Cited by 80Advanced Neuroimaging Techniques and ApplicationsFunctional Brain Connectivity StudiesAnatomy and Medical Technology

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Diffusion MRI tractography for neurosurgery: the basics, current state, technical reliability and challenges

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Yang, Joseph Yuan-Mou, Yeh, Chun-Hung, Poupon, Cyril, Calamante, Fernando·2021·Physics in Medicine & Biology

DOI 10.1088/1361-6560/ac0d90

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Abstract

Diffusion magnetic resonance imaging (dMRI) tractography is currently the only imaging technique that allows for non-invasive delineation and visualisation of white matter (WM) tracts in vivo, prompting rapid advances in related fields of brain MRI research in recent years. One of its major clinical applications is for pre-surgical planning and intraoperative image guidance in neurosurgery, where knowledge about the location of WM tracts nearby the surgical target can be helpful to guide surgical resection and optimise post-surgical outcomes. Surgical injuries to these WM tracts can lead to permanent neurological and functional deficits, making the accuracy of tractography reconstructions paramount. The quality of dMRI tractography is influenced by many modifiable factors, ranging from MRI data acquisition through to the post-processing of tractography output, with the potential of error propagation based on decisions made at each and subsequent processing steps. Research over the last 25 years has significantly improved the anatomical accuracy of tractography. An updated review about tractography methodology in the context of neurosurgery is now timely given the thriving research activities in dMRI, to ensure more appropriate applications in the clinical neurosurgical realm. This article aims to review the dMRI physics, and tractography methodologies, highlighting recent advances to provide the key concepts of tractography-informed neurosurgery, with a focus on the general considerations, the current state of practice, technical challenges, potential advances, and future demands to this field.

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Authors: Yang, J. Y.-M., Yeh, C.-H., Poupon, C., & Calamante, F.
Affiliations: Royal Children's Hospital (AU)
Chang Gung University (TW)
Centre National de la Recherche Scientifique (FR)
The University of Sydney (AU)
Corresponding author: Yeh, Chun-Hung
ORCID: Yang, Joseph Yuan-Mou
Yeh, Chun-Hung
Poupon, Cyril
Calamante, Fernando
Venue: Physics in Medicine & Biology
Publisher: IOP Publishing
Published: 2021-07-22
Volume: 66
Issue: 15
Pages: 15TR01
ISSN: 0031-9155 (ISSN-L)
1361-6560
DOI: 10.1088/1361-6560/ac0d90
OpenAlex: W3173443563
Cited by: 80
References: 292
Citations by year: 2026: 16 · 2025: 25 · 2024: 14 · 2023: 15 · 2022: 8 · 2021: 2
FWCI: 1.59
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
iopscience.iop.org/info/page/text-and-data-mining (tdm)
Locations: Physics in Medicine and Biology (publishedVersion, cc-by)
PubMed (publishedVersion)
Minerva Access (University of Melbourne) (submittedVersion, cc-by)
Funders: Taiwan Ministry of Science and Technology (109-2222-E-182-001-MY3)
Topics: Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
Physical Sciences › Engineering › Biomedical Engineering › Anatomy and Medical Technology
Keywords: diffusion MRI, tractography, white matter tracts, neurosurgery, surgical planning, intraoperative image guidance, error propagation, surgical resection
MeSH terms: Magnetic Resonance Imaging, Neurosurgery, Reproducibility of Results, Diffusion Magnetic Resonance Imaging, Diffusion Tensor Imaging

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Diffusion MRI tractography for neurosurgery: the basics, current state, technical reliability and challenges

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