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Does 7 T MRI offer an added value in drug resistant temporal lobe epilepsy?

Zampeli, Ariadne LU ; Malac, Miroslav ; Björkman-Burtscher, Isabella M. LU ; Hansson, Boel LU ; Wennberg, Linda LU ; Bloch, Karin Markenroth LU orcid ; Källén, Kristina LU and Strandberg, Maria Compagno LU (2026) In Seizure 134. p.27-36
Abstract

Purpose To evaluate the added value of 7 Tesla (T) magnetic resonance imaging (MRI) in the presurgical assessment of patients with temporal lobe epilepsy (TLE), considering its overall impact on clinical decision-making, including both MRI-positive and MRI-negative cases, and its timing during the evaluation process. Methods Sixty-one patients with drug-resistant TLE, enrolled in this study underwent both 3 T and 7 T MRI, along with other diagnostic assessments (video electroencephalography, positron emission tomography, stereo electroencephalography). Patients were categorized into three phases of the presurgical evaluation: basic, intermediate, and advanced. The added value of 7 T MRI was assessed based on its ability to confirm,... (More)

Purpose To evaluate the added value of 7 Tesla (T) magnetic resonance imaging (MRI) in the presurgical assessment of patients with temporal lobe epilepsy (TLE), considering its overall impact on clinical decision-making, including both MRI-positive and MRI-negative cases, and its timing during the evaluation process. Methods Sixty-one patients with drug-resistant TLE, enrolled in this study underwent both 3 T and 7 T MRI, along with other diagnostic assessments (video electroencephalography, positron emission tomography, stereo electroencephalography). Patients were categorized into three phases of the presurgical evaluation: basic, intermediate, and advanced. The added value of 7 T MRI was assessed based on its ability to confirm, exclude, or detect new epileptogenic lesions, as well as its influence on surgical decision-making. Results 7 T MRI provided added clinical value in 51 % of cases, improving lesion detection and contributing to clinical decisions, particularly in patients with unclear or ambiguous findings. In some instances, it confirmed previously suspected lesions or revealed previously undetected lesions, leading to surgical interventions. It also helped exclude possible lesions, influencing decisions to avoid unnecessary surgery. Notably, hippocampal malrotation (HIMAL) was identified in several patients, warranting further investigation regarding its potential epileptogenic role. Conclusion 7 T MRI enhances the presurgical evaluation of TLE by improving lesion detection, clarifying ambiguous findings, and aiding clinical decision-making. Its use should be considered at various stages of the evaluation process, as it offers valuable diagnostic information for both MRI-positive and MRI-negative patients. Further research is needed to explore the possible epileptogenic significance of HIMAL.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
7 T magnetic resonance imaging, Added clinical value, Hippocampal malrotation, Hippocampal sclerosis, Temporal lobe epilepsy
in
Seizure
volume
134
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:105022255701
  • pmid:41270421
ISSN
1059-1311
DOI
10.1016/j.seizure.2025.11.004
language
English
LU publication?
yes
id
60db3991-c383-42f0-84a9-9e5461a938ee
date added to LUP
2026-02-11 11:38:33
date last changed
2026-02-11 11:39:21
@article{60db3991-c383-42f0-84a9-9e5461a938ee,
  abstract     = {{<p>Purpose To evaluate the added value of 7 Tesla (T) magnetic resonance imaging (MRI) in the presurgical assessment of patients with temporal lobe epilepsy (TLE), considering its overall impact on clinical decision-making, including both MRI-positive and MRI-negative cases, and its timing during the evaluation process. Methods Sixty-one patients with drug-resistant TLE, enrolled in this study underwent both 3 T and 7 T MRI, along with other diagnostic assessments (video electroencephalography, positron emission tomography, stereo electroencephalography). Patients were categorized into three phases of the presurgical evaluation: basic, intermediate, and advanced. The added value of 7 T MRI was assessed based on its ability to confirm, exclude, or detect new epileptogenic lesions, as well as its influence on surgical decision-making. Results 7 T MRI provided added clinical value in 51 % of cases, improving lesion detection and contributing to clinical decisions, particularly in patients with unclear or ambiguous findings. In some instances, it confirmed previously suspected lesions or revealed previously undetected lesions, leading to surgical interventions. It also helped exclude possible lesions, influencing decisions to avoid unnecessary surgery. Notably, hippocampal malrotation (HIMAL) was identified in several patients, warranting further investigation regarding its potential epileptogenic role. Conclusion 7 T MRI enhances the presurgical evaluation of TLE by improving lesion detection, clarifying ambiguous findings, and aiding clinical decision-making. Its use should be considered at various stages of the evaluation process, as it offers valuable diagnostic information for both MRI-positive and MRI-negative patients. Further research is needed to explore the possible epileptogenic significance of HIMAL.</p>}},
  author       = {{Zampeli, Ariadne and Malac, Miroslav and Björkman-Burtscher, Isabella M. and Hansson, Boel and Wennberg, Linda and Bloch, Karin Markenroth and Källén, Kristina and Strandberg, Maria Compagno}},
  issn         = {{1059-1311}},
  keywords     = {{7 T magnetic resonance imaging; Added clinical value; Hippocampal malrotation; Hippocampal sclerosis; Temporal lobe epilepsy}},
  language     = {{eng}},
  pages        = {{27--36}},
  publisher    = {{Elsevier}},
  series       = {{Seizure}},
  title        = {{Does 7 T MRI offer an added value in drug resistant temporal lobe epilepsy?}},
  url          = {{http://dx.doi.org/10.1016/j.seizure.2025.11.004}},
  doi          = {{10.1016/j.seizure.2025.11.004}},
  volume       = {{134}},
  year         = {{2026}},
}