Enrico De Vita1,2, Harpreet Hyare1,3, Gerard Ridgway4, Simon Mead3, Peter Rudge3, John C. Collinge3, Tarek A. Yousry1,2, John S. Thornton1,2
1Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; 2Academic Neuroradiological Unit, Institute of Neurology, University College London, London, United Kingdom; 3MRC Prion Unit, Institute of Neurology, University College London, London, United Kingdom; 4Dementia Research Centre. Dept. of Neurodegenerative Diseases, Institute of Neurology, University College London, London, United Kingdom
Diffusion weighted imaging (DWI) is the most sensitive MRI sequence for diagnosis in human prion disease. High-b-value (b~3000s/mm2; b3k) DWI was shown to be more sensitive to pathology in sporadic Creutzfeldt-Jacob disease than standard DWI (b~1000s/mm2; b1k). Most previous prion disease studies used region of interest analyses. We employed operator-independent voxel-based morphometry and voxel-based analysis (VBA) of DWI (b1k and b3k) to characterise structural parenchymal changes in inherited prion disease (iPD) patients. In this cohort, DWI-VBA resulted more sensitive than VBM, potentially indicating microstructural changes occurring before grey matter atrophy becomes detectable; b1k acquisitions resulted relatively more sensitive vs b3k.