Practical Application of fMRI for Surgical Planning

We report our experience evaluating tasks designed to visualize regions of motor and language brain activation using functional magnetic resonant imaging (fMRI). Our goal was to identify a battery of tasks which would provide a range of brain imaging studies which could be used clinically for surgical planning, with the requirement that they could be performed and analyzed rapidly, thus, cost effectively. These tasks were chosen to assess (1) motor control of the hands, fingers, and feet, and (2) language processing using both auditory and visual task presentations. From January through April 2001, five patients and eight normal subjects were studied. A selection of three or four tasks acquired with an EPI sequence coupled with a high resolution 3D MR sequence were completed in 45– 60 min of scanner time. Identification of the location of eloquent cortex serving aspects of motor and language functions was successful in four of the five patients and all of the eight normal subjects.