From the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas.
Medical Physics Graduate Program (J.M.T.), The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas.
AJNR Am J Neuroradiol. 2024 Nov 7;45(11):1798-1804. doi: 10.3174/ajnr.A8383.
BACKGROUND AND PURPOSE: Patients with brain tumors have high intersubject variation in putative language regions, which may limit the utility of straightforward application of healthy subject brain atlases in clinical scenarios. The purpose of this study was to develop a probabilistic functional brain atlas that consolidates language functional activations of sentence completion and Silent Word Generation language paradigms using a large sample of patients with brain tumors. MATERIALS AND METHODS: The atlas was developed using retrospectively collected fMRI data from patients with brain tumors who underwent their first standard-of-care presurgical language fMRI scan at our institution between July 18, 2015, and May 13, 2022. Three hundred seventeen patients (861 fMRI scans) were used to develop the language functional atlas. An independent presurgical language fMRI data set of 39 patients with brain tumors from a previous study was used to evaluate our atlas. Family-wise error-corrected binary functional activation maps from sentence completion, letter fluency, and category fluency presurgical fMRI were used to create probability overlap maps and pooled probabilistic overlap maps in Montreal Neurological Institute standard space. The Wilcoxon signed-rank test was used to determine a significant difference in the maximum Dice coefficient for our atlas compared with a meta-analysis-based template with respect to expert-delineated primary language area activations. RESULTS: Probabilities of activating the left anterior primary language area and left posterior primary language area in the temporal lobe were 87.9% and 91.5%, respectively, for sentence completion, 88.5% and 74.2%, respectively, for letter fluency, and 83.6% and 67.6%, respectively, for category fluency. Maximum Dice coefficients for templates derived from our language atlas were significantly higher than the meta-analysis-based template in the left anterior primary language area (0.351 and 0.326, respectively, < .05) and the left posterior primary language area in the temporal lobe (0.274 and 0.244, respectively, < .005). CONCLUSIONS: Brain tumor patient- and paradigm-specific probabilistic language atlases were developed. These atlases had superior spatial agreement with fMRI activations in individual patients compared with the meta-analysis-based template.
背景与目的:脑肿瘤患者在假定的语言区域存在较高的个体间变异性,这可能限制了在临床环境中直接应用健康受试者脑图谱的效用。本研究的目的是开发一种概率功能脑图谱,该图谱整合了句子完成和无声单词生成语言范式的语言功能激活,使用大量脑肿瘤患者的样本。
材料与方法:该图谱是使用我们机构 2015 年 7 月 18 日至 2022 年 5 月 13 日期间首次接受标准术前语言 fMRI 扫描的脑肿瘤患者的回顾性采集 fMRI 数据开发的。317 名患者(861 次 fMRI 扫描)用于开发语言功能图谱。使用来自先前研究的 39 名脑肿瘤患者的独立术前语言 fMRI 数据集来评估我们的图谱。从句子完成、字母流畅性和类别流畅性术前 fMRI 获得的经家族-wise 错误校正的二进制功能激活图用于在 Montreal Neurological Institute 标准空间中创建概率重叠图和汇总概率重叠图。使用 Wilcoxon 符号秩检验确定我们的图谱与基于元分析的模板相比,在专家划定的主要语言区域激活方面的最大 Dice 系数差异的显著性。
结果:句子完成时,左侧前主要语言区和左侧后主要语言区的激活概率分别为 87.9%和 91.5%,字母流畅性分别为 88.5%和 74.2%,类别流畅性分别为 83.6%和 67.6%。来自我们语言图谱的模板的最大 Dice 系数在左侧前主要语言区(分别为 0.351 和 0.326,均<0.05)和左侧后主要语言区在颞叶(分别为 0.274 和 0.244,均<0.005)明显高于基于元分析的模板。
结论:开发了脑肿瘤患者和范式特异性概率语言图谱。与基于元分析的模板相比,这些图谱与个体患者的 fMRI 激活具有更高的空间一致性。
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