Presurgical motor and somatosensory cortex mapping with functional magnetic resonance imaging and positron emission tomography

Bittar, Richard. G., Olivier, Andre., Sadikot, Abbas F., Andermann, Frederick, Pike, Bruce,G. and Reutens, David C. (1999) Presurgical motor and somatosensory cortex mapping with functional magnetic resonance imaging and positron emission tomography. Journal of Neurosurgery, 91 6: 915-921. doi:10.3171/jns.1999.91.6.0915


Author Bittar, Richard. G.
Olivier, Andre.
Sadikot, Abbas F.
Andermann, Frederick
Pike, Bruce,G.
Reutens, David C.
Title Presurgical motor and somatosensory cortex mapping with functional magnetic resonance imaging and positron emission tomography
Journal name Journal of Neurosurgery   Check publisher's open access policy
ISSN 0022-3085
1933-0693
Publication date 1999-12-01
Year available 1999
Sub-type Article (original research)
DOI 10.3171/jns.1999.91.6.0915
Open Access Status Not yet assessed
Volume 91
Issue 6
Start page 915
End page 921
Total pages 7
Editor John A. Jane
Place of publication Charlottesville, Virginia , U.S.A.
Publisher The American Association of Neurosurgeons
Language eng
Subject 11 Medical and Health Sciences
Abstract Object. Accurate identification of eloquent cortex is important to ensure that resective surgery in the region surrounding the central sulcus is performed with minimum risk of permanent neurological deficit. Functional localization has traditionally been accomplished using intraoperative cortical stimulation (ICS). However, this technique suffers from several disadvantages that make the development and validation of noninvasive methods desirable. Functional localization accomplished by activation studies in which positron emission tomography (PET) scanning and the tracer [O-15]H2O have been used has been shown to correlate well with the results of ICS. Another noninvasive method for functional localization is functional magnetic resonance (fMR) imaging. We compared the locations of activation peaks obtained in individual patients using fMR and [O-15]H2O PET imaging.
Formatted abstract
Object.
Accurate identification of eloquent cortex is important to ensure that resective surgery in the region surrounding the central sulcus is performed with minimum risk of permanent neurological deficit. Functional localization has traditionally been accomplished using intraoperative cortical stimulation (ICS). However, this technique suffers from several disadvantages that make the development and validation of noninvasive methods desirable. Functional localization accomplished by activation studies in which positron emission tomography (PET) scanning and the tracer [15O]H2O have been used has been shown to correlate well with the results of ICS. Another noninvasive method for functional localization is functional magnetic resonance (fMR) imaging. We compared the locations of activation peaks obtained in individual patients using fMR and [15O]H2O PET imaging.

Methods.
Twenty-six combined PET activation—fMR imaging studies were performed in 11 patients who were admitted for evaluation before undergoing surgery in the region surrounding the central sulcus. The PET scans were obtained using bolus injections of the cerebral blood flow tracer [15O]H2O (10 mCi). Multislice T2*-weighted gradient-echo echoplanar images were acquired using a 1.5-tesla MR imaging system. Activation maps were aligned with anatomical MR images and transformed into stereotactic space, after which the locations of activation peaks obtained using both modalities were compared. The average distance between activation peaks obtained using fMR imaging and those obtained using PET imaging was 7.9 ± 4.8 mm (p > 0.05), with 96% of the peaks being located on either the same or adjacent sulci and gyri. Overlapping of voxels activated by each modality occurred in 92% of the studies. Functional MR imaging failed to activate the primary sensorimotor cortex in one study and produced results that were ambiguous in the clinical setting in three cases.

Conclusions.
Overall, fMR imaging produced activation that correlated well with that obtained using PET scanning. Discrepancies between the sites of activation identified using these two techniques may reflect differences in their physiological bases.
Keyword Magnetic Resonance Imaging
Positron emission tomography scanning
Epilepsy
Tumor
Sensorimotor cortex
Human Brian
Automated Algorithm
Precental Gyrus
Central Sulcus
PET Images
Localization
Contrast
Identification
Activation Barriers
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
Queensland Brain Institute Publications
 
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Created: Fri, 13 Nov 2009, 18:01:23 EST