51
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Agarwal S, Lu H, Pillai JJ. Value of Frequency Domain Resting-State Functional Magnetic Resonance Imaging Metrics Amplitude of Low-Frequency Fluctuation and Fractional Amplitude of Low-Frequency Fluctuation in the Assessment of Brain Tumor-Induced Neurovascular Uncoupling. Brain Connect 2018; 7:382-389. [PMID: 28657344 DOI: 10.1089/brain.2016.0480] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to explore whether the phenomenon of brain tumor-related neurovascular uncoupling (NVU) in resting-state blood oxygen level-dependent functional magnetic resonance imaging (BOLD fMRI) (rsfMRI) may also affect the resting-state fMRI (rsfMRI) frequency domain metrics the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF). Twelve de novo brain tumor patients, who underwent clinical fMRI examinations, including task-based fMRI (tbfMRI) and rsfMRI, were included in this Institutional Review Board-approved study. Each patient displayed decreased/absent tbfMRI activation in the primary ipsilesional (IL) sensorimotor cortex in the absence of a corresponding motor deficit or suboptimal task performance, consistent with NVU. Z-score maps for the motor tasks were obtained from general linear model analysis (reflecting motor activation vs. rest). Seed-based correlation analysis (SCA) maps of sensorimotor network, ALFF, and fALFF were calculated from rsfMRI data. Precentral and postcentral gyri in contralesional (CL) and IL hemispheres were parcellated using an automated anatomical labeling template for each patient. Region of interest (ROI) analysis was performed on four maps: tbfMRI, SCA, ALFF, and fALFF. Voxel values in the CL and IL ROIs of each map were divided by the corresponding global mean of ALFF and fALFF in the cortical brain tissue. Group analysis revealed significantly decreased IL ALFF (p = 0.02) and fALFF (p = 0.03) metrics compared with CL ROIs, consistent with similar findings of significantly decreased IL BOLD signal for tbfMRI (p = 0.0005) and SCA maps (p = 0.0004). The frequency domain metrics ALFF and fALFF may be markers of lesion-induced NVU in rsfMRI similar to previously reported alterations in tbfMRI activation and SCA-derived resting-state functional connectivity maps.
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Affiliation(s)
- Shruti Agarwal
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Hanzhang Lu
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland.,2 Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Jay J Pillai
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland.,3 Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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52
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Liu P, De Vis JB, Lu H. Cerebrovascular reactivity (CVR) MRI with CO2 challenge: A technical review. Neuroimage 2018; 187:104-115. [PMID: 29574034 DOI: 10.1016/j.neuroimage.2018.03.047] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/06/2018] [Accepted: 03/19/2018] [Indexed: 11/16/2022] Open
Abstract
Cerebrovascular reactivity (CVR) is an indicator of cerebrovascular reserve and provides important information about vascular health in a range of brain conditions and diseases. Unlike steady-state vascular parameters, such as cerebral blood flow (CBF) and cerebral blood volume (CBV), CVR measures the ability of cerebral vessels to dilate or constrict in response to challenges or maneuvers. Therefore, CVR mapping requires a physiological challenge while monitoring the corresponding hemodynamic changes in the brain. The present review primarily focuses on methods that use CO2 inhalation as a physiological challenge while monitoring changes in hemodynamic MRI signals. CO2 inhalation has been increasingly used in CVR mapping in recent literature due to its potency in causing vasodilation, rapid onset and cessation of the effect, as well as advances in MRI-compatible gas delivery apparatus. In this review, we first discuss the physiological basis of CVR mapping using CO2 inhalation. We then review the methodological aspects of CVR mapping, including gas delivery apparatus, the timing paradigm of the breathing challenge, the MRI imaging sequence, and data analysis. In addition, we review alternative approaches for CVR mapping that do not require CO2 inhalation.
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Affiliation(s)
- Peiying Liu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States.
| | - Jill B De Vis
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, 21287, United States; F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, 21205, United States
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53
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Trattnig S, Springer E, Bogner W, Hangel G, Strasser B, Dymerska B, Cardoso PL, Robinson SD. Key clinical benefits of neuroimaging at 7T. Neuroimage 2018; 168:477-489. [PMID: 27851995 PMCID: PMC5832016 DOI: 10.1016/j.neuroimage.2016.11.031] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/06/2016] [Accepted: 11/12/2016] [Indexed: 01/15/2023] Open
Abstract
The growing interest in ultra-high field MRI, with more than 35.000 MR examinations already performed at 7T, is related to improved clinical results with regard to morphological as well as functional and metabolic capabilities. Since the signal-to-noise ratio increases with the field strength of the MR scanner, the most evident application at 7T is to gain higher spatial resolution in the brain compared to 3T. Of specific clinical interest for neuro applications is the cerebral cortex at 7T, for the detection of changes in cortical structure, like the visualization of cortical microinfarcts and cortical plaques in Multiple Sclerosis. In imaging of the hippocampus, even subfields of the internal hippocampal anatomy and pathology may be visualized with excellent spatial resolution. Using Susceptibility Weighted Imaging, the plaque-vessel relationship and iron accumulations in Multiple Sclerosis can be visualized, which may provide a prognostic factor of disease. Vascular imaging is a highly promising field for 7T which is dealt with in a separate dedicated article in this special issue. The static and dynamic blood oxygenation level-dependent contrast also increases with the field strength, which significantly improves the accuracy of pre-surgical evaluation of vital brain areas before tumor removal. Improvement in acquisition and hardware technology have also resulted in an increasing number of MR spectroscopic imaging studies in patients at 7T. More recent parallel imaging and short-TR acquisition approaches have overcome the limitations of scan time and spatial resolution, thereby allowing imaging matrix sizes of up to 128×128. The benefits of these acquisition approaches for investigation of brain tumors and Multiple Sclerosis have been shown recently. Together, these possibilities demonstrate the feasibility and advantages of conducting routine diagnostic imaging and clinical research at 7T.
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Affiliation(s)
- Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; Christian Doppler Laboratory for Clinical Molecular MRI, Vienna, Austria.
| | - Elisabeth Springer
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; Christian Doppler Laboratory for Clinical Molecular MRI, Vienna, Austria.
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
| | - Gilbert Hangel
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
| | - Bernhard Strasser
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
| | - Barbara Dymerska
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
| | - Pedro Lima Cardoso
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
| | - Simon Daniel Robinson
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria.
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Hadjiabadi DH, Pung L, Zhang J, Ward BD, Lim WT, Kalavar M, Thakor NV, Biswal BB, Pathak AP. Brain tumors disrupt the resting-state connectome. NEUROIMAGE-CLINICAL 2018; 18:279-289. [PMID: 29876248 PMCID: PMC5987800 DOI: 10.1016/j.nicl.2018.01.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/15/2018] [Accepted: 01/20/2018] [Indexed: 01/18/2023]
Abstract
Brain tumor patients often experience functional deficits that extend beyond the tumor site. While resting-state functional MRI (rsfMRI) has been used to map such functional connectivity changes in brain tumor patients, the interplay between abnormal tumor vasculature and the rsfMRI signal is still not well understood. Therefore, there is an exigent need for new tools to elucidate how the blood‑oxygenation-level-dependent (BOLD) rsfMRI signal is modulated in brain cancer. In this initial study, we explore the utility of a preclinical model for quantifying brain tumor-induced changes on the rsfMRI signal and resting-state brain connectivity. We demonstrate that brain tumors induce brain-wide alterations of resting-state networks that extend to the contralateral hemisphere, accompanied by global attenuation of the rsfMRI signal. Preliminary histology suggests that some of these alterations in brain connectivity may be attributable to tumor-related remodeling of the neurovasculature. Moreover, this work recapitulates clinical rsfMRI findings from brain tumor patients in terms of the effects of tumor size on the neurovascular microenvironment. Collectively, these results lay the foundation of a preclinical platform for exploring the usefulness of rsfMRI as a potential new biomarker in patients with brain cancer.
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Affiliation(s)
- Darian H Hadjiabadi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Leland Pung
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jiangyang Zhang
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - B D Ward
- Department of Biophysics, The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Woo-Taek Lim
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meghana Kalavar
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nitish V Thakor
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Bharat B Biswal
- Department of Biomedical Engineering, The New Jersey Institute of Technology, Newark NJ, USA
| | - Arvind P Pathak
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA; Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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55
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Huang H, Ding Z, Mao D, Yuan J, Zhu F, Chen S, Xu Y, Lou L, Feng X, Qi L, Qiu W, Zhang H, Zang YF. PreSurgMapp: a MATLAB Toolbox for Presurgical Mapping of Eloquent Functional Areas Based on Task-Related and Resting-State Functional MRI. Neuroinformatics 2018; 14:421-38. [PMID: 27221107 DOI: 10.1007/s12021-016-9304-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The main goal of brain tumor surgery is to maximize tumor resection while minimizing the risk of irreversible postoperative functional sequelae. Eloquent functional areas should be delineated preoperatively, particularly for patients with tumors near eloquent areas. Functional magnetic resonance imaging (fMRI) is a noninvasive technique that demonstrates great promise for presurgical planning. However, specialized data processing toolkits for presurgical planning remain lacking. Based on several functions in open-source software such as Statistical Parametric Mapping (SPM), Resting-State fMRI Data Analysis Toolkit (REST), Data Processing Assistant for Resting-State fMRI (DPARSF) and Multiple Independent Component Analysis (MICA), here, we introduce an open-source MATLAB toolbox named PreSurgMapp. This toolbox can reveal eloquent areas using comprehensive methods and various complementary fMRI modalities. For example, PreSurgMapp supports both model-based (general linear model, GLM, and seed correlation) and data-driven (independent component analysis, ICA) methods and processes both task-based and resting-state fMRI data. PreSurgMapp is designed for highly automatic and individualized functional mapping with a user-friendly graphical user interface (GUI) for time-saving pipeline processing. For example, sensorimotor and language-related components can be automatically identified without human input interference using an effective, accurate component identification algorithm using discriminability index. All the results generated can be further evaluated and compared by neuro-radiologists or neurosurgeons. This software has substantial value for clinical neuro-radiology and neuro-oncology, including application to patients with low- and high-grade brain tumors and those with epilepsy foci in the dominant language hemisphere who are planning to undergo a temporal lobectomy.
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Affiliation(s)
- Huiyuan Huang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, 58 Haishu Road, Hangzhou, 311121, People's Republic of China.,School of Education Science, Hangzhou Normal University, Hangzhou, Zhejiang, 311121, People's Republic of China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, 310015, People's Republic of China
| | - Zhongxiang Ding
- Department of Radiology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Dewang Mao
- Department of Radiology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Jianhua Yuan
- Department of Radiology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Fangmei Zhu
- Department of Radiology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Shuda Chen
- Department of Neurosurgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Yan Xu
- Department of Neurosurgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Lin Lou
- Department of Neurosurgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Xiaoyan Feng
- Department of Neurosurgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Le Qi
- Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, 310015, People's Republic of China
| | - Wusi Qiu
- Department of Neurosurgery, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, 310015, People's Republic of China
| | - Han Zhang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, 58 Haishu Road, Hangzhou, 311121, People's Republic of China. .,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, 310015, People's Republic of China.
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, 58 Haishu Road, Hangzhou, 311121, People's Republic of China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang, 310015, People's Republic of China
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56
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Agarwal S, Sair HI, Pillai JJ. The Resting-State Functional Magnetic Resonance Imaging Regional Homogeneity Metrics-Kendall's Coefficient of Concordance-Regional Homogeneity and Coherence-Regional Homogeneity-Are Valid Indicators of Tumor-Related Neurovascular Uncoupling. Brain Connect 2018; 7:228-235. [PMID: 28363248 DOI: 10.1089/brain.2016.0482] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study is to determine whether regional homogeneity (ReHo) of resting-state blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (rsfMRI) data based on Kendall's coefficient of concordance (KCC-ReHo) and coherence (Cohe-ReHo) metrics may allow detection of brain tumor-induced neurovascular uncoupling (NVU) in the sensorimotor network similar to findings in standard motor task-based BOLD fMRI (tbfMRI) activation. Twelve de novo brain tumor patients undergoing clinical fMRI exams (tbfMRI and rsfMRI) were included in this Institutional Review Board (IRB)-approved study. Each patient displayed decreased/absent tbfMRI activation in the primary ipsilesional sensorimotor cortex in the absence of corresponding motor deficit or suboptimal task performance, consistent with NVU. Z-score maps for motor tasks were obtained from the general linear model (GLM) analysis (reflecting motor activation vs. rest). KCC-ReHo and Cohe-ReHo maps were calculated from rsfMRI data. Precentral and postcentral gyri in contralesional (CL) and ipsilesional (IL) hemispheres were parcellated using an automated anatomical labeling (AAL) template for each patient. Similar region of interest (ROI) analysis was performed on tbfMRI, KCC-ReHo, and Cohe-ReHo maps to allow direct comparison of results. Voxel values in CL and IL ROIs of each map were divided by the corresponding global mean of KCC-ReHo and Cohe-ReHo in bihemispheric cortical brain tissue. Group analysis revealed significantly decreased IL mean KCC-ReHo (p = 0.02) and Cohe-ReHo (p = 0.04) metrics compared with respective values in the CL ROIs, consistent with similar findings of significantly decreased ipsilesional BOLD signal for tbfMRI (p = 0.0005). Ipsilesional abnormalities in ReHo derived from rsfMRI may serve as potential indicators of NVU in patients with brain tumors and other resectable brain lesions; as such, ReHo findings may complement findings on tbfMRI used for presurgical planning.
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Affiliation(s)
- Shruti Agarwal
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Haris I Sair
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Jay J Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
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57
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Bowden SG, Gill BJA, Englander ZK, Horenstein CI, Zanazzi G, Chang PD, Samanamud J, Lignelli A, Bruce JN, Canoll P, Grinband J. Local Glioma Cells Are Associated with Vascular Dysregulation. AJNR Am J Neuroradiol 2018; 39:507-514. [PMID: 29371254 DOI: 10.3174/ajnr.a5526] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 11/09/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Malignant glioma is a highly infiltrative malignancy that causes variable disruptions to the structure and function of the cerebrovasculature. While many of these structural disruptions have known correlative histopathologic alterations, the mechanisms underlying vascular dysfunction identified by resting-state blood oxygen level-dependent imaging are not yet known. The purpose of this study was to characterize the alterations that correlate with a blood oxygen level-dependent biomarker of vascular dysregulation. MATERIALS AND METHODS Thirty-two stereotactically localized biopsies were obtained from contrast-enhancing (n = 16) and nonenhancing (n = 16) regions during open surgical resection of malignant glioma in 17 patients. Preoperative resting-state blood oxygen level-dependent fMRI was used to evaluate the relationships between radiographic and histopathologic characteristics. Signal intensity for a blood oxygen level-dependent biomarker was compared with scores of tumor infiltration and microvascular proliferation as well as total cell and neuronal density. RESULTS Biopsies corresponded to a range of blood oxygen level-dependent signals, ranging from relatively normal (z = -4.79) to markedly abnormal (z = 8.84). Total cell density was directly related to blood oxygen level-dependent signal abnormality (P = .013, R2 = 0.19), while the neuronal labeling index was inversely related to blood oxygen level-dependent signal abnormality (P = .016, R2 = 0.21). The blood oxygen level-dependent signal abnormality was also related to tumor infiltration (P = .014) and microvascular proliferation (P = .045). CONCLUSIONS The relationship between local, neoplastic characteristics and a blood oxygen level-dependent biomarker of vascular function suggests that local effects of glioma cell infiltration contribute to vascular dysregulation.
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Affiliation(s)
- S G Bowden
- From the Department of Neurological Surgery (S.G.B.), Oregon Health & Science University, Portland, Oregon.,The Gabriele Bartoli Brain Tumor Research Laboratory (S.G.B., B.J.A.G., Z.K.E., J.S., J.N.B., P.C.)
| | - B J A Gill
- The Gabriele Bartoli Brain Tumor Research Laboratory (S.G.B., B.J.A.G., Z.K.E., J.S., J.N.B., P.C.).,Departments of Neurological Surgery (B.J.A.G., Z.K.E., J.N.B., P.C.)
| | - Z K Englander
- The Gabriele Bartoli Brain Tumor Research Laboratory (S.G.B., B.J.A.G., Z.K.E., J.S., J.N.B., P.C.).,Departments of Neurological Surgery (B.J.A.G., Z.K.E., J.N.B., P.C.)
| | - C I Horenstein
- Department of Radiology (C.I.H.), North Shore University Hospital, Long Island, New York
| | - G Zanazzi
- Pathology and Cell Biology (G.Z., P.C.)
| | - P D Chang
- Department of Radiology (P.D.C.), University of California, San Francisco, California
| | - J Samanamud
- The Gabriele Bartoli Brain Tumor Research Laboratory (S.G.B., B.J.A.G., Z.K.E., J.S., J.N.B., P.C.)
| | - A Lignelli
- Radiology (A.L., J.G.), Columbia University Medical Center, New York, New York
| | - J N Bruce
- The Gabriele Bartoli Brain Tumor Research Laboratory (S.G.B., B.J.A.G., Z.K.E., J.S., J.N.B., P.C.).,Departments of Neurological Surgery (B.J.A.G., Z.K.E., J.N.B., P.C.)
| | - P Canoll
- The Gabriele Bartoli Brain Tumor Research Laboratory (S.G.B., B.J.A.G., Z.K.E., J.S., J.N.B., P.C.).,Departments of Neurological Surgery (B.J.A.G., Z.K.E., J.N.B., P.C.).,Pathology and Cell Biology (G.Z., P.C.)
| | - J Grinband
- Radiology (A.L., J.G.), Columbia University Medical Center, New York, New York
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58
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Pronin IN, Batalov AI, Zakharova NE, Fadeeva LM, Pogosbekyan EL, Goryaynov SA, Buklina SB, Ogurtsova AA, Kulikov AS, Rodionov PV, Voss HU, Peck KK, Holodny AI, Potapov AA. [Evaluation of vascular reactivity to overcome limitations of neurovascular uncoupling in BOLD fMRI of malignant brain tumors]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2018; 82:21-29. [PMID: 30412153 DOI: 10.17116/neiro20188205121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The sensitivity of fMRI in identification of eloquent cortical centers in the case of large infiltrative growing tumors and pronounced peritumoral edema may be reduced or significantly limited in some cases. The main cause is an attenuated Blood-Oxygen-Level-Dependent response (BOLD) caused by pathological vascular reactivity and subsequent neurovascular uncoupling of fMRI. In our study, we attempted to overcome these limitations and increase the sensitivity of this technique in identification of eloquent cortical areas adjacent to brain tumors by using vasoreactivity features of a breath-holding test and including these data in the BOLD analysis. Local vasoreactivity using a breath-holding paradigm with the same block design of both motor and speech tests was determined in 5 healthy volunteers and 3 patients in the preoperative period (two patients with high grade gliomas and one patient with single metastasis). A coherence-based model was developed for analysis of BOLD fMRI, which took into account altered hemodynamics in peritumoral zones. Obtained coherence maps demonstrated clinically more significant activation zones that were not seen with standard methods of fMRI processing. Thus, neurovascular uncoupling that is known to affect the accuracy of the BOLD fMRI response adjacent to brain tumors may be partially overcome by including an independent measurement of vasoreactivity using a breath-holding test in the BOLD analysis.
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Affiliation(s)
- I N Pronin
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A I Batalov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - L M Fadeeva
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | | | - S B Buklina
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - A S Kulikov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - P V Rodionov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - H U Voss
- Weill Medical College of Cornell University, New York, USA
| | - K K Peck
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - A I Holodny
- Weill Medical College of Cornell University, New York, USA; Memorial Sloan Kettering Cancer Center, New York, USA
| | - A A Potapov
- Burdenko Neurosurgical Institute, Moscow, Russia
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59
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Silva MA, See AP, Essayed WI, Golby AJ, Tie Y. Challenges and techniques for presurgical brain mapping with functional MRI. NEUROIMAGE-CLINICAL 2017; 17:794-803. [PMID: 29270359 PMCID: PMC5735325 DOI: 10.1016/j.nicl.2017.12.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/10/2017] [Accepted: 12/05/2017] [Indexed: 01/22/2023]
Abstract
Functional magnetic resonance imaging (fMRI) is increasingly used for preoperative counseling and planning, and intraoperative guidance for tumor resection in the eloquent cortex. Although there have been improvements in image resolution and artifact correction, there are still limitations of this modality. In this review, we discuss clinical fMRI's applications, limitations and potential solutions. These limitations depend on the following parameters: foundations of fMRI, physiologic effects of the disease, distinctions between clinical and research fMRI, and the design of the fMRI study. We also compare fMRI to other brain mapping modalities which should be considered as alternatives or adjuncts when appropriate, and discuss intraoperative use and validation of fMRI. These concepts direct the clinical application of fMRI in neurosurgical patients. fMRI is increasingly used for presurgical brain mapping for surgical planning. Understanding of the limitations of fMRI is critical for its clinical use. Clinical fMRI's challenges and potential solutions are discussed. Intraoperative use and validation of fMRI are discussed.
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Affiliation(s)
- Michael A Silva
- Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Alfred P See
- Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Walid I Essayed
- Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Alexandra J Golby
- Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Yanmei Tie
- Harvard Medical School, Boston, MA, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA.
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60
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Pak RW, Hadjiabadi DH, Senarathna J, Agarwal S, Thakor NV, Pillai JJ, Pathak AP. Implications of neurovascular uncoupling in functional magnetic resonance imaging (fMRI) of brain tumors. J Cereb Blood Flow Metab 2017; 37:3475-3487. [PMID: 28492341 PMCID: PMC5669348 DOI: 10.1177/0271678x17707398] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Functional magnetic resonance imaging (fMRI) serves as a critical tool for presurgical mapping of eloquent cortex and changes in neurological function in patients diagnosed with brain tumors. However, the blood-oxygen-level-dependent (BOLD) contrast mechanism underlying fMRI assumes that neurovascular coupling remains intact during brain tumor progression, and that measured changes in cerebral blood flow (CBF) are correlated with neuronal function. Recent preclinical and clinical studies have demonstrated that even low-grade brain tumors can exhibit neurovascular uncoupling (NVU), which can confound interpretation of fMRI data. Therefore, to avoid neurosurgical complications, it is crucial to understand the biophysical basis of NVU and its impact on fMRI. Here we review the physiology of the neurovascular unit, how it is remodeled, and functionally altered by brain cancer cells. We first discuss the latest findings about the components of the neurovascular unit. Next, we synthesize results from preclinical and clinical studies to illustrate how brain tumor induced NVU affects fMRI data interpretation. We examine advances in functional imaging methods that permit the clinical evaluation of brain tumors with NVU. Finally, we discuss how the suppression of anomalous tumor blood vessel formation with antiangiogenic therapies can "normalize" the brain tumor vasculature, and potentially restore neurovascular coupling.
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Affiliation(s)
- Rebecca W Pak
- 1 Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Darian H Hadjiabadi
- 1 Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Janaka Senarathna
- 1 Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Shruti Agarwal
- 2 Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Nitish V Thakor
- 1 Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Jay J Pillai
- 2 Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Arvind P Pathak
- 1 Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, USA.,2 Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, USA.,3 Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, USA
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61
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Dierker D, Roland JL, Kamran M, Rutlin J, Hacker CD, Marcus DS, Milchenko M, Miller-Thomas MM, Benzinger TL, Snyder AZ, Leuthardt EC, Shimony JS. Resting-state Functional Magnetic Resonance Imaging in Presurgical Functional Mapping: Sensorimotor Localization. Neuroimaging Clin N Am 2017; 27:621-633. [PMID: 28985933 PMCID: PMC5773116 DOI: 10.1016/j.nic.2017.06.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article compares resting-state functional magnetic resonance (fMR) imaging with task fMR imaging for presurgical functional mapping of the sensorimotor (SM) region. Before tumor resection, 38 patients were scanned using both methods. The SM area was anatomically defined using 2 different software tools. Overlap of anatomic regions of interest with task activation maps and resting-state networks was measured in the SM region. A paired t-test showed higher overlap between resting-state maps and anatomic references compared with task activation when using a maximal overlap criterion. Resting state-derived maps are more comprehensive than those derived from task fMR imaging.
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Affiliation(s)
- Donna Dierker
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Jarod L Roland
- Department of Neurological Surgery, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Mudassar Kamran
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Jerrel Rutlin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Carl D Hacker
- Department of Neurological Surgery, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Daniel S Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Mikhail Milchenko
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Michelle M Miller-Thomas
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Tammie L Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA; Department of Neurological Surgery, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Abraham Z Snyder
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA; Department of Neurology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Eric C Leuthardt
- Department of Neurological Surgery, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA; Department of Biomedical Imaging, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4525 Scott Avenue, Saint Louis, MO 63110, USA.
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62
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Fang S, Liang J, Qian T, Wang Y, Liu X, Fan X, Li S, Wang Y, Jiang T. Anatomic Location of Tumor Predicts the Accuracy of Motor Function Localization in Diffuse Lower-Grade Gliomas Involving the Hand Knob Area. AJNR Am J Neuroradiol 2017; 38:1990-1997. [PMID: 28838912 DOI: 10.3174/ajnr.a5342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/04/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The accuracy of preoperative blood oxygen level-dependent fMRI remains controversial. This study assessed the association between the anatomic location of a tumor and the accuracy of fMRI-based motor function mapping in diffuse lower-grade gliomas. MATERIALS AND METHODS Thirty-five patients with lower-grade gliomas involving motor areas underwent preoperative blood oxygen level-dependent fMRI scans with grasping tasks and received intraoperative direct cortical stimulation. Patients were classified into an overlapping group and a nonoverlapping group, depending on the extent to which blood oxygen level-dependent fMRI and direct cortical stimulation results concurred. Tumor location was quantitatively measured, including the shortest distance from the tumor to the hand knob and the deviation distance of the midpoint of the hand knob in the lesion hemisphere relative to the midline compared with the normal contralateral hemisphere. RESULTS A 4-mm shortest distance from the tumor to the hand knob value was identified as optimal for differentiating the overlapping and nonoverlapping group with the receiver operating characteristic curve (sensitivity, 84.6%; specificity, 77.8%). The shortest distances from the tumor to the hand knob of ≤4 mm were associated with inaccurate fMRI-based localizations of the hand motor cortex. The shortest distances from the tumor to the hand knob were larger (P = .002), and the deviation distances for the midpoint of the hand knob in the lesion hemisphere were smaller (P = .003) in the overlapping group than in the nonoverlapping group. CONCLUSIONS This study suggests that the shortest distance from the tumor to the hand knob and the deviation distance for the midpoint of the hand knob on the lesion hemisphere are predictive of the accuracy of blood oxygen level-dependent fMRI results. Smaller shortest distances from the tumor to the hand knob and larger deviation distances for the midpoint of hand knob on the lesion hemisphere are associated with less accuracy of motor cortex localization with blood oxygen level-dependent fMRI. Preoperative fMRI data for surgical planning should be used cautiously when the shortest distance from the tumor to the hand knob is ≤4 mm, especially for lower-grade gliomas anterior to the central sulcus.
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Affiliation(s)
- S Fang
- From the Department of Neurosurgery (S.F., Y.W., T.J.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China
| | - J Liang
- Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China
| | - T Qian
- MR Collaborations NE Asia (T.Q.), Siemens Healthcare, Beijing, China
| | - Y Wang
- From the Department of Neurosurgery (S.F., Y.W., T.J.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China
| | - X Liu
- Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China
| | - X Fan
- Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China
| | - S Li
- Functional Neuroradiology Center (S.L.), Beijing Neurosurgical Institute, Beijing, China
| | - Y Wang
- Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China
| | - T Jiang
- From the Department of Neurosurgery (S.F., Y.W., T.J.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China .,Beijing Neurosurgical Institute (S.F., J.L., Y.W., X.L., X.F., Y.W., T.J.), Capital Medical University, Beijing, China.,Beijing Institute for Brain Disorders Brain Tumor Center (T.J.), Beijing, China
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63
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Castellano A, Cirillo S, Bello L, Riva M, Falini A. Functional MRI for Surgery of Gliomas. Curr Treat Options Neurol 2017; 19:34. [PMID: 28831723 DOI: 10.1007/s11940-017-0469-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Advanced neuroimaging techniques such as functional MRI (fMRI) and diffusion MR tractography have been increasingly used at every stage of the surgical management of brain gliomas, as a means to improve tumor resection while preserving brain functions. This review provides an overview of the last advancements in the field of functional MRI techniques, with a particular focus on their current clinical use and reliability in the preoperative and intraoperative setting, as well as their future perspectives for personalized multimodal management of patients with gliomas. RECENT FINDINGS fMRI and diffusion MR tractography give relevant insights on the anatomo-functional organization of eloquent cortical areas and subcortical connections near or inside a tumor. Task-based fMRI and diffusion tensor imaging (DTI) tractography have proven to be valid and highly sensitive tools for localizing the distinct eloquent cortical and subcortical areas before surgery in glioma patients; they also show good accuracy when compared with intraoperative stimulation mapping data. Resting-state fMRI functional connectivity as well as new advanced HARDI (high angular resolution diffusion imaging) tractography methods are improving and reshaping the role of functional MRI for surgery of gliomas, with potential benefit for personalized treatment strategies. Noninvasive functional MRI techniques may offer the opportunity to perform a multimodal assessment in brain tumors, to be integrated with intraoperative mapping and clinical data for improving surgical management and oncological and functional outcome in patients affected by gliomas.
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Affiliation(s)
- Antonella Castellano
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 58-60, 20132, Milan, Italy.
| | - Sara Cirillo
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 58-60, 20132, Milan, Italy
| | - Lorenzo Bello
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.,Unit of Oncological Neurosurgery, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marco Riva
- Unit of Oncological Neurosurgery, Humanitas Research Hospital, Rozzano, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Andrea Falini
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 58-60, 20132, Milan, Italy
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64
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Lima Cardoso P, Fischmeister FPS, Dymerska B, Geißler A, Wurnig M, Trattnig S, Beisteiner R, Robinson SD. Robust presurgical functional MRI at 7 T using response consistency. Hum Brain Mapp 2017; 38:3163-3174. [PMID: 28321965 PMCID: PMC5434844 DOI: 10.1002/hbm.23582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 03/07/2017] [Accepted: 03/11/2017] [Indexed: 12/31/2022] Open
Abstract
Functional MRI is valuable in presurgical planning due to its non-invasive nature, repeatability, and broad availability. Using ultra-high field MRI increases the specificity and sensitivity, increasing the localization reliability and reducing scan time. Ideally, fMRI analysis for this application should identify unreliable runs and work even if the patient deviates from the prescribed task timing or if there are changes to the hemodynamic response due to pathology. In this study, a model-free analysis method-UNBIASED-based on the consistency of fMRI responses over runs was applied, to ultra-high field fMRI localizations of the hand area. Ten patients with brain tumors and epilepsy underwent 7 Tesla fMRI with multiple runs of a hand motor task in a block design. FMRI data were analyzed with the proposed approach (UNBIASED) and the conventional General Linear Model (GLM) approach. UNBIASED correctly identified and excluded fMRI runs that contained little or no activation. Generally, less motion artifact contamination was present in UNBIASED than in GLM results. Some cortical regions were identified as activated in UNBIASED but not GLM results. These were confirmed to show reproducible delayed or transient activation, which was time-locked to the task. UNBIASED is a robust approach to generating activation maps without the need for assumptions about response timing or shape. In presurgical planning, UNBIASED can complement model-based methods to aid surgeons in making prudent choices about optimal surgical access and resection margins for each patient, even if the hemodynamic response is modified by pathology. Hum Brain Mapp 38:3163-3174, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Pedro Lima Cardoso
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
| | - Florian Ph. S. Fischmeister
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Barbara Dymerska
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
| | - Alexander Geißler
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Moritz Wurnig
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Siegfried Trattnig
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
| | - Roland Beisteiner
- Study Group Clinical fMRI, Department of NeurologyMedical University of ViennaWähringer Gürtel 18‐20, A‐1090ViennaAustria
| | - Simon Daniel Robinson
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaLazarettgasse 14, A‐1090ViennaAustria
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65
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Yahyavi-Firouz-Abadi N, Pillai JJ, Lindquist MA, Calhoun VD, Agarwal S, Airan RD, Caffo B, Gujar SK, Sair HI. Presurgical Brain Mapping of the Ventral Somatomotor Network in Patients with Brain Tumors Using Resting-State fMRI. AJNR Am J Neuroradiol 2017; 38:1006-1012. [PMID: 28364005 DOI: 10.3174/ajnr.a5132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 12/25/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Resting-state fMRI readily identifies the dorsal but less consistently the ventral somatomotor network. Our aim was to assess the relative utility of resting-state fMRI in the identification of the ventral somatomotor network via comparison with task-based fMRI in patients with brain tumor. MATERIALS AND METHODS We identified 26 surgically naïve patients referred for presurgical fMRI brain mapping who had undergone both satisfactory ventral motor activation tasks and resting-state fMRI. Following standard preprocessing for task-based fMRI and resting-state fMRI, general linear model analysis of the ventral motor tasks and independent component analysis of resting-state fMRI were performed with the number of components set to 20, 30, 40, and 50. Visual overlap of task-based fMRI and resting-state fMRI at different component levels was assessed and categorized as full match, partial match, or no match. Rest-versus-task-fMRI concordance was calculated with Dice coefficients across varying fMRI thresholds before and after noise removal. Multithresholded Dice coefficient volume under the surface was calculated. RESULTS The ventral somatomotor network was identified in 81% of patients. At the subject level, better matches between resting-state fMRI and task-based fMRI were seen with an increasing order of components (53% of cases for 20 components versus 73% for 50 components). Noise-removed group-mean volume under the surface improved as component numbers increased from 20 to 50, though ANOVA demonstrated no statistically significant difference among the 4 groups. CONCLUSIONS In most patients, the ventral somatomotor network can be identified with an increase in the probability of a better match at a higher component number. There is variable concordance of the ventral somatomotor network at the single-subject level between resting-state and task-based fMRI.
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Affiliation(s)
- N Yahyavi-Firouz-Abadi
- From the Department of Radiology (N.Y.-F.-A.), Mid-Atlantic Permanente Medical Group of Kaiser Permanente, Kensington, Maryland .,Division of Neuroradiology, (N.Y.-F.-A., J.J.P., S.A., R.D.A., S.K.G., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - J J Pillai
- Division of Neuroradiology, (N.Y.-F.-A., J.J.P., S.A., R.D.A., S.K.G., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - M A Lindquist
- Department of Biostatistics (M.A.L., B.C.), Johns Hopkins University, Baltimore, Maryland
| | - V D Calhoun
- The Mind Research Network (S.A., V.D.C.), Departments of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico
| | - S Agarwal
- Division of Neuroradiology, (N.Y.-F.-A., J.J.P., S.A., R.D.A., S.K.G., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.,The Mind Research Network (S.A., V.D.C.), Departments of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico
| | - R D Airan
- Division of Neuroradiology, (N.Y.-F.-A., J.J.P., S.A., R.D.A., S.K.G., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - B Caffo
- Department of Biostatistics (M.A.L., B.C.), Johns Hopkins University, Baltimore, Maryland
| | - S K Gujar
- Division of Neuroradiology, (N.Y.-F.-A., J.J.P., S.A., R.D.A., S.K.G., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - H I Sair
- Division of Neuroradiology, (N.Y.-F.-A., J.J.P., S.A., R.D.A., S.K.G., H.I.S.), The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Mulugeta G, Eckert MA, Vaden KI, Johnson TD, Lawson AB. Methods for the Analysis of Missing Data in FMRI Studies. ACTA ACUST UNITED AC 2017; 8. [PMID: 31080693 PMCID: PMC6510494 DOI: 10.4172/2155-6180.1000335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Mark A Eckert
- Department of Otolaryngology-Head & Neck Surgery, MUSC, Charleston, SC, USA
| | - Kenneth I Vaden
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Timothy D Johnson
- Department of Otolaryngology-Head & Neck Surgery, MUSC, Charleston, SC, USA
| | - Andrew B Lawson
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Iranmahboob A, Peck KK, Brennan NP, Karimi S, Fisicaro R, Hou B, Holodny AI. Vascular Reactivity Maps in Patients with Gliomas Using Breath-Holding BOLD fMRI. J Neuroimaging 2017; 26:232-9. [PMID: 26250554 DOI: 10.1111/jon.12278] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 05/31/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE To evaluate whether breath-holding (BH) blood oxygenation level-dependent (BOLD) fMRI can quantify differences in vascular reactivity (VR), as there is a need for improved contrast mechanisms in gliomas. METHODS 16 patients (gliomas, grade II = 5, III = 2, IV = 9) were evaluated using the BH paradigm: 4-second single deep breath followed by 16 seconds of BH and 40 seconds of regular breathing for five cycles. VR was defined as the difference in BOLD signal between the minimal signal seen at the end of the deep breath and maximal signal seen at the end of BH (peak-to-trough). VR was measured for every voxel and compared for gray versus white matter and tumor versus normal contralateral brain. VR maps were compared to the areas of enhancement and FLAIR/T2 abnormality. RESULTS VR was significantly lower in normal white matter than gray matter (P < .05) and in tumors compared to the normal, contralateral brain (P < 0.002). The area of abnormal VR (1103 ± 659 mm²) was significantly greater (P = .019) than the enhancement (543 ± 530 mm²), but significantly smaller (P = .0011) than the FLAIR abnormality (2363 ± 1232 mm²). However, the variability in the areas of gadolinium contrast enhancement versus VR abnormality indicates that the contrast mechanism elicited by BH (caused by abnormal arteriolar smooth muscles) appears to be fundamentally different from the contrast mechanism of gadolinium enhancement (caused by the presence of "leaky" gap junctions). CONCLUSIONS BH maps based on peak-to-trough can be used to characterize VR in brain tumors. VR maps in brain tumor patients appear to be caused by a different mechanism than gadolinium enhancement.
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Cerebrovascular reactivity mapping without gas challenges. Neuroimage 2016; 146:320-326. [PMID: 27888058 DOI: 10.1016/j.neuroimage.2016.11.054] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/16/2016] [Accepted: 11/21/2016] [Indexed: 11/22/2022] Open
Abstract
Cerebrovascular reactivity (CVR), the ability of cerebral vessels to dilate or constrict, has been shown to provide valuable information in the diagnosis and treatment evaluation of patients with various cerebrovascular conditions. CVR mapping is typically performed using hypercapnic gas inhalation as a vasoactive challenge while collecting BOLD images, but the inherent need of gas inhalation and the associated apparatus setup present a practical obstacle in applying it in routine clinical use. Therefore, we aimed to develop a new method to map CVR using resting-state BOLD data without the need of gas inhalation. This approach exploits the natural variation in respiration and measures its influence on BOLD MRI signal. In this work, we first identified a surrogate of the arterial CO2 fluctuation during spontaneous breathing from the global BOLD signal. Second, we tested the feasibility and reproducibility of the proposed approach to use the above-mentioned surrogate as a regressor to estimate voxel-wise CVR. Third, we validated the "resting-state CVR map" with a conventional CVR map obtained with hypercapnic gas inhalation in healthy volunteers. Finally, we tested the utility of this new approach in detecting abnormal CVR in a group of patients with Moyamoya disease, and again validated the results using the conventional gas inhalation method. Our results showed that global BOLD signal fluctuation in the frequency range of 0.02-0.04Hz contains the most prominent contribution from natural variation in arterial CO2. The CVR map calculated using this signal as a regressor is reproducible across runs (ICC=0.91±0.06), and manifests a strong spatial correlation with results measured with a conventional hypercapnia-based method in healthy subjects (r=0.88, p<0.001). We also found that resting-state CVR was able to identify vasodilatory deficit in patients with steno-occlusive disease, the spatial pattern of which matches that obtained using the conventional gas method (r=0.71±0.18). These results suggest that CVR obtained with resting-state BOLD may be a useful alternative in detecting vascular deficits in clinical applications when gas challenge is not feasible.
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69
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Fraga de Abreu VH, Peck KK, Petrovich-Brennan NM, Woo KM, Holodny AI. Brain Tumors: The Influence of Tumor Type and Routine MR Imaging Characteristics at BOLD Functional MR Imaging in the Primary Motor Gyrus. Radiology 2016; 281:876-883. [PMID: 27383533 DOI: 10.1148/radiol.2016151951] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the effects of histologic features and anatomic magnetic resonance (MR) imaging characteristics of brain tumors on the functional MR imaging signal in the primary motor cortex (PMC), as false-negative blood oxygen level-dependent (BOLD) functional MR imaging activation can limit the accurate localization of eloquent cortices. Materials and Methods Institutional review board approval was obtained, and informed consent was waived for this HIPAA-compliant retrospective study. It comprised 63 patients referred between 2006 and 2014 for preoperative functional MR imaging localization of the Rolandic cortex. The patients had glioblastoma multiforme (GBM) (n = 20), metastasis (n = 21), or meningioma (n = 22). The volumes of functional MR imaging activation were measured during performance of a bilateral hand motor task. Ratios of functional MR imaging activation were normalized to PMC volume. Statistical analysis was performed for the following: (a) differences between hemispheres within each histologic tumor type (paired Wilcoxon test), (b) differences across tumor types (Kruskal-Wallis and Fisher tests), (c) pairwise tests between tumor types (Mann-Whitney U test), (d) relationships between fast fluid-attenuated inversion recovery (FLAIR) data and enhancement volume with activation (Spearman rank correlation coefficient), and (e) differences in activation volumes by tumor location (Mann-Whitney U test). Results A significant interhemispheric difference was found between the activation volumes in GBMs (mean, 511.43 voxels ± 307.73 [standard deviation] and 330.78 voxels ± 278.95; P < .01) but not in metastases (504.68 voxels ± 220.98 and 460.22 voxels ± 276.83; P = .15) or meningiomas (424.07 voxels ± 247.58 and 415.18 voxels ± 222.36; P = .85). GBMs showed significantly lower activation ratios (median, 0.49; range, 0.04-1.15) than metastases (median, 0.79; range, 0.28-1.66; P = .043) and meningiomas (median, 0.91; range, 0.52-2.05; P < .01). There was a moderate correlation with the volumes of FLAIR abnormality in metastases (ρ = -0.50) and meningiomas (ρ = -0.55). Enhancement volume (ρ = -0.11) and tumor distance from the PMC (median, 0.73 and range, 0.04-2.05 for near and median, 0.82 and range, 0.39-1.66 for far; P = .14) did not influence activation. Conclusion BOLD functional MR imaging activation in the ipsilateral PMC is influenced by tumor type and is significantly reduced in GBMs. FLAIR abnormality correlates moderately with the activation ratios in metastases and meningiomas. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Vitor Hugo Fraga de Abreu
- From the Functional MRI Laboratory, Department of Radiology (V.H.F.d.A., K.K.P., N.M.P., A.I.H.), the Department of Medical Physics (K.K.P.), the Department of Epidemiology-Biostatistics (K.M.W.), and the Brain Tumor Center (A.I.H.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and the Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway (V.H.F.d.A.)
| | - Kyung K Peck
- From the Functional MRI Laboratory, Department of Radiology (V.H.F.d.A., K.K.P., N.M.P., A.I.H.), the Department of Medical Physics (K.K.P.), the Department of Epidemiology-Biostatistics (K.M.W.), and the Brain Tumor Center (A.I.H.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and the Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway (V.H.F.d.A.)
| | - Nicole M Petrovich-Brennan
- From the Functional MRI Laboratory, Department of Radiology (V.H.F.d.A., K.K.P., N.M.P., A.I.H.), the Department of Medical Physics (K.K.P.), the Department of Epidemiology-Biostatistics (K.M.W.), and the Brain Tumor Center (A.I.H.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and the Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway (V.H.F.d.A.)
| | - Kaitlin M Woo
- From the Functional MRI Laboratory, Department of Radiology (V.H.F.d.A., K.K.P., N.M.P., A.I.H.), the Department of Medical Physics (K.K.P.), the Department of Epidemiology-Biostatistics (K.M.W.), and the Brain Tumor Center (A.I.H.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and the Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway (V.H.F.d.A.)
| | - Andrei I Holodny
- From the Functional MRI Laboratory, Department of Radiology (V.H.F.d.A., K.K.P., N.M.P., A.I.H.), the Department of Medical Physics (K.K.P.), the Department of Epidemiology-Biostatistics (K.M.W.), and the Brain Tumor Center (A.I.H.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and the Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway (V.H.F.d.A.)
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Presurgical motor, somatosensory and language fMRI: Technical feasibility and limitations in 491 patients over 13 years. Eur Radiol 2016; 27:267-278. [PMID: 27193934 DOI: 10.1007/s00330-016-4369-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 04/05/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To analyse the long-term feasibility and limitations of presurgical fMRI in a cohort of tumour and epilepsy patients with different MR-scanners at 1.5 and 3.0 T. METHODS Four hundred and ninety-one consecutive patients undergoing presurgical fMRI between 2000 and 2012 on five different MR-scanners using established paradigms and semi-automated data processing were included. Success rates of task performance and BOLD-activation were determined for motor and somatosensory somatotopic mapping and language localisation. Procedural success, failures and imaging artifacts were analysed. MR-field strengths were compared. RESULTS Two thousand three hundred fifteen of 2348 (98.6 %) attempted paradigms (1033 motor, 1220 speech, 95 somatosensory) were successfully performed. 100 paradigms (4.3 %) were repetition runs. 23 speech, 6 motor and 2 sensory paradigms failed for non-compliance and technical issues. Most language paradigm failures were noted in overt sentence generation. Average significant BOLD-activation was higher for motor than language paradigms (95.8 vs. 81.6 %). Most language paradigms showed significantly higher activation rates at 3 T compared to 1.5 T, whereas no significant difference was found for motor paradigms. CONCLUSIONS fMRI proved very robust for the presurgical localisation of the different motor and somatosensory body representations, as well as Broca's and Wernicke's language areas across different MR-scanners at 1.5 and 3.0 T over 13 years. KEY POINTS • Standardised presurgical motor and language fMRI is robust across various MRI platforms. • Motor fMRI is less dependent on field strength than language fMRI. • fMRI task failures are relatively low and are reduced by paradigm repetition.
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Cardoso PL, Fischmeister FPS, Dymerska B, Geißler A, Wurnig M, Trattnig S, Beisteiner R, Robinson SD. Improving the clinical potential of ultra-high field fMRI using a model-free analysis method based on response consistency. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:435-49. [PMID: 26965512 PMCID: PMC4891377 DOI: 10.1007/s10334-016-0533-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/19/2016] [Accepted: 02/06/2016] [Indexed: 12/16/2022]
Abstract
Objective To develop an analysis method that is sensitive to non-model-conform responses often encountered in ultra-high field presurgical planning fMRI. Using the consistency of time courses over a number of experiment repetitions, it should exclude low quality runs and generate activation maps that reflect the reliability of responses. Materials and methods 7 T fMRI data were acquired from six healthy volunteers: three performing purely motor tasks and three a visuomotor task. These were analysed with the proposed approach (UNBIASED) and the GLM. Results UNBIASED results were generally less affected by false positive results than the GLM. Runs that were identified as being of low quality were confirmed to contain little or no activation. In two cases, regions were identified as activated in UNBIASED but not GLM results. Signal changes in these areas were time-locked to the task, but were delayed or transient. Conclusion UNBIASED is shown to be a reliable means of identifying consistent task-related signal changes regardless of response timing. In presurgical planning, UNBIASED could be used to rapidly generate reliable maps of the consistency with which eloquent brain regions are activated without recourse to task timing and despite modified hemodynamics. Electronic supplementary material The online version of this article (doi:10.1007/s10334-016-0533-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro Lima Cardoso
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
| | - Florian Ph. S. Fischmeister
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Barbara Dymerska
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
| | - Alexander Geißler
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Moritz Wurnig
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Siegfried Trattnig
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
| | - Roland Beisteiner
- />Study Group Clinical fMRI, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Simon Daniel Robinson
- />Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre, Medical University of Vienna, Lazarettgasse 14/BT32, 1090 Vienna, Austria
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Niu C, Liu X, Yang Y, Zhang K, Min Z, Wang M, Li W, Guo L, Lin P, Zhang M. Assessing Region of Interest Schemes for the Corticospinal Tract in Patients With Brain Tumors. Medicine (Baltimore) 2016; 95:e3189. [PMID: 27015212 PMCID: PMC4998407 DOI: 10.1097/md.0000000000003189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) techniques are widely used for identifying the corticospinal tract (CST) white matter pathways as part of presurgical planning. However, mass effects in patients with brain tumors tend to cause anatomical distortions and compensatory functional reorganization of the cortex, which may lead to inaccurate mapping of white matter tracts. To overcome these problems, we compared different region-of-interest (ROI) selection schemes to track CST fibers in patients with brain tumors. Our study investigated the CSTs of 16 patients with intracranial tumors. The patients were classified into 3 subgroups according to the spatial relationships of the lesion and the primary motor cortex (PMC)/internal capsule. Specifically, we investigated the key factors that cause distorted tractography in patients with tumors. We compared 3 CST tractography methods that used different ROI selection schemes. The results indicate that CST fiber tracking methods based only on anatomical ROIs could possibly lead to distortions near the PMC region and may be unable to effectively localize the PMC. In contrast, the dual ROI method, which uses ROIs that have been selected from both blood oxygen level-dependent functional MRI (BOLD-fMRI) activation and anatomical landmarks, enabled the tracking of fibers to the motor cortex. The results demonstrate that the dual ROI method can localize the entire CST fiber pathway and can accurately describe the spatial relationships of CST fibers relative to the tumor. These results illustrate the reliability of using fMRI-guided DTT in patients with tumors. The combination of fMRI and anatomical information enhances the identification of tracts of interest in brains with anatomical deformations, which provides neurosurgeons with a more accurate approach for visualizing and localizing white matter fiber tracts in patients with brain tumors. This approach enhances surgical performance and perserves brain function.
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Affiliation(s)
- Chen Niu
- From the Department of Medical Imaging, The First Affiliated Hospital of Xi'An Jiaotong University, Xi'an, Shaanxi (CN, MG, WL, LG, MZ); Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an (XL); School of Information Technology, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China (YY); Department of Electronics Engineering, Northwestern Polytechnical University, Xi'an (KZ); Department of Neurosurgey, First Affiliated Hospital of Xi'An Jiaotong University, Xi'an, Shaanxi (MW); Key Laboratory of Biomedical Information Engineering of Education Ministry, Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an (PL); and Department of Medical Imaging, The First Affiliated Hospital of Xi'An Jiaotong University, Xi'an (MZ), Shaanxi, China
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73
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Agarwal S, Sair HI, Airan R, Hua J, Jones CK, Heo HY, Olivi A, Lindquist MA, Pekar JJ, Pillai JJ. Demonstration of Brain Tumor-Induced Neurovascular Uncoupling in Resting-State fMRI at Ultrahigh Field. Brain Connect 2016; 6:267-72. [PMID: 26918887 DOI: 10.1089/brain.2015.0402] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
To demonstrate in a small case series for the first time the phenomenon of brain tumor-related neurovascular uncoupling (NVU) in resting-state blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) at ultrahigh field (7T). Two de novo (i.e., untreated) brain tumor patients underwent both BOLD resting-state fMRI (rsfMRI) on a 7T MRI system and motor task-based BOLD fMRI at 3T. Ipsilesional (i.e., ipsilateral to tumor or IL) and contralesional (i.e., contralateral to tumor or CL) region of interest (ROI) analysis was performed on both 3T motor task-related general linear model-derived activation maps and on 7T rsfMRI independent component analysis (ICA)-derived sensorimotor network maps for each case. Asymmetry scores (ASs) were computed based on numbers of suprathreshold voxels in the IL and CL ROIs. In each patient, ASs derived from ROI analysis of suprathreshold voxels in IL and CL ROIs in task-related activation maps and rsfMRI ICA-derived sensorimotor component maps indicate greater number of suprathreshold voxels in contralesional than ipsilesional sensorimotor cortex in both maps. In patient 1, an AS of 0.2 was obtained from the suprathreshold Z-score spectrum (voxels with Z-scores >5.0) of the task-based activation map and AS of 1.0 was obtained from the suprathreshold Z-score spectrum (Z-scores >5.0) of the ICA-derived sensorimotor component map. Similarly, in patient 2, an AS of 1.0 was obtained from the suprathreshold Z-score spectrum (Z-scores >5.0) of the task-based activation map and an AS of 1.0 was obtained from the suprathreshold Z-score spectrum (Z-scores >5.0) of the ICA-derived sensorimotor component map. Overall, decreased BOLD signal was noted in IL compared with CL ROIs on both task-based activation maps and ultrahigh field resting-state maps, indicating the presence of NVU. We have demonstrated evidence of NVU on ultrahigh field 7T rsfMRI comparable with the findings on standard 3T motor task-based fMRI in both cases.
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Affiliation(s)
- Shruti Agarwal
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Haris I Sair
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Raag Airan
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Jun Hua
- 2 Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
- 3 F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute , Baltimore, Maryland
| | - Craig K Jones
- 2 Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
- 3 F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute , Baltimore, Maryland
| | - Hye-Young Heo
- 2 Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
- 3 F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute , Baltimore, Maryland
| | - Alessandro Olivi
- 4 Department of Neurosurgery, Johns Hopkins University School of Medicine , Baltimore, Maryland
| | - Martin A Lindquist
- 5 Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland
| | - James J Pekar
- 2 Division of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
- 3 F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute , Baltimore, Maryland
| | - Jay J Pillai
- 1 Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine , Baltimore, Maryland
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Fierstra J, Burkhardt JK, van Niftrik CHB, Piccirelli M, Pangalu A, Kocian R, Neidert MC, Valavanis A, Regli L, Bozinov O. Blood oxygen-level dependent functional assessment of cerebrovascular reactivity: Feasibility for intraoperative 3 Tesla MRI. Magn Reson Med 2016; 77:806-813. [PMID: 26918794 DOI: 10.1002/mrm.26135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/29/2015] [Accepted: 12/26/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE To assess the feasibility of functional blood oxygen-level dependent (BOLD) MRI to evaluate intraoperative cerebrovascular reactivity (CVR) at 3 Tesla field strength. METHODS Ten consecutive neurosurgical subjects scheduled for a clinical intraoperative MRI examination were enrolled in this study. In addition to the clinical protocol a BOLD sequence was implemented with three cycles of 44 s apnea to calculate CVR values on a voxel-by-voxel basis throughout the brain. The CVR range was then color-coded and superimposed on an anatomical volume to create high spatial resolution CVR maps. RESULTS Ten subjects (mean age 34.8 ± 13.4; 2 females) uneventfully underwent the intraoperative BOLD protocol, with no complications occurring. Whole-brain CVR for all subjects was (mean ± SD) 0.69 ± 0.42, whereas CVR was markedly higher for tumor subjects as compared to vascular subjects, 0.81 ± 0.44 versus 0.33 ± 0.10, respectively. Furthermore, color-coded functional maps could be robustly interpreted for a whole-brain assessment of CVR. CONCLUSION We demonstrate that intraoperative BOLD MRI is feasible in creating functional maps to assess cerebrovascular reactivity throughout the brain in subjects undergoing a neurosurgical procedure. Magn Reson Med 77:806-813, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jorn Fierstra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | | | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Athina Pangalu
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Roman Kocian
- Department of Neuro-anesthesia, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Marian Christoph Neidert
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Antonios Valavanis
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Luca Regli
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Oliver Bozinov
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
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Bailey PD, Zacà D, Basha MM, Agarwal S, Gujar SK, Sair HI, Eng J, Pillai JJ. Presurgical fMRI and DTI for the Prediction of Perioperative Motor and Language Deficits in Primary or Metastatic Brain Lesions. J Neuroimaging 2015; 25:776-784. [DOI: 10.1111/jon.12273] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Paul D. Bailey
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins Hospital & The Johns Hopkins University School of Medicine; Baltimore MD
| | - Domenico Zacà
- Center for Mind/Brain Sciences; University of Trento; Trento Italy
| | | | - Shruti Agarwal
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins Hospital & The Johns Hopkins University School of Medicine; Baltimore MD
| | - Sachin K. Gujar
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins Hospital & The Johns Hopkins University School of Medicine; Baltimore MD
| | - Haris I. Sair
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins Hospital & The Johns Hopkins University School of Medicine; Baltimore MD
| | - John Eng
- Division of General and Diagnostic Radiology, Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins Hospital & The Johns Hopkins University School of Medicine; Baltimore MD
| | - Jay J. Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins Hospital & The Johns Hopkins University School of Medicine; Baltimore MD
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Agarwal S, Sair HI, Yahyavi-Firouz-Abadi N, Airan R, Pillai JJ. Neurovascular uncoupling in resting state fMRI demonstrated in patients with primary brain gliomas. J Magn Reson Imaging 2015. [PMID: 26201672 DOI: 10.1002/jmri.25012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND To demonstrate that the problem of brain tumor-related neurovascular uncoupling (NVU) is a significant issue with respect to resting state blood oxygen level dependent (BOLD) functional MRI (rsfMRI) similar to task-based BOLD fMRI, in which signal detectability can be compromised by breakdown of normal neurovascular coupling. METHODS We evaluated seven de novo brain tumor patients who underwent resting state fMRI as part of comprehensive clinical fMRI exams at 3 Tesla. For each of the seven patients who demonstrated evidence of NVU on task-based motor fMRI, we performed both an independent component analysis (ICA) and an atlas-based parcellation-based seed correlation analysis (SCA) of the resting state fMRI data. For each patient, ipsilesional (IL) and contralesional (CL) regions of interest (ROIs) comprising primary motor and somatosensory cortices were used to evaluate BOLD signal changes on Z score maps derived from both ICA and SCA analysis for evidence of NVU. A subsequent two-tailed t-test was performed to determine whether statistically significant differences between the two sides were present that were consistent with NVU. RESULTS In seven patients, overall decreased BOLD signal (based on suprathreshold voxels in ICA and SCA-derived Z-score maps) was noted in IL compared with CL ROIs (P < 0.01), consistent with NVU. CONCLUSION We have demonstrated that NVU can result in false negative BOLD signal changes on rsfMRI comparable to previously published findings on standard motor task-based fMRI.
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Affiliation(s)
- Shruti Agarwal
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Haris I Sair
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Noushin Yahyavi-Firouz-Abadi
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Raag Airan
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Boudiaf N, Attyé A, Warnking JM, Troprès I, Lamalle L, Pietras J, Krainik A. BOLD fMRI of cerebrovascular reactivity in the middle cerebral artery territory: A 100 volunteers' study. J Neuroradiol 2015; 42:338-44. [PMID: 26031884 DOI: 10.1016/j.neurad.2015.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/26/2015] [Accepted: 04/05/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE The assessment of cerebrovascular reactivity (CVR) has shown promising results for its use in medical diagnosis and prognosis, especially in patients suffering from severe intracranial arterial stenosis. However, its quantification remains uncertain because of a large variability inherent in brain anatomy and in methodological settings. To overcome this variability, we provide lateralization index (LI) values for CVR within the middle cerebral artery territory to detect CVR impairment. MATERIALS AND METHODS We assessed CVR in 100 volunteers (41 females; 47.52 ± 21.58 years) without cervico-encephalic arterial stenosis using BOLD-fMRI contrast with a block-design hypercapnic challenge. Averaged end-tidal CO2 was used as a physiological regressor for statistical analyses with a general linear model. We measured %BOLD signal-change in segmented gray matter regions of interest in the middle cerebral artery territory (MCA). We calculated a laterality index according to the following formula: LI=(CVRleft-CVRright)/(CVRleft+CVRright). We tested the effects of methodological settings (i.e. hypercapnic gas, gas administration means, MR acquisition and sex) on %BOLD signal change and LI values with analysis of variance. RESULTS No adverse effects of the hypercapnic challenge were reported. LI values were independent of experimental conditions. Mean LI calculated in MCA territories was 0.016 ± 0.031, giving the lower and upper limits of 95% (m ± 2SD) of this population distribution at]-0.05; 0.08[. CONCLUSION LI can effectively help us to overcome measurement variabilities. Therefore, it can be used to detect abnormal asymmetries in CVR and identify patients at higher risk of ischemic stroke.
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Affiliation(s)
- Naïla Boudiaf
- Université Grenoble Alpes 3bis, CNRS, LPNC, 38000 Grenoble, France; Université Savoie 3, LPNC, 73000 Chambéry, France.
| | - Arnaud Attyé
- Inserm, université Grenoble Alpes, GIN, CHU de Grenoble, 38000 Grenoble, France; Department of Neuroradiology and MRI, University Hospital of Grenoble-IFR1, Grenoble, France
| | - Jan M Warnking
- Inserm, université Grenoble Alpes, GIN, CHU de Grenoble, 38000 Grenoble, France
| | - Irène Troprès
- Inserm, université Grenoble Alpes, GIN, CHU de Grenoble, 38000 Grenoble, France; Inserm, université Grenoble Alpes, CNRS, IRMaGe, CHU de Grenoble, 38000 Grenoble, France
| | - Laurent Lamalle
- Inserm, université Grenoble Alpes, CNRS, IRMaGe, CHU de Grenoble, 38000 Grenoble, France
| | - Johan Pietras
- Inserm, université Grenoble Alpes, CNRS, IRMaGe, CHU de Grenoble, 38000 Grenoble, France
| | - Alexandre Krainik
- Inserm, université Grenoble Alpes, GIN, CHU de Grenoble, 38000 Grenoble, France; Inserm, université Grenoble Alpes, CNRS, IRMaGe, CHU de Grenoble, 38000 Grenoble, France; Department of Neuroradiology and MRI, University Hospital of Grenoble-IFR1, Grenoble, France
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Chan ST, Evans KC, Rosen BR, Song TY, Kwong KK. A case study of magnetic resonance imaging of cerebrovascular reactivity: a powerful imaging marker for mild traumatic brain injury. Brain Inj 2014; 29:403-7. [PMID: 25384127 DOI: 10.3109/02699052.2014.974209] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To use breath-hold functional magnetic resonance imaging (fMRI) to localize the brain regions with impaired cerebrovascular reactivity (CVR) in a female patient diagnosed with mild traumatic brain injury (mTBI). The extent of impaired CVR was evaluated 2 months after concussion. Follow-up scan was performed 1 year post-mTBI using the same breath-hold fMRI technique. RESEARCH DESIGN Case report. METHODS AND PROCEDURES fMRI blood oxygenation dependent level (BOLD) signals were measured under breath-hold challenge in a female mTBI patient 2 months after concussion followed by a second fMRI with breath-hold challenge 1 year later. CVR was expressed as the percentage change of BOLD signals per unit time of breath-hold. MAIN OUTCOMES In comparison with CVR measurement of normal control subjects, statistical maps of CVR revealed substantial neurovascular deficits and hemispheric asymmetry within grey and white matter in the initial breath-hold fMRI scan. Follow-up breath-hold fMRI performed 1 year post-mTBI demonstrated normalization of CVR accompanied with symptomatic recovery. CONCLUSIONS CVR may serve as an imaging biomarker to detect subtle deficits in both grey and white matter for individual diagnosis of mTBI. The findings encourage further investigation of hypercapnic fMRI as a diagnostic tool for mTBI.
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Affiliation(s)
- Suk-tak Chan
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging and
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Zacà D, Agarwal S, Gujar SK, Sair HI, Pillai JJ. Special considerations/technical limitations of blood-oxygen-level-dependent functional magnetic resonance imaging. Neuroimaging Clin N Am 2014; 24:705-15. [PMID: 25441509 DOI: 10.1016/j.nic.2014.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this review, limitations affecting the results of presurgical mapping with blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) are discussed. There is a great need to standardize fMRI acquisition and analysis methods and establish guidelines to address quality control issues. Several national and international organizations are formulating guidelines and standards for both clinical and research applications of BOLD fMRI. Consensus regarding management of these issues will likely both improve the clinical standard of care and enhance future research applications of fMRI.
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Affiliation(s)
- Domenico Zacà
- Center for Mind/Brain Sciences, University of Trento, Via delle Regole 101, Mattarello (TN) 38121, Italy; Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - Shruti Agarwal
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - Sachin K Gujar
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - Haris I Sair
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - Jay J Pillai
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
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80
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Rosazza C, Aquino D, D’Incerti L, Cordella R, Andronache A, Zacà D, Bruzzone MG, Tringali G, Minati L. Preoperative mapping of the sensorimotor cortex: comparative assessment of task-based and resting-state FMRI. PLoS One 2014; 9:e98860. [PMID: 24914775 PMCID: PMC4051640 DOI: 10.1371/journal.pone.0098860] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 05/08/2014] [Indexed: 11/18/2022] Open
Abstract
Resting state fMRI (rs-fMRI) has recently been considered as a possible complement or alternative to task-based fMRI (tb-fMRI) for presurgical mapping. However, evidence of its usefulness remains scant, because existing studies have investigated relatively small samples and focused primarily on qualitative evaluation. The aim of this study is to investigate the clinical usefulness of rs-fMRI in the context of presurgical mapping of motor functions, and in particular to determine the degree of correspondence with tb-fMRI which, while not a gold-standard, is commonly used in preoperative setting. A group of 13 patients with lesions close to the sensorimotor cortex underwent rs-fMRI and tb-fMRI to localize the hand, foot and mouth motor areas. We assessed quantitatively the degree of correspondence between multiple rs-fMRI analyses (independent-component and seed-based analyses) and tb-fMRI, with reference to sensitivity and specificity of rs-fMRI with respect to tb-fMRI, and centre-of-mass distances. Agreement with electro-cortical stimulation (ECS) was also investigated, and a traditional map thresholding approach based on agreement between two experienced operators was compared to an automatic threshold determination method. Rs-fMRI can localize the sensorimotor cortex successfully, providing anatomical specificity for hand, foot and mouth motor subregions, in particular with seed-based analyses. Agreement with tb-fMRI was only partial and rs-fMRI tended to provide larger patterns of correlated activity. With respect to the ECS data available, rs-fMRI and tb-fMRI performed comparably, even though the shortest distance to stimulation points was observed for the latter. Notably, the results of both were on the whole robust to thresholding procedure. Localization performed by rs-fMRI is not equivalent to tb-fMRI, hence rs-fMRI cannot be considered as an outright replacement for tb-fMRI. Nevertheless, since there is significant agreement between the two techniques, rs-fMRI can be considered with caution as a potential alternative to tb-fMRI when patients are unable to perform the task.
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Affiliation(s)
- Cristina Rosazza
- Neuroradiology Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Scientific Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- * E-mail:
| | - Domenico Aquino
- Neuroradiology Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Ludovico D’Incerti
- Neuroradiology Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Roberto Cordella
- Neurosurgery Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Adrian Andronache
- Neuroradiology Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Domenico Zacà
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
| | - Maria Grazia Bruzzone
- Neuroradiology Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Giovanni Tringali
- Neurosurgery Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - Ludovico Minati
- Scientific Department, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
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81
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Niu C, Zhang M, Min Z, Rana N, Zhang Q, Liu X, Li M, Lin P. Motor network plasticity and low-frequency oscillations abnormalities in patients with brain gliomas: a functional MRI study. PLoS One 2014; 9:e96850. [PMID: 24806463 PMCID: PMC4013133 DOI: 10.1371/journal.pone.0096850] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 04/09/2014] [Indexed: 11/18/2022] Open
Abstract
Brain plasticity is often associated with the process of slow-growing tumor formation, which remodels neural organization and optimizes brain network function. In this study, we aimed to investigate whether motor function plasticity would display deficits in patients with slow-growing brain tumors located in or near motor areas, but who were without motor neurological deficits. We used resting-state functional magnetic resonance imaging to probe motor networks in 15 patients with histopathologically confirmed brain gliomas and 15 age-matched healthy controls. All subjects performed a motor task to help identify individual motor activity in the bilateral primary motor cortex (PMC) and supplementary motor area (SMA). Frequency-based analysis at three different frequencies was then used to investigate possible alterations in the power spectral density (PSD) of low-frequency oscillations. For each group, the average PSD was determined for each brain region and a nonparametric test was performed to determine the difference in power between the two groups. Significantly reduced inter-hemispheric functional connectivity between the left and right PMC was observed in patients compared with controls (P<0.05). We also found significantly decreased PSD in patients compared to that in controls, in all three frequency bands (low: 0.01-0.02 Hz; middle: 0.02-0.06 Hz; and high: 0.06-0.1 Hz), at three key motor regions. These findings suggest that in asymptomatic patients with brain tumors located in eloquent regions, inter-hemispheric connection may be more vulnerable. A comparison of the two approaches indicated that power spectral analysis is more sensitive than functional connectivity analysis for identifying the neurological abnormalities underlying motor function plasticity induced by slow-growing tumors.
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Affiliation(s)
- Chen Niu
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P. R. China
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P. R. China
| | - Zhigang Min
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P. R. China
| | - Netra Rana
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P. R. China
| | - Qiuli Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P. R. China
| | - Xin Liu
- Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P.R. China
| | - Min Li
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P. R. China
| | - Pan Lin
- Institute of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi-Province, P.R. China
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82
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Pillai JJ, Mikulis DJ. Cerebrovascular reactivity mapping: an evolving standard for clinical functional imaging. AJNR Am J Neuroradiol 2014; 36:7-13. [PMID: 24788129 DOI: 10.3174/ajnr.a3941] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
SUMMARY This review article explains the methodology of breath-hold cerebrovascular reactivity mapping, both in terms of acquisition and analysis, and reviews applications of this method to presurgical mapping, particularly with respect to blood oxygen level-dependent fMRI. Its main application in clinical fMRI is for the assessment of neurovascular uncoupling potential. Neurovascular uncoupling is potentially a major limitation of clinical fMRI, particularly in the setting of mass lesions in the brain such as brain tumors and intracranial vascular malformations that are associated with alterations in regional hemodynamics on either an acquired or congenital basis. As such, breath-hold cerebrovascular reactivity mapping constitutes an essential component of quality control analysis in clinical fMRI, particularly when performed for presurgical mapping of eloquent cortex. Exogenous carbon dioxide challenges used for cerebrovascular reactivity mapping will also be discussed, and their applications to the evaluation of cerebrovascular reserve and cerebrovascular disease will be described.
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Affiliation(s)
- J J Pillai
- From the Division of Neuroradiology (J.J.P.), Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - D J Mikulis
- Department of Medical Imaging (D.J.M.), The University of Toronto, The University Health Network, The Toronto Western Hospital, Toronto, Ontario, Canada
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83
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Tang MY, Chen TW, Zhang XM, Huang XH. GRE T2∗-weighted MRI: principles and clinical applications. BIOMED RESEARCH INTERNATIONAL 2014; 2014:312142. [PMID: 24987676 PMCID: PMC4009216 DOI: 10.1155/2014/312142] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/19/2014] [Indexed: 12/20/2022]
Abstract
The sequence of a multiecho gradient recalled echo (GRE) T2*-weighted imaging (T2*WI) is a relatively new magnetic resonance imaging (MRI) technique. In contrast to T2 relaxation, which acquires a spin echo signal, T2* relaxation acquires a gradient echo signal. The sequence of a GRE T2*WI requires high uniformity of the magnetic field. GRE T2*WI can detect the smallest changes in uniformity in the magnetic field and can improve the rate of small lesion detection. In addition, the T2* value can indirectly reflect changes in tissue biochemical components. Moreover, it can be used for the early diagnosis and quantitative diagnosis of some diseases. This paper reviews the principles and clinical applications as well as the advantages and disadvantages of GRE T2*WI.
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Affiliation(s)
- Meng Yue Tang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Tian Wu Chen
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Xiao Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Xiao Hua Huang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
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