Metabolic activity diffusion imaging (MADI): A new paradigm
Abstract
Since the seminal 1990 article by Michael Moseley et al. on the early detection of regional cerebral ischemia in cat by diffusion-weighted MRI (Magn Reson Med. 1990;14(2):330-346), numerous studies have probed possible biophysical mechanisms for the substantial and rapid decrease in the water apparent diffusion coefficient (ADC) in brain regions experiencing ischemic insult. Indeed, while a host of informative reports have explored the determinants of tissue water diffusion in normal and physiologically challenged brain, the underlying mechanism responsible for the ADC decrease in stroke has remained in question. Two companion articles by Charles Springer et al. in this issue of NMR in Biomedicine offer a compelling mechanistic hypothesis, one that implicates the sodium pump as the principal enabler of water exchange across the cell membrane and thus the governing determinant of water diffusion in tissue. While described primarily in the context of brain and cancer, the mechanistic hypothesis should be broadly applicable to all parenchymal tissue types and to both normal and physiologically challenged tissues. Tissue-water diffusion is hindered and restricted by the boundaries defining various microstructural compartments/spaces within a given tissue type (e.g., brain, muscle, bone, spinal cord). In the simplest conceptual (two-compartment) model, brain tissue water is resident in either the intracellular or extracellular space, with the cell membrane forming the boundary…
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