The power of hybrid/fusion imaging metrics in future PACS systems: A case study into the white matter hyperintensity prenumbra using FLAIR and diffusion MR

Sinchai Tsao, Samantha J. Ma, Peter A. Michels, Niharika Gajawelli, Meng Law, Helena Chui, Natasha Lepore

Research output: Chapter in Book/Report/Conference proceedingConference PaperResearchpeer-review

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Most white matter related neurological disease exhibit a large number of White Matter Hyperintensities (WMHs) on FLAIR MRI images. However, these lesions are not well understood. At the same time, Diffusion MRI has been gaining popularity as a powerful method of characterizing White Matter (WM) integrity. This work aims to study the behavior of the diffusion signal within the WMH voxels. The goal is to develop hybrid MR metrics that leverage information from multiple MR acquisitions to solve clinical problems. In our case, we are trying to address the WMH penumbra (as defined by Maillard et al 20112) where WMH delineates a foci that is more widespread than the actual damage area presumably due to acute inflammation. Our results show that diffusion MR metrics may be able to better delineate tissue that is inflamed versus scar tissue but may be less specific to lesions than FLAIR. Therefore, a hybrid metric that encodes information from both FLAIR and Diffusion MR may yield new and novel imaging information about the progression of white matter disease progression. We hope that this work also demonstrates how future PACS systems could have image fusion capabilities that would be able to leverage information from multiple imaging series to yield new and novel imaging contrast.

Original languageEnglish
Title of host publicationMedical Imaging 2014 - PACS and Imaging Informatics
Subtitle of host publicationNext Generation and Innovations
EditorsMaria Y. Law, Tessa S. Cook
Place of PublicationUSA
Number of pages5
ISBN (Print)9780819498328
Publication statusPublished - 1 Jan 2014
Externally publishedYes
EventConference on Medical Imaging - PACS and Imaging Informatics 2014: Next Generation and Innovations - San Diego, United States of America
Duration: 18 Feb 201420 Feb 2014 (Link to the SPIE proceedings)


ConferenceConference on Medical Imaging - PACS and Imaging Informatics 2014
Country/TerritoryUnited States of America
CitySan Diego
Internet address


  • Alzheimer's Disease
  • Dementia
  • Diusion MRI
  • DTI
  • MRI
  • Neu-roimaging
  • White Matter
  • WMH

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