Planning Brain Tumor Resection Using a Probabilistic Atlas of Cortical and Subcortical Structures Critical for Functional Processing: A Proof of Concept

被引：12

作者：

Sarubbo, Silvio ^{[1
,2
]}

Annicchiarico, Luciano ^{[1
,2
]}

Corsini, Francesco ^{[1
,2
]}

Zigiotto, Luca ^{[1
,2
]}

Herbet, Guillaume ^{[3
,4
]}

Moritz-Gasser, Sylvie ^{[3
,4
]}

Dalpiaz, Chiara ^{[5
]}

Vitali, Luca ^{[5
]}

Tate, Matthew ^{[6
,7
]}

De Benedictis, Alessandro ^{[8
]}

Amorosino, Gabriele ^{[9
,10
]}

Olivetti, Emanuele ^{[9
,10
]}

Rozzanigo, Umberto ^{[11
]}

Petralia, Benedetto ^{[11
]}

Duffau, Hugues ^{[3
,4
]}

Avesani, Paolo ^{[9
,10
]}

机构：

[1] Azienda Prov & Serv Sanit, Dept Neurosurg, S Chiara Hosp, 9 Largo Medaglie Oro, I-38122 Trento, Italy

[2] Azienda Prov & Serv Sanit, Struct & Funct Connect Lab Project, S Chiara Hosp, Trento, Italy

[3] Montpellier Univ, Gui de Chauliac Hosp, Dept Neurosurg, Med Ctr, Montpellier, France

[4] Univ Montpellier, Natl Inst Hlth & Med Res INSERM, Inst Funct Genom, NSERM U1191, Montpellier, France

[5] Azienda Prov & Serv Sanit, Dept Anesthesiol & Intens Care, S Chiara Hosp, Trento, Italy

[6] Northwestern Univ, Feinberg Sch Med, Dept Neurosurg, Chicago, IL 60611 USA

[7] Northwestern Univ, Feinberg Sch Med, Dept Neurol, Chicago, IL 60611 USA

[8] Bambino Gesu Childrens Hosp IRCCS, Dept Neurosci, Neurosurg Unit, Rome, Italy

[9] Bruno Kessler Fdn FBK, Neuroinformat Lab NiLab, Trento, Italy

[10] Univ Trento, Ctr Mind Brain Sci CIMeC, Rovereto, Italy

[11] Azienda Prov & Serv Sanit, Dept Radiol, Div Neuroradiol, S Chiara Hosp, Trento, Italy

来源：

OPERATIVE NEUROSURGERY | 2021年 / 20卷 / 03期

关键词：

Preoperative planning; Functional atlas; Direct electrical stimulation; Brain mapping; Neuro-oncology; RESTING STATE FMRI; STIMULATION;

D O I：

10.1093/ons/opaa396

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND: Functional preoperative planning for resection of intrinsic brain tumors in eloquent areas is still a challenge. Predicting subcortical functional framework is especially difficult. Direct electrical stimulation (DES) is the recommended technique for resection of these lesions. A reliable probabilistic atlas of the critical cortical epicenters and subcortical framework based on DES data was recently published. OBJECTIVE: To propose a pipeline for the automated alignment of the corticosubcortical maps of this atlas with T1-weighted MRI. METHODS: To test the alignment, we selected 10 patients who underwent resection of brain lesions by usingDES. We aligned different cortical and subcortical functional maps to preoperative volumetric T1 MRIs (with/without gadolinium). For each patient we quantified the quality of the alignment, and we calculated the match between the location of the functional sites found at DES and the functional maps of the atlas. RESULTS: We found an accurate brain extraction and alignment of the functional maps with both the T1 MRIs of each patient. The matching analysis between functional maps and functional responses collected during surgeries was 88% at cortical and, importantly, 100% at subcortical level, providing a further proof of the correct alignment. CONCLUSION: We demonstrated quantitatively and qualitatively the reliability of this tool that may be used for presurgical planning, providing further functional information at the cortical level and a unique probabilistic prevision of distribution of the critical subcortical structures. Finally, this tool offers the chance for multimodal planning through integrating this functional information with other neuroradiological and neurophysiological techniques.

引用

页码：E175 / E183

页数：9