A rhesus monkey reference label atlas for template driven segmentation

Background We have acquired dual‐echo spin‐echo (DE SE) MRI data of the rhesus monkey brain since 1994 as part of an ongoing study of normal aging. To analyze these legacy data for regional volume changes, we have created a reference label atlas for the Template Driven Segmentation (TDS) algorithm. Methods The atlas was manually created from DE SE legacy MRI data of one behaviorally normal, young, male rhesus monkey and consisted of 14 regions of interest (ROI’s). We analyzed the reproducibility and validity of the TDS algorithm using the atlas relative to manual segmentation. Results ROI volumes were comparable between the two segmentation methodologies, except TDS overestimated the volume of basal ganglia regions. Both methodologies were highly reproducible, but TDS had lower sensitivity and comparable specificity. Conclusions TDS segmentation calculates accurate volumes for most ROI’s. Sensitivity will be improved in future studies through the acquisition of higher quality data.     

Application of Dual Modality Contrast Agent Combined with Multi-Scale Representation in Ultrasound-Magnetic Resonance Imaging Registration Scheme

To achieve the image registration/fusion and perfect the quality of the integration, with dual modality contrast agent (DMCA), a novel multi-scale representation registration method between ultrasound imaging (US) and magnetic resonance imaging (MRI) is presented in the paper, and how DMCA influence on registration accuracy is chiefly discussed. Owing to US’s intense speckle noise, it is a tremendous challenge to register US with any other modality images. How to improve the algorithms for US processing has become the bottleneck, and in the short term it is difficult to have a breakthrough. In that case, DMCA is employed in both US and MRI to enhance the region of interest. Then, because multi-scale representation is a strategy that attempts to diminish or eliminate several possible local minima and lead to convex optimization problems to be solved quickly and more efficiently, a multi-scale representation Gaussian pyramid based affine registration (MRGP-AR) scheme is constructed to complete the US-MRI registration process. In view of the above-mentioned method, the comparison tests indicate that US-MRI registration/fusion may be a remarkable method for gaining high-quality registration image. The experiments also show that it is feasible that novel nano-materials combined with excellent algorithm are used to solve some hard tasks in medical image processing field.     

T1-weighted and T2-weighted MRI image synthesis with convolutional generative adversarial networks

BackgroundThe objective of this study was to propose an optimal input image quality for a conditional generative adversarial network (GAN) in T1-weighted and T2-weighted magnetic resonance imaging (MRI) images.Materials and methodsA total of 2,024 images scanned from 2017 to 2018 in 104 patients were used. The prediction framework of T1-weighted to T2-weighted MRI images and T2-weighted to T1-weighted MRI images were created with GAN. Two image sizes (512 × 512 and 256 × 256) and two grayscale level conversion method (simple and adaptive) were used for the input images. The images were converted from 16-bit to 8-bit by dividing with 256 levels in a simple conversion method. For the adaptive conversion method, the unused levels were eliminated in 16-bit images, which were converted to 8-bit images by dividing with the value obtained after dividing the maximum pixel value with 256.ResultsThe relative mean absolute error (rMAE ) was 0.15 for T1-weighted to T2-weighted MRI images and 0.17 for T2-weighted to T1-weighted MRI images with an adaptive conversion method, which was the smallest. Moreover, the adaptive conversion method has a smallest mean square error (rMSE) and root mean square error (rRMSE), and the largest peak signal-to-noise ratio (PSNR) and mutual information (MI). The computation time depended on the image size.ConclusionsInput resolution and image size affect the accuracy of prediction. The proposed model and approach of prediction framework can help improve the versatility and quality of multi-contrast MRI tests without the need for prolonged examinations.     

Kinetics of MRI Contrast Agents with a Size Ranging Between Gd-DTPA and Albumin-Gd-Dtpa Use of CASCADE-Gd-DTPA-24 Polymer

A unified kinetic theory describing the dynamic properties of magnetic resonance imaging (MRI) contrast agents with a size ranging between that of Gd-DTPA and albumin-(Gd-DTPA)₃₀ was developed and tested in disease models of cancer and myocardial reperfusion injury. Specifically, a two-compartment kinetic model was solved analytically, and a range of special cases of the model was studied. MRI was performed with strongly T₁-weighted sequences before and dynamically after administration of albumin-(Gd-DTPA)₃₀, a prototype macromolecular contrast medium (MMCM) designed for blood-pool enhancement; a new MMCM: Gd-DTPA-cascade polymer (Schering AG, Berlin, Germany, MW < 30 kDa); or Gd-DTPA, representing small paramagnetic extracellular agents. The greatest dynamic range of contrast-agent sensitivity to disease was found for albumin-(Gd-DTPA)₃₀.     

Quantitative Measurements in the Human Hippocampus and Related Areas: Correspondence between Ex-Vivo MRI and Histological Preparations

The decrease of volume estimates in different structures of the medial temporal lobe related to memory correlate with the decline of cognitive functions in neurodegenerative diseases. This study presents data on the association between MRI quantitative parameters of medial temporal lobe structures and their quantitative estimate in microscopic examination. Twelve control cases had ex-vivo MRI, and thereafter, the temporal lobe of both hemispheres was sectioned from the pole as far as the level of the splenium of the corpus callosum. Nissl stain was used to establish anatomical boundaries between structures in the medial temporal lobe. The study included morphometrical and stereological estimates of the amygdaloid complex, hippocampus, and temporal horn of the lateral ventricle, as well as different regions of grey and white matter in the temporal lobe. Data showed a close association between morphometric MRI images values and those based on the histological determination of boundaries. Only values in perimeter and circularity of the piamater were different. This correspondence is also revealed by the stereological study, although irregular compartments resulted in a lesser agreement. Neither age (< 65 yr and > 65yr) nor hemisphere had any effect. Our results indicate that ex-vivo MRI is highly associated with quantitative information gathered by histological examination, and these data could be used as structural MRI biomarker in neurodegenerative diseases.     

Histogram Analysis of Gadoxetic Acid-Enhanced MRI for Quantitative Hepatic Fibrosis Measurement

Purpose

The diagnosis and monitoring of liver fibrosis is an important clinical issue; however, this is usually achieved by invasive methods such as biopsy. We aimed to determine whether histogram analysis of hepatobiliary phase images of gadoxetic acid-enhanced magnetic resonance imaging (MRI) can provide non-invasive quantitative measurement of liver fibrosis.

Methods

This retrospective study was approved by the institutional ethics committee, and a waiver of informed consent was obtained. Hepatobiliary phase images of preoperative gadoxetic acid-enhanced MRI studies of 105 patients (69 males, 36 females; age 56.1±12.2) with pathologically documented liver fibrosis grades were analyzed. Fibrosis staging was F0/F1/F2/F3/F4 (METAVIR system) for 11/20/13/15/46 patients, respectively. Four regions-of-interest (ROI, each about 2 cm²) were placed on predetermined locations of representative images. The measured signal intensity of pixels in each ROI was used to calculate corrected coefficient of variation (cCV), skewness, and kurtosis. An average value of each parameter was calculated for comparison. Statistical analysis was performed by ANOVA, receiver operating characteristic (ROC) curve analysis, and linear regression.

Results

The cCV showed statistically significant differences among pathological fibrosis grades (P<0.001) whereas skewness and kurtosis did not. Univariable linear regression analysis suggested cCV to be a meaningful parameter in predicting the fibrosis grade (P<0.001, β = 0.40 and standard error  = 0.06). For discriminating F0-3 from F4, the area under ROC score was 0.857, standard deviation 0.036, 95% confidence interval 0.785–0.928.

Conclusion

Histogram analysis of hepatobiliary phase images of gadoxetic acid-enhanced MRI can provide non-invasive quantitative measurements of hepatic fibrosis.     

Optical effects on the surrounding structure during quantitative analysis using indocyanine green videoangiography: A phantom vessel study

Various reports have been published regarding quantitative evaluations of intraoperative fluorescent intensity studies using indocyanine green (ICG) with videoangiography (VAG). The effects of scattering and point‐spread functions (PSF) on quantitative ICG‐VAG evaluations have not been investigated. Clinically, when ICG is administered through the peripheral vein, it reaches the tissue intra‐arterially. To achieve more reliable intraoperative quantitative intensity evaluations, we examined the impact of high‐intensity structures on close areas. The study was conducted using a phantom model and surgical fluorescent microscope. A region of interest (ROI) was created for the vessel model and another ROI was created within 3 cm of that. With an ROI of 6.8 mm in the vessel phantom model, 10% intensity was confirmed, even though there was no fluorescent structure. Intensity decreased gradually as the ROI moved further from the vessel model. Our study results suggest that the presence of a high‐intensity structure and the size of the ROI may affect quantitative intensity evaluations using ICG‐VAG. Results of linear regression analysis indicate that the relationship of intensity (Y) and distance (X) is as follows: Y(real/A) = 29 Exp(?0.062X) + 164.3 Exp(?1.81X). The optical effect should be considered when performing an intraoperative intensity study with a surgical microscope.      

磁共振波谱成像结合扩散加权成像在脑胶质瘤及脑转移瘤鉴别诊断中的意义

目的:评估磁共振波谱成像(Proton Magnetic Resonance Spectroscopy,1H-MRS)联合磁共振扩散加权成像(Diffusion Weighted Imaging,DWI)在鉴别脑胶质瘤及孤立的脑转移瘤中的作用。方法:应用3.0T磁共振扫描仪,对临床手术确诊及组织病理学诊断证实的49例脑肿瘤患者(35例多形性胶质母细胞瘤,14例脑转移瘤)进行常规磁共振成像、磁共振波谱成像及磁共振扩散加权成像,并并对获得的数据进一步测量瘤内及瘤周区的代谢比、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)值以及表观弥散系数(ADC值),分析两肿瘤组之间不同参数的统计学差异。此外,我们研究了感兴趣区域(ROI)的大小对肿瘤区域的病变扩散性能潜在影响。结果:胶质母细胞瘤瘤周N-乙酰天门冬氨酸(NAA)、肌酸(Cr),胆碱(Cho)/Cr,Cho/NAA和r CBV显著高于颅内转移瘤(P0.05);ADC值在两肿瘤组之间无显著差异(P0.05)。结论:在瘤周区1H-MRS有助于鉴别胶质母细胞瘤与单发的脑转移瘤。在瘤内扩散性的定量特性依赖ROI大小的设置。     

Effects of MRI image normalization techniques in prostate cancer radiomics

The variance in intensities of MRI scans is a fundamental impediment for quantitative MRI analysis. Intensity values are not only highly dependent on acquisition parameters, but also on the subject and body region being scanned. This warrants the need for image normalization techniques to ensure that intensity values are consistent within tissues across different subjects and visits. Many intensity normalization methods have been developed and proven successful for the analysis of brain pathologies, but evaluation of these methods for images of the prostate region is lagging.In this paper, we compare four different normalization methods on 49 T2-w scans of prostate cancer patients: 1) the well-established histogram normalization, 2) the generalized scale normalization, 3) an extension of generalized scale normalization called generalized ball-scale normalization, and 4) a custom normalization based on healthy prostate tissue intensities. The methods are compared qualitatively and quantitatively in terms of behaviors of intensity distributions as well as impact on radiomic features.Our findings suggest that normalization based on prior knowledge of the healthy prostate tissue intensities may be the most effective way of acquiring the desired properties of normalized images. In addition, the histogram normalization method outperform the generalized scale and generalized ball-scale methods which have proven superior for other body regions.     

恒河猴正常子宫及妊娠后期胎儿的MRI研究

目的研究恒河猴正常子宫及妊娠后期胎儿的MRI表现。方法对3只未妊娠和3只妊娠135d的恒河猴分别进行磁共振成像（MRI）扫描,观察子宫及胎儿的影像学特点。结果未妊娠恒河猴的子宫T1WI冠状位呈椭圆形,子宫体各层呈中等信号,矢状位呈葫芦形。在T2WI上,冠状位显示宫体可见2～3层不同的信号带,在矢状位子宫体肌层的信号高于子宫颈,信号的移行区是体颈的交界处。妊娠恒河猴的子宫肌层变薄,胎盘及胎儿的脑、脊柱、肝、肺等结构显示清楚。结论MRI能很好地显示恒河猴子宫的形态、胎儿各部分的结构。对人畸形胎儿的产前诊断有一定的参考价值。     

Development of a dynamic imaging method for gravitropism in pea sprouts using clinical magnetic resonance imaging system

Although magnetic resonance imaging (MRI) is a useful technique, only a few studies have investigated the dynamic behavior of small subjects using MRI owing to constraints such as experimental space and signal amount. In this study, to acquire high-resolution continuous three-dimensional gravitropism data of pea (Pisum sativum) sprouts, we developed a small-bore MRI signal receiver coil that can be used in a clinical MRI and adjusted the imaging sequence. It was expected that such an arrangement would improve signal sensitivity and improve the signal-to-noise ratio (SNR) of the acquired image. All MRI experiments were performed using a 3.0-T clinical MRI scanner. An SNR comparison using an agarose gel phantom to confirm the improved performance of the small-bore receiver coil and an imaging experiment of pea sprouts exhibiting gravitropism were performed. The SNRs of the images acquired with a standard 32-channel head coil and the new small-bore receiver coil were 5.23±0.90 and 57.75±12.53, respectively. The SNR of the images recorded using the new coil was approximately 11-fold higher than that of the standard coil. In addition, when the accuracy of MR imaging that captures the movement of pea sprout was verified, the difference in position information from the optical image was found to be small and could be used for measurements. These results of this study enable the application of a clinical MRI system for dynamic plant MRI. We believe that this study is a significant first step in the development of plant MRI technique.     

MRI and PET in Mouse Models of Myocardial Infarction

Myocardial infarction is one of the leading causes of death in the Western world. The similarity of the mouse heart to the human heart has made it an ideal model for testing novel therapeutic strategies.In vivo magnetic resonance imaging (MRI) gives excellent views of the heart noninvasively with clear anatomical detail, which can be used for accurate functional assessment. Contrast agents can provide basic measures of tissue viability but these are nonspecific. Positron emission tomography (PET) is a complementary technique that is highly specific for molecular imaging, but lacks the anatomical detail of MRI. Used together, these techniques offer a sensitive, specific and quantitative tool for the assessment of the heart in disease and recovery following treatment.In this paper we explain how these methods are carried out in mouse models of acute myocardial infarction. The procedures described here were designed for the assessment of putative protective drug treatments. We used MRI to measure systolic function and infarct size with late gadolinium enhancement, and PET with fluorodeoxyglucose (FDG) to assess metabolic function in the infarcted region. The paper focuses on practical aspects such as slice planning, accurate gating, drug delivery, segmentation of images, and multimodal coregistration. The methods presented here achieve good repeatability and accuracy maintaining a high throughput.     

A Modified DWT-SVD Algorithm for T1-w Brain MR Images Contrast Enhancement

BackgroundImage contrast enhancement is considered as the most useful technique permitting a better appearance of the low contrast images. This paper presents a modified Discret Wavelet Transform - Singular Value Decomposition (DWT-SVD) approach for the enhancement of low contrast Brain MR Images used for brain tissues exploration.MethodsThe proposed technique is processed as follows: first of all, we consider low contrast T1-weighted MRI slices as input images (A1) on which we apply General Histogram Equalization (GHE) algorithm to have equalized images referred as (A2) having zero as mean and one as variance. Secondly, by using the Discrete Wavelet Transform (DWT) algorithm, both (A1) and (A2) are divided into low and high frequency sub-bands. On the low frequency (LL1) and (LL2) sub-bands, SVD is processed in order to generate three matrix factorization (U, V and Σ) where the maximums of (U) and (V) matrix are used for the estimation of a correction coefficient (ξ). Our contribution in this paper is to estimate the new singular value matrix (New Σ) using a weighted sum of both original and equalized singular value matrix thanks to an adjustable parameter (μ) for the targeted low contrast images. This parameter, ranged between 0.05 and 0.95, is determined empirically according to the input low contrast image. Finally, the enhanced resulting image is easily reconstructed using the Inverse SVD (ISVD) and the Inverse DWT (IDWT) processes.ResultsThe database considered in our research consisted of 120 MR brain images where T1-weighted MR brain modality are selected for the contrast enhancement process. Considering the qualitative results, our proposed contrast enhancement method have shown better distinction between brain tissues and have preserved all White Matter (WM), Gray Matter (GM) and Cerebro-Spinal Fluid (CSF) pixel edges. In fact, histogram plots of images enhanced by proposed method covered all the gray level intensities. For the quantitative results, proposed method gives the highest PSNR, QRCM, SSIM, FSIM and EME values and the lowest AMBE values for (μ) equal to 0.65 as comparing to the rest of methods. These results signifies that proposed contrast enhancement method have provided greater image quality with preservation of image structure, feature and brightness.ConclusionProposed method improved performance of contrast enhancement image without creating unwanted artifact and without destroying image edge information or affecting the specificities of brain tissues. This is due to the use of an empirically (μ) parameter adjustable according to the input MR images. Hence, the proposed approach is appropriate for enhancing contrast of huge type of low contrast images.     

Predicting Therapeutic Efficacy of Vascular Disrupting Agent CA4P in Rats with Liver Tumors by Hepatobiliary Contrast Agent Mn-DPDP-Enhanced MRI

To evaluate hepatobiliary-specific contrast agent (CA) mangafodipir trisodium (Mn-DPDP)–enhanced magnetic resonance imaging (MRI) for predicting the therapeutic efficacy of the vascular disrupting agent combretastatin A4 phosphate (CA4P) in rats with primary and secondary liver tumors, 36 primary hepatocellular carcinomas (HCCs) were raised by diethylnitrosamine gavage in 16 male rats, in 6 of which one rhabdomyosarcomas (R1) was intrahepatically implanted as secondary liver tumors. On a 3.0T MR scanner with a wrist coil, tumors were monitored weekly by T2-/T1-weighted images (T2WI/T1WI) and characterized by Mn-DPDP-enhanced MRI. CA4P-induced intratumoral necrosis was depicted by nonspecific gadoterate meglumine (Gd-DOTA)–enhanced MRI before and 12 h after therapy. Changes of tumor-to-liver contrast (ΔT/L) on Mn-DPDP-enhanced images were analyzed. In vivo MRI findings were verified by postmortem microangiography and histopathology. Rat models of primary HCCs in a full spectrum of differentiation and secondary R1 liver tumors were successfully generated. Mn-DPDP-enhanced ΔT/L was negatively correlated with HCC differentiation grade (P < 0.01). After treatment with CA4P, more extensive tumoral necrosis was found in highly differentiated HCCs than that in moderately and poorly differentiated ones (P < 0.01); nearly complete necrosis was induced in secondary liver tumors. Mn-DPDP-enhanced MRI may help in imaging diagnosis of primary and secondary liver malignancies of different cellular differentiations and further in predicting CA4P therapeutic efficacy in primary HCCs and intrahepatic metastases.     

MRI在喉癌术前分期中的临床应用价值

目的:探讨MRI在喉癌术前诊断、分期中的临床应用价值。方法:对114例行电子喉镜检查并经病理学证实为喉癌的患者行术前MRI扫描,根据图像资料判断肿瘤侵及范围及判断有无淋巴结转移;同时进行术前分期、分型,并与术后病理分期、分型对照研究。结果:术前MRI T1期27例,其中25例经病理证实为T1期,2例为T2期,准确率为92.6%;术前MRI T2期39例,其中经病理证实35例为T2期,3例T1期,1例T3期,准确率为89.7%;术前MRI T3期29例,其中经病理证实25例为T3期,4例T2期,准确率为86.2%;术前MRI T4期17例,其中经病理证实15例为T4期,2例T3期,准确率为88.2%;MRI术前T分期总准确率为87.7%。N1期准确率为81.8%,N2期准确率为94.1%。结论:MRI图像能很好地显示喉癌肿块的侵及范围及淋巴结转移等,对喉癌的术前分期、分型及制定合理的手术方案具有指导意义。     

TEP-TDM au FNa et IRM avec séquences de diffusion dans la détection des métastases osseuses : étude comparative prospective par lésion

IntroductionThe development of technologies aimed to detect bone metastases in nuclear medicine and radiology prompts us to compare their performance in their most effective form: positron emission tomography (PET) with NaF combined with computed tomography (CT) and magnetic resonance imaging (MRI) using anatomical and diffusion weighted sequences (T1-STIR, and DWI MRI), as well as to study several factors involved in the visualization of these lesions (anatomo-functional correlation, nature, size and localization).Materials and methodsThirteen patients underwent NaF PET-CT and T1-STIR-DWI MRI in a prospective study. One hundred and sixty-four lesions were found. For each, a malignancy score of 1 to 5 was assigned. Expert consensus and follow-up data for each patient, available in their medical records, determined the final diagnosis as gold standard.ResultsThe sensitivities, specificities, precision and AUC of the lesion-based analysis were respectively 78.3%, 93.8%, 89.3% and 0.85 for NaF PET-CT and 60.9%, 97.4%, 86.7% and 0.81 for T1-STIR-DWI MRI. Results were independent on the nature, size or location of the metastases. A significant change in AUC when CT was combined with PET, and when DWI was combined with T1-STIR was found for one of the two observers in both fields.ConclusionThe performance of PET-CT at NaF and T1-STIR-DWI MRI appeared equivalent. The combination of functional and morphological images is beneficial in both fields (nuclear and magnetic resonance) but its contribution varies depending on the observer.     

MRI 在脊柱骨巨细胞瘤诊疗中的临床意义

目的:探讨MRI在脊柱骨巨细胞瘤诊疗中的临床应用价值。方法:回顾性分析2005年4月-2010年11月我院5例经病理证实为脊柱骨巨细胞瘤患者的MRI检查表现。结果:椎体内病灶呈不同程度膨胀性破坏,T1WI呈等、低信号改变,T2WI呈混杂信号,增强扫描呈不同程度均匀强化。结论:MRI能有效显示骨巨细胞瘤的病变部位及范围,。     

High-resolution Structural Magnetic Resonance Imaging of the Human Subcortex In Vivo and Postmortem

The focus of this study was to test the resolution limits of structural MRI of a postmortem brain compared to living human brains. The resolution of structural MRI in vivo is ultimately limited by physiological noise, including pulsation, respiration and head movement. Although imaging hardware continues to improve, it is still difficult to resolve structures on the millimeter scale. For example, the primary visual sensory pathways synapse at the lateral geniculate nucleus (LGN), a visual relay and control nucleus in the thalamus that normally is organized into six interleaved monocular layers. Neuroimaging studies have not been able to reliably distinguish these layers due their small size that are less than 1 mm thick.The resolving limit of structural MRI, in a postmortem brain was tested using multiple images averaged over a long duration (~24 h). The purpose was to test whether it was possible to resolve the individual layers of the LGN in the absence of physiological noise. A proton density (PD)¹ weighted pulse sequence was used with varying resolution and other parameters to determine the minimum number of images necessary to be registered and averaged to reliably distinguish the LGN and other subcortical regions. The results were also compared to images acquired in living human brains. In vivo subjects were scanned in order to determine the additional effects of physiological noise on the minimum number of PD scans needed to differentiate subcortical structures, useful in clinical applications.     

MRI-guided dissection of the nonhuman primate brain: A case study

Numerous biochemical as well as electrophysiological techniques require tissue that must be retrieved very quickly following death in order to preserve the physiological integrity of the neuronal environment. Therefore, the ability to accurately predict the precise locations of brain regions of interest (ROI) and to retrieve those areas as quickly as possible following the brain harvest is critical for subsequent analyses. One way to achieve this objective is the utilization of high-resolution MRI to guide the subsequent dissections. In the present study, individual MRI images of the brains of rhesus and cynomolgus macaques that had chronically self-administered ethanol were employed in order to determine which blocks of dissected tissue contained specific ROIs. MRI-guided brain dissection of discrete brain regions was completely accurate in 100% of the cases. In comparison, approximately 60–70% accuracy was achieved in dissections that relied on external landmarks alone without the aid of MRI. These results clearly demonstrate that the accuracy of targeting specific brain areas can be improved with high-resolution MR imaging.     

Regional peak plantar pressures are highly sensitive to region boundary definitions

Traditional pedobarographic analyses subsample pressure data over a number of discrete anatomical regions of interest (ROIs). To our knowledge, the sensitivity of these data to ROI boundary definitions has not been previously addressed. Eight subjects each performed 20 trials of self-paced walking; commercial software was used to define 10 ROIs for each of the 160 total peak pressure images, and regional peak pressures (RPPs) were extracted for each image (total: 1600 values). We then asked three specific questions regarding RPP sensitivity to ROI boundary definition: (1) Is the ROI centroid representative of the RPP location? (2) How frequently do RPPs lie on the ROI boundary? and (3) By how much do RPP values change if the ROI boundary is changed by one pixel (resolution: 5.08×7.62 mm)? We found that the RPP locations differed from the ROI centroid in 80% of the cases and that the RPPs lay on the ROI boundary with a probability of 65%. We also found that a single-pixel change in the ROI boundary caused a mean RPP change of 10.8%. The most sensitive region was the midfoot for which a single-pixel ROI change yielded a median 29.4% change in RPP. These results indicate that RPP data are biased by regionalization schemes, which delineate pressure fields based on anatomy rather than on the field's geometric properties, and ultimately that regionalization may constitute a poor method of quantifying complex pressure fields. RPP sensitivity should be considered when making statistical inferences regarding foot function.