TRACTOGRAPHY AND NEURONAVIGATION: A NEW IMPORTANT TOOL FOR OPTIMIZING BRAIN LESION RESECTION?

Abstract

Diffusion tensor imaging (DTI) is a promising, noninvasive magnetic resonance imaging (MRI) method for studying the anatomical organization of major white matter fiber systems non-invasively. A topic currently is receiving increased attention, is the application of DTI and DTI fiber-tracking in the investigation of patients with intracranial tumors. This has been used in conjunction with neuronavigation systems during surgery, allowing precise tumor identification, and consequently, safe resection. Tractography can be used in combination with neuronavigation for guiding resection of brain lesions. Although this technology, and more specifically pediatric neurosurgery, is still under development, the potential is very promising. More studies will be necessary to establish the correlation of this technology and the supposed lower occurrence of brain shift when compared to conventional neuronavigation. The main goal of this study is to present the author’s experience and to evaluate the possible benefits of neuronavigation associated to tractography, during intracranial surgeries, in children.