{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:13:16Z","timestamp":1780535596876,"version":"3.54.1"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"19","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Open surgical treatment of insular epilepsy holds particular risk of injury to middle cerebral artery branches, the operculum (through retraction), and adjacent language-related white matter tracts in the language-dominant hemisphere. Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (LITT) is a surgical alternative that allows precise lesioning with potentially less operative risk. The authors presented the case of a 13-year-old girl with intractable, MRI-negative, left (dominant hemisphere) insular epilepsy that was treated with LITT. Diffusion tensor imaging (DTI) tractography was used to aid full posterior insular lesioning in the region of stereo electroencephalography\u2013determined seizure onset while avoiding thermal injury to the language-related superior longitudinal fasciculus (SLF)\/arcuate fasciculus (AF) and inferior fronto-occipital fasciculus (IFOF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>DTI tractography was used successfully in planning insular LITT and facilitated a robust insular ablation with sharp margins at the interfaces with the SLF\/AF and IFOF. These tracts were spared, and no neurological deficits were induced through LITT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Although it is technically demanding and has important limitations that must be understood, clinically available DTI tractography adds precision and confidence to insular laser ablation when used to protect important language-related white matter tracts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21113","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T15:50:40Z","timestamp":1621266640000},"source":"Crossref","is-referenced-by-count":5,"title":["The utility of diffusion tractography for speech preservation in laser ablation of the dominant insula: illustrative case"],"prefix":"10.3171","volume":"1","author":[{"given":"Timothy J.","family":"Kaufmann","sequence":"first","affiliation":[{"name":"Departments of Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vance T.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Departments of Radiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily C.","family":"Wong-Kisiel","sequence":"additional","affiliation":[{"name":"Neurology,"},{"name":"Pediatric and Adolescent Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Kerezoudis","sequence":"additional","affiliation":[{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai J.","family":"Miller","sequence":"additional","affiliation":[{"name":"Pediatric and Adolescent Medicine,"},{"name":"Neurologic Surgery, and"},{"name":"Biomedical Engineering, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Epilepsy Curr","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/1535759718822847","article-title":"The insula and its epilepsies","volume":"19","author":"Jobst BC","year":"2019","unstructured":"Jobst BC, Gonzalez-Martinez J, Isnard J,  The insula and its epilepsies. 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