Going Beyond Diffusion Tensor Imaging Tractography in Eloquent Glioma Surgery–High-Resolution Fiber Tractography: Q-Ball or Constrained Spherical Deconvolution?

Becker, Daniela; Scherer, Moritz; Neher, Peter; Jungk, Christine; Jesser, Jessica; Pflüger, Irada; Brinster, Regina; Bendszus, Martin; Bruckner, Th.; Maier‐Hein, Klaus H.; Unterberg, Andreas

doi:10.1016/j.wneu.2019.10.138

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…Future tractography studies may also employ alternative tracking algorithms that have already been proven feasible on brain tumor patients, such as spherical deconvolution tractography (Mormina et al, 2016;Becker et al, 2019) and multi-fiber tractography (Chen et al, 2015;Gong et al, 2018). These methods, similarly to q-ball tractography, were shown to improve the depiction of complex fiber orientations (Tournier et al, 2007;Malcolm et al, 2010;Fillard et al, 2011;Dell'Acqua and Tournier, 2019).…”

Section: Discussionmentioning

confidence: 99%

fMRI-Targeted High-Angular Resolution Diffusion MR Tractography to Identify Functional Language Tracts in Healthy Controls and Glioma Patients

et al. 2020

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Sanvito et al. fMRI-Targeted Language HARDI Tractography Results: MNI Atlases showed that fMRI-T is a subset of Anatomical-T, and that different task-specific fMRI-T involve both shared subsets and task-specific subsetse.g., verbal fluency fMRI-T strongly involves dorsal frontal tracts, consistently with the phonogical-articulatory features of this task. A quantitative analysis in patients revealed that Anatomical-T removed portions of AF-SLF and IFOF were significantly greater than verbal fluency fMRI-T ones, suggesting that fMRI-T is a more specific approach. In addition, qualitative analyses showed that fMRI-T AF-SLF and IFOF predict the exact functional limits of resection with increased specificity when compared to Anatomical-T counterparts, especially the superior frontal portion of IFOF, in a subcohort of patients. Conclusion: These results suggest that performing fMRI-T in addition to the 'classic' Anatomical-T may be useful in a preoperative setting to identify the 'high-risk subsets' that should be spared during the surgical procedure.

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Section: Discussionmentioning

confidence: 99%

fMRI-Targeted High-Angular Resolution Diffusion MR Tractography to Identify Functional Language Tracts in Healthy Controls and Glioma Patients

et al. 2020

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“…Advanced methods for MR tractography incorporate acquisition schemes allowing to perform both NODDI analysis and high angular resolution diffusion imaging (HARDI) tractography, such as q‐ball tractography (Berman et al, 2008) or constrained spherical deconvolution (Tournier, Calamante, Gadian, & Connelly, 2004), which were already proven applicable to brain tumor patients (Becker et al, 2019; Caverzasi et al, 2015; Mormina et al, 2016; Sanvito et al, 2020), and demonstrated higher accuracy than classic DTI‐tractography in the clinical setting (Bucci et al, 2013). Tractography is extensively employed in the presurgical workup of patients with brain tumors, to noninvasively identify the trajectories of eloquent WM tracts located in the proximity or inside the lesions, that should be spared by the surgeons to avoid serious impairment in patient's motor, cognitive, or visual functions (Castellano, Cirillo, Bello, Riva, & Falini, 2017; Riva et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Along‐tract statistics of neurite orientation dispersion and density imaging diffusion metrics to enhance MR tractography quantitative analysis in healthy controls and in patients with brain tumors

Pieri

Sanvito

Riva

et al. 2020

Human Brain Mapping

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Along‐tract statistics analysis enables the extraction of quantitative diffusion metrics along specific white matter fiber tracts. Besides quantitative metrics derived from classical diffusion tensor imaging (DTI), such as fractional anisotropy and diffusivities, new parameters reflecting the relative contribution of different diffusion compartments in the tissue can be estimated through advanced diffusion MRI methods as neurite orientation dispersion and density imaging (NODDI), leading to a more specific microstructural characterization. In this study, we extracted both DTI‐ and NODDI‐derived quantitative microstructural diffusion metrics along the most eloquent fiber tracts in 15 healthy subjects and in 22 patients with brain tumors. We obtained a robust intraprotocol reference database of normative along‐tract microstructural metrics, and their corresponding plots, from healthy fiber tracts. Each diffusion metric of individual patient's fiber tract was then plotted and statistically compared to the normative profile of the corresponding metric from the healthy fiber tracts. NODDI‐derived metrics appeared to account for the pathological microstructural changes of the peritumoral tissue more accurately than DTI‐derived ones. This approach may be useful for future studies that may compare healthy subjects to patients diagnosed with other pathological conditions.

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“…However, DTI-based tractography has several known limitations that may hamper value for clinical applications, including its limited ability to resolve geometrically complex situations such as crossing or kissing fibers ( 38 , 39 ). Previous research has shown that using more advanced techniques, such as q-ball and CSD-based fiber tractography, may lead to improved results ( 37 , 61 , 62 ). In turn, the proposed MLFT algorithm is developed from CSD-based tractography and similarly propagates fiber pathways based on FOD peaks.…”

Section: Discussionmentioning

confidence: 99%

Tracking the Corticospinal Tract in Patients With High-Grade Glioma: Clinical Evaluation of Multi-Level Fiber Tracking and Comparison to Conventional Deterministic Approaches

et al. 2021

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While the diagnosis of high-grade glioma (HGG) is still associated with a considerably poor prognosis, neurosurgical tumor resection provides an opportunity for prolonged survival and improved quality of life for affected patients. However, successful tumor resection is dependent on a proper surgical planning to avoid surgery-induced functional deficits whilst achieving a maximum extent of resection (EOR). With diffusion magnetic resonance imaging (MRI) providing insight into individual white matter neuroanatomy, the challenge remains to disentangle that information as correctly and as completely as possible. In particular, due to the lack of sensitivity and accuracy, the clinical value of widely used diffusion tensor imaging (DTI)-based tractography is increasingly questioned. We evaluated whether the recently developed multi-level fiber tracking (MLFT) technique can improve tractography of the corticospinal tract (CST) in patients with motor-eloquent HGGs. Forty patients with therapy-naïve HGGs (mean age: 62.6 ± 13.4 years, 57.5% males) and preoperative diffusion MRI [repetition time (TR)/echo time (TE): 5000/78 ms, voxel size: 2x2x2 mm3, one volume at b=0 s/mm2, 32 volumes at b=1000 s/mm2] underwent reconstruction of the CST of the tumor-affected and unaffected hemispheres using MLFT in addition to deterministic DTI-based and deterministic constrained spherical deconvolution (CSD)-based fiber tractography. The brain stem was used as a seeding region, with a motor cortex mask serving as a target region for MLFT and a region of interest (ROI) for the other two algorithms. Application of the MLFT method substantially improved bundle reconstruction, leading to CST bundles with higher radial extent compared to the two other algorithms (delineation of CST fanning with a wider range; median radial extent for tumor-affected vs. unaffected hemisphere – DTI: 19.46° vs. 18.99°, p=0.8931; CSD: 30.54° vs. 27.63°, p=0.0546; MLFT: 81.17° vs. 74.59°, p=0.0134). In addition, reconstructions by MLFT and CSD-based tractography nearly completely included respective bundles derived from DTI-based tractography, which was however favorable for MLFT compared to CSD-based tractography (median coverage of the DTI-based CST for affected vs. unaffected hemispheres – CSD: 68.16% vs. 77.59%, p=0.0075; MLFT: 93.09% vs. 95.49%; p=0.0046). Thus, a more complete picture of the CST in patients with motor-eloquent HGGs might be achieved based on routinely acquired diffusion MRI data using MLFT.

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Going Beyond Diffusion Tensor Imaging Tractography in Eloquent Glioma Surgery–High-Resolution Fiber Tractography: Q-Ball or Constrained Spherical Deconvolution?

Cited by 19 publications

References 31 publications

fMRI-Targeted High-Angular Resolution Diffusion MR Tractography to Identify Functional Language Tracts in Healthy Controls and Glioma Patients

fMRI-Targeted High-Angular Resolution Diffusion MR Tractography to Identify Functional Language Tracts in Healthy Controls and Glioma Patients

Along‐tract statistics of neurite orientation dispersion and density imaging diffusion metrics to enhance MR tractography quantitative analysis in healthy controls and in patients with brain tumors

Tracking the Corticospinal Tract in Patients With High-Grade Glioma: Clinical Evaluation of Multi-Level Fiber Tracking and Comparison to Conventional Deterministic Approaches

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