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Item Alzheimer disease brain atrophy subtypes are associated with cognition and rate of decline(American Academy of Neurology, 2017-11-21) Risacher, Shannon L.; Anderson, Wesley H.; Charil, Arnaud; Castelluccio, Peter F.; Shcherbinin, Sergey; Saykin, Andrew J.; Schwarz, Adam J.; Radiology and Imaging Sciences, School of MedicineOBJECTIVE: To test the hypothesis that cortical and hippocampal volumes, measured in vivo from volumetric MRI (vMRI) scans, could be used to identify variant subtypes of Alzheimer disease (AD) and to prospectively predict the rate of clinical decline. METHODS: Amyloid-positive participants with AD from the Alzheimer's Disease Neuroimaging Initiative (ADNI) 1 and ADNI2 with baseline MRI scans (n = 229) and 2-year clinical follow-up (n = 100) were included. AD subtypes (hippocampal sparing [HpSpMRI], limbic predominant [LPMRI], typical AD [tADMRI]) were defined according to an algorithm analogous to one recently proposed for tau neuropathology. Relationships between baseline hippocampal volume to cortical volume ratio (HV:CTV) and clinical variables were examined by both continuous regression and categorical models. RESULTS: When participants were divided categorically, the HpSpMRI group showed significantly more AD-like hypometabolism on 18F-fluorodeoxyglucose-PET (p < 0.05) and poorer baseline executive function (p < 0.001). Other baseline clinical measures did not differ across the 3 groups. Participants with HpSpMRI also showed faster subsequent clinical decline than participants with LPMRI on the Alzheimer's Disease Assessment Scale, 13-Item Subscale (ADAS-Cog13), Mini-Mental State Examination (MMSE), and Functional Assessment Questionnaire (all p < 0.05) and tADMRI on the MMSE and Clinical Dementia Rating Sum of Boxes (CDR-SB) (both p < 0.05). Finally, a larger HV:CTV was associated with poorer baseline executive function and a faster slope of decline in CDR-SB, MMSE, and ADAS-Cog13 score (p < 0.05). These associations were driven mostly by the amount of cortical rather than hippocampal atrophy. CONCLUSIONS: AD subtypes with phenotypes consistent with those observed with tau neuropathology can be identified in vivo with vMRI. An increased HV:CTV ratio was predictive of faster clinical decline in participants with AD who were clinically indistinguishable at baseline except for a greater dysexecutive presentation.Item Apolipoprotein ε4 Is Associated with Lower Brain Volume in Cognitively Normal Chinese but Not White Older Adults(PLoS, 2016-06-17) Yokoyama, Jennifer S.; Lee, Allen K.L.; Takada, Leonel T.; Busovaca, Edgar; Bonham, Luke W.; Chao, Steven Z.; Tse, Marian; He, Jing; Schwarz, Christopher G.; Carmichael, Owen T.; Matthews, Brandy R.; Karydas, Anna; Weiner, Michael W.; Coppola, Giovanni; DeCarli, Charles S.; Miller, Bruce L.; Rosen, Howard J.; Department of Neurology, IU School of MedicineStudying ethnically diverse groups is important for furthering our understanding of biological mechanisms of disease that may vary across human populations. The ε4 allele of apolipoprotein E (APOE ε4) is a well-established risk factor for Alzheimer's disease (AD), and may confer anatomic and functional effects years before clinical signs of cognitive decline are observed. The allele frequency of APOE ε4 varies both across and within populations, and the size of the effect it confers for dementia risk may be affected by other factors. Our objective was to investigate the role APOE ε4 plays in moderating brain volume in cognitively normal Chinese older adults, compared to older white Americans. We hypothesized that carrying APOE ε4 would be associated with reduced brain volume and that the magnitude of this effect would be different between ethnic groups. We performed whole brain analysis of structural MRIs from Chinese living in America (n = 41) and Shanghai (n = 30) and compared them to white Americans (n = 71). We found a significant interaction effect of carrying APOE ε4 and being Chinese. The APOE ε4xChinese interaction was associated with lower volume in bilateral cuneus and left middle frontal gyrus (Puncorrected<0.001), with suggestive findings in right entorhinal cortex and left hippocampus (Puncorrected<0.01), all regions that are associated with neurodegeneration in AD. After correction for multiple testing, the left cuneus remained significantly associated with the interaction effect (PFWE = 0.05). Our study suggests there is a differential effect of APOE ε4 on brain volume in Chinese versus white cognitively normal elderly adults. This represents a novel finding that, if verified in larger studies, has implications for how biological, environmental and/or lifestyle factors may modify APOE ε4 effects on the brain in diverse populations.Item Artificial Intelligence for Contrast-Free MRI: Scar Assessment in Myocardial Infarction Using Deep Learning-Based Virtual Native Enhancement(American Heart Association, 2022-11-15) Zhang, Qiang; Burrage, Matthew K.; Shanmuganathan, Mayooran; Gonzales, Ricardo A.; Lukaschuk, Elena; Thomas, Katharine E.; Mills, Rebecca; Pelado, Joana Leal; Nikolaidou, Chrysovalantou; Popescu, Iulia A.; Lee, Yung P.; Zhang, Xinheng; Dharmakumar, Rohan; Myerson, Saul G.; Rider, Oliver; Oxford Acute Myocardial Infarction (OxAMI) Study; Channon, Keith M.; Neubauer, Stefan; Piechnik, Stefan K.; Ferreira, Vanessa M.; Medicine, School of MedicineBackground: Myocardial scar is currently assessed non-invasively using cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) as an imaging gold-standard. However, a contrast-free approach would provide many advantages, including a faster and cheaper scan, without contrast-associated problems. Methods: Virtual Native Enhancement (VNE) is a novel technology that can produce virtual LGE-like images, without the need for contrast. VNE combines cine imaging and native T1-maps to produce LGE-like images using artificial intelligence (AI). VNE was developed for patients with prior myocardial infarction on 4271 datasets (912 patients), where each dataset is comprised of slice position-matched cine, T1-maps and LGE images. After quality control, 3002 datasets (775 patients) were used for development, and 291 datasets (68 patients) for testing. The VNE generator was trained using generative adversarial networks, employing two adversarial discriminators to improve the image quality. The left ventricle was contoured semi-automatically. Myocardial scar volume was quantified using the full width at half maximum method. Scar transmurality was measured using the centerline chord method and visualized on bull’s eye plots. Lesion quantification by VNE and LGE were compared using linear regression, Pearson correlation (R) and intraclass correlation coefficients (ICC). Proof-of-principle histopathological comparison of VNE in a porcine model of myocardial infarction was also performed. Results: VNE provided significantly better image quality than LGE on blinded analysis by 5 independent operators on 291 datasets (all p<0.001). VNE correlated strongly with LGE in quantifying scar size (R=0.89, ICC=0.94) and transmurality (R=0.84, ICC=0.90) in 66 patients (277 test datasets). Two CMR experts reviewed all test image slices and reported an overall accuracy of 84% of VNE in detecting scar when compared with LGE, with specificity of 100% and sensitivity of 77%. VNE also showed excellent visuospatial agreement with histopathology in 2 cases of a porcine model of myocardial infarction. Conclusions: VNE demonstrated high agreement with LGE-CMR for myocardial scar assessment in patients with prior myocardial infarction in visuospatial distribution and lesion quantification, with superior image quality. VNE is a potentially transformative AI-based technology, with promise to reduce scan times and costs, increase clinical throughput, and improve the accessibility of CMR in the very-near future.Item Association of MRI T1 relaxation time with neuropsychological test performance in manganese- exposed welders(Elsevier, 2018-01) Bowler, R.M.; Yeh, C-L.; Adams, S.W.; Ward, E.J.; Ma, R.; Dharmadhikari, S.; Snyder, S.A.; Zauber, E.; Wright, C.W.; Dydak, U.; Neurology, School of MedicineThis study examines the results of neuropsychological testing of 26 active welders and 17 similar controls and their relationship to welders' shortened MRI T1 relaxation time, indicative of increased brain manganese (Mn) accumulation. Welders were exposed to Mn for an average duration of 12.25 years to average levels of Mn in air of 0.11±0.05mg/m3. Welders scored significantly worse than controls on Fruit Naming and the Parallel Lines test of graphomotor tremor. Welders had shorter MRI T1 relaxation times than controls in the globus pallidus, substantia nigra, caudate nucleus, and the anterior prefrontal lobe. 63% of the variation in MRI T1 relaxation times was accounted for by exposure group. In welders, lower relaxation times in the caudate nucleus and substantia nigra were associated with lower neuropsychological test performance on tests of verbal fluency (Fruit Naming), verbal learning, memory, and perseveration (WHO-UCLA AVLT). Results indicate that verbal function may be one of the first cognitive domains affected by brain Mn deposition in welders as reflected by MRI T1 relaxation times.Item Central nervous system cryptococcosis: parenchymal calcification and large gelatinous pseudocysts(American Society of Neuroradiology, 1997-01) Caldemeyer, Karen S.; Mathews, Vincent P.; Edwards-Brown, Mary K.; Smith, Richard R.; Radiology and Imaging Sciences, School of MedicineIn an 11-year-old immunocompetent girl with protracted cryptococcal infection of the central nervous system, CT showed multiple areas of parenchymal calcification. MR imaging showed large gelatinous pseudocysts around the brain stem. These imaging features and the child's age are unusual for intracranial cryptococcosis.Item Cerebral Perfusion and Gray Matter Changes Associated With Chemotherapy-Induced Peripheral Neuropathy(American Society of Clinical Oncology, 2016-03-01) Nudelman, Kelly N.H.; McDonald, Brenna C.; Wang, Yang; Smith, Dori J.; West, John D.; O'Neill, Darren P.; Zanville, Noah R.; Champion, Victoria L.; Schneider, Bryan P.; Saykin, Andrew J.; IU School of NursingPURPOSE: To investigate the longitudinal relationship between chemotherapy-induced peripheral neuropathy (CIPN) symptoms (sx) and brain perfusion changes in patients with breast cancer. Interaction of CIPN-sx perfusion effects with known chemotherapy-associated gray matter density decrease was also assessed to elucidate the relationship between CIPN and previously reported cancer treatment-related brain structural changes. METHODS: Patients with breast cancer treated with (n = 24) or without (n = 23) chemotherapy underwent clinical examination and brain magnetic resonance imaging at the following three time points: before treatment (baseline), 1 month after treatment completion, and 1 year after the 1-month assessment. CIPN-sx were evaluated with the self-reported Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity four-item sensory-specific scale. Perfusion and gray matter density were assessed using voxel-based pulsed arterial spin labeling and morphometric analyses and tested for association with CIPN-sx in the patients who received chemotherapy. RESULTS: Patients who received chemotherapy reported significantly increased CIPN-sx from baseline to 1 month, with partial recovery by 1 year (P < .001). CIPN-sx increase from baseline to 1 month was significantly greater for patients who received chemotherapy compared with those who did not (P = .001). At 1 month, neuroimaging showed that for the group that received chemotherapy, CIPN-sx were positively associated with cerebral perfusion in the right superior frontal gyrus and cingulate gyrus, regions associated with pain processing (P < .001). Longitudinal magnetic resonance imaging analysis in the group receiving chemotherapy indicated that CIPN-sx and associated perfusion changes from baseline to 1 month were also positively correlated with gray matter density change (P < .005). CONCLUSION: Peripheral neuropathy symptoms after systemic chemotherapy for breast cancer are associated with changes in cerebral perfusion and gray matter. The specific mechanisms warrant further investigation given the potential diagnostic and therapeutic implications.Item Choroid plexus infections: neuroimaging appearances of four cases(American Society of Neuroradiology, 1992) Mathews, Vincent P.; Smith, Richard R.; Radiology and Imaging Sciences, School of MedicineItem Data of NODDI diffusion metrics in the brain and computer simulation of hybrid diffusion imaging (HYDI) acquisition scheme(Elsevier, 2016-06) Kodiweera, Chandana; Wu, Yu-Chien; Department of Radiology and Imaging Sciences, IU School of MedicineThis article provides NODDI diffusion metrics in the brains of 52 healthy participants and computer simulation data to support compatibility of hybrid diffusion imaging (HYDI), "Hybrid diffusion imaging"[1] acquisition scheme in fitting neurite orientation dispersion and density imaging (NODDI) model, "NODDI: practical in vivo neurite orientation dispersion and density imaging of the human brain"[2]. HYDI is an extremely versatile diffusion magnetic resonance imaging (dMRI) technique that enables various analyzes methods using a single diffusion dataset. One of the diffusion data analysis methods is the NODDI computation, which models the brain tissue with three compartments: fast isotropic diffusion (e.g., cerebrospinal fluid), anisotropic hindered diffusion (e.g., extracellular space), and anisotropic restricted diffusion (e.g., intracellular space). The NODDI model produces microstructural metrics in the developing brain, aging brain or human brain with neurologic disorders. The first dataset provided here are the means and standard deviations of NODDI metrics in 48 white matter region-of-interest (ROI) averaging across 52 healthy participants. The second dataset provided here is the computer simulation with initial conditions guided by the first dataset as inputs and gold standard for model fitting. The computer simulation data provide a direct comparison of NODDI indices computed from the HYDI acquisition [1] to the NODDI indices computed from the originally proposed acquisition [2]. These data are related to the accompanying research article "Age Effects and Sex Differences in Human Brain White Matter of Young to Middle-Aged Adults: A DTI, NODDI, and q-Space Study" [3].Item Diagnostic and Imaging Approaches to Chest Wall Lesions(RSNA, 2022-03) Mansour, Joseph; Raptis, Demetrios; Bhalla, Sanjeev; Heeger, Allen P.; Abbott, Gerald F.; Parkar, Nadeem; Hammer, Mark M.; Kiernan, Julia; Raptis, Constantine; Radiology and Imaging Sciences, School of MedicineChest wall lesions are relatively uncommon and may be challenging once they are encountered on images. Radiologists may detect these lesions incidentally at examinations performed for other indications, or they may be asked specifically to evaluate a suspicious lesion. While many chest wall lesions have characteristic imaging findings that can result in an accurate diagnosis with use of imaging alone, other entities are difficult to distinguish at imaging because there is significant overlap among them. The interpreting radiologist should be familiar with the imaging features of both "do not touch" benign entities (which can be confidently diagnosed with imaging only, with no need for biopsy or resection unless the patient is symptomatic) and lesions that cannot be confidently characterized and thus require further workup. CT and MRI are the main imaging modalities used to assess the chest wall, with each having different benefits and drawbacks. Chest wall lesions can be classified according to their predominant composition: fat, calcification and ossification, soft tissue, or fluid. The identification or predominance of signal intensities or attenuation for these findings, along with the patient age, clinical history, and lesion location, can help establish the appropriate differential diagnosis. In addition, imaging findings in other organs, such as the lungs or upper abdomen, can at times provide clues to the underlying diagnosis. The authors review different chest wall lesions classified on the basis of their composition and highlight the imaging findings that can assist the radiologist in narrowing the differential diagnosis and guiding management.Item Diffusion-Weighted Imaging of White Matter Abnormalities in Patients with Phenylketonuria(American Society of Neuroradiology, 2001-09) Phillips, Micheal D.; McGraw, Peter; Lowe, Mark J.; Mathews, Vincent P.; Hainline, Bryan E.; Radiology and Imaging Sciences, School of MedicinePhenylketonuria (PKU) is an autosomal recessive disorder caused by a deficiency of the enzyme phenylalanine hydroxylase (EC 1.14.16.1). Affected patients develop elevated plasma and tissue levels of phenylalanine and its related ketoacids. Untreated patients usually exhibit severe mental retardation and poor motor function, with characteristic T2 white matter signal abnormalities on conventional MR images. In the present study, we performed diffusion-weighted imaging in three PKU patients. All three patients demonstrated significantly restricted diffusion in all white matter areas examined.