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Functional MRI for Surgery of Gliomas

  • Neuro-oncology (R Soffietti, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of Review

Advanced neuroimaging techniques such as functional MRI (fMRI) and diffusion MR tractography have been increasingly used at every stage of the surgical management of brain gliomas, as a means to improve tumor resection while preserving brain functions. This review provides an overview of the last advancements in the field of functional MRI techniques, with a particular focus on their current clinical use and reliability in the preoperative and intraoperative setting, as well as their future perspectives for personalized multimodal management of patients with gliomas.

Recent Findings

fMRI and diffusion MR tractography give relevant insights on the anatomo-functional organization of eloquent cortical areas and subcortical connections near or inside a tumor. Task-based fMRI and diffusion tensor imaging (DTI) tractography have proven to be valid and highly sensitive tools for localizing the distinct eloquent cortical and subcortical areas before surgery in glioma patients; they also show good accuracy when compared with intraoperative stimulation mapping data. Resting-state fMRI functional connectivity as well as new advanced HARDI (high angular resolution diffusion imaging) tractography methods are improving and reshaping the role of functional MRI for surgery of gliomas, with potential benefit for personalized treatment strategies.

Summary

Noninvasive functional MRI techniques may offer the opportunity to perform a multimodal assessment in brain tumors, to be integrated with intraoperative mapping and clinical data for improving surgical management and oncological and functional outcome in patients affected by gliomas.

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Acknowledgements

We would like to thank Dr. Valeria Blasi and Dr. Luisa Altabella for the useful discussions on the topics of this review. We also would like to thank Prof. Roland G. Henry and the colleagues of the Departments of Neurology and Radiology and Biomedical Imaging and Graduate Program in Bioengineering, University of California, Berkeley/University of California, San Francisco, CA, for kindly allowing us to use the Dipy (Diffusion imaging in Python) software for processing of HARDI tractography data.

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Authors and Affiliations

  1. Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 58-60, 20132, Milan, Italy

    Antonella Castellano MD, PhD, Sara Cirillo MSc, PhD & Andrea Falini MD, PhD

  2. Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy

    Lorenzo Bello MD

  3. Unit of Oncological Neurosurgery, Humanitas Research Hospital, Rozzano, Milan, Italy

    Lorenzo Bello MD & Marco Riva MD

  4. Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy

    Marco Riva MD

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  1. Antonella Castellano MD, PhD
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  2. Sara Cirillo MSc, PhD
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  3. Lorenzo Bello MD
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  4. Marco Riva MD
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  5. Andrea Falini MD, PhD
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Correspondence to Antonella Castellano MD, PhD.

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Antonella Castellano, Sara Cirillo, Lorenzo Bello, Marco Riva, and Andrea Falini declare that they have no conflict of interest.

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This article is part of the Topical Collection on Neuro-oncology

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Castellano, A., Cirillo, S., Bello, L. et al. Functional MRI for Surgery of Gliomas. Curr Treat Options Neurol 19, 34 (2017). https://doi.org/10.1007/s11940-017-0469-y

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