Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift
When using preoperative tractography intraoperatively, inaccuracies due to brain shift might occur. Intraoperative tractography is rarely performed. Elastic fusion (EF) is a tool developed to compensate for brain shift, gravity, and tissue resection based on intraoperative images. Our hypothesis was...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/13/8/1787 |
| _version_ | 1797538337991426048 |
|---|---|
| author | Sebastian Ille Maximilian Schwendner Wei Zhang Axel Schroeder Bernhard Meyer Sandro M. Krieg |
| author_facet | Sebastian Ille Maximilian Schwendner Wei Zhang Axel Schroeder Bernhard Meyer Sandro M. Krieg |
| author_sort | Sebastian Ille |
| collection | DOAJ |
| description | When using preoperative tractography intraoperatively, inaccuracies due to brain shift might occur. Intraoperative tractography is rarely performed. Elastic fusion (EF) is a tool developed to compensate for brain shift, gravity, and tissue resection based on intraoperative images. Our hypothesis was that preoperative tractography is accurate and adjustments of tractography by intraoperative magnetic resonance imaging (ioMRI)-based EF (IBEF) compensate for brain shift. Between February 2018 and June 2019, 78 patients underwent eloquent (46 motor, 32 language) glioma resection in our department using intraoperative MRI. Mean distances between the resection cavity and tractography were analyzed and correlated with clinical outcomes. The mean ± standard deviation (range) distance after the application of IBEF was 5.0 ± 2.9 mm (0–10 mm) in patients without surgery-related motor deficits compared with 1.1 ± 1.6 mm (0–5 mm) in patients who showed new permanent surgery-related motor deficits postoperatively (<i>p</i> < 0.001). For language, the distance was 0.7 ± 1.2 mm (0–2 mm) in patients with new permanent deficits compared with 3.1 ± 4.5 mm (0–14 mm) in patients without new permanent surgery-related language deficits (<i>p</i> = 0.541). Preoperative tractography corrected by IBEF for subcortical resection of gliomas is highly accurate. However, at least for such subcortical anatomy, the severity of brain shift was considerably overestimated in the past. |
| first_indexed | 2024-03-10T12:29:08Z |
| format | Article |
| id | doaj.art-8e13e741ca0c43afaa19e1ba10fa4e1a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:29:08Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-8e13e741ca0c43afaa19e1ba10fa4e1a2023-11-21T14:47:56ZengMDPI AGCancers2072-66942021-04-01138178710.3390/cancers13081787Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain ShiftSebastian Ille0Maximilian Schwendner1Wei Zhang2Axel Schroeder3Bernhard Meyer4Sandro M. Krieg5Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyWhen using preoperative tractography intraoperatively, inaccuracies due to brain shift might occur. Intraoperative tractography is rarely performed. Elastic fusion (EF) is a tool developed to compensate for brain shift, gravity, and tissue resection based on intraoperative images. Our hypothesis was that preoperative tractography is accurate and adjustments of tractography by intraoperative magnetic resonance imaging (ioMRI)-based EF (IBEF) compensate for brain shift. Between February 2018 and June 2019, 78 patients underwent eloquent (46 motor, 32 language) glioma resection in our department using intraoperative MRI. Mean distances between the resection cavity and tractography were analyzed and correlated with clinical outcomes. The mean ± standard deviation (range) distance after the application of IBEF was 5.0 ± 2.9 mm (0–10 mm) in patients without surgery-related motor deficits compared with 1.1 ± 1.6 mm (0–5 mm) in patients who showed new permanent surgery-related motor deficits postoperatively (<i>p</i> < 0.001). For language, the distance was 0.7 ± 1.2 mm (0–2 mm) in patients with new permanent deficits compared with 3.1 ± 4.5 mm (0–14 mm) in patients without new permanent surgery-related language deficits (<i>p</i> = 0.541). Preoperative tractography corrected by IBEF for subcortical resection of gliomas is highly accurate. However, at least for such subcortical anatomy, the severity of brain shift was considerably overestimated in the past.https://www.mdpi.com/2072-6694/13/8/1787gliomaintraoperative MRIintraoperative neuromonitoringparesistractography |
| spellingShingle | Sebastian Ille Maximilian Schwendner Wei Zhang Axel Schroeder Bernhard Meyer Sandro M. Krieg Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift Cancers glioma intraoperative MRI intraoperative neuromonitoring paresis tractography |
| title | Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift |
| title_full | Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift |
| title_fullStr | Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift |
| title_full_unstemmed | Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift |
| title_short | Tractography for Subcortical Resection of Gliomas Is Highly Accurate for Motor and Language Function: ioMRI-Based Elastic Fusion Disproves the Severity of Brain Shift |
| title_sort | tractography for subcortical resection of gliomas is highly accurate for motor and language function iomri based elastic fusion disproves the severity of brain shift |
| topic | glioma intraoperative MRI intraoperative neuromonitoring paresis tractography |
| url | https://www.mdpi.com/2072-6694/13/8/1787 |
| work_keys_str_mv | AT sebastianille tractographyforsubcorticalresectionofgliomasishighlyaccurateformotorandlanguagefunctioniomribasedelasticfusiondisprovestheseverityofbrainshift AT maximilianschwendner tractographyforsubcorticalresectionofgliomasishighlyaccurateformotorandlanguagefunctioniomribasedelasticfusiondisprovestheseverityofbrainshift AT weizhang tractographyforsubcorticalresectionofgliomasishighlyaccurateformotorandlanguagefunctioniomribasedelasticfusiondisprovestheseverityofbrainshift AT axelschroeder tractographyforsubcorticalresectionofgliomasishighlyaccurateformotorandlanguagefunctioniomribasedelasticfusiondisprovestheseverityofbrainshift AT bernhardmeyer tractographyforsubcorticalresectionofgliomasishighlyaccurateformotorandlanguagefunctioniomribasedelasticfusiondisprovestheseverityofbrainshift AT sandromkrieg tractographyforsubcorticalresectionofgliomasishighlyaccurateformotorandlanguagefunctioniomribasedelasticfusiondisprovestheseverityofbrainshift |