Quadrantanopia caused by inadvertent severing of Meyer's Loop of the optic radiation is a well-recognised complication of temporal lobectomy for conditions such as epilepsy. Dissection studies indicate that the anterior extent of Meyer's Loop varies considerably between individuals. Quantifying this for individual patients is thus an important step to improve the safety profile of temporal lobectomies. Previous attempts to delineate Meyer's Loop using diffusion MRI tractography have had difficulty estimating its full anterior extent, required manual ROI placement, and/or relied on advanced diffusion sequences that cannot be acquired routinely in most clinics. Here we present CONSULT: a pipeline that can delineate the optic radiation from raw DICOM data in a completely automated way via a combination of robust pre-processing, segmentation, and alignment stages, plus simple improvements that bolster the efficiency and reliability of standard tractography. We tested CONSULT on 696 scans of predominantly healthy participants (539 unique brains), including both advanced acquisitions and simpler acquisitions that could be acquired in clinically acceptable timeframes. Delineations completed without error in 99.4% of the scans. The distance between Meyer's Loop and the temporal pole closely matched both averages and ranges reported in dissection studies for all tested sequences. Median scan-rescan error of this distance was 1 mm. When tested on two participants with considerable pathology, delineations were successful and realistic. Through this, we demonstrate not only how to identify Meyer's Loop with clinically feasible sequences, but also that this can be achieved without fundamental changes to tractography algorithms or complex post-processing methods.

中文翻译：

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使用临床上可行的序列全自动描绘用于手术计划的视辐射

由视辐射的 Meyer 袢意外切断引起的象限盲是一种公认​​的颞叶切除术并发症，例如癫痫。解剖研究表明，迈耶袢的前部范围因人而异。因此，对个体患者进行量化是提高颞叶切除术安全性的重要一步。以前使用弥散 MRI 纤维束成像描绘迈耶袢的尝试难以估计其完整的前部范围，需要手动放置 ROI，和/或依赖于大多数诊所无法常规获取的高级弥散序列。在这里，我们展示了 CONSULT：一个管道，它可以通过结合强大的预处理，以完全自动化的方式从原始 DICOM 数据中描绘出光辐射，分割和对齐阶段，加上简单的改进，提高了标准牵引成像的效率和可靠性。我们对主要健康参与者（539 个独特的大脑）的 696 次扫描测试了 CONSULT，包括可以在临床可接受的时间范围内获得的高级采集和更简单的采集。在 99.4% 的扫描中，描绘完成且没有错误。Meyer's Loop 和颞极之间的距离与解剖研究中报告的所有测试序列的平均值和范围非常匹配。该距离的中位扫描-重新扫描误差为 1 mm。当对两名患有严重病理的参与者进行测试时，描述是成功的和现实的。通过这一点，我们不仅展示了如何用临床上可行的序列识别迈耶袢，