1
|
Schilling KG, Combes AJE, Ramadass K, Rheault F, Sweeney G, Prock L, Sriram S, Cohen-Adad J, Gore JC, Landman BA, Smith SA, O'Grady KP. Influence of preprocessing, distortion correction and cardiac triggering on the quality of diffusion MR images of spinal cord. Magn Reson Imaging 2024; 108:11-21. [PMID: 38309376 PMCID: PMC11218893 DOI: 10.1016/j.mri.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 02/05/2024]
Abstract
Diffusion MRI of the spinal cord (SC) is susceptible to geometric distortion caused by field inhomogeneities, and prone to misalignment across time series and signal dropout caused by biological motion. Several modifications of image acquisition and image processing techniques have been introduced to overcome these artifacts, but their specific benefits are largely unproven and warrant further investigations. We aim to evaluate two specific aspects of image acquisition and processing that address image quality in diffusion studies of the spinal cord: susceptibility corrections to reduce geometric distortions, and cardiac triggering to minimize motion artifacts. First, we evaluate 4 distortion preprocessing strategies on 7 datasets of the cervical and lumbar SC and find that while distortion correction techniques increase geometric similarity to structural images, they are largely driven by the high-contrast cerebrospinal fluid, and do not consistently improve the geometry within the cord nor improve white-to-gray matter contrast. We recommend at a minimum to perform bulk-motion correction in preprocessing and posit that improvements/adaptations are needed for spinal cord distortion preprocessing algorithms, which are currently optimized and designed for brain imaging. Second, we design experiments to evaluate the impact of removing cardiac triggering. We show that when triggering is foregone, images are qualitatively similar to triggered sequences, do not have increased prevalence of artifacts, and result in similar diffusion tensor indices with similar reproducibility to triggered acquisitions. When triggering is removed, much shorter acquisitions are possible, which are also qualitatively and quantitatively similar to triggered sequences. We suggest that removing cardiac triggering for cervical SC diffusion can be a reasonable option to save time with minimal sacrifice to image quality.
Collapse
Affiliation(s)
- Kurt G Schilling
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Anna J E Combes
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Karthik Ramadass
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA; Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Francois Rheault
- Medical Imaging and Neuroinformatic (MINi) Lab, Department of Computer Science, University of Sherbrooke, Canada
| | - Grace Sweeney
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Logan Prock
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Subramaniam Sriram
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, University of Montreal, Montreal, QC, Canada; Mila - Quebec AI Institute, Montreal, QC, Canada; Centre de recherche du CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada
| | - John C Gore
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Bennett A Landman
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA; Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Seth A Smith
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Kristin P O'Grady
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
2
|
Corroenne R, Grevent D, Mahallati H, Gauchard G, Bussieres L, Ville Y, Salomon LJ. Diffusion tensor imaging of fetal spinal cord: feasibility and gestational-age-related changes. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:241-247. [PMID: 36971038 DOI: 10.1002/uog.26208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/27/2023] [Accepted: 03/16/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Diffusion tensor imaging (DTI) of the fetal brain is a relatively new technique that allows evaluation of white matter tracts of the central nervous system throughout pregnancy, as well as in certain pathological conditions. The objectives of this study were to evaluate the feasibility of DTI of the spinal cord in utero and to examine gestational-age (GA)-related changes in DTI parameters during pregnancy. METHODS This was a prospective study conducted between December 2021 and June 2022 in the LUMIERE Platform, Necker-Enfants Malades Hospital, Paris, France, as part of the LUMIERE SUR LE FETUS trial. Women with a pregnancy between 18 and 36 weeks of gestation without fetal or maternal abnormality were eligible for inclusion. Sagittal diffusion-weighted scans of the fetal spine were acquired, without sedation, using a 1.5-Tesla magnetic resonance imaging scanner. The imaging parameters were as follows: 15 non-collinear direction diffusion-weighted magnetic-pulsed gradients with a b-value 700 s/mm2 and one B0 image without diffusion-weighting; slice thickness, 3 mm; field of view (FOV), 36 mm; phase FOV, 1.00; voxel size, 4.5 × 2.8 × 3 mm3 ; number of slices, 7-10; repetition time, 2800 ms; echo time, minimum; and total acquisition time, 2.3 min. DTI parameters, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC), were extracted at the cervical, upper thoracic, lower thoracic and lumbar levels of the spinal cord. Cases with motion degradation and those with aberrant reconstruction of the spinal cord on tractography were excluded. Pearson's correlation analysis was performed to evaluate GA-related changes of DTI parameters during pregnancy. RESULTS During the study period, 42 pregnant women were included at a median GA of 29.3 (range, 22.0-35.7) weeks. Five (11.9%) patients were not included in the analysis because of fetal movement. Two (4.8%) patients with aberrant tractography reconstruction were also excluded from analysis. Acquisition of DTI parameters was feasible in all remaining cases (35/35). Increasing GA correlated with increasing FA averaged over the entire fetal spinal cord (r, 0.37; P < 0.01), as well as at the individual cervical (r, 0.519; P < 0.01), upper thoracic (r, 0.468; P < 0.01), lower thoracic (r, 0.425; P = 0.02) and lumbar (r, 0.427; P = 0.02) levels. There was no correlation between GA and ADC averaged over the entire spinal cord (r, 0.01; P = 0.99) or at the individual cervical (r, -0.109; P = 0.56), upper thoracic (r, -0.226; P = 0.22), lower thoracic (r, -0.052; P = 0.78) or lumbar (r, -0.11; P = 0.95) levels. CONCLUSIONS This study shows that DTI of the spinal cord is feasible in normal fetuses in typical clinical practice and allows extraction of DTI parameters of the spinal cord. There is a significant GA-related change in FA in the fetal spinal cord during pregnancy, which may result from decreasing water content as observed during myelination of fiber tracts occurring in utero. This study may serve as a basis for further investigation of DTI in the fetus, including research into its potential in pathological conditions that impact spinal cord development. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- R Corroenne
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - D Grevent
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Radiology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - H Mahallati
- Department of Radiology, University of Calgary, Alberta, Canada
| | - G Gauchard
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - L Bussieres
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Y Ville
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - L J Salomon
- EA Fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
- Department of Obstetrics, Fetal Medicine and Surgery, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| |
Collapse
|
3
|
Dauleac C, Frindel C, Pélissou-Guyotat I, Nicolas C, Yeh FC, Fernandez-Miranda J, Cotton F, Jacquesson T. Full cervical cord tractography: A new method for clinical use. Front Neuroanat 2022; 16:993464. [PMID: 36237419 PMCID: PMC9550930 DOI: 10.3389/fnana.2022.993464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
Despite recent improvements in diffusion-weighted imaging, spinal cord tractography is not used in routine clinical practice because of difficulties in reconstructing tractograms, with a pertinent tri-dimensional-rendering, in a long post-processing time. We propose a new full tractography approach to the cervical spinal cord without extensive manual filtering or multiple regions of interest seeding that could help neurosurgeons manage various spinal cord disorders. Four healthy volunteers and two patients with either cervical intramedullary tumors or spinal cord injuries were included. Diffusion-weighted images of the cervical spinal cord were acquired using a Philips 3 Tesla machine, 32 diffusion directions, 1,000 s/mm2b-value, 2 × 2 × 2 mm voxel size, reduced field-of-view (ZOOM), with two opposing phase-encoding directions. Distortion corrections were then achieved using the FSL software package, and tracking of the full cervical spinal cord was performed using the DSI Studio software (quantitative anisotropy-based deterministic algorithm). A unique region of avoidance was used to exclude everything that is not of the nervous system. Fiber tracking parameters used adaptative fractional anisotropy from 0.015 to 0.045, fiber length from 10 to 1,000 mm, and angular threshold of 90°. In all participants, a full cervical cord tractography was performed from the medulla to the C7 spine level. On a ventral view, the junction between the medulla and spinal cord was identified with its pyramidal bulging, and by an invagination corresponding to the median ventral sulcus. On a dorsal view, the fourth ventricle—superior, middle, and inferior cerebellar peduncles—was seen, as well as its floor and the obex; and gracile and cuneate tracts were recognized on each side of the dorsal median sulcus. In the case of the intramedullary tumor or spinal cord injury, the spinal tracts were seen to be displaced, and this helped to adjust the neurosurgical strategy. This new full tractography approach simplifies the tractography pipeline and provides a reliable 3D-rendering of the spinal cord that could help to adjust the neurosurgical strategy.
Collapse
Affiliation(s)
- Corentin Dauleac
- Service de Neurochirurgie, Hôpital neurologique et neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, INSA-Lyon, Villeurbanne, France
- Université de Lyon I, Lyon, France
- *Correspondence: Corentin Dauleac
| | - Carole Frindel
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, INSA-Lyon, Villeurbanne, France
- Université de Lyon I, Lyon, France
| | - Isabelle Pélissou-Guyotat
- Service de Neurochirurgie, Hôpital neurologique et neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Célia Nicolas
- Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, Service de Radiologie, Lyon, France
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Juan Fernandez-Miranda
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - François Cotton
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, INSA-Lyon, Villeurbanne, France
- Université de Lyon I, Lyon, France
- Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, Service de Radiologie, Lyon, France
| | - Timothée Jacquesson
- Service de Neurochirurgie, Hôpital neurologique et neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, INSA-Lyon, Villeurbanne, France
- Université de Lyon I, Lyon, France
| |
Collapse
|
4
|
Yang HE, Kim WT, Kim DH, Kim SW, Yoo WK. Utility of Diffusion and Magnetization Transfer MRI in Cervical Spondylotic Myelopathy: A Pilot Study. Diagnostics (Basel) 2022; 12:diagnostics12092090. [PMID: 36140491 PMCID: PMC9497906 DOI: 10.3390/diagnostics12092090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Diffusion tensor imaging (DTI) and magnetization transfer (MT) magnetic resonance imaging (MRI) can help detect spinal cord pathology, and tract-specific analysis of their parameters, such as fractional anisotropy (FA), mean diffusivity, axial diffusivity (AD), radial diffusivity (RD) and MT ratio (MTR), can give microstructural information. We performed the tract-based acquisition of MR parameters of three major motor tracts: the lateral corticospinal (CS), rubrospinal (RuS) tract, and lateral reticulospinal (RS) tract as well as two major sensory tracts, i.e., the fasciculus cuneatus (FC) and spinal lemniscus, to detect pathologic change and find correlations with clinical items. MR parameters were extracted for each tract at three levels: the most compressed lesion level and above and below the lesion. We compared the MR parameters of eight cervical spondylotic myelopathy patients and 12 normal controls and analyzed the correlation between clinical evaluation items and MR parameters in patients. RuS and lateral RS showed worse DTI parameters at the lesion level in patients compared to the controls. Worse DTI parameters in those tracts were correlated with weaker power grasp at the lesion level. FC and lateral CS showed a correlation between higher RD and lower FA and MTR with a weaker lateral pinch below the lesion level.
Collapse
Affiliation(s)
- Hea-Eun Yang
- Department of Rehabilitation Medicine, VHS Medical Center, Seoul 05368, Korea
| | - Wan-Tae Kim
- Department of Radiology, VHS Medical Center, Seoul 05368, Korea
| | - Dae-Hyun Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Seok-Woo Kim
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
| | - Woo-Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
- Correspondence:
| |
Collapse
|
5
|
Dauleac C, Boulogne S, Barrey CY, Guyotat J, Jouanneau E, Mertens P, Berhouma M, Jung J, André-Obadia N. Predictors of functional outcome after spinal cord surgery: Relevance of intraoperative neurophysiological monitoring combined with preoperative neurophysiological and MRI assessments. Neurophysiol Clin 2022; 52:242-251. [PMID: 35396150 DOI: 10.1016/j.neucli.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To assess the accuracy of intraoperative neurophysiological monitoring (IONM) in predicting immediate and 3-month postoperative neurological new deficit (or deterioration) in patients benefiting from spinal cord (SC) surgery; and to identify factors associated with a higher risk of postoperative clinical worsening. METHODS Consecutive patients who underwent SC surgery with IONM were included. Pre and postoperative clinical (modified McCormick scale), radiological (lesion-occupying area ratio), and electrophysiological features were collected. RESULTS A total of 99 patients were included: 14 (14.1%) underwent extradural surgery, 50 (50.5%) intradural extramedullary surgery, and 35 (35.4%) intramedullary surgery. Cumulatively, multimodal IONM (motor and somatosensory evoked potentials, D-wave whenever possible) significantly predicted postoperative deficits (p<0.001), with a sensitivity, specificity, positive predictive value, and negative predictive value of 0.81, 0.93, 0.83, and 0.92, respectively. Sixty (60.6%) patients displayed no IONM change, whereas 39 (39.4%) displayed IONM worsening. In multivariate analysis, predictors for postoperative clinical worsening were: abnormal preoperative electrophysiological assessment (p=0.03), intramedullary tumor (p<0.001), lesion-occupying area ratio ≥0.7 (p<0.001), and IONM alterations (p<0.001). Three months after the surgical procedure, in patients presenting at least one of the risk factors described above, 45/81 (55.6%) and 19/81 (23.5%) were clinically and electrophysiologically improved, respectively; while 13/81 (16.0%) and 10/81 (12.3%) were clinically and electrophysiologically worsened. CONCLUSION Multimodal IONM is an essential tool to guide SC surgery, and enables the accurate prediction of postoperative neurological outcome. Specific attention should be given to patients presenting with preoperative electrophysiological abnormalities, large tumor volume, and intramedullary tumor location.
Collapse
Affiliation(s)
- Corentin Dauleac
- Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et Epileptologie, Lyon, France; Université Lyon I, Université Claude Bernard, Lyon, France; Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, INSA-Lyon; Université de Lyon I, Lyon, France.
| | - Sébastien Boulogne
- Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et Epileptologie, Lyon, France; Université Lyon I, Université Claude Bernard, Lyon, France; Centre de Recherche de Neurosciences de Lyon, INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, F-69000 Lyon, France
| | - Cédric Y Barrey
- Université Lyon I, Université Claude Bernard, Lyon, France; Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurochirurgie C, Lyon, France
| | - Jacques Guyotat
- Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurochirurgie D, Lyon, France
| | - Emmanuel Jouanneau
- Université Lyon I, Université Claude Bernard, Lyon, France; Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurochirurgie B, Lyon, France
| | - Patrick Mertens
- Université Lyon I, Université Claude Bernard, Lyon, France; Centre de Recherche de Neurosciences de Lyon, INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, F-69000 Lyon, France; Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurochirurgie A, Lyon, France
| | - Moncef Berhouma
- Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et Epileptologie, Lyon, France; Laboratoire CREATIS, CNRS UMR5220, Inserm U1206, INSA-Lyon; Université de Lyon I, Lyon, France; Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurochirurgie D, Lyon, France
| | - Julien Jung
- Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et Epileptologie, Lyon, France; Université Lyon I, Université Claude Bernard, Lyon, France; Centre de Recherche de Neurosciences de Lyon, INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, F-69000 Lyon, France
| | - Nathalie André-Obadia
- Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et Epileptologie, Lyon, France; Université Lyon I, Université Claude Bernard, Lyon, France; Centre de Recherche de Neurosciences de Lyon, INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, F-69000 Lyon, France
| |
Collapse
|
6
|
Dauleac C, Manet R, Meyronet D, Jacquesson T, Berhouma M, Robinson P, Berthiller J, Jouanneau E, Barrey CY, Mertens P. Prognostic factors for progression-free survival of the filum terminale ependymomas in adults. Neurochirurgie 2022; 68:273-279. [PMID: 34998798 DOI: 10.1016/j.neuchi.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To define the prognostic factors for progression and to determine the impact of the histological grading (according to the World Health Organization) on the progression-free survival (PFS) of filum terminale ependymomas. METHODS A retrospective chart review of 38 patients with ependymoma of the filum terminale was performed, focusing on demographic data, preoperative symptoms, tumor size, quality of resection, presence of a tumor capsule, and histological grade. RESULTS Gross total resection (GTR) was achieved in 30 patients (78.9%). Histopathological analysis found 21 (55.3%) myxopapillary grade I ependymoma (MPE), 16 (42.1%) ependymoma grade II (EGII), and 1 (2.6%) ependymoma grade III. There was no significant difference between the mean ± SD volume of MPE (5840.5 ± 5244.2 mm3) and the one of EGII (7220.3 ± 6305.9 mm3, p=0.5). The mean ± SD follow-up was 54.1 ± 38.4 months. At last follow-up, 30 (78.9%) patients were free of progression. In multivariate analysis, subtotal resection (p=0.015) and infiltrative tumor (p=0.03) were significantly associated with progression. The PFS was significantly higher in patients with encapsulated tumor than in patients with infiltrative tumor (log-rank p=0.01) and in patients who had a GTR in comparison with those who had an incomplete resection (log-rank p=0.05). There was no difference in PFS between patient with MPE and EGII (p=0.1). CONCLUSION The progression of ependymoma of the filum terminale highly depends on the quality of resection, and whether the tumor is encapsulated. Except for anaplastic grade, histopathological type does not influence progression.
Collapse
Affiliation(s)
- Corentin Dauleac
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France.
| | - Romain Manet
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France
| | - David Meyronet
- Université de Lyon I, Université de Lyon, Lyon, France; Service d'Anatomo-pathologie, Hospices Civils de Lyon, Lyon, France
| | - Timothée Jacquesson
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Moncef Berhouma
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Philip Robinson
- Unité d'Appui Méthodologique, Département de la Recherche Clinique et Innovation, Hospices Civils de Lyon, Lyon, France
| | - Julien Berthiller
- Unité d'Appui Méthodologique, EPICIME, Cellule Innovation DRCI, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Jouanneau
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Cédric Y Barrey
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| | - Patrick Mertens
- Service de Neurochirurgie, Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Lyon, France; Université de Lyon I, Université de Lyon, Lyon, France
| |
Collapse
|
7
|
Structural and resting state functional connectivity beyond the cortex. Neuroimage 2021; 240:118379. [PMID: 34252527 DOI: 10.1016/j.neuroimage.2021.118379] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/21/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022] Open
Abstract
Mapping the structural and functional connectivity of the central nervous system has become a key area within neuroimaging research. While detailed network structures across the entire brain have been probed using animal models, non-invasive neuroimaging in humans has thus far been dominated by cortical investigations. Beyond the cortex, subcortical nuclei have traditionally been less accessible due to their smaller size and greater distance from radio frequency coils. However, major neuroimaging developments now provide improved signal and the resolution required to study these structures. Here, we present an overview of the connectivity between the amygdala, brainstem, cerebellum, spinal cord and the rest of the brain. While limitations to their imaging and analyses remain, we also provide some recommendations and considerations for mapping brain connectivity beyond the cortex.
Collapse
|