Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics
Tumors infiltrating the motor system lead to significant disability, often caused by corticospinal tract injury. The delineation of the healthy-pathological white matter (WM) interface area, for which diffusion magnetic resonance imaging (dMRI) has shown promising potential, may improve treatment ou...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.622358/full |
| _version_ | 1819296061546561536 |
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| author | Lucius S. Fekonja Lucius S. Fekonja Ziqian Wang Dogu B. Aydogan Timo Roine Melina Engelhardt Melina Engelhardt Felix R. Dreyer Felix R. Dreyer Peter Vajkoczy Thomas Picht Thomas Picht Thomas Picht |
| author_facet | Lucius S. Fekonja Lucius S. Fekonja Ziqian Wang Dogu B. Aydogan Timo Roine Melina Engelhardt Melina Engelhardt Felix R. Dreyer Felix R. Dreyer Peter Vajkoczy Thomas Picht Thomas Picht Thomas Picht |
| author_sort | Lucius S. Fekonja |
| collection | DOAJ |
| description | Tumors infiltrating the motor system lead to significant disability, often caused by corticospinal tract injury. The delineation of the healthy-pathological white matter (WM) interface area, for which diffusion magnetic resonance imaging (dMRI) has shown promising potential, may improve treatment outcome. However, up to 90% of white matter (WM) voxels include multiple fiber populations, which cannot be correctly described with traditional metrics such as fractional anisotropy (FA) or apparent diffusion coefficient (ADC). Here, we used a novel fixel-based along-tract analysis consisting of constrained spherical deconvolution (CSD)-based probabilistic tractography and fixel-based apparent fiber density (FD), capable of identifying fiber orientation specific microstructural metrics. We addressed this novel methodology’s capability to detect corticospinal tract impairment. We measured and compared tractogram-related FD and traditional microstructural metrics bihemispherically in 65 patients with WHO grade III and IV gliomas infiltrating the motor system. The cortical tractogram seeds were based on motor maps derived by transcranial magnetic stimulation. We extracted 100 equally distributed cross-sections along each streamline of corticospinal tract (CST) for along-tract statistical analysis. Cross-sections were then analyzed to detect differences between healthy and pathological hemispheres. All metrics showed significant differences between healthy and pathologic hemispheres over the entire tract and between peritumoral segments. Peritumoral values were lower for FA and FD, but higher for ADC within the entire cohort. FD was more specific to tumor-induced changes in CST than ADC or FA, whereas ADC and FA showed higher sensitivity. The bihemispheric along-tract analysis provides an approach to detect subject-specific structural changes in healthy and pathological WM. In the current clinical dataset, the more complex FD metrics did not outperform FA and ADC in terms of describing corticospinal tract impairment. |
| first_indexed | 2024-12-24T04:52:07Z |
| format | Article |
| id | doaj.art-ff695495cfb04c53b2d01df172e97ddb |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-24T04:52:07Z |
| publishDate | 2021-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-ff695495cfb04c53b2d01df172e97ddb2022-12-21T17:14:31ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-01-011010.3389/fonc.2020.622358622358Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based MetricsLucius S. Fekonja0Lucius S. Fekonja1Ziqian Wang2Dogu B. Aydogan3Timo Roine4Melina Engelhardt5Melina Engelhardt6Felix R. Dreyer7Felix R. Dreyer8Peter Vajkoczy9Thomas Picht10Thomas Picht11Thomas Picht12Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, GermanyCluster of Excellence: “Matters of Activity. Image Space Material”, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, FinlandDepartment of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, FinlandDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, GermanyEinstein Center for Neurosciences Berlin, Charité-Universitätsmedizin Berlin, Berlin, GermanyCluster of Excellence: “Matters of Activity. Image Space Material”, Humboldt-Universität zu Berlin, Berlin, GermanyBrain Language Laboratory, Department of Philosophy and Humanities, Freie Universität Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, GermanyCluster of Excellence: “Matters of Activity. Image Space Material”, Humboldt-Universität zu Berlin, Berlin, GermanyEinstein Center for Neurosciences Berlin, Charité-Universitätsmedizin Berlin, Berlin, GermanyTumors infiltrating the motor system lead to significant disability, often caused by corticospinal tract injury. The delineation of the healthy-pathological white matter (WM) interface area, for which diffusion magnetic resonance imaging (dMRI) has shown promising potential, may improve treatment outcome. However, up to 90% of white matter (WM) voxels include multiple fiber populations, which cannot be correctly described with traditional metrics such as fractional anisotropy (FA) or apparent diffusion coefficient (ADC). Here, we used a novel fixel-based along-tract analysis consisting of constrained spherical deconvolution (CSD)-based probabilistic tractography and fixel-based apparent fiber density (FD), capable of identifying fiber orientation specific microstructural metrics. We addressed this novel methodology’s capability to detect corticospinal tract impairment. We measured and compared tractogram-related FD and traditional microstructural metrics bihemispherically in 65 patients with WHO grade III and IV gliomas infiltrating the motor system. The cortical tractogram seeds were based on motor maps derived by transcranial magnetic stimulation. We extracted 100 equally distributed cross-sections along each streamline of corticospinal tract (CST) for along-tract statistical analysis. Cross-sections were then analyzed to detect differences between healthy and pathological hemispheres. All metrics showed significant differences between healthy and pathologic hemispheres over the entire tract and between peritumoral segments. Peritumoral values were lower for FA and FD, but higher for ADC within the entire cohort. FD was more specific to tumor-induced changes in CST than ADC or FA, whereas ADC and FA showed higher sensitivity. The bihemispheric along-tract analysis provides an approach to detect subject-specific structural changes in healthy and pathological WM. In the current clinical dataset, the more complex FD metrics did not outperform FA and ADC in terms of describing corticospinal tract impairment.https://www.frontiersin.org/articles/10.3389/fonc.2020.622358/fulltractographycorticospinal tractdiffusion magnetic resonance imagingmotor functionapparent diffusion coefficienttumor |
| spellingShingle | Lucius S. Fekonja Lucius S. Fekonja Ziqian Wang Dogu B. Aydogan Timo Roine Melina Engelhardt Melina Engelhardt Felix R. Dreyer Felix R. Dreyer Peter Vajkoczy Thomas Picht Thomas Picht Thomas Picht Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics Frontiers in Oncology tractography corticospinal tract diffusion magnetic resonance imaging motor function apparent diffusion coefficient tumor |
| title | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
| title_full | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
| title_fullStr | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
| title_full_unstemmed | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
| title_short | Detecting Corticospinal Tract Impairment in Tumor Patients With Fiber Density and Tensor-Based Metrics |
| title_sort | detecting corticospinal tract impairment in tumor patients with fiber density and tensor based metrics |
| topic | tractography corticospinal tract diffusion magnetic resonance imaging motor function apparent diffusion coefficient tumor |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.622358/full |
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