Abstract
While resting state fMRI (rs-fMRI) has gained widespread application in neuroimaging clinical research, its penetration into clinical medicine has been more limited. We surveyed a neuroradiology professional group to ascertain their experience with rs-fMRI, identify perceived barriers to using rs-fMRI clinically and elicit suggestions about ways to facilitate its use in clinical practice. The electronic survey also collected information about demographics and work environment using Likert scales. We found that 90% of the respondents had adequate equipment to conduct rs-fMRI and 82% found rs-fMRI data easy to collect. Fifty-nine percent have used rs-fMRI in their past research and 72% reported plans to use rs-fMRI for research in the next year. Nevertheless, only 40% plan to use rs-fMRI in clinical practice in the next year and 82% agreed that their clinical fMRI use is largely confined to pre-surgical planning applications. To explore the reasons for the persistent low utilization of rs-fMRI in clinical applications, we identified barriers to clinical rs-fMRI use related to the availability of robust denoising procedures, single-subject analysis techniques, demonstration of functional connectivity map reliability, regulatory clearance, reimbursement, and neuroradiologist training opportunities. In conclusion, while rs-fMRI use in clinical neuroradiology practice is limited, enthusiasm appears to be quite high and there are several possible avenues in which further research and development may facilitate its penetration into clinical practice.
Highlights
Techniques for quantifying spatial and temporal brain activity have developed rapidly since the first demonstrations that MRI could be used to measure modulations in blood oxygen level dependent (BOLD) tissue contrast [1]
The observation that MRI could be used to monitor temporally correlated low-frequency activity fluctuations in spatially remote brain areas led to widespread use of resting state functional magnetic resonance imaging to evaluate resting state network (RSN) properties
After obtaining a human subjects research exemption, an invitation to participate in a 20 item electronic survey was sent to American Society for Functional Neuroradiology (ASFNR) members to collect information concerning their use of resting state functional magnetic resonance imaging (rs-fMRI) in clinical research and practice, demographics, and work environment
Summary
Techniques for quantifying spatial and temporal brain activity have developed rapidly since the first demonstrations that MRI could be used to measure modulations in blood oxygen level dependent (BOLD) tissue contrast [1]. The observation that MRI could be used to monitor temporally correlated low-frequency activity fluctuations in spatially remote brain areas led to widespread use of resting state functional magnetic resonance imaging (rs-fMRI) to evaluate resting state network (RSN) properties. While BOLD-contrast is an indirect measure of neural activity, similar inter-regional coherent spontaneous neural activity correlations have been observed with electrophysiological techniques [2], suggesting that rs-fMRI networks can provide useful information about the macroscopic organization of neural processing systems. 10,000 rs-fMRI papers are currently listed in PubMed. The most rapidly developing type of functional connectivity research involves investigations of disease-related group differences
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