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• W2494900306 abstract "Diffusion tractography forms a natural extension of presurgical functional MRI to exert an impact on actual surgical decisions. It improves the preoperative evaluation, planning and targeting by intraoperative neuronavigation, as well as prediction of procedural risks and postprocedural outcome. This chapter discusses clinical applications of presurgical tractography, methods available to it, indications for when and how to perform fiber tracking prior to surgical procedures, and intrinsic limitations. Presurgical applications are most concerned about false-negative tractography results (i.e. partial and total tracking failures). Probabilistic tractography is shown to increase the sensitivity of preoperative fiber detections under aversive clinical conditions, such as low fractional anisotropy (FA) due to perifocal tumor edema. Presurgical tractography applications ought to take advantage of these benefits and should not trade speed for accuracy. Potential tractography indications cover (i) preservation of functionally indispensable tracts by surgical procedures, (ii) selective tract transections, and (iii) pre-implantation trackings. While the former has been translated into medical practice, both of the latter are largely future prospects for presurgical tractography applications. The following tracts should be preserved from surgical resections whenever possible: the pyramidal tract, the arcuate, inferior fronto-occipital, longitudinal and presumably parts of Wernicke’s perpendicular fasciculus, and the optic radiation. Presurgical tractography also has the potential to replace or at least guide intraoperative electrical stimulation mapping by selective subcortical stimulation sites. In surgical transections, tractography may eventually improve targeting for pain, spasm, and seizure control. Prior to surgical implantation (e.g. of auditory or deep brain stimulation electrodes), connectivity analyses and tractography can already supplement preoperative assessments. These presurgical applications are illustrated and discussed on the basis of clinical showcases." @default.
• W2494900306 created "2016-08-23" @default.
• W2494900306 creator A5010331921 @default.
• W2494900306 creator A5040714848 @default.
• W2494900306 creator A5046004300 @default.
• W2494900306 date "2014-01-01" @default.
• W2494900306 modified "2023-09-25" @default.
• W2494900306 title "Presurgical Tractography Applications" @default.
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