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Lindig T, Ruff C, Rattay TW, König S, Schöls L, Schüle R, Nägele T, Ernemann U, Klose U, Bender B. Detection of spinal long fiber tract degeneration in HSP: Improved diffusion tensor imaging. Neuroimage Clin 2022; 36:103213. [PMID: 36270162 PMCID: PMC9668628 DOI: 10.1016/j.nicl.2022.103213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
Spinal diffusion tensor imaging (sDTI) is still a challenging technique for selectively evaluating anatomical areas like the pyramidal tracts (PT), dorsal columns (DC), and anterior horns (AH) in clinical routine and for reliably quantifying white matter anisotropy and diffusivity. In neurodegenerative diseases, the value of sDTI is promising but not yet well understood. The objective of this prospective, single-center study was to evaluate the long fiber tract degeneration within the spinal cord in normal aging (n = 125) and to prove its applicability in pathologic conditions as in patients with molecular genetically confirmed hereditary spastic paraplegias (HSP; n = 40), a prototypical disease of the first motor neuron and in some genetic variants with affection of the dorsal columns. An optimized monopolar Stejskal-Tanner sequence for high-resolution, axial sDTI of the cervical spinal cord at 3.0 T with advanced standardized evaluation methods was developed for a robust DTI value estimation of PT, DC, and AH in both groups. After sDTI measurement at C2, an automatic motion correction and an advanced semi-automatic ROI-based, standardized evaluation of white matter anisotropy and diffusivity was performed to obtain regional diffusivity measures for PT, DC, and AH. Reliable and stable sDTI values were acquired in a healthy population without significant decline between age 20 and 65. Reference values for PT, DC, and AH for fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) were established. In HSP patients, the decline of the long spinal fiber tracts could be demonstrated by diffusivity abnormalities in the pyramidal tracts with significantly reduced PTFA (p < 0.001), elevated PTRD (p = 0.002) and reduced PTMD (p = 0.003) compared to healthy controls. Furthermore, FA was significantly reduced in DCFA (p < 0.001) with no differences in AH. In a genetically homogeneous subgroup of SPG4 patients (n = 12) with affection of the dorsal columns, DCRD significantly correlated with the overall disease severity as measured by the Spastic Paraplegia Rating Scale (SPRS) (r = - 0.713, p = 0.009). With the most extensive sDTI study in vivo to date, we showed that axial sDTI combined with motion correction and advanced data post-processing strategies enables robust measurements and is ready to use, allowing recognition and quantification of disease- and age-related changes of the PT, DC, and AH. These results may also encourage the usage of sDTI in other neurodegenerative diseases with spinal cord involvement to explore its capability as selective biomarkers.
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Affiliation(s)
- Tobias Lindig
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Christer Ruff
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany.
| | - Tim W Rattay
- Center for Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research, Hoppe-Seyler-Str. 3, Tübingen 72076, Germany; German Research Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Str. 23, Tübingen 72076, Germany
| | - Stephan König
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Ludger Schöls
- Center for Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research, Hoppe-Seyler-Str. 3, Tübingen 72076, Germany; German Research Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Str. 23, Tübingen 72076, Germany
| | - Rebecca Schüle
- Center for Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research, Hoppe-Seyler-Str. 3, Tübingen 72076, Germany; German Research Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Str. 23, Tübingen 72076, Germany
| | - Thomas Nägele
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, Tübingen 72076, Germany
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Wu P, Huang C, Shi B, Jin A. Comparison of region-of-interest delineation methods for diffusion tensor imaging in patients with cervical spondylotic radiculopathy. BMC Musculoskelet Disord 2022; 23:677. [PMID: 35840941 PMCID: PMC9284815 DOI: 10.1186/s12891-022-05639-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/06/2022] [Indexed: 11/20/2022] Open
Abstract
Background Diffusion tensor imaging is a promising technique for determining the responsible lesion of cervical radiculopathy, but the selection and delineation of the region of interest (ROI) affect the results. This study explored the impact of different ROI sketching methods on the repeatability and consistency of DTI measurement values in patients with cervical spondylotic radiculopathy (CSR). Methods This retrospective study included CSR patients who underwent DTI imaging. The images were analyzed independently by two radiologists. Four delineation methods were used: freehand method, maximum roundness, quadrilateral method, and multi-point averaging method. They re-examined the images 6 weeks later. The intra-class correlation coefficient (ICC) was used to investigate the consistency between the two measurements and the reproducibility between two radiologists. Results Forty-two CSR patients were included in this study. The distribution of the compressed nerve roots was five C4, eight C5, sixteen C6, eleven C7, and two C8. No differences were found among the four methods in fractional anisotropy (FA) or apparent diffusion coefficient (ADC), irrespective of radiologists (all P>0.05). Similar results were observed between the first and second measurements (all P>0.05), but some significant differences were observed for radiologist 2 for the four-small rounds method (P=0.033). The freehand and single largest circle methods were the two methods with the highest ICC between the two measurements and the two radiologists (all ICC >0.90). Conclusion The freehand and single largest circle methods were the most consistent methods for delineating DTI ROI in patients with CSR.
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Affiliation(s)
- Penghuan Wu
- Shaoguan First People's Hospital, Affiliated Shaoguan First People's Hospital, Southern Medical University, Guangdong, China
| | - Chengyan Huang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Benchao Shi
- Department of Spinal Surgery, Orthopedics Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Anmin Jin
- Department of Spinal Surgery, Orthopedics Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Hu J, Li M, Dai Y, Geng C, Tong B, Zhou Z, Liang X, Yang W, Zhang B. Combining SENSE and reduced field-of-view for high-resolution diffusion weighted magnetic resonance imaging. Biomed Eng Online 2018; 17:77. [PMID: 29903023 PMCID: PMC6003092 DOI: 10.1186/s12938-018-0511-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/05/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In diffusion-weighted magnetic resonance imaging (DWI) using single-shot echo planar imaging (ss-EPI), both reduced field-of-view (FOV) excitation and sensitivity encoding (SENSE) alone can increase in-plane resolution to some degree. However, when the two techniques are combined to further increase resolution without pronounced geometric distortion, the resulted images are often corrupted by high level of noise and artifact due to the numerical restriction in SENSE. Hence, this study is aimed to provide a reconstruction method to deal with this problem. METHODS The proposed reconstruction method was developed and implemented to deal with the high level of noise and artifact in the combination of reduced FOV imaging and traditional SENSE, in which all the imaging data were considered jointly by incorporating the motion induced phase variations among excitations. The in vivo human spine diffusion images from ten subjects were acquired at 1.5 T and reconstructed using the proposed method, and compared with SENSE magnitude average results for a range of reduction factors in reduced FOV. These images were evaluated by two radiologists using visual scores (considering distortion, noise and artifact levels) from 1 to 10. RESULTS The proposed method was able to reconstruct images with greatly reduced noise and artifact compared to SENSE magnitude average. The mean g-factors were maintained close to 1 along with enhanced signal-to-noise ratio efficiency. The image quality scores of the proposed method were significantly higher (P < 0.01) than SENSE magnitude average for all the evaluated reduction factors. CONCLUSION The proposed method can improve the combination of SENSE and reduced FOV for high-resolution ss-EPI DWI with reduced noise and artifact.
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Affiliation(s)
- Jisu Hu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Ming Li
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China
| | - Yakang Dai
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Chen Geng
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Baotong Tong
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Zhiyong Zhou
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Xue Liang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China
| | - Wen Yang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China.
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Alcaide-Leon P, Cybulsky K, Sankar S, Casserly C, Leung G, Hohol M, Selchen D, Montalban X, Bharatha A, Oh J. Quantitative spinal cord MRI in radiologically isolated syndrome. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2018; 5:e436. [PMID: 29359174 PMCID: PMC5773843 DOI: 10.1212/nxi.0000000000000436] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 11/06/2017] [Indexed: 01/20/2023]
Abstract
Objectives To assess whether quantitative spinal cord MRI (SC-MRI) measures, including atrophy, and diffusion tensor imaging (DTI) and magnetization transfer imaging metrics were different in radiologically isolated syndrome (RIS) vs healthy controls (HCs). Methods Twenty-four participants with RIS and 14 HCs underwent cervical SC-MRI on a 3T magnet. Manually segmented regions of interest circumscribing the spinal cord cross-sectional area (SC-CSA) between C3 and C4 were used to extract SC-CSA, fractional anisotropy, mean, perpendicular, and parallel diffusivity (MD, λ⊥, and λ||) and magnetization transfer ratio (MTR). Spinal cord (SC) lesions, SC gray matter (GM), and SC white matter (WM) areas were also manually segmented. Multivariable linear regression was performed to evaluate differences in SC-MRI measures in RIS vs HCs, while controlling for age and sex. Results In this cross-sectional study of participants with RIS, 71% had lesions in the cervical SC. Of quantitative SC-MRI metrics, spinal cord MTR showed a trend toward being lower in RIS vs HCs (p = 0.06), and there was already evidence of brain atrophy (p = 0.05). There were no significant differences in SC-DTI metrics, GM, WM, or CSA between RIS and HCs. Conclusion The SC demonstrates minimal microstructural changes suggestive of demyelination and inflammation in RIS. These findings are in contrast to established MS and raise the possibility that the SC may play an important role in triggering clinical symptomatology in MS. Prospective follow-up of this cohort will provide additional insights into the role the SC plays in the complex sequence of events related to MS disease initiation and progression.
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Affiliation(s)
- Paula Alcaide-Leon
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Kateryna Cybulsky
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Stephanie Sankar
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Courtney Casserly
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - General Leung
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Marika Hohol
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Daniel Selchen
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Xavier Montalban
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Aditya Bharatha
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
| | - Jiwon Oh
- Division of Neurology (P.A.-L., K.C., S.S., C.C., M.H., D.S., X.M., J.O.), Department of Medicine; Division of Neuroradiology (P.A.-L., G.L., A.B.), Department of Medical Imaging; Division of Neurosurgery (A.B.), Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada; Department of Neurology-Neuroimmunology Neurorehabilitation Unit (X.M.), Multiple Sclerosis Center of Catalonia (Cemcat), Barcelona, Spain; and Department of Neurology (J.O.), Johns Hopkins University, Baltimore, MD
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