Dr. Dan Cousin
Medsurity Experts
1-833-9-BE-SURE
(1-833-923-7873)
The following is important information for both Plaintiffs and Defense to know regarding TBI claims with DTI analysis. Plaintiffs are more commonly employing advanced imaging techniques such as MRI Brain with DTI (Diffusion Tensor Imaging) to make claims for TBI. Often the dedicated MRI brain is normal but the reader interprets the DTI as positive. Here are some important points to remember. I am happy to lecture to your office at no charge to expand on these points and please feel free to contact my office if interested, Medsurity Experts – cousin@post.harvard.edu.
- The colorful picture of brain tracts is very pretty, technical looking, buys credibility with the lay viewer, but is essentially meaningless.
- DTI provides precise measurements but lacks the ability to identify underlying causes of abnormalities, making it less useful in diagnosing specific conditions.
- DTI lacks standardization, is highly variable and operator-dependent, limiting its reliability, especially outside of research centers.
- DTI is not a standard of care for clinical practice and is rarely performed as part of routine brain MRI scans.
- The RSNA notes there is insufficient evidence to support the routine clinical use of advanced neuroimaging like DTI for individual diagnosis and prognosis.
- DTI as used in TBI is considered experimental, and reimbursement status should be reviewed to determine if it was authorized or paid out-of-pocket.
- DTI is often used in personal injury cases, but most radiologists do not use it in daily practice, leading to challenges in finding clinical experts for defense cases.
- Proprietary software and differences between machines make DTI results inconsistent and subjective, especially when comparing results from different MRI machines.
- Without a pre-incident DTI scan, it is impossible to know if abnormalities are new or existed prior to an injury.
- Positive DTI findings are nonspecific and could be due to aging, alcohol, medications, sleep apnea, prior injuries, even just normal aging, etc., highlighting the nonspecific nature of DTI abnormalities.
- DTI measures water properties, not brain function, and function can be normal despite structural abnormalities.
- Adults commonly show DTI abnormalities unrelated to traumatic brain injuries, making a completely negative DTI uncommon.
With training from Harvard, Yale, Columbia, and other top-tier institutions, Dr. Daniel Cousin is a dual-boarded fellowship-trained expert in Diagnostic Radiology in active clinical practice who offers same-day (<24 hr) turnarounds on radiology consultations. Dr. Cousin is a pioneer in 4D demonstrative evidence, has an impressive lecturing and public speaking experience, presents well before juries, and has testified as an expert over 100 times in the last 4 years. As of 2021, his plaintiff defense split is approximately 50/50. For the expanded education on this interesting topic of TBI claims using DTI, please contact Dr. Dan’s office. Dr. Dan founded Medsurity Experts over a decade ago to provide clients with Top-tier, Best-Kept-Secret, Ivy League-Trained, Active Clinical Practitioners as Medical Experts. His current arsenal includes hundreds of experts in all medical subspecialties. With no referral fees charged, Medsurity Experts is a one-stop-shop for all your expert needs.
Contact my office.
Dr. Dan
Medsurity Experts – cousin@post.harvard.edu.
With training from Harvard, Yale, Columbia, and other top-tier institutions, Dr. Daniel Cousin is a dual-boarded fellowship-trained expert in Diagnostic Radiology in active clinical practice who offers same-day (<24 hr) turnarounds on radiology consultations. Dr. Cousin is a pioneer in 4D demonstrative evidence, has an impressive lecturing and public speaking experience, presents well before juries, and has testified as an expert over 100 times in the last 4 years. As of 2021, his plaintiff defense split is approximately 50/50. For the expanded education on this interesting topic of TBI claims using DTI, please contact Dr. Dan’s office. Dr. Dan founded Medsurity Experts over a decade ago to provide clients with Top-tier, Best-Kept-Secret, Ivy League-Trained, Active Clinical Practitioners as Medical Experts. His current arsenal includes hundreds of experts in all medical subspecialties. With no referral fees charged, Medsurity Experts is a one-stop-shop for all your expert needs.
Sincerely yours,
Daniel Cousin, M.D.
Diagnostic Radiologist
Certified by the American Board of Radiology
Radsurity, P.A., President
“Be sure with Radsurity”
WWW.RADSURITY.COM
cousin@post.harvard.edu
646-303-3125 (cell)