Save
Neuroimaging of White Matter Recovery: A New Outcome Measure in Tumor Surgery
Author(s): ,
S. Koga
Affiliations:
Ochsner Neuroscience Institute, University of Queensland, Department of Neurosurgery, New Orleans, United States
S. Fillip
Affiliations:
Ochsner Neuroscience Institute, University of Queensland, New Orleans, United States
EANS Academy. Koga S. Oct 21, 2018; 225986; EP3026
Assoc. Prof. Sebastian Koga
Assoc. Prof. Sebastian Koga
Login now to access Regular content available to all registered users.

Access to Privileged content is currently a membership benefit.

Click here to join EANS or renew your membership.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Background:
Advances in diffusion tensor imaging and neuronavigation have brought white matter tractography to the forefront of brain tumor surgery. The technology is used for planning transsulcal parafascicular approaches to subcortical lesions. Our study is the first to define and quantify the distortion of white matter tracts pre-operatively and the recovery of white matter tracts post-operatively. This provides a proxy outcome measure based on neuroimaging, and opens new avenues for studying the progression of subcortical lesions.

Methods:
A prospective study of 50 patients undergoing resection of subcortical lesions was undertaken using transsulcal parafascicular approaches. Three dimensional fiber tract maps were created from DTI MRI images and were analyzed in a dynamic fashion using automated computational models and dynamic manipulation of the fiber tracts. The concept of 'tract recovery” was developed by quantifying deviation, deformation, infiltration, interruption and degeneration before and after surgery. Complex computational models were reduce to create a simple 'coefficient of coherence (ξ)' measuring tract variation from the normal hemisphere, and from normal anatomy based on brain atlas models.

Results:
Our quantification model using high-fidelity tractography allows surgeons to demonstrate white matter recovery and to plan optimal corridors for tract preservation. Recovery of white matter tracts was noted in all cases, even in congenital lesions, yielding unexpected insights into neural plasticity. The workload of 3D computational analysis was reduced to a clinically useful 'coefficient of coherence (ξ)' which indicates return to normal anatomy. Tractography outcomes were accurately correlated to clinical outcomes.

Conclusion:
The advent of tridimensional DTI maps and automated tractography can enhanced not only surgical planning, but also the measurement of surgical outcomes using existing neuroimaging tools. Meaningful simplification of algorithms can give surgeons useful and user-friendly tools such as the coefficient of coherence (ξ).
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings