1628. Postoperative Neurosurgical Complication Rates Using Resting State Versus Task-Based Functional MRI Preoperative Mapping
Authors * Denotes Presenting Author
  1. Anup Bhattacharya *; Mallinckrodt Institute of Radiology
  2. Eric Leuthardt; Mallinckrodt Institute of Radiology
  3. Joshua Shimony; Mallinckrodt Institute of Radiology
Pre-operative imaging is commonly performed for neurosurgical planning. The current standard of care is utilization of task-based fMRI (T-fMRI) for this purpose; however, resting state fMRI (rsfMRI) is gaining acceptance as a backup method when T-fMRI fails. Safety studies have not been performed to compare these methods. In the current study we aim to compare surgical complication rates between rsfMRI and T-fMRI in the pre-operative setting.

Materials and Methods:
A retrospective review of all neurosurgical cases pre-operatively imaged with both T-fMRI and rsfMRI ranging from January 2017 to March 2019 in our Department of Radiology was performed and included both tumor and epilepsy cases. Cases were selected in which the rsfMRI was used for surgical planning due to inadequate T-fMRI data. A chart review was performed to determine surgical complications of each case, which were subsequently classified according to their severity, and the obtained complication rates were compared with known rates in the literature. Other important case characteristics, including tumor pathology, pre-operative presenting signs and symptoms, lateralization of the pathology, extent of resection and treatment received were also noted, to ensure consistency of comparison with studies in the literature.

60 patients were included in the study. The mean age of all patients was 40.5 years, with a standard deviation of 23.2 years. 32 (53.5%) patients were male and 28 (46.7%) were female. 42 (70%) patients had pre-operative imaging in the setting of brain tumors while 18 (30%) had imaging performed in the setting of epilepsy. The most common pathology was glioblastoma multiforme and the most common presenting sign was seizures, seen in 53.3% of patients. Overall, the total surgical complication rate was 11.5%, with 14.3% seen in the tumor arm and 5.6% seen in the epilepsy group. The average total surgical complication rate across multiple otherwise comparable fMRI-using studies in the literature was 12.2%, ranging from 0% to 33.3%.

Our study demonstrates a comparable surgical complication rate when rsfMRI is used in the pre-operative setting as compared to T-fMRI, lending support to the use of rsfMRI for surgical planning in the future.