Functional Magnetic Resonance Imaging at 3T as a Clinical Tool in Patients with Intracranial Tumors

• Published in: Acta radiologica (1987) 2005-10, Vol.46 (6), p.599-609
• Main Authors: van Westen, D., Skagerberg, G., Olsrud, J., Fransson, P., Larsson, E.-M.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Brain Neoplasms - diagnosis; Brain Neoplasms - physiopathology; Brain Neoplasms - surgery; Clinical Medicine; Decision Making; Female; Frontal Lobe - physiopathology; Functional magnetic resonance imaging; Humans; Image Enhancement - methods; Image Processing, Computer-Assisted - methods; intracranial tumors; Investigative techniques, diagnostic techniques (general aspects); Klinisk medicin; Language; Magnetic Resonance Imaging - methods; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Motor Cortex - physiopathology; Movement - physiology; Neurology; Neurosurgical Procedures; Patient Care Planning; Preoperative Care; Prospective Studies; Radiologi och bildbehandling; Radiology, Nuclear Medicine and Medical Imaging; Somatosensory Cortex - physiopathology; Touch - physiology; Tumors of the nervous system. Phacomatoses
• ISSN: 0284-1851; 1600-0455; 1600-0455
• DOI: 10.1080/02841850510021652

Purpose: To investigate the potential of functional magnetic resonance imaging (fMRI) at 3T as a clinical tool in the preoperative evaluation of patients with intracranial tumors. High magnetic field strength such as 3T is of benefit for fMRI because signal-to-noise ratio and sensitivity to susceptibility changes are field-strength-dependent. Material and Methods: Twenty patients with tumors close to eloquent sensorimotor or language areas were studied. Motor, sensory, and two language paradigms (word generation, rhyming) were used; their effectiveness was determined as the percentage of patients in whom the functional area of interest was activated. Activation maps were calculated and their quality rated as high, adequate, or insufficient. The influence of fMRI on the neurosurgical decision regarding operability, surgical approach, and extent of the resection, was assessed. Results: Paradigm effectiveness was 90% for motor and 95% for sensory stimulation, and varied from 79% to 95% for word generation and rhyming in combination. Ninety percent of the activation maps held high or adequate quality. fMRI proved useful: in the decision to operate (9 patients), in the surgical approach (13 patients), and in extent of the resection (12 patients). Conclusion: fMRI at 3T is a clinically applicable tool in the work-up of patients with intracranial tumors.