Watch this session on ECR Live: Wednesday, March 4, 08:30–10:00, Room E1
Tweet #ECR2015E1 #SF1B

Hearing loss can present many difficulties and obstacles to sufferers, and with ageing populations it’s set to become a major healthcare challenge. Many conditions such as congenital malformation of the inner ear or hypoplastic cochlear nerve can also lead to hearing loss, and sometimes deafness.

Fortunately, many new treatments are available to recover hearing, both partially and completely. Imaging plays an increasingly important role in therapy planning and follow-up, and there is hope on the research front, experts will show during a dedicated Special Focus session on Wednesday morning.

Microtia – congenital anomaly of external and middle ear, resulting in
conductive hearing loss. External auditory canal is not patent (arrow),
mastoid process is underdeveloped (arrowhead)

The prevalence of auditory problems in the Western world has doubled over the past 30 years. It is estimated that between 15 and 17% of the population will suffer hearing loss, due to ageing or congenital malformation, but also bad habits, according to Agnieszka Trojanowska, a radiologist at Lublin University Medical School, Poland, who will
chair the session.

“We start to see young adults in their early 30s with sensorineural hearing loss or other related problems because of high frequency noise, which is typical for listening to music. Twenty years ago, such a condition was linked with working in fabrics or on the street. But the good news is that even if you use your iPod a lot, the degree of hearing
loss is light to moderate, so this is not something that will considerably affect your life,” she said.

Read more…

NH 7 – The human connectome, A-158 – Connectomics in brain pathology (M.P. v.d. Heuvel)

A short preview of lecture A-158 ‘Connectomics in brain pathology’, from the session NH 7 ‘The human connectome: a comprehensive map of brain connections’ at ECR 2014, given by M.P. van den Heuvel from Utrecht, Netherlands.

Watch the whole lecture and many more at http://ipp.myESR.org
Direct link: http://bit.ly/The_human_connectome

Friday, March 7, 16:00 – 17:30 / Room Board Room B

Abstract:

Healthy brain function depends on efficient functional communication within a complex network of structural neural connections, a network known as the connectome. Conversely, damage to the brain’s network, disrupting local neuronal processes and/or global communication between remote functional systems may lead to brain dysfunction. In the last few years, emerging evidence from a wide variety of studies suggests that connectome abnormalities may indeed play an important role in the aetiology of several brain disorders. In my talk, I will discuss the results of recent studies suggesting an important role for affected connectome organization in a number of neurological and psychiatric disorders. In particular, I will highlight the findings of affected functional and structural brain network in neurodegenerative disorders such as Alzheimer’s and ALS, as well as discuss how the application of network science and connectomics may aid our understanding of the biological basis of psychiatric disorders such as autism and schizophrenia.

In recognition of his exceptional contributions to medical research, particularly in the field of neuroradiology, the European Society of Radiology invited Professor Paul M. Parizel from Antwerp, Belgium, to present the Wilhelm Conrad Röntgen Honorary Lecture at ECR 2014.

Professor Paul M. Parizel from
Antwerp, Belgium.

Paul M. Parizel is chairman of Antwerp University Hospital’s department of radiology and full professor of radiology at the University of Antwerp’s faculty of medicine. He is also an elected member of the University of Antwerp’s board of trustees, representing the faculty of medicine and health sciences.

In 1982, Prof. Parizel received his medical degree (summa cum laude) from the University of Antwerp and he later went on to earn a PhD degree with a dissertation on ‘The influence of field strength on magnetic resonance imaging: a comparative study in physiochemical phantoms, isolated brain specimens and clinical applications’. He then continued his research thanks to a three-year grant from the Belgian government’s National Foundation for Scientific Research.

Read more…

Watch this session on ECR Live: Friday, March 7, 16:00–17:30, room BRB
Tweet #ECR2014BRB #NH7

Radiologists often say that the brain is the next frontier. But as diffusion MRI techniques progress, the most mysterious organ in the human body starts to unveil more and more of its secrets, and what was once inconceivable a decade ago is now almost at hand.

White matter fibre pathways of the brain as depicted with MR
tractography.
(Provided by Patric Hagmann, CHUV-UNIL, Lausanne, Switzerland)

Researchers are now better able to understand how neurons connect with one another and how disease affects these connections in the human brain. The production and later study of maps of neural connections obtained with MRI are vital to this task. A dedicated New Horizons session will cover this fascinating topic today at the ECR.

Patric Hagmann, who will chair the session, is an attending physician and neuroradiologist at Lausanne University Hospital (CHUV, Centre hospitalier universitaire vaudois) in Switzerland. In his introduction, he will describe what he calls the connectome, a term he coined in his thesis on diffusion MRI and brain connectomics back in 2005*.

“We could sum up the connectome as a comprehensive map of neural connections in the brain. The production and study of connectomes is what we refer to as connectomics; it may range from a detailed map of neurons and synapses within part of, or all of, the nervous system to a description of the functional and structural connectivity between all cortical areas and subcortical structures,” he said.

In his presentation, Hagmann will not only introduce important concepts related to connectomics like scaling, the relation between structural and functional connectivity, and the integration-segregation, but also show how advances in MRI facilitate the mapping of the human connectome.

Read more…

A-205 Can non-invasive techniques as CTA and MRA replace catheter angio for diagnostic work-up?

L. van den Hauwe, M. Voormolen, T. van der Zijden, R. Salgado, J. Van Goethem, P.M. Parizel | Saturday, March 9, 08:30 – 10:00 / Room B

Although catheter angiography remains the gold standard for cerebrovascular imaging, in recent years, it has been replaced to some extent by less-invasive techniques, such as CTA, MRA, and ultrasound. Some of these techniques allow for cerebrovascular imaging without exposure to ionizing radiation, and/or without requiring an exogenous contrast agent that could cause nephrotoxicity, allergic reaction, or other adverse effects. Moreover, all of these techniques avoid the extra time, expense, and possibility of complications that are associated with arterial catheterization. Ongoing developments in CT- and MR-based angiography continue to improve the effectiveness of these techniques, and to expand the clinical roles that they can fulfill. Nowadays, these noninvasive techniques not only provide images with high spatial resolution, but also offer time-resolved images, in which arterial and venous phases can be distinguished, and can provide selective visualization of vessels supplied by a single supplying artery. This presentation will review the latest developments in CT- and MR-based cerebral angiography, and illustrate the use of these CT- and MR-techniques in the diagnosis of cerebral aneurysms and vascular malformations.

B-0403 MR spectroscopy in mild and moderate cognitive impairment as illness outcome predictor: preliminary experience

J. Forner Giner, A. Alberich-Bayarri, G. Garcia Marti, A. Pomar-Nadal, J. Rayón-Aledo, L. Martí-Bonmatí | Friday, March 8, 14:00 – 15:30 / Room B

Purpose: To evaluate Alzheimer’s disease premature diagnosis based on spectroscopy MRI.
Methods and Materials: We carried out a prospective study on 178 patients (116 women and 62 men) whose ages ranged 27 to 68 years (mean age 65 ± 12). Every patient presented mild or moderate cognitive impairment according to Reisberg score (3-4 grade). Standard brain MR and spectroscopy brain MR were performed using a 3 T intensity MRI device (Archieva TX, Philips Healthcare, Best, The Netherlands). Spectroscopy MR was focused in posterior parietal and frontal lobes gray substance using a unique volume (20 x 20 x 15 mm) and two different echo-times, TE (32 and 136). Morphology and volume of temporal lobes were evaluated through FLAIR coronal images which were used to quantify temporal horn width and so classify patients in four groups. JMRUI (Java Magnetic Resonance User Interface) was used to calculate quantitative parameters in MR spectroscopy. MR was used to measure: calculation of NAA (N-acetyl aspartate), Cr (creatinine), Cho (choline) and mI (myo-inositol) metabolites ratios. We used analysis of variance to compare metabolite ratios between the different patient groups previously defined.
Results: We found significant differences (p ≤ 0,05) between groups in NAA/Cho concentration (p=0,022), both in long and in short eco times and frontal and parietal anatomical regions. No other significant differences between groups were found.
Conclusion: MR spectroscopy could increase efficiency in Alzheimer’s disease premature diagnosis as well as turning out to be a useful additional tool for the clinician next to clinical history.

B-0118 Determination of the vascular input function using magnitude or phase-based MRI: influence on dynamic contrast-enhanced MRI model parameters in carotid plaques

 R.H.M. van Hoof, M.T.B. Truijman, E. Hermeling, R.J. van Oostenbrugge, R.J. van der Geest, M.J.A.P. Daemen, J.E. Wildberger, W.H. Backes, M.E. Kooi | Thursday, March 7, 10:30 – 12:00 / Room N/O

Purpose: A reliable vascular input function (VIF) is important for quantitative analysis of atherosclerotic carotid plaque microvasculature using dynamic contrast-enhanced (DCE) MRI. In tumour imaging and brain perfusion studies, it has been demonstrated that a phase-based VIF (ph-VIF) is less sensitive to flow artefacts compared to magnitude-based VIF (m-VIF). The purpose is (1) to compare m-VIF and ph-VIF and (2) to investigate the influence of different VIFs on DCE MRI model parameters in carotid plaques.
Methods and Materials: 21 patients with 30-99% carotid stenosis underwent 3 T DCE MRI. Data from four patients, scanned with a high temporal resolution were used to construct group-averaged m-VIF and ph-VIF of the jugular vein. The other 17 patients were used for calculating K^trans (measure of plaque microvasculature) using m-VIF and ph-VIF. The effect of neglecting flow on the m-VIF was estimated using the Bloch equations.
Results: Peak concentrations of m-VIFs were on average 4-fold lower than for ph-VIFs (p<0.001). Despite these differences, strong and significant correlation between K^trans determined using group averaged m-VIF and ph-VIF was found (Pearson’s correlation 0.91, p<0.001). Taking into account a theoretical flow of 8 cm/sec, the discrepancy in peak concentration of m-VIF and ph-VIF disappeared.
Conclusion: Our data suggest a strong influence of flow when calculating m-VIF of the jugular vein. Despite this, strong correlation between K^transparameters determined using m-VIF and ph-VIF was found. It is expected that a phase-based VIF results in a quantitative more realistic value of K^trans.

B-0406 Increased regional grey matter volume in Parkinson’s disease patients with excessive daytime sleepiness: an MRI study

L.C. Tzarouchi, M. Chondrogiorgi, A. Zikou, P. Kosta, M.I. Argyropoulou, S. Konitsiotis | Friday, March 8, 14:00 – 15:30 / Room B

Purpose: Excessive daytime sleepiness (EDS) is an important non-motor symptom of Parkinson’s disease (PD). The underlying neuropathological mechanism accounting for EDS is not well understood. The purpose of the present study was to determine regional grey matter (GM) volume changes in PD patients with EDS.
Methods and Materials: Seventeen PD patients with EDS (Epworth Sleepiness Scale ESS ≥ 12) (EDS-PD), 17 age and disease duration-matched PD patients (Epworth Sleepiness Scale ESS ≤ 6) and 17 age-matched healthy controls were enrolled in the study. The χ² and Student’s t tests were used to test for differences in demographic and clinical characteristics between groups. Differences in GM volume between groups were evaluated by applying the voxel-based morphometry (VBM) method.
Results: Total calculated levodopa equivalent dose was higher in EDS-PD when compared to PD patients (p<0.05). Comparison of EDS-PD with PD patients and controls showed increased GM volume bilaterally in the hippocampus, the parahippocampal gyrus, the fusiform gyrus and in cortical areas in the temporal, frontal and parietal lobes (p<0.001).
Conclusion: EDS-PD patients present increased regional GM volume in the mesolimbic/mesocortical dopamine pathway, which is activated during sleep. Drug-induced GM volume increase through a process of neuronal plasticity may represent the underlying mechanism.

A-224 C. Metabolic disorders

J.F. Schneider | Saturday, March 9, 08:30 – 10:00 / Room E2

Metabolic disorders may present at any age. Their clinical symptoms are often scarce or non-specific. Brain MRI is often used in the setting of an acute illness but may be delayed in slowly progressive disease. Imaging appearance can be confusing as acute and chronic signal intensity alterations may overlap in many disorders. Furthermore, imaging appearance will vary during the course of the disease. Recognition of signal changes in specific structures is most helpful in the acute setting before chronic changes set in, which will blur characteristic patterns. A systematic approach based on the pattern of brain involvement is useful in the analysis of neurometabolic disorders, and has even been computerized. First, a decision whether grey or white matter involvement or both must be made based upon volume and signal alterations on T1-wi, T2-wi, FLAIR imaging and contrast enhancement. Second, alterations within either focal grey matter structures or specific white matter tracts must be recorded and estimation upon their timing, whether acute or chronic, must be made. Finally, this pattern recognition must be supplemented by microstructural data from diffusion-weighted images (DWI) and metabolic data from proton MR spectroscopy (MRS). Additional information from DWI is often restricted to the acute setting, because chronic diffusivity changes are mainly driven by unspecific myelin breakdown. On the other hand, MRS may not only identify abnormal levels of normal metabolites or demonstrate the presence of abnormal metabolites, but can also be used to monitor therapy.

B-0120 Determining the vulnerable plaque: correlation between 18F-FDG PET and dynamic contrast-enhanced MRI in atherosclerotic plaques of symptomatic patients

M.T.B. Truijman, R.M. Kwee, R.H.M. van Hoof, R.J. van Oostenbrugge, W.H. Mess, J.E. Wildberger, W.H. Backes, J.A. Bucerius, M.E. Kooi | Thursday, March 7, 10:30 – 12:00 / Room N/O

Purpose: Identifying vulnerable atherosclerotic plaques in symptomatic patients with moderate (30-69%) carotid artery stenosis can contribute to clinical decision making. Hallmarks of plaque vulnerability are inflammation and increased neovascularisation. Inflammation can be assessed with ¹⁸F-FDG PET, while neovascularisation can be quantified with dynamic contrast-enhanced (DCE) MRI. We aimed to investigate the correlation between inflammation as assessed by¹⁸F-FDG PET and neovascularisation as assessed by DCE-MRI.
Methods and Materials: Fifty-eight patients with transient ischaemic attack (TIA) or minor stroke in the carotid territory and ipsilateral carotid plaque causing a moderate stenosis were included. All patients underwent 1.5 T multi-sequence MR imaging. Quantification of neovascularisation was done using a custom-made Matlab program which calculates K^trans. A 3D PET-CT scan was performed on all patients one hour after injection of 2.75 MBq/kg body weight ¹⁸F-FDG. Dedicated fusion software was used to calculate mean blood-normalised ¹⁸F-FDG standard uptake values (SUV) of the plaque.
Results: Of the 58 patients, 9 were excluded due to poor image quality of the DCE-MRI. In total, we analysed 49 patients. The mean K^trans and mean normalised SUV were 0.110 (±0.027) and 1.446 (±0.255), respectively. We found a weak but significant positive correlation between the mean normalised SUV and the meanK^trans (Spearman’s r=0.302, p=0.035).
Conclusion: There is a weak but significant positive correlation between K^trans, which is a marker for neovascularisation and SUV, which is a marker for inflammation. Future studies are warranted to investigate whether DCE-MRI and/or 18F-FDG PET can be used to predict cerebrovascular events.