title: Diagnostic benefits of presurgical fMRI in patients with brain tumours in the primary sensorimotor cortex.
abstract: OBJECTIVE
  Reliable imaging of eloquent tumour-adjacent brain areas is necessary for planning function-preserving neurosurgery. This study evaluates the potential diagnostic benefits of presurgical functional magnetic resonance imaging (fMRI) in comparison to a detailed analysis of morphological MRI data.
  
  
  METHODS
  Standardised preoperative functional and structural neuroimaging was performed on 77 patients with rolandic mass lesions at 1.5 Tesla. The central region of both hemispheres was allocated using six morphological and three functional landmarks.
  
  
  RESULTS
  fMRI enabled localisation of the motor hand area in 76/77 patients, which was significantly superior to analysis of structural MRI (confident localisation of motor hand area in 66/77 patients; p < 0.002). FMRI provided additional diagnostic information in 96% (tongue representation) and 97% (foot representation) of patients. FMRI-based presurgical risk assessment correlated in 88% with a positive postoperative clinical outcome.
  
  
  CONCLUSIONS
  Routine presurgical FMRI allows for superior assessment of the spatial relationship between brain tumour and motor cortex compared with a very detailed analysis of structural 3D MRI, thus significantly facilitating the preoperative risk-benefit assessment and function-preserving surgery. The additional imaging time seems justified. FMRI has the potential to reduce postoperative morbidity and therefore hospitalisation time.
authors.affiliation: Department of Neuroradiology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. martina.wengenroth@med.uni-heidelberg.de
authors.forename: Martina
authors.initials: M
authors.lastname: Wengenroth
authors.forename: M
authors.initials: M
authors.lastname: Blatow
authors.forename: J
authors.initials: J
authors.lastname: Guenther
authors.forename: M
authors.initials: M
authors.lastname: Akbar
authors.forename: V M
authors.initials: VM
authors.lastname: Tronnier
authors.forename: C
authors.initials: C
authors.lastname: Stippich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology*; D038361:Neuronavigation / Q000379:methods; D011300:Preoperative Care
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA