Document Detail

Metabolic and electrophysiological validation of functional MRI.
MedLine Citation:
PMID:  11723198     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Although functional MRI is widely used for preoperative planning and intraoperative neuronavigation, its accuracy to depict the site of neuronal activity is not exactly known. Experience with methods that may validate fMRI data and the results obtained when coregistering fMRI with different preoperative and intraoperative mapping modalities including metabolically based (18)F-fluorodeoxyglucose PET, electrophysiologcally based transcranial magnetic stimulation (TMS), and direct electrical cortical stimulation (DECS) are described. METHODS: Fifty patients were included. PET was performed in 30, TMS in 10, and DECS in 41 patients. After coregistration using a frameless stereotactic system, results were grouped into overlapping (<1 cm distance), neighbouring (<2 cm), or contradictory (>2 cm). RESULTS: Comparing fMRI with PET, 18 overlapping, seven neighbouring, and one contradictory result were obtained. In four patients no comparison was possible (because of motion artefacts, low signal to noise ratio, and unusual high tumour metabolism in PET). The comparison of TMS and fMRI showed seven overlapping and three neighbouring results. In three patients no DECS results could be obtained. Of the remaining 38 patients, fMRI hand motor tasks were compared with DECS results of the upper limb muscles in 36 patients, and fMRI foot motor tasks were compared with DECS results of the lower limb on 13 occasions. Of those 49 studies, overlapping results were obtained in 31 patients, and neighbouring in 14. On four occasions fMRI did not show functional information (because of motion artefacts and low signal to noise). CONCLUSIONS: All validation techniques have intrinsic limitations that restrict their spatial resolution. However, of 50 investigated patients, there was only one in whom results contradictory to fMRI were obtained. Although it is not thought that fMRI can replace the intraoperatively updated functional information (DECS), it is concluded that fMRI is an important adjunct in the preoperative assessment of patients with tumours in the vicinity of the central region.
T Krings; M Schreckenberger; V Rohde; H Foltys; U Spetzger; O Sabri; M H Reinges; S Kemeny; P T Meyer; W Möller-Hartmann; M Korinth; J M Gilsbach; U Buell; A Thron
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  71     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-11-27     Completed Date:  2001-12-28     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  762-71     Citation Subset:  IM    
Department of Neuroradiology, University Hospital of the Technical University, Pauwelsstrasse 30, 52057 Aachen, Germany.
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MeSH Terms
Bias (Epidemiology)
Brain Mapping / instrumentation,  methods*
Brain Neoplasms / diagnosis*,  metabolism,  physiopathology,  surgery
Electrodiagnosis / instrumentation,  methods*,  standards*
Electrophysiology / instrumentation,  methods*,  standards*
Fluorodeoxyglucose F18 / diagnostic use*
Magnetic Resonance Imaging / instrumentation,  methods*,  standards*
Magnetics / diagnostic use*,  instrumentation
Middle Aged
Preoperative Care
Psychomotor Performance
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Signal Processing, Computer-Assisted
Stereotaxic Techniques / instrumentation,  standards
Tomography, Emission-Computed / instrumentation,  methods*,  standards*
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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