Diffuse Tensor Imaging

ABC News was reporting a breakthrough on imaging of the brain, diffuse tensor imaging.  As one can see DTI was one of our first posts on this site in 2010 – so it is not new as the beginning of the article claims.  However the report describes why this research is different from the previous efforts;

While the data showing that diffuse tensor imaging can distinguish unique brain abnormalities has been previously reported, the researchers took their study one step further and found that a new way of looking at the information from these scans — an approach known as functional anisotropy, or FA for short — can reveal whether the brain may have swelling.

Intriguingly, in a separate group of patients included in the study, people with concussions still had evidence of brain injury over one year after their head injury.

“The unique thing about this study is that there are brain abnormalities [still present] at multiple time points,” said Dr. Jeff Bazarian, an associate professor of neurology and neurosurgery at the University of Rochester in Rochester, N.Y. “This highlights that the brain is abnormal on a cellular level for a long time.”

If and when massive control groups can be sought out to back up this information (highly probable in my opinion) we will then begin to understand what trauma to the brain is doing in real-time and how long the effects are lasting.  This indeed would be a breakthrough with many applications: immediate evaluation and objective findings, serial testing, return to play, and thresholds.

In general, Lipton said, this study raises awareness that even seemingly benign head injuries can lead to widespread brain abnormalities.

“A concussion which is seemingly quite mild is accompanied by real changes,” he said.

3 thoughts on “Diffuse Tensor Imaging

  1. joe bloggs June 8, 2012 / 14:58

    Unfortunately DTI has been reported as a breakthrough for more than five years. The reality is that inter-rater reliability problems limit its utility, that is, two people viewing the same film often form differing opinions. Furthermore, it is expensive, it is not widely available and not reimbursable.

    The experiment seemed to be well constructed but it is under-powered. I would also like to see another center replicate the findings as the Washington U study failed on that count (the first report of a breakthrough a couple of years ago).

  2. Jake Benford June 8, 2012 / 22:57

    Thanks Joe, your input and comments are invaluable.

  3. mriphysician January 28, 2013 / 09:15

    I would also agree that inter observer agreement is a possible problem. However it should be noted that this is true of any imaging test. What is needed for the scientists to all agree on a similar and single technique. That the results be done with a large double blinded trail. There is no such trial so far. But I would add that our facility will do a DTI study for $500 and then $500 for the 1 hour interpretation. So $1000 total. We have a 3T 32 channel MRI scanner. MRI Consultants Lewes – hope this is OK in a comment.
    mriphysician Phil

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