title: Diffusion tensor tractography in the presurgical assessment of cerebral gliomas.
abstract: Glioma is the most common intra-axial brain tumor characterized by invasion into the surrounding white matter (WM) tracts. These tumors are usually diagnosed by conventional MRI, but this method is unable to describe the relationship between tumor and neighboring WM tracts. Diffusion tensor tractography (DTT) is a new imaging modality which can solve this problem. The current study evaluated the application of DTT imaging in the presurgical assessment of gliomas, and introduces this new modality and its importance to physicians and imaging centers in Iran. Ten patients with intra-axial brain tumor and suspicion of glioma underwent conventional brain MRI pulse sequences and DTT imaging between December 2011 and February 2013 with a 1.5 Tesla system using 64 independent diffusion encoding directions. Acquired images were assessed by the neuroradiologist and neurosurgeon. The treatment strategies were recognized and compared using data before and after the tractography. On the basis of DTT data, the treatment strategy changed from radiotherapy to the craniotomy in seven patients, and in one patient, the neurosurgeon preferred to avoid surgery. In one patient, the treatment technique did not change, and in the last one radiosurgery was replaced by craniotomy. As we can infer from this study, based on the tractography results, the treatment strategy may be changed, and the treatment technique could be devised more accurately and may lead to fewer postoperative neurological deficits and better outcomes.
authors.affiliation: Radiology Technology Department, School of Paramedicine, Shahid Beheshti University of Medical Sciences; Tehran, Iran - f_faeghi@sbmu.ac.ir.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Farshidfar
authors.affiliation: Radiology Technology Department, School of Paramedicine, Shahid Beheshti University of Medical Sciences; Tehran, Iran.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Faeghi
authors.affiliation: Neurosurgery Department, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences; Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Mohseni
authors.affiliation: Functional Neurosurgery Research Center of Shohada Tajrish Hospital; Tehran, Iran.
authors.forename: Afsoun
authors.initials: A
authors.lastname: Seddighi
authors.affiliation: Radiology Department, Rasule Akram Hospital, Tehran University of Medical Sciences; Tehran, Iran.
authors.forename: Homayoun Hadizadeh
authors.initials: HH
authors.lastname: Kharrazi
authors.affiliation: Radiology Technology Department, School of Paramedicine, Shahid Beheshti University of Medical Sciences; Tehran, Iran.
authors.forename: Jamil
authors.initials: J
authors.lastname: Abdolmohammadi
mesh_terms: D000293:Adolescent; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D056324:Diffusion Tensor Imaging; D005260:Female; D005909:Glioblastoma / Q000473:pathology / Q000601:surgery; D005910:Glioma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D018316:Gliosarcoma / Q000473:pathology / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D009837:Oligodendroglioma / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D013238:Stereotaxic Techniques
keywords: brain glial tumor; diffusion tensor tractography; presurgical assessment