Journal
OPERATIVE NEUROSURGERY
Volume 16, Issue 2, Pages 197-210Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1093/ons/opy062
Keywords
Accuracy; Algorithm; fMRI; iMRI; nTMS; Tractography
Categories
Funding
- Medtronic Navigation Inc, Louisville, Colorado
- Neurosurgery Research Foundation of the DGNC
Ask authors/readers for more resources
BACKGROUND: Tractography is a popular tool for visualizing the corticospinal tract (CST). However, results may be influenced by numerous variables, eg, the selection of seeding regions of interests (ROIs) or the chosen tracking algorithm. OBJECTIVE: To compare different variable sets by correlating tractography results with intraoperative subcortical stimulation of the CST, correcting intraoperative brain shift by the use of intraoperative MRI. METHODS: Seeding ROIs were created by means of motor cortex segmentation, functional MRI (fMRI), and navigated transcranial magnetic stimulation (nTMS). Based on these ROIs, tractography was run for each patient using a deterministic and a probabilistic algorithm. Tractographies were processed on pre- and postoperatively acquired data. RESULTS: Using a linear mixed effects statistical model, best correlation between subcortical stimulation intensity and the distance between tractography and stimulation sites was achieved by using the segmented motor cortex as seeding ROI and applying the probabilistic algorithm on preoperatively acquired imaging sequences. Tractographies based on fMRI or nTMS results differed very little, but with enlargement of positive nTMS sites the stimulation-distance correlation of nTMS-based tractography improved. CONCLUSION: Our results underline that the use of tractography demands for careful interpretation of its virtual results by considering all influencing variables.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available