Pertti Ryymin

Characterization of breast cancer types by texture analysis of magnetic resonance images.

RATIONALE AND OBJECTIVES This novel study aims to investigate texture parameters in distinguishing healthy breast tissue and breast cancer in breast magnetic resonance imaging (MRI). A specific aim was to identify possible differences in the texture characteristics of histological types (lobular and ductal) of invasive breast cancer and to determine the value of these differences for computer-assisted lesion classification. MATERIALS AND METHODS Twenty patients (mean age 50.6 + or - SD 10.6; range 37-70 years), with histopathologically proven invasive breast cancer (10 lobular and 10 ductal) were included in this preliminary study. The median MRI lesion size was 25 mm (range, 7-60 mm). The selected T1-weighted precontrast, post-contrast, and subtracted images were analyzed and classified with texture analysis (TA) software MaZda and additional statistical tests were used for testing the parameters separability. RESULTS All classification methods employed were able to differentiate between cancer and healthy breast tissue and also invasive lobular and ductal carcinoma with classification accuracy varying between 80% and 100%, depending on the used imaging series and the type of region of interest. We found several parameters to be significantly different between the regions of interest studied. The co-occurrence matrix based parameters proved to be superior to other texture parameters used. CONCLUSIONS The results of this study indicate that MRI TA differentiates breast cancer from normal tissue and may be able to distinguish between two histological types of breast cancer providing more accurate characterization of breast lesions thereby offering a new tool for radiological analysis of breast MRI.

Acute mild traumatic brain injury is not associated with white matter change on diffusion tensor imaging

This study was designed to (i) evaluate the influence of age on diffusion tensor imaging measures of white matter assessed using tract-based spatial statistics; (ii) determine if mild traumatic brain injury is associated with microstructural changes in white matter, in the acute phase following injury, in a large homogenous sample that was carefully screened for pre-injury medical, psychiatric, or neurological problems; and (iii) examine if injury severity is related to white matter changes. Participants were 75 patients with acute mild traumatic brain injury (age = 37.2 ± 12.0 years, 45 males and 30 females) and 40 controls (age = 40.6 ± 12.2 yrs, 20 males and 20 females). Age effects were analysed by comparing control subgroups aged 31-40, 41-50, and 51-60 years against a group of 18-30-year-old control subjects. Widespread statistically significant areas of abnormal diffusion tensor measures were observed in older groups. Patients and controls were compared using age and gender as covariates and in age- and gender-matched subgroups. Subgroups of patients with more severe injuries were compared to age-and gender-matched controls. No significant differences were detected in patient-control or severity analyses (all P-value > 0.01). In this large, carefully screened sample, acute mild traumatic brain injury was not associated with diffusion tensor imaging abnormalities detectable with tract-based spatial statistics.

Diffusion tensor imaging of the brain in a healthy adult population: Normative values and measurement reproducibility at 3 T and 1.5 T

Background: Diffusion tensor imaging (DTI) is an increasingly used method for investigation of brain white matter integrity in both research and clinical applications. Familiarity with normal variation of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values and measurement reproducibility is essential when DTI measurements are interpreted in clinical patients. Purpose: To establish normal values for FA and ADC in a healthy adult population at 1.5 T and 3 T MRI based on region of interest (ROI) analysis, and to study the inter- and intra-observer reproducibility of the measurements. Material and Methods: Forty healthy volunteers (26 women, 14 men, mean age 38.3, SD 11.6 years) underwent conventional MRI and DTI of the brain, 30 with 3 T and 10 with 1.5 T clinical scanners. ROI-based measurements for FA and ADC values were performed in five different anatomic locations of each hemisphere and in three locations within the corpus callosum. Mean values for FA and ADC for each region were calculated. Inter-observer variation of ROI measurements was evaluated by comparing the results of the two observers, intra-observer variation by repeated measurement of 10 subjects by both observers. Results: The FA values varied considerably between different regions. The highest values were found in the genu and splenium of the corpus callosum and the lowest in the corona radiata, respectively. In general, ADC values showed less variation; the highest values were found in the body of the corpus callosum and the lowest in the corona radiata. The reproducibility of both inter- and intra-observer measurements also varied regionally. The highest agreement was found for the corpus callosum and the lowest for the corona radiata and centrum semiovale. Conclusion: In a normal adult population FA and ADC values of the brain white matter show regional variation. The repeatability of the ROI measurements also varies regionally. This regional variability must be acknowledged when these measurements are interpreted in clinical patients.

Brain Iron Deposition and Sequence Characteristics in Parkinsonism: Comparison of SWI, T2* Maps, T2-Weighted-, and FLAIR-SPACE

Objectives:To compare quantitatively T2- and T2*-based magnetic resonance imaging sequences in patients with symptoms of Parkinson disease and to evaluate the information content of those sequences regarding brain iron concentration. Materials and Methods:We imaged 51 patients with symptoms of Parkinson disease on 3-T magnetic resonance imaging with T2-weighted sampling perfection with application optimized contrasts using different flip-angle evolution (SPACE), fluid attenuation inversion recovery (FLAIR)-SPACE, susceptibility-weighted imaging (SWI), and parametric T2* sequence (MapIt). Signal analysis was performed in 22 regions of interest in the brain. Results:Correlations (r2 = 0.82…0.96) with brain iron concentration were excellent. Contrast and tissue separability ratios were best in the T2* maps and FLAIR-SPACE, respectively. Good correlations of contrast were reached between SWI and both T2-weighted SPACE and FLAIR-SPACE. Their relation to quantitative T2* values was reminiscent of a quadratic curve shape. However, separation into gray and white matter revealed a linear positive and negative correlation, respectively. Conclusions:SWI showed potential in differentiating illnesses characterized by brain iron deposition. Closely similar information was given by T2-weighted SPACE and FLAIR-SPACE, whereas other sequence comparisons revealed dispersion from intersequence agreement.

Magnetic resonance imaging compared to ultrasonography in fetal weight and volume estimation in diabetic and normal pregnancy

Objective. To estimate fetal volume and weight in diabetic and normal pregnancy using high‐resolution magnetic resonance imaging.

Repeatability and variation of region-of-interest methods using quantitative diffusion tensor MR imaging of the brain

BackgroundDiffusion tensor imaging (DTI) is increasingly used in various diseases as a clinical tool for assessing the integrity of the brain’s white matter. Reduced fractional anisotropy (FA) and an increased apparent diffusion coefficient (ADC) are nonspecific findings in most pathological processes affecting the brain’s parenchyma. At present, there is no gold standard for validating diffusion measures, which are dependent on the scanning protocols, methods of the softwares and observers. Therefore, the normal variation and repeatability effects on commonly-derived measures should be carefully examined.MethodsThirty healthy volunteers (mean age 37.8 years, SD 11.4) underwent DTI of the brain with 3T MRI. Region-of-interest (ROI) -based measurements were calculated at eleven anatomical locations in the pyramidal tracts, corpus callosum and frontobasal area. Two ROI-based methods, the circular method (CM) and the freehand method (FM), were compared. Both methods were also compared by performing measurements on a DTI phantom. The intra- and inter-observer variability (coefficient of variation, or CV%) and repeatability (intra-class correlation coefficient, or ICC) were assessed for FA and ADC values obtained using both ROI methods.ResultsThe mean FA values for all of the regions were 0.663 with the CM and 0.621 with the FM. For both methods, the FA was highest in the splenium of the corpus callosum. The mean ADC value was 0.727 ×10-3 mm2/s with the CM and 0.747 ×10-3 mm2/s with the FM, and both methods found the ADC to be lowest in the corona radiata. The CV percentages of the derived measures were < 13% with the CM and < 10% with the FM. In most of the regions, the ICCs were excellent or moderate for both methods. With the CM, the highest ICC for FA was in the posterior limb of the internal capsule (0.90), and with the FM, it was in the corona radiata (0.86). For ADC, the highest ICC was found in the genu of the corpus callosum (0.93) with the CM and in the uncinate fasciculus (0.92) with FM.ConclusionsWith both ROI-based methods variability was low and repeatability was moderate. The circular method gave higher repeatability, but variation was slightly lower using the freehand method. The circular method can be recommended for the posterior limb of the internal capsule and splenium of the corpus callosum, and the freehand method for the corona radiata.

Mild Traumatic Brain Injury: Tissue Texture Analysis Correlated to Neuropsychological and DTI Findings

RATIONALE AND OBJECTIVES The aim of this study was to evaluate whether texture analysis (TA) can detect subtle changes in cerebral tissue caused by mild traumatic brain injury (MTBI) and to determine whether these changes correlate with neuropsychological and diffusion tensor imaging (DTI) findings. MATERIALS AND METHODS Forty-two patients with MTBIs were imaged using 1.5T magnetic resonance imaging within 3 weeks after head injury. TA was performed for the regions corresponding to the mesencephalon, centrum semiovale, and corpus callosum. Using DTI, the fractional anisotropic and apparent diffusion coefficient values for the same regions were evaluated. The same analyses were performed on a group of 10 healthy volunteers. Patients also underwent a battery of neurocognitive tests within 6 weeks after injury. RESULTS TA revealed textural differences between the right and left hemispheres in patients with MTBIs, whereas differences were minimal in healthy controls. A significant correlation was found between scores on memory tests and texture parameters (sum of squares, sum entropy, inverse difference moment, and sum average) in patients in the area of the mesencephalon and the genu of the corpus callosum. Significant correlations were also found between texture parameters for the left mesencephalon and both fractional anisotropic and apparent diffusion coefficient values. CONCLUSIONS The data suggest that heterogeneous texture and abnormal DTI patterns in the area of the mesencephalon may be linked with verbal memory deficits among patients with MTBIs. Therefore, TA combined with DTI in patients with MTBIs may increase the ability to detect early and subtle neuropathologic changes.

Comparison of different MRI sequences in lesion detection and early response evaluation of diffuse large B-cell lymphoma--a whole-body MRI and diffusion-weighted imaging study.

To compare different MRI sequences for the detection of lesions and the evaluation of response to chemotherapy in patients with diffuse large B‐cell lymphoma (DLBCL), 18 patients with histology‐confirmed DLBCL underwent 3‐T MRI scanning prior to and 1 week after chemotherapy. The MRI sequences included T1‐weighted pre‐ and post‐contrast, T2‐weighted with and without fat suppression, and a single‐shot echo‐planar diffusion‐weighted imaging (DWI) with two b values (0 and 800 s/mm2). Conventional MRI sequence comparisons were performed using the contrast ratio between tumor and normal vertebral body instead of signal intensity. The apparent diffusion coefficient (ADC) of the tumor was measured directly on the parametric ADC map. The tumor volume was used as a reference for the evaluation of chemotherapy response. The mean tumor volume was 374 mL at baseline, and decreased by 65% 1 week after chemotherapy (p < 0.01). The T2‐weighted image with fat suppression showed a significantly higher contrast ratio compared with images from all other conventional MRI sequences, both before and after treatment (p < 0.01, respectively). The contrast ratio of the T2‐weighted image with fat suppression decreased significantly (p < 0.01), and that of the T1‐weighted pre‐contrast image increased significantly (p < 0.01), after treatment. However, there was no correlation between the change in contrast ratio and tumor volume. The mean ADC value was 0.68 × 10–3 mm2/s at baseline; it increased by 89% after chemotherapy (p < 0.001), and the change in ADC value correlated with the change in tumor volume (r = 0.66, p < 0.01). The baseline ADC value also correlated inversely with the percentage change in ADC after treatment (r = −0.62, p < 0.01). In conclusion, this study indicates that T2‐weighted imaging with fat suppression is the best conventional sequence for the detection of lesions and evaluation of the efficacy of chemotherapy in DLBCL. DWI with ADC mapping is an imaging modality with both diagnostic and prognostic value that could complement conventional MRI. Copyright

MRI texture analysis of femoral neck: Detection of exercise load-associated differences in trabecular bone.

To assess the ability of co‐occurrence matrix‐based texture parameters to detect exercise load‐associated differences in MRI texture at the femoral neck cross‐section.

Diffusion tensor imaging of the cervical spinal cord in healthy adult population: normative values and measurement reproducibility at 3T MRI

Background Compared to diffusion tensor imaging (DTI) of the brain, there is a paucity of reports addressing the applicability of DTI in the evaluation of the spinal cord. Most normative data of cervical spinal cord DTI consist of relatively small and arbitrarily collected populations. Comprehensive normative data are necessary for clinical decision-making. Purpose To establish normal values for cervical spinal cord DTI metrics with region of interest (ROI)- and fiber tractography (FT)-based measurements and to assess the reproducibility of both measurement methods. Material and Methods Forty healthy adults underwent cervical spinal cord 3T MRI. Sagittal and axial conventional T2 sequences and DTI in the axial plane were performed. Whole cord fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were determined at different cervical levels from C2 to C7 using the ROI method. DTI metrics (FA, axial, and radial diffusivities based on eigenvalues λ1, λ2, and λ3, and ADC) of the lateral and posterior funicles were measured at C3 level. FA and ADC of the whole cord and the lateral and posterior funicles were also measured using quantitative tractography. Intra- and inter-observer variation of the measurement methods were assessed. Results Whole cord FA values decreased and ADC values increased in the rostral to caudal direction from C2 to C7. Between the individual white matter funicles no statistically significant difference for FA or ADC values was found. Both axial diffusivity and radial diffusivity of both lateral funicles differed significantly from those of the posterior funicle. Neither gender nor age correlated with any of the DTI metrics. Intra-observer variation of the measurements for whole cord FA and ADC showed almost perfect agreement with both ROI and tractography-based measurements. There was more variation in measurements of individual columns. Inter-observer agreement varied from moderate to strong for whole cord FA and ADC. Conclusion Both ROI- and FT-based measurements are applicable methods yielding reproducible results for cervical spinal cord DTI metrics. Normative values for both measurement methods are presented.