Quantitative Diffusion Tensor Imaging Analysis of Low-Grade Gliomas: From Preclinical Application to Patient Care

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• 作者：Tamara Ius¹ ; ^{tamara.ius@gmail.com} ; Luca Turella² ; Giada Pauletto³ ; Miriam Isola⁴ ; Marta Maieron⁵ ; Giovanni Sciacca¹ ; Riccardo Budai³ ; Serena D&rsquo ; Agostini⁶ ; Roberto Eleopra³ ; Miran Skrap¹
• 关键词：Brain mapping ; Diffusion tensor imaging analysis ; Extent of resection ; Intraoperative electric stimulation ; Low-grade gliomas ; Motor evoked potentials
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：333-343
• 全文大小：6757 K
• 卷排序：97

文摘

Preoperative diffusion tensor tractography (DTT) has recently been used to aid in the mapping of functional pathways to limit damage associated with resection of low-grade gliomas (LGGs).ObjectiveTo assess the predictive capacity of DTT as a biomarker of postoperative motor outcomes in patients with LGGs involving the corticospinal tract (CST). CST parameters obtained using a quantitative fiber tracking approach were used to investigate the reliability of the DTT biomarker by comparing their values in the tumoral (Tcst) and healthy (Hcst) hemispheres.MethodsThirty-seven patients with LGGs involving the CST were enrolled. Quantification of structural differences between the Tcst and Hcst were analyzed according to the novel biomarker (NF index), defined as follows: (Hcst NF – Tcst NF)/Hcst NF, where NF represents the number of fibers in each region. Logistic regression analysis was used to examine associations among clinical postoperative outcomes and NF index values, tumoral patterns, and premotor/motor evoked potentials.ResultsNF values significantly differed between the Tcst and Hcst. Analysis of the NF index showed that patients with a preoperative NF index <0.22 had a significantly lower risk of developing transient postoperative deficits (area under the curve, 0.92; 95% binomial confidence interval, 0.834–1). Patients with less pronounced differences in NF between the Tcst and Hcst also experienced better clinical outcomes.ConclusionsThe NF index may be a useful biomarker for predicting clinical outcomes in patients with LGGs. Furthermore, the NF index may provide a preoperative estimate of the patient's potential for recovery from possible postsurgical neurologic deficits.