Presurgical Functional Magnetic Resonance Imaging (fMRI)

Preoperative functional magnetic resonance imaging (fMRI) permits noninvasive measurement, localization and lateralization of important functions of the human brain in patients with brain tumors, facilitating selection of the least harmful treatment and surgery which preserves function. Preoperative fMRI of motor and language function can be performed when reliably proven clinical imaging protocols are used. Standardization of the respective imaging procedures is essential to the diagnostic use of fMRI. However, fMRI cannot be considered a fully established method of diagnostic neuroimaging due to a lack of recommendations or guidelines from the relevant medical associations, and also the lack of medical licensing of important hardware and software components. This article reviews current research in the field and provides the reader with the practical information necessary to perform presurgical fMRI.ZusammenfassungDie prächirurgische funktionelle Magnetresonanztomographie (fMRT) ermöglicht die nichtinvasive Messung, Lokalisation und Lateralisation wichtiger Hirnfunktionen vor Operationen an Hirntumoren. Dies erleichtert die Auswahl der schonendsten Therapie und ein funktionserhaltendes Operieren. Mit klinisch erprobten Untersuchungsprotokollen ist die prächirurgische fMRT für Motorik und Sprache zuverlässig durchführbar. Voraussetzung für die diagnostische Anwendung ist eine technisch-methodische Standardisierung. Wegen fehlender Empfehlungen oder Richtlinien der zuständigen medizinischen Fachgesellschaften und fehlender Zulassung wichtiger Hard- und Softwarekomponenten ist die fMRT noch keine abschließend etablierte Methode der klinischen MR-Bildgebung. Dieser Artikel fasst den gegenwärtigen Wissensstand zusammen und beinhaltet die nötige praktische Information zur Durchführung der prächirurgischen fMRT-Diagnostik.

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