title: Neuronavigation Based on Track Density Image Extracted from Deterministic High-Definition Fiber Tractography.
abstract: BACKGROUND
  Diffusion tensor imaging-based navigation is unable to resolve crossing fibers or to determine with accuracy the fanning, origin, and termination of fibers. It is important to improve the accuracy of localizing white matter fibers for improved surgical approaches. We propose a solution to this problem using navigation based on track density imaging extracted from high-definition fiber tractography (HDFT).
  
  
  METHODS
  A 28-year-old asymptomatic female patient with a left-lateral ventricle meningioma was enrolled in the present study. Language and visual tests, magnetic resonance imaging findings, both preoperative and postoperative HDFT, and the intraoperative navigation and surgery process are presented. Track density images were extracted from tracts derived using full q-space (514 directions) diffusion spectrum imaging (DSI) and integrated into a neuronavigation system. Navigation accuracy was verified via intraoperative records and postoperative DSI tractography, as well as a functional examination. DSI successfully represented the shape and range of the Meyer loop and arcuate fasciculus. Extracted track density images from the DSI were successfully integrated into the navigation system. The relationship between the operation channel and surrounding tracts was consistent with the postoperative findings, and the patient was functionally intact after the surgery.
  
  
  CONCLUSIONS
  DSI-based TDI navigation allows for the visualization of anatomic features such as fanning and angling and helps to identify the range of a given tract. Moreover, our results show that our HDFT navigation method is a promising technique that preserves neural function.
authors.affiliation: Department of Neurosurgery, The General Hospital of People's Liberation Army, Beijing, China.
authors.forename: Peng-Hu
authors.initials: PH
authors.lastname: Wei
authors.affiliation: State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China; Graduated School, University of the Chinese Academy of Sciences, Beijing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Cong
authors.affiliation: Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Ming-Chu
authors.initials: MC
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, The General Hospital of People's Liberation Army, Beijing, China. Electronic address: Pro_xinguang_yu@126.com.
authors.forename: Xin-Guang
authors.initials: XG
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address: Pro_baoyuhai@126.com.
authors.forename: Yu-Hai
authors.initials: YH
authors.lastname: Bao
mesh_terms: D000328:Adult; D016880:Anisotropy; D001111:Arcuate Nucleus of Hypothalamus / Q000000981:diagnostic imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008579:Meningioma / Q000000981:diagnostic imaging* / Q000601:surgery; D009412:Nerve Fibers / Q000473:pathology*; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000473:pathology*; D038361:Neuronavigation
keywords: Arcuate fasciculus; Diffusion spectrum imaging; Meyer loop; Navigation; Track density imaging