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

<p><b>INTRODUCTION</b>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.</p><p><b>MATERIALS AND METHODS</b>The protocols included motor, auditory, visual and language fMRI. The choice of protocols was dependant on clinical request and lesion locale.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>