Is Preoperative Functional Magnetic Resonance Imaging Reliable for Language Areas Mapping in Brain Tumor Surgery? Review of Language Functional Magnetic Resonance Imaging and Direct Cortical Stimulation Correlation Studies

Giussani, Carlo; Roux, Franck‐Emmanuel; Ojemann, Jeffrey G.; Sganzerla, Erik P.; Pirillo, David; Papagno, Costanza

doi:10.1227/01.neu.0000360392.15450.c9

Cited by 346 publications

(227 citation statements)

References 51 publications

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“…Importantly, fMRI is not validated for comprehensive language mapping to tailor surgical margins and avoid post-surgical language decline [Giussani et al, 2010; Szaflarski et al, 2017]. Clinical guidelines for fMRI use are available within radiology [American College of Radiology, 2014] and neuropsychology [Bobholz et al, 2004].…”

Section: 1 Introductionmentioning

confidence: 99%

Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning

Benjamin

Blumenfeld

et al. 2018

Human Brain Mapping

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The goal of this study was to document current clinical practice and report patient outcomes in presurgical language functional MRI (fMRI) for epilepsy surgery. Epilepsy surgical programs worldwide were surveyed as to the utility, implementation, and efficacy of language fMRI in the clinic; 82 programs responded. Respondents were predominantly from the US (61%) academic programs (85%), and evaluated adults (44%), adults and children (40%), or children only (16%). Nearly all (96%) reported using language fMRI. Surprisingly, fMRI is used to guide surgical margins (44% of programs) as well as language lateralization (100%). Sites using fMRI for localization most often use a distance margin around activation of 10mm. While considered useful, 56% of programs reported at least one instance of disagreement with other measures. Direct brain stimulation typically confirmed fMRI findings (74%) when guiding margins, but instances of unpredicted decline were reported by 17% of programs and unexpected preservation of function by 54%. Programs reporting unexpected decline did not clearly differ from those which did not. Clinicians using fMRI to guide surgical margins do not typically map known language-critical areas beyond Broca’s and Wernicke’s. This initial data shows many clinical teams are confident using fMRI not only for language lateralization but also to guide surgical margins. Reported cases of unexpected language preservation when fMRI activation is resected, and cases of language decline when it is not, emphasize a critical need for further validation. Comprehensive studies comparing commonly-used fMRI paradigms to predict stimulation mapping and post-surgical language decline remain of high importance.

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Section: 1 Introductionmentioning

confidence: 99%

Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning

Benjamin

Blumenfeld

et al. 2018

Human Brain Mapping

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“…It is generally agreed that while fMRI identifies cortical regions involved in language, ECS identifies those critical to the function. [9] fMRI language mapping in epilepsy patients relies on blood oxygen level-dependent (BOLD) contrast. This contrast measures changes in haemodynamic response related to neuronal energy consumption on T2*-weighted MR images while an expressive or receptive language task is being performed.…”

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confidence: 99%

Functional MRI language mapping in pre-surgical epilepsy patients: Findings from a series of patients in the Epilepsy Unit at Mediclinic Constantiaberg

2013

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Background. Functional magnetic resonance imaging (fMRI) is commonly applied to study the neural substrates of language in clinical research and for neurosurgical planning. fMRI language mapping is used to assess language lateralisation, or determine hemispheric dominance, and to localise regions of the brain involved in language. Routine fMRI has been introduced in the Epilepsy Unit at Mediclinic Constantiaberg to contribute to the current functional mapping procedures used in pre-surgical planning. Method. In this paper we describe the language paradigms used in these routine studies as well as the results from 22 consecutive epilepsy patients. Multi-subject analyses were performed to assess the reliability of activation patterns generated by two language mapping paradigms, namely a verb generation task and passive listening task. Results from a finger-tapping task are also presented. Results. The paradigms generate reliable and robust signal changes, enabling both the lateralisation of language and localisation of expressive and receptive language cortex. Conclusion. The fMRI results are meaningful at the group and individual level and can be recommended for language mapping in presurgical patients.

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“…Therefore, their results are not comparable, in the vast majority of cases. However, a systematic review of the existent clinical studies show that fMRI constitutes a routine clinical practice in many neuro-oncology centers around the world, which provides the opportunity to the performing neurosurgeon for a more realistic and accurate preoperative discussion with the patient, a wiser decision-making process, a safer surgical planning, and a more aggressive tumor resection [Atlas et al, 1996;Berntsen et al, 2010;Bizzi et al, 2008;Fandino et al, 1999;Fitzgerald et al, 1997;Giussani et al, 2010;Haberg et al, 2004;Hirsch et al, 2000;Hoenig et al, 2005;Krasnow et al, 2003;Krishnan et al, 2004;Lehericy et al, 2000;Li et al, 2010;Lurito et al, 2000;Mueller et al, 1996;National Comprehensive Cancer Network, 2007;Petrovich et al, 2005;Pouratian et al, 2002;Puce et al, 1995;Ruge et al, 1999;Roux et al, 2003;Rutten et al, 2002;Sanai & Berger, 2008;Schulder et al, 1998;Signorelli et al, 2003;Tieleman et al, 2007;Tomczak et al, 2000;Yetkin et al, 1997;Yousry et al, 1995]. Several studies also emphasize that fMRI can localize more accurately motor and sensory cortical areas than language areas, and therefore they indicate the necessity for employing complimentary intraoperative electrophysiological stimulation studies, in cases of tumor proximity to language-associated cortical areas [Berntsen et al, 2010;Giussani et al, 2010;Hirsch et al, 2000;Roux et al, 2003;…”

Section: Neurosurgical Considerations and Clinical Experiencementioning

confidence: 99%

The Role of Functional MRI in Intracranial Glioma Resection

Kapsalaki¹,

Verganelakis²,

Kapsalakis³

et al. 2012

Neuroimaging - Clinical Applications

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Is Preoperative Functional Magnetic Resonance Imaging Reliable for Language Areas Mapping in Brain Tumor Surgery? Review of Language Functional Magnetic Resonance Imaging and Direct Cortical Stimulation Correlation Studies

Cited by 346 publications

References 51 publications

Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning

Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning

Functional MRI language mapping in pre-surgical epilepsy patients: Findings from a series of patients in the Epilepsy Unit at Mediclinic Constantiaberg

The Role of Functional MRI in Intracranial Glioma Resection

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