Appliance of preoperative diffusion tensor imaging and fiber tractography in patients with brainstem lesions

Cao, Zhikai; Liu, Jianping; Wei, Xinhua; Quan, Wei

doi:10.4103/0028-3886.73736

Cited by 19 publications

(16 citation statements)

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“…found that in their retrospective analysis, preoperative planning using DTI enabled the surgeon to investigate individual patient specific surgical approach and can significantly improve the surgical outcome, they have also concluded in their study that preoperative planning using DTI improves neurologic outcome in patients with brainstem lesions. [ 26 ] Preoperative estimation of damage was shown to be possible using fMRI/DTI data in a recent study. [ 27 ] A study by Castellano et al .…”

Section: Discussionmentioning

confidence: 99%

Role of diffusion tensor imaging in brain tumor surgery

2018

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Object:The objective is to evaluate the role of diffusion tensor imaging (DTI) in intra-axial brain tumor cases (gliomas and metastasis). To preoperatively assess the integrity and location of white matter (WM) tracts and plan the surgical corridor to cause least damage to the WM tracts with minimum postoperative new neurological deficits.Materials and Methods:A total of 34 patients were included in this study. Pre-operative contrast-enhanced magnetic resonance imaging and DTI scans of the patients were taken into consideration. Pre- and post-operative neurological examinations were performed and the outcome was assessed.Results:Preoperative planning of surgical corridor and extent of resection were planned so that maximum possible resection could be achieved without disturbing the WM tracts. DTI indicated the involvement of fiber tracts. A total of 21 (61.7%) patients had a displacement of tracts only and they were not invaded by tumor. A total of 11 (32.3%) patients had an invasion of tracts by the tumor, whereas in 4 (11.7%) patients the tracts were disrupted. Postoperative neurologic examination revealed deterioration of motor power in 4 (11.7%) patients, deterioration of language function in 3 (8.82%) patients, and memory in one patient. Total resection was achieved in 11/18 (61.1%) patients who had displacement of fibers, whereas it was achieved in 5/16 (31.2%) patients when there was infiltration/disruption of tracts.Conclusion:DTI provides crucial information regarding the infiltration of the tract and their displaced course due to the tumor. This study indicates that it is a very important tool for the preoperative planning of surgery. The involvement of WM tracts is a strong predictor of the surgical outcome.

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Section: Discussionmentioning

confidence: 99%

Role of diffusion tensor imaging in brain tumor surgery

2018

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“…The articles were published from the year 2005 to 2021. The studies included both prospective studies (n = 9) [7,8,[19][20][21][22][23][24][25] and retrospective (n = 8) [1,[26][27][28][29][30][31][32]. Data collection was performed by extracting information on demographic data, composed of the author, year of publication, type of study, origin country, number of patients and participants, patients' mean age, tumor type and its histology, tumor location, and the details of the control group, as shown in Table 2.…”

Section: Data Extraction and Study Designmentioning

confidence: 99%

“…The total number of patients reviewed was 877, with 234 control patients, with slightly more male patient recruitment (n = 360) compared to female patient recruitment (n = 283). The age range for these studies was 1 to 87 years old, and we included five studies [21,24,26,27,30] that had pediatric patients, but this would not affect our objective, as only a few patients were involved. All types of tumor were studied.…”

Section: Participantsmentioning

confidence: 99%

“…Although there were studies with patients with cavernous malformation brain lesions, our study excluded only the irrelevant patients, who were diagnosed with arteriovenous malformations, cavernous angiomas, and cavernous malformations, as the authors listed all of the individuals' tumor types. Thus, we included these two papers [19,26]. The tumor site was not exclusive; however, three of the publications discussed tumors exclusively in the brainstem [1,26,30].…”

Section: Participantsmentioning

confidence: 99%

“…Thus, we included these two papers [19,26]. The tumor site was not exclusive; however, three of the publications discussed tumors exclusively in the brainstem [1,26,30]. We decided to include all tumors from all locations.…”

Section: Participantsmentioning

confidence: 99%

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The Utilization of Diffusion Tensor Imaging as an Image-Guided Tool in Brain Tumor Resection Surgery: A Systematic Review

Manan

Yahya

Idris

et al. 2022

Cancers

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The diffusion tensor imaging technique has been recognized as a neuroimaging tool for in vivo visualization of white matter tracts. However, DTI is not a routine procedure for preoperative planning for brain tumor resection. Our study aimed to systematically evaluate the effectiveness of DTI and the outcomes of surgery. The electronic databases, PubMed/MEDLINE and Scopus, were searched for relevant studies. Studies were systematically reviewed based on the application of DTI in pre-surgical planning, modification of operative planning, re-evaluation of preoperative DTI data intraoperatively, and the outcome of surgery decisions. Seventeen studies were selected based on the inclusion and exclusion criteria. Most studies agreed that preoperative planning using DTI improves postoperative neuro-deficits, giving a greater resection yield and shortening the surgery time. The results also indicate that the re-evaluation of preoperative DTI intraoperatively assists in a better visualization of white matter tract shifts. Seven studies also suggested that DTI modified the surgical decision of the initial surgical approach and the rate of the GTR in tumor resection surgery. The utilization of DTI may give essential information on white matter tract pathways, for a better surgical approach, and eventually reduce the risk of neurologic deficits after surgery.

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