Assessment of quantitative corticospinal tract diffusion changes in patients affected by subcortical gliomas using common available navigation software.

Objective: The aim of this study is to analyze the quantitative DTI parameters of the CST in patients suffering from subcortical gliomas affecting the CST using generally available navigation software.

Methods: A retrospective study was conducted on 22 subjects with diagnosis of primary cerebral glioma and preoperative motor deficits. Exclusion criteria were: involvement of motor cortex, lesion involving both hemispheres, previous surgical treatment. All patients were studied using magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) sequences. Volume, fractional anisotropy (FA) and mean diffusivity value (MD) of the entire CSTs were estimated. Moreover, distance from midline, diameters, FA and MD were calculated on axial images at the point of minimal distance between tumor and CST. Statistical analysis was performed.

Results: There was a statistically significant difference of CST volume between affected and non-affected hemispheres (p<0.01). Mean overall/local FA, overall/local MD and sagittal diameter of CST were also significantly different between the two sides (p<0.05). Correlation tests resulted positive between the shift of CST and overall/local MD. Moreover there is significance between CST volume of tumor hemisphere and preoperative duration of motor deficits (p<0.05).

Conclusion: The present study has demonstrated for the first time a significant difference of DTI based quantitative parameters of the CST between a tumor affected and a non-affected hemisphere in patients with a corresponding motor deficit. This preliminary data suggests a correlation between DTI based integrity of CST and its function.