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16.03.2020 | Review

The role of diffusion tractography in refining glial tumor resection

verfasst von: Davy Charles Vanderweyen, Guillaume Theaud, Jasmeen Sidhu, François Rheault, Silvio Sarubbo, Maxime Descoteaux, David Fortin

Erschienen in: Brain Structure and Function | Ausgabe 4/2020

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Abstract

Primary brain tumors are notoriously hard to resect surgically. Due to their infiltrative nature, finding the optimal resection boundary without damaging healthy tissue can be challenging. One potential tool to help make this decision is diffusion-weighted magnetic resonance imaging (dMRI) tractography. dMRI exploits the diffusion of water molecule along axons to generate a 3D modelization of the white matter bundles in the brain. This feature is particularly useful to visualize how a tumor affects its surrounding white matter and plan a surgical path. This paper reviews the different ways in which dMRI can be used to improve brain tumor resection, its benefits and also its limitations. We expose surgical tools that can be paired with dMRI to improve its impact on surgical outcome, such as loading the 3D tractography in the neuronavigation system and direct electrical stimulation to validate the position of the white matter bundles of interest. We also review articles validating dMRI findings using other anatomical investigation techniques, such as postmortem dissections, manganese-enhanced MRI, electrophysiological stimulations, and phantom studies with known ground truth. We will be discussing the areas of the brain where dMRI performs well and where the future challenges are. We will conclude this review with suggestions and take home messages for neurosurgeons, tractographers, and vendors for advancing the field and on how to benefit from tractography’s use in clinical practice.

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Titel: The role of diffusion tractography in refining glial tumor resection
verfasst von: Davy Charles Vanderweyen
Guillaume Theaud
Jasmeen Sidhu
François Rheault
Silvio Sarubbo
Maxime Descoteaux
David Fortin
Publikationsdatum: 16.03.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Brain Structure and Function / Ausgabe 4/2020
Print ISSN: 1863-2653
Elektronische ISSN: 1863-2661
DOI: https://doi.org/10.1007/s00429-020-02056-z

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The role of diffusion tractography in refining glial tumor resection

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