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Article: Impact of Deltoid Computer Tomography Image Data on the Accuracy of Machine Learning Predictions of Clinical Outcomes after Anatomic and Reverse Total Shoulder Arthroplasty.

Rajabzadeh-Oghaz, Hamidreza / Kumar, Vikas / Berry, David B / Singh, Anshu / Schoch, Bradley S / Aibinder, William R / Gobbato, Bruno / Polakovic, Sandrine / Elwell, Josie / Roche, Christopher P

Journal of clinical medicine

2024 Volume 13, Issue 5

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-02-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13051273
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Article ; Online: The association between hemodynamics and wall characteristics in human intracranial aneurysms: a review.

Rajabzadeh-Oghaz, Hamidreza / Siddiqui, Adnan H / Asadollahi, Arash / Kolega, John / Tutino, Vincent M

Neurosurgical review

2021 Volume 45, Issue 1, Page(s) 49–61

Abstract: Hemodynamics plays a key role in the natural history of intracranial aneurysms (IAs). However, studies exploring the association between aneurysmal hemodynamics and the biological and mechanical characteristics of the IA wall in humans are sparse. In ... ...

Abstract	Hemodynamics plays a key role in the natural history of intracranial aneurysms (IAs). However, studies exploring the association between aneurysmal hemodynamics and the biological and mechanical characteristics of the IA wall in humans are sparse. In this review, we survey the current body of literature, summarize the studies' methodologies and findings, and assess the degree of consensus among them. We used PubMed to perform a systematic review of studies that explored the association between hemodynamics and human IA wall features using different sources. We identified 28 publications characterizing aneurysmal flow and the IA wall: 4 using resected tissues, 17 using intraoperative images, and 7 using vessel wall magnetic resonance imaging (MRI). Based on correlation to IA tissue, higher flow conditions, such as high wall shear stress (WSS) with complex pattern and elevated pressure, were associated with degenerated walls and collagens with unphysiological orientation and faster synthesis. MRI studies strongly supported that low flow, characterized by low WSS and high blood residence time, was associated with thicker walls and post-contrast enhancement. While significant discrepancies were found among those utilized intraoperative images, they generally supported that thicker walls coexist at regions with prolonged residence time and that thinner regions are mainly exposed to higher pressure with complex WSS patterns. The current body of literature supports a theory of two general hemodynamic-biologic mechanisms for IA development. One, where low flow conditions are associated with thickening and atherosclerotic-like remodeling, and the other where high and impinging flow conditions are related to wall degeneration, thinning, and collagen remodeling.
MeSH term(s)	Hemodynamics ; Humans ; Intracranial Aneurysm/surgery ; Magnetic Resonance Imaging ; Stress, Mechanical
Language	English
Publishing date	2021-04-29
Publishing country	Germany
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-021-01554-w
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Article: Aneurysm risk metrics and hemodynamics are associated with greater vessel wall enhancement in intracranial aneurysms.

Veeturi, Sricharan S / Rajabzadeh-Oghaz, Hamidreza / Pintér, Nándor K / Waqas, Muhammad / Hasan, David M / Snyder, Kenneth V / Siddiqui, Adnan H / Tutino, Vincent M

Royal Society open science

2021 Volume 8, Issue 11, Page(s) 211119

Abstract: Vessel wall enhancement (VWE) in contrast-enhanced magnetic resonance imaging (MRI) is a potential biomarker for intracranial aneurysm (IA) risk stratification. In this study, we investigated the relationship between VWE features, risk metrics, ... ...

Abstract	Vessel wall enhancement (VWE) in contrast-enhanced magnetic resonance imaging (MRI) is a potential biomarker for intracranial aneurysm (IA) risk stratification. In this study, we investigated the relationship between VWE features, risk metrics, morphology and hemodynamics in 41 unruptured aneurysms. We reconstructed the IA geometries from MR angiography and mapped pituitary stalk-normalized MRI intensity on the aneurysm surface using an in-house tool. For each case, we calculated the maximum intensity (CR
Language	English
Publishing date	2021-11-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2787755-3
ISSN	2054-5703
ISSN	2054-5703
DOI	10.1098/rsos.211119
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Article: Aberrant Whole Blood Gene Expression in the Lumen of Human Intracranial Aneurysms.

Tutino, Vincent M / Lu, Yongjun / Ishii, Daizo / Poppenberg, Kerry E / Rajabzadeh-Oghaz, Hamidreza / Siddiqui, Adnan H / Hasan, David M

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 8

Abstract: The rupture of an intracranial aneurysm (IA) causes devastating hemorrhagic strokes. Yet, most IAs remain asymptomatic and undetected until they rupture. In the search for circulating biomarkers of unruptured IAs, we previously performed transcriptome ... ...

Abstract	The rupture of an intracranial aneurysm (IA) causes devastating hemorrhagic strokes. Yet, most IAs remain asymptomatic and undetected until they rupture. In the search for circulating biomarkers of unruptured IAs, we previously performed transcriptome profiling on whole blood and identified an IA-associated panel of 18 genes. In this study, we seek to determine if these genes are also differentially expressed within the IA lumen, which could provide a mechanistic link between the disease and the observed circulating gene expression patterns. To this end, we collected blood from the lumen of 37 IAs and their proximal parent vessels in 31 patients. The expression levels of 18 genes in the lumen and proximal vessel were then measured by quantitative polymerase chain reaction. This analysis revealed that the expression of 6/18 genes (
Language	English
Publishing date	2021-08-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11081442
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Article ; Online: Identification of intima-to-media signals for flow-induced vascular remodeling using correlative gene expression analysis.

Kolega, John / Poppenberg, Kerry E / Lim, Hee-Woong / Gutierrez, Liza C / Veeturi, Sricharan S / Siddiqui, Adnan H / Rajabzadeh-Oghaz, Hamidreza / Tutino, Vincent M

Scientific reports

2021 Volume 11, Issue 1, Page(s) 16142

Abstract: Changes in blood flow can induce arterial remodeling. Intimal cells sense flow and send signals to the media to initiate remodeling. However, the nature of such intima-media signaling is not fully understood. To identify potential signals, New Zealand ... ...

Abstract	Changes in blood flow can induce arterial remodeling. Intimal cells sense flow and send signals to the media to initiate remodeling. However, the nature of such intima-media signaling is not fully understood. To identify potential signals, New Zealand white rabbits underwent bilateral carotid ligation to increase flow in the basilar artery or sham surgery (n = 2 ligated, n = 2 sham). Flow was measured by transcranial Doppler ultrasonography, vessel geometry was determined by 3D angiography, and hemodynamics were quantified by computational fluid dynamics. 24 h post-surgery, the basilar artery and terminus were embedded for sectioning. Intima and media were separately microdissected from the sections, and whole transcriptomes were obtained by RNA-seq. Correlation analysis of expression across all possible intima-media gene pairs revealed potential remodeling signals. Carotid ligation increased flow in the basilar artery and terminus and caused differential expression of 194 intimal genes and 529 medial genes. 29,777 intima-media gene pairs exhibited correlated expression. 18 intimal genes had > 200 medial correlates and coded for extracellular products. Gene ontology of the medial correlates showed enrichment of organonitrogen metabolism, leukocyte activation/immune response, and secretion/exocytosis processes. This demonstrates correlative expression analysis of intimal and medial genes can reveal novel signals that may regulate flow-induced arterial remodeling.
MeSH term(s)	Animals ; Basilar Artery/anatomy & histology ; Basilar Artery/physiology ; Female ; Gene Expression Profiling ; Gene Ontology ; Hemodynamics/genetics ; Hemodynamics/physiology ; Models, Animal ; Models, Cardiovascular ; Rabbits ; Signal Transduction ; Tunica Intima/physiology ; Tunica Media/physiology ; Vascular Remodeling/genetics ; Vascular Remodeling/physiology
Language	English
Publishing date	2021-08-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-95403-x
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Article ; Online: Automated Cerebral Vessel Segmentation of Magnetic Resonance Imaging in Patients with Intracranial Atherosclerotic Diseases.

Patel, Tatsat R / Pinter, Nandor / Sarayi, Seyyed M M J / Siddiqui, Adnan H / Tutino, Vincent M / Rajabzadeh-Oghaz, Hamidreza

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

2021 Volume 2021, Page(s) 3920–3923

Abstract: Time-of-flight (TOF) magnetic resonance angiography is a non-invasive imaging modality for the diagnosis of intracranial atherosclerotic diseases (ICAD). Evaluation of the degree of the stenosis and status of posterior and anterior communicating arteries ...

Abstract	Time-of-flight (TOF) magnetic resonance angiography is a non-invasive imaging modality for the diagnosis of intracranial atherosclerotic diseases (ICAD). Evaluation of the degree of the stenosis and status of posterior and anterior communicating arteries to supply enough blood flow to the distal arteries is very critical, which requires accurate evaluation of arteries. Recently, deep-learning methods have been firmly established as a robust tool in medical image segmentation, which has been resulted in developing multiple customized algorithms. For instance, BRAVE-NET, a context-based successor of U-Net-has shown promising results in MRA cerebrovascular segmentation. Another widely used context-based 3D CNN-DeepMedic-has been shown to outperform U-Net in cerebrovascular segmentation of 3D digital subtraction angiography. In this study, we aim to train and compare the two state-of-the-art deep-learning networks, BRAVE-NET and DeepMedic, for automated and reliable brain vessel segmentation from TOF-MRA images in ICAD patients. Using specially labeled data-labeled on TOF MRA and corrected on high-resolution black-blood MRI, of 51 patients with ICAD due to severe stenosis, we trained and tested both models. On an independent test dataset of 11 cases, DeepMedic slightly outperformed BRAVE-NET in terms of DSC (0.905±0.012 vs 0.893±0.015, p: 0.539) and 95HD (0.754±0.223 vs 1.768±0.609, p: 0.134), and significantly outperformed BRAVE-NET in terms of Recall (0.940±0.023 vs 0.855±0.030, p: 0.036). Qualitative assessment confirmed the superiority of DeepMedic in capturing the small and distal arteries. While BRAVE-NET consistently reported higher precision, DeepMedic generally overpredicted and could better visualize the smaller and distal arteries. In future studies, ensemble models that can leverage best of both should be developed and tested on larger datasets.Clinical Relevance- This study helps elevate the state-of-the-art for brain vessel segmentation from non-invasive MRA, which could accelerate the translation of vessel status-based biomarkers into the clinical setting.
MeSH term(s)	Angiography, Digital Subtraction ; Arteries ; Humans ; Intracranial Arteriosclerosis/diagnostic imaging ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging
Language	English
Publishing date	2021-12-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2694-0604
ISSN (online)	2694-0604
DOI	10.1109/EMBC46164.2021.9630626
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Article ; Online: RNA Sequencing Data from Human Intracranial Aneurysm Tissue Reveals a Complex Inflammatory Environment Associated with Rupture.

Tutino, Vincent M / Zebraski, Haley R / Rajabzadeh-Oghaz, Hamidreza / Chaves, Lee / Dmytriw, Adam A / Siddiqui, Adnan H / Kolega, John / Poppenberg, Kerry E

Molecular diagnosis & therapy

2021 Volume 25, Issue 6, Page(s) 775–790

Abstract: Background: Intracranial aneurysm (IA) rupture leads to deadly subarachnoid hemorrhages. However, the mechanisms leading to rupture remain poorly understood. Altered gene expression within IA tissue is linked to the pathobiology of aneurysm development ... ...

Abstract	Background: Intracranial aneurysm (IA) rupture leads to deadly subarachnoid hemorrhages. However, the mechanisms leading to rupture remain poorly understood. Altered gene expression within IA tissue is linked to the pathobiology of aneurysm development and progression. Here, we analyzed expression patterns of control tissue samples and compared them to those of unruptured and ruptured IA tissue samples using data from the Gene Expression Omnibus (GEO). Methods: FASTQ files for 21 ruptured IAs, 21 unruptured IAs, and 16 control tissue samples were accessed from the GEO database. DESeq2 was used for differential expression analysis in three comparisons: unruptured IA versus control, ruptured IA versus control, and ruptured versus unruptured IA. Genes that were differentially expressed in multiple comparisons were evaluated to find those progressively increasing/decreasing from control to unruptured to ruptured. Significance was tested by either analysis of variance/Gabriel or Brown-Forsythe/Games Howell (p < 0.05 was considered significant). We used additional RNA sequencing and proteomics datasets to evaluate if our differentially expressed genes (DEGs) were present in other studies. Bioinformatics analyses were performed with g:Profiler and Ingenuity Pathway Analysis. Results: In total, we identified 1768 DEGs, of which 318 were found in multiple comparisons. Unruptured versus control reflected vascular remodeling processes, while ruptured versus control reflected inflammatory responses and cell activation/signaling. When comparing ruptured to unruptured IAs, we found massive activation of inflammation, inflammatory responses, and leukocyte responses. Of the 318 genes in multiple comparisons, 127 were found to be significant in the multi-cohort correlation analysis. Those that progressively increased (70 genes) were associated with immune system processes, while those that progressively decreased (38 genes) did not return any gene ontology terms. Many of our DEGs were also found in the other IA tissue sequencing studies. Conclusions: We found unruptured IAs relate more to remodeling processes, while ruptured IAs reflect more inflammatory and immune responses.
MeSH term(s)	Aneurysm, Ruptured/genetics ; Humans ; Intracranial Aneurysm/genetics ; RNA ; Sequence Analysis, RNA ; Whole Exome Sequencing
Chemical Substances	RNA (63231-63-0)
Language	English
Publishing date	2021-08-17
Publishing country	New Zealand
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2232796-4
ISSN	1179-2000 ; 1177-1062
ISSN (online)	1179-2000
ISSN	1177-1062
DOI	10.1007/s40291-021-00552-4
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Zs.A 5202: Show issues

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Article ; Online: Rupture Resemblance Models May Correlate to Growth Rates of Intracranial Aneurysms: Preliminary Results.

Varble, Nicole / Kono, Kenichi / Rajabzadeh-Oghaz, Hamidreza / Meng, Hui

World neurosurgery

2017 Volume 110, Page(s) e794–e805

Abstract: Background: Treatment of intracranial aneurysms (IAs) is largely guided by IA size and growth. Preliminary investigations have found a relationship between clinical factors and growth; yet, the relationship between morphologic and hemodynamic risk ... ...

Abstract	Background: Treatment of intracranial aneurysms (IAs) is largely guided by IA size and growth. Preliminary investigations have found a relationship between clinical factors and growth; yet, the relationship between morphologic and hemodynamic risk prediction models in IA growth is unknown. Methods: We analyzed serial images of 5 growing and 6 stable IAs. Rupture resemblance scores (RRSs) were calculated from three-dimensional segmented images and computational fluid dynamics simulations. The morphologic (RRS Results: Our results indicate that there is no statistical difference in IAs at the baseline time point; however, growing IAs tend to have a higher aspect ratio (P = 0.066), undulation index (P = 0.086), and RRS Conclusions: Based on this preliminary study, we conjecture that aneurysms that resemble ruptured IAs may grow faster.
MeSH term(s)	Aftercare ; Aged ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/physiopathology ; Cerebral Angiography ; Cerebrovascular Circulation ; Disease Progression ; Female ; Humans ; Hydrodynamics ; Imaging, Three-Dimensional ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/physiopathology ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Models, Cardiovascular ; Models, Neurological ; Stress, Mechanical
Language	English
Publishing date	2017-11-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2017.11.093
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Zs.A 1159: Show issues

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Article ; Online: Inter-patient variations in flow boundary conditions at middle cerebral artery from 7T PC-MRI and influence on Computational Fluid Dynamics of intracranial aneurysms.

Rajabzadeh-Oghaz, Hamidreza / van Ooij, Pim / Veeturi, Sricharan S / Tutino, Vincent M / Zwanenburg, Jaco Jm / Meng, Hui

Computers in biology and medicine

2020 Volume 120, Page(s) 103759

Abstract: Background: Computational fluid dynamics(CFD) of intracranial aneurysms requires flow boundary conditions(BCs) as inputs. Patient-specific BCs are usually unavailable and substituted by literature-derived generic BCs. Therefore, we investigated inter- ... ...

Abstract	Background: Computational fluid dynamics(CFD) of intracranial aneurysms requires flow boundary conditions(BCs) as inputs. Patient-specific BCs are usually unavailable and substituted by literature-derived generic BCs. Therefore, we investigated inter-patient BC variations and their influence on middle cerebral artery aneurysmal hemodynamics. Method: We retrospectively collected CT angiography and 7-T Phase-Contrast(PC)-MRI data from eight middle-cerebral-artery bifurcation aneurysms to reconstruct the geometry and measure the arterial flowrates, respectively. The coefficient of variation(CoV) was calculated for the inlet flowrate and the pulsatility index(PI). The outflow split estimated by Murray's law was compared with PC-MRI measurements. For each aneurysm, we performed seven simulations: "baseline" using PC-MRI-derived BCs and the other six with changing BCs to explore the influence of BC variations on hemodynamics. Results: From PC-MRI, the inlet flowrate was 1.94 ± 0.71 cm Conclusion: Inflow rate and outflow split have a drastic impact on hemodynamics of intracranial aneurysms. Inlet waveform has a negligible impact on WSS and NWSS but major impact on OSI. CFD-based models need to consider such sensitivity.
MeSH term(s)	Blood Flow Velocity ; Cerebrovascular Circulation ; Computed Tomography Angiography ; Computer Simulation ; Contrast Media ; Hemodynamics ; Humans ; Hydrodynamics ; Imaging, Three-Dimensional ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/pathology ; Intracranial Aneurysm/physiopathology ; Magnetic Resonance Angiography ; Middle Cerebral Artery/diagnostic imaging ; Middle Cerebral Artery/pathology ; Middle Cerebral Artery/physiopathology ; Models, Cardiovascular ; Multimodal Imaging ; Pulsatile Flow ; Retrospective Studies
Chemical Substances	Contrast Media
Language	English
Publishing date	2020-04-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2020.103759
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Zs.A 653: Show issues

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Article ; Online: Aberrant Whole Blood Gene Expression in the Lumen of Human Intracranial Aneurysms

Vincent M. Tutino / Yongjun Lu / Daizo Ishii / Kerry E. Poppenberg / Hamidreza Rajabzadeh-Oghaz / Adnan H. Siddiqui / David M. Hasan

Diagnostics, Vol 11, Iss 1442, p

2021 Volume 1442

Abstract	The rupture of an intracranial aneurysm (IA) causes devastating hemorrhagic strokes. Yet, most IAs remain asymptomatic and undetected until they rupture. In the search for circulating biomarkers of unruptured IAs, we previously performed transcriptome profiling on whole blood and identified an IA-associated panel of 18 genes. In this study, we seek to determine if these genes are also differentially expressed within the IA lumen, which could provide a mechanistic link between the disease and the observed circulating gene expression patterns. To this end, we collected blood from the lumen of 37 IAs and their proximal parent vessels in 31 patients. The expression levels of 18 genes in the lumen and proximal vessel were then measured by quantitative polymerase chain reaction. This analysis revealed that the expression of 6/18 genes ( CBWD6 , MT2A , MZT2B , PIM3 , SLC37A3 , and TNFRSF4 ) was significantly higher in intraluminal blood, while the expression of 3/18 genes ( ST6GALNAC1 , TCN2 , and UFSP1 ) was significantly lower. There was a significant, positive correlation between intraluminal and proximal expression of CXCL10 , MT2A , and MZT2B , suggesting local increases of these genes is reflected in the periphery. Expression of ST6GALNAC1 and TIFAB was significantly positively correlated with IA size, while expression of CCDC85B was significantly positively correlated with IA enhancement on post-contrast MRI, a metric of IA instability and risk. In conclusion, intraluminal expression differences in half of the IA-associated genes observed in this study provide evidence for IA tissue-mediated transcriptional changes in whole blood. Additionally, some genes may be informative in assessing IA risk, as their intraluminal expression was correlated to IA size and aneurysmal wall enhancement.
Keywords	cerebral aneurysm ; biomarkers ; gene expression ; transcriptomics ; whole blood ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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