• Masanori Yoshino, Taichi Kin, Akihiro Ito, Toki Saito, Daichi Nakagawa, Kyousuke Kamada, Harushi Mori, Akira Kunimatsu, Hirofumi Nakatomi, Hiroshi Oyama, and Nobuhito Saito.
• Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, ymasa-tky@umin.ac.jp.
• Int J Comput Assist Radiol Surg. 2015 Apr 1; 10 (4): 383-92.

PurposeDiffusion tensor tractography (DTT) is not adequately reliable for prediction of facial and vestibulocochlear (VII-VIII) nerve locations, especially relative to a vestibular schwannoma (VS). Furthermore, it is often not possible to visualize normal VII-VIII nerves by DTT (visualization rates were 12.5-63.6%). Therefore, DTT post-processing was optimized for normal VII-VIII nerve visualization with and without manual noise elimination.MethodsDTT examinations of ten patients were evaluated to assess the improvement in performance by modifying seed region of interest (ROI) and fractional anisotropy (FA) threshold. Seed ROI was placed at the porus of the internal auditory meatus, and FA threshold values were either fixed or variable for each patient. DTT visualization of cranial nerves VII-VIII was evaluated and the noise effect was measured.ResultsCranial nerves VII-VIII were visualized in 90% of patients without using manual noise elimination by modifying the seed ROI and FA threshold. The visualization rate with FA threshold of the upper limit in each patient (100%) was significantly higher than that with FA threshold of 0.1 (75%) (p = 0.02). The incidence rate of noise with FA threshold of the upper limit (10%) was not significantly different than the FA threshold of 0.1 (20%) (p = 0.66).ConclusionSeed ROI modification and FA thresholding can improve the visualization of cranial nerve VII-VIII locations in DTT. This technique is promising for its potential to determine the relationship of cranial nerves VII-VIII to VS.

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