Background and aims Quantitative measurement of brain maturation is increasingly performed in preterm infants using diffusion tensor imaging (DTI). To study white matter properly, reliability of underlying DTI data is of paramount importance, as acquisition and processing steps can substantially affect DTI analyses. We systematically reviewed literature to raise awareness regarding these matters.
Methods We systematically reviewed studies published between 1991 and September 2013, in which DTI scanning of preterm infants was performed within 28 days after term-equivalent age. Based on our inclusion criteria, 75 preterm DTI studies were considered relevant and further analysed. We primarily focused on use of dedicated neonatal equipment, DTI acquisition parameters and processing methodology.
Results There was wide variation among different studies in acquisition and processing methodology, and frequently incomplete reporting of these settings. 25.3% reported the use of dedicated neonatal equipment. Data quality assessment was not reported in 34.7%. Correction for artefacts and exclusion of datasets was not reported in 45.3% respectively 30.7%. Only 54.7% of the studies reported specific correction methods. Tensor estimation methodology was reported in 82.7%. Fast but less accurate tensor calculation algorithms were applied more frequently than advanced algorithms.
Conclusion DTI acquisition and processing settings are described incompletely in current literature, and vary considerably among different neonatal DTI research groups. In addition, described settings do frequently not meet the highest standards possible. Hence the premature population should be regarded as one of the most challenging groups to image using DTI, maximal awareness regarding these matters is a prerequisite.
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