The radiological study of traumatic brain injury: an emphasis upon molecular imaging

Introduction: 1. To review the clinical practices in the radiological assessment of neurological trauma 2. To assess the value of functional imaging in the hyperacute, acute, subacute, and chronic phases of traumatic brain injury (TBI).

Methods: Several large scientific databases, including PubMed, Web of Science, and Google Scholar, were used to accumulate review articles and scientific communications relating to the standing/clinical radiological practices in imaging TBI. Next, review articles and scientific studies were compiled from the aforementioned databases as a means of accumulating a comprehensive body of literature. Specifically, articles will encompass the standing knowledge of TBIs as derived from the functional imaging studies. Importantly, a large subset of such studies will reflect the most recent innovations in the functional imaging of neurological trauma.

Results: Present radiological practice in the acute care of TBI relies heavily upon the use of CT imaging to assess for gross structural deformity and abnormal fluid accumulations. This radiological triage allows physicians to make rapid decisions with respect to the need for surgical intervention, further imaging studies, or medical management otherwise. While functional imaging is not commonplace in established common practice, functional imaging, namely through PET has contributed to a profound understanding of the neurological abnormalities underpinning each severity of TBI. Recent functional imaging studies have sought to better characterize neurometabolic alterations present in TBI through the application of FDG-PET. Other studies have attempted to utilize experimental tracers to better understand particular processes, such as inflammation or prion deposition, as a result of TBI.

Conclusions: While structural imaging modalities have accounted for most of the clinical applications of radiological imaging in TBI, functional imaging presents a rapidly growing and exciting domain. Functional imaging with FDG-PET, has provided unparallel insight into the in-vivo consequences of TBI. Recent and on-going studies have moved to understand particular processes involved in TBI and otherwise characterizing the temporal response of the neurological systems in response to TBI. Functional imaging will continue to play a significant role in the future neurological study of TBI.