Diffusion MRI tractography for improved transcranial MRI-guided focused ultrasound thalamotomy targeting for essential tremor

Autor: Christian J. Thaler, Jennifer A. McNab, Maged Goubran, Kim Butts Pauly, Pejman Ghanouni, Raag D. Airan, Qiyuan Tian, Michael Zeineh, W. Jeffrey Elias, Diane S. Huss, Jaimie M. Henderson, Casey H. Halpern, Max Wintermark
Rok vydání: 2018
Předmět:
Transcranial MRI-guided focused ultrasound
Essential Tremor
Ultrasonic Therapy
Cognitive Neuroscience
Dentatothalamic tract
medicine.medical_treatment
Thalamus
lcsh:Computer applications to medicine. Medical informatics
lcsh:RC346-429
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Diffusion Tractography
lcsh:Neurology. Diseases of the nervous system
Diffusion tractography
Brain Mapping
business.industry
Thalamotomy
Motor Cortex
Regular Article
Magnetic Resonance Imaging
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Treatment Outcome
Dentate nucleus
medicine.anatomical_structure
Ventral intermediate nucleus
Neurology
lcsh:R858-859.7
Neurosurgical targeting
Neurology (clinical)
Nuclear medicine
business
030217 neurology & neurosurgery
Diffusion MRI
Motor cortex
Tractography
Zdroj: NeuroImage: Clinical, Vol 19, Iss, Pp 572-580 (2018)
NeuroImage : Clinical
ISSN: 2213-1582
DOI: 10.1016/j.nicl.2018.05.010
Popis: Purpose To evaluate the use of diffusion magnetic resonance imaging (MRI) tractography for neurosurgical guidance of transcranial MRI-guided focused ultrasound (tcMRgFUS) thalamotomy for essential tremor (ET). Materials and methods Eight patients with medication-refractory ET were treated with tcMRgFUS targeting the ventral intermediate nucleus (Vim) of the thalamus contralateral to their dominant hand. Diffusion and structural MRI data and clinical evaluations were acquired pre-treatment and post-treatment. To identify the optimal target location, tractography was performed on pre-treatment diffusion MRI data between the treated thalamus and the hand-knob region of the ipsilateral motor cortex, the entire ipsilateral motor cortex and the contralateral dentate nucleus. The tractography-identified locations were compared to the lesion location delineated on 1 year post-treatment T2-weighted MR image. Their overlap was correlated with the clinical outcomes measured by the percentage change of the Clinical Rating Scale for Tremor scores acquired pre-treatment, as well as 1 month, 3 months, 6 months and 1 year post-treatment. Results The probabilistic tractography was consistent from subject-to-subject and followed the expected anatomy of the thalamocortical radiation and the dentatothalamic tract. Higher overlap between the tractography-identified location and the tcMRgFUS treatment-induced lesion highly correlated with better treatment outcome (r = −0.929, −0.75, −0.643, p = 0.00675, 0.0663, 0.139 for the tractography between the treated thalamus and the hand-knob region of the ipsilateral motor cortex, the entire ipsilateral motor cortex and the contralateral dentate nucleus, respectively, at 1 year post-treatment). The correlation for the tractography between the treated thalamus and the hand-knob region of the ipsilateral motor cortex is the highest for all time points (r = −0.719, −0.976, −0.707, −0.929, p = 0.0519, 0.000397, 0.0595, 0.00675 at 1 month, 3 months, 6 months and 1 year post-treatment, respectively). Conclusion Our data support the use of diffusion tractography as a complementary approach to current targeting methods for tcMRgFUS thalamotomy.
Highlights • Retrospectively used tractography to define a target for MRgFUS thalamotomy for ET. • Larger overlap between tractography and lesion correlates with better outcomes. • Strongest correlations for tract between the thalamus and motor hand-knob region • Diffusion tractography is a complementary approach to current targeting methods.
Databáze: OpenAIRE
Externí odkaz: