Clinical functional magnetic resonance imaging for pre-surgical planning--the Singapore General Hospital experience with the first 30 patients.

INTRODUCTION Functional magnetic resonance imaging (fMRI) is a neuroradiological technique for the localisation of cortical function. FMRI made its debut in cognitive neuroscience and then eventually to other clinical applications. We report our experience with pre-surgical fMRI on a high field scanner, based purely on a clinical platform. MATERIALS AND METHODS The protocols included motor, auditory, visual and language fMRI. The choice of protocols was dependant on clinical request and lesion locale. RESULTS Retrospective analysis and audit of the fi rst 30 consecutive patients over a 12-month period revealed that about 85% of patients had a successful examination. In a pictorial essay, we demonstrate that patients with weakness in performing a motor task showed abnormal activations of the pre-motor and supplementary motor areas. CONCLUSION FMRI data greatly enhances the pre-surgical planning process and the conduct of surgery when it is incorporated into the surgical navigation system in the operating theatre.