The Use of Diffusion Tensor Imaging in Neuronavigation during Brain Tumor Surgery: Case Reports

Czech version

Authors: A. Zolal ¹; M. Sameš ¹; P. Vachata ¹; R. Bartoš ¹; M. Nováková ²; M. Derner ²
Authors‘ workplace: Neurochirurgické oddělení Masarykovy nemocnice, Ústí nad Labem ¹; Radiodiagnostické oddělení Masarykovy nemocnice, Ústí nad Labem ²
Published in: Cesk Slov Neurol N 2008; 71/104(3): 352-357
Category: Case Report

Overview

Aim:
The aim of this work is to describe a procedure for visualization of the white matter fiber tracts with the use of DTI (Diffusion Tensor Imaging), the use of the reconstructed image data in neuronavigation, and to document the clinical relevance of the method.

Materials and methods:
This paper contains descriptions of two cases of patients with supratentorial tumorous lesion, where tractography results were used intraoperatively. A procedure that was previously described in literature, using the applications Volume One and dTV, was used for the fiber-tracking and for the import into the neuronavigation system. Resulting fiber tracts were voxelized and fused with the non-diffusion weighted dataset (b = 0 s/mm²), the fused images were imported into the neuronavigation and registered with the anatomical datasets.

Results:
In both cases, clinically relevant neural tracts were successfully reconstructed with the use of the described method, and the reconstructed images were imported into the neuronavigation system. The optimal trajectory and extent of the resection could be planned with the use of the neuronavigation, respecting the course of the displayed fiber tracts in the vicinity of the resected lesion.

Conclusion:
The results of DTI tractography can be reliably integrated into the neuronavigation system using the described method. The use of tractography is beneficial for the optimal planning of the surgical trajectory and the extent of the resection.

Key words:
DTI – tractography – neuronavigation– neural tracts – brain tumours

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