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Scan Technique Shows Individual Brain Fibers

March 2, 2012
Written by: , Filed in: Diagnostic Imaging, Neuroradiology
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The incredibly detailed images provided by a new technique called high definition fiber tracking (HDFT) can help therapists plan rehabilitation regimens for victims of traumatic brain injury—or guide brain surgeons in minimizing damage to healthy tissue.

A study published online today in the Journal of Neurosurgery (and freely available) shows the new imaging technique’s potential through its use on a 32-year-old man with severe traumatic brain injury (TBI).

The man had crashed an all-terrain vehicle while not wearing a helmet. CT and conventional MRI showed damage on the right side of the brain but couldn’t identify the precise reasons why the man was unable to move his left leg, arm, and hand.

HDFT could. It pinpointed exactly which brain pathways had been disrupted. The technique, which involves computer-processed high-definition MRI scanning from 257 directions, revealed white-matter fiber damage correlated to the man’s specific motor deficits.

David O. Okonkwo, MD, PhD, explained just how broadly HDFT might be applied:

There are about 1.7 million cases of TBI in the country each year, and all too often conventional scans show no injury or show improvement over time even though the patient continues to struggle.

As a consequence, Dr. Okonkwo said, “We have had no objective way of identifying how the injury damaged the patient’s brain tissue, predicting how the patient would fare, or planning rehabilitation to maximize the recovery.”

Dr. Okonkwo, co-senior author of the study, is an assistant professor of neurological surgery at the University of Pittsburgh School of Medicine. He was quoted in a University of Pittsburgh Schools of the Health Sciences news release.

Robert Friedlander, MD, chair of the Pitt neurological surgery department, said he had used HDFT to help him plan brain surgery that required him to cut through normal tissue:

It shows me where significant functional pathways are relative to the lesion so that I can make better decisions about which fiber tracts must be avoided and what might be an acceptable sacrifice to maintain the patient’s best quality of life after surgery.

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Will ultrasound be the next big thing in interventional radiology? See our Facebook page to find out why one analyst thinks so.

Related seminar: Neuroradiology Review

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