Magnetic resonance diffusion tensor imaging of the optic nerves to guide treatment of pediatric suprasellar tumors.
OBJECTIVE
As a preoperative planning tool, conventional magnetic resonance (MR) imaging may have limited value in differentiating tumors from white matter tracts. MR diffusion tensor imaging (MRDTI) has become a useful tool for evaluating white matter tracts in relation to surrounding structures and has been used in surgical planning for brain tumors involving white matter. We investigated the use of DTI of the optic nerves in surgical planning for pediatric suprasellar tumors.


METHODS
We present findings in 10 pediatric control patients and 2 cases of pediatric suprasellar tumors in which a routine 6-direction DTI of the brain was performed at 3 T. Postprocessing permitted the study of the diffusion tensor parameters, as well as the tractography, of the optic nerves.


RESULTS
The control patients demonstrated the optimization of the technique and permitted the quantitation of fractional anisotropy and apparent diffusion coefficient values. The tumor cases demonstrated the utility of optic nerve DTI to differentiate between optic nerves and suprasellar/chiasmatic brain tumors.


CONCLUSIONS
A routine 6-direction DTI of the pediatric brain at 3 T permits a detailed DTI study of the optic nerves. Optic nerve tractography can be used to aid in the evaluation and treatment of pediatric brain tumors in the area of the optic chiasm.
Salmela
Michael B
MB
Department of Radiology, University of Vermont College of Medicine-Fletcher Allen Health Care, Burlington, VY 05401, USA. msalmela@uvm.edu
Cauley
Keith A
KA
Andrews
Trevor
T
Gonyea
Jay V
JV
Tarasiewicz
Izabela
I
Filippi
Christopher G
CG
D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D009900:Optic Nerve / Q000473:pathology*; D011300:Preoperative Care / Q000379:methods; D012016:Reference Values; D012680:Sensitivity and Specificity