## Section: Scientific Foundations

### Computational Diffusion MRI

Diffusion MRI (dMRI) provides a non-invasive way of estimating in-vivo CNS fiber structures using the average random thermal movement (diffusion) of water molecules as a probe. It's a recent field of research with a history of roughly three decades. It was introduced in the mid 80's by Le Bihan et al [68] , Merboldt et al [72] and Taylor et al [81] . As of today, it is the unique non-invasive technique capable of describing the neural connectivity in vivo by quantifying the anisotropic diffusion of water molecules in biological tissues. The great success of dMRI comes from its ability to accurately describe the geometry of the underlying microstructure and probe the structure of the biological tissue at scales much smaller than the imaging resolution.

The diffusion of water molecules is Brownian in an isotropic medium and under normal unhindered conditions, but in fibrous structure such as white matter, the diffusion is very often directionally biased or anisotropic and water molecules tend to diffuse along fibers. For example, a molecule inside the axon of a neuron has a low probability to cross a myelin membrane. Therefore the molecule will move principally along the axis of the neural fiber. Conversely if we know that molecules locally diffuse principally in one direction, we can make the assumption that this corresponds to a set of fibers.

**Diffusion Tensor Imaging**

Shortly after the first acquisitions of diffusion-weighted images
(DWI) were made in
vivo [74] , [75] , Basser
et al [53] , [52]
proposed the rigorous formalism of the second order Diffusion Tensor
Imaging model (DTI). DTI describes the three-dimensional (3D) nature
of anisotropy in tissues by assuming that the average diffusion of
water molecules follows a Gaussian distribution. It encapsulates the
diffusion properties of water molecules in biological tissues (inside
a typical 1-3 mm^{3} sized voxel) as an effective self-diffusion
tensor given by a 3×3 symmetric positive definite tensor
[53] , [52] .
Diffusion tensor imaging (DTI) thus produces a three-dimensional image
containing, at each voxel, the estimated tensor . This
requires the acquisition of at least six Diffusion Weighted Images
(DWI) S_{k} in several non-coplanar encoding directions as well as an
unweighted image S_{0} . Because of the signal attenuation, the image
noise will affect the measurements and it is therefore important to
take into account the nature and the strength of this noise in all the
pre-processing steps. From the diffusion tensor , a neural
fiber direction can be inferred from the tensor's main eigenvector
while various diffusion anisotropy measures, such as the Fractional
Anisotropy (FA), can be computed using the associated eigenvalues to
quantify anisotropy, thus describing the inequality of diffusion
values among particular directions.

DTI has now proved to be extremely useful to study the normal and pathological human brain [69] , [60] . It has led to many applications in clinical diagnosis of neurological diseases and disorder, neurosciences applications in assessing connectivity of different brain regions, and more recently, therapeutic applications, primarily in neurosurgical planning. An important and very successful application of diffusion MRI has been brain ischemia, following the discovery that water diffusion drops immediately after the onset of an ischemic event, when brain cells undergo swelling through cytotoxic edema.

The increasing clinical importance of diffusion imaging has drived our interest to develop new processing tools for Diffusion MRI. Because of the complexity of the data, this imaging modality raises a large amount of mathematical and computational challenges. We have therefore started to develop original and efficient algorithms relying on Riemannian geometry, differential geometry, partial differential equations and front propagation techniques to correctly and efficiently estimate, regularize, segment and process Diffusion Tensor MRI (DT-MRI) (see [71] , [8] and [70] ).

**High Angular Resolution Diffusion Imaging**

In DTI, the Gaussian assumption over-simplifies the diffusion of water
molecules. While it is adequate for voxels in which there is only a
single fiber orientation (or none), it breaks for voxels in which
there are more complex internal structures. This is an important
limitation, since resolution of DTI acquisition is between 1mm ^{3} and
3mm ^{3} while the physical diameter of fibers can be between 1 m
and 30 m [78] , [54] . Research groups
currently agree that there is complex fiber architecture in most fiber
regions of the brain [77] . In fact, it
is currently thought that between one third to two thirds of imaging
voxels in the human brain white matter contain multiple fiber bundle
crossings [55] . This has led to the
development of various High Angular Resolution Diffusion Imaging
(HARDI) techniques [83] such as Q-Ball
Imaging (QBI) or Diffusion Spectrum Imaging
(DSI) [84] , [85] , [87] to
explore more precisely the microstructure of biological tissues.

HARDI samples q-space along as many directions as possible in order to reconstruct estimates of the true diffusion probability density function (PDF) – also referred as the Ensemble Average Propagator (EAP) – of water molecules. This true diffusion PDF is model-free and can recover the diffusion of water molecules in any underlying fiber population. HARDI depends on the number of measurements N and the gradient strength (b -value), which will directly affect acquisition time and signal to noise ratio in the signal.

Typically, there are two strategies used in HARDI: 1) sampling of the
whole q-space 3D Cartesian grid and estimation of the EAP by inverse
Fourier transformation or 2) single shell spherical sampling and
estimation of fiber distributions from the diffusion/fiber ODF (QBI),
Persistent Angular Structure [66] or
Diffusion Orientation Transform [89] .
In the first case, a large number of q-space points are taken over the
discrete grid (N>200 ) and the inverse Fourier transform of the
measured Diffusion Weighted Imaging (DWI) signal is taken to obtain an
estimate of the diffusion PDF. This is Diffusion Spectrum Imaging
(DSI) [87] , [84] , [85] . The
method requires very strong imaging gradients (500b20000
s/mm ^{2} ) and a long time for acquisition (15-60 minutes) depending on
the number of sampling directions. To infer fiber directions of the
diffusion PDF at every voxel, people take an isosurface of the
diffusion PDF for a certain radius. Alternatively, they can use the
second strategy known as Q-Ball imaging (QBI) i.e just a single shell
HARDI acquisition to compute the diffusion orientation distribution
function (ODF). With QBI, model-free mathematical approaches can be
developed to reconstruct the angular profile of the diffusion
displacement probability density function (PDF) of water molecules
such as the ODF function which is fundamental in tractography due to
the fact that it contains the full angular information of the
diffusion PDF and has its maxima aligned with the underlying fiber
directions at every voxel.

QBI and the diffusion ODF play a central role in our work related to the development of a robust and linear spherical harmonic estimation of the HARDI signal and to our development of a regularized, fast and robust analytical QBI solution that outperforms the state-of-the-art ODF numerical technique available. Those contributions are fundamental and have already started to impact on the Diffusion MRI, HARDI and Q-Ball Imaging community. They are at the core of our probabilistic and deterministic tractography algorithms devised to best exploit the full distribution of the fiber ODF (see [58] , [4] and [59] ,[5] ).

**High Order Tensors **

Other High Order Tensors (HOT) models to estimate the diffusion function while overcoming the shortcomings of the 2nd order tensor model have also been recently proposed such as the Generalized Diffusion Tensor Imaging (G-DTI) model developed by Ozarslan et al [88] , [90] or 4th order Tensor Model [51] . For more details, we refer the reader to our recent article in [63] where we review HOT models and to our article in [7] , co-authored with some of our close collaborators, where we review recent mathematical models and computational methods for the processing of Diffusion Magnetic Resonance Images, including state-of-the-art reconstruction of diffusion models, cerebral white matter connectivity analysis, and segmentation techniques.

All these powerful techniques are of utmost importance to acquire a better understanding of the CNS mechanisms and have helped to efficiently tackle and solve a number of important and challenging problems. They have also opened up a landscape of extremely exciting research fields for medicine and neuroscience. Hence, due to the complexity of the CNS data and as the magnetic field strength of scanners increase, as the strength and speed of gradients increase and as new acquisition techniques appear [3] , these imaging modalities raise a large amount of mathematical and computational challenges at the core of the research we develop at Athena .