title: Preoperative activation and intraoperative stimulation of language-related areas in patients with glioma.
abstract: OBJECTIVE
  Evaluation of the accuracy of preoperative localization of language-related cortex by magnetic resonance imaging-guided positron emission tomography.
  
  
  METHODS
  Patients with gliomas in the left dominant hemisphere were examined preoperatively with magnetic resonance imaging-guided positron emission tomography and intraoperatively by electrical stimulation of cortex.
  
  
  RESULTS
  A verb generation task yielded more intense and better lateralized local increases of cerebral blood flow in the positron emission tomographic examination than did a naming task. Significant correspondence of preoperative and intraoperative findings was observed for the verb generation task. Cortical sites with aphasic disturbance during electrical stimulation had a significantly higher cerebral blood flow increase during preoperative activation than did sites without intraoperative language impairment. Areas with cerebral blood flow increases above an optimum threshold had 73% sensitivity and 81% specificity to predict aphasic disturbance during intraoperative stimulation.
  
  
  CONCLUSIONS
  The data suggest that with further technical improvements, imaging of language function may become a preoperative diagnostic tool for patients with tumors close to language-related brain structures.
authors.affiliation: Max-Planck-Institut, Köln, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Herholz
authors.forename: H J
authors.initials: HJ
authors.lastname: Reulen
authors.forename: H M
authors.initials: HM
authors.lastname: von Stockhausen
authors.forename: A
authors.initials: A
authors.lastname: Thiel
authors.forename: J
authors.initials: J
authors.lastname: Ilmberger
authors.forename: J
authors.initials: J
authors.lastname: Kessler
authors.forename: W
authors.initials: W
authors.lastname: Eisner
authors.forename: T A
authors.initials: TA
authors.lastname: Yousry
authors.forename: W D
authors.initials: WD
authors.lastname: Heiss
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004558:Electric Stimulation; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed; D014705:Verbal Behavior / Q000502:physiology*