Cited by 50Advanced Neuroimaging Techniques and ApplicationsFunctional Brain Connectivity StudiesAdvanced MRI Techniques and Applications

Advancements in diffusion MRI tractography for neurosurgery

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Kamagata, Koji, Andica, Christina, Uchida, Wataru, Takabayashi, Kaito, Saito, Yuya, Lukies, Matthew, Hagiwara, Akifumi, Fujita, Shohei +6 more·2024·Investigative Radiology

Abstract

Diffusion magnetic resonance imaging tractography is a noninvasive technique that enables the visualization and quantification of white matter tracts within the brain. It is extensively used in preoperative planning for brain tumors, epilepsy, and functional neurosurgical procedures such as deep brain stimulation. Over the past 25 years, significant advancements have been made in imaging acquisition, fiber direction estimation, and tracking methods, resulting in considerable improvements in tractography accuracy. The technique enables the mapping of functionally critical pathways around surgical sites to avoid permanent functional disability. When the limitations are adequately acknowledged and considered, tractography can serve as a valuable tool to safeguard critical white matter tracts and provides insight regarding changes in normal white matter and structural connectivity of the whole brain beyond local lesions. In functional neurosurgical procedures such as deep brain stimulation, it plays a significant role in optimizing stimulation sites and parameters to maximize therapeutic efficacy and can be used as a direct target for therapy. These insights can aid in patient risk stratification and prognosis. This article aims to discuss state-of-the-art tractography methodologies and their applications in preoperative planning and highlight the challenges and new prospects for the use of tractography in daily clinical practice.

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  • Tractography is increasingly used to estimate the relationship between tumors and eloquent pathways before surgery, but infiltration, edema, mass effect, crossing fibers, reduced anisotropy, algorithmic choices, and intraoperative brain shift may generate false-positive or false-negative reconstructions.

    “Tractography is increasingly used to estimate the relationship between tumors and eloquent pathways before surgery (Kamagata et al., 2024; Yang et al., 2021), but infiltration, edema, mass effect, crossing fibers, reduced anisotropy, algorithmic choices, and intraoperative brain shift may generate false-positive or false-negative reconstructions.”

    From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Kamagata et al., 2024

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Authors
Kamagata, K., Andica, C., Uchida, W., Takabayashi, K., Saito, Y., Lukies, M., Hagiwara, A., Fujita, S., Akashi, T., Wada, A., Hori, M., Kamiya, K., Zalesky, A., & Aoki, S.
Affiliations
Toho University (JP)
Corresponding author
Kamagata, Koji
Venue
Investigative Radiology
Published
2023-09-14
Volume
59
Issue
1
Pages
13-25
ISSN
  • 0020-9996 (ISSN-L)
  • 1536-0210
OpenAlex
W4386725533
Cited by
50
References
120
Citations by year
2026: 22 · 2025: 21 · 2024: 7
FWCI
8.28
Type
journal article
Language
en
Open access
Locations
  • Investigative Radiology (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-nd)
Funders
  • Japan Agency for Medical Research and Development (JP21wm0425006, JP19dm0307101)
  • Promotion and Mutual Aid Corporation for Private Schools of Japan
  • Japan Society for the Promotion of Science (23H02865)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
Keywords
diffusion MRI tractography, white matter tracts, surgical planning, brain tumors, epilepsy, deep brain stimulation, functional neurosurgery, white matter connectivity, risk stratification
MeSH terms
Brain, Humans, Neurosurgery, Neurosurgical Procedures, Diffusion Magnetic Resonance Imaging, Diffusion Tensor Imaging

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