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Register a new userDiffusion-Weighted MR imaging: Clinical applications of kurtosis analysis to prostate cancer
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Magnetic resonance imaging technique known as DWI (diffusion-weighted imaging) allows measurement of water diffusivity on a pixel basis for evaluating pathology throughout the body and is now routinely incorporated into many body MRI protocols, mainly in oncology. Indeed water molecules motion reflects the interactions with other molecules, membranes, cells, and in general the interactions with the environment. Microstructural changes as e.g. cellular organization and/or integrity then affect the motion of water molecules, and consequently alter the water diffusion properties measured by DWI. Then DWI technique can be used to extract information about tissue organization at the cellular level indirectly from water motion. In general the signal intensity in DWI can be quantified by using a parameter known as ADC (Apparent Diffusion Coefficient) emphasizing that it is not the real diffusion coefficient, which is a measure of the average water molecular motion. In the simplest models, the distribu- tion of a water molecule diffusing in a certain period of time is considered to have a Gaussian form with its width proportional to the ADC. However, water in biological structures often displays non-Gaussian diffusion behavior, consequently the DWI signal shows a more complex behavior that need to be modeled following different approaches. In this work we explore the possibility to quantify the degree to which water diffusion in biologic tissues is non-Gaussian introducing the AKC parameter (Apparent Kurtosis Coefficient). In this work we have realized DWI non-Gaussian diffusion maps to be used in the clinical routine along with standard ADC maps, giving to the radiologist another tool to explore how much structure inside a voxel is organized. In particular in this work some prostate DWI examples have been analyzed and will be shown.
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Prostate cancer (PCa) is the second most common cancer in men worldwide and the most frequently diagnosed cancer among men in more developed countries. The prognosis of PCa is excellent if detected at an early stage, making early screening crucial for detection and treatment. In recent years, a new form of diffusion magnetic resonance imaging called correlated diffusion imaging (CDI) was introduced, and preliminary results show promise as a screening tool for PCa. In the largest study of its kind, we investigate the relationship between PCa presence and a new variant of CDI we term synthetic correlated diffusion imaging (CDI$^s$), as well as its performance for PCa delineation compared to current standard MRI techniques (T2-weighted (T2w) imaging, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging) across a cohort of 200 patient cases. Statistical analyses reveal that hyperintensity in CDI$^s$ is a strong indicator of PCa presence and achieves strong delineation of clinically significant cancerous tissue compared to T2w, DWI, and DCE. These results suggest that CDI$^s$ hyperintensity may be a powerful biomarker for the presence of PCa, and may have a clinical impact as a diagnostic aid for improving PCa screening.
In this work, we introduce a novel computational framework that we developed to use numerical simulations to investigate the complexity of brain tissue at a microscopic level with a detail never realised before. Directly inspired by the advances in computational neuroscience for modelling brain cells, we propose a generative model that enables us to simulate molecular diffusion within realistic digitalised brain cells, such as neurons and glia, in a completely controlled and flexible fashion. We validate our new approach by showing an excellent match between the morphology and simulated DW-MR signal of the generated digital model of brain cells and those of digital reconstruction of real brain cells from available open-access databases. We demonstrate the versatility and potentiality of the framework by showing a select set of examples of relevance for the DW-MR community. Further development is ongoing, which will support even more realistic conditions like dense packing of numerous 3D complex cell structures and varying cell surface permeability.
Prostate cancer is the most common disease in men and the second leading cause of death from cancer. Generic large imaging instruments used in cancer diagnosis have sensitivity, spatial resolution, and contrast inadequate for the task of imaging details of a small organ such as the prostate. In addition, multimodality imaging can play a significant role merging anatomical and functional details coming from simultaneous PET and MRI. Indeed, multi-parametric PET/MRI was demonstrated to improve diagnosis, but it suffers from too many false positives. In order to address the above limits of the current techniques, we have proposed, built and tested, thanks to the TOPEM project funded by Italian National Institute of Nuclear Phisics a prototype of an endorectal PET-TOF/MRI probe. In the applied magnification PET geometry, performance is dominated by a high-resolution detector placed closer to the source. The expected spatial resolution in the selected geometry is about 1.5 mm FWHM and efficiency a factor of 2 with respect to what obtained with the conventional PET scanner. In our experimental studies, we have obtained timing resolution of ~ 320 ps FWHM and at the same time Depth of Interaction (DOI) resolution of under 1 mm. Tests also showed that mutual adverse PET-MR effects are minimal. In addition, the matching endorectal RF coil was designed, built and tested. In the next planned studies, we expect that benefiting from the further progress in scintillator crystal surface treatment, in SiPM technology and associated electronics would allow us to significantly improve TOF resolution
Data augmentation refers to a group of techniques whose goal is to battle limited amount of available data to improve model generalization and push sample distribution toward the true distribution. While different augmentation strategies and their combinations have been investigated for various computer vision tasks in the context of deep learning, a specific work in the domain of medical imaging is rare and to the best of our knowledge, there has been no dedicated work on exploring the effects of various augmentation methods on the performance of deep learning models in prostate cancer detection. In this work, we have statically applied five most frequently used augmentation techniques (random rotation, horizontal flip, vertical flip, random crop, and translation) to prostate Diffusion-weighted Magnetic Resonance Imaging training dataset of 217 patients separately and evaluated the effect of each method on the accuracy of prostate cancer detection. The augmentation algorithms were applied independently to each data channel and a shallow as well as a deep Convolutional Neural Network (CNN) were trained on the five augmented sets separately. We used Area Under Receiver Operating Characteristic (ROC) curve (AUC) to evaluate the performance of the trained CNNs on a separate test set of 95 patients, using a validation set of 102 patients for finetuning. The shallow network outperformed the deep network with the best 2D slice-based AUC of 0.85 obtained by the rotation method.
In this work, we propose a free-breathing magnetic resonance fingerprinting method that can be used to obtain $B_1^+$-robust quantitative maps of the abdomen in a clinically acceptable time. A three-dimensional MR fingerprinting sequence with a radial stack-of-stars trajectory was implemented for quantitative abdominal imaging. The k-space acquisition ordering was adjusted to improve motion-robustness. The flip angle pattern was optimized using the Cramer-Rao Lower Bound, and the encoding efficiency of sequences with 300, 600, 900, and 1800 flip angles was evaluated. To validate the sequence, a movable multicompartment phantom was developed. Reference multiparametric maps were acquired under stationary conditions using a previously validated MRF method. Periodic motion of the phantom was used to investigate the motion-robustness of the proposed sequence. The best performing sequence length (600 flip angles) was used to image the abdomen during a free-breathing volunteer scan. When using a series of 600 or more flip angles, the estimated $T_1$ values in the stationary phantom showed good agreement with the reference scan. Phantom experiments revealed that motion-related artefacts can appear in the quantitative maps, and confirmed that a motion-robust k-space ordering is essential in preventing these artefacts. The in vivo scan demonstrated that the proposed sequence can produce clean parameter maps while the subject breathes freely. Using this sequence, it is possible to generate $B_1^+$-robust quantitative maps of proton density, $T_1$, and $B_1^+$ under free-breathing conditions at a clinically usable resolution within 5 minutes.
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