Tractography in neurosurgery a review article

Background: To create a 3D representation of the white matter bundles in the brain, dMRI uses the diffusion of water molecules along axons. This function is very helpful for planning a surgical approach and seeing how a tumor affects the surrounding white matter. Objective: This article examines the various applications of dMRI in improving brain surgery, as well as its advantages and drawbacks. We discuss surgical methods that can be used in conjunction with dMRI to enhance the impact of the procedure on the patient’s recovery, such as loading 3D tractography into the neuronavigation system and using direct electrical stimulation to confirm the location of the targeted white matter bundles. Methods: We looked at research that support dMRI results with other anatomical study methods, like postmortem dissections, manganese-enhanced MRI, electrical stimulations, and phantom experiments with established ground truth, in recent meta-analysis, research articles. We will talk about the parts of the brain where dMRI works well and where the obstacles lie in the future. Results: Tractography has lots of potential. Preoperative Tractography can assess the neural pathways and assist surgeons for optimal surgical approach. The technology is still in development. Conclusion: The review will be concluded with recommendations and key takeaways for neurosurgeons, on how to advance the discipline and reap the rewards of using tractography in clinical practice.