Functional Magnetic Resonance Imaging for Preoperative Planning in Brain Tumour Surgery

Can J Neurol Sci. 2017 Jan;44(1):59-68. doi: 10.1017/cjn.2016.306.

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.

Keywords: brain tumour; eloquence; functional MRI; neuro-oncology - surgical; neurosurgery; surgical planning.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / complications
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / surgery
  • Craniotomy / methods
  • Female
  • Glioma / complications
  • Glioma / diagnostic imaging*
  • Glioma / surgery
  • Humans
  • Image Processing, Computer-Assisted
  • Language Disorders / etiology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Memory Disorders / etiology
  • Meningioma / complications
  • Meningioma / diagnostic imaging*
  • Meningioma / surgery
  • Middle Aged
  • Movement Disorders / etiology
  • Oxygen / blood
  • Preoperative Care*
  • Retrospective Studies
  • Young Adult

Substances

  • Oxygen