Improved nTMS- and DTI-derived CST tractography through anatomical ROI seeding on anterior pontine level compared to internal capsule

摘要: Imaging of the course corticospinal tract (CST) by diffusion tensor imaging (DTI) is useful for function-preserving tumour surgery. The integration functional localizer data into tracking algorithms offers to establish a direct structure–function relationship in DTI data. However, alterations MRI signals and adjacent brain tumours often lead spurious results. We here compared impact subcortical seed regions placed at different positions influences somatotopic location cortical clinical co-factors on fibre plausibility patients. The CST 32 patients with intracranial was investigated means deterministic neuronavigated transcranial magnetic stimulation (nTMS). seeds were defined nTMS hot spots primary motor area (M1) hand, foot tongue representation. originating from contralesional M1 hand mapped as intra-individual reference. As region interests (ROI), we used posterior limb internal capsule (PLIC) and/or anterior inferior pontine (aiP). trajectories assessed a-priori anatomical criteria. following potential analysed: Karnofsky Performance Scale (KPS), resting threshold (RMT), T1-CE volume, T2 oedema presence within PLIC, fractional anisotropy (FAT) elicit minimum amount fibres minimal length. The results showed higher proportion plausible tracts aiP-ROI PLIC-ROI. Low FAT values peritumoural PLIC led less Most obtained when ranged above cut-off 0.105. In addition, there strong effect ROI; best contralateral (100%), followed ipsilesional (>95%), (>85%) (>75%) CST. summary, found that yielded better IC-ROI using tractography patients, especially tracked. case lower than 0.10, result respective should be interpreted caution respect Moreover, considered negative predictor tracking.