gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Predictive value of inferior fronto-occipital fasciculus DTI-Fiber Tracking for determining preoperatively the extent of resection for surgery of frontal and temporal gliomas

Meeting Abstract

  • G. Bertani - Cattedra Neurochirurgica, Università degli Studi di Milano
  • G. Carrabba - Cattedra Neurochirurgica, Università degli Studi di Milano
  • A. Casarotti - Cattedra Neurochirurgica, Università degli Studi di Milano
  • A. Falini - Neuroradiology Department and CERMAC (Centro di Eccellenza Risonanza Magnetica ad Alto Campo)
  • S. Gaini - Cattedra Neurochirurgica, Università degli Studi di Milano
  • L. Bello - Cattedra Neurochirurgica, Università degli Studi di Milano

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.07-06

DOI: 10.3205/09dgnc041, URN: urn:nbn:de:0183-09dgnc0417

Published: May 20, 2009

© 2009 Bertani et al.
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Outline

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Objective: This work reports the analysis of the relationship between inferior fronto-occipital fasciculus (IFO), neoplastic lesions and surgical resection, in patients operated for gliomas located in the frontal, temporal and insular lobes of the dominant hemisphere. Aim of the study is evaluating the predictive value of inferior fronto-occipital fasciculus DTI-Fiber Tracking for determining the extent of the resection preoperatively.

Methods: We selected 38 cases affected by lesions located in the frontal, temporal and insular lobes of the dominant hemisphere, which were related to the trajectory of the IFO. For each patient preoperative and postoperative MR images and DTI-FT were loaded into the neuronavigation system and merged; volumetric scan analysis was used for establishing tumor location and topography, as well as the volume of the lesion and of the residual tumor. All preoperative fiber tracking datasets were evaluated and the position of the tract (IFO) compared to the tumor was recorded. Postoperative MR scans were then compared with DTI-FT, in order to evaluate the correlation between the resection boundaries and the trajectory of the fiber tract.

Results: Amongst the cases in which the IFO was inside the lesion, we found only incomplete resections (5 subtotal and 6 partial resections), while considering the cases in which the IFO was located outside the tumor, it was possible to perform a relevant (total/subtotal) resection in 18 of them (78%).

Conclusions: Fiber tracking of the inferior frontal-occipital fasciculus predicts the possibility and the extent of the resection for a frontal, temporal and/or insular lesion of the dominant hemisphere.