• Jija S James, Ashalatha Radhakrishnan, Bejoy Thomas, Mini Madhusoodanan, Chandrashekharan Kesavadas, Mathew Abraham, Ramshekhar Menon, Chaturbhuj Rathore, and George Vilanilam.
• Department of Imaging and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
• Epilepsy Res. 2015 Feb 1;110:95-104.

PurposeWhether Meyer's loop (ML) tracking using diffusion tensor imaging tractography (DTIT) can be utilized to avoid post-operative visual field deficits (VFD) after anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE) using a large cohort of controls and patients. Also, we wanted to create a normative atlas of ML in normal population.MethodsDTIT was used to study ML in 75 healthy subjects and 25 patients with and without VFD following ATL. 1.5T MRI echo-planar DTI sequences with DTI data were processed in Nordic ICE using a probabilistic method; a multiple region of interest technique was used for reconstruction of optic radiation trajectory. Visual fields were assessed in patients pre- and post-operatively.ResultsResults of ANOVA showed that the left ML-TP distance was less than right across all groups (p = 0.01). The average distance of ML from left temporal pole was 37.44 ± 4.7 mm (range: 32.2-46.6 mm) and from right temporal pole 39.08 ± 4.9 mm (range: 34.3-49.7 mm). Average distance of left and right temporal pole to tip of temporal horn was 28.32 ± 2.03 mm (range: 26.4-32.8 mm) and was 28.92 ± 2.09 mm, respectively (range: 25.9-33.3 mm). If the anterior limit of the Meyer's loop was ≤38 mm on the right and ≤35 mm on the left from the temporal pole, they are at a greater risk of developing VFDs.ConclusionsDTIT is a novel technique to delineate ML and plays an important role in planning surgical resection in TLE to predict post-operative visual performance and disability.Copyright © 2014 Elsevier B.V. All rights reserved.

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