Diffusion Kurtosis Imaging Fiber Tractography of Major White Matter Tracts in Neurosurgery.

Miriam Bopp,Barbara Carl,Julia Emde,Benjamin Saß,Christopher Nimsky

doi:10.3390/brainsci11030381

Abstract

Diffusion tensor imaging (DTI)-based fiber tractography is routinely used in clinical applications to visualize major white matter tracts, such as the corticospinal tract (CST), optic radiation (OR), and arcuate fascicle (AF). Nevertheless, DTI is limited due to its capability of resolving intra-voxel multi-fiber populations. Sophisticated models often require long acquisition times not applicable in clinical practice. Diffusion kurtosis imaging (DKI), as an extension of DTI, combines sophisticated modeling of the diffusion process with short acquisition times but has rarely been investigated in fiber tractography. In this study, DTI- and DKI-based fiber tractography of the CST, OR, and AF was investigated in healthy volunteers and glioma patients. For the CST, significantly larger tract volumes were seen in DKI-based fiber tractography. Similar results were obtained for the OR, except for the right OR in patients. In the case of the AF, results of both models were comparable with DTI-based fiber tractography showing even significantly larger tract volumes in patients. In the case of the CST and OR, DKI-based fiber tractography contributes to advanced visualization under clinical time constraints, whereas for the AF, other models should be considered.

Highlights

IntroductionDiffusion tensor imaging (DTI) and DTI-based fiber tractography have become routine tools for estimating and visualizing the course, location, and extent of major white matter tracts, such as the corticospinal tract (CST), optic radiation (OR), and arcuate fascicle (AF), especially in neurosurgical applications
For healthy volunteers as well as patients, significantly larger tract volumes were seen in Diffusion kurtosis imaging (DKI)-based tractography compared to Diffusion tensor imaging (DTI)-based tractography of the left and right corticospinal tract (CST)
DKI- and DTI-based fiber tractography of three major white matter tracts, the CST, optic radiation (OR), and arcuate fascicle (AF), was investigated in healthy volunteers and glioma patients to evaluate the potential of DKI to overcome limitations of DTI-based fiber tractography, often underestimating the spatial extent of major white matter tracts

Summary

Introduction

Diffusion tensor imaging (DTI) and DTI-based fiber tractography have become routine tools for estimating and visualizing the course, location, and extent of major white matter tracts, such as the corticospinal tract (CST), optic radiation (OR), and arcuate fascicle (AF), especially in neurosurgical applications. The application of DTI and DTIbased fiber tractography has been shown to support the concept of maximized tumor volume resection, whilst preserving neurological functions, thereby contributing to low postoperative morbidity [1,2,3,4]. There are fundamental limitations in accurately outlining major white matter tracts incorporating multi-fiber populations, and underestimating their spatial extent [5,6], thereby affecting the surgical decision on how to safely maximize the extent of resection

Methods

Results

Discussion

Conclusion