The role of probabilistic tractography in the surgical treatment of thalamic gliomas

Dávid Kis, Adrienn Máté, Zsigmond Tamás Kincses, E. Vörös, P. Barzó

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Thalamic gliomas represent a great challenge for neurosurgeons because of the high surgical risk of damaging the surrounding anatomy. Preoperative planning may considerably help the surgeon find the most ideal operative trajectory, avoiding thalamic nuclei and important white matter pathways adjacent to the tumor tissue. Thalamic segmentation is a promising imaging tool based on diffusion tensor magnetic resonance imaging. It provides the possibility to predict the relationship of the tumor to thalamic nuclei. Objective: To propose a new tool in thalamic glioma surgery that may help to differentiate between normal thalamus and tumor tissue, making preoperative planning possible and facilitating the choice of the optimal surgical approach and trajectory for neuronavigation-assisted surgery. Methods: Four patients with thalamic gliomas preoperatively underwent conventional and diffusion-weighted magnetic resonance imaging conducted on 1.5 T. Subsequently, probabilistic tractography and thalamic segmentation were performed with the FSL Software as preoperative planning. We also present a case when thalamic segmentation was applied retrospectively using preoperative images. All patients went through neuronavigation-assisted surgery (1 partial, 4 subtotal resections). Results: Surgery performed based on the output of thalamic segmentation caused no deterioration in the neurological symptoms of our patients. Indeed, we noticed improvement in the neurological condition in 3 cases; furthermore, in 2 patients, a concern-free state was achieved. Conclusion: We suggest that thalamic segmentation may be applied successfully and routinely in the surgical treatment of thalamic gliomas.

Original languageEnglish
Pages (from-to)262-272
Number of pages11
JournalNeurosurgery
Volume10
DOIs
Publication statusPublished - 2014

Fingerprint

Glioma
Neuronavigation
Thalamic Nuclei
Diffusion Magnetic Resonance Imaging
Neoplasms
Therapeutics
Thalamus
Anatomy
Software

Keywords

  • Diffusion tensor tractography
  • Glioma
  • Magnetic resonance imaging
  • Surgery
  • Thalamus

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

The role of probabilistic tractography in the surgical treatment of thalamic gliomas. / Kis, Dávid; Máté, Adrienn; Kincses, Zsigmond Tamás; Vörös, E.; Barzó, P.

In: Neurosurgery, Vol. 10, 2014, p. 262-272.

Research output: Contribution to journalArticle

Kis, Dávid ; Máté, Adrienn ; Kincses, Zsigmond Tamás ; Vörös, E. ; Barzó, P. / The role of probabilistic tractography in the surgical treatment of thalamic gliomas. In: Neurosurgery. 2014 ; Vol. 10. pp. 262-272.
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