title: Local and global fiber tractography in patients with epilepsy.
abstract: OBJECTIVE
  Fiber tractography is increasingly used in the preoperative evaluation of endangered fiber bundles. From a clinical point of view, an accurate and methodologically transparent procedure is desired. Our aim was to evaluate the recently described global tracking algorithm compared with other established methods, such as deterministic and probabilistic tractography.
  
  
  METHODS
  Twenty patients, candidates for excision of epileptogenic lesions, were subjected to higher-angular resolution diffusion imaging-based fiber tractography. Seed points were created without manual bias, predominantly by FreeSurfer and voxel-based atlases. We focused on 2 important fiber bundles, namely the descending motor pathways and the optic radiation. Postoperatively, the accuracy of the predicted fiber route was controlled by structural MR imaging and by inflicted functional deficits.
  
  
  RESULTS
  Among the 3 evaluated methods, global tracking was the only method capable of reconstructing the full extent of the descending motor pathways, including corticobulbar fibers from the area of face representation. Still, probabilistic tractography depicted the optic radiation better, especially the Meyer loop. The deterministic algorithm performed less adequately.
  
  
  CONCLUSIONS
  The probabilistic method seems to be the best balance between computational time and effectiveness and seems to be the best choice in most cases, particularly for the optic radiation. If, however, a detailed depiction of the fiber anatomy is intended and tract crossings are implicated, then the computationally time-consuming global tracking should be preferred.
authors.affiliation: From the Clinic of Neuropediatrics and Neuromuscular Diseases (C.A.).
authors.forename: C
authors.initials: C
authors.lastname: Anastasopoulos
authors.forename: M
authors.initials: M
authors.lastname: Reisert
authors.forename: V G
authors.initials: VG
authors.lastname: Kiselev
authors.forename: T
authors.initials: T
authors.lastname: Nguyen-Thanh
authors.forename: A
authors.initials: A
authors.lastname: Schulze-Bonhage
authors.forename: J
authors.initials: J
authors.lastname: Zentner
authors.forename: I
authors.initials: I
authors.lastname: Mader
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004525:Efferent Pathways / Q000473:pathology*; D004827:Epilepsy / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009900:Optic Nerve / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult