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(Pre-)Clinical and Applications with DTI

(Pre-)Clinical and Applications with DTI. Guido Gerig UNC Chapel Hill. DTI Applications. Normal brain development and aging Congenital anomalies and diseases of white matter Traumatic brain injury Encephalopathies – toxic, metabolic, infectious

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(Pre-)Clinical and Applications with DTI

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  1. (Pre-)Clinical and Applications with DTI Guido Gerig UNC Chapel Hill

  2. DTI Applications • Normal brain development and aging • Congenital anomalies and diseases of white matter • Traumatic brain injury • Encephalopathies – toxic, metabolic, infectious • Demyelinating and neurodegenerative diseases • Ischemia and stroke • Neoplasm, preoperative planning • Epilepsy • Dementia, schizophrenia, depression • Developmental disorders - fragile X, autism • Spinal Cord DT-MRI Alexander

  3. Normal Brain Development Courtesy J. Neil Washington Univ., St. Louis DT-MRI Alexander

  4. Anterior .8 Genu .7 frontal pericallosal Left pericallosal Right pericallosal .6 centrum semiovale genu FA .5 .4 .3 20 30 40 50 60 70 80 Age Centrum Semiovale Posterior .48 Splenium Left pericallosal .46 .8 Right pericallosal .44 .7 .42 .6 .40 FA splenium .38 .5 .36 parietal pericallosal .4 .34 20 30 40 50 60 70 80 .3 Age 20 30 40 50 60 70 80 Age WM AnisotropyChanges with Age Pfefferbaum et al. MRM 2000 Courtesy K. Lim, Univ. Minn. DT-MRI Alexander

  5. Multiple Sclerosis STANFORD S C H O O L OF M E D I C I N E Lucas MRS/I Center R. Bammer, F. Fazekas, Neuroim Clinics N Am, Feb. 2002. DT-MRI Alexander

  6. Deviated Infiltrated DTI in Cerebral Neoplasms Edematous Destroyed DT-MRI Alexander

  7. Tract Displacement T2W ADC FA FA  1 DT-MRI Alexander

  8. Cerebral Palsy Courtesy of Susumu Mori

  9. PNL Schizophrenia Study Martha Shenton, PNL Harvard Guido Gerig, UNC Chapel Hill

  10. Atlas: Average + Set of transformed tensor fields ROIs and tracts in atlas space transferred to every image.

  11. Tractography in PNL Atlas Cingulum full Corpus Callosum middle part Cingulum “spine”

  12. Tractography per Group Cingulum SZ Group Cingulum Control Group Tractography applied to tensor fields of the set of controls mapped to the atlas (left) ad the set of SZ mapped to the atlas (right).

  13. Very, very preliminary tests … SZ seems to have lower FA in middle portion of cingulum. What does it mean w.r.t. diffusion properties?

  14. ctd. SZ group seems to have lower lambda1 and slightly higher radial diffusion (average lambda2 + lambda3) in middle region.

  15. ctd. MD seems very similar for both groups. GA shows same pattern as FA but much higher values.

  16. DTI Population Atlases • Related work: • Alexander, D., Pierpaoli, C., Basser, P., Gee, J.: Spatial transformations of diffusion tensor magnetic resonance images. IEEE Transactions on Medical Imaging 20(11) (2001) • Zhang, H., Yushkevich, P., Gee, J.: Registration of diffusion tensor images. In: CVPR. (2004)

  17. DTI Population Atlases Neonates (N=50) 1yr olds (N=25) 2yr olds (N=15)

  18. Fiber Tractography in Atlases cingulate fornix and uncinate motor tracts uncinate genu, splenium, motor Neonate atlas DTI 1yr atlas DTI

  19. Krabbe Disease Maria Luisa Escolar, M.D. Director, Program for the Study of Neurodevelopmental Function in Rare Disorders Center for the Study of Development and Learning University of North Carolina at Chapel Hill

  20. Neuroimaging for Phenotyping Motor Tract Motor Circuitry UCBT Cerebellar Peduncles

  21. Normative Atlas (50 neonates), DTI: Average and statistics Z-scores indicating regions with significant differences Neuroimaging for Phenotyping: Atlas-based white matter analysis Patient DTI Please note absence of wm structuring (high FA) in right external capsule

  22. Bundles obtained from 50case atlas by tractography Full tracts Selection of center and off-center regions of interest

  23. FA MD T1w T2w FA MD T1w T2w Early postnatal development of white matter: Joint analysis of sMRI and DTI • Analysis of white matter in healthy controls (N=47) • Co-registration of sMRI and DTI (deformable) • Fibertract-based segmentation of ROIs • Quantitative analysis of FA, MD, T1w, T2w

  24. Early postnatal development of white matter Analysis of white matter in healthy controls (N=47) Myelination and axon elimination: • FA center >> peripheral • FA splenium > genu • MD splenium & genu > intcaps • T1w splenium & genu < intcaps Gilmore/Lin/Gerig , submitted AJNR

  25. Early postnatal development of white matter Joint analysis of structural MRI and DTI: Genu at center (non myelinated) versus internal capsule (myelinated) • FA genu ≈ FA intcaps • T1w genu >> T1w intcaps Analysis detects differences between dense structuring and early myelination Procedure to be used to measure maturation process

  26. Longitudinal Follow-up Neonate 1 year old

  27. Neonate (2 wks) Infant (1 year) Adult Corpus callosum: Commissural bundles, color coding of FA (0=blue, 1=red) Corpus Callosum Tracts: Study of Early Development

  28. “Maturation” of white matter tracts

  29. Neonate 1year Tensor Statistics Genu/Splenium: Neonate to 1years genu splenium MD MD Neo FA FA 1yr

  30. Conclusions • Diffusion Imaging adds a measurement not obtained by other structural imaging sequences. • Invaluable for studying white matter disease, lesions, neurodevelopment and neurodegeneration. • MR-DTI made huge progress to provide high resolution with isotropic voxels. • Tools for comprehensive analysis available.

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