MP-PCA denoising of fMRI time-series data can lead to artificial activation "spreading".

MP-PCA denoising has become the method of choice for denoising MRI data since it provides an objective threshold to separate the signal components from unwanted thermal noise components. In rodents, thermal noise in the coils is an important source of noise that can reduce the accuracy of activation mapping in fMRI. Further confounding this problem, vendor data often contains zero-filling and other post-processing steps that may violate MP-PCA assumptions. Here, we develop an approach to denoise vendor data and assess activation "spreading" caused by MP-PCA denoising in rodent task-based fMRI data. Data was obtained from N = 3 mice using conventional multislice and ultrafast fMRI acquisitions (1 s and 50 ms temporal resolution, respectively), using a visual stimulation paradigm. MP-PCA denoising produced SNR gains of 64% and 39%, and Fourier Spectral Amplitude (FSA) increases in BOLD maps of 9% and 7% for multislice and ultrafast data, respectively, when using a small [2 2] denoising window. Larger windows provided higher SNR and FSA gains with increased spatial extent of activation that may or may not represent real activation. Simulations showed that MP-PCA denoising can incur activation "spreading" with increased false positive rate and smoother functional maps due to local "bleeding" of principal components, and that the optimal denoising window for improved specificity of functional mapping, based on Dice score calculations, depends on the data's tSNR and functional CNR. This "spreading" effect applies also to another recently proposed low-rank denoising method (NORDIC), although to a lesser degree. Our results bode well for enhancing spatial and/or temporal resolution in future fMRI work, while taking into account the sensitivity/specificity trade-offs of low-rank denoising methods.

Tensor denoising of multidimensional MRI data.

PURPOSE: To develop a denoising strategy leveraging redundancy in high-dimensional data. THEORY AND METHODS: The SNR fundamentally limits the information accessible by MRI. This limitation has been addressed by a host of denoising techniques, recently including the so-called MPPCA: principal component analysis of the signal followed by automated rank estimation, exploiting the Marchenko-Pastur distribution of noise singular values. Operating on matrices comprised of data patches, this popular approach objectively identifies noise components and, ideally, allows noise to be removed without introducing artifacts such as image blurring, or nonlocal averaging. The MPPCA rank estimation, however, relies on a large number of noise singular values relative to the number of signal components to avoid such ill effects. This condition is unlikely to be met when data patches and therefore matrices are small, for example due to spatially varying noise. Here, we introduce tensor MPPCA (tMPPCA) for the purpose of denoising multidimensional data, such as from multicontrast acquisitions. Rather than combining dimensions in matrices, tMPPCA uses each dimension of the multidimensional data's inherent tensor-structure to better characterize noise, and to recursively estimate signal components. RESULTS: Relative to matrix-based MPPCA, tMPPCA requires no additional assumptions, and comparing the two in a numerical phantom and a multi-TE diffusion MRI data set, tMPPCA dramatically improves denoising performance. This is particularly true for small data patches, suggesting that tMPPCA can be especially beneficial in such cases. CONCLUSIONS: The MPPCA denoising technique can be extended to high-dimensional data with improved performance for smaller patch sizes.

A user independent denoising method for x-nuclei MRI and MRS.

PURPOSE: X-nuclei (also called non-proton MRI) MRI and spectroscopy are limited by the intrinsic low SNR as compared to conventional proton imaging. Clinical translation of x-nuclei examination warrants the need of a robust and versatile tool improving image quality for diagnostic use. In this work, we compare a novel denoising method with fewer inputs to the current state-of-the-art denoising method. METHODS: Denoising approaches were compared on human acquisitions of sodium (23 Na) brain, deuterium (2 H) brain, carbon (13 C) heart and brain, and simulated dynamic hyperpolarized 13 C brain scans, with and without additional noise. The current state-of-the-art denoising method Global-local higher order singular value decomposition (GL-HOSVD) was compared to the few-input method tensor Marchenko-Pastur principal component analysis (tMPPCA). Noise-removal was quantified by residual distributions, and statistical analyses evaluated the differences in mean-square-error and Bland-Altman analysis to quantify agreement between original and denoised results of noise-added data. RESULTS: GL-HOSVD and tMPPCA showed similar performance for the variety of x-nuclei data analyzed in this work, with tMPPCA removing ˜5% more noise on average over GL-HOSVD. The mean ratio between noise-added and denoising reproducibility coefficients of the Bland-Altman analysis when compared to the original are also similar for the two methods with 3.09 ± 1.03 and 2.83 ± 0.79 for GL-HOSVD and tMPPCA, respectively. CONCLUSION: The strength of tMPPCA lies in the few-input approach, which generalizes well to different data sources. This makes the use of tMPPCA denoising a robust and versatile tool in x-nuclei imaging improvements and the preferred denoising method.

Diffusion time dependence, power-law scaling, and exchange in gray matter.

Characterizing neural tissue microstructure is a critical goal for future neuroimaging. Diffusion MRI (dMRI) provides contrasts that reflect diffusing spins' interactions with myriad microstructural features of biological systems. However, the specificity of dMRI remains limited due to the ambiguity of its signals vis-à-vis the underlying microstructure. To improve specificity, biophysical models of white matter (WM) typically express dMRI signals according to the Standard Model (SM) and have more recently in gray matter (GM) taken spherical compartments into account (the SANDI model) in attempts to represent cell soma. The validity of the assumptions underlying these models, however, remains largely undetermined, especially in GM. To validate these assumptions experimentally, observing their unique, functional properties, such as the b-1/2 power-law associated with one-dimensional diffusion, has emerged as a fruitful strategy. The absence of this signature in GM, in turn, has been explained by neurite water exchange, non-linear morphology, and/or by obscuring soma signal contributions. Here, we present diffusion simulations in realistic neurons demonstrating that curvature and branching does not destroy the stick power-law behavior in impermeable neurites, but also that their signal is drowned by the soma signal under typical experimental conditions. Nevertheless, by studying the GM dMRI signal's behavior as a function of diffusion weighting as well as time, we identify an attainable experimental regime in which the neurite signal dominates. Furthermore, we find that exchange-driven time dependence produces a signal behavior opposite to that which would be expected from restricted diffusion, thereby providing a functional signature that disambiguates the two effects. We present data from dMRI experiments in ex vivo rat brain at ultrahigh field of 16.4T and observe a time dependence that is consistent with substantial exchange but also with a GM stick power-law. The first finding suggests significant water exchange between neurites and the extracellular space while the second suggests a small sub-population of impermeable neurites. To quantify these observations, we harness the Kärger exchange model and incorporate the corresponding signal time dependence in the SM and SANDI models.

Correlation Tensor MRI deciphers underlying kurtosis sources in stroke.

Noninvasively detecting and characterizing modulations in cellular scale micro-architecture remains a desideratum for contemporary neuroimaging. Diffusion MRI (dMRI) has become the mainstay methodology for probing microstructure, and, in ischemia, its contrasts have revolutionized stroke management. Diffusion kurtosis imaging (DKI) has been shown to significantly enhance the sensitivity of stroke detection compared to its diffusion tensor imaging (DTI) counterparts. However, the interpretation of DKI remains ambiguous as its contrast may arise from competing kurtosis sources related to the anisotropy of tissue components, diffusivity variance across components, and microscopic kurtosis (e.g., arising from cross-sectional variance, structural disorder, and restriction). Resolving these sources may be fundamental for developing more specific imaging techniques for stroke management, prognosis, and understanding its pathophysiology. In this study, we apply Correlation Tensor MRI (CTI) - a double diffusion encoding (DDE) methodology recently introduced for deciphering kurtosis sources based on the unique information captured in DDE's diffusion correlation tensors - to investigate the underpinnings of kurtosis measurements in acute ischemic lesions. Simulations for the different kurtosis sources revealed specific signatures for cross-sectional variance (representing neurite beading), edema, and cell swelling. Ex vivo CTI experiments at 16.4 T were then performed in an experimental photothrombotic stroke model 3 h post-stroke (N = 10), and successfully separated anisotropic, isotropic, and microscopic non-Gaussian diffusion sources in the ischemic lesions. Each of these kurtosis sources provided unique contrasts in the stroked area. Particularly, microscopic kurtosis was shown to be a primary "driver" of total kurtosis upon ischemia; its large increases, coupled with decreases in anisotropic kurtosis, are consistent with the expected elevation in cross-sectional variance, likely linked to beading effects in small objects such as neurites. In vivo experiments at 9.4 T at the same time point (3 h post ischemia, N = 5) demonstrated the stability and relevance of the findings and showed that fixation is not a dominant confounder in our findings. In future studies, the different CTI contrasts may be useful to address current limitations of stroke imaging, e.g., penumbra characterization, distinguishing lesion progression form tissue recovery, and elucidating pathophysiological correlates.

Beyond the diffusion standard model in fixed rat spinal cord with combined linear and planar encoding.

Information about tissue on the microscopic and mesoscopic scales can be accessed by modelling diffusion MRI signals, with the aim of extracting microstructure-specific biomarkers. The standard model (SM) of diffusion, currently the most broadly adopted microstructural model, describes diffusion in white matter (WM) tissues by two Gaussian components, one of which has zero radial diffusivity, to represent diffusion in intra- and extra-axonal water, respectively. Here, we reappraise these SM assumptions by collecting comprehensive double diffusion encoded (DDE) MRI data with both linear and planar encodings, which was recently shown to substantially enhance the ability to estimate SM parameters. We find however, that the SM is unable to account for data recorded in fixed rat spinal cord at an ultrahigh field of 16.4 T, suggesting that its underlying assumptions are violated in our experimental data. We offer three model extensions to mitigate this problem: first, we generalize the SM to accommodate finite radii (axons) by releasing the constraint of zero radial diffusivity in the intra-axonal compartment. Second, we include intracompartmental kurtosis to account for non-Gaussian behaviour. Third, we introduce an additional (third) compartment. The ability of these models to account for our experimental data are compared based on parameter feasibility and Bayesian information criterion. Our analysis identifies the three-compartment description as the optimal model. The third compartment exhibits slow diffusion with a minor but non-negligible signal fraction (∼12%). We demonstrate how failure to take the presence of such a compartment into account severely misguides inferences about WM microstructure. Our findings bear significance for microstructural modelling at large and can impact the interpretation of biomarkers extracted from the standard model of diffusion.

Evidence for microscopic kurtosis in neural tissue revealed by correlation tensor MRI.

PURPOSE: The impact of microscopic diffusional kurtosis (µK), arising from restricted diffusion and/or structural disorder, remains a controversial issue in contemporary diffusion MRI (dMRI). Recently, correlation tensor imaging (CTI) was introduced to disentangle the sources contributing to diffusional kurtosis, without relying on a-priori multi-gaussian component (MGC) or other microstructural assumptions. Here, we investigated µK in in vivo rat brains and assessed its impact on state-of-the-art methods ignoring µK. THEORY AND METHODS: CTI harnesses double diffusion encoding (DDE) experiments, which were here improved for speed and minimal bias using four different sets of acquisition parameters. The robustness of the improved CTI protocol was assessed via simulations. In vivo CTI acquisitions were performed in healthy rat brains using a 9.4T pre-clinical scanner equipped with a cryogenic coil, and targeted the estimation of µK, anisotropic kurtosis, and isotropic kurtosis. RESULTS: The improved CTI acquisition scheme substantially reduces scan time and importantly, also minimizes higher-order-term biases, thus enabling robust µK estimation, alongside Kaniso and Kiso metrics. Our CTI experiments revealed positive µK both in white and gray matter of the rat brain in vivo; µK is the dominant kurtosis source in healthy gray matter tissue. The non-negligible µK substantially were found to bias prior MGC analyses of Kiso and Kaniso . CONCLUSIONS: Correlation Tensor MRI offers a more accurate and robust characterization of kurtosis sources than its predecessors. µK is non-negligible in vivo in healthy white and gray matter tissues and could be an important biomarker for future studies. Our findings thus have both theoretical and practical implications for future dMRI research.

Toward more robust and reproducible diffusion kurtosis imaging.

PURPOSE: The general utility of diffusion kurtosis imaging (DKI) is challenged by its poor robustness to imaging artifacts and thermal noise that often lead to implausible kurtosis values. THEORY AND METHODS: A robust scalar kurtosis index can be estimated from powder-averaged diffusion-weighted data. We introduce a novel DKI estimator that uses this scalar kurtosis index as a proxy for the mean kurtosis to regularize the fit. RESULTS: The regularized DKI estimator improves the robustness and reproducibility of the kurtosis metrics and results in parameter maps with enhanced quality and contrast. CONCLUSION: Our novel DKI estimator promotes the wider use of DKI in clinical research and potentially diagnostics by improving the reproducibility and precision of DKI fitting and, as such, enabling enhanced visual, quantitative, and statistical analyses of DKI parameters.

The impact of realistic axonal shape on axon diameter estimation using diffusion MRI.

To study axonal microstructure with diffusion MRI, axons are typically modeled as straight impermeable cylinders, whereby the transverse diffusion MRI signal can be made sensitive to the cylinder's inner diameter. However, the shape of a real axon varies along the axon direction, which couples the longitudinal and transverse diffusion of the overall axon direction. Here we develop a theory of the intra-axonal diffusion MRI signal based on coarse-graining of the axonal shape by 3-dimensional diffusion. We demonstrate how the estimate of the inner diameter is confounded by the diameter variations (beading), and by the local variations in direction (undulations) along the axon. We analytically relate diffusion MRI metrics, such as time-dependent radial diffusivity D⊥(t)and kurtosis K⊥(t),to the axonal shape, and validate our theory using Monte Carlo simulations in synthetic undulating axons with randomly positioned beads, and in realistic axons reconstructed from electron microscopy images of mouse brain white matter. We show that (i) In the narrow pulse limit, the inner diameter from D⊥(t)is overestimated by about twofold due to a combination of axon caliber variations and undulations (each contributing a comparable effect size); (ii) The narrow-pulse kurtosis K⊥|t→∞deviates from that in an ideal cylinder due to caliber variations; we also numerically calculate the fourth-order cumulant for an ideal cylinder in the wide pulse limit, which is relevant for inner diameter overestimation; (iii) In the wide pulse limit, the axon diameter overestimation is mainly due to undulations at low diffusion weightings b; and (iv) The effect of undulations can be considerably reduced by directional averaging of high-b signals, with the apparent inner diameter given by a combination of the axon caliber (dominated by the thickest axons), caliber variations, and the residual contribution of undulations.

Microscopic anisotropy misestimation in spherical-mean single diffusion encoding MRI.

PURPOSE: Microscopic fractional anisotropy (µFA) can disentangle microstructural information from orientation dispersion. While double diffusion encoding (DDE) MRI methods are widely used to extract accurate µFA, it has only recently been proposed that powder-averaged single diffusion encoding (SDE) signals, when coupled with the diffusion standard model (SM) and a set of constraints, could be used for µFA estimation. This study aims to evaluate µFA as derived from the spherical mean technique (SMT) set of constraints, as well as more generally for powder-averaged SM signals. METHODS: SDE experiments were performed at 16.4 T on an ex vivo mouse brain (Δ/δ = 12/1.5 ms). The µFA maps obtained from powder-averaged SDE signals were then compared to maps obtained from DDE-MRI experiments (Δ/τ/δ = 12/12/1.5 ms), which allow a model-free estimation of µFA. Theory and simulations that consider different types of heterogeneity are presented for corroborating the experimental findings. RESULTS: µFA, as well as other estimates derived from powder-averaged SDE signals produced large deviations from the ground truth in both gray and white matter. Simulations revealed that these misestimations are likely a consequence of factors not considered by the underlying microstructural models (such as intercomponent and intracompartmental kurtosis). CONCLUSION: Powder-averaged SMT and (2-component) SM are unable to accurately report µFA and other microstructural parameters in ex vivo tissues. Improper model assumptions and constraints can significantly compromise parameter specificity. Further developments and validations are required prior to implementation of these models in clinical or preclinical research.

Resolving degeneracy in diffusion MRI biophysical model parameter estimation using double diffusion encoding.

PURPOSE: Biophysical tissue models are increasingly used in the interpretation of diffusion MRI (dMRI) data, with the potential to provide specific biomarkers of brain microstructural changes. However, it has been shown recently that, in the general Standard Model, parameter estimation from dMRI data is ill-conditioned even when very high b-values are applied. We analyze this issue for the Neurite Orientation Dispersion and Density Imaging with Diffusivity Assessment (NODDIDA) model and demonstrate that its extension from single diffusion encoding (SDE) to double diffusion encoding (DDE) resolves the ill-posedness for intermediate diffusion weightings, producing an increase in accuracy and precision of the parameter estimation. METHODS: We analyze theoretically the cumulant expansion up to fourth order in b of SDE and DDE signals. Additionally, we perform in silico experiments to compare SDE and DDE capabilities under similar noise conditions. RESULTS: We prove analytically that DDE provides invariant information non-accessible from SDE, which makes the NODDIDA parameter estimation injective. The in silico experiments show that DDE reduces the bias and mean square error of the estimation along the whole feasible region of 5D model parameter space. CONCLUSIONS: DDE adds additional information for estimating the model parameters, unexplored by SDE. We show, as an example, that this is sufficient to solve the previously reported degeneracies in the NODDIDA model parameter estimation.

Evaluation of principal component analysis image denoising on multi-exponential MRI relaxometry.

PURPOSE: Multi-exponential relaxometry is a powerful tool for characterizing tissue, but generally requires high image signal-to-noise ratio (SNR). This work evaluates the use of principal-component-analysis (PCA) denoising to mitigate these SNR demands and improve the precision of relaxometry measures. METHODS: PCA denoising was evaluated using both simulated and experimental MRI data. Bi-exponential transverse relaxation signals were simulated for a wide range of acquisition and sample parameters, and experimental data were acquired from three excised and fixed mouse brains. In both cases, standard relaxometry analysis was performed on both original and denoised image data, and resulting estimated signal parameters were compared. RESULTS: Denoising reduced the root-mean-square-error of parameters estimated from multi-exponential relaxometry by factors of ≈3×, for typical acquisition and sample parameters. Denoised images and subsequent parameter maps showed little or no signs of spatial artifact or loss of resolution. CONCLUSION: Experimental studies and simulations demonstrate that PCA denoising of MRI relaxometry data is an effective method of improving parameter precision without sacrificing image resolution. This simple yet important processing step thus paves the way for broader applicability of multi-exponential MRI relaxometry.

Quantifying brain microstructure with diffusion MRI: Theory and parameter estimation.

We review, systematize and discuss models of diffusion in neuronal tissue, by putting them into an overarching physical context of coarse-graining over an increasing diffusion length scale. From this perspective, we view research on quantifying brain microstructure as occurring along three major avenues. The first avenue focusses on transient, or time-dependent, effects in diffusion. These effects signify the gradual coarse-graining of tissue structure, which occurs qualitatively differently in different brain tissue compartments. We show that transient effects contain information about the relevant length scales for neuronal tissue, such as the packing correlation length for neuronal fibers, as well as the degree of structural disorder along the neurites. The second avenue corresponds to the long-time limit, when the observed signal can be approximated as a sum of multiple nonexchanging anisotropic Gaussian components. Here, the challenge lies in parameter estimation and in resolving its hidden degeneracies. The third avenue employs multiple diffusion encoding techniques, able to access information not contained in the conventional diffusion propagator. We conclude with our outlook on future directions that could open exciting possibilities for designing quantitative markers of tissue physiology and pathology, based on methods of studying mesoscopic transport in disordered systems.

Accurate estimation of microscopic diffusion anisotropy and its time dependence in the mouse brain.

Microscopic diffusion anisotropy (µA) has been recently gaining increasing attention for its ability to decouple the average compartment anisotropy from orientation dispersion. Advanced diffusion MRI sequences, such as double diffusion encoding (DDE) and double oscillating diffusion encoding (DODE) have been used for mapping µA, usually using measurements from a single b shell. However, the accuracy of µA estimation vis-à-vis different b-values was not assessed. Moreover, the time-dependence of this metric, which could offer additional insights into tissue microstructure, has not been studied so far. Here, we investigate both these concepts using theory, simulation, and experiments performed at 16.4T in the mouse brain, ex-vivo. In the first part, simulations and experimental results show that the conventional estimation of microscopic anisotropy from the difference of D(O)DE sequences with parallel and orthogonal gradient directions yields values that highly depend on the choice of b-value. To mitigate this undesirable bias, we propose a multi-shell approach that harnesses a polynomial fit of the signal difference up to third order terms in b-value. In simulations, this approach yields more accurate µA metrics, which are similar to the ground-truth values. The second part of this work uses the proposed multi-shell method to estimate the time/frequency dependence of µA. The data shows either an increase or no change in µA with frequency depending on the region of interest, both in white and gray matter. When comparing the experimental results with simulations, it emerges that simple geometric models such as infinite cylinders with either negligible or finite radii cannot replicate the measured trend, and more complex models, which, for example, incorporate structure along the fibre direction are required. Thus, measuring the time dependence of microscopic anisotropy can provide valuable information for characterizing tissue microstructure.

The effects of capillary transit time heterogeneity on the BOLD signal.

Neurovascular coupling mechanisms give rise to vasodilation and functional hyperemia upon neural activation, thereby altering blood oxygenation. This blood oxygenation level dependent (BOLD) contrast allows studies of activation patterns in the working human brain by functional MRI (fMRI). The BOLD-weighted fMRI signal shows characteristic transients in relation to functional activation, such as the so-called initial dip, overshoot, and post-stimulus undershoot. These transients are modulated by other physiological stimuli and in disease, but the underlying physiological mechanisms remain incompletely understood. Capillary transit time heterogeneity (CTH) has been shown to affect oxygen extraction, and hence blood oxygenation. Here, we examine how recently reported redistributions of capillary blood flow during functional activation would be expected to affect BOLD signal transients. We developed a three-compartment (hemoglobin, plasma, and tissue) model to predict the BOLD signal, incorporating the effects of dynamic changes in CTH. Our model predicts that the BOLD signal represents the superposition of a positive component resulting from increases in cerebral blood flow (CBF), and a negative component, resulting from elevated tissue metabolism and homogenization of capillary flows (reduced CTH). The model reproduces salient features of BOLD signal dynamics under conditions such as hypercapnia, hyperoxia, and caffeine intake, where both brain physiology and BOLD characteristics are altered. Neuroglial signaling and metabolism could affect CBF and capillary flow patterns differently. Further studies of neurovascular and neuro-capillary coupling mechanisms may help us relate BOLD signals to the firing of certain neuronal populations based on their respective BOLD "fingerprints."

On modeling.

Mapping tissue microstructure with MRI holds great promise as a noninvasive window into tissue organization at the cellular level. Having originated within the realm of diffusion NMR in the late 1970s, this field is experiencing an exponential growth in the number of publications. At the same time, model-based approaches are also increasingly incorporated into advanced MRI acquisition and reconstruction techniques. However, after about two decades of intellectual and financial investment, microstructural mapping has yet to find a single commonly accepted clinical application. Here, we suggest that slow progress in clinical translation may signify unresolved fundamental problems. We outline such problems and related practical pitfalls, as well as review strategies for developing and validating tissue microstructure models, to provoke a discussion on how to bridge the gap between our scientific aspirations and the clinical reality. We argue for recalibrating the efforts of our community toward a more systematic focus on fundamental research aimed at identifying relevant degrees of freedom affecting the measured MR signal. Such a focus is essential for realizing the truly revolutionary potential of noninvasive three-dimensional in vivo microstructural mapping.

White matter biomarkers from fast protocols using axially symmetric diffusion kurtosis imaging.

White matter tract integrity (WMTI) can characterize brain microstructure in areas with highly aligned fiber bundles. Several WMTI biomarkers have now been validated against microscopy and provided promising results in studies of brain development and aging, as well as in a number of brain disorders. Currently, WMTI is mostly used in dedicated animal studies and clinical studies of slowly progressing diseases, and has not yet emerged as a routine clinical tool. To this end, a less data intensive experimental method would be beneficial by enabling high resolution validation studies, and ease clinical applications by speeding up data acquisition compared with typical diffusion kurtosis imaging (DKI) protocols utilized as part of WMTI imaging. Here, we evaluate WMTI based on recently introduced axially symmetric DKI, which has lower data demand than conventional DKI. We compare WMTI parameters derived from conventional DKI with those calculated analytically from axially symmetric DKI. We employ numerical simulations, as well as data from fixed rat spinal cord (one sample) and in vivo human (three subjects) and rat brain (four animals). Our analysis shows that analytical WMTI based on axially symmetric DKI with sparse data sets (19 images) produces WMTI metrics that correlate strongly with estimates based on traditional DKI data sets (60 images or more). We demonstrate the preclinical potential of the proposed WMTI technique in in vivo rat brain (300 µm isotropic resolution with whole brain coverage in a 1 h acquisition). WMTI parameter estimates are subject to a duality leading to two solution branches dependent on a sign choice, which is currently debated. Results from both of these branches are presented and discussed throughout our analysis. The proposed fast WMTI approach may be useful for preclinical research and e.g. clinical evaluation of patients with traumatic white matter injuries or symptoms of neurovascular or neuroinflammatory disorders.

Conventions and nomenclature for double diffusion encoding NMR and MRI.

Stejskal and Tanner's ingenious pulsed field gradient design from 1965 has made diffusion NMR and MRI the mainstay of most studies seeking to resolve microstructural information in porous systems in general and biological systems in particular. Methods extending beyond Stejskal and Tanner's design, such as double diffusion encoding (DDE) NMR and MRI, may provide novel quantifiable metrics that are less easily inferred from conventional diffusion acquisitions. Despite the growing interest on the topic, the terminology for the pulse sequences, their parameters, and the metrics that can be derived from them remains inconsistent and disparate among groups active in DDE. Here, we present a consensus of those groups on terminology for DDE sequences and associated concepts. Furthermore, the regimes in which DDE metrics appear to provide microstructural information that cannot be achieved using more conventional counterparts (in a model-free fashion) are elucidated. We highlight in particular DDE's potential for determining microscopic diffusion anisotropy and microscopic fractional anisotropy, which offer metrics of microscopic features independent of orientation dispersion and thus provide information complementary to the standard, macroscopic, fractional anisotropy conventionally obtained by diffusion MR. Finally, we discuss future vistas and perspectives for DDE.

The effects of capillary dysfunction on oxygen and glucose extraction in diabetic neuropathy.

Diabetic neuropathy is associated with disturbances in endoneurial metabolism and microvascular morphology, but the roles of these factors in the aetiopathogenesis of diabetic neuropathy remain unclear. Changes in endoneurial capillary morphology and vascular reactivity apparently predate the development of diabetic neuropathy in humans, and in manifest neuropathy, reductions in nerve conduction velocity correlate with the level of endoneurial hypoxia. The idea that microvascular changes cause diabetic neuropathy is contradicted, however, by reports of elevated endoneurial blood flow in early experimental diabetes, and of unaffected blood flow when early histological signs of neuropathy first develop in humans. We recently showed that disturbances in capillary flow patterns, so-called capillary dysfunction, can reduce the amount of oxygen and glucose that can be extracted by the tissue for a given blood flow. In fact, tissue blood flow must be adjusted to ensure sufficient oxygen extraction as capillary dysfunction becomes more severe, thereby changing the normal relationship between tissue oxygenation and blood flow. This review examines the evidence of capillary dysfunction in diabetic neuropathy, and whether the observed relation between endoneurial blood flow and nerve function is consistent with increasingly disturbed capillary flow patterns. The analysis suggests testable relations between capillary dysfunction, tissue hypoxia, aldose reductase activity, oxidative stress, tissue inflammation and glucose clearance from blood. We discuss the implications of these predictions in relation to the prevention and management of diabetic complications in type 1 and type 2 diabetes, and suggest ways of testing these hypotheses in experimental and clinical settings.

Correction of diffusion-weighted magnetic resonance imaging for brachytherapy of locally advanced cervical cancer.

BACKGROUND: Geometrical distortion is a major obstacle for the use of echo planar diffusion-weighted magnetic resonance imaging (DW-MRI) in planning of radiotherapy. This study compares geometrical distortion correction methods of DW-MRI at time of brachytherapy (BT) in locally advanced cervical cancer patients. MATERIAL AND METHODS: In total 21 examinations comprising DW-MRI, dual gradient echo (GRE) for B0 field map calculation and T2-weighted (T2W) fat-saturated MRI of eight patients with locally advanced cervical cancer were acquired during BT with a plastic tandem and ring applicator in situ. The ability of B0 field map correction (B0M) and deformable image registration (DIR) to correct DW-MRI geometric image distortion was compared to the non-corrected DW-MRI including evaluation of apparent diffusion coefficient (ADC) for the gross tumor volume (GTV). RESULTS: Geometrical distortion correction decreased tandem displacement from 3.3 ± 0.9 mm (non-corrected) to 2.9 ± 1.0 mm (B0M) and 1.9 ± 0.6 mm (DIR), increased mean normalized cross-correlation from 0.69 ± 0.1 (non- corrected) to 0.70 ± 0.10 (B0M) and 0.77 ± 0.1 (DIR), and increased the Jaccard similarity coefficient from 0.72 ± 0.1 (non-corrected) to 0.73 ± 0.06 (B0M) and 0.77 ± 0.1 (DIR). For all parameters only DIR corrections were significant (p < 0.05). ADC of the GTV did not change significantly with either correction method. CONCLUSION: DIR significantly improved geometrical accuracy of DW-MRI, with remaining residual uncertainties of less than 2 mm, while no significant improvement was seen using B0 field map correction.