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Comparative validation of automated presurgical tractography based on constrained spherical deconvolution and
Ahmed Mohamed Radwan1,2, Louise Emsell1,2,3,4, Kristof Vansteelandt2,3,4
1KU Leuven, Department of Imaging and Pathology, Translational MRI, Leuven, Belgium.
Human Brain Mapping
|April 22, 2024
Summary
Constrained spherical deconvolution (CSD) methods provide more accurate presurgical white matter mapping than diffusion tensor imaging (DTI) methods. This improved accuracy, validated by direct electrical stimulation, enhances surgical planning and patient outcomes.
Area of Science:
- Neuroimaging
- Neurosurgery
- Computational Neuroscience
Background:
- Accurate presurgical brain mapping is crucial for risk assessment and intraoperative guidance.
- Diffusion imaging techniques like DTI and CSD are used for white matter tractography.
- Direct electrical stimulation (DES) serves as a gold standard for validating functional brain mapping.
Purpose of the Study:
- To compare the accuracy of constrained spherical deconvolution (CSD) versus diffusion tensor imaging (DTI)-based tractography methods for presurgical white matter mapping.
- To determine which diffusion imaging method provides superior alignment with intraoperative direct electrical stimulation (DES) findings.
- To assess the clinical utility of CSD for enhancing neurosurgical precision.
Main Methods:
- A cross-sectional study involving 22 neurosurgical patients undergoing DES mapping.
- Reconstruction of the corticospinal tract (CST) and arcuate fasciculus (AF) using three DTI-based and two CSD-based tractography methods.
- Comparison of tractogram distances to DES coordinates using receiver-operating characteristic (ROC) curves, binary agreement, and linear modeling.
Main Results:
- Constrained spherical deconvolution (CSD)-based tractograms showed significantly higher agreement with positive direct electrical stimulation (pDES) coordinates compared to DTI-based tractograms.
- ROC analysis indicated higher sensitivity for CSD (8.5 mm cutoff) versus DTI (14.5 mm cutoff).
- CSD-based CST tractograms demonstrated superior accuracy when validated against DES mapping of motor and sensory functions (PFWE < .05).
Conclusions:
- CSD-based tractography offers enhanced accuracy for presurgical white matter mapping compared to DTI-based methods.
- The findings support the clinical adoption of CSD for improved structural mapping in neurosurgery.
- This improved mapping has the potential to refine surgical navigation and reduce risks associated with white matter damage.
Keywords:
constrained spherical deconvolutiondiffusion tensor imagingdirect electrical stimulationneurosurgerypresurgical planningwhite matter
