Presurgical motor, somatosensory and language fMRI: Technical feasibility and limitations in 491 patients over 13 years

Eur Radiol. 2017 Jan;27(1):267-278. doi: 10.1007/s00330-016-4369-4. Epub 2016 May 19.

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.

Keywords: Brain tumour; Functional MRI; Language; Motor; Somatosensory.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Artifacts
  • Brain Mapping / methods*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / physiopathology
  • Brain Neoplasms / surgery*
  • Epilepsy / pathology
  • Epilepsy / physiopathology
  • Epilepsy / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Language*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Preoperative Care / methods
  • Retrospective Studies
  • Somatosensory Cortex / physiopathology*
  • Young Adult