Current State of Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Traumatic Brain Injury Prognostication

Matthew Grant; JiaJing Liu; Max Wintermark; Ulas Bagci; David Douglas

doi:10.1016/j.nic.2023.01.004

Current State of Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Traumatic Brain Injury Prognostication

Neuroimaging Clin N Am. 2023 May;33(2):279-297. doi: 10.1016/j.nic.2023.01.004.

Authors

Matthew Grant¹, JiaJing Liu², Max Wintermark³, Ulas Bagci⁴, David Douglas⁵

Affiliations

¹ Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA; Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA; Department of Radiology, Landstuhl Regional Medical Center, Dr Hitzelberger Straße, 66849 Landstuhl, Germany. Electronic address: mgrant84@stanford.edu.
² Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA.
³ Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA; Neuroradiology Department, The University of Texas Anderson Cancer Center, 1400 Pressler Street, Unit 1482, Houston, TX 77030, USA.
⁴ Radiology and Biomedical Engineering Department, Northwestern University, 737 North Michigan Drive, Suite 1600, Chicago, IL 60611, USA; Department of Computer Science, University of Central Florida, 4328 Scorpius Street, Orlando, Florida, 32816.
⁵ Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA; Department of Radiology, 96th Medical Group, Eglin Air Force Base, 307 Boatner Road, Eglin Air Force Base, Florida 32542, USA.

PMID: 36965946
DOI: 10.1016/j.nic.2023.01.004

Abstract

Advanced imaging techniques are needed to assist in providing a prognosis for patients with traumatic brain injury (TBI), particularly mild TBI (mTBI). Diffusion tensor imaging (DTI) is one promising advanced imaging technique, but has shown variable results in patients with TBI and is not without limitations, especially when considering individual patients. Efforts to resolve these limitations are being explored and include developing advanced diffusion techniques, creating a normative database, improving study design, and testing machine learning algorithms. This article will review the fundamentals of DTI, providing an overview of the current state of its utility in evaluating and providing prognosis in patients with TBI.

Keywords: Anisotropy; Concussion; Diffusion tensor imaging (DTI); Kurtosis; MR imaging; Machine learning (ML); Prognosis; Traumatic brain injury (TBI).

Publication types

Review

MeSH terms

Brain / diagnostic imaging
Brain Concussion*
Brain Injuries, Traumatic* / diagnostic imaging
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging / methods
Humans
Prognosis