ATLANTA, GA -- April 30, 2002 -- A new diagnostic technique (tensor diffusion imaging) that measures the motion of water particles in a person's brain is showing promise in better diagnosing multiple sclerosis. It is being used to monitor the progress of children treated for deadly Krabbe disease, and it may be useful in more common brain disorders, such as Alzheimer's disease, researchers at Duke University Medical Center report.
"Tensor diffusion imaging is a form of MR imaging that allows radiologists to measure the rate and direction of water particles in the white matter structures of the brain," says James Provenzale, MD, professor of radiology. The white matter structures connect regions of the brain that are important for movement and speech; water particles in specific parts of the brain tend to move in well-defined directions if the white matter is normal, says Dr. Provenzale. "Tensor diffusion imaging allows us to find changes in the white matter of multiple sclerosis (MS) patients that we can't see on standard MR images," says Dr. Provenzale. "Standard MR images can show plaques (the areas of white matter affected by the disease), but by the time the plaque shows up on the MR image, the patient usually has more advanced disease. In addition, the MR images can appear somewhat normal, while the patient has severe symptoms of multiple sclerosis. The images don't necessarily correlate well with the patient's actual condition," says Dr. Provenzale.
"When we scanned MS patients with standard MR then with diffusion tensor imaging, we found that the area around the plaque, which had looked normal on the standard MR image, was actually abnormal," says Dr. Provenzale. "Furthermore, we found that other areas of the white matter were also abnormal on tensor diffusion imaging even though they looked normal on standard MR images," he says. "Tensor imaging is allowing us to more accurately detect abnormalities in MS patients, which may allow us to diagnose the disease before the patient has any symptoms; early detection can mean earlier treatment," Dr. Provenzale says. Dr. Provenzale predicts that radiologists will eventually be able to use tensor diffusion imaging in brain disorders, such as Alzheimer's disease, to determine who will develop the symptoms of the disease and the effectiveness of treatments.
Currently, Duke researchers are using tensor diffusion imaging in Krabbe disease, a rare but deadly disease, that affects infants. "The disease is hereditary," says Dr. Provenzale. Until recently, there was no way of treating these patients or monitoring their progress. Duke researchers are now performing umbilical cord transplantation and are "having good results when the transplantation is performed very early," says Dr. Provenzale. "Tensor imaging plays an important role in the evaluation and treatment of this disease. We are using it to detect the brain abnormalities earlier and to monitor the success of treatment," he says. "We are finding that if we scan patients at risk for the disease within the first month of life, and begin treatment immediately, their brains remain more similar to those of normal children than those infants treated later," he says.
Tensor diffusion imaging is still being investigated, but Dr. Provenzale predicts that it will soon be more widely available.
Dr. Provenzale will be a keynote speaker at the American Roentgen Ray Society annual meeting April 30 in Atlanta, GA.
SOURCE: American Roentgen Ray Society
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