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Description
Heart transplantation is the final treatment option for end-stage heart failure. In the United States, 70 pediatric patients die annually on the waitlist while 800 well-functioning organs get discarded. Concern for potential size-mismatch is one source of allograft waste and high waitlist mortality. Clinicians use the donor-recipient body weight (DRBW)

Heart transplantation is the final treatment option for end-stage heart failure. In the United States, 70 pediatric patients die annually on the waitlist while 800 well-functioning organs get discarded. Concern for potential size-mismatch is one source of allograft waste and high waitlist mortality. Clinicians use the donor-recipient body weight (DRBW) ratio, a standalone metric, to evaluate allograft size-match. However, this body weight metric is far removed from cardiac anatomy and neglects an individual’s anatomical variations. This thesis body of work developed a novel virtual heart transplant fit assessment tool and investigated the tool’s clinical utility to help clinicians safely expand patient donor pools.

The tool allowed surgeons to take an allograft reconstruction and fuse it to a patient’s CT or MR medical image for virtual fit assessment. The allograft is either a reconstruction of the donor’s actual heart (from CT or MR images) or an analogue from a health heart library. The analogue allograft geometry is identified from gross donor parameters using a regression model build herein. The need for the regression model is donor images may not exist or they may not become available within the time-window clinicians have to make a provisional acceptance of an offer.

The tool’s assessment suggested > 20% of upper DRBW listings could have been increased at Phoenix Children’s Hospital (PCH). Upper DRBW listings in the UNOS national database was statistically smaller than at PCH (p-values: < 0.001). Delayed sternal closure and surgeon perceived complication variables had an association (p-value: 0.000016) with 9 of the 11 cases that surgeons had perceived fit-related complications had delayed closures (p-value: 0.034809).

A tool to assess allograft size-match has been developed. Findings warrant future preclinical and clinical prospective studies to further assess the tool’s clinical utility.
ContributorsPlasencia, Jonathan (Author) / Frakes, David H (Thesis advisor) / Kodibagkar, Vikram (Thesis advisor) / Sadleir, Rosalind (Committee member) / Kamarianakis, Yiannis (Committee member) / Zangwill, Steven (Committee member) / Pophal, Stephen (Committee member) / Arizona State University (Publisher)
Created2018
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Description
A direct Magnetic Resonance (MR)-based neural activity mapping technique with high spatial and temporal resolution may accelerate studies of brain functional organization.

The most widely used technique for brain functional imaging is functional Magnetic Resonance Image (fMRI). The spatial resolution of fMRI is high. However, fMRI signals are highly influenced

A direct Magnetic Resonance (MR)-based neural activity mapping technique with high spatial and temporal resolution may accelerate studies of brain functional organization.

The most widely used technique for brain functional imaging is functional Magnetic Resonance Image (fMRI). The spatial resolution of fMRI is high. However, fMRI signals are highly influenced by the vasculature in each voxel and can be affected by capillary orientation and vessel size. Functional MRI analysis may, therefore, produce misleading results when voxels are nearby large vessels. Another problem in fMRI is that hemodynamic responses are slower than the neuronal activity. Therefore, temporal resolution is limited in fMRI. Furthermore, the correlation between neural activity and the hemodynamic response is not fully understood. fMRI can only be considered an indirect method of functional brain imaging.

Another MR-based method of functional brain mapping is neuronal current magnetic resonance imaging (ncMRI), which has been studied over several years. However, the amplitude of these neuronal current signals is an order of magnitude smaller than the physiological noise. Works on ncMRI include simulation, phantom experiments, and studies in tissue including isolated ganglia, optic nerves, and human brains. However, ncMRI development has been hampered due to the extremely small signal amplitude, as well as the presence of confounding signals from hemodynamic changes and other physiological noise.

Magnetic Resonance Electrical Impedance Tomography (MREIT) methods could have the potential for the detection of neuronal activity. In this technique, small external currents are applied to a body during MR scans. This current flow produces a magnetic field as well as an electric field. The altered magnetic flux density along the main magnetic field direction caused by this current flow can be obtained from phase images. When there is neural activity, the conductivity of the neural cell membrane changes and the current paths around the neurons change consequently. Neural spiking activity during external current injection, therefore, causes differential phase accumulation in MR data. Statistical analysis methods can be used to identify neuronal-current-induced magnetic field changes.
ContributorsFu, Fanrui (Author) / Sadleir, Rosalind (Thesis advisor) / Kodibagkar, Vikram (Committee member) / Kleim, Jeffrey (Committee member) / Muthuswamy, Jitendran (Committee member) / Helms Tillery, Stephen (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Magnetic resonance spectroscopic imaging (MRSI) is a valuable technique for assessing the in vivo spatial profiles of metabolites like N-acetylaspartate (NAA), creatine, choline, and lactate. Changes in metabolite concentrations can help identify tissue heterogeneity, providing prognostic and diagnostic information to the clinician. The increased uptake of glucose by solid tumors

Magnetic resonance spectroscopic imaging (MRSI) is a valuable technique for assessing the in vivo spatial profiles of metabolites like N-acetylaspartate (NAA), creatine, choline, and lactate. Changes in metabolite concentrations can help identify tissue heterogeneity, providing prognostic and diagnostic information to the clinician. The increased uptake of glucose by solid tumors as compared to normal tissues and its conversion to lactate can be exploited for tumor diagnostics, anti-cancer therapy, and in the detection of metastasis. Lactate levels in cancer cells are suggestive of altered metabolism, tumor recurrence, and poor outcome. A dedicated technique like MRSI could contribute to an improved assessment of metabolic abnormalities in the clinical setting, and introduce the possibility of employing non-invasive lactate imaging as a powerful prognostic marker.

However, the long acquisition time in MRSI is a deterrent to its inclusion in clinical protocols due to associated costs, patient discomfort (especially in pediatric patients under anesthesia), and higher susceptibility to motion artifacts. Acceleration strategies like compressed sensing (CS) permit faithful reconstructions even when the k-space is undersampled well below the Nyquist limit. CS is apt for MRSI as spectroscopic data are inherently sparse in multiple dimensions of space and frequency in an appropriate transform domain, for e.g. the wavelet domain. The objective of this research was three-fold: firstly on the preclinical front, to prospectively speed-up spectrally-edited MRSI using CS for rapid mapping of lactate and capture associated changes in response to therapy. Secondly, to retrospectively evaluate CS-MRSI in pediatric patients scanned for various brain-related concerns. Thirdly, to implement prospective CS-MRSI acquisitions on a clinical magnetic resonance imaging (MRI) scanner for fast spectroscopic imaging studies. Both phantom and in vivo results demonstrated a reduction in the scan time by up to 80%, with the accelerated CS-MRSI reconstructions maintaining high spectral fidelity and statistically insignificant errors as compared to the fully sampled reference dataset. Optimization of CS parameters involved identifying an optimal sampling mask for CS-MRSI at each acceleration factor. It is envisioned that time-efficient MRSI realized with optimized CS acceleration would facilitate the clinical acceptance of routine MRSI exams for a quantitative mapping of important biomarkers.
ContributorsVidya Shankar, Rohini (Author) / Kodibagkar, Vikram D (Thesis advisor) / Pipe, James (Committee member) / Chang, John (Committee member) / Sadleir, Rosalind (Committee member) / Frakes, David (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Dynamic susceptibility contrast MRI (DSC-MRI) is a powerful tool used to quantitatively measure parameters related to blood flow and volume in the brain. The technique is known as a “bolus-tracking” method and relies upon very fast scanning to accurately measure the flow of contrast agent into and out of a

Dynamic susceptibility contrast MRI (DSC-MRI) is a powerful tool used to quantitatively measure parameters related to blood flow and volume in the brain. The technique is known as a “bolus-tracking” method and relies upon very fast scanning to accurately measure the flow of contrast agent into and out of a region of interest. The need for high temporal resolution to measure contrast agent dynamics limits the spatial coverage of perfusion parameter maps which limits the utility of DSC-perfusion studies in pathologies involving the entire brain. Typical clinical DSC-perfusion studies are capable of acquiring 10-15 slices, generally centered on a known lesion or pathology.

The methods developed in this work improve the spatial coverage of whole-brain DSC-MRI by combining a highly efficient 3D spiral k-space trajectory with Generalized Autocalibrating Partial Parallel Acquisition (GRAPPA) parallel imaging without increasing temporal resolution. The proposed method is capable of acquiring 30 slices with a temporal resolution of under 1 second, covering the entire cerebrum with isotropic spatial resolution of 3 mm. Additionally, the acquisition method allows for correction of T1-enhancing leakage effects by virtue of collecting two echoes, which confound DSC perfusion measurements. The proposed DSC-perfusion method results in high quality perfusion parameter maps across a larger volume than is currently available with current clinical standards, improving diagnostic utility of perfusion MRI methods, which ultimately improves patient care.
ContributorsTurley, Dallas C (Author) / Pipe, James G (Thesis advisor) / Kodibagkar, Vikram (Thesis advisor) / Frakes, David (Committee member) / Sadleir, Rosalind (Committee member) / Schmainda, Kathleen (Committee member) / Arizona State University (Publisher)
Created2017
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Description
Magnetic resonance flow imaging techniques provide quantitative and qualitative information that can be attributed to flow related clinical pathologies. Clinical use of MR flow quantification requires fast acquisition and reconstruction schemes, and minimization of post processing errors. The purpose of this work is to provide improvements to the post

Magnetic resonance flow imaging techniques provide quantitative and qualitative information that can be attributed to flow related clinical pathologies. Clinical use of MR flow quantification requires fast acquisition and reconstruction schemes, and minimization of post processing errors. The purpose of this work is to provide improvements to the post processing of volumetric phase contrast MRI (PCMRI) data, identify a source of flow bias for cine PCMRI that has not been previously reported in the literature, and investigate a dynamic approach to image bulk cerebrospinal fluid (CSF) drainage in ventricular shunts. The proposed improvements are implemented as three research projects.

In the first project, the improvements to post processing are made by proposing a new approach to estimating noise statistics for a single spiral acquisition, and using the estimated noise statistics to generate a mask distinguishing flow regions from background noise and static tissue in an image volume. The mask is applied towards reducing the computation time of phase unwrapping. The proposed noise estimation is shown to have comparable noise statistics as that of a vendor specific noise dynamic scan, with the added advantage of reduced scan time. The sparse flow region subset of the image volume is shown to speed up phase unwrapping for multidirectional velocity encoded 3D PCMRI scans. The second research project explores the extent of bias in cine PCMRI based flow estimates is investigated for CSF flow in the cerebral aqueduct. The dependance of the bias on spatial and temporal velocity gradient components is described. A critical velocity threshold is presented to prospectively determine the extent of bias as a function of scan acquisition parameters.

Phase contrast MR imaging is not sensitive to measure bulk CSF drainage. A dynamic approach using a CSF label is investigated in the third project to detect bulk flow in a ventricular shunt. The proposed approach uses a preparatory pulse to label CSF signal and a variable delay between the preparatory pulse and data acquisition enables tracking of the CSF bulk flow.
ContributorsRagunathan, Sudarshan (Author) / Pipe, James G (Thesis advisor) / Frakes, David (Thesis advisor) / Kodibagkar, Vikram (Committee member) / Sadleir, Rosalind (Committee member) / Hu, Houchun (Committee member) / Arizona State University (Publisher)
Created2017
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Description
For two centuries, electrical stimulation has been the conventional method for interfacing with the nervous system. As interfaces with the peripheral nervous system become more refined and higher-resolution, several challenges appear, including immune responses to invasive electrode application, large-to-small axon recruitment order, and electrode size-dependent spatial selectivity. Optogenetics offers a

For two centuries, electrical stimulation has been the conventional method for interfacing with the nervous system. As interfaces with the peripheral nervous system become more refined and higher-resolution, several challenges appear, including immune responses to invasive electrode application, large-to-small axon recruitment order, and electrode size-dependent spatial selectivity. Optogenetics offers a solution that is less invasive, more tissue-selective, and has small-to-large axon recruitment order. By adding genes to express photosensitive proteins optogenetics provides neuroscientists the ability to genetically select cell populations to stimulate with simple illumination. However, optogenetic stimulation of peripheral nerves uses diffuse light to activate the photosensitive neural cell lines. To increase the specificity of stimulus response, research was conducted to test the hypothesis that multiple, focused light emissions placed around the circumference of optogenetic mouse sciatic nerve could be driven to produce differential responses in hindlimb motor movement depending on the pattern of light presented. A Monte Carlo computer simulation was created to model the number of emitters, the light emission size, and the focal power of accompanying micro-lenses to provide targeted stimulation to select regions within the sciatic nerve. The computer simulation results were used to parameterize the design of micro-lenses. By modeling multiple focused beams, only fascicles within a nerve diameter less than 1 mm are expected to be fully accessible to focused optical stimulation; a minimum of 4 light sources is required to generate a photon intensity at a point in a nerve over the initial contact along its surface. To elicit the same effect in larger nerves, focusing lenses would require a numerical aperture > 1. Microlenses which met the simulation requirements were fabricated and deployed on a flexible nerve cuff which was used to stimulate the sciatic nerve in optogenetic mice. Motor neuron responses from this stimulation were compared to global illumination; stimulation using the optical cuff resulted in fine motor movement of the extensor muscles of the digits in the hindlimb. Increasing optical power resulted in a shift to gross motor movement of hindlimb. Finally, varying illumination intensity across the cuff showed changes in the extension of individual digits.
ContributorsFritz, Nicholas (Author) / Blain Christen, Jennifer (Thesis advisor) / Abbas, James (Committee member) / Goryll, Michael (Committee member) / Sadleir, Rosalind (Committee member) / Helms-Tillery, Stephen (Committee member) / Arizona State University (Publisher)
Created2021
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Description
Finite element models (FEMs) of spine segments validated in their intact states are often used to make predictions following structural modifications simulating surgical procedures, including posterior fusion with pedicle screws and rods (PSR) and laminectomy (removal of posterior column bone to decompress the spinal cord). The gold standard for spine

Finite element models (FEMs) of spine segments validated in their intact states are often used to make predictions following structural modifications simulating surgical procedures, including posterior fusion with pedicle screws and rods (PSR) and laminectomy (removal of posterior column bone to decompress the spinal cord). The gold standard for spine FEM validation compares predicted vs. experimental intervertebral ranges of motion (ROM). Given that muscle co-contraction compresses the spine, validation that considers compression may produce a more robust FEM. One research goal was to evaluate an experimental method of compressing a lumbar spine segment through its sagittal plane balance (pivot) point (BP) using a 6DOF robotic test system. Experimental data supported the hypothesis that structural modifications, such as PSR and laminectomy alter the segment’s BP location and its compressive stiffness. However, evaluation showed that the experimental BP method is sensitive to specimen posture in the robotic test frame; slight flexion or extension produced shear loads during compression that affect BP location and should be included in specimen-specific FEMs to ensure similar load conditions. Another goal was to develop a uniquely calibrated specimen-specific FEM of an intact L4-5 motion segment using the experimental BP data. A specimen-specific FEM was created and calibrated using experimental BP compressive stiffness data, however matching experimental BP location data was unsuccessful. The BP-compression calibrated FEM was evaluated by comparing predicted responses to loads following simulated PSR and laminectomy to specimen-specific experimental data. Predictions using the BP-calibrated and ROM-calibrated FEMs were compared. The BP-calibration process helped identify an unrealistic FEM disc geometry (nucleus pulposus size and location). Both BP-compression and ROM-calibrated FEMs predicted effects of PSR on stiffness (compressive and flexural) that were greater than experimental, which helped identify a problem with simplified representations of bone in the posterior column and at the anterior column interface. The BP-compression calibrated FEMs predicted relative shifts in BP locations and bone surface strains during compression that were closer to experimental data than similarly modified ROM-calibrated FEMs. Collectively, these results support the use of BP measures in experimental and model-based investigations of surgical modifications of the spine.
ContributorsSawa, Anna Genowefa Ulrika (Author) / Abbas, James (Thesis advisor) / Crawford, Neil R (Thesis advisor) / Kelly, Brian P (Committee member) / Helms-Tillery, Stephen (Committee member) / Sadleir, Rosalind (Committee member) / Arizona State University (Publisher)
Created2023
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Description
Electrical stimulation of the human peripheral nervous system can be a powerful tool to treat various medical conditions and provide insight into nervous system processes. A critical challenge for many applications is to selectively activate neurons that have the desired effect while avoiding the activation of neurons that produce side

Electrical stimulation of the human peripheral nervous system can be a powerful tool to treat various medical conditions and provide insight into nervous system processes. A critical challenge for many applications is to selectively activate neurons that have the desired effect while avoiding the activation of neurons that produce side effects. To stimulate peripheral fibers, the longitudinal intrafascicular electrode (LIFE) targets small groups of fibers inside the fascicle using low-amplitude pulses and is well-suited for chronic use. This work aims to understand better the ability to use intrafascicular stimulation with LIFEs to activate small groups of neurons within a fascicle selectively.A hybrid workflow was developed to simulate: 1) the production/propagation of the electric field induced by the stimulation pulse and 2) the effect of the electric field on fiber activation (recruitment). To create efficient and robust strategies for the selective recruitment of axons, recognizing the effect of each parameter on their recruitment and activation pattern is essential. Thus, using this hybrid workflow, the effects of various factors such as fascicular anatomy, electrode parameters, and stimulation pulse parameters on recruitment have been characterized, and the sensitivity of the recruitment patterns to these parameters has been explored. Results demonstrated the potential advantages of specific stimulation strategies and the sensitivity of recruitment patterns to electrode placement and tissue properties. For example, it is demonstrated: the significant effect of endoneurium conductivities on threshold levels; that a configuration with a LIFE as a local ground can be used to deselect its surrounding axons; the advantages of changing the delay between pulses in dual monopolar stimulation in targeting different axons clusters and increasing the activation frequency of some axons; how monopolar and bipolar configurations can be used to enhance spatial selectivity; the effect of longitudinal displacement of axons, electrode length and electrode movement on the recruitment and the activation pattern. In summary, this work forms the foundation for developing stimulation strategies to enhance the selectivity that can be achieved with intrafascicular stimulation.
ContributorsRouhani, Morteza (Author) / Abbas, James J (Thesis advisor) / Crook, Sharon M (Thesis advisor) / Baer, Steven M (Committee member) / Sadleir, Rosalind (Committee member) / Gardner, Carl (Committee member) / Arizona State University (Publisher)
Created2022
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Description
This dissertation research project developed as an urgent response to physical inactivity, which has resulted in increased rates of obesity, diabetes, and metabolic disease worldwide. Incorporating enough daily physical activity (PA) is challenging for most people. This research aims to modulate the brain's reward systems to increase motivation for PA

This dissertation research project developed as an urgent response to physical inactivity, which has resulted in increased rates of obesity, diabetes, and metabolic disease worldwide. Incorporating enough daily physical activity (PA) is challenging for most people. This research aims to modulate the brain's reward systems to increase motivation for PA and, thus, slow the rapid increase in sedentary lifestyles. Transcranial direct current stimulation (tDCS) involves brain neuromodulation by facilitating or inhibiting spontaneous neural activity. tDCS applied to the dorsolateral prefrontal cortex (DLPFC) increases dopamine release in the striatum, an area of the brain involved in the reward–motivation pathways. I propose that a repeated intervention, consisting of tDCS applied to the DLPFC followed by a short walking exercise stimulus, enhances motivation for PA and daily PA levels in healthy adults. Results showed that using tDCS followed by short-duration walking exercise may enhance daily PA levels in low-physically active participants but may not have similar effects on those with higher levels of daily PA. Moreover, there was a significant effect on increasing intrinsic motivation for PA in males, but there were no sex-related differences in PA. These effects were not observed during a 2-week follow-up period of the study after the intervention was discontinued. Further research is needed to confirm and continue exploring the effects of tDCS on motivation for PA in larger cohorts of sedentary populations. This novel research will lead to a cascade of new evidence-based technological applications that increase PA by employing approaches rooted in biology.
ContributorsRuiz Tejada, Anaissa (Author) / Katsanos, Christos (Thesis advisor) / Neisewander, Janet (Committee member) / Sadleir, Rosalind (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2023
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Description
In 1946 Felix Bloch first demonstrated the phenomenon of nuclear magnetic resonance using continuous-wave signal generation and acquisition. Shortly after in 1966, Richard R. Ernst demonstrated the breakthrough that nuclear magnetic resonance needed to develop into magnetic resonance imaging: the application of Fourier transforms for sensitive pulsed imaging. Upon this

In 1946 Felix Bloch first demonstrated the phenomenon of nuclear magnetic resonance using continuous-wave signal generation and acquisition. Shortly after in 1966, Richard R. Ernst demonstrated the breakthrough that nuclear magnetic resonance needed to develop into magnetic resonance imaging: the application of Fourier transforms for sensitive pulsed imaging. Upon this discovery, the world of research began to develop high power radio amplifiers and fast radio switches for pulsed experimentation. Consequently, continuous-wave imaging placed on the backburner.Although high power pulses are dominant in clinical imaging, there are unique advantages to low power, continuous-wave pulse sequences that transmit and receive signals simultaneously. Primarily, tissues or materials with short T2 time constants can be imaged and the peak radio power required is drastically reduced. The fundamental problem with this lies in its nature; the transmitter leaks a strong leakage signal into the receiver, thus saturating the receiver and the intended nuclear magnetic resonance signal is lost noise. Demonstrated in this dissertation is a multichannel standalone simultaneous transmit and receive (STAR) system with remote user-control that enables continuous- wave full-duplex imaging. STAR calibrates cancellation signals through vector modulators that match the leakage signal of each receiver in amplitude but opposite in phase, therefore destructively interfering the leakage signals. STAR does not require specific imaging coils or console inputs for calibration. It was designed to be general- purpose, therefore integrating into any imaging system. To begin, the user uses an Android tablet to tune STAR to match the Larmor frequency in the bore. Then, the user tells STAR to begin calibration. After self-calibrating, the user may fine-tune the calibration state of the system before enabling a low-power mode for system electronics and imaging may commence. STAR was demonstrated to isolate two receiver coils upwards of 70 dB from the transmit coil and is readily upgradable to enable the use of four receive coils. Some primary concerns of STAR are the removal of transceivers for multichannel operation, digital circuit noise, external noise, calibration speed, upgradability, and the isolation introduced; all of which are addressed in the proceeding thesis.
ContributorsColwell, Zachary Allen (Author) / Sohn, Sung-Min (Thesis advisor) / Trichopoulos, Georgios (Thesis advisor) / Aberle, James (Committee member) / Sadleir, Rosalind (Committee member) / Arizona State University (Publisher)
Created2023