Use of diffusion tensor imaging in glioma resection

Abdullah, Kalil G.; Lubelski, Daniel; Nucifora, Paolo; Brem, Steven

doi:10.3171/2013.1.focus12412

Cited by 73 publications

(49 citation statements)

References 55 publications

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“…These series report thresholds ranging from 70% to 100% [7][8][9] , with the caveats that they were obtained retrospectively. 15 and can help distinguish between post-operative vascular damage and residual enhancing tumor. 16 Dynamic contrast-enhanced (DCE) sequences in the preoperative setting measure pharmacokinetic parameters of contrast uptake, which may be associated with early disease progression and survival.…”

Section: Initial Diagnosis and Surgical Managementmentioning

confidence: 99%

Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

Shukla¹,

Alexander²,

Bakas³

et al. 2018

JHN Journal

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Section: Initial Diagnosis and Surgical Managementmentioning

confidence: 99%

Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

Shukla¹,

Alexander²,

Bakas³

et al. 2018

JHN Journal

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“…The authors recognize the fact of the difficulties presented by this protocol to depict the Meyer loop which remains a major challenge. investigation 4 . After opening the dura mater and after manipulation in the brain by removing the tumor or the cerebrospinal fluid loss we don`t have the same conditions as before surgery.…”

Section: Representative Resultsmentioning

confidence: 99%

DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions

Hana

Husch

Gunness

et al. 2014

JoVE

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DTI is a technique that identifies white matter tracts (WMT) non-invasively in healthy and non-healthy patients using diffusion measurements. Similar to visual pathways (VP), WMT are not visible with classical MRI or intra-operatively with microscope. DTI will help neurosurgeons to prevent destruction of the VP while removing lesions adjacent to this WMT. We have performed DTI on fifty patients before and after surgery between March 2012 to January 2014. To navigate we used a 3DT1-weighted sequence. Additionally, we performed a T2-weighted and DTIsequences. The parameters used were, FOV: 200 x 200 mm, slice thickness: 2 mm, and acquisition matrix: 96 x 96 yielding nearly isotropic voxels of 2 x 2 x 2 mm. Axial MRI was carried out using a 32 gradient direction and one b0-image. We used Echo-Planar-Imaging (EPI) and ASSET parallel imaging with an acceleration factor of 2 and b-value of 800 s/mm². The scanning time was less than 9 min.The DTI-data obtained were processed using a FDA approved surgical navigation system program which uses a straightforward fiber-tracking approach known as fiber assignment by continuous tracking (FACT). This is based on the propagation of lines between regions of interest (ROI) which is defined by a physician. A maximum angle of 50, FA start value of 0.10 and ADC stop value of 0.20 mm²/s were the parameters used for tractography.There are some limitations to this technique. The limited acquisition time frame enforces trade-offs in the image quality. Another important point not to be neglected is the brain shift during surgery. As for the latter intra-operative MRI might be helpful. Furthermore the risk of false positive or false negative tracts needs to be taken into account which might compromise the final results. Video LinkThe video component of this article can be found at

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“…It can improve target volume delineation for image-guided biopsies and help predict the extent of resection, which in turn, can have prognostic value [12,13]. Fractional anisotropy values measured using DTI were shown to be predictors of cellularity in astrocytic tumors, such as glioblastoma, anaplastic astrocytoma and pilocytic astrocytoma [14].…”

Section: Novel Techniques In Mrimentioning

confidence: 99%

Emerging methods for disease monitoring in malignant gliomas

2013

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Summary MRI remains the backbone of measuring disease burden and treatment response in individuals with malignant gliomas. Traditional radiographic approaches, however, are largely limited to depicting anatomic changes and are not a direct measure of disease burden. For example, contrast enhancement is related to blood–brain barrier integrity rather than actual tumor size. Without accurate measures of disease, common clinical dilemmas include ‘pseudo-progression’ (e.g., after chemoradiation) or ‘pseudo-response’ (e.g., with steroid treatment and antiangiogenic agents), which can lead to delays in therapy, premature discontinuation of successful treatments and to unnecessary surgical procedures. This overview focuses on novel, minimally invasive approaches in the area of imaging and blood-based biomarkers that aim to more accurately determine disease status and response to treatment in malignant brain tumors.

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Use of diffusion tensor imaging in glioma resection

Cited by 73 publications

References 55 publications

Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

Advanced Magnetic Resonance Imaging in Glioblastoma: A Review

DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions

Emerging methods for disease monitoring in malignant gliomas

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