Reconstruction of the arcuate fasciculus for surgical planning in the setting of peritumoral edema using two-tensor unscented Kalman filter tractography

Neuroimage Clin. 2015 Mar 20;7:815-22. doi: 10.1016/j.nicl.2015.03.009. eCollection 2015.

Abstract

Background: Diffusion imaging tractography is increasingly used to trace critical fiber tracts in brain tumor patients to reduce the risk of post-operative neurological deficit. However, the effects of peritumoral edema pose a challenge to conventional tractography using the standard diffusion tensor model. The aim of this study was to present a novel technique using a two-tensor unscented Kalman filter (UKF) algorithm to track the arcuate fasciculus (AF) in brain tumor patients with peritumoral edema.

Methods: Ten right-handed patients with left-sided brain tumors in the vicinity of language-related cortex and evidence of significant peritumoral edema were retrospectively selected for the study. All patients underwent 3-Tesla magnetic resonance imaging (MRI) including a diffusion-weighted dataset with 31 directions. Fiber tractography was performed using both single-tensor streamline and two-tensor UKF tractography. A two-regions-of-interest approach was applied to perform the delineation of the AF. Results from the two different tractography algorithms were compared visually and quantitatively.

Results: Using single-tensor streamline tractography, the AF appeared disrupted in four patients and contained few fibers in the remaining six patients. Two-tensor UKF tractography delineated an AF that traversed edematous brain areas in all patients. The volume of the AF was significantly larger on two-tensor UKF than on single-tensor streamline tractography (p < 0.01).

Conclusions: Two-tensor UKF tractography provides the ability to trace a larger volume AF than single-tensor streamline tractography in the setting of peritumoral edema in brain tumor patients.

Keywords: Arcuate fasciculus; Diffusion tensor imaging; Neurosurgical planning; Peritumoral edema; Tractography.

Publication types

  • Clinical Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Brain Edema / etiology
  • Brain Edema / pathology*
  • Brain Neoplasms / complications
  • Brain Neoplasms / surgery*
  • Cerebral Cortex / pathology*
  • Diffusion Tensor Imaging
  • Female
  • Frontal Lobe / pathology
  • Glioblastoma / pathology
  • Glioblastoma / surgery*
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Imaging
  • Male
  • Meningioma / pathology
  • Meningioma / surgery*
  • Middle Aged
  • Nerve Fibers / pathology*
  • Neural Pathways / pathology*
  • Neurosurgical Procedures
  • Oligodendroglioma / pathology
  • Oligodendroglioma / surgery*
  • Organ Size
  • Parietal Lobe / pathology
  • Retrospective Studies
  • Surgery, Computer-Assisted / methods*
  • Temporal Lobe / pathology