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DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
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A Simplified Method of Accurate Postprocessing of Diffusion Tensor Imaging for Use in Brain Tumor Resection
Phillip A Bonney1, Andrew K Conner1, Lillian B Boettcher1
1Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Operative Neurosurgery (Hagerstown, Md.)
|September 22, 2017
Summary
Diffusion tensor imaging (DTI) simplifies brain tumor resection by enabling quick mapping of white matter tracts. This technique aids surgeons in preserving patient function during tumor removal.
Area of Science:
- Neurosurgery
- Medical Imaging
- Neuroscience
Background:
- Diffusion tensor imaging (DTI) use in brain tumor resection is hindered by implementation challenges.
- A simplified DTI postprocessing method is needed for routine neurosurgical practice.
Purpose of the Study:
- To demonstrate a simple DTI postprocessing method executable by non-neuroscientists.
- To report on preserving patient function during aggressive tumor resection using DTI.
Main Methods:
- DTI data acquisition in patients with tumors near eloquent cortices.
- White matter tract mapping and neuronavigation integration in under 20 minutes by non-experts.
- Comparison of DTI findings with intraoperative stimulation mapping in 43 awake craniotomy patients.
Main Results:
- High sensitivity (98%) and specificity (95%) of DTI in identifying critical white matter tracts.
- Low rates of permanent neurological deficits: 2% for speech and 7% for motor function.
- Successful >90% tumor resection achieved in 74% of cases.
Conclusions:
- Accurate DTI is easily acquired, processed, and integrated into neuronavigation.
- DTI facilitates aggressive tumor resection while preserving eloquent brain structures and networks.
