Nowacki, Andreas and Schlaier, Juergen and Debove, Ines and Pollo, Claudio (2019) Validation of diffusion tensor imaging tractography to visualize the dentatorubrothalamic tract for surgical planning. JOURNAL OF NEUROSURGERY, 130 (1). pp. 99-108. ISSN 0022-3085, 1933-0693
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVE The dentatorubrothalamic tract (DRTT) has been suggested as the anatomical substrate for deep brain stimulation (DBS)-induced tremor alleviation. So far, little is known about how accurately and reliably tracking results correspond to the anatomical DRTT. The objective of this study was to systematically investigate and validate the results of different tractography approaches for surgical planning. METHODS The authors retrospectively analyzed 4 methodological approaches for diffusion tensor imaging (DTI)-based fiber tracking using different regions of interest in 6 patients with essential tremor. Tracking results were analyzed and validated with reference to MRI-based anatomical landmarks, were projected onto the stereotactic atlas of Morel at 3 predetermined levels (vertical levels -3.6, -1.8, and 0 mm below the anterior commissure-posterior commissure line), and were correlated to clinical outcome. RESULTS The 4 different methodologies for tracking the DRTT led to divergent results with respect to the MRI-based anatomical landmarks and when projected onto the stereotactic atlas of Morel. There was a statistically significant difference in the lateral and anteroposterior coordinates at the 3 vertical levels (p < 0.001, 2-way ANOVA). Different fractional anisotropy values ranging from 0.1 to 0.46 were required for anatomically plausible tracking results and led to varying degrees of success. Tracking results were not correlated to postoperative tremor reduction. CONCLUSIONS Different tracking methods can yield results with good anatomical approximation. The authors recommend using 3 regions of interest including the dentate nucleus of the cerebellum, the posterior subthalamic area, and the precentral gyrus to visualize the DRTT. Tracking results must be cautiously evaluated for anatomical plausibility and accuracy in each patient.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | DEEP BRAIN-STIMULATION; FIBER TRACKING; ELECTRICAL-STIMULATION; ESSENTIAL TREMOR; ATLAS; RECONSTRUCTION; NUCLEUS; AREA; DBS; dentatorubrothalamic tract; DTI fiber tracking; surgical planning; deep brain stimulation; functional neurosurgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 22 Apr 2020 08:19 |
| Last Modified: | 22 Apr 2020 08:19 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27933 |
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