Evaluation of Diffusion-Tensor Imaging based Global Search and Tractography for Tumor Surgery close to the Language System

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2013
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Zolal, Amir
Ganslandt, Oliver
Buchfelder, Michael
Nimsky, Christopher
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PLoS ONE. 2013, 8(1), e50132. eISSN 1932-6203. Available under: doi: 10.1371/journal.pone.0050132
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Pre-operative planning and intra-operative guidance in neurosurgery require detailed information about the location of functional areas and their anatomo-functional connectivity. In particular, regarding the language system, post-operative deficits such as aphasia can be avoided. By combining functional magnetic resonance imaging and diffusion tensor imaging, the connectivity between functional areas can be reconstructed by tractography techniques that need to cope with limitations such as limited resolution and low anisotropic diffusion close to functional areas. Tumors pose particular challenges because of edema, displacement effects on brain tissue and infiltration of white matter. Under these conditions, standard fiber tracking methods reconstruct pathways of insufficient quality. Therefore, robust global or probabilistic approaches are required. In this study, two commonly used standard fiber tracking algorithms, streamline propagation and tensor deflection, were compared with a previously published global search, Gibbs tracking and a connection-oriented probabilistic tractography approach. All methods were applied to reconstruct neuronal pathways of the language system of patients undergoing brain tumor surgery, and control subjects. Connections between Broca and Wernicke areas via the arcuate fasciculus (AF) and the inferior fronto-occipital fasciculus (IFOF) were validated by a clinical expert to ensure anatomical feasibility, and compared using distance- and diffusion-based similarity metrics to evaluate their agreement on pathway locations. For both patients and controls, a strong agreement between all methods was observed regarding the location of the AF. In case of the IFOF however, standard fiber tracking and Gibbs tracking predominantly identified the inferior longitudinal fasciculus that plays a secondary role in semantic language processing. In contrast, global search resolved connections in almost every case via the IFOF which could be confirmed by probabilistic fiber tracking. The results show that regarding the language system, our global search is superior to clinically applied conventional fiber tracking strategies with results similar to time-consuming global or probabilistic approaches.

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ISO 690RICHTER, Mirco, Amir ZOLAL, Oliver GANSLANDT, Michael BUCHFELDER, Christopher NIMSKY, Dorit MERHOF, 2013. Evaluation of Diffusion-Tensor Imaging based Global Search and Tractography for Tumor Surgery close to the Language System. In: PLoS ONE. 2013, 8(1), e50132. eISSN 1932-6203. Available under: doi: 10.1371/journal.pone.0050132
BibTex
@article{Richter2013Evalu-22407,
  year={2013},
  doi={10.1371/journal.pone.0050132},
  title={Evaluation of Diffusion-Tensor Imaging based Global Search and Tractography for Tumor Surgery close to the Language System},
  number={1},
  volume={8},
  journal={PLoS ONE},
  author={Richter, Mirco and Zolal, Amir and Ganslandt, Oliver and Buchfelder, Michael and Nimsky, Christopher and Merhof, Dorit},
  note={This study was supported by the DFG Research Training Group GK-1042 "Explorative Analysis and Visualization of Large Information Spaces" at the University of Konstanz. Article Number: e50132}
}
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This study was supported by the DFG Research Training Group GK-1042 "Explorative Analysis and Visualization of Large Information Spaces" at the University of Konstanz.
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