Segmenting brain white matter, gray matter and cerebro-spinal fluid using diffusion tensor-MRI derived indices

Based on its ability to provide quantitative information about tissue microstructure, diffusion tensor magnetic resonance imaging (DT-MRI) might be a valuable approach to improve the reliability of segmentation of the various brain tissues. In this study, a fully automated and easy-to-implement technique based on 2D histogram analysis of DT-MRI derived images was used to segment white and gray matter of the brain from 10 healthy subjects (aged = 27-56 years). The results obtained with this novel segmentation strategy were compared to those achieved by two experienced observers using an operator-dependent segmentation on the dual-echo scans. Visual inspection of the segmented tissues from a third senior observer disclosed that the automated technique worked properly on all images from all subjects and was more accurate than the human raters in defining thalamus white and gray matter portions as well as in tissue classification at the external brain edge. In addition, this segmentation technique resulted in an average gray/white matter ratio similar to that reported by post-mortem assessment. The application of the operator-dependent segmentation strategy was extremely timeconsuming and the two observers achieved poorly reproducible results. Segmenting brain white and gray matter using information from DT-MRI proved to be an accurate approach with the potential for improving the understanding of the pathophysiology of many neurologic conditions.