Demarcation for brain tumour neurosurgical resection is typically performed using Fluid Attenuated Inversion Recovery images hyperintensities. In this study, we investigated in glioma patients whether these hyperintensities represent structural alterations that are metabolically and functionally homogeneous using simultaneous measurements of quantitative 18-Fluoro-deoxyglucose PET and resting state functional magnetic resonance imaging. FLAIR hyperintense regions resulted to be heterogeneous both at metabolic and functional standpoint and only partially significantly altered when compared with contralateral homologous white matter. These results support the hypothesis that multi-parametric approaches might improve the outcome of brain surgery informing the resection procedure.
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