title: A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury.
abstract: The incidence of traumatic brain injury (TBI) in the United States was 3.5 million cases in 2009, according to the Centers for Disease Control and Prevention. It is a contributing factor in 30.5% of injury-related deaths among civilians. Additionally, since 2000, more than 260,000 service members were diagnosed with TBI, with the vast majority classified as mild or concussive (76%). The objective assessment of TBI via imaging is a critical research gap, both in the military and civilian communities. In 2011, the Department of Defense (DoD) prepared a congressional report summarizing the effectiveness of seven neuroimaging modalities (computed tomography [CT], magnetic resonance imaging [MRI], transcranial Doppler [TCD], positron emission tomography, single photon emission computed tomography, electrophysiologic techniques [magnetoencephalography and electroencephalography], and functional near-infrared spectroscopy) to assess the spectrum of TBI from concussion to coma. For this report, neuroimaging experts identified the most relevant peer-reviewed publications and assessed the quality of the literature for each of these imaging technique in the clinical and research settings. Although CT, MRI, and TCD were determined to be the most useful modalities in the clinical setting, no single imaging modality proved sufficient for all patients due to the heterogeneity of TBI. All imaging modalities reviewed demonstrated the potential to emerge as part of future clinical care. This paper describes and updates the results of the DoD report and also expands on the use of angiography in patients with TBI.
authors.affiliation: 1 The Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda, Maryland.|2 Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland.
authors.forename: Franck
authors.initials: F
authors.lastname: Amyot
authors.affiliation: 3 Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine , Houston, Texas.|4 Brain Injury Research , TIRR Memorial Hermann, Houston, Texas.
authors.forename: David B
authors.initials: DB
authors.lastname: Arciniegas
authors.affiliation: 5 United States Army , retired; formerly with the Geneva Foundation.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Brazaitis
authors.affiliation: 6 Combat Casualty Care Directorate (RAD2), U.S. Army Medical Research and Materiel Command , Fort Detrick, Maryland.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Curley
authors.affiliation: 2 Center for Neuroscience and Regenerative Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland.
authors.forename: Ramon
authors.initials: R
authors.lastname: Diaz-Arrastia
authors.affiliation: 1 The Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda, Maryland.
authors.forename: Amir
authors.initials: A
authors.lastname: Gandjbakhche
authors.affiliation: 7 Positron Emission Tomography Department, National Institutes of Health Clinical Center , Bethesda, Maryland.
authors.forename: Peter
authors.initials: P
authors.lastname: Herscovitch
authors.affiliation: 8 Defense and Veterans Brain Injury Center , Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Silver Spring, Maryland.
authors.forename: Sidney R
authors.initials: SR
authors.lastname: Hinds
authors.affiliation: 9 Brain and Spinal Injury Center, Department of Neurological Surgery, University of California , San Francisco, San Francisco, California.
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Manley
authors.affiliation: 10 Congressionally Directed Medical Research Programs , Fort Detrick, Maryland.
authors.forename: Anthony
authors.initials: A
authors.lastname: Pacifico
authors.affiliation: 11 Sentient NeuroCare Services, Inc., Hunt Valley, Maryland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Razumovsky
authors.affiliation: 12 Queens University , Kingston, Ontario, Canada .|13 ArcheOptix Inc., Picton, Ontario, Canada .
authors.forename: Jason
authors.initials: J
authors.lastname: Riley
authors.affiliation: 10 Congressionally Directed Medical Research Programs , Fort Detrick, Maryland.
authors.forename: Wanda
authors.initials: W
authors.lastname: Salzer
authors.affiliation: 14 Walter Reed National Military Medical Center , Bethesda, Maryland.
authors.forename: Robert
authors.initials: R
authors.lastname: Shih
authors.affiliation: 15 Department of Radiology, Neurology, and Biomedical Informatics, Uniformed Services University of the Health Sciences , Bethesda, Maryland.
authors.forename: James G
authors.initials: JG
authors.lastname: Smirniotopoulos
authors.affiliation: 14 Walter Reed National Military Medical Center , Bethesda, Maryland.
authors.forename: Derek
authors.initials: D
authors.lastname: Stocker
mesh_terms: D001930:Brain Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004569:Electroencephalography; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging / Q000379:methods*; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial
keywords: electrophysiology; imaging; spectroscopy; tomography; ultrasound