Journal Article

Differential tractography and whole brain connectometry in primary motor area gliomas resection: A feasibility study

Kehayov, Ivo, Ordóñez-Rubiano, Edgar G., Hakim, Fernando, Mejía-Cordovez, Juan A., Pimienta-Redondo, Hebert D., Gomez-Amarillo, Diego A., Luzzi, Sabino, Figueredo, Luisa F., Angelova, Polina, Baldoncini, Matías, Johnson, Jason M., Almeida, Joao P., Apostolov, Georgi

2024

Overview

Establish the evolution of the connectome before and after resection of motor area glioma using a comparison of connectome maps and high-definition differential tractography (DifT). DifT was done using normalized quantitative anisotropy (NQA) with DSI Studio. The quantitative analysis involved obtaining mean NQA and fractional anisotropy (FA) values for the disrupted pathways tracing the corticospinal tract (CST), and white fiber network changes over time. We described the baseline tractography, DifT, and white matter network changes from two patients who underwent resection of an oligodendroglioma (Case 1) and an IDH mutant astrocytoma, grade 4 (Case 2). Case 1. There was a slight decrease in the diffusion signal of the compromised CST in the immediate postop. The NQA and FA values increased at the 1-year follow-up (0.18 vs. 0.32 and 0.35 vs. 0.44, respectively). Case 2. There was an important decrease in the immediate postop, followed by an increase in the follow-up. In the 1-year follow-up, the patient presented with radiation necrosis and tumor recurrence, increasing NQA from 0.18 in the preop to 0.29. Fiber network analysis: whole-brain connectome comparison demonstrated no significant changes in the immediate postop. However, in the 1-year follow up there was a notorious reorganization of the fibers in both cases, showing the decreased density of connections. Connectome studies and DifT constitute new potential tools to predict early reorganization changes in a patient’s networks, showing the brain plasticity capacity, and helping to establish timelines for the progression of the tumor and treatment-induced changes. •Differential NQA and FA values are subjective measurements of the preservation of function postoperatively.•Our study sheds light on how the connectome undergoes sequential reorganization in an evolving manner, varying on a case-by-case basis.•The reorganization of the fibers and changes in the values may not necessarily correlate with clinical outcomes, particularly in high-grade gliomas.•DfT directly reflects brain plasticity; however, functionality prediction requires more sophisticated methods, such as predictability models.

• Publisher: Elsevier B.V,Elsevier Limited
• Subject: Adult / Anisotropy / Astrocytoma / Astrocytoma - diagnostic imaging / Astrocytoma - pathology / Astrocytoma - surgery / Brain cancer / Brain Neoplasms - diagnostic imaging / Brain Neoplasms - pathology / Brain Neoplasms - surgery / connectome / Connectome - methods / connectometrics / connectomics / Convulsions & seizures / Diffusion Tensor Imaging - methods / Feasibility Studies / Female / Glioma / Glioma - diagnostic imaging / Glioma - pathology / Glioma - surgery / Humans / Male / Middle Aged / Motor Cortex - diagnostic imaging / Motor Cortex - physiopathology / Motor Cortex - surgery / Neurology / Neuroplasticity / Neurosurgery / Oligodendroglioma / Oligodendroglioma - diagnostic imaging / Oligodendroglioma - pathology / Oligodendroglioma - surgery / Pyramidal tracts / Pyramidal Tracts - diagnostic imaging / Software / Substantia alba / tractography / Tumors