Cargando…

Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients

Background: Tractography has become a standard technique for planning neurosurgical operations in the past decades. This technique relies on diffusion magnetic resonance imaging. The cutoff value for the fractional anisotropy (FA) has an important role in avoiding false-positive and false-negative r...

Descripción completa

Detalles Bibliográficos
Autores principales: Wende, Tim, Kasper, Johannes, Wilhelmy, Florian, Dietel, Eric, Hamerla, Gordian, Scherlach, Cordula, Meixensberger, Jürgen, Fehrenbach, Michael Karl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155834/
https://www.ncbi.nlm.nih.gov/pubmed/34065682
http://dx.doi.org/10.3390/brainsci11050650
_version_ 1783699295723061248
author Wende, Tim
Kasper, Johannes
Wilhelmy, Florian
Dietel, Eric
Hamerla, Gordian
Scherlach, Cordula
Meixensberger, Jürgen
Fehrenbach, Michael Karl
author_facet Wende, Tim
Kasper, Johannes
Wilhelmy, Florian
Dietel, Eric
Hamerla, Gordian
Scherlach, Cordula
Meixensberger, Jürgen
Fehrenbach, Michael Karl
author_sort Wende, Tim
collection PubMed
description Background: Tractography has become a standard technique for planning neurosurgical operations in the past decades. This technique relies on diffusion magnetic resonance imaging. The cutoff value for the fractional anisotropy (FA) has an important role in avoiding false-positive and false-negative results. However, there is a wide variation in FA cutoff values. Methods: We analyzed a prospective cohort of 14 patients (six males and eight females, 50.1 ± 4.0 years old) with intracerebral tumors that were mostly gliomas. Magnetic resonance imaging (MRI) was obtained within 7 days before and within 7 days after surgery with T1 and diffusion tensor image (DTI) sequences. We, then, reconstructed the corticospinal tract (CST) in all patients and extracted the FA values within the resulting volume. Results: The mean FA in all CSTs was 0.4406 ± 0.0003 with the fifth percentile at 0.1454. FA values in right-hemispheric CSTs were lower (p < 0.0001). Postoperatively, the FA values were more condensed around their mean (p < 0.0001). The analysis of infiltrated or compressed CSTs revealed a lower fifth percentile (0.1407 ± 0.0109 versus 0.1763 ± 0.0040, p = 0.0036). Conclusion: An FA cutoff value of 0.15 appears to be reasonable for neurosurgical patients and may shorten the tractography workflow. However, infiltrated fiber bundles must trigger vigilance and may require lower cutoffs.
format Online
Article
Text
id pubmed-8155834
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-81558342021-05-28 Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients Wende, Tim Kasper, Johannes Wilhelmy, Florian Dietel, Eric Hamerla, Gordian Scherlach, Cordula Meixensberger, Jürgen Fehrenbach, Michael Karl Brain Sci Article Background: Tractography has become a standard technique for planning neurosurgical operations in the past decades. This technique relies on diffusion magnetic resonance imaging. The cutoff value for the fractional anisotropy (FA) has an important role in avoiding false-positive and false-negative results. However, there is a wide variation in FA cutoff values. Methods: We analyzed a prospective cohort of 14 patients (six males and eight females, 50.1 ± 4.0 years old) with intracerebral tumors that were mostly gliomas. Magnetic resonance imaging (MRI) was obtained within 7 days before and within 7 days after surgery with T1 and diffusion tensor image (DTI) sequences. We, then, reconstructed the corticospinal tract (CST) in all patients and extracted the FA values within the resulting volume. Results: The mean FA in all CSTs was 0.4406 ± 0.0003 with the fifth percentile at 0.1454. FA values in right-hemispheric CSTs were lower (p < 0.0001). Postoperatively, the FA values were more condensed around their mean (p < 0.0001). The analysis of infiltrated or compressed CSTs revealed a lower fifth percentile (0.1407 ± 0.0109 versus 0.1763 ± 0.0040, p = 0.0036). Conclusion: An FA cutoff value of 0.15 appears to be reasonable for neurosurgical patients and may shorten the tractography workflow. However, infiltrated fiber bundles must trigger vigilance and may require lower cutoffs. MDPI 2021-05-16 /pmc/articles/PMC8155834/ /pubmed/34065682 http://dx.doi.org/10.3390/brainsci11050650 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wende, Tim
Kasper, Johannes
Wilhelmy, Florian
Dietel, Eric
Hamerla, Gordian
Scherlach, Cordula
Meixensberger, Jürgen
Fehrenbach, Michael Karl
Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients
title Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients
title_full Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients
title_fullStr Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients
title_full_unstemmed Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients
title_short Assessment of a Reliable Fractional Anisotropy Cutoff in Tractography of the Corticospinal Tract for Neurosurgical Patients
title_sort assessment of a reliable fractional anisotropy cutoff in tractography of the corticospinal tract for neurosurgical patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155834/
https://www.ncbi.nlm.nih.gov/pubmed/34065682
http://dx.doi.org/10.3390/brainsci11050650
work_keys_str_mv AT wendetim assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT kasperjohannes assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT wilhelmyflorian assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT dieteleric assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT hamerlagordian assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT scherlachcordula assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT meixensbergerjurgen assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients
AT fehrenbachmichaelkarl assessmentofareliablefractionalanisotropycutoffintractographyofthecorticospinaltractforneurosurgicalpatients