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To develop a magnetic resonance (MR) "fingerprinting" technique for quantitative abdominal imaging. This HIPAA-compliant study had institutional review board approval, and informed consent was obtained from all subjects. To achieve accurate quantification in the presence of marked B0 and B1 field inhomogeneities, the MR fingerprinting framework was extended by using a two-dimensional fast imaging with steady-state free precession, or FISP, acquisition and a Bloch-Siegert B1 mapping method. The accuracy of the proposed technique was validated by using agarose phantoms. Quantitative measurements were performed in eight asymptomatic subjects and in six patients with 20 focal liver lesions. A two-tailed Student t test was used to compare the T1 and T2 results in metastatic adenocarcinoma with those in surrounding liver parenchyma and healthy subjects. Phantom experiments showed good agreement with standard methods in T1 and T2 after B1 correction. In vivo studies demonstrated that quantitative T1, T2, and B1 maps can be acquired within a breath hold of approximately 19 seconds. T1 and T2 measurements were compatible with those in the literature. Representative values included the following: liver, 745 msec ± 65 (standard deviation) and 31 msec ± 6; renal medulla, 1702 msec ± 205 and 60 msec ± 21; renal cortex, 1314 msec ± 77 and 47 msec ± 10; spleen, 1232 msec ± 92 and 60 msec ± 19; skeletal muscle, 1100 msec ± 59 and 44 msec ± 9; and fat, 253 msec ± 42 and 77 msec ± 16, respectively. T1 and T2 in metastatic adenocarcinoma were 1673 msec ± 331 and 43 msec ± 13, respectively, significantly different from surrounding liver parenchyma relaxation times of 840 msec ± 113 and 28 msec ± 3 (P < .0001 and P < .01) and those in hepatic parenchyma in healthy volunteers (745 msec ± 65 and 31 msec ± 6, P < .0001 and P = .021, respectively). A rapid technique for quantitative abdominal imaging was developed that allows simultaneous quantification of multiple tissue
Computed tomography, which uses ionizing radiation and expensive software packages for analysis of scans, can be used to quantify abdominal fat. The objective of this study is to measure abdominal fat with 3T MRI using free software for image analysis and to correlate these findings with anthropometric and laboratory parameters in adolescents. This prospective observational study included 24 overweight/obese and 33 healthy adolescents (mean age 16.55 years). All participants underwent abdominal MRI exams. Visceral and subcutaneous fat area and percentage were correlated with anthropometric parameters, lipid profile, glucose metabolism, and insulin resistance. Student's t test and Mann-Whitney's test was applied. Pearson's chi-square test was used to compare proportions. To determine associations Pearson's linear correlation or Spearman's correlation were used. In both groups, waist circumference (WC) was associated with visceral fat area (P = 0.001 and P = 0.01 respectively), and triglycerides were associated with fat percentage (P = 0.046 and P = 0.071 respectively). In obese individuals, total cholesterol/HDL ratio was associated with visceral fat area (P = 0.03) and percentage (P = 0.09), and insulin and HOMA-IR were associated with visceral fat area (P = 0.001) and percentage (P = 0.005). 3T MRI can provide reliable and good quality images for quantification of visceral and subcutaneous fat by using a free software package. The results demonstrate that WC is a good predictor of visceral fat in obese adolescents and visceral fat area is associated with total cholesterol/HDL ratio, insulin and HOMA-IR.
Ultrasound is increasingly becoming a 3D modality. Mechanical and matrix array transducers are able to deliver 3D images with good spatial and temporal resolution. The 3D imaging facilitates the application of automated image analysis to enhance workflows, which has the potential to make ultrasound a less operator dependent modality. However, the analysis of the more complex 3D images and definition of all examination standards on 2D images pose barriers to the use of 3D in daily clinical practice. In this paper, we address a part of the canonical fetal screening program, namely the localization of the abdominal cross-sectional plane with the corresponding measurement of the abdominal circumference in this plane. For this purpose, a fully automated pipeline has been designed starting with a random forest based anatomical landmark detection. A feature trained shape model of the fetal torso including inner organs with the abdominal cross-sectional plane encoded into the model is then transformed into the patient space using the landmark localizations. In a free-form deformation step, the model is individualized to the image, using a torso probability map generated by a convolutional neural network as an additional feature image. After adaptation, the abdominal plane and the abdominal torso contour in that plane are directly obtained. This allows the measurement of the abdominal circumference as well as the rendering of the plane for visual assessment. The method has been trained on 126 and evaluated on 42 abdominal 3D US datasets. An average plane offset error of 5.8 mm and an average relative circumference error of 4.9 % in the evaluation set could be achieved.
Free-breathing abdomen imaging requires non-rigid motion registration of unavoidable respiratory motion in three-dimensional undersampled data sets. In this work, we introduce an image registration method based on the convolutional neural network (CNN) to obtain motion-free abdominal images throughout the respiratory cycle. Abdominal data were acquired from 10 volunteers using a 1.5 T MRI system. The respiratory signal was extracted from the central-space spokes, and the acquired data were reordered in three bins according to the corresponding breathing signal. Retrospective image reconstruction of the three near-motion free respiratory phases was performed using non-Cartesian iterative SENSE reconstruction. Then, we trained a CNN to analyse the spatial transform among the different bins. This network could generate the displacement vector field and be applied to perform registration on unseen image pairs. To demonstrate the feasibility of this registration method, we compared the performance of three different registration approaches for accurate image fusion of three bins: non-motion corrected (NMC), local affine registration method (LREG) and CNN. Visualization of coronal images indicated that LREG had caused broken blood vessels, while the vessels of the CNN were sharper and more consecutive. As shown in the sagittal view, compared to NMC and CNN, distorted and blurred liver contours were caused by LREG. At the same time, zoom-in axial images presented that the vessels were delineated more clearly by CNN than LREG. The statistical results of the signal-to-noise ratio, visual score, vessel sharpness and registration time over all volunteers were compared among the NMC, LREG and CNN approaches. The SNR indicated that the CNN acquired the best image quality (207.42 ± 96.73), which was better than NMC (116.67 ± 44.70) and LREG (187.93 ± 96.68). The image visual score agreed with SNR, marking CNN (3.85 ± 0.12) as the best, followed by LREG (3.43 ± 0
Diffusion-weighted (DW) imaging is an emerging technique in body imaging that provides indirect information about the microenvironment of tissues and lesions and helps detect, characterize, and follow up abnormalities. Two main challenges in the application of DW imaging to body imaging are the decreased signal-to-noise ratio of body tissues compared with neuronal tissues due to their shorter T2 relaxation time, and image degradation related to physiologic motion (eg, respiratory motion). Use of smaller b values and newer motion compensation techniques allow the evaluation of anatomic structures with DW imaging. DW imaging can be performed as a breath-hold sequence or a free-breathing sequence with or without respiratory triggering. Depending on the mobility of water molecules in their microenvironment, different normal tissues have different signals at DW imaging. Some normal tissues (eg, lymph nodes, spleen, ovarian and testicular parenchyma) are diffusion restricted, whereas others (eg, gallbladder, corpora cavernosa, endometrium, cartilage) show T2 shine-through. Epiphyses that contain fatty marrow and bone cortex appear dark on both DW images and apparent diffusion coefficient maps. Current and emerging applications of DW imaging in pediatric body imaging include tumor detection and characterization, assessment of therapy response and monitoring of tumors, noninvasive detection and grading of liver fibrosis and cirrhosis, detection of abscesses, and evaluation of inflammatory bowel disease. RSNA, 2014
Abdominal Non-Hodgkin lymphomas (NHL) are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI), Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15). Thirty patients (86%) presented with abdominal pain, 23 patients (66%) presented with abdominal mass and distention, 13 patients (34%) presented with weight loss, and intestinal obstruction occurred in six patients (17%). The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively). Burkitt's lymphoma was the most common histological type in 29 patients (83%). Ten (28.5%) stage II (group A) and 25 (71.5%) stage III (group B). Complete resections were performed in 10 (28.5%), debulking in 6 (17%) and imaging guided biopsy in 19 (54%). A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months). The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL. PMID:24212775 2b1af7f3a8