Cambridge Team Pioneers MRI Breakthrough to Perform Groundbreaking Epilepsy Surgery for Adults
A new technique has enabled ultra-powerful magnetic resonance imaging (MRI) scanners to identify tiny differences in patients' brains that cause treatment-resistant epilepsy. In the first study to use this approach, it has allowed doctors at Addenbrooke’s Hospital, Cambridge, to offer the patients surgery to cure their condition.
Previously, 7T MRI scanners – so called because they operate using a 7 Tesla magnetic field, more than double the strength of previous 3T scanners – have suffered from signal blackspots in crucial parts of the brain. But in research published today in Epilepsia, researchers in Cambridge and Paris have used a technique that overcomes this problem.
Around 360,000 people in the UK have a condition known as focal epilepsy, which causes seizures to spread from part of the brain. A third of these individuals have persistent seizures despite medication, and the only treatment that can cure their condition is surgery. Epileptic seizures are the sixth most common reason for hospital admission.
Ultra-high field 7T MRI scanners allow much more detailed resolution on brain scans and have been shown in other countries to be better than the NHS’s best 3T MRI scanners at detecting these lesions in patients with drug-resistant epilepsy
Chris Rodgers, Professor of Biomedical Imaging at the University of Cambridge, said: “It used to be the case that MRI scanners used a single radio transmitter, but in a similar way to how single wifi routers leave areas where you will struggle to get a signal, so these scanners would tend to leave blackspots on brain scans where it was hard to make out the relevant tissue.
“Now, by using multiple radio transmitters positioned around the patients’ head – like having a wifi mesh around your home – we can get much clearer images with fewer blackspots. This is important for the epilepsy scans because we need to see very precisely which part of the brain is misbehaving.
As a result of their findings, more than half of the patients (18 patients, or 58%) had the management of their epilepsy changed. Nine patients were offered surgery to remove the lesion, and one patient was offered laser interstitial thermal therapy (which uses heat to remove the lesion). For three patients, scans showed more complex lesions, meaning that surgery was no longer an option.
“7T scanners have shown promise over the past few years since their introduction, and now, thanks to this new technique, more epilepsy patients will be eligible for life-changing surgery
Ref: Klodowski, K et al. Parallel transmit 7T MRI for adult epilepsy pre-surgical evaluation. Epilepsia; 21 March 2025: DOI: 10.1111/epi.18353
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