Impact of fMRI-guided advanced DTI fiber tracking techniques on their clinical applications in patients with brain tumors

Kleiser, Raimund; Staempfli, Philipp; Valavanis, Anton; Boesiger, Peter; Kollias, Spyros

doi:10.1007/s00234-009-0539-2

Cited by 103 publications

(70 citation statements)

References 47 publications

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“…An emerging method of reconstructing white matter fibers is by using functional MR imaging-guided fiber tracking technology. This technology has been performed in healthy participants 46 and in patients with brain tumors 47,48 by using DTI. This methodology has potential to be used in patients with stroke for mapping the cortical representations for upper and lower extremity motor function and guiding the placement of seeds for reconstructing CST fibers associated with upper and lower extremity motor function.…”

Section: Discussionmentioning

confidence: 99%

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Tang

Ko²,

Luo³

et al. 2010

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Tang

Ko²,

Luo³

et al. 2010

AJNR Am J Neuroradiol

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“…Comparison with known fiber pathways has been used to validate computed dMRI track lines at a qualitative level (28), and studies in animals have compared diffusion methods to the results from anatomical tracer experiments, sometimes in the same brains (29)(30)(31). In recent years the clinical value of this method has become apparent, as tractography has become a viable tool both for surgical planning (32) and the monitoring of neuropathology (33).…”

mentioning

confidence: 99%

Superficial white matter fiber systems impede detection of long-range cortical connections in diffusion MR tractography

Reveley

Seth

Pierpaoli

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

397

399

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In vivo tractography based on diffusion magnetic resonance imaging (dMRI) has opened new doors to study structure-function relationships in the human brain. Initially developed to map the trajectory of major white matter tracts, dMRI is used increasingly to infer long-range anatomical connections of the cortex. Because axonal projections originate and terminate in the gray matter but travel mainly through the deep white matter, the success of tractography hinges on the capacity to follow fibers across this transition. Here we demonstrate that the complex arrangement of white matter fibers residing just under the cortical sheet poses severe challenges for long-range tractography over roughly half of the brain. We investigate this issue by comparing dMRI from very-high-resolution ex vivo macaque brain specimens with histological analysis of the same tissue. Using probabilistic tracking from pure gray and white matter seeds, we found that ∼50% of the cortical surface was effectively inaccessible for long-range diffusion tracking because of dense white matter zones just beneath the infragranular layers of the cortex. Analysis of the corresponding myelin-stained sections revealed that these zones colocalized with dense and uniform sheets of axons running mostly parallel to the cortical surface, most often in sulcal regions but also in many gyral crowns. Tracer injection into the sulcal cortex demonstrated that at least some axonal fibers pass directly through these fiber systems. Current and future high-resolution dMRI studies of the human brain will need to develop methods to overcome the challenges posed by superficial white matter systems to determine long-range anatomical connections accurately. diffusion MRI | tractography | neuroanatomy | white matter | connectome T he primate cerebral cortex consists of dozens of areas distinguished by their cytoarchitectonic profiles (1), sensory maps (2), functional specialization (3), and spontaneous activity covariation (4). Attention within neuroscience has increasingly focused on understanding how connectivity among these regions underpins brain function in health and in disease (5). The macaque monkey (Macaca mulatta) has been a fruitful neuroscientific model because the functional organization of its brain is similar in many ways to that of the human (6-8). Tracer injections in the macaque have revealed that virtually all cortical areas give rise to long-range connections, many of which project to other cortical areas, potentially to form processing hierarchies (9). This understanding continues to shape views of functional organization in the human brain. However, studying long-range connections through tracer injections is time consuming, inefficient, and prone to sampling biases, because a given experiment can measure connectivity to only one or a small number of cortical sites. Moreover, although in many respects the macaque brain is a good approximation of the human brain, both species have undergone profound evolutionary changes since the time of their most recent...

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“…To improve the accuracy and reliability of DTI mapping, recent studies have examined the use of functional MRI or MEG to help localize eloquent cortical functions and use these as seed points to reconstruct white matter tractography. Although such approaches have been used to map CST alterations in adults and children with brain tumors, 6,10 they have yet to be applied to children with AVMs.…”

mentioning

confidence: 99%

Corticospinal tract mapping in children with ruptured arteriovenous malformations using functionally guided diffusion-tensor imaging

Ellis¹,

Rutka²,

Kulkarni³

et al. 2012

PED

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Arteriovenous malformations (AVMs) can lead to distortion or reorganization of functional brain anatomy, making localization of eloquent white matter tracts challenging. To improve the accuracy of corticospinal tract (CST) mapping, recent studies have examined the use of functional imaging techniques to help localize cortical motor activations and use these as seed points to reconstruct CSTs using diffusion-tensor imaging (DTI). The authors examined the role of pretreatment functionally guided DTI CST mapping in 3 children with ruptured AVMs. In 2 patients, magnetoencephalography motor activations were adjacent to the nidus and/or hemorrhagic cavity. However, in 1 child, functional MRI motor activations were detected in both hemispheres, suggestive of partial transfer of cortical motor function. In all children, quantitative analysis showed that fractional anisotropy values and fiber density indices were reduced in the CSTs of the hemisphere harboring the AVM compared with the unaffected side. In 2 children, CST caliber was slightly diminished, corresponding to no motor deficit in 1 patient and a temporary motor deficit in the other. In contrast, 1 child demonstrated marked reduction and displacement of the CSTs, correlating with severe motor deficit. Preoperative motor tractography data were loaded onto the intraoperative neuronavigation platform to guide complete resection of the AVM in 2 cases without permanent neurological deficits. These preliminary results confirm the feasibility of CST mapping in children with ruptured AVMs using functionally guided DTI tractography. Prospective studies are needed to assess the full value of this technique in the risk stratification, prognosis, and multimodality management of pediatric AVMs.

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Impact of fMRI-guided advanced DTI fiber tracking techniques on their clinical applications in patients with brain tumors

Abstract: fMRI-guided advanced DTI fiber tracking has the potential to provide accurate anatomical and functional information for a more informed therapeutic decision making.

Cited by 103 publications

References 47 publications

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Tract-Specific and Region of Interest Analysis of Corticospinal Tract Integrity in Subcortical Ischemic Stroke: Reliability and Correlation with Motor Function of Affected Lower Extremity

Superficial white matter fiber systems impede detection of long-range cortical connections in diffusion MR tractography

Corticospinal tract mapping in children with ruptured arteriovenous malformations using functionally guided diffusion-tensor imaging

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