• Sonia Pujol, William Wells, Carlo Pierpaoli, Caroline Brun, James Gee, Guang Cheng, Baba Vemuri, Olivier Commowick, Sylvain Prima, Aymeric Stamm, Maged Goubran, Ali Khan, Terry Peters, Peter Neher, Klaus H Maier-Hein, Yundi Shi, Antonio Tristan-Vega, Gopalkrishna Veni, Ross Whitaker, Martin Styner, Carl-Fredrik Westin, Sylvain Gouttard, Isaiah Norton, Laurent Chauvin, Hatsuho Mamata, Guido Gerig, Arya Nabavi, Alexandra Golby, and Ron Kikinis.
• Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
• J Neuroimaging. 2015 Nov 1; 25 (6): 875-82.

Background And PurposeDiffusion tensor imaging (DTI) tractography reconstruction of white matter pathways can help guide brain tumor resection. However, DTI tracts are complex mathematical objects and the validity of tractography-derived information in clinical settings has yet to be fully established. To address this issue, we initiated the DTI Challenge, an international working group of clinicians and scientists whose goal was to provide standardized evaluation of tractography methods for neurosurgery. The purpose of this empirical study was to evaluate different tractography techniques in the first DTI Challenge workshop.MethodsEight international teams from leading institutions reconstructed the pyramidal tract in four neurosurgical cases presenting with a glioma near the motor cortex. Tractography methods included deterministic, probabilistic, filtered, and global approaches. Standardized evaluation of the tracts consisted in the qualitative review of the pyramidal pathways by a panel of neurosurgeons and DTI experts and the quantitative evaluation of the degree of agreement among methods.ResultsThe evaluation of tractography reconstructions showed a great interalgorithm variability. Although most methods found projections of the pyramidal tract from the medial portion of the motor strip, only a few algorithms could trace the lateral projections from the hand, face, and tongue area. In addition, the structure of disagreement among methods was similar across hemispheres despite the anatomical distortions caused by pathological tissues.ConclusionsThe DTI Challenge provides a benchmark for the standardized evaluation of tractography methods on neurosurgical data. This study suggests that there are still limitations to the clinical use of tractography for neurosurgical decision making.Copyright © 2015 by the American Society of Neuroimaging.

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