International Conference on Neuroimaging and Interventional Radiology August 22-23, 2016 Vienna, Austria

Biography:

Sarah Crawford received the Master’s Degree in Biochemistry from Princeton University in 1982 and a Ph.D. Degree from the Department of Biochemistry and Biophysics, Columbia University College of Physicians and Surgeons in 1987. I have been affiliated with Southern Connecticut State University for over 20 years, currently Full Professor in the Department of Biology where I teach Genetics and Medical Genetics, and direct a research laboratory in cancer biology. In 2013 I was awarded a patent by the US Patent Office for a novel cancer treatment for the brain cancer, glioblastoma.

Abstract:

The Quantitative Threshold Exposure (QTE) hypothesis is a multifactorial threshold model that accounts for the cumulative effects of risk factor exposure in both the causation of autism spectrum disorder (ASD) and its dramatic increase over the past 30 years. The QTE hypothesis proposes that ASD is triggered by the cumulative effects of high-level exposure to endogenous and environmental factors that act as antigens to impair normal immune system (IS) and associated central nervous system (CNS) functions during critical developmental stages. The quantitative threshold parameters that comprise a cumulative risk for the development of ASD are identified by the assessment of documented epidemiological factors that, in sum, determine the likelihood that ASD will occur as a result of their effects on critically integrated IS and CNS pathways active during prenatal, neo-natal and early childhood brain maturation. The model proposes an explanation for the relationship between critical developmental stages of brain/immune system development in conjunction with the quantitative effects of genetic and environmental risk factors that may interface with these critical developmental windows. This model may be useful even when the individual contributions of specific risk factors cannot be quantified, as it proposes that the combined quantitative level of exposure to risk factors for ASD rather than exposure to any one risk factor per se defines threshold occurrence rates.

Biography:

Czeslawa Kowal completed her PhD in the Institute of Organic Chemistry of the Polish Academy of Sciences, Warsaw, Poland, and her postdoctoral training in molecular biology and in immunology at Columbia University and at the Albert Einstein College of Medicine New York. She has published 45 peer reviewed papers and book chapters in reputed journals. She is a member of the American Association of Immunologists.

Abstract:

Lupus is an autoimmune disease affecting primarily women in child bearing age. It is a multiorgan involvement disease, with frequent central nervous system (CNS) manifestation, most particularly, cognitive impairment. Lupus is characterized by the production of antinuclear autoantibodies and in particular, anti-dsDNA antibodies. We have created an animal model of CNS lupus in which autoantibodies cross-reactive with dsDNA and with the NMDA receptor (NMDAR) lead to an enhanced NMDAR activation and, at higher concentration to neuronal death when present in the brain parenchyma. We have shown that this requires breaching of the blood brain barrier. We have further demonstrated in the mouse model that the impact of these antibodies on neurons was concentration dependent and that at higher concentration, these antibodies promote neuronal excitotoxicity through enhanced mitochondrial permeability transition. In the model spatial recognition deficits are caused by the presence of these antibodies in the hippocampus. Structural analysis revealed a substantial reduction in dendritic processes and spines accompanied by a significant expansion of a place field size of surviving CA1 pyramidal.

We and others have shown that the presence of these antibodies in the cerebrospinal fluid of lupus patients correlates with diff use manifestations of CNS lupus.

Recent studies of lupus patients harboring dsDNA and NMDAR reactive antibodies demonstrate an association with an impairment in spatial memory. This observation is in striking similarity to the mouse model.

Biography:

António Pais de Lacerda was graduated in medicine at the Medical School of the University of Lisbon (Portugal), and he has a master’s degree in Medical Education. His current position is as intensive care consultant in an Intensive Care Unit (Hospital de Santa Maria); He is Assistant Professor of the Disciplines of “Introduction to Medicine”, “Electrocardiography” and “Intensive Care Medicine”. His main interests are on “pre- and post-graduate medical education “, “Medicine in the movies”, “Sepsis” and “HIV /AIDS medicine.” He has about 80 published papers, and two books on AIDS.

Abstract:

Human immunodeficiency virus (HIV) infection has been associated to premature atherosclerosis. Carotid intima-media thickness (CIMT) and pulsatility index (PI) accessed by carotid duplex ultrasonography (CDU) and transcranial Doppler (TCD), may be useful markers. Carotid and Cerebral circulation were evaluated by CDU and TCD in forty HIV-infected Caucasian men (mean age 49,4±5,9 years). CD4+ T-cell current and nadir counts, current and zenith viral load and duration of antiretroviral therapy (ART) were registered and cardiovascular risk scores were assessed. Multivariate regression analysis and Pearson’s correlation coefficient were used. All men received ART and presented mean CD4+ count of 817±369 cells/mm3, (mean nadir: 242,8 ±158,2 cells/mm3), 95% had non-detectable viral load (mean zenith: 381.416±858.881 copies/mm3), 35% of men had history of high blood pressure, 35% dyslipidaemia, 7,5% diabetes, 80% tobacco consumption. Mean Framingham Risk Score was 8,5±6,6%; 35% presented low risk by SCORE, 55% moderate risk and 7,5% high risk. Mean ASCVD score was 7±4% at 10 years and 49±12% lifetime. 67.5% men had increased CIMT (mean 0,92±0,13mm), but none presented increased PI. No correlation was found between duration of infection, ART or cardiovascular risk scores with CDU or TCD data. However, a significantly positive association between a CD4+ nadir count <400 cells/mm3 and an increase of 0,12 in PI, was confirmed by regression analysis where CD4 categories showed significant effect over PI (p=.04). In this series, HIV infection showed an association with premature cerebral atherosclerosis, even at low cardiovascular risk scores. PI may be an early marker of atherosclerosis in HIV-infected people with CD4+ nadir <400 cells/mm³

Biography:

Zhengqin Zhai has completed her Bachelor’s degree from Shandong University and now has been working for her Master’s degree in Peking Union Medical College.

Abstract:

Autonomic dysfunction, characterized by sympathetic activation and vagal withdrawal, contributes to the occurrence of ventricular arrhythmias after myocardial infarction. Here, we hypothesize that a novel pathway nerve stimulation - median nerve stimulation inhibit the occurrence of ventricular arrhythmias after myocardial infarction in rabbits. Two weeks after the ligation of the left coronary artery, 11 surviving New Zealand rabbits were randomized to median nerve stimulated (MI-MNS, n = 5) group and sham-stimulated (MI-SS, n = 6) group. Using an implantable electrical stimulator, we stimulated the bilateral median nerve for 2 weeks with the frequency of 5 HZ, width of 200ms, cycle of 10s on and 30s off, and the intensity of electrical stimulation was adjusted to the threshold of not resulting in the tremble of upper limbs. A holter was implanted to record the types and frequencies of arrhythmias. The treated rabbits had significantly lower percentage of ventricular arrhythmias (3.67% ± 1.73% vs. 6.69% ± 2.50%, p< 0.001) and lower norepinephrine (NE) level in blood (7.88 ± 2.34 pg/ml vs. 17.57 pg/ml± 11.72pg/ml, p = 0.01) than the untreated rabbits. Median nerve modulation markedly decreased the incidence of ventricular arrhythmias after myocardial infarction in rabbits through reducing the NE level in blood.

Biography:

Giovanni Antioco Putzu is working as professor in Neurology and Clinical Neurophysiology in Casa di Cura Sant’Elena, Italy. He has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute

Abstract:

We demonstrated, by the means of double immunochemistry technique, that TNF-alpha was localized in both axons and Schwann Cells, leading to demyelination and axonal in the peripheral nerve of patients with Guillain-Barré Syndrome (GBS, Putzu G.A. et al, J. Neurol. Sci, 2000). The pivotal role of pro-inflammatory cytokines such as IL-1Beta in GBS was also investigated.

We present an original immunochemistry study with a panel of antibodies directed against TNF-alpha, INF-gamma, IL-1Beta, CD68, CD11, CD3 and C5b9 in the peripheral nerve of seventy-five patients affected by vasculitis. Sixty patients (27 males and 23 females, mean age 63 years) were classified as systemic vasculitic neuropathy (SVN) where as 15 patients (7 males and 8 females, mean age 52 years) had non systemic vasculitic neuropathy (NSVN).

Results suggested a prevalent Th 1 immune response in both SVN e NSVN. The presence of great amounts of TNF alpha and IL-1Beta into the vasculature determines a pro-coagulant effect with thrombosis of the vasa nervorum and hypoxia of the nervous fascicules. TNF-alpha was localized in axons as well, suggesting that it may be responsible for an axonal degeneration per se. Peripheral nerves of SNV e NSVN were immunoreactive to INF-gamma antibodies. This finding indirectly confirms the presence in the vasculature of IL-28A, a powerful pro-inflammatory cytokines. CD11, an antibody reacting with leucocytes and ICAM (Intercellular Adhesion Molecule) was also detected in the peripheral nerve of SVN and NSVN. Immunoreactivity to CD68 (macrophage antigen) and C5b9 (activated complement fraction) were also easily detected.

In conclusion, immune response in SVN and NSVN is of Th 1 type (cellular). The role of TNF-alpha and cytokines is crucial in vascular thrombosis. Axonal degeneration may be the consequence of both hypoxia and direct toxic effect of TNF-alpha on axons. Moreover, pattern of immune response is not specific in SVN and NSVN.

Biography:

Weimin Yang has completed his PhD from Sichuan University and visitor scholor studies from Melbourne University. He is the professor in Dept. of Neurology, First Affiliated Hospital of Zhengzhou University, master tutor, innovative talents of Henan Province Health Sciences and Technology. His research work mainly related to clinical features of Chinese stroke patients, stroke register, dementia, and systematic reviews of therapies from China. He has published more than 25 papers in reputed journals.

Abstract:

Background: Intracerebral hemorrhage (ICH) is a significant contributor to global health-related morbidity and mortality. Due to improved recognition and treatment of atrial fibrillation by antithrombotics, there is an increase in proportion of ICH caused by warfarin and novel oral anticoagulants. However, the relationship between anticoagulation intensity and hematoma expansion remains unclear. We aimed to investigate the effects of INR on hematoma expansion post ICH.

Methods: We conducted a retrospective study of all patients hospitalized for ICH at a single institution from January 1, 2008 and August 1, 2014. Hematoma volumes on initial CT scans and repeat CT scans were analyzed by the AxBxC/2 method. Univariate analysis was used to compare baseline characteristics and median regression analysis was performed to estimate the effects of INR and hematoma volume changes.

Results: We included 224 consecutive ICH patients. Median age (IQR) was 68.5 years (17.0), 60.3% were male, median presentation Glasgow Coma Scale (GCS) (IQR) was 14.0 (4.0), median volume (IQR) of the first CT was 11.7ml (25.6), median INR (IQR) was 1.1 (0.2). We showed that INR and time lapsed between first CT and second CT were independent risk factors to hematoma volume change, adjusting for baseline hematoma volume and time. For each 1.0 increase in INR was associated with hematoma volume increased by 2.4ml (p = 0.015).

Conclusions: We showed that high INR was associated with hematoma growth post ICH. However, the effects of reversal anticoagulation in the attenuation of hematoma growth remain uncertain and require confirmation in future randomized controlled studies.

Biography:

Lenka Maruscakova, MD. was graduated in General Medicine at the School of Medicine, Comenius University Bratislava, Slovakia. She does her post gradual studies at Institute of Immunology School of Medicine, Comenius University Bratislava, Slovakia. Her PhD. thesis is devoted to the inflammatory markers in brain tumors. Her scientific work is multidisciplinary approach connecting field of immunology, oncology and neurology.

Abstract:

Immune cells and molecules in tumor microenvironment are crucial in tumorigenesis. Inflammation is known as one of hallmarks of cancer and is considered as an protumorigenic factor. Glioma tumor microenvironment glioma still needs deeper insight into its immunological characteristics. Both local and systemic chronic low grade inflammatory response are operative for correlation with gliomas grading and their prognosis. Complex network of immune signals and pathways is in intricate background of most of cancer hallmarks. This concept is an intersection of three huge research fields: immunology, oncology and neurology. Cancer immunology has a perspective in complex approach to diagnosis of gliomas. There is an appealing importance of establishing immune molecules in gliomas. TREM-1 (Triggering receptor expressed on myelocytes) is an inflammation amplifier, hovewer its role in glioma remains still unclear. The aim of our study is to establish the expression of TREM-1 in glioma tissues and to correlate it with staging, grading and other laboratory parameters. Establishing of TREM-1 expression could have a promising role in pathophysiology of gliomas. Our preliminary results show densely infiltrating TREM-1+ immune cells in tumor tissue. At signal pathways level, inflammation is interconnect with molecules related to hypoxia. Cross-talk of inflammation and hypoxia becomes more obvious in glioma as well. Consideration of relations dynamics is also necessary. But, deep understanding of their signal network in glioma tumorigenesis is challenging. Our aim is to provide critical view on our pivotal results in framework of data from literature and discuss their significance for deep understanding of glioma tumorigenesis.

Biography:

Teena Shetty is a Fulbright scholar who received her medical degree and bachelor’s degree with honours from Brown University and her master of philosophy degree in medicine from the University of Cambridge. Her residency was completed at Weill Cornell Medical College, New York-Presbyterian Hospital. Dr. Shetty received her fellowship training in neuromuscular diseases at Harvard Medical School, Brigham and Women’s Hospital and in neuromuscular diseases and intraoperative monitoring at Hospital for Special Surgery. Dr. Teena Shetty is now a neurologist at Hospital for Special Surgery and is triple board-certified in neurology, neuromuscular medicine, and electro diagnostic medicine. Her research interests include concussion, post-operative neuropathies, muscle diseases, and intraoperative monitoring, and she has authored more than 30 publications on these topics.

Abstract:

Historically, routine types of neurological imaging for mTBI include CT and Conventional MRI, both of which are usually normal in mild TBI (mTBI). Newer MRI methods may demonstrate more abnormalities following mTBI than just CT or Conventional MRI alone (Brody et al 2015). These include, but are not limited to, SWI, DTI, rs-fMRI, ASL and Volumetry. Susceptibility Weighted Imaging (SWI) uses contrast to highlight differences between tissues that can show changes in blood products in the brain. Diffusion Tensor Imaging (DTI) can detect brain abnormalities in white matter through its sensitivity to microstructural axonal injury. Resting State Functional MRI (rs-fMRI) measures changes in blood perfusion to determine if pathways of communication within the brain have been disrupted. ASL (arterial spin labelling) uses spatially selective inversion of inflowing arterial blood as a method to label blood flow and measure perfusion. Lastly, volumetric MRI measures the volume and structure of regions in the brain and can detect changes in the volume of gray matter that may result from mTBI. These specific types of imaging can be incorporated into research in order to learn more about concussions, their diagnosis, and their prognosis. This is the case for the GE-NFL Study on Advanced MRI Applications for mild TBI. By utilizing a research pack for neurological imaging that includes SWI, DTI, Volumetric T1, ASL, and rs-fMRI, researchers have been able to detect abnormalities, including white matter lesions, in the brains of several patients who have suffered from mTBI. Overall, neuroimaging is evolving such that white matter abnormalities, changes in gray matter volume, and blood perfusion in the brains of mTBI patients may be visualized. However, these scans cannot be used conclusively and these techniques are limited to research tools at this time. Therefore, continued study is necessary to further validate these software techniques.

Biography:

Rafael Ferreira, MD is professor at Universidade Federal de Santa Catarina, in Florianopolis Brazil. His neuroradiology training was done at Hospital Beneficencia Portuguesa ( Sao Paulo, Brasil) and Massashusetts General Hospital ( Boston, US). He Works at Diagnostico das Americas (DASA – Florianopolis unit) and is the director of MF imagens in Biguacu, Brazil. He has a 8 year experience doing functional MRI in surgical planning of brain tumors , publishing papers in reputed jornals and serving as editorial board member of repute.

Abstract:

Functional Magnetic Resonance Imaging (fMRI) is a technique that takes advantage of the diferences in magnetic susceptibility between oxyhemoglobin and deoxyhemoglobin. Once the goal of neurosurgery is to maximize patient safety and to minimize residual tumor, fMRI may be an alternative, non-invasive and reproducible tool for assessing potential risk of dysfunction resulting from brain ressection near eloquente cortex. Tumoral mass effects can distort normal cortical anatomy losing anatomical landmarks. So fMRI studies with specific –tasks combines structural with physiological information and provides data helping in localizing cortex controlling language, motor, sensory, hearing and visual pathways , according to tumor region. In addition, many studies confirm the large individual variability in cortical localization of language and fmri data may aid in the determination of language laterality and localization of Wernicke’s and Broca’s areas in cases of temporo-parietal lesions. Althout fmri can show cortical signals, imaging the White matter bundle may be just as crucial. Therefore Diffusion Tensor imaging complements fMRI examinations and provides the surgeon with fiber-tracking information. In summary, fMRI data can alter a neurosurgical approach to a tumor, indicates eloquent cortex in distorted areas, guide surgical resections or even emphasize too high risk in total tumor resection in other cases. Clinical cases showing such fMRI applications and a literature review about clinical outcomes is presented.

Biography:

T2-weighted magnetic resonance images (MRI) can display cerebral white matter intensity changes, which are common in elderly subjects and linked to vascular diseases. Few studies have investigated the spatial and temporal associations between the white matter intensity distribution and the retention of amyloid-PET radiotracers Florbetapir and PiB. In this study, we explore these correlations using data from Alzheimer’s disease neuroimaging initiative (ADNI). One of the main objectives is to determine whether the selection of the radiotracer can alter these associations. Methods: For both PET data, we used images with minimum amount of smoothing in order to preserve spatial clusters in images and to determine whether white matter T2 voxel intensity values in the vicinity of high activity clusters in amyloid PET images are different than other areas. These localized spatial correlations were explored by utilizing a new image analysis approach that is based on a randomized sampling of voxel pairs between the two modalities. Results: While in several subjects we observed a slight T2 increase in areas close to the high activity PET clusters, there were some regional and inter-subject variabilities, which could be due to regional differences in amyloid clearance mechanism or the presence of cerebral amyloid angiopathy. However, further studies are required to verify these hypotheses. Conclusion: This study provides new imaging-based methodologies to investigate the presence of subtle within-subject spatial associations between amyloid PET radiotracer retention and its surrounding white matter in Alzheimer’s disease.

Abstract:

Functional Magnetic Resonance Imaging (fMRI) is a technique that takes advantage of the diferences in magnetic susceptibility between oxyhemoglobin and deoxyhemoglobin. Once the goal of neurosurgery is to maximize patient safety and to minimize residual tumor, fMRI may be an alternative, non-invasive and reproducible tool for assessing potential risk of dysfunction resulting from brain ressection near eloquente cortex. Tumoral mass effects can distort normal cortical anatomy losing anatomical landmarks. So fMRI studies with specific –tasks combines structural with physiological information and provides data helping in localizing cortex controlling language, motor, sensory, hearing and visual pathways , according to tumor region. In addition, many studies confirm the large individual variability in cortical localization of language and fmri data may aid in the determination of language laterality and localization of Wernicke’s and Broca’s areas in cases of temporo-parietal lesions. Althout fmri can show cortical signals, imaging the White matter bundle may be just as crucial. Therefore Diffusion Tensor imaging complements fMRI examinations and provides the surgeon with fiber-tracking information. In summary, fMRI data can alter a neurosurgical approach to a tumor, indicates eloquent cortex in distorted areas, guide surgical resections or even emphasize too high risk in total tumor resection in other cases. Clinical cases showing such fMRI applications and a literature review about clinical outcomes is presented.

Biography:

Prof. Radu Mutihac got his PhD in Physics at the University of Bucharest in 1994 and became full professor in 2000 and PhD student supervisor in 2008, presently acting as Chief of Medical Physics Section. His main research fields are Neuroscience, Signal Processing, Microelectronics, and Artificial Intelligence. As postdoc/research associate/visiting professor/full professor he run his research and didactic activity at the University of Bucharest, at the International Centre for Theoretical Physics (Trieste), Ecole Polytechnique (Palaiseau), Institut Henri Poincare (Paris), KU Leuven (Belgium). He dealt with data mining and exploratory analysis of neuroimaging time series during two Fulbright Grants in Neuroscience: Yale School of Medicine (New Haven, CT) and University of New Mexico (Albuquerque, NM). Most of his significant research in fused biomedical imaging modalities was carried out at the Johns Hopkins University and Kennedy Krieger Institute (Baltimore, MD), National Institutes of Health (Bethesda, MD), and Walter Reed Army Institute of Research (Silver Spring, MD). He is member of the ISMRM, ESMRMB, OHBM, Romanian US Alumni Association, and Fellow of Signal Processing and Neural Networks Society IEEE, as well as referee for several journals of the Institute of Physics (London, UK), Neural Networks (Elsevier), IEEE Transactions on Image Processing, and evaluator/expert for the ISMRM, OHBM, ARACIS, CNCSIS, UEFISCDI, the Romanian-U.S. Fulbright Commission. and the European Commission (FP7, H2020). He published more than 90 papers in reputed journals, 12 monographs, and several invited book chapters.

Abstract:

Two approaches are employed in functional neuroimaging to reveal statistical regularities that can be associated with brain function: hypothesis-driven and data-driven analysis. Most functional neuroimaging data display significant higher-order statistics representing tendencies to grouping along various shapes, even if such feature is commonly hidden by the overall distribution. Exploratory data analysis (EDA) methods like independent component analysis or fuzzy cluster analysis reveal task-related, transiently task-related, and function-related activity without reference to any experimental protocol and including unanticipated/missed activations as well. EDA techniques can be regarded as hypothesis generating methods based on the underlying structure in data: a representative time course of activation for a set of voxels acts as an alternative hypothesis to the null hypothesis H0 (no activation). Any exploratory approach of neuroimaging data comes out with a set of estimated projections irrespective of the validity of the working hypothesis. As such, some means to statistically validate the data subspace is needed. Resampling is a statistical method producing surrogate data sets, which allows to approximate each parameter of the population by repeated learning of that parameter. Exploratory methods may reveal interesting features reporting on brain activations, whereas confirmatory methods are still necessary to validate the models and their statistical significance. Resampling based on prewhitening transform driven by an explicit noise model proves robust in the presence of BOLD signal. Repeated decompositions of functional neuroimaging data sets by different EDA algorithms reveal the stability/reliability of projections found.

Biography:

Dr. Pavithra Mannam has completed her M.D. in Radio diagnosis from Christian Medical College, Vellore and currently working as an assistant professor of Radiology in Christian Medical College Vellore, India. Her research focuses on Neuroradiology, CNS infections and Diffusion tensor imaging of the brain and spinal cord

Abstract:

Burkholderia pseudomallei is a gram negative environmental bacterium found in soil and surface water which causes melioidosis, commonly reported to occur in south-east Asia and northern Australia. It is being increasingly reported in India and transmission is through inhalation, inoculation and ingestion. Two clinical forms are recognised – acute septicemic form and the chronic granulomatous form. Both these forms are recognised to affect the neuraxis and the adjacent soft tissues and bone. Involvement of these structures is rare but of importance due to the significant mortality and morbidity associated with cranio-spinal infection Methods: 14 culture proven cases with involvement of the cranio-spinal structures were retrospectively identified between Jan 2008 and May 2016 via search of the hospital’s electronic database Involvement of the cranio-spinal structures included multiple parenchymal abscesses(5) which usually occurred in contiguity with skull osteomyelitis. Parenchymal and leptomeningeal disease was secondary to septicaemia. Pachymeningeal disease was found to be secondary to sino-nasal involvement and otomastoid infections(5). Acute myelitis (1) and spondylodiscitis (3) were the other forms seen Parenchymal involvement ranged from cerebritis, early and mature parenchymal abscess formation. Patients with fewer abscesses which were amenable to surgical evacuation had a favourable outcome compared to those who had multiple small, widespread abscesses Chronic pachymeningeal disease was invariably associated with sino-nasal, otomastoid infections or a skull osteomyelitis. Multiple cranial neuropathies were recorded in those with pachymeningitis. Local inoculation or inhalation is presumed to be the route of infection One patient who presented with longitudinally extensive transverse myelitis had received immunosuppression prior to admission and this exacerbated the progression of disease 2 patients with parenchymal abscesses and the one with myelitis succumbed to their illness Conclusion: CNS manifestations of Burkholderia in the form of pachymeningeal disease and myelitis must be suspected in the appropriate clinical scenario as alternative imaging and clinical differentials entail therapy with immunosuppression which are detrimental

Biography:

Born in Urbino (PU), Italy, in 1955, is married with Maria Chiara and , has one daughter, Ginevra. Degree in Medicine and Surgery, University of Modena, 1980, board on Radiology, University of Modena in 1984, board on Neurology, University of Siena in 1994. He Patented the device, "Axial Loader” and development of neuroradiological imaging techniques known as" Axial Loaded - Computed Tomography - AL-CT " and " Axial Loaded Magnetic Resonance - AL-MR "for the in vivo biomechanical study of the spine in 1992. At present is Senior Assistant Radiologist at the Radiology Service, Ospedale S. Giovanni – EOC Bellinzona, Switzerland. He has published as Author and co-author many scientific publications, abstracts and reports in national and international journals. He also collaborated on several chapters on international treaties of Neuroradiology. Main interests are "Diagnostic and Spinal non-vascular Interventional Neuroradiology, with special reference to CT and MRI, " Biomedical applications of Virtual Reality,” Biomechanics of the spine and joints. " He is Ordinary Member of the Italian Association of Neuroradiology – AINR,- Full Member of the European Society of Neuroradiology - ESNR.

Abstract:

The comprehension of the inner mechanism of low back pain is hard and often the conventional diagnostic approach can’t reveal the exact cause of the disease. The functional radiologic study of the spine is not so precise, and only bone structures are directly seen. More complex conventional radiologic functional studies like myelography and stereo-radiology are invasive or obsolete and difficult to obtain; in any case the informations obtained are quite always “indirect”, since anatomical structures as discs, roots and ligaments are not visible. In last 20 years, a possible “in vivo” bio-mechanic approach in the study of the spine has been proposed with the use of devices like the Axial Loader and the Dynawell able to produce a variable axial load on the spine during CT or MR examinations on conventional diagnostic units. This allows to directly image all the anatomical structures in a precise way during a work. This lecture reviews the personal experience in the study mainly on the lumbar spine with the Axial Loader (AL) both in CT and in MR. The Axial Loader device is described together with the CT and MR acquisitions. The disc, intersomatic and articular facet changes obtained during the examinations are described with a breakdown of the classification of findings as Elementary Dynamic Modifications (EDMs) or Complex Dynamic Modifications (CDMs). From this data derived a possible functional model of the lumbar spine. A particular look will be given to the post-surgical functional evaluation of the lumbar spine. Early data from AL studies of pediatric isthmian lysis with MR will be presented. Finally a comparison with data from studies with MR units that allows real orthostatic spine studies will be attempted.

Biography:

Haris Huseinagić is the head of Department of radiology and nuclear medicine in University Clinical Center Tuzla Tuzla, Bosnia and Herzegovina.

Abstract:

Endovascular treatment of giant basilar artery aneurysm is a complex procedure that requires the work of an experienced team and a range of materials and techniques available. Treatment of a giant aneurysm of the basilar artery in the body which includes the initial parts of both arteriae cerebelaris posterior was a special kind of technical challenges and use techniques Waffle cone.
Technically it was not possible to implement the classic waffle cone technique, and made modifications to the horizontal stenting in the right artery cerebelaris posterior, and above it are set Koil, and the aneurysm successfully closed with rear patent cerebellar artery. Technical correctly written procedure with good outcome for the patient left the question of objective verification of results.
Using Voronoi diagrams and indirect visualization of the 3D models of aneurysms with the analysis of the dynamics of flow (flow dynamics), an objective verification of results. Results of verification coincide with the real results to the patient. The new method of analysis of endovascular treatment has proven to be an effective model verification results.

Biography:

Mirza Moranjkic is a renowned neurosurgeon of Clinical Center Tuzla Tuzla, Bosnia and Herzegovina.

Abstract:

Introduction: Fusiform and some wide-neck aneurysms remained unaddressed by both reconstructive surgical and endovascular techniques until the introduction of  dedicated intracranial self-expandable stent.

Aim: The aim of the current study was to review a single center experience with stent-assited aneurysm coilling.

Results: Approximately 200 endovascular procedures were performed in our department for various cerebrovascular conditions over the course of some 30 months. Of those, there were over 100 aneurysm patients, and over 50 patients were treated with stent-assisted coilling. We encountered 2 technical complications (one stent migration, and one stent dislodgment). No thromboembolic complications were noted, and none of those technical complications proved to be clinically relevant.

Conclusion: Stent-assisted aneurysm coiling is a safe and highly effective endovascular technique that provides us with means to treat aneurysms previously deemed untreatable by endovascular means.   

Biography:

Biljana Milatović has completed her postgraduate Specialist academic studies in Radiology with the paper entitled “The Comparison of Digital Subtraction Angiography and Multi slice CT Angiography in the Evaluation of Intracranial Aneurysms“ and completed her PhD in neuroradiology with paper entitled as “ Predictive factors for haemorrhage in arteriovenous malformations by digital subtraction angiography and MDCT angiography of the brain”. In 2006 and 2007 she worked as a general practitioner at the Institute for the Medical Protection of Mother and Child, at the Radiology department. She started working as a general practitioner at Radiology – Neurosurgery department (Interventional Neuroradiology, MSCT neuroradiology imaging and MRI imaging) in October 2007. She has worked at the Emergency and Trauma Center since September 1st, 2009 (Diagnostic emergency neuroradiology, Ultrasound diagnostics and x-ray diagnostics). Dr. Biljana Milatović is currently working at the Clinical center of Serbia as a neuroradiologist in Center for Radiology and Magnetic resonance Imaging since February 1st, 2008. She is a member of the European Association of Radiologists since 2008.

Abstract:

Patients with brain arteriovenous malformation (AVM) have a certain risk to bleed, and the goal of this study is to examine the effect of radiological and clinical predictive characteristics of AVM hemorrhage using multidetector CT angiography (MDCT).

Material: this is a series of 57 patients with a mean age of 35.46 years, who were diagnosed at the Institute for Radiology and MRI, while the same were hospitalized at the Clinic of Neurosurgery, Clinical Center of Serbia in the period from January 2008 to March 2016. For all patients, the diagnosis was made using MDCT angiography. Two groups of patients were observed. The first group includes patients who were not initially presented by hemorrhage, while the second group was initially presented by hemorrhage. Both groups were treated with medical therapy, or a combination of medical therapy with embolization / surgery / radiotherapy.

Results: Deep venous drainage (p <0.05), the combined arterial supply from different basins (p<0.05) with a length> 60mm, venous dilation present in the drainage vein (p <0.01) and the angle of casting supply arteries in the nidus (p <0.01), carry a risk of repeated bleeding. In the group of patients who had initial hemorrhage a mean value of the sized corner casting was 130o, while the group that did not had initially bleeding mean value of the size of the measured angle was 103.81 with a standard deviation of 17.21 (p <0.01).

Conclusion: arterio-venous malformations with the deep venous drainage from the carotid and VB basin, the length of the feeding arteries> 60mm, angle of casting feeding arteries in the nidus ≥ 130 ° and dilatation and / or venous aneurysm drainage vessel are predictive model for clinical presenting by hemorrhage.

Key Words: AVM of the brain, bleeding, morphological parameters4

Biography:

Geetika Singla is an alumnus of the Armed Forces Medical College, Pune . After serving for 7 years in Armed Forces Medical Services which included tenures in rural peripheral areas , She is pursuing MD(Radiodiagnosis) at Command Hospital , Bangalore. Her areas of interest are intervention radiology and neuroradiology.

Abstract:

Acute Ischemic stroke is a medical emergency and accounts for a worldwide mortality of 6.2 million lives each year. There has been a revolution of sorts in the endovascular management of acute ischemic stroke in the past two years. Our hospital experience in acute ischemic strokes presenting in the window period has evolved with a view to better the management outcomes of such cases. Based on intra-hospital logistics imaging in these cases has evolved from MRI & MRA to NCCT & CTA and more recently to CT based collateral scoring. The endovascular management similary has seen the use of various stentreivers and more recently the use of thromboaspiration using the ADAPT technique utilising the Penumbra system. The paper shall also cover the current evidence in the endovascular management of Acute ischmic stroke.

Biography:

Stefan Golaszewski was born 1964 in Vienna where he studied Technical Physics and Medicine. From 1995 to 2001 he worked as Neurologist at the University Innsbruck where he focused on clinical applications of functional Magnetic Resonance Imaging (fMRI). From 2001 to 2002 he worked at the Medical University Graz. Since 2005 he works as associate Professor at the Department of Neurology at the Paracelsus Medical University (PMU) Salzburg in Austria and focuses on the investigation of cortical reorganization after stroke. Since 2010 he is medical head of the Neuroscience-Institute of the PMU. He published 125 papers in international peer-reviewed journals.

Abstract:

Diffusion tensor imaging (DTI) is a promising tool in diagnosis of SCI-patients. The aim of this study was to correlate DTI-parameters with electrophysiological and neurological measures in these patients. 7 SCI-patients participated in this study and 8 healthy controls. DTI data of the spinal cord were acquired with a Philips Achieva 3T-MR-scanner using a single-shot EPI-sequence. Neurological and electrophysiological measures (MEP, SSEP) and American Spinal Injury Association (ASIA) impairment scale scores were assessed in the patients. In SCI-patients the Fractional Anisotropy (FA) values for the lesioned fiber tracks were significantly decreased compared to the healthy controls. The decrease in FA was significant for corticospinal and sensory tracts. The decrease of DTI values correlated with the SSEP and MEP latencies and amplitudes and the ASIA score. The reduced DTI values seen in the SCI-patients are likely due to demyelination and axonal degeneration of spinal tracts. A reduction in DTI values in regions remote from the lesion site suggests their involvement with wallerian axonal degeneration. DTI can be used for the quantitative evaluation of the extent of spinal cord damage, and eventually to monitor the effects of future regeneration-inducing treatments.

Biography:

Wenjun Ji has completed his MD at the age of 32 years from Capital University of China. He is an associate professor in department of Interventional neuroradiology, Beijing Tiantan Hospital, China. He has published more than 40 papers in reputed journals.

Abstract:

Background: Unruptured paraclinoid aneurysms have a high incidence of aneurysm recanalization (AR) after endovascular treatment. We aimed to identify the incidence and predictors of AR in these lesions. Methods: We retrospectively analyzed consecutive patients with unruptured paraclinoid aneurysms who underwent endovascular treatment between January 2013 and December 2014. Patients with fusiform aneurysms, dissection aneurysms, traumatic aneurysms, or without digital subtraction angiography (DSA) at follow-up, were excluded. AR was defined as any aneurysm remnant that had increased in size or contrast filling that was observed via DSA at the follow-up. Univariate and multivariate logistic regression analyses were performed to assess the predictors of AR. Results: We included 145 patients with 150 unruptured paraclinoid aneurysms in the analysis. The incidence of AR was 8.7% (95% confidence intervals [CI]: 4.7–13.3%) at a mean follow-up of 7.4 months. In the univariate analysis, AR was associated with aneurysm size (odd ratios [OR]: 6.098; 95% CI: 1.870–19.886; P = 0.003), location (OR: 3.88; 95% CI: 1.196–12.583; P = 0.024), inflow angle (OR: 6.852; 95% CI: 1.463–32.087; P = 0.015), and Raymond scale (OR: 12.473; 95% CI: 2.7496–56.59; P < 0.001). In the adjusted multivariate analysis, AR was independently predicted by Raymond scale (OR: 9.136; 95% CI: 1.683–49.587; P = 0.001) and inflow angle (OR: 16.159; 95% CI: 3.211–81.308; P = 0.01). Conclusions: Unruptured paraclinoid aneurysms had a high incidence of AR after endovascular treatment. An inflow angle of ≥90° and incomplete occlusion were significant predictors of AR.

Biography:

Marymol Koshy is an Associate Professor of Radiology and Senior Consultant radiologist at the Faculty of Medicine, Universiti Teknologi MARA, Malaysia. As the faculty was a new faculty she spearheaded the planning and designing of the Unit and also the purchasing and Installation of equipments. She also developed the radiology component of the medical students curriculum. In the meantime she subspecialized in cardiovascular imaging in CT and MRI. She has a keen interest in research in most fields of radiology and supervises Masters and PhD students. She is involved in many clinically based researches and has received grant funding.

Abstract:

Malignant gliomas are highly infiltrative and aggressive primary brain tumors. Intraoperatively the extent of resection of the tumor is believed to be key prognostic factor, however there is no distinct margin between the tumor mass and surrounding oedematous brain. Achieving gross total resection (GTR) using conventional white light microsurgical technique is a challenge. 5-aminolevulinic acid (5-ALA) can be used as an adjunct for the surgery of adult malignant glioma and improves the rate of gross total resection and patient survival. The department of neurosurgery, Sungai Buloh Hospital is the first public hospital in Malaysia to adopt fluorescence guided surgery using 5-ALA. Application of early pre and post operative MR is also done to assess the volumetric extent of resection. The findings in this study demonstrates the enormous potential of 5-ALA for visualization of tumor tissue intraoperatively. Fluorescence-guided surgery enabled a GTR in 100% patients. Performing early postoperative MR imaging yielded reliable and accurate information in detecting residual tumor. However due to small sample, the study was underpowered, and thus, did not reach statistical significance. We advocate to increase the sample size, which in turn will increase the power of the statistical analysis. The application of 5-ALA has a great potential as a novel standard in neurosurgery in Malaysia to maximize tumor resections for malignant gliomas.

Biography:

Prof Haris Huseinagić is the head of Department of radiology and nuclear medicine in University Clinical Center Tuzla Tuzla, Bosnia and Herzegovina

Abstract:

Endovascular treatment of giant basilar artery aneurysm is a complex procedure that requires the work of an experienced team and a range of materials and techniques available. Treatment of a giant aneurysm of the basilar artery in the body which includes the initial parts of both arteriae cerebelaris posterior was a special kind of technical challenges and use techniques Waffle cone. Technically it was not possible to implement the classic waffle cone technique, and made modifications to the horizontal stenting in the right artery cerebelaris posterior, and above it are set Koil, and the aneurysm successfully closed with rear patent cerebellar artery. Technical correctly written procedure with good outcome for the patient left the question of objective verification of results. Using Voronoi diagrams and indirect visualization of the 3D models of aneurysms with the analysis of the dynamics of flow (flow dynamics), an objective verification of results. Results of verification coincide with the real results to the patient. The new method of analysis of endovascular treatment has proven to be an effective model verification results

Biography:

Dr. Mirza Moranjkic is a renowned neurosurgeon of Clinical Center Tuzla Tuzla, Bosnia and Herzegovina

Abstract:

Introduction: Fusiform and some wide-neck aneurysms remained unaddressed by both reconstructive surgical and endovascular techniques until the introduction of dedicated intracranial self-expandable stent. Aim: The aim of the current study was to review a single center experience with stent-assited aneurysm coilling. Results: Approximately 200 endovascular procedures were performed in our department for various cerebrovascular conditions over the course of some 30 months. Of those, there were over 100 aneurysm patients, and over 50 patients were treated with stent-assisted coilling. We encountered 2 technical complications (one stent migration, and one stent dislodgment). No thromboembolic complications were noted, and none of those technical complications proved to be clinically relevant. Conclusion: Stent-assisted aneurysm coiling is a safe and highly effective endovascular technique that provides us with means to treat aneurysms previously deemed untreatable by endovascular means.

Biography:

Rafael Ferreira, MD is professor at Universidade Federal de Santa Catarina, in Florianopolis Brazil. His neuroradiology training was done at Hospital Benefi cencia Portuguesa ( Sao Paulo, Brazil) and Massashusetts General Hospital ( Boston, US). He Works at Diagnostico das Americas (DASA – Florianopolis unit) and is the director of MF imagens in Biguacu, Brazil. He has a 8 year experience doing functional MRI in surgical planning of brain tumors , publishing papers in reputed jornals and serving as editorial board member of repute.

Abstract:

Functional Magnetic Resonance Imaging (fMRI) is a technique that takes advantage of the diferences in magnetic susceptibility between oxyhemoglobin and deoxyhemoglobin. Once the goal of neurosurgery is to maximize patient safety and to minimize residual tumor, fMRI may be an alternative, non-invasive and reproducible tool for assessing potential risk of dysfunction resulting from brain ressection near eloquente cortex. Tumoral mass eff ects can distort normal cortical anatomy losing anatomical landmarks.

So fMRI studies with specific –tasks combines structural with physiological information and provides data helping in localizing cortex controlling language, motor, sensory, hearing and visual pathways , according to tumor region. In addition, many studies confirm the large individual variability in cortical localization of language and fmri data may aid in the determination of language laterality and localization of Wernicke’s and Broca’s areas in cases of temporo-parietal lesions. Althout fmri can show cortical signals, imaging the White matter bundle may be just as crucial. Therefore Diffusion Tensor imaging complements fMRI examinations and provides the surgeon with fi ber-tracking information. In summary, fMRI data can alter a neurosurgical approach to a tumor, indicates eloquent cortex in distorted areas, guide surgical resections or even emphasize too high risk in total tumor resection in other cases. Clinical cases showing such fMRI applications and a literature review about clinical outcomes is presented.

Biography:

Born in Urbino (PU), Italy, in 1955, is married with Maria Chiara and, has one daughter, Ginevra. Degree in Medicine and Surgery, University of Modena, 1980, board on Radiology, University of Modena in 1984, board on Neurology, University of Siena in 1994. He Patented the device, “Axial Loader” and development of neuroradiological imaging techniques known as” Axial Loaded - Computed Tomography - AL-CT “ and “ Axial Loaded Magnetic Resonance - AL-MR “for the in vivo biomechanical study of the spine in 1992. At present is Senior Assistant Radiologist at the Radiology Service, Ospedale S. Giovanni – EOC Bellinzona, Switzerland. He has published as Author and co-author many scientifi c publications, abstracts and reports in national and international journals. He also collaborated on several chapters on international treaties of Neuroradiology. Main interests are “Diagnostic and Spinal non-vascular Interventional Neuroradiology, with special reference to CT and MRI, “ Biomedical applications of Virtual Reality,” Biomechanics of the spine and joints. “ He is Ordinary Member of the Italian Association of Neuroradiology – AINR,- Full Member of theEuropean Society of Neuroradiology – ESNR

Abstract:

The comprehension of the inner mechanism of low back pain is hard and often the conventional diagnostic approach can’t reveal the exact cause of the disease. The functional radiologic study of the spine is not so precise, and only bone structures are directly seen. More complex conventional radiologic functional studies like myelography and stereo-radiology are invasive or obsolete and difficult to obtain; in any case the informations obtained are quite always “indirect”, since anatomical structures as discs, roots and ligaments are not visible.

In last 20 years, a possible “in vivo” bio-mechanic approach in the study of the spine has been proposed with the use of devices like the Axial Loader and the Dynawell able to produce a variable axial load on the spine during CT or MR examinations on conventional diagnostic units. This allows to directly image all the anatomical structures in a precise way during a work. This lecture reviews the personal experience in the study mainly on the lumbar spine with the Axial Loader (AL) both in CT and in MR. The Axial Loader device is described together with the CT and MR acquisitions. The disc, intersomatic and articular facet changes obtained during the examinations are described with a breakdown of the classification of findings as Elementary Dynamic Modifi cations (EDMs) or Complex Dynamic Modifi cations (CDMs). From this data derived a possible functional model of the lumbar spine. A particular look will be given to the post-surgical functional evaluation of the lumbar spine. Early data from AL studies of pediatric isthmian lysis with MR will be presented. Finally a comparison with data from studies with MR units that allows real orthostatic spine studies will be attempted.

Biography:

Ammar Mallouhi has completed his Specialization in diagnostic radiology in Innsbruck, Austria in 2006 and he was awarded a Venia Docendi in 2007 and working as an associate professor in the Department of Neuroradiology at Vienna Medical University in Vienna, Austria since 2010. He has published more than 40 papers and Proceedings in reputed journals and Books. He was awarded with several international scientific awards including three “Certificate of Merit” from the RSNA.

Abstract:

Purpose:

It has been shown that using variable window width and center level settings facilitates the detection of ischemic brain parenchyma in unenhanced cerebral CT (CCT) by accentuating the contrast between normal and edematous tissue. The aim of this study was to apply color-coded volume rendering to CCT datasets and assess the clinical value of the resulting volume-rendered CCT images in the detection of early infarction signs.

Method and Materials:

Ethics committee at our institute approved this study. The calculated sample size was 80 patients. Unenhanced CCT datasets of 80 consecutive patients with clinical suspicion of acute stroke were retrospectively evaluated. Utilizing commercially available software, CCT images were reconstructed and a specific color was assigned to each voxel corresponding to its HU value. Two resident doctors, after completion of their neuroradiological training, evaluated source and volume-rendered CCT images. The reference standard was MRI with DWI that proved or ruled out an acute infarction. The diagnostic confidence in the presence of acute brain ischemia was scored by using a 5-point ordinal scale (1, definitely present and 5, definitely absent) and assessed with ROC analysis.

Results:

All volume-rendered CCT images were of good and diagnostic image quality. On DWI, 57 hyperacute cerebral infarction foci in 43 patients were identified. Volume-rendered CCT images allowed better performance than gray-scale CT images (Az, 0.84 and 0.61, respectively) in detecting early signs of infarction. Mean sensitivity, specificity and accuracy were 79%, 86% and 81%, respectively for volume-rendered images and 53%, 86% and 59%, respectively for source images. Interobserver agreement was substantial for volume-rendered and moderate for gray-scale CT images.

Conclusion:

Particularly for radiologists in training, color-coded volume-rendered CCT images may facilitate the visualization of ischemic brain parenchyma and augment its diagnostic confidence in the detection of acute stroke.

Biography:

Ryszard Gomolka has commenced his Master's Degree in Electronics and IT in Medicine from Warsaw University of Technology (WUT). Earlier, he received a Bachelor's Degree in the field of medical Electroradiology, from Medical University of Warsaw (WUM).  Currently, he is a PhD Candidate and Assistant at the WUT. He specializes in signal and image processing, and modeling of physiological control systems. Since 2006 he participates in research on computer aided diagnosis in hemorrhagic and ischemic stroke in NCCT, as well in research on modeling of central regulation of blood pressure in basic conditions, hypertension, obesity and acute stress.   

Abstract:

NCCT states a first-line diagnostic procedure for the emergency assessment of acute stroke. Although the NCCT is highly specific in differentiation of intracerebral hemorrhage from ischemia, it has a poor sensitivity in evaluation of acute ischemic stroke. Hence, computer-aided diagnosis is able to improve the performance.

In 2013 we introduced a computational method for detection and localization of visible infarcts in NCCT. Herein, we aimed to evaluate and extend our method to localize a non-visible hyperacute ischemia by means of Stroke Imaging Marker (SIM).

Based on the SIM and its components: ratio of percentile differences in subranges of HU distribution (P-ratio), ratio of voxels count in ranges of brain CT intensity (N-ratio), median HU attenuation value (MAV); the infarct localization was performed in 140 early and follow-up scans of 70 patients. The infarct was not visible to a radiologist or to an experienced stroke neuroradiologist in any of the early scans. The infarcted hemisphere detection rate and sensitivity of infarct localization were measured by comparing the detected region in the initial scan, with the gold standard set in respective follow-up examination.

The best performance of the algorithm was found for the P-ratio including 7 percentile subranges within the range of 35^th-75^th percentile. The modified SIM provided 76% ischemic hemisphere detection rate and 54% sensitivity in spatial localization of hyperacute ischemia (68% among properly detected sides).

The improved SIM is a dedicated and potentially useful tool for hyperacute non-visible brain infarcts detection in NCCT and may contribute to decision to triage.

Biography:

Yacov Rofe is a professor of psychology from Bar-Ilan University, and the President of educational college, Israel. I have published various articles in leading journal of psychology, including a new theory, entitled “Stress and affi liation: A utility theory”, published by Psychological Review, 1984. An additional infl uential article, published in Review of General Psychology, 2008, is a review which refutes the existence of repression and the Freudian Unconscious. In the recent years, my scientific work is focused on the development of new theory of psychopathology, which challenges the validity of traditional theories of psychological disorders have published a book, entitled, the Rationality of Psychological Disorders, by Kluwer, 2000. I have demonstrated in three articles that my theory can integrate all therapeutic methods pertaining to neurosis into one theoretical framework (Rofé, 2010), explain all data relevant to the development and treatment of conversion disorder (Rofé & Rofé, 2013), and resolve the theoretical confusion regarding the explanation of panic disorder, agoraphobia and other forms of bizarre phobia (e.g., chocolate phobia) (Rofé, 2015). I completed a new book, entitled Psycho-Bizarreness: An intuitive Rational-Choice Theory of Madness, which I hope to publish it by one of the leading University Publishing Company. A warm letter of recommendation was written by Israel Aumann, the Nobel Prize Winner of economy, which indicts that my theory is consistent with his game theory.

Abstract:

Yacov Rofe is a professor of psychology from Bar-Ilan University, and the President of educational college, Israel. I have published various articles in leading journal of psychology, including a new theory, entitled “Stress and affi liation: A utility theory”, published by Psychological Review, 1984. An additional infl uential article, published in Review of General Psychology, 2008, is a review which refutes the existence of repression and the Freudian Unconscious. In the recent years, my scientific work is focused on the development of new theory of psychopathology, which challenges the validity of traditional theories of psychological disorders have published a book, entitled, the Rationality of Psychological Disorders, by Kluwer, 2000. I have demonstrated in three articles that my theory can integrate all therapeutic methods pertaining to neurosis into one theoretical framework (Rofé, 2010), explain all data relevant to the development and treatment of conversion disorder (Rofé & Rofé, 2013), and resolve the theoretical confusion regarding the explanation of panic disorder, agoraphobia and other forms of bizarre phobia (e.g., chocolate phobia) (Rofé, 2015). I completed a new book, entitled Psycho-Bizarreness: An intuitive Rational-Choice Theory of Madness, which I hope to publish it by one of the leading University Publishing Company. A warm letter of recommendation was written by Israel Aumann, the Nobel Prize Winner of economy, which indicts that my theory is consistent with his game theory.

Biography:

Nilu Malpani Dhoot completed her MBBS and MD/DNB in Radio-diagnosis from Mumbai University, India. She did a fellowship in Intervention Radiology for one year in Kolkata, India. She has many national and international posters and paper presentations, including one at AIUM, Las Vegas. She has three peer reviewed original research articles in international journals, two of which are in head and neck radiology.

Abstract:

Endoscopy and cross-sectional imaging are  considered indispensible for evaluation of  larynx and oral cavity. USG is undoubtedly a powerful investigative tool in head and neck pathologies. Larynx and tongue are no exception. But, when compared to cross-sectional imaging where does USG stand is the question raised and answered in this paper. It is important to follow a systematic USG technique to evaluate the larynx and the tongue.

USG has accuracy of 71.4% while CT had 92.8% accuracy in assessing cancer of hypopharynx. USG has accuracy of 61%, while MRI has accuracy of 91% in assessing tongue cancer. Post cricoid extension and small PFS growth are not appreciable on USG in cases of larynx cancers, where as small intrinsic tongue muscle growths and alveolar involvement were not seen on USG in cases of tongue malignancy. USG can easily visualize vocal cord movements, pre-epiglottic space lesions and submandibular duct involvement, which are relatively difficult to appreciate on cross-sectional imaging. Even though small tumors are difficult to visualize, USG can play a significant role in assessment of the tumor extension inside and outside the organ. Especially when cross-sectional imaging is unavailable, unaffordable, contraindicated and in post treatment follow up cases.

Biography:

Dr. Yun Zhou is Assistant Professor at the Russell H. Morgan Department of Radiology and Radiological Science, and Guest Professor of Peking University First Hospital. He obtained his M.S. in Biomathematics and Ph.D. in Biomedical Physics from University of California at Los Angeles.

Abstract:

Brain PET is a well-established quantitative functional imaging technique to measure physiological and biochemical process. As recent advances in hybrid imaging technology, such as PET-CT and PET-MRI, for whole-body PET imaging, there are urgent needs to develop and validate technologies for quantitative whole-body PET from data acquisition to quantification. The fundamentals of quantitative PET developed in last three decades which include kinetic modeling approach and parametric imaging algorithms will be briefly reviewed. Recent developments in quantitative PET imaging on dopamine and serotonin receptors and transporters will be highlighted. Tremendous efforts have been made to extend quantitative brain or organ-specific PET to dynamic whole-body PET in last few years. We investigated the feasibility of quantitative dynamic whole-body PET via multi-bed multi-pass technology. Optimization in data acquisition and quantification were studied by both computer simulation and an ongoing multi-center multi-tracer dynamic whole-body PET project. The potentials and challenges in quantitative whole-body PET in clinical diagnosis, monitoring disease progression, responses to treatments or psychological/pharmacological stimulations will be discussed with our promising results.

Biography:

Jianhua Zhang has completed his M.S. in 2004 and M.D. studies in 2012 from Peking University, majoring in Radiology and Nuclear Medicine. He joined the faculty of nuclear medicine at Peking University First Hospital.in 2004 and now is the associate professor. He has published more than 20 papers in journals and 20 chapters in proceedings and medical textbooks. The research interests of Dr. Zhang include application of positron emission tomography (PET) in studies of tumors, especially the lymphoma, and quantitve analysis. He has mentored 1 doctoral student and has been involved in teaching of more than 30 residents.

Abstract:

18F-FDG PET/CT imaging has become a crucial component of oncological management for a wide variety of malignancies and is routinely used in staging, restaging and treatment response assessment tasks. Compared to qualitative method and semi-quantitative method, quantitative method is more accurate and can overcome the limitations of the routine methods, but it is more complicated on the management of many cancer patients. As for the quantitative method, plasma input function and FDG influx rate constant (Ki) are indispensable. An emphasis in the present work is to develop non-invasive plasma input function estimation techniques in order to facilitate clinical acceptance. Image derived input function method will be studied and validated in the novel context of whole body dynamically-acquired images to facilitate parametric imaging. The present work is expected to significantly enhance the capability of dynamic whole body FDG PET/CT imaging to quantify the kinetics of FDG, and in turn, has the long-term potential to significantly enhance diagnostic, prognostic and treatment response monitoring capabilities of the FDG PET imaging modality and to fundamentally alter routine clinical practice.

Biography:

Prof. & Dr. Rong Fu Wang has completed his MD at the age of 27 years from Fujian Medical University in 1982, postdoctoral studies from Paris V University School of Medicine in 1993 and his PhD at the age of 40 years from Toulous IIl University in 1995. He is the director of Department of Nuclear Medicine, Peking University Health Science Center. The research interests of Dr. Wang include experimental study and clinical application of molecular and clinical nuclear medicine. He has published more than 400 papers in reputed journals and has been serving as many editorial board member of reputed journals at home and abroad. He has published 3 monographs, and has got 3 patents of invention and 3 provincial and ministerial Awards

Abstract:

18F-FDG uptake rate constant Ki is a most interested and commonly used parameter for absolute quantification of 18F-FDG PET/CT. Ki is usually estimated by fitting a kinetic model with plasma input function (PIF) to the measured dynamic PET data. The need for arterial blood sampling to measure PIF (mPIF) is a main barrier to estimate Ki for clinical 18F-FDG PET. Two existing noninvasive PIF estimation methods, image derived PIF and simultaneous fitting method with kinetic model and parametric PIF, require image data to be acquired continuously and immediately post tracer injection. The objective of the study is to validate and optimize a generalized population-based PIF estimation method for noninvasive quantification of dynamic 18F-FDG PET for sparsely sampled PIF. Eight 60-min 27-frame monkey dynamic 18F-FDG PET studies were collected from a Philips Gemini GXL PET/CT with 3D data acquisition mode. Total 34 arterial blood samples were taken during PET scan as: 22 samples for the first 4 min, and followed by sampling at 5, 6, 8, 10, 12, 15, 20, 25, 30, 40, 50 and 60 min. Time activity curves (TACs) of 7 cerebral regions of interests (ROIs) were generated from each study. A generalized population-based approach to recover full kinetics of the PIF from sparsely sampled blood data is proposed. The estimated PIF (ePIF) from the incomplete PIF sampling data was determined by interpolation and extrapolation using scale-calibrated population mean of normalized PIFs. The optimal blood sampling scheme with given sample size m was determined by maximizing coefficient coefficients of Ki estimates between the Kis from measured PIF (mPIF) and estimated PIF (ePIF). The leave-two-out cross validation was performed. The linear correlations between the Ki estimates from the ePIF (with optimal sampling scheme) and those from the mPIF were: Ki(ePIF; 1 sample at 40 min) = 1.015Ki(mPIF) -0.000, R2 = 0.974; Ki(ePIF; 2 samples at 25 and 50 min) = 1.029Ki(mPIF) - 0.000, R2 = 0.985; Ki(ePIF; 3 samples at 8, 20, and 50 min) = 1.039Ki(mPIF) - 0.001, R2= 0.993; and Ki(ePIF; 4 samples at 8,12, 25, 40, and 55 min) = 1.02Ki(mPIF)-0.000, R2=0.997. The correlations of R2 from leave-2-out validation study were 0.978±0.007, 0.990±0.006, and 0.996±0.003 (mean ±SD) for 1, 2, and 3 samples of optimal sampling scheme, respectively. The generalized population-based PIF estimation method is a reliable method to estimate PIFs from incomplete blood sampling data for quantification of dynamic 18F-FDG PET using the Gjedde-Patlak plot.

Biography:

Dr. Zhoulei Li has completed her PhD in 2013 from Ludwig-Maximilians-University of Munich and postdoctoral studies from technical university Munich. She has published more than 10 papers in reputed journals. She is a research leader, managing a pharmaceutical project from Helmholtz Center Munich. Before that, She was a postdoc researcher, managed the clinical research lab at nuclear medicine of technical university Munich, supervised research staff and graduate students. She has extensive hands on experience on molecular imaging. Her research focuses on monitoring progress of cancer therapy and developing biomarker for cancer therapy.

Abstract:

The prognosis of relapsed or refractory aggressive lymphoma is poor. The huge variety of currently evolving targeted treatment approaches would benefit from tools for early prediction of response or resistance. Molecular imaging is recently recognized as a tool that can improve every facet of cancer care. PET images biochemical or physiologic phenomena in comparison with computed tomography (CT) or magnetic resonance imaging (MRI), which show anatomic details. PET imaging would predict areas of abnormal metabolic behaviour of cancers in vivo, and the addition of CT imaging underlines the site of malignancy. More accurate andprecise interpretation of cancer lesions can therefore be performed by PET/CT imaging than PET or CT imaging alone. We used various lymphoma cell lines (ALCL, DLBCL, MCL, Myc-induced murine lymphoma etc.) to evaluate therapeutic effect of different anti-cancer drugs in vitro by molecular biological and biochemical methods. Micro-FDG- and/or FLT-positron emission tomography (PET) or PET/CT imaging studies were carried out with the suitable xenograft or transgenic mouse models to assess early treatment response to anti-cancer therapy in vivo. Interestingly, we detected a significant reduction of FLT-uptake in ALCL bearing animals using targeted drug therapy compared with baseline as early as 2 days after initiation of targeted therapy. Immunostaining showed a decrease in Ki-67 and an increase in cleaved caspase-3 staining. Additionally, the detection of therapeutic response of other aggressive cancer was proved to be highly correlated with other in vito and in vivo data, suggests that PET/CT is a suitable method for detection of therapeutic respons on cancer.

Biography:

Dr. Tang graduated from University of South China and received her master’s degree in plastic and reconstruction surgery form Peking Union Medical College. She finished her surgical residency training and became a breast surgery specialist in 2011. After that, she has been working as a postdoctoral fellow at Surgical Oncology of Massachusetts General Hospital.She has published 20 peer reviewed journal papers. Her interests include oncoplastic breast procedures, breast cancer shaved cavity margins, nipple sparing mastectomy, and novel breast imaging methods.

Abstract:

Intraoperative specimen imaging is commonly performed to confirm complete excision breast lesions, but has false positive and false negative rates that lead to incorrect specimen assessment in 21-44% of cases. Micro-CT provides non-invasive, highly quantitative imaging in small specimens within a few minutes. We explored the use of micro-CT for intraoperative assessment of a variety of breast specimens. Excised breast specimens, including lumpectomy specimens, shaved cavity margins(SCM), mastectomy specimens and axillary lymph nodes, were evaluated with a table top micro-CT scanner, Skyscan 1173 (Skyscan, Belgium), with a 40-130kV,8W X-ray source. Scanning for 7 minutes and reconstruction for another 7 minutes provided desired resolution in breast specimens. In lumpectomy specimens, micro-CT could clearly visualize orienting sutures and see the location of tumor masses and associated calcifications relative to specimen margins. In separately excised cavity margin specimens, micro-CT visualized tumor masses and calcifications that indicated the need for additional tissue excision. Micro-CT provided detailed images of axillary lymph nodes and their vessels’ 3D structure. 103 SCM from 26 lumpectomies were scanned and compaired with histopathology results. Margin status by micro-CT was concordant with histopathology in 86/103 (83%) SCM. Micro-CT had 73% sensitivity, 85% specificity, 46% positive predictive value, and 95% negative predictive value of SCM. 5/26(19%) case required a re-excision based on the final margin status, micro-CT could identify 3 out of these 5 cases intraoperatively. Micro-CT is a potentially useful tool for assessment of breast cancer specimens, allowing real-time analysis of breast lumpectomy specimens or cavity shaved margins.

Biography:

Abstract:

Introduction:   Febrile seizures (FS) are always a relevant topic; thermoregulation and febrile responses, complex processes, are important aspects of the unsolved puzzle.

Methods: Here, FS are explored from comparative “evolutionary pressure” data-sets for insights/contributing factors to age dependent vulnerability and for potential MRI data acquisition for evidence-based medicine.

Results/Discussion: Thermoregulatory responses’ evolutionary quest is for maximal performance at optimal temperature, experimentally shown for insects’/viruses’ population growth, not performance. Relying on external heat sources, ectotherms’ narrow range of performance thermal sensitivities is explained by natural selection, not thermodynamics; endotherms’, birds’/mammals’, thermally constrained set-points evolved promoting heat loss, not enhancing performance.   Mammalian brains’ selective brain cooling (SBC) is a special evolutionary case within the thermal core because hyperthermia, causing febrile seizures, limits performance; SBC separates brain temperature (T) regulation independently from the body to keep T_brain < T_trunk, p<0.01.

Species-specific SBC mechanisms during hyperthermia promote reversing normal blood flow, from brainàskin to skinàbrain, to cool/maintain constant cerebral metabolism. A 4-part venous pathway connects extracranial diploic/emissary veins with intracranial meningeal veins/sinuses; the richly vascularized/complex human diploe has an age dependent developmental pattern, fully established, age 5, large variations at each age. Primate emissary veins respond immediately to hyperthermia; their parietal/mastoid/condyloid/post-glenoid foramina prominence shifts in an evolutionary pattern: Tarsius 0%,0%,0%,100%; Lemurs 0%,74.4%,0%,99%; orangutan 3%,81.6%, 1%,2%; chimpanzee 8.7%,14%,16.5%,0%; human 60.5%,68%,77%,0.6%.

Furthermore, intrinsic brain geometry plays an important evolutionary role in thermoregulatory patterns/heat distribution. Notably, perinatal discontinuity of ontological size/shape changes in chimps/humans at 4-6 months, p<0.0044, produces topographical changes in vascular system; an expanded human frontoparietal volume, now globular, with highest concentration of diploic/emissary veins, richly anastomosed/reticulated, affects heat dissipation. Brain surface:volume ratio values for chimps’/humans’ heat loading, 1.59 vs 0.91, respectively, confirms globular shape decreases thermic values in heat transfer.

Conclusion:  In light of evolution, human ontological variations from MRI measurements may offer an option to FS’ unsolved puzzle for evidence-based medicine. 

Biography:

Marymol Koshy is an Associate Professor of Radiology and Senior Consultant radiologist at the Faculty of Medicine, Universiti Teknologi MARA, Malaysia. As the faculty was a new faculty she spearheaded the planning and designing of the Unit and also the purchasing and Installation of equipments. She also developed the radiology component of the medical students curriculum. In the meantime she subspecialized in cardiovascular imaging in CT and MRI. She has a keen interest in research in most fields of radiology and supervises Masters and PhD students. She is involved in many clinically based researches and has received grant funding.

Abstract:

Background: Malignant gliomas are highly infiltrative and aggressive primary brain tumors. Achieving gross total resection (GTR) using conventional white light microsurgical technique is a challenge. Five-aminolevulinic acid (5-ALA) can be used as an adjunct for the surgery of adult malignant glioma and improves the rate of gross total resection and patient survival. The use of this method in clinical practice is relatively new in Malaysia. We evaluate the extent of malignant glioma resection under fluorescence-guided resection (FGR) using volumetric MR neuroimaging.

Methodology: A prospective pilot study was carried out in 5 newly diagnosed malignant glioma patients that underwent FGR using 5-ALA. All cases were subjected to both pre and postoperative MR that was performed 72 hours prior to and post surgery. The volumetric assessment was performed using special soft ware program. Th e Extent of Resection (EOR) was then classified into three

categories: Gross total resection (GTR, >90% tumor removal), Subtotal resection (STR, resection of 10-90% of tumor) and Partial resection, <10% tumor removal)

Results: Five patients (mean age 54 years, range 45–60 years), 3 males and 2 females were recruited and analysed. These patients harbored Grade IV glioblastoma. The location of the tumor was predominantly in the frontal lobe (n =3, 60%). The median preoperative tumor volume was 35.67cm³ (range 19.4-95.79) and the median postoperative tumor volume was 1.47cm³ (range 0.12- 2.37). GTR of >90% was achieved in all 5 patients.

Conclusion: Our experience using Fluorescence-guided surgery enabled a GTR in 100% patients with glioma. We advocate increasing the sample size, which in turn will increase the power of the statistical analysis. The application of 5-ALA has a great potential as a novel standard in neurosurgery in Malaysia to maximize tumor resections for malignant gliomas.

Biography:

Abstract:

Introduction: Burkholderia pseudomallei is a gram negative environmental bacterium found in soil and surface water which causes melioidosis, commonly reported to occur in south-east Asia and northern Australia. It is being increasingly reported in India and transmission is through inhalation, inoculation and ingestion.

Two clinical forms are recognised – acute septicemic form and the chronic granulomatous form. Both these forms are recognised to affect the neuraxis and the adjacent soft tissues and bone. Involvement of these structures is rare but of importance due to the significant mortality and morbidity associated with cranio-spinal infection

Methods: 14 culture proven cases with involvement of the cranio-spinal structures were retrospectively identified between Jan 2008 and May 2016 via search of the hospital’s electronic database  

Involvement of the cranio-spinal structures included multiple parenchymal abscesses(5) which usually occurred in contiguity with skull osteomyelitis.

Parenchymal and leptomeningeal disease was secondary to septicaemia. Pachymeningeal disease was found to be secondary to sino-nasal involvement and otomastoid infections(5). Acute myelitis (1) and spondylodiscitis (3) were the other forms seen

Parenchymal involvement ranged from cerebritis, early and mature parenchymal abscess formation. Patients with fewer abscesses which were amenable to surgical evacuation had a favourable outcome compared to those who had multiple small, widespread abscesses

Chronic pachymeningeal disease was invariably associated with sino-nasal, otomastoid infections or a skull osteomyelitis. Multiple cranial neuropathies were recorded in those with pachymeningitis. Local inoculation or inhalation is presumed to be the route of infection

One patient who presented with longitudinally extensive transverse myelitis had received immunosuppression prior to admission and this exacerbated the progression of disease

2 patients with parenchymal abscesses and the one with myelitis succumbed to their illness

Conclusion:

CNS manifestations of Burkholderia in the form of pachymeningeal disease and myelitis must be suspected in the appropriate clinical scenario as alternative imaging and clinical differentials entail therapy with immunosuppression which are detrimental

Biography:

Luca Pasquini has graduated cum laude at the age of 24 years from University of Florence. He is a radiology resident and researcher at La Sapienza-University of Rome. He is cooperating in many publications and conferences.

Abstract:

The exact role of Magnetic Resonance (MR) in the evaluation of Graves's ophtalmopaty (GO) onset is still not completely delineated, especially regarding the convenience of performing an MR acquisition with gadolinium-based contrast administration or not. The purpose of this retrospective study was therefore to verify the correlation between MR and clinical and laboratory data in GO at its clinical onset and during follow-up, by comparing pre-contrast and post-contrast sequences. MR examinations of 58 patients with affected by GO were retrospectively included. In each patient "signal intensity ratio "values (SIR) in the most affected extrinsic orbital muscle, in both T2 and post-contrast T1-weighted sequences, ocular proptosis and optical nerve impingement was evaluated. Univariate ANOVA analysis (p<0,05) to compare clinical activity (CAS) and severity scores, TSH receptor antibodies (TRAb) titre and single or global radiological measurements was performed. The statistical analysis showed a significant correlation between T2-SIR value and CAS (p=0.023) at diagnosis and during follow-up. CE-SIR correlated only with TRAb titre (p=0.008). Finally the global MR index (T2 SIR + proptosis + impingement) correlated with both CAS (p=0,036) and antibodies (p=0,014). MR orbits evaluation demonstrates a good correlation with clinical informations in patients affected by GO at diagnosis and during follow-up. T2-weighted sequences show a better correlation compared to post-contrast T1 weighted sequences, suggesting to avoid contrast administration for standard MR protocol for GO. Measurement of a global MR index may further support clinicians in the management of GO, improving a multidisciplinary approach to the disease.

Biography:

I am a professor of psychology from Bar-Ilan University, and the President of educational college, Israel. I have published various articles in leading journal of psychology, including a new theory, entitled "Stress and affiliation: A utility theory", published by Psychological Review, 1984. An additional influential article, published in Review of General Psychology, 2008, is a review which refutes the existence of repression and the Freudian Unconscious. In the recent years, my scientific work is focused on the development of new theory of psychopathology, which challenges the validity of traditional theories of psychological disorders have published a book, entitled, the Rationality of Psychological Disorders, by Kluwer, 2000. I have demonstrated in three articles that my theory can integrate all therapeutic methods pertaining to neurosis into one theoretical framework (Rofé, 2010), explain all data relevant to the development and treatment of conversion disorder (Rofé & Rofé, 2013), and resolve the theoretical confusion regarding the explanation of panic disorder, agoraphobia and other forms of bizarre phobia (e.g., chocolate phobia) (Rofé, 2015). I completed a new book, entitled Psycho-Bizarreness: An intuitive Rational-Choice Theory of Madness, which I hope to publish it by one of the leading University Publishing Company. A warm letter of recommendation was written by Israel Aumann, the Nobel Prize Winner of economy, which indicts that my theory is consistent with his game theory.

Abstract:

Both psychoanalysis and medical models, the two theoretical empires of psychological empires of mental disorders, suffer from serious theoretical and empirical difficulties (see Rofé, 2000, 2010; Rofé & Rofé, 2013, 2015). In an attempt to resolve the theoretical confusion in this field, a new theory was proposed termed, Psycho-Bizarreness: An intuitive Rational-Choice Theory of Madness. Basically, this theory claims that when individuals are confronted with intolerable levels of current stress, they are likely to choose a mad behavior when other options, such as suicide, drug abuse, and antisocial behaviors, are unavailable or too costly. The major benefit of madness is repression, which the new theory defines in line with Freud's (1915, p. 147) original suggestion, as distraction. The distractive effect of the mad behaviors is so strong that it blocks the accessibility of stress-related thoughts. Hence, while Freud claimed that repression causes madness, according to Psycho-Bizarreness Theory (PBT), madness results in repression. Accordingly, the choice of a specific mad behavior is determined by the same principles used in consumer decision-making when purchasing a specific economic product. Lack of awareness of the Knowledge of Self-Involvement (KSI) is induced through sophisticated information processing that causes the forgetting of KSI and enables the development of a self-deceptive belief. As already demonstrated, PBT can integrate all studies pertaining to the development and treatment of neuroses and psychos into one theoretical framework (see Rofé, 2000, 2010; Rofé & Rofé, 2013, 2015).

Biography:

Prof. Akirav has completed hers PhD from the University of Haifa and postdoctoral studies from the Weizmann Institute of Science in Israel. She is the director of the learning and Mmeory lab since 2006 at the department of Psychology, University of Haifa.

Abstract:

The formation of a fear memory following a traumatic event is an important mechanism for the subsequent development of post-traumatic stress disorder (PTSD). PTSD is different from other psychiatric disorders, in that it has a very clear point of onset. Hence, it seems that what we do in the first few hours after exposure to the traumatic event might have the potential to dramatically alter the trajectory of PTSD. We aimed to examine whether intervention in the first few hours after trauma exposure using cannabinoids would prevent stress-induced alterations in extinction and plasticity. Maladaptive synaptic plasticity processes in response to specific external challenges are believed to underlie disorders such as PTSD. Growing attention has been focused on striatal plasticity which regulates mood and motivation, as well as fear-related behaviors after stress exposure. We show that exposure to an emotional trauma impairs extinction and plasticity in the fear circuit (hippocampus, nucleus accumbens and amygdala) and that these effects are prevented by enhancing endocannabinoid signalling. The preventive effects were found to be associated with alterations in cannabinoid CB1 and glucocorticoid receptors (GR) in the brain's fear circuit.

Biography:

Noha ElSaid has graduated on 1993 and completed postdoctoral studies from Cairo University on 2005. She has published more than 10 papers in different fields of radiology mainly women Imaging and shared in many international conferences

Abstract:

Leukemia is the most common pediatric malignancy. Acute lymphoblastic leukemia accounts for about one-fourth of all childhood cancers and about 75% of all childhood leukemias. Recent advances in therapy such as aggressive polychemotherapy, intrathecal cytostatic prophylaxis for pediatric leukemia have greatly improved the prognosis but have resulted in an increased incidence of associated complications and toxic effects. The main neuro-imaging features in pediatric patients with leukemia treated with chemotherapy were prospectively studied. Aim of the study: is to evaluate the role of MRI in the detection of the side effects of chemotherapy on the brain in leukemic children presenting with clinical symptoms. Patients and methods: 20 pediatric patients their age range 1-16 years receiving or have received chemotherapy for acute leukemia have undergone MR examination of the brain for evaluation of neurological symptoms related to treatment from August to December 2015. Results: This study included 20 children, 15 (75%) were male and 5 (25%) were female. Their ages at the time of the study ranged from 1-16 years. 17 patients (85%) were on maintenance chemotherapy, 2 patients (10%) were on induction and 1 patient (5%) had finished treatment. Multiple complications were recorded by MRI and its correlation to the treatment phase of the cases. All cases of Sino-venous thrombosis & hemorrhage occurred within the maintenance phase. Leuco-encephalopathy was divided equally between maintenance & induction phases.Brain atrophy was divided equally between induction & maintenance phases. PRES occurred within the maintenance phase. Most of infection cases (sinusitis & otitis media) occurred within maintenance; only one case was seen in a patient who just ended his chemotherapy. Conclusion: Chemotherapy is associated with certain side effects that can be evaluated by utilization of MRI. An elevated degree of suspicion is needed to recognize the radiologic features of CNS complications of chemotherapy and familiarity with the imaging findings is essential for proper diagnosis and further treatment of neurologic symptoms in pediatric patients with leukemia.

Biography:

Maria Pachalska has completed her PhD at the age of 30 years from Gdańsk University, and her full Professor from Gdansk University. She is the head of the Chair of Neuropsychology at Cracow University, and consultant in Center for Cognition and Communication, New York, NY, USA. She is the President of the Polish Neuropsychological Society since 1992 and the Editor in chief of Acta Neuropsychologica. She published 9 books and more than 200 papers in reputed journals and has been serving as an editorial board member of 11 repute journals for many years.

Abstract:

Background: The aim of the study was to evaluate the effectiveness of individually tailored neurofeedback protocol for the reduction of depression which was diagnosed in the patient with schizophrenia spectrum complicated with TIA. The neuromarkers in Quantitative EEG (QEEG) and Event-related potentials (ERPs) were utilized in the construction of protocol and evaluation.

Case study: A 54-year-old patient, experienced TIA. The patient was treated before for more than 20 years for schizophrenia. However the patient complained low mood, difficulties with sleeping as well as an inability to continue work in his given profession. Specialist tests were to show the presence within him of depression. As a result of which the patient was provided with neurofeedback therapy. The effectiveness of this therapy in the reduction (eradication) of the symptoms of depression were evaluated through the utilization of quantitative EEG (QEEG) and Event related potentials (ERPs).

Results: It was found that in the first examination that ERPs display the most significant deviations from the reference in the two components: (1) the one component is generated within the cingulate cortex. The pattern of its deviation from the norms. In contrast to healthy subjects the component repeats itself twice; (2) the second component is generated in the medial prefrontal cortex. Its pattern (neuromarker) is similar to that found in depresive patients. In the second examination, after neurofeedback training, the ERPs were similar to the norm. The patient returned to work. Conclusions. Chronic depression developed within the patient with schizophrenia spectrum. The application of a method of therapy (neurofeedback) resulted in the withdrawal of the syndrome symptoms. ERPs in a GO/NOGO task can be used to plan neurofeedback and in the assessment of functional brain changes induced by neurotherapeutic programmes.

Biography:

Izabela Blaszczyk received her MD-degree from the Medical University of Silesia, Katowice, Poland in 1992. Following a 5 years residence in the Orthopaedic Department in Gorzow Wielkopolski, Poland and 2 years in Hand Surgery Department at the University Hospital of Louise Pasteur, Strasbourg, France, she became a specialist in hand surgery (FESSH European Diploma 1999). Since 2000 she has a permanent position at the Department of Hand and Plastic Surgery, University Hospital of Northern Sweden, Umeå. Her special interest is the treatment of spasticity in the upper limb of children and adults with CP, stroke or brain injury.

Abstract:

The dyskinetic subtype of cerebral palsy is difficult to manage, and there is no established gold standard for treating the condition. External rotation of the shoulder(s) is often managed non-surgically non surgically using injections of botulinum toxin A into the external rotator muscles. I present a novel surgical technique designed to for manage external rotation when botulinum toxin A treatment is not sufficient or possible. Six patients with dyskinetic cerebral palsy underwent denervation of the infraspinatus muscle and release of the posterior part of the deltoid muscle. Postoperative questionnaires were given to the patients/caregivers, and video recordings were made both pre and postoperatively. Preoperative and postoperative Assisting Hand Assessment was possible in only 1 case. Five patients were very satisfied with their outcome. Four patients’ video recordings showed improvement in of their condition. One patient developed postoperative complications. The results indicate that denervation of the infraspinatus muscle and posterior deltoid release can be an option for patients with dyskinetic cerebral palsy to manage external rotation of the shoulder when other treatment alternatives are insufficient.

Biography:

Abstract:

Purpose: Because unusual entrance of vertebral artery into the cervical transverse foramen (UE-V2S) is relatively common anomaly in clinical field, therefore spine surgeon always have one’s eye to understand its anatomical characteristics and clinical implications. The aim of this study is to assess the above task with a very large number of UE-V2S anomaly cases.

Methods: Retrospectively, the authors analysed 2207 three-dimensional head and neck computed tomographic angiograms (CTA) without a specific vascular abnormalities. After confirming the unusual entrance of the vertebral artery (VA) into the transverse foramen (TF), we measured its vertebral artery diameter (VAD), transverse foramen area (TFA) and pedicle width (PW) from C3 toC7, bilaterally. The shortest horizontal distance from the vertical line in the medial margin of the TF to VA (D-TFVA) were measured in extra-osseous region to estimate the exact location of extra-osseous VA, excepting C7 level.

Results: The unusual V2 entrance was observed in 11.4 % (252 patients) of all 2207 consecutive patients and 6.5 % (268 courses) of all 4414 courses. The prevalence of unilateral UE-V2S level was followed as below: E5 > E4 > E7> E3 and prevalence of bilateral UE-V2S were ordered as below: E5 (bilateral) was most prominent and E4 (right) / E5 (left ) and E4 (bilateral) was followed. Generally, the VAD of the anomaly side was statistically smaller than the normal contra-lateral side, which can induce small value of TFA in all subaxial level. Although UE-V2S can assure larger PW dimension in below adjacent level of UE-V2S, the difference value of PW between anomaly and normal side was not much in it, or insignificant in some types of UE-V2S (E4-Right and E7-both). The least value of D-TFVA was -3.8 mm in this study, which means that we should take a care not to pass exceeding 3.8mm medial to the vertical line of medial wall of TF during dissection in anterior cervical approach.

Conclusions: For avoiding unexpected VA injury or improving efficiency of cervical operation, spine surgeon should know the possible presence of UE-V2S in a routine cervical operation and understand its clinical characteristics in advance.

Keywords: Cervical spine, Vertebral artery, V2 segment, Anomalous course, CT angiography

Biography:

Abstract:

Object: Frame-based image-guided system is the most widely used for stereotactic brain biopsy. Recently frameless stereotactic biopsy techniques have become utilized. We evaluated the application usefulness of skull-mounted frameless image-guided stereotactic brain biopsy system.

Methods: We reviewed consecutive 10 patients using skull-mounted frameless image-guided stereotactic brain biopsy system compared to patients using conventional frame-based system. We evaluated the usability and the advantage of both systems.

Results: To set up frameless system needed less invasive procedure and shortened surgical time in comparison to frame-based system. In many cases frame-based system required the drilling of the external table and the diploe of calvaria to insert the biopsy needle away from the skull. Consequently large skin incision were made. On the other hand there is a limit of insertion angle in the frameless system. In one case flame-less system could not be used due to this limitation.

Conclusion: With regard to less invasiveness and shortening of the surgical time, skull-mounted frameless image-guided stereotactic brain biopsy system may represent more efficient means of biopsy though there is a limitation of biopsy needle insertion angle.

Biography:

Lin Leng Chieh, Medicine Doctor, now is a Clinical Assistant Professor and Deputy Director, Department of Emergency Medicine, Chang Gung Memorial Hospital. Taiwan. He got his Medicine Doctor’s degree at National Yang Ming University, Taipei, Taiwan. And Dr. Lin Leng Chieh got the Clinical Applications Award in 2012 and 2014. Currently Dr. Lin Leng Chieh researches focus on the biomarkers of dehydration and fluid therapy of acute ischemic stroke.

Abstract:

Background: Dehydration is associated with poor outcome after acute ischemic stroke. However, the relationship between hydration therapy during acute ischemic stroke and clinical outcome remains unclear. Our study aimed to determine whether providing hydration therapy to patients with a blood urea nitrogen/creatinine (BUN/Cr) ratio ≥15 improves their clinical outcome.

Methods: A non-blinded, phase II single arm prospective study of patients with acute ischemic stroke and BUN/Cr ratio ≥15 was conducted from January 2011 to December 2013, with historical controls from November 2007 to June 2010. The hydration group received intravenous bolus (300–500 mL) saline followed by maintenance saline infusion (40–80 mL/h for the first 72 h), while the control group received maintenance saline infusion (40–60 mL/h for the first 24 h and 0–60 mL/h for 24–72 h). The study endpoint was the proportion of patients with favorable outcome, defined as modified Rankin scale (mRS) ≤ 2 at 3 months post stroke.

Results: Overall, 237 patients were enrolled (hydration group, n = 134; control group, n = 103). The median volume of infused saline from day 1 to day 3 was significantly larger (P < 0.001) and the rate of favorable outcome at 3 months post stroke was significantly higher (P =0.016) in the hydration group. Dividing acute ischemic stroke into lacunar and non-lacunar subtypes, the difference was significant only in the lacunar stroke subtype (P=0.020). Conclusion: Thus, providing saline hydration therapy to patients with acute ischemic stroke based on BUN/Cr ratio can significantly increase the rate of favorable clinical outcome with functional independence at 3 months post stroke.

Biography:

Abstract:

Background: Brain tumors can present to the emergency department for many causes. It is unusual for those patients to need emergency tumor resection surgery. One of the exceptions is patients with markedly increased ICP secondary to the tumor mass.

Objective: To define an international guideline for the indications of urgent surgical resection of brain tumors according to inclusion criteria.

Methods: A prospective analysis for twenty patients who undergone urgent brain tumor resection surgery at Neurosurgery Teaching Hospital –Baghdad-Iraq was conducted from October 2014 to February 2016. The variables assessed for each case is gender, age, GCS score (pre and post-op.), functional deficit (pre and post-op.), Brain CT-scan criteria for each tumor, medical therapy trial in hours and the histopathological data.

Results: Analysis for the 20 urgently operated cases is done. According to this analysis the female gender is 55%, the mean age is 43 year (SD 16.056), the mean pre-op GCS score is 9, 19 brain tumors is supratentorial and 1 brain tumor is infratentorial, For supratentorial tumors 11 tumors is in the right hemisphere, the tumors are 55% intra-axial, 45% extra-axial, the lobes aff ected are temporal (11 patient) then parietal (5 patient), others (3 patients), hemorrhagic tumor is found in 20%, the minimum midline shift in brain CT scan is 1 cm (mean 1.79 cm), the mean tumor size is 5.5 cm in maximum diameter, medical therapy is tried for a minimum of 2 hours (mean 3.50 hours), the histopathological data as follows meningioma (9 patients), glioma (6 patients 4 of those are glioblastoma multiforme), metastasis (5 patients), post-op GCS score is 15 (except 1 case GCS score 14), the paired test for pre and post-op GCS score shows strongly significant improvement (P value > 0.01), ), the paired test for pre and post-op functional deterioration shows strongly significant improvement (P value > 0.01).

Conclusion: From the study result we suggest the following inclusion criteria as indication guideline for urgent brain tumor resection surgery. The selected patient for surgery must fulfill all the following criteria: (1) Acute neurological deterioration [life-threatening decrease in GCS or functional deterioration (motor or visual function)]. (2) Significant midline shift in Brain CT-scan ( < 1cm).(3) The response to medical therapy trial to decrease ICP is either unexpected or failed. (4) Th e tumor mass is the main cause of deterioration: (A) Strong indication: tumor size maximum diameter > 4 cm or tumors that involve or compress the temporal lobe. (B)

Relative Indication: hemorrhagic tumors.

Abbreviations: GCS= Glascow Coma scale, CT=Computerized Tomography

Biography:

Ammar Mallouhi has completed his Specialization in diagnostic radiology in Innsbruck, Austria in 2006 and he was awarded a Venia Docendi in 2007 and working as an associate professor in the Department of Neuroradiology at Vienna Medical University in Vienna, Austria since 2010. He has published more than 40 papers and Proceedings in reputed journals and Books. He was awarded with several international scientific awards including three “Certificate of Merit” from the RSNA.

Abstract:

It has been shown that using variable window width and center level settings facilitates the detection of ischemic brain parenchyma in unenhanced cerebral CT (CCT) by accentuating the contrast between normal and edematous tissue. The aim of this study was to apply color-coded volume rendering to CCT datasets and assess the clinical value of the resulting volume-rendered CCT images in the detection of early infarction signs. Ethics committee at our institute approved this study. The calculated sample size was 80 patients. Unenhanced CCT datasets of 80 consecutive patients with clinical suspicion of acute stroke were retrospectively evaluated. Utilizing commercially available software, CCT images were reconstructed and a specific color was assigned to each voxel corresponding to its HU value. Two resident doctors, after completion of their neuroradiological training, evaluated source and volume-rendered CCT images. The reference standard was MRI with DWI that proved or ruled out an acute infarction. The diagnostic confidence in the presence of acute brain ischemia was scored by using a 5-point ordinal scale (1, definitely present and 5, definitely absent) and assessed with ROC analysis. Particularly for radiologists in training, color-coded volume-rendered CCT images may facilitate the visualization of ischemic brain parenchyma and augment its diagnostic confidence in the detection of acute stroke.

Biography:

The presentation will address blood and imaging biomarkers in mild Traumatic Brain injury and studies led by Dr. Shetty at the Hospital for Special Surgery. The GE-NFL Avanced MRI Applications/Abbot Biomarker Candidates for mTBI study is an anlaysis of investigational MR imaging and blood biomarker identification in subjects who have recently sustained a concussion. The specialized MRI software is correlated with detailed neurological assessments and 11 brain-tissue specific blood biomarkers that are expected to peak and then normalize following a concussion. Presently, 44 subjects are enrolled in the imaging portion with 42 subjects co-enrolled in the blood biomarker portion. 20 subjects have been enrolled in both imaging and blood biomarker at encounter 1 (within 72 hours of injury). 86 subjects were enrolled between March 2014 and June 2015 with 26 healthy controls matched for age, gender, handedness, level of education, and socioeconomic status.

Abstract:

Dr. Teena Shetty is a neurologist at Hospital for Special Surgery and is triple board-certified in neurology, neuromuscular medicine, and electrodiagnostic medicine. She is a Fulbright scholar who received her medical degree from Brown University. She attended Oxford University and the University of Cambridge where she received her master of philosophy degree in medicine. Her residency was completed at Weill Cornell Medical College, NewYork-Presbyterian Hospital. She received her fellowship training at Harvard Medical School, Brigham and Women's Hospital and Hospital for Special Surgery. Her research in head trauma involves brain-imaging after repeated concussions or mild traumatic brain injuries.

Biography:

Mulugeta Semework is currently a post-doctoral research scientist at the department of Neuroscience, Columbia University (Goldberg Lab) where he is investigating the neural mechanisms of environmental memory, (single and multi-cell neurophysiology of environmental memory), and cortical and subcortical mechanisms for eye movements and spatial processing. He came to Columbia after getting his Ph.D. in Neural Science and Behavior (Brain Machine Interface, Somatosensory Neuroprosthesis) from SUNY Downstate Medical Center, Brooklyn, NY. He has studied at Ben-Gurion University, Israel (Master of Science with Honors in Physiology/Biochemistry (thesis defense pending), Georgia State University (M.Sc. in Neurobiology), GA, and Alemaya University, Ethiopia (Bachelor of Science with Honors in Agronomy/Physiology).

Abstract:

Surgical planning, precise pre-operative positioning of incision sites and instrumentation, biopsy localization and tumor resection planning, looking inside inanimate objects, such as machines, etc. all require the use of common imaging tools. MRI, X-ray and CT scans have been in wide use and continue to be popular. This talk will introduce and discuss a compound (patent pending, IR# CU13187), which is MRI, X-ray and CT scan visible paste that can be applied to any surface and therefore provide an external reference point to an internal structure. It has made our and neighboring lab research efforts much easier and effective. In short, the great advantage of this product is that it shows as the same color in different scan types while common, and mostly of specific utility products such as contrast agents are oppositely colored. A recent test on X-rays and CT scans has shown that the paste has well delineated radio density. It is anticipated that the invention will eventually be manufactured as a sterile product that can easily and safely be applied to exposed body parts including to exposed brain. It can be made with different viscosities (consistencies), colors, odor, etc. for different uses, including other imaging strategies and purposes, such as for industrial/engineering objectives. It can be used in intraoperative stereotactic guidance for surgical instruments and devices, especially minimally invasive and robotic surgical planning and image based guidance. It has other advantages such as not requiring other adhesives for attachment to structures.

Biography:

Dnyanesh Tipre has obtained PhD in Pharmaceutics from Mumbai University in 2002. He completed postdoctoral fellowship at the National Institutes of Health, USA. He worked for Howard University Hospital, Johns Hopkins University, Schering-Plough Corporation, Columbia University Medical Center & Stony Brook University. He contributed research in pharmaceutical and molecular imaging field. He published quality research and review papers and his contribution is available online. He is a Founder and Chairman of United Translational Molecular Imaging Center which would serve professionals from Pharmaceutical and Molecular Imaging field. You are most welcome to join this organization and accept membership.

Abstract:

Various teams of scientists have contributed their efforts in assessing the metabotropic glutamate receptor 5 (mGluR5) as a biomarker in neuropsychiatric disorders and diseases. Development of positive and negative allosteric modulators of mGluR5 and PET radioligands that have the potential to measure mGluR5 receptor density in neurological disorders and during therapeutic interventions have been investigated. PET imaging provides an effective tool to assess the specificity of new drugs, select dose regimens in clinical trials, and study drug mechanisms of action. This presentation will deliver comparative analyses of mGluR5-specific PET radiotracers and their applications in understanding the pathophysiology of mGluR5-related nervous system disorders and to speed up drug development. Transcranial magnetic stimulation (TMS) is a magnetic method used to stimulate small regions of the brain. Evidence suggests it is useful for neuropathic pain and treatment-resistant major depressive disorder (MDD). The presentation will cover application of TMS in MDD with or without drug treatment. The presentation will also highlight potential applications of multi-imaging modalities such PET/MRS to measure functional changes in the brain before and after treatment.

Biography:

Ryszard Gomolka has commenced his Master's Degree in Electronics and IT in Medicine from Warsaw University of Technology (WUT). Earlier, he received a Bachelor's Degree in the field of medical Electroradiology, from Medical University of Warsaw (WUM). Currently, he is a PhD Candidate and Assistant at the WUT. He specializes in signal and image processing, and modeling of physiological control systems. Since 2006 he participates in research on computer aided diagnosis in hemorrhagic and ischemic stroke in NCCT, as well in research on modeling of central regulation of blood pressure in basic conditions, hypertension, obesity and acute stress.

Abstract:

NCCT states a first-line diagnostic procedure for the emergency assessment of acute stroke. Although the NCCT is highly specific in differentiation of intracerebral hemorrhage from ischemia, it has a poor sensitivity in evaluation of acute ischemic stroke. Hence, computer-aided diagnosis is able to improve the performance. In 2013 we introduced a computational method for detection and localization of visible infarcts in NCCT. Herein, we aimed to evaluate and extend our method to localize a non-visible hyperacute ischemia by means of Stroke Imaging Marker (SIM). Based on the SIM and its components: ratio of percentile differences in subranges of HU distribution (P-ratio), ratio of voxels count in ranges of brain CT intensity (N-ratio), median HU attenuation value (MAV); the infarct localization was performed in 140 early and follow-up scans of 70 patients. The infarct was not visible to a radiologist or to an experienced stroke neuroradiologist in any of the early scans. The infarcted hemisphere detection rate and sensitivity of infarct localization were measured by comparing the detected region in the initial scan, with the gold standard set in respective follow-up examination. The best performance of the algorithm was found for the P-ratio including 7 percentile subranges within the range of 35th-75th percentile. The modified SIM provided 76% ischemic hemisphere detection rate and 54% sensitivity in spatial localization of hyperacute ischemia (68% among properly detected sides). The improved SIM is a dedicated and potentially useful tool for hyperacute non-visible brain infarcts detection in NCCT and may contribute to decision to triage.

Biography:

Jun Deng received his PhD from University of Virginia in 1998 and completed his postdoctoral study at Stanford University School of Medicine in 2001. Currently, he is an Associate Professor of Therapeutic Radiology at Yale University School of Medicine, an American Board of Radiology certified medical physicist, a Fellow of Institute of Physics and a Fellow of American Association of Physicists in Medicine. At Yale, his research has been focused on medical imaging and its impact on cancer radiotherapy and public health. He has published 65 papers in peer-reviewed journals and been serving on editorial board of 14 international journals.

Abstract:

Medical imaging has revolutionized medical practices in the past hundred years, particularly in the diagnostic and radiotherapeutic management of cancers where anatomical and functional imaging procedures are applied routinely in the clinic worldwide for better diagnosis and treatment. Driven largely by technological advances as well as a fee-for-service healthcare model, the use of medical imaging modalities in cancer diagnosis and therapy has increased dramatically in the past thirty years. In addition, the application of imaging procedures in cancer diagnosis and radiotherapy remains largely non-personalized: a ‘one-protocol-fits-all’ practice is often applied in the clinic worldwide. Essentially, the imaging protocols provided by manufacturers are uniformly applied without considering individual differences of patients being scanned. As such, radiation exposure to individuals from medical imaging nowadays has increased over 8 times since 1980, which may become a serious public health concern due to increased secondary cancer risk. Whether to image and how to image an individual patient is not only an ongoing technical issue but also becoming an ethical concern in the clinic. This lecture will address the trend and issues of medical imaging in the US and around the world, and highlight a personalized imaging protocol approach that can be used to assist clinicians in making the best use of medical imaging with their patients worldwide to minimize radiation exposure and cancer risk, reduce medical costs and improve patient care.

Biography:

Permanently employed at the Clinical center of Serbia as a neuroradiologist in Center for Radiology and Magnetic resonance Imaging since February 1st, 2008; Have finished my radiology specialization on Octobar, 2013; Worked as a general practitioner at the Instutute for the Medical Protection of Mother and Child in 2006 and 2007, at the Radiology department; Started working as a general practitioner at Radiology – Neurosurgery department (Interventional Neuroradiology, MSCT neuroradiology imaging and MRI imaging) in October 2007; Have worked at the Emergency and Trauma Center since September 1st, 2009 (Diagnostic emergency neuroradiology, Ultrasound diagnostics and x-ray diagnostics); University of Nis, Faculty of Medicine, Department of Medicine, 1999- 2005; Average mark 9.84; Completed compulsory one-year internship at the Clinical Center of Serbia; Chosen as the valedictorian at the third and sixth year of studies at the Faculty of Medicine in Nis; Chosen as the valedictorian among the students of generation 1999/2000; Received the award for academic achievements given by the Ministry of Science and Environmental protection and the Ministry of Education

Abstract:

Patients with brain arteriovenous malformation (AVM) have a certain risk to bleed, and the goal of this study is to examine the effect of radiological and clinical predictive characteristics of AVM hemorrhage using multidetector CT angiography (MDCT). MATERIAL: this is a series of 57 patients with a mean age of 35.46 years, who were diagnosed at the Institute for Radiology and MRI, while the same were hospitalized at the Clinic of Neurosurgery, Clinical Center of Serbia in the period from January 2008 to March 2016. For all patients, the diagnosis was made using MDCT angiography. Two groups of patients were observed. The first group includes patients who were not initially presented by hemorrhage, while the second group was initially presented by hemorrhage. Both groups were treated with medical therapy, or a combination of medical therapy with embolization / surgery / radiotherapy. RESULTS: Deep venous drainage (p <0.05), the combined arterial supply from different basins (p <0.05) with a length> 60mm, venous dilation present in the drainage vein (p <0.01) and the angle of casting supply arteries in the nidus (p <0.01), carry a risk of repeated bleeding. In the group of patients who had initial hemorrhage a mean value of the sized corner casting was 130o, while the group that did not had initially bleeding mean value of the size of the measured angle was 103.81 with a standard deviation of 17.21 (p <0.01). CONCLUSION: arterio-venous malformations with the deep venous drainage from the carotid and VB basin, the length of the feeding arteries> 60mm, angle of casting feeding arteries in the nidus ≥ 130 ° and dilatation and / or venous aneurysm drainage vessel are predictive model for clinical presenting by hemorrhage.

Biography:

Dr Nilu Malpani Dhoot, completed my MBBS and MD/DNB in radio diagnosis from Mumbai University , India. She did a fellowship in intervention radiology for one year in Kolkata, India. She has many national and international posters and paper presentations, including one at AIUM, Las Vegas. She has three peer reviewed original research articles in international journals, two of which are in head and neck radiology.

Abstract:

Endoscopy and cross-sectional imaging are considered indispensible for evaluation of larynx and oral cavity. USG is undoubtedly a powerful investigative tool in head and neck pathologies. Larynx and tongue are no exception. But, when compared to cross-sectional imaging where does USG stand is the question raised and answered in this paper. It is important to follow a systematic USG technique to evaluate the larynx and the tongue. USG has accuracy of 71.4% while CT had 92.8% accuracy in assessing cancer of hypopharynx. USG has accuracy of 61%, while MRI has accuracy of 91% in assessing tongue cancer. Post cricoid extension and small PFS growth are not appreciable on USG in cases of larynx cancers, where as small intrinsic tongue muscle growths and alveolar involvement were not seen on USG in cases of tongue malignancy. USG can easily visualize vocal cord movements, pre-epiglottic space lesions and submandibular duct involvement, which are relatively difficult to appreciate on cross-sectional imaging. Even though small tumors are difficult to visualize, USG can play a significant role in assessment of the tumor extension inside and outside the organ. Especially when cross-sectional imaging is unavailable, unaffordable, contraindicated and in post treatment follow up cases.

Biography:

Professor Hou is an expert in developing and optimizing MRI pulse sequences and applying advanced MRI methods in clinical applications, especially for the applications on function, diffusion, and perfusion MRI. His researches focus on using quantitative MRI methods for brain diseases. He has developed and applied MRI and statistics methods to investigate brain structures and functions and changes due to diseases such as brain tumors, and AVMs. Current projects include using task and rest state functional MRI for patients with various brain diseases, and exposing “silence neurons” in BOLD fMRI for patients with the brain diseases.

Abstract:

We hypothesized that tumor cells’ infiltration and vasculatures in the adjacent primary sensory motor cortex (PSMC) are two main factors for diminishing BOLD signal (SI) in the PSMC or changing functional connectivity (FC) in the sensory and motor network (SMN) of patients with glioblastoma multiforme (GBM), and the effects on the signal or on the FC are different. The t-test results (i.e., the P values) on 10 patients with GBMs suggest there are statistical differences for the SI, FCs and rCBF in the two brain hemispheres: SI and FC will be diminished, and the rCBF will be increased. The R2 of the fitting results demonstrated that the distance of the tumor edges to PSMCs: a surrogate indicator of the tumor cells’ penetration is positively linear correlated the SI, but the R2 for the distance of the tumor edges to SMNs VS the FCs suggested no correlation between tumor cell’s infiltration and the FCs. The R2 suggests the distance of tumor vasculatures, which is an index of neural-vasculature decoupling (NVD) and neural blood stealing factor, to PSMCs or SMN plays more important role for diminishing the SI and FC due to the exponential decreasing trends for both. The R2 for the rCBF ratios VS the SI ratios exposes a negative linear relation, and the R2 demonstrates no correlation between the rCBF ratios and the FC ratios. The SI’s reducing is linked to the tumor and rCBF distances and its value, and the FC’s reduction is only associated to the rCBF distance.

Biography:

Dr. Cross has a BSE in Aerospace Engineering and a PhD in Neuroscience from The University of Michigan. Her research passion is to make a significant impact on the therapeutic and diagnostic options for neurological disorders and dementia through imaging. During her graduate studies, Dr. Cross developed in vivo manganese-enhanced MRI to evaluate axonal transport in rodents. She was the first to demonstrate in vivo age-related decline in transport rates and recovery of axonal connections in the olfactory tract after brain injury using an intranasal administration of paramagnetic MR contrast. During Dr. Cross’ tenure as junior faculty, this research expertise expanded to use imaging in studies of Alzheimer’s disease and traumatic brain injury in humans and animal models. Her research innovation is demonstrated by investigations with diverse application such as a new therapeutic approach for brain injury and neurodegeneration using intranasal administration of microtubule-stabilizing agents. Also, in collaboration with researchers at the VA Puget Sound Dr. Cross has been investigating the underlying neuronal substrate for the mild but persistent cognitive deficits presenting in veterans with mild traumatic brain injury from explosive blasts and the results were recently featured in Science Translational Medicine. Another innovative project collaborating with researchers in Environmental Science used FDG-PET to investigate human face recognition in wild American crows. Dr. Cross has active service with several national and international scientific organizations including Radiological Society of North America (RSNA): Research and Education Study Section, Program Committee, the Educational Exhibits committee, and Molecular Imaging Abstract Review Subcommittee, the Society of Nuclear Medicine and Molecular Imaging (SNMMI): Vice Chair for the Scientific Program Committee (Neurosciences), the Society for Neuroscience (SfN) and International Society for Magnetic Resonance in Medicine (ISMRM). Dr. Cross has recently moved to Salt Lake City to continue her research efforts at the University of Utah.

Abstract:

Approximately 1.7 million traumatic brain injuries (TBIs) occur per year in the United States. In addition, TBI is a significant environmental risk factor for the development of neurodegenerative diseases such as chronic traumatic encephalopathy (CTE) and Alzheimer’s disease (AD). In TBI, shear forces generated by impact cause cytoskeleton misalignment and disruption of axonal transport followed by a cascade of metabolic and neuroinflammatory events. We hypothesize that cytoskeletal injuries may synergistically increase the initiation and progression of the neurodegenerative process. However, there is no effective pharmacological intervention to improve outcome in TBI or slow the neurodegenerative progress of Alzheimer’s disease. We propose that microtubule-stabilizing drugs under use as chemotherapeutics, may be administered in low doses to stabilize the cytoskeleton and to maintain axonal transport known to be disrupted in TBI and AD. Although, taxanes such as paclitaxel do not significantly penetrate across blood brain barrier, this limitation may be overcome by intranasal delivery. This research used preclinical neuroimaging (FDG-PET and MRI) combined with neurocognitive testing in mouse models of TBI and AD to show the therapeutic efficacy of intranasal paclitaxel. In addition, immunohistochemistry for AD pathology supported in vivo findings and the ability of the drug to restore axonal transport was shown using in vitro kinetic analysis of axonal dynamics. This study provides evidence of the efficacy for intranasally administered paclitaxel to improve outcome following TBI and to slow cognitive decline and development of pathology in AD. The use of in vivo neuroimaging for therapeutic development aids clinical translation.

Biography:

Dr. Alexandra Kunz has completed her undergraduate training in Dentistry (Periodontal Hygienist), Graduate in Medicine and Post-graduate: Evolutionary Anthropology.Her goal is to bring evolution to Medicine for clinical relevance; current research approaches the unsolved puzzle of febrile seizures using an evolutionary understanding and with the intent of making a tool to predict febrile seizure potential in children, as a part of a routine well baby check-up, worldwide.

Abstract:

Febrile seizures (FS) are always a relevant topic; thermoregulation and febrile responses, complex processes, are important aspects of the unsolved puzzle. Methods: Here, FS are explored from comparative “evolutionary pressure” data-sets for insights/contributing factors to age dependent vulnerability and for potential MRI data acquisition for evidence-based medicine. Results/Discussion: Thermoregulatory responses’ evolutionary quest is for maximal performance at optimal temperature, experimentally shown for insects’/viruses’ population growth, not performance. Relying on external heat sources, ectotherms’ narrow range of performance thermal sensitivities is explained by natural selection, not thermodynamics; endotherms’, birds’/mammals’, thermally constrained set-points evolved promoting heat loss, not enhancing performance. Mammalian brains’ selective brain cooling (SBC) is a special evolutionary case within the thermal core because hyperthermia, causing febrile seizures, limits performance; SBC separates brain temperature (T) regulation independently from the body to keep Tbrain < Ttrunk, p<0.01. Species-specific SBC mechanisms during hyperthermia promote reversing normal blood flow, from brainskin to skinbrain, to cool/maintain constant cerebral metabolism. A 4-part venous pathway connects extracranial diploic/emissary veins with intracranial meningeal veins/sinuses; the richly vascularized/complex human diploe has an age dependent developmental pattern, fully established, age 5, large variations at each age. Primate emissary veins respond immediately to hyperthermia; their parietal/mastoid/condyloid/post-glenoid foramina prominence shifts in an evolutionary pattern: Tarsius 0%,0%,0%,100%; Lemurs 0%,74.4%,0%,99%; orangutan 3%,81.6%, 1%,2%; chimpanzee 8.7%,14%,16.5%,0%; human 60.5%,68%,77%,0.6%. Furthermore, intrinsic brain geometry plays an important evolutionary role in thermoregulatory patterns/heat distribution. Notably, perinatal discontinuity of ontological size/shape changes in chimps/humans at 4-6 months, p<0.0044, produces topographical changes in vascular system; an expanded human frontoparietal volume, now globular, with highest concentration of diploic/emissary veins, richly anastomosed/reticulated, affects heat dissipation. Brain surface:volume ratio values for chimps’/humans’ heat loading, 1.59 vs 0.91, respectively, confirms globular shape decreases thermic values in heat transfer. Conclusion: In light of evolution, human ontological variations from MRI measurements may offer an option to FS’ unsolved puzzle for evidence-based medicine.

Biography:

Stefan Golaszewski was born 1964 in Vienna where he studied Technical Physics and Medicine. From 1995 to 2001 he worked as Neurologist at the University Innsbruck where he focused on clinical applications of functional Magnetic Resonance Imaging (fMRI). From 2001 to 2002 he worked at the Medical University Graz. Since 2005 he works as associate Professor at the Department of Neurology at the Paracelsus Medical University (PMU) Salzburg in Austria and focuses on the investigation of cortical reorganization after stroke. Since 2010 he is medical head of the Neuroscience-Institute of the PMU. He published 125 papers in international peer-reviewed journals.

Abstract:

Recently, an intense discussion started about the nomenclature and examination protocols of patients with disorders of consciousness and related syndromes as the locked-in-syndrome (LIS). As the number of publications finding brain responses to different stimuli using fMRI or Evoked Potentials in these patients increases, we are in need of a diagnosis scheme which best fits to describe these patients. LIS plus (LIPS) is proposed as the diagnostic category for patients who show typical signs of LIS combined with disorders of consciousness. We collected clinical and instrumental data of these patients to start with the development of a new classification for patients. 10 patients with pontine and other brain lesions following vascular injuries were examined clinically, with standardized behavioral assessment scales, MRI and fMRI. All 10 patients showed different degrees of arousal, consciousness, and other neurological and behavioral symptoms. Additionally the extent of structural brain damage and brain response in fMRI was found to be variable in spread. The main clinical differences between LIS and LIPS comprise a variety of additional extra-pontine brain lesions and frequently occurring symptoms as hypersonic syndromes, frontal release signs, thalamic posturing of hand and/or feet. Rarely an akinetic mutism may be present in LIPS. Extra-pontine brain lesions may frequently occur in mesencephalic, thalamic and cerebellar brain structures. Also an involvement of occipital and temporal brain regions is possible, depending on varieties of the vertebro-basilar artery blood supplying system. Due to the heterogeneity of the collected data a new diagnostic category should be implemented in clinical practice.

Biography:

Dr. Cross has a BSE in Aerospace Engineering and a PhD in Neuroscience from The University of Michigan. Her research passion is to make a significant impact on the therapeutic and diagnostic options for neurological disorders and dementia through imaging. During her graduate studies, Dr. Cross developed in vivo manganese-enhanced MRI to evaluate axonal transport in rodents. She was the first to demonstrate in vivo age-related decline in transport rates and recovery of axonal connections in the olfactory tract after brain injury using an intranasal administration of paramagnetic MR contrast. During Dr. Cross’ tenure as junior faculty, this research expertise expanded to use imaging in studies of Alzheimer’s disease and traumatic brain injury in humans and animal models. Her research innovation is demonstrated by investigations with diverse application such as a new therapeutic approach for brain injury and neurodegeneration using intranasal administration of microtubule-stabilizing agents. Also, in collaboration with researchers at the VA Puget Sound Dr. Cross has been investigating the underlying neuronal substrate for the mild but persistent cognitive deficits presenting in veterans with mild traumatic brain injury from explosive blasts and the results were recently featured in Science Translational Medicine. Another innovative project collaborating with researchers in Environmental Science used FDG-PET to investigate human face recognition in wild American crows. Dr. Cross has active service with several national and international scientific organizations including Radiological Society of North America (RSNA): Research and Education Study Section, Program Committee, the Educational Exhibits committee, and Molecular Imaging Abstract Review Subcommittee, the Society of Nuclear Medicine and Molecular Imaging (SNMMI): Vice Chair for the Scientific Program Committee (Neurosciences), the Society for Neuroscience (SfN) and International Society for Magnetic Resonance in Medicine (ISMRM). Dr. Cross has recently moved to Salt Lake City to continue her research efforts at the University of Utah.

Abstract:

Approximately 1.7 million traumatic brain injuries (TBIs) occur per year in the United States. In addition, TBI is a significant environmental risk factor for the development of neurodegenerative diseases such as chronic traumatic encephalopathy (CTE) and Alzheimer’s disease (AD). In TBI, shear forces generated by impact cause cytoskeleton misalignment and disruption of axonal transport followed by a cascade of metabolic and neuroinflammatory events. We hypothesize that cytoskeletal injuries may synergistically increase the initiation and progression of the neurodegenerative process. However, there is no effective pharmacological intervention to improve outcome in TBI or slow the neurodegenerative progress of Alzheimer’s disease. We propose that microtubule-stabilizing drugs under use as chemotherapeutics, may be administered in low doses to stabilize the cytoskeleton and to maintain axonal transport known to be disrupted in TBI and AD. Although, taxanes such as paclitaxel do not significantly penetrate across blood brain barrier, this limitation may be overcome by intranasal delivery. This research used preclinical neuroimaging (FDG-PET and MRI) combined with neurocognitive testing in mouse models of TBI and AD to show the therapeutic efficacy of intranasal paclitaxel. In addition, immunohistochemistry for AD pathology supported in vivo findings and the ability of the drug to restore axonal transport was shown using in vitro kinetic analysis of axonal dynamics. This study provides evidence of the efficacy for intranasally administered paclitaxel to improve outcome following TBI and to slow cognitive decline and development of pathology in AD. The use of in vivo neuroimaging for therapeutic development aids clinical translation.

Biography:

Dr Felix U. Uduma, MB.BCh, FWACS, FICS is a senior Lecturer in Department Of Radiology,in Faculty Of Clinical Sciences, College Of Health Sciences, University Of Uyo, Uyo, Nigeria. He is the Head of Department of Radiology in University of Uyo,Nigeria. He is a former Adjunct Lecturer in Madonna University, Elele, Nigeria and also a former Consultant Radiologist, Polyclinic Bonanjo, Douala, Cameroon. Dr. Uduma is a member of Medical Advisory Board in University of Uyo teaching hospital, Nigeria. He is also an associate Editor of many journals including West African Journal of Radiology. He has published not less than 30 articles.

Abstract:

Computed tomographic (CT) scan is the neuro-imaging gold standard for evaluation of head injured patients. It guarantees a definitive diagnosis and guides specific treatment. Intracranial haemorrhage is the commonest cranio-cerebral computed tomographic finding in head injury cases seen in our centre. CT scan remains invaluable in the assessment and treatment of some patients with head injuries, considering the high rate of abnormal findings.

Biography:

Saiedeh Saghafi received her BSc degree in applied physics from the University of Tehran. In 1996, she started her MSc degree in optical physics at University of Sydney in Professor Colin Sheppard group. She studied Gaussian beam propagation in and beyond the paraxial approximation. In 1998, she won an overseas postgraduate award to attend the PhD program in the Physics Department at Macquarie University in Australia. In 2000, she won two research awards from the Australian Optical Society and IEEE/LEOS Graduate Fellowship. In 2001, she received her PhD in modal analysis of lasers employing unstable resonators. Her thesis was nominated for the AIP Bragg gold medal for the best PhD thesis. She held a postdoctoral position for one year in CLA—Centre for lasers and Applications. Then, she worked as an assistant professor in the Biophotonics group at IAU, working on the medical applications of laser beam. Since 2008, she has worked with Professor Hans-Ulrich Dodt at Vienna University of Technology, FKE, Department of Bioelectronics on Ultramicroscopy techniques.

Abstract:

Ultramicroscopy-UM is a noninvasive powerful tool for volumetric measurements and 3D visualization of even cm-sized specimens such as cancerous tissues, spinal cords or whole mouse brain. It utilizes thin laser light sheet for optical sectioning of the samples in fluorescence microscopy. It enables us to obtain high resolution 3D images through computer reconstruction of stack of images revealing fine details of the outer as well as inner structure such as neuronal network of the brain. Lasers operating in the fundamental mode emit a circular radial bell-shaped beam, the so-called “Gaussian beam”. In standard UM, a combination of slit aperture and a cylindrical lens of focal length f that focuses the beam in one direction and approximately provides no changes in the perpendicular direction is used to produce a thin sheet of light. However, hard edge aperture effects, major power loss, non-uniformity in the intensity distribution along the light sheet and rapid expansion of the light sheet width are some of the drawbacks of the standard design. Here, we present a novel UM that utilize aspheric- as well as Meso-optical elements in combination with particular soft aperture that converts Gaussian beam into an ultrathin laser light sheet. The optical properties of the light sheet show marked improvements. Furthermore, our latest research and optimization related to sample clearing process (for reducing light scattering inside the tissues) as well as compensating the refractive index mismatch that occurs while collecting the signals by microscope objectives are presented.

Biography:

WanYue, male,deputy director of the physician, master of medicine, Wuhan university affiliated Zhongshan hospital. Depaty director of neurology. Wuhan city the first medical backbone of middle-aged and yong talents, the stroke association. Engaged in basic research of cerebrovascular disease and the clinical work for 15 years. For the treatment of ischemic cerebbrovascular disease intervention has a wealth of experience, complete all kinds of interventional treatment for surgery more than 2000 units. Host and participate in five of the subject, more than 20 professional core papers published.

Abstract:

Acute intracranial artery occlusion in opening has been recognized and writing guide, but the intracranial artery chronic complete occlusion of natural history is not yet clear. Intervention from intracranial artery stenosis stent treatment without confirmation under the background of medical evidence, intracranial artery more cautious in interventional treatment of chronic complete occlusion. But symptomatic intracranial artery chronic complete occlusion is easy to break out repeatedly degradation, poor prognosis, durg treatment, effect is poor. Five patients with chronic middle cerebral artery occlusions who have recurrent ischemic symptoms despite maximal medical therapy, treatment options are limited. Due to concerns about the safety of endovascular revascularization of these occlusions and the technical skills required, these procedures have not been widely performed. We report five patients with successful revascularization of the chronic middle cerebral artery occlusion, one by angioplasty only, and otherc by stenting, with continued demonstration of vessel patency on follow up. Revascularization is technically feasible and can be considered an option for carefully selected patients with recurrent ischemic symptoms despite maximal medical therapy.