Comparison of multiple tractography pipelines for corticospinal tract reconstruction applied to brain tumor patients

Determining the best-performing corticospinal tract (CST) tractography pipelines based on the experts score for patients with four types of edema degree and tumor locations.

Twenty-three patients were stratified into four groups based on tumor location and edema degree: tumors near the precentral cortex without edema, tumors near the precentral cortex with edema, tumors located deep without edema, and tumors located deep with edema. The dataset included 13 males and 10 females, with an average age of 51.04 ± 14.50 years. Diffusion MRI data (b = 1,000 s/mm², 15 directions) were used. Five tractography pipelines were compared: SD-Stream, iFOD2, DSIstudio, TractSeg, and UKF-2T. Three clinical experts evaluate the quality of tractograms based on anatomical expert judgment. Then, quantitative anatomical measures CST gray matter coverage, volume, false-positive streamlines, and reconstruction rate are calculated to provide additional support for expert judgment.

TractSeg performed best for tumors without edema, achieving the highest expert score. UKF-2T and DSIstudio obtained the highest expert score when tumors with edema near the precentral cortex, and tumors located in deep brain, respectively. Quantitative results showed minimal interhemispheric differences in gray matter coverage for DSIstudio and UKF-2T, with slightly higher values on the healthy side. UKF-2T exhibited the highest CST volume. TractSeg generated the lowest false-positive streamlines.

Different tumor locations and edema degrees require specific tractography pipelines. TractSeg is optimal for tumors without edema, while UKF-2T and DSIstudio are superior for tumors with edema.