Interventional MRI Magnetoencephalography

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Presentation transcript:

Interventional MRI Magnetoencephalography Verification of Functional Imaging with Interventional MRI: Mapping of Epilepsy and Eloquent Cortex

Steven Stufflebeam, M.D. (MGH) Ronald Kikinis, M.D. (BWH) Partners Radiology Research Award

Interictal Spike Localization MEG This shows some of the information missing from the previous section: timing. In this case the propagation of a spike detected with MEG. Lower shows the classic way to find epileptic events:EEG. Looking at squiggles, but with a lot of information on the temporal patterns of spontaneous brain activity. No spieks in EEG, but a spike in MEG. Originally thought to be frontal lobe epilepsy

Brain Connectivity Structural Connectivity: DTI Tractography Greg Sorensen Functional Connectivity: BOLD fMRI Vincent & Buckner, 2006 Effective Connectivity: MEG dynamic SEM Fa-Hsuan Lin

Tumor, MEG, MRAngo, DTI fMRI Combining Advanced Imaging Technologies: Sum is greater than the Parts I’m often asked whats the next advancement in imaging, particularly MEG. Not a single innovation but a more rigorous integration of the existing technologies. Here is an image make from MEG from MGH and MRI at BWH, in collaboration with Ron Kikinis and Steve Pieper We’ve extracted information from each technology and put it into a common coordinate system. This is very simple to do, but can be extremely powerful. It shows how mapping points can be put relative to a tumor (green) an other vital structures (white matter tracks) How can we intelligently put these together? Including intraoperative mapping (often the goal standard, but it’s an arrest similar to tMS) Tumor, MEG, MRAngo, DTI fMRI Stephen Piper, Ph.D.

Language Mapping in Temporal Lobe Tumor T2 MRI Tumor Isopoential Field Maps (MEG) DTI MEG Dipole For Language Stimuli Dr. Alexandra Golby Dr. Ralph Suarez Dr. Ronald Kikinis. Dr. Stufflebeam C

Dr. Alex Golby Dr. Ralph Suarez. Dr. Stufflebeam Blue blobs represent MEG language localizations. Red blobs represent fMRI language localizations. Brown cords represent white matter tractography. Green blob represents the tumor lesion. Red tags represent intra-operative language mapping sites ascertained by intra-operative ECS. Note the regions where MEG and fMRI language overlap, these co-localizations were used as seeding points for tractography generation. Note the unsafe distance observed here between the tumor lesion and functional language systems. Dr. Alex Golby Dr. Ralph Suarez. Dr. Stufflebeam

Why is this research important? Translational research: bench to bedside. Multidisciplinary and cross-institutional: Physics, software engineering, mathematics, neurosurgery, neurology. Leverages the resources of the BWH & MGH to advance researchdirectly to patients/physicians. 250 epilepsy & brain tumor patients from MGH/BWH Awards at ISCAMEG, HBM, ISB HST.583 Imaging Biophysics & Clin Apps Grants R01, P41, K08, K25, CIMIT

Thanks BWH MGH/Martinos Center Ron Kikikis Stephen Piper Ferenc Jolesz Ralph Suarez Alexandra Golby Joseph Madsen Ed Bromfield Barabara Dworetzky Jong Lee Emad Eskandar Reese Cosgrove Andy Cole Ronan Kilbride Matti Hamalainen Fa-Hsuan Lin Greg Sorensen Randy Buckner Gordon Harris Giorgio Bonmassar