title: Diffusion-tensor imaging of white matter tracts in patients with cerebral neoplasm.
abstract: OBJECTIVE
  Preserving vital cerebral function while maximizing tumor resection is a principal goal in surgical neurooncology. Although functional magnetic resonance imaging has been useful in the localization of eloquent cerebral cortex, this method does not provide information about the white matter tracts that may be involved in invasive, intrinsic brain tumors. Recently, diffusion-tensor (DT) imaging techniques have been used to map white matter tracts in the normal brain. The aim of this study was to demonstrate the role of DT imaging in preoperative mapping of white matter tracts in relation to cerebral neoplasms.
  
  
  METHODS
  Nine patients with brain malignancies (one pilocytic astrocytoma, five oligodendrogliomas, one low-grade oligoastrocytoma, one Grade 4 astrocytoma, and one metastatic adenocarcinoma) underwent DT imaging examinations prior to tumor excision. Anatomical information about white matter tract location, orientation, and projections was obtained in every patient. Depending on the tumor type and location, evidence of white matter tract edema (two patients), infiltration (two patients), displacement (five patients), and disruption (two patients) could be assessed with the aid of DT imaging in each case.
  
  
  CONCLUSIONS
  Diffusion-tensor imaging allowed for visualization of white matter tracts and was found to be beneficial in the surgical planning for patients with intrinsic brain tumors. The authors' experience with DT imaging indicates that anatomically intact fibers may be present in abnormal-appearing areas of the brain. Whether resection of these involved fibers results in subtle postoperative neurological deficits requires further systematic study.
authors.affiliation: Department ofNeurological Surgery, University of Wisconsin School of Medicine, Madison 53792, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Witwer
authors.forename: Roham
authors.initials: R
authors.lastname: Moftakhar
authors.forename: Khader M
authors.initials: KM
authors.lastname: Hasan
authors.forename: Praveen
authors.initials: P
authors.lastname: Deshmukh
authors.forename: Victor
authors.initials: V
authors.lastname: Haughton
authors.forename: Aaron
authors.initials: A
authors.lastname: Field
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Arfanakis
authors.forename: Jane
authors.initials: J
authors.lastname: Noyes
authors.forename: Chad H
authors.initials: CH
authors.lastname: Moritz
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Meyerand
authors.forename: Howard A
authors.initials: HA
authors.lastname: Rowley
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Alexander
authors.forename: Behnam
authors.initials: B
authors.lastname: Badie
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000473:pathology; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005909:Glioblastoma / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009837:Oligodendroglioma / Q000473:pathology* / Q000601:surgery*