7 Tesla multi voxel spectroscopy (MRSI) may detect focal cortical dysplasia in intractable epilepsy patients as targets for epilepsy surgery
EANS Academy. Wais J. 10/06/21; 339524; EP08016
Dr. Jonathan Wais
Contributions
Contributions
Abstract
Objective: Structural 7 Tesla MRI has proven to enhance the diagnostic yield of detecting focal cortical dysplasia in refractory epilepsy patients. The aim of our study was to investigate, if multi voxel spectroscopy (MRSI) using 7 Tesla may improve the detection rate even further.
Methods: We measured 10 patients suffering from medically refractory epilepsy using MRSI covering the whole brain with 3.4mm isotropic resolution in 15 min. Quantification used a basis set of neurochemical components including Choline, Creatine, NAA, Glutamate and GABA.
Results: Different patient specific patterns of investigated metabolites were detected. Strong focal choline uptake was found in 3 patients, corresponding to suspected areas of focal cortical dysplasia in the structural images. These findings correlated strongly to the suspected epileptogenic zone defined by electro-clinical investigations and PET imaging. Intraoperatively, a tailored resection of these MRSI choline areas using neuronavigation and electro-corticography (ECoG) in these 3 patients was successfully performed and FCD I and IIb histology verified. Patients are seizure free so far.
Conclusion: 7 Tesla Choline MRSI may contribute to identify FCDs in patients with intractable epilepsy and guide the resection when included in the intraoperative neuronavigation.
Methods: We measured 10 patients suffering from medically refractory epilepsy using MRSI covering the whole brain with 3.4mm isotropic resolution in 15 min. Quantification used a basis set of neurochemical components including Choline, Creatine, NAA, Glutamate and GABA.
Results: Different patient specific patterns of investigated metabolites were detected. Strong focal choline uptake was found in 3 patients, corresponding to suspected areas of focal cortical dysplasia in the structural images. These findings correlated strongly to the suspected epileptogenic zone defined by electro-clinical investigations and PET imaging. Intraoperatively, a tailored resection of these MRSI choline areas using neuronavigation and electro-corticography (ECoG) in these 3 patients was successfully performed and FCD I and IIb histology verified. Patients are seizure free so far.
Conclusion: 7 Tesla Choline MRSI may contribute to identify FCDs in patients with intractable epilepsy and guide the resection when included in the intraoperative neuronavigation.
Objective: Structural 7 Tesla MRI has proven to enhance the diagnostic yield of detecting focal cortical dysplasia in refractory epilepsy patients. The aim of our study was to investigate, if multi voxel spectroscopy (MRSI) using 7 Tesla may improve the detection rate even further.
Methods: We measured 10 patients suffering from medically refractory epilepsy using MRSI covering the whole brain with 3.4mm isotropic resolution in 15 min. Quantification used a basis set of neurochemical components including Choline, Creatine, NAA, Glutamate and GABA.
Results: Different patient specific patterns of investigated metabolites were detected. Strong focal choline uptake was found in 3 patients, corresponding to suspected areas of focal cortical dysplasia in the structural images. These findings correlated strongly to the suspected epileptogenic zone defined by electro-clinical investigations and PET imaging. Intraoperatively, a tailored resection of these MRSI choline areas using neuronavigation and electro-corticography (ECoG) in these 3 patients was successfully performed and FCD I and IIb histology verified. Patients are seizure free so far.
Conclusion: 7 Tesla Choline MRSI may contribute to identify FCDs in patients with intractable epilepsy and guide the resection when included in the intraoperative neuronavigation.
Methods: We measured 10 patients suffering from medically refractory epilepsy using MRSI covering the whole brain with 3.4mm isotropic resolution in 15 min. Quantification used a basis set of neurochemical components including Choline, Creatine, NAA, Glutamate and GABA.
Results: Different patient specific patterns of investigated metabolites were detected. Strong focal choline uptake was found in 3 patients, corresponding to suspected areas of focal cortical dysplasia in the structural images. These findings correlated strongly to the suspected epileptogenic zone defined by electro-clinical investigations and PET imaging. Intraoperatively, a tailored resection of these MRSI choline areas using neuronavigation and electro-corticography (ECoG) in these 3 patients was successfully performed and FCD I and IIb histology verified. Patients are seizure free so far.
Conclusion: 7 Tesla Choline MRSI may contribute to identify FCDs in patients with intractable epilepsy and guide the resection when included in the intraoperative neuronavigation.
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