Search

Purpose: Various MRI-based techniques were tested for the differentiation of neurodegenerative Parkinson syndromes (NPS); the value of these techniques in direct comparison and combination is uncertain. We thus compared the diagnostic performance of macrostructural, single compartmental, and multicompartmental MRI in the differentiation of NPS., Methods: We retrospectively included patients with NPS, including 136 Parkinson's disease (PD), 41 multiple system atrophy (MSA) and 32 progressive supranuclear palsy (PSP) and 27 healthy controls (HC). Macrostructural tissue probability values (TPV) were obtained by CAT12. The microstructure was assessed using a mesoscopic approach by diffusion tensor imaging (DTI), neurite orientation dispersion and density imaging (NODDI), and diffusion microstructure imaging (DMI). After an atlas-based read-out, a linear support vector machine (SVM) was trained on a training set (n = 196) and validated in an independent test cohort (n = 40). The diagnostic performance of the SVM was compared for different inputs individually and in combination., Results: Regarding the inputs separately, we observed the best diagnostic performance for DMI. Overall, the combination of DMI and TPV performed best and correctly classified 88% of the patients. The corresponding area under the receiver operating characteristic curve was 0.87 for HC, 0.97 for PD, 1.0 for MSA, and 0.99 for PSP., Conclusion: We were able to demonstrate that (1) MRI parameters that approximate the microstructure provided substantial added value over conventional macrostructural imaging, (2) multicompartmental biophysically motivated models performed better than the single compartmental DTI and (3) combining macrostructural and microstructural information classified NPS and HC with satisfactory performance, thus suggesting a complementary value of both approaches., (© 2024. The Author(s).)

The aim of this study was to evaluate whether ganglioglioma (GGL), dysembryoplastic neuroepithelial tumour (DNET) and FCD (focal cortical dysplasia) are distinguishable through diffusion tensor imaging. Additionally, it was investigated whether the diffusion measures differed in the perilesional (pNAWM) and in the contralateral normal appearing white matter (cNAWM). Six GGLs, eight DNETs and seven FCDs were included in this study. Quantitative diffusion measures, that is, axial, radial and mean diffusivity and fractional anisotropy, were determined in the lesion identified on isotropic T2 or FLAIR-weighted images and in pNAWM and cNAWM, respectively. DNET differed from FCD in mean diffusivity, and GGL from FCD in radial diffusivity. Both types of glioneuronal tumours were different from pNAWM in fractional anisotropy and radial diffusivity. For identifying the tumour edges, threshold values for tumour-free tissue were investigated with receiver operating characteristic analyses: tumour could be separated from pNAWM at a threshold ≤ 0.32 (fractional anisotropy) or ≥ 0.56 (radial diffusivity) *10 -3 mm 2 /s (area under the curve 0.995 and 0.990 respectively). While diffusion parameters of FCDs differed from cNAWM (radial diffusivity (*10 -3  mm/s 2 ): 0.74 ± 0.19 vs. 0.43 ± 0.05; corrected p-value < 0.001), the pNAWM could not be differentiated from the FCD.

Tractography based on diffusion-weighted MRI investigates the large scale arrangement of the neurite fibers in brain white matter. It is usually assumed that the signal is a convolution of a fiber specific response function (FRF) with a fiber orientation distribution (FOD). The FOD is the focus of tractography. While in the past the FRF was estimated beforehand and was usually assumed to be fix, more recent approaches estimate the response function during tractography. This work proposes a novel objective function independent of the FRF, just aiming for FOD reconstruction. The objective is integrated into global tractography showing promising results., (Copyright © 2018 Elsevier Inc. All rights reserved.)

One overarching challenge of clinical magnetic resonance imaging (MRI) is to quantify tissue structure at the cellular scale of micrometers, based on an MRI acquisition with a millimeter resolution. Diffusion MRI (dMRI) provides the strongest sensitivity to the cellular structure. However, interpreting dMRI measurements has remained a highly ill-posed inverse problem. Here we propose a framework that resolves the above challenge for human white matter fibers, by unifying intra-voxel mesoscopic modeling with global fiber tractography. Our algorithm is based on a Simulated Annealing approach which simultaneously optimizes diffusion parameters and fiber locations. Each fiber carries its by their individual set of diffusion parameters which allows to link them structural relationships.

Simple Summary: Perilesional T2 hyperintensity in glioblastomas and brain metastases shows neuropathologically detectable differences in the extent of edema formation. We compared novel diffusion microstructure imaging (DMI) with the more established NODDI and DTI techniques to determine if they could detect differences in free water content. Using DMI V-CSF and DTI MD, we found significant differences between glioblastomas and brain metastases in this regard but not with NODDI V-ISO. Although the free water content within the perilesional T2 hyperintense region should differ between glioblastomas (GBM) and brain metastases based on histological differences, the application of classical MR diffusion models has led to inconsistent results regarding the differentiation between these two entities. Whereas diffusion tensor imaging (DTI) considers the voxel as a single compartment, multicompartment approaches such as neurite orientation dispersion and density imaging (NODDI) or the recently introduced diffusion microstructure imaging (DMI) allow for the calculation of the relative proportions of intra- and extra-axonal and also free water compartments in brain tissue. We investigate the potential of water-sensitive DTI, NODDI and DMI metrics to detect differences in free water content of the perilesional T2 hyperintense area between histopathologically confirmed GBM and brain metastases. Respective diffusion metrics most susceptible to alterations in the free water content (MD, V-ISO, V-CSF) were extracted from T2 hyperintense perilesional areas, normalized and compared in 24 patients with GBM and 25 with brain metastases. DTI MD was significantly increased in metastases (p = 0.006) compared to GBM, which was corroborated by an increased DMI V-CSF (p = 0.001), while the NODDI-derived ISO-VF showed only trend level increase in metastases not reaching significance (p = 0.060). In conclusion, diffusion MRI metrics are able to detect subtle differences in the free water content of perilesional T2 hyperintense areas in GBM and metastases, whereas DMI seems to be superior to DTI and NODDI. [ABSTRACT FROM AUTHOR]

Simple Summary: Glioblastomas and brain metastases are the most common malignant intracerebral tumors in adults and are often difficult to differentiate using conventional MRI. Common to both is contrast enhancement on T1w post-Gd sequences and perilesional T2 hyperintensity, which in glioblastomas corresponds to diffuse tumor infiltration rather than to edema alone. Characterization of perifocal T2 hyperintensity in glioblastoma has been poor using MRI, and tumor recurrences frequently occur in these areas. Using a novel diffusion microstructure imaging (DMI) approach, we observed that in metastases, perilesional T2 hyperintensity is more likely due to edema alone with a higher fraction of free water and reduced cellular compartments compared to glioblastomas. DMI might be a powerful diagnostic tool, as it could be used to distinguish metastases from GBM, as well as characterizing perifocal T2 hyperintensity in GBM. Purpose: Glioblastomas (GBM) and brain metastases are often difficult to differentiate in conventional MRI. Diffusion microstructure imaging (DMI) is a novel MR technique that allows the approximation of the distribution of the intra-axonal compartment, the extra-axonal cellular, and the compartment of interstitial/free water within the white matter. We hypothesize that alterations in the T2 hyperintense areas surrounding contrast-enhancing tumor components may be used to differentiate GBM from metastases. Methods: DMI was performed in 19 patients with glioblastomas and 17 with metastatic lesions. DMI metrics were obtained from the T2 hyperintense areas surrounding contrast-enhancing tumor components. Resected brain tissue was assessed in six patients in each group for features of an edema pattern and tumor infiltration in the perilesional interstitium. Results: Within the perimetastatic T2 hyperintensities, we observed a significant increase in free water (p < 0.001) and a decrease in both the intra-axonal (p = 0.006) and extra-axonal compartments (p = 0.024) compared to GBM. Perilesional free water fraction was discriminative regarding the presence of GBM vs. metastasis with a ROC AUC of 0.824. Histologically, features of perilesional edema were present in all assessed metastases and absent or marginal in GBM. Conclusion: Perilesional T2 hyperintensities in brain metastases and GBM differ significantly in DMI-values. The increased free water fraction in brain metastases suits the histopathologically based hypothesis of perimetastatic vasogenic edema, whereas in glioblastomas there is additional tumor infiltration. [ABSTRACT FROM AUTHOR]

Abstract This work evaluates the accuracy and precision of the Diffusion parameter EStImation with Gibbs and NoisE Removal (DESIGNER) pipeline, developed to identify and minimize common sources of methodological variability including: thermal noise, Gibbs ringing artifacts, Rician bias, EPI and eddy current induced spatial distortions, and motion-related artifacts. Following this processing pipeline, iterative parameter estimation techniques were used to derive diffusion parameters of interest based on the diffusion tensor and kurtosis tensor. We evaluated accuracy using a software phantom based on 36 diffusion datasets from the Human Connectome project and tested the precision by analyzing data from 30 healthy volunteers scanned three times within one week. Preprocessing with both DESIGNER or a standard pipeline based on smoothing (instead of noise removal) improved parameter precision by up to a factor of 2 compared to preprocessing with motion correction alone. When evaluating accuracy, we report average decreases in bias (deviation from simulated parameters) over all included regions for fractional anisotropy, mean diffusivity, mean kurtosis, and axonal water fraction of 9.7%, 8.7%, 4.2%, and 7.6% using DESIGNER compared to the standard pipeline, demonstrating that preprocessing with DESIGNER improves accuracy compared to other processing methods. Highlights • Diffusion parameter EStImation with Gibbs and NoisE Removal (DESIGNER) pipeline. • DESIGNER removes parameter bias caused by noise, artifacts, and partial volume. • DESIGNER maximizes accuracy of diffusion parameters without lowering resolution. • DESIGNER increases precision by a factor ∼2 compared to other pipelines. • DESIGNER works optimally on noisy clinical diffusion data. [ABSTRACT FROM AUTHOR]