Artikel
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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Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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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.