Combined use of diffusion tensor tractography and multifused contrast-enhanced FIESTA for predicting facial and cochlear nerve positions in relation to vestibular schwannoma

Abstract

By using a combination of DTT and multifused CE-FIESTA, the authors were able to increase the number of vestibular schwannoma patients for whom predicted results corresponded with the courses of both the facial and cochlear nerves, a result that has been considered difficult to achieve by use of a single modality only. Although the 3D image including these prediction results helped with comprehension of the 3D operative anatomy, the reliability of prediction remains to be established.

Preoperative diffusion tensor imaging–fiber tracking for facial nerve identification in vestibular schwannoma: a systematic review on its evolution and current status with a pooled data analysis of surgical concordance rates

“…The study by Nakai et al, 14 published in 2013, involved preoperative detection of the FN via high-field MRI in VS patients but did not use DTI and hence was ex-cluded. A 2015 study by Yoshino et al in 11 patients 25 was excluded to avoid duplication of patients; this same group of authors reported on a larger series of 22 patients 24 later that same year, which included those previous 11 patients.…”

“…11 Hodaie et al introduced DTT to cranial nerve tracking. 9 Taoka et al first reported the use of tracking the FN with DTT in patients with VS. 20 Since then, several investigators have described their experience in applying this technique to reconstruct the FN tract in patients with VS. 2,4,6,8,11,13,15,19,20,22,24,[27][28][29] Diffusion tensor tractography reconstruction of FN fibers is considered successful if a continuous tract of fibers is seen to extend from the internal auditory meatus to the brainstem along the tumor capsule. 4…”

“…25 The studies by Wei et al and Yoshino et al demonstrated that superselective FT and setting the fractional anisotropy (FA) threshold at the upper limit may help to detect the FN and vestibulocochlear nerve; however, this capacity may be limited. 22,24,28 In a study of 30 patients, Zhang et al combined superselective tracking and 3D FIESTA with cycled phase sequences (3D FIESTA-C) image integration, which enabled them to identify individual nerve bundles and to distinguish them from artifacts based on anatomical information provided by the 3D FIESTA-C images. 28 Additionally, to increase the tracking success rate, these authors set various FA threshold values for each patient.…”

Simultaneous multislice readout‐segmented echo planar imaging for accelerated diffusion tensor imaging of the mandibular nerve: A feasibility study

“…For example, accelerated rs‐EPI might improve the detection of microstructural abnormalities of the trigeminal nerve in patients with trigeminal neuralgia with and without neurovascular compression . Furthermore, the presented technique might enable the assessment and preoperative visualization of the facial and/or cochlear nerve in patients with malignant pathologies . In general, the obtained gain in SNR over time might be either invested in accelerated scan time or other parameters, such as increased spatial resolution, allowing a flexible adaptation depending on the clinical context.…”

“…45 Furthermore, the presented technique might enable the assessment and preoperative visualization of the facial and/or cochlear nerve in patients with malignant pathologies. 46,47 In general, the obtained gain in SNR over time might be either invested in accelerated scan time or other parameters, such as increased spatial resolution, allowing a flexible adaptation depending on the clinical context. Therefore, accelerated rs-EPI yields a promising clinical potential, which should be examined in future studies investigating pathologies of further cranial nerves.…”