Evaluation of preoperative high magnetic field motor functional MRI (3 Tesla) in glioma patients by navigated electrocortical stimulation and postoperative outcome

Roessler, K., Donat, M., Lanzenberger, R., Novak, K., Geissler, A., Gartus, A., Tahamtan, A. R., Milakara, D., Czech, T., Barth, M., Knosp, E. and Beisteiner, R. (2005) Evaluation of preoperative high magnetic field motor functional MRI (3 Tesla) in glioma patients by navigated electrocortical stimulation and postoperative outcome. Journal of Neurology, Neurosurgery and Psychiatry, 76 8: 1152-1157. doi:10.1136/jnnp.2004.050286


Author Roessler, K.
Donat, M.
Lanzenberger, R.
Novak, K.
Geissler, A.
Gartus, A.
Tahamtan, A. R.
Milakara, D.
Czech, T.
Barth, M.
Knosp, E.
Beisteiner, R.
Title Evaluation of preoperative high magnetic field motor functional MRI (3 Tesla) in glioma patients by navigated electrocortical stimulation and postoperative outcome
Journal name Journal of Neurology, Neurosurgery and Psychiatry   Check publisher's open access policy
ISSN 0022-3050
1468-330X
Publication date 2005-08-01
Sub-type Article (original research)
DOI 10.1136/jnnp.2004.050286
Open Access Status Not yet assessed
Volume 76
Issue 8
Start page 1152
End page 1157
Total pages 6
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Formatted abstract
Objectives: The validity of 3 Tesla motor functional magnetic resonance imaging (fMRI) in patients with gliomas involving the primary motor cortex was investigated by intraoperative navigated motor cortex stimulation (MCS).

Methods: Twenty two patients (10 males, 12 females, mean age 39 years, range 10-65 years) underwent preoperative fMRI studies, performing motor tasks including hand, foot, and mouth movements. A recently developed high field clinical fMRI technique was used to generate pre-surgical maps of functional high risk areas defining a motor focus. Motor foci were tested for validity by intraoperative motor cortex stimulation (MCS) employing image fusion and neuronavigation. Clinical outcome was assessed using the Modified Rankin Scale.

Results: FMRI motor foci were successfully detected in all patients preoperatively. In 17 of 22 patients (77.3%), a successful stimulation of the primary motor cortex was possible. All 17 correlated patients showed 100% agreement on MCS and fMRI motor focus within 10 mm. Technical problems during stimulation occurred in three patients (13.6%), no motor response was elicited in two (9.1%), and MCS induced seizures occurred in three (13.6%). Combined fMRI and MCS mapping results allowed large resections in 20 patients (91%) (gross total in nine (41%), subtotal in 11 (50%)) and biopsy in two patients (9%). Pathology revealed seven low grade and 15 high grade gliomas. Mild to moderate transient neurological deterioration occurred in six patients, and a severe hemiparesis in one. All patients recovered within 3 months (31.8% transient, 0% permanent morbidity).

Conclusions: The validation of clinically optimised high magnetic field motor fMRI confirms high reliability as a preoperative and intraoperative adjunct in glioma patients selected for surgery within or adjacent to the motor cortex.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Centre for Advanced Imaging Publications
 
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