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Acta Neurochirurgica
Published in: Acta Neurochirurgica 6/2015

01-06-2015 | Clinical Article - Neurosurgical Techniques

Tractography of Meyer’s loop for temporal lobe resection—validation by prediction of postoperative visual field outcome‬‬‬‬

Authors: Ylva Lilja, Maria Ljungberg, Göran Starck, Kristina Malmgren, Bertil Rydenhag, Daniel T. Nilsson

Published in: Acta Neurochirurgica | Issue 6/2015

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Abstract

Background

Postoperative visual field defects are common after temporal lobe resection because of injury to the most anterior part of the optic radiation, Meyer’s loop. Diffusion tensor tractography is a promising technique for visualizing the optic radiation preoperatively. The aim of this study was to assess the anatomical accuracy of Meyer’s loop, visualized by the two most common tractography methods—deterministic (DTG) and probabilistic tractography (PTG)—in patients who had undergone temporal lobe resection.

Methods

Eight patients with temporal lobe resection for temporal lobe pathology were included. Perimetry and diffusion tensor imaging were performed pre- and postoperatively. Two independent operators analyzed the distance between the temporal pole and Meyer’s loop (TP-ML) using DTG and PTG. Results were compared to each other, to data from previously published dissection studies and to postoperative perimetry results. For the latter, Spearman’s rank correlation coefficient (rs) was used.

Results

Median preoperative TP-ML distances for nonoperated sides were 42 and 35 mm, as determined by DTG and PTG, respectively. TP-ML assessed with PTG was a closer match to dissection studies. Intraclass correlation coefficients were 0.4 for DTG and 0.7 for PTG. Difference between preoperative TP-ML (by DTG and PTG, respectively) and resection length could predict the degree of postoperative visual field defects (DTG: rs = −0.86, p < 0.05; PTG: rs = −0.76, p < 0.05).

Conclusion

Both DTG and PTG could predict the degree of visual field defects. However, PTG was superior to DTG in terms of reproducibility and anatomical accuracy. PTG is thus a strong candidate for presurgical planning of temporal lobe resection that aims to minimize injury to Meyer’s loop.
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Metadata
Title
Tractography of Meyer’s loop for temporal lobe resection—validation by prediction of postoperative visual field outcome‬‬‬‬
Authors
Ylva Lilja
Maria Ljungberg
Göran Starck
Kristina Malmgren
Bertil Rydenhag
Daniel T. Nilsson
Publication date
01-06-2015
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 6/2015
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-015-2403-y

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