Diffusion Tensor Imaging and Neurite Orientation Dispersion and Density Imaging Assessment of Optic Pathway Function in Patients With Anterior Visual Pathway Compression.

Abstract

In patients with sellar or parasellar tumors, it is crucial to evaluate visual field impairment in the preoperative stage and to predict visual field improvement after the surgery. The purpose of this study was to investigate the associations of diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) parameters in the optic radiations with preoperative and postoperative visual field impairment. This prospective study included 81 participants with sellar or parasellar tumors. Multishell diffusion imaging and a visual field impairment score (VFIS) were acquired before and after the surgery. The multishell diffusion-weighted imaging was acquired to measure the neurite density and neurite orientation dispersion, as well as the diffusivity. DTI parameters were fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity (RD). NODDI provided intracellular volume fraction (Vic), the orientation dispersion index, and isotropic volume fraction (Viso). The associations of DTI and NODDI parameters in the optic radiations with VFIS were investigated, adjusting for age, tumor height, and symptom duration. Among 162 optic radiations, 117 were functionally impaired in the preoperative stage. FA and Vic had significant negative correlations, whereas MD and RD had significant positive correlations with the VFIS (all P < 0.001). In the preoperative stage, lower FA (P = 0.001; odds ratio = 0.750) and Vic (P = 0.003; OR = 0.827) and higher MD (P = 0.007; OR = 1.244) and RD (P < 0.001; OR = 1.361) were significantly associated with the presence of visual field impairment. For the degree of postoperative improvement, preoperative lower Vic (P = 0.034; OR = 0.910) and higher MD (P = 0.037; OR = 1.103) and RD (P = 0.047; OR = 1.090) were significantly associated with more postoperative improvement. DTI and NODDI parameters in the optic radiations were correlated with VFIS and associated with preoperative visual field impairments and postoperative improvement. It may help in predicting visual field improvement after the surgery in patients with sellar or parasellar tumors.