ReviewNeurosurgery practice2025
Does Fiber Orientation Distribution Really Outperform Diffusion Tensor Imaging-Based Tractography in the Clinic? A Diagnostic Test Accuracy Systematic Review and Meta-Analysis of Intraoperative Tractography.
Review in Neurosurgery practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesTractography of the corticospinal tract (CST) is routinely used for neurosurgical planning and navigation. It allows the noninvasive, patient-specific visualization of fiber tracts which can be used for surgical planning and risk stratification. This systematic review and meta-analysis sought to synthesize the accuracy of CST tractography by comparing diffusion tensor imaging (DTI)-based and fiber orientation distribution (FOD)-based tractography approaches to direct (sub)cortical electrical stimulation of motor fibers.
methodsWe systematically searched 4 databases (MEDLINE Ovid, Embase Ovid, Web of Science, CENTRAL) on 01.10.2024. Studies were included if they were (1) cross-sectional (2) original research studies that (3) had participants with motor-eloquent pathologies undergoing surgery, (4) performed intraoperative mapping of the CST, (5) compared stimulation sites with tractography, and (6) reported measures of test accuracy, e.g., sensitivity and specificity. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data were analyzed using a fixed-effect logistic regression model to derive pooled effect estimates of sensitivity and specificity of DTI-based and FOD-based tractography.
resultsWe included 16 studies of which 12 used DTI-based, 2 used FOD-based, and 2 used both DTI-based and FOD-based tractography. For DTI-based tractography, sensitivity ranged from 25% to 100% and specificity from 55.6% to 100%. For FOD-based tractography, sensitivity ranged from 36% to 79% and specificity from 77% to 98%. Clinically, 10 studies reported functional outcomes, although the time of postoperative testing varied: 1 study reported a decrease, 6 a preservation, and 3 an improvement in motor function at follow-up.
conclusionOverall, incomplete reporting prevented a quantitative comparison of DTI-based and FOD-based tractography. Although 2 studies indicate that FOD-based tractography may be superior to DTI-based tractography for sensitivity in a clinical setting, evidence to this end is, as of yet, insufficient. Future cross-sectional studies evaluating multiple tractography approaches within one setting are recommended.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.