Significant alterations in integrity of distant white matter tracts in patients with left temporal tumors revealed by diffusion tensor imagingReportar como inadecuado




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1 Hospital of the University of Pennsylvania, Department of Neurosurgery 2 SBIA - Section for Biomedical Image Analysis

Abstract : To determine the local and remote effects of tumors in the -eloquent- left temporal lobe on white matter integrity, we measured the extent of edema, overlap with ipsilateral tracts in proximity as well as distant tracts using fractional anisotropy FA. Twelve patients with intracerebral tumors gliomas or metastases were evaluated preoperatively using 30-direction DTI sequences, registered, and tumor-edema volumes calculated, using EVE atlas of regions of interest, segmenting four bilateral tracts: corticospinal tract CST; n=12; inferior fronto-occipital fasciculus IFOF; n=9; inferior longitudinal fasciculus ILF; n=10, and arcuate fasciculus AF; n=9.The distance between the tumor Fig. 1 and ipsilateral and contralateral tracts, the overlap between the tract and edema, and the histogram similarity were calculated. The student-s t-test determined statistical significance. The distance from tumor to tract was least for the left ILF and IFOF, then the AF, and farthest for the CST Fig 1. Edema overlap was greatest for ILF, then AF and IFOF, and least for CST Fig 1. Tracts ipsilateral to tumor had reduced FA compared to contralateral CST, ILF, and IFOF Fig 1,p < 0.05. Decreased FA for specific tracts between subjects was linked to edema overlap Fig 2. The average distance from tumor to tract correlated with the cosine similarity of the FA Fig 2, R^2=0.967. Temporal lobe tumors affected the FA values of fiber tracts in proximity ILF, ILFOF as well as at a distance CST, suggesting that FA values may be a sensitive indicator of widespread changes in the white matter, linked to the interconnected -hodological- view of the brain that underlies the human connectome. Future studies of neuroplasticity and neurocognitive effects of tumors and tumor surgery should include tracts remote from the tumor as well as those in immediate contiguity.





Autor: Edward Larkin - Jérémy Lecoeur - Kalil Abdullah - Ragini Verma - Luke Macyszyn - Steven Brem -

Fuente: https://hal.archives-ouvertes.fr/



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