A study to see if a type of MRI scan can help doctors planning surgery to treat brain tumours

Cancer type:

Brain (and spinal cord) tumours

Cancer spread to the brain

Secondary cancers

Status:

Results

Phase:

Pilot

This study looked at a type of MRI scan called functional MRI (fMRI) to see if it could help surgeons avoid important areas of the brain when operating.

If you have surgery to treat a brain tumour, the surgeon will aim to remove as much of the tumour as possible. The surgeon will try not to damage what doctors call 'eloquent brain regions'. These are very important areas of the brain that control sight, movement and speech.

Brain surgeons must find out whether the tumour is growing in any of these important areas before they operate. They can then decide how surgery will affect the person’s quality of life Open a glossary item and whether the benefits are greater than the risks involved. At the moment to do this they pass a small electric current through the brain tumour and around it to see if this affects things such as language or movement ('intra operative cortical stimulation' or ICS). But as the person has to be awake for this procedure, it can be distressing.

Researchers wanted to test a new way of finding out whether the tumour was growing in any of these important areas. They used a type of MRI scan called functional MRI (fMRI). These scans showed how eloquent brain regions use oxygen. An area of the brain lights up on the scan when the person moves their fingers or speaks, for example. If doctors could look at a scan to decide whether and how to carry out surgery it could prevent people having to be woken during surgery.

The main aim of this study was to see how useful fMRI was to map parts of the brain in these situations.

Summary of results

With the analysis of the results so far, the study team found that the functional MRI scan (fMRI) is useful to map important areas of the brain (the eloquent brain regions).

This was a pilot study. They wanted to recruit 70 people into 3 groups of

Healthy volunteers
People waiting to have surgery to remove their brain tumour
People having steroids to treat their brain tumour

The study stopped recruiting because the surgeon leading the study team retired unexpectedly. At this time the team had recruited 11 healthy volunteers and 23 people who were waiting to have surgery.

With the information from the 11 healthy volunteers’ fMRI, the study team were able to confirm the procedures needed for planning the surgery. They were also able to mark out more clearly where the eloquent brain regions might be.

Of the 23 people recruited into the surgery group, the team were able to obtain a full data set from 19. For 9 out of every 10 of these people a fMRI map was successfully created.

In 8 of them, the eloquent brain regions were not in the expected place. This was due to the tumour pushing the regions away but surgery could be done without waking the patients. The researchers knew that the eloquent regions were pushed away because the people’s behaviour was the same before surgery and afterwards.

9 people also underwent Intra operative Cortical Stimulation (ICS) during their surgery. The researchers did this to see how well the fMRI was able to map the eloquent regions compared to ICS. They found that they corresponded totally.

Although the study didn’t recruit the full number of people and the analysis of the results are still ongoing, the study team can conclude that fMRI is an accurate and reliable tool to map the eloquent regions surrounding brain tumours. They say that this means fMRI can be used routinely making surgery to remove brain tumours safer and cheaper. The study team are continuing to analyse the results. As more results become available we will update this summary.

We have based this summary on information from the team who ran the trial. As far as we are aware, the information they sent us has not been reviewed independently (peer reviewed Open a glossary item ) or published in a medical journal yet. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.