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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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nrTMS-based DTI fiber tracking for language-relevant subcortical fibre tracts – feasibility of the probabibilistic algorithm

nrTMS-basiertes DTI Fiber Tracking von sprachassoziierten Faserbahnen – Anwendung des probabilistischen Algorithmus

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  • presenting/speaker Chiara Negwer - Klinikum rechts der Isar, München, Deutschland
  • Ioana-Sabina Rautu - Klinikum rechts der Isar, München, Deutschland
  • Sebastian Ille - Klinikum rechts der Isar, München, Deutschland
  • Nico Sollmann - Klinikum rechts der Isar, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, München, Deutschland
  • Sandro Krieg - Klinikum rechts der Isar, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP183

doi: 10.3205/19dgnc519, urn:nbn:de:0183-19dgnc5197

Published: May 8, 2019

© 2019 Negwer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Preservation of language function in patients with perisylvian brain tumors is an important aspect in modern neurooncological treatment. For preservation of subcortical structures nrTMS-based DTI FT is a helpful method for preoperative planning and intraoperative application. Most published protocols use a deterministic algorithm, so the main objective of our study is the feasibility and applicability of a probabilistic fiber tracking algorithm in the clinical routine.

Methods: Twenty patients, suffering from perisylvian space-occupying lesions, could be included between 01/2018 and 09/2018. Every patient received nrTMS language mapping preoperatively. The nrTMS data were then exported to our tractography software (Mrtrx). A probabilistic algorithm then was performed for DTI FT using 77 different settings of minimal fiber length and fractional anisotropy thresholds.

Results: The probabilisitic algorithm was eligible in 100% of our patients. Language-relevant fiber tracts as the arcuate fascicle and the superior longitudinal fascicle could be portrayed in every patient using nrTMS data as seeding points.

Conclusion: Probabilistic nrTMS-based DTI FT is feasible in 100% of our patient cohort and delivers good results regarding the portrayal of subcortical white matter tracts. Further studies are needed to evaluate the benefits compared to the standard deterministic approach.