Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11719
Title: White matter fiber tractography: why we need to move beyond DTI.
Authors: Farquharson, Shawna;Tournier, Jacques-Donald;Calamante, Fernando;Fabinyi, Gavin;Schneider-Kolsky, Michal;Jackson, Graeme D;Connelly, Alan
Affiliation: Brain Research Institute, Florey Institute of Neuroscience and Mental Health, Department of Medicine, Austin Health & Northern Health, University of Melbourne, Melbourne, Australia.
Issue Date: 29-Mar-2013
Citation: Journal of Neurosurgery 2013; 118(6): 1367-77
Abstract: Diffusion-based MRI tractography is an imaging tool increasingly used in neurosurgical procedures to generate 3D maps of white matter pathways as an aid to identifying safe margins of resection. The majority of white matter fiber tractography software packages currently available to clinicians rely on a fundamentally flawed framework to generate fiber orientations from diffusion-weighted data, namely diffusion tensor imaging (DTI). This work provides the first extensive and systematic exploration of the practical limitations of DTI-based tractography and investigates whether the higher-order tractography model constrained spherical deconvolution provides a reasonable solution to these problems within a clinically feasible timeframe.Comparison of tractography methodologies in visualizing the corticospinal tracts was made using the diffusion-weighted data sets from 45 healthy controls and 10 patients undergoing presurgical imaging assessment. Tensor-based and constrained spherical deconvolution-based tractography methodologies were applied to both patients and controls.Diffusion tensor imaging-based tractography methods (using both deterministic and probabilistic tractography algorithms) substantially underestimated the extent of tracks connecting to the sensorimotor cortex in all participants in the control group. In contrast, the constrained spherical deconvolution tractography method consistently produced the biologically expected fan-shaped configuration of tracks. In the clinical cases, in which tractography was performed to visualize the corticospinal pathways in patients with concomitant risk of neurological deficit following neurosurgical resection, the constrained spherical deconvolution-based and tensor-based tractography methodologies indicated very different apparent safe margins of resection; the constrained spherical deconvolution-based method identified corticospinal tracts extending to the entire sensorimotor cortex, while the tensor-based method only identified a narrow subset of tracts extending medially to the vertex.This comprehensive study shows that the most widely used clinical tractography method (diffusion tensor imaging-based tractography) results in systematically unreliable and clinically misleading information. The higher-order tractography model, using the same diffusion-weighted data, clearly demonstrates fiber tracts more accurately, providing improved estimates of safety margins that may be useful in neurosurgical procedures. We therefore need to move beyond the diffusion tensor framework if we are to begin to provide neurosurgeons with biologically reliable tractography information.
Internal ID Number: 23540269
URI: http://ahro.austin.org.au/austinjspui/handle/1/11719
DOI: 10.3171/2013.2.JNS121294
URL: http://www.ncbi.nlm.nih.gov/pubmed/23540269
Type: Journal Article
Subjects: Adolescent
Adult
Algorithms
Case-Control Studies
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging.methods
Female
Humans
Male
Middle Aged
Neurosurgery.trends
Pyramidal Tracts.pathology
Reproducibility of Results
Young Adult
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.