Sensory motor cortex: correlation of presurgical mapping with functional MR imaging and invasive cortical mapping.

Jack, Clifford R.; Thompson, Richard M.; Butts, Raymond; Sharbrough, F. W.; Kelly, Patrick J.; Hanson, Dennis P.; Riederer, Stephen J.; Ehman, Richard L.; Hangiandreou, Nicholas J.; Cascino, G. D.

doi:10.1148/radiology.190.1.8259434

Cited by 326 publications

(104 citation statements)

References 16 publications

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“…Functional Magnetic Resonance Imaging (fMRI) is being used as a means to localize eloquent cortex in patients with brain tumors and other lesions [1][2][3][4][5][6][7][8][9][10][11][12][13]. The results of this study strengthen the rationale for using fMRI as an additional modality for planning neurosurgical procedures.…”

Section: Discussionsupporting

confidence: 58%

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Rater-dependent accuracy in predicting the spatial location of functional centers on anatomical MR images

Rolls¹,

Yoo²,

Kelly³

et al. 2007

Clinical Neurology and Neurosurgery

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Objectives-The determination of eloquent cortex is essential when planning neurosurgical approaches to brain lesions. This study examined the abilities of medical personnel of various backgrounds to predict the location of functional cortex using anatomical information provided by MR imaging.Patients and Methods-Neurosurgeons, neuroscientists, neuroradiologists, medical students and MR technologists viewed anatomical MR images acquired from patients with brain tumors and healthy controls. These five groups of raters were then asked to locate the Primary Motor Hand, Supplementary Motor and Primary Auditory Areas and their predictions were compared to fMRI data acquired from the same subjects.Results-The overall the mean distance from the center of the fMRI activation was 2.38 cm. The neuroscientists performed the best and MR technologists performed the worst (mean distance from center of 1.83 cm and 3.04 cm respectively, p < 0.05). The difference between patients and controls was not significant. The mean distance by ROI was Primary Motor Hand 2.03 cm, Auditory Area 2.06 cm and Supplementary Motor Area 3.18 cm (p < 0.05). Raters also performed best in the mediallateral direction, compared to superior-inferior and anterior-posterior directions (mean distances from center 0.42, 1.04 and 1.81 cm, respectively). Finally, the approximate minimum fields of view necessary to capture the entire fMRI activations using the raters' predictions ranged from 5 to 15 cm, or 3 to 12 cm larger than the fMRI activations.Conclusion-Medical personnel of various training perform poorly when using only anatomical information to predict the location of functional areas of cortex.

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Section: Discussionsupporting

confidence: 58%

“…Functional MRI is being used increasingly for applications such as surgical planning [1][2][3][4][5][6][7][8][9][10][11][12][13]. Typically, susceptibility-weighted echo-planar imaging (EPI) is used to rapidly acquire a time series of whole-brain images while the patient performs specific tasks designed to activate relevant cortical areas.…”

Section: Introductionmentioning

confidence: 99%

Rater-dependent accuracy in predicting the spatial location of functional centers on anatomical MR images

Rolls¹,

Yoo²,

Kelly³

et al. 2007

Clinical Neurology and Neurosurgery

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“…This accounts for the changes in signal intensity registered by the BOLD fMRI technique (1). Presurgical BOLD fMRI has been used to define functional cortices of the brain in preoperative planning for glioma surgery (2)(3)(4)(5)(6). However, a number of factors are known to affect the blood flow in areas of the brain adjacent to a tumor that lead to the observed decrease of BOLD-signal in brain tumor patients in comparison to the contralateral hemisphere (7)(8)(9)(10).…”

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confidence: 99%

BOLD signal in the motor cortex shows a correlation with the blood volume of brain tumors

Lüdemann

Förschler

Grieger

et al. 2006

Magnetic Resonance Imaging

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Purpose: To investigate whether and how the blood-oxygenation-level-dependent (BOLD) functional MRI (fMRI) signal is modified by brain tumors. Materials and Methods:The BOLD signal depends on the perfusion, which in turn may be affected in the presence of a tumor. Some studies have demonstrated a reduced BOLD signal in the tumor-bearing hemisphere. The BOLD signal variation in the motor cortex area was studied with finger tapping in a brain tumor group and a control group. An a priori volume-of-interest (VOI)-based method was applied that allows quantification of the mean BOLD signal amplitude and extent of activated volume. BOLD signal amplitude and activated volume were correlated with the extent of edema, a mass effect on the central sulcus, tumor volume, distance of tumor to somatosensory cortex, and tumor blood volume. Results:In the tumor group the ipsilateral activated volume was reduced by 21% (P ϭ 0.025) and the mean signal amplitude was reduced by 16% (P ϭ 0.004). The mean BOLD signal amplitude shows a significant correlation with the total intratumoral blood volume (P ϭ 0.014). Conclusion:We concluded that the peritumoral perfusion was reduced resulting due to a tumor aspirating perfusion (steal phenomenon).

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“…Since 1995, several groups have reported obtaining correlations between functional (f)MR imaging and intraoperative electrical cortical stimulation (ECS). [17,29,36,41,[49][50][51] Efforts in these mostly preliminary studies have focused primarily on neurophysiological and/or neuroradiological aspects and, because of the novelty of the technique, have included poorly standardized protocols and selective, not consecutive, series of patients.In the present work we attempt, by using a standardized protocol, to validate intraoperatively the fMR imaging technique for localization of the motor cortex in a consecutive series of patients with tumors in the central region. We focus primarily on the surgical applicability of this new technology and cortical reorganization phenomena observed in patients whose lesions involved the primary sensorimotor cortex.…”

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confidence: 99%

Intraoperative validation of functional magnetic resonance imaging and cortical reorganization patterns in patients with brain tumors involving the primary motor cortex

Fandiño¹,

Kollias²,

Wieser³

et al. 1999

FOC

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The purpose of the present study was to compare the results of functional magnetic resonance (fMR) imaging with those of intraoperative cortical stimulation in patients who harbored tumors close to or involving the primary motor area and to assess the usefulness of fMR imaging in the objective evaluation of motor function as part of the surgical strategy in the treatment of these patients. A total of 11 consecutive patients, whose tumors were near to or involving the central region, underwent presurgical blood oxygen level-dependent fMR imaging while performing a motor paradigm that required the patients to clench and spread their hands contra- and ipsilateral to the tumor. Statistical cross-correlation functional maps covering the primary and secondary motor cortical areas were generated and overlaid onto high-resolution anatomical MR images. Intraoperative electrical cortical stimulation was performed to validate the presurgical fMR imaging findings. In nine (82%) of 11 patients, the anatomical fMR imaging localization of motor areas could be verified by intraoperative electrical cortical stimulation. In seven patients two or more activation sites were demonstrated on fMR imaging, which were considered a consequence of reorganization phenomena of the motor cortex: contralateral primary motor area (nine sites), contralateral premotor area (four sites), ipsilateral primary motor area (two sites), and ipsilateral premotor area (four sites). Functional MR imaging can be used to perform objective evaluation of motor function and surgical planning in patients who harbor lesions near or involving the primary motor cortex. Correlation between fMR imaging findings and the results of direct electrical brain stimulation is high, although not 100%. Based on their study, the authors believe that cortical reorganization patterns of motor areas might explain the differences in motor function and the diversity of postoperative motor function among patients with central tumors.

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Sensory motor cortex: correlation of presurgical mapping with functional MR imaging and invasive cortical mapping.

Abstract: Presurgical mapping of the sensory motor cortex is a potentially useful clinical application of functional MR imaging.

Cited by 326 publications

References 16 publications

Rater-dependent accuracy in predicting the spatial location of functional centers on anatomical MR images

Rater-dependent accuracy in predicting the spatial location of functional centers on anatomical MR images

BOLD signal in the motor cortex shows a correlation with the blood volume of brain tumors

Intraoperative validation of functional magnetic resonance imaging and cortical reorganization patterns in patients with brain tumors involving the primary motor cortex

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