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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
- Source :
- Neuroradiology 64(4), 753-764 (2022). doi:10.1007/s00234-021-02884-8, Neuroradiology, 64(4), 753-764. Springer, Cham
- Publication Year :
- 2022
- Publisher :
- Springer Science and Business Media LLC, 2022.
-
Abstract
- 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.
- Subjects :
- SELECTION
Drug Resistant Epilepsy
SURGERY
UHF MRI
ILAE COMMISSION
CONSENSUS CLASSIFICATION
PROPOSAL
Epilepsy surgery
Humans
Radiology, Nuclear Medicine and imaging
Longitudinal Studies
Prospective Studies
INTRACTABLE EPILEPSY
Child
Epilepsy
MEG
SURGICAL OUTCOMES
7 T
Magnetic Resonance Imaging
9.4 T
CORTICAL DYSPLASIA
Treatment Outcome
Epilepsies, Partial
Neurology (clinical)
Cardiology and Cardiovascular Medicine
HOC TASK-FORCE
Subjects
Details
- ISSN :
- 14321920 and 00283940
- Volume :
- 64
- Database :
- OpenAIRE
- Journal :
- Neuroradiology
- Accession number :
- edsair.doi.dedup.....daea730fa817bdfc1166b5b47f543762
- Full Text :
- https://doi.org/10.1007/s00234-021-02884-8