Task-Based Presurgical Functional MRI in Patients with Brain Tumors

Stippich, Christoph; Blatow, Maria; Alzamora, Meritxell Garcia

doi:10.1007/978-3-030-83343-5_4

Cited by 4 publications

(4 citation statements)

References 403 publications

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“…In fundamental contrast to fMRI in neurocognitive research, which often serves as a tool to understand brain function through differences hypothesized and analyzed at group level, clinical fMRI is solely focused on functional diagnostics for individual subjects whose neuroanatomic dynamics may be suppressed in group-level analysis. 69 The goal in clinical fMRI is identification of eloquent cortex and its location relative to a surgical target through neuroradiologists' interpretation of single-subject results, for the benefit of a surgical team and ultimately the patient's postsurgical function. Activation thresholds need to be assessed on a per-subject and possibly per-region basis due to interindividual variability in BOLD responses, obviating use of predefined thresholds and necessitating case-specific evaluation.…”

Section: Discussionmentioning

confidence: 99%

Enhanced clinical task-based fMRI metrics through locally low-rank denoising of complex-valued data

et al. 2022

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Objective This study investigates a locally low-rank (LLR) denoising algorithm applied to source images from a clinical task-based functional MRI (fMRI) exam before post-processing for improving statistical confidence of task-based activation maps. Methods Task-based motor and language fMRI was obtained in eleven healthy volunteers under an IRB approved protocol. LLR denoising was then applied to raw complex-valued image data before fMRI processing. Activation maps generated from conventional non-denoised (control) data were compared with maps derived from LLR-denoised image data. Four board-certified neuroradiologists completed consensus assessment of activation maps; region-specific and aggregate motor and language consensus thresholds were then compared with nonparametric statistical tests. Additional evaluation included retrospective truncation of exam data without and with LLR denoising; a ROI-based analysis tracked t-statistics and temporal SNR (tSNR) as scan durations decreased. A test-retest assessment was performed; retest data were matched with initial test data and compared for one subject. Results fMRI activation maps generated from LLR-denoised data predominantly exhibited statistically significant ( p = 4.88×10–4 to p = 0.042; one p = 0.062) increases in consensus t-statistic thresholds for motor and language activation maps. Following data truncation, LLR data showed task-specific increases in t-statistics and tSNR respectively exceeding 20 and 50% compared to control. LLR denoising enabled truncation of exam durations while preserving cluster volumes at fixed thresholds. Test-retest showed variable activation with LLR data thresholded higher in matching initial test data. Conclusion LLR denoising affords robust increases in t-statistics on fMRI activation maps compared to routine processing, and offers potential for reduced scan duration while preserving map quality.

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Section: Discussionmentioning

confidence: 99%

Enhanced clinical task-based fMRI metrics through locally low-rank denoising of complex-valued data

et al. 2022

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“…This is especially true for clinical applications, where the relative importance of false positives and false negatives is different to that in research 39 . Furthermore, ad hoc thresholds are routinely used in clinical fMRI, where the operator manually adjusts the thresholds until a satisfactory activation map had been achieved, 40 or sets them in accordance with the relative ease of detecting activations for different tasks 20 . As our work is not focused on settling these questions but on demonstrating the feasibility of generating and using fOARs for Gamma Knife treatment planning, we chose an arbitrary thresholding level with strong control of family‐wise error rates.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of inverse treatment planning for gamma knife radiosurgery using fMRI brain activation maps as organs at risk

Abramian,

Blystad,

Eklund

2023

Medical Physics

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BackgroundStereotactic radiosurgery (SRS) can be an effective primary or adjuvant treatment option for intracranial tumors. However, it carries risks of various radiation toxicities, which can lead to functional deficits for the patients. Current inverse planning algorithms for SRS provide an efficient way for sparing organs at risk (OARs) by setting maximum radiation dose constraints in the treatment planning process.PurposeWe propose using activation maps from functional MRI (fMRI) to map the eloquent regions of the brain and define functional OARs (fOARs) for Gamma Knife SRS treatment planning.MethodsWe implemented a pipeline for analyzing patient fMRI data, generating fOARs from the resulting activation maps, and loading them onto the GammaPlan treatment planning software. We used the Lightning inverse planner to generate multiple treatment plans from open MRI data of five subjects, and evaluated the effects of incorporating the proposed fOARs.ResultsThe Lightning optimizer designs treatment plans with high conformity to the specified parameters. Setting maximum dose constraints on fOARs successfully limits the radiation dose incident on them, but can have a negative impact on treatment plan quality metrics. By masking out fOAR voxels surrounding the tumor target it is possible to achieve high quality treatment plans while controlling the radiation dose on fOARs.ConclusionsThe proposed method can effectively reduce the radiation dose incident on the eloquent brain areas during Gamma Knife SRS of brain tumors.

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“… 3 Recent research has emphasized the crucial importance of fMRI in improving the accuracy of cortical mapping, which helps in performing brain tumor removal surgery while safeguarding vital neurological processes. 4 , 5 Neurosurgical efforts focus on maximizing tumor removal while minimizing neurological impairments. 5 Having a proper balance is essential for enhancing the quality of life after surgery and prolonging the survival of patients, especially in cases of glioma, where the degree of resection is closely linked to better treatment results.…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 Neurosurgical efforts focus on maximizing tumor removal while minimizing neurological impairments. 5 Having a proper balance is essential for enhancing the quality of life after surgery and prolonging the survival of patients, especially in cases of glioma, where the degree of resection is closely linked to better treatment results. Yet, attaining this equilibrium is filled with obstacles, as the elimination of brain tissue heightens the likelihood of functional impairment.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review Between Resting-State fMRI and Task fMRI in Planning for Brain Tumour Surgery

Abu Mhanna,

Omar,

Md Radzi

et al. 2024

JMDH

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As an alternative to task-based functional magnetic resonance imaging (T-fMRI), resting-state functional magnetic resonance imaging (Rs-fMRI) is suggested for preoperative mapping of patients with brain tumours, with an emphasis on treatment guidance and neurodegeneration prediction. A systematic review was conducted of 18 recent studies involving 1035 patients with brain tumours and Rs-fMRI protocols. This was accomplished by searching the electronic databases PubMed, Scopus, and Web of Science. For clinical benefit, we compared Rs-fMRI to standard T-fMRI and intraoperative direct cortical stimulation (DCS). The results of Rs-fMRI and T-fMRI were compared and their correlation with intraoperative DCS results was examined through a systematic review. Our exhaustive investigation demonstrated that Rs-fMRI is a dependable and sensitive preoperative mapping technique that detects neural networks in the brain with precision and identifies crucial functional regions in agreement with intraoperative DCS. Rs-fMRI comes in handy, especially in situations where T-fMRI proves to be difficult because of patient-specific factors. Additionally, our exhaustive investigation demonstrated that Rs-fMRI is a valuable tool in the preoperative screening and evaluation of brain tumours. Furthermore, its capability to assess brain function, forecast surgical results, and enhance decision-making may render it applicable in the clinical management of brain tumours.

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Task-Based Presurgical Functional MRI in Patients with Brain Tumors

Cited by 4 publications

References 403 publications

Enhanced clinical task-based fMRI metrics through locally low-rank denoising of complex-valued data

Enhanced clinical task-based fMRI metrics through locally low-rank denoising of complex-valued data

Evaluation of inverse treatment planning for gamma knife radiosurgery using fMRI brain activation maps as organs at risk

Systematic Review Between Resting-State fMRI and Task fMRI in Planning for Brain Tumour Surgery

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