MEG-guided analysis of 7T-MRI in patients with epilepsy

Colon, Albert; Osch, Matthias J.P. van; Buijs, Mathijs; Hillebrand, Arjan; Schijns, Olaf; Wagner, G.J.; Ossenblok, Pauly; Hofman, Paul; Buchem, Mark A. van; Boon, Paul

doi:10.1016/j.seizure.2018.05.019

Cited by 25 publications

(29 citation statements)

References 46 publications

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“…Three Tesla (3T) MRI increases the detection of epileptogenic lesions (2.57 times more likely than 1.5 Tesla according to Phal et al [30]). This has been demonstrated by several studies using 3 Tesla (3T) MRI machines compared to 1.5 Tesla (1.5T) [31,32], while other studies suggest ultra-high field 7 Tesla (7T) MRI is superior to 3T MRI machines [33,34]. Higher field MRI performed better not only in the detection but also in characterizing identified lesions [23,30].…”

Section: Morphological Imaging In Epilepsymentioning

confidence: 95%

“…The magnetization-prepared two rapid acquisition gradient echoes (MP2RAGE) sequence is a volumetric T1 weighted novel sequence, which acquires two gradient echo images after an inversion pulse and is currently used as part of the routine epilepsy protocol in our institution. It provides excellent contrast-to-noise ratio with minimal effect of B1 inhomogeneity (B1 is the radiofrequency field, which is applied perpendicular to the main magnetic field of an MRI machine) and improved delineation of gray/white matter interface (well demonstrated in Figure 2a) and has, therefore, allowed increased detection and characterization of subtle cortical malformations, especially FCD [33]. Furthermore, it allows automated volume calculation of different brain regions [33].…”

Section: Morphological Imaging In Epilepsymentioning

confidence: 99%

“…The SWI sequence also allows distinction between calcification and hemorrhage and thus, supplementary CT for this purpose can be avoided, reducing irradiation risk, especially in the pediatric population. Furthermore, according to Pittau et al, SWI in 7T ultra-high field revealed subtle changes in the vascular architecture of the cortical lesions responsible for medically refractory epilepsy [33].…”

Section: Morphological Imaging In Epilepsymentioning

confidence: 99%

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Morphological and Advanced Imaging of Epilepsy: Beyond the Basics

et al. 2019

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The etiology of epilepsy is variable and sometimes multifactorial. Clinical course and response to treatment largely depend on the precise etiology of the seizures. Along with the electroencephalogram (EEG), neuroimaging techniques, in particular, magnetic resonance imaging (MRI), are the most important tools for determining the possible etiology of epilepsy. Over the last few years, there have been many developments in data acquisition and analysis for both morphological and functional neuroimaging of people suffering from this condition. These innovations have increased the detection of underlying structural pathologies, which have till recently been classified as “cryptogenic” epilepsy. Cryptogenic epilepsy is often refractory to anti-epileptic drug treatment. In drug-resistant patients with structural or consistent functional lesions related to the epilepsy syndrome, surgery is the only treatment that can offer a seizure-free outcome. The pre-operative detection of the underlying structural condition increases the odds of successful surgical treatment of pharmacoresistant epilepsy. This article provides a comprehensive overview of neuroimaging techniques in epilepsy, highlighting recent advances and innovations and summarizes frequent etiologies of epilepsy in order to improve the diagnosis and management of patients suffering from seizures, especially young patients and children.

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Section: Morphological Imaging In Epilepsymentioning

confidence: 95%

Section: Morphological Imaging In Epilepsymentioning

confidence: 99%

Section: Morphological Imaging In Epilepsymentioning

confidence: 99%

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Morphological and Advanced Imaging of Epilepsy: Beyond the Basics

et al. 2019

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“…The pathophysiology of epilepsy includes the simultaneous presence of hippocampal sclerosis and its comorbidities associated with psychiatric and cognitive complications ( 28 ). Clinically, MRI is routinely performed to diagnose and assess non-lesional cingulate epilepsy ( 19 , 29 , 30 ). Dce-MRI examination has previously demonstrated considerable accuracy in the preoperative localization of epileptic foci, suggesting that Dce-MRI is suitable for use as a basic reference for the diagnosis of patients with epilepsy ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Preoperative evaluation of dynamic contrast‑enhanced MRI‑guided lesion identification using morphometric and textural analysis for patients with epilepsy

Du¹,

Guan²,

Wang³

et al. 2020

Exp Ther Med

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Diagnosing epilepsy at the early stages is pivotal in the prevention and subsequent treatment of major epileptic events. MRI has been previously demonstrated to be beneficial in optimizing diagnostic efficacy and the subsequent treatment of epilepsy. In the present study, morphometric and textural analysis was performed pre-operatively on dynamic contrast-enhanced (Dce)-magnetic resonance imaging (MRI)-guided lesions in patients with epilepsy. The diagnostic efficacies of MRI and Dce-MRI were evaluated in 280 patients with epilepsy. The performance of Dce-MRI (n=140) was compared with that of classic MRI (n=140) in the analysis of the morphometric and textural features of the lesions, and the accuracy of mapping to regions of the brain that were potentially associated with the region of seizure onset was also investigated. Diagnostic quality was evaluated by comparing the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the hippocampus, the grey-white matter contrast and the morphometric and textural analysis of epileptogenic lesions. Data from the present study demonstrated that the regions of suspected epileptic activity in the brain were mapped more successfully using Dce-MRI compared with MRI. Image quality obtained by Dce-MRI was adequate for the detection of epileptic lesions, including those of focal cortical dysplasia or periventricular nodular heterotopia (PNH). The diagnostic value of Dce-MRI for subtle lesions such as PNH was found to be more efficient compared with that of MRI due to the significantly increased SNR and CNR. In addition, Dce-MRI exhibited higher accuracy compared with MRI for the identification of cortical lesions and for the mapping to the zone of suspected seizure onset. Dce-MRI also exhibited higher sensitivity and specificity in the diagnosis of patients with epilepsy and mapping to the lesions associated with epilepsy compared with MRI. These findings indicate that Dce-MRI is a feasible technique that may be beneficial in the diagnosis and subsequent management of patients with epilepsy.

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“…Unfortunately not all lesions are detected with current MRI imaging techniques, particularly so in patients suspected of minimal malformation of cortical development (mMCD) or with some subtypes of focal cortical dysplasia (FCD) 42,70,92 . In so-called MRI negative patients, ultra high-field MRI (7 tesla) can lead to an additional lesion detection in approximately a fifth of the patients 99,155,156 . Improving MRI lesion detection and delineation could lead to more refractory epilepsy patients becoming eligible for surgery and could improve surgical outcome.…”

Section: Correlation Between In Vivo and Ex Vivo Multimodal High Fielmentioning

confidence: 99%

Epilepsy Surgery for Focal Cortical Dysplasia: Clinicopathological Correlates and Advances in Neuroimaging.

Veersema¹

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Table of Contents Chapter 1 Introduction Chapter 2 Long-term seizure outcome after epilepsy surgery in patients with mild malformation of cortical development and focal cortical dysplasia Chapter 3 Cognitive functioning after epilepsy surgery in children with mild malformation of cortical development and focal cortical dysplasia Chapter 4 Seven tesla MRI Improves detection of focal cortical dysplasia in patients with refractory focal epilepsy Chapter 5 7 tesla T 2 *-weighted MRI as a tool to improve detection of focal cortical Dysplasia-a case series Chapter 6 Changes in vascular density in resected tissue of 97 patients with focal cortical dysplasia or TSC-related cortical tubers Chapter 7 Correlation between in vivo and ex vivo multimodal high field MRI and histopathological parameters in cortical dysplasias Chapter 8 Summary and general discussion Appendices References Nederlandse samenvatting 148 Dankwoord 161 Curriculum Vitae 166 List of publications 167 Figure 1. Examples of histological findings in mMCD and FCD. A: NeuN/mMCD type 2. Normal cytoarchitecture of cortical layers II-VI, but excess neurons in molecular layer (top of figure) and in white matter (bottom of figure). B: NeuN/FCD IA. abnormal radial cortical lamination, with typical microcolumnar organisation. C: NeuN/FCD IIB. In FCD II subtypes there is often complete disruption of cortical layering, and loss of grey/white matter border. D: SMI32/FCD IIA. Immature, dysmorphic neurons with abnormal orientation and positive staining by SMI32 characterise FCD IIA. E: Vimentin/FCD IIB. Typical balloon cells, large undifferentiated cells lacking Nissl substance, and positive Vimentin staining.

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MEG-guided analysis of 7T-MRI in patients with epilepsy

Abstract: In 32% of patients 7T MRI showed abnormalities that could indicate an epileptogenic lesion whereas previous 3T MRI did not, especially when visual inspection was guided by the presence of focal interictal MEG abnormalities.

Cited by 25 publications

References 46 publications

Morphological and Advanced Imaging of Epilepsy: Beyond the Basics

Morphological and Advanced Imaging of Epilepsy: Beyond the Basics

Preoperative evaluation of dynamic contrast‑enhanced MRI‑guided lesion identification using morphometric and textural analysis for patients with epilepsy

Epilepsy Surgery for Focal Cortical Dysplasia: Clinicopathological Correlates and Advances in Neuroimaging.

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