Die Analyse von Implantat-Gewebe-Wechselwirkungen basiert derzeit hauptsächlich auf histologischen Techniken. Der invasive Charakter der histologischen Präparation lässt allerdings keine Untersuchung am lebenden Tier zu. Dadurch ist es nicht möglich, den Prozess der Implantateinheilung wiederholt an einem Tier zu beobachten. Die Folgen sind eine hohe Anzahl aufzuwendender Versuchstiere und eine Vergrößerung der Messunsicherheit infolge der gestiegenen biologischen Variabilität. Nicht-invasive, bildgebende Verfahren spielen daher eine zunehmende Rolle für die Entwicklung neuer Biomaterialien. Während die Computertomographie (CT) häufig zur Untersuchung der knöchernen Implantateinheilung verwendet wird, hat sich die Nutzung der Magnetresonanztomographie (MRT) für diese Fragestellungen bisher nicht etabliert. Bei der Magnetresonanztomographie handelt es sich, analog zur Computertomographie, um ein bildgebendes Verfahren zur nicht-invasiven Erzeugung digitaler Schnittbilder. Im Gegensatz zur CT, die das Hartgewebe abbildet, wird bei der MRT das Weichgewebe detektiert, wobei keine ionisierende Strahlung verwendet wird. Der große Vorteil der MRT gegenüber anderen bildgebenden Methoden besteht darin, dass es möglich ist, das Weichgewebe auf den Schnittbildern anhand verschiedener Kontraste darzustellen. Zusätzlich können MR-spezifische Parameter quantifiziert werden, die einen direkten Rückschluss auf die Struktur zulassen. Mit diesen Kennzahlen ist es möglich, Veränderungen im Weichgewebe analysieren. Das Ziel der Arbeit war es deshalb, die Eignung und mögliche Anwendungen der Magnetresonanzto-mographie (MRT) zur Analyse der Implantat-Gewebe-Wechselwirkungen zu erörtern. Für die Untersu-chungen wurde ein NMR-Spektrometer inklusive Imaging-Zubehör verwendet. Die Dissertationsarbeit beinhaltete sowohl die Untersuchung verschiedener Materialsysteme hinsichtlich ihrer Eignung für die MRT und deren Biokompatibilität, als auch die Analyse der knöchernen Einheilung ausgewählter Biomaterialien. Diese umfasste Aussagen zur Darstellbarkeit und Abgrenzbarkeit von Strukturen und beinhaltete auch quantitativ gewonnene Messparameter. Die Ergebnisse wurden stets im Vergleich mit der Histologie diskutiert. In der Arbeit konnte dargestellt werden, dass die Überprüfung der Eignung des zu untersuchenden Materials für die MRT vor der Analytik erfolgen muss. Es wurde demonstriert, dass Metalle erheblich mit dem MR-System wechselwirken können, was in der Konsequenz zu drastischen Störungen der Bildqualität führt. Diese Effekte waren stark von den ausgewählten Messparametern abhängig. Als ein MRT-geeignetes Verbundmaterial wurde Titan-beschichtetes Polyetheretherketon (PEEK/Ti) vorgeschlagen. Die Beschichtung mit Titan führte zu einer signifikant verbesserten Biokompatibilität des Kunststoffes. Die erfolgreiche Analyse der knöchernen Einheilung mit der Magnetresonanztomographie wurde im Rahmen von zwei tierexperimentellen Studien an verschiedenen Biomaterialien gezeigt (die Analyse erfolg-te ex vivo). Die Untersuchung der knöchernen Integration eines Zahnimplantates aus PEEK/Ti hatte das Ziel, die Darstellbarkeit des Implantates und knöcherner Strukturen mit der Magnetresonanztomographie zu evaluieren. Außerdem wurde ebenfalls gezeigt, dass es anhand der MRT-Schnittbilder möglich ist, quantitative Messgrößen zur Beschreibung des Einheilprozesses zu gewinnen. Aufgrund der geringen Versuchstierzahl wurde jedoch eine breite Streuung der Messdaten festgestellt. Allerdings besitzt die Studie durch die Untersuchung eines Zahnimplantates aus Polyetheretherketon/Titan mit der MRT nicht nur Neuheitswert in der Biomaterialforschung, sondern schlägt gleichzeitig eine Brücke zur klinischen, dentalen Implantologie. Die Bewertung der Darstellbarkeit knöcherner Strukturen und der verwendeten (teils tissue-engineerten) Knochenersatzmaterialien mit MRT und Histologie und des klinischen Erfolges derselben bildeten einen Schwerpunkt der zweiten tierexperimentellen Studie (die Analyse erfolgte ex vivo). Es war möglich, mit beiden bildgebenden Verfahren zu zeigen, dass sich die verwendeten Knochenersatzmaterialien nicht für die vorgesehene Anwendung eigneten. Die Beurteilung der Übereinstimmung der quantitativ gewonnenen Parameter beider Analysenmethoden bildete den Abschluss der Arbeit. Es wurde festgestellt, dass zwischen den Messdaten stets ein syste-matischer Unterschied bestand. Nachweislich war dieser aber weniger das Resultat der ungleichen lateralen Auflösungen oder der unterschiedlichen Darstellbarkeit von Gewebestrukturen der beiden Verfahren, sondern konnte auf den Einfluss der Analyse verschiedener Schichtebenen und individueller Unterschiede bei der digitalen Quantifizierung der auswertenden Personen zurückgeführt werden. / Currently, histological techniques are used to analyse implant-tissue-interactions. However, these methods are destructive and do not allow for the investigation of living animals. Therefore, it is not possible to study the integration of biomaterials repeatedly with one animal, resulting in a large number of animals and an increase of biological variability. Non-invasive imaging techniques have gained interest in the field of biomaterials. Whereas Computed Tomography (CT) was often used to evaluate the osseous integration, the assessment using Magnetic Resonance Imaging (MRI) has not been established, yet. MRI is a non-invasive medical imaging method that detects soft tissue. In contrast to CT the method does not require individuals to be exposed to radiation. The most important benefit of MRI is the possibility to acquire different soft tissue contrasts in situ because the various tissues have different signal intensities on MR images that can be altered by using different experimental parameters. Furthermore, it is possible to gain MR-specific properties that allow conclusions to the tissue structure. Thus, the objective of the doctoral thesis has been to investigate the suitability of MRI for the use in biometerial research and to show potential areas of application. The examinations were performed using a laboratory NMR-spectrometer inclusive imaging accessory. The thesis included an evaluation of the MR compatibility of different materials and their biocompati-bility and an analysis of the ingrowth of chosen biomaterials into bone. For that, the detection and identification of tissue structures and biomaterials was investigated with both, MRI and histology. Additionally, quantitative parameters were acquired and their comparability was assessed. It was clearly demonstrated, that metals interacted with the MR system and provoked large image distortions. These effects were strongly dependent on experimental parameters chosen. Polyetheretherketone with titanium coating (PEEK/Ti) was investigated and has been found to be MR safe. Above all, it was demonstrated that the biocompatibility of the polymer was significantly enhanced by coating with titanium. Within two animal studies the successful analysis of the osseous healing of different biomaterials with MRI was presented. To demonstrate the visibility of bony structures and biomaterials a dental implant made of PEEK/Ti was analysed. The ability to measure quantitative data in analogy to histomorphometry was shown, ditto. A large variation of the values was detected due to the limited number of animals used for the pilot study. Evaluating the displayability of bone and (to some extent tissue engineered) bone substitutes and assessing the clinical success of these materials was one main focus of the second animal study. Both, MRI and histological analysis could undeniably illustrate that all of the bone substitutes were not suitable for the chosen application. The thesis was completed with the determination of the agreement of quantitative values from both analysing methods. It was concluded that all values gained from the animal study were significantly different. It was proven that the chosen slice position and the image interpretation with two evaluators had a larger share to disagreement than the different lateral resolution of MRI and histological images or the diverging displayability of bone and bone substitutes. By investigating a MR suitable dental PEEK implant the doctoral thesis fulfils the criteria of novelty in biomaterial research. Moreover, it forges links between preclinical research and dental implantology.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13133号 / 論医博第2137号 / 新制||医||1024(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 溝脇 尚志, 教授 妹尾 浩, 教授 鈴木 実 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Most of PDE-based restoration models and their numerical realizations show a common drawback: loss of fine structures. In particular, they often introduce an unnecessary numerical dissipation on regions where the image content changes rapidly such as on edges and textures. This thesis studies the magnitude data/imagery of magnetic resonance imaging (MRI) which follows Rician distribution. It analyzes statistically that the noise in the magnitude MRI data is approximately Gaussian of mean zero and of the same variance as in the frequency-domain measurements. Based on the analysis, we introduce a novel partial differential equation (PDE)-based denoising model which can restore fine structures satisfactorily and simultaneously sharpen edges as needed. For an efficient simulation we adopt an incomplete Crank-Nicolson (CN) time-stepping procedure along with the alternating direction implicit (ADI) method. The algorithm is analyzed for stability. It has been numerically verified that the new model can reduce the noise satisfactorily, outperforming the conventional PDE-based restoration models in 3-4 alternating direction iterations, with the residual (the difference between the original image and the restored image) being nearly edgeree. It has also been verified that the model can perform edge-enhancement effectively during the denoising of the magnitude MRI imagery. Numerical examples are provided to support the claim.

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The ability to read proficiently is key to social participation and an important premise for individual well-being and vocational success. Individuals with developmental dyslexia, a highly prevalent neurodevelopmental disorder affecting hundreds of millions of children and adults worldwide, face severe and persistent difficulties in attaining adequate reading levels. Despite years of extensive research efforts to elucidate the neurobiological origin of this disorder, its exact etiology remains unclear to date. In this context, most neuroimaging research on dyslexia in humans has focused on the cerebral cortex and has identified alterations in a distributed left-lateralized cortical language network. However, pioneering post-mortem human studies and animal models suggest that dyslexia might also be associated with alterations in subcortical sensory thalami and early sensory pathways. The largely cortico-centric view of dyslexia is due in part to considerable technical challenges in assessing the human sensory thalami non-invasively using conventional magnetic resonance imaging (MRI). As a result, the role that sensory thalami may play in dyslexia has been largely unaddressed. In this dissertation, I leveraged recent advances in high-field MRI to investigate the role of the human lateral geniculate nucleus (LGN) of the visual thalamus in adults with dyslexia in-vivo. In three multi-modal high-field MRI studies, I show that (i) dyslexia is associated with structural alterations in the direct V1-bypassing white matter pathway connecting the LGN with cortical motion-sensitive area V5/MT in the left hemisphere; (ii) the connectivity strength of which predicts a core symptom of the disorder, i.e., rapid naming ability. I further demonstrate that (iii) the two major functional subdivisions of the LGN can be distinguished non-invasively based on differences in tissue microstructure; and that (iv) adults with dyslexia show functional response alterations specifically in the magnocellular subdivision of the LGN. I also demonstrate that this subdivision deficit (v) is more pronounced in male than female dyslexics; and (vi) predicts rapid naming ability in male dyslexics only. The results of this doctoral thesis are the first to confirm previous post-mortem evidence of LGN alterations in dyslexia in-vivo and point to their relevance to key symptoms of the disorder. In synergy, our research findings offer new perspectives on explanatory models of dyslexia and bear potential implications also for prospective treatment strategies.:Contribution Statement i Acknowledgments iii Abstract v Table of Contents vii 1 General Introduction 1 1.1 Developmental Dyslexia 1 1.1.1 Diagnostic Criteria 1 1.1.2 Prevalence and Etiology 2 1.1.3 Cognitive and Behavioral Symptoms 3 1.1.4 Explanatory Models in Cognitive Neuroscience 4 1.2 Lateral Geniculate Nucleus 7 1.2.1 Anatomy and Function 7 1.2.2 Technical Challenges in Conventional MRI 8 1.2.3 High-Field MRI 9 1.3 Research Aim and Chapter Outline 10 2 Altered Structural Connectivity of the Left Visual Thalamus in Developmental Dyslexia 13 2.1 Summary 14 2.2 Results and Discussion 15 2.3 Conclusions 22 2.4 Materials and Methods 23 2.4.1 Subject Details 23 2.4.2 High-Resolution MRI Acquisition and Preprocessing 23 2.4.3 Lateral Geniculate Nucleus Definition 24 2.4.4 Cortical Region of Interest Definition 26 2.4.5 Probabilistic Tractography 27 2.4.6 Quantification and Statistical Analysis 29 2.5 Supplementary Information 30 3 Mapping the Human Lateral Geniculate Nucleus and its Cytoarchitectonic Subdivisions Using Quantitative MRI 33 3.1 Abstract 34 3.2 Introduction 35 3.3 Materials and Methods 37 3.3.1 In-Vivo MRI 37 3.3.2 Post-Mortem MRI and Histology 41 3.4 Results 44 3.4.1 Lateral Geniculate Nucleus Subdivisions in In-Vivo MRI 44 3.4.2 Lateral Geniculate Nucleus Subdivisions in Post-Mortem MRI 46 3.5 Discussion 50 3.6 Supplementary Information 54 3.6.1 In-Vivo MRI 54 3.6.2 Post-Mortem MRI and Histology 58 3.6.3 Data and Code Availability 60 4 Dysfunction of the Visual Sensory Thalamus in Developmental Dyslexia 61 4.1 Abstract 62 4.2 Introduction 63 4.3 Materials and Methods 66 4.3.1 Subject Details 66 4.3.2 High-Resolution MRI Experiments 66 4.3.3 High-Resolution MRI Acquisition and Preprocessing 67 4.3.4 Lateral Geniculate Nucleus Definition 68 4.3.5 Quantification and Statistical Analysis 69 4.4 Results 70 4.5 Discussion 75 4.6 Supplementary Information 77 4.6.1 Supporting Methods 77 4.6.2 Supporting Results 81 4.6.3 Data and Code Availability 82 5 General Conclusion 83 5.1 Summary of Research Findings 83 5.2 Implications for Dyslexia Models 84 5.2.1 Phonological Deficit Hypothesis 84 5.2.2 Magnocellular Theory 84 5.2.3 Model According to Ramus 85 5.2.4 Need for Revised Model 86 5.3 Implications for Remediation 87 5.4 Research Prospects 88 5.5 Brief Concluding Remarks 90 6 Bibliography 91 7 List of Tables 113 8 List of Figures 115 9 Selbstständigkeitserklärung 117

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This review examines the factors that can influence an investigation into the unexpected death of a child before considering if using imaging techniques could be of benefit. Method A systematic search strategy was adopted to search databases using keywords, these results were then subjected to inclusion and exclusion criteria to filter and refine the evidence base further. Discussion More research is published on the use of MRI in comparison with other modalities. There is evidence in the case of MRI in particular that its use could be of benefit in identifying and ruling out potential causes of death in children. Conclusion More research is needed on the use of CT but the routine use of MRI in child death investigation could now be considered. Ethical considerations appear to be a barrier to research in this area and discussions as to how such considerations can be overcome is necessary.

Denna uppsats presenterar resultaten av en kvalitativ undersökning som syftar till att ge en djupare förståelse för användningen av AI inom radiologi, dess framtida påverkan på yrket och hur det används idag. Genom att genomföra tre intervjuer med personer som arbetar inom radiologi, har datainsamlingen fokuserat på att identifiera de positiva och negativa aspekterna av AI i radiologi, samt dess potentiella konsekvenser på yrket. Resultaten visar på en allmän acceptans för AI inom radiologi och dess förmåga att förbättra diagnostiska processer och effektivisera arbetet. Samtidigt finns det en viss oro för att AI kan ersätta människor och minska behovet av mänskliga bedömningar. Denna uppsats ger en grundläggande förståelse för hur AI används inom radiologi och dess möjliga framtida konsekvenser. / This essay presents the results of a qualitative study aimed at gaining a deeper understanding of the use of artificial intelligence (AI) in radiology, its potential impact on the profession and how it’s used today. By conducting three interviews with individuals working in radiology, data collection focused on identifying the positive and negative aspects of AI in radiology, as well as its potential consequences on the profession. The results show a general acceptance of AI in radiology and its ability to improve diagnostic processes and streamline work. At the same time, there is a certain concern that AI may replace humans and reduce the need for human judgments. This report provides a basic understanding of how AI is used in radiology and its possible future consequences.

L’Imagerie par résonance magnétique (IRM) est un outil fondamental pour l’exploration in vivo du développement du cerveau chez le fœtus, le bébé et l’enfant. Elle fournit plusieurs paramètres quantitatifs qui reflètent les changements des propriétés tissulaires au cours du développement en fonction de différents processus de maturation. Cependant, l’évaluation fiable de la maturation de la substance blanche est encore une question ouverte: d'une part, aucun de ces paramètres ne peut décrire toute la complexité des changements sous-jacents; d'autre part, aucun d'eux n’est spécifique d’un processus de développement ou d’une propriété tissulaire particulière. L’implémentation d’approches multiparamétriques combinant les informations complémentaires issues des différents paramètres IRM devrait permettre d’améliorer notre compréhension du développement du cerveau. Dans ce travail de thèse, je présente deux exemples de telles approches et montre leur pertinence pour l'étude de la maturation des faisceaux de substance blanche. La première approche fournit une mesure globale de la maturation basée sur la distance de Mahalanobis calculée à partir des différents paramètres IRM (temps de relaxation T1 et T2, diffusivités longitudinale et transverse du tenseur de diffusion DTI) chez des nourrissons (âgés de 3 à 21 semaines) et des adultes. Cette approche offre une meilleure description de l’asynchronisme de maturation à travers les différents faisceaux que les approches uniparamétriques. De plus, elle permet d'estimer les délais relatifs de maturation entre faisceaux. La seconde approche vise à quantifier la myélinisation des tissus cérébraux, en calculant la fraction de molécules d’eau liées à la myéline (MWF) en chaque voxel des images. Cette approche est basée sur un modèle tissulaire avec trois composantes ayant des caractéristiques de relaxation spécifiques, lesquelles ont été pré-calibrées sur trois jeunes adultes sains. Elle permet le calcul rapide des cartes MWF chez les nourrissons et semble bien révéler la progression de la myélinisation à l’échelle cérébrale. La robustesse de cette approche a également été étudiée en simulations. Une autre question cruciale pour l'étude du développement de la substance blanche est l'identification des faisceaux dans le cerveau des enfants. Dans ce travail de thèse, je décris également la création d'un atlas préliminaire de connectivité structurelle chez des enfants âgés de 17 à 81 mois, permettant l'extraction automatique des faisceaux à partir des données de tractographie. Cette approche a démontré sa pertinence pour l'évaluation régionale de la maturation de la substance blanche normale chez l’enfant. Pour finir, j’envisage dans la dernière partie du manuscrit les applications potentielles des différentes méthodes précédemment décrites pour l’étude fine des réseaux de substance blanche dans le cadre de deux exemples spécifiques de pathologies : les épilepsies focales et la leucodystrophie métachromatique. / Magnetic Resonance Imaging (MRI) is a fundamental tool for in vivo investigation of brain development in newborns, infants and children. It provides several quantitative parameters that reflect changes in tissue properties during development depending on different undergoing maturational processes. However, reliable evaluation of the white matter maturation is still an open question: on one side, none of these parameters can describe the whole complexity of the undergoing changes; on the other side, neither of them is specific to any particular developmental process or tissue property. Developing multiparametric approaches combining complementary information from different MRI parameters is expected to improve our understanding of brain development. In this PhD work, I present two examples of such approaches and demonstrate their relevancy for investigation of maturation across different white matter bundles. The first approach provides a global measure of maturation based on the Mahalanobis distance calculated from different MRI parameters (relaxation times T1 and T2, longitudinal and transverse diffusivities from Diffusion Tensor Imaging, DTI) in infants (3-21 weeks) and adults. This approach provides a better description of the asynchronous maturation across the bundles than univariate approaches. Furthermore, it allows estimating the relative maturational delays between the bundles. The second approach aims at quantifying myelination of brain tissues by calculating Myelin Water Fraction (MWF) in each image voxel. This approach is based on a 3-component tissue model, with each model component having specific relaxation characteristics that were pre-calibrated in three healthy adult subjects. This approach allows fast computing of the MWF maps from infant data and could reveal progression of the brain myelination. The robustness of this approach was further investigated using computer simulations. Another important issue for studying white matter development in children is bundles identification. In the last part of this work I also describe creation of a preliminary atlas of white matter structural connectivity in children aged 17-81 months. This atlas allows automatic extraction of the bundles from tractography datasets. This approach demonstrated its relevance for evaluation of regional maturation of normal white matter in children. Finally, in the last part of the manuscript I describe potential future applications of the previously developed methods to investigation of the white matter in cases of two specific pathologies: focal epilepsy and metachromatic leukodystrophy.

Les récents progrès en neuroimagerie ont permis, au cours des dernières années, de faire avancer les connaissances sur les maladies neurologiques et psychiatriques en offrant la possibilité de mieux comprendre l’évolution des maladies neurodégénératives et la nature du comportement, des émotions, de la personnalité, et de la cognition. Plusieurs défis éthiques ont émergés suite à l’utilisation de ces nouvelles technologies d’imagerie cérébrale. La perspective des chercheurs concernant les pratiques d’évaluation des protocoles de recherche en neuroimagerie ainsi que les défis éthiques, sociaux et légaux auxquels font face les chercheurs n'ont pas encore été étudiés, même s’ils constituent des acteurs clés. Nous avons entrepris une étude empirique sur les perspectives des chercheurs quant au processus d'évaluation par les comités d’éthique de la recherche (CÉR) afin d’examiner les enjeux éthiques, légaux et sociaux liés à la pratique de la neuroimagerie au Canada. Pour ce faire, nous avons expédié un questionnaire en ligne et réalisé des entrevues semi-structurées avec des chercheurs en neuroimagerie et des présidents des CÉR. Les entrevues ont été transcrites et analysées à l'aide du logiciel d'analyse qualitative Nvivo. Nos résultats ont mis en lumière plusieurs aspects éthiques légaux et sociaux suscitant une attention particulière afin de remédier aux défis actuels dans la recherche en neuroimagerie ainsi qu’au processus d’évaluation de la recherche par les CÉR. Nos données comportent également des recommandations provenant des chercheurs eux-mêmes afin d'améliorer le processus d'évaluation. Finalement, notre propre expérience avec cette étude multicentrique nous a permis de constater plusieurs des défis mentionnés par les chercheurs. / Over the past years, advances in neuroimaging have allowed for a better understanding of neurologic and psychiatric disorders and yielded insights into behavior, emotion, personality, and cognition as well as allowed for a deeper understanding of neurodegenerative diseases. In light of the uses of these new imaging technologies, several ethical issues have emerged. The perspectives of researchers on current ethics review of neuroimaging protocols and ethical, legal and social issues present in neuroimaging have not been investigated, even though they are key stakeholders. We undertook an empirical study of researcher perspectives regarding the REB review process to examine ethical, legal and social issues associated with the practice of neuroimaging in Canada. We conveyed an online questionnaire survey and conducted semi-structured interviews with neuroimaging researchers and REB chairs. Interviews were transcribed and analyzed using the NVivo qualitative analysis software. Our results put into perspective emerging ethical, social and legal issues which are important challenges to address in the field of neuroimaging as well as practical challenges in the REB process. Our data also contain recommendations, coming from the neuroimagers themselves, in order to improve the evaluation process. Finally, our experience conducting this research has allowed us to confirm the challenges and stakeholders faced by neuroimagers.