Jarod L. Roland, MD¹,* , Natalie Griffin, BA², Carl D. Hacker, MD, PhD¹, Ananth K. Vellimana, MD¹, S. Hassan Akbari, MD¹, Joshua S. Shimony, MD, PhD³, Matthew D. Smyth, MD¹˒⁴, Eric C. Leuthardt, MD¹˒⁵˒⁶˒⁷˒⁸˒⁹, and David D. Limbrick Jr., MD, PhD¹˒⁴

¹Department of Neurological Surgery, Washington University in St. Louis, Missouri

²Department of School of Medicine, Washington University in St. Louis, Missouri

³Department of Radiology, Washington University in St. Louis, Missouri

⁴Department of Pediatrics, Washington University in St. Louis, Missouri

⁵Department of Neuroscience, Washington University in St. Louis, Missouri

⁶Department of Biomedical Engineering, Washington University in St. Louis, Missouri

⁷Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, Missouri

⁸Center for Innovation in Neuroscience and Technology, Washington University in St. Louis, Missouri

⁹Brain Laser Center, Washington University in St. Louis, Missouri

Abstract

OBJECTIVE— Cerebral mapping for surgical planning and operative guidance is a challenging task in neurosurgery. Pediatric patients are often poor candidates for many modern mapping techniques because of inability to cooperate due to their immature age, cognitive deficits, or other factors. Resting-state functional MRI (rs-fMRI) is uniquely suited to benefit pediatric patients because it is inherently noninvasive and does not require task performance or significant cooperation. Recent advances in the field have made mapping cerebral networks possible on an individual basis for use in clinical decision making. The authors present their initial experience translating rs-fMRI into clinical practice for surgical planning in pediatric patients.