Prediction of Motor Recovery Using Diffusion Tensor Imaging and Regional Cerebral Blood Flow in Postoperative Brain Tumors

TL;DR

This study shows that brain imaging techniques can help predict whether patients with brain tumors will recover motor function after surgery.

Contribution

The study introduces a novel approach combining DTI parameters and rCBF to predict postoperative motor recovery in brain tumor patients.

Findings

DTI parameters and rCBF at the CST differ significantly between groups with and without motor recovery.

Higher rFA and lower rMD/rRD at the internal capsule correlate with better postoperative motor outcomes.

Increased rCBF at multiple CST regions is associated with motor recovery.

Abstract

Objective: To determine whether diffusion tensor image (DTI) parameters and regional cerebral blood flow (rCBF) serve to preoperatively predict postoperative motor outcomes in patients with brain tumors.

Methods: We included 81 patients with brain tumors who underwent surgical treatment. Motor function was assessed using the manual muscle test in the upper and lower limbs at admission and discharge. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and their ratios (rFA, rMD, rAD, and rRD) were measured at the corona radiata, internal capsule, and cerebral peduncle of the corticospinal tract (CST). In addition, DTI and single photon emission computed tomography (SPECT) were synthesized to measure rCBF at the CST.

Result: Both DTI parameters and rCBF at the CST in the preoperative motor weakness group significantly differed from those of the preoperative normal function group. rFA at the cerebral peduncle and the internal capsule was considerably higher in those showing postoperative motor recovery than in those postoperative unchanged or with deteriorated motor function (P < 0.05). Moreover, there was significantly lower rMD and rRD at the internal capsule in the motor recovery group (P < 0.05, P < 0.01). Furthermore, rCBF was higher at all the cerebral peduncle, internal capsule, and corona radiate in the motor recovery group than in the unchanged and deteriorated motor function group (P < 0.05, P < 0.01, P < 0.01).

Conclusion: The analysis of DTI parameters and rCBF is useful in predicting postoperative motor outcomes in patients with brain tumors.

Figures