The critical role of quality assurance in fMRI

Functional MRI (fMRI) has become one of the most powerful tools in neuroscience and clinical practice. It enables us to map brain activity, support risk assessment and surgical planning, and explore the mechanisms behind neurological and psychiatric conditions.

But the signals that drive fMRI are remarkably small. This extreme sensitivity is what makes fMRI so powerful, yet it is also what makes it fragile. Even minor fluctuations in scanner performance can affect the quality of the results. That is why quality assurance (QA) should not be considered an optional step, but the foundation of trustworthy fMRI.

Veriflux: a stablereference

To monitor scanner performance in are liable way, researchers and clinicians use reference test objects known as phantoms. One such tool is the Veriflux phantom, developed to mimic brain tissue and provide stable, reproducible signals across time. The Veriflx system includes a fully automated analysis software, allowing clinical users to complete QA measurements quickly and efficiently. By incorporating Veriflux into QA routines, it becomes possible to detect scanner drift or technical issues before they affect patient care or research outcomes.  

At NordicNeuroLab’s fMRI user meeting earlier this year, Professor Xavier Golay, CEO of Gold Standard Phantoms, reminded the audience that the true value of fMRI is not just in producing images of the brain – it is in knowing those images can be trusted.

–  fMRI captures subtle changes in blood oxygen levels inside the brain. These fluctuations indicate neural activity, but the signals are very small – often just a few percent. Because of this, even minor instability in the scanner can mask true brain activations or generate misleading results.

Why QA matters

The value of QA becomes clear when  at the two main arenas where fMRI is used.

In clinical practice, fMRI guides delicate interventions such as brain surgery. Successful mapping of speech, motor or sensory areas can have a truly positive impact on patient safety. If scanner performance is unstable, critical regions may be overlooked – and decisions could made on incomplete or misleading information.

In research, large-scale studies and clinical trials depend on consistent data across participants, sites and timepoints. Even small variations can add noise, weaken results, and undermine credibility.

Hidden changes, new challenges

During his presentation at the fMRI user meeting, Xavier also highlighted that modern scanners add another layer of complexity. Manufacturers frequently introduce updates – new software, reconstruction methods, or AI-based denoising tools. While these innovations often improve image quality in standard structural imaging sequences, they can also alter data in ways that are not fully transparent. This makes comparisons across sites or across time more difficult for such sensitive techniques as fMRI.

Systems like the Veriflux serve as a safeguard here. Image quality can be monitored objectively over time to ensure any changes on the scanner are not adversely affecting results.

Ensuring trust in fMRI

QA provides the confidence that what we see reflects true neural activity rather than technical artifacts. Without that assurance, missing signals can easily be misinterpreted. As Xavier explains:

–      Absence of evidence is not evidence of absence. That’s the biggest issue in clinical fMRI. If you don’t see an activation, it doesn’t always mean it’s not there – it could also mean your scanner cannot detect it.

At its heart, fMRI is about discoveryand care – unlocking new insights into the brain and improving lives. That mission depends on confidence: in the scanner, in the signals and in the conclusions drawn.

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Watch full presentation here:

https://vimeo.com/1096878835/ab1e40c56b?share=copy

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Departments across the world are beginning to incorporate dedicated QA tools like Veriflux into their routines. If you’re interested in exploring practical ways to build trust in your fMRI data, we’d be happy to help

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Get in touch

https://www.nordicneurolab.com/contact#contact-form

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