Radiosurgery

Preoperative Cortical Localization with Functional MRI for Use in Stereotactic Radiosurgery
Thomas C. Witt, Douglas Kondziolka, Stephen B. Baumann, Douglas C. Noll, Steven L. Small, L. Dade Lunsford

Departments of Neurological Surgery, Radiation Oncology, Radiology, and Neurology, and Center for Image-Guided Neurosurgery, University of Pittsburgh, Pa., USA

Address of Corresponding Author

Stereotact Funct Neurosurg 1996;66:24-29 (DOI: 10.1159/000099663)

  Key Words

• Functional MRI
• Radiosurgery
• Cortical mapping

  Abstract

Accurate localization of the lesion with respect to functionally significant brain is essential to safe stereotactic radiosurgical dose planning. We report the use of functional MR imaging in 3 patients to identify critical areas of surrounding brain and to provide assistance with dose planning, especially with regard to shaping the peripheral isodose around the lesion. We used a functional MRI system employing a conventional 1.5-tesla MRI unit that can detect decreases in deoxyhemoglobin concentration occurring with performance of specific tasks. Two of the patients .had supratentorial arteriovenous malformations and 1 patient had a recurrent parasagittal meningioma. Functional MRI provided information on the location of speech, motor, and sensory cortex in these patients. Radiosurgical dose plans were constructed that kept these cortical areas outside of the 30% isodose curves. We believe that the safety of supratentorial parenchymal radiosurgery will be enhanced by the localization of critical brain regions around the target.

Copyright © 1996 S. Karger AG, Basel

  Author Contacts

Douglas Kondziolka, MD, FRCS(C), Department of Neurological Surgery, Suite B-400, Presbyterian University Hospital, Pittsburgh, PA 15213 (USA)

  Article Information

Number of Print Pages : 6