FiberBlender: A Realistic Computer Model of Nerve Bundles for Simulating and Validating the Acquisition of Diffusion Tensor Imaging

Diffusion Tensor Imaging (DTI) is a powerful medical imaging technique that provides a unique method to investigate the structure and connectivity of neural pathways. DTI is a special magnetic resonance imaging (MRI) modality that combines the principles of magnetic resonance with molecular diffusion to trace the motion of water molecules. In the central nervous system, where nerve fibers are packed in highly-directional bundles, these molecules diffuse along the orientation of the fibers. Hence, characterizing the motion of water with DTI delivers a non-invasive in vivo technique to capture the connectivity of nerves themselves. Despite its promises and successful clinical applications for nearly thirty years, problems with validation and interpretation of measurements still persist. Most validation studies attempt to generate ground-truth data from animal models, phantoms, and computer models. This dissertation proposes a novel validation system, FiberBlender, capable of reproducing three-dimensional fiber structures and simulating the diffusion of water molecules to generate ground-truth synthetic DTI data. In particular FiberBlender contributes to: (i) creating more biologically accurate representations of fiber bundles with the inclusion of myelin and glial cells, (ii) examining the effect of demyelination and gliosis on DTI measurements, (iii) optimizing acquisition sequences, and (iv) evaluating the performance of multi-tensor models for the study of crossing fibers. FiberBlender strays away from the “one size fits all” approach taken by previous studies and uses computer algorithms in conjunction with some limited manual operations to produce brain-like geometries that take into account the random spatial location of axons and correct distributions of axon diameters, myelin to axon radius, and myelin to glia ratio. In this way no two models are the same and the system is capable of generating structures that can potentially represent any region of the brain and encompass the heterogeneity between human subjects. This feature is essential for optimization as the performance of DTI acquisition sequences may vary among subjects and the type of scanner used. In addition to better accuracy, the system offers a high degree of flexibility as the geometry can be modified to simulate events that cause drastic changes to the fiber structure. Specially, this dissertation looks at demyelination (an extensive loss of myelin volume), gliosis (a proliferation of glial cells), and axon compaction (a condensation of axons due to a loss of total brain volume) to determine their effects on the observed DTI signal. Simulation results confirm that axon compaction and partial remyelination have similar characteristics. Results also show that some standard clinically used acquisition sequences are incapable of capturing the effects of demyelination, gliosis and compaction when performing longitudinal studies. A novel sequence optimization technique based on Shannon entropy and mutual information is proposed to better capture demyelination. Optimized sequences are tested on a number of non-identical models to confirm their validity and can be used to improve the quality of DTI diagnostics. Finally this work looks at crossing fibers for the validation of multi-tensor models in their ability to characterize crossing diffusion profiles. The performance of multi-tensor models from CHARMED, Q-ball and spherical deconvolution that are widely used in both research and clinical settings are evaluated against ground-truth data generated with FiberBlender. The study is performed on a number of different crossing geometries and preliminary results show that the CHARMED model is the most comprehensive approach

NOVEL PHANTOMS AND POST-PROCESSING FOR DIFFUSION SPECTRUM IMAGING

High Angular Resolution Diffusion Imaging (HARDI) techniques, including Diffusion Spectrum Imaging (DSI), have been proposed to resolve crossing and other complex fiber architecture in the human brain white matter. In these methods, directional information of diffusion is inferred from the peaks in the orientation distribution function (ODF). Extensive studies using histology on macaque brain, cat cerebellum, rat hippocampus and optic tracts, and bovine tongue are qualitatively in agreement with the DSI-derived ODFs and tractography. However, there are only two studies in the literature which validated the DSI results using physical phantoms and both these studies were not performed on a clinical MRI scanner. Also, the limited studies which optimized DSI in a clinical setting, did not involve a comparison against physical phantoms. Finally, there is lack of consensus on the necessary pre- and post-processing steps in DSI; and ground truth diffusion fiber phantoms are not yet standardized. Therefore, the aims of this dissertation were to design and construct novel diffusion phantoms, employ post-processing techniques in order to systematically validate and optimize (DSI)-derived fiber ODFs in the crossing regions on a clinical 3T MR scanner, and develop user-friendly software for DSI data reconstruction and analysis. Phantoms with a fixed crossing fiber configuration of two crossing fibers at 90° and 45° respectively along with a phantom with three crossing fibers at 60°, using novel hollow plastic capillaries and novel placeholders, were constructed. T2-weighted MRI results on these phantoms demonstrated high SNR, homogeneous signal, and absence of air bubbles. Also, a technique to deconvolve the response function of an individual peak from the overall ODF was implemented, in addition to other DSI post-processing steps. This technique greatly improved the angular resolution of the otherwise unresolvable peaks in a crossing fiber ODF. The effects of DSI acquisition parameters and SNR on the resultant angular accuracy of DSI on the clinical scanner were studied and quantified using the developed phantoms. With a high angular direction sampling and reasonable levels of SNR, quantification of a crossing region in the 90°, 45° and 60° phantoms resulted in a successful detection of angular information with mean ± SD of 86.93°±2.65°, 44.61°±1.6° and 60.03°±2.21° respectively, while simultaneously enhancing the ODFs in regions containing single fibers. For the applicability of these validated methodologies in DSI, improvement in ODFs and fiber tracking from known crossing fiber regions in normal human subjects were demonstrated; and an in-house software package in MATLAB which streamlines the data reconstruction and post-processing for DSI, with easy to use graphical user interface was developed. In conclusion, the phantoms developed in this dissertation offer a means of providing ground truth for validation of reconstruction and tractography algorithms of various diffusion models (including DSI). Also, the deconvolution methodology (when applied as an additional DSI post-processing step) significantly improved the angular accuracy of the ODFs obtained from DSI, and should be applicable to ODFs obtained from the other high angular resolution diffusion imaging techniques

Development of Advanced, Clinically Feasible Neuroimaging Methodology with Diffusional Kurtosis Imaging

Diffusion MRI (dMRI) is a powerful, non-invasive tool for probing the structural organization of the human brain. Quantitative dMRI analyses provide unique capabilities for the characterization of tissue microstructure as well as imaging contrast that is not available to other modalities. White matter tractography relies on dMRI and is currently the only non-invasive technique for mapping structural connections in the human brain. In this chapter, we will describe diffusional kurtosis imaging, an effective and versatile dMRI technique, and discuss a clinical problem in temporal lobe epilepsy (TLE) which is insurmountable with current diagnostic approaches. Subsequent chapters will further develop the capabilities of DKI and demonstrate how it may be particularly well suited to overcome current barriers to care in the clinical management of TLE