PURPOSE: With the success that surgical approaches can provide for localization-related epilepsy, accurate seizure localization remains important. Although magnetic resonance (MR) spectroscopy has had success in earlier studies in medial temporal lobe epilepsy, there have been fewer studies evaluating its use in a broader range of localization-related epilepsy. With improvements in signal-to-noise with ultra-high field MR, we report on the use of high resolution 7T MR spectroscopic imaging (MRSI) in 25 surgically treated patients studied over a 3.5-year period. METHODS: Patients were included in this analysis if the region of MRSI study included the surgical resection region. Concordance between region of MRSI abnormalities and of surgical resection was classified into three groups (complete, partial, or no agreement) and outcome was dichotomized by International League Against Epilepsy (ILAE) I-III and IV-VI groups. MRSI was performed with repetition time/echo time 1.5 s/40 msec in two-dimensional (2D) or three-dimensional (3D) encoding for robust detection of singlets N-acetyl aspartate (NAA), creatine (Cr), and choline with abnormalities in NAA/Cr determined with correction for tissue content of gray matter. KEY FINDINGS: The concordance between MRSI-determined abnormality and surgical resection region was significantly related to outcome: Outcome was better if the resected tissue was metabolically abnormal. All 14 patients with complete resection of the region with the most severe metabolic abnormality had good outcome, including five requiring intracranial electroencephalography (EEG) analysis, whereas only 3/11 without complete resection of the most severe metabolic abnormality had good outcome (p < 0.001). SIGNIFICANCE: This is consistent with the seizure-onset zone being characterized by metabolic dysfunction and suggests that high resolution MRSI can help define these regions for the purposes of outcome prediction. Wiley Periodicals, Inc.
PURPOSE: With the success that surgical approaches can provide for localization-related epilepsy, accurate seizure localization remains important. Although magnetic resonance (MR) spectroscopy has had success in earlier studies in medial temporal lobe epilepsy, there have been fewer studies evaluating its use in a broader range of localization-related epilepsy. With improvements in signal-to-noise with ultra-high field MR, we report on the use of high resolution 7T MR spectroscopic imaging (MRSI) in 25 surgically treated patients studied over a 3.5-year period. METHODS:Patients were included in this analysis if the region of MRSI study included the surgical resection region. Concordance between region of MRSI abnormalities and of surgical resection was classified into three groups (complete, partial, or no agreement) and outcome was dichotomized by International League Against Epilepsy (ILAE) I-III and IV-VI groups. MRSI was performed with repetition time/echo time 1.5 s/40 msec in two-dimensional (2D) or three-dimensional (3D) encoding for robust detection of singlets N-acetyl aspartate (NAA), creatine (Cr), and choline with abnormalities in NAA/Cr determined with correction for tissue content of gray matter. KEY FINDINGS: The concordance between MRSI-determined abnormality and surgical resection region was significantly related to outcome: Outcome was better if the resected tissue was metabolically abnormal. All 14 patients with complete resection of the region with the most severe metabolic abnormality had good outcome, including five requiring intracranial electroencephalography (EEG) analysis, whereas only 3/11 without complete resection of the most severe metabolic abnormality had good outcome (p < 0.001). SIGNIFICANCE: This is consistent with the seizure-onset zone being characterized by metabolic dysfunction and suggests that high resolution MRSI can help define these regions for the purposes of outcome prediction. Wiley Periodicals, Inc.
Authors: J T Vaughan; M Garwood; C M Collins; W Liu; L DelaBarre; G Adriany; P Andersen; H Merkle; R Goebel; M B Smith; K Ugurbil Journal: Magn Reson Med Date: 2001-07 Impact factor: 4.668
Authors: Nihal C de Lanerolle; Jung H Kim; Anne Williamson; Susan S Spencer; Hitten P Zaveri; Tore Eid; Dennis D Spencer; Toye Eid Journal: Epilepsia Date: 2003-05 Impact factor: 5.864
Authors: Stefan Blüml; Jessica L Wisnowski; Marvin D Nelson; Lisa Paquette; Floyd H Gilles; Hannah C Kinney; Ashok Panigrahy Journal: Cereb Cortex Date: 2012-09-05 Impact factor: 5.357
Authors: Susanne G Mueller; Andreas Ebel; Jerome Barakos; Cathy Scanlon; Ian Cheong; Daniel Finlay; Paul Garcia; Michael W Weiner; Kenneth D Laxer Journal: J Neurol Date: 2010-10-26 Impact factor: 4.849
Authors: David X Feng; Joseph P McCauley; Fea K Morgan-Curtis; Redoan A Salam; David R Pennell; Mary E Loveless; Adrienne N Dula Journal: Br J Radiol Date: 2015-10-20 Impact factor: 3.039
Authors: Chathura Kumaragamage; Henk M De Feyter; Peter Brown; Scott McIntyre; Terence W Nixon; Robin A de Graaf Journal: Magn Reson Med Date: 2019-11-19 Impact factor: 4.668
Authors: Rupa Radhakrishnan; James L Leach; Francesco T Mangano; Michael J Gelfand; Leonid Rozhkov; Lili Miles; Hansel M Greiner Journal: Pediatr Radiol Date: 2016-04-25
Authors: Chathura Kumaragamage; Henk M De Feyter; Peter Brown; Scott McIntyre; Terence W Nixon; Robin A de Graaf Journal: NMR Biomed Date: 2020-10-01 Impact factor: 4.478
Authors: Andrew A Maudsley; Ovidiu C Andronesi; Peter B Barker; Alberto Bizzi; Wolfgang Bogner; Anke Henning; Sarah J Nelson; Stefan Posse; Dikoma C Shungu; Brian J Soher Journal: NMR Biomed Date: 2020-04-29 Impact factor: 4.044
Authors: Giske Opheim; Anja van der Kolk; Karin Markenroth Bloch; Albert J Colon; Kathryn A Davis; Thomas R Henry; Jacobus F A Jansen; Stephen E Jones; Jullie W Pan; Karl Rössler; Joel M Stein; Maria C Strandberg; Siegfried Trattnig; Pierre-Francois Van de Moortele; Maria Isabel Vargas; Irene Wang; Fabrice Bartolomei; Neda Bernasconi; Andrea Bernasconi; Boris Bernhardt; Isabella Björkman-Burtscher; Mirco Cosottini; Sandhitsu R Das; Lucie Hertz-Pannier; Sara Inati; Michael T Jurkiewicz; Ali R Khan; Shuli Liang; Ruoyun Emily Ma; Srinivasan Mukundan; Heath Pardoe; Lars H Pinborg; Jonathan R Polimeni; Jean-Philippe Ranjeva; Esther Steijvers; Steven Stufflebeam; Tim J Veersema; Alexandre Vignaud; Natalie Voets; Serge Vulliemoz; Christopher J Wiggins; Rong Xue; Renzo Guerrini; Maxime Guye Journal: Neurology Date: 2020-12-22 Impact factor: 9.910