Affiliation:
1. Department of Neurosurgery, Beijing Tiantan Hospital Capital Medical University Beijing China
2. Department of Neurological Surgery University of Pittsburgh Pittsburgh Pennsylvania USA
3. Department of Bioengineering University of Pittsburgh Pittsburgh Pennsylvania USA
4. Department of Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital Capital Medical University Beijing China
5. Department of Radiology Beijing Tiantan Hospital, Capital Medical University Beijing China
Abstract
BackgroundInsular low‐grade gliomas (LGGs) are surgically challenging due to their proximity to critical structures like the corticospinal tract (CST).PurposeThis study aims to determine if preoperative CST shape metrics correlate with postoperative motor complications in insular LGG patients.Study TypeRetrospective.Population42 patients (mean age 40.26 ± 10.21 years, 25 male) with insular LGGs.Field Strength/SequenceImaging was performed using 3.0 Tesla MRI, incorporating T1‐weighted magnetization‐prepared rapid gradient‐echo, T2‐weighted space dark‐fluid with spin echo (SE), and diffusional kurtosis imaging (DKI) with gradient echo sequences, all integrated with echo planar imaging.AssessmentShape metrics of the CST, including span, irregularity, radius, and irregularity of end regions (RER and IER, respectively), were compared between the affected and healthy hemispheres. Total end region radius (TRER) was determined as the sum of RER 1 and RER 2. The relationships between shape metrics and postoperative short‐term (4 weeks) and long‐term (>8 weeks) motor disturbances assessing by British Medical Research Council grading system, was analyzed using multivariable regression models.Statistical TestingPaired t‐tests compared CST metrics between hemispheres. Logistic regression identified associations between these metrics and motor disturbances. The models were developed using all available data and there was no independent validation dataset. Significance was set at P < 0.05.ResultsShort‐term motor disturbance risk was significantly related to TRER (OR = 199.57). Long‐term risk significantly correlated with IER 1 (OR = 59.84), confirmed as a significant marker with an AUC of 0.78. Furthermore, the CST on the affected side significantly had the greater irregularity, larger TRER and RER 1, and smaller span compared to the healthy side.Data ConclusionPreoperative evaluation of TRER and IER 1 metrics in the CST may serve as a tool for assessing the risk of postoperative motor complications in insular LGG patients.Level of Evidence2Technical EfficacyStage 2
Subject
Radiology, Nuclear Medicine and imaging
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