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Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics
Tumors infiltrating the motor system lead to significant disability, often caused by corticospinal tract injury. The delineation of the healthy-pathological white matter (WM) interface area, for which diffusion magnetic resonance imaging (dMRI) has shown promising potential, may improve treatment ou...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873606/ https://www.ncbi.nlm.nih.gov/pubmed/33585250 http://dx.doi.org/10.3389/fonc.2020.622358 |
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author | Fekonja, Lucius S. Wang, Ziqian Aydogan, Dogu B. Roine, Timo Engelhardt, Melina Dreyer, Felix R. Vajkoczy, Peter Picht, Thomas |
author_facet | Fekonja, Lucius S. Wang, Ziqian Aydogan, Dogu B. Roine, Timo Engelhardt, Melina Dreyer, Felix R. Vajkoczy, Peter Picht, Thomas |
author_sort | Fekonja, Lucius S. |
collection | PubMed |
description | Tumors infiltrating the motor system lead to significant disability, often caused by corticospinal tract injury. The delineation of the healthy-pathological white matter (WM) interface area, for which diffusion magnetic resonance imaging (dMRI) has shown promising potential, may improve treatment outcome. However, up to 90% of white matter (WM) voxels include multiple fiber populations, which cannot be correctly described with traditional metrics such as fractional anisotropy (FA) or apparent diffusion coefficient (ADC). Here, we used a novel fixel-based along-tract analysis consisting of constrained spherical deconvolution (CSD)-based probabilistic tractography and fixel-based apparent fiber density (FD), capable of identifying fiber orientation specific microstructural metrics. We addressed this novel methodology’s capability to detect corticospinal tract impairment. We measured and compared tractogram-related FD and traditional microstructural metrics bihemispherically in 65 patients with WHO grade III and IV gliomas infiltrating the motor system. The cortical tractogram seeds were based on motor maps derived by transcranial magnetic stimulation. We extracted 100 equally distributed cross-sections along each streamline of corticospinal tract (CST) for along-tract statistical analysis. Cross-sections were then analyzed to detect differences between healthy and pathological hemispheres. All metrics showed significant differences between healthy and pathologic hemispheres over the entire tract and between peritumoral segments. Peritumoral values were lower for FA and FD, but higher for ADC within the entire cohort. FD was more specific to tumor-induced changes in CST than ADC or FA, whereas ADC and FA showed higher sensitivity. The bihemispheric along-tract analysis provides an approach to detect subject-specific structural changes in healthy and pathological WM. In the current clinical dataset, the more complex FD metrics did not outperform FA and ADC in terms of describing corticospinal tract impairment. |
format | Online Article Text |
id | pubmed-7873606 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78736062021-02-11 Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics Fekonja, Lucius S. Wang, Ziqian Aydogan, Dogu B. Roine, Timo Engelhardt, Melina Dreyer, Felix R. Vajkoczy, Peter Picht, Thomas Front Oncol Oncology Tumors infiltrating the motor system lead to significant disability, often caused by corticospinal tract injury. The delineation of the healthy-pathological white matter (WM) interface area, for which diffusion magnetic resonance imaging (dMRI) has shown promising potential, may improve treatment outcome. However, up to 90% of white matter (WM) voxels include multiple fiber populations, which cannot be correctly described with traditional metrics such as fractional anisotropy (FA) or apparent diffusion coefficient (ADC). Here, we used a novel fixel-based along-tract analysis consisting of constrained spherical deconvolution (CSD)-based probabilistic tractography and fixel-based apparent fiber density (FD), capable of identifying fiber orientation specific microstructural metrics. We addressed this novel methodology’s capability to detect corticospinal tract impairment. We measured and compared tractogram-related FD and traditional microstructural metrics bihemispherically in 65 patients with WHO grade III and IV gliomas infiltrating the motor system. The cortical tractogram seeds were based on motor maps derived by transcranial magnetic stimulation. We extracted 100 equally distributed cross-sections along each streamline of corticospinal tract (CST) for along-tract statistical analysis. Cross-sections were then analyzed to detect differences between healthy and pathological hemispheres. All metrics showed significant differences between healthy and pathologic hemispheres over the entire tract and between peritumoral segments. Peritumoral values were lower for FA and FD, but higher for ADC within the entire cohort. FD was more specific to tumor-induced changes in CST than ADC or FA, whereas ADC and FA showed higher sensitivity. The bihemispheric along-tract analysis provides an approach to detect subject-specific structural changes in healthy and pathological WM. In the current clinical dataset, the more complex FD metrics did not outperform FA and ADC in terms of describing corticospinal tract impairment. Frontiers Media S.A. 2021-01-27 /pmc/articles/PMC7873606/ /pubmed/33585250 http://dx.doi.org/10.3389/fonc.2020.622358 Text en Copyright © 2021 Fekonja, Wang, Aydogan, Roine, Engelhardt, Dreyer, Vajkoczy and Picht http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Fekonja, Lucius S. Wang, Ziqian Aydogan, Dogu B. Roine, Timo Engelhardt, Melina Dreyer, Felix R. Vajkoczy, Peter Picht, Thomas Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
title | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
title_full | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
title_fullStr | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
title_full_unstemmed | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
title_short | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
title_sort | detecting corticospinal tract impairment in tumor patients with fiber density and tensor-based metrics |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873606/ https://www.ncbi.nlm.nih.gov/pubmed/33585250 http://dx.doi.org/10.3389/fonc.2020.622358 |
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