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Use of Spinal Cord Diffusion Tensor Imaging to Quantify Neural Ablation and Evaluate Outcome after Percutaneous Cordotomy for Intractable Cancer Pain. Stereotact Funct Neurosurg 2017;95(1):34-39

Date

01/16/2017

Pubmed ID

28088799

Pubmed Central ID

PMC5455141

DOI

10.1159/000453279

Scopus ID

2-s2.0-85009960944 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

BACKGROUND: Up to 20% of patients experience only partial pain relief after percutaneous cordotomy for cancer pain.

OBJECTIVE: To determine whether diffusion tensor imaging (DTI) can quantify neural ablation and help evaluate early postoperative outcomes after cordotomy.

METHODS: Patients undergoing percutaneous CT-guided cordotomy for intractable cancer pain were prospectively studied. Pre- and postoperative assessment was made using the visual analog scale (VAS) on pain and the pain severity scores of the Brief Pain Inventory Short Form. On postoperative day 1, DTI images of the high cervical spinal cord were obtained. DTI metrics were correlated with the number of ablations as well as early postoperative pain outcomes.

RESULTS: Seven patients (4 male, mean age 53.8 ± 4.6 years) were studied. Fractional anisotropy of the hemicord was significantly lower on the side of the lesion as compared to the contralateral side (0.54 ± 0.03 vs. 0.63 ± 0.03, p < 0.001). Mean diffusivity correlated with the improvement in the VAS score at 1 week (r = 0.88, 95% CI = 0.34-1.00, p = 0.008), as well as the change in pain severity scores at 1 week (r = 0.99, 95% CI = 0.82-1.00, p < 0.001).

CONCLUSION: DTI metrics are sensitive to the number of ablations as well as early improvement in pain scores after cordotomy. DTI of the cervical spinal cord is a potential biomarker of neural ablation after percutaneous cordotomy for intractable cancer pain.

Author List

Vedantam A, Hou P, Chi TL, Dougherty PM, Hess KR, Viswanathan A

Author

Aditya Vedantam MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cancer Pain
Cordotomy
Diffusion Tensor Imaging
Female
Humans
Male
Middle Aged
Pain, Intractable
Spinal Cord
Treatment Outcome