Volume 35, Number 5 October 2014 Letter From the Guest Editor: Brain White Matter Tracts D iffusion tensor imaging (DTI) is now a well-established neuroimaging technique within the research sphere but remains relatively obscure and underutilized in routine clinical practice. With this issue of Seminars in US, CT and MRI, my main aim was to demonstrate how this information can both inform our understanding of disease processes but more importantly how practising radiologists can use it to improve diagnostic performance. In my opinion, one of the most satisfying aspects of neuroradiology is neuroanatomical correlation, that is the ability to explain clinical presentation through understanding of anatomical structures affected by lesions identified on neuroimaging studies. Cortical topography is relatively easy to grasp but it is only through DTI that one can confidently identify the location of relevant white matter tracts in individual patients. To this end, the issue begins with the article by Gerrish et al demonstrating the normal anatomical structures routinely identifiable on clinical DTI and how this knowledge can be applied in multiple different clinical situations. The corpus callosum is easily identifiable on routine magnetic resonance imaging—Fillippi and Cauley explore how DTI is helping us in understanding its functional organization and how DTI studies in different diseases are illuminating its role in different brain functions. In the article by Lövblad et al, we see the range of pathologies that can affect the limbic system with a review of its white matter tract connections and how this influences clinical presentation. Hussain et al show us not only how DTI outlines the major ascending and descending pathways but also how it can be applied in prognostication of stroke recovery and diagnosis of devastating disease, such as amyotrophic lateral sclerosis. Swienton and Thomas show us how a functional anatomical approach, aided by DTI can improve lesion identi fication in disorders of the visual pathway. Prof M. Smits and colleagues provide us not only with a comprehensive review of both the normal anatomical structures involved in language and speech but also how DTI is helping to provide neuroanatomical correlates of subtypes of the primary progressive aphasias. Finally, the brainstem white matter tracts and control of eye movements are explored by Sakai et al —a location where even tiny lesions can have profound and interesting neurologic consequences. I would like to extend my thanks to Joel Swartz, MD, for the opportunity to edit this issue as well as all the aforementioned authors. In particular, I would like to thank Dr Rob Dineen, Associate Professor of Neuroradiology at the University of Nottingham, for inspiring my interest in both neuroradiology and neuroanatomical correlation. Adam G. Thomas, MSc, MRCP, FRCR Guest Editor http://dx.doi.org/10.1053/j.sult.2014.06.002 431 0887-2171/& 2014 Elsevier Inc. All rights reserved.

Letter From the Guest Editor: Brain White Matter Tracts

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Volume 35, Number 5 October 2014

Letter From the Guest Editor: Brain WhiteMatter Tracts

Diffusion tensor imaging (DTI) is now a well-establishedneuroimaging technique within the research sphere but

remains relatively obscure and underutilized in routine clinicalpractice. With this issue of Seminars in US, CT and MRI, mymain aim was to demonstrate how this information can bothinform our understanding of disease processes but moreimportantly how practising radiologists can use it to improvediagnostic performance.In my opinion, one of the most satisfying aspects of

neuroradiology is neuroanatomical correlation, that is the abilityto explain clinical presentation through understanding ofanatomical structures affected by lesions identified on neuroi-maging studies. Cortical topography is relatively easy to graspbut it is only through DTI that one can confidently identify thelocation of relevant white matter tracts in individual patients.To this end, the issue begins with the article by Gerrish et al

demonstrating the normal anatomical structures routinelyidentifiable on clinical DTI and how this knowledge can beapplied in multiple different clinical situations. The corpuscallosum is easily identifiable on routine magnetic resonanceimaging—Fillippi andCauley explore howDTI is helping us inunderstanding its functional organization and howDTI studiesin different diseases are illuminating its role in different brainfunctions. In the article by Lövblad et al, we see the range ofpathologies that can affect the limbic systemwith a review of its

white matter tract connections and how this influences clinicalpresentation. Hussain et al show us not only howDTI outlinesthe major ascending and descending pathways but also how itcan be applied in prognostication of stroke recovery anddiagnosis of devastating disease, such as amyotrophic lateralsclerosis. Swienton and Thomas show us how a functionalanatomical approach, aided by DTI can improve lesionidentification in disorders of the visual pathway.Prof M. Smits and colleagues provide us not only with acomprehensive review of both the normal anatomical struc-tures involved in language and speech but also how DTI ishelping to provide neuroanatomical correlates of subtypes ofthe primary progressive aphasias. Finally, the brainstem whitematter tracts and control of eye movements are explored bySakai et al—a location where even tiny lesions can haveprofound and interesting neurologic consequences.I would like to extendmy thanks to Joel Swartz, MD, for the

opportunity to edit this issue as well as all the aforementionedauthors. In particular, I would like to thank Dr Rob Dineen,Associate Professor of Neuroradiology at the University ofNottingham, for inspiring my interest in both neuroradiologyand neuroanatomical correlation.

Adam G. Thomas, MSc, MRCP, FRCRGuest Editor

431

http://dx.doi.org/10.1053/j.sult.2014.06.002

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