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. 2021 Dec 14;11:761169. doi: 10.3389/fonc.2021.761169

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Copyright © 2021 Zhylka, Sollmann, Kofler, Radwan, De Luca, Gempt, Wiestler, Menze, Krieg, Zimmer, Kirschke, Sunaert, Leemans and Pluim

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Exemplary case for reconstruction of the corticospinal tract (CST) depending on the algorithm used for tractography. This illustrative exemplary case of a patient suffering from a right-sided high-grade glioma (HGG) shows the reconstructed CST within the tumor-affected hemisphere as derived from diffusion tensor imaging (DTI)-based tractography, constrained spherical deconvolution (CSD)-based tractography, and multi-level fiber tracking (MLFT). The CST reconstructions are fused with axial and coronal contrast-enhanced T1-weighted images to outline the lesion-to-CST relationship as well as the CST volume and course. The MLFT approach enables fiber tracking with a larger radial extent, thus displaying also fanning of the CST and fibers with acute angles (red arrow).