European Radiology

, 19:2798

Pre-surgical planning and MR-tractography utility in brain tumour resection

  • A. Romano
  • G. D’Andrea
  • G. Minniti
  • L. Mastronardi
  • L. Ferrante
  • L. M. Fantozzi
  • A. Bozzao
Neuro

DOI: 10.1007/s00330-009-1483-6

Cite this article as:
Romano, A., D’Andrea, G., Minniti, G. et al. Eur Radiol (2009) 19: 2798. doi:10.1007/s00330-009-1483-6

Abstract

The purposes of this study were (1) to evaluate the possible identification of trajectories of fibre tracts, (2) to examine the useful of a neuronavigation system for pre-surgical planning, (3) to assess pre- and post-surgery patients’ clinical condition and (4) to evaluate the impact of this information on surgical planning and procedure. Twenty-eight right-handed patients were prospectively and consecutively studied. All the patients were clinically assessed by a neurologist in both pre- and post-surgical phases. Separately the pyramidal tract, optic radiation and arcuate fasciculus were reconstructed. The trajectories were considered suitable for surgical planning if there were no interruptions of any of the layers at the level of the lesion. Dedicated software ‘merged’ the acquired images with the tractographic processing, and the whole dataset was sent to the neuronavigation system. The assessment of the 37 visualised trajectories close to the tumour resulted in a modification of the surgical approach to corticotomy in six patients (21%); the impact on the definition of the resection margins during surgery was 64% (18 cases). The overall impact percentage on the surgical procedure was 82%. In 27 cases, the symptoms had not changed. MR-tractography provides the neurosurgeon with a new anatomical view that has an impact on the surgical resection planning for brain neoplasms.

Keywords

Pre-surgical planningDiffusion tensor imagingMR tractographyIntra-operative MRIIntra-axial brain tumours

Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • A. Romano
    • 1
  • G. D’Andrea
    • 2
  • G. Minniti
    • 3
  • L. Mastronardi
    • 2
  • L. Ferrante
    • 2
  • L. M. Fantozzi
    • 1
  • A. Bozzao
    • 1
  1. 1.Department of Neuroradiology, S. Andrea HospitalUniversity SapienzaRomeItaly
  2. 2.Department of Neurosurgery, S. Andrea HospitalUniversity SapienzaRomeItaly
  3. 3.Department of Radiotherapy, S. Andrea HospitalUniversity SapienzaRomeItaly