Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients

Joshua Francis Betz, Jiachen Zhuo, Anindya Roy, Kathirkamanthan Shanmuganathan, Rao P. Gullapalli

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Diffuse axonal injury (DAI) represents the most common primary intra-axial form of traumatic brain injury (TBI), comprising approximately half of all such injuries. Patients presenting with DAI follow a highly variable clinical course, with initial status frequently discrepant from long-term neurological outcome. Diffusion Tensor Imaging (DTI) is sensitive to disruptions in neuronal structure that may not be appreciated on CT or conventional MRI and may serve as an important prognostic imaging marker. In this study, we retrospectively evaluated the data from 84 patients to determine if the whole brain DTI parameters (axial diffusivity λ1, radial diffusivity λPERP, apparent diffusion coefficient ADC, and fractional anisotropy FA) are predictive of their clinical outcome as determined by discharge Glasgow Coma Scale (GCS). The first group consisted of 52 severely injured patients (GCS≤8) that either died (n=10), had poor outcome (n=12) or good outcome (n=27). The second group was comprised of mildly injured patients (GCS≥14 during entire hospitalization) that served as the reference group. Whole brain measurements of the DTI parameters were measured on each patient, and using non-parametric statistics, the measures from within each group were compared. Significant differences were found in ADC, λ1, and λPERP between the three outcome groups. Further, these measures were shown to be significantly related to GCS at scan. Using ordinal logistic regression models adjusted for age, gender, and admission GCS, DTI parameters were shown to significantly predict outcomes in severe TBI patients (death, poor outcome, good outcome, or mild injury). Evaluation of TBI patients may be improved using DTI measures as they correlate well with clinical measures, reflect the severity of injury, and can predict outcome. This method may provide a valuable independent tool to predict clinical outcomes in DAI.

Original languageEnglish (US)
Title of host publicationIFMBE Proceedings
Pages38-41
Number of pages4
Volume32 IFMBE
DOIs
StatePublished - 2010
Externally publishedYes
Event26th Southern Biomedical Engineering Conference, SBEC 2010 - College Park, MD, United States
Duration: Apr 30 2010May 2 2010

Other

Other26th Southern Biomedical Engineering Conference, SBEC 2010
CountryUnited States
CityCollege Park, MD
Period4/30/105/2/10

Fingerprint

Diffusion tensor imaging
Brain
Magnetic resonance imaging
Logistics
Anisotropy
Statistics
Imaging techniques

Keywords

  • diffusion tensor imaging
  • magnetic resonance imaging
  • outcome
  • traumatic brain injury

ASJC Scopus subject areas

  • Biomedical Engineering
  • Bioengineering

Cite this

Betz, J. F., Zhuo, J., Roy, A., Shanmuganathan, K., & Gullapalli, R. P. (2010). Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients. In IFMBE Proceedings (Vol. 32 IFMBE, pp. 38-41) https://doi.org/10.1007/978-3-642-14998-6_10

Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients. / Betz, Joshua Francis; Zhuo, Jiachen; Roy, Anindya; Shanmuganathan, Kathirkamanthan; Gullapalli, Rao P.

IFMBE Proceedings. Vol. 32 IFMBE 2010. p. 38-41.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Betz, JF, Zhuo, J, Roy, A, Shanmuganathan, K & Gullapalli, RP 2010, Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients. in IFMBE Proceedings. vol. 32 IFMBE, pp. 38-41, 26th Southern Biomedical Engineering Conference, SBEC 2010, College Park, MD, United States, 4/30/10. https://doi.org/10.1007/978-3-642-14998-6_10
Betz, Joshua Francis ; Zhuo, Jiachen ; Roy, Anindya ; Shanmuganathan, Kathirkamanthan ; Gullapalli, Rao P. / Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients. IFMBE Proceedings. Vol. 32 IFMBE 2010. pp. 38-41
@inproceedings{f5493577d0044fc0a1c8eb11ded6b539,
title = "Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients",
abstract = "Diffuse axonal injury (DAI) represents the most common primary intra-axial form of traumatic brain injury (TBI), comprising approximately half of all such injuries. Patients presenting with DAI follow a highly variable clinical course, with initial status frequently discrepant from long-term neurological outcome. Diffusion Tensor Imaging (DTI) is sensitive to disruptions in neuronal structure that may not be appreciated on CT or conventional MRI and may serve as an important prognostic imaging marker. In this study, we retrospectively evaluated the data from 84 patients to determine if the whole brain DTI parameters (axial diffusivity λ1, radial diffusivity λPERP, apparent diffusion coefficient ADC, and fractional anisotropy FA) are predictive of their clinical outcome as determined by discharge Glasgow Coma Scale (GCS). The first group consisted of 52 severely injured patients (GCS≤8) that either died (n=10), had poor outcome (n=12) or good outcome (n=27). The second group was comprised of mildly injured patients (GCS≥14 during entire hospitalization) that served as the reference group. Whole brain measurements of the DTI parameters were measured on each patient, and using non-parametric statistics, the measures from within each group were compared. Significant differences were found in ADC, λ1, and λPERP between the three outcome groups. Further, these measures were shown to be significantly related to GCS at scan. Using ordinal logistic regression models adjusted for age, gender, and admission GCS, DTI parameters were shown to significantly predict outcomes in severe TBI patients (death, poor outcome, good outcome, or mild injury). Evaluation of TBI patients may be improved using DTI measures as they correlate well with clinical measures, reflect the severity of injury, and can predict outcome. This method may provide a valuable independent tool to predict clinical outcomes in DAI.",
keywords = "diffusion tensor imaging, magnetic resonance imaging, outcome, traumatic brain injury",
author = "Betz, {Joshua Francis} and Jiachen Zhuo and Anindya Roy and Kathirkamanthan Shanmuganathan and Gullapalli, {Rao P.}",
year = "2010",
doi = "10.1007/978-3-642-14998-6_10",
language = "English (US)",
isbn = "9783642149979",
volume = "32 IFMBE",
pages = "38--41",
booktitle = "IFMBE Proceedings",

}

TY - GEN

T1 - Prognostic ability of diffusion tensor imaging parameters among severely injured traumatic brain injury patients

AU - Betz, Joshua Francis

AU - Zhuo, Jiachen

AU - Roy, Anindya

AU - Shanmuganathan, Kathirkamanthan

AU - Gullapalli, Rao P.

PY - 2010

Y1 - 2010

N2 - Diffuse axonal injury (DAI) represents the most common primary intra-axial form of traumatic brain injury (TBI), comprising approximately half of all such injuries. Patients presenting with DAI follow a highly variable clinical course, with initial status frequently discrepant from long-term neurological outcome. Diffusion Tensor Imaging (DTI) is sensitive to disruptions in neuronal structure that may not be appreciated on CT or conventional MRI and may serve as an important prognostic imaging marker. In this study, we retrospectively evaluated the data from 84 patients to determine if the whole brain DTI parameters (axial diffusivity λ1, radial diffusivity λPERP, apparent diffusion coefficient ADC, and fractional anisotropy FA) are predictive of their clinical outcome as determined by discharge Glasgow Coma Scale (GCS). The first group consisted of 52 severely injured patients (GCS≤8) that either died (n=10), had poor outcome (n=12) or good outcome (n=27). The second group was comprised of mildly injured patients (GCS≥14 during entire hospitalization) that served as the reference group. Whole brain measurements of the DTI parameters were measured on each patient, and using non-parametric statistics, the measures from within each group were compared. Significant differences were found in ADC, λ1, and λPERP between the three outcome groups. Further, these measures were shown to be significantly related to GCS at scan. Using ordinal logistic regression models adjusted for age, gender, and admission GCS, DTI parameters were shown to significantly predict outcomes in severe TBI patients (death, poor outcome, good outcome, or mild injury). Evaluation of TBI patients may be improved using DTI measures as they correlate well with clinical measures, reflect the severity of injury, and can predict outcome. This method may provide a valuable independent tool to predict clinical outcomes in DAI.

AB - Diffuse axonal injury (DAI) represents the most common primary intra-axial form of traumatic brain injury (TBI), comprising approximately half of all such injuries. Patients presenting with DAI follow a highly variable clinical course, with initial status frequently discrepant from long-term neurological outcome. Diffusion Tensor Imaging (DTI) is sensitive to disruptions in neuronal structure that may not be appreciated on CT or conventional MRI and may serve as an important prognostic imaging marker. In this study, we retrospectively evaluated the data from 84 patients to determine if the whole brain DTI parameters (axial diffusivity λ1, radial diffusivity λPERP, apparent diffusion coefficient ADC, and fractional anisotropy FA) are predictive of their clinical outcome as determined by discharge Glasgow Coma Scale (GCS). The first group consisted of 52 severely injured patients (GCS≤8) that either died (n=10), had poor outcome (n=12) or good outcome (n=27). The second group was comprised of mildly injured patients (GCS≥14 during entire hospitalization) that served as the reference group. Whole brain measurements of the DTI parameters were measured on each patient, and using non-parametric statistics, the measures from within each group were compared. Significant differences were found in ADC, λ1, and λPERP between the three outcome groups. Further, these measures were shown to be significantly related to GCS at scan. Using ordinal logistic regression models adjusted for age, gender, and admission GCS, DTI parameters were shown to significantly predict outcomes in severe TBI patients (death, poor outcome, good outcome, or mild injury). Evaluation of TBI patients may be improved using DTI measures as they correlate well with clinical measures, reflect the severity of injury, and can predict outcome. This method may provide a valuable independent tool to predict clinical outcomes in DAI.

KW - diffusion tensor imaging

KW - magnetic resonance imaging

KW - outcome

KW - traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=78049408041&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78049408041&partnerID=8YFLogxK

U2 - 10.1007/978-3-642-14998-6_10

DO - 10.1007/978-3-642-14998-6_10

M3 - Conference contribution

AN - SCOPUS:78049408041

SN - 9783642149979

VL - 32 IFMBE

SP - 38

EP - 41

BT - IFMBE Proceedings

ER -