Technical and functional validations of High Angular Resolution Diffusion Imaging (HARDI)-MR tractography in paediatric epilepsy patients

Abstract

Event Abstract Back to Event Technical and functional validations of High Angular Resolution Diffusion Imaging (HARDI)-MR tractography in paediatric epilepsy patients Sarah M. Barton1*, Joseph Y. Yang2, Wirginia Maixner2, A. Simon Harvey3, 4, Jeremy Freeman3, Richard Beare1, Marc Seal1, 4 and Vicki Anderson4, 5, 6 1 Murdoch Childrens Research Institute, Developmental Imaging, Australia 2 The Royal Children’s Hospital, Department of Neurosurgery, Australia 3 The Royal Children’s Hospital, Department of Neurology, Australia 4 The University of Melbourne, Department of Paediatrics, Australia 5 Murdoch Childrens Research Institute, Child Neuropsychology, Australia 6 The University of Melbourne, School of Psychological Sciences, Australia Background: HARDI-MR tractography is a neuroimaging technique that allows modelling of white matter tracts in the brain. The ability to visualise white matter tracts pre-operatively has the potential to improve neurosurgery accuracy and outcome. However despite its growing popularity, questions remain regarding its technical reproducibility and validity in routine clinical use. Here we examine the reliability of a locally practised HARDI-MR tractography method in paediatric epilepsy patients and in a novel demonstration present the functional validation of the technique against multimodal clinical investigations. Methods: Eight patients were identified retrospectively from our Children’s Epilepsy Program database. All cases had pre-operative diffusion MRI sequences and motor and/or language functional MRI (fMRI). In select cases, intra- or extra-operative motor and/or language cortical mapping results were available. Corticospinal (CST) and superior longitudinal fasciculus (SLF) tracts were generated by two different operators. Coefficients of variation (CV), intra-class correlation coefficients (ICC) and dice similarity coefficients (DSC) were calculated to assess reproducibility of tract metrics and degree of tract overlap between the operators. Tractography results were compared to fMRI activation, cortical mapping results and the patient’s clinical assessment findings. Results: All white matter tracts generated were visually comparable between operators. The tract measures showed low CV values, high ICC values and high DSC scores, indicating there was a high degree of reproducibility and overlap within and between the two operators. Cortical origin and terminations of all CST and SLF tracts matched with the patient’s areas of motor or language fMRI activation. In all but one case, tractography results matched cortical stimulation findings. Tracts were also compatible with the clinical assessment findings. Discussion: In a group of paediatric epilepsy patients, tractography results could be reliably generated and reproduced. In a novel demonstration, there was correspondence between the anatomical course of the tracts with areas of fMRI activation and, in all but one case, cortical stimulation findings. This suggests that in experienced hands, HARDI-MR tractography can be a reliable and valid technique in clinical settings. HARDI-MR tractography has the potential to make valuable contributions to neurosurgery planning to improve outcome for patients. Keywords: tractography, corticospinal tract, Superior longitudinal fasciculus, Paediatric, Epilepsy, Neurosurgery, diffusion imaging Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Poster Topic: Other Citation: Barton SM, Yang JY, Maixner W, Harvey A, Freeman J, Beare R, Seal M and Anderson V (2013). Technical and functional validations of High Angular Resolution Diffusion Imaging (HARDI)-MR tractography in paediatric epilepsy patients. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00059 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 15 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Dr. Sarah M Barton, Murdoch Childrens Research Institute, Developmental Imaging, Parkville, Victoria, Australia, sarah.barton@mcri.edu.au Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Sarah M Barton Joseph Y Yang Wirginia Maixner A. Simon Harvey Jeremy Freeman Richard Beare Marc Seal Vicki Anderson Google Sarah M Barton Joseph Y Yang Wirginia Maixner A. Simon Harvey Jeremy Freeman Richard Beare Marc Seal Vicki Anderson Google Scholar Sarah M Barton Joseph Y Yang Wirginia Maixner A. Simon Harvey Jeremy Freeman Richard Beare Marc Seal Vicki Anderson PubMed Sarah M Barton Joseph Y Yang Wirginia Maixner A. 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