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Published online by Cambridge University Press: 10 July 2025
Background: Diffusion tensor imaging (DTI) tractography enables detailed visualization of white matter tracts (WMT) relevant to surgical planning. Head-to-head performance of clinically available DTI software has not been assessed. We retrospectively compared Synaptive’s Modus Plan™(vers. 2.0.1.1743) and Medtronic’s StealthViz™(vers. 1.4) software, focusing on workflow, usability, stability, and capacity to generate WMT reconstructions. Methods: Retrospective evaluation of patients (n=13) with intrinsic brain lesions (01/2021-12/2023) with MP and SV software. Corticospinal and optic radiation WMT reconstruction was attempted according to the manufacturers specifications and was rated as clinically useful or not, based on anatomic plausibility. Duration of each analysis step (image importing, post-processing, segmentation, fine-tuning and tract export) was recorded. Ease of use, degree of clinician input, program stability, and tract output type were also assessed. Results: 13 patients (31±;19 yrs; 6F) were included. Mean workflow duration was significantly longer for MP (22:51 min) versus SV (7:35 min) (p<0.0001). Successful WMT reconstruction occurred in 9/13 (69.2%) with MP, versus 5/13 (38.5%) for SV. MP was rated to have superior usability, stability and required less clinician input but technical parameters (e.g. FA) or export object type was inflexible. Conclusions: Synaptive’s MP permitted more robust WMT reconstruction with enhanced usability and stability but with significantly longer workflow.