Differential Diagnosis of Dementia Subtypes with Fixel-Based Analysis: Insights From Real-World Diffusion MRI

Motivation: Memory clinics mainly use basic T1-weighted/FLAIR MRI for dementia diagnosis, but these modalities are not sensitive or informative enough to differentiate between dementia subtypes, which is essential for management and prognosis. Goal(s): To investigate whether an advanced MRI acquisition and analysis (fixel-based analysis of diffusion MRI) is feasible in memory clinics, is able to differentiate between dementia subtypes and should be adopted in practice. Approach: We analyse diffusion MRI data from memory clinic patients with fixel-based analysis to investigate whether such an analysis is possible with imperfect real-world data and whether FBA metrics in white matter tracts can differentiate between dementia subtypes. Impact: A translational study providing convincing evidence of the feasibility and diagnostic usefulness of advanced MRI modalities in clinics could contribute to a shift in clinical practice and a tangible improvement for patients in the form of more accurate early diagnosis.