It has been led by neuroradiologists from Bellvitge Hospital, IDI and IDIBELL.
Multidisciplinary unit of Bellvitge Hospital: expert in presurgical mapping techniques in high-risk patients who have to undergo neurosurgery.
A research led by the radiologist Àngels Camins and other neuroradiologists of the Bellvitge Hospital, the Institute of Diagnostic Imaging (IDI) and IDIBELL, which also involved the Neurosurgery Service of the Hospital de Bellvitge and the Unit of Cognition and Brain Plasticity of the UB and IDIBELL, will make it possible from now on to remove brain tumours better preserving a language area. The imaging technique allowing this describes, depending on the position and degree of the tumour, the type of displacement or destruction of a part of the brain directly related to the semantics and spelling.
The research was carried out as part of a programme at Bellvitge Hospital to apply advanced functional magnetic resonance imaging techniques to the care setting. The study has been published in the Journal of Neuroimaging, the official publication of the American Society of Neuroimaging.
The preservation of the language area during surgery is an essential factor in avoiding permanent neurological deficits and has an important impact on the patient's quality of life after surgery.
In this study, researchers have used MRI and, more specifically, the technique known as "diffusion tensor imaging" to better pinpoint how tumour grade and tumour location influence language areas.
The damage of this inferior fronto-occipital fascicle can cause the patient to deform or substitute words during speech. According to Dr Àngels Camins, thanks to the information provided by this study, "surgeons will be able to systematically and non-invasively identify this fascicle, helping to precisely define the limits of tumour resection". Functional MRI allows the non-invasive detection of physiological changes in the brain related to mental processes, for instance during the execution of a task. MRI images are obtained by using certain magnetic properties of matter and are based on the premise that, when a mental process occurs, the neurons involved require a greater amount of energy.
Bellvitge University Hospital started functional language studies through magnetic resonance imaging about twelve years ago, with the aim of carrying out the best possible pre-surgical planning in patients with tumours and vascular malformations presenting a high risk of postoperative deficits. For this reason, the multidisciplinary pre-surgical mapping unit was created, made up of neurosurgeons, neuroradiologists and neuropsychologists, and specific imaging study protocols were developed.
In this type of study, images are obtained while the patient is executing a specific language task. This makes it possible to identify the exact spot in the cerebral cortex where this activity takes place. These images are complemented by diffusion tensor imaging, which provides information on the brain fibres or tracts that connect the cortical areas obtained in the functional MRI. Dr Andreu Gabarrós, head of the Neurosurgery Department at Bellvitge Hospital and co-author of the study, stresses, "in addition to its usefulness in research and cognitive neurosciences, functional magnetic resonance imaging has become a fundamental tool in clinical practice to identify specific neurological functions and thus establish the best surgical trajectory to preserve these functions".
Reference article
Camins À, Naval-Baudin P, Majós C, Sierpowska J, Sanmillan JL, Cos M, Rodriguez-Fornells A, Gabarrós A. Inferior fronto-occipital fascicle displacement in temporoinsular gliomas using diffusion tensor imaging. J Neuroimaging. 2022 Mar 30. doi: 10.1111/jon.12992. Epub ahead of print. PMID: 35352437.