Improving ultra-high field MRI scans to clearly show tiny structural abnormalities that cause epileptic seizures and guide curative epilepsy surgery
Anatomical Society co-funded PhD Studentship
£110,000
Prof Chris Rodgers
University of Cambridge
In Britain, 120,000 people have drug-resistant focal epilepsy (DRFE), which causes unpredictable and life-threatening seizures. Surgery is the only curative treatment but will only stop seizures if it removes the “lesion” driving the seizures.
Current NHS practice uses “3T MRI” and “FDG-PET” scans to find epilepsy lesions, but too often these don’t show the epilepsy lesion clearly enough to justify surgery. The remaining option is to surgically implant electrodes and record brain activity which costs ~£30,000 and carries a risk of complications.
We developed a new high-resolution parallel transmit (7T-pTx) MRI protocol. When we tested it in patients whose normal scans were inconclusive, it found epilepsy lesions in 15 out of 31 patients.
Yet we found only 1-2 of these lesions in the temporal lobes, whereas we should have found 4-5 lesions there based on historic clinical detection rates. Neuroradiologists tell us that poor image quality in temporal lobes is making it impossible to spot all lesions there.
We will invent new 7T-pTx MRI scans that show lesions clearly anywhere in the brain including the temporal lobes. We will achieve this by applying the latest MRI theory to control for the effects of myelin, and by using AI to suppress speckly noise that can hide lesions.
We will evaluate these new scans in 100 DRFE patients utilising 15-min “add-on” scan time funded by MRC as part of our multisite evaluation of 7T-pTx MRI for epilepsy. Neuroradiologists will log how often these new scans reveal a previously unseen lesion.
We expect that our new 7T-pTx scans will reveal temporal lobe lesions in 9 patients who would not otherwise be helped by current 7T-pTx scans during our 100-patient MRC-funded study. These patients will be able to access potentially life-changing surgery as a direct consequence of this work, without needing expensive and risky invasive tests. This will accrue significant health economic benefits as the patients lead productive working and social lives.
If we can also correct existing scans retrospectively, that increases to 15 patients.
We will share our new scans openly with 7T MRI facilities internationally to benefit many more people now and for years to come.
