Cortical mapping by functional magnetic resonance imaging in patients with brain tumors

Abstract

The aim of our study was to establish the effectiveness of the functional MRI (fMRI) technique in comparison with intraoperative cortical stimulation (ICS) in planning cortex-saving neurosurgical interventions. The combination of sensory and motor stimulation during fMRI experiments was used to improve the exactness of central sulcus localization. The study subjects were 30 volunteers and 33 patients with brain tumors in the rolandic area. Detailed topographical relations of activated areas in fMRI and intraoperative techniques were compared. The agreement in the location defined by the two methods for motor centers was found to be 84%; for sensory centers it was 83%. When both kinds of activation are taken into account this agreement increases to 98%. A significant relation was found between fMRI and ICS for the agreement of the distance both for motor and sensory centers (p=0.0021-0.0024). Also a strong dependence was found between the agreement of the location and the agreement of the distance for both kinds of stimulation. The spatial correlation between fMRI and ICS methods for the sensorimotor cortex is very high. fMRI combining functional and structural information is very helpful for preoperative neurosurgical planning. The sensitivity of the fMRI technique in brain mapping increases when using both motor and sensory paradigms in the same patient.

Impact of Preoperative Functional Magnetic Resonance Imaging during Awake Craniotomy Procedures for Intraoperative Guidance and Complication Avoidance

“…We used the visual inspection and overlay technique in most patients and this has proven reliable and accurate, as reported in previous studies (fig. 1) [11,12,13]. Though the visual overlay technique may not be the most appropriate method to identify areas of function, it was very consistent and less time consuming to the surgeon.…”

Comparison of fMRI coregistration results between human experts and software solutions in patients and healthy subjects

“…Its applications include preoperative mapping of cortical functions to avoid damage of eloquent brain areas during surgery (e.g., [3][4][5]), postoperative investigation of brain function recovery (e.g., [5,6]) and evaluation of brain activation in patients suffering from degenerative brain diseases (e.g., [7]). Especially the identification of brain areas that are essential for language, motor control or memory functions and that therefore must be excluded from resection is crucial for neurosurgical planning and treatment.…”

Presurgical Functional Magnetic Resonance Imaging (fMRI)

“…Several studies report a high correlation between fMRI localizations and the results of the ECoG [71][72][73] with conformity rates between 83% in 33 patients [74] and 92% in 60 patients [33]. In larger patient groups with rolandic brain tumors, higher sensitivity to presurgical fMRI was also detected with 85% in 103 patients [75] and 97% in 125 patients [76], respectively.…”