ArticleJournal of the neurological sciences2025
Utility of MR fingerprinting in differentiating epileptogenic from non-epileptogenic cortical malformations.
Article in Journal of the neurological sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study investigates the potential of magnetic resonance fingerprinting (MRF) as a non-invasive method to differentiate epileptogenic from non-epileptogenic cortical malformations.
methodsSixty-nine subjects were included: four patients with complex cortical malformations who underwent detailed pre-surgical assessments including Stereo-EEG (SEEG) and/or subsequent surgery, 17 with histopathologically confirmed FCD II, and 48 healthy controls (HC). All subjects underwent a whole-brain 3 T MRF acquisition, the reconstruction of which generated T1 and T2 relaxometry maps. A 3D ROI was created for each lesion, and ROI-based z-score normalization using HC data was performed to minimize bias from lesion location. Within-patient comparisons were performed in Cases 1-3 (each with multiple lesions); across-patient comparisons were performed in Cases 1, 2, and 4 (with radiologically diagnosed FCD II), using a reference library of histopathologically confirmed, epileptogenic FCD II lesions. The most effective MRF measures for distinguishing epileptogenic from non-epileptogenic cortical malformations were identified based on their concordance with SEEG findings, surgical location and seizure outcomes.
resultsIn all four cases, epileptogenic malformations showed significantly increased gray-matter (GM) T1 values compared to non-epileptogenic ones, both within and across patients. In Case 4, an MRI-negative epileptogenic region exhibited elevated GM and white-matter (WM) T1 and T2 values than normal cortex, which was undetectable on conventional MRI, highlighting the sensitivity of these measures. SIGNIFICANCE: Quantitative MRF metrics, especially GM T1, hold promise as a non-invasive tool to to differentiate epileptogenic from non-epileptogenic cortical malformations. Our approach could aid SEEG implantation and surgical planning when complex/multiple cortical malformations are present.
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