Integration of diffusion tensor-based arcuate fasciculus fibre navigation and intraoperative MRI into glioma surgery

2012 ◽  
Vol 19 (2) ◽  
pp. 255-261 ◽  
Author(s):  
Yan Zhao ◽  
Xiaolei Chen ◽  
Fei Wang ◽  
Guochen Sun ◽  
Yubo Wang ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Intraoperative Mri ◽  
Arcuate Fasciculus ◽  
Glioma Surgery

scholarly journals Structural and Functional Imaging in Glioma Management

Neurosurgery ◽  
2020 ◽  
Author(s):  
Bledi C Brahimaj ◽  
Ryan B Kochanski ◽  
John J Pearce ◽  
Melike Guryildirim ◽  
Carter S Gerard ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Imaging Modalities ◽  
Hemispheric Dominance ◽  
Tumor Control ◽  
Histopathological Diagnosis ◽  
Glioma Surgery ◽  
Multiple Modalities ◽  
Advantages And Disadvantages ◽  
Multiple Imaging

Abstract The goal of glioma surgery is maximal safe resection in order to provide optimal tumor control and survival benefit to the patient. There are multiple imaging modalities beyond traditional contrast-enhanced magnetic resonance imaging (MRI) that have been incorporated into the preoperative workup of patients presenting with gliomas. The aim of these imaging modalities is to identify cortical and subcortical areas of eloquence, and their relationship to the lesion. In this article, multiple modalities are described with an emphasis on the underlying technology, clinical utilization, advantages, and disadvantages of each. functional MRI and its role in identifying hemispheric dominance and areas of language and motor are discussed. The nuances of magnetoencephalography and transcranial magnetic stimulation in localization of eloquent cortex are examined, as well as the role of diffusion tensor imaging in defining normal white matter tracts in glioma surgery. Lastly, we highlight the role of stimulated Raman spectroscopy in intraoperative histopathological diagnosis of tissue to guide tumor resection. Tumors may shift the normal arrangement of functional anatomy in the brain; thus, utilization of multiple modalities may be helpful in operative planning and patient counseling for successful surgery.

scholarly journals MS-2 Minimally invasive glioma surgery with navigation system and tubular retractor

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii2-ii3
Author(s):  
Kazuhiko Kurozumi
Keyword(s):  
Navigation System ◽  
Diffusion Tensor ◽  
Therapeutic Option ◽  
Normal Brain ◽  
Navigation Systems ◽  
Glioma Surgery ◽  
Tubular Retractor ◽  
Neuronavigation System ◽  
Magnetic Resonance Imaging Mri ◽  
Neurological Surgery

Abstract Navigation systems are reliable and safe for neurological surgery. Navigation is an attractive and innovative therapeutic option. Recently, endo and exoscopic surgeries have been gradually increasing in neurosurgery. We are currently trialing to use 4K and 8K systems to improve the accuracy and safety of our surgical procedures. Surgeries for deep-seated tumors are challenging because of the difficulty in creating a corridor and observing the interface between lesions and the normal area. In total, 315 patients underwent surgery at Okayama University between 2017 and 2019. Among them, we experienced 92 glioma surgeries using navigation systems. Preoperatively, we performed computed tomography imaging and contrast-enhanced magnetic resonance imaging (MRI) for the neuronavigation system. We experienced Curve(TM) Image Guided Surgery (BrainLab, Munich, Germany). The surgical trajectory was planned with functional MRI and diffusion tensor imaging to protect the eloquent area and critical vasculature of the brain. We used a clear plastic tubular retractor system, the ViewSite Brain Access System, for surgery of deep seated gliomas. We gently inserted and placed the ViewSite using the neuronavigation. The tumor was observed and resected through the ViewSite tubular retractor under a microscope and endoscope. If the tumor was large, we switched the ViewSite tubular retractor to brain spatulas to identify the boundary between the normal brain and lesion. We are currently using the combination of the tubular retractor and brain spatulas using navigation system. Here, we present and analyze our preoperative simulation, surgical procedure, and outcomes.

scholarly journals No Evidence for Systematic White Matter Correlates of Dyslexia and Dyscalculia

2018 ◽  
Author(s):  
David Moreau ◽  
Anna J. Wilson ◽  
Nicole S. McKay ◽  
Kasey Nihill ◽  
Karen E. Waldie
Keyword(s):  
Learning Disabilities ◽  
White Matter ◽  
Diffusion Tensor ◽  
Null Model ◽  
White Matter Integrity ◽  
Current View ◽  
Arcuate Fasciculus ◽  
Bayesian Hypothesis Testing ◽  
Structural Differences ◽  
And Mathematics

AbstractLearning disabilities such as dyslexia, dyscalculia and their comorbid manifestation are prevalent, affecting as much as fifteen percent of the population. Structural neuroimaging studies have indicated that these disorders can be related to differences in white matter integrity, although findings remain disparate. In this study, we used a unique design composed of individuals with dyslexia, dyscalculia, both disorders and controls, to systematically explore differences in fractional anisotropy across groups using diffusion tensor imaging. Specifically, we focused on the corona radiata and the arcuate fasciculus, two tracts associated with reading and mathematics in a number of previous studies. Using Bayesian hypothesis testing, we show that the present data favor the null model of no differences between groups for these particular tracts—a finding that seems to go against the current view but might be representative of the disparities within this field of research. Together, these findings suggest that structural differences associated with dyslexia and dyscalculia might not be as reliable as previously thought, with potential ramifications in terms of remediation.

scholarly journals Structural disconnectivity in schizophrenia: a diffusion tensor magnetic resonance imaging study

2003 ◽  
Vol 182 (5) ◽  
pp. 439-443 ◽  
Author(s):  
J. Burns ◽  
D. Job ◽  
M. E. Bastin ◽  
H. Whalley ◽  
T. Macgillivray ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Fractional Anisotropy ◽  
Structural Integrity ◽  
Diffusion Tensor ◽  
Uncinate Fasciculus ◽  
Arcuate Fasciculus ◽  
Resonance Imaging ◽  
White Matter Tracts

BackgroundThere is growing evidence that schizophrenia is a disorder of cortical connectivity Specifically, frontotemporal and frontoparietal connections are thought to be functionally impaired. Diffusion tensor magnetic resonance imaging (DT–MRI) is a technique that has the potential to demonstrate structural disconnectivity in schizophrenia.AimsTo investigate the structural integrity of frontotemporal and frontoparietal white matter tracts in schizophrenia.MethodThirty patients with DSM–IV schizophrenia and thirty matched control subjects underwent DT–MRI and structural MRI. Fractional anisotropy – an index of the integrity of white matter tracts – was determined in the uncinate fasciculus, the anterior cingulum and the arcuate fasciculus and analysed using voxel-based morphometry.ResultsThere was reduced fractional anisotropy in the left uncinate fasciculus and left arcuate fasciculus in patients with schizophrenia compared with controls.ConclusionsThe findings of reduced white matter tract integrity in the left uncinate fasciculus and left arcuate fasciculus suggest that there is frontotemporal and frontoparietal structural disconnectivity in schizophrenia.

scholarly journals Diffusion tensor spectroscopy and imaging of the arcuate fasciculus

NeuroImage ◽  
2008 ◽  
Vol 39 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Jaymin Upadhyay ◽  
Kevin Hallock ◽  
Mathieu Ducros ◽  
Dae-Shik Kim ◽  
Itamar Ronen
Keyword(s):  
Diffusion Tensor ◽  
Arcuate Fasciculus

scholarly journals Stereotactic diffusion tensor imaging tractography for Gamma Knife radiosurgery

2016 ◽  
Vol 125 (Supplement_1) ◽  
pp. 139-146 ◽  
Author(s):  
Cormac G. Gavin ◽  
H. Ian Sabin
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Stereotactic Radiosurgery ◽  
Treatment Planning ◽  
Vestibular Schwannoma ◽  
Diffusion Tensor ◽  
Gamma Knife Radiosurgery ◽  
Optic Radiation ◽  
Arcuate Fasciculus ◽  
Stereotactic Frame

OBJECTIVEThe integration of modern neuroimaging into treatment planning has increased the therapeutic potential and safety of stereotactic radiosurgery. The authors report their method of integrating stereotactic diffusion tensor imaging (DTI) tractography into conventional treatment planning for Gamma Knife radiosurgery (GKRS). The aim of this study was to demonstrate the feasibility of this technique and to address some of the technical limitations of previously reported techniques.METHODSTwenty patients who underwent GKRS composed the study cohort. They consisted of 1 initial test case (a patient with a vestibular schwannoma), 5 patients with arteriovenous malformations, 9 patients with cerebral metastases, 1 patient with parasagittal meningioma, and 4 patients with vestibular schwannoma. DT images were obtained at the time of standard GKRS protocol MRI (T1 and T2 weighted) for treatment, with the patient's head secured by a Leksell stereotactic frame. All studies were performed using a 1.5-T magnet with a single-channel head coil. DTI was performed with diffusion gradients in 32 directions and coregistered with the volumetric T1-weighted study. DTI postprocessing by means of commercially available software allowed tensor computation and the creation of directionally encoded color–, apparent diffusion coefficient–, and fractional anisotropy–mapped sequences. In addition, the software allowed visualized critical tracts to be exported as a structural volume and integrated into GammaPlan as an “organ at risk” during shot planning. Combined images were transferred to GammaPlan and integrated into treatment planning.RESULTSStereotactic DT images were successfully acquired in all patients, with generation of correct directionally encoded color images. Tract generation with the software was straightforward and reproducible, particularly for axial tracts such as the optic radiation and the arcuate fasciculus. Corticospinal tract visualization was hampered by some artifacts from the base of the stereotactic frame, but this was overcome by a combination of frame/MRI volume adjustment and DTI seeding parameters. Coregistration of the DTI series with the T1-weighted treatment volume at the time of imaging was essential for the generation of correct tensor data. All patients with the exception of the vestibular schwannoma cases had treatment pathology in the vicinity of eloquent tracts and/or the cortex. No new neurological deficits due to radiation were recorded at the short-term follow-up.CONCLUSIONSRecent reports in the medical literature have suggested that white matter tracts (particularly the optic radiation and arcuate fasciculus) are more vulnerable to radiation during stereotactic radiosurgery than previously thought. Integration of stereotactic tractography into GKRS represents a promising tool for preventing GKRS complications by reduction in radiation doses to functional organs at risk, including critical cortical areas and subcortical white matter tracts.

scholarly journals Contemporary intraoperative visualization for GBM with use of exoscope, 5-ALA fluorescence-guided surgery and tractography

2022 ◽  
Vol 6 (1) ◽  
pp. V5
Keyword(s):  
Diffusion Tensor ◽  
High Grade Glioma ◽  
Brain Regions ◽  
High Grade ◽  
Glioma Surgery ◽  
Guided Surgery ◽  
Word Finding ◽  
Patient Consent ◽  
Dti Fiber Tracking ◽  
Intraoperative Visualization

Maximal safe resection is the primary goal of glioma surgery. By incorporating improved intraoperative visualization with the 3D exoscope combined with 5-ALA fluorescence, in addition to neuronavigation and diffusion tensor imaging (DTI) fiber tracking, the safety of resection of tumors in eloquent brain regions can be maximized. This video highlights some of the various intraoperative adjuncts used in brain tumor surgery for high-grade glioma. In this case, the authors highlight the resection of a left posterior temporal lobe high-grade glioma in a 33-year-old patient, who initially presented with seizures, word-finding difficulty, and right-sided weakness. They demonstrate the multiple surgical adjuncts used both before and during surgical resection, and how multiple adjuncts can be effectively orchestrated to make surgery in eloquent brain areas safer for patients. Patient consent was obtained for publication. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21174

Sign in / Sign up

Export Citation Format

Share Document