Abstract
Background
Functional connectivity analysis of resting-state functional magnetic resonance imaging data (fcrs-fMRI) has been shown to be a robust non-invasive method for localization of functional networks (without using specific tasks) and to be promising for presurgical planning. However, in order to transfer the approach to everyday clinical practice, fcrs-fMRI needs to be further validated and made easily accessible to neurosurgeons. This paper addresses the latter by presenting a software tool designed for neurosurgeons for analyzing and visualizing fcrs-fMRI data.
Methods
A prototypical interactive visualization tool was developed to enable neurosurgeons to explore functional connectivity data and evaluate its usability. The implementation builds upon LIPSIA, an established software package for the assessment of functional neuroimaging data, and integrates the selection of a region-of-interest with the computation and visualization of functionally connected areas. The tool was used to explore data from a healthy participant and eight brain lesion patients. The usability of the software was evaluated with four neurosurgeons previously unacquainted with the methodology, who were asked to identify prominent, large-scale cortical networks.
Findings
With this novel tool, previously published findings, such as tumor displacement of the sensorimotor cortex and other disturbances of functional networks, were reproduced. The neurosurgeons were able to consistently obtain results similar to the results of an expert, with the exception of the language network. Immediate feedback helped to pinpoint functional networks quickly and intuitively, with even inexperienced users requiring less than 3 min per network.
Conclusions
Although fcrs-fMRI is a nascent method still undergoing evaluation with respect to established standards, the interactive software is nonetheless a promising tool for non-invasive exploration of individual functional connectivity networks in neurosurgical practice, both for well-known networks and for those less typically addressed.
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Joachim Böttger and Daniel S. Margulies contributed equally.
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Online Resource 1
Textual description of the methods used to generate Fig. 1, the comparison of resting-state and task-based fMRI and DTI-based fiber tracking. (PDF 129 kb)
Video that demonstrates interaction with our functional connectivity tool and four functional networks. (MOV 4713 kb)
Online Resource 3
The edema under the tumor area is distinguishable from the surrounding healthy brain tissue in the fMRI scan. (GIF 27 kb)
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Böttger, J., Margulies, D.S., Horn, P. et al. A software tool for interactive exploration of intrinsic functional connectivity opens new perspectives for brain surgery. Acta Neurochir 153, 1561–1572 (2011). https://doi.org/10.1007/s00701-011-0985-6
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DOI: https://doi.org/10.1007/s00701-011-0985-6