Functional MRI vs. navigated TMS to optimize M1 seed volume delineation for DTI tractography. A prospective study in patients with brain tumours adjacent to the corticospinal tract Carolin Weiss Lucas, Irada Tursunova, Volker Neuschmelting, Charlotte Nettekoven, Ana-Maria Oros-Peusquens, Gabriele Stoffels, Andrea Maria Faymonville, Shah N. Jon, Karl Josef Langen, Hannah Lockau, Roland Goldbrunner, Christian Grefkes PII: DOI: Reference:
S2213-1582(16)30230-3 doi: 10.1016/j.nicl.2016.11.022 YNICL 873
To appear in:
NeuroImage: Clinical
Received date: Revised date: Accepted date:
13 October 2016 18 November 2016 19 November 2016
Please cite this article as: Lucas, Carolin Weiss, Tursunova, Irada, Neuschmelting, Volker, Nettekoven, Charlotte, Oros-Peusquens, Ana-Maria, Stoffels, Gabriele, Faymonville, Andrea Maria, Jon, Shah N., Langen, Karl Josef, Lockau, Hannah, Goldbrunner, Roland, Grefkes, Christian, Functional MRI vs. navigated TMS to optimize M1 seed volume delineation for DTI tractography. A prospective study in patients with brain tumours adjacent to the corticospinal tract, NeuroImage: Clinical (2016), doi: 10.1016/j.nicl.2016.11.022
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*WEISS LUCAS Carolin, M.D. , *TURSUNOVA Irada , NEUSCHMELTING Volker, M.D. , 1,2
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NETTEKOVEN Charlotte, Ph.D. , OROS-PEUSQUENS Ana-Maria, Ph.D. , STOFFELS 2
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Gabriele, M.D. , FAYMONVILLE Andrea Maria, M.D. , SHAH N. Jon, Ph.D.
Christian, M.D.
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, LANGEN Karl 1
, LOCKAU Hannah, M.D. , GOLDBRUNNER Roland, M.D. , GREFKES 2,3
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*Both authors contributed equally to the manuscript (shared first authorship)
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Josef, M.D.
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Journal Article Manuscript
Functional MRI vs navigated TMS to optimize M1 seed volume delineation
adjacent to the corticospinal tract.
AFFILIATIONS:
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for DTI tractography. A prospective study in patients with brain tumours
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1 University of Cologne, Center of Neurosurgery, 50924 Cologne, Germany 2 Institute of Neuroscience and Medicine, Research Centre Jülich, 52425 Jülich, Germany
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3 University of Cologne, Department of Neurology, 50924 Cologne, Germany
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4 University of Cologne, Department of Radiology, 50937 Cologne, Germany 5 RWTH Aachen University, University Clinic Aachen, Departments of Nuclear Medicine and Neurology, 52074 Aachen, Germany
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6 Department of Electrical and Computer Systems Engineering, Monash Institute of Medical Engineering, and Monash Biomedical Imaging, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
CORRESPONDING AUTHOR: Name: Carolin WEISS LUCAS, M.D. Address: Klinik für Allgemeine Neurochirurgie. Uniklinik Köln, Bettenhaus Eb. 8. Kerpener Str. 62. 50931 Cologne. GERMANY. Telephone Number: +49 (0)221 478-97711 / -0 Telefacsimile Number: +49 (0)221 478-6257 Email:
[email protected]
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ACCEPTED MANUSCRIPT Abstract Background: DTI-based tractography is an increasingly important tool for planning brain surgery in patients suffering from brain tumours. However, there is on ongoing debate which tracking approaches yield the most valid results. Especially the use of functional localizer data
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such as navigated transcranial magnetic stimulation (nTMS) or functional magnetic resonance
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imaging (fMRI) seem to improve fiber tracking data in conditions where anatomical landmarks are less informative due to tumour-induced distortions of the gyral anatomy. We here compared which of the two localizer techniques yield more plausible results with respect to
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mapping different functional portions of the corticospinal tract (CST) in brain tumour patients. Methods: The CSTs of 18 patients with intracranial tumours in the vicinity of the primary motor
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area (M1) were investigated by means of deterministic DTI. The core zone of the tumouradjacent hand, foot and/or tongue M1 representation served as cortical regions of interest (ROIs). M1 core zones were defined by both the nTMS hot-spots and the fMRI local activation maxima. In addition, for all patients, a subcortical ROI at the level of the inferior anterior pons was implemented into the tracking algorithm in order to improve the anatomical specificity of CST reconstructions. As intra-individual control, we additionally tracked the CST of the hand
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motor region of the unaffected, i.e., non-lesional hemisphere, again comparing fMRI and nTMS M1 seeds. The plausibility of the fMRI-ROI- vs. nTMS-ROI-based fibre trajectories was assessed by a-priori defined anatomical criteria. Moreover, the anatomical relationship of
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different fibre courses was compared regarding their distribution in the anterior-posterior direction as well as their location within the posterior limb of the internal capsule (PLIC).
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Results: Overall, higher plausibility rates were observed for the use of nTMS- as compared to fMRI-defined cortical ROIs (p
