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van Lanen RHGJ, Colon AJ, Wiggins CJ, et al. Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review. Neuroimage Clin. 2021;30:102602doi: 10.1016/j.nicl.2021.102602.
van Lanen, R. H. G. J., Colon, A. J., Wiggins, C. J., Hoeberigs, M. C., Hoogland, G., Roebroeck, A., Ivanov, D., Poser, B. A., Rouhl, R. P. W., Hofman, P. A. M., Jansen, J. F. A., Backes, W., Rijkers, K., & Schijns, O. E. M. G. (2021). Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review. NeuroImage. Clinical, 30102602. https://doi.org/10.1016/j.nicl.2021.102602
van Lanen, R H G J, et al. "Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review." NeuroImage. Clinical vol. 30 (2021): 102602. doi: https://doi.org/10.1016/j.nicl.2021.102602
van Lanen RHGJ, Colon AJ, Wiggins CJ, Hoeberigs MC, Hoogland G, Roebroeck A, Ivanov D, Poser BA, Rouhl RPW, Hofman PAM, Jansen JFA, Backes W, Rijkers K, Schijns OEMG. Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review. Neuroimage Clin. 2021;30:102602. doi: 10.1016/j.nicl.2021.102602. Epub 2021 Feb 22. PMID: 33652376; PMCID: PMC7921009.
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Neuroimage Clin. 2021;30:102602. doi: 10.1016/j.nicl.2021.102602. Epub 2021 Feb 22.

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

NeuroImage. Clinical

R H G J van Lanen, A J Colon, C J Wiggins, M C Hoeberigs, G Hoogland, A Roebroeck, D Ivanov, B A Poser, R P W Rouhl, P A M Hofman, J F A Jansen, W Backes, K Rijkers, O E M G Schijns

Affiliations

  1. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands. Electronic address: [email protected].
  2. Academic Center for Epileptology, Kempenhaeghe/Maastricht University Medical Center, Heeze/Maastricht, The Netherlands.
  3. Scannexus, Ultra High Field MRI Research Center, Maastricht, The Netherlands.
  4. Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
  5. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands; Academic Center for Epileptology, Kempenhaeghe/Maastricht University Medical Center, Heeze/Maastricht, The Netherlands.
  6. Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
  7. School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands; Academic Center for Epileptology, Kempenhaeghe/Maastricht University Medical Center, Heeze/Maastricht, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
  8. School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands; Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
  9. School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands; Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.

PMID: 33652376 PMCID: PMC7921009 DOI: 10.1016/j.nicl.2021.102602

Abstract

RATIONALE: Resective epilepsy surgery is an evidence-based curative treatment option for patients with drug-resistant focal epilepsy. The major preoperative predictor of a good surgical outcome is detection of an epileptogenic lesion by magnetic resonance imaging (MRI). Application of ultra-high field (UHF) MRI, i.e. field strengths ≥ 7 Tesla (T), may increase the sensitivity to detect such a lesion.

METHODS: A keyword search strategy was submitted to Pubmed, EMBASE, Cochrane Database and clinicaltrials.gov to select studies on UHF MRI in patients with epilepsy. Follow-up study selection and data extraction were performed following PRISMA guidelines. We focused on I) diagnostic gain of UHF- over conventional MRI, II) concordance of MRI-detected lesion, seizure onset zone and surgical decision-making, and III) postoperative histopathological diagnosis and seizure outcome.

RESULTS: Sixteen observational cohort studies, all using 7T MRI were included. Diagnostic gain of 7T over conventional MRI ranged from 8% to 67%, with a pooled gain of 31%. Novel techniques to visualize pathological processes in epilepsy and lesion detection are discussed. Seizure freedom was achieved in 73% of operated patients; no seizure outcome comparison was made between 7T MRI positive, 7T negative and 3T positive patients. 7T could influence surgical decision-making, with high concordance of lesion and seizure onset zone. Focal cortical dysplasia (54%), hippocampal sclerosis (12%) and gliosis (8.1%) were the most frequently diagnosed histopathological entities.

SIGNIFICANCE: UHF MRI increases, yet variably, the sensitivity to detect an epileptogenic lesion, showing potential for use in clinical practice. It remains to be established whether this results in improved seizure outcome after surgical treatment. Prospective studies with larger cohorts of epilepsy patients, uniform scan and sequence protocols, and innovative post-processing technology are equally important as further increasing field strengths. Besides technical ameliorations, improved correlation of imaging features with clinical semiology, histopathology and clinical outcome has to be established.

Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

Keywords: 7T; Epilepsy; MRI; Magnetic resonance imaging; Ultra-high field

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