Diffusion tensor imaging of the physis: the ABC’s

• Published in: Pediatric radiology Vol. 53; no. 12; pp. 2355 - 2368
• Main Authors: Santos, Laura A., Sullivan, Brendan, Kvist, Ola, Jambawalikar, Sachin, Mostoufi-Moab, Sogol, Raya, Jose M., Nguyen, Jie, Marin, Diana, Delgado, Jorge, Tokaria, Rumana, Nelson, Ronald R., Kammen, Bamidele, Jaramillo, Diego
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2023; Springer Nature B.V
• Subjects: Adolescent; Amino acid sequence; Anisotropy; Bone and Bones; Bones; Cartilage; Cell membranes; Chemotherapy; Child; Child development; Children & youth; Columns (structural); Diffusion Tensor Imaging - methods; Growth hormones; Growth plate; Growth Plate - diagnostic imaging; How I do it; Humans; Image acquisition; Imaging; Long bone; Magnetic resonance imaging; Mathematical analysis; Medical imaging; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Pediatrics; Puberty; Radiation therapy; Radiology; Tensors; Ultrasound; Water; Water chemistry; Growth plate; Magnetic resonance imaging; Anisotropy; Tractography; Physis; Child; Diffusion tensor imaging
• ISSN: 1432-1998; 0301-0449; 1432-1998
• DOI: 10.1007/s00247-023-05753-z

The physis, or growth plate, is the primary structure responsible for longitudinal growth of the long bones. Diffusion tensor imaging (DTI) is a technique that depicts the anisotropic motion of water molecules, or diffusion. When diffusion is limited by cellular membranes, information on tissue microstructure can be acquired. Tractography, the visual display of the direction and magnitude of water diffusion, provides qualitative visualization of complex cellular architecture as well as quantitative diffusion metrics that appear to indirectly reflect physeal activity. In the growing bones, DTI depicts the columns of cartilage and new bone in the physeal-metaphyseal complex. In this “How I do It”, we will highlight the value of DTI as a clinical tool by presenting DTI tractography of the physeal-metaphyseal complex of children and adolescents during normal growth, illustrating variation in qualitative and quantitative tractography metrics with age and skeletal location. In addition, we will present tractography from patients with physeal dysfunction caused by growth hormone deficiency and physeal injury due to trauma, chemotherapy, and radiation therapy. Furthermore, we will delineate our process, or “DTI pipeline,” from image acquisition to data interpretation.
Graphical Abstract