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Biomedical subjects

Naoto Hayashi

Publications and source records attributed to Naoto Hayashi.

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↗

A mechanism-based binding model for the population pharmacokinetics and pharmacodynamics of omalizumab.

AIM: Omalizumab, a humanized IgG monoclonal antibody that binds to human immunoglobulin E (IgE), interrupts the allergic cascade in asthmatic patients. The aim was to compare simultaneously drug exposure and IgE biomarker responses in Japanese and White patient populations. METHODS: An instantaneous equilibrium drug-ligand binding and turnover population model was built from 202 Japanese patients. A posterior predictive evaluation for the steady-state distributions of omalizumab and IgE was then carried out against 531 White patients. RESULTS: The mean parameters estimated from the Japanese patients were as follows: omalizumab clearance 7.32 +/- 0.153 ml h(-1), IgE clearance 71.0 +/- 4.68 ml h(-1) and the difference between that for omalizumab and the complex 5.86 +/- 0.920 ml h(-1), the volume of distribution for omalizumab and IgE 5900 +/- 107 ml, and that for the complex 3630 +/- 223 ml, the rate of IgE production 30.3 +/- 2.04 microg h(-1). Half-lives of IgG (23 days) and IgE (2.4 days) were close to previous reports. The dissociation constant for binding, 1.07 nM, was similar to in vitro values. Clearance and volume of distribution for omalizumab varied with bodyweight, whereas the clearance and rate of production of IgE were predicted accurately by baseline IgE. Overall, these covariates explained much of the interindividual variability. CONCLUSIONS: The predictiveness of the Japanese model was confirmed by Monte-Carlo simulations for a White population, also providing evidence that the pharmacokinetics of omalizumab and IgE were similar in these two populations. Furthermore, the model enabled the estimation of not only omalizumab disposition parameters, but also the binding with and the rate of production, distribution and elimination of its target, IgE.

Anti-Asthmatic Agents↗

Assessment of major aortopulmonary collateral arteries with multidetector-row computed tomography.

Multidetector-row computed tomography (MDCT) studies were performed in three adult patients with pulmonary atresia with a ventricular septal defect. In all patients, the native pulmonary arteries were absent, and the pulmonary circulation was totally supplied by major aortopulmonary collateral arteries (MAPCAs). MDCT studies with 1-mm collimation provided detailed information on MAPCAs and bronchial collaterals, such as the numbers and sites of origin, their varying diameters, their courses, and the areas of the lungs they supply. MDCT studies may provide an efficient road map for safe and successful selective catheterization and may substitute for conventional angiography in patients with considerable risks.

Abnormalities, Multiple↗

Bezier surface reformation: an original visualization technique of cervical nerve roots on myelographic CT.

PURPOSE: The aim of this study was to assess the feasibility of an original reformation method of cervical myelographic computed tomography (CT) using the Bezier surface technique. MATERIAL AND METHODS: Presurgical myelographic computed tomography (CT) scans using a multidetector row CT scanner were performed in 25 patients with avulsion injury of the cervical nerve roots. Each volumetric data set was reformatted using Bezier surface technique to depict the individual nerve root in a single image. In the reformatted images, visualization of the dorsal and ventral nerve roots between C4 and T1 on the uninjured side (300 nerves) was rated. RESULTS: Bezier surface reformation (BSR) images depicted the dorsal and the ventral nerve roots between C4 and C8 in 125 (100%) and 125 (100%) of 125 nerves, respectively. The dorsal and the ventral nerve roots of T1 were depicted in 25 (100%) and 22 (88%) in 25 nerves, respectively. CONCLUSION: The BSR technique of cervical myelographic CT enables simultaneous display of multiple cervical nerve roots in one image. BSR is a feasible technique for the assessment of the cervical nerve roots.

Accidents, Traffic↗

Brachial plexus injury: clinical manifestations, conventional imaging findings, and the latest imaging techniques.

Brachial plexus injury (BPI) is a severe neurologic injury that causes functional impairment of the affected upper limb. Imaging studies play an essential role in differentiating between preganglionic and postganglionic injuries, a distinction that is crucial for optimal treatment planning. Findings at standard myelography, computed tomographic (CT) myelography, and conventional magnetic resonance (MR) imaging help determine the location and severity of injuries. MR imaging sometimes demonstrates signal intensity changes in the spinal cord, and enhancement of nerve roots and paraspinal muscles at MR imaging indicates the presence of root avulsion injuries. New techniques including MR myelography, diffusion-weighted neurography, and Bezier surface reformation can also be useful in the evaluation and management of BPI. MR myelography with state-of-the-art technology yields remarkably high-quality images, although it cannot replace CT myelography entirely. Diffusion-weighted neurography is a cutting-edge technique for visualizing postganglionic nerve roots. Bezier surface reformation allows the depiction of entire intradural nerve roots on a single image. CT myelography appears to be the preferred initial imaging modality, with standard myelography and contrast material-enhanced MR imaging being recommended as additional studies. Work-up will vary depending on the equipment used, the management policy of peripheral nerve surgeons, and, most important, the individual patient.

Brachial Plexus↗

Intracranial extracerebral glioneuronal heterotopia. Case report and review of the literature.

The authors report a case of intracranial extracerebral glioneuronal heterotopia (IEGH) in an infant. Glioneuronal heterotopias are rare congenital disorders that arise in the head, face, spine, and thoracic cavity. They consist of nodular accumulations of neuronal and glial cells that have developed abnormally, ranging in size from small lesions to large masses. Among heterotopias, IEGHs are relatively rare. They cause various clinical symptoms, depending on their size and location. The neuroimaging studies, histological examinations, and intraoperative findings presented provide insight into the pathogenesis of this disorder. The findings support the separation and detachment theory, which proposes that IEGHs originate from a third telencephalon that erroneously forms between the 4th and 6th week of embryogenesis. More detailed case reports are necessary to understand fully the pathogenesis of IEGHs.

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↗

The optimal trackability threshold of fractional anisotropy for diffusion tensor tractography of the corticospinal tract.

PURPOSE: In order to ensure that three-dimensional diffusion tensor tractography (3D-DTT) of the corticospinal tract (CST), is performed accurately and efficiently, we set out to find the optimal lower threshold of fractional anisotropy (FA) below which tract elongation is terminated (trackability threshold). METHODS: Thirteen patients with acute or early subacute ischemic stroke causing motor deficits were enrolled in this study. We performed 3D-DTT of the CST with diffusion tensor MR (magnetic resonance) imaging. We segmented the CST and established a cross-section of the CST in a transaxial plane as a region of interest. Thus, we selectively measured the FA values of the right and left corticospinal tracts at the level of the cerebral peduncle, the posterior limb of the internal capsule, and the centrum semiovale. The FA values of the CST were also measured on the affected side at the level where the clinically relevant infarction was present in isotropic diffusion-weighted imaging. RESULTS: 3D-DTT allowed us to selectively measure the FA values of the CST. Among the 267 regions of interest we measured, the minimum FA value was 0.22. The FA values of the CST were smaller and more variable in the centrum semiovale than in the other regions. The mean minus twice the standard deviation of the FA values of the CST in the centrum semiovale was calculated at 0.22 on the normal unaffected side and 0.16 on the affected side. CONCLUSION: An FA value of about 0.20 was found to be the optimal trackability threshold.

Aged↗

Utilization of low-field MR scanners.

The evident advantage of high-field MR (magnetic resonance) scanners is their higher signal-to-noise ratio, which results in improved imaging. While no reliable efficacy studies exist that compare the diagnostic capabilities of low- versus high-field scanners, the adoption and acceptance of low-field MRI (magnetic resonance imaging) is subject to biases. On the other hand, the cost savings associated with low-field MRI hardware are obvious. The running costs of a non-superconductive low-field scanner show even greater differences in favor of low-field scanners. Patient anxiety and safety issues also reflect the advantages of low-field scanners. Recent technological developments in the realm of low-field MR scanners will lead to higher image quality, shorter scan times, and refined imaging protocols. Interventional and intraoperative use also supports the installation of low-field MR scanners. Utilization of low-field systems has the potential to enhance overall cost reductions with little or no loss of diagnostic performance.

Cost-Benefit Analysis↗

Amyotrophic lateral sclerosis: diffusion tensor tractography and voxel-based analysis.

The purpose of this study is to investigate whether the diffusional anisotropy of water molecules is disrupted in the pyramidal and extra-pyramidal regions in patients with amyotrophic lateral sclerosis (ALS). We studied seven patients with probable ALS (four women, mean age +/- SD, 57.3 +/- 6.2 years old) according to the criteria of the World Federation of Neurology. A control group consisted of 11 age- and sex-matched volunteers (six women, 57.1 +/- 4.5) without disorders affecting the central nervous system. Voxel-based diffusion tensor analysis was made with statistical parametric mapping (SPM99). We also created the normalized corticospinal tractography from the diffusion tensor data. The significant fractional anisotropy (FA) decrease in the ALS group was found in the right frontal subgyral white matter and left frontal precentral white matter. These clusters with significant FA decrease corresponded well to the average group map of the corticospinal tract in a standard reference frame. These results suggested that the combination of voxel-based diffusion tensor analysis and diffusion tensor tractography might help determine the location of the affected neuronal tissues among ALS patients in a non-invasive manner.

Algorithms↗

New method of using reconstructed images for assessment of patency of intracochlear spaces for cochlear implant candidates.

OBJECTIVE/HYPOTHESIS: A new method of reconstruction using multidetector-row helical computed tomography (MDCT) was applied for assessment of cochlear patency in cochlear implantation candidates. STUDY DESIGN: Descriptive study comparing radiologic and surgical findings in eight radiologically normal cochleas and four abnormal cases. METHODS: In unusual cases including cochlear ossification and misinsertion of electrodes, intracochlear space was evaluated on two types of reconstructed images: the "basal turn plane" that was vertical to the modiolus and contained whole basal turn was effective in the assessment of the lining of the inner bony wall of the otic capsule; "cochlear cross plane" images allowed evaluation of the patency of the intracochlear space and the location of inserted electrodes at the sections vertical to the direction of insertion of the electrodes. RESULTS: Preoperative evaluation was useful for predicting possible problems in electrode insertion and therefore helped in decision-making in regards to surgical strategies, especially in candidates with a high probability of cochlear ossification such as those with meningitis and otosclerosis. Furthermore, the new reconstruction method also provided useful information on the position of the cochlear implant electrodes after surgery. CONCLUSIONS: These unusual cases demonstrated that preoperative MDCT evaluation by our reconstruction method was useful for predicting possible problems in electrode insertion and decision-making in regards to surgical strategies, especially in cochlear implantation candidates with a high probability of cochlear stenosis.

Adolescent↗

[Distinguishing between occluded and low-flow vessels with PROPELLER DWI sequence: a phantom study].

PURPOSE: To evaluate the ability of periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted imaging (PROPELLER DWI) to distinguish between vessel occlusion and slow flow. MATERIALS AND METHODS: Using a flow phantom with various velocities (1.37 to 11.1 cm/s), the signal-intensity ratios of the phantom, with the intensity of no flow as baseline, were measured using the following imaging sequences: PROPELLER DWI, spin-echo T1-weighted imaging (SE T1WI), fast-spin-echo T2-weighted imaging (FSE T2WI), two-dimensional phase-contrast imaging (2D PC), and two-dimensional time-of-flight imaging (2D TOF). The b-factor of PROPELLER DWI was varied from 0 to 1000 s/mm(2). The velocity encoding of 2D PC was varied from 2 to 30 cm/s. RESULTS: At the lowest flow velocity (1.37 cm/s) , the signal-intensity ratio was 0.0075 for PROPELLER DWI (b-factor=1000 s/mm(2)), 1.8 for SE T1WI, 0.67 for FSE T2WI, 11 for 2D PC (velocity encoding=2 cm/s), and 1.4 for 2D TOF. The signal-intensity ratio was smallest for PROPELLER DWI, even when the reciprocals of the signal-intensity ratio of 2D PC or 2D TOF were considered. CONCLUSION: The results indicate that PROPELLER DWI provides the best signal intensity-ratio between vessel occlusion and slow flow. Although DWI with single-shot echo-planar imaging (EPI) or multi-shot EPI may have similarly high sensitivity for slow flow, these sequences do not have high spatial resolution or robustness to susceptibility artifacts. PROPELLER DWI would be a better choice for distinguishing between occluded and low-velocity arteries in the skull base or parasellar regions.

Blood Flow Velocity↗

[Imaging characteristics of PROPELLER T2-weighted imaging].

As the PROPELLER sequence is a combination of the radial scan and fast-spin-echo (FSE) sequence, it can be considered an FSE sequence with a motion correlation. However, there are some differences between PROPELLER and FSE owing to differences in k-space trajectory. We clarified the imaging characteristics of PROPELLER T2-weighted imaging (T2WI) for different parameters in comparison with usual FSE T2WI. When the same parameters were used, PROPELLER T2WI showed a higher signal-to-noise ratio (SNR) and lower spatial resolution than usual FSE. Effective echo time (TE) changed with different echo train lengths (ETL) or different bandwidths on PROPELLER, and imaging contrast changed accordingly to be more effective.

Artifacts↗

Development of intraarterial contrast-enhanced 2D MRDSA with a 0.3 tesla open MRI system.

PURPOSE: The purpose of this study was to develop a new technique for a high temporal resolution two-dimensional MR digital subtraction angiography (2D MRDSA) sequence under intraarterial injection of contrast material to permit the visualization of vascular anatomy and hemodynamics. METHODS: 2D MRDSA was imaged on a 0.3T open MR scanner with a T(1)-weighted fast gradient echo sequence. The phantom study examined vials containing gadolinium (Gd) solutions ranging in concentration from 0.5 mmol/L to 100 mmol/L. Repetition time and echo time were fixed at minimal values in order to achieve high temporal resolution, and only the flip angle was changed in 10-degree increments between 10 and 90 degrees. The in vivo study examined a brachial artery of a human volunteer. MRDSA images were acquired continuously during intraarterial injections of Gd solutions ranging in concentration from 0.5 mmol/L to 100 mmol/L. The subtracted images were displayed on the monitor in real time at a frame rate of one frame per second and evaluated to determine the optimal concentration of contrast material. RESULTS: In the phantom study, a 10-mmol/L Gd concentration with a flip angle of 50 degrees -90 degrees and a 25-mmol/L Gd concentration with a flip angle of 60 degrees -90 degrees showed high signal-to-noise ratios. In the human brachial artery experiment, the forearm arteries were well visualized when solutions of 5-50 mmol/L Gd concentration were used. The 10- and 25-mmol/L Gd concentrations were considered optimal. The palmar digital arteries were also visualized. Higher Gd concentrations showed a paradoxical signal increase when diluted by blood. CONCLUSION: We successfully developed an intraarterial contrast-enhanced 2D MRDSA sequence. With appropriate settings of imaging parameters and Gd concentrations, we obtained acceptable vessel visualization in the human study. The low Gd concentration for optimal visualization permits repeated intraarterial injections. This technique can be a useful tool for investigating the vascular anatomy and hemodynamics required for MR-guided vascular interventions.

Adult↗

Feasibility of a curvature-based enhanced display system for detecting cerebral aneurysms in MR angiography.

PURPOSE: To assess the feasibility of a curvature-based enhanced display system for detecting cerebral aneurysms in MR angiography. METHODS: MR angiography studies of 18 patients (eight male and 10 female, average age 65.7, age range 50 to 75 years old) with 23 known aneurysms were evaluated with a curvature-based display system. The two curvature features-the volumetric shape index and curvedness values-were calculated at each voxel. These were displayed independently on a workstation, overlaid on volume-rendered images. Two neuroradiologists evaluated the images for visibility and diagnosis of the cerebral aneurysms. The diagnostic results were compared with the original reports. RESULTS: The calculation time for each curvature index was 30 to 40 s for 120 to 140 slices of original MR angiography data. Shape index images emphasized smooth and round aneurysms more than aneurysms with irregular surfaces. Curvedness images revealed aneurysms well when the aneurysms had diameters that differed from those of the surrounding vessels. The computer-assisted-detection method detected 24 aneurysms, three of which were not pointed out in the initial report. CONCLUSION: Our results show that the curvature-based display system we have developed is feasible and that it may help to detect small aneurysms that are prone to be overlooked in routine readings.

Aged↗

MR diffusion tensor imaging: recent advance and new techniques for diffusion tensor visualization.

Recently, diffusion tensor imaging is attracting the biomedical researchers for its application in depiction of fiber tracts based on diffusion anisotropy. In this paper, we briefly describe the basic theory of diffusion tensor MR imaging, the determination process of diffusion tensor, and the basic concepts of diffusion tensor visualization techniques. Several results of clinical application in our institute are also introduced. Finally, the limitations, advantages and disadvantages of the techniques are discussed for further application of diffusion tensor visualization.

Anisotropy↗