Changing the Paradigm for Tractography Segmentation in Neurosurgery: Validation of a Streamline-Based Approach

作者：Silvio Sarubbo, Laura Vavassori, Luca Zigiotto, Francesco Corsini, Luciano Annicchiarico, Umberto Rozzanigo, Paolo Avesani · 发表于：Brain Sciences · 年份：2024 · DOI：10.3390/brainsci14121232 · 被引用次数：4 · 研究领域：Advanced Neuroimaging Techniques and Applications、Medical Imaging and Analysis、Peripheral Nerve Disorders

In glioma surgery, maximizing the extent of resection while preserving cognitive functions requires an understanding of the unique architecture of the white matter (WM) pathways of the single patient and of their spatial relationship with the tumor. Tractography enables the reconstruction of WM pathways, and bundle segmentation allows the identification of critical connections for functional preservation. This study evaluates the effectiveness of a streamline-based approach for bundle segmentation on a clinical dataset as compared to the traditional ROI-based approach. We performed bundle segmentation of the arcuate fasciculus, of its indirect anterior and posterior segments, and of the inferior fronto-occipital fasciculus in the healthy hemisphere of 25 high-grade glioma patients using both ROI- and streamline-based approaches. ROI-based segmentation involved manually delineating ROIs on MR anatomical images in Trackvis (V0.6.2.1). Streamline-based segmentations were performed in Tractome, which integrates clustering algorithms with the visual inspection and manipulation of streamlines. Shape analysis was conducted on each bundle. A paired t-test was performed on the irregularity measurement to compare segmentations achieved with the two approaches. Qualitative differences were evaluated through visual inspection. Streamline-based segmentation consistently yielded significantly lower irregularity scores (p < 0.001) compared to ROI-based segmentation for all the examined b...