Effect of number of diffusion-encoding directions in diffusion metrics of 5-year-olds using tract-based spatial statistical analysis.

Methodological aspects and effects of different imaging parameters on DTI (diffusion tensor imaging) results and their reproducibility have been recently studied comprehensively in adult populations. Although MR imaging of children's brains has become common, less interest has been focussed on researching whether adult-based optimised parameters and pre-processing protocols can be reliably applied to paediatric populations. Furthermore, DTI scalar values of preschool aged children are rarely reported. We gathered a DTI dataset from 5-year-old children (N = 49) to study the effect of the number of diffusion-encoding directions on the reliability of resultant scalar values with TBSS (tract-based spatial statistics) method. Additionally, the potential effect of within-scan head motion on DTI scalars was evaluated. Reducing the number of diffusion-encoding directions deteriorated both the accuracy and the precision of all DTI scalar values. To obtain reliable scalar values, a minimum of 18 directions for TBSS was required. For TBSS fractional anisotropy values, the intraclass correlation coefficient with two-way random-effects model (ICC[2,1]) for the subsets of 6 to 66 directions ranged between 0.136 [95%CI 0.0767;0.227] and 0.639 [0.542;0.740], whereas the corresponding values for subsets of 18 to 66 directions were 0.868 [0.815;0.913] and 0.995 [0.993;0.997]. Following the exclusion of motion-corrupted volumes, minor residual motion did not associate with the scalar values. A minimum of 18 diffusion directions is recommended to result in reliable DTI scalar results with TBSS. We suggest gathering extra directions in paediatric DTI to enable exclusion of volumes with motion artefacts and simultaneously preserve the overall data quality.