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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Advancements in Diffusion MRI Tractography for Neurosurgery
Koji Kamagata1, Christina Andica, Wataru Uchida
1From the Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan (K.K., C.A., W.U., K.T., Y.S., A.H., S.F., T.A., A.W., S.A.); Faculty of Health Data Science, Juntendo University, Chiba, Japan (C.A., S.A.); Department of Radiology, Alfred Health, Melbourne, Victoria, Australia (M.L.); Department of Radiology, University of Tokyo, Tokyo, Japan (S.F.); Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan (M.H., K.K.); Melbourne Neuropsychiatry Center, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, Victoria, Australia (A.Z.); and Melbourne School of Engineering, University of Melbourne, Melbourne, Victoria, Australia (A.Z.).
Diffusion magnetic resonance imaging tractography visualizes brain white matter tracts for surgical planning. Advanced methods improve accuracy, safeguarding critical pathways and optimizing functional neurosurgery outcomes.
Area of Science:
- Neuroimaging
- Neuroscience
- Medical Technology
Background:
- Diffusion magnetic resonance imaging tractography is a noninvasive brain imaging technique.
- It visualizes and quantifies white matter tracts, crucial for neurological function.
- Widely used in preoperative planning for neurosurgical procedures.
Purpose of the Study:
- To discuss state-of-the-art tractography methodologies.
- To highlight applications in preoperative planning and functional neurosurgery.
- To address challenges and future prospects of tractography in clinical practice.
Main Methods:
- Review of advancements in imaging acquisition, fiber direction estimation, and tracking algorithms.
- Focus on tractography's role in mapping critical pathways and optimizing deep brain stimulation.
- Consideration of tractography's limitations and benefits in clinical settings.
Main Results:
- Significant improvements in tractography accuracy over the past 25 years.
- Enables mapping of functionally critical pathways to avoid surgical complications.
- Provides insights into white matter changes and brain structural connectivity.
Conclusions:
- Tractography is a valuable tool for safeguarding white matter tracts during surgery.
- It aids in optimizing functional neurosurgical procedures and patient risk stratification.
- Acknowledging limitations is key to its effective use in daily clinical practice.
