Spherical means-based free-water volume fraction from diffusion MRI increases non-linearly with age in the white matter of the healthy human brain

Producción CientíficaThe term free-water volume fraction (FWVF) refers to the signal fraction that could be found as the cerebrospinal fluid of the brain, which has been demonstrated as a sensitive measure that correlates with cognitive performance and various neuropathological processes. It can be quantified by properly fitting the isotropic component of the magnetic resonance (MR) signal in diffusion-sensitized sequences. Using healthy subjects (178F/109M) aged 25-94, this study examines in detail the evolution of the FWVF obtained with the spherical means technique from multi-shell acquisitions in the human brain white matter across the adult lifespan, which has been previously reported to exhibit a positive trend when estimated from single-shell data using the bi-tensor signal representation. We found evidence of a noticeably non-linear gain after the sixth decade of life, with a region-specific variate and varying change rate of the spherical means-based multi-shell FWVF parameter with age, at the same time, a heteroskedastic pattern across the adult lifespan is suggested. On the other hand, the FW corrected diffusion tensor imaging (DTI) leads to a region-dependent flattened age-related evolution of the mean diffusivity (MD) and fractional anisotropy (FA), along with a considerable reduction in their variability, as compared to the studies conducted over the standard (single-component) DTI. This way, our study provides a new perspective on the trajectory-based assessment of the brain and explains the conceivable reason for the variations observed in FA and MD parameters across the lifespan with previous studies under the standard diffusion tensor imaging.Ministerio de Ciencia e Innovación (MCIN-AEI) y FEDER-UE (grant PID2021-124407NB-I00)Ministerio de Ciencia e Innovación (MCIN-AEI) - Unión Europea “NextGenerationEU/PRTR” (grant TED2021-130758B-I00)Ministry of Science and Higher Education (Poland) - Bekker programme (grant PPN/BEK/2019/1/00421)Norwegian ExtraFoundation for Health and Rehabilitation (2015/FO5146)European Union's Horizon 2020 research and Innovation program (ERC 802998

Challenges of assessing community mortality due to respiratory viruses in children aged less than 5 years

Background: Estimating the real impact of respiratory syncytial virus (RSV) disease is key for the development of vaccines and treatments. Ascertaining the burden of community mortality due to RSV is challenging due to the lack of primary data. Therefore, conducting observational studies to determine the factors associated with community mortality due to the virus in developing countries is important.Objective: Our aim in this study was to describe the obstacles, gaps, and challenges that investigators face in low-income, vulnerable regions in 4 developing countries on 3 continents.Results: The main obstacles and challenges of ascertaining community mortality due to RSV were defining strategies to consent families for testing before burial, sampling individuals at the household level, supporting bereaved parents with different cultural and religious backgrounds, establishing tailored strategies for studies in challenging settings, and integrating RSV mortality data from nasopharyngeal samples.Conclusion: Detailed logistical planning based on population sociodemographic information, grief counseling, staff training, and a multidisciplinary approach with adequate laboratory infrastructure is critical to successful observational community-based RSV studies

Validation of deep learning techniques for quality augmentation in diffusion MRI for clinical studies

The objective of this study is to evaluate the efficacy of deep learning (DL) techniques in improving the quality of diffusion MRI (dMRI) data in clinical applications. The study aims to determine whether the use of artificial intelligence (AI) methods in medical images may result in the loss of critical clinical information and/or the appearance of false information. To assess this, the focus was on the angular resolution of dMRI and a clinical trial was conducted on migraine, specifically between episodic and chronic migraine patients. The number of gradient directions had an impact on white matter analysis results, with statistically significant differences between groups being drastically reduced when using 21 gradient directions instead of the original 61. Fourteen teams from different institutions were tasked to use DL to enhance three diffusion metrics (FA, AD and MD) calculated from data acquired with 21 gradient directions and a b-value of 1000 s/mm2. The goal was to produce results that were comparable to those calculated from 61 gradient directions. The results were evaluated using both standard image quality metrics and Tract-Based Spatial Statistics (TBSS) to compare episodic and chronic migraine patients. The study results suggest that while most DL techniques improved the ability to detect statistical differences between groups, they also led to an increase in false positive. The results showed that there was a constant growth rate of false positives linearly proportional to the new true positives, which highlights the risk of generalization of AI-based tasks when assessing diverse clinical cohorts and training using data from a single group. The methods also showed divergent performance when replicating the original distribution of the data and some exhibited significant bias. In conclusion, extreme caution should be exercised when using AI methods for harmonization or synthesis in clinical studies when processing heterogeneous data in clinical studies, as important information may be altered, even when global metrics such as structural similarity or peak signal-to-noise ratio appear to suggest otherwise

Diffusion-relaxation scattered MR signal representation in a multi-parametric sequence

This work focuses on obtaining a magnetic resonance imaging (MRI) signal representation that accounts for a longitudinal T1 and transverse T2⋆ relaxations while at the same time integrating directional diffusion in the context of scattered multi-parametric acquisitions, where only a few diffusion gradient directions and b-values are available for each pair of echo and inversion times. The method is based on the three-dimensional simple harmonic oscillator-based reconstruction and estimation (SHORE) representation of the diffusion signal, which enables the estimation of the orientation distribution function and the retrieval of various quantitative indices such as the generalized fractional anisotropy or the return-to-the-origin probability while simultaneously resolving for T1 and T2⋆ relaxation times. Our technique, the Relax-SHORE, has been tested on both in silico and in vivo diffusion-relaxation scattered MR data. The results show that Relax-SHORE is accurate in the context of scattered acquisitions while guaranteeing flexibility in the diffusion signal representation from multi-parametric sequences

Q-Space Quantitative Diffusion MRI Measures Using a Stretched-Exponential Representation

Diffusion magnetic resonance imaging (dMRI) is a relatively modern technique used to study tissue microstructure in a non-invasive way. Non-Gaussian diffusion representation is related to the restricted diffusion and can provide information about the underlying tissue properties. In this paper, we analytically derive nth order statistics of the signal considering a stretched-exponential representation of the diffusion. Then, we retrieve the Q-space quantitative measures such as the Return-To-the-Origin Probability (RTOP), Q-space mean square displacement (QMSD), Q-space mean fourth-order displacement (QMFD). The stretched-exponential representation enables the handling of the diffusion contributions from a higher b-value regime under a non-Gaussian assumption, which can be useful in diagnosing or prognosis of neurodegenerative diseases in the early stages. Numerical implementation of the method is freely available at https://github.com/TPieciak/Stretched