Insights from the IronTract challenge: Optimal methods for mapping brain pathways from multi-shell diffusion MRI.

Limitations in the accuracy of brain pathways reconstructed by diffusion MRI (dMRI) tractography have received considerable attention. While the technical advances spearheaded by the Human Connectome Project (HCP) led to significant improvements in dMRI data quality, it remains unclear how these data should be analyzed to maximize tractography accuracy. Over a period of two years, we have engaged the dMRI community in the IronTract Challenge, which aims to answer this question by leveraging a unique dataset. Macaque brains that have received both tracer injections and ex vivo dMRI at high spatial and angular resolution allow a comprehensive, quantitative assessment of tractography accuracy on state-of-the-art dMRI acquisition schemes. We find that, when analysis methods are carefully optimized, the HCP scheme can achieve similar accuracy as a more time-consuming, Cartesian-grid scheme. Importantly, we show that simple pre- and post-processing strategies can improve the accuracy and robustness of many tractography methods. Finally, we find that fiber configurations that go beyond crossing (e.g., fanning, branching) are the most challenging for tractography. The IronTract Challenge remains open and we hope that it can serve as a valuable validation tool for both users and developers of dMRI analysis methods.

The usefulness of trauma scores in determining the life threatening condition of trauma victims for writing medical-legal reports.

OBJECTIVES: In the Turkish legal system the severity of the victim's injury determines the severity of the criminal penalty, and the life threatening condition stated in the medical-legal report is one of the main determinants for injury severity. The aim of this study is to investigate the effectiveness and usefulness of the trauma scores in determining the life threatening condition of trauma victims from the forensic aspect in order to write accurate medical-legal reports. METHODS: Data of 296 forensic cases with blunt and penetrating trauma were obtained. The life threatening condition of patients stated in the medical-legal reports according to the criteria based on traditional forensic opinion were examined. For each case, Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated. The ROC curve analysis was used to investigate the success of the trauma scores in distinguishing patients with/without life threatening conditions. Logistic regression analysis was performed to measure the association between trauma scores and life threatening conditions. RESULTS: The relations between all scores and groups (with and without life threatening risk) were found statistically significant. ISS was the most successful method in distinguishing traumatised patients both in a life threatening or non life threatening condition. CONCLUSIONS: Trauma scores can be used for making more objective, standardised, and accurate judgement on whether the injury was a life threatening one or not. These advantages of using trauma scores in such situations will also be helpful for the conclusion of the lawsuits shortly, but further studies are needed to confirm these findings.