title: Diagnostic functional MRI: illustrated clinical applications and decision-making.
abstract: Functional magnetic resonance imaging (fMRI) has become a popular research tool, yet its use for diagnostic purposes and actual treatment planning has remained less widespread. The literature yields rather sparse evidence-based data on clinical fMRI applications and accordant decision-making. Notwithstanding, blood oxygenation level dependent (BOLD)- and arterial spin labeling (ASL)-fMRI can be judiciously combined with perfusion measurements, electroencephalographic (EEG) recordings, diffusion-weighted imaging (DWI), and fiber tractographies to assist clinical decisions. In this article we provide an overview of clinical fMRI applications based on illustrative examples. Assessment of cochlear implant candidates by fMRI is covered in some detail, and distinct reference is made to particular challenges imposed by brain tumors, other space-occupying lesions, cortical dysplasias, seizure disorders, and vascular malformations. Specific strategies, merits, and pitfalls of analyzing and interpreting diagnostic fMRI studies in individual patients are highlighted.
authors.affiliation: Department of Neuroradiology, University of Wuerzburg, Wuerzburg, Germany. bartsch@neuroradiologie.uni-wuerzburg.de
authors.forename: Andreas Joachim
authors.initials: AJ
authors.lastname: Bartsch
authors.forename: György
authors.initials: G
authors.lastname: Homola
authors.forename: Armin
authors.initials: A
authors.lastname: Biller
authors.forename: László
authors.initials: L
authors.lastname: Solymosi
authors.forename: Martin
authors.initials: M
authors.lastname: Bendszus
mesh_terms: D001927:Brain Diseases / Q000175:diagnosis*; D001931:Brain Mapping / Q000379:methods*; D020000:Decision Support Systems, Clinical; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009422:Nervous System Diseases / Q000175:diagnosis*