A Preliminary Study On The Application Of DTI In The Treatment Of Brain Tumors In Motor Function Areas With Gamma Knife

Objective: We applied DTI to the development of gamma knife radiosurgery for the treatment of brain tumors in motor function areas,with the aim of enhancing the safety of treatment,protecting the patient’s neurological function and improving the quality of life.on the one hand,to explore the help of DTI in the treatment of intracranial functional tumors with gamma knife,on the other hand,to make clear the advantages of DTI in gamma knife radiosurgery.Methods: 74 patients with brain tumors in motor function areas were treated with gamma knife in our department from January 2015 to ~ June 2016,including DTI and control group(n = 37).All patients received routine MRI and contrast-enhanced scan within 1 week before treatment,and the patients in group DTI underwent DTI scan in the first 3 days before treatment,with the aim of reconstructing the pyramidal tract.Fusion the reconstructed pyramidal tract into the planning of DTI group,adjusting the expected treatment plan with the help of the location and shape of pyramidal tract lesions,well the control group making plans according to the normal anatomy and clinical experience of the operator.Patients with movement disorder were examined for muscle strength before discharge.To assess the tumor control probability,all patients review of conventional and enhanced MR imaging for about 3 months after treatment,at the same time,performing the KPS and ZEW scores and evaluating the muscle strength on all patients.Then evaluate the muscle strength,KPS and ZEW score of all patients 6 months after treatment.Calculating the percentage of patients who obtain KPS≥70,ZEW≤3,Lovett>Ⅲ and the incidence of side effects of the two groups.Quantitative data were analyzed by two independent and paired samples t-test,and the chi square test was used to compare the qualitative data.Results: The motor function response rate before discharge of DTI group(69%)is higher than that of the control group(52%),but the difference was not statistically significant(X~2=1.626,P=0.266).The two groups tumor control probability,complication rate,muscle strength and KPS score were not statistically significant(P=0.430;P=0.495;P=0.498;P=0.457)3 months after treatment,but there was a significant difference in the score of ZEW(X~2=5.638,P=0.035).The incidence of side effects and movement disorder strength stability of DTI group was significantly better than the control group(X~2=5.115,P=0.044;X~2=5.955,P=0.028)6 months after treatment,and the KPS score and ZEW score of DTI group were also better than the control group(X~2=5.409,P=0.036;X~2=4.893,P=0.048).Conclusion: The application of DTI in the gamma knife radiosurgery for brain tumors in motor function areas can accurately determine the relationship between tumor and pyramidal tract relatively,helping make an individual plan,ensuring the local tumor control probability and protection of the patient’s neurological function at the same time,reducing the incidence of side effects,and improving the patients quality of life,so as to achieve the target that as far as possible to eliminate the lesion,as far as possible to prevent functional damage.