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Abstract #2108

Multi-level fiber tractography in brain tumor patients using functional mapping for seeding

Andrey Zhylka1, Josien Pluim1, Florian Kofler2,3,4, Ahmed Radwan5,6, Alberto De Luca7,8, Axel Schroeder9, Benedikt Wiestler2,4, Jan S. Kirschke2,10, Bjoern Menze3,11, Stefan Sunaert5,6,12, Alexander Leemans7, Sandro M. Krieg9,13, and Nico Sollmann2,13,14
1Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands, 2Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany, 3Department of Informatics, Technical University of Munich, Munich, Germany, 4TranslaTUM - Central Institute for Translational Cancer Research, Technical University of Munich, Munich, Germany, 5Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium, 6Department of Neuroscience, Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium, 7Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands, 8Neurology Department, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands, 9Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany, 10TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munic, Munich, Germany, 11Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland, 12Department of Radiology, UZ Leuven, Leuven, Belgium, 13TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany, 14Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany

Synopsis

Navigated transcranial magnetic stimulation (nTMS) motor mapping allows locating function in the individual patient pre-operatively and, to a certain extent, decreases the false-positive rate for fiber tractography. However, the false-negative rate is still high. In this work we evaluate novel multi-level fiber tractography (MLFT) along with conventional deterministic algorithms in patients with motor-eloquent high-grade glioma, combined with nTMS mapping-based region of interest (ROI) placement. The results were compared based on the coverage of nTMS motor maps, revealing reconstruction of the corticospinal tract (CST) with significantly higher volume and better coverage of the eloquent motor cortex for MLFT.

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