Introduction: In this study we describe initial experience with resting state functional MRI (RS fMRI) as a tool of sensorimotor mapping preoperatively and intraoperatively for glioma patients. Function connectivity was the key method used in motor area localization for presurgical planning and intraoperative real-time estimation as well. Direct cortical stimulation (DCS) for motor area was performed in the surgery to confirm the result of the processed data from the RS fMRI. Our objective is to evaluate the usage of the RS fMRI in motor area localization and to try to perform maximal safe resection of gliomas invading sensorimotor area.
Methods: RS fMRI and conventional task-based fMRI were acquired in 15 patients with gliomas involved in sensorimotor cortex before surgery. RS fMRI scans were also acquired during the surgery in the 3T iMRI surgical suite. Function connectivity was used to process the RS fMRI data. At the meantime, DCS for motor area was performed to confirm the results of the processed data from the RS fMRI.
Results: Images from all 15 patients with gliomas invading the sensorimotor cortex were obtained with RS fMRI as well as task-based fMRI before operation. Intraoperative images from 9 patients were obtained with RS fMRI. Sensorimotor areas localized by RS fMRI were consistent with the results of DCS in 11 patients. Meanwhile, intraoperative images form 7 patients were satisfying.
Conclusions: Function connectivity with RS fMRI is a promising tool for localization of sensorimotor cortex not only in presurgical planning but also in real- time estimation of the eloquent area. The images from RS fMRI showed optimal results consistent with DCS. The intraoperative images provide valuable information for the neurosurgeons before further resection of gliomas.
Patient Care: Function connectivity with RS fMRI is a promising tool for localization of sensorimotor cortex not only in presurgical planning but also in real- time estimation of the eloquent area. The intraoperative images provide valuable information for the neurosurgeons before further resection of gliomas, which will help perform maximal safe resection of gliomas invading sensorimotor area.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of the usage of RS fMRI in Sensorimotor mapping, 2) Discuss, the advantages and disadvantages of the RS fMRI, 3) Identify a promising technology to localize the sensorimotor areas.