Motor and language DTI Fiber Tracking combined with intraoperative subcortical mapping for surgical removal of gliomas

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dc.contributor.authorBello, L
dc.contributor.authorGambini, A
dc.contributor.authorCastellano, A
dc.contributor.authorCarrabba, G
dc.contributor.authorAcerbi, F
dc.contributor.authorFava, E
dc.contributor.authorGiussani, C
dc.contributor.authorCadiolib, M
dc.contributor.authorBlasi, V
dc.contributor.authorCasarotti, A
dc.contributor.authorPapagno, C
dc.contributor.authorGupta, AK
dc.contributor.authorGaini, S
dc.contributor.authorScotti, G
dc.contributor.authorFalini, A
dc.date.accessioned2017-03-10T03:27:39Z
dc.date.available2017-03-10T03:27:39Z
dc.date.issued2008
dc.description.abstractPreoperative DTI Fiber Tracking (DTI-FT) reconstruction of functional tracts combined with intraoperative subcortical mapping (ISM) is potentially useful to improve surgical procedures in gliomas located in eloquent areas. Aims of the study are: (1) to evaluate the modifications of fiber trajectory induced by the tumor; (2) to validate preoperative DTI-FT results with intraoperative identification of functional subcortical sites through direct subcortical stimulation; (3) to evaluate the impact of preoperative DTI-FT reconstructions in a neuronavigational setup combined with ISM technique on duration and modalities of surgical procedures, and on functional outcome of the patients. Data are available on 64 patients (52 low-grade and 12 high-grade gliomas). DTI-FT was acquired by a 3-T MR scanner with a single-shot EPI sequence (TR/TE 8986/80 ms, b=1000 s/mm) with gradients applied along 32 non-collinear directions. 3D Fast Field Echo (FFE) T1-weighted imaging (TR/TE 8/4 ms) was performed for anatomic guidance. The corticospinal tract (CST), superior longitudinal, inferior fronto-occipital and uncinatus fasciculi were reconstructed. Data were transferred to the neuronavigational system. Functional subcortical sites identified during ISM were correlated with fiber tracts depicted by DTI-FT. In high-grade gliomas, DTI-FT depicted tracts mostly at the tumor periphery; in low-grade gliomas, fibers were frequently located inside the tumor mass. There was a high correlation between DTI-FT and ISM (sensitivity for CST=95%, language tracts=97%). For a proper reconstruction of the tracts, it was necessary to use a low FA threshold of fiber tracking algorithm and to position additional regions of interest (ROIs). The combination of DTI-FT and ISM decreased the duration of surgery, patient fatigue, and intraoperative seizures. Combination of DTI-FT and ISM allows accurate identification of eloquent fiber tracts and enhances surgical performance and safety maintaining a high rate of functional preservation. (C) 2007 Elsevier Inc. All rights reserved.
dc.identifier.citation39 ,1;369-382en_US
dc.identifier.uri10.1016/j.neuroimage.2007.08.031
dc.identifier.urihttps://dspace.sctimst.ac.in/handle/123456789/10086
dc.publisherNEUROIMAGE
dc.subjectNeurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging
dc.titleMotor and language DTI Fiber Tracking combined with intraoperative subcortical mapping for surgical removal of gliomas
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