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Office of Public Health
Ansgar Furst, Ph.D.Director of Neuroimaging Laboratory, WRIISC
VA Palo Alto, CA
Clinical Assistant Professor (Affiliated) of Psychiatry and Behavioral Sciences and of Neurology and
Neurological Sciences
Stanford University School of Medicine, CA
DTI as a promising tool for a deeper understanding of white matter pathology
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Neuroimaging- What else?
Diffusion Tensor Imaging (DTI) F-MRI Diffusion-Weighted Imaging Diffusion-Spectrum Imaging Magnetic Resonance Spectroscopy Magnetization Transfer Imaging Magnetic Source Imaging
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Neuroimaging- What else?
Diffusion Tensor Imaging (DTI) F-MRI Diffusion-Weighted Imaging Diffusion-Spectrum Imaging Magnetic Resonance Spectroscopy Magnetization Transfer Imaging Magnetic Source Imaging
Too many imaging sequences ?
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Broad classification scheme
T1-weighted
T2-weightedT2-FLAIRT2*-GRE
SWI
DTIfMRIPET
Structure Function
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Broad classification scheme
Structure Function
Mass effects Volume changesMidline shifts
Altered synaptic/
metabolic activity, network
connectivity
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Broad classification scheme
Structure
Mass effects Volume changesMidline shifts
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Broad classification scheme
Function
Stay tuned …
Altered synaptic/
metabolic activity, network
connectivity
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Diffusion Tensor Imaging (DTI) MR sequence (available since the 90s)
relatively simple to implement and time efficient
Measures microscopic motion of water molecules in brain tissue
Gives an indirect account of integrity & connectivity of white matter fiber tracts
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How does it work ?
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How does it work ?
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Soaker hose analogy
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Soaker hose analogy
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FA maps – no sense of direction
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Tensors code direction of movement
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(Directionally) colored FA maps
Anterior
Posterior
Left Right
Superior
Inferior
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Patient 014
32-year old OIF veteran Blow to the head with LOC ~ 2 min,
additional LOC in bar fight and motor cycle accident < 1 min
Was in vicinity of numerous mortar blasts – no LOC but confused about circumstances afterwards
Patient complains about severe headache
Was diagnosed with TBI during WRIISC visit
Patient 014
Patient 014
Patient 014
Patient 014
Patient 014
Patient 014
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DTI – just pretty pictures ?
DTI imaging (particularly fiber tracking) can be a very powerful tool in identifying otherwise unnoticed white matter compromises
However, customized fiber tracking is very time consuming and difficult to automatize as each patient’s fiber tract architecture is unique
In order to be useful to clinicians more easily interpretable, reliable quantification of white matter damage is needed
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Please come and visit us at our poster!
DTI – towards a diagnostic tool
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Suggested reading
If you want to learnmore about DTI
Recent data showingsuperior sensitivity ofDTI in detecting TBI
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THANK YOU!