Lanzafame S, Giannelli M, Garaci F, Floris R, Duggento A, Guerrisi M, Toschi N
Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome 00133, Italy.
Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana," Pisa 56126, Italy.
Med Phys. 2016 May;43(5):2464. doi: 10.1118/1.4946819.
An increasing number of studies have aimed to compare diffusion tensor imaging (DTI)-related parameters [e.g., mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD)] to complementary new indexes [e.g., mean kurtosis (MK)/radial kurtosis (RK)/axial kurtosis (AK)] derived through diffusion kurtosis imaging (DKI) in terms of their discriminative potential about tissue disease-related microstructural alterations. Given that the DTI and DKI models provide conceptually and quantitatively different estimates of the diffusion tensor, which can also depend on fitting routine, the aim of this study was to investigate model- and algorithm-dependent differences in MD/FA/RD/AD and anisotropy mode (MO) estimates in diffusion-weighted imaging of human brain white matter.
The authors employed (a) data collected from 33 healthy subjects (20-59 yr, F: 15, M: 18) within the Human Connectome Project (HCP) on a customized 3 T scanner, and (b) data from 34 healthy subjects (26-61 yr, F: 5, M: 29) acquired on a clinical 3 T scanner. The DTI model was fitted to b-value =0 and b-value =1000 s/mm(2) data while the DKI model was fitted to data comprising b-value =0, 1000 and 3000/2500 s/mm(2) [for dataset (a)/(b), respectively] through nonlinear and weighted linear least squares algorithms. In addition to MK/RK/AK maps, MD/FA/MO/RD/AD maps were estimated from both models and both algorithms. Using tract-based spatial statistics, the authors tested the null hypothesis of zero difference between the two MD/FA/MO/RD/AD estimates in brain white matter for both datasets and both algorithms.
DKI-derived MD/FA/RD/AD and MO estimates were significantly higher and lower, respectively, than corresponding DTI-derived estimates. All voxelwise differences extended over most of the white matter skeleton. Fractional differences between the two estimates [(DKI - DTI)/DTI] of most invariants were seen to vary with the invariant value itself as well as with MK/RK/AK values, indicating substantial anatomical variability of these discrepancies. In the HCP dataset, the median voxelwise percentage differences across the whole white matter skeleton were (nonlinear least squares algorithm) 14.5% (8.2%-23.1%) for MD, 4.3% (1.4%-17.3%) for FA, -5.2% (-48.7% to -0.8%) for MO, 12.5% (6.4%-21.2%) for RD, and 16.1% (9.9%-25.6%) for AD (all ranges computed as 0.01 and 0.99 quantiles). All differences/trends were consistent between the discovery (HCP) and replication (local) datasets and between estimation algorithms. However, the relationships between such trends, estimated diffusion tensor invariants, and kurtosis estimates were impacted by the choice of fitting routine.
Model-dependent differences in the estimation of conventional indexes of MD/FA/MO/RD/AD can be well beyond commonly seen disease-related alterations. While estimating diffusion tensor-derived indexes using the DKI model may be advantageous in terms of mitigating b-value dependence of diffusivity estimates, such estimates should not be referred to as conventional DTI-derived indexes in order to avoid confusion in interpretation as well as multicenter comparisons. In order to assess the potential and advantages of DKI with respect to DTI as well as to standardize diffusion-weighted imaging methods between centers, both conventional DTI-derived indexes and diffusion tensor invariants derived by fitting the non-Gaussian DKI model should be separately estimated and analyzed using the same combination of fitting routines.
越来越多的研究旨在比较扩散张量成像(DTI)相关参数[如平均扩散率(MD)、分数各向异性(FA)、径向扩散率(RD)和轴向扩散率(AD)]与通过扩散峰度成像(DKI)得出的补充新指标[如平均峰度(MK)/径向峰度(RK)/轴向峰度(AK)]在区分组织疾病相关微观结构改变方面的潜力。鉴于DTI和DKI模型在概念上和定量上对扩散张量的估计不同,且这也可能取决于拟合程序,本研究的目的是调查人脑白质扩散加权成像中MD/FA/RD/AD和各向异性模式(MO)估计中与模型和算法相关的差异。
作者使用了(a)在人类连接组计划(HCP)中,从33名健康受试者(20 - 59岁,女性:15名,男性:18名)在定制的3T扫描仪上收集的数据,以及(b)从34名健康受试者(26 - 61岁,女性:5名,男性:29名)在临床3T扫描仪上获取的数据。DTI模型拟合b值 = 0和b值 = 1000 s/mm²的数据,而DKI模型通过非线性和加权线性最小二乘法算法分别拟合包含b值 = 0、1000和3000/2500 s/mm²[针对数据集(a)/(b)]的数据。除了MK/RK/AK图外,还从两个模型和两种算法估计了MD/FA/MO/RD/AD图。使用基于纤维束的空间统计学方法,作者对两个数据集和两种算法在脑白质中两个MD/FA/MO/RD/AD估计值之间零差异的原假设进行了检验。
DKI得出的MD/FA/RD/AD和MO估计值分别显著高于和低于相应的DTI得出的估计值。所有体素级差异在大部分白质骨架上都有分布。大多数不变量的两个估计值之间的分数差异[(DKI - DTI)/DTI]被发现随不变量值本身以及MK/RK/AK值而变化,表明这些差异存在显著的解剖学变异性。在HCP数据集中,整个白质骨架上体素级百分比差异的中位数(非线性最小二乘法算法)为:MD为14.5%(8.2% - 23.1%),FA为4.3%(1.4% - 17.3%),MO为 - 5.2%( - 48.7%至 - 0.8%),RD为12.5%(6.4% - 21.2%),AD为16.1%(9.9% - 25.6%)(所有范围计算为0.01和0.99分位数)。所有差异/趋势在发现(HCP)和复制(本地)数据集之间以及估计算法之间都是一致的。然而,这些趋势、估计的扩散张量不变量和峰度估计之间的关系受到拟合程序选择的影响。
MD/FA/MO/RD/AD传统指标估计中与模型相关的差异可能远远超出常见的疾病相关改变。虽然使用DKI模型估计扩散张量衍生指标在减轻扩散率估计对b值的依赖性方面可能具有优势,但为了避免解释上的混淆以及多中心比较中的问题,不应将此类估计称为传统的DTI衍生指标。为了评估DKI相对于DTI的潜力和优势,以及在各中心之间标准化扩散加权成像方法,应使用相同的拟合程序组合分别估计和分析传统的DTI衍生指标和通过拟合非高斯DKI模型得出的扩散张量不变量。