Functional magnetic resonance imaging–guided resection of low-grade gliomas

2005 ◽  
Vol 64 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Walter A. Hall ◽  
Haiying Liu ◽  
Charles L. Truwit
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Low Grade ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Low Grade Gliomas

scholarly journals Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

2016 ◽  
Vol 7 (04) ◽  
pp. 571-576 ◽  
Author(s):  
Ahmed Abdullah ◽  
Hisham El Shitany ◽  
Waleed Abbass ◽  
Amr Safwat ◽  
Amr K Elsamman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Surgical Resection ◽  
Awake Craniotomy ◽  
Low Grade ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Low Grade Gliomas ◽  
Eloquent Areas

ABSTRACT Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. Materials and Methods: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforementioned tools in safe excision of the aforementioned tumors. Results: Total-near total excision in 14 (66.67%) subtotal in 6 (28.57%), and biopsy in 1 case (4.57%). In long-term follow–up, only one case experienced persistent dysphasia. Conclusion: In spite of its simplicity, the identification of the safe anatomical landmarks guided by the preoperative fMRI is a useful technique that serves in safe excision of LGGs in eloquent areas. Such technique can replace intraoperative evoked potentials or the awake craniotomy in most of the cases. However, navigation-guided excision might be crucial in deeply seated and large tumors to allow safe and radical excision.

scholarly journals P.105 Clinical impact of functional magnetic resonance imaging for pre-operative planning in patients with low grade gliomas

2016 ◽  
Vol 43 (S2) ◽  
pp. S44-S44
Author(s):  
SE Kosteniuk ◽  
JC Lau ◽  
JF Megyesi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Propensity Score ◽  
Functional Magnetic Resonance Imaging ◽  
Low Grade ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Who Grade ◽  
Operative Planning ◽  
The Impact

Background: This study aims to evaluate the impact of pre-operative functional magnetic resonance imaging (fMRI) on low grade glioma (LGG) patients’ outcomes. Methods: In this retrospective matched cohort study (N =48) of a single surgeon’s patients, we are comparing two groups of LGG patients (WHO grade II) based on exposure to fMRI. A 1:2 propensity score match from a pool of 764 brain tumour patients was performed. Results: Within the group of 16 LGG patients who have undergone fMRI studies over a 12-year period, mean age was 40 years, and most presented with seizures (81%). Most lesions were left-sided (81%), and the lobes most commonly involved were frontal (75%) and temporal (31%). Patients underwent either craniotomy (50%), stereotactic biopsy (25%) or nonsurgically management (25%). In surgical patients, between presurgical assessment and eight week post-surgical follow-up, mean modified Rankin scale improved from 1.80±0.79 to 1.50±0.97. In our cohort, 5-year mortality was 12.5% (patients followed for a mean duration of 5.46 years). Conclusions: Data analysis is ongoing with plans to compare relevant demographics and outcomes via 1:2 propensity score matching of LGG patients who underwent fMRI against a control cohort.

scholarly journals PC3 - 190 Impact of Functional Magnetic Resonance Imaging on Clinical Decision Making and Outcomes in Patients with Low Grade Gliomas

2016 ◽  
Vol 43 (S4) ◽  
pp. S19-S20
Author(s):  
E. Kosteniuk ◽  
J.C. Lau ◽  
J.F. Megyesi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Decision Making ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Fmri Data ◽  
Low Grade ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
The Impact

This study aims to evaluate the impact of preoperative functional magnetic resonance imaging (fMRI) on low grade glioma (LGG) patients’ outcomes and surgical planning. Methods In this retrospective matched cohort study of a single surgeon’s patients, we are comparing two groups of LGG patients (WHO grade II) based on exposure to fMRI. Sixteen LGG patients who underwent fMRI were selected, and 32 control (non-fMRI exposed) patients are being selected through propensity score matching from a pool of 764 brain tumour patients. To assess the impact of fMRI data on clinicians’ decision making process, neurosurgeons within a single centre are completing questionnaires regarding treatment options for each LGG fMRI patient based on clinical data and structural imaging before and after fMRI. Results Within the group of 16 LGG patients who have undergone fMRI studies over a 12-year period, most patients presented with seizures (81 percent), and most lesions were left-sided (81 percent) and frontal (75 percent). Patients underwent either craniotomy (50 percent), stereotactic biopsy (25 percent) or nonsurgically management (25 percent). In surgical patients, between presurgical assessment and eight week post-surgical follow-up, mean modified Rankin scale improved from 1.80 (sd 0.79) to 1.50 (sd 0.97). In our cohort, 5-year mortality was 12.5 percent (mean follow-up duration 5.46 years). Conclusions Data analysis is ongoing with plans to compare relevant patient demographics and outcomes, and to analyse questionnaires to elucidate how surgeons incorporate fMRI data into their therapeutic approach.

Functional Magnetic Resonance Imaging-integrated Neuronavigation: Correlation between Lesion-to-Motor Cortex Distance and Outcome

Neurosurgery ◽  
2004 ◽  
Vol 55 (4) ◽  
pp. 904-915 ◽  
Author(s):  
René Krishnan ◽  
Andreas Raabe ◽  
Elke Hattingen ◽  
Andrea Szelényi ◽  
Hilal Yahya ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Motor Cortex ◽  
Functional Magnetic Resonance Imaging ◽  
Motor Deficit ◽  
Outcome Analysis ◽  
Low Grade ◽  
Incomplete Resection ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging

Abstract OBJECTIVE: The integration of functional magnetic resonance imaging (fMRI) data into neuronavigation is a new concept for surgery adjacent to the motor cortex. However, the clinical value remains to be defined. In this study, we investigated the correlation between the lesion-to-fMRI activation distance and the occurrence of a new postoperative deficit. METHODS: fMRI-integrated “functional” neuronavigation was used for surgery around the motor strip in 54 patients. During standardized paradigms for hand, foot, and tongue movements, echo-planar imaging T2* blood oxygen level-dependent sequences were acquired and processed with BrainVoyager 2000 software (Brain Innovation, Maastricht, The Netherlands). Neuronavigation was performed with the VectorVision2 system (BrainLAB, Heimstetten, Germany). For outcome analysis, patient age, histological findings, size of lesion, distance to the fMRI areas, preoperative and postoperative Karnofsky index, postoperative motor deficit, and type of resection were analyzed. RESULTS: In 45 patients, a gross total resection (>95%) was performed, and for 9 lesions (low-grade glioma, 4; glioblastoma, 5), a subtotal resection (80–95%) was achieved. The neurological outcome improved in 16 patients (29.6%), was unchanged in 29 patients (53.7%), and deteriorated in 9 patients (16.7%). Significant predictors of a new neurological deficit were a lesion-to-activation distance of less than 5 mm (P < 0.01) and incomplete resection (P < 0.05). CONCLUSION: fMRI-integrated neuronavigation is a useful concept to assess the risk of a new motor deficit after surgery. Our data suggest that a lesion-to-activation distance of less than 5 mm is associated with a higher risk of neurological deterioration. Within a 10-mm range, cortical stimulation should be performed. For a lesion-to-activation distance of more than 10 mm, a complete resection can be achieved safely. The visualization of fiber tracks is desirable to complete the representation of the motor system.

scholarly journals Functional magnetic resonance imaging of cortical changes in a low-grade glioma patient

2010 ◽  
Vol 67 (11) ◽  
pp. 941-944
Author(s):  
Olivera Sveljo ◽  
Katarina Koprivsek ◽  
Milos Lucic ◽  
Ljubodrag Minic
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Left Hemisphere ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Glioma Patient ◽  
Hemisphere Dominance

Introduction. New methods for studying brain functions have provided the new insights into human brain. It is really possible to study a cortical adaptation in adults who have sustained injury. We reported cortical changes in a left frontal low-grade glioma patient during disease progression and after reoperation by functional magnetic resonance imaging (fMRI). Case report. The use of fMRI exams for localisation of eloquent motor and language areas were performed three times in a period of 15 months: seven years after initial tumor resection, eleven months later and three months after the reoperation. The first fMRI demonstrated cortical activation for motor tasks in the expected location of primary motor area while later examinations showed activations of both primary motor areas for right hand movement. The first exam language evaluation showed the left hemisphere dominance for both language tasks, while the second fMRI demonstrated the right hemisphere dominance for complex word generation task, but the left hemisphere remained dominant in simple language task. After the reoperation, language mapping revealed the left hemisphere dominance for both language tasks. Conclusion. fMRI evaluation of cortical changes in low-grade glioma patients may additionally optimize and individualize neurosurgical treatment.

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