gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Registration of functional MRI and fibertracking for intraoperative identification of the pyramidal tract

Registrierung von funktionellem MR und Fibertracking zur intraoperativen Identifizierung der Pyramidenbahn

Meeting Abstract

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  • corresponding author C. Nimsky - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Erlangen
  • O. Ganslandt - Neurochirurgische Klinik,; Neurozentrum, Universität Erlangen-Nürnberg, Erlangen
  • P. Grummich - Neurozentrum, Universität Erlangen-Nürnberg, Erlangen
  • F. Enders - Neurozentrum, Universität Erlangen-Nürnberg, Erlangen
  • D. Merhof - Neurozentrum, Universität Erlangen-Nürnberg, Erlangen
  • R. Fahlbusch - Neurochirurgische Klinik, Universität Erlangen-Nürnberg, Erlangen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-08.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0205.shtml

Published: May 4, 2005

© 2005 Nimsky et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To identify the pyramidal tract in glioma patients by combining functional magnetic resonance imaging (fMRI) with diffusion tensor imaging (DTI) based fiber tracking.

Methods

Single-shot spin-echo diffusion weighted echo planar imaging was used for DTI. 3-D fibertracking was generated applying a knowledge-based multiple-ROI (region of interest) approach with user-defined seed regions. Tracking was initiated in both retro- and orthograde directions according to the direction of the principal eigenvector in each voxel of the ROI. Fibertracking was integrated into navigation by defining the coordinate system of the reconstructed fiber tracts by a rigid registration of DTI-B0 images with 3-D T1-weighted anatomical datasets. Additionally functional data from fMRI identifying the motor cortex were registered with these data.

Results

In 36 patients fMRI and DTI data were acquired. fMRI allowed a reliable initiation of the tracking algorithm using the fMRI activity identifying the motor gyrus as cortical seed region. The registration of fMRI and fiber tracking data was consistent in all cases. In 20 patients fiber tract data were visualised during surgery by microscope-based neuronavigation. In none of these patients a new postoperative neurological deficit was observed. Fiber tract generation and integration into the navigation needed about 25-30 minutes in each case.

Conclusions

Fibertracking registered with fMRI results in a reliable identification of the course of the pyramidal tract in glioma patients. Integration of these data into a neuronavigation setup is possible, allowing removal of tumours adjacent to eloquent brain areas with low morbidity.