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Diffusion-weighted magnetic resonance imaging

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Diffusion-weighted magnetic resonance imaging

Diffusion-weighted magnetic resonance imaging (DWI or DW-MRI) is the use of specific MRI sequences as well as software that generates images from the resulting data that uses the diffusion of water molecules to generate contrast in MR images. It allows the mapping of the diffusion process of molecules, mainly water, in biological tissues, in vivo and non-invasively. Molecular diffusion in tissues is not random, but reflects interactions with many obstacles, such as macromolecules, fibers, and membranes. Water molecule diffusion patterns can therefore reveal microscopic details about tissue architecture, either normal or in a diseased state. A special kind of DWI, diffusion tensor imaging (DTI), has been used extensively to map white matter tractography in the brain.

In diffusion weighted imaging (DWI), the intensity of each image element (voxel) reflects the best estimate of the rate of water diffusion at that location. Because the mobility of water is driven by thermal agitation and highly dependent on its cellular environment, the hypothesis behind DWI is that findings may indicate (early) pathologic change. For instance, DWI is more sensitive to early changes after a stroke than more traditional MRI measurements such as T1 or T2 relaxation rates. A variant of diffusion weighted imaging, diffusion spectrum imaging (DSI), was used in deriving the Connectome data sets; DSI is a variant of diffusion-weighted imaging that is sensitive to intra-voxel heterogeneities in diffusion directions caused by crossing fiber tracts and thus allows more accurate mapping of axonal trajectories than other diffusion imaging approaches.

Diffusion-weighted images are very useful to diagnose vascular strokes in the brain. It is also used more and more in the staging of non-small-cell lung cancer, where it is a serious candidate to replace positron emission tomography as the 'gold standard' for this type of disease. Diffusion tensor imaging is being developed for studying the diseases of the white matter of the brain as well as for studies of other body tissues (see below). DWI is most applicable when the tissue of interest is dominated by isotropic water movement e.g. grey matter in the cerebral cortex and major brain nuclei, or in the body—where the diffusion rate appears to be the same when measured along any axis. However, DWI also remains sensitive to T1 and T2 relaxation. To entangle diffusion and relaxation effects on image contrast, one may obtain quantitative images of the diffusion coefficient, or more exactly the apparent diffusion coefficient (ADC). The ADC concept was introduced to take into account the fact that the diffusion process is complex in biological tissues and reflects several different mechanisms.

Diffusion tensor imaging (DTI) is important when a tissue—such as the neural axons of white matter in the brain or muscle fibers in the heart—has an internal fibrous structure analogous to the anisotropy of some crystals. Water will then diffuse more rapidly in the direction aligned with the internal structure (axial diffusion), and more slowly as it moves perpendicular to the preferred direction (radial diffusion). This also means that the measured rate of diffusion will differ depending on the direction from which an observer is looking.

Diffusion Basis Spectrum Imaging (DBSI) further separates DTI signals into discrete anisotropic diffusion tensors and a spectrum of isotropic diffusion tensors to better differentiate sub-voxel cellular structures. For example, anisotropic diffusion tensors correlate to axonal fibers, while low isotropic diffusion tensors correlate to cells and high isotropic diffusion tensors correlate to larger structures (such as the lumen or brain ventricles). DBSI has been shown to differentiate some types of brain tumors and multiple sclerosis with higher specificity and sensitivity than conventional DTI. DBSI has also been useful in determining microstructure properties of the brain.

Traditionally, in diffusion-weighted imaging (DWI), three gradient-directions are applied, sufficient to estimate the trace of the diffusion tensor or 'average diffusivity', a putative measure of edema. Clinically, trace-weighted images have proven to be very useful to diagnose vascular strokes in the brain, by early detection (within a couple of minutes) of the hypoxic edema.

More extended DTI scans derive neural tract directional information from the data using 3D or multidimensional vector algorithms based on six or more gradient directions, sufficient to compute the diffusion tensor. The diffusion tensor model is a rather simple model of the diffusion process, assuming homogeneity and linearity of the diffusion within each image voxel. From the diffusion tensor, diffusion anisotropy measures such as the fractional anisotropy (FA), can be computed. Moreover, the principal direction of the diffusion tensor can be used to infer the white-matter connectivity of the brain (i.e. tractography; trying to see which part of the brain is connected to which other part).

Recently, more advanced models of the diffusion process have been proposed that aim to overcome the weaknesses of the diffusion tensor model. Amongst others, these include q-space imaging and generalized diffusion tensor imaging.

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