• World Neurosurg · Jan 2017

    Quantitative diffusion tensor imaging analysis of low grade gliomas: from pre-clinical application to patient care.

    • Tamara Ius, Luca Turella, Giada Pauletto, Miriam Isola, Marta Maieron, Giovanni Sciacca, Riccardo Budai, Serena D'Agostini, Roberto Eleopra, and Miran Skrap.
    • Department of Neurosurgery, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy. Electronic address: tamara.ius@gmail.com.
    • World Neurosurg. 2017 Jan 1; 97: 333-343.

    BackgroundPreoperative diffusion tensor tractography (DTT) has recently been used to aid in the mapping of functional pathways to limit damage associated with resection of low-grade gliomas (LGGs).ObjectiveTo assess the predictive capacity of DTT as a biomarker of postoperative motor outcomes in patients with LGGs involving the corticospinal tract (CST). CST parameters obtained using a quantitative fiber tracking approach were used to investigate the reliability of the DTT biomarker by comparing their values in the tumoral (Tcst) and healthy (Hcst) hemispheres.MethodsThirty-seven patients with LGGs involving the CST were enrolled. Quantification of structural differences between the Tcst and Hcst were analyzed according to the novel biomarker (NF index), defined as follows: (Hcst NF - Tcst NF)/Hcst NF, where NF represents the number of fibers in each region. Logistic regression analysis was used to examine associations among clinical postoperative outcomes and NF index values, tumoral patterns, and premotor/motor evoked potentials.ResultsNF values significantly differed between the Tcst and Hcst. Analysis of the NF index showed that patients with a preoperative NF index <0.22 had a significantly lower risk of developing transient postoperative deficits (area under the curve, 0.92; 95% binomial confidence interval, 0.834-1). Patients with less pronounced differences in NF between the Tcst and Hcst also experienced better clinical outcomes.ConclusionsThe NF index may be a useful biomarker for predicting clinical outcomes in patients with LGGs. Furthermore, the NF index may provide a preoperative estimate of the patient's potential for recovery from possible postsurgical neurologic deficits.Copyright © 2016 Elsevier Inc. All rights reserved.

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