Mean apparent propagator (MAP) MRI: a novel diffusion imaging method for mapping tissue microstructure

Diffusion tensor subspace imaging of double diffusion-encoded MRI delineates small fibers and gray-matter microstructure not visible with single encoding techniques

PURPOSE

Double diffusion encoding (DDE) acquisition strategies promise specificity for small-dimensional structures inaccessible to single diffusion encoding (SDE). For DDE-weighted MRI scans to become relevant for whole brain imaging, signal reconstruction frameworks must accurately report microstructural features of interest-especially microscale anisotropy in complex tissue environments. This study examined the recently developed diffusion tensor subspace imaging (DiTSI) framework and its radial and spherical anisotropy metrics (RA and SA, respectively) in postmortem human brain tissue specimens.

METHODS

MRI microscopy including multishell SDE-weighted and DDE-weighted imaging was performed for healthy brain stem and temporal lobe specimens and for specimens with Alzheimer's disease pathology and neurodegeneration. The DiTSI framework was compared with four other diffusion MRI frameworks, and angular and radial DDE sampling were evaluated.

RESULTS

DDE acquisition and the DiTSI metric maps of SA and RA in temporal lobe and brain-stem specimens were found to be distinct from fractional anisotropy and orientation dispersion index in providing complementary and selective contrast of microscale anisotropy at the gray-matter/white-matter interface in the cortex and in hippocampal layers. DiTSI maps also unmasked small fascicles in the brain stem that were not detectable by SDE techniques and provided selective contrast across the major fiber pathways. Results also revealed prominent reductions of SA and RA in tissue with Alzheimer's disease pathology that were not observed for any other framework.

CONCLUSIONS

New contrasts were evident for DiTSI framework metrics over a range of tissue environments with promise toward providing novel markers of pathology.

Measuring the velocity autocorrelation function using diffusion NMR

Molecular self-diffusion in the presence of barriers results in time-dependent displacements that are controlled by barrier characteristics, such as thickness, arrangement, and permeability, which manifests itself in the form of the ensemble-average velocity autocorrelation function (VAF). We describe a direct method to measure the VAF based on a combination of diffusion-weighted nuclear magnetic resonance (NMR) measurements in which two time-shifted diffusion encodings are separated by a longitudinal storage period. The VAF estimated from simulated data is shown to agree with the known expression for impermeable parallel planes. Simulations of diffusion in periodically spaced, permeable planes and connected, box-shaped pores are also presented. We find that scaling of the VAF faster than t-1/2 is indicative of barrier permeation or exchange between domains and that this can be captured by the proposed method. As an experimental proof-of-concept, we present data from an ex vivo neonatal mouse spinal cord studied using a permanent magnet NMR MOUSE system. We report a transition from t-1/2 to t-3/2 scaling at t ≈ 10 ms, consistent perhaps with transmembrane water exchange. Compared to other NMR-based approaches, this method can potentially access several orders of magnitude in time (ms - s), revealing a wealth of VAF behaviors with one experimental paradigm.

Uncertainty mapping and probabilistic tractography using Simulation-based Inference in diffusion MRI: A comparison with classical Bayes

Simulation-Based Inference (SBI) has recently emerged as a powerful framework for Bayesian inference: Neural networks are trained on simulations from a forward model, and learn to rapidly estimate posterior distributions. We here present an SBI framework for parametric spherical deconvolution of diffusion MRI data of the brain. We demonstrate its utility for estimating white matter fibre orientations, mapping uncertainty of voxel-based estimates and performing probabilistic tractography by spatially propagating fibre orientation uncertainty. We conduct an extensive comparison against established Bayesian methods based on Markov-Chain Monte-Carlo (MCMC) and find that: a) in-silico training can lead to calibrated SBI networks with accurate parameter estimates and uncertainty mapping for both single- and multi-shell diffusion MRI, b) SBI allows amortised inference of the posterior distribution of model parameters given unseen observations, which is orders of magnitude faster than MCMC, c) SBI-based tractography yields reconstructions that have a high level of agreement with their MCMC-based counterparts, equal to or higher than scan-rescan reproducibility of estimates. We further demonstrate how SBI design considerations (such as dealing with noise, defining priors and handling model selection) can affect performance, allowing us to identify optimal practices. Taken together, our results show that SBI provides a powerful alternative to classical Bayesian inference approaches for fast and accurate model estimation and uncertainty mapping in MRI.

Ex vivo brain MRI to assess conventional and FLASH brain irradiation effects

BACKGROUND AND PURPOSE

The FLASH effect expands the therapeutic ratio of tumor control to normal tissue toxicity observed after delivery of ultra-high (>100 Gy/s FLASH-RT) vs. conventional dose rate radiation (CONV-RT). In this first exploratory study, we assessed whether ex vivo Magnetic Resonance Imaging (MRI) could reveal long-term differences after FLASH-RT and CONV-RT whole-brain irradiation.

MATERIALS AND METHODS

Female C57BL/6 mice were divided into three groups: control (non-irradiated), conventional (CONV-RT 0.1 Gy/s), and ultra-high dose rates (FLASH-RT 1 pulse, 5.5 x 10^6 Gy/s), and received 10 Gy of whole-brain irradiation in a single fraction at 10 weeks of age. Mice were evaluated by Novel Object Recognition cognitive testing at 10 months post-irradiation and were sampled at 13 months post-irradiation. Ex vivo brains were imaged with a 14.1 Tesla/26 cm magnet with a multimodal MRI protocol, including T2-weighted TurboRare (T2W) and diffusion-weighted imaging (DWI) sequences.

RESULTS

In accordance with previous results, cognitive tests indicated that animals receiving CONV-RT exhibited a decline in cognitive function, while FLASH-RT performed similarly to the controls. Ex vivo MRI showed decreased hippocampal mean intensity in the CONV-RT mice compared to controls, but not in the FLASH-RT group. Comparing CONV-RT to control, we found significant changes in multiple whole-brain diffusion metrics, including the mean Apparent Diffusion Coefficient (ADC) and Mean Apparent Propagator (MAP) metrics. By contrast, no significant diffusion changes were found between the FLASH-RT and control groups. In an exploratory analysis, compared to controls, regional diffusion metrics were primarily altered in the basal forebrain and the insular cortex after conventional radiation therapy (CONV-RT), and to a lesser extent after flash radiation therapy (FLASH-RT).

CONCLUSION

This study presents initial evidence that ex vivo MRI uncovered changes in the brain after CONV-RT but not after FLASH-RT. The study indicates the potential use of ex vivo MRI to analyze the brain radiation responses at different dose rates.

Spatial transcriptomics of the aging mouse brain reveals origins of inflammation in the white matter

To systematically understand age-induced molecular changes, we performed spatial transcriptomics of young, middle-aged, and old mouse brains and identified seven transcriptionally distinct regions. All regions exhibited age-associated upregulation of inflammatory mRNAs and downregulation of mRNAs related to synaptic function. Notably, aging white matter fiber tracts showed the most prominent changes with pronounced effects in females. The inflammatory signatures indicated major ongoing events: microglia activation, astrogliosis, complement activation, and myeloid cell infiltration. Immunofluorescence and quantitative MRI analyses confirmed physical interaction of activated microglia with fiber tracts and concomitant reduction of myelin in old mice. In silico analyses identified potential transcription factors influencing these changes. Our study provides a resourceful dataset of spatially resolved transcriptomic features in the naturally aging murine brain encompassing three age groups and both sexes. The results link previous disjointed findings and provide a comprehensive overview of brain aging identifying fiber tracts as a focal point of inflammation.

Estimating Brain Similarity Networks with Diffusion MRI

Structural similarity has emerged as a promising tool in mapping the network organization of an individual, living human brain. Here, we propose diffusion similarity networks (DSNs), which employ rotationally invariant spherical harmonic features derived from diffusion magnetic resonance imaging (dMRI), to map gray matter structural organization. Compared to prior approaches, DSNs showed clearer laminar, cytoarchitectural, and micro-architectural organization; greater sensitivity to age, cognition, and sex; higher heritability in a large dataset of healthy young adults; and straightforward extension to non-cortical regions. We show DSNs are correlated with functional, structural, and gene expression connectomes and their gradients align with the sensory-fugal and sensorimotor-association axes of the cerebral cortex, including neuronal oscillatory dynamics, metabolism, immunity, and dopaminergic and glutaminergic receptor densities. DSNs can be easily integrated into conventional dMRI analysis, adding information complementary to structural white matter connectivity, and could prove useful in investigating a wide array of neurological and psychiatric conditions.

Use of mean apparent propagator (MAP) MRI in patients with acute ischemic stroke: A comparative study with DTI and NODDI

PURPOSE

To evaluate the Mean Apparent Propagator (MAP) MRI for processing multi-shell diffusion imaging in patients with acute ischemic stroke (AIS) and correlate to diffusion tensor imaging (DTI) and neurite orientation and dispersion density imaging (NODDI).

METHODS

We enrolled patients with AIS from 1/2022 to 4/2024 who underwent multi-shell diffusion imaging on a 3.0-Tesla scanner to generate DTI, NODDI and MAP measures. Mean intensity and standard deviation (SD) were calculated for the infarcted regions-of-interest in b0, fractional anisotropy (FA), mean diffusivity (MD), intra-cellular volume fraction (ICVF), free water fraction (FWF), and orientation dispersion index (ODI), return to the origin probability (RTOP), return to the plane probability (RTPP), return to the axis probability (RTAP), propagator anisotropy (PA), q-space Mean Square Displacement (QMSD), and non-Gaussianity (NG).

RESULTS

Twenty-two patients were included with an average age of 69.5 ± 13.5, mean NIHSS of 12.4 ± 7.7, and median infarct of 73.3 ± 10.1 ml. ICVF was correlated with RTPP (ρ = 0.82, p < 0.01), RTAP (ρ = 0.76, p < 0.01) and RTOP (ρ = 0.79, p < 0.01), ODI with PA (ρ = -0.83, p < 0.01), FWF with RTOP (ρ = -0.73, p < 0.01), RTAP (ρ = -0.69, p < 0.01), and RTPP (ρ = -0.73, p < 0.01), MD with RTPP (ρ = -0.80, p < 0.01), RTOP (ρ = -0.79, p < 0.01), and RTAP (ρ = -0.77, p < 0.01), FA with RTAP (ρ = 0.77, p < 0.01), RTOP (ρ = 0.67, p = 0.01), PA (ρ = 0.74, p < 0.01), and SD PA (ρ = 0.85, p < 0.01). Multivariable linear regression identified the SD QMSD (β = 0.406, p = 0.008), thrombectomy (β = 0.481, p = 0.002), and infarct volume (β = 0.292, p = 0.051) as predictive of stroke severity based on NIHSS.

CONCLUSIONS

Given its short processing time, MAP MRI is a valuable alternative with potential for clinical use in AIS.

Quasi-Diffusion Imaging: Application to Ultra-High b-Value and Time-Dependent Diffusion Images of Brain Tissue

We demonstrate that quasi-diffusion imaging (QDI) is a signal representation that extends towards the negative power law regime. We evaluate QDI for in vivo human and ex vivo fixed rat brain tissue acrossb $$ b $$ -value ranges from 0 to 25,000 s mm-2, determine whether accurate parameter estimates can be acquired from clinically feasible scan times and investigate their diffusion time-dependence. Several mathematical properties of the QDI representation are presented. QDI describes diffusion magnetic resonance imaging (dMRI) signal attenuation by two fitting parameters within a Mittag-Leffler function (MLF). We present its asymptotic properties at low and highb $$ b $$ -values and define the inflection point (IP) above which the signal tends to a negative power law. To show that QDI provides an accurate representation of dMRI signal, we apply it to two human brain datasets (Dataset 1:0 ≤ b ≤ 15,000 $$ 0\le b\le \mathrm{15,000} $$ s mm-2; Dataset 2:0 ≤ b ≤ 17,800 $$ 0\le b\le \mathrm{17,800} $$  s mm-2) and an ex vivo fixed rat brain (Dataset 3:0 ≤ b ≤ 25,000 $$ 0\le b\le \mathrm{25,000} $$  s mm-2, diffusion times17.5 ≤ ∆ ≤ 200 $$ 17.5\le \Delta \le 200 $$  ms). A clinically feasible 4b $$ b $$ -value subset of Dataset 1 (0 ≤ b ≤ 15,000 $$ 0\le b\le \mathrm{15,000} $$  s mm-2) is also analysed (acquisition time 6 min and 16 s). QDI showed excellent fits to observed signal attenuation, identified signal IPs and provided an apparent negative power law. Stable parameter estimates were identified upon increasing the maximumb $$ b $$ -value of the fitting range to near and above signal IPs, suggesting QDI is a valid signal representation within in vivo and ex vivo brain tissue across largeb $$ b $$ -value ranges with multiple diffusion times. QDI parameters were accurately estimated from clinically feasible shorter data acquisition, and time-dependence was observed with parameters approaching a Gaussian tortuosity limit with increasing diffusion time. In conclusion, QDI provides a parsimonious representation of dMRI signal attenuation in brain tissue that is sensitive to tissue microstructural heterogeneity and cell membrane permeability.

Assessing Visual Pathway White Matter Degeneration in Primary Open-Angle Glaucoma Using Multiple MRI Morphology and Diffusion Metrics

BACKGROUND

Primary open-angle glaucoma (POAG), a leading cause of irreversible blindness, is associated with neurodegeneration in the visual pathway, but the underlying pathophysiology remains incompletely resolved.

PURPOSE

To characterize macro- and microstructural white matter abnormalities in optic tract (OT) and optic radiation (OR) of POAG.

STUDY TYPE

Prospective.

POPULATIONS

A total of 34 POAG patients (21 males, 13 females) and 25 healthy controls (HCs) (16 males, nine females).

FIELD STRENGTH/SEQUENCE

3 T; multiband spin-echo echo planar diffusion spectrum imaging (DSI).

ASSESSMENT

We compared multiple morphology metrics, including volume, area, length, and shape metrics, as well as diffusion metrics such as diffusion tensor imaging (fractional anisotropy [FA], mean diffusivity, radial diffusivity, and axial diffusivity), mean apparent propagator (mean squared displacement, q-space inverse variance, return-to-origin probability, return-to-axis probabilities [RTAP] and return-to-plane probabilities, non-Gaussianity, perpendicular non-Gaussianity, parallel non-Gaussianity), and neurite orientation dispersion and density imaging (intracellular volume fraction, orientation dispersion index [ODI], and isotropic volume fraction of the OT and OR).

STATISTICAL TESTS

Statistical comparisons and classifications employed linear mixed model and logistic regression. Diagnostic performance was assessed using area under the receiver operating characteristic curve (AUC). P-value <0.05 was statistically significant.

RESULTS

Morphology analysis in POAG revealed a lower span in the OR (29.43 ± 2.30 vs. 30.59 ± 2.01, 3.8%) and OT (19.73 ± 2.21 vs. 20.68 ± 1.37, 4.6%), and a higher curl (3.03 ± 0.22 vs. 2.90 ± 0.16, 4.5%) in OT. Diffusion metrics revealed lower mean FA (OR: 0.328 ± 0.03 vs. 0.340 ± 0.018, 3.5%; OT: 0.255 ± 0.022 vs. 0.268 ± 0.018, 4.9%) and lower mean RTAP (OR: 5.919 ± 0.529 vs. 6.216 ± 0.489, 4.8%; OT: 4.089 ± 0.402 vs. 4.280 ± 0.353, 4.5%), with higher mean ODI in the OT (0.448 ± 0.029 vs. 0.433 ± 0.025, 3.5%). Combined models, incorporating these MRI metrics, effectively discriminated POAG from HCs, achieving AUCs of 0.84 for OR and 0.83 for OT.

DATA CONCLUSIONS

DSI-derived morphology and diffusion metrics demonstrated macro- and micro abnormalities in the visual pathway, providing insights into POAG-related neurodegeneration.

LEVEL OF EVIDENCE

2 TECHNICAL EFFICACY: Stage 3.

Ex vivo massively multidimensional diffusion-relaxation correlation MRI: scan-rescan reproducibility and caveats

Massively multidimensional diffusion-relaxation correlation MRI (MMD-MRI) provides information beyond the traditional voxel-averaged metric that may better characterize the microstructural characteristics of biological tissues. MMD-MRI reproducibility has been established in clinical settings, but has yet to be thoroughly evaluated under preclinical conditions, where superior hardware and modulated gradient waveforms enhance its performance. In this study, we investigate the reproducibility of MMD-MRI on a micro-imaging system using ex vivo mouse brains. Notably, the estimated signal fractions of intra-voxel spectral components in the MD-MRI distribution, corresponding to white and gray matter, along with the frequency-dependent parameters, demonstrated high reproducibility. We identified bias between scan and rescan in some of the metrics, which we attribute to the time gap between repeated scans pointing to a long-time progressive fixation effect. We compare our results with in vivo results from clinical scanners and show the reproducibility of diffusion frequency-dependent metrics to benefit from the improved gradient hardware on our preclinical setup. Our results inform future micro-imaging ex vivo MMD-MRI studies of the reproducibility of MMD-MRI metrics and their dependence on fixation time.

Diffusion MRI with double diffusion encoding and variable mixing times disentangles water exchange from transient kurtosis

Double diffusion encoding (DDE) makes diffusion MRI sensitive to a wide range of microstructural features, and the acquired data can be analysed using different approaches. Correlation tensor imaging (CTI) uses DDE to resolve three components of the diffusional kurtosis: isotropic, anisotropic, and microscopic kurtosis. The microscopic kurtosis is estimated from the contrast between single diffusion encoding (SDE) and parallel DDE signals at the same b-value. Another approach is multi-Gaussian exchange (MGE), which employs DDE to measure exchange. Sensitivity to exchange is obtained by contrasting SDE and DDE signals at the same b-value. CTI and MGE exploit the same signal contrast to quantify microscopic kurtosis and exchange, and this study investigates the interplay between these two quantities. We perform Monte Carlo simulations in different geometries with varying levels of exchange and study the behaviour of the parameters from CTI and MGE. We conclude that microscopic kurtosis from CTI is sensitive to the exchange rate and that intercompartmental exchange and the transient kurtosis of individual compartments are distinct sources of microscopic kurtosis. In an attempt to disentangle these two sources, we propose a heuristic signal representation referred to as tMGE (MGE incorporating transient kurtosis) that accounts for both effects by exploiting the distinct signatures of exchange and transient kurtosis with varying mixing time: exchange causes a slow dependence of the signal on mixing time while transient kurtosis arguably has a much faster dependence. We find that applying tMGE to data acquired with multiple mixing times for both parallel and orthogonal DDE may enable estimation of the exchange rate as well as isotropic, anisotropic, and transient kurtosis.

White matter microstructural alterations are associated with cognitive decline in benzodiazepine use disorders: a multi-shell diffusion magnetic resonance imaging study

Background

Benzodiazepine use disorders (BUDs) have become a public health issue that cannot be ignored. We aimed to demonstrate that patients with BUDs might undergo changes in white matter (WM) integrity, which are related to impaired cognitive function.

Methods

We used diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and mean apparent propagator (MAP) to observe changes in WM structure from 29 patients with sleep disorders with BUD (SDBUD), 33 patients with sleep disorders with non-BUD (SDNBUD), and 25 healthy participants. We also compared the diagnostic performance of the diffusion metrics and models in predicting the status of BUDs and evaluated the relationship between WM changes and cognitive impairment.

Results

BUD was closely associated with WM damage in the corpus callosum (CC) and pontine crossing tract (PCT). There were 14 main diffusion metrics that could be used to predict BUD status (P=0.001-0.023). DTI, DKI, NODDI, and MAP had similar satisfactory performance for predicting BUD status (P=0.001-0.021). Pearson correlation analysis showed a close relationship between the Trail Making Test B (TMT-B) and DTI/NODDI metrics in the splenium of the CC and PCT and between the Montreal Cognitive Assessment (MoCA) and MAP metrics in the splenium of the CC in the SDBUD group (P=0.008-0.040).

Conclusions

Our findings provide evidence for the neurobiological mechanism of benzodiazepine addiction and a novel method for the clinical diagnosis of BUDs.

Multi-parametric diffusion spectrum imaging in tuberous sclerosis complex: Identifying cortical tubers and predicting genotypes

OBJECTIVES

This study employed advanced MRI diffusion imaging techniques to identify cortical tubers in Tuberous Sclerosis Complex (TSC) patients and compared the diagnostic efficacy of various diffusion model parameters in predicting TSC genotypes.

METHODS

From July 2019 to April 2024, a prospective study was conducted at our Hospital. Participants meeting specific criteria underwent genetic testing and Diffusion Spectrum Imaging (DSI) data collection. The Dipy toolbox calculated parameters for Diffusion Tensor Imaging (DTI), Diffusion Kurtosis Imaging (DKI), Neurite Orientation Dispersion and Density Imaging (NODDI), and Mean Apparent Propagator (MAP) models. Lesion visibility and contrast were scored by two neuroradiologists. Significant parameters were identified through univariate logistic regression, and predictive models were developed using multivariate logistic regression and backward stepwise regression, resulting in a nomogram.

RESULTS

Eighty-three TSC patients were included (49 females, median age 5 years, IQR 3-9 years). Significant differences were found in lesion visibility and contrast among different diffusion model parameter maps (p < 0.001), with NODDI-ICVF and MAP-QIV showing clear advantages. The DTI, DKI, and MAP models struggled to distinguish small lesions near cerebral sulci from cerebrospinal fluid, while NODDI-ICVF performed well. The combined model using ICVF, QIV, and RTOP parameters demonstrated potentially better diagnostic performance compared to single diffusion models, with the nomogram indicating strong discrimination (AUC of 0.89, 95 % CI: 0.86-0.92). Clinical decision curves indicated significant net benefits at probability thresholds of 15 %-95 %.

CONCLUSION

NODDI and MAP models reveal cortical tubers more clearly. The combined model based on advanced diffusion parameters offers the best predictive efficiency for TSC genotypes.

Synthetic Diffusion Tensor Imaging Maps Generated by 2D and 3D Probabilistic Diffusion Models: Evaluation and Applications

Diffusion tensor imaging (DTI) is a key neuroimaging modality for assessing brain tissue microstructure, yet high-quality acquisitions are costly, time-intensive, and prone to artifacts. To address data scarcity and privacy concerns - and to augment the available data for training deep learning methods - synthetic DTI generation has gained interest. Specifically, denoising diffusion probabilistic models (DDPMs) have emerged as a promising approach due to their superior fidelity, diversity, controllability, and stability compared to generative adversarial networks (GANs) and variational autoencoders (VAEs). In this work, we evaluate the quality, fidelity and added value for downstream applications of synthetic DTI mean diffusivity (MD) maps generated by 2D slice-wise and 3D volume-wise DDPMs. We evaluate their computational efficiency and utility for data augmentation in two downstream tasks: sex classification and dementia classification using 2D and 3D convolutional neural networks (CNNs). Our findings show that 3D synthesis outperforms 2D slice-wise generation in downstream tasks. We present a benchmark analysis of synthetic diffusion-weighted imaging approaches, highlighting key trade-offs in image quality, diversity, efficiency, and downstream performance.

Super-resolution mapping of anisotropic tissue structure with diffusion MRI and deep learning

Diffusion magnetic resonance imaging (diffusion MRI) is widely employed to probe the diffusive motion of water molecules within the tissue. Numerous diseases and processes affecting the central nervous system can be detected and monitored via diffusion MRI thanks to its sensitivity to microstructural alterations in tissue. The latter has prompted interest in quantitative mapping of the microstructural parameters, such as the fiber orientation distribution function (fODF), which is instrumental for noninvasively mapping the underlying axonal fiber tracts in white matter through a procedure known as tractography. However, such applications demand repeated acquisitions of MRI volumes with varied experimental parameters demanding long acquisition times and/or limited spatial resolution. In this work, we present a deep-learning-based approach for increasing the spatial resolution of diffusion MRI data in the form of fODFs obtained through constrained spherical deconvolution. The proposed approach is evaluated on high quality data from the Human Connectome Project, and is shown to generate upsampled results with a greater correspondence to ground truth high-resolution data than can be achieved with ordinary spline interpolation methods. Furthermore, we employ a measure based on the earth mover's distance to assess the accuracy of the upsampled fODFs. At low signal-to-noise ratios, our super-resolution method provides more accurate estimates of the fODF compared to data collected with 8 times smaller voxel volume.

Evaluating Synthetic Diffusion MRI Maps created with Diffusion Denoising Probabilistic Models

Generative AI models, such as Stable Diffusion, DALL-E, and MidJourney, have recently gained widespread attention as they can generate high-quality synthetic images by learning the distribution of complex, high-dimensional image data. These models are now being adapted for medical and neuroimaging data, where AI-based tasks such as diagnostic classification and predictive modeling typically use deep learning methods, such as convolutional neural networks (CNNs) and vision transformers (ViTs), with interpretability enhancements. In our study, we trained latent diffusion models (LDM) and denoising diffusion probabilistic models (DDPM) specifically to generate synthetic diffusion tensor imaging (DTI) maps. We developed models that generate synthetic DTI maps of mean diffusivity by training on real 3D DTI scans, and evaluating realism and diversity of the synthetic data using maximum mean discrepancy (MMD) and multi-scale structural similarity index (MS-SSIM). We also assess the performance of a 3D CNN-based sex classifier, by training on combinations of real and synthetic DTIs, to check if performance improved when adding the synthetic scans during training, as a form of data augmentation. Our approach efficiently produces realistic and diverse synthetic data, potentially helping to create interpretable AI-driven maps for neuroscience research and clinical diagnostics.

Differentiating unirradiated mice from those exposed to conventional or FLASH radiotherapy using MRI

Background and purpose

The FLASH effect expands the therapeutic ratio of tumor control to normal tissue toxicity observed after delivery of ultra-high (>100 Gy/s FLASH-RT) vs. conventional dose rate radiation (CONV-RT). In this first exploratory study, we assessed whether ex-vivo Magnetic Resonance Imaging (MRI) could reveal long-term differences after FLASH-RT and CONV-RT whole-brain irradiation.

Materials and methods

Female C57BL/6 mice were divided into three groups: control (non-irradiated), conventional (CONV-RT 0.1 Gy/s), and ultra-high dose rates (FLASH-RT 1 pulse, 5.5 × 10^6 Gy/s), and received 10 Gy of whole-brain irradiation in a single fraction at 10 weeks of age. Mice were evaluated by Novel Object Recognition cognitive testing at 10 months post-irradiation and were sampled at 13 months post-irradiation. Ex-vivo brains were imaged with a 14.1 Tesla/26 cm magnet with a multimodal MRI protocol, including T2-weighted TurboRare (T2W) and diffusion-weighted imaging (DWI) sequences.

Results

In accordance with previous results, cognitive tests indicated that animals receiving CONV-RT exhibited a decline in cognitive function, while FLASH-RT performed similarly to the controls. MRI showed decreased hippocampal mean intensity in the CONV-RT mice compared to controls but not in the FLASH-RT group. Comparing CONV-RT to control, we found significant changes in multiple whole-brain diffusion metrics, including the mean Apparent Diffusion Coefficient (ADC) and Mean Apparent Propagator (MAP) metrics. By contrast, no significant diffusion changes were found between the FLASH-RT and control groups. In an exploratory analysis compared to controls, regional diffusion metrics were primarily altered in the basal forebrain and the insular cortex after CONV-RT, and after FLASH-RT, a trend reduction was also observed.

Conclusion

This study presents initial evidence that MRI can uncover clear changes in the brain after CONV-RT but not after FLASH-RT. The MRI results aligned with the observed cognitive protection after FLASH-RT, indicating the potential use of MRI to analyze the FLASH response.

"Pscore": A Novel Percentile-Based Metric to Accurately Assess Individual Deviations in Non-Gaussian Distributions of Quantitative MRI Metrics

BACKGROUND

Quantitative magnetic resonance imaging (MRI) metrics could be used in personalized medicine to assess individuals against normative distributions. Conventional Zscore analysis is inadequate in the presence of non-Gaussian distributions. Therefore, if quantitative MRI metrics deviate from normality, an alternative is needed.

PURPOSE

To confirm non-Gaussianity of diffusion MRI (dMRI) metrics on a publicly available dataset, and to propose a novel percentile-based method, "Pscore" to address this issue.

STUDY TYPE

Retrospective cohort.

POPULATION

Nine hundred and sixty-one healthy young adults (age: 22-35 years, females: 53%) from the Human Connectome Project.

FIELD STRENGTH/SEQUENCE

3-T, spin-echo diffusion echo-planar imaging, T1-weighted: MPRAGE.

ASSESSMENT

The dMRI data were preprocessed using the TORTOISE pipeline. Forty-eight regions of interest (ROIs) from the JHU atlas were redrawn on a study-specific diffusion tensor (DT) template and average values were computed from various DT and mean apparent propagator (MAP) metrics. For each ROI, percentile ranks across participants were computed to generate "Pscores"-which normalized the difference between the median and a participant's value with the corresponding difference between the median and the 5th/95th percentile values.

STATISTICAL TESTS

ROI-wise distributions were assessed using log transformations, Zscore, and the "Pscore" methods. The percentages of extreme values above-95th and below-5th percentile boundaries (PEV>95(%), PEV<5(%)) were also assessed in the overall white matter. Bootstrapping was performed to test the reliability of Pscores in small samples (N = 100) using 100 iterations.

RESULTS

The dMRI metric distributions were systematically non-Gaussian, including positively skewed (eg, mean and radial diffusivity) and negatively skewed (eg, fractional and propagator anisotropy) metrics. This resulted in unbalanced tails in Zscore distributions (PEV>95 ≠ 5%, PEV<5 ≠ 5%) whereas "Pscore" distributions were symmetric and balanced (PEV>95 = PEV<5 = 5%); even for small bootstrapped samples (averagePEV > 95 ¯ = PEV < 5 ¯ = 5 ± 0 % [SD]).

DATA CONCLUSION

The inherent skewness observed for dMRI metrics may preclude the use of conventional Zscore analysis. The proposed "Pscore" method may help estimating individual deviations more accurately in skewed normative data, even from small datasets.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY: Stage 1.

Direct segmentation of cortical cytoarchitectonic domains using ultra-high-resolution whole-brain diffusion MRI

We assess the potential of detecting cortical laminar patterns and areal borders by directly clustering voxel values of microstructural parameters derived from high-resolution mean apparent propagator (MAP) magnetic resonance imaging (MRI), as an alternative to conventional template-warping-based cortical parcellation methods. We acquired MAP-MRI data with 200μm resolution in a fixed macaque monkey brain. To improve the sensitivity to cortical layers, we processed the data with a local anisotropic Gaussian filter determined voxel-wise by the plane tangent to the cortical surface. We directly clustered all cortical voxels using only the MAP-derived microstructural imaging biomarkers, with no information regarding their relative spatial location or dominant diffusion orientations. MAP-based 3D cytoarchitectonic segmentation revealed laminar patterns similar to those observed in the corresponding histological images. Moreover, transition regions between these laminar patterns agreed more accurately with histology than the borders between cortical areas estimated using conventional atlas/template-warping cortical parcellation. By cross-tabulating all cortical labels in the atlas- and MAP-based segmentations, we automatically matched the corresponding MAP-derived clusters (i.e., cytoarchitectonic domains) across the left and right hemispheres. Our results demonstrate that high-resolution MAP-MRI biomarkers can effectively delineate three-dimensional cortical cytoarchitectonic domains in single individuals. Their intrinsic tissue microstructural contrasts enable the construction of whole-brain mesoscopic cortical atlases.

Differentiation between high-grade gliomas and solitary brain metastases based on multidiffusion MRI model quantitative analysis

Background and purpose

Differentiating high-grade gliomas (HGGs) from solitary brain metastases (SBMs) using conventional magnetic resonance imaging (MRI) remains challenging due to their similar imaging features. This study aimed to evaluate the diagnostic performance of advanced diffusion models, such as neurite orientation dispersion and density imaging (NODDI) and mean apparent propagator magnetic resonance imaging (MAP-MRI), incomparison to traditional techniques like diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI) for distinguishing HGGs from SBMs.

Methods

In total, 17 patients with HGGs and 26 patients with SBMs were prospectively recruited based on the established inclusion and exclusion criteria. Structural MRI sequences and diffusion spectrum imaging (DSI) were utilized to assess quantitative parameter models, including NODDI, MAP-MRI, DWI, DTI, and DKI. Quantitative parameters were measured for both the tumor parenchymal area and the peritumoral edema area. The quantitative parameters of the two patient groups were compared using either the independent Student's t-test or the Mann-Whitney U test. The effectiveness of each model was evaluated using receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC). Finally, the DeLong test was employed to compare the diagnostic performance of each model through pairwise comparisons of ROC curves.

Results

Isotropic volume fraction (Viso) based on NODDI; mean squared displacement (MSD) and the return to plane probabilities (RTPP) based on MAP-MRI; radial diffusivity (RDk) and mean diffusivity (MDk) based on DKI; and axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) based on DTI of the peritumoral edema tumor were significantly different between HGGs and SBMs (p < 0.05). The optimal single discriminant parameters for each model are NODDI_Viso, MAP-MRI_MSD, DKI_MDk, and DTI_AD. Among these, the AUC of Viso (0.809) exceeds that of MSD (0.733), MDk (0.718), and AD (0.779). The combined model, which incorporates DTI_AD, DKI_RD, and NODDI_Viso, demonstrated superior diagnostic performance (0.897).

Conclusions

Advanced diffusion MRI quantitative parameters derived from NODDI, such as Viso, have the potential to enhance the differentiation between HGGs and SBMs. The integrated utilization of these models is anticipated to enhance diagnostic accuracy and refine MRI protocols for brain tumor assessment.

Advanced Framework for Fetal Diffusion MRI: Dynamic Distortion and Motion Correction

Diffusion magnetic resonance imaging (dMRI) is essential for studying the microstructure of the developing fetal brain. However, fetal motion during scans and its interaction with magnetic field inhomo-geneities lead to amplified artifacts and data scattering, compromising the consistency of dMRI analysis. This work introduces HAITCH, a novel open-source framework for correcting and reconstructing high-angular resolution dMRI data from challenging fetal scans. Our multi-stage approach incorporates an optimized multi-shell design for increased information capture and motion tolerance, a blip-reversed dual-echo multi-shell acquisition for dynamic distortion correction, advanced motion correction for robust and model-free reconstruction, and outlier detection for improved reconstruction fidelity. Validation experiments on real fetal dMRI scans demonstrate significant improvements and accurate correction across diverse fetal ages and motion levels. HAITCH effectively removes artifacts and reconstructs high-fidelity dMRI data suitable for advanced diffusion modeling and tractography.

Tumor Multiregional Mean Apparent Propagator (MAP) Features in Evaluating Gliomas-A Comparative Study With Diffusion Kurtosis Imaging (DKI)

BACKGROUND

Glioma classification affects treatment and prognosis. Reliable imaging methods for preoperatively evaluating gliomas are essential.

PURPOSE

To evaluate tumor multiregional mean apparent propagator (MAP) features in glioma diagnosis and to compare those with diffusion-kurtosis imaging (DKI).

STUDY TYPE

Retrospective study.

SUBJECTS

70 untreated glioma patients (31 LGGs (low-grade gliomas), 34 women; mean age, 47 ± 12 years, training (60%, n = 42) and testing cohorts (40%, n = 28)).

FIELD STRENGTH/SEQUENCE

3-T, diffusion-MRI using q-space Cartesian grid sampling with 11 different b-values.

ASSESSMENT

Tumor multiregional MAP (mean squared displacement (MSD); q-space inverse variance (QIV); non-Gaussianity (NG); axial/radial non-Gaussianity (NGAx, NGRad); return-to-origin/axis/plane probability (RTOP, RTAP, and RTPP)); and DKI metrics (axial/mean/radial kurtosis (AK, MK, and RK)) on tumor parenchyma (TP) and peritumoral areas (PT) in histopathologically gliomas grading and genotyping were assessed.

STATISTICAL TESTS

Mann-Whitney U; Kruskal-Wallis; Benjamini-Hochberg; Bonferroni-correction; receiver operating curve (ROC) and area under curve (AUC); DeLong's test; Random Forest (RF). P value<0.05 was considered statistically significant after multiple comparisons correction.

RESULTS

Compared with LGGs, MSD, and QIV were significantly lower in TP, whereas NG, NGAx, NGRad, RTOP, RTAP, RTPP, and DKI metrics were significantly higher in HGGs (high-grade gliomas) (P ≤ 0.007), as well as in isocitrate-dehydrogenase (IDH)-mutated than IDH-wildtype gliomas (P ≤ 0.039). These trends were reversed for PT (tumor grades, P ≤ 0.011; IDH-mutation status, P ≤ 0.012). ROC analysis showed that, in TP, DKI metrics performed best in TP (AUC 0.83), whereas in PT, RTPP performed best (AUC 0.77) in glioma grading. AK performed best in TP (AUC 0.77), whereas MSD and RTPP performed best in PT (AUC 0.73) in IDH genotyping. Further RF analysis with DKI and MAP demonstrated good performance in grading (AUC 0.91, Accuracy 82%) and IDH genotyping (AUC 0.87, Accuracy 79%).

DATA CONCLUSION

Tumor multiregional MAP features could effectively evaluate gliomas. The performance of MAP may be similar to DKI in TP, while in PT, MAP may outperform DKI.

LEVEL OF EVIDENCE

4 TECHNICAL EFFICACY: Stage 2.

Advanced Diffusion-Weighted MRI for Cancer Microstructure Assessment in Body Imaging, and Its Relationship With Histology

Diffusion-weighted magnetic resonance imaging (DW-MRI) aims to disentangle multiple biological signal sources in each imaging voxel, enabling the computation of innovative maps of tissue microstructure. DW-MRI model development has been dominated by brain applications. More recently, advanced methods with high fidelity to histology are gaining momentum in other contexts, for example, in oncological applications of body imaging, where new biomarkers are urgently needed. The objective of this article is to review the state-of-the-art of DW-MRI in body imaging (ie, not including the nervous system) in oncology, and to analyze its value as compared to reference colocalized histology measurements, given that demonstrating the histological validity of any new DW-MRI method is essential. In this article, we review the current landscape of DW-MRI techniques that extend standard apparent diffusion coefficient (ADC), describing their acquisition protocols, signal models, fitting settings, microstructural parameters, and relationship with histology. Preclinical, clinical, and in/ex vivo studies were included. The most used techniques were intravoxel incoherent motion (IVIM; 36.3% of used techniques), diffusion kurtosis imaging (DKI; 16.7%), vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT; 13.3%), and imaging microstructural parameters using limited spectrally edited diffusion (IMPULSED; 11.7%). Another notable category of techniques relates to innovative b-tensor diffusion encoding or joint diffusion-relaxometry. The reviewed approaches provide histologically meaningful indices of cancer microstructure (eg, vascularization/cellularity) which, while not necessarily accurate numerically, may still provide useful sensitivity to microscopic pathological processes. Future work of the community should focus on improving the inter-/intra-scanner robustness, and on assessing histological validity in broader contexts. LEVEL OF EVIDENCE: NA TECHNICAL EFFICACY: Stage 2.

Super-resolution reconstruction improves multishell diffusion: using radiomics to predict adult-type diffuse glioma IDH and grade

Objectives

Multishell diffusion scanning is limited by low spatial resolution. We sought to improve the resolution of multishell diffusion images through deep learning-based super-resolution reconstruction (SR) and subsequently develop and validate a prediction model for adult-type diffuse glioma, isocitrate dehydrogenase status and grade 2/3 tumors.

Materials and methods

A simple diffusion model (DTI) and three advanced diffusion models (DKI, MAP, and NODDI) were constructed based on multishell diffusion scanning. Migration was performed with a generative adversarial network based on deep residual channel attention networks, after which images with 2x and 4x resolution improvements were generated. Radiomic features were used as inputs, and diagnostic models were subsequently constructed via multiple pipelines.

Results

This prospective study included 90 instances (median age, 54.5 years; 39 men) diagnosed with adult-type diffuse glioma. Images with both 2x- and 4x-improved resolution were visually superior to the original images, and the 2x-improved images allowed better predictions than did the 4x-improved images (P<.001). A comparison of the areas under the curve among the multiple pipeline-constructed models revealed that the advanced diffusion models did not have greater diagnostic performance than the simple diffusion model (P>.05). The NODDI model constructed with 2x-improved images had the best performance in predicting isocitrate dehydrogenase status (AUC_validation=0.877; Brier score=0.132). The MAP model constructed with the original images performed best in classifying grade 2 and grade 3 tumors (AUC_validation=0.806; Brier score=0.168).

Conclusion

SR improves the resolution of multishell diffusion images and has different advantages in achieving different goals and creating different target diffusion models.

Long-term table tennis training alters dynamic functional connectivity and white matter microstructure in large scale brain regions

Table tennis training has been employed as an exercise treatment to enhance cognitive brain functioning in patients with mental illnesses. However, research on its underlying mechanisms remains limited. In this study, we investigated functional and structural changes in large-scale brain regions between 20 table tennis players (TTPs) and 21 healthy controls (HCs) using 7-Tesla magnetic resonance imaging (MRI) techniques. Compared with those of HCs, TTPs exhibited significantly greater fractional anisotropy (FA) and axial diffusivity (AD) values in multiple fiber tracts. We used the locations with the most significant structural changes in white matter as the seed areas and then compared static and dynamic functional connectivity (sFC and dFC). Brodmann 11, located in the orbitofrontal cortex, showed altered dFC values to large-scale brain regions, such as the occipital lobe, thalamus, and cerebellar hemispheres, in TTPs. Brodmann 48, located in the temporal lobe, showed altered dFC to the parietal lobe, frontal lobe, cerebellum, and occipital lobe. Furthermore, the AD values of the forceps minor (Fmi) and right anterior thalamic radiations (ATRs) were negatively correlated with useful field of view (UFOV) test scores in TTPs. Our results suggest that table tennis players exhibit a unique pattern of dynamic neural activity, this provides evidence for potential mechanisms through which table tennis interventions can enhance attention and other cognitive functions.

Design and validation of the ADNI MR protocol

Phase four of the Alzheimer's Disease Neuroimaging Initiative (ADNI4) magnetic resonance imaging (MRI) protocols aim to maintain longitudinal consistency across two decades of data acquisition, while adopting new technologies. Here we describe and justify the study's design and targeted biomarkers. The ADNI4 MRI protocol includes nine MRI sequences. Some sequences require the latest hardware and software system upgrades and are continuously rolled out as they become available at each site. The main sequence additions/changes in ADNI4 are: (1) compressed sensing (CS) T1-weighting, (2) pseudo-continuous arterial spin labeling (ASL) on all three vendors (GE, Siemens, Philips), (3) multiple-post-labeling-delay ASL, (4) 1 mm3 isotropic 3D fluid-attenuated inversion recovery, and (5) CS 3D T2-weighted. ADNI4 aims to help the neuroimaging community extract valuable imaging biomarkers and provide a database to test the impact of advanced imaging strategies on diagnostic accuracy and disease sensitivity among individuals lying on the cognitively normal to impaired spectrum. HIGHLIGHTS: A summary of MRI protocols for phase four of the Alzheimer's Disease Neuroimaging Initiative (ADNI 4). The design and justification for the ADNI 4 MRI protocols. Compressed sensing and multi-band advances have been applied to improve scan time. ADNI4 protocols aim to streamline safety screening and therapy monitoring. The ADNI4 database will be a valuable test bed for academic research.

XAI-Based Assessment of the AMURA Model for Detecting Amyloid-β and Tau Microstructural Signatures in Alzheimer's Disease

Brain microstructural changes already occur in the earliest phases of Alzheimer's disease (AD) as evidenced in diffusion magnetic resonance imaging (dMRI) literature. This study investigates the potential of the novel dMRI Apparent Measures Using Reduced Acquisitions (AMURA) as imaging markers for capturing such tissue modifications.Tract-based spatial statistics (TBSS) and support vector machines (SVMs) based on different measures were exploited to distinguish between amyloid-beta/tau negative (A[Formula: see text]-/tau-) and A[Formula: see text]+/tau+ or A[Formula: see text]+/tau- subjects. Moreover, eXplainable Artificial Intelligence (XAI) was used to highlight the most influential features in the SVMs classifications and to validate the results by seeing the explanations' recurrence across different methods.TBSS analysis revealed significant differences between A[Formula: see text]-/tau- and other groups in line with the literature. The best SVM classification performance reached an accuracy of 0.73 by using advanced measures compared to more standard ones. Moreover, the explainability analysis suggested the results' stability and the central role of the cingulum to show early sign of AD.By relying on SVM classification and XAI interpretation of the outcomes, AMURA indices can be considered viable markers for amyloid and tau pathology. Clinical impact: This pre-clinical research revealed AMURA indices as viable imaging markers for timely AD diagnosis by acquiring clinically feasible dMR images, with advantages compared to more invasive methods employed nowadays.

Q-space imaging based on Gaussian radial basis function with Laplace regularization

PURPOSE

To introduce the diffusion signal characteristics presented by spherical harmonics (SH) basis into the q-space imaging method based on Gaussian radial basis function (GRBF) to robustly reconstruct ensemble average diffusion propagator (EAP) in diffusion MRI (dMRI).

METHODS

We introduced the Laplacian regularization of the signal into the dMRI imaging method based on GRBF, and derived the relevant indicators of microstructure imaging and the orientation distribution function (ODF) providing fiber bundle direction information based on EAP. In addition, this method is combined with a multi-compartment model to calculate the diameter of fiber bundle axons. The evaluation of the results included qualitative comparisons and quantitative assessments of the signal fitting.

RESULTS

The results show that the proposed method achieves the more significant accuracy improvement in reconstructing signal. Meanwhile, ODFs estimated by the proposed method show the sharper profiles and less spurious peaks, even under the sparse and noisy conditions. In the 36 sets of axon diameter estimation experiments, 34 and 30 sets of results showed that the proposed method reduced the mean and SD of axon diameter estimates, respectively. Moreover, compared with the current state-of-the-art method, the mean and SD of axon diameter estimated by the proposed method are mostly lower, with 32 and 29 of 36 groups.

CONCLUSION

The proposed method outperforms the GRBF regarding signal fitting and the estimation of the EAP and ODF with multi-shell sparse samples. Moreover, it shows the potential to recover important features of microstructures with less uncertainty by using proposed method together with multi-compartment models.

Neuronal microstructural changes in the human brain are associated with neurocognitive aging

Gray matter (GM) alterations play a role in aging-related disorders like Alzheimer's disease and related dementias, yet MRI studies mainly focus on macroscopic changes. Although reliable indicators of atrophy, morphological metrics like cortical thickness lack the sensitivity to detect early changes preceding visible atrophy. Our study aimed at exploring the potential of diffusion MRI in unveiling sensitive markers of cortical and subcortical age-related microstructural changes and assessing their associations with cognitive and behavioral deficits. We leveraged the Human Connectome Project-Aging cohort that included 707 participants (394 female; median age = 58, range = 36-90 years) and applied the powerful mean apparent diffusion propagator model to measure microstructural parameters, along with comprehensive behavioral and cognitive test scores. Both macro- and microstructural GM characteristics were strongly associated with age, with widespread significant microstructural correlations reflective of cellular morphological changes, reduced cellular density, increased extracellular volume, and increased membrane permeability. Importantly, when correlating MRI and cognitive test scores, our findings revealed no link between macrostructural volumetric changes and neurobehavioral performance. However, we found that cellular and extracellular alterations in cortical and subcortical GM regions were associated with neurobehavioral performance. Based on these findings, it is hypothesized that increased microstructural heterogeneity and decreased neurite orientation dispersion precede macrostructural changes, and that they play an important role in subsequent cognitive decline. These alterations are suggested to be early markers of neurocognitive performance that may distinctly aid in identifying the mechanisms underlying phenotypic aging and subsequent age-related functional decline.

Brain Age Analysis and Dementia Classification using Convolutional Neural Networks trained on Diffusion MRI: Tests in Indian and North American Cohorts

Deep learning models based on convolutional neural networks (CNNs) have been used to classify Alzheimer's disease or infer dementia severity from T1-weighted brain MRI scans. Here, we examine the value of adding diffusion-weighted MRI (dMRI) as an input to these models. Much research in this area focuses on specific datasets such as the Alzheimer's Disease Neuroimaging Initiative (ADNI), which assesses people of North American, largely European ancestry, so we examine how models trained on ADNI, generalize to a new population dataset from India (the NIMHANS cohort). We first benchmark our models by predicting "brain age" - the task of predicting a person's chronological age from their MRI scan and proceed to AD classification. We also evaluate the benefit of using a 3D CycleGAN approach to harmonize the imaging datasets before training the CNN models. Our experiments show that classification performance improves after harmonization in most cases, as well as better performance for dMRI as input.

Mean Apparent Propagator MRI: Quantitative Assessment of Tumor-Stroma Ratio in Invasive Ductal Breast Carcinoma

Purpose To determine whether metrics from mean apparent propagator (MAP) MRI perform better than apparent diffusion coefficient (ADC) value in assessing the tumor-stroma ratio (TSR) status in breast carcinoma. Materials and Methods From August 2021 to October 2022, 271 participants were prospectively enrolled (ClinicalTrials.gov identifier: NCT05159323) and underwent breast diffusion spectral imaging and diffusion-weighted imaging. MAP MRI metrics and ADC were derived from the diffusion MRI data. All participants were divided into high-TSR (stromal component < 50%) and low-TSR (stromal component ≥ 50%) groups based on pathologic examination. Clinicopathologic characteristics were collected, and MRI findings were assessed. Logistic regression was used to determine the independent variables for distinguishing TSR status. The area under the receiver operating characteristic curve (AUC) and sensitivity, specificity, and accuracy were compared between the MAP MRI metrics, either alone or combined with clinicopathologic characteristics, and ADC, using the DeLong and McNemar test. Results A total of 181 female participants (mean age, 49 years ± 10 [SD]) were included. All diffusion MRI metrics differed between the high-TSR and low-TSR groups (P < .001 to P = .01). Radial non-Gaussianity from MAP MRI and lymphovascular invasion were significant independent variables for discriminating the two groups, with a higher AUC (0.81 [95% CI: 0.74, 0.87] vs 0.61 [95% CI: 0.53, 0.68], P < .001) and accuracy (138 of 181 [76%] vs 106 of 181 [59%], P < .001) than that of the ADC. Conclusion MAP MRI may serve as a better approach than conventional diffusion-weighted imaging in evaluating the TSR of breast carcinoma. Keywords: MR Diffusion-weighted Imaging, MR Imaging, Breast, Oncology ClinicalTrials.gov Identifier: NCT05159323 Supplemental material is available for this article. © RSNA, 2024.

HAITCH: A Framework for Distortion and Motion Correction in Fetal Multi-Shell Diffusion-Weighted MRI

Diffusion magnetic resonance imaging (dMRI) is pivotal for probing the microstructure of the rapidly-developing fetal brain. However, fetal motion during scans and its interaction with magnetic field inhomogeneities result in artifacts and data scattering across spatial and angular domains. The effects of those artifacts are more pronounced in high-angular resolution fetal dMRI, where signal-to-noise ratio is very low. Those effects lead to biased estimates and compromise the consistency and reliability of dMRI analysis. This work presents HAITCH, the first and the only publicly available tool to correct and reconstruct multi-shell high-angular resolution fetal dMRI data. HAITCH offers several technical advances that include a blip-reversed dual-echo acquisition for dynamic distortion correction, advanced motion correction for model-free and robust reconstruction, optimized multi-shell design for enhanced information capture and increased tolerance to motion, and outlier detection for improved reconstruction fidelity. The framework is open-source, flexible, and can be used to process any type of fetal dMRI data including single-echo or single-shell acquisitions, but is most effective when used with multi-shell multi-echo fetal dMRI data that cannot be processed with any of the existing tools. Validation experiments on real fetal dMRI scans demonstrate significant improvements and accurate correction across diverse fetal ages and motion levels. HAITCH successfully removes artifacts and reconstructs high-fidelity fetal dMRI data suitable for advanced diffusion modeling, including fiber orientation distribution function estimation. These advancements pave the way for more reliable analysis of the fetal brain microstructure and tractography under challenging imaging conditions.

Novel pore size-controlled, susceptibility matched, 3D-printed MRI phantoms

PURPOSE

We report the design concept and fabrication of MRI phantoms, containing blocks of aligned microcapillaires that can be stacked into larger arrays to construct diameter distribution phantoms or fractured, to create a "powder-averaged" emulsion of randomly oriented blocks for vetting or calibrating advanced MRI methods, that is, diffusion tensor imaging, AxCaliber MRI, MAP-MRI, and multiple pulsed field gradient or double diffusion-encoded microstructure imaging methods. The goal was to create a susceptibility-matched microscopically anisotropic but macroscopically isotropic phantom with a ground truth diameter that could be used to vet advanced diffusion methods for diameter determination in fibrous tissues.

METHODS

Two-photon polymerization, a novel three-dimensional printing method is used to fabricate blocks of capillaries. Double diffusion encoding methods were employed and analyzed to estimate the expected MRI diameter.

RESULTS

Susceptibility-matched microcapillary blocks or modules that can be assembled into large-scale MRI phantoms have been fabricated and measured using advanced diffusion methods, resulting in microscopic anisotropy and random orientation.

CONCLUSION

This phantom can vet and calibrate various advanced MRI methods and multiple pulsed field gradient or diffusion-encoded microstructure imaging methods. We demonstrated that two double diffusion encoding methods underestimated the ground truth diameter.

Brain Age Analysis and Dementia Classification using Convolutional Neural Networks trained on Diffusion MRI: Tests in Indian and North American Cohorts

Deep learning models based on convolutional neural networks (CNNs) have been used to classify Alzheimer's disease or infer dementia severity from T1-weighted brain MRI scans. Here, we examine the value of adding diffusion-weighted MRI (dMRI) as an input to these models. Much research in this area focuses on specific datasets such as the Alzheimer's Disease Neuroimaging Initiative (ADNI), which assesses people of North American, largely European ancestry, so we examine how models trained on ADNI, generalize to a new population dataset from India (the NIMHANS cohort). We first benchmark our models by predicting 'brain age' - the task of predicting a person's chronological age from their MRI scan and proceed to AD classification. We also evaluate the benefit of using a 3D CycleGAN approach to harmonize the imaging datasets before training the CNN models. Our experiments show that classification performance improves after harmonization in most cases, as well as better performance for dMRI as input.

Assessing brain microstructural changes in chronic kidney disease: a diffusion imaging study using multiple models

Objectives

To explore the effectiveness of diffusion quantitative parameters derived from advanced diffusion models in detecting brain microstructural changes in patients with chronic kidney disease (CKD).

Methods

The study comprised 44 CKD patients (eGFR<59 mL/min/1.73 m2) and 35 age-and sex-matched healthy controls. All patients underwent diffusion spectrum imaging (DSI) and conventional magnetic resonance imaging. Reconstructed to obtain diffusion MRI models, including diffusion tensor imaging (DTI), neurite orientation dispersion and density imaging (NODDI) and Mean Apparent Propagator (MAP)-MRI, were processed to obtain multi-parameter maps. The Tract-Based Spatial Statistics (TBSS) analysis was utilized for detecting microstructural differences and Pearson correlation analysis assessed the relationship between renal metabolism markers and diffusion parameters in the brain regions of CKD patients. Receiver operating characteristic (ROC) curve analysis assessed the diagnostic performance of diffusion models, with AUC comparisons made using DeLong's method.

Results

Significant differences were noted in DTI, NODDI, and MAP-MRI parameters between CKD patients and controls (p < 0.05). DTI indicated a decrease in Fractional Anisotropy(FA) and an increase in Mean and Radial Diffusivity (MD and RD) in CKD patients. NODDI indicated decreased Intracellular and increased Extracellular Volume Fractions (ICVF and ECVF). MAP-MRI identified extensive microstructural changes, with elevated Mean Squared Displacement (MSD) and Q-space Inverse Variance (QIV) values, and reduced Non-Gaussianity (NG), Axial Non-Gaussianity (NGAx), Radial Non-Gaussianity (NGRad), Return-to-Origin Probability (RTOP), Return-to-Axis Probability (RTAP), and Return-to-Plane Probability (RTPP). There was a moderate correlation between serum uric acid (SUA) and diffusion parameters in six brain regions (p < 0.05). ROC analysis showed the AUC values of DTI_FA ranged from 0.70 to 0.793. MAP_NGAx in the Retrolenticular part of the internal capsule R reported a high AUC value of 0.843 (p < 0.05), which was not significantly different from other diffusion parameters (p > 0.05).

Conclusion

The advanced diffusion models (DTI, NODDI, and MAP-MRI) are promising for detecting brain microstructural changes in CKD patients, offering significant insights into CKD-affected brain areas.

Microstructural Mapping of Neural Pathways in Alzheimer's Disease using Macrostructure-Informed Normative Tractometry

Introduction

Diffusion MRI is sensitive to the microstructural properties of brain tissues, and shows great promise in detecting the effects of degenerative diseases. However, many approaches analyze single measures averaged over regions of interest, without considering the underlying fiber geometry.

Methods

Here, we propose a novel Macrostructure-Informed Normative Tractometry (MINT) framework, to investigate how white matter microstructure and macrostructure are jointly altered in mild cognitive impairment (MCI) and dementia. We compare MINT-derived metrics with univariate metrics from diffusion tensor imaging (DTI), to examine how fiber geometry may impact interpretation of microstructure.

Results

In two multi-site cohorts from North America and India, we find consistent patterns of microstructural and macrostructural anomalies implicated in MCI and dementia; we also rank diffusion metrics' sensitivity to dementia.

Discussion

We show that MINT, by jointly modeling tract shape and microstructure, has potential to disentangle and better interpret the effects of degenerative disease on the brain's neural pathways.

Neuroimaging Findings in US Government Personnel and Their Family Members Involved in Anomalous Health Incidents

Importance

US government personnel stationed internationally have reported anomalous health incidents (AHIs), with some individuals experiencing persistent debilitating symptoms.

Objective

To assess the potential presence of magnetic resonance imaging (MRI)-detectable brain lesions in participants with AHIs, with respect to a well-matched control group.

Design, Setting, and Participants

This exploratory study was conducted at the National Institutes of Health (NIH) Clinical Center and the NIH MRI Research Facility between June 2018 and November 2022. Eighty-one participants with AHIs and 48 age- and sex-matched control participants, 29 of whom had similar employment as the AHI group, were assessed with clinical, volumetric, and functional MRI. A high-quality diffusion MRI scan and a second volumetric scan were also acquired during a different session. The structural MRI acquisition protocol was optimized to achieve high reproducibility. Forty-nine participants with AHIs had at least 1 additional imaging session approximately 6 to 12 months from the first visit.

Exposure

AHIs.

Main Outcomes and Measures

Group-level quantitative metrics obtained from multiple modalities: (1) volumetric measurement, voxel-wise and region of interest (ROI)-wise; (2) diffusion MRI-derived metrics, voxel-wise and ROI-wise; and (3) ROI-wise within-network resting-state functional connectivity using functional MRI. Exploratory data analyses used both standard, nonparametric tests and bayesian multilevel modeling.

Results

Among the 81 participants with AHIs, the mean (SD) age was 42 (9) years and 49% were female; among the 48 control participants, the mean (SD) age was 43 (11) years and 42% were female. Imaging scans were performed as early as 14 days after experiencing AHIs with a median delay period of 80 (IQR, 36-544) days. After adjustment for multiple comparisons, no significant differences between participants with AHIs and control participants were found for any MRI modality. At an unadjusted threshold (P < .05), compared with control participants, participants with AHIs had lower intranetwork connectivity in the salience networks, a larger corpus callosum, and diffusion MRI differences in the corpus callosum, superior longitudinal fasciculus, cingulum, inferior cerebellar peduncle, and amygdala. The structural MRI measurements were highly reproducible (median coefficient of variation <1% across all global volumetric ROIs and <1.5% for all white matter ROIs for diffusion metrics). Even individuals with large differences from control participants exhibited stable longitudinal results (typically, <±1% across visits), suggesting the absence of evolving lesions. The relationships between the imaging and clinical variables were weak (median Spearman ρ = 0.10). The study did not replicate the results of a previously published investigation of AHIs.

Conclusions and Relevance

In this exploratory neuroimaging study, there were no significant differences in imaging measures of brain structure or function between individuals reporting AHIs and matched control participants after adjustment for multiple comparisons.

Geometric deep learning for diffusion MRI signal reconstruction with continuous samplings (DISCUS)

Diffusion-weighted magnetic resonance imaging (dMRI) permits a detailed in-vivo analysis of neuroanatomical microstructure, invaluable for clinical and population studies. However, many measurements with different diffusion-encoding directions and possibly b-values are necessary to infer the underlying tissue microstructure within different imaging voxels accurately. Two challenges particularly limit the utility of dMRI: long acquisition times limit feasible scans to only a few directional measurements, and the heterogeneity of acquisition schemes across studies makes it difficult to combine datasets. Left unaddressed by previous learning-based methods that only accept dMRI data adhering to the specific acquisition scheme used for training, there is a need for methods that accept and predict signals for arbitrary diffusion encodings. Addressing these challenges, we describe the first geometric deep learning method for continuous dMRI signal reconstruction for arbitrary diffusion sampling schemes for both the input and output. Our method combines the reconstruction accuracy and robustness of previous learning-based methods with the flexibility of model-based methods, for example, spherical harmonics or SHORE. We demonstrate that our method outperforms model-based methods and performs on par with discrete learning-based methods on single-, multi-shell, and grid-based diffusion MRI datasets. Relevant for dMRI-derived analyses, we show that our reconstruction translates to higher-quality estimates of frequently used microstructure models compared to other reconstruction methods, enabling high-quality analyses even from very short dMRI acquisitions.

Longitudinal changes in diffusion tensor imaging in hemodialysis patients

INTRODUCTION

Hemodialysis patients have increased white matter and gray matter pathology in the brain relative to controls based on MRI. Diffusion tensor imaging is useful in detecting differences between hemodialysis and controls but has not identified the expected longitudinal decline in hemodialysis patients. In this study we implemented specialized post-processing techniques to reduce noise to detect longitudinal changes in diffusion tensor imaging parameters and evaluated for any association with changes in cognition.

METHODS

We collected anatomical and diffusion MRIs as well as cognitive testing from in-center hemodialysis patients at baseline and 1 year later. Gray matter thickness, white matter volume, and white matter diffusion tensor imaging parameters were measured to identify longitudinal changes. We analyzed the diffusion tensor imaging parameters by averaging the whole white matter and using a pothole analysis. Eighteen hemodialysis patients were included in the longitudinal analysis and 15 controls were used for the pothole analysis. We used the NIH Toolbox Cognition Battery to assess cognitive performance over the same time frame.

FINDINGS

Over the course of a year on hemodialysis, we found a decrease in white matter fractional anisotropy across the entire white matter (p < 0.01), and an increase in the number of white matter fractional anisotropy voxels below pothole threshold (p = 0.03). We did not find any relationship between changes in whole brain structural parameters and cognitive performance.

DISCUSSION

By employing noise reducing techniques, we were able to detect longitudinal changes in diffusion tensor imaging parameters in hemodialysis patients. The fractional anisotropy declines over the year indicate significant decreases in white matter health. However, we did not find that declines in fractional anisotropy was associated with declines in cognitive performance.

The Subcortical Atlas of the Marmoset ("SAM") monkey based on high-resolution MRI and histology

A comprehensive three-dimensional digital brain atlas of cortical and subcortical regions based on MRI and histology has a broad array of applications in anatomical, functional, and clinical studies. We first generated a Subcortical Atlas of the Marmoset, called the "SAM," from 251 delineated subcortical regions (e.g. thalamic subregions, etc.) derived from high-resolution Mean Apparent Propagator-MRI, T2W, and magnetization transfer ratio images ex vivo. We then confirmed the location and borders of these segmented regions in the MRI data using matched histological sections with multiple stains obtained from the same specimen. Finally, we estimated and confirmed the atlas-based areal boundaries of subcortical regions by registering this ex vivo atlas template to in vivo T1- or T2W MRI datasets of different age groups (single vs. multisubject population-based marmoset control adults) using a novel pipeline developed within Analysis of Functional NeuroImages software. Tracing and validating these important deep brain structures in 3D will improve neurosurgical planning, anatomical tract tracer injections, navigation of deep brain stimulation probes, functional MRI and brain connectivity studies, and our understanding of brain structure-function relationships. This new ex vivo template and atlas are available as volumes in standard NIFTI and GIFTI file formats and are intended for use as a reference standard for marmoset brain research.

Advanced brain aging in Parkinson's disease with cognitive impairment

Patients with Parkinson's disease and cognitive impairment (PD-CI) deteriorate faster than those without cognitive impairment (PD-NCI), suggesting an underlying difference in the neurodegeneration process. We aimed to verify brain age differences in PD-CI and PD-NCI and their clinical significance. A total of 94 participants (PD-CI, n = 27; PD-NCI, n = 34; controls, n = 33) were recruited. Predicted age difference (PAD) based on gray matter (GM) and white matter (WM) features were estimated to represent the degree of brain aging. Patients with PD-CI showed greater GM-PAD (7.08 ± 6.64 years) and WM-PAD (8.82 ± 7.69 years) than those with PD-NCI (GM: 1.97 ± 7.13, Padjusted = 0.011; WM: 4.87 ± 7.88, Padjusted = 0.049) and controls (GM: -0.58 ± 7.04, Padjusted = 0.004; WM: 0.88 ± 7.45, Padjusted = 0.002) after adjusting demographic factors. In patients with PD, GM-PAD was negatively correlated with MMSE (Padjusted = 0.011) and MoCA (Padjusted = 0.013) and positively correlated with UPDRS Part II (Padjusted = 0.036). WM-PAD was negatively correlated with logical memory of immediate and delayed recalls (Padjusted = 0.003 and Padjusted < 0.001). Also, altered brain regions in PD-CI were identified and significantly correlated with brain age measures, implicating the neuroanatomical underpinning of neurodegeneration in PD-CI. Moreover, the brain age metrics can improve the classification between PD-CI and PD-NCI. The findings suggest that patients with PD-CI had advanced brain aging that was associated with poor cognitive functions. The identified neuroimaging features and brain age measures can serve as potential biomarkers of PD-CI.

Diffusion kurtosis MRI tracks gray matter myelin content in the primate cerebral cortex

Diffusion magnetic resonance imaging (dMRI) has been widely employed to model the trajectory of myelinated fiber bundles in white matter. Increasingly, dMRI is also used to assess local tissue properties throughout the brain. In the cerebral cortex, myelin content is a critical indicator of the maturation, regional variation, and disease related degeneration of gray matter tissue. Gray matter myelination can be measured and mapped using several non-diffusion MRI strategies; however, first order diffusion statistics such as fractional anisotropy (FA) show only weak spatial correlation with cortical myelin content. Here we show that a simple higher order diffusion parameter, the mean diffusion kurtosis (MK), is strongly correlated with the laminar and regional variation of myelin in the primate cerebral cortex. We carried out ultra-high resolution, multi-shelled dMRI in ex vivo marmoset monkey brains and compared dMRI parameters from a number of higher order models (diffusion kurtosis, NODDI and MAP MRI) to the distribution of myelin obtained using histological staining, and via Magnetization Transfer Ratio MRI (MTR), a non-diffusion MRI method. In contrast to FA, MK closely matched the myelin content assessed by histology and by MTR in the same sample. The parameter maps from MAP-MRI and NODDI also showed good correspondence with cortical myelin content. The results demonstrate that dMRI can be used to assess the variation of local myelin content in the primate cortical cortex, which may be of great value for assessing tissue integrity and tracking disease in living human patients.

Diffusion MRI tracks cortical microstructural changes during the early stages of Alzheimer's disease

There is increased interest in developing markers reflecting microstructural changes that could serve as outcome measures in clinical trials. This is especially important after unexpected results in trials evaluating disease-modifying therapies targeting amyloid-β (Aβ), where morphological metrics from MRI showed increased volume loss despite promising clinical treatment effects. In this study, changes over time in cortical mean diffusivity, derived using diffusion tensor imaging, were investigated in a large cohort (n = 424) of non-demented participants from the Swedish BioFINDER study. Participants were stratified following the Aβ/tau (AT) framework. The results revealed a widespread increase in mean diffusivity over time, including both temporal and parietal cortical regions, in Aβ-positive but still tau-negative individuals. These increases were steeper in Aβ-positive and tau-positive individuals and robust to the inclusion of cortical thickness in the model. A steeper increase in mean diffusivity was also associated with both changes over time in fluid markers reflecting astrocytic activity (i.e. plasma level of glial fibrillary acidic protein and CSF levels of YKL-40) and worsening of cognitive performance (all P < 0.01). By tracking cortical microstructural changes over time and possibly reflecting variations related to the astrocytic response, cortical mean diffusivity emerges as a promising marker for tracking treatments-induced microstructural changes in clinical trials.

Improved reconstruction of crossing fibers in the mouse optic pathways with orientation distribution function fingerprinting

PURPOSE

The accuracy of diffusion MRI tractography reconstruction decreases in the white matter regions with crossing fibers. The optic pathways in rodents provide a challenging structure to test new diffusion tractography approaches because of the small crossing volume within the optic chiasm and the unbalanced 9:1 proportion between the contra- and ipsilateral neural projections from the retina to the lateral geniculate nucleus, respectively.

METHODS

Common approaches based on Orientation Distribution Function (ODF) peak finding or statistical inference were compared qualitatively and quantitatively to ODF Fingerprinting (ODF-FP) for reconstruction of crossing fibers within the optic chiasm using in vivo diffusion MRI (n = 18 $$ n=18 $$ healthy C57BL/6 mice). Manganese-Enhanced MRI (MEMRI) was obtained after intravitreal injection of manganese chloride and used as a reference standard for the optic pathway anatomy.

RESULTS

ODF-FP outperformed by over 100% all the tested methods in terms of the ratios between the contra- and ipsilateral segments of the reconstructed optic pathways as well as the spatial overlap between tractography and MEMRI.

CONCLUSION

In this challenging model system, ODF-Fingerprinting reduced uncertainty of diffusion tractography for complex structural formations of fiber bundles.

Harmonized diffusion MRI data and white matter measures from the Adolescent Brain Cognitive Development Study

The Adolescent Brain Cognitive Development (ABCD) Study® has collected data from over 10,000 children across 21 sites, providing insights into adolescent brain development. However, site-specific scanner variability has made it challenging to use diffusion MRI (dMRI) data from this study. To address this, a dataset of harmonized and processed ABCD dMRI data (from release 3) has been created, comprising quality-controlled imaging data from 9,345 subjects, focusing exclusively on the baseline session, i.e., the first time point of the study. This resource required substantial computational time (approx. 50,000 CPU hours) for harmonization, whole-brain tractography, and white matter parcellation. The dataset includes harmonized dMRI data, 800 white matter clusters, 73 anatomically labeled white matter tracts in full and low resolution, and 804 different dMRI-derived measures per subject (72.3 TB total size). Accessible via the NIMH Data Archive, it offers a large-scale dMRI dataset for studying structural connectivity in child and adolescent neurodevelopment. Additionally, several post-harmonization experiments were conducted to demonstrate the success of the harmonization process on the ABCD dataset.

Cortical microstructural associations with CSF amyloid and pTau

Diffusion MRI (dMRI) can be used to probe microstructural properties of brain tissue and holds great promise as a means to non-invasively map Alzheimer's disease (AD) pathology. Few studies have evaluated multi-shell dMRI models such as neurite orientation dispersion and density imaging (NODDI) and mean apparent propagator (MAP)-MRI in cortical gray matter where many of the earliest histopathological changes occur in AD. Here, we investigated the relationship between CSF pTau181 and Aβ1-42 burden and regional cortical NODDI and MAP-MRI indices in 46 cognitively unimpaired individuals, 18 with mild cognitive impairment, and two with dementia (mean age: 71.8 ± 6.2 years) from the Alzheimer's Disease Neuroimaging Initiative. We compared findings to more conventional cortical thickness measures. Lower CSF Aβ1-42 and higher pTau181 were associated with cortical dMRI measures reflecting less hindered or restricted diffusion and greater diffusivity. Cortical dMRI measures, but not cortical thickness measures, were more widely associated with Aβ1-42 than pTau181 and better distinguished Aβ+ from Aβ- participants than pTau+ from pTau- participants. dMRI associations mediated the relationship between CSF markers and delayed logical memory performance, commonly impaired in early AD. dMRI metrics sensitive to early AD pathogenesis and microstructural damage may be better measures of subtle neurodegeneration in comparison to standard cortical thickness and help to elucidate mechanisms underlying cognitive decline.

Multiple diffusion metrics in differentiating solid glioma from brain inflammation

Background and purpose

The differential diagnosis between solid glioma and brain inflammation is necessary but sometimes difficult. We assessed the effectiveness of multiple diffusion metrics of diffusion-weighted imaging (DWI) in differentiating solid glioma from brain inflammation and compared the diagnostic performance of different DWI models.

Materials and methods

Participants diagnosed with either glioma or brain inflammation with a solid lesion on MRI were enrolled in this prospective study from May 2016 to April 2023. Diffusion-weighted imaging was performed using a spin-echo echo-planar imaging sequence with five b values (500, 1,000, 1,500, 2000, and 2,500 s/mm2) in 30 directions for each b value, and one b value of 0 was included. The mean values of multiple diffusion metrics based on diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), mean apparent propagator (MAP), and neurite orientation dispersion and density imaging (NODDI) in the abnormal signal area were calculated. Comparisons between glioma and inflammation were performed. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) of diffusion metrics were calculated.

Results

57 patients (39 patients with glioma and 18 patients with inflammation) were finally included. MAP model, with its metric non-Gaussianity (NG), shows the greatest diagnostic performance (AUC = 0.879) for differentiation of inflammation and glioma with atypical MRI manifestation. The AUC of DKI model, with its metric mean kurtosis (MK) are comparable to NG (AUC = 0.855), followed by NODDI model with intracellular volume fraction (ICVF) (AUC = 0.825). The lowest value was obtained in DTI with mean diffusivity (MD) (AUC = 0.758).

Conclusion

Multiple diffusion metrics can be used in differentiation of inflammation and solid glioma. Non-Gaussianity (NG) from mean apparent propagator (MAP) model shows the greatest diagnostic performance for differentiation of inflammation and glioma.

Neuronal microstructural changes in the human brain are associated with neurocognitive aging

Gray matter (GM) alterations play a role in aging-related disorders like Alzheimer's disease and related dementias, yet MRI studies mainly focus on macroscopic changes. Although reliable indicators of atrophy, morphological metrics like cortical thickness lack the sensitivity to detect early changes preceding visible atrophy. Our study aimed at exploring the potential of diffusion MRI in unveiling sensitive markers of cortical and subcortical age-related microstructural changes and assessing their associations with cognitive and behavioral deficits. We leveraged the Human Connectome Project-Aging cohort that included 707 unimpaired participants (394 female; median age = 58, range = 36-90 years) and applied the powerful mean apparent diffusion propagator model to measure microstructural parameters, along with comprehensive behavioral and cognitive test scores. Both macro- and microstructural GM characteristics were strongly associated with age, with widespread significant microstructural correlations reflective of cellular morphological changes, reduced cellular density, increased extracellular volume, and increased membrane permeability. Importantly, when correlating MRI and cognitive test scores, our findings revealed no link between macrostructural volumetric changes and neurobehavioral performance. However, we found that cellular and extracellular alterations in cortical and subcortical GM regions were associated with neurobehavioral performance. Based on these findings, it is hypothesized that increased microstructural heterogeneity and decreased neurite orientation dispersion precede macrostructural changes, and that they play an important role in subsequent cognitive decline. These alterations are suggested to be early markers of neurocognitive performance that may distinctly aid in identifying the mechanisms underlying phenotypic aging and subsequent age-related functional decline.

'Pscore' - A Novel Percentile-Based Metric to Accurately Assess Individual Deviations in Non-Gaussian Distributions of Quantitative MRI Metrics

BACKGROUND

Quantitative MRI metrics could be used in personalized medicine to assess individuals against normative distributions. Conventional Zscore analysis is inadequate in the presence of non-Gaussian distributions. Therefore, if quantitative MRI metrics deviate from normality, an alternative is needed.

PURPOSE

To confirm non-Gaussianity of diffusion MRI (dMRI) metrics on a publicly available dataset, and to propose a novel percentile-based method, 'Pscore' to address this issue.

STUDY TYPE

Retrospective cohort.

POPULATION

961 healthy young-adults (age:22-35 years, Females:53%) from the Human Connectome Project.

FIELD STRENGTH/SEQUENCE

3-T, spin-echo diffusion echo-planar imaging, T1-weighted: MPRAGE.

ASSESSMENT

The dMRI data were preprocessed using the TORTOISE pipeline. Forty-eight regions of interest (ROIs) from the JHU-atlas were redrawn on a study-specific diffusion tensor (DT) template and average values were computed from various DT and mean apparent propagator (MAP) metrics. For each ROI, percentile ranks across participants were computed to generate 'Pscores'- which normalized the difference between the median and a participant's value with the corresponding difference between the median and the 5th/95th percentile values.

STATISTICAL TESTS

ROI-wise distributions were assessed using Log transformations, Zscore, and the 'Pscore' methods. The percentages of extreme values above-95th and below-5th percentile boundaries (PEV < 5 ( % ) ,PEV < 5 ( % ) ) were also assessed in the overall white matter. Bootstrapping was performed to test the reliability of Pscores in small samples (n=100) using 100 iterations.

RESULTS

The dMRI metric distributions were systematically non-Gaussian, including positively skewed (e.g., mean and radial distributions P E V > 95 ≠ 5 % , P E V < 5 ≠ 5 % whereas 'Pscore' distributions were symmetric and balanced P E V > 95 = P E V < 5 = 5 % ; even for small bootstrapped samples (average P E V > 95 ¯ = P E V < 5 ¯ = 5 ± 0 % S D ).

DATA CONCLUSION

The inherent skewness observed for dMRI metrics may preclude the use of conventional Zscore analysis. The proposed 'Pscore' method may help estimating individual deviations more accurately in skewed normative data, even from small datasets.