Improved targeting of the globus pallidus interna using quantitative susceptibility mapping prior to MR-guided focused ultrasound ablation in Parkinson's disease
Magnetic resonance guided focused ultrasound (MRgFUS) of the globus pallidus interna (GPi) has shown promise in the treatment of drug-resistant Parkinson's disease, though direct visualization of the GPi remains challenging with MRI. The purpose of this study was to compare various preoperative...
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| Veröffentlicht in: | Clinical imaging 2020-12, Vol.68, p.94-98 |
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| creator | Ebani, Edward J. Kaplitt, Michael G. Wang, Yi Nguyen, Thanh D. Askin, Gulce Chazen, J. Levi |
| description | Magnetic resonance guided focused ultrasound (MRgFUS) of the globus pallidus interna (GPi) has shown promise in the treatment of drug-resistant Parkinson's disease, though direct visualization of the GPi remains challenging with MRI. The purpose of this study was to compare various preoperative MR imaging techniques and to evaluate the utility of quantitative susceptibility imaging (QSM) in the depiction of the GPi prior to MRgFUS ablation.
Six patients with medication refractory advanced idiopathic Parkinson's disease were referred for preoperative MR imaging prior to MRgFUS pallidotomy. Axial T1WI and T2WI, Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR), and QSM sequences were acquired. DTI tractography was performed to delineate the corticospinal tracts. Qualitative visualization scores and contrast to noise ratios (CNR) were recorded and measured on all images.
QSM had significantly higher median qualitative visualization scores (3.00) compared with the T1WI (1.00), T2WI (1.50), and FGATIR sequences (1.50) (p |
| doi_str_mv | 10.1016/j.clinimag.2020.06.017 |
| format | Article |
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Six patients with medication refractory advanced idiopathic Parkinson's disease were referred for preoperative MR imaging prior to MRgFUS pallidotomy. Axial T1WI and T2WI, Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR), and QSM sequences were acquired. DTI tractography was performed to delineate the corticospinal tracts. Qualitative visualization scores and contrast to noise ratios (CNR) were recorded and measured on all images.
QSM had significantly higher median qualitative visualization scores (3.00) compared with the T1WI (1.00), T2WI (1.50), and FGATIR sequences (1.50) (p < 0.05). QSM provided superior CNR for GPi depiction in each category (GPi-GPe and GPi-IC), respectively. For GPi-GPe, median CNR for T1WI, T2WI, FGATIR, and QSM was 1.13, 1.68, 0.79, and 10.78. For GPi-IC, median CNR for T1WI, T2WI, FGATIR, and QSM was 1.48, 4.63, 4.24, and 40.26, respectively (p < 0.05).
QSM offers improved visualization of the GPi compared with the traditional and currently recommended MR sequences prior to MRgFUS ablation in patients with Parkinson's disease. These results suggest that QSM should be considered as part of all preoperative imaging protocols prior to MRgFUS pallidotomy.
•QSM can provide increased contrast and conspicuity of the GPi and its borders relative to standard MRI sequences that are currently recommended•Delineation of the GPi borders is critical to a safe and successful ablation for patients with Parkinson disease</description><identifier>ISSN: 0899-7071</identifier><identifier>EISSN: 1873-4499</identifier><identifier>DOI: 10.1016/j.clinimag.2020.06.017</identifier><language>eng</language><publisher>Philadelphia: Elsevier Inc</publisher><subject>Ablation ; Ablative materials ; Clinical trials ; Deep brain stimulation ; Drug resistance ; General anesthesia ; Globus pallidus ; Globus Pallidus Interna ; Image contrast ; Imaging techniques ; Magnetic permeability ; Magnetic resonance guided focused ultrasound ; Magnetic resonance imaging ; Medical imaging ; Medical treatment ; Movement disorders ; Neurodegenerative diseases ; Pallidotomy ; Parkinson's disease ; Patients ; Pyramidal tracts ; Quantitative susceptibility mapping ; Software ; Substantia grisea ; Tremor (Muscular contraction) ; Ultrasonic imaging ; Ultrasound ; Visualization</subject><ispartof>Clinical imaging, 2020-12, Vol.68, p.94-98</ispartof><rights>2020</rights><rights>Copyright Elsevier Limited Dec 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-1fd0cdb37d4d21eee98f327b964b1c90d31a260c4d77104bf7b03aa4bf5117243</citedby><cites>FETCH-LOGICAL-c373t-1fd0cdb37d4d21eee98f327b964b1c90d31a260c4d77104bf7b03aa4bf5117243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clinimag.2020.06.017$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids></links><search><creatorcontrib>Ebani, Edward J.</creatorcontrib><creatorcontrib>Kaplitt, Michael G.</creatorcontrib><creatorcontrib>Wang, Yi</creatorcontrib><creatorcontrib>Nguyen, Thanh D.</creatorcontrib><creatorcontrib>Askin, Gulce</creatorcontrib><creatorcontrib>Chazen, J. Levi</creatorcontrib><title>Improved targeting of the globus pallidus interna using quantitative susceptibility mapping prior to MR-guided focused ultrasound ablation in Parkinson's disease</title><title>Clinical imaging</title><description>Magnetic resonance guided focused ultrasound (MRgFUS) of the globus pallidus interna (GPi) has shown promise in the treatment of drug-resistant Parkinson's disease, though direct visualization of the GPi remains challenging with MRI. The purpose of this study was to compare various preoperative MR imaging techniques and to evaluate the utility of quantitative susceptibility imaging (QSM) in the depiction of the GPi prior to MRgFUS ablation.
Six patients with medication refractory advanced idiopathic Parkinson's disease were referred for preoperative MR imaging prior to MRgFUS pallidotomy. Axial T1WI and T2WI, Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR), and QSM sequences were acquired. DTI tractography was performed to delineate the corticospinal tracts. Qualitative visualization scores and contrast to noise ratios (CNR) were recorded and measured on all images.
QSM had significantly higher median qualitative visualization scores (3.00) compared with the T1WI (1.00), T2WI (1.50), and FGATIR sequences (1.50) (p < 0.05). QSM provided superior CNR for GPi depiction in each category (GPi-GPe and GPi-IC), respectively. For GPi-GPe, median CNR for T1WI, T2WI, FGATIR, and QSM was 1.13, 1.68, 0.79, and 10.78. For GPi-IC, median CNR for T1WI, T2WI, FGATIR, and QSM was 1.48, 4.63, 4.24, and 40.26, respectively (p < 0.05).
QSM offers improved visualization of the GPi compared with the traditional and currently recommended MR sequences prior to MRgFUS ablation in patients with Parkinson's disease. These results suggest that QSM should be considered as part of all preoperative imaging protocols prior to MRgFUS pallidotomy.
•QSM can provide increased contrast and conspicuity of the GPi and its borders relative to standard MRI sequences that are currently recommended•Delineation of the GPi borders is critical to a safe and successful ablation for patients with Parkinson disease</description><subject>Ablation</subject><subject>Ablative materials</subject><subject>Clinical trials</subject><subject>Deep brain stimulation</subject><subject>Drug resistance</subject><subject>General anesthesia</subject><subject>Globus pallidus</subject><subject>Globus Pallidus Interna</subject><subject>Image contrast</subject><subject>Imaging techniques</subject><subject>Magnetic permeability</subject><subject>Magnetic resonance guided focused ultrasound</subject><subject>Magnetic resonance imaging</subject><subject>Medical imaging</subject><subject>Medical treatment</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Pallidotomy</subject><subject>Parkinson's disease</subject><subject>Patients</subject><subject>Pyramidal tracts</subject><subject>Quantitative susceptibility mapping</subject><subject>Software</subject><subject>Substantia grisea</subject><subject>Tremor (Muscular contraction)</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><subject>Visualization</subject><issn>0899-7071</issn><issn>1873-4499</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFkc1u1TAQhSMEUi-FV6gssYBNgp248c0OVAGt1KoIwdpy7EmYi2On_rlSH4c3xdEtGzasZhbfOaM5p6ouGG0YZf37Q6MtOlzU3LS0pQ3tG8rEs2rH9qKrOR-G59WO7oehFlSws-pljAdahAMXu-r3zbIGfwRDkgozJHQz8RNJP4HM1o85klVZi6Ys6BIEp0iOG_SQlUuYVMIjkJijhjXhiBbTI1nUum7MGtAHkjy5-1bPGU25MnmdY5nZpqCiz84QNdri4l05QL6q8Atd9O5tJAYjqAivqheTshFeP83z6sfnT9-vruvb-y83Vx9va92JLtVsMlSbsROGm5YBwLCfulaMQ89HpgdqOqbanmpuhGCUj5MYaadUWS4ZEy3vzqt3J9-Sx0OGmOSC5StrlQOfo2w5E7yjJdOCvvkHPfhcorEb1bNL3u4HVqj-ROngYwwwyZLHosKjZFRuzcmD_Nuc3JqTtJeluSL8cBJCefeIEGTUCE6DwQA6SePxfxZ_AJRQqZU</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Ebani, Edward J.</creator><creator>Kaplitt, Michael G.</creator><creator>Wang, Yi</creator><creator>Nguyen, Thanh D.</creator><creator>Askin, Gulce</creator><creator>Chazen, J. Levi</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>202012</creationdate><title>Improved targeting of the globus pallidus interna using quantitative susceptibility mapping prior to MR-guided focused ultrasound ablation in Parkinson's disease</title><author>Ebani, Edward J. ; Kaplitt, Michael G. ; Wang, Yi ; Nguyen, Thanh D. ; Askin, Gulce ; Chazen, J. Levi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-1fd0cdb37d4d21eee98f327b964b1c90d31a260c4d77104bf7b03aa4bf5117243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ablation</topic><topic>Ablative materials</topic><topic>Clinical trials</topic><topic>Deep brain stimulation</topic><topic>Drug resistance</topic><topic>General anesthesia</topic><topic>Globus pallidus</topic><topic>Globus Pallidus Interna</topic><topic>Image contrast</topic><topic>Imaging techniques</topic><topic>Magnetic permeability</topic><topic>Magnetic resonance guided focused ultrasound</topic><topic>Magnetic resonance imaging</topic><topic>Medical imaging</topic><topic>Medical treatment</topic><topic>Movement disorders</topic><topic>Neurodegenerative diseases</topic><topic>Pallidotomy</topic><topic>Parkinson's disease</topic><topic>Patients</topic><topic>Pyramidal tracts</topic><topic>Quantitative susceptibility mapping</topic><topic>Software</topic><topic>Substantia grisea</topic><topic>Tremor (Muscular contraction)</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>Visualization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ebani, Edward J.</creatorcontrib><creatorcontrib>Kaplitt, Michael G.</creatorcontrib><creatorcontrib>Wang, Yi</creatorcontrib><creatorcontrib>Nguyen, Thanh D.</creatorcontrib><creatorcontrib>Askin, Gulce</creatorcontrib><creatorcontrib>Chazen, J. Levi</creatorcontrib><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ebani, Edward J.</au><au>Kaplitt, Michael G.</au><au>Wang, Yi</au><au>Nguyen, Thanh D.</au><au>Askin, Gulce</au><au>Chazen, J. Levi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved targeting of the globus pallidus interna using quantitative susceptibility mapping prior to MR-guided focused ultrasound ablation in Parkinson's disease</atitle><jtitle>Clinical imaging</jtitle><date>2020-12</date><risdate>2020</risdate><volume>68</volume><spage>94</spage><epage>98</epage><pages>94-98</pages><issn>0899-7071</issn><eissn>1873-4499</eissn><abstract>Magnetic resonance guided focused ultrasound (MRgFUS) of the globus pallidus interna (GPi) has shown promise in the treatment of drug-resistant Parkinson's disease, though direct visualization of the GPi remains challenging with MRI. The purpose of this study was to compare various preoperative MR imaging techniques and to evaluate the utility of quantitative susceptibility imaging (QSM) in the depiction of the GPi prior to MRgFUS ablation.
Six patients with medication refractory advanced idiopathic Parkinson's disease were referred for preoperative MR imaging prior to MRgFUS pallidotomy. Axial T1WI and T2WI, Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR), and QSM sequences were acquired. DTI tractography was performed to delineate the corticospinal tracts. Qualitative visualization scores and contrast to noise ratios (CNR) were recorded and measured on all images.
QSM had significantly higher median qualitative visualization scores (3.00) compared with the T1WI (1.00), T2WI (1.50), and FGATIR sequences (1.50) (p < 0.05). QSM provided superior CNR for GPi depiction in each category (GPi-GPe and GPi-IC), respectively. For GPi-GPe, median CNR for T1WI, T2WI, FGATIR, and QSM was 1.13, 1.68, 0.79, and 10.78. For GPi-IC, median CNR for T1WI, T2WI, FGATIR, and QSM was 1.48, 4.63, 4.24, and 40.26, respectively (p < 0.05).
QSM offers improved visualization of the GPi compared with the traditional and currently recommended MR sequences prior to MRgFUS ablation in patients with Parkinson's disease. These results suggest that QSM should be considered as part of all preoperative imaging protocols prior to MRgFUS pallidotomy.
•QSM can provide increased contrast and conspicuity of the GPi and its borders relative to standard MRI sequences that are currently recommended•Delineation of the GPi borders is critical to a safe and successful ablation for patients with Parkinson disease</abstract><cop>Philadelphia</cop><pub>Elsevier Inc</pub><doi>10.1016/j.clinimag.2020.06.017</doi><tpages>5</tpages></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Ablation Ablative materials Clinical trials Deep brain stimulation Drug resistance General anesthesia Globus pallidus Globus Pallidus Interna Image contrast Imaging techniques Magnetic permeability Magnetic resonance guided focused ultrasound Magnetic resonance imaging Medical imaging Medical treatment Movement disorders Neurodegenerative diseases Pallidotomy Parkinson's disease Patients Pyramidal tracts Quantitative susceptibility mapping Software Substantia grisea Tremor (Muscular contraction) Ultrasonic imaging Ultrasound Visualization |
| title | Improved targeting of the globus pallidus interna using quantitative susceptibility mapping prior to MR-guided focused ultrasound ablation in Parkinson's disease |
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