Diagnostic benefits of presurgical fMRI in patients with brain tumours in the primary sensorimotor cortex

Abstract

ObjectivesReliable imaging of eloquent tumour-adjacent brain areas is necessary for planning function-preserving neurosurgery. This study evaluates the potential diagnostic benefits of presurgical functional magnetic resonance imaging (fMRI) in comparison to a detailed analysis of morphological MRI data.MethodsStandardised preoperative functional and structural neuroimaging was performed on 77 patients with rolandic mass lesions at 1.5 Tesla. The central region of both hemispheres was allocated using six morphological and three functional landmarks.ResultsfMRI enabled localisation of the motor hand area in 76/77 patients, which was significantly superior to analysis of structural MRI (confident localisation of motor hand area in 66/77 patients; p < 0.002). FMRI provided additional diagnostic information in 96% (tongue representation) and 97% (foot representation) of patients. FMRI-based presurgical risk assessment correlated in 88% with a positive postoperative clinical outcome.ConclusionRoutine presurgical FMRI allows for superior assessment of the spatial relationship between brain tumour and motor cortex compared with a very detailed analysis of structural 3D MRI, thus significantly facilitating the preoperative risk-benefit assessment and function-preserving surgery. The additional imaging time seems justified. FMRI has the potential to reduce postoperative morbidity and therefore hospitalisation time.

Simple fMRI Postprocessing Suffices for Normal Clinical Practice

“…Our results corroborate the findings of previous studies that show that fMRI can be a helpful and robust tool to locate eloquent areas (motor and language) when planning neurosurgery, 8,9 even with commercial software. …”

Process of the Functional Reorganization of the Cortical Centers for Movement in GBM Patients: fMRI Study

“…There were 6 small tumors, with a volume up to 40 cm 3 , and 10 large tumors with V > 40 cm 3 . Maximal resection was feasible in 5 patients (F = 0.31), whereas 11 patients had subtotal resection (F = 0.69).…”

“…Majos et al affected center by intact cortical areas would be crucial in the decision-making process in terms of planning and executing the surgical treatment [3,4].…”

A quantitative spatial comparison of high-density diffuse optical tomography and fMRI cortical mapping

“…However, functional imaging of the brain has, so far, found only limited clinical application with early uses in pre-operative planning (Nelles et al, 2009;Shimony et al, 2009;Wengenroth et al, 2011;Zhang et al, 2009). Functional imaging has the potential to play a larger clinical role in diagnosis, prognosis and monitoring due to its ability to find subtle changes in function before disease progresses to large-scale structural change.…”