Resting-State fMRI to Map Language Function for Surgical Planning in Patients With Brain Tumors: A Feasibility Study

In neurosurgery, functional MRI is crucial for preoperative planning to obtain the cortical cortex map of language areas. This preliminary work involved analyzing the functional MRIs of 20 oncological patients. Our question is if resting-state functional MRI (rs-fMRI) can replace standard task-based functional MRI (tb-fMRI) in routine clinical applications. The aim of this challenge is to determine if rs-fMRI is as effective as tb-fMRI and to develop a systematic approach for the extraction of a cortical language map.

We started by analyzing our rs-fMRI images and validated the correct mapping of language regions using an independent components analysis approach; then, we used the analysis of connectivity networks to compare the two techniques.

The regions identified in rs-fMRI align with established medical knowledge; a comparison of rs-fMRI and tb-fMRI reveals that the four language regions-Broca's and Wernicke's areas in both hemispheres-exhibit activation in both techniques; furthermore, we highlighted that rs-fMRI reveals more comprehensive details about functional connectivity in contrast to tb-fMRI.

rs-MRI and tb-MRI provide similar levels of efficacy in revealing the functional areas of the brain for preoperative mapping when a lesion lies in areas related to language; thus, both techniques can be utilized for this goal. Based on this, we developed an rs-fMRI processing pipeline for clinical usage and applied it to a patient outside the study.