Recommendations for structural brain MRI in the diagnosis of epilepsy

Czech version

Authors: M. Kynčl ^1*; Z. Holubová ^1*; J. Tintěra ²; N. Profantová ¹; J. Šanda ¹; D. Kala ³; Y. Prysiazhniuk ⁴; M. Kudr ⁵; P. Kršek ⁵; A. Kalina ⁶; J. Zárubová ⁶; V. Komárek ⁵; J. Otáhal ⁷; P. Marusič ⁶
Authors‘ workplace: Oba autoři přispěli rovným dílem. ^*; Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha ¹; Pracoviště radiodiagnostiky a intervenční radiologie, IKEM, Praha ²; Fyziologický ústav AV ČR ³; Ústav fyziologie, 2. LF UK, Praha ⁴; Klinika dětské neurologie 2. LF UK a FN Motol, Praha ⁵; Neurologická klinika 2. LF UK a FN Motol, Praha ⁶; Ústav patologické fyziologie, 2. LF UK, Praha ⁷
Published in: Cesk Slov Neurol N 2023; 86(1): 18-24
Category: Review Article
doi: https://doi.org/10.48095/cccsnn202318

Overview

Epilepsy affects about 0.5-1.5% of the population, of which approximately 30% of patients are drug-resistant. The importance of MRI in diagnosis lies mainly in the detection of structural etiology of the disease, assessing the patient‘s prognosis and, to a limited extent, planning appropriate treatment. Despite technological advances and technical equipment in medical centers, there is a considerable inconsistency in the MRI protocols used for structural brain imaging in patients with epilepsy. We aim to recommend a standardized MR structural brain imaging protocol for patients with epilepsy based on current international recommendations. Its widespread implementation will enable the establishment of a unified neuroimaging platform in the Czech Republic for these indications.

Keywords:

Epilepsy – magnetic resonance imaging – structural brain imaging

Sources

1. Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000; 342 (5): 314–319. doi: 10.1056/NEJM200002033420503.

2. Tavakol S, Royer J, Lowe AJ et al. Neuroimaging and connectomics of drug-resistant epilepsy at multiple scales: from focal lesions to macroscale networks. Epilepsia 2019; 60 (4): 593–604. doi: 10.1111/epi.14688.

3. Marusič P. Resekční chirurgická léčba epilepsie. Neurol Praxi 2018; 19 (1): 16–21. doi: 10.36290/neu.2018.004.

4. Engel J, McDermott MP, Wiebe S et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA 2012; 307 (9): 922–930. doi: 10.1001/jama.2012.220.

5. Dwivedi R, Ramanujam B, Chandra PS et al. Surgery for drug-resistant epilepsy in children. N Engl J Med 2017; 377 (17): 1639–1647. doi: 10.1056/NEJMoa1615 335.

6. Lamberink HJ, Otte WM, Blümcke I et al. Seizure outcome and use of antiepileptic drugs after epilepsy surgery according to histopathological diagnosis: a retrospective multicentre cohort study. Lancet Neurol 2020; 19 (9): 748–757. doi: 10.1016/S1474-4422 (20) 30220-9.

7. Bonilha L, Lee CY, Jensen JH et al. Altered microstructure in temporal lobe epilepsy: a diffusional kurtosis imaging study. AJNR Am J Neuroradiol 2015; 36 (4): 719–724. doi: 10.3174/ajnr.A4185.

8. Glenn GR, Jensen JH, Helpern JA et al. Epilepsy-related cytoarchitectonic abnormalities along white matter pathways. J Neurol Neurosurg Psychiatry 2016; 87 (9): 930–936. doi: 10.1136/jnnp-2015-312980.

9. Hogan RE. Quantitative measurement of longitudinal relaxation time (qT1) mapping in TLE: a marker for intracortical microstructure? Epilepsy Curr 2017; 17 (6): 358–360. doi: 10.5698/1535-7597.17.6.358.

10. Jbabdi S, Johansen-Berg H. Tractography: where do we go from here? Brain Connect 2011; 1 (3): 169–183. doi: 10.1089/brain.2011.0033.

11. Kini LG, Gee JC, Litt B. Computational analysis in epilepsy neuroimaging: a survey of features and methods. Neuroimage Clin 2016; 11: 515–529. doi: 10.1016/ j.nicl.2016.02.013.

12. Zijlmans M, Zweiphenning W, van Klink N. Changing concepts in presurgical assessment for epilepsy surgery. Nat Rev Neurol 2019; 15 (10): 594–606. doi: 10.1038/s41582-019-0224-y.

13. Gaillard WD, Cross JH, Duncan JS et al. Epilepsy imaging study guideline criteria: commentary on diagnostic testing study guidelines and practice parameters. Epilepsia 2011; 52 (9): 1750–1756. doi: 10.1111/j.15 28-1167.2011.03155.x.

14. Wellmer J, Quesada CM, Rothe L et al. Proposal for a magnetic resonance imaging protocol for the detection of epileptogenic lesions at early outpatient stages. Epilepsia 2013; 54 (11): 1977–1987. doi: 10.1111/epi.12 375.

15. Bernasconi A, Cendes F, Theodore WH et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: a consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia 2019; 60 (6): 1054–1068. doi: 10.1111/epi.15612.

16. Winston GP, Micallef C, Kendell BE et al. The value of repeat neuroimaging for epilepsy at a tertiary referral centre: 16 years of experience. Epilepsy Res 2013; 105 (3): 349–355. doi: 10.1016/j.eplepsyres.2013.02.022.

17. Von Oertzen J, Urbach H, Jungbluth S et al. Standard magnetic resonance imaging is inadequate for patients with refractory focal epilepsy. J Neurol Neurosurg Psychiatry 2002; 73 (6): 643–647. doi: 10.1136/jnnp.73.6.643.

18. Kreilkamp BAK, Das K, Wieshmann UC et al. Neuroradiological findings in patients with “non-lesional” focal epilepsy revealed by research protocol. Clin Radiol 2019; 74 (1): 78.e1–78.e11. doi: 10.1016/j.crad.2018.08.013.

19. Severino M, Geraldo AF, Utz N et al. Definitions and classification of malformations of cortical development: practical guidelines. Brain 2020; 143 (10): 2874–2894. doi: 10.1093/brain/awaa174.

20. Cendes F, Theodore WH, Brinkmann BH et al. Neuroimaging of epilepsy. Handb Clin Neurol 2016; 136: 985–1014. doi: 10.1016/B978-0-444-53486-6.00051-X.

21. Recommendations for neuroimaging of patients with epilepsy. Commission on Neuroimaging of the International League Against Epilepsy. Epilepsia 1997; 38 (11): 1255–1256. doi: 10.1111/j.1528-1157.1997.tb01226.x.

22. Wong-Kisiel LC, Britton JW, Witte RJ et al. Double inversion recovery magnetic resonance imaging in identifying focal cortical dysplasia. Pediatr Neurol 2016; 61: 87–93. doi: 10.1016/j.pediatrneurol.2016.04.013.

23. Middlebrooks EH, Lin C, Westerhold E et al. Improved detection of focal cortical dysplasia using a novel 3D imaging sequence: Edge-Enhancing Gradient Echo (3D-EDGE) MRI. Neuroimage Clin 2020; 28: 102449. doi: 10.1016/j.nicl.2020.102449.

24. Chen X, Qian T, Kober T et al. Gray-matter-specific MR imaging improves the detection of epileptogenic zones in focal cortical dysplasia: a new sequence called fluid and white matter suppression (FLAWS). Neuroimage Clin 2018; 20: 388–397. doi: 10.1016/j.nicl.2018. 08.010.

25. Toledano R, Jiménez-Huete A, Campo P et al. Small temporal pole encephalocele: a hidden cause of “normal” MRI temporal lobe epilepsy. Epilepsia 2016; 57 (5): 841–851. doi: 10.1111/epi.13371.

26. Dussaule C, Masnou P, Nasser G et al. Can developmental venous anomalies cause seizures? J Neurol 2017; 264 (12): 2495–2505. doi: 10.1007/s00415-017-8456-5.

27. Mendes A, Sampaio L. Brain magnetic resonance in status epilepticus: a focused review. Seizure 2016; 38: 63–67. doi: 10.1016/j.seizure.2016.04.007.

28. So EL, Lee RW. Epilepsy surgery in MRI-negative epilepsies. Curr Opin Neurol 2014; 27 (2): 206–212. doi: 10.1097/WCO.0000000000000078.

29. FreeSurfer. [online]. Available from URL: https: //surfer.nmr.mgh.harvard.edu.

30. Huppertz HJ, Grimm C, Fauser S et al. Enhanced visualization of blurred gray-white matter junctions in focal cortical dysplasia by voxel-based 3D MRI analysis. Epilepsy Res 2005; 67 (1–2): 35–50. doi: 10.1016/j.eplepsyres.2005.07.009.

31. Kudr M, Krsek P, Marusic P et al. SISCOM and FDG--PET in patients with non-lesional extratemporal epilepsy: correlation with intracranial EEG, histology, and seizure outcome. Epileptic Disord 2013; 15 (1): 3–13. doi: 10.1684/epd.2013.0560.

32. Sone D, Sato N, Maikusa N et al. Automated subfield volumetric analysis of hippocampus in temporal lobe epilepsy using high-resolution T2-weighed MR imaging. Neuroimage Clin 2016; 12: 57–64. doi: 10.1016/j.nicl.2016.06.008.