Vincent Kyu Lee1, Meredith Monsour2, Sudhir Pathak2, Vincent Schmithorst3, Catherine Fissell2, Ashok Panigrahy1,3, and Walt Schneider2
1Radiology, University of Pittsburgh, Pittsburgh, PA, United States, 2University of Pittsburgh, Pittsburgh, PA, United States, 3Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
Synopsis
High
angular-resolution diffusion imaging (HARDI) is the best imaging technique to
distinguish crossing fibers and high turning angle neuronal tracts, which is critical
for identifying and characterizing the microstructural changes in neuro
pathology and traumatic brain injury.
Its main disadvantage has been the lengthy scan time needed to acquire
analyzable images – a challenge especially in children and neonates who do not
tolerate long scanning sessions. This study presents the preliminary fiber
tractography of healthy neonatal and pediatric subjects acquired using
multiband multi-shell HARDI sequence within a practicable scan time without
sacrificing image quality. Background and Purpose
High
angular-resolution diffusion imaging (HARDI) has advantages over Diffusion
Tensor Imaging in its ability to resolve crossing fibers and distinguish
neuronal tracks with higher turning angles [1, 2]. These features of HARDI are crucial for identifying
and characterizing the microstructural changes in neuro pathology and traumatic
brain injury [3]. HARDI has already been
shown to improve fiber resolution in adults [4]. However, the main short-coming of HARDI is
the extended scan time, which can be more than four times of standard DTI of
similar spatial resolution. The longer
scan time is already problematic in adults leading to higher rates of acquisition
failure – such as increased movement and patient fatigue – and made more
challenging in children. Multiband MRI
techniques have been used to reduce scan time. In this study we present the preliminary fiber tractography of healthy
neonatal and pediatric subjects acquired using multiband multi-shell HARDI
sequence.
Methods
A total of 10 heathy pediatric subjects
(6-17 years 3 females, 7 males) and 12 healthy neonates (1-6 weeks, 4 males, 8
females) were scanned on a 3T Skyra (Siemens AG, Erlangen, Germany) using
32-channel head coil. The multiband
multi-shell HARDI acquisition consisted of four modular complementary
sequences, each acquiring the volumes as three simultaneous bands in tandem. The sequences are divided into two B-value
(B=5000 and B=3000), and two sets of 128-unique directions (total of 256 unique
directions at each B value). The
sequence is EPI with following parameters: FOV=240mm, voxel size=2.4mm
(isotropic), matrix size=100x100x60, TE/TR=130ms/3600ms. Each sequence is around 240 ± 15 seconds, and the entire
acquisition can be accomplished in under 16 minutes. Image reconstruction, motion correction, and
pre-processing were conducted using a custom image processing pipeline internally
developed (Scheider Laboratory, Pittsburgh PA, U.S.A) [5]. Fiber tracking and preliminary comparison
analysis in post-processed images were done on DSI studio [6, 7].
Results
All
pediatric subjects and 75% of neonates tolerated and completed the scan. For each subject, the following 16 tracts
were analyzed: genu, body, and splenium of corpus callosum (CC); fornix; corona
radiata; thalamic radiations; corticospinal tract; external capsule; frontal
aslant; arcuate; superior and inferior longitudinal fasciculus; optic
radiations; inferior fronto-occipital fasciculus; cingulum; and uncinated. Most tracts showed no observable differences
between youngest and oldest subjects. Compared
to Healthy Adults, sparse frontal connectivity across all pediatric scans was observed (Figure1). Increased visualization of
fornix in younger age group (Figure2A), and increased lateralization of all segments
of CC in older age group (Figure2B).
With a few exception, no graph abnormalities were observed compared to
healthy adult controls.
Discussion
This study showed that a multiband multi-shell sequence
could acquire HARDI images at a scan time practicable for pediatric patients. The visualization of tracts in younger
subjects were comparable to the adults.
The quality of fiber tracking is comparable to healthy adult controls,
and superior in some cases such as the fornix.
An in depth study and quantitative analysis with more healthy subjects
are required to characterize and standardize HARDI based fiber tracking in
younger subjects.
Acknowledgements
Christine Johnston, Alexandria Zahner, Emily BrownReferences
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