gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Correlation of visual field deficits and q-ball high resolution fiber tractography of the optic radiation for adjacently located intracerebral lesions

Korrelation hochauflösender Fasertraktographie und objektivierter Gesichtfelddefekte bei intrazerebralen Läsionen nahe der Sehstrahlung

Meeting Abstract

  • presenting/speaker Pavlina Lenga - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Moritz Scherer - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Jan Teuber - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Peter Neher - German Cancer Research Center (DKFZ), Division of Medical Image Computing, Heidelberg, Deutschland
  • Martin Bendszus - Universitätsklinikum Heidelberg, Klinik für Neuroradiologie, Heidelberg, Deutschland
  • Klaus Maier-Hein - German Cancer Research Center (DKFZ), Division of Medical Image Computing, Heidelberg, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland
  • Daniela Becker - Universitätsklinikum Heidelberg, Neurochirurgische Klinik, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV315

doi: 10.3205/22dgnc302, urn:nbn:de:0183-22dgnc3029

Veröffentlicht: 25. Mai 2022

© 2022 Lenga et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Visual field deficits (VFD) due to optic radiation (OR) injury are a common complication among patients with lesions in the temporo-occipital lobe.The advent of diffusion tensor fiber tractography (DTI-FT) has been well established for planning neurological surgeries to diminish visual field deficits (VFD).The introduction of more sophisticated diffusion signal models for high resolution FT (HRFT) has already delivered promising and beneficial results compared with DTI.Our study aims to examine the utilization of DTI-FT and HRFT based on the q-ball model (QBI) in pre-surgical planning of lesions in the proximity of the OR and evaluate possible associations between VFD and 1) the nearest distance from lesion to the fibers of OR (nD-LOR), 2) the lesions volume (LV).

Methods: This is an on-going prospective clinical trial collecting clinical and imaging data on patients with lesions in deterrent areas. For this sub analysis, 10 patients with lesions (9 gliomas and 1 cavernoma) in proximity to the OR were analyzed.Probalistic QBI-, and DTI-FT was performed for OR reconstruction based on a conventional diffusion-weighted MRI sequence.Quantitative analysis evaluated LV and nD-LOR. VFD were determined in accordance to standardized automated perimetry.

Results: A total of 10 patients with a mean age of 53 years (SD 10.1) were included. Four patients presented with normal vision, and six with preexisting VFD. Five lesions were in the temporo-occipital lobe, two in the occipital lobe and three in the temporal lobe. According to QBI-FT, the median nD-LOR was significantly smaller in patients with VFD (-3.5 IQR 2.6) compared to those without VFD (9.7 IQR 11.7; p=0.01). Tumor volume was significantly larger among patients with VFD (24.9 IQR 9.4 vs. 6.8 IQR 5.1; p=0.01). No significant differences were observed in nD-LOR between the groups, as measured with DTI-FT. Overall, increased tumor volume was significantly correlated with a decreased nD as computed with QBI-FT (rs=-0.71, p=0.022).

Conclusion: Our preliminary findings suggest that in cases with VFD the lesions are substantially larger and located close or even within the reconstructed OR-fiber bundle.These phenomena could be detected only by using QBI-FT, not DTI-FT.It seems the deployment of QBI-FT might be a promising tool to detect preexisting VFD and prevent further damage during surgery for lesions adjacent to the OR.