Perimetric visual field and functional MRI correlation: implications for image-guided surgery in occipital brain tumours

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 71; no. 4; pp. 505 - 514
• Main Authors: Roux, F-E, Ibarrola, D, Lotterie, J-A, Chollet, F, Berry, I
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.10.2001; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Abnormalities; Adult; Aged; Biological and medical sciences; Biopsy; Brain cancer; Brain Neoplasms - physiopathology; Brain Neoplasms - surgery; Brain tumors; Clinical medicine; Defects; Female; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Investigative techniques, diagnostic techniques (general aspects); Magnetic fields; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Nervous system; neuronavigation; Occipital Lobe - physiopathology; Occipital Lobe - surgery; occipital tumour; Patient Care Planning; Patients; perimetric evaluation; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Stereotaxic Techniques; Suprachiasmatic Nucleus - physiopathology; Suprachiasmatic Nucleus - surgery; Surgery; Tumors; User-Computer Interface; Visual cortex; Visual Cortex - physiopathology; Visual Cortex - surgery; Visual Field Tests; Visual fields; Visual Fields - physiology; Volunteers; United Kingdom; Human; Nervous system diseases; Visual cortex; Navigation; Indication; Technical assistance; Surgical resection; Perimetry; Nuclear magnetic resonance imaging; Cerebral disorder; Occipital lobe; Guidance; Eye disease; Visual field disease; Surgery; Central nervous system disease; Medical imagery; Tumor; Technique; Comparative study; Functional imaging
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.71.4.505

OBJECTIVE To compare the results of visual functional MRI with those of perimetric evaluation in patients with visual field defects and retrochiasmastic tumours and in normal subjects without visual field defect. The potential clinical usefulness of visual functional MRI data during resective surgery was evaluated in patients with occipital lobe tumours. METHODS Eleven patients with various tumours and visual field defects and 12 normal subjects were studied by fMRI using bimonocular or monocular repetitive photic stimulation (8 Hz). The data obtained were analyzed with the statistical parametric maps software (p<10-8) and were compared with the results of Goldmann visual field perimetric evaluation. In patients with occipital brain tumours undergoing surgery, the functional data were registered in a frameless stereotactic device and the images fused into anatomical three standard planes and three dimensional reconstructions of the brain surface. RESULTS Two studies of patients were discarded, one because of head motion and the other because of badly followed instructions. On the remaining patients the functional activations found in the visual cortex were consistent with the results of perimetric evaluation in all but one of the patients and all the normal subjects although the results of fMRI were highly dependent on the choices of the analysis thresholds. Visual functional MRI image guided data were used in five patients with occipital brain tumours. No added postoperative functional field defect was detected. CONCLUSIONS There was a good correspondence between fMRI data and the results of perimetric evaluation although dependent on the analysis thresholds. Visual fMRI data registered into a frameless stereotactic device may be useful in surgical planning and tumour removal.