Case Report

Functional MRI in pre-surgical planning: Case study and cautionary notes

Bruce S Spottiswoode, S Du Plessis, Armin Gretschel, Jan W Lotz
South African Journal of Radiology | Vol 16, No 3 | a293 | DOI: | © 2012 Bruce S Spottiswoode, S Du Plessis, Armin Gretschel, Jan W Lotz | This work is licensed under CC Attribution 4.0
Submitted: 24 February 2012 | Published: 10 September 2012

About the author(s)

Bruce S Spottiswoode, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, University of Cape Town, and Division of Radiology, Stellenbosch University, South Africa
S Du Plessis, Division of Psychiatry, Stellenbosch University, South Africa
Armin Gretschel, Division of Neurosurgery, Stellenbosch University, South Africa
Jan W Lotz, Division of Radiodiagnosis, Stellenbosch University, South Africa


Background. Since its inception almost 20 years ago, functional magnetic resonance imaging (fMRI) has greatly advanced our knowledge of human brain function. Although the clinical applications of fMRI are still limited, there have recently been encouraging advances for its use in pre-operative functional cortical mapping to identify potentially eloquent areas prior to neurosurgery.

Objectives. We explore the potential use of this emerging technique by presenting a neurosurgical case study, as performed at the Cape Universities Brain Imaging Centre (CUBIC), Tygerberg, Cape Town. We conclude with a brief summary of the potential pitfalls of this technique, as well as cautionary guidelines based on our experience.

Methods and results. A 22-year-old male patient from Tygerberg Hospital underwent the successful resection of an anaplastic astrocytoma after fMRI presurgical planning at our facility. The subject was able to leave the ward unassisted.

Conclusion. If consideration is given to the many limitations of this emerging technique, fMRI can be useful in aiding the neurosurgeon in pre-operative planning of his surgical approach.


fMRI; Neurosurgical planning


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