Abstract
DTI fiber tracking allows for the 3D reconstruction of main white matter fascicles, including the corticospinal tract (CST). Nevertheless, standard diffusion tensor imaging fiber tracking (DTI FT) is limited by the fact that it is based on the selection of anatomical landmarks as seeding regions of interest (ROIs) for tract computation. This reduces the reliability and reproducibility of DTI FT results, especially in brain tumor patients, in which the neural plasticity induced by the tumor itself causes a reorganization of the motor network, resulting in a mismatch between anatomical and functional landmarks. The nTMS technique provides a reliable mapping of the functional organization of the motor cortex that can be successfully used as seeding ROI for the DTI computation of the CST. This improves the reliability and accuracy of the DTI FT of the CST compared to the standard DTI technique. Moreover, it provides the somatotopic organization of the CST, especially improving the visualization of fiber bundles connected to the motor cortical representation of arm and face muscles.
This chapter presents data on the intraoperative correlation of nTMS-based DTI FT of the CST to subcortical direct electrical stimulation and describes the various published protocols of nTMS-based DTI FT of the CST in detail.
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References
Basser PJ. Inferring microstructural features and the physiological state of tissues from diffusion-weighted images. NMR Biomed. 1995;8(7–8):333–44.
Basser PJ, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging. Biophys J. 1994;66(1):259–67. doi:10.1016/S0006-3495(94)80775-1.
Bozzao A, Romano A, Angelini A, D’Andrea G, Calabria LF, Coppola V, et al. Identification of the pyramidal tract by neuronavigation based on intraoperative magnetic resonance tractography: correlation with subcortical stimulation. Eur Radiol. 2010;20(10):2475–81. doi:10.1007/s00330-010-1806-7.
Burgel U, Madler B, Honey CR, Thron A, Gilsbach J, Coenen VA. Fiber tracking with distinct software tools results in a clear diversity in anatomical fiber tract portrayal. Cent Eur Neurosurg. 2009;70(1):27–35. doi:10.1055/s-0028-1087212.
Catani M, Thiebaut de Schotten M. A diffusion tensor imaging tractography atlas for virtual in vivo dissections. Cortex. 2008;44(8):1105–32. doi:10.1016/j.cortex.2008.05.004.
Catani M, Howard RJ, Pajevic S, Jones DK. Virtual in vivo interactive dissection of white matter fasciculi in the human brain. Neuroimage. 2002;17(1):77–94.
Conti A, Raffa G, Granata F, Rizzo V, Germano A, Tomasello F. Navigated transcranial magnetic stimulation for “somatotopic” tractography of the corticospinal tract. Neurosurgery. 2014;10(Suppl 4):542–554. discussion 554. doi:10.1227/NEU.0000000000000502.
Conturo TE, Lori NF, Cull TS, Akbudak E, Snyder AZ, Shimony JS, et al. Tracking neuronal fiber pathways in the living human brain. Proc Natl Acad Sci U S A. 1999;96(18):10422–7.
Duffau H. The dangers of magnetic resonance imaging diffusion tensor tractography in brain surgery. World Neurosurg. 2014;81(1):56–8. doi:10.1016/j.wneu.2013.01.116.
Feigl GC, Hiergeist W, Fellner C, Schebesch KM, Doenitz C, Finkenzeller T, et al. Magnetic resonance imaging diffusion tensor tractography: evaluation of anatomic accuracy of different fiber tracking software packages. World Neurosurg. 2014;81(1):144–50. doi:10.1016/j.wneu.2013.01.004.
Forster MT, Hoecker AC, Kang JS, Quick J, Seifert V, Hattingen E, et al. Does navigated transcranial stimulation increase the accuracy of tractography? A prospective clinical trial based on intraoperative motor evoked potential monitoring during deep brain stimulation. Neurosurgery. 2015;76(6):766–76. doi:10.1227/NEU.0000000000000715.
Frey D, Strack V, Wiener E, Jussen D, Vajkoczy P, Picht T. A new approach for corticospinal tract reconstruction based on navigated transcranial stimulation and standardized fractional anisotropy values. Neuroimage. 2012;62(3):1600–9. doi:10.1016/j.neuroimage.2012.05.059.
Frey D, Schilt S, Strack V, Zdunczyk A, Rosler J, Niraula B, et al. Navigated transcranial magnetic stimulation improves the treatment outcome in patients with brain tumors in motor eloquent locations. Neuro Oncol. 2014;16(10):1365–72. doi:10.1093/neuonc/nou110.
Giordano M, Nabavi A, Gerganov VM, Javadi AS, Samii M, Fahlbusch R, et al. Assessment of quantitative corticospinal tract diffusion changes in patients affected by subcortical gliomas using common available navigation software. Clin Neurol Neurosurg. 2015;136:1–4. doi:10.1016/j.clineuro.2015.05.004.
Goebell E, Fiehler J, Ding XQ, Paustenbach S, Nietz S, Heese O, et al. Disarrangement of fiber tracts and decline of neuronal density correlate in glioma patients—a combined diffusion tensor imaging and 1H-MR spectroscopy study. AJNR Am J Neuroradiol. 2006;27(7):1426–31.
Hakulinen U, Brander A, Ryymin P, Ohman J, Soimakallio S, Helminen M, et al. Repeatability and variation of region-of-interest methods using quantitative diffusion tensor MR imaging of the brain. BMC Med Imaging. 2012;12:30. doi:10.1186/1471-2342-12-30.
Holodny AI, Watts R, Korneinko VN, Pronin IN, Zhukovskiy ME, Gor DM, et al. Diffusion tensor tractography of the motor white matter tracts in man: current controversies and future directions. Ann N Y Acad Sci. 2005;1064:88–97. doi:10.1196/annals.1340.016.
Kamada K, Todo T, Ota T, Ino K, Masutani Y, Aoki S, et al. The motor-evoked potential threshold evaluated by tractography and electrical stimulation. J Neurosurg. 2009;111(4):785–95. doi:10.3171/2008.9.JNS08414.
Krieg SM, Buchmann NH, Gempt J, Shiban E, Meyer B, Ringel F. Diffusion tensor imaging fiber tracking using navigated brain stimulation—a feasibility study. Acta Neurochir. 2012a;154(3):555–63. doi:10.1007/s00701-011-1255-3.
Krieg SM, Shiban E, Buchmann N, Gempt J, Foerschler A, Meyer B, et al. Utility of presurgical navigated transcranial magnetic brain stimulation for the resection of tumors in eloquent motor areas. J Neurosurg. 2012b;116(5):994–1001. doi:10.3171/2011.12.JNS111524.
Krieg SM, Shiban E, Buchmann N, Meyer B, Ringel F. Presurgical navigated transcranial magnetic brain stimulation for recurrent gliomas in motor eloquent areas. Clin Neurophysiol. 2013;124(3):522–7. doi:10.1016/j.clinph.2012.08.011.
Krieg SM, Sabih J, Bulubasova L, Obermueller T, Negwer C, Janssen I, et al. Preoperative motor mapping by navigated transcranial magnetic brain stimulation improves outcome for motor eloquent lesions. Neuro Oncol. 2014;16(9):1274–82. doi:10.1093/neuonc/nou007.
Kristo G, Leemans A, de Gelder B, Raemaekers M, Rutten GJ, Ramsey N. Reliability of the corticospinal tract and arcuate fasciculus reconstructed with DTI-based tractography: implications for clinical practice. Eur Radiol. 2013;23(1):28–36. doi:10.1007/s00330-012-2589-9.
Kwon HG, Hong JH, Jang SH. Anatomic location and somatotopic arrangement of the corticospinal tract at the cerebral peduncle in the human brain. AJNR Am J Neuroradiol. 2011;32(11):2116–9. doi:10.3174/ajnr.A2660.
Lebel C, Benner T, Beaulieu C. Six is enough? Comparison of diffusion parameters measured using six or more diffusion-encoding gradient directions with deterministic tractography. Magn Reson Med. 2012;68(2):474–83. doi:10.1002/mrm.23254.
Lee DH, Park JW, Park SH, Hong C. Have you ever seen the impact of crossing fiber in DTI?: demonstration of the corticospinal tract pathway. PLoS One. 2015;10(7):e0112045. doi:10.1371/journal.pone.0112045.
Lehericy S, Duffau H, Cornu P, Capelle L, Pidoux B, Carpentier A, et al. Correspondence between functional magnetic resonance imaging somatotopy and individual brain anatomy of the central region: comparison with intraoperative stimulation in patients with brain tumors. J Neurosurg. 2000;92(4):589–98. doi:10.3171/jns.2000.92.4.0589.
Lu S, Ahn D, Johnson G, Cha S. Peritumoral diffusion tensor imaging of high-grade gliomas and metastatic brain tumors. AJNR Am J Neuroradiol. 2003;24(5):937–41.
Maesawa S, Fujii M, Nakahara N, Watanabe T, Wakabayashi T, Yoshida J. Intraoperative tractography and motor evoked potential (MEP) monitoring in surgery for gliomas around the corticospinal tract. World Neurosurg. 2010;74(1):153–61. doi:10.1016/j.wneu.2010.03.022.
Minati L, Grisoli M, Bruzzone MG. MR spectroscopy, functional MRI, and diffusion-tensor imaging in the aging brain: a conceptual review. J Geriatr Psychiatry Neurol. 2007;20(1):3–21. doi:10.1177/0891988706297089.
Morita N, Wang S, Kadakia P, Chawla S, Poptani H, Melhem ER. Diffusion tensor imaging of the corticospinal tract in patients with brain neoplasms. Magn Reson Med Sci. 2011;10(4):239–43.
Nimsky C, Ganslandt O, Hastreiter P, Wang R, Benner T, Sorensen AG, et al. Intraoperative diffusion-tensor MR imaging: shifting of white matter tracts during neurosurgical procedures—initial experience. Radiology. 2005;234(1):218–25. doi:10.1148/radiol.2341031984.
Niu C, Liu X, Yang Y, Zhang K, Min Z, Wang M, et al. Assessing region of interest schemes for the corticospinal tract in patients with brain tumors. Medicine (Baltimore). 2016;95(12):e3189. doi:10.1097/MD.0000000000003189.
Nossek E, Korn A, Shahar T, Kanner AA, Yaffe H, Marcovici D, et al. Intraoperative mapping and monitoring of the corticospinal tracts with neurophysiological assessment and 3-dimensional ultrasonography-based navigation. Clinical article. J Neurosurg. 2011;114(3):738–46. doi:10.3171/2010.8.JNS10639.
Ohue S, Kohno S, Inoue A, Yamashita D, Harada H, Kumon Y, et al. Accuracy of diffusion tensor magnetic resonance imaging-based tractography for surgery of gliomas near the pyramidal tract: a significant correlation between subcortical electrical stimulation and postoperative tractography. Neurosurgery. 2012;70(2):283–293. discussion 294. doi:10.1227/NEU.0b013e31823020e6.
Ostry S, Belsan T, Otahal J, Benes V, Netuka D. Is intraoperative diffusion tensor imaging at 3.0T comparable to subcortical corticospinal tract mapping? Neurosurgery. 2013;73(5):797–807. discussion 806–797. doi:10.1227/NEU.0000000000000087.
Picht T, Mularski S, Kuehn B, Vajkoczy P, Kombos T, Suess O. Navigated transcranial magnetic stimulation for preoperative functional diagnostics in brain tumor surgery. Neurosurgery. 2009;65(6 Suppl):93–8.
Picht T, Schmidt S, Brandt S, Frey D, Hannula H, Neuvonen T, et al. Preoperative functional mapping for rolandic brain tumor surgery: comparison of navigated transcranial magnetic stimulation to direct cortical stimulation. Neurosurgery. 2011a;69(3):581–588. discussion 588. doi:10.1227/NEU.0b013e3182181b89.
Picht T, Schmidt S, Woitzik J, Suess O. Navigated brain stimulation for preoperative cortical mapping in paretic patients: case report of a hemiplegic patient. Neurosurgery. 2011b;68(5):E1475–E1480. discussion E1480. doi:10.1227/NEU.0b013e318210c7df.
Pujol S, Wells W, Pierpaoli C, Brun C, Gee J, Cheng G, et al. The DTI challenge: toward standardized evaluation of diffusion tensor imaging tractography for neurosurgery. J Neuroimaging. 2015;25(6):875–82. doi:10.1111/jon.12283.
Robles SG, Gatignol P, Lehericy S, Duffau H. Long-term brain plasticity allowing a multistage surgical approach to World Health Organization Grade II gliomas in eloquent areas. J Neurosurg. 2008;109(4):615–24. doi:10.3171/JNS/2008/109/10/0615.
Romano A, D’Andrea G, Calabria LF, Coppola V, Espagnet CR, Pierallini A, et al. Pre- and intraoperative tractographic evaluation of corticospinal tract shift. Neurosurgery. 2011;69(3):696–704. discussion 704–695. doi:10.1227/NEU.0b013e31821a8555.
Sarubbo S, De Benedictis A, Merler S, Mandonnet E, Balbi S, Granieri E, et al. Towards a functional atlas of human white matter. Hum Brain Mapp. 2015; doi:10.1002/hbm.22832.
Takahashi S, Jussen D, Vajkoczy P, Picht T. Plastic relocation of motor cortex in a patient with LGG (low grade glioma) confirmed by NBS (navigated brain stimulation). Acta Neurochir. 2012;154(11):2003–8. doi:10.1007/s00701-012-1492-0.
Takahashi S, Vajkoczy P, Picht T. Navigated transcranial magnetic stimulation for mapping the motor cortex in patients with rolandic brain tumors. Neurosurg Focus. 2013;34(4):E3. doi:10.3171/2013.1.FOCUS133.
Wakana S, Caprihan A, Panzenboeck MM, Fallon JH, Perry M, Gollub RL, Hua K, Zhang J, Jiang H, Dubey P, Blitz A, van Zijl P, Mori S. Reproducibility of quantitative tractography methods applied to cerebral white matter. Neuroimage. 2007;36(3):630–44.
Weiss C, Nettekoven C, Rehme AK, Neuschmelting V, Eisenbeis A, Goldbrunner R, et al. Mapping the hand, foot and face representations in the primary motor cortex—retest reliability of neuronavigated TMS versus functional MRI. Neuroimage. 2013;66:531–42. doi:10.1016/j.neuroimage.2012.10.046.
Weiss C, Tursunova I, Neuschmelting V, Lockau H, Nettekoven C, Oros-Peusquens AM, et al. Improved nTMS- and DTI-derived CST tractography through anatomical ROI seeding on anterior pontine level compared to internal capsule. Neuroimage Clin. 2015;7:424–37. doi:10.1016/j.nicl.2015.01.006.
Yao X, Yu T, Liang B, Xia T, Huang Q, Zhuang S. Effect of increasing diffusion gradient direction number on diffusion tensor imaging fiber tracking in the human brain. Korean J Radiol. 2015;16(2):410–8. doi:10.3348/kjr.2015.16.2.410.
Yen PS, Teo BT, Chiu CH, Chen SC, Chiu TL, Su CF. White matter tract involvement in brain tumors: a diffusion tensor imaging analysis. Surg Neurol. 2009;72(5):464–469. discussion 469. doi:10.1016/j.surneu.2009.05.008.
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Raffa, G., Scibilia, A., Germanò, A., Conti, A. (2017). nTMS-Based DTI Fiber Tracking of Motor Pathways. In: M. Krieg, S. (eds) Navigated Transcranial Magnetic Stimulation in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-54918-7_6
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