Clinical Use of DTI
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MIDAG@UNC
Clinical Use of DTI
Guido Gerig
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Early Brain Development MIDAG@UNC
Contributors:
• Andy Alexander• Susumo Mori • The University of North Carolina Chapel Hill (UNC)
National Alliance for Medical Image Computing (NIH U54EB005149)
Acknowledgments
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ASNR 2003 –Washington,DC DT-MRI Alexander 6
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
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ASNR 2003 –Washington,DC DT-MRI Alexander 7
Courtesy J. Neil Washington Univ., St. Louis
Normal Brain Development
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ASNR 2003 –Washington,DC DT-MRI Alexander 8
WM AnisotropyChanges with Age
genu
frontalpericallosal
centrumsemiovale
GenuLeft pericallosalRight pericallosal
.3
.4
.5
.6
.7
.8
20 30 40 50 60 70 80Age
Anterior
FA
SpleniumLeft pericallosalRight pericallosal
.3
.4
.5
.6
.7
.8
20 30 40 50 60 70 80Age
Posterior
FA
.34
.36
.38
.40
.42
.44
.46
.48
20 30 40 50 60 70 80Age
Centrum Semiovale
parietalpericallosal
splenium
Pfefferbaum et al.MRM 2000
Courtesy K. Lim, Univ. Minn.
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ASNR 2003 –Washington,DC DT-MRI Alexander 9R. Bammer, F. Fazekas, Neuroim Clinics N Am, Feb. 2002.
S T A N F O R D S C H O O L OF M E D I C I N E
Lucas MRS/I Center
Multiple Sclerosis
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ASNR 2003 –Washington,DC DT-MRI Alexander 12
DTI in Cerebral NeoplasmsDeviated
Edematous Destroyed
Infiltrated
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ASNR 2003 –Washington,DC DT-MRI Alexander 13
Tract Displacement T2W ADC
FA FA 1
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Cerebral Palsy
Courtesy of Susumu Mori
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MICCAI 2005MICCAI 2005 - 17 - October 27, 2005
Fiber Tract-Oriented Statistics for Fiber Tract-Oriented Statistics for Quantitative Diffusion Tensor MRI Quantitative Diffusion Tensor MRI AnalysisAnalysis
11Depts of Computer Science, Depts of Computer Science, 22Psychiatry, Psychiatry, 33Radiation Oncology, UNC-Chapel Hill, USARadiation Oncology, UNC-Chapel Hill, USA44Scientific Computing and Imaging Institute, University of Utah, USAScientific Computing and Imaging Institute, University of Utah, USA
Isabelle CorougeIsabelle Corouge1,21,2, , P. Thomas FletcherP. Thomas Fletcher44, , Sarang JoshiSarang Joshi33, , John H. GilmoreJohn H. Gilmore22, , Guido GerigGuido Gerig1,21,2
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MICCAI 2005MICCAI 2005 - 18 - October 27, 2005
Quantitative Tractography
- Tractography for ROI definition
- Tensor-math. for statistics along tracts
FA along tractsTract ROIs
Tensors statisics along spines
FA motor tract MD motor tract
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MICCAI 2005MICCAI 2005 - 19 - October 27, 2005
Fiber Tract Modeling and Analysis
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MICCAI 2005MICCAI 2005 - 20 - October 27, 2005
Experiments and Results• Data
– 3Tesla high resolution (2x2x2 mm3) DT MRI database– 8 subjects: 4 neonates at 2 weeks-old, 4 one year-old– Fiber tracts: genu and splenium
Neonate at 2 weeks-old One year-old
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MICCAI 2005MICCAI 2005 - 21 - October 27, 2005
Experiments and Results
• Average of diffusion tensors in cross-sections along tracts
2 weeks-old One year-old
Sple
nium
Gen
u
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MICCAI 2005MICCAI 2005 - 22 - October 27, 2005
Experiments and Results• Diffusion properties along fiber tracts
Sple
nium
Gen
u
Eigenvalues Mean Diffusivity Fractional Anistropy
0
0 0 0
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MICCAI 2005MICCAI 2005 - 23 - October 27, 2005
Neonate Krabbe’s - Motor• Internal capsule
from brain stem to superior cortex
• Left and right hemispheric bundles
• FA values on bundle
Motor cortex
VL thalamus
Pontine nucleiCerebellar cortex
Deep cerebellar nuc-dentate
middle cerebellarpeduncle
superior cerebellarpeduncle
corona radiata
internal capsule cerebral
peduncle
Fallon
Premotor cortex
Prefrontal cortex
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MICCAI 2005MICCAI 2005 - 24 - October 27, 2005
Visualization - Left Bundle
Controls
• At 1.5y• Walks• Good
motor
• At 1y• Weak
trunk• Bad
motor
• At 3m• Ok so
far
FA seems to correlate with outcome
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MICCAI 2005MICCAI 2005 - 25 - October 27, 2005
Visualization - Right Bundle
Controls
• At 1.5y• Walks• Good
motor
• At 3m• Ok so
far
• At 1y• Weak
trunk• Bad
motor
FA higher in Cnt than Krabbe
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MICCAI 2005MICCAI 2005 - 26 - October 27, 2005
FA Statistics along Fibers• Lower FA across most of
bundle for Krabbe• Bad motor case has
consistently lowest FA on left bundle
• Possible predictor for outcome?
LEFT: FA along Fiber
0.00
0.10
0.20
0.30
0.40
0.50
0.60
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29
444595k4k5k6
RIGHT: FA along Fiber
0.00
0.10
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0.30
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Q ui ckTi me™ and aTI FF (LZW) decompressor
are needed to see thi s pi cture.
Controlsgood motorbad motorgood motor