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Free-water correction DTI-based tractography in brain tumor surgery: assessment with functional and electrophysiological mapping of the white matter

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Abstract

Peritumoral edema prevents fiber tracking from diffusion tensor imaging (DTI). A free-water correction may overcome this drawback, as illustrated in the case of a patient undergoing awake surgery for brain metastasis. The anatomical plausibility and accuracy of tractography with and without free-water correction were assessed with functional mapping and axono-cortical evoked-potentials (ACEPs) as reference methods. The results suggest a potential synergy between corrected DTI-based tractography and ACEPs to reliably identify and preserve white matter tracts during brain tumor surgery.

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Data availability

The anonymized MRI and electrophysiolgical data are available to any qualified investigator upon request, after completion of a data sharing agreement.

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Funding

This study was supported and funded by the University Hospital of Nice (grant number: 19-AOIP-01).

Dr. Fabien Almairac has received research grants from the NeuroMod Institute, Université Côte d’Azur, and the Société Française de Neurochirurgie (SFNC), France.

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Authors and Affiliations

  1. Neurosurgery Department, Pasteur 2 Hospital, University Hospital of Nice, 06000, Nice, France

    Fabien Almairac, Petru Isan, Marie Onno & Denys Fontaine

  2. UR2CA PIN, Université Côte d’Azur, Nice, France

    Fabien Almairac, Petru Isan & Denys Fontaine

  3. Diffusion and Connectomics in Precision Healthcare Research Lab, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA

    Drew Parker & Ragini Verma

  4. Neuroradiology department, Pasteur 2 Hospital, University Hospital of Nice, 06000, Nice, France

    Lydiane Mondot

  5. UR2CA URRIS, Université Côte d’Azur, Nice, France

    Lydiane Mondot

  6. CRONOS team, Centre INRIA d’Université Côte d’Azur, Nice, France

    Théodore Papadopoulo

  7. CAI2R, NYU Langone Health, New York, NY, USA

    Patryk Filipiak

Authors
  1. Fabien Almairac
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  2. Drew Parker
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  3. Lydiane Mondot
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  4. Petru Isan
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  5. Marie Onno
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  6. Théodore Papadopoulo
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  7. Patryk Filipiak
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  8. Denys Fontaine
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  9. Ragini Verma
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Corresponding author

Correspondence to Fabien Almairac.

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Ethical approval

The patient gave her informed consent prior to her inclusion in the study. This study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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The authors declare no competing interests.

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Almairac, F., Parker, D., Mondot, L. et al. Free-water correction DTI-based tractography in brain tumor surgery: assessment with functional and electrophysiological mapping of the white matter. Acta Neurochir 165, 1675–1681 (2023). https://doi.org/10.1007/s00701-023-05608-4

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  • DOI: https://doi.org/10.1007/s00701-023-05608-4

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