7 T and beyond: toward a synergy between fMRI-based presurgical mapping at ultrahigh magnetic fields, AI, and robotic neurosurgery release_burwpya7tfhp5iz4azkvkbdvfm

Abstract

<jats:title>Abstract</jats:title>Presurgical evaluation with functional magnetic resonance imaging (fMRI) can reduce postsurgical morbidity. Here, we discuss presurgical fMRI mapping at ultra-high magnetic fields (UHF), <jats:italic>i.e.</jats:italic>, ≥ 7 T, in the light of the current growing interest in artificial intelligence (AI) and robot-assisted neurosurgery. The potential of submillimetre fMRI mapping can help better appreciate uncertainty on resection margins, though geometric distortions at UHF might lessen the accuracy of fMRI maps. A useful trade-off for UHF fMRI is to collect data with 1-mm isotropic resolution to ensure high sensitivity and subsequently a low risk of false negatives. Scanning at UHF might yield a revival interest in slow event-related fMRI, thereby offering a richer depiction of the dynamics of fMRI responses. The potential applications of AI concern denoising and artefact removal, generation of super-resolution fMRI maps, and accurate fusion or coregistration between anatomical and fMRI maps. The latter can benefit from the use of T1-weighted echo-planar imaging for better visualization of brain activations. Such AI-augmented fMRI maps would provide high-quality input data to robotic surgery systems, thereby improving the accuracy and reliability of robot-assisted neurosurgery. Ultimately, the advancement in fMRI at UHF would promote clinically useful synergies between fMRI, AI, and robotic neurosurgery.<jats:bold>Relevance statement</jats:bold> This review highlights the potential synergies between fMRI at UHF, AI, and robotic neurosurgery in improving the accuracy and reliability of fMRI-based presurgical mapping.<jats:bold>Key points</jats:bold>• Presurgical fMRI mapping at UHF improves spatial resolution and sensitivity.• Slow event-related designs offer a richer depiction of fMRI responses dynamics.• AI can support denoising, artefact removal, and generation of super-resolution fMRI maps.• AI-augmented fMRI maps can provide high-quality input data to robotic surgery systems. <jats:bold>Graphical Abstract</jats:bold>
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