Corso Integrato di Metodi per Immagini bio-mediche e Chirurgia Assistita MIMCAS. Metodi per bioimmagini Prof. G. Baselli Seminario 24/04/2012

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1 Corso Integrato di Metodi per Immagini bio-mediche e Chirurgia Assistita MIMCAS Metodi per bioimmagini Prof. G. Baselli Seminario 24/04/2012 DTI Applications Maria Giulia Preti

2 Summary DTI and Tractography main applications Tractographic Atlas construction fmri-driven tractography

3 Tractography in dementias Why? Evaluation of WM damage patterns in dementias Analysis of subjects showing a Mild Cognitive Impairment (MCI, pre-dementia stage) to early predict a possible conversion to dementia Study of structural connections underlying functional activations White matter damages compromised tractographic reconstruction E.g. Alzheimer s Disease (AD) Healthy subject AD patient Healthy subject atrophy

4 Tractpgraphy and Multiple Sclerosis MULTIPLE SCLEROSIS demyelinating pathology causing: 1. White matter lesions: macroscopical areas in which tissue is damaged 2. Cerebral Atrophy 3. Microscopical damages both in white and gray matter o Not visible with conventional MR o Assessable with Diffusion Weighted Imaging Immagine pesata in DP di un paziente con CL=29.61 ml e EDSS = 6. Immagine pesata in T2 di un soggetto sano Immagine pesata in T2 di un paziente con EDSS = 6.5

5 Tractography in Multiple Sclerosis MULTIPLE SCLEROSIS LESIONS: LOW FA Interruption of tractographic reconstruction Possible solutions - Lower AF threshold - Compute indexes by a normal atlas soggetto sano paziente SM (EDSS=6.5) paziente SM (EDSS=6.5)

6 Tractography and brain tumor: deviated fibers A: T2 weighted; B: T1 weighted; C: Directional map, axial plane D: D. map, coronal plane E: WM tracts deviated by the tumor

7 Tractography and brain tumor: interrupted fibers A : T2 weighted B: T1 weighted C: FA map D: Directional map

8 Tractographic Atlases Why an atlas? Study of anatomy Study of patients when individual tractography is not possible Tractographic Atlas: a template of a specific bundle, obtained from the mean of healthy subjects Optimisation of atlas construction - Different approaches are possible - Coregistration is fundamental

9 Regisitration AFFINE registration: 12 DOF in 3D space Rotation, traslation, sharing, scaling ELASTIC registration : control points grid overimposed to the original image, different deformation for every different point Rotation Scaling Higher precision in the registration of morphologically different structures

10 Tractographic Atlases Atlas 1: mean DWI, affine registration Atlas 2: mean DWI, elastic registration Atlas 1 Atlas 2 Atlas 3: mean DTI, affine registration Atlas 4: mean DTI, elastic registration Atlas 3 Atlas 4

11 Tractographic Atlases Atlas 1 IFOF ILF Erroneous terminations Atlas 2 IFOF Erroneous termination of tractography IFOF ILF

12 Tractographic Atlases T=360 L=123.5 (14.06) FA=0,353 (0,102) T=215 L=54.25 (15.94) FA=0,336 (0,123) T=1123 L=71.87 (28.17) FA=0,308 (0,103) IFOF ILF ARCUATE T=787 L=52.92 (18.65) FA=0,375 (0,111) T=693 L=64.22 (22.63) FA=0,349 (0,108) T=812 L=54.07 (20.89) FA=0,356 (0,111) IFOF ILF ARCUATE

13 Tractographic Atlases CC Probabilistic Atlas -Inidivdual tractography for healthy subjects: CC divided in 7 regions - Tract density maps - Binarisation - Average -Threshold (0.9)

14 Tractographic Atlases Example of atlases: ILF UNCINATE IFOF GENU BODY SPLENIUM

15 Atlas-based tractography Atlas-based approach: Evaluation of individual FA values in the positions given by a probabilistic atlas 1)Atlas construction 2) Atlas application to patients FA maps REG within the atlas locations: Mean FA weighted for the probability given by the atlas Individual FA maps Template FA Masking of FA maps (FA>0.2) with the atlas ANOVA test (Bonferroni corr.) for between group comparisons

16 fmri-driven Tractography Exploring brain anatomy and function with MRI Study of anatomical connectivity: atlas-based tractography Study of brain functionality: fmri Integration between fmri and tractography

17 fmri-driven Tractography Functional activation areas = seed points for tractography reconstruction of the bundles recruited for a certain cortical activation Evaluation of anatomical and functional connectivity Example Healthy control activation areas with motor task (right foot movement) Cortico-spinal tract reconstruction

18 fmri-driven Tractography Which anatomical connections are recruited in a particular functional activation? Healthy elderly subject fmri Activations (Categorial task) fmri-guided tractography: arcuate fasciuculus

19 fmri-driven Tractography MCI patient Use of different circuits in MCI? fmri Activations (Categorial task) fmri-guided tractography: arcuate and IFOF

20 fmri-driven Tractography Case report: Cortico-basal degeneration (right ehmisphere) Normal tractography Left CST (healthy): More tracts fmri-guided tractography Left CST(healthy): More focused activation fmri Activations (hand movement)

21 fmri-driven Tractography 2 STEP: GROUP ANALYSIS Seed for every subject from mean group activation Find the tracts which are involved in average in one group We can apply the same approach of atlas construction, to consider average tracts of one group

22 Thank you

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