Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Nov 2014
ReviewThe economics of functional magnetic resonance imaging: clinical and research.
It is difficult to justify maintaining a clinical functional magnetic resonance imaging (fMRI) program based solely on revenue generation. The use of fMRI is, therefore, based mostly in patient care considerations, leading to better outcomes. The high costs of the top-of-the-line equipment, hardware, and software needed for state-of-the-art fMRI and the time commitment by multiple professionals are not adequately reimbursed at a representative rate by current payor schemes for the Current Procedure Terminology codes assigned.
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Neuroimaging Clin. N. Am. · Nov 2014
ReviewMemory assessment in the clinical context using functional magnetic resonance imaging: a critical look at the state of the field.
The use of functional magnetic resonance imaging to map language and sensorimotor regions in the brain is rapidly becoming a clinical standard in neurosurgical centers. Despite a wealth of cognitive neuroscience data showing focal medial temporal activation elicited by memory encoding and retrieval tasks in controls, translating such findings to generate reliable metrics for clinical use has been slow. The current review documents some of the successes that have been achieved, using both activation and resting-state functional connectivity in the clinical context of temporal lobe epilepsy, and discusses some of the challenges that remain to be addressed.
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Neuroimaging Clin. N. Am. · Nov 2014
ReviewResting-state blood oxygen level-dependent functional magnetic resonance imaging for presurgical planning.
Resting-state functional MR imaging (rsfMR imaging) measures spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signal and can be used to elucidate the brain's functional organization. It is used to simultaneously assess multiple distributed resting-state networks. ⋯ This article presents a brief introduction of rsfMR imaging processing methods followed by a detailed discussion on the use of rsfMR imaging in presurgical planning. Example cases are provided to highlight the strengths and limitations of the technique.
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Neuroimaging Clin. N. Am. · Nov 2014
ReviewPreoperative diffusion tensor imaging: improving neurosurgical outcomes in brain tumor patients.
Preoperative mapping has revolutionized neurosurgical care for brain tumor patients. Maximizing resections has improved diagnosis, optimized treatment algorithms, and decreased potentially devastating postoperative deficits. ⋯ A thorough understanding of DTI, data visualization methods, and limitations with mastery of functional and dysfunctional white matter anatomy is necessary to realize the potential of DTI. By establishing spatial relationships between lesion borders and functional networks preoperatively and intraoperatively, DTI is central to high-risk neurosurgical resections and becoming the standard of care.