[Preoperative functional magnetic resonance imaging in patients with brain tumors].
BACKGROUND
Functional Magnetic Resonance Imaging (fMRI) allows important functions in the brain cortex to be mapped noninvasively. The purpose with this work was to investigate a possible correlation between the distance from the tumour margin to fMRI activity and postoperative neurological deficits by means of a standardised method for measurement of distance. A second purpose was to investigate the influence of preoperative fMRI on the neurosurgical decision-making process.


METHODS
Retrospective study of 25 patients. The inclusion criteria were surgery or biopsy after fMRI plus a three-month postoperative assessment. A total of 14 patients complied with these requirements (six men and eight women, the mean age was 39 years). fMRI raw data was collected using a three tesla magnetic resonance scanner (Signa HDx R14M5, GE Healthcare). The distance from the tumour margin to fMRI activation was measured using GE-reformat version 4.2 after raw data had been postprocessed using GE BrainwavePA version 1.3.08130. The neurosurgeons valuation of fMRI in the preoperative decision-making process was obtained using a standard questionnaire.


RESULTS
There was a trend of association between distance from tumour to eloquent functional areas and the patients' postoperative neurological outcome (Fisher's exact test: distance < 15 mm, p = 0.43; distance < 10 mm, p = 0.14). fMRI proved very useful when deciding whether to operate or not (42%), when deciding the surgical approach (50%) and when deciding the extent of the surgical approach (83%).


CONCLUSIONS
The standardised method for measurement of distance between tumour margin and fMRI activity can contribute to the preoperative risk assessment in patients with brain tumours.
Laustsen
Søren Ravn
SR
Arhus Universitetshospital, Aalborg Sygehus, Radiologisk Afdeling, Denmark. sorl@rn.dk
Sørensen
Preben
P
Fründ
Torben
T
Larsson
Henrik B W
HB
Christensen
Thorkil
T
Larsson
Elna-Marie
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002648:Child; D003657:Decision Making; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods; D009837:Oligodendroglioma / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult