Advertisement

European Radiology

, Volume 15, Issue 6, pp 1148–1158 | Cite as

Cortical mapping by functional magnetic resonance imaging in patients with brain tumors

  • Agata Majos
  • Krzysztof Tybor
  • Ludomir Stefańczyk
  • Bożena Góraj
Neuro

Abstract

The aim of our study was to establish the effectiveness of the functional MRI (fMRI) technique in comparison with intraoperative cortical stimulation (ICS) in planning cortex-saving neurosurgical interventions. The combination of sensory and motor stimulation during fMRI experiments was used to improve the exactness of central sulcus localization. The study subjects were 30 volunteers and 33 patients with brain tumors in the rolandic area. Detailed topographical relations of activated areas in fMRI and intraoperative techniques were compared. The agreement in the location defined by the two methods for motor centers was found to be 84%; for sensory centers it was 83%. When both kinds of activation are taken into account this agreement increases to 98%. A significant relation was found between fMRI and ICS for the agreement of the distance both for motor and sensory centers (p=0.0021–0.0024). Also a strong dependence was found between the agreement of the location and the agreement of the distance for both kinds of stimulation. The spatial correlation between fMRI and ICS methods for the sensorimotor cortex is very high. fMRI combining functional and structural information is very helpful for preoperative neurosurgical planning. The sensitivity of the fMRI technique in brain mapping increases when using both motor and sensory paradigms in the same patient.

Keywords

Functional magnetic resonance imaging Intraoperative stimulation Cortical mapping Sensorimotor cortex 

Notes

Acknowledgement

The work supported by an ECR Research and Education Grant.

References

  1. 1.
    Lee C, Heidi AW, Sharbrough FW et al (1999) Assessment of functional MR imaging in neurosurgical planning. AJNR 20:1511–1519Google Scholar
  2. 2.
    Ojemann JG, Miller JW, Silbergeld DL (1996) Preserved function in brain invaded by tumor. Neurosurgery 39:253–259CrossRefGoogle Scholar
  3. 3.
    Roux FE, Boulanouar K, Ranjrva JP et al (1999) Usefulness of motor functional MRI correlated to cortical mapping in rolandic low-grade astrocytomas. Acta Neurochir 141:71–79CrossRefGoogle Scholar
  4. 4.
    Bittar RG, Olivier A, Sadicot AF et al (2000) Cortical motor and somatosensory representation: effect of cerebral lesions. J Neurosurg 92:242–248Google Scholar
  5. 5.
    Janin P, Morandi X, Fleig MS et al (2002) Integration of sulcal and functional information for multimodal neuronavigation. J Neurosurg 96:713–723Google Scholar
  6. 6.
    Krings T, Reul J, Klusmann A et al (1998) Functional magnetic resonance imaging of sensory motor cortex for image-guided neurosurgical intervention. Acta Neurochir (Wien) 140:215–222CrossRefGoogle Scholar
  7. 7.
    Lehericy S, Duffau H, Cornu P et al (2000) Correspondence between functional magnetic resonance imaging somatotopy and individual brain anatomy of the central region: comparison with intraoperative stimulation in patients with brain tumors. J Neurosurg 92:589–598Google Scholar
  8. 8.
    Tomczak RJ, Wunderlich AP, Wang Y et al (2000) fMRI for preoperative neurosurgical mapping of motor cortex and language in a clinical setting. J Comput Assist Tomogr 24:927–934CrossRefGoogle Scholar
  9. 9.
    Fandino J, Kollias SS, Wieser HG et al (1999) Intraoperative validation of functional magnetic resonance imaging and cortical reorganisation patterns in patients with brain tumors involving the primary motor cortex. J Neurosurg 91:238–250Google Scholar
  10. 10.
    Pujol J, Conesa G, Deus J et al (1998) Clinical application of functional magnetic resonance imaging in presurgical identification of the central sulcus. J Neurosurg 88:863–869Google Scholar
  11. 11.
    Roux FE, Boulanouar K, Ranjrva JP et al (1999) Cortical intraoperative stimulation in brain tumors as a tool to evaluate spatial data from motor functional MRI. Invest Radiol 34:225–229CrossRefGoogle Scholar
  12. 12.
    Roux FE, Ibarrola D, Tremoulet M et al (2001) Methodological and technical issues for integrating functional magnetic resonance imaging data in a neuronavigation system. Neurosurgery 49:1145–1157CrossRefGoogle Scholar
  13. 13.
    Friston KJ, Holmes AP, Worsley KJ et al (1995) Statistical parametric maps in functional imaging: a general approach. Hum Brain Mapp 2:189–210Google Scholar
  14. 14.
    Agresti A (1984) Analysis of ordinal categorical data. Wiley, New YorkGoogle Scholar
  15. 15.
    Fisher LD, van Belle G (1993) Biostatistics. A methodology for the health sciences. Wiley, New YorkGoogle Scholar
  16. 16.
    Goodman LA, Kruskal WH (1954) Measures of association for crossclassification. J Am Stat Assoc 49:732–764Google Scholar
  17. 17.
    Warfield SK, Talos F, Kemper C et al (2003) Capturing brain deformation. In: Lecture notes in computer science. Springer-Verlag, Heidelberg, pp 203–217Google Scholar
  18. 18.
    Chapman PH, Buchbinder RR, Cosgrove R et al (1995) Functional magnetic resonance imaging for cortical mapping in pediatric neurosurgery. Pediatr Neurosurg 23:122–126Google Scholar
  19. 19.
    Atlas SW, Howard RS, Maldjian J et al (1996) Functional magnetic resonance imaging of regional brain activity in patients with intracerebral gliomas: findings and implications for clinical management. Neurosurgery 38:329–338CrossRefGoogle Scholar
  20. 20.
    McDonald JD, Chong BW, Lewine JD et al (1999) Integration of preoperative functional brain mapping in a frameless stereotactic environment for lesions near eloquent cortex. J Neurosurg 90:591–598Google Scholar
  21. 21.
    Stapleton SR, Kiriakopoulos E, Mikulis D et al (1997) Combined utility of functional MRI, cortical mapping, and frameless stereotaxy in the resection of lesions in eloquent areas of brain in children. Pediatr Neurosurg 26:68–82Google Scholar
  22. 22.
    Panfield W, Boldrey E (1937) Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain 60:389–443Google Scholar
  23. 23.
    Nitschke MF, Melchert UH, Hahn C et al (1998) Preoperative functional magnetic resonance imaging (fMRI) of the motor system in patients with tumours in the parietal lobe. Acta Neurochir 140:1223–1229CrossRefGoogle Scholar
  24. 24.
    Bellieveau JW, Kennedy DN, McKinstry RC et al (1991) Functional mapping of the human visual cortex by magnetic resonance imaging. Science 254:716–719Google Scholar
  25. 25.
    Jack CR, Thompson RM, Butts RK et al (1994) Sensory motor cortex: correlation of presurgical mapping with functional MR imaging and invasive cortical mapping. Radiology 190:85–92Google Scholar
  26. 26.
    Naganawa S, Koshikawa T, Fukatsu H et al (2004) Whole-brain vascular reactivity measured by fMRI using hyperventilation and breath-holding tasks: efficacy of 3D prospective acquisition correction (3D-PACE) for head motion. Eur Radiol 14:1484–1488Google Scholar
  27. 27.
    Holodny AI, Schulder M, Liu W-C et al (2000) The effect of brain tumors on BOLD functional MR imaging activation in the adjacent motor cortex: implications for image-guided neurosurgery. AJNR 21:1415–11422Google Scholar
  28. 28.
    Roux FE, Boulanouar K, Ibarrola D et al (2000) Functional MRI and intraoperative brain mapping to evaluate brain plasticity in patients with brain tumours and hemiparesis. J Neurol Neurosurg Psychiatry 69:453–463CrossRefGoogle Scholar
  29. 29.
    Schreiber A, Hubbe U, Ziyeh S et al (2000) The influence of gliomas and nonglial space-occupying lesions on blood-oxygen-level-dependent contrast enhancement. AJNR 21:1055–1063Google Scholar
  30. 30.
    Hirch J, Ruge MI, kim KHS et al (2000) An integrated functional magnetic resonance imaging procedure for preoperative mapping of cortical areas associated with tactile, motor, language, and visual functions. Neurosurgery 47:711–722CrossRefGoogle Scholar
  31. 31.
    Schulder M, Maldjian JA, Liu WC et al (1998) Functional image-guided surgery of intracranial tumors located in or near the sensorimotor cortex. J Neurosurg 89:412–418Google Scholar
  32. 32.
    Hesselmann V, Sorger B, Girnus R et al (2004) Intraoperative functional MRI as a new approach to monitor deep brain stimulation in Parkinson’s disease. Eur Radiol 14:686–690CrossRefPubMedGoogle Scholar
  33. 33.
    Fellner C, Schlaier J, Fellner F et al (1999) Functional MR imaging of the motor cortex in healthy volunteers and patients with brain tumours: qualitative and quantitative results. Rontgenpraxis 52:3–14Google Scholar
  34. 34.
    Li A, Yetkin FZ, Cox R et al (1996) Ipsilateral hemisphere activation during motor and sensory tasks. AJNR 17:651–655Google Scholar
  35. 35.
    Stippich C, Drueen K, Kapfer D et al (2002) Somatotopic mapping of motor- and somatosensory cortices in patients with perirolandic tumors using functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG). MAGMA 15:81Google Scholar
  36. 36.
    Yousry TA, Schmid UD, Jassoy AG et al (1995) Topography of the cortical motor hand area: prospective study with functional MR imaging and direct motor mapping at surgery. Radiology 195:23–29Google Scholar
  37. 37.
    Achten E, Jackson GD, Cameron JA et al (1999) Presurgical evaluation of the motor hand area with functional MR imaging in patients with tumors and dysplastic lesions. Radiology 210:529–538Google Scholar
  38. 38.
    Bannur U, Rajshekhar V (2000) Post operative supplementary motor area syndrome: cilnics features and outcome. Br J Neurosurg 14:204–210CrossRefGoogle Scholar
  39. 39.
    Carpentier AC, Constable RT, Schlosser MJ et al (2001) Patterns of functional magnetic resonance imaging activation association with structural lesions in the rolandic region: a classification system. J Neurosurg 94:946–954Google Scholar
  40. 40.
    Caramia MD, Telera S, Palmieri MG et al (1998) Ipsilateral motor activation in patients with cerebral gliomas. Neurology 51:196–202Google Scholar
  41. 41.
    Krainik A, Lehericy S, Duffau H et al (2001) Role of the supplementary motor area in motor deficit following medial frontal lobe surgery. Neurology 57:871–878Google Scholar
  42. 42.
    Yoshiura T, Hasuo K, Mihara F et al (1997) Increased activity of the ipsilateral motor cortex during a hand motor task in patients with brain tumor and paresis. AJNR 18:865–869Google Scholar
  43. 43.
    Yetkin FZ, McAuliffe TL, Cox R et al (1996) Test–rest precision of functional MR in sensory and motor task activation. AJNR 17:95–98Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Agata Majos
    • 1
    • 3
  • Krzysztof Tybor
    • 2
  • Ludomir Stefańczyk
    • 1
  • Bożena Góraj
    • 1
  1. 1.Department of RadiologyMedical University of LodzLodzPoland
  2. 2.Department of NeurosurgeryMedical University of LodzLodzPoland
  3. 3.LodzPoland

Personalised recommendations