Preoperative FMRI Associated with Decreased Mortality and Morbidity in Brain Tumor Patients

Siarhei Vysotski¹, Casey Madura², Benjamin Swan³, Ryan Holdsworth¹, Yunzhi Lin⁴, Alejandro Munoz Del Rio^{1

5}, Joel Wood⁶, Bornali Kundu⁷, Amy Penwarden⁸, Jed Voss¹, Thomas Gallagher⁹, Veena A Nair¹, Aaron Field^{1

10}, Camille Garcia-Ramos⁵, Elizabeth M Meyerand^{10

5}, Mustafa Baskaya², Vivek Prabhakaran¹, John S Kuo^{11

12}

Affiliations

¹ Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252.
² Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252.
³ Department of Radiology, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138.
⁴ Department of Statistics, University of Wisconsin Madison, 1300 University Avenue, Madison, WI 53705.
⁵ Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research (WIMR), 1111 Highland Avenue Rm 1005, Madison, WI 53705.
⁶ Department of General Surgery, UW Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792-3252.
⁷ Medical Scientist Training Program, University of Wisconsin Madison, 6001 Research Park Blvd. Rm 1056, Madison, WI 51719.
⁸ Department of Anesthesiology, University of North Carolina -Chapel Hill, 106 Bel Arbor Ln Carrboro, NC 27510.
⁹ Department of Radiology, Northwestern University Feinberg School of Medicine, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago IL 60611.
¹⁰ Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA.
¹¹ UW Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA.
¹² UW Center for Stem Cell and Regenerative Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, K3/803 Clinical Science Center, Mail Code 8660, 600 Highland Avenue, Madison, WI 53792-3252.

PMID: 31341789
PMCID: PMC6653633
DOI: 10.1016/j.inat.2018.02.001

Preoperative FMRI Associated with Decreased Mortality and Morbidity in Brain Tumor Patients

Siarhei Vysotski et al. Interdiscip Neurosurg. 2018 Sep.

. 2018 Sep:13:40-45.

doi: 10.1016/j.inat.2018.02.001. Epub 2018 Feb 14.

Authors

Affiliations

¹ Department of Radiology, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252.
² Neurological Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252.
³ Department of Radiology, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138.
⁴ Department of Statistics, University of Wisconsin Madison, 1300 University Avenue, Madison, WI 53705.
⁵ Department of Medical Physics, University of Wisconsin-Madison, Wisconsin Institutes for Medical Research (WIMR), 1111 Highland Avenue Rm 1005, Madison, WI 53705.
⁶ Department of General Surgery, UW Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792-3252.
⁷ Medical Scientist Training Program, University of Wisconsin Madison, 6001 Research Park Blvd. Rm 1056, Madison, WI 51719.
⁸ Department of Anesthesiology, University of North Carolina -Chapel Hill, 106 Bel Arbor Ln Carrboro, NC 27510.
⁹ Department of Radiology, Northwestern University Feinberg School of Medicine, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago IL 60611.
¹⁰ Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53706, USA.
¹¹ UW Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA.
¹² UW Center for Stem Cell and Regenerative Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, K3/803 Clinical Science Center, Mail Code 8660, 600 Highland Avenue, Madison, WI 53792-3252.

PMID: 31341789
PMCID: PMC6653633
DOI: 10.1016/j.inat.2018.02.001

Abstract

Background: Functional Magnetic Resonance Imaging (fMRI) is a presurgical planning technique used to localize functional cortex so as to maximize resection of diseased tissue and avoid viable tissue. In this retrospective study, we examined differences in morbidity and mortality of brain tumor patients who received preoperative fMRI in comparison to those who did not.

Methods: Brain tumor patients (n=206) were selected from a retrospective review of neurosurgical case logs from 2001-2009 at the University of Wisconsin-Madison.

Results: Univariate analysis showed improved mortality in the fMRI group and the fMRI+Electrical Cortical Stimulation Mapping (ECM) group compared to the No-fMRI group. Multivariate analyses showed improved mortality of the fMRI group and the fMRI+ECM group compared to the No-fMRI group, with age and tumor grade being the most significant influencers. Overall, the fMRI group showed survival benefits at 3 years; twice that of the No-fMRI group. Furthermore, patients with high-grade tumors showed significant survival benefits in the fMRI group, while patients with low-grade tumors did not (controlling for age and ECM). There was also a significant difference in the two groups with respect to morbidity, with patients receiving fMRI showing improved outcomes in the motor and language domains.

Conclusions: This study analyzing a large retrospective series of brain tumor patients with and without the use of fMRI in the preoperative planning has resulted in improved mortality and morbidity outcomes with the use of fMRI. These results point to the importance of incorporating fMRI in presurgical planning in the clinical management of patients with brain tumors.

Keywords: brain mapping; brain tumors; functional neuroimaging.

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Figures

**Figure 1:**
FMRI vs No-fMRI groups. Survival of those receiving preoperative fMRIs vs those without preoperative fMRIs.

**Figure 2:**
FMRI+ECM vs fMRI-alone vs no mapping. Survival of those receiving fMRI with ECM vs preoperative fMRIs alone vs without any mapping.

See this image and copyright information in PMC

References

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Preoperative FMRI Associated with Decreased Mortality and Morbidity in Brain Tumor Patients

Affiliations

Preoperative FMRI Associated with Decreased Mortality and Morbidity in Brain Tumor Patients

Authors

Affiliations

Abstract

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources