Diffusion tensor tractography for the surgical management of peripheral nerve sheath tumors

Neurosurgical Focus
Manfred SchmidtOskar C Aszmann

Abstract

OBJECT Peripheral nerve sheath tumors (PNSTs) are uncommon but bear a significant risk of malignancy. High-resolution MRI is the standard technique for characterizing PNSTs. However, planning the appropriate extent of resection and subsequent reconstructive strategies is highly dependent on the intraoperative findings because preoperative MRI evaluation can be insufficient. Diffusion tensor tractography (DTT) represents a recently developed advanced MRI technique that reveals the microstructure of tissues based on monitoring the random movement of water molecules. DTT has the potential to provide diagnostic insights beyond conventional MRI techniques due to its mapping of specific fibrillar nerve structures. Here, DTT was applied to evaluate PNSTs and to examine the usefulness of this method for the correct delineation of tumor and healthy nerve tissue and the value of this information in the preoperative planning of surgical interventions. METHODS In this prospective study, patients with the clinical symptoms of a PNST were investigated using DTT 3-Tesla MRI scans. Image data processing and tractography were performed using the FACT (fiber assessment by continuous tracking) algorithm and multiple-regions-of-interest approach. ...Continue Reading

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Citations

Oct 3, 2017·Continuum : Lifelong Learning in Neurology·Francis O Walker
Apr 6, 2019·La Radiologia medica·Federico BrunoAntonio Barile
Jan 17, 2019·Annals of Surgery·Erika M WalshJason M Warram
Oct 28, 2019·Journal of Magnetic Resonance Imaging : JMRI·Darryl B SneagJaemin Shin
Jul 16, 2017·European Radiology·Avneesh ChhabraGustav Andreisek
Jun 20, 2020·European Journal of Radiology·Alexandra S GersingKlaus Woertler

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Methods Mentioned

BETA
dissection

Software Mentioned

Philips Achieva
DTT

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