Human brain mapping using co-registered fUS, fMRI and ESM during awake brain surgeries: A proof-of-concept study

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 under -standing of hemodynamics-based functional brain imaging.

Automated summary

This study demonstrates the importance and potential of functional Ultrasound (fUS) in human brain imaging. By comparing with fMRI and Electrocortical Stimulation Mapping (ESM), it is shown that fUS can accurately reveal important functional regions and visualize microvascular morphology underlying hemodynamics.