Impact of fMRI-guided advanced DTI fiber tracking techniques on their clinical applications in patients with brain tumors

• Published in: Neuroradiology 2010, Vol.52 (1), p.37-46
• Main Authors: Kleiser, Raimund, Staempfli, Philipp, Valavanis, Anton, Boesiger, Peter, Kollias, Spyros
• Format: Article
• Language: English
• Subjects: Algorithms; Biological and medical sciences; Brain; Brain - pathology; Brain - physiopathology; Brain Neoplasms - pathology; Brain Neoplasms - physiopathology; Diffusion Tensor Imaging - instrumentation; Diffusion Tensor Imaging - methods; Electrodiagnosis. Electric activity recording; Feasibility Studies; Functional Laterality; Functional Neuroradiology; Glioma - pathology; Glioma - physiopathology; Humans; Imaging; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Medical sciences; Medicine; Medicine & Public Health; Meningioma - pathology; Meningioma - physiopathology; Nerve Fibers, Myelinated - pathology; Nerve Fibers, Myelinated - physiology; Nervous system; Neural Pathways - pathology; Neural Pathways - physiopathology; Neurology; Neuroradiology; Neurosciences; Neurosurgery; NMR; Nuclear magnetic resonance; Psychomotor Performance - physiology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Tumors
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-009-0539-2

Introduction White matter tractography based on diffusion tensor imaging has become a well-accepted non-invasive tool for exploring the white matter architecture of the human brain in vivo. There exist two main key obstacles for reconstructing white matter fibers: firstly, the implementation and application of a suitable tracking algorithm, which is capable of reconstructing anatomically complex fascicular pathways correctly, as, e.g., areas of fiber crossing or branching; secondly, the definition of an appropriate tracking seed area for starting the reconstruction process. Large intersubject, anatomical variations make it difficult to define tracking seed areas based on reliable anatomical landmarks. An accurate definition of seed regions for the reconstruction of a specific neuronal pathway becomes even more challenging in patients suffering from space occupying pathological processes as, e.g., tumors due to the displacement of the tissue and the distortion of anatomical landmarks around the lesion. Methods To resolve the first problem, an advanced tracking algorithm, called advanced fast marching, was applied in this study. The second challenge was overcome by combining functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) in order to perform fMRI-guided accurate definition of appropriate seed areas for the DTI fiber tracking. In addition, the performance of the tasks was controlled by a MR-compatible power device. Results Application of this combined approach to eight healthy volunteers and exemplary to three tumor patients showed that it is feasible to accurately reconstruct relevant fiber tracts belonging to a specific functional system. Conclusion fMRI-guided advanced DTI fiber tracking has the potential to provide accurate anatomical and functional information for a more informed therapeutic decision making.