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<meta name="citation_funding_source" content="citation_grant_number=P30 CA016672;citation_grant_number=R01 CA258788;" />
<meta name="issue_cover_image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/11.cover-source.jpg" />
<meta name="type" content="article" />
<meta name="category" content="research-article" />
<meta name="HW.identifier" content="/ajnr/45/11/1798.atom" />
<meta name="HW.pisa" content="ajnr;45/11/1798" />
<meta name="DC.Format" content="text/html" />
<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Probabilistic Presurgical Language fMRI Atlas of Patients with Brain Tumors" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8383" />
<meta name="DC.Date" content="2024-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Patients with brain tumors have high intersubject variation in putative language regions, which may limit the utility of straightforward application of healthy subject brain atlases in clinical scenarios. The purpose of this study was to develop a probabilistic functional brain atlas that consolidates language functional activations of sentence completion and Silent Word Generation language paradigms using a large sample of patients with brain tumors.

MATERIALS AND METHODS: The atlas was developed using retrospectively collected fMRI data from patients with brain tumors who underwent their first standard-of-care presurgical language fMRI scan at our institution between July 18, 2015, and May 13, 2022. Three hundred seventeen patients (861 fMRI scans) were used to develop the language functional atlas. An independent presurgical language fMRI data set of 39 patients with brain tumors from a previous study was used to evaluate our atlas. Family-wise error–corrected binary functional activation maps from sentence completion, letter fluency, and category fluency presurgical fMRI were used to create probability overlap maps and pooled probabilistic overlap maps in Montreal Neurological Institute standard space. The Wilcoxon signed-rank test was used to determine a significant difference in the maximum Dice coefficient for our atlas compared with a meta-analysis-based template with respect to expert-delineated primary language area activations.

RESULTS: Probabilities of activating the left anterior primary language area and left posterior primary language area in the temporal lobe were 87.9% and 91.5%, respectively, for sentence completion, 88.5% and 74.2%, respectively, for letter fluency, and 83.6% and 67.6%, respectively, for category fluency. Maximum Dice coefficients for templates derived from our language atlas were significantly higher than the meta-analysis-based template in the left anterior primary language area (0.351 and 0.326, respectively, P  &lt; .05) and the left posterior primary language area in the temporal lobe (0.274 and 0.244, respectively, P  &lt; .005).

CONCLUSIONS: Brain tumor patient- and paradigm-specific probabilistic language atlases were developed. These atlases had superior spatial agreement with fMRI activations in individual patients compared with the meta-analysis-based template.

aPLA
:   anterior PLA
BTLA
:   basal temporal language area
CAT
:   category fluency
DLPFC
:   dorsolateral prefrontal cortex
LETT
:   letter fluency
MNI
:   Montreal Neurological Institute
PLA
:   primary language area
POM
:   probabilistic overlap map
pPLAP
:   posterior PLA in the parietal lobe
pPLAT
:   posterior PLA in the temporal lobe
SENT
:   sentence completion
SMA
:   supplementary motor area" />
<meta name="DC.Contributor" content="Jian Ming Teo" />
<meta name="DC.Contributor" content="Vinodh A. Kumar" />
<meta name="DC.Contributor" content="Jina Lee" />
<meta name="DC.Contributor" content="Rami W. Eldaya" />
<meta name="DC.Contributor" content="Ping Hou" />
<meta name="DC.Contributor" content="Mu-Lan Jen" />
<meta name="DC.Contributor" content="Kyle R. Noll" />
<meta name="DC.Contributor" content="Peng Wei" />
<meta name="DC.Contributor" content="Sherise D. Ferguson" />
<meta name="DC.Contributor" content="Sujit S. Prabhu" />
<meta name="DC.Contributor" content="Max Wintermark" />
<meta name="DC.Contributor" content="Ho-Ling Liu" />
<meta name="article:published_time" content="2024-11-01" />
<meta name="article:section" content="Neuroimaging Physics/Functional Neuroimaging/CT and MRI Technology" />
<meta name="citation_title" content="Probabilistic Presurgical Language fMRI Atlas of Patients with Brain Tumors" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Patients with brain tumors have high intersubject variation in putative language regions, which may limit the utility of straightforward application of healthy subject brain atlases in clinical scenarios. The purpose of this study was to develop a probabilistic functional brain atlas that consolidates language functional activations of sentence completion and Silent Word Generation language paradigms using a large sample of patients with brain tumors.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;The atlas was developed using retrospectively collected fMRI data from patients with brain tumors who underwent their first standard-of-care presurgical language fMRI scan at our institution between July 18, 2015, and May 13, 2022. Three hundred seventeen patients (861 fMRI scans) were used to develop the language functional atlas. An independent presurgical language fMRI data set of 39 patients with brain tumors from a previous study was used to evaluate our atlas. Family-wise error–corrected binary functional activation maps from sentence completion, letter fluency, and category fluency presurgical fMRI were used to create probability overlap maps and pooled probabilistic overlap maps in Montreal Neurological Institute standard space. The Wilcoxon signed-rank test was used to determine a significant difference in the maximum Dice coefficient for our atlas compared with a meta-analysis-based template with respect to expert-delineated primary language area activations.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Probabilities of activating the left anterior primary language area and left posterior primary language area in the temporal lobe were 87.9% and 91.5%, respectively, for sentence completion, 88.5% and 74.2%, respectively, for letter fluency, and 83.6% and 67.6%, respectively, for category fluency. Maximum Dice coefficients for templates derived from our language atlas were significantly higher than the meta-analysis-based template in the left anterior primary language area (0.351 and 0.326, respectively, &lt;i&gt;P &lt;/i&gt;&amp;lt; .05) and the left posterior primary language area in the temporal lobe (0.274 and 0.244, respectively, &lt;i&gt;P &lt;/i&gt;&amp;lt; .005).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Brain tumor patient- and paradigm-specific probabilistic language atlases were developed. These atlases had superior spatial agreement with fMRI activations in individual patients compared with the meta-analysis-based template.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2024/11/01" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A8383" />
<meta name="citation_pmid" content="38889968" />
<meta name="citation_volume" content="45" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Neuroimaging Physics/Functional Neuroimaging/CT and MRI Technology" />
<meta name="citation_firstpage" content="1798" />
<meta name="citation_lastpage" content="1804" />
<meta name="citation_author" content="Jian Ming Teo" />
<meta name="citation_author_institution" content="aFrom the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_institution" content="bMedical Physics Graduate Program (J.M.T.), The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-3543-1719" />
<meta name="citation_author" content="Vinodh A. Kumar" />
<meta name="citation_author_institution" content="cDepartment of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8322-1233" />
<meta name="citation_author" content="Jina Lee" />
<meta name="citation_author_institution" content="cDepartment of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0009-0003-1350-4419" />
<meta name="citation_author" content="Rami W. Eldaya" />
<meta name="citation_author_institution" content="cDepartment of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-7801-1015" />
<meta name="citation_author" content="Ping Hou" />
<meta name="citation_author_institution" content="aFrom the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-1518-571X" />
<meta name="citation_author" content="Mu-Lan Jen" />
<meta name="citation_author_institution" content="aFrom the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author" content="Kyle R. Noll" />
<meta name="citation_author_institution" content="dDepartment of Neuro-Oncology (K.R.N.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-7105-1900" />
<meta name="citation_author" content="Peng Wei" />
<meta name="citation_author_institution" content="eDepartment of Biostatistics (P.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author" content="Sherise D. Ferguson" />
<meta name="citation_author_institution" content="fDepartment of Neurosurgery (S.D.F., S.S.P.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6344-0615" />
<meta name="citation_author" content="Sujit S. Prabhu" />
<meta name="citation_author_institution" content="fDepartment of Neurosurgery (S.D.F., S.S.P.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8155-0623" />
<meta name="citation_author" content="Max Wintermark" />
<meta name="citation_author_institution" content="cDepartment of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6726-3951" />
<meta name="citation_author" content="Ho-Ling Liu" />
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<meta name="twitter:title" content="Probabilistic Presurgical Language fMRI Atlas of Patients with Brain Tumors" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/11.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Patients with brain tumors have high intersubject variation in putative language regions, which may limit the utility of straightforward application of healthy subject brain atlases in clinical scenarios. The purpose of this study was to develop a probabilistic functional brain atlas that consolidates language functional activations of sentence completion and Silent Word Generation language paradigms using a large sample of patients with brain tumors.

MATERIALS AND METHODS: The atlas was developed using retrospectively collected fMRI data from patients with brain tumors who underwent their first standard-of-care presurgical language fMRI scan at our institution between July 18, 2015, and May 13, 2022. Three hundred seventeen patients (861 fMRI scans) were used to develop the language functional atlas. An independent presurgical language fMRI data set of 39 patients with brain tumors from a previous study was used to evaluate our atlas. Family-wise error–corrected binary functional activation maps from sentence completion, letter fluency, and category fluency presurgical fMRI were used to create probability overlap maps and pooled probabilistic overlap maps in Montreal Neurological Institute standard space. The Wilcoxon signed-rank test was used to determine a significant difference in the maximum Dice coefficient for our atlas compared with a meta-analysis-based template with respect to expert-delineated primary language area activations.

RESULTS: Probabilities of activating the left anterior primary language area and left posterior primary language area in the temporal lobe were 87.9% and 91.5%, respectively, for sentence completion, 88.5% and 74.2%, respectively, for letter fluency, and 83.6% and 67.6%, respectively, for category fluency. Maximum Dice coefficients for templates derived from our language atlas were significantly higher than the meta-analysis-based template in the left anterior primary language area (0.351 and 0.326, respectively, P  &lt; .05) and the left posterior primary language area in the temporal lobe (0.274 and 0.244, respectively, P  &lt; .005).

CONCLUSIONS: Brain tumor patient- and paradigm-specific probabilistic language atlases were developed. These atlases had superior spatial agreement with fMRI activations in individual patients compared with the meta-analysis-based template.

aPLA
:   anterior PLA
BTLA
:   basal temporal language area
CAT
:   category fluency
DLPFC
:   dorsolateral prefrontal cortex
LETT
:   letter fluency
MNI
:   Montreal Neurological Institute
PLA
:   primary language area
POM
:   probabilistic overlap map
pPLAP
:   posterior PLA in the parietal lobe
pPLAT
:   posterior PLA in the temporal lobe
SENT
:   sentence completion
SMA
:   supplementary motor area" />
<meta name="og-title" property="og:title" content="Probabilistic Presurgical Language fMRI Atlas of Patients with Brain Tumors" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/11/1798" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Patients with brain tumors have high intersubject variation in putative language regions, which may limit the utility of straightforward application of healthy subject brain atlases in clinical scenarios. The purpose of this study was to develop a probabilistic functional brain atlas that consolidates language functional activations of sentence completion and Silent Word Generation language paradigms using a large sample of patients with brain tumors.

MATERIALS AND METHODS: The atlas was developed using retrospectively collected fMRI data from patients with brain tumors who underwent their first standard-of-care presurgical language fMRI scan at our institution between July 18, 2015, and May 13, 2022. Three hundred seventeen patients (861 fMRI scans) were used to develop the language functional atlas. An independent presurgical language fMRI data set of 39 patients with brain tumors from a previous study was used to evaluate our atlas. Family-wise error–corrected binary functional activation maps from sentence completion, letter fluency, and category fluency presurgical fMRI were used to create probability overlap maps and pooled probabilistic overlap maps in Montreal Neurological Institute standard space. The Wilcoxon signed-rank test was used to determine a significant difference in the maximum Dice coefficient for our atlas compared with a meta-analysis-based template with respect to expert-delineated primary language area activations.

RESULTS: Probabilities of activating the left anterior primary language area and left posterior primary language area in the temporal lobe were 87.9% and 91.5%, respectively, for sentence completion, 88.5% and 74.2%, respectively, for letter fluency, and 83.6% and 67.6%, respectively, for category fluency. Maximum Dice coefficients for templates derived from our language atlas were significantly higher than the meta-analysis-based template in the left anterior primary language area (0.351 and 0.326, respectively, P  &lt; .05) and the left posterior primary language area in the temporal lobe (0.274 and 0.244, respectively, P  &lt; .005).

CONCLUSIONS: Brain tumor patient- and paradigm-specific probabilistic language atlases were developed. These atlases had superior spatial agreement with fMRI activations in individual patients compared with the meta-analysis-based template.

aPLA
:   anterior PLA
BTLA
:   basal temporal language area
CAT
:   category fluency
DLPFC
:   dorsolateral prefrontal cortex
LETT
:   letter fluency
MNI
:   Montreal Neurological Institute
PLA
:   primary language area
POM
:   probabilistic overlap map
pPLAP
:   posterior PLA in the parietal lobe
pPLAT
:   posterior PLA in the temporal lobe
SENT
:   sentence completion
SMA
:   supplementary motor area" />
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1798-1804; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8383 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-111463--61190540485" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Jian Ming Teo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Medical Physics Graduate Program (J.M.T.), The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jian%2BMing%2BTeo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Teo%20JM&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJian%2BMing%2BTeo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3543-1719" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Jian Ming Teo</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Vinodh A. Kumar </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Vinodh%2BA.%2BKumar%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kumar%20VA&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AVinodh%2BA.%2BKumar%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8322-1233" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Vinodh A. Kumar</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Jina Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jina%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJina%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0009-0003-1350-4419" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Jina Lee</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Rami W. Eldaya </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Rami%2BW.%2BEldaya%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Eldaya%20RW&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ARami%2BW.%2BEldaya%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7801-1015" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Rami W. Eldaya</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Ping Hou </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Ping%2BHou%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hou%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3APing%2BHou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1518-571X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ping Hou</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Mu-Lan Jen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Mu-Lan%2BJen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jen%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AMu-Lan%2BJen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">Kyle R. Noll </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neuro-Oncology (K.R.N.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Kyle%2BR.%2BNoll%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Noll%20KR&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AKyle%2BR.%2BNoll%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7105-1900" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Kyle R. 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Prabhu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Neurosurgery (S.D.F., S.S.P.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Sujit%2BS.%2BPrabhu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Prabhu%20SS&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ASujit%2BS.%2BPrabhu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8155-0623" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Sujit S. Prabhu</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">Max Wintermark </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic Radiology (V.A.K., J.L., R.W.E., M.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Max%2BWintermark%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wintermark%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AMax%2BWintermark%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6726-3951" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Max Wintermark</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">Ho-Ling Liu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Imaging Physics (J.M.T., P.H., M.-L.J., H.-L.L.), The University of Texas MD Anderson Cancer Center, Houston, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Ho-Ling%2BLiu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Liu%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AHo-Ling%2BLiu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0284-5889" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Ho-Ling Liu</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Patients with brain tumors have high intersubject variation in putative language regions, which may limit the utility of straightforward application of healthy subject brain atlases in clinical scenarios. The purpose of this study was to develop a probabilistic functional brain atlas that consolidates language functional activations of sentence completion and Silent Word Generation language paradigms using a large sample of patients with brain tumors.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> The atlas was developed using retrospectively collected fMRI data from patients with brain tumors who underwent their first standard-of-care presurgical language fMRI scan at our institution between July 18, 2015, and May 13, 2022. Three hundred seventeen patients (861 fMRI scans) were used to develop the language functional atlas. An independent presurgical language fMRI data set of 39 patients with brain tumors from a previous study was used to evaluate our atlas. Family-wise error–corrected binary functional activation maps from sentence completion, letter fluency, and category fluency presurgical fMRI were used to create probability overlap maps and pooled probabilistic overlap maps in Montreal Neurological Institute standard space. The Wilcoxon signed-rank test was used to determine a significant difference in the maximum Dice coefficient for our atlas compared with a meta-analysis-based template with respect to expert-delineated primary language area activations.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> Probabilities of activating the left anterior primary language area and left posterior primary language area in the temporal lobe were 87.9% and 91.5%, respectively, for sentence completion, 88.5% and 74.2%, respectively, for letter fluency, and 83.6% and 67.6%, respectively, for category fluency. Maximum Dice coefficients for templates derived from our language atlas were significantly higher than the meta-analysis-based template in the left anterior primary language area (0.351 and 0.326, respectively, <em>P </em>&lt; .05) and the left posterior primary language area in the temporal lobe (0.274 and 0.244, respectively, <em>P </em>&lt; .005).</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> Brain tumor patient- and paradigm-specific probabilistic language atlases were developed. These atlases had superior spatial agreement with fMRI activations in individual patients compared with the meta-analysis-based template.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">aPLA<span class="def-item-dt-sep"></span></dt><dd>anterior PLA<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">BTLA<span class="def-item-dt-sep"></span></dt><dd>basal temporal language area<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CAT<span class="def-item-dt-sep"></span></dt><dd>category fluency<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">DLPFC<span class="def-item-dt-sep"></span></dt><dd>dorsolateral prefrontal cortex<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">LETT<span class="def-item-dt-sep"></span></dt><dd>letter fluency<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">MNI<span class="def-item-dt-sep"></span></dt><dd>Montreal Neurological Institute<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">PLA<span class="def-item-dt-sep"></span></dt><dd>primary language area<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">POM<span class="def-item-dt-sep"></span></dt><dd>probabilistic overlap map<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">pPLA<sub>P</sub><span class="def-item-dt-sep"></span></dt><dd>posterior PLA in the parietal lobe<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">pPLA<sub>T</sub><span class="def-item-dt-sep"></span></dt><dd>posterior PLA in the temporal lobe<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">SENT<span class="def-item-dt-sep"></span></dt><dd>sentence completion<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">SMA<span class="def-item-dt-sep"></span></dt><dd>supplementary motor area</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2024 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/45/11/1798.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2024 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1798-1804; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8383 </span></div>
  
  
  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1798-1804; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8383 </span></div>
  
  
  
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