Ahead of Print: Tractography in Peritumoral Edema

Screen Shot 2013-11-04 at 11.59.04 AMBackground: Diffusion tensor imaging (DTI) tractography enables the in vivo visualization of white matter tracts inside normal brain tissue, which provides the neurosurgeon important information to plan tumor resections. However, DTI is associated with restrictions in the resolution of crossing fibers, in the vicinity of the tumor or in edema. We find that generalized q-sampling imaging (GQI) can overcome these difficulties and is advantageous over DTI for the tractography of the fiber bundle in peritumoral edema.

Objective: To demonstrate the differences between GQI and DTI in the preoperative mapping of fiber tractography in peritumoral edema of cerebral tumors, and discuss the clinical application of GQI in neurosurgical planning.

Methods: Five patients with brain tumors underwent 3-T magnetic resonance imaging scans, and the data were reconstructed by DTI and GQI. We adjusted the parameters and compared the differences between DTI and GQI in visualizing the fiber tracts in the peritumoral edema of cerebral tumors.

Results: GQI and DTI showed substantial differences in displaying the nerve fibers in the edema surrounding the tumor. The GQI tractography method could fully display existing intact fibers in the edema, while the fiber tracts in edema displayed by DTI tractography were incomplete, missing, or ruptured.

Conclusion: GQI can visualize the tracts in the peritumoral edema of cerebral tumors better than DTI. Although GQI suffers many limitations, its future in the preoperative guidance of brain tumor lesions is promising.

From: Differences Between Generalized Q-Sampling Imaging and Diffusion Tensor Imaging in the Preoperative Visualization of the Nerve Fiber Tracts Within Peritumoral Edema in Brain by Zhang et al.

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