Johannes M Hoogduin

University of Groningen, Groningen, Groningen, Netherlands

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Publications (19)80.24 Total impact

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    ABSTRACT: The aim of this study is to assess the geometric accuracy of diffusion weighted (DW)-MRI by quantification of geometric distortions in the gross tumor volume (GTV) in head and neck (HN) cancer. A retrospective analysis was performed on the data of 23 patients (with 24 lesions). For these patients, magnetic field maps and DW-MRI were acquired. The magnetic field maps were converted to voxel displacement maps. GTV delineations were transferred onto these voxel displacement maps and the voxel shifts in the GTV were analyzed. The median shift was 3.2mm and the maximal posterior and anterior shifts were up to 15.0 and 26.0mm respectively. The range of shifts varied from 11.8 to 25.6mm. The percentage of GTV voxels that showed a shift of at least 6mm was found to be 23.2%. Current DW-MRI images of HN tumors show severe distortions up to centimeters, which restrict the use of DW-MRI scans for GTV definition in RT treatment planning.
    Radiotherapy and Oncology 10/2013; · 4.52 Impact Factor
  • Daniel Louis Polders, Johannes Marinus Hoogduin
    PET Clinics 07/2013; 8(3):245–257.
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    ABSTRACT: BACKGROUND: Cerebral blood flow (CBF) is reduced in normal-appearing white matter (NAWM) of subjects with multiple sclerosis (MS), but the underlying mechanism is unknown. OBJECTIVE: The objective of this article is to assess the relationship between reduced NAWM CBF and both axonal mitochondrial metabolism and astrocytic phosphocreatine (PCr) metabolism. METHODS: Ten healthy controls and 25 MS subjects were studied with 3 Tesla magnetic resonance imaging. CBF was measured using pseudo-continuous arterial spin labeling. N-acetylaspartate/creatine (NAA/Cr) ratios (axonal mitochondrial metabolism) were obtained using (1)H-MR spectroscopy and PCr/β-ATP ratios using (31)P-MR spectroscopy. In centrum semiovale NAWM, we assessed correlations between CBF and both NAA/Cr and PCr/β-ATP ratios. RESULTS: Subjects with MS had a widespread reduction in CBF of NAWM (centrum semiovale, periventricular, frontal and occipital), and gray matter (frontoparietal cortex and thalamus). Compared to controls, NAA/Cr in NAWM of the centrum semiovale of MS subjects was decreased, whereas PCr/β-ATP was increased. We found no correlations between CBF and PCr/β-ATP. CBF and NAA/Cr correlated in controls (p = 0.02), but not in MS subjects (p = 0.68). CONCLUSIONS: Our results suggest that in MS patients there is no relationship between reduced CBF in NAWM and impaired axonal mitochondrial metabolism or astrocytic PCr metabolism.
    Multiple Sclerosis 02/2013; · 4.47 Impact Factor
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    ABSTRACT: Pathophysiology of tremor generation remains uncertain in 'familial cortical myoclonic tremor with epilepsy' (FCMTE) and essential tremor (ET). In both disorders, imaging and pathological studies suggest involvement of the cerebellum and its projection areas. MR diffusion tensor imaging allows estimation of white matter tissue composition, and therefore is well suited to quantify structural changes in vivo. This study aimed to compare cerebellar fiber density between FCMTE and ET patients and healthy controls. Seven FCMTE patients, eight ET patients, and five healthy controls were studied. Cerebellum was annotated based on fractional anisotropy (FA) and mean diffusivity volumes. Mean cerebellar FA values were computed as well as mean cerebellar volume. Group statistics included one-way ANOVAs and post hoc independent t tests. Mean FA of the cerebellar region for FCMTE was 0.242 (SD = 0.012), for ET 0.259 (SD = 0.0115), and for controls 0.262 (SD = 0.0146). There was a significant group effect for FA (F(2) = 4.9, p = 0.02). No difference in mean cerebellar volume was found. Post hoc independent t tests revealed significantly decreased mean FA in FCMTE patients compared to controls (t[10] = 2.5, p = 0.03) and ET patients (t[13] = 2.9, p = 0.01), while there was no difference in mean FA between ET patients and controls (t[11] < 1.0). This study indicates for the first time microstructural damage of the cerebellar white matter in FCMTE in vivo. These results ascertain a role of the cerebellum in 'cortical tremor'.
    The Cerebellum 09/2012; · 2.60 Impact Factor
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    ABSTRACT: The underlying pathology of lacunar infarcts, white matter lesions and also of microbleeds is poorly understood. We assessed whether the presence of lacunar infarcts, white matter lesions or microbleeds on MRI was associated with a decrease in cerebrovascular reactivity, and assessed whether this association was similar for lacunar infarcts, white matter lesions and microbleeds. BOLD-fMRI scan with breath-holding at 7 T and anatomical scans at 1.5 T were available in 49 patients with atherosclerotic disease from the Second Manifestations of ARTerial disease (SMART) study. Microbleeds and lacunar infarcts were scored visually and volumetric assessment of white matter lesions was performed on the 1.5 T scan. The percentage of voxels with a significant signal change on breath-holding and the whole brain signal change were calculated as measures of cerebrovascular reactivity. The mean percentage of voxels with a significant signal change was 25.1% (SD 6.6) and the mean percentage whole brain signal change was 1.20% (SD 0.51). Age, gender, and diastolic blood pressure were significantly associated with cerebrovascular reactivity. Cerebrovascular reactivity was lower with increasing age, lower in females compared to males and lower with lower diastolic blood pressure. ANCOVA showed that patients with microbleeds (n=18) had a significantly lower whole brain signal change than patients without microbleeds, with a mean difference of -0.36% (95% CI -0.64 to 0.07), independent of age, sex, systolic and diastolic blood pressure and non-lacunar infarcts. No significant associations were found for presence of lacunar infarcts or white matter lesion volume with whole brain signal change or percentage of voxels with a significant signal change. The results show that presence of microbleeds is associated with an impaired cerebrovascular reactivity in patients with atherosclerotic disease, whereas no significant association was found for the presence of lacunar infarcts or white matter lesions in our study.
    NeuroImage 09/2011; 59(2):950-6. · 6.25 Impact Factor
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    ABSTRACT: To investigate the association of 7-T magnetic resonance (MR) imaging characteristics with metastatic nodal invasion, determined with histopathologic assessment in dissected sentinel lymph nodes of breast cancer patients. Institutional review board approval and informed consent were obtained. From November 2008 to July 2010, 114 dissected lymph nodes from 33 women (mean age, 57 years; range, 31-80 years) with breast cancer were included. For morphological analysis, three-dimensional (3D) T1-weighted fat-suppressed fast field- (gradient-) echo (isotropic resolution, 180 μm) MR was performed; 3D nodal dimensions, maximum cortical thickness, and presence of fatty hilum were noted. For quantitative parametric analysis, two-dimensional T1-weighted and 3D T2-, T2*-, and diffusion-weighted images were acquired. Statistical analysis included generalized estimating equations (GEEs), forward and backward stepwise regression analyses, and calculation of positive predictive value (PPV) and negative predictive value (NPV). Of 114 nodes, 26 (23%) were malignant. Morphological criteria showed weak discriminatory power: A fatty center was absent in 35% of malignant nodes and 30% of benign nodes (P = .9). Nodal volume and length-width ratio were not significantly different (P = .11 and .75, respectively). Cortical thickness (threshold level, 3 mm; P = .02) showed 91% NPV for malignancy and 95% NPV for presence of macrometastases. Quantitative parametric analyses showed comparable mean T1, T2, and T2* relaxation time constants and apparent diffusion coefficient for metastatic and benign nodes: 991 msec, 30 msec, and 18 msec and 0.17 mm²/sec versus 1035 msec (P = .14), 31 msec (P = .001; not significant after GEE), and 15 msec (P = .002) and 0.20 mm²/sec (P = .38), respectively. Mean T2* alone offered an additive discriminatory effect for identification of metastatic nodes. Consistent with the notion of pannodal changes accompanying tumor infiltration, mean T2* differed significantly even if only micrometastases were present. The interindividual differences were small, precluding easy clinical implementation. Morphological criteria showed poor discriminatory power, even with very-high-spatial-resolution imaging. T2* quantification allowed identification of metastatic nodal invasion.
    Radiology 06/2011; 261(1):127-35. · 6.34 Impact Factor
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    ABSTRACT: To compare diffusion tensor imaging (DTI) measurements at ultra high field strength (7 Tesla [T]) in human volunteers with DTI measurements performed at 1.5 and 3 Tesla. The signal to noise ratio (SNR) and the uncertainty in fitted DTI parameters fractional anisotropy and primary eigenvector are assessed with tractography based regions of interest, measured in nine volunteers at 1.5T, 3T, and 7T with clinically available hardware configurations. An increase in SNR is observed on the 7T system compared with the 1.5 or 3T system. The measured increase in SNR at 7T is larger than expected from field strength alone, indicating the large influence of improved receive coil hardware. Additionally, while the average fractional anisotropy remains relatively constant across field strengths, a decrease in uncertainty in the fitted values for fractional anisotropy and the principal eigenvector of the DTI tensor was found. Increased spatial heterogeneity of signal intensities is observed at 7T. Given the current hardware constraints, DTI at ultra-high field strengths is possible with improved performance in selected regions of interest.
    Journal of Magnetic Resonance Imaging 06/2011; 33(6):1456-63. · 2.57 Impact Factor
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    ABSTRACT: A method to reduce the acoustic noise generated by gradient systems in MRI has been recently proposed; such a method is based on the linear response theory. Since the physical cause of MRI acoustic noise is the time derivative of the gradient current, a common trapezoid current shape produces an acoustic gradient coil response mainly during the rising and falling edge. In the falling edge, the coil acoustic response presents a 180 degrees phase difference compared to the rising edge. Therefore, by varying the width of the trapezoid and keeping the ramps constant, it is possible to suppress one selected frequency and its higher harmonics. This value is matched to one of the prominent resonance frequencies of the gradient coil system. The idea of cancelling a single frequency is extended to a second frequency, using two successive trapezoid-shaped pulses presented at a selected interval. Overall sound pressure level reduction of 6 and 10 dB is found for the two trapezoid shapes and a single pulse shape, respectively. The acoustically optimized pulse shape proposed is additionally tested in a simulated echo planar imaging readout train, obtaining a sound pressure level reduction of 12 dB for the best case.
    Magnetic Resonance in Medicine 08/2010; 64(2):546-53. · 3.27 Impact Factor
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    ABSTRACT: The aim of the present study is to develop a submillimeter volumetric (three-dimensional) fluid-attenuated inversion recovery sequence at 7T. Implementation of the fluid-attenuated inversion recovery sequence is difficult as increased T(1) weighting from prolonged T(1) constants at 7T dominate the desired T(2) contrast and yield suboptimal signal-to-noise ratio. Magnetization preparation was used to reduce T(1) weighting and improve the T(2) weighting. Also, practical challenges limit the implementation. Long refocusing trains with low flip angles were used to mitigate the specific absorption rate constraints. This resulted in a three-dimensional magnetization preparation fluid-attenuated inversion recovery sequence with 0.8 x 0.8 x 0.8 = 0.5 mm(3) resolution in a clinically acceptable scan time. The contrast-to-noise ratio between gray matter and white matter (contrast-to-noise ratio = signal-to-noise ratio [gray matter] - signal-to-noise ratio [white matter]) increased from 12 +/- 9 without magnetization preparation to 28 +/- 8 with magnetization preparation (n = 12). The signal-to-noise ratio increased for white matter by 13 +/- 6% and for gray matter by 48 +/- 15%. In conclusion, three-dimensional fluid-attenuated inversion recovery with high resolution and full brain coverage is feasible at 7T. Magnetization preparation reduces the T(1) weighting, thereby improving the T(2) weighted contrast and signal-to-noise ratio.
    Magnetic Resonance in Medicine 07/2010; 64(1):194-202. · 3.27 Impact Factor
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    ABSTRACT: Two studies using (31)P-magnetic resonance spectroscopy (MRS) reported enhanced phosphocreatine (PCr) levels in normal appearing white matter (NAWM) of subjects with multiple sclerosis (MS), but this finding could not be properly explained. We performed (31)P-MRS and (1)H-MRS in the NAWM in 36 subjects, including 17 with progressive MS, 9 with benign MS, and 10 healthy controls. Compared to controls, PCr/beta-ATP and PCr/total (31)P ratios were significantly increased in subjects with progressive MS, but not with benign MS. There was no correlation between PCr ratios and the N-acetylaspartate/creatine ratio, suggesting that elevated PCr levels in NAWM were not secondary to axonal loss. In the central nervous system, PCr is degraded by creatine kinase B (CK-B), which in the white matter is confined to astrocytes. In homogenates of NAWM from 10 subjects with progressive MS and 10 controls without central nervous system disease, we measured CK-B levels with an ELISA, and measured its activity with an enzymatic assay kit. Compared to controls, both CK-B levels and activity were decreased in subjects with MS (22.41 versus 46.28 microg/ml; p = 0.0007, and 2.89 versus 7.76 U/l; p<0.0001). Our results suggest that PCr metabolism in the NAWM in MS is impaired due to decreased CK-B levels. Our findings raise the possibility that a defective PCr metabolism in astrocytes might contribute to the degeneration of oligodendrocytes and axons in MS.
    PLoS ONE 01/2010; 5(5):e10811. · 3.53 Impact Factor
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    ABSTRACT: This study used arterial spin labeling (ASL) fMRI to measure brain perfusion in a group of healthy men under conditions that closely resembled customary sexual behavior. Serial perfusion measures for 30 min during two self-limited periods of partnered penis stimulation, and during post-stimulatory periods, revealed novel sexual activity-related cerebral blood flow (rCBF) changes, mainly in subcortical parts of the brain. Ventral pallidum rCBF was highest during the onset of penile erection, and lowest after the termination of penis stimulation. The perceived level of sexual arousal showed the strongest positive association with rCBF in the right basal forebrain. In addition, our results demonstrate that distinct subregions of the hypothalamus and cingulate cortex subserve opposite functions during human male sexual behavior. The lateral hypothalamus and anterior part of the middle cingulate cortex showed increased rCBF correlated with penile erection. By contrast, the anteroventral hypothalamus and subgenual anterior cingulate cortex exhibited rCBF changes correlated with penile detumescence after penile stimulation. Continuous rapid and high-resolution brain perfusion imaging during normal sexual activity has provided novel insights into the central mechanisms that control male sexual arousal.
    NeuroImage 12/2009; 50(1):208-16. · 6.25 Impact Factor
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    ABSTRACT: To investigate reproducibility of proton magnetic resonance spectroscopy ((1)H-MRS) to measure hepatic triglyceride content (HTGC). In 24 subjects, HTGC was evaluated using (1)H-MRS at 3.0 Tesla. We studied "between-weeks" reproducibility and reproducibility of (1)H-MRS in subjects with fatty liver. We also studied within liver variability and within day reproducibility. Reproducibility was assessed by coefficient of variation (CV), repeatability coefficient (RC), and intraclass correlation coefficient (ICC). The CV of between weeks reproducibility was 9.5%, with a RC of 1.3% HTGC (ICC 0.998). The CV in fatty livers was 4.1%, with a RC of 1.3% HTGC (ICC 0.997). Within day CV was 4.5%, with a RC of 0.4% HTGC (ICC 0.999). CV for within liver variability was 14.5%. Reproducibility of (1)H-MRS to measure HTGC for "between-weeks" measurements and in fatty livers is high, which is important for follow-up studies. Within liver variability displays a larger variation, meaning that liver fat is not equally distributed and during consecutive measurements the same voxel position should be used.
    Journal of Magnetic Resonance Imaging 09/2009; 30(2):444-8. · 2.57 Impact Factor
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    ABSTRACT: Functional magnetic resonance imaging (fMRI) enables sites of brain activation to be localized in human subjects. For auditory system studies, however, the acoustic noise generated by the scanner tends to interfere with the assessments of this activation. Understanding and modeling fMRI acoustic noise is a useful step to its reduction. To study acoustic noise, the MR scanner is modeled as a linear electroacoustical system generating sound pressure signals proportional to the time derivative of the input gradient currents. The transfer function of one MR scanner is determined for two different input specifications: 1) by using the gradient waveform calculated by the scanner software and 2) by using a recording of the gradient current. Up to 4 kHz, the first method is shown as reliable as the second one, and its use is encouraged when direct measurements of gradient currents are not possible. Additionally, the linear order and average damping properties of the gradient coil system are determined by impulse response analysis. Since fMRI is often based on echo planar imaging (EPI) sequences, a useful validation of the transfer function prediction ability can be obtained by calculating the acoustic output for the EPI sequence. We found a predicted sound pressure level (SPL) for the EPI sequence of 104 dB SPL compared to a measured value of 102 dB SPL. As yet, the predicted EPI pressure waveform shows similarity as well as some differences with the directly measured EPI pressure waveform.
    IEEE transactions on bio-medical engineering 10/2008; 55(9):2115-23. · 2.15 Impact Factor
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    ABSTRACT: The pathogenesis of dystonia in Complex Regional Pain Syndrome type 1 (CRPS-1) is unclear. In primary dystonia, functional magnetic resonance imaging (fMRI) has revealed changes in cerebral networks during execution of movement. The aim of this study was to determine cerebral network function in CRPS-1 patients with dystonic postures. Cerebral processing related to both execution and imagining of hand movements in patients and controls was assessed with fMRI. Eight CRPS-1 patients with dystonic postures of the right upper extremity and 17 age-matched healthy controls were studied. Compared with controls, imaginary movement of the affected hand in patients showed reduced activation ipsilaterally in the premotor and adjacent prefrontal cortex, and in a cluster comprising frontal operculum, the anterior part of the insular cortex and the superior temporal gyrus. Contralaterally, reduced activation was seen in the inferior parietal and adjacent primary sensory cortex. There were no differences between patients and controls when they executed movements, nor when they imagined moving their unaffected hand. The altered cerebral activation pattern in patients with CRPS-1 linked dystonia most likely reflects an interface between pain-associated circuitry and higher order motor control, which points at a specific mechanistic pathophysiology of this type of dystonia.
    Pain 03/2008; 134(3):302-9. · 5.64 Impact Factor
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    ABSTRACT: The goal of the present validation study is to show that continuous surface EMG recorded simultaneously with 3T fMRI can be used to identify local brain activity related to (1) motor tasks, and to (2) muscle activity independently of a specific motor task, i.e. spontaneous (abnormal) movements. Five healthy participants performed a motor task, consisting of posture (low EMG power), and slow (medium EMG power) and fast (high EMG power) wrist flexion-extension movements. Brain activation maps derived from a conventional block design analysis (block-only design) were compared with brain activation maps derived using EMG-based regressors: (1) using the continuous EMG power as a single regressor of interest (EMG-only design) to relate motor performance and brain activity, and (2) using EMG power variability as an additional regressor in the fMRI block design analysis to relate movement variability and brain activity (mathematically) independent of the motor task. The agreement between the identified brain areas for the block-only design and the EMG-only design was excellent for all participants. Additionally, we showed that EMG power variability correlated well with activity in brain areas known to be involved in movement modulation. These innovative EMG-fMRI analysis techniques will allow the application of novel motor paradigms. This is an important step forward in the study of both the normally functioning motor system and the pathophysiological mechanisms in movement disorders.
    Human Brain Mapping 12/2007; 28(11):1117-27. · 6.88 Impact Factor
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    ABSTRACT: To apply and validate the use of electromyogram (EMG) recorded during functional magnetic resonance imaging (fMRI) in patients with movement disorders, to directly relate involuntary movements to brain activity. Eight "familial cortical myoclonic tremor with epilepsy" (FCMTE) patients, with tremor-like cortical myoclonus and cerebellar Purkinje cell degeneration, and nine healthy controls performed hand posture and movement in an on/off fashion (block design). Superfluous movements were quantified as deviations in EMG power, positive and negative, with respect to the average EMG per session. This measure, "residual EMG" (r-EMG), was derived by Gram-Schmidt orthogonalization. Activation maps resulting from conventional block regressors and novel r-EMG regressors were compared. In healthy participants, the block posture regressor identified mainly cerebellar activity and some activity in other areas belonging to motor circuitry. In FCMTE patients, no cerebellar activity was seen with the block posture regressor, compatible with cerebellar Purkinje cell changes in FCMTE. EMG power showed little variation during posture in healthy controls. Therefore, the r-EMG regressor was almost constant and revealed no brain activity as expected. In contrast, in FCMTE patients the r-EMG posture regressor was highly variable due to continuous myoclonic jerks. It identified sensorimotor cortical areas, compatible with cortical hyperexcitability in FCMTE patients. Conventional block regressors can be used to identify neuronal circuitry associated with a specific motor task, whereas r-EMG regressors can help identify brain activation directly related to involuntary movements. Simultaneous EMG-fMRI is complementary to conventional fMRI and will facilitate studies of hyperkinetic movement disorders.
    Human Brain Mapping 12/2007; 29(12):1430-41. · 6.88 Impact Factor
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    ABSTRACT: Lexical semantic ambiguity is the phenomenon when a word has multiple meanings (e.g. 'bank'). The aim of this event-related functional MRI study was to identify those brain areas, which are involved in contextually driven ambiguity resolution. Ambiguous words were selected which have a most frequent, dominant, and less frequent, subordinate meaning. These words were presented in two types of sentences: (1) a sentence congruent with the dominant interpretation and (2) a sentence congruent with the subordinate interpretation. Sentences without ambiguous words served as a control condition. The ambiguous words always occurred early in the sentences and were biased towards one particular meaning by the final word(s) of the sentence; the event at the end of the sentences was modeled. The results indicate that a bilaterally distributed network supports semantic ambiguity comprehension: left (BA 45/44) and right (BA 47) inferior frontal gyri and left (BA 20/37) and right inferior/middle temporal gyri (BA 20). The pattern of activation is most consistent with a scenario in which initially a frequency-based probabilistic choice is made between the alternative meanings, and the meaning is updated when this interpretation does not fit into the final disambiguating context. The neural pattern is consistent with the results of other neuroimaging experiments which manipulated various aspects of integrative and context processing task demands. The presence of a bilateral network is also in line with the lesion and divided visual field literature, but contrary to earlier claims, the two hemispheres appear to play similar roles during semantic ambiguity resolution.
    NeuroImage 03/2007; 34(3):1270-9. · 6.25 Impact Factor
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    ABSTRACT: Progressive visual field defects, such as age-related macular degeneration and glaucoma, prevent normal stimulation of visual cortex. We investigated whether in the case of visual field defects, concentrations of metabolites such as N-acetylaspartate (NAA), a marker for degenerative processes, are reduced in the occipital brain region. Participants known with glaucoma, age-related macular degeneration (the two leading causes of visual impairment in the developed world), and controls were examined by proton MR spectroscopic ((1)H-MRS) imaging. Absolute NAA, Creatine and Choline concentrations were derived from a single-voxel in the occipital region of each brain hemisphere. No significant differences in metabolites concentrations were found between the three groups. We conclude that progressive retinal visual field defects do not affect metabolite concentration in visual brain areas suggesting that there is no ongoing occipital degeneration. We discuss the possibility that metabolite change is too slow to be detectable.
    PLoS ONE 02/2007; 2(2):e222. · 3.53 Impact Factor
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    ABSTRACT: Functional MRI (fMRI) generally employs gradient-echo echo-planar imaging (GE-EPI) to measure blood oxygen level-dependent (BOLD) signal changes that result from changes in tissue relaxation time T(*) (2) between activation and rest. Since T(*) (2) strongly varies across the brain and BOLD contrast is maximal only where the echo time (TE) equals the local T(*) (2), imaging at a single TE is a compromise in terms of overall sensitivity. Furthermore, the long echo train makes EPI very sensitive to main field inhomogeneities, causing strong image distortion. A method is presented that uses accelerated parallel imaging to reduce image artifacts and acquire images at multiple TEs following a single excitation, with no need to increase TR. Sensitivity gains from the broadened T(*) (2) coverage are optimized by pixelwise weighted echo summation based on local T(*) (2) or contrast-to-noise ratio (CNR) measurements. The method was evaluated using an approach that allows differential BOLD CNR to be calculated without stimulation, as well as with a Stroop experiment. Results obtained at 3 T showed that BOLD sensitivity improved by 11% or more in all brain regions, with larger gains in areas typically affected by strong susceptibility artifacts. The use of parallel imaging markedly reduces image distortion, and hence the method should find widespread application in functional brain imaging.
    Magnetic Resonance in Medicine 07/2006; 55(6):1227-35. · 3.27 Impact Factor