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Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
Published on: August 12, 2019
Modern preoperative imaging and functional mapping in patients with intracranial glioma
Nico Sollmann1,2,3,4, Haosu Zhang5, Christopher Kloth1
1Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
Abstract:
Magnetic resonance imaging (MRI) in therapy-naïve intracranial glioma is paramount for neuro-oncological diagnostics, and it provides images that are helpful for surgery planning and intraoperative guidance during tumor resection, including assessment of the involvement of functionally eloquent brain structures. This study reviews emerging MRI techniques to depict structural information, diffusion characteristics, perfusion alterations, and metabolism changes for advanced neuro-oncological imaging. In addition, it reflects current methods to map brain function close to a tumor, including functional MRI and navigated transcranial magnetic stimulation with derived function-based tractography of subcortical white matter pathways. We conclude that modern preoperative MRI in neuro-oncology offers a multitude of possibilities tailored to clinical needs, and advancements in scanner technology (e. g., parallel imaging for acceleration of acquisitions) make multi-sequence protocols increasingly feasible. Specifically, advanced MRI using a multi-sequence protocol enables noninvasive, image-based tumor grading and phenotyping in patients with glioma. Furthermore, the add-on use of preoperatively acquired MRI data in combination with functional mapping and tractography facilitates risk stratification and helps to avoid perioperative functional decline by providing individual information about the spatial location of functionally eloquent tissue in relation to the tumor mass. KEY POINTS:: · Advanced preoperative MRI allows for image-based tumor grading and phenotyping in glioma.. · Multi-sequence MRI protocols nowadays make it possible to assess various tumor characteristics (incl. perfusion, diffusion, and metabolism).. · Presurgical MRI in glioma is increasingly combined with functional mapping to identify and enclose individual functional areas.. · Advancements in scanner technology (e. g., parallel imaging) facilitate increasing application of dedicated multi-sequence imaging protocols.. CITATION FORMAT: · Sollmann N, Zhang H, Kloth C et al. Modern preoperative imaging and functional mapping in patients with intracranial glioma. Fortschr Röntgenstr 2023; 195: 989 - 1000.
Insights
Advanced MRI techniques improve brain tumor grading and surgical planning for glioma patients. Combining imaging with functional mapping aids risk stratification and preserves neurological function.
Area of Science:
- Neuro-oncology
- Radiology
- Medical Imaging
Background:
- Magnetic resonance imaging (MRI) is crucial for diagnosing intracranial glioma, aiding surgical planning and intraoperative guidance.
- Assessing the involvement of functionally eloquent brain structures is vital for neuro-oncological surgery.
Purpose of the Study:
- To review emerging MRI techniques for advanced neuro-oncological imaging of gliomas.
- To reflect on current methods for mapping brain function near tumors.
- To highlight the benefits of multi-sequence MRI protocols and functional mapping in glioma management.
Main Methods:
- Review of advanced MRI techniques including structural, diffusion, perfusion, and metabolic imaging.
- Integration of functional MRI and navigated transcranial magnetic stimulation with tractography.
- Utilizing multi-sequence MRI protocols for comprehensive tumor assessment.
Main Results:
- Advanced MRI enables noninvasive, image-based tumor grading and phenotyping in glioma patients.
- Multi-sequence protocols assess diverse tumor characteristics like perfusion, diffusion, and metabolism.
- Preoperative MRI combined with functional mapping facilitates risk stratification and avoids perioperative functional decline.
Conclusions:
- Modern preoperative MRI offers tailored solutions for neuro-oncology clinical needs.
- Advancements in scanner technology accelerate multi-sequence protocol feasibility.
- Advanced MRI with functional mapping provides crucial spatial information for safe glioma resection.
