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Sensitivity of diffusion tensor imaging increased with use of baseline vs control data
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Use of individual baseline data in diffusion tensor imaging analysis for traumatic axonal injury after concussion among National Football League players yielded higher sensitivity than comparing data to a normative control group, according to published results.
Sumit N. Niogi , MD, PhD, and colleagues assessed diffusion tensor imaging, conventional MRI and standard clinical workup among 49 active NFL players. Researchers had participants undergo an optional preseason baseline scan and a scan within 5 days of concussion during gameplay. Researchers also obtained diffusion tensor imaging from 25 controls who were matched for age and sex. To examine diffusion tensor imaging at individual and group levels, researchers used semiautomated region-of-interest analysis and fully automated tract-based spatial statistics.
Researchers assessed seven players at baseline during the preseason and after acute concussion, 18 players after acute concussion only and 24 players at preseason baseline.
Compared with conventional MRI, results showed diffusion tensor imaging may be more sensitive to suspected traumatic axonal injury, with four players demonstrating decreased fractional anisotropy in multiple tracts despite normal conventional MRI findings. Researchers also found higher sensitivity with individual assessment of diffusion tensor imaging data using baseline premorbid imaging than with comparing data to a normative control group. Use of the typical normative database reference found one reduced fractional anisotropy compared with 10 statistically significant reduced fractional anisotropy tracts with the internal control baseline data, according to results. Researchers noted all group-level comparisons were statistically insignificant.
“By comparing individuals to their own baseline scans before the injury, we discuss a method that can potentially take quantitative assessment of [diffusion tensor imaging] DTI from a research tool to a clinical tool for patients,” Niogi, of Weill Cornell Medicine, told Healio.com/Orthopedics. “While the study is preliminary and should be expanded to larger populations, the results are promising. The study suggests that longer-term longitudinal studies with baseline imaging might be a better way to accurately assess the true impact of concussion on athletes, which remains largely unknown.” – by Casey Tingle
Disclosures: Niogi reports he is the inventor of the Reproducible Objective Quantification Scheme. Please see the study for a list of all other authors’ relevant financial disclosures.
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