![]() ![]() 17, 18 Particularly, DTI-based tractography is commonly applied to reconstruct certain fiber tracts, relating to its comparatively wide availability and low false-positive rate. ![]() ![]() 6, 14 ⇓- 16 In the preoperative setup, DWI with tractography is used for delineation of WM architecture, which can then be visualized and respected during tumor resection. Imaging and mapping of brain function are essential for a maximum safe resection combined with a high extent of resection and a low-risk profile for permanent functional deterioration. 10, 11 Additionally, subcortical WM pathways such as efferent fibers that interconnect certain brain areas or course down to the periphery may need to be respected to avoid lasting functional deficits. 7 ⇓- 9 However, a maximum extent of resection needs to be weighed against the risk of surgery-related functional decline such as persistent paresis or aphasia, which may arise from tumor resection in or near functionally eloquent structures such as the motor or language cortex. 4 ⇓- 6 Specifically, a maximum extent of resection correlates to prolonged survival and improved quality of life. 1 ⇓- 3 Contemporary treatment combines neurosurgical tumor resection with extended focal radiation therapy and adjuvant chemotherapy. Gliomas are the most prevalent malignant brain tumors in adults, and particularly anaplastic astrocytoma and glioblastoma as representatives of high-grade gliomas have poor prognoses. ABBREVIATIONS: ADT angular deviation threshold CSD constrained spherical deconvolution CST corticospinal tract FAT fractional anisotropy threshold FOD fiber orientation distribution MLFT multilevel fiber tractography nTMS navigated transcranial magnetic stimulation ![]()
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