Dual-Imaging Technique Helpful Before and During Neurosurgery

Neuroradiologist James Leach, M.D., and colleagues from the Neuroscience Institute at the University of Cincinnati (UC; OH, USA) and University Hospital (Cincinnati) are among the first in the United States to combine functional magnetic resonance imaging (fMRI) and diffusion tensor tractography data to outline important areas of brain function and their connections prior to surgery--and then transfer that information to the operating room to monitor those areas during actual surgery.

This approach, according to Dr. Leach, has already been used in 20 cases at Cincinnati's University Hospital. "Combining tractography and functional MRI intraoperatively has been in use clinically for only a few years,” said Dr. Leach, associate professor of radiology at UC and a neuroradiologist with University Hospital, "but our preliminary information is very promising because it allows us to optimize surgical approaches to treating brain tumors to ultimately improve patient outcomes.”

Dr. Leach reported that combining conventional visual, sound, and voice-based tests, whose results are measured by fMRI, performed on a high-field-strength (3 Tesla) scanner, with a precise intraoperative guidance system will improve patients' post-operative speech, movement, and memory, and also optimize quality of life for those with brain tumors and other neurologic conditions.

To combine both fMRI and diffusion tensor tractography images in the operating room, Dr. Leach and his colleagues use a high-tech surgical navigation system known as BrainLab, developed by BrainLab (Feldkirchen, Germany; www.brainlab.com). The BrainLab technology incorporates functional MRI data to identify brain areas linked to speech, movement, and vision, and diffusion tensor imaging data to map critical "white-matter tracts”--the electrical connections between different parts of the brain that should be avoided during surgery.

According to Dr. Leach, the detailed, easy-to-understand images produced from functional MRI data also help patients understand what is happening in their head and how the surgery will be conducted. "We can essentially show patients a color-coded picture of their brain and explain to them where their tumor is in relation to areas that control critical functions like expressive speech, movement, and vision,” remarked Dr. Leach.

Dr. Leach presented these preliminary findings at the American Society of Neuroradiology's annual meeting, June 9-13, 2007, in Chicago, IL, USA.


Related Links:
University of Cincinnati
BrainLab