Ensemble classification and segmentation for intracranial metastatic tumors on MRI images based on 2D U-nets

AbstractThe extraction of brain tumor tissues in 3D Brain Magnetic Resonance Imaging (MRI) plays an important role in diagnosis before the gamma knife radiosurgery (GKRS). In this article, the post-contrast T1 whole-brain MRI images had been collected by Taipei Veterans General Hospital (TVGH) and stored in DICOM format (dated from 1999 to 2018). The proposed method starts with the active contour model to get the region of interest (ROI) automatically and enhance the image contrast. The segmentation models are trained by MRI images with tumors to avoid imbalanced data problem under model construction. In order to achieve this objective, a two-step ensemble approach is used to establish such diagnosis, first, classify whether there is any tumor in the image, and second, segment the intracranial metastatic tumors by ensemble neural networks based on 2D U-Net architecture. The ensemble for classification and segmentation simultaneously also improves segmentation accuracy. The result of classification achieves a F1-measure of $$75.64\%$$ 75.64 % , while the result of segmentation achieves an IoU of $$84.83\%$$ 84.83 % and a DICE score of $$86.21\%$$ 86.21 % . Significantly reduce the time for manual labeling from 30 min to 18 s per patient.

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Prevalence of brain magnetic resonance imaging meeting Barkhof and McDonald criteria for dissemination in space among headache patients

Multiple Sclerosis Journal ◽

10.1177/1352458512471874 ◽

2013 ◽

Vol 19 (8) ◽

pp. 1101-1105 ◽

Cited By ~ 52

Author(s):

Syrone Liu ◽

Jonathan Kullnat ◽

Dennis Bourdette ◽

Jack Simon ◽

Dale F Kraemer ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Demyelinating Disease ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Post Contrast ◽

Mcdonald Criteria ◽

Magnetic Resonance Imaging Mri ◽

Headache Patients

Background: Incidental T2 white matter hyperintensities (WMHs) in headache patients on brain magnetic resonance imaging (MRI) may prompt concern for demyelinating disease. Objective: We reviewed brain MRI studies in patients with headaches without known demyelinating disease to determine the prevalence meeting imaging criteria for multiple sclerosis (MS) using two different definitions of “juxtacortical” and “periventricular”. Methods: Consecutive patients undergoing pre- and post-contrast MRI for headaches over a 25-month period were retrospectively identified. Exclusions included patients under age 10 and over 55 years or with known demyelinating disorder. Patients were classified as meeting: 1) Barkhof and 2) 2010 McDonald dissemination in space criteria for MS based on: FLAIR/T2 scans for WMH and enhanced T1-weighted images for enhancement. Both groups were further differentiated by defining “periventricular” and “juxtacortical” as WMH contacting ventricle and cortex (Barkhof “touching”, McDonald “touching”) versus WMH within 3 mm (Barkhof – 3 mm, McDonald – 3 mm). Results: 326/564 (58%) studies met inclusion criteria. WMH prevalence was 168/326 (51.53%). Barkhof “touching” criteria were met in 4/168 (2.4%) and in 12/168 (7.1%) of the 3 mm group. McDonald criteria were met in 41/168 (24.4%) for “touching” and 58/168 (34.5%) for 3 mm, respectively. Conclusion: Barkhof and McDonald criteria were met in 2.4–7.1% and 24.4–34.5%, respectively.

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Pediatric Reversible Cerebral Vasoconstriction Syndrome: Two Unique Cases with a Review of all Reported Children

Journal of Pediatric Neurology ◽

10.1055/s-0041-1722959 ◽

2021 ◽

Author(s):

Neelu Desai ◽

Rahul Badheka ◽

Nitin Shah ◽

Vrajesh Udani

Keyword(s):

Magnetic Resonance ◽

Cerebral Arteries ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Reversible Cerebral Vasoconstriction Syndrome ◽

Neurological Deficits ◽

Cerebral Vasoconstriction ◽

Magnetic Resonance Imaging Mri ◽

Reversible Encephalopathy ◽

Mr Angiogram

AbstractReversible cerebral vasoconstriction syndrome (RCVS) has been well described in adults, but pediatric cases are yet under recognized. We describe two children with RCVS and review similar already published pediatric cases. The first patient was a 10-year-old girl who presented with severe headaches and seizures 3 days after blood transfusion. Brain magnetic resonance imaging (MRI) showed changes compatible with posterior reversible encephalopathy syndrome and subarachnoid hemorrhage. Magnetic resonance angiogram showed diffuse vasoconstriction of multiple cerebral arteries. The second patient was a 9-year-old boy who presented with severe thunderclap headaches. Brain MRI showed isolated intraventricular hemorrhage. Computed tomography/MR angiogram and digital subtraction angiogram were normal. A week later, he developed focal neurological deficits. Repeated MR angiogram showed diffuse vasospasm of multiple intracranial arteries. Both children recovered completely. A clinico-radiological review of previously reported childhood RCVS is provided.

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Prevalence and Clinical Implications of Incidentally Detected Parotid Lesions as Blind Spot on Brain MRI: A Single-Center Experience

Medicina ◽

10.3390/medicina57080836 ◽

2021 ◽

Vol 57 (8) ◽

pp. 836

Author(s):

In-Chul Nam ◽

Hye-Jin Baek ◽

Kyeong-Hwa Ryu ◽

Jin-Il Moon ◽

Eun Cho ◽

...

Keyword(s):

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Blind Spot ◽

Clinical Implications ◽

Single Center Experience ◽

Superficial Lobe ◽

Mean Size ◽

Magnetic Resonance Imaging Mri ◽

Clinical Awareness ◽

Low Prevalence

Background and objective: This study was conducted to assess the prevalence and clinical implications of parotid lesions detected incidentally during brain magnetic resonance imaging (MRI) examination. Materials and Methods: Between February 2016 and February 2021, we identified 86 lesions in the brain MRI reports of 84 patients that contained the words “parotid gland” or “PG”. Of these, we finally included 49 lesions involving 45 patients following histopathological confirmation. Results: Based on the laboratory, radiological or histopathological findings, the prevalence of incidental parotid lesions was low (1.2%). Among the 45 study patients, 41 (91.1%) had unilateral lesions, and the majority of the lesions were located in the superficial lobe (40/49, 81.6%). The mean size of the parotid lesions was 1.3 cm ± 0.4 cm (range, 0.5 cm–2.8 cm). Of these, 46 parotid lesions (93.9%) were benign, whereas the remaining three lesions were malignant (6.1%). Conclusions: Despite the low prevalence and incidence of malignancy associated with incidental parotid lesions detected on brain MRI, the clinical implications are potentially significant. Therefore, clinical awareness and appropriate imaging work-up of these lesions are important for accurate diagnosis and timely management.

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Can we evaluate cranial aneurysms on conventional brain magnetic resonance imaging?

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.165425 ◽

2016 ◽

Vol 7 (01) ◽

pp. 83-86 ◽

Cited By ~ 1

Author(s):

Emine Caliskan ◽

Yeliz Pekcevik ◽

Adnan Kaya

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Characteristic Curve ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Kappa Statistics ◽

Resonance Imaging ◽

Vascular Structures ◽

Magnetic Resonance Imaging Mri ◽

Age Range

ABSTRACT Purpose: To evaluate the contribution of conventional brain magnetic resonance imaging (MRI) for the determination of intracranial aneurysms. Materials and Methods: Brain MRI and computed tomography angiography (CTA) of 45 patients (29 women and 16 men; age range, 32–80 years) with aneurysm were analyzed. A comparison was made between brain MRI and CTA based on size and presence of aneurysm. The comparisons between MRI and CTA were investigated through Bland-Altman graphics, receiver operating characteristic curve, and Kappa statistics. Results: Fifty-seven aneurysms were evaluated. Forty-five percent of 57 aneurysms on CTA were detected on conventional brain MRI. A significant correlation was found between CTA and brain MRI in the diagnosis of aneurysm (P < 0.05). In an analysis of the size measurement, a significant correlation was observed between CTA and brain MRI. Seventy-seven percent of aneurysms <4 mm was not detected and the efficiency of MRI in the detection of aneurysms <4 mm was found to be low. Conclusion: Aneurysms can also be appreciated on conventional brain MRI, and vascular structures should be reviewed carefully while analyzing brain MRI.

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Catamenial Synkinetic Retroauricular Pain

Cephalalgia ◽

10.1046/j.1468-2982.2003.00483.x ◽

2003 ◽

Vol 23 (3) ◽

pp. 214-217 ◽

Cited By ~ 2

Author(s):

DE Jacome

Keyword(s):

White Matter Hyperintensities ◽

Rare Complication ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Bell’S Palsy ◽

Bell's Palsy ◽

Patient Reported ◽

Magnetic Resonance Imaging Mri ◽

Eye Closure ◽

Facial Synkinesis

A report of two female patients with persistent unilateral retroauricular pain and cranial synkinesis following Bell's palsy. Pain occurred during menses in the first patient and was exacerbated by menses in the second patient. Retroauricular pain often precedes or follows Bell's palsy. Pain normally disappears within 2 weeks from the onset of paralysis. Neurological examination, brain magnetic resonance imaging (MRI), computed tomography of the head and cranial electrophysiological testing were performed. The first patient had severe right retroauricular pain during her menses for several years following Bell's palsy. Her brain MRI showed non-specific T2 white matter hyperintensities. On her electromyogram she had facial synkinesis with tonic motor unit discharges on her right orbicularis oris and mentalis muscles during sustained eye closure. The second patient reported hearing a sound over her left ear when she blinked or protruded her jaw after Bell's palsy. She had ipsilateral retroauricular pain, exacerbated during menses. Her brain MRI was normal. Electromyogram showed facial synkinesis. Chronic retroauricular pain, occurring or exacerbated during menses, may be a rare complication of Bell's palsy. It can be associated with facial subclinical synkinetic dystonia and trigemino-facial synkinesis.

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A Novel SUCLA2 Mutation Presenting as a Complex Childhood Movement Disorder

Journal of Child Neurology ◽

10.1177/0883073816666221 ◽

2016 ◽

Vol 32 (2) ◽

pp. 246-250 ◽

Cited By ~ 3

Author(s):

Caterina Garone ◽

Juliana Gurgel-Giannetti ◽

Simone Sanna-Cherchi ◽

Sindu Krishna ◽

Ali Naini ◽

...

Keyword(s):

Magnetic Resonance ◽

Movement Disorder ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Mitochondrial Respiratory Chain ◽

Resonance Spectroscopy ◽

Homozygous Mutation ◽

Psychomotor Delay ◽

Mtdna Depletion ◽

Magnetic Resonance Imaging Mri

SUCLA2 defects have been associated with mitochondrial DNA (mtDNA) depletion and the triad of hypotonia, dystonia/Leigh-like syndrome, and deafness. A 9-year-old Brazilian boy of consanguineous parents presented with psychomotor delay, deafness, myopathy, ataxia, and chorea. Despite the prominent movement disorder, brain magnetic resonance imaging (MRI) was normal while 1H-magnetic resonance spectroscopy (MRS) showed lactate peaks in the cerebral cortex and lateral ventricles. Decreased biochemical activities of mitochondrial respiratory chain enzymes containing mtDNA-encoded subunits and mtDNA depletion were observed in muscle and fibroblasts. A novel homozygous mutation in SUCLA2, the first one in the ligase coenzyme A (CoA) domain of the protein, was identified. Escalating doses of CoQ10 up to 2000 mg daily were associated with improvement of muscle weakness and stabilization of the disease course. The findings indicate the importance of screening for mitochondrial dysfunction in patients with complex movement disorders without brain MRI lesions and further investigation for potential secondary CoQ10 deficiency in patients with SUCLA2 mutations.

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The Implications of Brain MRI in Autism Spectrum Disorder

Journal of Child Neurology ◽

10.1177/0883073816665548 ◽

2016 ◽

Vol 31 (14) ◽

pp. 1611-1616 ◽

Cited By ~ 10

Author(s):

Alison S. Cooper ◽

Eron Friedlaender ◽

Susan E. Levy ◽

Karuna V. Shekdar ◽

Andrea Bennett Bradford ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Neurologic Examination ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

Low Prevalence

Our objective was to describe the types of providers who refer children with autism spectrum disorder (ASD) for brain magnetic resonance imaging (MRI), the referral reason, and MRI results. The most common referral reasons were autism spectrum disorder with seizures (33.7%), autism spectrum disorder alone (26.3%), and autism spectrum disorder with abnormal neurologic examination or preexisting finding (24%). Neurology (62.5%), general pediatric (22.3%), and developmental/behavioral practitioners (8.9%) referred the most patients. The prevalence of definite pathology was highest in children referred for autism spectrum disorder with abnormal neurologic examination/preexisting finding (26.2%, 95% CI: 16.8%-36%), headaches (25.7%, 95% CI: 11.2%-40.2%), or seizures (22%, 95% CI: 14.6%-29.5%), and was lowest in children referred for autism spectrum disorder alone (6.5%, 95% CI: 1.5%-11.6%). We concluded that there is a low prevalence of definite pathology in children with autism spectrum disorder undergoing brain MRI. In children with abnormal neurologic examination or preexisting finding, seizures, or headaches, one may consider performing brain MRI given the higher prevalence of pathology.

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Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458513494490 ◽

2013 ◽

Vol 20 (2) ◽

pp. 214-219 ◽

Cited By ~ 25

Author(s):

Antonio Giorgio ◽

Maria Laura Stromillo ◽

Maria Letizia Bartolozzi ◽

Francesca Rossi ◽

Marco Battaglini ◽

...

Keyword(s):

Multiple Sclerosis ◽

Brain Mri ◽

Univariate Analysis ◽

Brain Lesion ◽

Brain Magnetic Resonance Imaging ◽

Stepwise Multiple Regression ◽

Lesion Volume ◽

Magnetic Resonance Imaging Mri ◽

Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

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Parahippocampal Corpora Amylacea

Neurosurgery ◽

10.1227/01.neu.0000369196.94664.4e ◽

2010 ◽

Vol 66 (6) ◽

pp. E1206-E1207 ◽

Cited By ~ 8

Author(s):

Taylor J. Abel ◽

Adam O. Hebb ◽

C. Dirk Keene ◽

Donald E. Born ◽

Daniel L. Silbergeld

Keyword(s):

Hippocampal Sclerosis ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

High Density ◽

Low Grade ◽

Corpora Amylacea ◽

Hypoxic Injury ◽

Migraine Headaches ◽

History Of ◽

Magnetic Resonance Imaging Mri

Abstract OBJECTIVE Corpora amylacea (CA) normally accumulate within perivascular, subpial, and subependymal astrocytic processes. CA are associated with a number of conditions including normal aging, hippocampal sclerosis associated with temporal lobe epilepsy, multiple sclerosis, Lafora-type progressive myoclonic epilepsy, and adult polyglucosan body disease. Reports of massive localized accumulation of CA in the brain outside of these conditions are rare. CLINICAL PRESENTATION A 49-year-old woman, with a long-standing history of migraine headaches, presented to her primary care provider for increased headache duration. Brain magnetic resonance imaging (MRI) revealed a left parahippocampal lesion, suggestive of low-grade glioma. INTERVENTION Given the MRI suggestive of left parahippocampal glioma, left-sided frontotemporal craniotomy was performed for resection of the lesion. Specimens obtained during the operation revealed focal high-density accumulation of CA with no evidence of neoplasm, ischemia, or hypoxic injury. CONCLUSION This case illustrates the possibility that localized high-density CA accumulation can present as an intrinsic lesion on brain MRI. CA should be included in the differential diagnosis for patients presenting with brain MRI suggestive of nonenhancing space-occupying lesions.

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Bilateral Medial Medullary Stroke: A Challenge in Early Diagnosis

Case Reports in Neurological Medicine ◽

10.1155/2013/274373 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3

Author(s):

Amir M. Torabi

Keyword(s):

Cervical Spine ◽

Early Diagnosis ◽

Brain Mri ◽

Brain Magnetic Resonance Imaging ◽

Mri Findings ◽

Rare Type ◽

Abnormal Signal ◽

Acute Vestibular Syndrome ◽

Spine Mr ◽

Magnetic Resonance Imaging Mri

Bilateral medial medullary stroke is a very rare type of stroke, with catastrophic consequences. Early diagnosis is crucial. Here, I present a young patient with acute vertigo, progressive generalized weakness, dysarthria, and respiratory failure, who initially was misdiagnosed with acute vestibular syndrome. Initial brain magnetic resonance imaging (MRI) that was done in the acute phase was read as normal. Other possibilities were excluded by lumbar puncture and MRI of cervical spine. MR of C-spine showed lesion at medial medulla; therefore a second MRI of brain was requested, showed characteristic “heart appearance” shape at diffusion weighted (DWI), and confirmed bilateral medial medullary stroke. Retrospectively, a vague-defined hyperintense linear DWI signal at midline was noted in the first brain MRI. Because of the symmetric and midline pattern of this abnormal signal and similarity to an artifact, some radiologists or neurologists may miss this type of stroke. Radiologists and neurologists must recognize clinical and MRI findings of this rare type of stroke, which early treatment could make a difference in patient outcome. The abnormal DWI signal in early stages of this type of stroke may not be a typical “heart appearance” shape, and other variants such as small dot or linear DWI signal at midline must be recognized as early signs of stroke. Also, MRI of cervical spine may be helpful if there is attention to brainstem as well.

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