Advanced Brain Tumor Mapping

Advancements in MRI make it possible to evaluate the location of brain tumors based upon neuroanatomical and neurofunctional information far beyond what is available by conventional MRI examinations. Nebraska Medicine neuroradiology has established a program to perform advanced brain tumor mapping in order to map gray matter function, the white matter pathways and how these relate to brain tumors or other masses.  Functional cortex is determined utilizing functional MRI (fMRI).  The complex white matter tracts are mapped out utilizing diffusion tensor imaging (DTI) techniques.  We work closely with neurosurgery, neurology, and neuropsychology to determine the significance and utility of our findings.

There are numerous reasons that functional mapping should be performed if you have a brain tumor.  Brain tumors often distort the brain and this can make it not possible to determine exactly where functional brain tissue lies.  Also, functional brain tissue can reorganize (change position) in the presence of a brain tumor.   Advanced neuroanatomical and neurofunctional information can be vital in order to optimize decisions about treatment options.  This information helps clinicians decide if surgery is possible, if a total resection can be attempted, and how to approach the resection. 

Utilizing advance neuroanatomical and neurofunctional information intra-operatively can help realize a surgical resection with the greatest preservation of function possible.  At Nebraska Medicine, neuroradiology helps make this possible.  We not only generate advanced neuroanatomical and neurofunctional information but are able to export this data into the operating room for use by the neurosurgeons.  The functional brain maps are merged onto high resolution anatomical images of the brain so that the functional tissues relationships to the underlying brain tumor can be easily demonstrated.

Our team has extensive experience utilizing these techniques.  Experience is a critical factor when applying these techniques and maximizes utilization and outcomes.  We are constantly comparing our data to intra-operative findings and post-operative functional outcomes.  We keep our fMRI paradigms and DTI sequences optimized via literature review and MRI equipment optimization.  Advanced mapping doesn’t guarantee functional preservation but it helps to optimize it.  In many circumstances advanced brain functional mapping is often the only way one may gain a better estimation on what functions should be expected to be preserved and a clearer understanding of what functional losses may occur with surgery.