The Journal of World Neurosurgery in a case study concludes that the successful application of a safe, timely and affordable DTI tractography reconstruction algorithm to aid in planning of language pathways in intrinsic frontotemporal lesions and in postoperative evaluation of the integrity of the white matter of the tract.

OBJECTIVE: Diffusion tensor imaging (DTI) tractography provides useful information that can be used to optimize surgical planning and help avoid injury during subcortical dissection of eloquent tracts. The objective is to provide a safe,
timely, and affordable algorithm for preoperative DTI language reconstruction for intrinsic frontotemporal diseases.

METHODS: We reviewed a prospectively acquired database of preoperative DTI reconstruction for resection of left frontotemporal lesions over 3 years at Hospital de San José and Hospital Infantil Universitario San José, Fundación Universitaria de Ciencias de la Salud, Bogota, Colombia. Preoperative and postoperative clinical and radiographic features were determined from retrospective chart review. A comprehensive review of the structural and functional anatomy of the language tracts was performed. Separate reconstruction of both ventral (semantic) and dorsal (phonologic) stream pathways is described: arcuate fasciculus, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus.

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Identification of Preopetative Language Tracts for Intrinsic Frontotemporal Diseases: A Pilot Reconstruction Algorithm in a Middle-Income Country