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Quantitative Imaging Report Framework for the Cleveland Alzheimer’s Disease Research Center (CADRC) Neuroimaging Core (NIC)1The Cleveland Clinic, Cleveland, OH, United States, 2Case Western Reserve University, Cleveland, OH, United States, 3Hanku University of Foreign Studies, Seoul, Korea, Republic of
Synopsis
Keywords: Alzheimer's Disease, Quantitative Imaging, Neurodegeneration
Motivation: We have developed an approach to provide a quantitative summary of regional brain measures from an advanced imaging protocol in AD and ADRD subjects as part of the CADRC’s Neuroimaging Core.
Goal(s): To establish a panel of advanced imaging markers that will supplement data acquired by the ADRC network.
Approach: Structural, functional and quantitative imaging has been implemented, along with procedures for quality assurance and summary outcome measures.
Results: 86 subjects have been scanned to date, including those with normal cognition, mild cognitive impairment (MCI) and dementia. Subtypes of impairment include typical and atypical AD, dementia with lewy bodies (DLB).
Impact: Although AD is the most common cause of dementia, related and overlapping dementias are common. An inclusive approach to both recruitment and imaging have been implemented to explore new tools for informing patient care in dementia.
INTRODUCTION
The NIH/NIA supports a network of 33 ADRCs to promote translation of research to improved patient care. The neuroimaging core of the CADRC has developed a panel of advanced MRI methods to explore their use in the context of AD and related dementias. We provide an overview of the methods and the overall framework for analysis and distillation of the imaging data into a summary of regional measures.METHODS
Subjects are recruited from the community for annual evaluation. All imaging is performed on a Siemens Prisma 3T MRI with a standard 32 channel head coil (Siemens Healthineers, Erlangen, Germany). Imaging included anatomical, resting state functional MRI (rs-fMRI)1 and diffusion MRI (dMRI) scans based on the ADNI3 advanced protocol (https://adni.loni.usc.edu/). Additional scans including quantitative arterial spin labeling (ASL)2,3, multiecho gradient echo (MGE), myelin-weighted image (MWI)4 using ViSTa5, dynamic contrast enhancement (DCE)6 and magnetic resonance fingerprinting (MRF)7. MGE is used to generate susceptibility-weighted images (SWI) and quantitative susceptibility maps (QSM)8. dMRI is used to calculate both diffusion tensor imaging (DTI)9 and neurite orientation dispersion and density imaging (NODDI)10 maps. Due to concerns related to patient comfort and compliance, scans are acquired in two separate scan session, allowing subjects to take a break between sessions. Further details about the imaging and purpose of each scan are provided in Table 1. Histograms of tissue properties of each scan are generated from each scan session as a quality assurance step. Outcome measures consist of average values from within brain parcels defined by freesurfer11 that have been coregistered to native space using AFNI12.RESULTS
To date, eighty six subjects (36 female) have been scanned. Age was 68±11 years (mean±std). Years of education was 16±3 years. Thirty-seven were cognitively normal, 18/3/2/2 had mild cognitive impairment of typical AD/atypical AD/DLB/Other types, 6/2/4/1 had typical AD/atypical AD/Down’s syndrome AD/Other dementia and 3 were awaiting consensus diagnosis. Figure 1 shows an example of histograms used as part of the quality assurance. Figure 2 depicts an example of outcome measures. Tables 2 and 3 show examples of outcome measures from one subject in regions commonly affected in AD.DISCUSSION
We present a brief overview of the imaging acquired by the CADRC-NIC. While measures of neurodegeneration from structural imaging are well-established for AD, imaging data from other modalities need to be acquired from a large population of subjects in order to evaluate their utility for patient management. Providing a quantitative summary of regional brain measures from an advanced imaging protocol can help to facilitate analyses by the regional and national network of AD and ADRD researchers. These data are made readily available and are intended to help in furthering the development of these advanced measures as biomarkers for AD diagnosis and progression.Acknowledgements
We gratefully acknowledge funding from NIH P30AG072959.References
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