Diffusion-tensor imaging of white matter tracts in patients with cerebral neoplasm

Brian P. Witwer Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Brian P. Witwer in
Current site
Google Scholar
PubMed Close
 M.D.
,
Roham Moftakhar Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Roham Moftakhar in
Current site
Google Scholar
PubMed Close
 M.D.
,
Khader M. Hasan Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Khader M. Hasan in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Praveen Deshmukh Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Praveen Deshmukh in
Current site
Google Scholar
PubMed Close
 M.D.
,
Victor Haughton Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Victor Haughton in
Current site
Google Scholar
PubMed Close
 M.D.
,
Aaron Field Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Aaron Field in
Current site
Google Scholar
PubMed Close
 M.D., Ph.D.
,
Konstantinos Arfanakis Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Konstantinos Arfanakis in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Jane Noyes Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Jane Noyes in
Current site
Google Scholar
PubMed Close
 N.P.
,
Chad H. Moritz Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Chad H. Moritz in
Current site
Google Scholar
PubMed Close
 B.S.
,
M. Elizabeth Meyerand Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by M. Elizabeth Meyerand in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Howard A. Rowley Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Howard A. Rowley in
Current site
Google Scholar
PubMed Close
 M.D.
,
Andrew L. Alexander Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Andrew L. Alexander in
Current site
Google Scholar
PubMed Close
 Ph.D.
, and
Behnam Badie Departments of Neurological Surgery, Radiology, Medical Physics, and Psychiatry, University of Wisconsin School of Medicine, Madison, Wisconsin

Search for other papers by Behnam Badie in
Current site
Google Scholar
PubMed Close
 M.D.
Page Range:
568–575
Volume/Issue:
Volume 97: Issue 3
DOI link:
https://doi.org/10.3171/jns.2002.97.3.0568
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $525.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $624.00
Click here for subscription options

  • Purchase Now

    USD  $45.00

  • JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

    USD  $525.00

  • JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

    USD  $624.00
USD  $45.00
USD  $525.00
USD  $624.00
Print or Print + Online Sign in

Object. Preserving vital cerebral function while maximizing tumor resection is a principal goal in surgical neurooncology. Although functional magnetic resonance imaging has been useful in the localization of eloquent cerebral cortex, this method does not provide information about the white matter tracts that may be involved in invasive, intrinsic brain tumors. Recently, diffusion-tensor (DT) imaging techniques have been used to map white matter tracts in the normal brain. The aim of this study was to demonstrate the role of DT imaging in preoperative mapping of white matter tracts in relation to cerebral neoplasms.

Methods. Nine patients with brain malignancies (one pilocytic astrocytoma, five oligodendrogliomas, one low-grade oligoastrocytoma, one Grade 4 astrocytoma, and one metastatic adenocarcinoma) underwent DT imaging examinations prior to tumor excision. Anatomical information about white matter tract location, orientation, and projections was obtained in every patient. Depending on the tumor type and location, evidence of white matter tract edema (two patients), infiltration (two patients), displacement (five patients), and disruption (two patients) could be assessed with the aid of DT imaging in each case.

Conclusions. Diffusion-tensor imaging allowed for visualization of white matter tracts and was found to be beneficial in the surgical planning for patients with intrinsic brain tumors. The authors' experience with DT imaging indicates that anatomically intact fibers may be present in abnormal-appearing areas of the brain. Whether resection of these involved fibers results in subtle postoperative neurological deficits requires further systematic study.

  • Collapse
  • Expand

Contributor Notes

Address reprint requests to: Behnam Badie, M.D., Department of Neurological Surgery, University of Wisconsin Medical School, K4/805 Clinical Science Center, 600 Highland Avenue, Madison, Wisconsin 53792. email: Badie@neurosurg.wisc.edu.
  • 1.

    Ammirati M, , Vick N, & Liao YL, et al: Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas. Neurosurgery 21:201–206, 1987 Ammirati M, Vick N, Liao YL, et al: Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas. Neurosurgery 21:201–206, 1987

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Atlas SW, , Howard RS II, & Maldjian J, et al: Functional magnetic resonance imaging of regional brain activity in patients with intracerebral gliomas: findings and implications for clinical management. Neurosurgery 38:329–338, 1996 Atlas SW, Howard RS II, Maldjian J, et al: Functional magnetic resonance imaging of regional brain activity in patients with intracerebral gliomas: findings and implications for clinical management. Neurosurgery 38:329–338, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Basser PJ, , Pajevic S, & Pierpaoli C, et al: In vivo fiber tractography using DT-MRI data. Magn Reson Med 44:625–632, 2000 Basser PJ, Pajevic S, Pierpaoli C, et al: In vivo fiber tractography using DT-MRI data. Magn Reson Med 44:625–632, 2000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Basser PJ, & Pierpaoli C: Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 111:209–219, 1996 Basser PJ, Pierpaoli C: Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 111:209–219, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Berger MS, & Ojemann GA: Intraoperative brain mapping techniques in neuro-oncology. Stereotact Funct Neurosurg 58:153–161, 1992 Berger MS, Ojemann GA: Intraoperative brain mapping techniques in neuro-oncology. Stereotact Funct Neurosurg 58:153–161, 1992

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Bittar RG, , Olivier A, & Sadikot AF, et al: Cortical motor and somatosensory representation: effect of cerebral lesions. J Neurosurg 92:242–248, 2000 Bittar RG, Olivier A, Sadikot AF, et al: Cortical motor and somatosensory representation: effect of cerebral lesions. J Neurosurg 92:242–248, 2000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Brunberg JA, , Chenevert TL, & McKeever PE, et al: In vivo MR determination of water diffusion coefficients and diffusion anisotropy: correlation with structural alteration in gliomas of the cerebral hemispheres. AJNR 16:361–371, 1995 Brunberg JA, Chenevert TL, McKeever PE, et al: In vivo MR determination of water diffusion coefficients and diffusion anisotropy: correlation with structural alteration in gliomas of the cerebral hemispheres. AJNR 16:361–371, 1995

    • Search Google Scholar
    • Export Citation
  • 8.

    Chien D, , Kwong KK, & Gress DR, et al: MR diffusion imaging of cerebral infarction in humans. AJNR 13:1097–1105, 1992 Chien D, Kwong KK, Gress DR, et al: MR diffusion imaging of cerebral infarction in humans. AJNR 13:1097–1105, 1992

    • Search Google Scholar
    • Export Citation
  • 9.

    Ciric I, , Ammirati M, & Vick N, et al: Supratentorial gliomas: surgical considerations and immediate postoperative results. Gross total resection versus partial resection. Neurosurgery 21:21–26, 1987 Ciric I, Ammirati M, Vick N, et al: Supratentorial gliomas: surgical considerations and immediate postoperative results. Gross total resection versus partial resection. Neurosurgery 21:21–26, 1987

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Conturo TE, , Lori NF, & Cull TS, et al: Tracking neuronal fiber pathways in the living human brain. Proc Nat Acad Sci USA 96:10422–10427, 1999 Conturo TE, Lori NF, Cull TS, et al: Tracking neuronal fiber pathways in the living human brain. Proc Nat Acad Sci USA 96:10422–10427, 1999

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Cosgrove GR, , Buchbinder BR, & Jiang H: Functional magnetic resonance imaging for intracranial navigation. Neurosurg Clin N Am 7:313–322, 1996 Cosgrove GR, Buchbinder BR, Jiang H: Functional magnetic resonance imaging for intracranial navigation. Neurosurg Clin N Am 7:313–322, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Daumas-Duport C, , Scheithauer W, & O'Fallon J, et al: Grading of astrocytomas. A simple and reproducible method. Cancer 62:2152–2165, 1988 Daumas-Duport C, Scheithauer W, O'Fallon J, et al: Grading of astrocytomas. A simple and reproducible method. Cancer 62:2152–2165, 1988

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Doran M, , Hajnal JV, & Van Bruggen N, et al: Normal and abnormal white matter tracts shown by MR imaging using directional diffusion weighted sequences. J Comput Assist Tomogr 14:865–873, 1990 Doran M, Hajnal JV, Van Bruggen N, et al: Normal and abnormal white matter tracts shown by MR imaging using directional diffusion weighted sequences. J Comput Assist Tomogr 14:865–873, 1990

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Grafton ST, , Woods RP, & Mazziotta JC, et al: Somatotopic mapping of the primary motor cortex in humans: activation studies with cerebral blood flow and positron emission tomography. J Neurophysiol 66:735–743, 1991 Grafton ST, Woods RP, Mazziotta JC, et al: Somatotopic mapping of the primary motor cortex in humans: activation studies with cerebral blood flow and positron emission tomography. J Neurophysiol 66:735–743, 1991

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Hasan KM, , Parker DL, & Alexander AL: Comparison of gradient encoding schemes for diffusion-tensor MRI. J Magn Reson Imaging 13:769–780, 2001 Hasan KM, Parker DL, Alexander AL: Comparison of gradient encoding schemes for diffusion-tensor MRI. J Magn Reson Imaging 13:769–780, 2001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Jones DK, , Simmons A, & Williams SC, et al: Non-invasive assessment of axonal fiber connectivity in the human brain via diffusion tensor MRI. Magn Reson Med 42:37–41, 1999 Jones DK, Simmons A, Williams SC, et al: Non-invasive assessment of axonal fiber connectivity in the human brain via diffusion tensor MRI. Magn Reson Med 42:37–41, 1999

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Kelly PJ: Volumetric stereotactic surgical resection of intra-axial brain mass lesions. Mayo Clin Proc 63:1186–1198, 1988 Kelly PJ: Volumetric stereotactic surgical resection of intra-axial brain mass lesions. Mayo Clin Proc 63:1186–1198, 1988

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Lehericy S, , Duffau H, & Cornu P, et al: Correspondence between functional magnetic resonance imaging somatotopy and individual brain anatomy of the central region: comparison with intraoperative stimulation in patients with brain tumors. J Neurosurg 92:589–598, 2000 Lehericy S, Duffau H, Cornu P, et al: Correspondence between functional magnetic resonance imaging somatotopy and individual brain anatomy of the central region: comparison with intraoperative stimulation in patients with brain tumors. J Neurosurg 92:589–598, 2000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    McDonald JD, , Chong BW, & Lewine JD, et al: Integration of preoperative and intraoperative functional brain mapping in a frame-less stereotactic environment for lesions near eloquent cortex. Technical note. J Neurosurg 90:591–598, 1999 McDonald JD, Chong BW, Lewine JD, et al: Integration of preoperative and intraoperative functional brain mapping in a frame-less stereotactic environment for lesions near eloquent cortex. Technical note. J Neurosurg 90:591–598, 1999

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Mueller WM, , Yetkin FZ, & Hammeke TA, et al: Functional magnetic resonance imaging mapping of the motor cortex in patients with cerebral tumors. Neurosurgery 39:515–521, 1996 Mueller WM, Yetkin FZ, Hammeke TA, et al: Functional magnetic resonance imaging mapping of the motor cortex in patients with cerebral tumors. Neurosurgery 39:515–521, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Ojemann JG, , Miller JW, & Silbergeld DL: Preserved function in brain invaded by tumor. Neurosurgery 39:253–259, 1996 Ojemann JG, Miller JW, Silbergeld DL: Preserved function in brain invaded by tumor. Neurosurgery 39:253–259, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Pajevic S, & Pierpaoli C: Color schemes to represent the orientation of anisotropic tissues from diffusion tensor data: application to white matter fiber tract mapping in the human brain. Magn Reson Med 42:526–540, 1999 Pajevic S, Pierpaoli C: Color schemes to represent the orientation of anisotropic tissues from diffusion tensor data: application to white matter fiber tract mapping in the human brain. Magn Reson Med 42:526–540, 1999

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Pierpaoli C, , Jezzard P, & Basser PJ, et al: Diffusion tensor MR imaging of the human brain. Radiology 201:637–648, 1996 Pierpaoli C, Jezzard P, Basser PJ, et al: Diffusion tensor MR imaging of the human brain. Radiology 201:637–648, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Roux FE, , Boulanouar K, & Ranjeva JP, et al: Cortical intraoperative stimulation in brain tumors as a tool to evaluate spatial data from motor functional MRI. Invest Radiol 34:225–229, 1999 Roux FE, Boulanouar K, Ranjeva JP, et al: Cortical intraoperative stimulation in brain tumors as a tool to evaluate spatial data from motor functional MRI. Invest Radiol 34:225–229, 1999

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Skirboll SS, , Ojemann GA, & Berger MS, et al: Functional cortex and subcortical white matter located within gliomas. Neurosurgery 38:678–685, 1996 Skirboll SS, Ojemann GA, Berger MS, et al: Functional cortex and subcortical white matter located within gliomas. Neurosurgery 38:678–685, 1996

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Stieltjes B, , Kaufmann WE, & van Zijl PC, et al: Diffusion tensor imaging and axonal tracking in the human brainstem. Neuroimage 14:723–735, 2001 Stieltjes B, Kaufmann WE, van Zijl PC, et al: Diffusion tensor imaging and axonal tracking in the human brainstem. Neuroimage 14:723–735, 2001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Wieshmann UC, , Symms MR, & Parker GJ, et al: Diffusion tensor imaging demonstrates deviation of fibers in normal appearing white matter adjacent to a brain tumor. J Neurol Neurosurg Psychiatry 68:501–503, 2000 Wieshmann UC, Symms MR, Parker GJ, et al: Diffusion tensor imaging demonstrates deviation of fibers in normal appearing white matter adjacent to a brain tumor. J Neurol Neurosurg Psychiatry 68:501–503, 2000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Woods RP, , Mazziotta JC, & Cherry SR: MRI-PET registration with automated algorithm. J Comput Assist Tomogr 17:536–546, 1993 Woods RP, Mazziotta JC, Cherry SR: MRI-PET registration with automated algorithm. J Comput Assist Tomogr 17:536–546, 1993

    • Crossref
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1873 418 38
Full Text Views 389 14 0
PDF Downloads 197 22 0
EPUB Downloads 0 0 0