TY - JOUR
T1 - Assessing informative tract segmentation and nTMS for pre-operative planning
AU - Lucena, Oeslle
AU - Lavrador, Jose Pedro
AU - Irzan, Hassna
AU - Semedo, Carla
AU - Borges, Pedro
AU - Vergani, Francesco
AU - Granados, Alejandro
AU - Sparks, Rachel
AU - Ashkan, Keyoumars
AU - Ourselin, Sebastien
N1 - Funding Information:
Oeslle Lucena is funded by EPSRC Research Council ( EPSRC DTP EP/R513064/1 ). Pedro Borges is funded by the Wellcome Flagship Programme ( WT213038/Z/18/Z ) and Wellcome EPSRC CME ( WT203148/Z/16/Z ). This work was also supported by core funding from the Wellcome/EPSRC [ WT203148/Z/16/Z; NS/A000049/1 ].
Publisher Copyright:
© 2023 The Authors
PY - 2023/8/1
Y1 - 2023/8/1
N2 - BACKGROUND: Deep learning-based (DL) methods are the best-performing methods for white matter tract segmentation in anatomically healthy subjects. However, tract annotations are variable or absent in clinical data and manual annotations are especially difficult in patients with tumors where normal anatomy may be distorted. Direct cortical and subcortical stimulation is the gold standard ground truth to determine the cortical and sub-cortical lo- cation of motor-eloquent areas intra-operatively. Nonetheless, this technique is invasive, prolongs the surgical procedure, and may cause patient fatigue. Navigated Transcranial Magnetic Stimulation (nTMS) has a well-established correlation to direct cortical stimulation for motor mapping and the added advantage of being able to be acquired pre-operatively.NEW METHOD: In this work, we evaluate the feasibility of using nTMS motor responses as a method to assess corticospinal tract (CST) binary masks and estimated uncertainty generated by a DL-based tract segmentation in patients with diffuse gliomas.RESULTS: Our results show CST binary masks have a high overlap coefficient (OC) with nTMS response masks. A strong negative correlation is found between estimated uncertainty and nTMS response mask distance to the CST binary mask.COMPARISON WITH EXISTING METHODS: We compare our approach (UncSeg) with the state-of-the-art TractSeg in terms of OC between the CST binary masks and nTMS response masks.CONCLUSIONS: In this study, we demonstrate that estimated uncertainty from UncSeg is a good measure of the agreement between the CST binary masks and nTMS response masks distance to the CST binary mask boundary.
AB - BACKGROUND: Deep learning-based (DL) methods are the best-performing methods for white matter tract segmentation in anatomically healthy subjects. However, tract annotations are variable or absent in clinical data and manual annotations are especially difficult in patients with tumors where normal anatomy may be distorted. Direct cortical and subcortical stimulation is the gold standard ground truth to determine the cortical and sub-cortical lo- cation of motor-eloquent areas intra-operatively. Nonetheless, this technique is invasive, prolongs the surgical procedure, and may cause patient fatigue. Navigated Transcranial Magnetic Stimulation (nTMS) has a well-established correlation to direct cortical stimulation for motor mapping and the added advantage of being able to be acquired pre-operatively.NEW METHOD: In this work, we evaluate the feasibility of using nTMS motor responses as a method to assess corticospinal tract (CST) binary masks and estimated uncertainty generated by a DL-based tract segmentation in patients with diffuse gliomas.RESULTS: Our results show CST binary masks have a high overlap coefficient (OC) with nTMS response masks. A strong negative correlation is found between estimated uncertainty and nTMS response mask distance to the CST binary mask.COMPARISON WITH EXISTING METHODS: We compare our approach (UncSeg) with the state-of-the-art TractSeg in terms of OC between the CST binary masks and nTMS response masks.CONCLUSIONS: In this study, we demonstrate that estimated uncertainty from UncSeg is a good measure of the agreement between the CST binary masks and nTMS response masks distance to the CST binary mask boundary.
KW - Humans
KW - Transcranial Magnetic Stimulation/methods
KW - Brain Neoplasms/diagnostic imaging
KW - Diffusion Tensor Imaging/methods
KW - Brain Mapping/methods
KW - Glioma/surgery
KW - Neuronavigation/methods
UR - http://www.scopus.com/inward/record.url?scp=85166538312&partnerID=8YFLogxK
U2 - 10.1016/j.jneumeth.2023.109933
DO - 10.1016/j.jneumeth.2023.109933
M3 - Article
C2 - 37524245
SN - 0165-0270
VL - 396
SP - 109933
JO - Journal of Neuroscience Methods
JF - Journal of Neuroscience Methods
M1 - 109933
ER -