Mild traumatic brain injury (mTBI), also referred to as concussion, remains a controversial diagnosis because the brain often appears quite normal on conventional computed tomography (CT) and magnetic resonance imaging (MRI) scans. Such conventional tools, however, do not adequately depict brain injury in mTBI because they are not sensitive to detecting diffuse axonal injuries (DAI), also described as traumatic axonal injuries (TAI), the major brain injuries in mTBI. Furthermore, for the 15 to 30% of those diagnosed with mTBI on the basis of cognitive and clinical symptoms, i.e., the “miserable minority,” the cognitive and physical symptoms do not resolve following the first three months post-injury. Instead, they persist, and in some cases lead to long-term disability. The explanation given for these chronic symptoms, i.e., postconcussive syndrome, particularly in cases where there is no discernible radiological evidence for brain injury, has led some to posit a psychogenic origin. Such attributions are made all the easier since both post-traumatic stress disorder (PTSD) and depression are frequently co-morbid with mTBI. The challenge is thus to use neuroimaging tools that are sensitive to DAI/TAI, such as diffusion tensor imaging (DTI), in order to detect brain injuries in mTBI. Of note here, recent advances in neuroimaging techniques, such as DTI, make it possible to characterize better extant brain abnormalities in mTBI. These advances may lead to the development of biomarkers of injury, as well as to staging of reorganization and reversal of white matter changes following injury, and to the ability to track and to characterize changes in brain injury over time. Such tools will likely be used in future research to evaluate treatment efficacy, given their enhanced sensitivity to alterations in the brain. In this article we review the incidence of mTBI and the importance of characterizing this patient population using objective radiological measures. Evidence is presented for detecting brain abnormalities in mTBI based on studies that use advanced neuroimaging techniques. Taken together, these findings suggest that more sensitive neuroimaging tools improve the detection of brain abnormalities (i.e., diagnosis) in mTBI. These tools will likely also provide important information relevant to outcome (prognosis), as well as play an important role in longitudinal studies that are needed to understand the dynamic nature of brain injury in mTBI. Additionally, summary tables of MRI and DTI findings are included. We believe that the enhanced sensitivity of newer and more advanced neuroimaging techniques for identifying areas of brain damage in mTBI will be important for documenting the biological basis of postconcussive symptoms, which are likely associated with subtle brain alterations, alterations that have heretofore gone undetected due to the lack of sensitivity of earlier neuroimaging techniques. Nonetheless, it is noteworthy to point out that detecting brain abnormalities in mTBI does not mean that other disorder...

This paper addresses the problem of image segmentation by means of active contours, whose evolution is driven by the gradient flow derived from an energy functional that is based on the Bhattacharyya distance. In particular, given the values of a photometric variable (or of a set thereof), which is to be used for classifying the image pixels, the active contours are designed to converge to the shape that results in maximal discrepancy between the empirical distributions of the photometric variable inside and outside of the contours. The above discrepancy is measured by means of the Bhattacharyya distance that proves to be an extremely useful tool for solving the problem at hand. The proposed methodology can be viewed as a generalization of the segmentation methods, in which active contours maximize the difference between a finite number of empirical moments of the "inside" and "outside" distributions. Furthermore, it is shown that the proposed methodology is very versatile and flexible in the sense that it allows one to easily accommodate a diversity of the image features based on which the segmentation should be performed. As an additional contribution, a method for automatically adjusting the smoothness properties of the empirical distributions is proposed. Such a procedure is crucial in situations when the number of data samples (supporting a certain segmentation class) varies considerably in the course of the evolution of the active contour. In this case, the smoothness properties of the empirical distributions have to be properly adjusted to avoid either over-or underestimation artifacts. Finally, a number of relevant segmentation results are demonstrated and some further research directions are discussed.

We describe a technique that uses tractography to drive the local fiber model estimation. Existing techniques use independent estimation at each voxel so there is no running knowledge of confidence in the estimated model fit. We formulate fiber tracking as recursive estimation: at each step of tracing the fiber, the current estimate is guided by those previous. To do this we perform tractography within a filter framework and use a discrete mixture of Gaussian tensors to model the signal. Starting from a seed point, each fiber is traced to its termination using an unscented Kalman filter to simultaneously fit the local model to the signal and propagate in the most consistent direction. Despite the presence of noise and uncertainty, this provides a causal estimate of the local structure at each point along the fiber. Using two- and three-fiber models we demonstrate in synthetic experiments that this approach significantly improves the angular resolution at crossings and branchings. In vivo experiments confirm the ability to trace through regions known to contain such crossing and branching while providing inherent path regularization.

This work presents an anatomically curated white matter atlas to enable consistent white matter tract parcellation across different populations. Leveraging a well-established computational pipeline for fiber clustering, we create a tract-based white matter atlas including information from 100 subjects. A novel anatomical annotation method is proposed that leverages population-based brain anatomical information and expert neuroanatomical knowledge to annotate and categorize the fiber clusters. A total of 256 white matter structures are annotated in the proposed atlas, which provides one of the most comprehensive tract-based white matter atlases covering the entire brain to date. These structures are composed of 58 deep white matter tracts including major long range association and projection tracts, commissural tracts, and tracts related to the brainstem and cerebellar connections, plus 198 short and medium range superficial fiber clusters organized into 16 categories according to the brain lobes they connect. Potential false positive connections are annotated in the atlas to enable their exclusion from analysis or visualization. In addition, the proposed atlas allows for a whole brain white matter parcellation into 800 fiber clusters to enable whole brain connectivity analyses. The atlas and related computational tools are open-source and publicly available. We evaluate the proposed atlas using a testing dataset of 584 diffusion MRI scans from multiple independently acquired populations, across genders, the lifespan (1 day-82 years), and different health conditions (healthy control, neuropsychiatric disorders, and brain tumor patients). Experimental results show successful white matter parcellation across subjects from different populations acquired on multiple scanners, irrespective of age, gender or disease indications. Over 99% of the fiber tracts annotated in the atlas were detected in all subjects on average. One advantage in terms of robustness is that the tract-based pipeline does not require any cortical or subcortical segmentations, which can have limited success in young children and patients with brain tumors or other structural lesions. We believe this is the first demonstration of consistent automated white matter tract parcellation across the full lifespan from birth to advanced age.

We have developed a novel method to describe human white matter anatomy using an approach that is both intuitive and simple to use, and which automatically extracts white matter tracts from diffusion MRI volumes. Further, our method simplifies the quantification and statistical analysis of white matter tracts on large diffusion MRI databases. This work reflects the careful syntactical definition of major white matter fiber tracts in the human brain based on a neuroanatomist’s expert knowledge. The framework is based on a novel query language with a near-to-English textual syntax. This query language makes it possible to construct a dictionary of anatomical definitions that describe white matter tracts. The definitions include adjacent gray and white matter regions, and rules for spatial relations. This novel method makes it possible to automatically label white matter anatomy across subjects. After describing this method, we provide an example of its implementation where we encode anatomical knowledge in human white matter for ten association and 15 projection tracts per hemisphere, along with seven commissural tracts. Importantly, this novel method is comparable in accuracy to manual labeling. Finally, we present results applying this method to create a white matter atlas from 77 healthy subjects, and we use this atlas in a small proof-of-concept study to detect changes in association tracts that characterize schizophrenia.

Purpose To develop an efficient acquisition for high‐resolution diffusion imaging and allow in vivo whole‐brain acquisitions at 600‐ to 700‐μm isotropic resolution. Methods We combine blipped‐controlled aliasing in parallel imaging simultaneous multislice (SMS) with a novel slab radiofrequency (RF) encoding gSlider (generalized slice‐dithered enhanced resolution) to form a signal‐to‐noise ratio–efficient volumetric simultaneous multislab acquisition. Here, multiple thin slabs are acquired simultaneously with controlled aliasing, and unaliased with parallel imaging. To achieve high resolution in the slice direction, the slab is volumetrically encoded using RF encoding with a scheme similar to Hadamard encoding. However, with gSlider, the RF‐encoding bases are specifically designed to be highly independent and provide high image signal‐to‐noise ratio in each slab acquisition to enable self‐navigation of the diffusion's phase corruption. Finally, the method is combined with zoomed imaging (while retaining whole‐brain coverage) to facilitate low‐distortion single‐shot in‐plane encoding with echo‐planar imaging at high resolution. Results A 10‐slices‐per‐shot gSlider‐SMS acquisition was used to acquire whole‐brain data at 660 and 760 μm isotropic resolution with b‐values of 1500 and 1800 s/mm2, respectively. Data were acquired on the Connectome 3 Tesla scanner with 64‐channel head coil. High‐quality data with excellent contrast were achieved at these resolutions, which enable the visualization of fine‐scale structures. Conclusions The gSlider‐SMS approach provides a new, efficient way to acquire high‐resolution diffusion data. Magn Reson Med 79:141–151, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Despite the relative recency of its inception, the theory of compressive sampling (aka compressed sensing) (CS) has already revolutionized multiple areas of applied sciences, a particularly important instance of which is medical imaging. Specifically, the theory has provided a different perspective on the important problem of optimal sampling in magnetic resonance imaging (MRI), with an ever-increasing body of works reporting stable and accurate reconstruction of MRI scans from the number of spectral measurements which would have been deemed unacceptably small as recently as five years ago. In this paper, the theory of CS is employed to palliate the problem of long acquisition times, which is known to be a major impediment to the clinical application of high angular resolution diffusion imaging (HARDI). Specifically, we demonstrate that a substantial reduction in data acquisition times is possible through minimization of the number of diffusion encoding gradients required for reliable reconstruction of HARDI scans. The success of such a minimization is primarily due to the availability of spherical ridgelet transformation, which excels in sparsifying HARDI signals. What makes the resulting reconstruction procedure even more accurate is a combination of the sparsity constraints in the diffusion domain with additional constraints imposed on the estimated diffusion field in the spatial domain. Accordingly, the present paper describes an original way to combine the diffusion-and spatial-domain constraints to achieve a maximal reduction in the number of diffusion measurements, while sacrificing little in terms of reconstruction accuracy. Finally, details are provided on an efficient numerical scheme which can be used to solve the aforementioned reconstruction problem by means of standard and readily available estimation tools. The paper is concluded with experimental results which support the practical value of the proposed reconstruction methodology.

We propose a novel method to harmonize diffusion MRI data acquired from multiple sites and scanners, which is imperative for joint analysis of the data to significantly increase sample size and statistical power of neuroimaging studies. Our method incorporates the following main novelties: i) we take into account the scanner-dependent spatial variability of the diffusion signal in different parts of the brain; ii) our method is independent of compartmental modeling of diffusion (e.g., tensor, and intra/extra cellular compartments) and the acquired signal itself is corrected for scanner related differences; and iii) inter-subject variability as measured by the coefficient of variation is maintained at each site. We represent the signal in a basis of spherical harmonics and compute several rotation invariant spherical harmonic features to estimate a region and tissue specific linear mapping between the signal from different sites (and scanners). We validate our method on diffusion data acquired from seven different sites (including two GE, three Philips, and two Siemens scanners) on a group of age-matched healthy subjects. Since the extracted rotation invariant spherical harmonic features depend on the accuracy of the brain parcellation provided by Freesurfer, we propose a feature based refinement of the original parcellation such that it better characterizes the anatomy and provides robust linear mappings to harmonize the dMRI data. We demonstrate the efficacy of our method by statistically comparing diffusion measures such as fractional anisotropy, mean diffusivity and generalized fractional anisotropy across multiple sites before and after data harmonization. We also show results using tract-based spatial statistics before and after harmonization for independent validation of the proposed methodology. Our experimental results demonstrate that, for nearly identical acquisition protocol across sites, scanner-specific differences can be accurately removed using the proposed method.