Application of diffusion tensor tractography in the surgical treatment of brain tumors located in functional areas

Abstract

The present study aimed to explore the application of diffusion tensor tractography (DTT) in the preoperative planning and prognostic evaluation of tumors located in the functional areas of the brain. A total of 42 patients diagnosed with intracranial tumors were randomly assigned to either the trial or the control group. DT imaging (DTI) was performed on the basis of preoperative conventional magnetic resonance imaging (MRI) and analyzed for patients in the trial group. Patients in the control group underwent only routine MRI scans. The effect of DTT on the prognosis of patients was evaluated by tumor resection rate and quality of life evaluation using Karnofsky performance score (KPS) comparison between the trial and control groups. There were no significant differences for total tumor removal rate in the trial group (85.71%) compared with that in the control group (71.43%) (P>0.05). The rate of postoperative symptom improvement in the trial group (85.71%) was significantly higher compared with that in the control group (47.62%) (P<0.05). The KPS value of the trial group was significantly higher postoperatively (78.57±17.40) compared with that preoperatively (66.67±16.23) (P<0.05). The KPS value of the control group postoperatively (72.38±19.21) was significantly higher compared with that preoperatively (66.67±16.00) (P<0.05). The postoperative KPS improvement rate [postoperative value-preoperative value)/preoperative value] of the trial group was significantly higher compared with that in the control group. In conclusion, the use of DTT is an effective supplement to traditional MRI, with particular relevance in preoperative planning, particularly for tumors in the functional area of the brain, and can significantly improve the prognostic function of patients.

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

“…(2020) [22] The postoperative KPS score in the DTI group was significantly better than the control group, although there are no significant difference in GTR between the two groups…”

“…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.…”

“…This information is summarized in Table 2. The white matter tracts of interest in the studies were primarily those in close proximity to the tumor and those associated with brain function, such as the corticospinal tract related to motor function [19,20,27,[30][31][32], optic radiation responsible for eyesight [1,7,8,21,23,29,31], and inferior longitudinal fasciculus and arcuate fascicles that link to language [7,8,20,22,23,28,29,31]. These tracts were relevant for postoperative deficit assessment.…”

“…All of the studies discussed the utilization of the DTI in brain tumor resection. One of them was primarily concerned with the ability to reconstruct the fiber tract in the presence of a brain tumor [1,7,8,[19][20][21][22][23][24][25][26][27][28][29][30][31][32]. In addition, the use of DTI could predetermine the preplanning surgical approach [8].…”

“…In addition, the use of DTI could predetermine the preplanning surgical approach [8]. Evaluation of DTI was performed in comparison with control patients, non-DTI, and DTI patients' groups [1,[21][22][23]25,28]; intraoperatively evaluation [1,7,8,[19][20][21][22][23][24][25][26][27][28][29][30][31]; and quantified the sensitivity and specificity of the DTI technique in its tract identification, tumor resection rate, and mobility prediction [20,21,23,24,27,31]. We emphasized all these benefits of DTI for our primary investigation on whether re-evaluation and modifications of the preplanning surgery were made [7,8,26,27,29,30,32].…”