Two studies using (31)P-magnetic resonance spectroscopy (MRS) reported enhanced phosphocreatine (PCr) levels in normal appearing white matter (NAWM) of subjects with multiple sclerosis (MS), but this ...finding could not be properly explained.
We performed (31)P-MRS and (1)H-MRS in the NAWM in 36 subjects, including 17 with progressive MS, 9 with benign MS, and 10 healthy controls. Compared to controls, PCr/beta-ATP and PCr/total (31)P ratios were significantly increased in subjects with progressive MS, but not with benign MS. There was no correlation between PCr ratios and the N-acetylaspartate/creatine ratio, suggesting that elevated PCr levels in NAWM were not secondary to axonal loss. In the central nervous system, PCr is degraded by creatine kinase B (CK-B), which in the white matter is confined to astrocytes. In homogenates of NAWM from 10 subjects with progressive MS and 10 controls without central nervous system disease, we measured CK-B levels with an ELISA, and measured its activity with an enzymatic assay kit. Compared to controls, both CK-B levels and activity were decreased in subjects with MS (22.41 versus 46.28 microg/ml; p = 0.0007, and 2.89 versus 7.76 U/l; p<0.0001).
Our results suggest that PCr metabolism in the NAWM in MS is impaired due to decreased CK-B levels. Our findings raise the possibility that a defective PCr metabolism in astrocytes might contribute to the degeneration of oligodendrocytes and axons in MS.
Purpose
Flow‐based arterial spin labeling (ASL) techniques provide a transit‐time insensitive alternative to the more conventional spatially selective ASL techniques. However, it is not clear which ...flow‐based ASL technique performs best and also, how these techniques perform outside the brain (taking into account eg, flow‐dynamics, field‐inhomogeneity, and organ motion). In the current study we aimed to compare 4 flow‐based ASL techniques (ie, velocity selective ASL, acceleration selective ASL, multiple velocity selective saturation ASL, and velocity selective inversion prepared ASL VSI‐ASL) to the current spatially selective reference techniques in brain (ie, pseudo‐continuous ASL pCASL) and kidney (ie, pCASL and flow alternating inversion recovery FAIR).
Methods
Brain (n = 5) and kidney (n = 6) scans were performed in healthy subjects at 3T. Perfusion‐weighted signal (PWS) maps were generated and ASL techniques were compared based on temporal SNR (tSNR), sensitivity to perfusion changes using a visual stimulus (brain) and robustness to respiratory motion by comparing scans acquired in paced‐breathing and free‐breathing (kidney).
Results
In brain, all flow‐based ASL techniques showed similar tSNR as pCASL, but only VSI‐ASL showed similar sensitivity to perfusion changes. In kidney, all flow‐based ASL techniques had comparable tSNR, although all lower than FAIR. In addition, VSI‐ASL showed a sensitivity to B1‐inhomogeneity. All ASL techniques were relatively robust to respiratory motion.
Conclusion
In both brain and kidney, flow‐based ASL techniques provide a planning‐free and transit‐time insensitive alternative to spatially selective ASL techniques. VSI‐ASL shows the most potential overall, showing similar performance as the golden standard pCASL in brain. However, in kidney, a reduction of B1‐sensitivity of VSI‐ASL is necessary to match the performance of FAIR.
Lexical semantic ambiguity is the phenomenon when a word has multiple meanings (e.g. ‘bank’). The aim of this event-related functional MRI study was to identify those brain areas, which are involved ...in contextually driven ambiguity resolution. Ambiguous words were selected which have a most frequent, dominant, and less frequent, subordinate meaning. These words were presented in two types of sentences: (1) a sentence congruent with the dominant interpretation and (2) a sentence congruent with the subordinate interpretation. Sentences without ambiguous words served as a control condition. The ambiguous words always occurred early in the sentences and were biased towards one particular meaning by the final word(s) of the sentence; the event at the end of the sentences was modeled. The results indicate that a bilaterally distributed network supports semantic ambiguity comprehension: left (BA 45/44) and right (BA 47) inferior frontal gyri and left (BA 20/37) and right inferior/middle temporal gyri (BA 20). The pattern of activation is most consistent with a scenario in which initially a frequency-based probabilistic choice is made between the alternative meanings, and the meaning is updated when this interpretation does not fit into the final disambiguating context. The neural pattern is consistent with the results of other neuroimaging experiments which manipulated various aspects of integrative and context processing task demands. The presence of a bilateral network is also in line with the lesion and divided visual field literature, but contrary to earlier claims, the two hemispheres appear to play similar roles during semantic ambiguity resolution.
The underlying pathology of lacunar infarcts, white matter lesions and also of microbleeds is poorly understood. We assessed whether the presence of lacunar infarcts, white matter lesions or ...microbleeds on MRI was associated with a decrease in cerebrovascular reactivity, and assessed whether this association was similar for lacunar infarcts, white matter lesions and microbleeds. BOLD-fMRI scan with breath-holding at 7T and anatomical scans at 1.5T were available in 49 patients with atherosclerotic disease from the Second Manifestations of ARTerial disease (SMART) study. Microbleeds and lacunar infarcts were scored visually and volumetric assessment of white matter lesions was performed on the 1.5T scan. The percentage of voxels with a significant signal change on breath-holding and the whole brain signal change were calculated as measures of cerebrovascular reactivity. The mean percentage of voxels with a significant signal change was 25.1% (SD 6.6) and the mean percentage whole brain signal change was 1.20% (SD 0.51). Age, gender, and diastolic blood pressure were significantly associated with cerebrovascular reactivity. Cerebrovascular reactivity was lower with increasing age, lower in females compared to males and lower with lower diastolic blood pressure. ANCOVA showed that patients with microbleeds (n=18) had a significantly lower whole brain signal change than patients without microbleeds, with a mean difference of −0.36% (95% CI −0.64 to 0.07), independent of age, sex, systolic and diastolic blood pressure and non-lacunar infarcts. No significant associations were found for presence of lacunar infarcts or white matter lesion volume with whole brain signal change or percentage of voxels with a significant signal change. The results show that presence of microbleeds is associated with an impaired cerebrovascular reactivity in patients with atherosclerotic disease, whereas no significant association was found for the presence of lacunar infarcts or white matter lesions in our study.
► BOLD fMRI at 7T can be used as a measure of cerebrovascular reactivity (CVR). ► CVR is lower in females, with increasing age, and lower diastolic blood pressure. ► Patients with microbleeds have impaired CVR. ► Lacunar infarcts and WML are not significantly associated with impaired CVR.
To develop technical recommendations on the acquisition and post-processing of renal longitudinal (T1) and transverse (T2) relaxation time mapping. A multidisciplinary panel consisting of 18 experts ...in the field of renal T1 and T2 mapping participated in a consensus project, which was initiated by the European Cooperation in Science and Technology Action PARENCHIMA CA16103. Consensus recommendations were formulated using a two-step modified Delphi method. The first survey consisted of 56 items on T1 mapping, of which 4 reached the pre-defined consensus threshold of 75% or higher. The second survey was expanded to include both T1 and T2 mapping, and consisted of 54 items of which 32 reached consensus. Recommendations based were formulated on hardware, patient preparation, acquisition, analysis and reporting. Consensus-based technical recommendations for renal T1 and T2 mapping were formulated. However, there was considerable lack of consensus for renal T1 and particularly renal T2 mapping, to some extent surprising considering the long history of relaxometry in MRI, highlighting key knowledge gaps that require further work. This paper should be regarded as a first step in a long-term evidence-based iterative process towards ever increasing harmonization of scan protocols across sites, to ultimately facilitate clinical implementation.
Purpose
Diffusion‐weighted (DW) MRI, showing high contrast between tumor and background tissue, is a promising technique in radiotherapy for tumor delineation. However, its use for head‐and‐neck ...patients is hampered by poor geometric accuracy in conventional echo planar imaging (EPI) DW‐MRI. An alternative turbo spin echo sequence, DW‐SPLICE, is implemented and demonstrated in patients.
Methods
The DW‐SPLICE sequence was implemented on a 3.0 T system and evaluated in 10 patients. The patients were scanned in treatment position, using a customized head support and immobilization mask. Image distortions were quantified at the gross tumor volume (GTV) using field map analysis. The apparent diffusion coefficient (ADC) was evaluated using an ice water phantom.
Results
The DW images acquired by DW‐SPLICE showed no image distortions. Field map analysis at the gross tumor volumes resulted in a median distortion of 0.2 mm for DW‐SPLICE, whereas for the conventional method this was 7.2 mm. ADC values, measured using an ice water phantom were in accordance with literature values.
Conclusions
The implementation of DW‐SPLICE allows for diffusion‐weighted imaging of patients in treatment position with excellent geometrical accuracy. The images can be used to facilitate target volume delineation in RT treatment planning.
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