A study conducted at Addenbrooke’s Hospital has demonstrated that ultra-powerful MRI scans could help patients with focus epilepsy receive curative surgery.
Focal epilepsy is a condition caused by lesions in the brain that lead to seizures, and affects around 360,000 people in the UK, with a third of those struggling to control symptoms with medication.
Lesions can be removed through surgery, which requires MRI to pinpoint their locations – but standard strength MRIs, which generate magnetic fields 1.5 Teslas strong, are too weak to find smaller lesions.
Cambridge University Hospitals is currently using a 7 Tesla MRI scanner for research, which is capable of producing highly detailed images. Following a study at Addenbrooke’s Hospital, researchers were able to develop a technique allowing this stronger MRI to detect small lesions.
'More patients eligible for life-changing surgery'
Dr Thomas Cope, consultant neurologist at Cambridge University Hospitals, said: “Having epilepsy that doesn’t respond to anti-seizure medications can have a huge impact on patients’ lives, often affecting their independence and their ability to maintain a job.
“We know we can cure many of these patients, but that requires us to be able to pinpoint exactly where in the brain is the root of their seizures. Thanks to this new technique, more epilepsy patients will be eligible for life-changing surgery.”
Ultra-powerful MRIs are typically not used for brain imaging, because of a weakness which produces “signal blackspots” in key areas of the brain.
Results published today in medical journal Epilepsia by University of Cambridge’s Wolfson Brain Imaging Centre and the Université Paris-Saclay, however, have demonstrated a “triangulation” technique that addresses these blackspots.
Parallel transmit MRI
Known as “parallel transmit MRI”, multiple transmitters are positioned around the patient’s head, meaning clinicians can now detect smaller lesions and allow more patients to be offered surgery to cure their condition.
The study scanned 31 patients with the parallel transmit technique, and mroe than half (57 per cent) of produced images were clearer than with existing methods, while the rest were of equal quality.
As a result, 18 patients are managing their epilepsy differently, including nine who are now able to have potentially curative surgery.
Just as comfortable
The study also investigated the patient experience of the new scan, which showed it was just as comfortable as standard MRI.
The research team at CUH are continuing trials using 7T MRI and hope more patients will benefit as a result of taking part.
The research was supported by the Cambridge University Hospitals Academic Fund and the Medical Research Council, with support from the NIHR Cambridge Biomedical Research Centre.
(Image: Ultra-powerful 7T MRI scanner, via Cambridge University Hospitals)