DEBATE: is tractography accurate enough to be used to inform surgery?

IF 2.7 3区 医学 Q1 ANATOMY & MORPHOLOGY
Fracesco Vergani, Silvio Sarubbo, Joseph Yuan-Mou Yang
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引用次数: 0

Abstract

The integration of diffusion MRI tractography into neurosurgical practice raises an essential question: is this technology accurate enough to be used to inform surgery? This short communication summarizes the key points of a debate held at the 2024 Tract-Anat Retreat on the clinical utility and limitations of tractography in neurosurgery. While tractography in neurosurgery offers unique insights into patient-specific white matter anatomy and has proven value for surgical planning, risk stratification and patient counselling, we identified limitations, challenges, and areas for improvement. These include variability in reconstruction methods, the importance of multimodal integration, false negative results and intrinsic limitations at surgery, such as brain shift during navigation. These perspectives highlight the need for standardized protocols, functional validation, and enhanced surgeon training to ensure the cautious and effective use of tractography in the operative setting.

争论:肛管造影是否足够精确,可以用来指导手术?
弥散性MRI束状造影与神经外科实践的结合提出了一个基本问题:这项技术是否足够精确,可以用于外科手术?这篇简短的通讯总结了在2024年的Tract-Anat会议上,关于神经外科中导管造影的临床应用和局限性的辩论的关键点。虽然神经外科中的神经束造影提供了对患者特异性白质解剖的独特见解,并已被证明对手术计划、风险分层和患者咨询有价值,但我们确定了局限性、挑战和需要改进的领域。这些因素包括重建方法的可变性、多模态整合的重要性、假阴性结果和手术的内在局限性,如导航过程中的脑偏移。这些观点强调了标准化方案、功能验证和加强外科医生培训的必要性,以确保在手术环境中谨慎有效地使用牵道造影。
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来源期刊
Brain Structure & Function
Brain Structure & Function 医学-解剖学与形态学
CiteScore
6.00
自引率
6.50%
发文量
168
审稿时长
8 months
期刊介绍: Brain Structure & Function publishes research that provides insight into brain structure−function relationships. Studies published here integrate data spanning from molecular, cellular, developmental, and systems architecture to the neuroanatomy of behavior and cognitive functions. Manuscripts with focus on the spinal cord or the peripheral nervous system are not accepted for publication. Manuscripts with focus on diseases, animal models of diseases, or disease-related mechanisms are only considered for publication, if the findings provide novel insight into the organization and mechanisms of normal brain structure and function.
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