Introduction to

Neuroimaging
WHAT IS NEUROIMAGING?

Neuroimaging is a branch of medical imaging that focuses on the

brain. In addition to diagnosing disease and assessing brain health,
neuroimaging also studies:
How the brain works
How various activities impact the brain
Importance of neuroimaging in
understanding the brain
 Neuroimaging has revolutionized our understanding of brain
function and has become an essential tool for researchers
studying neurological disorders. Functional magnetic resonance
imaging (fMRI) and electroencephalography (EEG) are two
widely used neuroimaging techniques to review changes in brain
activity. fMRI is a noninvasive technique that uses magnetic
fields and radio waves to produce detailed brain images. An EEG
is a noninvasive technique that records the brain’s electrical
activity through electrodes placed on the scalp. This review
overviews recent developments in noninvasive functional
neuroimaging methods, including fMRI and EEG.
 Neuroimaging plays a crucial role in studying brain functions as
it allows us to non-invasively observe the structure and activity of
the brain
 By visualizing the brain’s structure and activity, neuroimaging
techniques can help us understand how different brain regions are
involved in various cognitive and behavioral processes, such as
perception, attention, memory, language, decision-making, and
emotion regulation
 These techniques can provide researchers with different spatial
and temporal resolution levels, allowing them to investigate brain
activity at different scales of time and space. For example, fMRI
measures changes in blood flow in the brain, which reflect
changes in neural activity. This technique can localize brain
activity to specific regions and has been used to study various
cognitive processes, such as attention and working memory.
Types of Neuroimaging Techniques

 Structural Neuroimaging
 Magnetic Resonance Imaging (MRI)
 Computed Tomography (CT)
 Electroencephalogram(EEG)
 Functional Neuroimaging
 Positron Emission Tomography (PET)
 Functional Magnetic Resonance Imaging (fMRI)
Computer Tomography
(CT)
 CT/ CAT scanning:
Introduction
 Computerised Tomography is well
accepted imaging modality for
evaluation of the entire body.

 Use thousands of narrow-beam X-rays

to pass through the tissue at different
angles
 X-rays are detected forming slices of
images of the tissues
 CT looks at structures rather than
functions
 Used to detect brain disease
 Small structures cannot be
distinguished
 CT/ CAT scanning:Methodology
•2D measurement are taken in a helical manner all around the patient
•Contrast dye is sometimes used to make the internal organs more visible
in the image
•Bone appears white (hyper-intensity) ; gases and liquids are black
(hypo-intensity); tissues are gray
Basically, a narrow beam of X ray
scans across a patient in synchrony
with a radiation detector on the
opposite side of the patient.

CT scan
Showing a
brain
tumor
Magnetic Resonance
Imaging (MRI)
 What is a MRI?
MRI stands for magnetic
resonance imaging.

A MRI scanner has a

magnetic field that is
frequently up to 60,000
times as strong as Earth’s
magnetic field!

MRI equipment is expensive. 1.5 tesla scanners often cost between $1 million and $1.5
million USD. 3.0 tesla scanners often cost between $2 million and $2.3 million USD.
MRI How does it work? The Basics
 Patient is bathed in a magnetic field
 This field causes some of the body’s nuclei to behave like tiny compasses and line up
 The nuclei spins on an axis, a bit like a spinning top
 The atom that the MRI uses is the hydrogen atom
 Protons are most strongly affected by the Magnetic field – it is more likely to line up than other
atoms
 Then the nuclei are hit by pulsing radio waves-This RF makes the protons spin at a particular
frequency, in a particular direction – This is the Resonance bit
 Once the RF pulses stop the nuclei go back to their state induced by the magnet
 The energy now released by the nuclei acts like miniature radio stations giving out a signal
 The coil now picks up that excess energy and sends the signals to the computer – which is the
Imaging part of the scan

Molecules with magnetic A radio frequency is

charges align with the strong used to tip these
magnetic field. molecules over.
MRI How the image is made
 Often, patients are injected with a contrast dye during the scan
 The dye will reach different tissues at different rates
 The image being sent back to the computer will have different strengths depending on
the level of contrast dye in the tissues
Applications:
 Diagnosing: MS; strokes; infections of the brain/spine/CNS; tendonitis
 Visualizing: Injuries; torn ligaments – especially in areas difficult to see like the wrist,
ankle or knee
 Evaluating: Masses in soft tissue; cysts; bone tumors or disc problems.

Magnetic Resonance Imaging (MRI) image of the brain

 MRI:Advantages
 The MRI does not use ionizing radiation, which is a comfort to patients
 Also the contrast dye has a very low chance of side effects
 A non invasive way of diagnosing diseases and conditions-They have given doctors the chance
to detect cancers earlier than ever before-a view into the body without surgery
 While CT provides good spatial resolution (the ability to distinguish two separate structures an
arbitrarily small distance from each other), MRI provides comparable resolution with far
better contrast resolution (the ability to distinguish the differences between two arbitrarily
similar but not identical tissues).
• Variable thickness, any plane
• Many details without I.V
contrast

CT vs MRI
MRI the disadvantages
 Claustrophobia. Patients are in a very enclosed space.
 Weight and size. There are limitations to how big a patient can be.
 Noise. The scanner is very noisy-gets really scary
 Keeping still. Patients have to keep very still for extended periods of time.
 Cost. A scanner is very, very expensive, therefore scanning is also costly.
 Medical Contraindications. Pacemakers, metal objects in body etc.
 Time consuming
 Not easily available (long waiting list)
 No on-call service
 Need to tweak sequences as per the clinical questions; hence cannot be generalised
 MRI has limitations:
 Bone
 Air-Pain abdomen ? cause
 Time consuming
 Expertise!
Material to read latter-Before MRI, there is a
checklist!
 No mobiles, no credit cards, please!
 Known potential safety concerns due to large static magnetic field:
 Internal cardiac pacemakers
 Steel cerebral aneurysm clips (ferromagnetic)
 Small steel slivers embedded in eye
 Life-support equipment with magnetic steel
 Cochlear implants
 Stents anywhere in the body
Types of MRI images: Magnetic resonance angiography
(MRA)
Magnetic Resonance Angiography (MRA) is a group of techniques based on
Magnetic Resonance Imaging (MRI) to image blood vessels. MRA generates
pictures of the arteries to evaluate them for stenosis (abnormal narrowing) or
aneurysms (vessel wall dilatations, at risk of rupture). A variety of techniques can
be used to generate the pictures, such as administration of a paramagnetic contrast
agent (gadolinium, Gd). Magnetic Resonance
Angiography:
Maximum intensity
projection of an MRA
covering from the top of
the heart to just below the
circle of Willis

MRA showing
the circle of
Willis in the
brain.
Spine imaging
 MR is the investigation of choice
 Conventional CT, CT myelogram and conventional myelogram are no longer
performed, unless MRI is contraindicated.
 First line of investigation in suspected spinal infection, cord compression, cauda
equina, sciatica
 Virtually everyone after the age of 40 years will have at least one degenerative
disc/end plate
fMRI
Functional Magnetic Resonance Imaging (fMRI)

 Looks at functions using oxygen uptake

 With functional magnetic resonance imaging (fMRI), is based on hemoglobin (the blood
protein that binds oxygen). The fMRI can measure the oxygen used by the brain, and the
most active brain areas use the most oxygen.
 Hemoglobin is diamagnetic when oxygenated (oxyhemoglobin) but paramagnetic when
deoxygenated (deoxyhemoglobin). The magnetic resonance (MR) signal of blood is therefore
slightly different depending on the level of oxygenation.

fMRI scan of the brain. The red areas are

the ones showing the highest level of
brain activity
Electroencephalograph
(EEG)
 Electroencephalograph (EEG)
 Electroencephalograph is used measure brain activity, electrodes
(sometimes just a few and sometimes more than a hundred) are placed on the
outside of the head. These electrodes are temporarily glued in place with glue
that is easy to remove with an alcohol wipe. These electrodes measure the
average amount of activity at any point in time for the cells that are directly
under the electrode.
 The main use is research into brain function, diagnosis
of epilepsy, sleep disorders.
 No risks (unlike CT scans for example)
 They are not as spatially accurate as fMRI
Magnetoencephalograph
(MEG)
Material to read latter-Magnetoencephalograph (MEG)

 A magnetoencephalograph (MEG) is similar to an electroencephalograph,

but it doesn’t measure electrical activity. Instead, it measures the
magnetic fields that brain activity produces naturally. MEGs are very
sensitive and can measure changes in the brain’s activity from one
millisecond to another.
Positron Emission
Tomography (PET)
PET
 Positron Emission Tomography-nuclear
medical imaging technique
 Inject short half-life radioactive
isotopes(tracers) into body, then detect gamma
rays
 PET detects the radiation emitted from
radioactive substances injected into the body
 Gamma rays given off are detected by PET
 Gamma rays are converted to photons of light,
and electrical signals
 The signals convert into slices of images
 Can show glucose metabolism in the brain,
detect cancer, detect dementia and seizures,
map brain function
Clinical Examples
Wilson’s disease

Hyperintensities due to copper deposition in the bilateral

basal ganglia and thalami shown by T2-weighted MRI of the
brain

Das SK and Ray K (2006) Wilson's disease: an update

Nat Clin Pract Neurol 2: 482–493
10.1038/ncpneuro0291
Glioblastoma multiforme (GBM)
Radiology: Glioblastoma is usually seen as a grossly heterogeneous mass. Ring enhancement
surrounding a necrotic center is the most common presentation, but there may be multiple
rings. Characterized by irregular ring-enhancement surrounding a central non-enhancing
region of necrosis. Note the shaggy inner-margin of the ring, and the remarkable variation in its
thickness. The small foci of internal enhancement represent islands of living tumor within the
regions of necrosis. Surrounding vasogenic edema can be impressive, and adds significantly to
the mass effect.
Axial Gd Enhanced T1W MRI Axial T2W MRI
Metastatic brain tumors
MRI appearance two months after whole brain radiation (small
lesions gone and large lesion much smaller)
 Multiple sclerosis (MS)
MRI imaging of the brain Gd enhanced helps diagnose MS. Typical MS white
matter lesions are bright lesions on T2-weighted image (left image), especially in
the corpus callosum and periventricular regions.
T2W sagittal
T2W axial

Axial Gd Enhanced T1W MR Axial T2W MR

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That’s all folks!
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