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. 2020 Oct 15;10:17410. doi: 10.1038/s41598-020-74624-6

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Three different fractional anisotropy (FA) measurement methods at the C2/C3 level applied in diffusion tensor images of a 53-year-old woman. (a) The mean region-of-interest (ROI) method using each voxel inside the spinal cord on the axial image, guided by a sagittal T₂-weighted turbo spin-echo (TSE) image. A total of eight voxels were placed on the spinal cord. (b) The calculated average FA values for all voxels inside the spinal cord from the mean ROI method range from 0.332 to 0.479. These FA values were averaged per cord level across all subjects. In this patient, the mean FA value is 0.417. Additional apparent diffusion coefficient (ADC) values for each voxel were also automatically calculated. (c) The manual ROI method, using a freehand technique, which represents approximately one voxel. The calculated FA value is 0.417. (d) The sagittal ROI method, using a freehand technique, which represents approximately one voxel. The calculated FA value is 0.400.