A practical approach to diseases affecting dentate nuclei

Khadilkar, Satish V; Jaggi, Sunila; Patel, Bhagyadhan A.; Yadav, Rajesh; Hanagandi, Prasad B.; Amaral, Lázaro Luís Faria do

doi:10.1016/j.crad.2015.09.010

Cited by 19 publications

(18 citation statements)

References 58 publications

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“…Radiation-related injury to the brain may result in calcifications, which are visible as an increase of magnetic resonance signal intensity. [ 40 ] Post-radiation changes may give non-specific hyperintense signal changes which are similar to many other conditions affecting the dentate nuclei [ 41 ]; therefore, patients who had undergone brain irradiation are commonly excluded from the studies examining the presence of hyperintense signal changes in relation to previous gadolinium exposure. In our review, Adin’s at al.…”

Section: Resultsmentioning

confidence: 99%

The presence of the gadolinium-based contrast agent depositions in the brain and symptoms of gadolinium neurotoxicity - A systematic review

et al. 2017

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Background and purposeGadolinium based contrast agents (GBCAs) are widely used in magnetic resonance imaging, but recently, high signal intensity in the cerebellum structures was reported after repeated administrations of contrast- enhanced magnetic resonance images. The aim of this systematic review was to investigate the association between increased signal intensity in the dentate nucleus and globus pallidus in the brain and repeated administrations of GBCAs. Additionally, we focused on possible short- and long-term consequences of gadolinium use in those patients.MethodsSystematic review of retrospective investigations in PubMed and Medline was performed in July 2016. Primary outcomes included the presence of increased signal intensity within the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images in patients following administrations of GBCAs. Two independent reviewers were responsible for search and data extraction.Results25 publications satisfied inclusion criteria (19 magnetic resonance images analyses, 3 case reports; 3 autopsy studies). Magnetic resonance images of 1247 patients with increased signal intensity on unenhanced T1-weighted MR images were analyzed as well as tissue specimens from 27 patients. Signal intensity correlated positively with the exposure to GBCAs and was greater after serial administrations of linear nonionic than cyclic contrast agents. Gadolinium was detected in all tissue examinations.ConclusionsHigh signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted magnetic resonance images were associated with previous administration of GBCAs. Signal intensity correlated negatively with stability of contrast agents. Clinical significance of gadolinium deposition in the brain remains unclear. There is a strong need for further research to identify type of gadolinium deposited in the brain as well as to gather knowledge about long-term consequences.

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Section: Resultsmentioning

confidence: 99%

The presence of the gadolinium-based contrast agent depositions in the brain and symptoms of gadolinium neurotoxicity - A systematic review

et al. 2017

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“…Further, tractography based on DWI may allow for studying connections of the whole cerebellar system [61]. As demonstrated in many literatures [4], [9]- [11], [17], [62], various structural MR imaging modalities also allow us to directly identify the DCN. Unfortunately, most of the modality 7T images in our database (e.g., susceptibilityweighted imaging and T2-weighted image) were optimized to cover the basal ganglia region that was needed for deep brain stimulation studies and thus did not contain the cerebellum.…”

Section: G Limitation and Future Workmentioning

confidence: 99%

Deep Cerebellar Nuclei Segmentation via Semi-Supervised Deep Context-Aware Learning from 7T Diffusion MRI

et al. 2020

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Deep cerebellar nuclei are a key structure of the cerebellum that are involved in processing motor and sensory information. It is thus a crucial step to accurately segment deep cerebellar nuclei for the understanding of the cerebellum system and its utility in deep brain stimulation treatment. However, it is challenging to clearly visualize such small nuclei under standard clinical magnetic resonance imaging (MRI) protocols and therefore precise segmentation is not feasible. Recent advances in 7 Tesla (T) MRI technology and great potential of deep neural networks facilitate automatic patient-specific segmentation. In this paper, we propose a novel deep learning framework (referred to as DCN-Net) for fast, accurate, and robust patientspecific segmentation of deep cerebellar dentate and interposed nuclei on 7T diffusion MRI. DCN-Net effectively encodes contextual information on the patch images without consecutive pooling operations and adding complexity via proposed dilated dense blocks. During the end-to-end training, label probabilities of dentate and interposed nuclei are independently learned with a hybrid loss, handling highly imbalanced data. Finally, we utilize self-training strategies to cope with the problem of limited labeled data. To this end, auxiliary dentate and interposed nuclei labels are created on unlabeled data by using DCN-Net trained on manual labels. We validate the proposed framework using 7T B0 MRIs from 60 subjects. Experimental results demonstrate that DCN-Net provides better segmentation than atlas-based deep cerebellar nuclei segmentation tools and other state-of-the-art deep neural networks in terms of accuracy and consistency. We further prove the effectiveness of the proposed components within DCN-Net in dentate and interposed nuclei segmentation. INDEX TERMS 7T diffusion MRI, deep cerebellar nuclei, deep neural networks, self-training, segmentation

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“…El diagnóstico diferencial de la hiperintensidad del ND y del GP en las imágenes ponderadas en T1 sin medio de contraste es amplio e incluye enfermedades metabólicas, neurofibromatosis, depósitos de otros metales y cambios por la edad, entre otros 26,27 (Tabla 2).…”

Section: Diagnóstico Diferencialunclassified