Probabilistic Tractography of the Cranial Nerves in Vestibular Schwannoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Objective Multiple recent studies have reported on diffusion tensor-based fiber tracking of cranial nerves in vestibular schwannoma, with conflicting results as to the accuracy of the method and the occurrence of cochlear nerve depiction. Probabilistic nontensor-based tractography might offer advantages in terms of better extraction of directional information from the underlying data in cranial nerves, which are of subvoxel size. Methods Twenty-one patients with large vestibular schwannomas were recruited. The probabilistic tracking was run preoperatively and the position of the potential depictions of the facial and cochlear nerves was estimated postoperatively by 3 independent observers in a blinded fashion. The true position of the nerve was determined intraoperatively by the surgeon. Thereafter, the imaging-based estimated position was compared with the intraoperatively determined position. Tumor size, cystic appearance, and postoperative House-Brackmann score were analyzed with regard to the accuracy of the depiction of the nerves. Results The probabilistic tracking showed a connection that correlated to the position of the facial nerve in 81% of the cases and to the position of the cochlear nerve in 33% of the cases. Altogether, the resulting depiction did not correspond to the intraoperative position of any of the nerves in 3 cases. Conclusions In a majority of cases, the position of the facial nerve, but not of the cochlear nerve, could be estimated by evaluation of the probabilistic tracking results. However, false depictions not corresponding to any nerve do occur and cannot be discerned as such from the image only.

Details

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalWorld neurosurgery
Volume107
Publication statusPublished - Nov 2017
Peer-reviewedYes

External IDs

PubMed 28754643

Keywords

ASJC Scopus subject areas

Keywords

  • Cranial nerves, Diffusion tensor imaging, Probabilistic tractography, Skull base tumors, Surgery, Vestibular schwannoma