Implementation and Clinical Evaluation of MR Tractography in Neurological Disorders

Diffusion tensor imaging (DTI) is a recently developed magnetic resonance imaging technique that allows the measurement and depiction of the diffusion of water molecules in vivo. Fiber tracking algorithms use voxel-based DTI data to estimate continuous curves of neuronal fiber tracts in the white matter of the brain. So far, considering sets of tracked fibers is the only way of gathering tractography and functional information on human brain white matter in vivo. The main outcome of this work is a software package that has been written as a framework for implementing various fiber tracking algorithms, as well as their parametrization and their application. The software offers an intuitive user interface and additional functionality for the utilization of diffusion tensor fiber tracking. Advantages and drawbacks of the different fiber tracking algorithms have been evaluated, their fundamental limitations and possible improvements are reported and discussed. An application of fiber tracking algorithms in pathological case studies demonstrates its usefulness in clinical application to inflammatory and neurodegenerative diseases like multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and stroke