The usefulness and limitations of diffusion tensor imaging – a review study

Diffusion tensor tractography (DTI) has been used for planning of a brain pathology surgeries. Knowledge about the distances between neural tracts and brain tumours is believed to increase the patient safety and implies the extent of resection. The aim of the study was to demonstrate the contemporary possibilities and the clinical usefulness of DTI. Following the explanation of the technical basics of DTI, we presented the drawbacks and limitations of this visualisation technique. The most commonly outlined tracts are corticospinal tract (CST), arcuate fasciculus (AF) and frontal aslant tract (FAT). Tumour located in frontal, parietal or temporal lobe can affect the course of the CST. There are two basic possibilities to visualise CST: deterministic and probabilistic. The usefulness of DTI seems limited in imaging the neoplasms of either frontal or temporal region causing aphasia, which infiltrate the AF or the FAT. This limitation is probably related to divergent and patient-specific location of functional speech areas. Acquisition disturbances, ill-defined mathematical algorithms, surgery-related brain shift and defining wrong non-functional brain area are the sources of DTI inaccuracy, which is limiting its clinical application.