18F-FDG PET-guided diffusion tractography reveals white matter abnormalities around the epileptic focus in medically refractory epilepsy: implications for epilepsy surgical evaluation

Poirier, Stefan E.; Kwan, Benjamin Y. M.; Jurkiewicz, Michael T.; Samargandy, Lina; Steven, David; Suller-Martí, Ana; Cheung, Victor; Khan, Ali Raza; Romsa, Jonathan; Prato, Frank S.; Burneo, Jorge G.; Thiessen, Jonathan D.; Anazodo, Udunna

doi:10.1186/s41824-020-00079-7

Cited by 9 publications

(12 citation statements)

References 59 publications

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“…For instance, epilepsy disproportionately impacts SSA (10x higher incidence compared to high-income countries) 44 , and up to 30% of epilepsy patients require surgery to resect brain lesions to alleviate seizures. Anatomical brain MRI performed as standard of care to localize the lesion for surgery, appears normal in one-third of these patients and luxury suite imaging using PET or MEG and high-density EEG are functionally used to localize lesion(s) 45 . In SSA, these luxury technologies are extremely scarce; 3 PET scanners and no MEG in the entire region (minus South Africa) 27 .…”

Section: Discussionmentioning

confidence: 99%

“…In SSA, these luxury technologies are extremely scarce; 3 PET scanners and no MEG in the entire region (minus South Africa) 27 . Functional MRI techniques (perfusion, diffusion spectroscopy) can functionally identify epileptic lesions 45 , but none of these are routinely used in clinics in the Global North and as such there are no standard image acquisition, processing, or interpretation guidelines Current research data reporting these techniques focus largely on 3T MRI studies using higher brain acquisition coils. By 1) training MRI radiographers to master acquisition of these advanced techniques and adapt parameters from research to their lower-field strength systems, 2) training MRI physicist to analyze images from their lower quality scanners leveraging on machine learning, 3) training biomedical engineers and physicists to build brain coils compatible with reconfigured and legacy systems to increase the spatial resolution, and 4) upskilling radiologists to read these novel MRI techniques, epilepsy surgical patients in SSA, may expect to have similar outcomes to their peers in the rest of the world.…”

Section: Discussionmentioning

confidence: 99%

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A Framework for Advancing Sustainable MRI Access in Africa

Anazodo

Ehiogu

et al. 2022

Preprint

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MRI technology has profoundly transformed current healthcare and research systems globally. The rapidly growing burden of non-communicable diseases in Africa has underscored the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education & Research in Africa (CAMERA) is a network of African experts, global partners, and ISMRM/ESMRMB members implementing novel strategies to advance MRI access and research in Africa. To identify challenges to MRI usage and provide a framework for addressing MRI needs in the region, CAMERA conducted a Needs Assessment Survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at <1, of which, 39% were obsolete low-field systems yet still in use to meet clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5T) MRI scanners in the region. However, these systems are underutilized with only 8% of facilities reporting clinical scans of 15 or more patients daily per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. Our NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at ISMRM and ESMRMB provided the basis for the framework presented here for advancing MRI capacity in SSA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Framework for Advancing Sustainable MRI Access in Africa

Anazodo

Ehiogu

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…• Novel readout and quantitation techniques including radiomics and machine learning/artificial intelligence informed algorithms benefit directly from inherently coregistered data and the high degree of standardization possible in PET/MRI, likely to result in improved performance of AI applications (176)(177)(178)(179)(180).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous PET/MRI: The future gold standard for characterizing motor neuron disease—A clinico-radiological and neuroscientific perspective

et al. 2022

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Neuroimaging assessment of motor neuron disease has turned into a cornerstone of its clinical workup. Amyotrophic lateral sclerosis (ALS), as a paradigmatic motor neuron disease, has been extensively studied by advanced neuroimaging methods, including molecular imaging by MRI and PET, furthering finer and more specific details of the cascade of ALS neurodegeneration and symptoms, facilitated by multicentric studies implementing novel methodologies. With an increase in multimodal neuroimaging data on ALS and an exponential improvement in neuroimaging technology, the need for harmonization of protocols and integration of their respective findings into a consistent model becomes mandatory. Integration of multimodal data into a model of a continuing cascade of functional loss also calls for the best attempt to correlate the different molecular imaging measurements as performed at the shortest inter-modality time intervals possible. As outlined in this perspective article, simultaneous PET/MRI, nowadays available at many neuroimaging research sites, offers the perspective of a one-stop shop for reproducible imaging biomarkers on neuronal damage and has the potential to become the new gold standard for characterizing motor neuron disease from the clinico-radiological and neuroscientific perspectives.

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“…Anatomical brain MRI performed as standard of care to localize the lesion for surgery appears normal in onethird of these patients and luxury suite imaging using PET or MEG and high-density EEG are functionally used to localize lesion(s). 54 In SSA, these luxury technologies are extremely scarce: there are three PET scanners and no MEG in the entire region (minus South Africa). 28 Functional MRI techniques (perfusion, diffusion spectroscopy) can functionally identify epileptic lesions, 54 but none of these are routinely used in clinics in the Global North and, as such, there are no standard image acquisition, processing, or interpretation guidelines.…”

Section: Anticipated Impactmentioning

confidence: 99%

A framework for advancing sustainable magnetic resonance imaging access in Africa

Anazodo

Ehiogu

et al. 2022

NMR in Biomedicine

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Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low‐resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2‐year period. The 68‐question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub‐Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low‐field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher‐field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up‐to‐date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high‐value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low‐resource settings.

show abstract

18F-FDG PET-guided diffusion tractography reveals white matter abnormalities around the epileptic focus in medically refractory epilepsy: implications for epilepsy surgical evaluation

Cited by 9 publications

References 59 publications

A Framework for Advancing Sustainable MRI Access in Africa

A Framework for Advancing Sustainable MRI Access in Africa

Simultaneous PET/MRI: The future gold standard for characterizing motor neuron disease—A clinico-radiological and neuroscientific perspective

A framework for advancing sustainable magnetic resonance imaging access in Africa

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