Usage of SWI (susceptibility weighted imaging) acquired at 7T for qualitative evaluation of temporal lobe epilepsy patients with histopathological and clinical correlation: An initial pilot study

Benjamin Y M Kwan; Fateme Salehi; Pavlo Ohorodnyk; Donald H Lee; Jorge G Burneo; Seyed M Mirsattari; David Steven; Robert Hammond; Terry M Peters; Ali R Khan

doi:10.1016/j.jns.2016.07.066

Usage of SWI (susceptibility weighted imaging) acquired at 7T for qualitative evaluation of temporal lobe epilepsy patients with histopathological and clinical correlation: An initial pilot study

J Neurol Sci. 2016 Oct 15:369:82-87. doi: 10.1016/j.jns.2016.07.066. Epub 2016 Aug 2.

Authors

Affiliations

¹ Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada.
² Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada.
³ Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada.
⁴ Imaging Research Laboratories, Robarts Research Institute, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada; Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada.
⁵ Imaging Research Laboratories, Robarts Research Institute, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada; Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St. North, London, Ontario, N6A 5B7, Canada. Electronic address: alik@robarts.ca.

PMID: 27653870
DOI: 10.1016/j.jns.2016.07.066

Abstract

Objectives: Ultra high field MRI at 7T is able to provide much improved spatial and contrast resolution which may aid in the diagnosis of hippocampal abnormalities. This paper presents a preliminary experience on qualitative evaluation of 7T MRI in temporal lobe epilepsy patients with a focus on comparison to histopathology.

Methods: 7T ultra high field MRI data, using T1-weighted, T2*-weighted and susceptibility-weighted images (SWI), were acquired for 13 patients with drug resistant temporal lobe epilepsy (TLE) during evaluation for potential epilepsy surgery. Qualitative evaluation of the imaging data for scan quality and presence of hippocampal and temporal lobe abnormalities were scored while blinded to the clinical data. Correlation of imaging findings with the clinical data was performed. Blinded evaluation of 1.5T scans was also performed.

Results: On the 7T MRI findings, eight out of 13 cases demonstrated concordance with the clinically suspected TLE. Among these concordant cases, three exhibited supportive abnormal 7T MRI findings which were not detected by the clinical 1.5T MRI. Of the ten cases that progressed to epilepsy surgery, seven showed concordance between 7T MRI findings and histopathology; of these, four cases had hippocampal sclerosis. SWI had the highest concordance with the clinical and histopathological findings. Similar clinical and histopathological concordance was found with 1.5T MRI.

Conclusions: There was moderate and high concordance between the 7T imaging findings with the clinical data and histopathology respectively.

Keywords: 7T MRI; Histopathology; Neuroradiology; Temporal lobe epilepsy.

MeSH terms

Adolescent
Adult
Aged
Epilepsy, Temporal Lobe / diagnostic imaging*
Female
Humans
Image Processing, Computer-Assisted*
Magnetic Resonance Imaging*
Male
Middle Aged
Pilot Projects
Statistics as Topic
Young Adult