Neuroimaging
Neuroimaging includes the use of various techniques to either directly or indirectly
image the
structure, function, or
pharmacology of the
brain. It is a relatively new discipline within
medicine and
neuroscience.
Neuroimaging falls into two broad categories: structural imaging and functional imaging.
Structural imaging deals with the structure of the brain and the diagnosis of gross (large scale) intracranial disease (such as tumor), and injury.
Functional imaging is used to diagnose metabolic diseases and lesions on on a finer scale (such as Alzheimer's disease) and also for neurological and
cognitive science research and building
brain-computer interfaces. Functional imaging enables, for example, the processing of information by centers in the brain to be visualized directly. Such processing causes the involved area of the brain to increase metabolism and "light up" on the scan.
CAT
|
CT scan slice showing indicating damage cause by stroke (arrow). |
Computed tomography (CT or CAT) scanning uses a series of
x-rays of the head taken from many different directions. Typically used for quickly viewing brain injuries, CT scanning has a computer program that uses a set of
algebraic equations to estimate how much of an x-ray beam is absorbed in a small volume of the brain. Typically the information is presented as cross sections of the brain
[ Jeeves, p. 21 ]. In approximation, the more dense a material is, the whiter a volume of it will appear on the scan (just as in the more familiar "flat" X-rays). CT scans are primarily used for evaluating swelling from tissue damage in the brain and in assessment of ventricle size. Modern CT scanning exposes the subject to about as much radiation as a single x-ray and can provide reasonably good images in a matter of minutes.
MRI
|
High-resolution sagittal MRI slice at the midline. |
Magnetic Resonance Imaging (MRI) uses magnetic fields and radio waves to produce high quality two- or three-dimensional images of brain structures without use of ionizing radiation (X-rays) or radioactive tracers. During an MRI, a large cylindrical
magnet creates a
magnetic field around the head of the patient through which radio waves are sent. When the magnetic field is imposed, each point in space has a unique
radio frequency at which the signal is received and transmitted (Preuss). Sensors read the frequencies and a computer uses the information to construct an image. The detection mechanisms are so precise that changes in structures over time can be detected. Using MRI, scientists can create images of both surface and subsurface structures with a high degree of
anatomical detail. MRI scans can produce cross sectional images in any direction from top to bottom, side to side, or front to back. The problem with original MRI technology was that while it provides a detailed assessment of the physical appearance, water content, and many kinds of subtle derangements of structure of the brain (such as inflamation or bleeding), it fails to provide information about the metabolism of the brain (how hard it is working, or even if it is working at all) at the time of imaging. The distinction is now made between MRI imaging and functional imaging, since the brain's function as well the brain's structure is of interest.
fMRI
|
Axial MRI slice at the level of the basal ganglia, showing fMRI BOLD signal changes overlayed in red (increase) and blue (decrease) tones. |
Functional magnetic resonance imaging (fMRI) relies on the paramagnetic properties of oxygenated and deoxygenated
hemoglobin to see images of changing blood flow in the brain associated with neural activity. This allows images to be generated that reflect which brain structures are activated (and how) during performance of different tasks. Most fMRI scanners allow subjects to be presented with different visual images, sounds and touch stimuli, and to make different actions such as pressing a button or moving a joystick. Consequently fMRI can be used to reveal brain structures and processes associated with perception, thought and action. The resolution of fMRI is about two or three millimeters at present, limited by the spatial spread of the hemodynamic response to neural activity. It has largely superseded PET for the study of brain activation patterns. PET, however, retains the significant advantage of being able to identify specific brain receptors associated with particular
neurotransmitters through its ability to image radiolabelled receptor "ligands" (receptor ligands are any chemicals which stick to receptors).
As well as reseach in healthy subjects, fMRI is increasingly used in medical diagnosis of disease. Because fMRI is exquisitly sensitive to blood flow, it is extremley sensitive to early changes in the brain resulting from ischemia (abnormally low blood flow), such as the changes which follow
stroke. Early diagnosis of certain types of stroke is increasingly important in neurology, since substances which disolve clots may be used in the first few hours after certain types of stroke occur, but are dangerous to use afterwards. Brain changes seen on fMRI may help to make the decision to treat with these agents.
PET
|
PET scan of normal 20 year old brain. |
Positron Emission Tomography (PET) measures emissions from radioactively labeled metabolically active chemicals that have been injected into the bloodstream and uses the data to produce two or three-dimensional images of the distribution of the chemicals throughout the brain (Nilsson 57). The
positron emitting
radioisotopes used are produced by a
cyclotron and chemicals are labelled with these radioactive atoms. The labeled compound, called a radiotracer, is injected into the bloodstream and eventually makes its way to the brain. Sensors in the PET scanner detect the radioactivity as the compound accumulates in different regions of the brain. A computer uses the data gathered by the sensors to create multicolored two or three-dimensional images that show where the compound acts in the brain.
The greatest benefit of PET scanning is that different compounds can show blood flow and oxygen and
glucose metabolism in the tissues of the working brain. These measurements reflect the amount of brain activity in the various regions of the brain and allow us to learn more about how the brain works. PET scans were superior to all other metabolic imaging methods in terms of resolution and speed of completion (as little as 30 seconds), when they first became available. The improved resolution permitted better study to be made as to the area of the brain activated by a particular task. The biggest drawback of PET scanning is that because the radioactivity decays rapidly, it is limited to monitoring short tasks (Nilsson 60). Before fMRI technology came online, PET scanning was the preferred method of brain imaging, and it still continues to make large contributions to
neuroscience.
PET scanning is also used for diagnosis of brain disease. Most notably, because brain tumors, strokes, and neuron-damaging diseases which cause dementia (such as Alzheimer's disease) all cause great changes in brain metabolism, all cause easily detectable changes in brain PET scans.
SPECT
SPECT is similar to PET.
Single photon emission computed tomography (SPECT) uses
gamma ray emitting
radioisotopes and a
gamma camera to record data that a computer uses to construct two- or three-dimensional images of active brain regions (Ball). SPECT relies on an injection of radioactive tracer, which is rapidly taken up by the brain but does not redistribute. Uptake of SPECT agent is nearly 100% complete within 30 â€" 60s, reflecting cerebral blood flow (CBF) at the time of injection. These properties of SPECT make it particularly well suited for epilepsy imaging, which is usually made difficult by problems with patient movement and variable seizure types. SPECT provides a "snapshot" of cerebral blood flow since scans can be acquired after seizure termination (so long as the radioactive tracer was injected at the time of the seizure). A significant limitation of SPECT is its poor resolution (about 1 cm) compared to that of MRI.
Like PET, SPECT also can be used to differentiate different kinds of disease process which produce dementia, and it is increasingly used for this purpose. Neuro-PET has a disadvantage of requiring use of a tracers with half-lives of at most 110 minutes, such as
FDG. These must be made in a cyclotron, and are expensive or even unavailable if necessary transport times are prolonged more than a few half-lives. SPECT, however, is able to make use of tracers with much longer half-lives, such as technetium-99m, and as a result, is far more widely available.
DOT
See diffuse optical imagingSee main article History of neuroimagingIn 1918 the American neurosurgeon Walter Dandy introduced the technique of ventriculography.
X-ray images of the
ventricular system within the brain were obtained by injection of filtered air directly into one or both lateral ventricles of the brain. Dandy also observed that air introduced into the subarachnoid space via lumbar spinal puncture could enter the cerebral ventricles and also demonstrate the cerebrospinal fluid compartments around the base of the brain and over its surface. This technique was called
pneumoencephalography.
In 1927
Egas Moniz, professor of neurology in
Lisbon, introduced cerebral
angiography, whereby both normal and abnormal blood vessels in and around the brain could be visualized with great accuracy.
In the early 1970s,
Allan McLeod Cormack and
Godfrey Newbold Hounsfield introduced
computerized axial tomography (CAT or CT scanning), and ever more detailed anatomic images of the brain became available for diagnostic and research purposes. Cormack and Hounsfield won the 1979
Nobel Prize for Physiology or Medicine for their work. Soon after the introduction of CAT in the early 1980's, the development of
radioligands allowed
single photon emission computed tomography (SPECT) and
positron emission tomography (PET) of the brain.
More or less concurrently,
magnetic resonance imaging (MRI or MR scanning) was developed by researchers including
Peter Mansfield and
Paul Lauterbur, who were awarded the
Nobel Prize for Physiology or Medicine in 2003. In the early 1980's MRI was introduced clinically, and during the 1980s a veritable explosion of technical refinements and diagnostic MR applications took place. Scientists soon learned that the large blood flow changes measured by PET could also be imaged by the correct type of MRI.
Functional magnetic resonance imaging (fMRI) was born, andSince the 1990s, fMRI has come to dominate the brain mapping field due to its low invasiveness, lack of radiation exposure, and relatively wide availability. As noted above fMRI is also beginning to dominate the field of stroke treatment.
In early 2000s the field of neuroimaging reached the stage where limited practical applications of functional brain imaging have became feasible. The main application area is crude forms of
brain-computer interface.
*
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