Super-Resolution Whole-Brain 3D MR Spectroscopic Imaging for Mapping D-2-Hydroxyglutarate and Tumor Metabolism in Isocitrate Dehydrogenase 1-mutated Human Gliomas.
- 作者列表："Li X","Strasser B","Jafari-Khouzani K","Thapa B","Small J","Cahill DP","Dietrich J","Batchelor TT","Andronesi OC
:Background Isocitrate dehydrogenase (IDH) mutations are highly frequent in glioma, producing high levels of the oncometabolite D-2-hydroxyglutarate (D-2HG). Hence, D-2HG represents a valuable imaging marker for IDH-mutated human glioma. Purpose To develop and evaluate a super-resolution three-dimensional (3D) MR spectroscopic imaging strategy to map D-2HG and tumor metabolism in IDH-mutated human glioma. Materials and Methods Between March and September 2018, participants with IDH1-mutated gliomas and healthy participants were prospectively scanned with a 3-T whole-brain 3D MR spectroscopic imaging protocol optimized for D-2HG. The acquired D-2HG maps with a voxel size of 5.2 × 5.2 × 12 mm were upsampled to a voxel size of 1.7 × 1.7 × 3 mm using a super-resolution method that combined weighted total variation, feature-based nonlocal means, and high-spatial-resolution anatomic imaging priors. Validation with simulated healthy and patient data and phantom measurements was also performed. The Mann-Whitney U test was used to check that the proposed super-resolution technique yields the highest peak signal-to-noise ratio and structural similarity index. Results Three participants with IDH1-mutated gliomas (mean age, 50 years ± 21 [standard deviation]; two men) and three healthy participants (mean age, 32 years ± 3; two men) were scanned. Twenty healthy participants (mean age, 33 years ± 5; 16 men) underwent a simulation of upsampled MR spectroscopic imaging. Super-resolution upsampling improved peak signal-to-noise ratio and structural similarity index by 62% (P < .05) and 7.3% (P < .05), respectively, for simulated data when compared with spline interpolation. Correspondingly, the proposed method significantly improved tissue contrast and structural information for the acquired 3D MR spectroscopic imaging data. Conclusion High-spatial-resolution whole-brain D-2-hydroxyglutarate imaging is possible in isocitrate dehydrogenase 1-mutated human glioma by using a super-resolution framework to upsample three-dimensional MR spectroscopic images acquired at lower resolution. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Huang and Lin in this issue.
背景: 异柠檬酸脱氢酶 (IDH) 突变在神经胶质瘤中非常常见，产生高水平的癌代谢物D-2-hydroxyglutarate (D-2HG)。因此，D-2HG代表IDH突变的人神经胶质瘤的有价值的成像标记。目的开发和评价超分辨三维磁共振光谱成像策略，以绘制IDH突变的人脑胶质瘤D-2HG和肿瘤代谢。材料和方法在2018年3月至9月期间，使用针对IDH1-mutated优化的3-T全脑3D MR光谱成像方案对患有D-2HG例胶质瘤的参与者和健康参与者进行前瞻性扫描。采用加权总变异、基于特征的非局部均值和高空间分辨率解剖成像先验相结合的超分辨率方法，将获取的D-2HG张体素大小为5.2 × 12毫米的体元图像上采样至1.7 × 3毫米的体元大小。还使用模拟的健康和患者数据和体模测量进行验证。使用Mann-Whitney U检验来检验所提出的超分辨率技术产生最高的峰值信噪比和结构相似性指数。结果: 对3名患有IDH1-mutated胶质瘤的参与者 (平均年龄，50岁 ± 21 [标准差]; 2名男性) 和3名健康参与者 (平均年龄，32岁 ± 3岁; 2名男性) 进行扫描。20名健康参与者 (平均年龄，33岁 ± 5岁; 16名男性) 接受了上采样MR光谱成像的模拟。与样条插值相比，超分辨率上采样将模拟数据的峰值信噪比和结构相似性指数分别提高了62% (P < .05) 和7.3% (P <.05)。相应地，所提出的方法显著改善了所采集的3dmr光谱成像数据的组织对比度和结构信息。结论高空间分辨率全脑D-2-hydroxyglutarate成像在异柠檬酸脱氢酶1突变的人脑胶质瘤中是可能的，通过使用超分辨率框架对在较低分辨率下获得的三维MR光谱图像进行上采样。©RSNA，2020在线补充材料可用于本文。另见本期黄和林的社论。
METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.
METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.
METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.