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James P. O'Shea
Graduate Student

University of California, Berkeley
Vision Science Program
Visualization Lab
Banks Lab
505 Minor Hall
University of California, Berkeley
Berkeley, CA 94720-2020

joshea (at) cs.berkeley.edu

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Integrated image- and function-guided surgery in eloquent cortex: a technique report

James P. O’Shea, Stephen Whalen, Daniel M. Branco, Nicole M. Petrovich, Kyle E. Knierim, Alexandra J. Golby

The ability to effectively identify eloquent cortex in close proximity to brain tumours is a critical component of surgical planning prior to resection. The use of electrocortical stimulation testing (ECS) during awake neurosurgical procedures remains the gold standard for mapping functional areas, yet the preoperative use of non-invasive brain imaging techniques such as fMRI are gaining popularity as supplemental surgical planning tools. In addition, the intraoperative three-dimensional display of fMRI findings co-registered to structural imaging data maximizes the utility of the preoperative mapping for the surgeon. Advances in these techniques have the potential to limit the size and duration of craniotomies as well as the strain placed on the patient, but more research accurately demonstrating their efficacy is required. In this paper, we demonstrate the integration of preoperative fMRI within a neuronavigation system to aid in surgical planning, as well as the integration of these fMRI data with intraoperative ECS mapping results into a threedimensional dataset for the purpose of cross-validation.

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Left: Offline view from the 3D Slicer application of the data for patient 4, including fMRI activation from the active left-hand motor task (blue). Positive ECS sites are depicted in red, negative ECS sites are green and electrodes are yellow. The tumour is not visible in this rendering because the cortical surface is opaque. Right: Offline view from the 3D Slicer application of the data for patient 4, with only the local maximum of the fMRI activation (blue) displayed from the active left-hand motor task. Because the local maximum was several millimetres below the cortical surface, the model of the cortical surface was rendered to be transparent, revealing the lesion (pink mass). The positive ECS sites are depicted in red, negative ECS sites in green and electrodes in yellow.


Research Paper: PDF

Integrated image- and function-guided surgery in eloquent cortex: a technique report
James P. O’Shea, Stephen Whalen, Daniel M. Branco, Nicole M. Petrovich, Kyle E. Knierim, Alexandra J. Golby
International Journal of Medical Robotics and Computer-Assisted Surgery
2006; 2: 75-83.