Aylmore, Holly;
Young, Fiona;
Aquilina, Kristian;
Clark, Chris A;
Clayden, Jonathan D;
(2025)
The use of intraoperative tractography in brain tumor and epilepsy surgery: a systematic review and meta-analysis.
Frontiers in Neuroimaging
, 4
, Article 1563996. 10.3389/fnimg.2025.1563996.
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Abstract
Introduction: Tractography is the only available technique for visualizing whitematter pathways within the living brain. Avoiding these pathways during surgical interventions for brain tumors and epilepsy is key to reducing postoperative neurological deficits whilst achieving maximum safe resection. Despite this, the use of intraoperative tractography is not widely adopted in clinical practice, with time required to run analyses often cited as a limitation. This systematic review and meta-analysis aimed to assess the impact of intraoperative tractography on neurosurgical outcomes in both tumor and epilepsy surgeries. Methods: Conducted in accordance with PRISMA guidelines, five major databases were searched using neurosurgery, tractography, brain tumor, and epilepsy terms. Original primary research studies in English were included. A risk of bias analysis was conducted using the MINORS tool. Results: The search strategy identified 2,611 papers. Following de-duplication and screening, 26 papers were included in the final analysis. Risk of bias was found to be moderate. Findings suggest that the use of intraoperative tractography has the potential to improve surgical outcomes for patients undergoing tumor and epilepsy surgery. Meta-analysis indicated a good rate of gross total resection, 79%, and only three studies of brain tumors and one study of epilepsy reported worsening of neurological deficits. Discussion: Though the evidence supporting its use remains limited, results indicate that intraoperative tractography can be a valuable tool in improving neurosurgical outcomes and reducing the risk of postoperative deficits. Further research is required to determine optimal use in clinical practice. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023427427, Identifier: CRD42023427427.
| Type: | Article |
|---|---|
| Title: | The use of intraoperative tractography in brain tumor and epilepsy surgery: a systematic review and meta-analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fnimg.2025.1563996 |
| Publisher version: | https://doi.org/10.3389/fnimg.2025.1563996 |
| Language: | English |
| Additional information: | Copyright © 2025 Aylmore, Young, Aquilina, Clark and Clayden. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | diusion tensor imaging, tractography, brain tumors, epilepsy, neurosurger |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10210122 |
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