Brain tissue segmentation in neurosurgery: a systematic analysis for quantitative tractography approaches

Acta Neurol Belg. 2024 Feb;124(1):1-15. doi: 10.1007/s13760-023-02170-9. Epub 2023 Jan 6.

Abstract

Diffusion magnetic resonance imaging (dMRI) is a cutting-edge imaging method that provides a macro-scale in vivo map of the white matter pathways in the brain. The measurement of brain microstructure and the enhancement of tractography rely heavily on dMRI tissue segmentation. Anatomical MRI technique (e.g., T1- and T2-weighted imaging) is the most widely used method for segmentation in dMRI. In comparison to anatomical MRI, dMRI suffers from higher image distortions, lower image quality, and making inter-modality registration more difficult. The dMRI tractography study of brain connectivity has become a major part of the neuroimaging landscape in recent years. In this research, we provide a high-level overview of the methods used to segment several brain tissues types, including grey and white matter and cerebrospinal fluid, to enable quantitative studies of structural connectivity in the brain in health and illness. In the first part of our review, we discuss the three main phases in the quantitative analysis of tractography, which are correction, segmentation, and quantification. Methodological possibilities are described for each phase, along with their popularity and potential benefits and drawbacks. After that, we will look at research that used quantitative tractography approaches to examine the white and grey matter of the brain, with an emphasis on neurodevelopment, ageing, neurological illnesses, mental disorders, and neurosurgery as possible applications. Even though there have been substantial advancements in methodological technology and the spectrum of applications, there is still no consensus regarding the "optimal" approach in the quantitative analysis of tractography. As a result, researchers should tread carefully when interpreting the findings of quantitative analysis of tractography.

Keywords: Cerebrospinal fluid; Fibre tractography; Gray matter; Neurosurgery; Segmentation; White matter; dMRI.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / surgery
  • Diffusion Magnetic Resonance Imaging / methods
  • Gray Matter
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Neurosurgery*
  • White Matter* / diagnostic imaging