Rapid Analysis of Intraoperatively Acquired DTI for Identification of Key White M

描述（由申请人提供）：手术切除或切除是脑肿瘤最重要的治疗方法。当肿瘤位于关键脑区附近时，如运动，感觉或语言功能，完全切除的目标必须与保留功能的目标相平衡。重要的白色连接或束的损伤将使患者出现严重的神经功能缺损。然而，在手术过程中，管道是不可见的外科医生的眼睛，他们的一致性可能是相同的肿瘤。因此，脑肿瘤的手术治疗可以从更完整，更准确的结构功能脑地图中受益匪浅。扩散张量MRI（DTI）是一种相对较新的MRI模式，对白色物质的结构敏感。该项目旨在将当前的DTI研究转化为手术室，以解决手术期间白色物质束识别的挑战。本项目的长期目标是改善神经外科的白色标测，并增加我们对神经外科对白色的影响的理解。白色物质束的轨迹可以使用扩散张量DTI纤维束成像来绘制。但由于必须在称为虚拟解剖的过程中选择感兴趣的纤维束进行查看，该过程每条纤维束可能需要10分钟，因此术中DTI纤维束成像的临床应用范围受到限制。大多数情况下，每个病人只有一个关键的管道被标测。我们假设，通过使用患者自己的大脑作为参考，即通过利用患者个性化手术计划中包含的关键神经束的患者特定模型，我们可以在手术期间扫描患者时快速准确地生成更新的大脑地图。我们将开发一个软件系统，在神经外科手术过程中实时生成白色脑图，并进行两项验证研究来验证我们的假设。我们提出了以下目标，这些目标将利用我们最先进的高场强术中3T MRI系统和我们的研究神经导航软件平台3D Slicer。(1)开发和优化计算方法，用于术中DTI中快速识别关键纤维束。该项目的这一部分将侧重于轨道相似性测量的数学发展，以及软件设计和实现。(2)通过手术室中的多名评估者研究和电刺激来验证系统的速度和准确性。该项目的这一部分将集中在神经外科医生和神经放射科医生对该系统的临床验证上，它将使我们能够测试我们最初的假设，即我们可以在手术过程中快速创建白色物质的准确大脑地图。

DESCRIPTION (provided by applicant): Surgical removal, or resection, is the most important treatment for brain tumors. When tumors are located near critical brain areas such as motor, sensory, or language functions, the goal of complete resection must be balanced with the goal of preservation of function. Injury to critical white matter connections, or tracts, will leave the patient with serious neurological deficits. However, during surgery, the tracts are not visible to the surgeon's eye, and their consistency may be the same as the tumor. Thus, the surgical treatment of brain tumors can benefit tremendously from more complete, accurate structural-functional brain maps. Diffusion tensor MRI (DTI) is a relatively new MRI modality that is sensitive to the structure of the white matter. This project aims to translate current DTI research into the operating room to address challenges of white matter tract identification during surgery. The long-term objectives of this project are to improve white matter mapping for neurosurgery and to increase our understanding of the effect of neurosurgery on the white matter. The trajectories of the white matter tracts can be mapped using diffusion tensor DTI tractography. But because the tracts of interest must be selected for viewing in a process called virtual dissection that can take 10 minutes per tract, the clinical use of intraoperative DTI tractography has been limited in scope. Most often only one crucial tract has been mapped per patient. We hypothesize that by using the patient's own brain as a reference, i.e. by taking advantage of patient-specific models of crucial tracts contained in their personalized surgical plan, we can quickly and accurately produce an updated brain map when the patient is scanned during surgery. We will develop a software system to produce the white matter brain map on the fly during neurosurgery, and we will perform two validation studies to test our hypothesis. We propose the following objectives that will take advantage of our new state-of-the-art, high field strength intraoperative 3T MRI system and our research neuronavigation software platform, 3D Slicer. (1) Develop and optimize computational methods for rapid identification of crucial fiber tracts in intraoperative DTI. This part of the project will focus on mathematical development of tract similarity measures, and on software design and implementation. (2) Validate speed and accuracy of the system via a multi-rater study and electrical stimulation in the OR. This part of the project will focus on clinical validation of the system by a neurosurgeon and neuroradiologist, and it will allow us to test our original hypothesis that we can quickly create an accurate brain map for the white matter during surgery.