gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

High angular resolution diffusion imaging (HARDI) with compressed sensing based fiber tractography – impact of clinical application in neurosurgical practice – initial experience

Meeting Abstract

  • D. Kuhnt - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • M. Bauer - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • A. Becker - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • D. Merhof - Visual Computing, Universität Konstanz, Konstanz
  • M. Richer - Visual Computing, Universität Konstanz, Konstanz
  • C. Nimsky - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.14.04

DOI: 10.3205/12dgnc292, URN: urn:nbn:de:0183-12dgnc2921

Published: June 4, 2012

© 2012 Kuhnt et al.
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Outline

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Objective: Diffusion tensor imaging (DTI) based fiber tractography has proven its impact in neurosurgical practice with low postoperative morbidity. However, there is a major drawback for the spatial locations of crossing-, kissing-, or fanning fibers and in the vicinity of tumor or edema. The diffusion model HARDI (High Angular Resolution Diffusion Imaging) is able to overcome this restriction, using multi-modal diffusion patterns. However, clinical use is limited as HARDI requires larger numbers of gradients resulting in long acquisition times. With compressed sensing (CS) techniques, HARDI signals can be calculated using a lower number of measurements, thus being a feasible tool for HARDI based fiber tractography in clinical practice.

Methods: Eight patients with high-grade gliomas in the vicinity of language related areas, all associated with significant perifocal edema, underwent 3T MRI including a diffusion-weighted dataset with 30 gradient directions. In addition fMRI (for cortical language sites) was also performed. Fiber tractography was performed with the FDA-approved tensor deflection algorithm based on DTI as well as with the HARDI+CS approach.

Results: Using fMRI as the seed-region, DTI-based tractography could be practically performed in all cases, but failed to vizualise language-related fibers within or in direct vicinity to the tumor or surrounding edema. By contrast, HARDI+CS-based reconstruction from the same MRI-dataset of language-related fiber bundels displayed these successfully in all cases (including both major fiber bundels arcuate fasciclus (AF) and inferior occipitofrontal fasciculus (IOFF)).

Conclusions: HARDI+CS seems to be a promising approach for fiber tractography in clinical practice for neuroanatomically complex fiber pathways, overcoming the problem of long acquisition times. Tractography results detected language-related fiber bundles in close proximity to high-grade gliomas, which could not be detected with commonly used DTI-based reconstruction