Value of ultra‐high‐field MRI in patients with drug‐resistant focal epilepsy and negative 3T MRI (EpiUltraStudy): Diagnostic gain of 7T structural analysis.
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| Title: | Value of ultra‐high‐field MRI in patients with drug‐resistant focal epilepsy and negative 3T MRI (EpiUltraStudy): Diagnostic gain of 7T structural analysis. |
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| Authors: | van Lanen, Rick H. G. J. (AUTHOR), Uher, Daniel (AUTHOR), Hoeberigs, Christianne M. C. (AUTHOR), Hofman, Paul A. M. (AUTHOR), Santegoeds, Remco (AUTHOR), Wiggins, Christopher (AUTHOR), Tse, Desmond H. Y. (AUTHOR), Steijvers, Esther G. M. (AUTHOR), Jansen, Jacobus F. A. (AUTHOR), Drenthen, Gerald S. (AUTHOR), Roebroeck, Alard (AUTHOR), Ivanov, Dimo (AUTHOR), Poser, Benedikt A. (AUTHOR), van Kuijk, Sander M. J. (AUTHOR), Hoogland, Govert (AUTHOR), Rijkers, Kim (AUTHOR), Wagner, Louis G. L. (AUTHOR), Widman, Guido (AUTHOR), Beckervordersandforth, Jan (AUTHOR), Klinkenberg, Sylvia (AUTHOR) |
| Source: | Epilepsia (Series 4). Feb2026, Vol. 67 Issue 2, p791-804. 14p. |
| Subjects: | Magnetic resonance imaging, Epilepsy surgery, Diagnostic imaging, Diagnosis of epilepsy, Brain imaging, Partial epilepsy |
| Abstract: | Objective: Resective epilepsy surgery is an evidence‐based treatment option for patients with focal drug‐resistant epilepsy (DRE). Seizure outcome after surgery is largely dependent on detection and delineation of an epileptogenic lesion on magnetic resonance imaging (MRI). However, detection fails in 30% of patients at 3 Tesla (T) MRI, thereby limiting surgical options. Diagnostic and therapeutic gain of ultra‐high‐field MRI in patients with 3T MRI‐negative DRE is evaluated in the EpiUltraStudy. Here we report the diagnostic gain of structural 7T MRI. Methods: Inclusion criteria were age ≥12 years and DRE with a suspected epileptogenic focus and negative conventional 3T MRI during pre‐surgical workup. Images were evaluated independently by two neuroradiologists and a neurologist or neurosurgeon in two runs: blinded (Run 1) and with the results of additional clinical investigations (Run 2). Results: Sixty patients underwent 7T MRI. No persistent adverse events were reported. Visual assessment of 7T MRI identified lesions in 9 cases (15%), undetected on prior 3T MRI. Possible positive scan rates increased from 17% (10/60) in the blinded run to 47% (28/60) in the informed run. However, after consensus review, many of these were reclassified as negative. Eight of nine positive 7T MRI scans were initially identified by only one or two assessors. After reassessment, a total of 56% (5/9) of 7T lesions were retrospectively identified on 3T. Significance: Our data suggest a benefit of 7T MRI for the detection of subtle epileptogenic lesions in patients with DRE and negative 3T MRI. Although the detection rate may appear modest compared to other reports, we present a nuanced discussion of our methodology and patient population, contributing meaningful context to the current literature. The availability of multimodal information and consensus reviews enhanced diagnostic accuracy but with higher rates of false positives, underscoring the importance of multidisciplinary cooperation in the clinical care for patients with DRE. Trial Registration Number: www.trialregister.nl: NTR7536. [ABSTRACT FROM AUTHOR] |
| Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 192080317 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Value of ultra‐high‐field MRI in patients with drug‐resistant focal epilepsy and negative 3T MRI (EpiUltraStudy): Diagnostic gain of 7T structural analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22van+Lanen%2C+Rick+H%2E+G%2E+J%2E%22">van Lanen, Rick H. G. J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Uher%2C+Daniel%22">Uher, Daniel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hoeberigs%2C+Christianne+M%2E+C%2E%22">Hoeberigs, Christianne M. C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hofman%2C+Paul+A%2E+M%2E%22">Hofman, Paul A. M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Santegoeds%2C+Remco%22">Santegoeds, Remco</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wiggins%2C+Christopher%22">Wiggins, Christopher</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tse%2C+Desmond+H%2E+Y%2E%22">Tse, Desmond H. Y.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Steijvers%2C+Esther+G%2E+M%2E%22">Steijvers, Esther G. M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jansen%2C+Jacobus+F%2E+A%2E%22">Jansen, Jacobus F. A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Drenthen%2C+Gerald+S%2E%22">Drenthen, Gerald S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Roebroeck%2C+Alard%22">Roebroeck, Alard</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ivanov%2C+Dimo%22">Ivanov, Dimo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Poser%2C+Benedikt+A%2E%22">Poser, Benedikt A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22van+Kuijk%2C+Sander+M%2E+J%2E%22">van Kuijk, Sander M. J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hoogland%2C+Govert%22">Hoogland, Govert</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rijkers%2C+Kim%22">Rijkers, Kim</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wagner%2C+Louis+G%2E+L%2E%22">Wagner, Louis G. L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Widman%2C+Guido%22">Widman, Guido</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beckervordersandforth%2C+Jan%22">Beckervordersandforth, Jan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Klinkenberg%2C+Sylvia%22">Klinkenberg, Sylvia</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Feb2026, Vol. 67 Issue 2, p791-804. 14p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis+of+epilepsy%22">Diagnosis of epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+imaging%22">Brain imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Partial+epilepsy%22">Partial epilepsy</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective: Resective epilepsy surgery is an evidence‐based treatment option for patients with focal drug‐resistant epilepsy (DRE). Seizure outcome after surgery is largely dependent on detection and delineation of an epileptogenic lesion on magnetic resonance imaging (MRI). However, detection fails in 30% of patients at 3 Tesla (T) MRI, thereby limiting surgical options. Diagnostic and therapeutic gain of ultra‐high‐field MRI in patients with 3T MRI‐negative DRE is evaluated in the EpiUltraStudy. Here we report the diagnostic gain of structural 7T MRI. Methods: Inclusion criteria were age ≥12 years and DRE with a suspected epileptogenic focus and negative conventional 3T MRI during pre‐surgical workup. Images were evaluated independently by two neuroradiologists and a neurologist or neurosurgeon in two runs: blinded (Run 1) and with the results of additional clinical investigations (Run 2). Results: Sixty patients underwent 7T MRI. No persistent adverse events were reported. Visual assessment of 7T MRI identified lesions in 9 cases (15%), undetected on prior 3T MRI. Possible positive scan rates increased from 17% (10/60) in the blinded run to 47% (28/60) in the informed run. However, after consensus review, many of these were reclassified as negative. Eight of nine positive 7T MRI scans were initially identified by only one or two assessors. After reassessment, a total of 56% (5/9) of 7T lesions were retrospectively identified on 3T. Significance: Our data suggest a benefit of 7T MRI for the detection of subtle epileptogenic lesions in patients with DRE and negative 3T MRI. Although the detection rate may appear modest compared to other reports, we present a nuanced discussion of our methodology and patient population, contributing meaningful context to the current literature. The availability of multimodal information and consensus reviews enhanced diagnostic accuracy but with higher rates of false positives, underscoring the importance of multidisciplinary cooperation in the clinical care for patients with DRE. Trial Registration Number: www.trialregister.nl: NTR7536. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/epi.18682 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 14 StartPage: 791 Subjects: – SubjectFull: Magnetic resonance imaging Type: general – SubjectFull: Epilepsy surgery Type: general – SubjectFull: Diagnostic imaging Type: general – SubjectFull: Diagnosis of epilepsy Type: general – SubjectFull: Brain imaging Type: general – SubjectFull: Partial epilepsy Type: general Titles: – TitleFull: Value of ultra‐high‐field MRI in patients with drug‐resistant focal epilepsy and negative 3T MRI (EpiUltraStudy): Diagnostic gain of 7T structural analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: van Lanen, Rick H. G. J. – PersonEntity: Name: NameFull: Uher, Daniel – PersonEntity: Name: NameFull: Hoeberigs, Christianne M. C. – PersonEntity: Name: NameFull: Hofman, Paul A. M. – PersonEntity: Name: NameFull: Santegoeds, Remco – PersonEntity: Name: NameFull: Wiggins, Christopher – PersonEntity: Name: NameFull: Tse, Desmond H. Y. – PersonEntity: Name: NameFull: Steijvers, Esther G. M. – PersonEntity: Name: NameFull: Jansen, Jacobus F. A. – PersonEntity: Name: NameFull: Drenthen, Gerald S. – PersonEntity: Name: NameFull: Roebroeck, Alard – PersonEntity: Name: NameFull: Ivanov, Dimo – PersonEntity: Name: NameFull: Poser, Benedikt A. – PersonEntity: Name: NameFull: van Kuijk, Sander M. J. – PersonEntity: Name: NameFull: Hoogland, Govert – PersonEntity: Name: NameFull: Rijkers, Kim – PersonEntity: Name: NameFull: Wagner, Louis G. L. – PersonEntity: Name: NameFull: Widman, Guido – PersonEntity: Name: NameFull: Beckervordersandforth, Jan – PersonEntity: Name: NameFull: Klinkenberg, Sylvia IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 00139580 Numbering: – Type: volume Value: 67 – Type: issue Value: 2 Titles: – TitleFull: Epilepsia (Series 4) Type: main |
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