Diffusion Tensor Imaging Color [Neurosurgery Wiki]

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====== Diffusion Tensor Imaging Color ======

[[White matter tract]]s can be observed using [[tractogram]]s generated from [[diffusion tensor imaging]] (DTI). However, the dependence of these [[white matter]] [[tract]] images on [[subjective]] variables, including how seed points are placed and the preferred level of [[fractional anisotropy]], introduces [[interobserver]] [[inconsistency]] and potential lack of [[reliability]]. Schneider et al. proposed that [[color-coded maps]] (CCM) generated from [[DTI]] can be a preferred method for the [[visualization]] of important white matter tracts, circumventing [[bias]] in preoperative brain [[tumor resection]] [[planning]].

[[DTI]] was acquired retrospectively in 25 patients with [[brain tumor]]s. Lesions included 15 tumors of [[glia]]l origin, 9 [[brain metastases]], 2 [[meningioma]]s, and 1 [[cavernous angioma]]. [[Tractogram]]s of the [[pyramidal tract]] and/or [[optic radiation]]s, based on tumor location, was created by marking seed regions of interest using known anatomical locations. We compared the degree of tract involvement and white matter alteration between CCMs and tractograms. Neurological outcomes were obtained from chart reviews.

Results: The pyramidal tract was evaluated in 20/25 patients, the visual tracts were evaluated in 10/25, and both tracts were evaluated in 5/25. In 19/25 studies, the same patterns of white matter alternations were found between the CCMs and tractograms. In the 6 patients where patterns differed, 2 tractograms were not useful in determining pattern alteration; in the remaining 4/6, no practical difference was seen in comparing the studies. Two patients were lost to follow-up. Thirteen patients were neurologically improved or remained intact after intervention. In these, 10 of the 13 patients showed tumor-induced white matter tract displacement on CCM. Twelve patients had no improvement of their preoperative deficit. In 9 of these 12 patients, CCM showed white matter disruption.

CCMs provide a convenient, practical, and objective method of visualizing white matter tracts, obviating the need for potentially subjective and time-consuming [[tractography]]. CCMs are at least as reliable as tractograms in predicting neurological outcomes after neurosurgical intervention
((Schneider JR, Raval AB, Black K, Schulder M. Diffusion Tensor Imaging Color-Coded Maps: An Alternative to Tractography. Stereotact Funct Neurosurg. 2021 Jan 18:1-10. doi: 10.1159/000512092. Epub ahead of print. PMID: 33461209.)).