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Diffusion tensor imaging and quantitative susceptibility mapping as diagnostic tools for motor neuron disorders.

Elizabeth K Weidman1, Andrew D Schweitzer1, Sumit N Niogi1

  • 1Department of Radiology, NewYork-Presbyterian Hospital - Weill Cornell Medicine, New York, NY, United States of America.

Clinical Imaging
|October 5, 2018
PubMed
Summary

Diffusion tensor imaging (DTI) and quantitative susceptibility mapping (QSM) show differences in upper motor neuron diseases like ALS/PLS. However, these imaging techniques did not significantly improve diagnostic performance compared to other neurological disorders.

Keywords:
Amyotrophic lateral sclerosisDiffusion tensor imagingMotor neuron diseaseQuantitative susceptibility mapping

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Area of Science:

  • Neuroimaging
  • Neurology

Background:

  • Amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS) are upper motor neuron diseases.
  • Accurate diagnosis is crucial for patient management and treatment.

Purpose of the Study:

  • To evaluate the diagnostic performance of DTI and QSM in differentiating ALS/PLS from other motor disorders.
  • To assess DTI and QSM metrics alone and in combination for diagnostic accuracy.

Main Methods:

  • Retrospective review of 3.0 Tesla MRI scans including DTI and QSM.
  • Measurement of corticospinal tract fractional anisotropy and motor cortex susceptibility.
  • Comparison of imaging metrics between ALS/PLS patients and mimic groups using t-tests and ROC curves.

Main Results:

  • Significant differences in fractional anisotropy (lower in ALS/PLS) and magnetic susceptibility (higher in ALS/PLS) were observed.
  • Area under the curve (AUC) for DTI and QSM alone showed no significant difference.
  • Combined DTI and QSM metrics did not significantly improve diagnostic performance.

Conclusions:

  • DTI and QSM reveal distinct imaging characteristics in upper motor neuron diseases.
  • Current DTI and QSM metrics do not significantly enhance the diagnostic differentiation of ALS/PLS from mimic conditions.