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

R. H. G. J. van Lanen; C. J. Wiggins; A. J. Colon; W. H. Backes; J. F. A. Jansen; D. Uher; G. S. Drenthen; A. Roebroeck; D. Ivanov; B. A. Poser; M. C. Hoeberigs; S. M. J. van Kuijk; G. Hoogland; K. Rijkers; G. L. Wagner; J. Beckervordersandforth; D. Delev; H. Clusmann; S. Wolking; S. Klinkenberg; R. P. W. Rouhl; P. A. M. Hofman; O. E. M. G. Schijns

doi:10.1007/s00234-021-02884-8

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

R. H. G. J. van Lanen^*, C. J. Wiggins, A. J. Colon, W. H. Backes, J. F. A. Jansen, D. Uher, G. S. Drenthen, A. Roebroeck, D. Ivanov, B. A. Poser, M. C. Hoeberigs, S. M. J. van Kuijk, G. Hoogland, K. Rijkers, G. L. Wagner, J. Beckervordersandforth, D. Delev, H. Clusmann, S. Wolking, S. KlinkenbergR. P. W. Rouhl, P. A. M. Hofman, O. E. M. G. Schijns

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	753-764
Number of pages	12
Journal	Neuroradiology
Volume	64
Issue number	4
Early online date	5 Jan 2022
DOIs	https://doi.org/10.1007/s00234-021-02884-8
Publication status	Published - Apr 2022

Keywords

7 T
9.4 T
CONSENSUS CLASSIFICATION
CORTICAL DYSPLASIA
Epilepsy
Epilepsy surgery
HOC TASK-FORCE
ILAE COMMISSION
INTRACTABLE EPILEPSY
MEG
PROPOSAL
SELECTION
SURGERY
SURGICAL OUTCOMES
UHF MRI

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Cite this

van Lanen, R. H. G. J., Wiggins, C. J., Colon, A. J., Backes, W. H., Jansen, J. F. A., Uher, D., Drenthen, G. S., Roebroeck, A., Ivanov, D., Poser, B. A., Hoeberigs, M. C., van Kuijk, S. M. J., Hoogland, G., Rijkers, K., Wagner, G. L., Beckervordersandforth, J., Delev, D., Clusmann, H., Wolking, S., ... Schijns, O. E. M. G. (2022). 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. Neuroradiology, 64(4), 753-764. https://doi.org/10.1007/s00234-021-02884-8

@article{c758ba44e6fe422b82fa52e07632193c,

title = "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",

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.",

keywords = "7 T, 9.4 T, CONSENSUS CLASSIFICATION, CORTICAL DYSPLASIA, Epilepsy, Epilepsy surgery, HOC TASK-FORCE, ILAE COMMISSION, INTRACTABLE EPILEPSY, MEG, PROPOSAL, SELECTION, SURGERY, SURGICAL OUTCOMES, UHF MRI",

author = "{van Lanen}, {R. H. G. J.} and Wiggins, {C. J.} and Colon, {A. J.} and Backes, {W. H.} and Jansen, {J. F. A.} and D. Uher and Drenthen, {G. S.} and A. Roebroeck and D. Ivanov and Poser, {B. A.} and Hoeberigs, {M. C.} and {van Kuijk}, {S. M. J.} and G. Hoogland and K. Rijkers and Wagner, {G. L.} and J. Beckervordersandforth and D. Delev and H. Clusmann and S. Wolking and S. Klinkenberg and Rouhl, {R. P. W.} and Hofman, {P. A. M.} and Schijns, {O. E. M. G.}",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = apr,

doi = "10.1007/s00234-021-02884-8",

language = "English",

volume = "64",

pages = "753--764",

journal = "Neuroradiology",

issn = "0028-3940",

publisher = "Springer, Cham",

number = "4",

}

van Lanen, RHGJ, Wiggins, CJ, Colon, AJ, Backes, WH , Jansen, JFA , Uher, D , Drenthen, GS , Roebroeck, A , Ivanov, D , Poser, BA , Hoeberigs, MC , van Kuijk, SMJ , Hoogland, G , Rijkers, K, Wagner, GL, Beckervordersandforth, J, Delev, D, Clusmann, H, Wolking, S, Klinkenberg, S , Rouhl, RPW , Hofman, PAM & Schijns, OEMG 2022, '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', Neuroradiology, vol. 64, no. 4, pp. 753-764. https://doi.org/10.1007/s00234-021-02884-8

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. / van Lanen, R. H. G. J.; Wiggins, C. J.; Colon, A. J. et al.
In: Neuroradiology, Vol. 64, No. 4, 04.2022, p. 753-764.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Value of ultra-high field MRI in patients with suspected focal epilepsy and negative 3 T MRI (EpiUltraStudy)

T2 - protocol for a prospective, longitudinal therapeutic study

AU - van Lanen, R. H. G. J.

AU - Wiggins, C. J.

AU - Colon, A. J.

AU - Backes, W. H.

AU - Jansen, J. F. A.

AU - Uher, D.

AU - Drenthen, G. S.

AU - Roebroeck, A.

AU - Ivanov, D.

AU - Poser, B. A.

AU - Hoeberigs, M. C.

AU - van Kuijk, S. M. J.

AU - Hoogland, G.

AU - Rijkers, K.

AU - Wagner, G. L.

AU - Beckervordersandforth, J.

AU - Delev, D.

AU - Clusmann, H.

AU - Wolking, S.

AU - Klinkenberg, S.

AU - Rouhl, R. P. W.

AU - Hofman, P. A. M.

AU - Schijns, O. E. M. G.

PY - 2022/4

Y1 - 2022/4

N2 - 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.

AB - 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.

KW - 7 T

KW - 9.4 T

KW - CONSENSUS CLASSIFICATION

KW - CORTICAL DYSPLASIA

KW - Epilepsy

KW - Epilepsy surgery

KW - HOC TASK-FORCE

KW - ILAE COMMISSION

KW - INTRACTABLE EPILEPSY

KW - MEG

KW - PROPOSAL

KW - SELECTION

KW - SURGERY

KW - SURGICAL OUTCOMES

KW - UHF MRI

U2 - 10.1007/s00234-021-02884-8

DO - 10.1007/s00234-021-02884-8

M3 - Article

C2 - 34984522

SN - 0028-3940

VL - 64

SP - 753

EP - 764

JO - Neuroradiology

JF - Neuroradiology

IS - 4

ER -