Review
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Clin Oncol. Jul 10, 2011; 2(7): 289-298
Published online Jul 10, 2011. doi: 10.5306/wjco.v2.i7.289
Cerebrovascular reactivity mapping for brain tumor presurgical planning
Domenico Zaca, Jun Hua, Jay J Pillai
Domenico Zaca, Jay J Pillai, Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, MD 21287, United States
Jun Hua, F.M. Kirby Research Center for Functional Brain Imaging, The Kennedy-Krieger Institute, 707 North Broadway, Baltimore, MD 21205, United States
Author contributions: Pillai JJ, Zaca D and Hua J contributed equally to this work; Pillai JJ, Zaca D and Hua J performed the research and wrote the paper.
Correspondence to: Jay J Pillai, MD, Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, 600 N. Wolfe Street, Phipps B-100, Baltimore, MD 21287, United States. jpillai1@jhmi.edu
Telephone: +1-410-9552353 Fax: +1-410-6141213
Received: June 2, 2011
Revised: June 23, 2011
Accepted: June 30, 2011
Published online: July 10, 2011
Abstract

This article provides a review of Blood Oxygen Level Dependent functional magnetic resonance imaging (BOLD fMRI) applications for presurgical mapping in patients with brain tumors who are being considered for lesion resection. Initially, the physical principle of the BOLD effect is discussed, followed by a general overview of the aims of presurgical planning. Subsequently, a review of sensorimotor, language and visual paradigms that are typically utilized in clinical fMRI is provided, followed by a brief description of studies demonstrating the clinical impact of preoperative BOLD fMRI. After this thorough introduction to presurgical fMRI, a detailed explanation of the phenomenon of neurovascular uncoupling (NVU), a major limitation of fMRI, is provided, followed by a discussion of the different approaches taken for BOLD cerebrovascular reactivity (CVR) mapping, which is an effective method of detecting NVU. We then include one clinical case which demonstrates the value of CVR mapping in clinical preoperative fMRI interpretation. The paper then concludes with a brief review of applications of CVR mapping other than for presurgical mapping.

Keywords: Blood oxygen level dependent; Brain tumor; Cerebrovascular reactivity; Functional magnetic resonance imaging; Neurovascular uncoupling; Presurgical