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Validity of primary motor area localization with fMRI versus electric cortical stimulation: A comparative study.
Bartoš, Robert ; Petrovický, Pavel (advisor) ; Zvěřina, Jaroslav (referee) ; Tintěra, Jaroslav (referee)
During my postgraduate studies, I have been working on the problems of surgery on eloquently located intrinsic brain tumors in a wider context. Towards the end of my research work, the technically challenging insular glioma surgery became the main topic. ln general, the radicality of the resection is an acceptable favourable prognostic factor even in low grade gliomas. However, for a safe resection to be possible, a mere knowledge of anatomy is not sufficient. In cases, where a suspicion of an eloquent tumor location arises, careful consideration should be made regarding the the position and the relationship of the functional cortex to the tumor. This consideration can be aided by the use of functional magnetic resonance results. ln our study, functional magnetic resonance was reliable in 83% of patients operated on a tumor in the central motor area (15/18). The distances between the fMRI activated cluster and the ECS targets were within the range of 5mm (error inherent for target-Iocalizing accuracy of neuronavigation system) in 20/26 of our measurements. The spread of the BOLD activation volume is significantly lower during more restrictive corrected thresholding P<0.05c. In all patients with this fMRI threshold, the concordance with the ECS result was absolute. If the volume of the gained corrected fMRI...
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Validity of primary motor area localization with fMRI versus electric cortical stimulation: A comparative study.
Bartoš, Robert ; Petrovický, Pavel (advisor) ; Zvěřina, Jaroslav (referee) ; Tintěra, Jaroslav (referee)
During my postgraduate studies, I have been working on the problems of surgery on eloquently located intrinsic brain tumors in a wider context. Towards the end of my research work, the technically challenging insular glioma surgery became the main topic. ln general, the radicality of the resection is an acceptable favourable prognostic factor even in low grade gliomas. However, for a safe resection to be possible, a mere knowledge of anatomy is not sufficient. In cases, where a suspicion of an eloquent tumor location arises, careful consideration should be made regarding the the position and the relationship of the functional cortex to the tumor. This consideration can be aided by the use of functional magnetic resonance results. ln our study, functional magnetic resonance was reliable in 83% of patients operated on a tumor in the central motor area (15/18). The distances between the fMRI activated cluster and the ECS targets were within the range of 5mm (error inherent for target-Iocalizing accuracy of neuronavigation system) in 20/26 of our measurements. The spread of the BOLD activation volume is significantly lower during more restrictive corrected thresholding P<0.05c. In all patients with this fMRI threshold, the concordance with the ECS result was absolute. If the volume of the gained corrected fMRI...
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