Physiologic imaging techniques such as BOLD fMRI and DTI have generated considerable excitement for their potential clinical applications. However, the translation of such technologies to clinical practice is often laden with significant unanticipated obstacles, caused by the unique conditions of disease. Like many other imaging techniques, fMRI and DTI were developed by imaging scientists using normal brain systems as a model and adapted for clinical use in abnormal brains by physicians and other clinical scientists. Yet, physiological techniques are especially sensitive to environmental conditions brought about by disease. Inherent limitations of the techniques and the interactions between normal and diseased brain environments will all impact the performance of a physiological parameter for a given disease application. Thus, the diseased brain can be considered a bio-system separate from normal for which each physiological technique can be adapted. Successful clinical translation requires an understanding of physical and physiological principals underlying the techniques, normal brain physiology and function, adaptive brain mechanisms, and the impact of disease on the very physiologic parameters sought by the new techniques. As there are invariably unknown influences of disease present, physiologic imaging techniques developed for clinical applications are likely to produce imperfect bio-parameters. The presentation here describes some of the complexities of translating functional brain mapping techniques (fMRI and DTI) for purposes of presurgical planning, and by way of analogy, is intended to illustrate challenges generally faced by clinicians adapting physiologic techniques to study brain disease. Despite imperfect presurgical functional imaging parameters, a strategy of functional imaging data integration, and congruence, with other parameters of neurological function and disease can be employed to significantly impact treatment planning of patients with surgical brain lesions.
Ulmer, J,
Neuroradiology/Head and Neck Keynote Speaker: Translating Functional Brain Imaging For Disease-specific Biosystems. Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL.
http://archive.rsna.org/2005/4420537.html
