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Weier Li, Scott D. Wait, Robert J. Ogg, Matt A. Scoggins, Ping Zou, James Wheless, and Frederick A. Boop

F unctional MRI identifies eloquent cortex via changes in blood oxygenation. Evidence showing the value of this powerful tool in presurgical planning is mounting, particularly in patients with intractable epilepsy or mass lesions. Typically, fMRI requires patients to cooperate with neuropsychological tasks during imaging acquisition, so its use may be restricted in children who are unwilling or unable to cooperate. Consequently, fMRI is rarely performed in young children. An fMRI paradigm that could be performed successfully in sedated children would

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Jingwen Hu, Xin Jin, Jong B. Lee, Liying Zhang, Vipin Chaudhary, Murali Guthikonda, King H. Yang, and Albert I. King

resection and gravitationally above the surgical site. 6 , 12 To improve surgical accuracy, MR imaging systems have been used to visualize intraoperative brain shift. However, the resolution of existing intraoperative MR imaging systems is relatively low, the associated costs are very high, and the current systems cannot be used as a presurgical planning tool. Given these shortcomings, numerical models designed to estimate intraoperative brain shift are viable alternatives to improve surgical outcomes at a very low cost. Finite element modeling is the most suitable

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Cary D. Alberstone, Stephen L. Skirboll, Edward C. Benzel, John A. Sanders, Blaine L. Hart, Nevan G. Baldwin, Charles L. Tessman, John T. Davis, and Roland R. Lee

was. When MS imaging revealed that the central sulcus had been displaced far anterior to the neoplasm and that the tumor was reasonably distant from functional cortex, the patient's surgeon, who initially was reluctant to subject the patient to surgery, chose to undertake an operation to resect the tumor. The surgical resection was performed safely and without complication. Although MS imaging is most commonly used in the presurgical planning stage, MS images may be used intraoperatively, in conjunction with a frameless or standard stereotactic system, to help guide

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Daiana R. Pur, Roy Eagleson, Marcus Lo, Michael T. Jurkiewicz, Andrea Andrade, and Sandrine de Ribaupierre

resting-state networks (RSNs) that can be obtained by applying functional connectivity analyses to rs-fMRI data. Interestingly, there is evidence that RSNs and task-based fMRI activation maps show similar topologies with high correspondence, suggesting that task activation is already contained in the more comprehensive rs-fMRI data. 14 Several studies have investigated the use of rs-fMRI in presurgical planning in adults with epilepsy or brain tumors, with favorable concordance with conventional methods. 15 , 16 Even though there are limited reports of rs-fMRI brain

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Sergio Paolini, Giuseppe Lanzino, Claudio Colonnese, Eugenio Venditti, Giampaolo Cantore, and Vincenzo Esposito

Dural arteriovenous fistulas (DAVFs) with pure leptomeningeal drainage may be cured by simple interruption of their venous side. This report illustrates the cases of 3 patients undergoing surgery for fistulas classified as Borden Type III, involving the posterior cranial fossa. Preoperatively, the surgical anatomy of these lesions was investigated with 3D reformatting of multislice CT angiography, in addition to conventional angiography. Reformatted images clarified the surgical anatomy of the malformation. Reconstructing both the osseous and the vascular structures and simulating the surgical orientation allowed localization of the dural takeoff point of the DAVF's drainage, showing its relationship with osseous landmarks. Precise localization of the DAVF's drainage may help in choosing the most direct and effective approach to treat the malformation. The reported cases could be treated with a standard retrosigmoid exposure, avoiding the need for more complex cranial base approaches.

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Eduardo Caverzasi, Shawn L. Hervey-Jumper, Kesshi M. Jordan, Iryna V. Lobach, Jing Li, Valentina Panara, Caroline A. Racine, Vanitha Sankaranarayanan, Bagrat Amirbekian, Nico Papinutto, Mitchel S. Berger, and Roland G. Henry

resection 8 , 26 with preservation of quality of life and neurological function. Complex functions, such as language, are subserved by a multicomponent organization consisting of ventral and dorsal pathways. 11 , 16 To reduce postoperative morbidity, increasing effort has been made to spare key white matter pathways underlying large-scale networks. To accomplish this, the precise characterization of white matter organization is crucial during presurgical planning. The model generated by fiber tractography with diffusion tensor imaging (DTI), which represents the

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Hillary Shurtleff, Molly Warner, Andrew Poliakov, Brian Bournival, Dennis W. Shaw, Gisele Ishak, Tong Yang, Mahesh Karandikar, Russell P. Saneto, Samuel R. Browd, and Jeffrey G. Ojemann

younger (age 5 or 6 years) and developmentally younger (3-year-old age equivalent) patients by using a variety of preparation and cooperation-enhancing strategies. Methods Patient Population Patients were identified by a review of the fMR images obtained for clinical, presurgical planning purposes at Seattle Children's Hospital. Studies obtained in all patients 8 years of age or younger who had undergone fMR imaging between 2005 and 2007 were reviewed. Patients were excluded from undergoing clinical fMR imaging for the following reasons: 1) language and

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Eric H. Hanson, Rahul K. Mishra, David S. Chang, Thomas G. Perkins, Daniel R. Bonifield, Richard D. Tandy, Peter E. Cartwright, Randal R. Peoples, and William W. Orrison Jr.

assessment of the whole spine on MR imaging. An accompanying coronal view of the lumbosacral junction by MR imaging or Ferguson view radiograph can be added for clinical indications or for presurgical planning purposes. Methods Patient Population This retrospective and anonymized study of MR images that were obtained for clinical purposes was performed with exemption approval from the institutional review board, and was in compliance with the Health Insurance Portability and Accountability Act. Personal information that would identify the patient was not

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Giovanni Raffa, Maria Catena Quattropani, and Antonino Germanò

structural organization at a cortical, subcortical, and molecular level. In many cases these data are essential prior to brain tumor surgery, especially for defining a customized presurgical plan based on the spatial relationship between the tumor and the surrounding important anatomical landmarks. Nevertheless, the recent hodotopic revolution disclosed the complexity of the brain’s functional organization. 6 Anatomical landmarks are important of course, but they do not always correspond to the hypothesized neurological functions, especially because of the possibility of

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Domenico Zacà, Jorge Jovicich, Francesco Corsini, Umberto Rozzanigo, Franco Chioffi, and Silvio Sarubbo

available to the neuroimaging community (e.g., AFNI, SPM, and FSL), it is possible to perform preoperative localization of critical cortical eloquent area for presurgical planning. 18 , 31 , 40 However, the setup of a clinical rs-fMRI analysis pipeline requires considering the following methodological and practical issues. 1) Multiple data QC parameters should be provided, including a) the determination of rs-fMRI volume outliers due to head motion, physiology, or hardware; 16 b) the quality of the coregistration between functional and structural MR images; 26 and c