title: Functional magnetic resonance image-guided surgery of tumors in or near the primary visual cortex.
abstract: OBJECTIVE
  To assess the accuracy of functional magnetic resonance imaging (fMRI) of the primary visual cortex in patients undergoing surgery for tumors in the occipital lobe.
  
  
  METHODS
  Two patients with nondominant occipital lobe tumors were studied, one with a solitary lung metastasis and another with radiation necrosis after radiosurgery for a low-grade astrocytoma. At surgery, visual evoked potentials (VEPs) were stimulated using Light-emitting-diode goggles and recorded using cortical grids placed immediately after brain exposure. The location of the peak VEP was compared to that predicted by the registered functional scan.
  
  
  RESULTS
  In each case, the epicenter of visual activation as represented on the registered fMRI corresponded to the site of peak VEP recording. Prediction error for the visual cortex, measured in patient 1, was 1.0 mm. Visual confirmation showed the registration in the second patient to be accurate as well.
  
  
  CONCLUSIONS
  As previously demonstrated for sensorimotor fMRI, visual fMRI accurately predicts the location of the primary visual cortex. Additional confirmation is expected with more clinical experience.
authors.affiliation: Divisions of Neurosurgery and Neuroradiology, New Jersey Medical School, Newark 07103, USA. schulder@umdnj.edu
authors.forename: M
authors.initials: M
authors.lastname: Schulder
authors.forename: A
authors.initials: A
authors.lastname: Holodny
authors.forename: W C
authors.initials: WC
authors.lastname: Liu
authors.forename: A
authors.initials: A
authors.lastname: Gray
authors.forename: G
authors.initials: G
authors.lastname: Lange
authors.forename: P W
authors.initials: PW
authors.lastname: Carmel
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000503:physiopathology / Q000556:secondary / Q000601:surgery*; D002277:Carcinoma / Q000503:physiopathology / Q000556:secondary / Q000601:surgery*; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries; D013238:Stereotaxic Techniques; D014793:Visual Cortex