title: Functional Magnetic Resonance Imaging for Preoperative Planning in Brain Tumour Surgery.
abstract: BACKGROUND
  Functional magnetic resonance imaging (fMRI) is being increasingly used for the preoperative evaluation of patients with brain tumours.
  
  
  METHODS
  The study is a retrospective chart review investigating the use of clinical fMRI from 2002 through 2013 in the preoperative evaluation of brain tumour patients. Baseline demographic and clinical data were collected. The specific fMRI protocols used for each patient were recorded.
  
  
  RESULTS
  Sixty patients were identified over the 12-year period. The tumour types most commonly investigated were high-grade glioma (World Health Organization grade III or IV), low-grade glioma (World Health Organization grade II), and meningioma. Most common presenting symptoms were seizures (69.6%), language deficits (23.2%), and headache (19.6%). There was a predominance of left hemispheric lesions investigated with fMRI (76.8% vs 23.2% for right). The most commonly involved lobes were frontal (64.3%), temporal (33.9%), parietal (21.4%), and insular (7.1%). The most common fMRI paradigms were language (83.9%), motor (75.0%), sensory (16.1%), and memory (10.7%). The majority of patients ultimately underwent a craniotomy (75.0%), whereas smaller groups underwent stereotactic biopsy (8.9%) and nonsurgical management (16.1%). Time from request for fMRI to actual fMRI acquisition was 3.1±2.3 weeks. Time from fMRI acquisition to intervention was 4.9±5.5 weeks.
  
  
  CONCLUSIONS
  We have characterized patient demographics in a retrospective single-surgeon cohort undergoing preoperative clinical fMRI at a Canadian centre. Our experience suggests an acceptable wait time from scan request to scan completion/analysis and from scan to intervention.
authors.affiliation: 1Department of Clinical Neurological Sciences (Neurosurgery),Western University,London,Ontario,Canada.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Lau
authors.affiliation: 1Department of Clinical Neurological Sciences (Neurosurgery),Western University,London,Ontario,Canada.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Kosteniuk
authors.affiliation: 1Department of Clinical Neurological Sciences (Neurosurgery),Western University,London,Ontario,Canada.
authors.forename: Frank
authors.initials: F
authors.lastname: Bihari
authors.affiliation: 1Department of Clinical Neurological Sciences (Neurosurgery),Western University,London,Ontario,Canada.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Megyesi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D005260:Female; D005910:Glioma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007806:Language Disorders / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008579:Meningioma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology; D010100:Oxygen / Q000097:blood; D011300:Preoperative Care; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: brain tumour; eloquence; functional MRI; neuro-oncology - surgical; neurosurgery; surgical planning