Multiband diffusion tensor imaging for presurgical mapping of motor and language pathways in patients with brain...

Assessment of the essential white matter fibers of arcuate fasciculus and corticospinal tract (CST), required for preoperative planning in brain tumor patients, relies on the reliability of diffusion tensor imaging (DTI). The recent development of multiband DTI (mb-DTI) based on simultaneous multislice excitation could maintain the overall quality of tractography while not exceeding standard clinical care time. To address this potential, we performed quantitative analyses to evaluate tractography results of arcuate fasciculus and CST acquired by mb-DTI in brain tumor patients.

We retrospectively analyzed 44 patients with brain lesions who underwent presurgical single-shot DTI (s-DTI) and mb-DTI. We measured DTI parameters: fractional anisotropy (FA) and mean diffusivity (MD [mm² s^-1 ]) in whole brain and tumor regions; and the tractography parameters: fiber FA, MD (mm² s^-1 ), volume (mm³ ), and length (mm) in the whole brain, arcuate fasciculus, and CST. Additionally, three neuroradiologists performed a blinded visual assessment comparing s-DTI with mb-DTI.

The mb-DTI showed higher mean FA and lower MD (r > .95, p < .002) in whole brain and tumor regions of interest; slightly higher fiber FA, volume, and length; and slightly lower fiber MD in whole brain, arcuate fasciculus, and CST than in s-DTI. These differences were significant for fiber FA in all tracts; length (mm) in arcuate fasciculus; and fiber MD (mm² s^-1 ) and volume (mm³ ) in all patients with tumor involved in the arcuate fasciculus, CST, and whole brain tracts (p = .001). Visual assessment demonstrated that both techniques produced visually similar tracts.

This study demonstrated the clinical potential and significant advantages of preoperative mb-DTI in brain tumor patients.