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Clinical Use of DTI

Clinical Use of DTI. Guido Gerig. Acknowledgments. Contributors: Andy Alexander Susumo Mori The University of North Carolina Chapel Hill (UNC) National Alliance for Medical Image Computing (NIH U54EB005149). DTI Applications. Normal brain development and aging

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Clinical Use of DTI

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  1. Clinical Use of DTI Guido Gerig

  2. Acknowledgments Contributors: • Andy Alexander • Susumo Mori • The University of North Carolina Chapel Hill (UNC) National Alliance for Medical Image Computing (NIH U54EB005149) Early Brain Development

  3. 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

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

  5. 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

  6. 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

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

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

  9. Cerebral Palsy Courtesy of Susumu Mori

  10. Fiber Tract-Oriented Statistics for Quantitative Diffusion Tensor MRI Analysis Isabelle Corouge1,2, P. Thomas Fletcher4, Sarang Joshi3, John H. Gilmore2, Guido Gerig1,2 1Depts of Computer Science, 2Psychiatry, 3Radiation Oncology, UNC-Chapel Hill, USA 4Scientific Computing and Imaging Institute, University of Utah, USA - 17 - October 27, 2005

  11. Quantitative Tractography Tract ROIs FA along tracts Tensors statisics along spines FA motor tract MD motor tract - Tractography for ROI definition - Tensor-math. for statistics along tracts - 18 - October 27, 2005

  12. Fiber Tract Modeling and Analysis - 19 - October 27, 2005

  13. 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 - 20 - October 27, 2005

  14. Experiments and Results • Average of diffusion tensors in cross-sections along tracts Genu Splenium 2 weeks-old One year-old - 21 - October 27, 2005

  15. Experiments and Results 0 • Diffusion properties along fiber tracts Eigenvalues Mean Diffusivity Fractional Anistropy Genu 0 0 0 Splenium - 22 - October 27, 2005

  16. Premotor cortex Motor cortex Prefrontal cortex superior cerebellar peduncle VL thalamus corona radiata Deep cerebellar nuc-dentate internal capsule cerebral peduncle Cerebellar cortex Pontine nuclei middle cerebellar peduncle Fallon Neonate Krabbe’s - Motor • Internal capsule from brain stem to superior cortex • Left and right hemispheric bundles • FA values on bundle - 23 - October 27, 2005

  17. Visualization - Left Bundle Controls FA seems to correlate with outcome • At 1y • Weak trunk • Bad motor • At 1.5y • Walks • Good motor • At 3m • Ok so far - 24 - October 27, 2005

  18. Visualization - Right Bundle Controls FA higher in Cnt than Krabbe • At 1y • Weak trunk • Bad motor • At 1.5y • Walks • Good motor • At 3m • Ok so far - 25 - October 27, 2005

  19. Controls good motor bad motor good motor 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? - 26 - October 27, 2005

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