′′Two are Better than One′′: Combining fMRI and DTI Based Fiber Tracking for Effective Pre-Surgical Mapping

T. Hendler, P. Pianka, M. Sigal, M. Kafri, D. Ben-Bashat, S. Constantini, M. Graif, I. Fried, Y. Assaf The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel Aviv, Israel, Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel Synopsis Functional MRI (fMRI) is used extensively for pre-surgical functional mapping. However, it is crucial for favorable neurosurgical outcome to delineate also fiber-tracks spreading in vicinity of brain lesion. The objects of this study were to combine diffusion tensor imaging (DTI) and fMRI for 3D visualization of motor functionality and related connectivity in vicinity of discrete brain lesions. The combination of fMRI and DTI based fiber tracking provides valuable functional information that cannot be extracted from each method separately. The use of three-dimensional visualization is crucial for understanding the spatial relation between the tumor, critical neuronal activations and fiber tracks.