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News Article | February 10, 2017
Site: www.biosciencetechnology.com

Evaluating the strength of connections in the brain is one avenue researchers have been exploring to help identify children at risk for autism spectrum disorder earlier in life. Now, researchers at Washington University School of Medicine in St. Louis, with colleagues from the multicenter Infant Brain Imaging Study (IBIS) network, have found associations between brain connectivity and a key social behavior that is a central feature of autism. If it becomes possible to identify children with autism spectrum disorder earlier in life, such knowledge could jump-start efforts to begin therapies that might help improve a child’s language and social skills. The findings are published online in the journal Cerebral Cortex. The new study from the IBIS network involved scientists at Washington University, the University of North Carolina, The Children’s Hospital of Philadelphia and the University of Washington. The researchers used functional MRI scans to identify brain networks involved in a phenomenon called initiation of joint attention. It occurs when a baby sees an object in his or her environment, such as a dog, a car or a ball, focuses on that object and — by pointing and/or shifting gaze — gets someone else to focus on that object. This behavior has been linked to language development and is impaired in children with autism spectrum disorder. “By the time most children are diagnosed with autism, they are 4 ½, but in studying the brains of younger children, we have found neural activity that may allow for earlier diagnosis, and that, in turn, may allow us to begin treatment sooner,” said John R. Pruett Jr., M.D., Ph.D., co-senior author and an associate professor of child psychiatry at Washington University. “We’re excited to link aspects of joint attention behavior to the functional architecture of the brain. This study represents the first time that has been done in children at an age when joint attention abilities are actually developing.” The researchers evaluated 116 young children at 12 months of age and 98 children who were 24 months old. Some children in the study had an elevated risk of autism because they had older siblings who had been diagnosed with the disorder. About 20 percent of babies with an affected sibling go on to develop autism spectrum disorder. The toddlers’ brains were scanned while they slept. The next day, the children were assessed to see how often they initiated joint attention — that is, drew another person’s attention to an object. The babies less likely to initiate joint attention had strong connections between their brains’ visual and dorsal attention networks. The dorsal attention network helps keep attention focused on something while still allowing the brain to respond to other potentially important sensory information. The researchers also identified stronger functional connectivity between the visual and the default mode networks in babies who were more likely to initiate joint attention. The default mode network is most active during quiet rest or daydreaming but generally shuts down while one is focused on a challenging task. “When an infant is engaged in initiating joint attention, the visual and default mode regions tend to work together while the visual and attention regions tend to decouple, so in these scans we’re seeing something like a fingerprint of how brain networks coordinate activity,” said first author Adam T. Eggebrecht, Ph.D., an instructor in radiology at Washington University’s Mallinckrodt Institute of Radiology. “Pointing to direct another person’s attention involves identifying an object, focusing one’s own attention on it, pointing toward it using the brain’s motor system and, possibly, perceiving that another person orients to that object, too. “Identifying the brain regions responsible for all of that will leave us better equipped to potentially uncover mechanisms underlying behavioral features of autism as they emerge over the second year of life.” Now that those associations have been identified, the researchers plan to conduct further studies to try to understand how connections between brain networks might influence children’s language abilities, as well as their social skills, both of which are impaired in children with autism spectrum disorder. “This research lays the groundwork for understanding how fundamentally aberrant processes develop in the brain as autism is first emerging in infants,” said Joseph Piven, M.D., co-senior author on the paper and a professor of psychiatry, pediatrics and psychology at the University of North Carolina and principal investigator of the IBIS Network.


News Article | December 1, 2015
Site: www.rdmag.com

With the aim of producing high-quality x-rays with minimal radiation exposure, particularly in children, researchers have developed a new approach to imaging patients. Surprisingly, the new technology isn’t a high-tech, high-dollar piece of machinery. Rather, it’s based on the Xbox gaming system. Using proprietary software developed for the Microsoft Kinect system, researchers at Washington Univ. School of Medicine in St. Louis have adapted hands-free technology used for the popular Xbox system to aid radiographers when taking x-rays. The software coupled with the Kinect system can measure thickness of body parts and check for motion, positioning and the x-ray field of view immediately before imaging, said Steven Don, MD, associate professor of radiology at the university’s Mallinckrodt Institute of Radiology. Real-time monitoring alerts technologists to factors that could compromise image quality. For example, “movement during an x-ray requires retakes, thereby increasing radiation exposure,” Don said. “The goal is to produce high-quality x-ray images at a low radiation dose without repeating images,” Don said. “It sounds surprising to say that the Xbox gaming system could help us to improve medical imaging, but our study suggests that this is possible.” The technology could benefit all patients but particularly children because of their sensitivity to radiation and greater variation in body sizes, which can range from premature infants to adult-sized teenagers. Setting appropriate x-ray techniques to minimize radiation exposure depends on the thickness of the body part being imaged. High-quality x-rays are critical in determining diagnoses and treatment plans. Traditionally steel calipers have been used to measure body-part thickness for x-rays. However, calipers are “time-consuming, intrusive and often scary to kids, especially those who are sick or injured,” said Don, a pediatric radiologist who treats patients at St. Louis Children’s Hospital. “To achieve the best image quality while minimizing radiation exposure, x-ray technique needs to be based on body-part thickness,” Don said. The gaming software has an infrared sensor to measure body-part thickness automatically without patient contact. “Additionally, we use the optical camera to confirm the patient is properly positioned,” he explained. Originally developed as a motion sensor and voice and facial recognition device for the Xbox gaming system, Microsoft Kinect software allows individuals to play games hands-free, or without a standard controller. Scientists, computer specialists and other inventors have since adapted the Xbox technology for nongaming applications. Don and his colleagues, for example, combined the Microsoft Kinect 1.0 technology with proprietary software to improve x-ray imaging. With help from Washington Univ.’s Office of Technology Management, the team applied for a patent last year. Don developed the technology with William Clayton, a former computer programmer at the School of Medicine, and Robert MacDougall, a clinical medical physicist at Boston Children’s Hospital. This year, Don and his colleagues have received funding from Washington Univ. and The Society for Pediatric Radiology. They will use these resources to continue research with the updated Microsoft Kinect 2.0 and seek feedback from radiological technologists to improve the software. While further research and development are needed, the eventual goal is to apply the technology to new x-ray machines as well as retrofitting older equipment. “Patients, technologists and radiologists want the best quality x-rays at the lowest dose possible without repeating images,” Don said. “This technology is a tool to help achieve that goal.”


News Article | December 2, 2015
Site: www.biosciencetechnology.com

With the aim of producing high-quality X-rays with minimal radiation exposure, particularly in children, researchers have developed a new approach to imaging patients. Surprisingly, the new technology isn’t a high-tech, high-dollar piece of machinery. Rather, it’s based on the Xbox gaming system. Using proprietary software developed for the Microsoft Kinect system, researchers at Washington University School of Medicine in St. Louis have adapted hands-free technology used for the popular Xbox system to aid radiographers when taking X-rays. The software coupled with the Kinect system can measure thickness of body parts and check for motion, positioning and the X-ray field of view immediately before imaging, said Steven Don, M.D., associate professor of radiology at the university’s Mallinckrodt Institute of Radiology. Real-time monitoring alerts technologists to factors that could compromise image quality. For example, “movement during an X-ray requires retakes, thereby increasing radiation exposure,” Don said. A feasibility study will be presented Wednesday, Dec. 2, at the Radiological Society of North America’s annual meeting in Chicago. “The goal is to produce high-quality X-ray images at a low radiation dose without repeating images,” Don said. “It sounds surprising to say that the Xbox gaming system could help us to improve medical imaging, but our study suggests that this is possible.” The technology could benefit all patients but particularly children because of their sensitivity to radiation and greater variation in body sizes, which can range from premature infants to adult-sized teenagers. Setting appropriate X-ray techniques to minimize radiation exposure depends on the thickness of the body part being imaged. High-quality X-rays are critical in determining diagnoses and treatment plans. Traditionally steel calipers have been used to measure body-part thickness for X-rays. However, calipers are “time-consuming, intrusive and often scary to kids, especially those who are sick or injured,” said Don, a pediatric radiologist who treats patients at St. Louis Children’s Hospital. “To achieve the best image quality while minimizing radiation exposure, X-ray technique needs to be based on body-part thickness,” Don said. The gaming software has an infrared sensor to measure body-part thickness automatically without patient contact. “Additionally, we use the optical camera to confirm the patient is properly positioned,” he explained. Originally developed as a motion sensor and voice and facial recognition device for the Xbox gaming system, Microsoft Kinect software allows individuals to play games hands-free, or without a standard controller. Scientists, computer specialists and other inventors have since adapted the Xbox technology for nongaming applications. Don and his colleagues, for example, combined the Microsoft Kinect 1.0 technology with proprietary software to improve X-ray imaging. With help from Washington University’s Office of Technology Management, the team applied for a patent last year. Don developed the technology with William Clayton, a former computer programmer at the School of Medicine, and Robert MacDougall, a clinical medical physicist at Boston Children’s Hospital. This year, Don and his colleagues have received funding from Washington University and The Society for Pediatric Radiology. They will use these resources to continue research with the updated Microsoft Kinect 2.0 and seek feedback from radiological technologists to improve the software. While further research and development are needed, the eventual goal is to apply the technology to new X-ray machines as well as retrofitting older equipment. “Patients, technologists and radiologists want the best quality X-rays at the lowest dose possible without repeating images,” Don said. “This technology is a tool to help achieve that goal.”


News Article | December 1, 2015
Site: phys.org

Using proprietary software developed for the Microsoft Kinect system, researchers at Washington University School of Medicine in St. Louis have adapted hands-free technology used for the popular Xbox system to aid radiographers when taking X-rays. The software coupled with the Kinect system can measure thickness of body parts and check for motion, positioning and the X-ray field of view immediately before imaging, said Steven Don, MD, associate professor of radiology at the university's Mallinckrodt Institute of Radiology. Real-time monitoring alerts technologists to factors that could compromise image quality. For example, "movement during an X-ray requires retakes, thereby increasing radiation exposure," Don said. A feasibility study will be presented Wednesday, Dec. 2, at the Radiological Society of North America's annual meeting in Chicago. "The goal is to produce high-quality X-ray images at a low radiation dose without repeating images," Don said. "It sounds surprising to say that the Xbox gaming system could help us to improve medical imaging, but our study suggests that this is possible." The technology could benefit all patients but particularly children because of their sensitivity to radiation and greater variation in body sizes, which can range from premature infants to adult-sized teenagers. Setting appropriate X-ray techniques to minimize radiation exposure depends on the thickness of the body part being imaged. High-quality X-rays are critical in determining diagnoses and treatment plans. Traditionally steel calipers have been used to measure body-part thickness for X-rays. However, calipers are a "time-consuming, intrusive and often scary to kids, especially those who are sick or injured," said Don, a pediatric radiologist who treats patients at St. Louis Children's Hospital. "To achieve the best image quality while minimizing radiation exposure, X-ray technique needs to be based on body-part thickness," Don said. The gaming software has an infrared sensor to measure body-part thickness automatically without patient contact. "Additionally, we use the optical camera to confirm the patient is properly positioned," he explained. Originally developed as a motion sensor and voice and facial recognition device for the Xbox gaming system, Microsoft Kinect software allows individuals to play games hands-free, or without a standard controller. Scientists, computer specialists and other inventors have since adapted the Xbox technology for nongaming applications. Don and his colleagues, for example, combined the Microsoft Kinect 1.0 technology with proprietary software to improve X-ray imaging. With help from Washington University's Office of Technology Management, the team applied for a patent last year. Don developed the technology with William Clayton, a former computer programmer at the School of Medicine, and Robert MacDougall, a clinical medical physicist at Boston Children's Hospital. This year, Don and his colleagues have received funding from Washington University and The Society for Pediatric Radiology. They will use these resources to continue research with the updated Microsoft Kinect 2.0 and seek feedback from radiological technologists to improve the software. While further research and development are needed, the eventual goal is to apply the technology to new X-ray machines as well as retrofitting older equipment. "Patients, technologists and radiologists want the best quality X-rays at the lowest dose possible without repeating images," Don said. "This technology is a tool to help achieve that goal."


Brooks F.J.,University of Washington | Grigsby P.W.,University of Washington | Grigsby P.W.,Mallinckrodt Institute of Radiology
Journal of Nuclear Medicine | Year: 2014

The number of studies in the literature involving quantification of the metabolic heterogeneity seen in 18F-FDG PET images has increased sharply over recent years. We hypothesized that inclusion of very small regions of interest as unique data points will have deleterious effects on these studies. Methods: Using a combination of probability theory and clinical 18F-FDG PET data, we numerically calculated the curve describing the probability a given tumor volume is large enough to adequately sample the underlying tumor biology assayed via a PET/CT scanner at a planar resolution of 4 mm and transaxial resolution of 4 mm (64 mm3 voxel size). We then used a computer simulation to isolate the effects of tumor volume on the image local entropy. Results: We computed the underlying global intensity distribution for 70 cervical cancer tumors ranging from 4 to 248 cm3), which were ensemble-averaged over the same intensity scale. From this distribution, we determined that about 700 total voxels (45 cm3) are required to give 95% certainty that the global intensity distribution has been sufficiently sampled for common statistical comparisons of individual tumor intensity distributions to be made canonically. We demonstrated that one previously suggested measure of heterogeneity is dependent on tumor volume and that measurement of heterogeneity is about = times more sensitive to volume changes for volumes below the proposed minimum than for those above it. Conclusion: Inclusion of tumor volumes below 45 cm3 can profoundly bias comparisons of intratumoral uptake heterogeneity metrics derived from data from the current generation of whole-body 18F-FDG PET scanners. Copyright © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.


Shenoy S.,Washington University in St. Louis | Darcy M.,Mallinckrodt Institute of Radiology
American Journal of Roentgenology | Year: 2013

OBJECTIVE. The rising prevalence of end-stage renal disease has resulted in increasing focus on delivery of vascular access care for hemodialysis. Duplex Doppler ultrasound, with its unique ability to reliably evaluate both structural and functional aspects of the peripheral vessels, is the preferred imaging modality for access planning and follow-up. CONCLUSION. This article will review how ultrasound is currently used to evaluate patients pre-, intra-, and postoperatively for vascular access. © American Roentgen Ray Society.


Rubin D.A.,Mallinckrodt Institute of Radiology
American Journal of Roentgenology | Year: 2013

OBJECTIVE. Proponents of femoroacetabular impingement (FAI) now claim that FAI is an important risk factor for hip osteoarthritis and argue that early, aggressive treatment is indicated to stave off long-term complications. The result is more young patients undergoing corrective surgery; does the literature support these claims or has hype trumped reality? This article critically reviews these assertions together with the current scientific evidence that defends (or refutes) them. CONCLUSION. Each reader will need to weigh the evidence carefully when interpreting images or planning management for patients with possible FAI. © American Roentgen Ray Society.


Foltz G.,Mallinckrodt Institute of Radiology
Seminars in Interventional Radiology | Year: 2014

The liver is a common site of primary and secondary malignancies, often resulting in significant morbidity and mortality. Evaluating these patients in a multidisciplinary setting allows for optimal utilization of all oncologic therapies including surgery, radiation, systemic chemotherapy, transarterial therapies, and ablation. While surgical intervention often provides the best outcomes when treating most hepatic tumors, many patients are not surgical candidates due to extensive tumor burden, underlying liver disease, or other comorbid conditions. The evolution of imaging and ablation devices has allowed for the increased utilization of percutaneous ablation as definitive and palliative treatment of primary and metastatic hepatic malignancies. Ablation induces tumor necrosis by injection of chemicals (chemical ablation) or temperature modification (thermal ablation). The goal of this review is to provide an overview of different ablation techniques commonly used for hepatic malignancies, discuss the oncologic outcomes of these interventions, and outline the current indications, contraindications, and reported complications of these therapies. © 2014 by Thieme Medical Publishers, Inc.


Wallace A.N.,Mallinckrodt Institute of Radiology | Greenwood T.J.,Mallinckrodt Institute of Radiology | Jennings J.W.,Mallinckrodt Institute of Radiology
American Journal of Roentgenology | Year: 2015

OBJECTIVE. The purpose of this article is to describe the role of imaging in the management of metastatic spine disease with percutaneous ablation and vertebral augmentation. Topics include the imaging diagnosis of spinal metastases, imaging factors related to patient selection and procedural planning, intraprocedural imaging guidance, and posttreatment imaging assessment. CONCLUSION. Radiologists should be familiar with pertinent imaging findings related to the percutaneous management of metastatic spine disease. © American Roentgen Ray Society.


Rubin D.A.,Mallinckrodt Institute of Radiology
American Journal of Roentgenology | Year: 2012

OBJECTIVE. Hamstring injuries are common in sports. Although management and outcomes are sport specific, clinical evaluation alone is a poor guide for treatment planning and prognostication. Cross-sectional imaging has added value in these cases. CONCLUSION. Specifically, the location (tendon attachment, classic or intramuscular myotendinous junction, or extramuscular portion of the tendon), specific muscles involved, and anatomic extent are factors that can influence the immediate treatment, expected convalescent period, and risk of recurrence in these athletes. © American Roentgen Ray Society.

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