Software

The most commonly used packages are SPM and Brain Voyager; both import DICOM data, perform 2D and 3D statistical analysis and process single- or multi-subject data. Brain Voyager also has a real time utility, Turbo Brain Voyager. There is no need to describe this well-known software in detail, suffice it to say that, at the beginning, fMRI was used only for research purposes and the software was targeted at this goal. With the increasing diffusion of this technique and its clinical application, manufacturers of magnetic equipment entered the market and began the production of new software. An example is the newly introduced GE software, BrainWave, which cannot process multi-subject data, but is very convenient and has many advantages so that we chose it as the software for fMRI analysis in the routine clinic. The package consists of two parts: Real Time and Post-Acquisition. Real Time allows visualization of statistical t-maps during the acquisition; as the acquisition proceeds, statistical activation maps are processed and superimposed in real time on the fMRI series just acquired. This way, it is possible to monitor the situation and the activating effects from the very beginning of the acquisition. The Post-Acquisition package per-

Fig. 19.1. An example of 3D reconstruction. Activation maps are superimposed on the high quality volumetric acquisition, giving a better opportunity to localize eloquent areas. MPR projections are also shown

Fig. 19.2 a-c. An example of BIP maps. The activated areas in the occipital lobe are bordered by a white line, leaving the inner area transparent, to better define the anatomical structures involved. (Modified from [21], with permission)

forms an in-depth analysis (similarly to Brain Voyager), but in a semiautomatic way; it may run in the background, during successive acquisitions or exams, and produces, in the final steps, two outputs: 3D coloured activation maps, and the so-called BIP maps, in which the activated areas, bounded by a white contour, are superimposed on the 3D structural isovolumetric sagittal acquisition. BIP maps are a DICOM output; they can be represented, in turn, in the three planes of the space (MPR) and, sent to the neuronavigator, are invaluable to the neurosurgeon (Fig. 19.2).

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