Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review

Lanen, Rick H. G. J. van; Colon, Albert; Wiggins, Christopher J.; Hoeberigs, M. Christianne; Hoogland, Govert; Roebroeck, Alard; Ivanov, Dimo; Poser, Benedikt A.; Rouhl, Rob P.W.; Hofman, Paul; Jansen, Jacobus F.A.; Backes, Walter H.; Rijkers, Kim; Schijns, Olaf

doi:10.1016/j.nicl.2021.102602

Cited by 28 publications

(28 citation statements)

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“…Application of ultra-high field 7T MRI increases the sensitivity to detect an epileptogenic lesion. Van Lanen et al [ 34 ] reported in a systematic review pooled diagnostic gain of 7T MRI over conventional clinical MRI. In this study 31% of included patients with negative 3T had positive 7T MRI and most of them had radiological hallmarks of FCD.…”

Section: Discussionmentioning

confidence: 99%

Occult focal cortical dysplasia may predict poor outcome of surgery for drug-resistant mesial temporal lobe epilepsy

Nowak

Bala

2021

PLoS ONE

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Purpose The results of surgery in patients with mesial temporal lobe epilepsy (MTLE) associated with hippocampal sclerosis (HS) are favorable, with a success rate over 70% following resection. An association of HS with focal cortical dysplasia (FCD) in the temporal lobe is one of the potential causes for poor surgical outcome in MTLE. We aimed to analyzed seizure outcome in a population of MTLE patients and recognize the role of occult FCD in achieving postoperative seizure control. Methods We retrospectively analyzed postoperative outcomes for 82 consecutive adult patients with the syndrome of MTLE due to HS, who had no concomitant lesions within temporal lobe in MRI and who underwent surgical treatment in the years 2005–2016, and correlated factors associated with seizure relapse. Results At the latest follow-up evaluation after surgery, 59 (72%) were free of disabling seizures (Engel Class I) and 48 (58,5%) had an Engel Class Ia. HS associated with FCD in neocortical structures were noted in 33 patients (40%). Analyzes have shown that dual pathology was the most significant negative predictive factor for Engel class I and Engel class Ia outcome. Conclusions The incidence of dual pathology in patients with temporal lobe epilepsy seems to be underestimated. An incomplete epileptogenic zone resection of occult focal temporal dysplasia within temporal lobe is supposed to be the most important negative prognostic factor for seizure freedom after epilepsy surgery in MTLE-HS patients. The study indicates the need to improve diagnostics for other temporal lobe pathologies, despite the typical clinical and radiological picture of MTLE-HS.

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Section: Discussionmentioning

confidence: 99%

Occult focal cortical dysplasia may predict poor outcome of surgery for drug-resistant mesial temporal lobe epilepsy

Nowak

Bala

2021

PLoS ONE

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“…Over the last years, some studies demonstrating the diagnostic gain of 7 T MRI over clinical 1.5 T or 3 T MRI in patients with drug-resistant focal epilepsy have been published [23,24,[46][47][48]. We recently published a systematic review discussing UHF MRI in human epilepsy [49].…”

Section: Diagnostic Valuementioning

confidence: 99%

Value of ultra-high field MRI in patients with suspected focal epilepsy and negative 3 T MRI (EpiUltraStudy): protocol for a prospective, longitudinal therapeutic study

Lanen

Wiggins²,

Colon

et al. 2022

Neuroradiology

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Purpose Resective epilepsy surgery is a well-established, evidence-based treatment option in patients with drug-resistant focal epilepsy. A major predictive factor of good surgical outcome is visualization and delineation of a potential epileptogenic lesion by MRI. However, frequently, these lesions are subtle and may escape detection by conventional MRI (≤ 3 T). Methods We present the EpiUltraStudy protocol to address the hypothesis that application of ultra-high field (UHF) MRI increases the rate of detection of structural lesions and functional brain aberrances in patients with drug-resistant focal epilepsy who are candidates for resective epilepsy surgery. Additionally, therapeutic gain will be addressed, testing whether increased lesion detection and tailored resections result in higher rates of seizure freedom 1 year after epilepsy surgery. Sixty patients enroll the study according to the following inclusion criteria: aged ≥ 12 years, diagnosed with drug-resistant focal epilepsy with a suspected epileptogenic focus, negative conventional 3 T MRI during pre-surgical work-up. Results All patients will be evaluated by 7 T MRI; ten patients will undergo an additional 9.4 T MRI exam. Images will be evaluated independently by two neuroradiologists and a neurologist or neurosurgeon. Clinical and UHF MRI will be discussed in the multidisciplinary epilepsy surgery conference. Demographic and epilepsy characteristics, along with postoperative seizure outcome and histopathological evaluation, will be recorded. Conclusion This protocol was reviewed and approved by the local Institutional Review Board and complies with the Declaration of Helsinki and principles of Good Clinical Practice. Results will be submitted to international peer-reviewed journals and presented at international conferences. Trial registration number www.trialregister.nl: NTR7536.

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“…Oftmals sind Läsionen jedoch im 3-Tesla-MRT nicht erkennbar, die erst in der Hochfeld-MR-Untersuchung mit 7-Tesla-cMRT sichtbar waren (Sensitivität ca. 30 %) [15].…”

Section: Bildgebung Mit Automatisierter Auswertung In Der Epileptologieunclassified

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2022

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Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review

Cited by 28 publications

References 71 publications

Occult focal cortical dysplasia may predict poor outcome of surgery for drug-resistant mesial temporal lobe epilepsy

Occult focal cortical dysplasia may predict poor outcome of surgery for drug-resistant mesial temporal lobe epilepsy

Value of ultra-high field MRI in patients with suspected focal epilepsy and negative 3 T MRI (EpiUltraStudy): protocol for a prospective, longitudinal therapeutic study

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