Teresa Gerhalter1, Martijn Cloos1,2, Anna M Chen1, Seena Dehkharghani1,3, Rosemary Peralta1, James S Babb1, Alejandro Zarate4, Tamara Bushnik4, Jonathan M Silver5, Brian S Im4, Stephen Wall6, Steven Baete1,7, Guillaume Madelin8, Ivan I Kirov9,10,11. 1. Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA. 2. Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia. 3. Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA. 4. Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA. 5. Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA. 6. Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, NY, USA. 7. Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, New York, NY, USA. 8. Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA. guillaume.madelin@nyulangone.org. 9. Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA. ivan.kirov@nyulangone.org. 10. Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA. ivan.kirov@nyulangone.org. 11. Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University Grossman School of Medicine, 660 First Avenue, New York, NY, USA. ivan.kirov@nyulangone.org.
Abstract
OBJECTIVES: To assess whether MR fingerprinting (MRF)-based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI. METHODS: Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T1 and T2 from MRF were compared in 12 gray and white matter regions with Mann-Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression. RESULTS: Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T1, T2, and ADC, while FA was lower in mTBI frontal white matter. T1 at timepoint 1 and the change in T1 exhibited more (n = 18) moderate to strong correlations (|r|= 0.6-0.85) with clinical outcome at timepoint 2 than T2 (n = 3), FA (n = 7), and ADC (n = 2). High T1 at timepoint 1, and serially increasing T1, accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80). CONCLUSION: T1 derived from MRF was found to have higher utility than T2, FA, and ADC for predicting 3-month outcome after mTBI. KEY POINTS: • In a region-of-interest approach, FA, ADC, and T1 and T2 all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T1 at 24 days, and the serial change in T1, revealed more and stronger predictive correlations with clinical outcome at 90 days than did T2, ADC, or FA. • T1 showed better prospective identification of non-recovered patients at 90 days than ADC, T2, and FA.
OBJECTIVES: To assess whether MR fingerprinting (MRF)-based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI. METHODS: Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T1 and T2 from MRF were compared in 12 gray and white matter regions with Mann-Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression. RESULTS: Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T1, T2, and ADC, while FA was lower in mTBI frontal white matter. T1 at timepoint 1 and the change in T1 exhibited more (n = 18) moderate to strong correlations (|r|= 0.6-0.85) with clinical outcome at timepoint 2 than T2 (n = 3), FA (n = 7), and ADC (n = 2). High T1 at timepoint 1, and serially increasing T1, accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80). CONCLUSION: T1 derived from MRF was found to have higher utility than T2, FA, and ADC for predicting 3-month outcome after mTBI. KEY POINTS: • In a region-of-interest approach, FA, ADC, and T1 and T2 all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T1 at 24 days, and the serial change in T1, revealed more and stronger predictive correlations with clinical outcome at 90 days than did T2, ADC, or FA. • T1 showed better prospective identification of non-recovered patients at 90 days than ADC, T2, and FA.
Authors: M E Shenton; H M Hamoda; J S Schneiderman; S Bouix; O Pasternak; Y Rathi; M-A Vu; M P Purohit; K Helmer; I Koerte; A P Lin; C-F Westin; R Kikinis; M Kubicki; R A Stern; R Zafonte Journal: Brain Imaging Behav Date: 2012-06 Impact factor: 3.978
Authors: Kaj Blennow; David L Brody; Patrick M Kochanek; Harvey Levin; Ann McKee; Gerard M Ribbers; Kristine Yaffe; Henrik Zetterberg Journal: Nat Rev Dis Primers Date: 2016-11-17 Impact factor: 52.329
Authors: Andrew I R Maas; David K Menon; P David Adelson; Nada Andelic; Michael J Bell; Antonio Belli; Peter Bragge; Alexandra Brazinova; András Büki; Randall M Chesnut; Giuseppe Citerio; Mark Coburn; D Jamie Cooper; A Tamara Crowder; Endre Czeiter; Marek Czosnyka; Ramon Diaz-Arrastia; Jens P Dreier; Ann-Christine Duhaime; Ari Ercole; Thomas A van Essen; Valery L Feigin; Guoyi Gao; Joseph Giacino; Laura E Gonzalez-Lara; Russell L Gruen; Deepak Gupta; Jed A Hartings; Sean Hill; Ji-Yao Jiang; Naomi Ketharanathan; Erwin J O Kompanje; Linda Lanyon; Steven Laureys; Fiona Lecky; Harvey Levin; Hester F Lingsma; Marc Maegele; Marek Majdan; Geoffrey Manley; Jill Marsteller; Luciana Mascia; Charles McFadyen; Stefania Mondello; Virginia Newcombe; Aarno Palotie; Paul M Parizel; Wilco Peul; James Piercy; Suzanne Polinder; Louis Puybasset; Todd E Rasmussen; Rolf Rossaint; Peter Smielewski; Jeannette Söderberg; Simon J Stanworth; Murray B Stein; Nicole von Steinbüchel; William Stewart; Ewout W Steyerberg; Nino Stocchetti; Anneliese Synnot; Braden Te Ao; Olli Tenovuo; Alice Theadom; Dick Tibboel; Walter Videtta; Kevin K W Wang; W Huw Williams; Lindsay Wilson; Kristine Yaffe Journal: Lancet Neurol Date: 2017-11-06 Impact factor: 44.182