Posted By: NITRC ADMIN - May 9, 2018
Tool/Resource: Journals
 

The Effect of Tumour Neovasculature on fMRI BOLD Activation.

World Neurosurg. 2018 May 05;:

Authors: Gould L, Ekstrand C, Fourney DR, Mickleborough MJS, Ellchuk T, Borowsky R

Abstract
We report a 40-year-old patient with a large, WHO grade III oligodendroglioma in the left parietal lobe. Presurgical planning included fMRI localization of language, motor, and somatosensory processing. The fMRI results for the motor and somatosensory tasks revealed activation in peri-lesional regions near the surgical resection, as well as deactivation in the tumour for the sensory task, suggesting that there is decreased autoregulation in the region due to the glioma. The fMRI results showed left hemisphere dominance for language, as well as activation in peri-lesional regions for all three speech tasks (i.e., word reading, picture naming, and semantic questions). In addition, the results demonstrated that the high vascularity of the lesion altered the BOLD function, resulting in false positive and false negative activation in the semantic questions and leg/foot rubbing task, respectively. Intraoperative direct cortical stimulation was conducted in the regions corresponding to the fMRI activation while the patient performed motor, sensory, and language tasks, and showed no loss of function. A follow-up fMRI scan revealed that there was no longer activation in the tumour or in peri-lesional regions, presumably due to the resection of the vascularized tumour. This case report highlights the importance of presurgical fMRI in order to inform the neurosurgical approach, but also emphasizes the need for careful interpretation of fMRI data, especially in malignant glioma cases, which can decrease autoregulation in the tumour and surrounding regions, thus affecting the fMRI BOLD signal.

PMID: 29738857 [PubMed - as supplied by publisher]



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