Fractional Anisotropy Color Research Articles

Deep learning-based parameter estimation in fetal diffusion-weighted MRI

Diffusion-weighted magnetic resonance imaging (DW-MRI) of fetal brain is challenged by frequent fetal motion and signal to noise ratio that is much lower than non-fetal imaging. As a result, accurate and robust parameter estimation in fetal DW-MRI remains an open problem. Recently, deep learning techniques have been successfully used for DW-MRI parameter estimation in non-fetal subjects. However, none of those prior works has addressed the fetal brain because obtaining reliable fetal training data is challenging. To address this problem, in this work we propose a novel methodology that utilizes fetal scans as well as scans from prematurely-born infants. High-quality newborn scans are used to estimate accurate maps of the parameter of interest. These parameter maps are then used to generate DW-MRI data that match the measurement scheme and noise distribution that are characteristic of fetal data. In order to demonstrate the effectiveness and reliability of the proposed data generation pipeline, we used the generated data to train a convolutional neural network (CNN) to estimate color fractional anisotropy (CFA). We evaluated the trained CNN on independent sets of fetal data in terms of reconstruction accuracy, precision, and expert assessment of reconstruction quality. Results showed significantly lower reconstruction error (n=100,p<0.001) and higher reconstruction precision (n=20,p<0.001) for the proposed machine learning pipeline compared with standard estimation methods. Expert assessments on 20 fetal test scans showed significantly better overall reconstruction quality (p<0.001) and more accurate reconstruction of 11 regions of interest (p<0.001) with the proposed method.

The splenial angle: a novel radiological index for idiopathic normal pressure hydrocephalus

ObjectivesTo evaluate the utility of the splenial angle (SA), an axial angular index of lateral ventriculomegaly measured on diffusion tensor MRI color fractional anisotropy maps, in differentiating NPH from Alzheimer’s disease (AD), Parkinson’s disease (PD), and healthy controls (HC), and post-shunt changes in NPH, compared to Evans’ index and callosal angle.MethodsEvans’ index, callosal angle, and SA were measured on brain MRI of 76 subjects comprising equal numbers of age- and sex-matched subjects from each cohort of NPH, AD, PD, and HC by two raters. Receiver operating characteristics (ROC) and multivariable analysis were used to assess the screening performance of each measure in differentiating and predicting NPH from non-NPH groups respectively. Temporal changes in the measures on 1-year follow-up MRI in 11 NPH patients (with or without ventriculoperitoneal shunting) were also assessed.ResultsInter-rater and intra-rater reliability were excellent for all measurements (intraclass correlation coefficients > 0.9). Pairwise comparison showed that SA was statistically different between NPH and AD/PD/HC subjects (p < 0.0001). SA performed the best in predicting NPH, with an area under the ROC curve of > 0.98, and was the only measure left in the final model of the multivariable analysis. Significant (p < 0.01) change in SA was seen at follow-up MRI of NPH patients who were shunted compared to those who were not.ConclusionsThe SA is readily measured on axial DTI color FA maps compared to the callosal angle and shows superior performance differentiating NPH from neurodegenerative disorders and sensitivity to ventricular changes in NPH after surgical intervention.Key Points• The splenial angle is a novel simple angular radiological index proposed for idiopathic normal pressure hydrocephalus, measured in the ubiquitous axial plane on DTI color fractional anisotropy maps.• The splenial angle quantitates the compression and stretching of the posterior callosal commissural fibers alongside the distended lateral ventricles in idiopathic normal pressure hydrocephalus (NPH) using tools readily accessible in clinical practice and shows excellent test-retest reliability.• Splenial angle outperforms Evans’ index and callosal angle in predicting NPH from healthy, Parkinson’s disease, and Alzheimer’s disease subjects on ROC analysis with an area under the curve of > 0.98 and is sensitive to morphological ventricular changes in NPH patients after ventricular shunting.

Injury of Corticospinal tract and Corticoreticular pathway caused by high-voltage electrical shock: a case report

BackgroundWe imaged the corticospinal tract (CST) and corticoreticular pathway (CRP) using diffusion tensor tractography (DTT) to evaluate the cause of muscle weakness in a patient who was exposed to high-voltage electricity.Case presentationA 39-year-old man presented with quadriparesis after high-voltage electrical shock from power lines while working about 5.8 years ago. The electrical current entered through the left hand and exited through the occipital area of the head. The degree of weakness on bilateral upper and lower extremities was 3–4 on the Medical Research Council strength scale. Diffusion tensor imaging (DTI) was performed 5.8 years after onset. The CST and CRP were depicted by placing two regions of interest for each neural tract on the two-dimensional fractional anisotropy color map. DTT of the DTI scan showed that the bilateral CST and CRP were thinned compared to those of the healthy control subject. On the nerve conduction test, abnormal findings suggesting peripheral nerve lesion were not observed. Therefore, injury of bilateral CST and CRP seems to have contributed to our patient’s weakness after the electrical shock.ConclusionDepiction of neural tracts in the brain using DTT can assist in the accurate and detailed evaluation of the cause of neural deficit after electrical injury.

Diffusion tensor imaging parameters in differentiation recurrent breast cancer from post-operative changes in patients with breast-conserving surgery

Aim of the workTo investigate mean diffusivity (MD) and fractional anisotropy (FA) measured by diffusion tensor imaging (DTI) as complementary tools to differentiate recurrent breast cancer from post-operative changes in patients with breast-conserving surgery (BCS). Patients and MethodsProspective study was conducted upon 30 patients with BCS that underwent DTI and dynamic contrast MR imaging. DTI was performed using an axial two-dimensional spin-echo echo-planar imaging sequence. The MD and FA of the lesions were calculated by 2 observers. A single pixel seed isotropic region of interest was placed in the solid part of the tumor on the axial color FA map guided by an enhanced part of the tumor. The final diagnosis was done by biopsy for all patients. ResultsThe pathological examination proved to be recurrent breast cancer (n = 13) and post-operative changes (n = 17). Recurrent breast cancer had significantly lower MD (P = 0.001, 0.001) and higher FA (P = 0.003, 0.02) than in post-operative changes for both observers respectively. At ROC curve analysis of MD, the AUC was 0.86 and 0.85 by both observers. The threshed MD was (0.86, 0.85 × 10−3 mm2/s) used for differentiation between entities revealed sensitivity (76.9%, 92.3%), specificity (82.4%, 64.7%) and accuracy (80%, 76.7%) of both observers respectively. At ROC curve analysis of FA, the AUC was 0.82 and 0.75 by both observers. The threshold FA (0.82, 0.75) was used for differentiation between entities revealed sensitivity (92.3%, 76.9%), specificity (70.6%, 70.6%) and accuracy of (80.0%, 73.3%) of both observers respectively. There was a strong positive correlation of MD (r = 0.86) and FA (r = 0.73) of both observers. Combined analysis of FA and MD used for differentiation between entities had AUC (0.90, 0.88) revealed sensitivity (92.3%, 92.3%), specificity (82.4%, 70.6%) and accuracy of (86.7%, 80.0%) for both observers respectively. ConclusionsCombined analysis of MD and FA of DTI may play an important role as a non-invasive method for differentiation recurrent breast cancer from post-operative changes in patients with BCS.

Gastric carcinoma: Evaluation with diffusion-tensor MR imaging and tractography ex vivo

PurposeTo determine the feasibility of diffusion-tensor imaging (DTI) and tractography as means of evaluating the depth of mural invasion by gastric carcinomas. Materials and methodsThis study was approved by our institutional review board, and written informed consent was obtained from each patient. Twenty gastric specimens containing a carcinoma were studied with a 7.0-T MR imaging system equipped with a four-channel phased-array surface coil. DTI was performed by using a field of view of 50–60mm×25–30mm, matrix of 256×128, section thickness of 1mm, b value of 1000s/mm2, and motion-probing gradients in seven noncollinear directions. The MR images were compared with the histopathologic findings as the reference standard. ResultsIn all 20 carcinomas (100%) the diffusion-weighted images, apparent diffusion coefficient (ADC) maps, fractional anisotropy (FA) maps, λ1 maps, and direction-encoded color FA maps made it possible to identify the same depth of tumor invasion of the gastric wall as observed during histopathologic examination. The λ1 maps provided the best contrast between the carcinomas and the layers of the gastric wall. The carcinomas also had lower ADC values and lower FA values than the normal gastric wall; thus, the carcinomas were clearly demarcated from the normal gastric wall. Tractography images were also useful for determining the depth of tumor invasion of the gastric wall. ConclusionsDTI and tractography are feasible means of evaluating gastric specimens and provide excellent diagnostic accuracy for evaluating mural invasion by gastric carcinomas.

Esophageal Carcinoma: Ex Vivo Evaluation with Diffusion-Tensor MR Imaging and Tractography at 7 T

To determine the feasibility of diffusion-tensor magnetic resonance (MR) imaging and tractography as a means of evaluating the depth of mural invasion by esophageal carcinomas. This study was approved by the institutional review board, and written informed consent was obtained from each patient. Twenty esophageal specimens, each containing a carcinoma, were studied with a 7.0-T MR imaging system equipped with a four-channel phased-array surface coil. Diffusion-tensor MR images were obtained with a field of view of 50-60 mm × 25-30 mm, matrix of 256 × 128, section thickness of 1 mm, b value of 1000 sec/mm(2), and motion-probing gradient in seven noncollinear directions. The MR images were compared with the histopathologic findings as the reference standard. The differences in diffusion-tensor MR imaging parameters between the carcinoma and the layers of the esophageal wall were statistically analyzed by using the Dunnett test. In all 20 carcinomas (100%), the diffusion-weighted images, apparent diffusion coefficient (ADC) maps, fractional anisotropy (FA) maps, λ1 maps, and direction-encoded color FA maps made it possible to determine the depth of tumor invasion of the esophageal wall that was observed during histopathologic examination. The λ1 maps showed the best contrast between the carcinomas and the layers of the esophageal wall. The carcinomas had both lower ADC values and lower FA values than the normal esophageal wall; thus, the carcinomas were clearly demarcated from the normal esophageal wall. Diffusion-tensor tractography images were also useful for determining the depth of tumor invasion of the esophageal wall. Diffusion-tensor MR imaging and tractography are feasible in esophageal specimens and provide excellent morphologic data for the evaluation of mural invasion by esophageal carcinomas.

Diffusion-tensor MRI and tractography of the esophageal wall ex vivo.

To demonstrate the feasibility of diffusion-tensor magnetic resonance imaging (MRI) and tractography as a means of evaluating the individual layers of the normal esophageal wall by using esophageal specimens containing carcinoma. Twelve esophageal specimens each containing a carcinoma that were preserved in formalin were studied with a 7.0-T small-bore MR system equipped with a four-channel phased-array surface coil. Diffusion-tensor MR images were obtained with a field of view of 50-60 × 25-30 mm, matrix of 256 × 128, section thickness of 1 mm, b value of 1000 sec/mm(2) , and motion-probing gradient in seven noncollinear directions. The diffusion-weighted images, apparent diffusion coefficient (ADC) maps, fractional anisotropy (FA) maps, direction-encoded color FA maps, and tractographic images in the 12 esophageal specimens were compared with the histopathologic findings, which served as the gold standard. The diffusion-weighted images, ADC maps, FA maps, and direction-encoded color FA maps depicted the normal esophageal wall in all 12 specimens (100%) as consisting of eight layers, which clearly corresponded to the tissue layers of the esophageal wall. The ADC, FA, λ1 , λ2 , and λ3 values of each layer of the normal esophageal wall were significantly different from the corresponding values of the adjacent layer or layers of the esophageal wall. Diffusion-tensor tractographic images were able to selectively display the layers of the normal esophageal wall. By looking at the normal part of esophageal specimens containing carcinoma, we have demonstrated that diffusion-tensor MRI and tractography are capable of depicting the individual tissue layers of the normal esophageal wall.

Visualization of mouse barrel cortex using ex-vivo track density imaging

We describe the visualization of the barrel cortex of the primary somatosensory area (S1) of ex vivo adult mouse brain with short-tracks track density imaging (stTDI). stTDI produced much higher definition of barrel structures than conventional fractional anisotropy (FA), directionally-encoded color FA maps, spin-echo T1- and T2-weighted imaging and gradient echo T1/T2*-weighted imaging. 3D high angular resolution diffusion imaging (HARDI) data were acquired at 48micron isotropic resolution for a (3mm)3 block of cortex containing the barrel field and reconstructed using stTDI at 10micron isotropic resolution. HARDI data were also acquired at 100micron isotropic resolution to image the whole brain and reconstructed using stTDI at 20micron isotropic resolution. The 10micron resolution stTDI maps showed exceptionally clear delineation of barrel structures. Individual barrels could also be distinguished in the 20micron stTDI maps but the septa separating the individual barrels appeared thicker compared to the 10micron maps, indicating that the ability of stTDI to produce high quality structural delineation is dependent upon acquisition resolution. Close homology was observed between the barrel structure delineated using stTDI and reconstructed histological data from the same samples. stTDI also detects barrel deletions in the posterior medial barrel sub-field in mice with infraorbital nerve cuts. The results demonstrate that stTDI is a novel imaging technique that enables three-dimensional characterization of complex structures such as the barrels in S1 and provides an important complementary non-invasive imaging tool for studying synaptic connectivity, development and plasticity of the sensory system.

Abstract TP290: Glyburide Reduces Cytotoxic Edema within the Cerebral Peduncles in Acute Ischemic Stroke

Introduction: Diffusion tensor imaging (DTI) measurements of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) within the cerebral peduncle (CP) and corticospinal tract (CST) correlate with functional outcomes in ischemic stroke. We evaluated the utility of FA and ADC as quantitative biomarkers of cytotoxic edema in acute stroke subjects treated with intravenous glyburide (RP-1127), which may prevent brain swelling after ischemia. Methods: Nine acute hemispheric stroke subjects enrolled in the Glyburide Advantage in Malignant Edema and Stroke (GAMES) Pilot study were compared to a cohort of seven stroke patients not treated with RP-1127. GAMES subjects received an intravenous bolus of RP-1127 within 10 hours of symptom onset, followed by an intravenous drip for 72 hours. The cohorts were matched for admission NIHSS score, infarct volume, and time from infarct to DTI data acquisition. CPs were manually traced on color FA maps and used as seed regions to identify CST fiber tracts using deterministic, streamline tractography. Ipsilesional FA and ADC values were normalized to contralesional values, yielding four quantitative metrics: CP FA ratio, CP ADC ratio, CST FA ratio, and CST ADC ratio. Results: Median NIHSS score was 19 in both cohorts. Mean time to DTI data acquisition was 2.5 ± 0.4 and 2.4 ± 0.6 days, and mean infarct volume was 170 ± 49 and 188 ± 13 cc in the GAMES and control cohorts, respectively. CP ADC ratios were significantly higher in patients treated with RP-1127 compared to the control cohort (1.05 vs. 0.98, p=0.045). No difference between the GAMES and control cohorts was observed for the CP FA ratio (1.02 vs. 0.98, p=0.30), CST FA ratio (1.0 vs. 0.99, p=0.78), or CST ADC ratio (0.92 vs. 0.93, p=0.75). Conclusions: CP ADC ratio may provide a quantitative imaging biomarker of response to RP-1127 in acute stroke. Higher CP ADC ratios reflect a reduction of cytotoxic edema within CST axons at the level of the CP, consistent with RP-1127’s proposed mechanism of preventing cellular edema.

3D isotropic high‐resolution diffusion‐weighted MRI of the whole brain with a motion‐corrected steady‐state free precession sequence

The main obstacle to high-resolution (<1.5 mm isotropic) 3D diffusion-weighted MRI is the differential motion-induced phase error from shot-to-shot. In this work, the phase error is addressed with a hybrid 3D navigator approach that corrects motion-induced phase in two ways. In the first, rigid-body motion is corrected for every shot. In the second, repeatable nonrigid-body pulsation is corrected for each portion of the cardiac cycle. These phase error corrections were implemented with a 3D diffusion-weighted steady- state free precession pulse sequence and were shown to mitigate signal dropouts caused by shot-to-shot phase inconsistencies compared to a standard gridding reconstruction in healthy volunteers. The proposed approach resulted in diffusion contrast more similar to the contrast observed in the reference echo-planer imaging scans than reconstruction of the same data without correction. Fractional anisotropy and Color fractional anisotropy maps generated with phase-corrected data were also shown to be more similar to echo-planer imaging reference scans than those generated without phase correction.

Diffusion Tensor Imaging and Colored Fractional Anisotropy Mapping of the Ventralis Intermedius Nucleus of the Thalamus

The ventralis intermedius (VIM) nucleus of the thalamus is the primary surgical target for treatment of tremor. Most centers rely on indirect targeting based on atlas-defined coordinates rather than patient-specific anatomy, making intraoperative physiological mapping critical. Detailed identification of this target based on patient-specific anatomic features can help optimize the surgical treatment of tremor. To study colored fractional anisotropic images and diffusion tensor imaging (DTI) tractography to identify characteristic magnetic resonance appearances of the VIM nucleus. Four patients undergoing stereotactic surgery for essential tremor (ET) were retrospectively studied with analysis of magnetic resonance imaging-based colored fractional anisotropy (FA) images and fiber tractography. All were scanned with a 1.5-T magnetic resonance imaging unit, and all sequences were obtained before frame placement. Because the goal of this study was to identify the DTI characteristics of physiologically defined VIM nucleus, we selected and studied patients who had undergone DTI and had efficacious tremor control with intraoperative microlesioning effect and tremor reduction with less than 2.0-V stimulation. Analysis of color FA maps, which graphically illustrate fiber directionality, revealed consistent anatomic patterns. The region of the VIM nucleus can be seen as an intermediate region where there is a characteristic transition of color. Presumptive VIM nucleus interconnectivity with sensorimotor cortex and cerebellum was identified via the internal capsule and the superior cerebellar peduncle, respectively. FA maps could also be used to distinguish segments of gray matter, white matter, and gray-white matter boundaries. Analysis of DTI and FA maps on widely available 1.5-T magnetic resonance imaging yields clear identification of various structures key to neurosurgical targeting. Prospective evaluation of integrating DTI into neurosurgical planning may be warranted.

The relation between fornix injury and memory impairment in patients with diffuse axonal injury: A diffusion tensor imaging study

Little is known about the relation between fornix injury and memory impairment in diffuse axonal injury (DAI). In the current study, we attempted to investigate fornix injury in patients with memory impairment following DAI, using diffusion tensor imaging (DTI). Nine patients with DAI and nine age-and sex-matched control subjects were recruited. The DTIs were acquired using a sensitivity-encoding head coil on a 1.5 T. Five regions of interest (ROI) were drawn manually on a color fractional anisotropy (FA) map: two ROIs for each column, one ROI for the body, and two ROIs for each crus. The FA and apparent diffusion coefficient (ADC) were measured in each of the ROIs. Cognitive function was evaluated using the Memory Assessment Scale, Wechsler Intelligence Scale, and Mini-Mental State Exam. In the DAI group, the FA value in the fornix body was significantly decreased compared with that of the control group. In contrast, we did not find significant differences in the column and crus of the fornix. Among all of the cognitive function scales, only the Memory Assessment Scale scores were significantly correlated with the FA values of the fornix body in the DAI group. We found that memory impairment in patients with DAI is closely related to neuronal injury of the fornix body among the three fornix regions that we assessed. DTI could be useful in the evaluation of patients with memory impairment following DAI.

Tract-Based Analysis of Callosal, Projection, and Association Pathways in Pediatric Patients with Multiple Sclerosis: A Preliminary Study

Region-of-interest (ROI) and tract-based diffusion tensor imaging (DTI) analyses have detected increased apparent diffusion coefficients (ADCs) and decreased fractional anisotropy (FA) in callosal and projection systems of adult patients with multiple sclerosis (MS). We explored whether similar changes occur in pediatric patients with MS, assessing 3 major white matter pathways (interhemispheric, projection, and intrahemispheric) in both visibly involved and normal-appearing white matter (NAWM). DTI datasets from 10 patients with established pediatric MS and 10 age- sex-, and imaging technique-matched controls were analyzed. Tracts were reconstructed by using a fiber assignment by continuous tracking algorithm with a diffusion-weighted imaging mask and a 35 degrees angular threshold. Tracts were selected by using standard ROI placements on color FA maps cross-referenced to b = 0 T2-weighted images for studying white matter pathways. Ten identical ROIs were placed in NAWM on b = 0 T2-weighted images to ensure that both ROIs and resulting tracts passed through NAWM. In pediatric MS, all tracts had higher mean ADC values (P = .002 to P < .04) and lower mean FA (P = .009 to P < .02) than those in healthy controls. Even when the tracts were confined to NAWM, the mean ADC was higher (P < .004 to P < .05) and the mean FA was lower (P = .002 to P < .02). T2 lesion burden correlated with tract-based mean ADC. ROI mean ADC increased, and both tract and ROI mean FA decreased with increasing T2 lesion burden, however with a statistically nonsignificant correlation. Increased mean ADC and decreased mean FA occur in all 3 major white matter pathways, both in visibly involved white matter and NAWM in pediatric MS.

Pontine Tegmental Cap Dysplasia: MR Imaging and Diffusion Tensor Imaging Features of Impaired Axonal Navigation

Malformations of the brain stem are uncommon. We present MR imaging and diffusion tensor imaging (DTI) features of 6 patients with pontine tegmental cap dysplasia, characterized by ventral pontine hypoplasia and a dorsal "bump," and speculate on potential mechanisms by which it forms. Birth and developmental records of 6 patients were reviewed. We reviewed MR imaging studies of all patients and DTIs of patient 3. Potential developmental causes were evaluated. All patients were born uneventfully after normal pregnancies except patient 6 (in utero growth retardation). They presented with multiple cranial neuropathies and evidence of cerebellar dysfunction. Variable hypotonia and motor dysfunction were present. Imaging revealed ventral pontine hypoplasia and mild cerebellar vermian hypoplasia, in addition to an unusual rounded to beaklike "bump" on the dorsal surface of the pons, extending into the fourth ventricle. Color fractional anisotropy maps showed the bump to consist of a bundle of axons directed horizontally (left-right). The bump appeared, on morphologic images, to be continuous with the middle cerebellar peduncles (MCPs), which were slightly diminished in size compared with those in healthy infants. Analysis of the DTI was, however, inconclusive regarding the connections of these axons. The decussation of the MCPs, transverse pontine fibers, and longitudinal brain stem axonal pathways was also abnormal. Our data suggest that the dorsal transverse axonal band in these disorders results from abnormal axonal pathfinding, abnormal neuronal migration, or a combination of the 2 processes.

Optimization of Acquisition Parameters of Diffusion-Tensor Magnetic Resonance Imaging in the Spinal Cord

The purpose of this study was to optimize imaging parameters for diffusion tensor imaging (DTI) of the cervical spinal cord using a recently developed sensitivity-encoded (SENSE) imaging technique, which can substantially reduce susceptibility artifacts. One hundred twenty sets of DTIs were performed of the cervical spinal cord in 40 normal volunteers, using a SENSE-based echo-planar imaging technique with different parameters (b-values, numbers of diffusion gradient directions, number of excitations, and slice thickness) in a stepwise approach. In step 1, DTI was performed of the cervical spinal cord with different b-values 500, 700, 900 seconds/mm; then with different numbers of diffusion gradient directions 6, 15, 32 in step 2; different number of excitations 1, 3, 5 in step 3; and different slice thicknesses 2, 3, 4 mm in step 4. In each step, 30 sets of DTIs were obtained from 10 volunteers. To determine the optimal imaging parameters, 3 radiologists evaluated the qualities of fractional anisotropy (FA) maps and color FA maps by visual analysis. The number of reconstructed fibers was measured for quantitative analysis. All qualitative and quantitative comparisons were analyzed by statistical methods using the Friedmann test and the Wilcoxon signed rank test. In step 1, DTIs using a b-value of 900 seconds/mm showed the highest number of reconstructed fibers and the best image quality of FA map and color map. In step 2, the use of 15 or 32 directions demonstrated better quality DTIs than 6 directions. No significant difference was evident between the quality of DTI with 15 directions and that with 32 directions. The scan time of DTI with 15 directions was shorter than with 32 directions. In step 3, as the number of excitations increased, the number of reconstructed fibers increased significantly and the image quality of the FA map and the color map improved significantly. In step 4, the numbers of reconstructed fibers were significantly the highest with a slice thickness of 4 mm. Optimal parameters for DTI in the cervical spinal cord included a b-value of 900 seconds/mm, 15 diffusion gradient directions, 5 excitations, and a slice thickness of 4mm.