Neurology & Neuro-Imaging

Overview

CTIPM’s advanced imaging techniques enable physicians to better diagnose and treat patients suffering from neurologic diseases such as Alzheimer’s disease, primary and metastatic brain tumors, movement disorders, multiple sclerosis, and epilepsy.

CTI Service: Post-Processing for Quantitative Segmental Volume Reporting and Assessment

3-Dimensional Image Acquisition and CTI Post Processing Allows Precise Tracking and Quantification of Neurodegeneration

CTI Brain Structure

A 73 year old patient with memory complaints was imaged using CTI’s Post-Processing for Quantitative Segmental Volume Assessment. At baseline, the patient showed lower-than-expected volumes of the brain’s memory structures (Left image, in yellow). Two years later, the same patient was imaged again (Right image).

Providing quantification of interval change, CTI’s precise image registration and segmentation also allows the radiologist to view the exact same slice position, regardless of head positioning, yielding improved visualization of change across time. As can be seen, the images provide objective support for an ongoing neurodegenerative process. The patient was subsequently enrolled in a clinical trial of a new Alzheimer’s disease therapeutic.

Quantitative imaging, the practice of extracting quantifiable information from magnetic resonance imaging (MRI), as well as advanced MR imaging techniques can help physicians better diagnose and treat patients with various neurological diseases.

For example, in neurodegenerative conditions that impair memory, this approach to imaging can help physicians measure the location and severity of brain damage impacting memory, enabling them to more precisely diagnose and treat their patients. In the field of neuro-oncology, quantitative imaging as well as advanced diffusion weighted imaging (also known as Restriction Spectrum Imaging, or RSI-MRI), magnetic resonance spectroscopy (MRS), and magnetic resonance perfusion (MRP) help clinicians to provide more accurate diagnoses and prognoses and to better assess how patients are responding to treatments.

Clinical Applications

Precision Quantitative Brain Imaging

  • Volumetric assessment of regional brain atrophy and tumor volumes with quantitative tracking of change across time
  • Precise registration of images, for improved visual assessment of subtle change across time
  • Distortion correction and cross-modality registration of brain imaging acquisitions, for improved multimodal assessment of regional disease
  • Automated delineation and quantitative assessment of brain fiber tracts
  • Three-dimensional real-time motion correction of acquired MR images
  • Advanced diffusion-weighted imaging, for assessment of brain tissue microstructure and improved characterization of brain tumors
  • Automated and quantitative assessment of amyloid and FDG Positron Emission Tomography data
  • Clinical fMRI, for pre-surgical brain mapping

Disease Applications

Neuro-Oncology:

  • Distortion correction of MR images for surgical and radiation planning
  • Measurement of tumor volumes, edema, and necrosis
  • Fiber tract visualization and measurement with correction for distortions
  • o Incorporation of post-processed data into surgical and radiation planning software

Memory Loss:

  • Alzheimer’s disease and mild cognitive impairment:
    • Quantitative assessment of age-related atrophy
    • Quantitative assessment of amyloid and FDG PET data
  • Sports-related concussion and other traumatic brain injury:
    • Assessment of regional volume and longitudinal change across time
    • Quantitative assessment of brain fiber tracts

Movement Disorders:

  • Quantitative assessment of basal ganglia, brainstem, and cerebellar structures and improved delineation of subcortical structures of interest
  • Assessment of anatomical asymmetry

Multiple Sclerosis:

  • Longitudinal assessment of white matter and grey matter atrophy
  • Quantification of demyelinating plaque burden and change across time to assess treatment response or failure
  • Quantitative assessment of brain fiber tracts

Epilepsy:

  • Hippocampal atrophy and asymmetry assessment
  • Quantitative PET reporting

Developmental/Congenital Disorders:

  • Volumetric assessment of regional brain anatomy
  • Comparison to genetically characterized normative database for pediatric population
  • Three-dimensional real-time motion correction for improved image quality

Directors:

James B. Brewer, MD, PhD

James B. Brewer, MD, PhD
Professor of Radiology at UC San Diego
Director for Neurology & Neuro-Imaging, CTIPM

Staff:

  • Nichol Ferng, Staff Research Assistant II
  • Elizabeth Orient, Staff Research Assistant II
  • Robin Jennings, Biostatistician
  • Helen Vanderswag, LPN
  • Darlene Evardone, Administrative Assistant

 

Nikdokht (Niky) Farid, MD

Nikdokht (Niky) Farid, MD
Associate Professor of Radiology at UC San Diego
Director for Neurology & Neuro-Imaging, CTIPM

Staff: Laura Anderson, Administrative Assistant

Partner Physicians:

Neurodegenerative (or Memory Loss)

Movement Disorders

Multiple Sclerosis

Neuro-Oncology

Neurosurgery

Radiation Oncology