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13 pages, 1903 KiB

Open AccessArticle

Quantitative Sodium (²³Na) MRI in Pediatric Gliomas: Initial Experience

by Aashim Bhatia, Vincent Kyu Lee, Yongxian Qian, Michael J. Paldino, Rafael Ceschin, Jasmine Hect, James M. Mountz, Dandan Sun, Gary Kohanbash, Ian F. Pollack, Regina I. Jakacki, Fernando Boada and Ashok Panigrahy

Diagnostics 2022, 12(5), 1223; https://doi.org/10.3390/diagnostics12051223 - 13 May 2022

Cited by 4 | Viewed by 2232

Abstract

Background: ²³Na MRI correlates with tumor proliferation, and studies in pediatric patients are lacking. The purpose of the study: (1) to compare total sodium concentration (TSC) between pediatric glioma and non-neoplastic brain tissue using ²³Na MRI; (2) compare tissue conspicuity of [...] Read more.

Background: ²³Na MRI correlates with tumor proliferation, and studies in pediatric patients are lacking. The purpose of the study: (1) to compare total sodium concentration (TSC) between pediatric glioma and non-neoplastic brain tissue using ²³Na MRI; (2) compare tissue conspicuity of bound sodium concentration (BSC) using ²³Na MRI dual echo relative to TSC imaging. Methods: TSC was measured in: (1) non-neoplastic brain tissues and (2) three types of manually segmented gliomas (diffuse intrinsic brainstem glioma (DIPG), recurrent supratentorial low-grade glioma (LGG), and high-grade glioma (HGG)). In a subset of patients, serial changes in both TSC and BSC (dual echo ²³Na MRI) were assessed. Results: Twenty-six pediatric patients with gliomas (median age of 12.0 years, range 4.9–23.3 years) were scanned with ²³Na MRI. DIPG treated with RT demonstrated higher TSC values than the uninvolved infratentorial tissues (p < 0.001). Recurrent supratentorial LGG and HGG exhibited higher TSC values than the uninvolved white matter (WM) and gray matter (GM) (p < 0.002 for LGG, and p < 0.02 for HGG). The dual echo ²³Na MRI suppressed the sodium signal within both CSF and necrotic foci. Conclusion: Quantitative ²³Na MRI of pediatric gliomas demonstrates a range of values that are higher than non-neoplastic tissues. Dual echo ²³Na MRI of BCS improves tissue conspicuity relative to TSC imaging. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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21 pages, 3340 KiB

Open AccessArticle

Morphological Biomarkers in the Amygdala and Hippocampus of Children and Adults at High Familial Risk for Depression

by Bradley S. Peterson, Tejal Kaur, Maria Andrea Baez, Ronald C. Whiteman, Siddhant Sawardekar, Juan Sanchez-Peña, Xuejun Hao, Kristin W. Klahr, Ardesheer Talati, Priya Wickramaratne, Myrna M. Weissman and Ravi Bansal

Diagnostics 2022, 12(5), 1218; https://doi.org/10.3390/diagnostics12051218 - 12 May 2022

Cited by 4 | Viewed by 2279

Abstract

Major Depressive Disorder (MDD) is highly familial, and the hippocampus and amygdala are important in the pathophysiology of MDD. Whether morphological markers of risk for familial depression are present in the hippocampus or amygdala is unknown. We imaged the brains of 148 individuals, [...] Read more.

Major Depressive Disorder (MDD) is highly familial, and the hippocampus and amygdala are important in the pathophysiology of MDD. Whether morphological markers of risk for familial depression are present in the hippocampus or amygdala is unknown. We imaged the brains of 148 individuals, aged 6 to 54 years, who were members of a three-generation family cohort study and who were at either high or low familial risk for MDD. We compared surface morphological features of the hippocampus and amygdala across risk groups and assessed their associations with depression severity. High- compared with low-risk individuals had inward deformations of the head of both hippocampi and the medial surface of the left amygdala. The hippocampus findings persisted in analyses that included only those participants who had never had MDD, suggesting that these are true endophenotypic biomarkers for familial MDD. Posterior extension of the inward deformations was associated with more severe depressive symptoms, suggesting that a greater spatial extent of this biomarker may contribute to the transition from risk to the overt expression of symptoms. Significant associations of these biomarkers with corresponding biomarkers for cortical thickness suggest that these markers are components of a distributed cortico-limbic network of familial vulnerability to MDD. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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14 pages, 2786 KiB

Open AccessArticle

Multi-Contrast MRI Image Synthesis Using Switchable Cycle-Consistent Generative Adversarial Networks

by Huixian Zhang, Hailong Li, Jonathan R. Dillman, Nehal A. Parikh and Lili He

Diagnostics 2022, 12(4), 816; https://doi.org/10.3390/diagnostics12040816 - 26 Mar 2022

Cited by 17 | Viewed by 4223

Abstract

Multi-contrast MRI images use different echo and repetition times to highlight different tissues. However, not all desired image contrasts may be available due to scan-time limitations, suboptimal signal-to-noise ratio, and/or image artifacts. Deep learning approaches have brought revolutionary advances in medical image synthesis, [...] Read more.

Multi-contrast MRI images use different echo and repetition times to highlight different tissues. However, not all desired image contrasts may be available due to scan-time limitations, suboptimal signal-to-noise ratio, and/or image artifacts. Deep learning approaches have brought revolutionary advances in medical image synthesis, enabling the generation of unacquired image contrasts (e.g., T1-weighted MRI images) from available image contrasts (e.g., T2-weighted images). Particularly, CycleGAN is an advanced technique for image synthesis using unpaired images. However, it requires two separate image generators, demanding more training resources and computations. Recently, a switchable CycleGAN has been proposed to address this limitation and successfully implemented using CT images. However, it remains unclear if switchable CycleGAN can be applied to cross-contrast MRI synthesis. In addition, whether switchable CycleGAN is able to outperform original CycleGAN on cross-contrast MRI image synthesis is still an open question. In this paper, we developed a switchable CycleGAN model for image synthesis between multi-contrast brain MRI images using a large set of publicly accessible pediatric structural brain MRI images. We conducted extensive experiments to compare switchable CycleGAN with original CycleGAN both quantitatively and qualitatively. Experimental results demonstrate that switchable CycleGAN is able to outperform CycleGAN model on pediatric MRI brain image synthesis. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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Review

Jump to: Research

25 pages, 6868 KiB

Open AccessReview

Proton MR Spectroscopy of Pediatric Brain Disorders

by Stefan Blüml, Alexander Saunders and Benita Tamrazi

Diagnostics 2022, 12(6), 1462; https://doi.org/10.3390/diagnostics12061462 - 14 Jun 2022

Cited by 7 | Viewed by 7209

Abstract

In vivo MR spectroscopy is a non -invasive methodology that provides information about the biochemistry of tissues. It is available as a “push-button” application on state-of-the-art clinical MR scanners. MR spectroscopy has been used to study various brain diseases including tumors, stroke, trauma, [...] Read more.

In vivo MR spectroscopy is a non -invasive methodology that provides information about the biochemistry of tissues. It is available as a “push-button” application on state-of-the-art clinical MR scanners. MR spectroscopy has been used to study various brain diseases including tumors, stroke, trauma, degenerative disorders, epilepsy/seizures, inborn errors, neuropsychiatric disorders, and others. The purpose of this review is to provide an overview of MR spectroscopy findings in the pediatric population and its clinical use. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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12 pages, 2110 KiB

Open AccessReview

Pediatric Brain Maturation and Migration Disorders

by Matthew J. Barkovich

Diagnostics 2022, 12(5), 1123; https://doi.org/10.3390/diagnostics12051123 - 30 Apr 2022

Cited by 4 | Viewed by 4486

Abstract

Neurodevelopmental disorders, including neuronal migration disorders, are best understood in the context of altered normal development. Neurons normally migrate from their site of origin to their (usually cortical) destination using a wide range of molecular and cellular signaling as a guide. In the [...] Read more.

Neurodevelopmental disorders, including neuronal migration disorders, are best understood in the context of altered normal development. Neurons normally migrate from their site of origin to their (usually cortical) destination using a wide range of molecular and cellular signaling as a guide. In the case of abnormal migration neurons: (1) do not migrate and remain at their site of origin; (2) incompletely migrate and remain within the white matter; (3) migrate to the cortex but fail to organize correctly; or (4) over-migrate, beyond the cortex. In this review, we discuss normal brain development, along with the malformations that result from these different migration abnormalities. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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19 pages, 988 KiB

Open AccessReview

A Descriptive Review of the Impact of Patient Motion in Early Childhood Resting-State Functional Magnetic Resonance Imaging

by Jenna Schabdach, Rafael Ceschin, Vanessa Schmithorst, M. Dylan Tisdall, Aaron Alexander-Bloch and Ashok Panigrahy

Diagnostics 2022, 12(5), 1032; https://doi.org/10.3390/diagnostics12051032 - 20 Apr 2022

Cited by 2 | Viewed by 2445

Abstract

Resting-state functional magnetic images (rs-fMRIs) can be used to map and delineate the brain activity occurring while the patient is in a task-free state. These resting-state activity networks can be informative when diagnosing various neurodevelopmental diseases, but only if the images are high [...] Read more.

Resting-state functional magnetic images (rs-fMRIs) can be used to map and delineate the brain activity occurring while the patient is in a task-free state. These resting-state activity networks can be informative when diagnosing various neurodevelopmental diseases, but only if the images are high quality. The quality of an rs-fMRI rapidly degrades when the patient moves during the scan. Herein, we describe how patient motion impacts an rs-fMRI on multiple levels. We begin with how the electromagnetic field and pulses of an MR scanner interact with a patient’s physiology, how movement affects the net signal acquired by the scanner, and how motion can be quantified from rs-fMRI. We then present methods for preventing motion through educational and behavioral interventions appropriate for different age groups, techniques for prospectively monitoring and correcting motion during the acquisition process, and pipelines for mitigating the effects of motion in existing scans. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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24 pages, 20108 KiB

Open AccessReview

MR Imaging of Pediatric Brain Tumors

by Alok Jaju, Kristen W. Yeom and Maura E. Ryan

Diagnostics 2022, 12(4), 961; https://doi.org/10.3390/diagnostics12040961 - 12 Apr 2022

Cited by 18 | Viewed by 10433

Abstract

Primary brain tumors are the most common solid neoplasms in children and a leading cause of mortality in this population. MRI plays a central role in the diagnosis, characterization, treatment planning, and disease surveillance of intracranial tumors. The purpose of this review is [...] Read more.

Primary brain tumors are the most common solid neoplasms in children and a leading cause of mortality in this population. MRI plays a central role in the diagnosis, characterization, treatment planning, and disease surveillance of intracranial tumors. The purpose of this review is to provide an overview of imaging methodology, including conventional and advanced MRI techniques, and illustrate the MRI appearances of common pediatric brain tumors. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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17 pages, 5767 KiB

Open AccessReview

Parenchymal Insults in Abuse—A Potential Key to Diagnosis

by Marguerite M. Caré

Diagnostics 2022, 12(4), 955; https://doi.org/10.3390/diagnostics12040955 - 12 Apr 2022

Cited by 4 | Viewed by 3291

Abstract

Subdural hemorrhage is a key imaging finding in cases of abusive head trauma and one that many radiologists and radiology trainees become familiar with during their years of training. Although it may prove to be a marker of trauma in a young child [...] Read more.

Subdural hemorrhage is a key imaging finding in cases of abusive head trauma and one that many radiologists and radiology trainees become familiar with during their years of training. Although it may prove to be a marker of trauma in a young child or infant that presents without a history of injury, the parenchymal insults in these young patients more often lead to the debilitating and sometimes devastating outcomes observed in this young population. It is important to recognize these patterns of parenchymal injuries and how they may differ from the imaging findings in other cases of traumatic injury in young children. In addition, these parenchymal insults may serve as another significant, distinguishing feature when making the medical diagnosis of abusive head injury while still considering alternative diagnoses, including accidental injury. Therefore, as radiologists, we must strive to look beyond the potential cranial injury or subdural hemorrhage for the sometimes more subtle but significant parenchymal insults in abuse. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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25 pages, 7208 KiB

Open AccessReview

MR Neuroimaging in Pediatric Inborn Errors of Metabolism

by Lillian M. Lai, Andrea L. Gropman and Matthew T. Whitehead

Diagnostics 2022, 12(4), 861; https://doi.org/10.3390/diagnostics12040861 - 30 Mar 2022

Cited by 6 | Viewed by 8431

Abstract

Inborn errors of metabolism (IEM) are a group of disorders due to functional defects in one or more metabolic pathways that can cause considerable morbidity and death if not diagnosed early. While individually rare, the estimated global prevalence of IEMs comprises a substantial [...] Read more.

Inborn errors of metabolism (IEM) are a group of disorders due to functional defects in one or more metabolic pathways that can cause considerable morbidity and death if not diagnosed early. While individually rare, the estimated global prevalence of IEMs comprises a substantial number of neonatal and infantile disorders affecting the central nervous system. Clinical manifestations of IEMs may be nonspecific. Newborn metabolic screens do not capture all IEMs, and likewise, genetic testing may not always detect pathogenic variants. Neuroimaging is a critical component of the work-up, given that imaging sometimes occurs before prenatal screen results are available, which may allow for recognition of imaging patterns that lead to early diagnosis and treatment of IEMs. This review will demonstrate the role of magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (¹H MRS) in the evaluation of IEMs. The focus will be on scenarios where MRI and ¹H MRS are suggestive of or diagnostic for IEMs, or alternatively, refute the diagnosis. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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13 pages, 9671 KiB

Open AccessReview

Clinical Applications of Fetal MRI in the Brain

by Usha D. Nagaraj and Beth M. Kline-Fath

Diagnostics 2022, 12(3), 764; https://doi.org/10.3390/diagnostics12030764 - 21 Mar 2022

Cited by 9 | Viewed by 7126

Abstract

Fetal magnetic resonance imaging (MRI) has become a widely used tool in clinical practice, providing increased accuracy in prenatal diagnoses of congenital abnormalities of the brain, allowing for more accurate prenatal counseling, optimization of perinatal management, and in some cases fetal intervention. In [...] Read more.

Fetal magnetic resonance imaging (MRI) has become a widely used tool in clinical practice, providing increased accuracy in prenatal diagnoses of congenital abnormalities of the brain, allowing for more accurate prenatal counseling, optimization of perinatal management, and in some cases fetal intervention. In this article, a brief description of how fetal ultrasound (US) and fetal MRI are used in clinical practice will be followed by an overview of the most common reasons for referral for fetal MRI of the brain, including ventriculomegaly, absence of the cavum septi pellucidi (CSP) and posterior fossa anomalies. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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18 pages, 3451 KiB

Open AccessReview

Magnetic Resonance Imaging in (Near-)Term Infants with Hypoxic-Ischemic Encephalopathy

by Corline E. J. Parmentier, Linda S. de Vries and Floris Groenendaal

Diagnostics 2022, 12(3), 645; https://doi.org/10.3390/diagnostics12030645 - 6 Mar 2022

Cited by 32 | Viewed by 13998

Abstract

Hypoxic-ischemic encephalopathy (HIE) is a major cause of neurological sequelae in (near-)term newborns. Despite the use of therapeutic hypothermia, a significant number of newborns still experience impaired neurodevelopment. Neuroimaging is the standard of care in infants with HIE to determine the timing and [...] Read more.

Hypoxic-ischemic encephalopathy (HIE) is a major cause of neurological sequelae in (near-)term newborns. Despite the use of therapeutic hypothermia, a significant number of newborns still experience impaired neurodevelopment. Neuroimaging is the standard of care in infants with HIE to determine the timing and nature of the injury, guide further treatment decisions, and predict neurodevelopmental outcomes. Cranial ultrasonography is a helpful noninvasive tool to assess the brain before initiation of hypothermia to look for abnormalities suggestive of HIE mimics or antenatal onset of injury. Magnetic resonance imaging (MRI) which includes diffusion-weighted imaging has, however, become the gold standard to assess brain injury in infants with HIE, and has an excellent prognostic utility. Magnetic resonance spectroscopy provides complementary metabolic information and has also been shown to be a reliable prognostic biomarker. Advanced imaging modalities, including diffusion tensor imaging and arterial spin labeling, are increasingly being used to gain further information about the etiology and prognosis of brain injury. Over the past decades, tremendous progress has been made in the field of neonatal neuroimaging. In this review, the main brain injury patterns of infants with HIE, the application of conventional and advanced MRI techniques in these newborns, and HIE mimics, will be described. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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21 pages, 6516 KiB

Open AccessReview

Pediatric Exposures to Neurotoxicants: A Review of Magnetic Resonance Imaging and Spectroscopy Findings

by Kim M. Cecil

Diagnostics 2022, 12(3), 641; https://doi.org/10.3390/diagnostics12030641 - 5 Mar 2022

Cited by 4 | Viewed by 2634

Abstract

Heavy metals, including lead and manganese, air pollution, pesticides, environmental tobacco smoke, and flame retardants are among the known and suspected environmental neurotoxicant exposures examined with magnetic resonance imaging (MRI)-based studies of pediatric populations. Many studies feature morphological changes associated with the exposures [...] Read more.

Heavy metals, including lead and manganese, air pollution, pesticides, environmental tobacco smoke, and flame retardants are among the known and suspected environmental neurotoxicant exposures examined with magnetic resonance imaging (MRI)-based studies of pediatric populations. Many studies feature morphological changes associated with the exposures while others employ magnetic resonance spectroscopy, diffusion imaging, task-based, and resting state functional magnetic resonance imaging to reveal abnormal metabolic concentrations, white matter disorganization, and atypical patterns of activation. Some studies follow pregnant women and their offspring throughout the lifespan with collection of individual specimens as exposure biomarkers. Others innovatively make use of public databases to obtain relevant exposure biomarkers while taking advantage of these studies in their efforts to monitor developmental features in large, population-based, imaging cohorts. As exposures to neurotoxicants in the womb and throughout childhood have life-long impacts on health and well-being, the importance of these innovative neuroimaging investigations is ever increasing. Full article

(This article belongs to the Special Issue MR Imaging of Pediatric Brain Diseases and Injury)

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