Brain Mapping with fMRI Can Improve Tumor Surgery

"In patients who underwent fMRI, neurosurgeons estimated that more tumor was removed at surgery, operations were shorter and skull incisions were smaller, compared with what they would have had if the fMRI data were not available,” said Jeffrey R. Petrella, M.D., associate professor of radiology in the neuroradiology division at Duke University Medical Center.

When brain tumors are located at the body's control center for thinking, sensation and movement, they can greatly affect an individual's physical and cognitive abilities. Furthermore, surgical removal can be dangerous because if major areas such as these are damaged, patients may experience postoperative symptoms such as limb weakness, language problems, or partial blindness. More than 120 different types of brain tumors have been identified, making effective treatment planning difficult.

In the current study, 39 patients diagnosed with potentially operable brain tumors were assessed with fMRI of the brain. During imaging, the patients performed sentence completion tasks to map areas of the brain involved in language function, and hand-squeezing tasks to identify sensory motor areas. The entire procedure, including the time it took to train patients and capture the images, took less than one hour.

The investigators discovered that in 19 of 39 patients (49%), the surgeons significantly changed their treatment plans after receiving the fMRI findings. Eighteen of the 19 patients underwent more aggressive approaches than originally planned.

Furthermore, the fMRI results helped decrease surgical time by an estimated 15 to 60 minutes in 22 patients. In six patients who had surgery, the neurosurgeon specifically noted that knowledge of the fMRI findings enabled a more complete resection than otherwise would have been achieved. No neurologic deficits were seen in any patients after undergoing surgical tumor removal.



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