Arnaud Attyé1,2,3,4, Alexandre Karkas5, Irène Troprès6,7,8, Matthieu Roustit9, Adrian Kastler10,6,7, Georges Bettega11, Laurent Lamalle6,7,8, Félix Renard7, Christian Righini5,12, Alexandre Krainik10,6,7. 1. Department of Neuroradiology and MRI, Grenoble University Hospital - SFR RMN Neurosciences, Grenoble, France. aattye@chu-grenoble.fr. 2. Inserm, US 17, Grenoble, France. aattye@chu-grenoble.fr. 3. University Grenoble Alpes, IRMaGe, F-38000, Grenoble, France. aattye@chu-grenoble.fr. 4. Neuroradiology and MR Unit, CS 10217- Grenoble University Hospital, F-38043, Grenoble, Cedex 9, France. aattye@chu-grenoble.fr. 5. Department of Otolaryngology-Head and Neck Surgery, University Hospital of Grenoble, Grenoble, France. 6. Inserm, US 17, Grenoble, France. 7. University Grenoble Alpes, IRMaGe, F-38000, Grenoble, France. 8. CNRS, UMS 3552, Grenoble, France. 9. Department of Statistics, University Hospital of Grenoble, Grenoble, France. 10. Department of Neuroradiology and MRI, Grenoble University Hospital - SFR RMN Neurosciences, Grenoble, France. 11. Department of Maxillofacial Surgery, University Hospital of Grenoble, Grenoble, France. 12. Albert Bonniot Institute, Grenoble, France.
Abstract
OBJECTIVES: To assess the feasibility of intraparotid facial nerve (VIIn) tractographic reconstructions in estimating the presence of a contact between the VIIn and the tumour, in patients requiring surgical resection of parotid tumours. METHODS: Patients underwent MR scans with VIIn tractography calculated with the constrained spherical deconvolution model. The parameters of the diffusion sequence were: b-value of 1000 s/mm(2); 32 directions; voxel size: 2 mm isotropic; scan time: 9'31'. The potential contacts between VIIn branches and tumours were estimated with different initial fractional anisotropy (iFA) cut-offs compared to surgical data. Surgeons were blinded to the tractography reconstructions and identified both nerves and contact with tumours using nerve stimulation and reference photographs. RESULTS: Twenty-six patients were included in this study and the mean patient age was 55.2 years. Surgical direct assessment of VIIn allowed identifying 0.1 as the iFA threshold with the best sensitivity to detect tumour contact. In all patients with successful VIIn identification by tractography, surgeons confirmed nerve courses as well as lesion location in parotid glands. Mean VIIn branch FA values were significantly lower in cases with tumour contact (t-test; p ≤ 0.01). CONCLUSIONS: This study showed the feasibility of intraparotid VIIn tractography to identify nerve contact with parotid tumours. KEY POINTS: • Diffusion imaging is an efficient method for highlighting the intraparotid VIIn. • Visualization of the VIIn may help to better manage patients before surgery. • We bring new insights to future trials for patients with VIIn dysfunction. • We aimed to provide radio-anatomical references for further studies.
OBJECTIVES: To assess the feasibility of intraparotid facial nerve (VIIn) tractographic reconstructions in estimating the presence of a contact between the VIIn and the tumour, in patients requiring surgical resection of parotid tumours. METHODS:Patients underwent MR scans with VIIn tractography calculated with the constrained spherical deconvolution model. The parameters of the diffusion sequence were: b-value of 1000 s/mm(2); 32 directions; voxel size: 2 mm isotropic; scan time: 9'31'. The potential contacts between VIIn branches and tumours were estimated with different initial fractional anisotropy (iFA) cut-offs compared to surgical data. Surgeons were blinded to the tractography reconstructions and identified both nerves and contact with tumours using nerve stimulation and reference photographs. RESULTS: Twenty-six patients were included in this study and the mean patient age was 55.2 years. Surgical direct assessment of VIIn allowed identifying 0.1 as the iFA threshold with the best sensitivity to detect tumour contact. In all patients with successful VIIn identification by tractography, surgeons confirmed nerve courses as well as lesion location in parotid glands. Mean VIIn branch FA values were significantly lower in cases with tumour contact (t-test; p ≤ 0.01). CONCLUSIONS: This study showed the feasibility of intraparotid VIIn tractography to identify nerve contact with parotid tumours. KEY POINTS: • Diffusion imaging is an efficient method for highlighting the intraparotid VIIn. • Visualization of the VIIn may help to better manage patients before surgery. • We bring new insights to future trials for patients with VIIn dysfunction. • We aimed to provide radio-anatomical references for further studies.
Authors: Kerstin Pannek; Jane L Mathias; Erin D Bigler; Greg Brown; Jamie D Taylor; Stephen E Rose Journal: Neuroimage Date: 2010-12-13 Impact factor: 6.556
Authors: Rajikha Raja; Xiaoxu Na; Alexandra Moore; Raymond Otoo; Charles M Glasier; Thomas M Badger; Xiawei Ou Journal: J Child Neurol Date: 2022-03-07 Impact factor: 2.363