Publications by authors named "Irvin Teh"

Background: Cardiac diffusion tensor imaging (cDTI) is sensitive to imaging parameters including the number of unique diffusion encoding directions (ND) and number of repetitions (NR; analogous to number of signal averages or NSA). However, there is no clear guidance for optimising these parameters in the clinical setting.

Methods: Spin echo cDTI data with 2 order motion compensated diffusion encoding gradients were acquired in ten healthy volunteers on a 3T MRI scanner with different diffusion encoding schemes in pseudo-randomised order.

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Background: Cardiac diffusion tensor imaging (cDTI) is an emerging technique for microstructural characterization of the heart and has shown clinical potential in a range of cardiomyopathies. However, there is substantial variation reported for in vivo cDTI results across the literature, and sensitivity of cDTI to differences in imaging sites, scanners, acquisition protocols and post-processing methods remains incompletely understood.

Methods: SIGNET is a prospective multi-centre, observational study in travelling and non-travelling healthy volunteers.

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Purpose: Cardiac diffusion tensor imaging (cDTI) can investigate the microstructure of heart tissue. At sufficiently high b-values, additional information on microstructure can be observed, but the data require a representation such as diffusion kurtosis imaging (DKI). cDTI is prone to image corruption, which is usually treated with shot rejection but which can be handled more generally with robust estimation.

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Purpose: Diffusion tensor imaging (DTI) is commonly used in cardiac diffusion magnetic resonance imaging (dMRI). However, the tissue's microstructure (cells, membranes, etc.) restricts the movement of the water molecules, making the spin displacements deviate from Gaussian behavior.

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Background: Root avulsion in patients with traumatic brachial plexus injury (tBPI) are common and MRI is used to help identify patients who need urgent reconstruction. Diffusion tensor MRI (DTI) generates proxy measures of nerve 'health' which are sensitive to myelination, axon diameter, fibre density and organisation. This prospective multicentre pilot study assessed the utility of DTI for detecting root avulsion in adults with acute traumatic brachial plexus injury.

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Background And Purpose: The use of magnetic resonance imaging (MRI) for radiotherapy (RT) simulation has grown, prompting quality assurance (QA) guidelines by the Institute of Physics and Engineering in Medicine (IPEM) and the American Association of Physicists in Medicine (AAPM). This study compares a novel multimodality anthropomorphic phantom to an American College of Radiology (ACR) phantom for a subset of these MRI-specific QA tests in RT.

Materials And Methods: A novel 3D-printed multimodality head-and-neck anthropomorphic phantom was compared to an ACR large MRI phantom.

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Cardiac diffusion tensor imaging (cDTI) is highly prone to image corruption, yet robust-fitting methods are rarely used. Single voxel outlier detection (SVOD) can overlook corruptions that are visually obvious, perhaps causing reluctance to replace whole-image shot-rejection (SR) despite its own deficiencies. SVOD's deficiencies may be relatively unimportant: corrupted signals that are not statistical outliers may not be detrimental.

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Thanks to recent developments in cardiovascular magnetic resonance (CMR), cardiac diffusion-weighted magnetic resonance is fast emerging in a range of clinical applications. Cardiac diffusion-weighted imaging (cDWI) and diffusion tensor imaging (cDTI) now enable investigators and clinicians to assess and quantify the tridimensional microstructure of the heart. Free-contrast DWI is uniquely sensitized to the presence and displacement of water molecules within the myocardial tissue, including the intracellular, extracellular, and intravascular spaces.

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Article Synopsis
  • The study aimed to evaluate how accurately MRI can diagnose nerve injuries related to brachial plexus birth injury (BPBI) compared to surgical exploration.
  • Eight studies were analyzed, involving 116 children, but all showed risk of bias; MRI had a sensitivity of 68% and specificity of 89% for detecting root avulsion, while pseudomeningocele was not a reliable indicator.
  • The findings suggest that surgical exploration remains the preferred method for diagnosis because MRI's diagnostic accuracy is not high enough for making critical treatment decisions.
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  • This study focused on optimizing CBCT protocols for head and neck radiotherapy using a 3D-printed phantom to improve patient positioning and reduce radiation dose.
  • Ten different CBCT protocols were tested, revealing that some protocols could cut radiation exposure by over 50% while still providing good image quality for treatment setup.
  • The research highlights the need for tailored imaging protocols based on the area being treated, indicating that future work is required to further refine these protocols for adaptive radiotherapy and to establish effective dose measurements.
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This study aims to identify and evaluate suitable and stable materials for developing a head and neck anthropomorphic multimodality phantom for radiotherapy purposes. These materials must mimic human head and neck tissues in both computed tomography (CT) and magnetic resonance imaging (MRI) and maintain stable imaging properties over time and after radiation exposure, including the high levels associated with linear accelerator (linac) use.Various materials were assessed by measuring their CT numbers and T1 and T2 relaxation times.

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This study aimed to examine different trajectory correction methods for spiral imaging on a preclinical scanner with high-performance gradients with respect to image quality in a phantom and in vivo. The gold standard method of measuring the trajectories in a separate experiment is compared to an isotropic delay-correction, a correction using the gradient system transfer function (GSTF), and a combination of the two. Three different spiral trajectories, with 96, 16, and three interleaves, are considered.

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Purpose: This work reports for the first time on the implementation and application of cardiac diffusion-weighted MRI on a Connectom MR scanner with a maximum gradient strength of 300 mT/m. It evaluates the benefits of the increased gradient performance for the investigation of the myocardial microstructure.

Methods: Cardiac diffusion-weighted imaging (DWI) experiments were performed on 10 healthy volunteers using a spin-echo sequence with up to second- and third-order motion compensation ( and ) and , and 1000 (twice the commonly used on clinical scanners).

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  • This study investigates how different preprocessing pipelines for Diffusion Tensor Imaging (DTI) affect the estimation of nerve health metrics, addressing the issue of artifacts in echo-planar imaging.
  • Researchers acquired DTI data from healthy volunteers and applied various correction methods, finding that while preprocessing enhances image similarity, it also leads to significant variability in the measurements of nerve health indicators across different pipelines.
  • Ultimately, the study concludes that even though preprocessing improves certain aspects of image quality, the choice of pipeline can significantly affect crucial diffusion metrics, highlighting the need for careful methodology in DTI studies of peripheral nerves.
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Background: In hypertrophic cardiomyopathy (HCM), myocyte disarray and microvascular disease (MVD) have been implicated in adverse events, and recent evidence suggests that these may occur early. As novel therapy provides promise for disease modification, detection of phenotype development is an emerging priority. To evaluate their utility as early and disease-specific biomarkers, we measured myocardial microstructure and MVD in 3 HCM groups-overt, either genotype-positive (G+LVH+) or genotype-negative (G-LVH+), and subclinical (G+LVH-) HCM-exploring relationships with electrical changes and genetic substrate.

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Purpose: This paper presents a hierarchical modeling approach for estimating cardiomyocyte major and minor diameters and intracellular volume fraction (ICV) using diffusion-weighted MRI (DWI) data in ex vivo mouse hearts.

Methods: DWI data were acquired on two healthy controls and two hearts 3 weeks post transverse aortic constriction (TAC) using a bespoke diffusion scheme with multiple diffusion times ( ), q-shells and diffusion encoding directions. Firstly, a bi-exponential tensor model was fitted separately at each diffusion time to disentangle the dependence on diffusion times from diffusion weightings, that is, b-values.

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Peripheral neuropathy affects 1 in 10 adults over the age of 40 years. Given the absence of a reliable diagnostic test for peripheral neuropathy, there has been a surge of research into diffusion tensor imaging (DTI) because it characterises nerve microstructure and provides reproducible proxy measures of myelination, axon diameter, fibre density and organisation. Before researchers and clinicians can reliably use diffusion tensor imaging to assess the 'health' of the major nerves of the upper limb, we must understand the "normal" range of values and how they vary with experimental conditions.

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Article Synopsis
  • This study explores the use of tensor-valued diffusion encoding to gain deeper insights into the microstructure of heart tissue compared to typical diffusion-weighted imaging techniques.
  • Researchers scanned ten healthy individuals using a 3T MRI and performed advanced data analysis to obtain metrics like mean diffusivity, fractional anisotropy, and more, assessing their repeatability and normal values.
  • The results indicate that the method is viable and could introduce new biomarkers for characterizing heart tissue, showcasing the first successful application of this technique in living humans.
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Background: Adverse LV remodeling post-ST-segment elevation myocardial infarction (STEMI) is associated with a poor prognosis, but the underlying mechanisms are not fully understood. Diffusion tensor (DT)-cardiac magnetic resonance (CMR) allows in vivo characterization of myocardial architecture and provides unique mechanistic insight into pathophysiologic changes following myocardial infarction.

Objectives: This study evaluated the potential associations between DT-CMR performed soon after STEMI and long-term adverse left ventricular (LV) remodeling following STEMI.

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In silico tissue models (viz. numerical phantoms) provide a mechanism for evaluating quantitative models of magnetic resonance imaging. This includes the validation and sensitivity analysis of imaging biomarkers and tissue microstructure parameters.

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  • Early diagnosis of obstetric brachial plexus injury (OBPI) in young children is difficult, and this study aims to evaluate the effectiveness of MRI compared to surgical exploration in detecting nerve injuries, specifically root avulsion.
  • The review will follow the PRISMA guidelines and will include studies that compare MRI results with surgical findings in children under 5 years old with OBPI, excluding case reports without clear diagnostic outcomes.
  • The analysis will involve multiple literature searches and independent reviews to gather data on MRI's ability to identify nerve abnormalities and pseudomeningoceles, assessing the quality and bias of the included studies.
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Anti-1-amino-3-fluorine-fluorocyclobutane-1-carboxylic acid (F-fluciclovine) positron emission tomography (PET) shows preferential glioma uptake but there is little data on how uptake correlates with post-contrast T1-weighted (Gd-T1) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) activity during adjuvant treatment. This pilot study aimed to compare F-fluciclovine PET, DCE-MRI and Gd-T1 in patients undergoing chemoradiotherapy for glioblastoma (GBM), and in a parallel pre-clinical GBM model, to investigate correlation between F-fluciclovine uptake, MRI findings, and tumour biology. F-fluciclovine-PET-computed tomography (PET-CT) and MRI including DCE-MRI were acquired before, during and after adjuvant chemoradiotherapy (60 Gy in 30 fractions with temozolomide) in GBM patients.

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Article Synopsis
  • - The study investigates the potential for cardiac diffusion tensor imaging (cDTI) to detect intramyocardial hemorrhage (IMH) after ST-elevation myocardial infarction (STEMI), which is important for patient prognosis.
  • - A total of 50 patients were examined at one week and three months post-STEMI, using various imaging techniques including T2* mapping, which is the standard for identifying IMH.
  • - Results showed that cDTI effectively identified IMH, with the presence of hypointense signals matching IMH areas found on T2* maps, and significant differences in mean diffusivity and fractional anisotropy values, indicating altered myocardial architecture due to IMH.
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