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Background: The status of the hypothalamic‐pituitary‐gonadal (HPG) axis is important for assessing the onset of physiological or pathological puberty. The reference standard gonadotropin‐releasing hormone (GnRH) stimulation test requires hospital admission and repeated blood samples. A simple noninvasive method would be beneficial. Objectives: To explore a noninvasive method for evaluating HPG axis activation in children using an MRI radiomics model. Study Type: Retrospective. Population: Two hundred thirty‐nine children (83 male; 3.6–14.6 years) with hypophysial MRI and GnRH stimulation tests, randomly divided a training set (168 children) and a test set (71 children). Field Strength/Sequence: 3.0 T, 3D isotropic fast spin echo (CUBE) T1‐weighted imaging (T1WI) sequences. Assessment: Radiomics features were extracted from sagittal 3D CUBE T1WI, and imaging signatures were generated using the least absolute shrinkage and selection operator (LASSO) with 10‐fold cross‐validation. Diagnostic performance for differential diagnosis of HPG status was compared between a radiomics model and MRI features (adenohypophyseal height [aPH] and volume [aPV]). Statistical Tests: Receiver operating characteristic (ROC) and decision curve analysis (DCA). A P value <0.05 was considered statistically significant. Results: Eight hundred fifty‐one radiomics features were extracted and reduced to 10 by the LASSO method in the training cohort. The radiomics model based on CUBE T1WI showed good performance in assessment of HPG axis activation with an area under the ROC curve (AUC) of 0.81 (95% CI: 0.71, 0.91) in the test set. The AUC of the radiomics model was significantly higher than that of aPH (0.81 vs. 0.65) but there was no significant difference compared to aPV (0.81 vs. 0.78, P = 0.58). In DCA analysis, the radiomics signature showed higher net benefit over the aPV and aPH models. Data Conclusions: The MRI radiomics model has potential to assess HPG axis activation status noninvasively, potentially providing valuable information in the diagnosis of patients with pathological puberty onset. Evidence Level: 4 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Introduction: Heterogeneous MRI manifestations restrict the efficiency and consistency of neuroradiologists in diagnosing hypoxic-ischemic encephalopathy (HIE) due to complex injury patterns. This study aimed to develop and validate an intelligent HIE identification model (termed as DLCRN, deep learning clinical-radiomics nomogram) based on conventional structural MRI and clinical characteristics. Methods: In this retrospective case-control study, full-term neonates with HIE and healthy controls were collected in two different medical centers from January 2015 to December 2020. Multivariable logistic regression analysis was implemented to establish the DLCRN model based on conventional MRI sequences and clinical characteristics. Discrimination, calibration, and clinical applicability were used to evaluate the model in the training and validation cohorts. Grad-class activation map algorithm was implemented to visualize the DLCRN. Results: 186 HIE patients and 219 healthy controls were assigned to the training, internal validation, and independent validation cohorts. Birthweight was incorporated with deep radiomics signatures to create the final DLCRN model. The DLCRN model achieved better discriminatory power than simple radiomics models, with an area under the curve (AUC) of 0.868, 0.813, and 0.798 in the training, internal validation, and independent validation cohorts, respectively. The DLCRN model was well calibrated and has clinical potential. Visualization of the DLCRN highlighted the lesion areas that conformed to radiological identification. Conclusion: Visualized DLCRN may be a useful tool in the objective and quantitative identification of HIE. Scientific application of the optimized DLCRN model may save time for screening early mild HIE, improve the consistency of HIE diagnosis, and guide timely clinical management. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study is to demonstrate the value of quantitative amide proton transfer (APT) imaging for differentiating glioma grades and detecting tumor proliferation.Procedures: This study included 32 subjects with 16 low-grade gliomas (LGG) and 16 high-grade gliomas (HGG) confirmed by histopathology. Chemical exchange saturation transfer (CEST) magnetic resonance imaging with APT weighting was performed on a 3 T scanner. After B0 correction, Z-spectra were fitted with Lorentzian functions corresponding to the upfield semi-solid magnetization transfer and nuclear overhauser enhancement (MT&NOE) effect, the direct saturation (DS) effect, and the downfield APT effect centered at around - 1.5, 0, and + 3.5 ppm, respectively. To compute the Z-spectral fitted APT (fitted_APT) in solid tumor tissue, double-peak histogram fitting of pixel MT&NOE effect from the whole tumor was used to remove necrosis regions. The fitted APT was then compared with the conventional APT based on magnetization transfer ratio asymmetry. Receiver operating characteristic (ROC) analysis was used to compare the performance between Z-spectral fitted contrasts and the con_APT for LGG versus HGG differentiation. Additionally, the correlations between the imaging contrasts (fitted_APT, con_APT, and fitted_MT&NOE) and Ki-67 labeling index for tumor proliferation were also evaluated.Results: Z-spectral fitted_APT shows improved statistical power for differentiating HGG and LGG (7.58 ± 0.99 vs. 6.79 ± 1.05 %, p < 0.05) than con_APT (4.34 ± 0.95 vs. 4.05 ± 2.02 %, p > 0.05) in solid tumor tissues. Analyses of whole tumor, on the other hand, have less differentiating power for both fitted_APT (p from 0.032 to 0.08) and con_APT (p from 0.696 to 0.809). Similarly, based on ROC analyses, fitted_APT shows larger area under the curve (AUC = 0.723) than con_APT (AUC = 0.543). The combination of fitted APT, DS, and MT&NOE further improved the specificity (75 %), diagnostic accuracy (78.2 %), and area under the curve (0.758) in differentiating LGG and HGG. Consistently, fitted_APT (r = 0.451, p = 0.018) is better correlated with Ki-67 than con_APT (r = 0.331, p = 0.092).Conclusions: Fitted APT from Z-spectrum improves differentiation of low- and high-grade gliomas and better correlated with tumor proliferation than conventional APT. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the diagnostic ability of rs-DWI to detect subtle acute infarction lesion in the different regions of the brain in comparison to routine DWI and the comparison between different b-values. Method. 35 acute brain infarction patients were included. The subtle acute infarction lesions in ss-DWI and rs-DWI sequence were evaluated in 9 anatomical regions of the brain, and the ss-EPI DWI was also acquired with different b-values of 0, 1000, 2000, and 3000s/mm2. The McNemar test was performed for comparing the diagnostic ability of ss-DWI and rs-DWI and different b-values. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the whole brain and in each anatomical region were calculated. Result. A total of 406 subtle acute infarction lesions were confirmed. The ss-DWI detected 338 subtle lesions, out of which 318 were true positive and 20 were false positive lesions. The rs-DWI detected 386 subtle lesions, out of which 385 were true positive lesions and 1 was true negative lesion. Sensitivity, specificity, positive predictive value, and negative predictive value in rs-DWI were better than ss-DWI in all anatomical regions of the brain. In the comparison of different b-values, b2000 was found better among b1000, b2000, and b3000. Conclusion. The rs-DWI offers a useful alternative to routine DWI for detecting the subtle acute infarctions, especially in the regions that are susceptible to distortion as in frontal cortex. In addition, high b-value can also provide benefit by increasing diffusion weighting but further raising can deteriorate image quality as SNR is decreased. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to use DKI to detect the microstructural change of the discs in matured normal rats. Methods Total 24 normal SD rats (12 males/12 females) underwent DWI/DKI and T2 sequences with a 3T MRI scanner to get the values of ADC, FA, MD, Da, Dr, MK, Ka and Kr. The discs were categorized using a five-grade degeneration grading system in the T2-images. The height of the discs and the parameters in DWI/DKI were measured to compare between the different grades and sexes. The histological images and the images of fiber tracking were also done in the discs. Results There were 30 Grade 1 and 18 Grade 2 in the discs. Compared with Grade 1, decreased ADC, increased FA and MK values were observed in Grade 2 (P < 0.05). By the ROC analysis of grades of the discs, there was low diagnostic accuracy in ADC value, while FA and MK showed higher accuracy. In Grade 1, there were lower ADC value, lower Dr, higher MK, Ka and Kr in male's group than them in female's group. There were no differences in the parameters except the ADC value in the two sexes in Grade 2. The different microstructure of the normal discs in the male and female rats had been proved by the histological images and the images of fiber tracking. Conclusion DKI is a noninvasive and sustainable means to test the changes of intervertebral discs. The discs in Grade 2 were also found in the normal matured SD rat tails. The assessment of the grade of the discs in T2-images should be done before the experimental management. There was microstructural difference in the nucleus pulposus in the discs in Grade 1 and 2. FA and MK showed higher diagnostic accuracy. The laboratory rats should be the same sex because the microstructure of the normal discs weren't the same. [ABSTRACT FROM AUTHOR]

A high-performance imaging probe with NIR luminescence and synergistically enhanced T1−T2 relaxivity was synthesized. This nanoprobe exhibits a relatively high tumor-targeting efficacy and enables NIR optical and T1-/T2-weighted MR imaging of hepatic tumor cells in vivo. [ABSTRACT FROM AUTHOR]

In order to delineate the location of the tumor both before and during operation, we developed targeted bi-functional polymeric micelles for magnetic resonance (MR) and fluorescence imaging in liver tumors. Hydrophobic superparamagnetic iron oxide nanoparticles (SPIONs) were loaded into the polymeric micelles through self-assembly of an amphiphilic block copolymer poly(ethylene glycol)-poly(ϵ-caprolactone). After, transferrin (Tf) and near-infrared fluorescence molecule Cy5.5 were conjugated onto the surface of the polymeric micelles to obtain the nanosized probe SPIO@PEG- b-PCL-Tf/Cy5.5 (SPPTC). Imaging capabilities of this nanoprobe were evaluated both in vitro and in vivo. The accumulation of SPPTC in HepG2 cells increased over SPIO@PEG- b-PCL-Cy5.5 (SPPC) by confocal microscopy. The targeted nanoprobe SPPTC possessed favorable properties on the MR and fluorescence imaging both in vitro and in vivo. The MTT results showed that the nanoprobes were well tolerated. SPPTC had the potential for pre-operation evaluation and intra-operation navigation of tumors in clinic. [ABSTRACT FROM AUTHOR]

Objective To compare the results of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in amyotrophic lateral sclerosis (ALS) patients. Methods Nineteen ALS patients and thirteen age-matched healthy controls underwent MRS and DTI between October 2013 and July 2014. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), N-acetylaspartate (NAA), choline (Cho), and creatine (Cr) were collected as the quantitative results of the imaging study. The ALS functional rating scale-revised (ALSFRS-R) and disease progression rate were evaluated to assess patients' disability. The imaging study results were compared between ALS patients and healthy controls. The relationship between disability assessment and imaging study results was analyzed. Results NAA/Cr in the motor cortex and FA in the corticospinal tract (CST) of both sides were significantly lower in patients than controls. There was no significant difference between the two groups in Cho/Cr, tract length, tract volume, ADC or NAA. No relationship was found between ALSFRS-R and FA (r = 0.243, p = 0.316) in the right CST; NAA (r = 0.095, p = 0.699) or NAA/Cr (r = 0.172, p = 0.481) in the left motor cortex; or NAA (r = 0.320, p = 0.182) or NAA/Cr (r = 0.193, p = 0.492) in the right motor cortex. There was no relationship between the disease progression rate and FA, NAA, or NAA/Cr on either side. Conclusion NAA/Cr and FA can help diagnose ALS. Regional brain NAA/Cr and FA values could not assess the ALSFRS-R or disease progression rate. [ABSTRACT FROM AUTHOR]

Glioma is the most common primary brain tumor and causes a disproportionate level of morbidity and mortality across a wide range of individuals. From previous clinical practices, definition of glioma margin is the key point for surgical resection. In order to outline the exact margin of glioma and provide a guide effect for the physicians both at pre-surgical planning stage and surgical resection stage, pH/temperature sensitive magnetic nanogels conjugated with Cy5.5-labled lactoferrin (Cy5.5-Lf-MPNA nanogels) were developed as a promising contrast agent. Due to its pH/te mperature sensitivity, Cy5.5-Lf-MPNA nanogels could change in its hydrophilic/hydrophobic properties and size at different pH and temperatures. Under physiological conditions (pH 7.4, 37 °C), Cy5.5-Lf-MPNA nanogels were hydrophilic and swollen, which could prolong the blood circulation time. In the acidic environment of tumor tissues (pH 6.8, 37 °C), Cy5.5-Lf-MPNA nanogels became hydrophobic and shrunken, which could be more easily accumulated in tumor tissue and internalized by tumor cells. In addition, lactoferrin, an effective targeting ligand for glioma, provides active tumor targeting ability. In vivo studies on rats bearing in situ glioma indicated that the MR/fluorescence imaging with high sensitivity and specificity could be acquired using Cy5.5-Lf-MPNA nanogels due to active targeting function of the Lf and enhancement of cellular uptake by tailoring the hydrophilic/hydrophobic properties of the nanogels. With good biocompatibility shown by cytotoxicity assay and histopathological analysis, Cy5.5-Lf-MPNA nanogels are hopeful to be developed as a specific and high-sensitive contrast agent for preoperative MRI and intraoperative fluorescence imaging of glioma. [ABSTRACT FROM AUTHOR]