantom and were able to reconstruct tractography. Straight tracts along the bundle were displayed when it was arranged linearly. It was easy to bend arcuately or bifurcate at one end; and tracts followed the course of the bundle, whether it was curved or branched and had good agreement with direct visual observation. Tractography with the other fibers was unsuccessful. CONCLUSION: The polyester phantom revealed a diffusion anisotropic structure according to its shape and would be utilizable repeatedly under the same conditions, differently from living central neuronal system. It would be useful to validate DT sequences and to optimize an algorithm or parameters of DT tractography software. Additionally, the flexibility of the phantom would enable us to model human axonal projections.

Anisotropy↗

Diffusion tensor imaging for preoperative evaluation of tumor grade in gliomas.

The relationship between water diffusion parameters measured using diffusion tensor imaging (DTI) and histological malignancy of gliomas was investigated. DTI was performed using a 3.0T MR scanner in 41 consecutive patients with histologically proven gliomas. Fractional anisotropy (FA) and mean diffusivity (MD) were calculated and compared with the WHO classification of the gliomas. The FA values of grade 1 gliomas (0.150 +/- 0.017) were significantly lower than those of grade 3 (0.23 +/- 0.033) or grade 4 gliomas (0.229 +/- 0.033) (P < 0.0001, respectively). The FA values of grade 2 gliomas (0.159 +/- 0.018) were significantly lower than those of grade 3 or grade 4 gliomas (P = 0.0002, P < 0.0001, respectively). The FA threshold between low grade and high grade gliomas was 0.188. The MD values of grade 1 gliomas (1619.1 +/- 157.4 x 10(-6) mm2/s) were significantly higher than those of grade 3 (1084.5 +/- 218.9 x 10(-6) mm2/s) (P = 0.0036) or grade 4 gliomas (1098.0 +/- 291.6 x 10(-6) mm2/s) (P = 0.0002). The MD values were not correlated with the other grades of glioma. FA values can distinguish between high grade and low grade gliomas. This is useful in deciding the surgical strategy or selecting the site of stereotactic biopsy.

Adolescent↗

Fractional anisotropy value by diffusion tensor magnetic resonance imaging as a predictor of cell density and proliferation activity of glioblastomas.

BACKGROUND: In vivo, water diffusion displays directionality due to presence of complex microstructural barriers in tissue. The extent of directionality of water diffusion can be expressed as a fractional anisotropy (FA) value using diffusion tensor magnetic resonance imaging (DTI). The FA value has been suggested as an indicator of the cell density of astrocytic tumors. The aim of the present study was to confirm beyond doubt that FA values indicate cell density even when limited in glioblastomas and to determine whether the FA value of a given patient predicts proliferation activity in the individual glioblastoma. METHODS: We performed DTI in 19 patients with glioblastoma and measured the FA values of tumor and normal brain regions prior to computed tomography-guided stereotactic biopsy. Differences in mean FA value between normal brain regions and glioblastoma lesion were compared. Cell density and MIB-1 indices were examined using tumor specimens obtained from biopsies. Correlation among FA values, cell density, and MIB-1 indices was also evaluated. RESULTS: The mean FA value significantly differed between normal brain regions and glioblastoma lesions. Positive correlation was observed between FA value and cell density (r = 0.73, P < 0.05) and between FA value and MIB-1 index (r = 0.80, P < 0.05). CONCLUSIONS: Our results suggest that the FA value of glioblastoma as determined by DTI prior to surgery is a good predictor of cell density and, consequently, proliferation activity.

Adult↗

Quantitative evaluation of the pyramidal tract segmented by diffusion tensor tractography: feasibility study in patients with amyotrophic lateral sclerosis.

PURPOSE: Diffusion tensor imaging can evaluate the cerebral white matter quantitatively using fractional anisotropy (FA) and also can extract a certain tract by tractography, but these two have been used separately and not combined. The purpose of this study was to assess the clinical feasibility of ROI analysis using diffusion tensor tractography (DTT) in patients with amyotrophic lateral sclerosis (ALS). MATERIALS AND METHODS: Sixteen patients with ALS (9 limb-onset type, 7 bulbar-onset type) and nine age-matched volunteers were studied. DTT of the corticobulbar tract (DTT-CBT) and corticospinal tract (DTT-CST) were visualized by free software (dTV/VOLUME-ONE). Regions-of-interest (ROIs) were semi-automatically placed on the tracts defined by DTT methods, and FA values within the ROIs were measured. RESULTS: Mean FA values of ALS patients in the ROIs along the DTT-CST (bulbar-onset: 0.574, limb-onset: 0.594) were significantly lower than those of controls (DTT-CST: 0.629) (p<0.05). The mean FA of DTT-CBT of the bulbar-onset type (0.509) was significantly lower than that of the limb-onset type (0.558) and that of volunteers (0.561). CONCLUSION: DTT could segmentate certain white matter tracts and evaluate them quantitatively. It could depict the subtle changes between subtypes of ALS as well as the changes between the patients and volunteers.

Amyotrophic Lateral Sclerosis↗

[In-vitro phantoms for estimating diffusion tensor tractography].

No literature has reported on in-vitro diffusion tensor tractography, although it is a useful method to visualize neuronal fiber projections in the living human brain. We applied this technique to phantoms of asparagus stems and bundled polyester yarn, and obtained tractography with high-quality images. On the asparagus stem phantom, straight tracts along the axis were displayed. On the polyester phantom, these tracts followed the course of the bundle whether it was straight or curved. These phantoms are useful for in-vitro evaluation of diffusion tensor tractography.

Algorithms↗

Use of fractional anisotropy value by diffusion tensor MRI for preoperative diagnosis of astrocytic tumors: case report.

The fractional anisotropy (FA) value calculated by diffusion tensor MRI can indicate the degree of directionality of water diffusion in astrocytic tumors. Here, we report a case of anaplastic astrocytoma in which FA proved invaluable for the preoperative differential diagnosis. A 60-year-old man complained of headache, and underwent routine neuroimaging and DTI. The routine images suggested a low-grade glioma in the left temporal lobe, based on lack of enhancement on MRI with contrast medium and lack of tumor staining on angiograms, whereas FA value was very high. Based on these findings, a preoperative diagnosis of high-grade glioma was suspected. The surgical specimen exhibited the histological features of anaplastic astrocytoma with a high density of spindle shaped cells and low vascularity. In this report, we discuss the relationship between FA and other characteristics of the present tumor, and discuss the utility of FA measurement in astrocytic tumors.

Anisotropy↗

Measurement of fractional anisotropy using diffusion tensor MRI in supratentorial astrocytic tumors.

In vivo, water diffusion displays directionality due to presence of complex microstructural barriers in tissue. The extent of directionality of water diffusion can be expressed as a fractional anisotropy (FA) value, using diffusion tensor MR imaging (DTI). The aim of this study was to determine whether FA values indicate microstructures in astrocytic tumors. We performed DTI in 31 patients with astrocytic tumor, and measured the FA values of tumor and normal brain regions prior to CT-guided stereotactic biopsy. After biopsy, FA values were compared to assess the cellularity and vascularity of tumor tissue. Although mean FA values trended to differ among histological types, all mean tumor FA values were lower than those of normal brain regions. Positive correlation was observed between FA values and both cellularity (r = 0.65, p < 0.05) and vascularity (r = 0.45, p < 0.05). We had hypothesized that the FA value of an astrocytic tumor would be determined by a balance between factors increasing the directionality of water diffusion, such as high cellularity and/or vascularity, and factors decreasing the directionality of water diffusion, such as fiber destruction. However, our results suggest that the FA values of glioblastoma, anaplastic astrocytoma, diffuse astrocytoma and pilocytic astrocytoma are largely affected by cellularity and/or vascularity, whereas that of gliomatosis cerebri are largely affected by the preservation of nerve fibers. Measurement of FA value using DTI will allow prediction of histological characteristics such as cellularity, vascularity and/or fiber structure in astrocytic tumors.

Adult↗

Diffusion tensor imaging in patients with major cerebral artery occlusive disease.

Diffusion tensor (DT) imaging provides quantitative information about the magnitude and the directionality (anisotropy) of water diffusion in vivo and can detect pathologic changes in brain ischemia. This study tried to detect ischemic brain damage using DT imaging in patients with symptomatic chronic major cerebral artery occlusive disease. DT imaging was performed using a 3.0 Tesla magnetic resonance (MR) scanner in 50 patients with unilateral internal carotid artery or middle cerebral artery stenosis or occlusion, who had no obvious infarct lesions on conventional MR imaging. Thirty-three patients underwent DT imaging before and after vascular reconstruction surgery. Fractional anisotropy (FA) was calculated in the middle cerebral artery territory. Preoperative FA values in the ipsilateral side were significantly lower than those in the contralateral side. After surgery, the FA value was significantly increased. DT imaging may indicate ischemic brain damage, not visualized by conventional MR imaging, in patients with major cerebral artery occlusive disease.

Adult↗

[Simple visualization of the corticospinal pathway using tractography: one-ROI and two-ROI methods].

Diffusion tensor imaging (DTI), a magnetic resonance (MR) technique to analyze diffusion anisotropy of the brain, is able to demonstrate subtle white matter anatomy. Tractography is expected to be a unique, non-invasive tool to provide more pertinent insights into brain structure and orientation not accessible by conventional MRI. In this report, preliminary experiences of visualization of the corticospinal tract using tractography are described. DTI of the brain was performed in 5 normal volunteers using single-shot echo-planar imaging, then tractography was generated by our original software. We determined that the two-region-of-interest (ROI) method is superior to the one-ROI method.

Adult↗

Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer.

BACKGROUND AND PURPOSE: Metastasis to the regional cervical lymph nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic nodes. METHODS: Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic cervical lymph nodes (25 nodes), benign lymphadenopathy (25 nodes), and nodal lymphomas (five nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm(2)). RESULTS: The ADC was significantly greater in metastatic lymph nodes (0.410 +/- 0.105 x 10(-3) mm(2)/s, P <.01) than in benign lymphadenopathy (0.302 +/- 0.062 x 10(-3) mm(2)/s). Nodal lymphomas showed even lower levels of the ADC (0.223 +/- 0.056 x 10(-3) mm(2)/s). ADC criteria for metastatic nodes (>/= 0.400 x 10(-3) mm(2)/s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A(z) = 0.8437 +/- 0.0230) and ADC (A(z) = 0.8440 +/- 0.0538) provided similar levels of diagnostic ability in differentiating metastatic nodes. The ADC from metastatic nodes from highly or moderately differentiated cancers (0.440 +/- 0.020 x 10(-3) mm(2)/s, P <.01) was significantly greater than that from poorly differentiated cancers (0.356 +/- 0.042 x 10(-3) mm(2)/s). CONCLUSION: Diffusion-weighted imaging is useful in discriminating metastatic nodes.

Adult↗

Optimal inversion time for acquiring flow-sensitive alternating inversion recovery images to quantify regional cerebral blood flow.

The purpose of this study was to correlate regional cerebral blood flow (rCBF) measured by I-123-IMP and flow-sensitive alternating inversion recovery (FAIR) studies with different inversion time (TI) values to find out the optimum TI that gives comparable rCBF and images on FAIR study. Nine patients with symptoms and signs of internal carotid or major cerebral arterial stenosis were enrolled in this study. Both I-123-IMP single photon emission computed tomography (SPECT) and FAIR images were acquired in all patients. Single-slice FAIR images (with different TI values) were acquired using a 1.5-T MRI unit. The rCBF was calculated from all I-123-IMP and FAIR images. Receiver operating characteristics (ROC) analysis was performed to detect hypoperfused segments on FAIR images. The rCBF calculated from FAIR and I-123-IMP studies were compared and correlated with each other. The ROC analysis showed no significant differences among the readers or TI values, but a trend of higher sensitivity, specificity, and accuracy was observed with TI of 1400 ms. The rCBF values of FAIR and I-123-IMP studies significantly correlated with each other. The FAIR images with TI value of 1400 ms gave more comparable CBF. A TI value of 1400 ms might be optimum for 1.5-T MR strength to get high quality FAIR images and comparable CBF.

Aged↗

Diffusion-weighted echoplanar MR imaging of the salivary glands.

OBJECTIVE: We determined the apparent diffusion coefficients of normal and dysfunctional salivary glands. SUBJECTS AND METHODS: A diffusion-weighted single-shot spin-echo type of echoplanar MR imaging was performed on the parotid or submandibular glands, or both, in 36 healthy subjects, 20 patients with Sjögren's syndrome, and six patients with sialoadenitis. The apparent diffusion coefficient of the salivary gland was calculated using two b factors (b = 500 and 1,000 sec/mm(2)). RESULTS: The apparent diffusion coefficient was lower in the parotid glands (0.28 x 10(-3) mm(2)/sec) than that of the submandibular glands (0.37 x 10(-3) mm(2)/sec). The apparent diffusion coefficient was increased in sialoadenitis, whereas it decreased with abscess formation. The apparent diffusion coefficients of the parotid glands in patients with Sjögren's syndrome correlated with the salivary flow rates but not with the sialographic gradings of the glands. We also found a correlation of the decreases in apparent diffusion coefficients with the severity of gland damage as assessed on T1-weighted MR images. CONCLUSION: Diffusion-weighted echoplanar MR imaging may reveal diseased states of the salivary glands.

Adult↗

Quantitative measurement of regional cerebral blood flow with flow-sensitive alternating inversion recovery imaging: comparison with [iodine 123]-iodoamphetamin single photon emission CT.

BACKGROUND AND PURPOSE: Flow-sensitive alternating inversion recovery (FAIR) MR imaging is a technique for depicting cerebral perfusion without contrast enhancement. Our purpose was to determine whether quantification at FAIR imaging can be used to assess regional cerebral blood flow (rCBF) in a manner similar to [iodine 123]-iodoamphetamin ((123)I-IMP) single photon emission CT (SPECT). METHODS: Nine patients with internal carotid or major cerebral arterial stenosis underwent (123)I-IMP SPECT and FAIR imaging (single section, different TIs, 1.5 T) at rest and after acetazolamide (Diamox) stress. FAIR and (123)I-IMP rCBF values were compared and correlated. Receiver operating characteristic analysis was conducted to detect hypoperfused segments on FAIR images. RESULTS: rCBF values of normally perfused segments were 41.53 and 51.91 mL/100 g/min for pre- and post-acetazolamide (123)I-IMP studies, respectively. Corresponding values for pre- and post-acetazolamide FAIR images, respectively, were 46.64 and 59.60 mL/100 g/min with a TI of 1200 milliseconds and 53.23 and 68.17 mL/100 g/min with a TI of 1400 milliseconds. (123)I-IMP and FAIR results were significantly correlated, with both pre- and post-acetazolamide images. Sensitivity (86%) in detecting hypoperfused segments was significantly higher with post-acetazolamide images (TI, 1400 milliseconds), and specificity (82-85%) and accuracy (80-82%) were higher with all pre- and post-acetazolamide images (all TIs). CONCLUSIONS: The significant correlation, high specificity and accuracy in detecting hypoperfused segments, similar increases in flow on both post-acetazolamide images, and absence of the need for contrast enhancement suggest that FAIR imaging, like nuclear medicine study, is complementary to routine MR imaging in the assessment of cerebral perfusion.

Acetazolamide↗

[Evaluation of PROPELLER MR imaging: preliminary experiences].

Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) MR imaging (MRI) has a unique ability to correct motion artifacts and is expected to be useful in diffusion-weighted MRI. This article describes preliminary experiences with PROPELLER MRI. PROPELLER uses a radial scan variation of the fast spin-echo sequence and it shows much less spatial deterioration than the echo-planar imaging sequence. To determine the optimal parameters of this technique, we calculated the signal intensities of phantoms and brains in various settings. PROPELLER MR examinations were also performed in 66 patients for clinical use. PROPELLER MRI appears to be a promising and useful technique.

Artifacts↗

Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients?

PURPOSE: Our goal was to test the hypothesis, as previously reported in other studies, that apparent diffusion coefficients (ADCs) provide specific information to diagnose ovarian tumors, especially to discriminate between benign and malignant lesions. METHOD: T1-and T2-weighted spin echo imaging and diffusion-weighted echo planar imaging were performed in 31 women with 61 cystic components of ovarian tumors. RESULTS: The lesions that showed typical watery intensity, hypointensity in T1-weighted imaging, and hyperintensity in T2-weighted imaging had similar ADCs, ranging from 1.54 to 1.84 x 10(-3) mm2 /s. The lesions that showed signal intensity different from typical watery intensity in conventional MRI tended to have low ADCs. In endometrial cysts, the mean ADC of the subgroup that showed typical watery intensity was higher than that of other subgroups. CONCLUSION: With conventional MRI, a tendency of ADCs could be predicted. ADCs may not provide additional information, especially to discriminate benign from malignant lesions.

Adult↗

Evaluation of super paramagnetic iron oxide-enhanced diffusion-weighted PROPELLER T2-fast spin echo magnetic resonance imaging: Preliminary experience.

OBJECTIVE: To evaluate the usefulness of super paramagnetic iron oxide-enhanced, diffusion-weighted, periodically rotated overlapping parallel lines with enhanced reconstruction (SPIO DWI PROPELLER) T2-fast spin echo (FSE) magnetic resonance imaging (MRI) for the detection of hepatic metastases. METHODS: Fourteen patients were examined with SPIO-enhanced T2-FSE (SPIO FSE) imaging and SPIO DWI PROPELLER T2-FSE imaging. The b-value of the diffusion-sensitizing gradient was 10 s/mm so as to suppress the signal of the hepatic vessels. Hepatic resections were performed on all patients, and the number of lesions on MRI was compared between the 2 pulse sequences with references from pathologic reports. RESULTS: Nearly all metastases 1 cm or larger, totalling 38 metastases, were detected with both pulse sequences. Among the 30 metastases less than 1 cm, more lesions were detected on SPIO DWI PROPELLER T2-FSE imaging than on SPIO FSE imaging (16 for SPIO FSE imaging and 24 for DWI PROPELLER T2-FSE imaging; P < 0.05, McNemar test). CONCLUSION: Super paramagnetic iron oxide-enhanced DWI PROPELLER T2-FSE is useful for detecting small hepatic metastases.

Adult↗