Human brain mapping using co-registered fUS, fMRI and ESM during awake brain surgeries: A proof-of-concept study
Sadaf Soloukey, Ellen Collée, Luuk Verhoef, Djaina Satoer, Clemens M.F. Dirven, Eelke M. Bos, Joost W. Schouten, Bastian S. Generowicz, Frits Mastik, Chris I. De Zeeuw, Sebastiaan K. E. Koekkoek, Arnaud J.P.E. Vincent, Marion Smits, Pieter Kruizinga
Abstract
• Functional Ultrasound (fUS) is a promising new functional brain imaging technique. • No in-human comparison between fUS-, fMRI- or ESM-maps is available as of yet. • We performed unique multimodal brain imaging experiments on awake craniotomy patients. • fUS shows the same functional maps as ESM and fMRI. • fUS concomitantly visualizes in-vivo microvascular morphology at high penetrative depth. Accurate, depth-resolved functional imaging is key in both understanding and treatment of the human brain. A new sonography-based imaging technique named functional Ultrasound (fUS) uniquely combines high sensitivity with submillimeter-subsecond spatiotemporal resolution available in large fields-of-view. In this proof-of-concept study we show that: (A) fUS reveals the same eloquent regions as found by fMRI while concomitantly visualizing in-vivo microvascular morphology underlying these functional hemodynamics and (B) fUS-based functional maps are confirmed by Electrocortical Stimulation Mapping (ESM), the current gold-standard in awake neurosurgical practice. This unique cross-modality experiment was performed using motor, visual and language-related functional tasks in patients undergoing awake brain tumor resection. The current work serves as an important milestone towards further maturity of fUS as well as a novel avenue to increase our understanding of hemodynamics-based functional brain imaging.