{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:02:32Z","timestamp":1787749352224,"version":"build-2784847793"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,9]]},"abstract":"\nObject<\/jats:title>\nTo prevent speech disturbances after Gamma Knife surgery (GKS), the authors integrated arcuate fasciculus (AF) tractography based on diffusion tensor (DT) MR imaging into treatment planning for GKS.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nArcuate fasciculus tractography was retrospectively integrated into planning that had been previously performed by neurosurgeons and radiation oncologists. This technique was retrospectively applied to 12 patients with arteriovenous malformations adjacent to the AF. Diffusion tensor images were acquired before the frame was affixed to the patient's head and DT tractography images of the AF were created using the authors' original software. The data from DT tractography and stereotactic 3D imaging studies obtained after frame fixation were transported to a treatment planning workstation for GKS and coregistered so that the delivered doses and incidence of posttreatment aphasia could be assessed.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe AF could not be depicted in 2 patients who initially presented with motor aphasia caused by hemorrhaging from arteriovenous malformations. During the median follow-up period of 29 months after GKS, aphasia developed in 2 patients: 30 Gy delivered to the frontal portion of the AF caused conduction aphasia in 1 patient, and 9.6 Gy to the temporal portion led to motor aphasia in the other. Speech dysfunction was not observed after a maximum radiation dose of 10.0\u201316.8 Gy was delivered to the frontal fibers in 4 patients, and 3.6\u20135.2 Gy to the temporal fibers in 3.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nThe authors found that administration of a 10-Gy radiation dose during GKS was tolerated in the frontal but not the temporal fibers of the AF. The authors recommend confirmation of the dose by integration of AF tractography with GKS, especially in lesions located near the temporal language fibers.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2008.4.17521","type":"journal-article","created":{"date-parts":[[2008,11,21]],"date-time":"2008-11-21T18:00:41Z","timestamp":1227290441000},"page":"520-526","source":"Crossref","is-referenced-by-count":24,"title":["Arcuate fasciculus tractography integrated into Gamma Knife surgery"],"prefix":"10.3171","volume":"111","author":[{"given":"Keisuke","family":"Maruyama","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Koga","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyousuke","family":"Kamada","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Ota","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Itoh","sequence":"additional","affiliation":[{"name":"Radiology, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ino","sequence":"additional","affiliation":[{"name":"Radiology, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Igaki","sequence":"additional","affiliation":[{"name":"Radiology, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Aoki","sequence":"additional","affiliation":[{"name":"Radiology, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Masutani","sequence":"additional","affiliation":[{"name":"Radiology, The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Shin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhito","family":"Saito","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1110520","series-title":"Neurosurgery","first-page":"56","article-title":"Radiosurgery for basal ganglia, internal capsule, and thalamus arteriovenous malformation: clinical outcome","volume":"56","author":"Andrade-Souza","year":"2005"},{"key":"b2-1110520","series-title":"Clinical Neuropsychology","first-page":"17","article-title":"Aphasia","author":"Benson","year":"1993"},{"key":"b3-1110520","series-title":"J Neurosurg","first-page":"509","article-title":"Diffusion tensor imaging analysis of long association bundles in the presence of an arteriovenous malformation","volume":"107","author":"Berube","year":"2007"},{"key":"b4-1110520","series-title":"Ann Neurol","first-page":"8","article-title":"Perisylvian language networks of the human brain","volume":"57","author":"Catani","year":"2005"},{"key":"b5-1110520","series-title":"Int J Radiat Oncol Biol Phys","first-page":"67","article-title":"A multi-institutional analysis of complication outcomes after arteriovenous malformation radiosurgery","volume":"44","author":"Flickinger","year":"1999"},{"key":"b6-1110520","series-title":"J Comput Assist Tomogr","first-page":"618","article-title":"Corticospinal tracts by diffusion tensor tractography in patients with arteriovenous malformations","volume":"30","author":"Itoh","year":"2006"},{"key":"b7-1110520","series-title":"J Neurosurg","first-page":"90","article-title":"Visualization of the frontotemporal language fibers by tractography combined with functional magnetic resonance imaging and magnetoencephalography","volume":"106","author":"Kamada","year":"2007"},{"key":"b8-1110520","series-title":"Handbook of Clinical Neurology","first-page":"287","article-title":"Aphasia","volume":"Vol 45","author":"Kertesz","year":"1985"},{"key":"b9-1110520","series-title":"J Neurosurg","first-page":"43","article-title":"Dose-response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery","volume":"88","author":"Leber","year":"1998"},{"key":"b10-1110520","series-title":"Acta Chir Scand","first-page":"585","article-title":"Cerebral radiosurgery. I. Gammathalamotomy in two cases of intractable pain","volume":"134","author":"Leksell","year":"1968"},{"key":"b11-1110520","series-title":"Neurology and Neurosurgery Illustrated","first-page":"120","article-title":"Disorder of language\u2014dysphasia","author":"Lindsay","year":"1997"},{"key":"b12-1110520","series-title":"Radiother Oncol","first-page":"311","article-title":"Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects","volume":"17","author":"Loeffler","year":"1990"},{"key":"b13-1110520","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1330","article-title":"Tolerance of pyramidal tract to gamma knife radiosurgery based on diffusion-tensor tractography","volume":"70","author":"Maruyama","year":"2008"},{"key":"b14-1110520","series-title":"J Neurosurg","first-page":"673","article-title":"Integration of three-dimensional corticospinal tractography into treatment planning for gamma knife surgery","volume":"102","author":"Maruyama","year":"2005"},{"key":"b15-1110520","series-title":"J Neurosurg","first-page":"721","article-title":"Optic radiation tractography integrated into simulated treatment planning for Gamma Knife surgery","volume":"107","author":"Maruyama","year":"2007"},{"key":"b16-1110520","series-title":"N Engl J Med","first-page":"146","article-title":"The risk of hemorrhage after radiosurgery for cerebral arteriovenous malformations","volume":"352","author":"Maruyama","year":"2005"},{"key":"b17-1110520","series-title":"J Neurosurg","first-page":"407","article-title":"Stereotactic radiosurgery for brainstem arterio-venous malformations: factors affecting outcome","volume":"100","author":"Maruyama","year":"2004"},{"key":"b18-1110520","series-title":"Neurosurgery","first-page":"1068","article-title":"Proposed treatment strategy for cavernous sinus meningiomas: a prospective study","volume":"55","author":"Maruyama","year":"2004"},{"key":"b19-1110520","series-title":"Eur J Radiol","first-page":"53","article-title":"MR diffusion tensor imaging: recent advance and new techniques for diffusion tensor visualization","volume":"46","author":"Masutani","year":"2003"},{"key":"b20-1110520","series-title":"J Neurosurg","first-page":"42","article-title":"Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients","volume":"90","author":"Morita","year":"1999"},{"key":"b21-1110520","series-title":"Neuroreport","first-page":"791","article-title":"Leftward asymmetry in relative fiber density of the arcuate fasciculus","volume":"16","author":"Nucifora","year":"2005"},{"key":"b22-1110520","series-title":"AJNR Am J Neuroradiol","first-page":"1107","article-title":"Diffusion tensor fiber tractography for arteriovenous malformations: quantitative analyses to evaluate the corticospinal tract and optic radiation","volume":"28","author":"Okada","year":"2007"},{"key":"b23-1110520","series-title":"J Neurosurg","first-page":"210","article-title":"Radiosurgery for arteriovenous malformations of the basal ganglia, thalamus, and brainstem","volume":"100","author":"Pollock","year":"2004"},{"key":"b24-1110520","series-title":"Neurosurgery","first-page":"1091","article-title":"Radiosurgery for epilepsy associated with cavernous malformation: retrospective study in 49 patients","volume":"47","author":"Regis","year":"2000"},{"key":"b25-1110520","series-title":"J Neurosurg","first-page":"285","article-title":"Arteriovenous malformations in the basal ganglia and thalamus: management and results in 101 cases","volume":"88","author":"Sasaki","year":"1998"},{"key":"b26-1110520","series-title":"Nature","first-page":"607","article-title":"Sex differences in the functional organization of the brain for language","volume":"373","author":"Shaywitz","year":"1995"},{"key":"b27-1110520","series-title":"Neuroimage","first-page":"1064","article-title":"Fiber density asymmetry of the arcuate fasciculus in relation to functional hemispheric language lateralization in both right- and left-handed healthy subjects: a combined fMRI and DTI study","volume":"35","author":"Vernooij","year":"2007"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/111\/3\/article-p520.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/111\/3\/article-p520.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/111\/3\/article-p520.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T09:42:19Z","timestamp":1679910139000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/111\/3\/article-p520.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2009,9]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2008.4.17521","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,9]]}}}