Improved image quality and detection of small cerebral infarctions with diffusion-tensor trace imaging

Area of Science:

• Radiology
• Neuroimaging
• Medical Imaging

Background:

• Standard diffusion-weighted imaging (DWI) is a common technique for detecting brain infarctions.
• Assessing the diagnostic performance and image quality of advanced diffusion imaging techniques is crucial for clinical adoption.

Purpose of the Study:

• To evaluate if diffusion-tensor trace imaging (DTI) can replace standard DWI for infarct detection due to its image quality and sensitivity.
• To compare the diagnostic capabilities of routine DWI and 15-direction DTI in a clinical setting.

Main Methods:

• A comparative study involving 2537 brain MRI scans (365 infarct-positive) using both routine DWI and 15-direction DTI with parallel acquisition on a 1.5-T scanner.
• Image quality and infarct detection sensitivity were assessed quantitatively and qualitatively, with a focus on small cerebral infarctions.

Main Results:

• 15-direction DTI demonstrated superior image quality, reduced distortion, and enhanced detail compared to routine DWI.
• Small infarcts were more clearly visualized on DTI, and 12 cases of infarcts were only detectable with DTI.
• The increased scanning time for DTI did not lead to significant motion-related image quality degradation.

Conclusions:

• Diffusion-tensor trace imaging with parallel acquisition offers improved image quality and sensitivity for detecting small cerebral infarctions over standard DWI.
• Routine DWI can be omitted when DTI data is acquired, streamlining the neuroimaging workflow.