Free-water correction DTI-based tractography in brain tumor surgery: assessment with functional and electrophysiological mapping of the white matter

Peritumoral edema prevents fiber tracking from diffusion tensor imaging (DTI). A free-water correction may overcome this drawback, as illustrated in the case of a patient undergoing awake surgery for brain metastasis. The anatomical plausibility and accuracy of tractography with and without free-wat...

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Bibliographic Details
Published in:Acta neurochirurgica 2023-06, Vol.165 (6), p.1675-1681
Main Authors: Almairac, Fabien, Parker, Drew, Mondot, Lydiane, Isan, Petru, Onno, Marie, Papadopoulo, Théodore, Filipiak, Patryk, Fontaine, Denys, Verma, Ragini
Format: Article
Language:English
Subjects:
Brain - pathology
Brain cancer
Brain Mapping - methods
Brain Neoplasms - diagnostic imaging
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Brain tumors
Case Report
Computer Science
Diffusion Tensor Imaging - methods
Edema
Electrodes
Human health and pathology
Humans
Interventional Radiology
Life Sciences
Magnetic resonance imaging
Medical Imaging
Medicine
Medicine & Public Health
Metastases
Metastasis
Minimally Invasive Surgery
Neuroimaging
Neurology
Neuroradiology
Neurosurgery
Substantia alba
Surgery
Surgical Orthopedics
Tumors
Wakefulness
Water
White Matter - diagnostic imaging
White Matter - pathology
White Matter - surgery
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Summary:Peritumoral edema prevents fiber tracking from diffusion tensor imaging (DTI). A free-water correction may overcome this drawback, as illustrated in the case of a patient undergoing awake surgery for brain metastasis. The anatomical plausibility and accuracy of tractography with and without free-water correction were assessed with functional mapping and axono-cortical evoked-potentials (ACEPs) as reference methods. The results suggest a potential synergy between corrected DTI-based tractography and ACEPs to reliably identify and preserve white matter tracts during brain tumor surgery.
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-023-05608-4