title: Traumatic brain injury imaging research roadmap.
abstract: The past decade has seen impressive advances in the types of neuroimaging information that can be acquired in patients with traumatic brain injury. However, despite this increase in information, understanding of the contribution of this information to prognostic accuracy and treatment pathways for patients is limited. Available techniques often allow us to infer the presence of microscopic changes indicative of alterations in physiology and function in brain tissue. However, because histologic confirmation is typically lacking, conclusions reached by using these techniques remain solely inferential in almost all cases. Hence, a need exists for validation of these techniques by using data from large population samples that are obtained in a uniform manner, analyzed according to well-accepted procedures, and correlated with closely monitored clinical outcomes. At present, many of these approaches remain confined to population-based research rather than diagnosis at an individual level, particularly with regard to traumatic brain injury that is mild or moderate in degree. A need and a priority exist for patient-centered tools that will allow advanced neuroimaging tools to be brought into clinical settings. One barrier to developing these tools is a lack of an age-, sex-, and comorbidities-stratified, sequence-specific, reference imaging data base that could provide a clear understanding of normal variations across populations. Such a data base would provide researchers and clinicians with the information necessary to develop computational tools for the patient-based interpretation of advanced neuroimaging studies in the clinical setting. The recent "Joint ASNR-ACR HII-ASFNR TBI Workshop: Bringing Advanced Neuroimaging for Traumatic Brain Injury into the Clinic" on May 23, 2014, in Montreal, Quebec, Canada, brought together neuroradiologists, neurologists, psychiatrists, neuropsychologists, neuroimaging scientists, members of the National Institute of Neurologic Disorders and Stroke, industry representatives, and other traumatic brain injury stakeholders to attempt to reach consensus on issues related to and develop consensus recommendations in terms of creating both a well-characterized normative data base of comprehensive imaging and ancillary data to serve as a reference for tools that will allow interpretation of advanced neuroimaging tests at an individual level of a patient with traumatic brain injury. The workshop involved discussions concerning the following: 1) designation of the policies and infrastructure needed for a normative data base, 2) principles for characterizing normal control subjects, and 3) standardizing research neuroimaging protocols for traumatic brain injury. The present article summarizes these recommendations and examines practical steps to achieve them.
authors: From the Neuroradiology Division (M.W.), Department of Radiology, Stanford University, Stanford, California Max.Wintermark@gmail.com.
authors: M
authors: M
authors: Wintermark
authors: American College of Radiology (L.C., M.T., R. Horton), Reston, Virginia.
authors: L
authors: L
authors: Coombs
authors: Departments of Radiology (T.J.D., J.R.S.).
authors: T J
authors: TJ
authors: Druzgal
authors: Neuroradiology Section (A.S.F.), Department of Radiology, University of Wisconsin, Madison, Wisconsin.
authors: A S
authors: AS
authors: Field
authors: Department of Radiology (C.G.F.), Columbia University, New York, New York Department of Radiology (C.G.F., P.C.S.), North Shore-Long Island Jewish Health System, Manhasset, New York.
authors: C G
authors: CG
authors: Filippi
authors: One Mind (R. Hicks), Seattle, Washington.
authors: R
authors: R
authors: Hicks
authors: American College of Radiology (L.C., M.T., R. Horton), Reston, Virginia.
authors: R
authors: R
authors: Horton
authors: Neuroradiology Division (Y.W.L.), Department of Radiology, NYU School of Medicine, New York, New York.
authors: Y W
authors: YW
authors: Lui
authors: Neuroradiology Section (M.L.), Department of Radiology, University of Southern California, Los Angeles, California.
authors: M
authors: M
authors: Law
authors: Neuroradiology Section (P.M.), Department of Radiology, University of California, San Francisco, San Francisco, California.
authors: P
authors: P
authors: Mukherjee
authors: Department of Radiology (A.N.), Boston University School of Medicine, Boston, Massachusetts.
authors: A
authors: A
authors: Norbash
authors: National Intrepid Center of Excellence (G.R.), Washington, DC.
authors: G
authors: G
authors: Riedy
authors: Department of Radiology (C.G.F., P.C.S.), North Shore-Long Island Jewish Health System, Manhasset, New York.
authors: P C
authors: PC
authors: Sanelli
authors: Departments of Radiology (T.J.D., J.R.S.) Medical Imaging and Neurological Surgery (J.R.S.), University of Virginia, Charlottesville, Virginia.
authors: J R
authors: JR
authors: Stone
authors: Neuroradiology Section (G.S.), Department of Radiology, Yale University, New Haven, Connecticut.
authors: G
authors: G
authors: Sze
authors: American College of Radiology (L.C., M.T., R. Horton), Reston, Virginia.
authors: M
authors: M
authors: Tilkin
authors: Department of Radiology-Neuroradiology and Translational Science Institute (C.T.W.), Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: C T
authors: CT
authors: Whitlow
authors: Departments of Physical Medicine and Rehabilitation, Neurology, and Radiology (E.A.W.), Baylor College of Medicine, Houston, Texas.
authors: E A
authors: EA
authors: Wilde
authors: San Antonio Military Medical Center (G.Y.), San Antonio, Texas.
authors: G
authors: G
authors: York
authors: Department of Radiology (J.M.P.), Duke University Medical Center, Durham, North Carolina.
authors: J M
authors: JM
authors: Provenzale
mesh_terms: D001930:Brain Injuries / Q000473:pathology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D059906:Neuroimaging
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