Optic radiations evaluation in patients affected by high-grade gliomas: a side-by-side constrained spherical...

Area of Science:

• Neurosurgery
• Radiology
• Neuroscience

Background:

• High-grade gliomas necessitate improved surgical efficacy.
• Advanced pre-surgical MRI techniques like tractography are crucial for planning.
• Optic radiations (ORs) are critical white matter tracts often affected in occipito-temporo-parietal gliomas.

Purpose of the Study:

• To investigate pre-surgical planning of ORs in high-grade gliomas.
• To compare the effectiveness of Constrained Spherical Deconvolution (CSD) and Diffusion Tensor Imaging (DTI) tractography for OR evaluation.
• To assess the impact of these techniques on surgical planning and patient outcomes.

Main Methods:

• Twelve patients with occipito-temporo-parietal high-grade gliomas were analyzed.
• A 3 Tesla MRI scanner and diffusion-weighted imaging (DWI) with 64 gradient directions were used.
• Qualitative and quantitative assessments of OR alterations were performed using CSD and DTI tractography.

Main Results:

• CSD-based tractography provided superior qualitative evaluation of white matter tracts compared to DTI.
• CSD identified OR involvement in 75% of patients, versus 41.67% with DTI at the highest cutoff.
• Quantitative analysis showed a significant decrease in fractional anisotropy (FA) with CSD, but not with DTI.

Conclusions:

• CSD-based tractography significantly improves pre-surgical planning for gliomas involving ORs.
• CSD offers more valuable information on white matter-neoplasm spatial relationships than DTI.
• Utilizing CSD for OR evaluation can optimize surgical margins and reduce the risk of post-operative visual deficits.