In this work we have evaluated the feasibility of incorporating advanced fMRI and tractography evaluations into the real-life presurgical management of patients undergoing brain lesion resections. In this pilot cohort of patients, all major preoperative imaging findings were validated by intraoperative measurements. With the inclusion of fMRI end regions, probabilistic tractography allowed a better reconstruction of the corticospinal tract and its branches in regions adjacent or within the tumour with altered or damaged fibre architecture. Robust fMRI-based language lateralization was able to describe likely dominance, in agreement with intraoperative findings and initial postoperative deficit.
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