Combined task activation display as an effective method to teach introductory fMRI users


      • CTAD increased trainee confidence and accuracy when evaluating language dominance.
      • CTAD decreased time to interpretation when evaluating language dominance.
      • Trainees preferred interpreting fMRI with CTAD over conventional display.


      Rationale and objectives

      Interpreting functional magnetic resonance imaging (fMRI) can be an overwhelming and challenging task for trainees, particularly when post processing, synthesizing and interpreting data from multiple language paradigms. Currently, there is no established best method for teaching fMRI interpretation to new trainees. The purpose of our study is to compare the use of combined task activation display (CTAD) and conventional display of fMRI language paradigms as an effective method to teach fMRI to the introductory learner.

      Materials and methods

      Following IRB approval, 43 unique cases (with 10 repeat cases to assess intra-reader variability) were identified based on the inclusion/exclusion criteria. Eight radiology trainees, without prior exposure to fMRI, were asked to determine language lateralization based on activation of Wernicke's area, Broca's area, and the pre-supplementary motor area. Prior to trainee interpretation, a 15-minute training session was conducted to describe the expected anatomic locations of the language centers. Trainees were asked to determine language dominance using either the CTAD or conventional methods. Following a 6-week washout period, the same eight trainees were asked to interpret the cases using the opposite interpretation approach.


      Interpreting fMRI with the CTAD method significantly increased trainee accuracy (85.4% vs 70.9% p < 0.001) and trainee confidence (4.3 vs 3.6 p < 0.001), while decreasing time to interpretation (mean difference of 29 min), and intra-reader variability when compared to the conventional approach.


      Combined task activation display is an effective method to teach fMRI to introductory learners.


      BOLD (blood oxygen level dependent), CTAD (combined task activation display), EHI (Edinburgh Handedness Inventory), fMRI (functional magnetic resonance imaging), LI (laterality index)


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