Preoperative Prediction of Location and Shape of Facial Nerve in Patients with Large Vestibular Schwannomas Using Diffusion Tensor Imaging–Based Fiber Tracking

Zhang, Yanyang; Mao, Zhiqi; Wei, Penghu; Jin, Yazhou; Ma, Lin; Zhang, Jun; Yu, Xin-guang

doi:10.1016/j.wneu.2016.11.110

Cited by 27 publications

(22 citation statements)

References 25 publications

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“…More studies are increasingly focused on DTI fiber-tracking application for selective nerve fiber protection beyond eloquent brain areas. Zhang et al 44) have utilized DTI fibertracking in the surgical treatment of vestibular schwannomas, proving that tracking modifications are useful for preoperatively predicting tumor location and intraoperatively protecting the facial nerve. Still other researchers are implementing DTI technique in the cortex of spinal cord injuries or tumors 18,36) .…”

Section: Benefit In Surgical Strategies Formationmentioning

confidence: 99%

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

Lin

Liu

et al. 2020

J Korean Neurosurg Soc

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Objective : To investigate the efficiency of diffusion tensor imaging (DTI) fiber-tracking based neuronavigation and assess its usefulness in the preoperative surgical planning, prognostic prediction, intraoperative course and outcome improvement. Methods : Seventeen patients with cerebral masses adjacent to corticospinal tract (CST) were given standard magnetic resonance imaging and DTI examination. By incorporation of DTI data, the relation between tumor and adjacent white matter tracts was reconstructed and assessed in the neuronavigation system. Distance from tumor border to CST was measured. Results : The sub-portion of CST in closest proximity to tumor was found displaced in all patients. The chief disruptive changes were classified as follows : complete interruption, partial interruption, or simple displacement. Partial interruption was evident in seven patients (41.2%) whose lesions were close to cortex. In the other 10 patients (58.8%), delineated CSTs were intact but distorted. No complete CST interruption was identified. Overall, the mean distance from resection border to CST was 6.12 mm (range, 0-21), as opposed to 8.18 mm (range, 2-21) with simple displacement and 2.33 mm (range, 0-5) with partial interruption. The clinical outcomes were analyzed in groups stratified by intervening distances (close, <5 mm; moderated, 5-10 mm; far, >10 mm). For the primary brain tumor patients, the proportion of completely resected tumors increased progressively from close to far grouping (42.9%, 50%, and 100%, respectively). Five patients out of seven (71.4%) experienced new neurologic deficits postoperatively in the close group. At meantime, motor deterioration was found in six cases in the close group. All patients in the far and moderate groups received excellent (modified Rankin Scale [mRS] score, 0-1) or good (mRS score, 2-3) rankings, but only 57.1% of patients in the close group earned good outcome scores. Conclusion : DTI fiber tracking based neuronavigation has merit in assessing the relation between lesions and adjacent white matter tracts, allowing prediction of patient outcomes based on lesion-CST distance. It has also proven beneficial in formulating surgical strategies.

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Section: Benefit In Surgical Strategies Formationmentioning

confidence: 99%

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

Lin

Liu

et al. 2020

J Korean Neurosurg Soc

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“…11 Hodaie et al introduced DTT to cranial nerve tracking. 9 Taoka et al first reported the use of tracking the FN with DTT in patients with VS. 20 Since then, several investigators have described their experience in applying this technique to reconstruct the FN tract in patients with VS. 2,4,6,8,11,13,15,19,20,22,24,[27][28][29] Diffusion tensor tractography reconstruction of FN fibers is considered successful if a continuous tract of fibers is seen to extend from the internal auditory meatus to the brainstem along the tumor capsule. 4…”

Section: Diffusion Tensor Imaging-fiber Tracking For Fn Localizationmentioning

confidence: 99%

“…25 The studies by Wei et al and Yoshino et al demonstrated that superselective FT and setting the fractional anisotropy (FA) threshold at the upper limit may help to detect the FN and vestibulocochlear nerve; however, this capacity may be limited. 22,24,28 In a study of 30 patients, Zhang et al combined superselective tracking and 3D FIESTA with cycled phase sequences (3D FIESTA-C) image integration, which enabled them to identify individual nerve bundles and to distinguish them from artifacts based on anatomical information provided by the 3D FIESTA-C images. 28 Additionally, to increase the tracking success rate, these authors set various FA threshold values for each patient.…”

Section: Evolution and Current Status Of Dti-ft For Fn Tracking In Vsmentioning

confidence: 99%

“…22,24,28 In a study of 30 patients, Zhang et al combined superselective tracking and 3D FIESTA with cycled phase sequences (3D FIESTA-C) image integration, which enabled them to identify individual nerve bundles and to distinguish them from artifacts based on anatomical information provided by the 3D FIESTA-C images. 28 Additionally, to increase the tracking success rate, these authors set various FA threshold values for each patient. Thus, rather than setting one FA value, Zhang et al gradually increased the FA threshold value by 0.01 from 0.06 to 2.0, thus allowing them to identify the appropriate FA threshold to obtain the primary tracking maps containing the most bundles that originated from the brainstem with the lowest density.…”

Section: Evolution and Current Status Of Dti-ft For Fn Tracking In Vsmentioning

confidence: 99%

“…6 As a result, DTI-FT findings (at present) in patients with large VSs may include the seventh and eighth cranial nerve complex. 28 In the future, diffusion spectrum imaging can be used to distinguish the FN from the vestibulocochlear nerve and warrants further investigation. 23 Zolal et al studied preoperative FN and cranial nerve positions in 21 patients with large VSs by using nontensorbased probabilistic tractography as compared to the standard tensor-based deterministic tractography.…”

Section: Evolution and Current Status Of Dti-ft For Fn Tracking In Vsmentioning

confidence: 99%

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Preoperative diffusion tensor imaging–fiber tracking for facial nerve identification in vestibular schwannoma: a systematic review on its evolution and current status with a pooled data analysis of surgical concordance rates

Savardekar¹,

Patra²,

Thakur³

et al. 2018

Neurosurgical Focus

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OBJECTIVETotal tumor excision with the preservation of neurological function and quality of life is the goal of modern-day vestibular schwannoma (VS) surgery. Postoperative facial nerve (FN) paralysis is a devastating complication of VS surgery. Determining the course of the FN in relation to a VS preoperatively is invaluable to the neurosurgeon and is likely to enhance surgical safety with respect to FN function. Diffusion tensor imaging–fiber tracking (DTI-FT) technology is slowly gaining traction as a viable tool for preoperative FN visualization in patients with VS.METHODSA systematic review of the literature in the PubMed, Cochrane Library, and Web of Science databases was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and those studies that preoperatively localized the FN in relation to a VS using the DTI-FT technique and verified those preoperative FN tracking results by using microscopic observation and electrophysiological monitoring during microsurgery were included. A pooled analysis of studies was performed to calculate the surgical concordance rate (accuracy) of DTI-FT technology for FN localization.RESULTSFourteen studies included 234 VS patients (male/female ratio 1:1.4, age range 17–75 years) who had undergone preoperative DTI-FT for FN identification. The mean tumor size among the studies ranged from 29 to 41.3 mm. Preoperative DTI-FT could not visualize the FN tract in 8 patients (3.4%) and its findings could not be verified in 3 patients (1.2%), were verified but discordant in 18 patients (7.6%), and were verified and concordant in 205 patients (87.1%).CONCLUSIONSPreoperative DTI-FT for FN identification is a useful adjunct in the surgical planning for large VSs (> 2.5 cm). A pooled analysis showed that DTI-FT successfully identifies the complete FN course in 96.6% of VSs (226 of 234 cases) and that FN identification by DTI-FT is accurate in 90.6% of cases (205 of 226 cases). Larger studies with DTI-FT–integrated neuronavigation are required to look at the direct benefit offered by this specific technique in preserving postoperative FN function.

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Preoperative diffusion tensor imaging: Fiber‐trajectory‐distribution‐based tractography to identify facial nerve in vestibular schwannoma

Hu,

Li,

et al. 2024

Magnetic Resonance in Med

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PurposeTractography of the facial nerve based on diffusion MRI is instrumental before surgery for the resection of vestibular schwannoma, but no excellent methods usable for the suppression of motion and image noise have been proposed. The aim of this study was to effectively suppress noise and provide accurate facial nerve reconstruction by extend a fiber trajectory distribution function based on the fourth‐order streamline differential equations.MethodsPreoperative MRI from 33 patients with vestibular schwannoma who underwent surgical resection were utilized in this study. First, T1WI and T2WI were used to obtain mask images and regions of interest. Second, probabilistic tractography was employed to obtain the fibers representing the approximate facial nerve pathway, and these fibers were subsequently translated into orientation information for each voxel. Last, the voxel orientation information and the peaks of the fiber orientation distribution were combined to generate a fiber trajectory distribution function, which was used to parameterize the anatomical information. The parameters were determined by minimizing the cost between the trajectory of fibers and the estimated directions.ResultsQualitative and visual analyses were used to compare facial nerve reconstruction with intraoperative recordings. Compared with other methods (SD_Stream, iFOD1, iFOD2, unscented Kalman filter, parallel transport tractography), the fiber‐trajectory‐distribution‐based tractography provided the most accurate facial nerve reconstructions.ConclusionThe fiber‐trajectory‐distribution‐based tractography can effectively suppress the effect of noise. It is a more valuable aid for surgeons before vestibular schwannoma resection, which may ultimately improve the postsurgical patient's outcome.

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Preoperative Prediction of Location and Shape of Facial Nerve in Patients with Large Vestibular Schwannomas Using Diffusion Tensor Imaging–Based Fiber Tracking

Cited by 27 publications

References 25 publications

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

Preoperative diffusion tensor imaging–fiber tracking for facial nerve identification in vestibular schwannoma: a systematic review on its evolution and current status with a pooled data analysis of surgical concordance rates

Preoperative diffusion tensor imaging: Fiber‐trajectory‐distribution‐based tractography to identify facial nerve in vestibular schwannoma

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