1. The BRAINs Orientation
Siegfried Schrei
Siemens MI Applications

2. Manual Orientation
In addition, the anterior commisure and posterior commisure are used for the horizontal orientation in the sagittal plane.
The standard orientation calls for lining up the interhemispheric fissure. This sets the alignment in the coronal and axial planes.

3. Where are the Anterior and Posterior commissure?
Positioning of Vertical AC and PC Lines

4. Where are the Anterior and Posterior commissure?
Positioning of Vertical AC and PC Lines (Spect fix distance)

5. Horizontal AC to PC line
Horizontal AC - PC Line.

6. Rotate Brain to Anterior and Posterior commissure axis
Horizontal AC - PC Line.

7. Size Alignments

8. Talairach Atlas in Neurogam

9. The mapped Brain

10. Where are the Anterior and Posterior commissure?
The perfect alignment:
Reperate right and left hemisphere
AC – PC line for correct Axial planes

11. Coregistration Modalities
MRI Image or CT images are co registered to the manually reoriented SPECT or PET image by use E.Soft Image Fusion or Syngo 3D Image registration.
Manually aligned by visual matching, surface matching or use of anatomical land marks. By far the preferable method is the fully automated alignment based on Mutual Information co registration.
When fitting is complete each MRI image is resampled to the SPECT or PET orientation and resolution (128 x 128 Matrix, ca 5 mm cubic voxels).
Point to point correspondence with any given set of coordinates referring to the same point in all of the images

12. Talairach Bounds
Define a Talairach-based atlas for the each scan individually (MRI more easy compared to SPECT)
Landmarks used
Right-most extent of the brain
Left-most extent of the brain
Anterior-most extent of the brain
Posterior-most extent of the brain
Superior-most extent of the brain
Inferior-most extent of the temporal lobe
AC and PC locations

13. Talairach Atlas Talairach atlas coordinate system
Resampled image with overlaid Talairach coordinate system

14. Talairach Bounds

15. Talairach levels of definition

16. Talairach Regions Talairach Boxes
Talairach Atlas warped onto current brain.
Various "boxes" assigned to various regions
Measure volumes of labelled brain regions
Talairach Boxes
Cyan - Frontal
Blue - Temporal
Green -Parietal
Red - Occipital
Pink - Cerebellum
Yellow - Subcortical
Gray - Brainstem

17. Talairach vs. Brodmann

18. The matched regions

19. T1 and T2 Images Tissue Classified Images

20. Cortical Surface

21. Neural Network Currently defines the following regions
Caudate
Putamen
Thalamus
Cerebellum
Cerebellar lobes (warping)
Hippocampus (requires editing)
Globus Pallidus (requires editing)
In the near future will use a warped method for all structures – more valid, less editing
Will also add nucleus accumbens and amygdala

22. Neural Network Inputs

23. Artifical Neural Networks

24. Cerebellum Lobes
Cerebellar Lobe Volumes: Uses landmark-based warp for semiautomated measurement of Lobes I through V (anterior lobe), Lobe VI and Crus I of VIIA (superior posterior lobe), Crus II of VIIA through Lobe X (inferior posterior lobe), and the central white matter and output nuclei(corpus medullare).

25. Talairach Atlas II What about the cerebellum?
Not included in Talairach Atlas
Used for automated gross regional measures
Provides a coordinate system for structure probability