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Biomedical subjects

K Farahani

Publications and source records attributed to K Farahani.

18 recordsLinked to original sources

Simultaneous PET and MR imaging.

We have developed a prototype PET detector which is compatible with a clinical MRI system to provide simultaneous PET and MR imaging. This single-slice PET system consists of 48 2 x 2 x 10 mm3 LSO crystals in a 38 mm diameter ring configuration that can be placed inside the receiver coil of the MRI system, coupled to three multi-channel photomultipliers housed outside the main magnetic field via 4 m long and 2 mm diameter optical fibres. The PET system exhibits 2 mm spatial resolution, 41% energy resolution at 511 keV and 20 ns timing resolution. Simultaneous PET and MR phantom images were successfully acquired.

Equipment Design

Biopsy of hepatic dome lesions: semi-real-time coronal MR guidance technique.

OBJECTIVE: MR imaging, with its coronal imaging capability, may be ideally suited for biopsies of hepatic dome lesions. We are reporting on the successful semi-real-time biopsy of such lesions using a 0.2-T open-configuration MR scanner in five patients. CONCLUSION: MR guidance holds promise for facilitating biopsies of hepatic dome masses.

Adult

Intracarotid infusion of RMP-7, a bradykinin analog, and transport of gallium-68 ethylenediamine tetraacetic acid into human gliomas.

The bradykinin analog, RMP-7, was investigated for its ability to increase selectively the transport of 68Ga ethylenediamine tetraacetic acid (EDTA) into recurrent malignant gliomas in nine patients. For each patient, two position emission tomography (PET) studies (one with and one without RMP-7) were performed. For studies with RMP-7, 10 to 300 ng/kg of the compound was infused into the supraophthalmic carotid artery over 15 minutes. In each PET study, a sequence of PET scans was initiated simultaneously with an intravenous bolus of 68Ga EDTA (5-10 mCi). Arterial samples were taken to provide the input function. All PET scans were coregistered to the magnetic resonance (MR) images of the patient. Regions of interest were defined for tumor and normal tissue regions on MR images and were copied to the coregistered PET dynamic images to provide brain tissue-time activity curves. The constant (Ki) for the transport of gallium-68 from plasma to brain tissue was determined using a simple compartmental model. Intracarotid infusion of RMP-7 significantly increased transport into tumor regions with an average increase of 46 +/- 42% (mean +/- standard deviation, p < 0.05). Permeability in normal tissue regions was not significantly increased. Tumors in three of six patients treated with 300 ng/kg RMP-7 and carboplatin had at least a 50% reduction in tumor volume as measured by MR imaging. Intracarotid infusion of RMP-7 is a novel technique for selective delivery of antitumor compounds into brain tumors.

Adult

Frequency-selective fat suppression MR imaging. Localized asymmetric failure of fat suppression mimicking orbital disease.

Our objectives were to further characterize an artifact related to the localized failure of the frequency-selective (FATSAT) fat suppression magnetic resonance (MR) imaging technique. We constructed two phantoms simulating human orbital anatomy and imaged them on a 1.5-T MR scanner using (FATSAT) and short T1 inversion recovery (STIR) techniques of fat suppression. The first phantom resembled orbit structural configurations; it was imaged in coronal and axial planes and in varying orientations with respect to the main magnetic field (Z axis) to study the features of the artifact and to reproduce the asymmetry seen in clinical cases. We designed the second phantom to enable quantification of the change in artifact size with change in orientation. We imaged the orbits of a normal human volunteer in similar planes and orientations, and compared the results to clinical cases demonstrating the artifact and true orbital disease. The artifact identified with localized failure of FATSAT fat suppression manifested as regions of hyperintensity maximal at fat-air interfaces, with gradual fading of the increased signal with distance from the interfaces. The artifact was most prominent when the interfaces were perpendicular to the axis of the main magnetic field (Z axis). The regions of increased brightness obscured normal orbital structures but were not associated with alterations in the geometry of these structures. Changes in orientation of the interfaces with respect to the Z axis, both in the phantoms and normal volunteer, reproduced the asymmetry of fat suppression failure seen in clinical cases. The relationship of size of the artifact to change in orientation was non-linear. The artifact was not seen on STIR images. We concluded that failure of FATSAT fat suppression may mimic orbital disease, particularly if asymmetric. As predicted by the Maxwell electromagnetism equation, slight variations in orientation of the fat-air interface to the Z axis may produce large asymmetries in fat suppression failure in the orbit. Confirmation may require either comparison with additional pulse sequences [T1-weighted spin echo (T1W SE) or STIR] or repositioning the patient's head to check for persistence of the finding with varying orientations.

Adipose Tissue

Magnetic resonance imaging of plantar plate rupture.

Degenerative plantar plate failure is an under-recognized cause of lesser metatarsalgia. We performed magnetic resonance imaging (MRI) with a small receiver coil in 13 patients in whom plantar plate ruptures of the second or third metatarsophalangeal joint were clinically suspected. In eight patients, MRI showed focal hyperintensity in the plantar plate that was interpreted as a rupture of the plate. Ruptures were confirmed in all five patients who underwent an operative procedure to treat the unstable, painful metatarsophalangeal joint. MRI is a noninvasive technique that can visualize plantar plate abnormalities and aid the clinical evaluation of problematic lesser metatarsalgia.

Aged

Interventional magnetic resonance imaging of the head and neck and new imaging techniques.

The use of magnetic resonance imaging to directly guide therapy is a new area of investigation. Clinical magnetic resonance imaging has the potential to evolve from a purely diagnostic tool into a guide for invasive procedures. The idea of using magnetic resonance to guide percutaneous biopsy developed one decade ago. Magnetic resonance-guided fine-needle aspiration for head and neck lesions has become a standard technique some institutions. Once the needle reaches a lesion in the head and neck, it is natural to explore the possibility of treatment in the same setting. The concept of interventional magnetic resonance imaging has generated interest among radiologists, surgeons, and manufacturers. This article provides an overview of interventional procedures of the head and neck and other new imaging techniques that have been developed.

Head and Neck Neoplasms

Hyperacute thermal lesions: MR imaging evaluation of development in the brain.

PURPOSE: To determine the natural time course of development of hyperacute thermal lesions in the brain. MATERIALS AND METHODS: Ten interstitial lesions were created in five rabbit brains with a radio-frequency probe; an electrode-tip temperature of 80 degrees C was maintained for 60 seconds. Continuous fast spin-echo magnetic resonance (MR) imaging was used to follow lesion development for a minimum of 30 minutes. Temporal variations in lesion size and signal intensity were examined. Findings in final images were correlated with histologic findings. RESULTS: Images demonstrated a focal hyperintense zone, which developed into an expanding ring of edema surrounding a necrotic center in about 10 minutes. Quantitative analysis revealed a 23% +/- 6 (standard deviation) increase in average signal intensity of the edema layer and a 152% +/- 41 increase in overall lesion size. CONCLUSION: Full development of a thermal lesion is delayed for a period of minutes. Clinical implications of this effect should be considered when MR imaging-guided thermal ablation is performed.

Animals

Early postoperative appearance of radiofrequency lesions on magnetic resonance imaging.

Eleven patients who underwent stereotactic radiofrequency lesions in the central nervous system had magnetic resonance imaging follow-up within 72 hours of surgery to determine the early appearance of their lesions. Eight patients with severe tremor, one with chronic pain, and two with dystonia were analyzed. There were six female patients and five male patients, age 7 to 75 years (mean +/- standard deviation = 42 +/- 21). Magnetic resonance imaging was performed postoperatively at 32 +/- 25 hours (range, 3-72). Postoperative T1-weighted spin echo images demonstrated foci of iso- to hyperintensity surrounded by an edge of hypointensity, and corresponding T2-weighted images showed a lesion with three concentric zones consisting of inner hypointense, middle hyperintense, and outer hypointense zones. Gadolinium increased T1-weighted image lesion visibility, and a ring of enhancement around the zone of hypointensity was observed. Lesions could be seen as early as 3 hours after surgery. The lesions were best shown on gadolinium-enhanced T1-weighted images and on T2-weighted images. The edema surrounding the lesion increased over time, up to the 72 hours studied. These data provide important information on the development of lesion appearance, which may be applied in the development of real-time magnetic resonance imaging monitoring of radiofrequency lesion formation. This technique associated with electrophysiological response and the real-time visualization of the anatomic correlation of the probe may allow for a very precise and selected lesion in the central nervous system for the treatment of functional disorders and brain tumors.

Adolescent

Dynamic MRI-guided interstitial laser therapy: a new technique for minimally invasive surgery.

Interstitial laser therapy (ILT) is a promising therapeutic technique in which laser energy is delivered percutaneously to various depths in tissue. In this study, the authors compared high-speed magnetic resonance imaging (MRI) of ILT in tissues during treatment with post-treatment histopathologic specimens. The use of 5-second MRI scans allowed detection of thermal damage by the 1064-nm neodymium:yttrium-aluminum-garnet laser in ex vivo liver and brain tissues. These tissues were treated by ILT with 20 W of laser output for 5 to 30 seconds via a 600-microns fiberoptic inserted 1 cm into the specimens at a power density of 7 kW/cm2 at the tip of the bare fiber. Sequential MRI measurements of lesion areas made during and after treatment were compared to measurements of laser-induced tissue damage in histopathologic sections. Fast MRI scans and tissue histology both demonstrated increased lesion size with time of ILT. Serial images obtained during ILT detected thermal changes as areas of low signal intensity that exceeded the size of the post-treatment lesions as measured on either final MRI or histology. The thermal effects detectable by these high-speed MRI sequences can be used to monitor laser-induced tissue changes during therapy, thereby providing a valuable noninvasive method for the intraoperative assessment of heat distribution during ILT.

Animals

Preliminary experience with MR-guided thermal ablation of brain tumors.

PURPOSE: To evaluate the feasibility of a technique of MR-guided stereotactic radio frequency ablation, which was developed as a minimally invasive treatment for brain tumors, and to determine MR characteristics and sequential evolution of radio frequency lesions created to ablate brain tumors. METHODS: Fourteen lesions in 12 patients with primary and metastatic brain tumors were treated with this technique and followed for up to 10 months. The stereotactic coordinates of the tumor and the angle of the radio frequency probe were calculated on MR imaging. The radio frequency lesion was generated in the awake patient by increasing the temperature to 80 degrees C within the tumor for 1 minute. This was repeated until the entire tumor volume was destroyed. MR imaging was performed before, during, and immediately after the radio frequency procedure, and sequential MR was obtained during clinical follow-up. RESULTS: MR imaging clearly showed well-defined radio frequency lesions and provided feedback for treatment planning. The radio frequency lesion boundary was well identified as a dark signal rim on T2-weighted images and showed ring enhancement on contrast-enhanced T1-weighted images. The sequential MR imaging showed the radio frequency lesions decreased in volume in all cases, suggesting focal control. CONCLUSION: Stereotactic MR-guided radio frequency brain tumor ablation is a feasible and promising technique that can be an attractive brain tumor treatment alternative. MR provided not only accurate tumor location but also visualization of feedback of thermal tissue changes that reflected therapeutic effect.

Adenocarcinoma

Plantar plate of the foot: findings on conventional arthrography and MR imaging.

The plantar plate of the foot is formed by the plantar aponeurosis and plantar capsule. The plantar plate arises from the distal plantar aspect of the metatarsal neck and inserts on the plantar aspect of the proximal phalangeal base. This thick plate supports the undersurface of the metatarsal head and resists hyperextension of the metatarsophalangeal joint (MTPJ) [1]. Plantar plate rupture may present as lesser metatarsalgia (the lesser metatarsals are the second through fifth), occasionally with exuberant synovitis. Plantar plate derangement also plays a central role in the genesis of the common hammertoe [2, 3]. Rupture or degeneration of the plantar plate destabilizes the MTPJ, allowing dorsal subluxation of the proximal phalanx. The resulting "cock-up" deformity at the MTPJ shortens and compromises the action of the extensor digitorum longus tendon, contributing over time to a flexion deformity at the interphalangeal joints.

Adult

Physiology of the lower eyelid retractors: tight linkage of the anterior capsulopalpebral fascia demonstrated using dynamic ultrafine surface coil MRI.

Although the histologic anatomy of the lower eyelid retractors is well defined, the physiology of the lower retractors has been determined only by interference based on anatomic and clinical findings. In this study, in five normal subjects we investigated the physiology of the lower eyelid retractors utilizing dynamic high resolution magnetic resonance imaging (MRI) with a custom designed surface coil. Measurements of the excursion of the cornea, lower eyelid margin, and anterior edge of the inferior oblique muscle were made from scans taken in upgaze and downgaze. We found that the corneal movement was substantially greater than the movement of the eyelid margin, a finding that can readily be made clinically. A more important result was that the movement of the eyelid margin and the movement of the inferior oblique margin were similar in all cases. Thus, the length of the anterior capsulopalpebral fascia between the tarsus and inferior oblique muscle remains constant in downgaze, and the source of the stretch in the lower eyelid retractors lies in the posterior capsulopalpebral system, at the capsulopalpebral head. High resolution eyelid MR has great potential to allow investigation of essential aspects of normal and pathologic eyelid anatomy and physiology.

Adult

Nd: YAG interstitial laser phototherapy guided by magnetic resonance imaging in an ex vivo model: dosimetry of laser-MR-tissue interaction.

Interstitial laser phototherapy (ILP) is a promising technique in which laser energy is delivered percutaneously to various depths of tumors. This technique will become clinically useful only when efficient, sensitive, and noninvasive monitoring systems are developed. In this study, the spatial distribution of ILP in bovine liver tissue, induced by a Nd: YAG laser with an interstitial sapphire-frosted contact probe, was evaluated by magnetic resonance imaging (MRI). Tissue was exposed to three energy densities of the Nd:YAG laser by a reproducible method of dosimetry. Thermal profiles were measured with a probe inserted 5 mm from the laser tip. T1-weighted magnetic resonance images were taken after the laser exposure. Tissue specimens were then evaluated for standard quantification of laser-induced damages. A linear correlation between the level of laser energy, induced temperature change, lesion size on T1 magnetic resonance image, and volume of histological damage was observed. Further improvement of this technique of dosimetry in an in vivo model should allow the development of software for MRI which will correlate the above parameters and render this technique of ILP clinically useful.

Animals

MR imaging-guided interstitial Nd:YAG laser phototherapy: dosimetry study of acute tissue damage in an in vivo model.

A dosimetry study of acute tissue damage induced by interstitial application of the neodymium-yttrium-aluminum-garnet (Nd:YAG) laser was performed with magnetic resonance (MR) imaging. The MR appearance of the lesion was correlated with gross and histopathologic findings. Seventy-six lesions were induced in rabbit muscle with laser power outputs of 5-20 W and exposure times of 20-600 seconds. MR imaging was performed immediately after laser exposure. T2-weighted spin-echo images clearly showed the acute thermal injuries caused by laser energy deposition and correlated best with histopathologic findings. These images showed three distinct layers, corresponding to central ablation, coagulative necrosis, and interstitial edema, respectively, in the pathologic findings. Lesion diameters measured on MR images showed a linear correlation with those in gross sections. Lesion volume increased not only with increasing total energy delivered but with increasing power output for a fixed total energy delivered. MR imaging is an accurate modality for dosimetry studies of laser-induced acute lesions.

Animals

MR imaging-histopathologic correlation of thermal injuries induced with interstitial Nd:YAG laser irradiation in the chronic model.

Magnetic resonance (MR) imaging-histopathologic correlation of thermal injuries induced with interstitial laser irradiation was performed in a chronic model up to 12 weeks after laser exposure. T2-weighted MR images showed irreversible coagulative necrosis as a low-signal-intensity area. A higher-intensity surrounding area, corresponding to edema, was also present in acute lesions on T2-weighted images. Serial studies of the chronic model showed that a substantial portion of the interstitial edema zone progressed to coagulative necrosis up to 7 days after laser irradiation. This necrotic zone decreased in size beyond 2 weeks, presumably through biologic healing. MR imaging and pathologic findings correlated well in the chronic model. MR imaging has the potential to depict acute, irreversible thermal damage even before morphologic change is seen at the standard pathologic examination. Recognizing the dynamics of tissue response to interstitial laser irradiation on MR images is valuable for estimation of true lesion volume.

Animals

MR-guided percutaneous ethanol ablation of liver tissue in a .2-T open MR system: preliminary study in porcine model.

The purpose of this study was to test the feasibility of MR-guided percutaneous ethanol ablation of liver tissue on a .2-T open MR scanner. Needles were placed by MR guidance first into an ex vivo sheep liver and then into livers of three anesthetized pigs, and injection of 10 ml of 96% alcohol was performed. T1 fast low-angle shot (FLASH), T2 turbo spin echo (TSE), and T1 spin echo (SE) images were obtained after incremental volumes of injection. In one pig, simultaneous injection of saline into normal liver was also performed with subsequent pathological correlation. Ethanol-infiltrated liver was hypointense to liver on all sequences, whereas saline caused no tissue signal changes on T1 SE and either isointense or hyperintense changes on T2 TSE images. Pathological examination confirmed ethanol-induced acute liver changes as compared with the control. MR guidance of needle placement and monitoring of ethanol effects on liver tissue is feasible. This may have implications for potential MR-guided hepatic tumor ablation.

Animals

Effect of field strength on susceptibility artifacts in magnetic resonance imaging.

In magnetic resonance imaging susceptibility artifacts occur at the interface of substances with large magnetic susceptibility differences, resulting in geometric distortions of the image at those boundaries. The susceptibility artifacts are often subtle on clinical images and if not carefully examined they may lead to misdiagnosis. Magnetic susceptibility artifacts are prevalent on the boundary of air-containing paranasal sinuses, as well as bone-soft tissue interfaces in the spinal canal. The appearance of these artifacts on images from three different magnetic field strength instruments, 0.3, 0.5, and 1.5 Tesla were studied. T1- and T2-weighted spin echo and gradient recalled echo pulse sequences were selected to image a water phantom containing substances of varying susceptibilities. The effects were also studied in MR images of the head in a normal human volunteer. At any given field strength the artifacts were more prominent in the gradient echo imaging than in the corresponding spin echo pulse sequence. As expected, the distortions were also greater at higher field strengths. The results in human subjects paralleled the findings in the phantom study.

Head