Enhanced Fiber Tractography Using Edema Correction: Application and Evaluation in High-Grade Gliomas
| Autor: | Drew Parker, Ragini Verma, Timothy H. Lucas, Michael L. McGarvey, Mark A. Elliott, Fraser Henderson, Steven Brem, Wesley B Hodges, Ronald L. Wolf, Lisa Desiderio, Jessica Harsch, Lauren Karpf, Anupa Ambili Vijayakumari, Eileen Maloney-Wilensky, Scott Levy |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
computer.software_genre
03 medical and health sciences 0302 clinical medicine Voxel Edema Fractional anisotropy Humans Medicine Diffusion Tractography medicine.diagnostic_test Brain Neoplasms business.industry Magnetic resonance imaging Glioma Magnetic Resonance Imaging Diffusion Tensor Imaging Research—Human—Clinical Studies 030220 oncology & carcinogenesis Surgery Neurology (clinical) medicine.symptom business Functional magnetic resonance imaging Nuclear medicine computer 030217 neurology & neurosurgery Diffusion MRI Tractography |
| Zdroj: | Neurosurgery |
| ISSN: | 1524-4040 0148-396X |
| Popis: | Background A limitation of diffusion tensor imaging (DTI)-based tractography is peritumoral edema that confounds traditional diffusion-based magnetic resonance metrics. Objective To augment fiber-tracking through peritumoral regions by performing novel edema correction on clinically feasible DTI acquisitions and assess the accuracy of the fiber-tracks using intraoperative stimulation mapping (ISM), task-based functional magnetic resonance imaging (fMRI) activation maps, and postoperative follow-up as reference standards. Methods Edema correction, using our bi-compartment free water modeling algorithm (FERNET), was performed on clinically acquired DTI data from a cohort of 10 patients presenting with suspected high-grade glioma and peritumoral edema in proximity to and/or infiltrating language or motor pathways. Deterministic fiber-tracking was then performed on the corrected and uncorrected DTI to identify tracts pertaining to the eloquent region involved (language or motor). Tracking results were compared visually and quantitatively using mean fiber count, voxel count, and mean fiber length. The tracts through the edematous region were verified based on overlay with the corresponding motor or language task-based fMRI activation maps and intraoperative ISM points, as well as at time points after surgery when peritumoral edema had subsided. Results Volume and number of fibers increased with application of edema correction; concordantly, mean fractional anisotropy decreased. Overlay with functional activation maps and ISM-verified eloquence of the increased fibers. Comparison with postsurgical follow-up scans with lower edema further confirmed the accuracy of the tracts. Conclusion This method of edema correction can be applied to standard clinical DTI to improve visualization of motor and language tracts in patients with glioma-associated peritumoral edema. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|