Vincent Kyu Lee1, Benjamin Meyers1, William T Reynolds2, Rafael Ceschin1, Vincent Schmithorst1, Jeffrey Berman3, Thomas Chenevert4, Borjan Gagoski5, Peter LaViolette6, Deqiang Qiu7, Sudhir Pathak1, Ashok Panigrahy1, and Walter Schneider8
1Radiology, University of Pittsburgh, Pittsburgh, PA, United States, 2Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States, 3Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States, 4Radiology, University of Michigan, Ann Arbor, MI, United States, 5Radiology, Harvard Medical School, Boston, MA, United States, 6Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, 7Radiology, Emory University, Atlanta, GA, United States, 8Psychology, University of Pittsburgh, Pittsburgh, PA, United States
Synopsis
Our study shows for the first time that synthetic phantoms
that simulate fiber anatomical characteristics
can provide in vitro corrections factors for reducing in-vivo inter-scanner variance specific to discrete
segments of cortical association fiber tracts.
The overall goal of our evolving rigorous harmonization approach is to reduce inter-scanner variance that can confound
biological variance derived from multi-center discovery and neuroprotection
clinical trials in the developing human brain.
Introduction
Diffusion tensor imaging
(DTI) is an important biomarker for multi-center discovery and neuroprotection
clinical trial for the developing brain. DTI
is sensitive to the scanner hardware specifications, sequence
parameters, and field inhomogeneities and has relatively higher inter-scanner
variance which can confound biological variance1. Current harmonization techniques like COMBAT
can leverage normative cohorts to retrospectively reduced inters-canner
variance, but may be limited in the evaluation of clinical populations that are
being testing in multi-centered studies2.
Here, for the first time, we aimed to develop more rigorous
prospectively harmonization tool to incorporate in vitro synthetic phantom3,4 measurements of (1) linear packing fiber
density (FA/fiber density correlation) and (2) crossing fiber density
(FA/crossing angle) utilizing similar DTI and HARDI acquisition protocols and
along tract post-processing5 across synthetic phantoms, human phantom (n=5), and
human clinical subjects 10-12 yrs
(Hypoplastic Left Heart Syndrome and age-matched healthy controls). We tested the feasibility of deriving an in
vitro correction factor to reduce in vivo inter-scanner variance of both linear and crossing fiber segments of
three types of tracts: (1) Cortical Spinal Tract; (2) Interhemispheric
-Callosal Tract; (4) Intrahemispheric Tract (superior longitudinal fasiculus).Methods
The synthetic and five human
phantoms were scanned at twelve participating sites at 3T at three separate
sessions for a total of 216 times. The scanners include three Siemens Skyra (S Skyra), five Siemens Prisma
(S Prisma), one Siemens Trio, two Philips Ingenia (P Ingenia), and one Philips
Achieva (P Achieva). Diffusion imaging was acquired using both a
42-direction DTI and a 256-direction diffusion set for high angular definition
diffusion imaging (HARDI) scheme. For the DTI the
following parameters were used across all platforms: FOV = 256mm, voxel size =
2.0mm (isotropic), TE/TR=92ms/12600 ms, B = 1000s/mm2.
As shown in Figure 1, the
synthetic phantom contains blocks with unidirectional longitudinal fibers at
different densities – 12.5%, 25%, 50%, and 100% density by volume. Average fractional anisotropy measurements
over ROIs were generated for the density blocks in DSI studio6. An estimate of
the linear relationship between FA and reference density was determined using
regression analysis. Our modeling for FA and crossing fiber density utilizing
HARDI is in progress. From this initial
analysis we generated a scanner-specific reference measurement correction
factor which is then applied to a second synthetic scan from the same scanner.
Each DTI scan of each human phantom are registered to other scans of the same individual using FSL FLIRT7 to incorporate all the brain
images into a common person-specific space.
Tractography was performed on DSI studio using a standardized scheme
employing a uniform set of ROIs and ROAs to generate, for the initial study, 11
white matter tracts: Genu, CC Body, Splenium, left and right CST, left and
right SLF, left and right ILF, and left and right FoF.Results
Our preliminary results from the currently ongoing analysis
examines scans at seven sites. Figure 2 shows the correction calculations using FA measurements from DTI imaging of the
synthetic phantom unidirectional fiber blocks.
The first set of scans (Figure 2A) were used to determine the scanner
specific correction factors which were then applied to the second set of scans.
For all scanners, the unidirectional
fibers showed a linear relationship between fiber density and corresponding FA
measurements, with FA increasing at higher fiber density. After the correction (Figure 2C), a reduction in cross
scanner variability is observed (decreased in mean squared error) in all
scanners. We also observed that the initial processing of 12.5% density blocks
have low SNR and were excluded from this preliminary analysis.
As shown in Figure 3 along-tract analysis where average FA
(or other diffusion metric) for cross sectional area of fiber bundle are calculated
along the longitudinal axis of each tract.
The graphs show the along-tract FA measurements of CC Body, Splenium,
Right CST, and Left SLF from one human phantom scanned at multiple sites. This initial analysis demonstrated, present
to varying degrees in all the tracts, regions that are more sensitive to
scanner variability (blue arrows) as well as regions that are reproducibly and
reliably measured (red arrows) regardless of MRI used. Both CC Body and Splenium showed lower
variance and higher measurement reproducibility (or convergence) around the
midline of the tract, while wider variability is seen on the more lateral
regions, especially in the Splenium. In
the CST, highly variable FA measurements across scanners is seen near the
inferior part of the tract, perhaps due to the abundance of decussating fibers
in that region. A region with minimized
variability is seen superiorly, corresponding to the internal capsule. The SLF
exhibit the highest variability among the presented tracts. This is perhaps due to its more dispersed
nature, which in turn render this tract more sensitive to the intrinsic scanner
factors.Discussion
Our study shows for the first time that synthetic phantoms that simulate fiber anatomical characteristics can provide in vitro corrections factors for reducing in-vivo inter-scanner variance specific to discrete segments of cortical association fiber tracts. The overall goal of our evolving rigorous harmonization approach is to reduce inter-scanner variance that can confound biological variance derived from multi-center discovery and neuroprotection clinical trials in the developing human brain.Acknowledgements
Christine Johnson, Nancy Beluk, Julia WallaceReferences
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