title: Assessing Region of Interest Schemes for the Corticospinal Tract in Patients With Brain Tumors.
abstract: Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) techniques are widely used for identifying the corticospinal tract (CST) white matter pathways as part of presurgical planning. However, mass effects in patients with brain tumors tend to cause anatomical distortions and compensatory functional reorganization of the cortex, which may lead to inaccurate mapping of white matter tracts. To overcome these problems, we compared different region-of-interest (ROI) selection schemes to track CST fibers in patients with brain tumors. Our study investigated the CSTs of 16 patients with intracranial tumors. The patients were classified into 3 subgroups according to the spatial relationships of the lesion and the primary motor cortex (PMC)/internal capsule. Specifically, we investigated the key factors that cause distorted tractography in patients with tumors. We compared 3 CST tractography methods that used different ROI selection schemes. The results indicate that CST fiber tracking methods based only on anatomical ROIs could possibly lead to distortions near the PMC region and may be unable to effectively localize the PMC. In contrast, the dual ROI method, which uses ROIs that have been selected from both blood oxygen level-dependent functional MRI (BOLD-fMRI) activation and anatomical landmarks, enabled the tracking of fibers to the motor cortex. The results demonstrate that the dual ROI method can localize the entire CST fiber pathway and can accurately describe the spatial relationships of CST fibers relative to the tumor. These results illustrate the reliability of using fMRI-guided DTT in patients with tumors. The combination of fMRI and anatomical information enhances the identification of tracts of interest in brains with anatomical deformations, which provides neurosurgeons with a more accurate approach for visualizing and localizing white matter fiber tracts in patients with brain tumors. This approach enhances surgical performance and perserves brain function.
authors.affiliation: From the Department of Medical Imaging, The First Affiliated Hospital of Xi'An Jiaotong University, Xi'an, Shaanxi (CN, MG, WL, LG, MZ); Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an (XL); School of Information Technology, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China (YY); Department of Electronics Engineering, Northwestern Polytechnical University, Xi'an (KZ); Department of Neurosurgey, First Affiliated Hospital of Xi'An Jiaotong University, Xi'an, Shaanxi (MW); Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an (PL); and Department of Medical Imaging, The First Affiliated Hospital of Xi'An Jiaotong University, Xi'an (MZ), Shaanxi, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Niu
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Min
authors.forename: Maode
authors.initials: M
authors.lastname: Wang
authors.forename: Wenfei
authors.initials: W
authors.lastname: Li
authors.forename: Liping
authors.initials: L
authors.lastname: Guo
authors.forename: Pan
authors.initials: P
authors.lastname: Lin
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology*