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Validation of diffusion tensor imaging tractography to visualize the dentatorubrothalamic tract for surgical planning
Journal article

Validation of diffusion tensor imaging tractography to visualize the dentatorubrothalamic tract for surgical planning

  • Nowacki, Andreas Departments of 1Neurosurgery and
  • Schlaier, Jürgen 2Department of Neurosurgery, University of Regensburg Medical Center, Regensburg, Germany
  • Debove, Ines 3Neurology, University Hospital Inselspital Bern, University of Bern, Switzerland; and
  • Pollo, Claudio Departments of 1Neurosurgery and
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Published in:
  • Journal of Neurosurgery. - Journal of Neurosurgery Publishing Group (JNSPG). - 2018, vol. 130, no. 1, p. 99-108
Surgery
Clinical Neurology
English OBJECTIVEThe dentatorubrothalamic tract (DRTT) has been suggested as the anatomical substrate for deep brain stimulation (DBS)–induced tremor alleviation. So far, little is known about how accurately and reliably tracking results correspond to the anatomical DRTT. The objective of this study was to systematically investigate and validate the results of different tractography approaches for surgical planning.METHODSThe authors retrospectively analyzed 4 methodological approaches for diffusion tensor imaging (DTI)–based fiber tracking using different regions of interest in 6 patients with essential tremor. Tracking results were analyzed and validated with reference to MRI-based anatomical landmarks, were projected onto the stereotactic atlas of Morel at 3 predetermined levels (vertical levels −3.6, −1.8, and 0 mm below the anterior commissure–posterior commissure line), and were correlated to clinical outcome.RESULTSThe 4 different methodologies for tracking the DRTT led to divergent results with respect to the MRI-based anatomical landmarks and when projected onto the stereotactic atlas of Morel. There was a statistically significant difference in the lateral and anteroposterior coordinates at the 3 vertical levels (p < 0.001, 2-way ANOVA). Different fractional anisotropy values ranging from 0.1 to 0.46 were required for anatomically plausible tracking results and led to varying degrees of success. Tracking results were not correlated to postoperative tremor reduction.CONCLUSIONSDifferent tracking methods can yield results with good anatomical approximation. The authors recommend using 3 regions of interest including the dentate nucleus of the cerebellum, the posterior subthalamic area, and the precentral gyrus to visualize the DRTT. Tracking results must be cautiously evaluated for anatomical plausibility and accuracy in each patient.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/89804
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