Functional MRI (fMRI) and Segmentation for Surgical Planning: Right Parietal Tumor |
Clinical Case: Right Parietal Tumor
Thirty six year-old female patient.
Parietal astrocytoma detected in the right hemisphere
No contrast enhancement, large oedema
Surgical treatment preferred but tumor close to right motor cortex
Motor and language fMRI requested in order to minimize post-operative deficit.
MR imaging
Siemens Trio 3T MR scanner
Tim multi-channel head coil
High resolution 3D T1-weigted anatomical scan
EPI sequence for BOLD imaging
motor (left hand): left finger tapping vs. rest (LHAN)
motor (left foot): left foot movements vs. rest (LFOO)
category-based semantic verbal fluency task: think of words that pertains to a specific category vs. rest (WCAT)
semantic word generation task based on short sentence processing (auditory stimuli): short sentences vs. reverse audio samples (AUDT)
fMRI analysis
Automatic SPM analysis with our AutoSPM+ software identified:
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Right pre-central gyrus activation (LHAN): primary motor area (hand knob), anterior to the tumor
Activation of the left inferior frontal gyrus, corresponding to Broca's area
Activation of the left dorso-lateral prefrontal cortex: not specific to language, but linked with attention and working memory. Always activated in language tests and lateralized in the dominant language hemisphere.
Bilateral activation of SMA (planning of articulatory movements)
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White Matter Segmentation
White Matter was segmented from our Brain Viewer, using SPM's segmentation algorithm.
Neuroradiology: Dr. Jean-Flory L. Tshibanda (Liege University Hospital, Liege, Belgium), fMRI experiment: Dr. Laurent Hermoye, Wojciech Gradkowski (Imagilys).
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