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Application of Diffusion Tensor-Based Tractography in Treatment of Brain Arteriovenous Malformations: A Systematic Review Publisher Pubmed



Shahbandi A1 ; Sattari SA2 ; Haghshomar M3 ; Shabbidar S4 ; Lawton MT5
Authors
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Authors Affiliations
  1. 1. School of Medicine, Tehran University of Medical Sciences, Enghelab Street, Tehran, Iran
  2. 2. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
  3. 3. Department of Radiology, Northwestern University, Chicago, IL, United States
  4. 4. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, United States

Source: Neurosurgical Review Published:2023


Abstract

There is no systematic review investigating the utility of Diffusion tensor-based tractography findings for treating brain arteriovenous malformations (bAVMs). This systematic review aims to investigate the outcomes following bAVM treatment when tractography data is incorporated into treatment planning. PubMed/MEDLINE, Scopus, and Cochrane Library, were searched for published studies. Prospective or retrospective studies involving at least one patient with confirmed bAVM and available data on tractography and clinical outcomes were included. A total of 16 studies were eligible for this review, consisting of 298 patients. 48.2% of patients were female. The mean age of the patients was 27.5 years (range: 5-77). Stereotactic radiosurgery (SRS) and microsurgical resection each were the treatment of choice in eight studies, respectively. Two-hundred forty-eight patients underwent SRS as the primary treatment, while microsurgery was used to resect the bAVMs in 50 patients. The corticospinal tract, optic pathway, and arcuate fasciculus were the most widely investigated white matter tracts. Tractography disruption and failure frequencies were 19.1% and 1.8%, respectively. The pooled proportions (95% CI) of obliteration rates were 88.78% (73.51-95.76) for microsurgery and 51.45% (13-17-88.10) following SRS. Treatment-related non-hemorrhagic complications rates occurred in 24.2% and 9.9% of patients who underwent microsurgical resection and SRS, respectively. Tractography findings can contribute to providing a more accurate dosimetry analysis of functional white matter tracts at risk prior to SRS and minimizing the surgical morbidity following microsurgical resection. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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