Evidence map›Paper›PMID 41417182›Full record

ArticleJournal of neuro-oncology2025

Connectomics in brain tumor surgery: large-scale clinical feasibility and hypothesis-generating tractometry findings.

Iñigo L Sistiaga, John Chen, Laura Mittelman, Shoaib Syed, Nitish Seenarine, James Duehr, Aditya Behal, Harshal A Shah, Daniel G Eichberg, Michael Schulder and 1 more

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Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Iñigo L SistiagaDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA. ilsistiaga@gmail.com.
John ChenDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Laura MittelmanDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Shoaib SyedDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Nitish SeenarineDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
James DuehrDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Aditya BehalDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Harshal A ShahDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Daniel G EichbergDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Michael SchulderDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Randy S D'AmicoDepartment of Neurosurgery, Northwell, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.

Funding

Northwell Health Cancer Institute Mentoring in Cancer Research
6 · The paper itself

Abstract

backgroundMaximal tumor resection with neurological preservation is central to brain tumor surgery. This study evaluates the integration of an artificial intelligence-based connectomics platform for surgical planning, with exploratory tractometry analysis of postoperative white matter changes.

methodsWe retrospectively reviewed 192 consecutive brain tumor surgeries performed between April 2023 and April 2025 using preoperative connectomic mapping (Quicktome, Omniscient Neurotechnology). Functional outcomes were assessed with Karnofsky Performance Status (KPS). In an opportunistic subgroup (n = 13), paired pre- and postoperative imaging enabled tractometry (Cleartome). Fractional anisotropy (FA) was measured across six major tracts, and three hemispheric FA asymmetry indices were calculated: difference in average FA (Diff FA), asymmetry index (AI), and percentage asymmetry (%Asym).

resultsThe cohort included intra-axial and extra-axial tumors. Median KPS remained stable at 3 months after surgery. In the tractometry subgroup, 12 of 13 patients showed postoperative shifts toward improved interhemispheric FA symmetry in at least one tract. Left-hemisphere cases most often showed changes in the uncinate fasciculus (UF) and inferior fronto-occipital fasciculi (IFOF) (median AI = - 0.68 and - 0.20, respectively), while right-hemisphere cases demonstrated alterations in the superior longitudinal fasciculus (SLF) (median AI = + 5.13; %Asym =-8.43). The corticospinal tract (CST) and IFOF improved in 61.5% of analyzed cases. Tract-based asymmetry indices captured subtle connectivity changes not evident in raw FA values alone.

conclusionsRoutine clinical use of AI-guided connectomics in brain tumor surgery was feasible, with stable short-term functional outcomes. Tract-based hemispheric FA asymmetry metrics suggested postoperative microstructural alterations; findings remain preliminary and warrant further prospective validation.

Indexed as

Brain NeoplasmsConnectomeNeurosurgical ProceduresWhite MatterAdultAgedArtificial IntelligenceDiffusion Tensor ImagingFeasibility StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesYoung AdultBrain networks, fractional anisotropyCognitionConnectomeQuicktomeTractography

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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.