OBJECTIVETo investigate the feasibility of applying diffusion tensor imaging (DTI)-based arcuate fasciculus tractography and intraoperative arcuate fasciculus navigation for neurosurgery.

METHODSTotally 85 patients with interhemispheric tumors who had undergone intra-operative magnetic resonance imaging (MRI) and neuronavigation were divided into sinistrocerebral tumor (SCT) group (n = 55) and sham group (n = 30). All patients accepted routine MRI and DTI preoperatively. The results from both DTI-based arcuate fasciculus tractography and neuronavigation were applied to guide the surgery. All patients were followed up at 2-4 weeks and 3-6 months postoperatively.

RESULTSAll patients smoothly received the pre-operative DTI-based arcuate fasciculus tractography. The three dimensional arcuate fasciculus was successfully integrated with the neuronavigation and achieved microscope heads-up display. Long-term follow-up showed that there were only 4 patients suffered from persistent language dysfunction.

CONCLUSIONSThe combined application of DTI-based arcuate fasciculus tractography and intraoperative arcuate fasciculus navigation is feasible for guiding brain surgery. It can improve the surgical outcomes of intracranial tumor involving language functional area. The technology also maximizes the retention of language function and improves the post-operative quality of life.