Intraoperative fiber tractography during pediatric posterior fossa tumor surgery - initial experience.

Motivation: Intraoperative fiber tractography could help to elucidate the nature of cerebellar mutism syndrome after tumor resection in pediatric posterior fossa tumor (pPFT) patients. Goal(s): To explore the feasibility of reconstructing eloquent fiber tracts with a short intraoperative diffusion MRI scan in pPFT patients. Approach: We reconstructed tracts intraoperatively in four pPFT patients and compared their structural properties to preoperative scans obtained with the same settings. Results: It is in general possible, but challenging, to reconstruct the eloquent tracts in pre- and intraoperative data of pPFT patients. However, further optimization of the fiber tractography model is required to increase their quality. Impact: The impact of the mechanical manipulation of the surgical procedure on the eloquent pathways in pediatric posterior fossa tumor patients is investigated through the development of a reliable fiber tractography model for intraoperative diffusion MRI.