Abstract
The functional mapping of brain activity is essential to perform optimal glioma surgery and to minimize the risk of postoperative deficits. We introduce a new, portable neuroimaging modality of the human brain based on functional ultrasound (fUS) for deep functional cortical mapping. Using plane-wave transmissions at an ultrafast frame rate (1 kHz), fUS is performed during surgery to measure transient changes in cerebral blood volume with a high spatiotemporal resolution (250 µm, 1 ms). fUS identifies, maps and differentiates regions of brain activation during task-evoked cortical responses within the depth of a sulcus in both awake and anaesthetized patients.
Highlights
Functional neuro-imaging during surgery would be highly beneficial, none of these techniques provides a simple and portable intraoperative brain imaging modality within the depth of a sulcus
This study provides a proof of concept that ultrasound can map brain activation in humans based on our experience with 33 adults (19 women, 14 men, aged 24–64 years, mean 42 years)
All patients had low-grade gliomas and were included because intraoperative functional mapping was planned in the removal of their tumours
Summary
Functional neuro-imaging during surgery would be highly beneficial, none of these techniques provides a simple and portable intraoperative brain imaging modality within the depth of a sulcus. Functional ultrasound (fUS) was developed[10] This technique allows for high spatiotemporal resolution imaging (250 μm, 1 ms) of brain microvasculature dynamics in response to brain activation without the need for a contrast agent. This fUS method relies on a new, ultrasensitive power Doppler imaging sequence that is sensitive enough to detect blood flow in most cerebral vessels (down to ~1 mm.s−1 blood flow speed). The repeated acquisition of such ultrasensitive Doppler images over time allows for the visualization of flow dynamics in the vessels that are modulated by local neuronal activity This new sequence is derived from the key concept of ultrafast imaging[11], which is based on the emission of very high frame rate ultrasonic plane waves (~20 kHz). We adapted and implemented this new modality intraoperatively in humans
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