DTI for presurgical mapping

While there are many current and potential applications for diffusion tensor imaging (DTI), the ability to map white matter tracts prior to surgical resection of brain tumors is responsible for the emergence of this powerful technology into the clinical realm. Dramatic successes have propelled the clinical translation. By defining spatial relationships between the lesion and functional white matter networks, DTI plays a critical role in creating a patient-specific neurosurgical plan and guiding intraoperative assessments. When used effectively, DTI can improve surgical outcomes, maximizing tumor resections while minimizing postsurgical deficits. Optimal utilization and interpretation of DTI require an understanding of the technique, data visualization methods, normal white matter anatomy, effect of pathological processes, and limitations.