Kenya Murase

Quantitative assessment of regional pulmonary perfusion in the entire lung using three-dimensional ultrafast dynamic contrast-enhanced magnetic resonance imaging: Preliminary experience in 40 subjects.

To assess regional differences in quantitative pulmonary perfusion parameters, i.e., pulmonary blood flow (PBF), mean transit time (MTT), and pulmonary blood volume (PBV) in the entire lung on a pixel‐by‐pixel basis in normal volunteers and pulmonary hypertension patients.

Efficient method for calculating kinetic parameters using T1-weighted dynamic contrast-enhanced magnetic resonance imaging.

It has become increasingly important to quantitatively estimate tissue physiological parameters such as perfusion, capillary permeability, and the volume of extravascular‐extracellular space (EES) using T1‐weighted dynamic contrast‐enhanced MRI (DCE‐MRI). A linear equation was derived by integrating the differential equation describing the kinetic behavior of contrast agent (CA) in tissue, from which K1 (rate constant for the transfer of CA from plasma to EES), k2 (rate constant for the transfer from EES to plasma), and Vp (plasma volume) can be easily obtained by the linear least‐squares (LLSQ) method. The usefulness of this method was investigated by means of computer simulations, in comparison with the nonlinear least‐squares (NLSQ) method. The new method calculated the above parameters faster than the NLSQ method by a factor of approximately 6, and estimated them more accurately than the NLSQ method at a signal‐to‐noise ratio (SNR) of < ∼10. This method will be useful for generating functional images of K1, k2, and Vp from DCE‐MRI data. Magn Reson Med 51:858–862, 2004.

Enlarged longitudinal dose profiles in cone-beam CT and the need for modified dosimetry

In order to examine phantom length necessary to assess radiation dose delivered to patients in cone-beam CT with an enlarged beamwidth, we measured dose profiles in cylindrical phantoms of sufficient length using a prototype 256-slice CT-scanner developed at our institute. Dose profiles parallel to the rotation axis were measured at the central and peripheral positions in PMMA (polymethylmethacrylate) phantoms of 160 or 320 mm diameter and 900 mm length. For practical application, we joined unit cylinders (150 mm long) together to provide phantoms of 900 mm length. Dose profiles were measured with a pin photodiode sensor having a sensitive region of approximately 2.8 x 2.8 mm2 and 2.7 mm thickness. Beamwidths of the scanner were varied from 20 to 138 mm. Dose profile integrals (DPI) were calculated using the measured dose profiles for various beamwidths and integration ranges. For the body phantom (320-mm-diam phantom), 76% of the DPI was represented for a 20 mm beamwidth and 60% was represented for a 138 mm beamwidth if dose profiles were integrated over a 100 mm range, while more than 90% of the DPI was represented for beamwidths between 20 and 138 mm if integration was carried out over a 300 mm range. The phantom length and integration range for dosimetry of cone-beam CT needed to be more than 300 mm to represent more than 90% of the DPI for the body phantom with the beamwidth of more than 20 mm. Although we reached this conclusion using the prototype 256-slice CT-scanner, it may be applied to other multislice CT-scanners as well.

Primary pulmonary hypertension: 3D dynamic perfusion MRI for quantitative analysis of regional pulmonary perfusion.

OBJECTIVE The purpose of this study was to determine whether quantitative pulmonary perfusion parameters obtained from 3D dynamic contrast-enhanced MR perfusion data can be used to assess the severity of primary pulmonary hypertension (PPH) as indicated by pulmonary vascular resistance (PVR) and mean pulmonary artery pressure (MPAP). CONCLUSION Three-dimensional dynamic contrast-enhanced MRI has potential for assessment of disease severity as indicated by PVR and MPAP in patients with PPH.

Determination of arterial input function using fuzzy clustering for quantification of cerebral blood flow with dynamic susceptibility contrast-enhanced MR imaging

An accurate determination of the arterial input function (AIF) is necessary for quantification of cerebral blood flow (CBF) using dynamic susceptibility contrast‐enhanced magnetic resonance imaging. In this study, we developed a method for obtaining the AIF automatically using fuzzy c‐means (FCM) clustering. The validity of this approach was investigated with computer simulations. We found that this method can automatically extract the AIF, even under very noisy conditions, e.g., when the signal‐to‐noise ratio is 2. The simulation results also indicated that when using a manual drawing of a region of interest (ROI) (manual ROI method), the contamination of surrounding pixels (background) into ROI caused considerable overestimation of CBF. We applied this method to six subjects and compared it with the manual ROI method. The CBF values, calculated using the AIF obtained using the manual ROI method [CBF(manual)], were significantly higher than those obtained with FCM clustering [CBF(fuzzy)]. This may have been due to the contamination of non‐arterial pixels into the manually drawn ROI, as suggested by simulation results. The ratio of CBF(manual) to CBF(fuzzy) ranged from 0.99–1.83 [1.31 ± 0.26 (mean ± SD)]. In conclusion, our FCM clustering method appears promising for determination of AIF because it allows automatic, rapid and accurate extraction of arterial pixels. J. Magn. Reson. Imaging 2001;13:797–806.

Comparison of Regional Brain Volume and Glucose Metabolism Between Patients with Mild Dementia with Lewy Bodies and Those with Mild Alzheimer's Disease

The aim of this study was to investigate regional differences between morphologic and functional changes in patients with mild dementia with Lewy bodies (DLB) compared with those with Alzheimers disease (AD). Methods: Twenty patients with very mild DLB (mean age, 74.5 y; mean Mini-Mental State Examination [MMSE] score, 24.0), 20 patients with very mild AD (mean age, 74.1 y; mean MMSE score, 24.0), and 20 age- and sex-matched healthy volunteers (normal controls [NC]) underwent both 18F-FDG PET and 3-dimensional spoiled gradient echo MRI. Fully automatic volumetry of the MRI data was used to obtain whole brain, hippocampal, occipital, and striatal volumes, which were compared with the results of a similar analysis of glucose metabolic data. Results: In DLB patients, volumetric data indicated a significant volume decrease in the striatum, whereas 18F-FDG PET showed significant glucose metabolic reductions in the temporal, parietal, and frontal areas—including in the occipital lobe—compared with those in the NC group. In contrast, in AD patients, both the hippocampal volume and glucose metabolism were significantly decreased, whereas the occipital volume and metabolism were preserved. Conclusion: Comparison of very mild DLB and AD revealed different morphologic and metabolic changes occurring in the medial temporal lobes and the occipital lobe, demonstrating characteristic pathophysiologic differences between these 2 diseases.

Accuracy of deconvolution analysis based on singular value decomposition for quantification of cerebral blood flow using dynamic susceptibility contrast-enhanced magnetic resonance imaging

Deconvolution analysis (DA) based on singular value decomposition (SVD) has been widely accepted for quantification of cerebral blood flow (CBF) using dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI). When using this method, the elements in the diagonal matrix obtained by SVD are set to zero when they are smaller than the threshold value given beforehand. In the present study, we investigated the effect of the threshold value on the accuracy of the CBF values obtained by this method using computer simulations. We also investigated the threshold value giving the CBF closest to the assumed value (optimal threshold value) under various conditions. The CBF values obtained by this method largely depended on the threshold value. Both the mean and the standard deviation of the estimated CBF values decreased with increasing threshold value. The optimal threshold value decreased with increasing signal-to-noise ratio and CBF, and increased with increasing cerebral blood volume. Although delay and dispersion in the arterial input function also affected the relationship between the estimated CBF and threshold values, the optimal threshold value tended to be nearly constant. In conclusion, our results suggest that the threshold value should be carefully considered when quantifying CBF in terms of absolute values using DSC-MRI for DA based on SVD. We believe that this study will be helpful in selecting the threshold value in SVD.

Numerical solutions to the time-dependent Bloch equations revisited.

The purpose of this study was to demonstrate a simple and fast method for solving the time-dependent Bloch equations. First, the time-dependent Bloch equations were reduced to a homogeneous linear differential equation, and then a simple equation was derived to solve it using a matrix operation. The validity of this method was investigated by comparing with the analytical solutions in the case of constant radiofrequency irradiation. There was a good agreement between them, indicating the validity of this method. As a further example, this method was applied to the time-dependent Bloch equations in the two-pool exchange model for chemical exchange saturation transfer (CEST) or amide proton transfer (APT) magnetic resonance imaging (MRI), and the Z-spectra and asymmetry spectra were calculated from their solutions. They were also calculated using the fourth/fifth-order Runge-Kutta-Fehlberg (RKF) method for comparison. There was also a good agreement between them, and this method was much faster than the RKF method. In conclusion, this method will be useful for analyzing the complex CEST or APT contrast mechanism and/or investigating the optimal conditions for CEST or APT MRI.

Attenuation correction of myocardial SPECT images with X-ray CT : Effects of registration errors between X-ray CT and SPECT

Purpose: Attenuation correction with an X-ray CT image is a new method to correct attenuation on SPECT imaging, but the effect of the registration errors between CT and SPECT images is unclear. In this study, we investigated the effects of the registration errors on myocardial SPECT, analyzing data from a phantom and a human volunteer.Methods: Registerion (fusion) of the X-ray CT and SPECT images was done with standard packaged software in three dimensional fashion, by using linked transaxial, coronal and sagittal images. In the phantom study, an X-ray CT image was shifted 1 to 3 pixels on thex, y andz axes, and rotated 6 degrees clockwise. Attenuation correction maps generated from each misaligned X-ray CT image were used to reconstruct misaligned SPECT images of the phantom filled with201Tl. In a human volunteer, X-ray CT was acquired in different conditions (during inspiration vs. expiration). CT values were transferred to an attenuation constant by using straight lines; an attenuation constant of 0/cm in the air (CT value=−1,000 HU) and that of 0.150/cm in water (CT value=0 HU). For comparison, attenuation correction with transmission CT (TCT) data and an external γ-ray source (99mTc) was also applied to reconstruct SPECT images.Results: Simulated breast attenuation with a breast attachment, and inferior wall attenuation were properly corrected by means of the attenuation correction map generated from X-ray CT. As pixel shift increased, deviation of the SPECT images increased in misaligned images in the phantom study. In the human study, SPECT images were affected by the scan conditions of the X-ray CT.Conclusion: Attenuation correction of myocardial SPECT with an X-ray CT image is a simple and potentially beneficial method for clinical use, but accurate registration of the X-ray CT to SPECT image is essential for satisfactory attenuation correction.

Quantification of Myocardial Perfusion by Contrast-Enhanced 64-MDCT: Characterization of Ischemic Myocardium

OBJECTIVE Assessment of hemodynamic changes in ischemic cardiac segments at rest using CT has yet to be performed. We hypothesized that variations in subendocardial perfusion during the cardiac cycle might be related to the appearances of ischemia. The purpose of this study was to investigate myocardial perfusion in ischemic segments using contrast-enhanced 64-MDCT. SUBJECTS AND METHODS We performed cardiac MDCT at rest and stress/rest (201)Tl myocardial perfusion scintigraphy (MPS) in 34 patients with suspected coronary artery disease. We reconstructed 2D long- and short-axis cardiac images in diastolic and systolic phases using raw data from coronary CT angiography. The attenuation value (in Hounsfield units) in the myocardium was used as an estimate of myocardial perfusion. We measured the subendocardial intensity of 17 segments according to the American Heart Association classification. Systolic perfusion or diastolic perfusion was calculated by dividing the subendocardial intensity at systole or diastole, respectively, for each segment by the mean value across all segments for each patient. We used stress/rest MPS to evaluate the variation in myocardial perfusion at systole and diastole for the segments diagnosed as ischemic or nonischemic. RESULTS Systolic perfusion for ischemic segments was significantly lower than that for nonischemic segments in 15 of 17 segments. The difference between systolic perfusion and diastolic perfusion in ischemic segments was significantly lower than that in nonischemic segments (14 of 17 segments). There was no significant difference in diastolic perfusion between ischemic and nonischemic segments (15 of 17 segments). CONCLUSION Our results suggest that a pattern of subendocardial hypoperfusion at systole and normal perfusion at diastole characterizes ischemic myocardium.