T 1 and T 2 quantification using magnetic resonance fingerprinting in mild traumatic brain injury

Objectives To assess whether MR fingerprinting (MRF)–based relaxation properties exhibit cross-sectional and prospective correlations with patient outcome and compare the results with those from DTI. Methods Clinical imaging, MRF, and DTI were acquired in patients (24 ± 10 days after injury (timepoint 1) and 90 ± 17 days after injury (timepoint 2)) and once in controls. Patient outcome was assessed with global functioning, symptom profile, and neuropsychological testing. ADC and fractional anisotropy (FA) from DTI and T 1 and T 2 from MRF were compared in 12 gray and white matter regions with Mann–Whitney tests. Bivariate associations between MR measures and outcome were assessed using the Spearman correlation and logistic regression. Results Data from 22 patients (38 ± 12 years; 17 women) and 18 controls (32 ± 8 years; 12 women) were analyzed. Fourteen patients (37 ± 12 years; 11 women) returned for timepoint 2, while two patients provided only timepoint 2 clinical outcome data. At timepoint 1, there were no differences between patients and controls in T 1 , T 2 , and ADC, while FA was lower in mTBI frontal white matter. T 1 at timepoint 1 and the change in T 1 exhibited more ( n = 18) moderate to strong correlations (| r |= 0.6–0.85) with clinical outcome at timepoint 2 than T 2 ( n = 3), FA ( n = 7), and ADC ( n = 2). High T 1 at timepoint 1, and serially increasing T 1 , accounted for five of the six MR measures with the highest utility for identification of non-recovered patients at timepoint 2 (AUC > 0.80). Conclusion T 1 derived from MRF was found to have higher utility than T 2 , FA, and ADC for predicting 3-month outcome after mTBI. Key Points • In a region-of-interest approach, FA, ADC, and T 1 and T 2 all showed limited utility in differentiating patients from controls at an average of 24 and 90 days post-mild traumatic brain injury. • T 1 at 24 days, and the serial change in T 1 , revealed more and stronger predictive correlations with clinical outcome at 90 days than did T 2 , ADC, or FA. • T 1 showed better prospective identification of non-recovered patients at 90 days than ADC, T 2 , and FA.