T-M Qiu1, F-Y Gong1, X Gong1, J-S Wu1, C-P Lin2, B B Biswal3, D-X Zhuang4, C-J Yao1, X-L Zhang1, J-F Lu1, F-P Zhu1, Y Mao1, L-F Zhou4. 1. From the Department of Neurological Surgery (T.-m.Q., F.-y.G., X.G., J.-s.W., D.-x.Z., C.-j.Y., X.-l.Z., J.-f.L., F.-p.Z., Y.M., L.-f.Z.), Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. 2. Center for Computational Systems Biology (C.-p.L.), Fudan University, Shanghai, China. 3. Department of Biomedical Engineering (B.B.B.), New Jersey Institute of Technology, Newark, New Jersey. 4. From the Department of Neurological Surgery (T.-m.Q., F.-y.G., X.G., J.-s.W., D.-x.Z., C.-j.Y., X.-l.Z., J.-f.L., F.-p.Z., Y.M., L.-f.Z.), Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China lfzhouc@126.com ernestzdx@163.com.
Abstract
BACKGROUND AND PURPOSE: Resting-state functional MR imaging has been used for motor mapping in presurgical planning but never used intraoperatively. This study aimed to investigate the feasibility of applying intraoperative resting-state functional MR imaging for the safe resection of gliomas using real-time motor cortex mapping during an operation. MATERIALS AND METHODS: Using interventional MR imaging, we conducted preoperative and intraoperative resting-state intrinsic functional connectivity analyses of the motor cortex in 30 patients with brain tumors. Factors that may influence intraoperative imaging quality, including anesthesia type (general or awake anesthesia) and tumor cavity (filled with normal saline or not), were studied to investigate image quality. Additionally, direct cortical stimulation was used to validate the accuracy of intraoperative resting-state fMRI in mapping the motor cortex. RESULTS: Preoperative and intraoperative resting-state fMRI scans were acquired for all patients. Fourteen patients who successfully completed both sufficient intraoperative resting-state fMRI and direct cortical stimulation were used for further analysis of sensitivity and specificity. Compared with those subjected to direct cortical stimulation, the sensitivity and specificity of intraoperative resting-state fMRI in localizing the motor area were 61.7% and 93.7%, respectively. The image quality of intraoperative resting-state fMRI was better when the tumor cavity was filled with normal saline (P = .049). However, no significant difference between the anesthesia types was observed (P = .102). CONCLUSIONS: This study demonstrates the feasibility of using intraoperative resting-state fMRI for real-time localization of functional areas during a neurologic operation. The findings suggest that using intraoperative resting-state fMRI can avoid the risk of intraoperative seizures due to direct cortical stimulation and may provide neurosurgeons with valuable information to facilitate the safe resection of gliomas.
BACKGROUND AND PURPOSE: Resting-state functional MR imaging has been used for motor mapping in presurgical planning but never used intraoperatively. This study aimed to investigate the feasibility of applying intraoperative resting-state functional MR imaging for the safe resection of gliomas using real-time motor cortex mapping during an operation. MATERIALS AND METHODS: Using interventional MR imaging, we conducted preoperative and intraoperative resting-state intrinsic functional connectivity analyses of the motor cortex in 30 patients with brain tumors. Factors that may influence intraoperative imaging quality, including anesthesia type (general or awake anesthesia) and tumor cavity (filled with normal saline or not), were studied to investigate image quality. Additionally, direct cortical stimulation was used to validate the accuracy of intraoperative resting-state fMRI in mapping the motor cortex. RESULTS: Preoperative and intraoperative resting-state fMRI scans were acquired for all patients. Fourteen patients who successfully completed both sufficient intraoperative resting-state fMRI and direct cortical stimulation were used for further analysis of sensitivity and specificity. Compared with those subjected to direct cortical stimulation, the sensitivity and specificity of intraoperative resting-state fMRI in localizing the motor area were 61.7% and 93.7%, respectively. The image quality of intraoperative resting-state fMRI was better when the tumor cavity was filled with normal saline (P = .049). However, no significant difference between the anesthesia types was observed (P = .102). CONCLUSIONS: This study demonstrates the feasibility of using intraoperative resting-state fMRI for real-time localization of functional areas during a neurologic operation. The findings suggest that using intraoperative resting-state fMRI can avoid the risk of intraoperative seizures due to direct cortical stimulation and may provide neurosurgeons with valuable information to facilitate the safe resection of gliomas.
Authors: Herie Sun; Behroze Vachha; Maria E Laino; Mehrnaz Jenabi; Jessica R Flynn; Zhigang Zhang; Andrei I Holodny; Kyung K Peck Journal: Radiology Date: 2020-01-14 Impact factor: 11.105
Authors: Maiko A Schneider; Poli M Spritzer; Luciano Minuzzi; Benicio N Frey; Sabrina K Syan; Tayane M Fighera; Karine Schwarz; Ângelo B Costa; Dhiordan C da Silva; Cláudia C G Garcia; Anna M V Fontanari; André G Real; Maurício Anes; Juliana U Castan; Fernanda R Cunegatto; Maria I R Lobato Journal: Front Neurosci Date: 2019-08-07 Impact factor: 4.677
Authors: Adam Kenji Yamamoto; Joerg Magerkurth; Laura Mancini; Mark J White; Anna Miserocchi; Andrew W McEvoy; Ian Appleby; Caroline Micallef; John S Thornton; Cathy J Price; Nikolaus Weiskopf; Tarek A Yousry Journal: Neuroimage Clin Date: 2019-07-02 Impact factor: 4.881