Authors :
Presenting Author: Subhan Ahmed Khan, MD – Westchester Medical Center Health Network
Shoaib Syed, BA – New York Medical College
Ariel Sacknovitz, MS – New York Medical College
Preeti Puntambekar, MD, PhD, FACNS, FAES – Westchester Medical Center Health Network, New York Medical College, Valhalla, NY, USA
Vishad Sukul, MD, FAANS, FCNS – Westchester Medical Center Health Network
Manisha Holmes, MD, FAES – Westchester Medical Center Health Network
Rationale:
Quicktome is a connectomic imaging platform from Omniscient Neurotechnology using advanced MRI data to map a patient’s individual brain networks. It uses a machine learning classifier (with clinical-grade MRI data from the Human Connectome Project) to produce parcellations in both healthy and anatomically distorted brains. (1) For resection of brain tumors near critical functional areas, it identifies functional brain networks (e.g., motor, language, vision) that may not align exactly with traditional anatomy, visualizing how a tumor displaces or disrupts these networks.(2,3) This aids in preserving critical brain functions by guiding safer tumor resection margins.
This study aims to compare stimulation mapping results with functional networks identified by Quicktome to evaluate whether connectomic imaging can reliably predict eloquent cortex. If Quicktome shows strong concordance with electrical stimulation findings, it may offer a noninvasive, standardized method to complement or refine invasive mapping in epilepsy surgery—particularly valuable in complex or pediatric cases where brain networks may be reorganized
References:
1. Burks JD, Bonney PA, Conner AK, Glenn CA, Briggs RG, Battiste JD, et al. A method for safely resecting anterior butterfly gliomas: the surgical anatomy of the default mode network and the relevance of its preservation. J Neurosurg. 2017;126(6):1795-811.
2. Doyen S, Nicholas P, Poologaindran A, Crawford L, Young IM, Romero-Garcia R, et al. Connectivity-based parcellation of normal and anatomically distorted human cerebral cortex. Hum Brain Mapp. 2022;43(4):1358-69.
3. Yeung JT, Taylor HM, Nicholas PJ, Young IM, Jiang I, Doyen S, et al. Using Quicktome for Intracerebral Surgery: Early Retrospective Study and Proof of Concept. World Neurosurg. 2021;154:e734-e42.
Methods:
A retrospective study was conducted analyzing patients with refractory epilepsy who underwent MRI Quicktome and SEEG implantation with subsequent bedside stimulation mapping both to provoke seizures and identify potential eloquent cortex. Motor responses elicited upon stimulation were recorded. Connectomic data from high quality DTI sequences of Quicktome were superimposed with high-resolution thin-cut T2 MRI sequences and SEEG contacts. Contacts eliciting responses were identified on overlapped images and compared to the Quicktome-identified functional areas. Results:
25 of 31 contacts (80.6%) with motor functional responses on stimulation mapping had overlap with Quicktome identified motor areas. This included a majority/all contacts tested on each electrode. There was one electrode with no overlap, which showed adjacent Quicktome-identified cingulate motor fibersConclusions:
This proof-of-concept study introduces Quicktome for epilepsy surgery planning. Our results suggest a strong correlation of functional stimulation mapping with Quicktome-defined areas in the brain. More robust studies are indicated to further assess utility of Quicktome in surgical planning to potentially improve epilepsy surgery outcomes. Funding:
This research received no funding from any agencies in the public, commercial, or not-for-profit sectors.