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01-07-2016 | Head and Neck

Parotid gland tumours: MR tractography to assess contact with the facial nerve

Authors: Arnaud Attyé, Alexandre Karkas, Irène Troprès, Matthieu Roustit, Adrian Kastler, Georges Bettega, Laurent Lamalle, Félix Renard, Christian Righini, Alexandre Krainik

Published in: European Radiology | Issue 7/2016

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/mm²; 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.

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Title: Parotid gland tumours: MR tractography to assess contact with the facial nerve
Authors: Arnaud Attyé
Alexandre Karkas
Irène Troprès
Matthieu Roustit
Adrian Kastler
Georges Bettega
Laurent Lamalle
Félix Renard
Christian Righini
Alexandre Krainik
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4049-9

At a glance: The STEP trials

Springer Medicine

Parotid gland tumours: MR tractography to assess contact with the facial nerve

Abstract

Objectives

Methods

Results

Conclusions

Key points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

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