A 3D-printed modular device for imaging the brain of small birds.

BACKGROUND: One potential barrier to using in vivo imaging in any new animal species is solving the basic problem of how to hold animals safely and securely during scans. NEW METHOD: In this paper, we describe the design, fabrication, use, and positional reproducibility of a 3D-printed plastic device (the Avian Imaging Device, or AID) for imaging the brain of 1 or 2 small songbirds. We designed two different types of head cones to use with this device: one that was not contoured and designed for anesthesia induction, and one contoured to the shape of a house sparrow head, designed to be used with a pre-anesthetized animal. RESULTS: Compared to no holder, using the AID with both contoured and non-contoured head cones significantly reduced the amount of translation necessary to align the head in pairs of CT scans (by 78% and 90%, respectively); using the contoured head cone also significantly reduced the amount of rotation necessary for head alignment in registering pairs of scans (by 90%). COMPARISON WITH EXISTING METHOD(S): Using an animal holder that can not only securely hold animals but which has high positional reproducibility is essential to take advantage of the maximum resolution possible with small animal imaging. 3D-printed materials are also compatible with PET and CT, environmentally stable, and fast and inexpensive to make. CONCLUSIONS: Researchers can learn from the design of the AID and use our CAD models as a starting point for fabricating devices for multiple small-animal imaging needs.

3D printing from diagnostic images: a radiologist's primer with an emphasis on musculoskeletal imaging-putting the 3D printing of pathology into the hands of every physician.

Three-dimensional (3D) printing has recently erupted into the medical arena due to decreased costs and increased availability of printers and software tools. Due to lack of detailed information in the medical literature on the methods for 3D printing, we have reviewed the medical and engineering literature on the various methods for 3D printing and compiled them into a practical "how to" format, thereby enabling the novice to start 3D printing with very limited funds. We describe (1) background knowledge, (2) imaging parameters, (3) software, (4) hardware, (5) post-processing, and (6) financial aspects required to cost-effectively reproduce a patient's disease ex vivo so that the patient, engineer and surgeon may hold the anatomy and associated pathology in their hands.

Comparison of agreement of cervical spine degenerative pathology findings in magnetic resonance imaging studies.

BACKGROUND CONTEXT: Magnetic resonance imaging (MRI) is often used in the evaluation of degenerative conditions of the cervical spine. However, the agreement of interpreting and reporting varying degenerative findings on cervical MRI has not been well assessed. PURPOSE: This study aimed to compare the inter-rater and intra-rater agreement of MRI findings between common degenerative findings of the cervical spine. STUDY DESIGN: A retrospective diagnostic study was used as study design. PATIENT SAMPLE: The sample consisted of 48 patients who underwent routine cervical spine MRI at our institution between January 2011 and June 2012. OUTCOME MEASURES: Reviewers evaluated each MRI study at each vertebral level for disc hydration, disc space height, central stenosis, foraminal stenosis, end plate changes, spondylolisthesis, and cord signal change. METHODS: A panel of two orthopedic spine surgeons and four musculoskeletal radiologists independently reviewed 48 sets of T2-weighted axial and sagittal MRI sequences for a series of preselected criteria, and their findings were compared with those of the other panelists to determine inter-rater agreement. Each panelist also re-reviewed the first 10 studies to determine intra-rater agreement. Absolute inter-rater and intra-rater agreements were then calculated and compared for different findings. A modified analysis ignored disagreements between the least severe grades of findings to determine the inter-rater and intra-rater agreements of the most clinically important severity grades. RESULTS: Absolute inter-rater agreement ranged from 54.6% to 95.0%. Disc hydration (54.6%), central stenosis (72.7%), and foraminal stenosis (73.1%) demonstrated the lowest inter-rater agreement, whereas spondylolisthesis (95.0%) and cord signal change (92.9%) demonstrated the highest agreement. The modified analysis found better inter-rater agreement, ranging from 80.9% to 95.0%. Absolute intra-rater agreement ranged from 74.2% to 94.7%. The modified analysis again found better agreement, ranging from 85.0% to 94.7%. As would be expected, overall intra-rater agreement (81.6%, 95% CI 78.9%-84.3%) was higher than inter-rater agreement (75.7%, 95% CI 74.4%-77.0%). The clinical specialty of the reviewer had no significant impact on inter- or intra-rater agreement. CONCLUSIONS: MRI findings play an important role in the management of patients with cervical spine conditions. For this reason, consistent descriptions of these findings are essential and physicians should be aware of the relative reliability of these findings. This systematic study developed standardized grading criteria and nomenclature for common clinically significant MRI findings in the cervical spine. Even in this optimized research setting, we found significant ranges in agreement across these MRI findings. In the clinical setting, inter- and intra-rater agreements may be lower, and the range of agreements between findings may be greater. Physicians should be aware of inconsistencies inherent in the interpretation of cervical MRI findings and should be aware that some findings demonstrate lower agreement than others.

Is imaging the extremities with PEM feasible? A novel application for a high-resolution positron emission scanner.

INTRODUCTION: Positron emission mammography (PEM) has better spatial resolution than positron emission tomography/computed tomography (PET/CT), or PET/CT. We evaluated the feasibility of extremity imaging with PEM using PET as a standard. METHODS/MATERIALS: Fourteen patients underwent sequential PET/CT and PEM. RESULTS/DISCUSSION: PEM visualized with equal or improved resolution all of the lesions identified on PET/CT. It often provided additional information such improved uptake localization and also visualized activity in an adjacent structures that was not seen on PET/CT or magnetic resonance imaging. We believe PEM can image the extremities in diseases like melanoma, arthritis and osteomyelitis and patients with metallic hardware.

Correlation of PUV and SUV in the extremities while using PEM as a high-resolution positron emission scanner.

OBJECTIVE: Owing to its unique configuration of two adjustable plate detectors positron emission mammography, or PEM, could theoretically also function as a high-resolution positron emission scanner for the extremities or neck. PEM quantitates its activity via a "PEM uptake value," or PUV, and although its relationship to the standardized uptake value, or SUV, has been demonstrated in the breasts, to our knowledge there are no studies validating PUV in other sites such as the extremities. MATERIALS AND METHODS: This was a retrospective chart review of two separate protocols of a total of 15 patients. The patients all had hypermetabolic lesions in the extremities or neck on imaging with PET/CT and were sent after their PET/CT to PEM for further imaging. Owing to the sequential nature of these examinations no additional radiotracer was administered. RESULTS: Spearman's rank order correlation was calculated between the PUVmax obtained from PEM images, and the SUVmax for all. Spearman's rank order correlation for all sites was 0.42, which is not significantly different from 0 (p = 0.13). When neck lesions were excluded from the group, there was a strong and statistically significant correlation between PUVmax and SUVmax, with Spearman's rank correlation of 0.73, and significantly different from 0 (p = 0.0068). DISCUSSION: The correlation of PUV and SUV in the extremities indicates the potential use of PEM as a semiquantitative, high-resolution positron emission scanner and warrants further investigation, especially in the realms of disease processes that often present in the extremities, such as melanoma, osteomyelitis, and arthritis, as well as playing a role in the imaging of patients with metallic hardware post-limb salvage surgery.

Brain stimulation reward is integrated by a network of electrically coupled GABA neurons.

The neural substrate of brain stimulation reward (BSR) has eluded identification since its discovery more than a half-century ago. Notwithstanding the difficulties in identifying the neuronal integrator of BSR, the mesocorticolimbic dopamine (DA) system originating in the ventral tegmental area (VTA) of the midbrain has been implicated. We have previously demonstrated that the firing rate of a subpopulation of gamma-aminobutyric acid (GABA) neurons in the VTA increases in anticipation of BSR. We show here that GABA neurons in the VTA, midbrain, hypothalamus, and thalamus of rats express connexin-36 (Cx36) gap junctions (GJs) and couple electrically upon DA application or by stimulation of the internal capsule (IC), which also supports self-stimulation. The threshold for responding for IC self-stimulation was the threshold for electrical coupling between GABA neurons, the degree of responding for IC self-stimulation was proportional to the magnitude of electrical coupling between GABA neurons, and GJ blockers increased the threshold for IC self-stimulation without affecting performance. Thus, a network of electrically coupled GABA neurons in the ventral brain may form the elusive neural integrator of BSR.

Ethanol suppression of ventral tegmental area GABA neuron electrical transmission involves N-methyl-D-aspartate receptors.

Ventral tegmental area (VTA) GABA neurons are critical substrates modulating the mesocorticolimbic dopamine system implicated in natural and drug reward. The aim of this study was to evaluate the effects of ethanol on glutamatergic and GABAergic modulation of VTA GABA neuron electrical synaptic transmission. We evaluated the effects of systemic ethanol (0.05-2.0 g/kg i.p.), the N-methyl-D-aspartate (NMDA) receptor antagonist dizocilpine (MK-801; 0.05-0.2 mg/kg i.v.), the connexin-36 gap junction blocker quinidine (5-20 mg/kg i.v.), the fast-acting barbiturate methohexital (Brevital; 5-10 mg/kg i.v.), and the benzodiazepine chlordiazepoxide (Librium; 5-10 mg/kg i.v.), as well as in situ VTA administration of NMDA and the GABA(A) receptor agonist muscimol, on VTA GABA neuron spontaneous activity and internal capsule stimulus-induced poststimulus spike discharges (ICPSDs). Systemic ethanol, quinidine, and dizocilpine reduced, whereas local NMDA enhanced, and the systemic and local GABA(A) receptor modulators did not significantly alter VTA GABA neuron ICPSDs. Ethanol potentiated dizocilpine inhibition of VTA GABA neuron ICPSDs, but not quinidine inhibition. In situ microelectrophoretic application of dopamine markedly enhanced VTA GABA neuron firing rate (131%), spike duration (124%), and spike coupling, which were blocked by systemic quinidine. These findings indicate that VTA GABA neurons are coupled electrically via gap junctions and that the inhibitory effect of ethanol on electrical transmission is primarily via inhibition of NMDA receptor-mediated excitation, not via enhancement of GABA receptor-mediated inhibition. Thus, the rewarding properties of ethanol may result from inhibitory effects on excitatory glutamatergic neurotransmission between electrically coupled networks of midbrain GABA neurons.