Lucas Hermans
In the management of low-grade glioma patients, decisions regarding surgery are highly dependent on the location of eloquent (i.e. functionally indispensable) brain areas relative to the tumor. This is because damage to either eloquent cortical areas or their subcortical connections can cause irreversible neurological damage. fMRI has shown to be capable of providing neurosurgeons with preoperative data on the location of eloquent cortical areas, which can aid in preoperative planning. However, similar methods to localize the subcortical fiber tracts which connect these eloquent cortical areas are not available. Therefore, we (Gert Kristo & I) aim to develop a protocol in which diffusion tensor imaging (DTI: an MRI technique capable of determining the direction of fiber tracts in the brain by measuring the direction of water diffusion) can localize eloquent subcortical regions of the brain. To do this, fMRI activation maps are used to identify eloquent cortical areas, which are then used as seed regions for probabilistic tractography. The resulting tractography data will then be compared to data from intraoperative electrostimulation mapping, a method which is used intraoperatively, and is considered to be a reference test in localizing eloquent cortical and subcortical regions.
