Diagnostic performance of diffusion tensor imaging and T2-mapping in diabetic peripheral neuropathy: Age- and diabetes duration-matched study using multi-parametric approach

Objective We aim to evaluate the diagnostic performances of diffusion tensor imaging (DTI) and T2-mapping derived parameters for detecting diabetic peripheral neuropathy (DPN), and whether their combination could further improve the diagnostic performance. Methods This prospective study included 17 diabetes patients with DPN, 16 diabetes patients without DPN, and 12 healthy controls, who underwent 3T knee MRI, including axial T2-weighted Dixon sequence, DTI sequence, and T2-mapping. The mean fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), and tibial nerve T2 relaxation time were calculated. The receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of DTI and T2-mapping parameters for the tibial nerve. Results The FA values of the tibial nerve in diabetic patients with and without DPN were significantly lower than those of healthy controls. The T2 relaxation times of the tibial nerve in patients with diabetes with and without DPN were significantly longer than those of healthy controls. In single-parameter model, FA showed superior diagnostic performance for detecting DPN. In multiparameter model, the combination of FA and T2 relaxation times showed the best diagnostic performance for detecting DPN. Conclusion The multiparameter model exhibited an overall improved performance in detecting DPN. Advances in knowledge The multiparameter model combining FA and T2 relaxation time has demonstrated improved diagnostic performance for detecting DPN.