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. 2011 Jul;21(7):1517-25.
doi: 10.1007/s00330-011-2067-9. Epub 2011 Jan 28.

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

Martina Wengenroth  1 , M Blatow, J Guenther, M Akbar, V M Tronnier, C Stippich
Affiliations

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

Martina Wengenroth et al. Eur Radiol. 2011 Jul.

Abstract

Objectives: Reliable 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.

Methods: Standardised 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.

Results: fMRI 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.

Conclusion: Routine 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.

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Figures

Fig. 1
Fig. 1
Anatomical landmarks of the central region (24-year-old female patient). Axial sections (top): hand knob (left), thickness sign (middle), bracket sign (right). Sagittal sections (bottom): gyrus frontalis inferior (GFI, left), precentral hook (middle), pars marginalis (right). From [43]
Fig. 2
Fig. 2
Functional landmarks of the central region (51-year-old female patient with cerebral metastasis of lung adenocarcinoma and impaired fine motor skills of the left hand). Axial (left), coronal (middle) and sagittal (right) sections depict motor areas for foot (top), hand (middle) and tongue (bottom). With morphological criteria alone, localisation of the central region was not feasible due to tumour-associated distortions. Functional landmarks however illustrate how the perifocal oedema but not the contrast-enhancing metastasis itself reaches eloquent areas of the postcentral gyrus. Anterior (A), posterior (P), left (L), right (R)
See this image and copyright information in PMC

References

    1. Vlieger EJ, Majoie CB, Leenstra S, Den Heeten GJ. Functional magnetic resonance imaging for neurosurgical planning in neurooncology. Eur Radiol. 2004;14:1143–1153. doi: 10.1007/s00330-004-2328-y. - DOI - PubMed
    1. Naidich TP, Grant JL, Altman N, et al. The developing cerebral surface. Preliminary report on the patterns of sulcal and gyral maturation—anatomy, ultrasound, and magnetic resonance imaging. Neuroimaging Clin N Am. 1994;4:201–240. - PubMed
    1. Rumeau C, Tzourio N, Murayama N, et al. Location of hand function in the sensorimotor cortex: MR and functional correlation. AJNR Am J Neuroradiol. 1994;15:567–572. - PMC - PubMed
    1. Achten E, Jackson GD, Cameron JA, Abbott DF, Stella DL, Fabinyi GC. Presurgical evaluation of the motor hand area with functional MR imaging in patients with tumors and dysplastic lesions. Radiology. 1999;210:529–538. - PubMed
    1. Yousry TA, Schmid UD, Alkadhi H, et al. Localization of the motor hand area to a knob on the precentral gyrus. A new landmark. Brain. 1997;120:141–157. doi: 10.1093/brain/120.1.141. - DOI - PubMed