Spinal cord injury-induced changes in thoracolumbar microarchitecture: a semi-automated DTI pipeline for improved clinical translation

Motivation: While diffusion tensor imaging (DTI) is sensitive to spinal cord injury (SCI)-induced microstructural changes, manual pre-processing of thoracolumbar spinal cord (TL-SC) data precludes its clinical translation. Goal(s): We aimed to optimise a semi-automatic TL-SC DTI protocol to detect SCI-induced microarchitectural changes. Approach: TL-SC DTI data from two participants with diagnosed SCI and six healthy volunteers were pre-processed to equate the TL-SC microarchitecture and then compared to semi-automated analysis. Results: Our optimised TL-SC DTI acquisition and semi-automatic analysis pipeline is sensitive to SCI-induced microstructural changes and may provide a more clinically viable method for TL-SC DTI analysis. Impact: This study assessed and validated our newly developed thoracolumbar spinal cord (TL-SC) diffusion tensor imaging (DTI) pipeline in detecting spinal cord injury (SCI)-induced microstructural changes and offers an alternative semi-automatic pre-processing method for improved clinical translation.