Presurgical language fMRI: Technical practices in epilepsy surgical planning
Presurgical language fMRI: Technical practices in epilepsy surgical planning
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DOI：
10.1002/hbm.24229
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发表时间：
2018-10-01
影响因子：
4.8
通讯作者：
Spencer, Dennis D.
中科院分区：
文献类型：
--
作者：
Benjamin, Christopher F. A.;Dhingra, Isha;Spencer, Dennis D.
尽管语言功能磁共振成像（fMRI）被广泛使用，但其在临床实践中的应用却知之甚少。在这里，我们全面记录了其在癫痫手术计划中的执行情况。一份调查问卷侧重于认知设计，图像采集，分析和解释，和实际的考虑。个人负责收集，分析，并解释临床语言功能磁共振成像数据在63癫痫手术计划作出回应。中心的发现是在功能磁共振成像的各个方面的显着异质性。大多数程序使用多个任务，五分之一经常使用2，3，4，或5个任务的模态运行时间为5分钟。超过15个协议的变体是在日常使用的形式名词-动词生成，语言流畅性，和语义决策最常用的。数据采集和分析的几乎所有方面都有明显的不同。两个最有效的协议都没有被超过10%的受访者使用。预处理步骤在各个站点之间大致一致，语言相关的血流最常使用一般线性模型（76%的受访者）进行识别，统计阈值通常因患者而异（79%）。SPM是最常用的软件。功能磁共振成像程序不一致地包括来自具有所有所需技能（成像，认知评估，MR物理，统计分析和脑行为关系）的专家的输入。这些数据突出了支持功能磁共振成像的证据与其临床应用之间的明显差距。执行语言功能磁共振成像的团队可能会受益于参考迄今为止最有效的协议来评估实践，并确保在功能磁共振成像的各个方面接受过培训的个人参与优化患者护理。
Little is known about how language functional MRI (fMRI) is executed in clinical practice in spite of its widespread use. Here we comprehensively documented its execution in surgical planning in epilepsy. A questionnaire focusing on cognitive design, image acquisition, analysis and interpretation, and practical considerations was developed. Individuals responsible for collecting, analyzing, and interpreting clinical language fMRI data at 63 epilepsy surgical programs responded. The central finding was of marked heterogeneity in all aspects of fMRI. Most programs use multiple tasks, with a fifth routinely using 2, 3, 4, or 5 tasks with a modal run duration of 5 min. Variants of over 15 protocols are in routine use with forms of noun-verb generation, verbal fluency, and semantic decision-making used most often. Nearly all aspects of data acquisition and analysis vary markedly. Neither of the two best-validated protocols was used by more than 10% of respondents. Preprocessing steps are broadly consistent across sites, language-related blood flow is most often identified using general linear modeling (76% of respondents), and statistical thresholding typically varies by patient (79%). The software SPM is most often used. fMRI programs inconsistently include input from experts with all required skills (imaging, cognitive assessment, MR physics, statistical analysis, and brain-behavior relationships). These data highlight marked gaps between the evidence supporting fMRI and its clinical application. Teams performing language fMRI may benefit from evaluating practice with reference to the best-validated protocols to date and ensuring individuals trained in all aspects of fMRI are involved to optimize patient care.