7T Epilepsy Task Force Consensus Recommendations on the Use of 7T MRI in Clinical Practice

Giske Opheim; Anja van der Kolk; Karin Markenroth Bloch; Albert J Colon; Kathryn A Davis; Thomas R Henry; Jacobus F A Jansen; Stephen E Jones; Jullie W Pan; Karl Rössler; Joel M Stein; Maria C Strandberg; Siegfried Trattnig; Pierre-Francois Van de Moortele; Maria Isabel Vargas; Irene Wang; Fabrice Bartolomei; Neda Bernasconi; Andrea Bernasconi; Boris Bernhardt; Isabella Björkman-Burtscher; Mirco Cosottini; Sandhitsu R Das; Lucie Hertz-Pannier; Sara Inati; Michael T Jurkiewicz; Ali R Khan; Shuli Liang; Ruoyun Emily Ma; Srinivasan Mukundan; Heath Pardoe; Lars H Pinborg; Jonathan R Polimeni; Jean-Philippe Ranjeva; Esther Steijvers; Steven Stufflebeam; Tim J Veersema; Alexandre Vignaud; Natalie Voets; Serge Vulliemoz; Christopher J Wiggins; Rong Xue; Renzo Guerrini; Maxime Guye

doi:10.1212/WNL.0000000000011413

7T Epilepsy Task Force Consensus Recommendations on the Use of 7T MRI in Clinical Practice

Neurology. 2021 Feb 16;96(7):327-341. doi: 10.1212/WNL.0000000000011413. Epub 2020 Dec 22.

Authors

Giske Opheim¹, Anja van der Kolk², Karin Markenroth Bloch², Albert J Colon², Kathryn A Davis², Thomas R Henry², Jacobus F A Jansen², Stephen E Jones², Jullie W Pan², Karl Rössler², Joel M Stein², Maria C Strandberg², Siegfried Trattnig², Pierre-Francois Van de Moortele², Maria Isabel Vargas², Irene Wang², Fabrice Bartolomei², Neda Bernasconi², Andrea Bernasconi², Boris Bernhardt², Isabella Björkman-Burtscher², Mirco Cosottini², Sandhitsu R Das², Lucie Hertz-Pannier², Sara Inati², Michael T Jurkiewicz², Ali R Khan², Shuli Liang², Ruoyun Emily Ma², Srinivasan Mukundan², Heath Pardoe², Lars H Pinborg², Jonathan R Polimeni², Jean-Philippe Ranjeva², Esther Steijvers², Steven Stufflebeam², Tim J Veersema², Alexandre Vignaud², Natalie Voets², Serge Vulliemoz², Christopher J Wiggins², Rong Xue², Renzo Guerrini², Maxime Guye²

Affiliations

¹ From the Neurobiology Research Unit (G.O., L.H.P.), and Epilepsy Clinic (L.H.P.), Department of Neurology, Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences (G.O.), UCPH, Denmark; Departments of Neurology and Neurosurgery (T.J.V.), UMC Utrecht Brain Center, and Department of Radiology (A.v.d.K.), University Medical Center Utrecht, Utrecht University; Department of Radiology (A.v.d.K.), Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam; Lund University Bioimaging Center (K.M.B.), Lund University, Sweden; Department of Neurology (A.J.C.), Neurophysiology and Neurosurgery, ACE Kempenhaeghe/MUMC, Heeze/Maastricht, the Netherlands; Department of Radiology (J.M.S.) and Penn Epilepsy Center (K.D.), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (T.R.H.) and Center for Magnetic Resonance Research (P.-F.V.d.M., R.E.M.), University of Minnesota, Minneapolis; Department of Radiology and Nuclear Medicine (J.F.A.J.), Maastricht University Medical Center; School for Mental Health and Neuroscience (J.F.A.J.), Maastricht University; Department of Electrical Engineering (J.F.A.J.), Eindhoven University of Technology, the Netherlands; Imaging Institute (S.E.J.) and Epilepsy Center (I.W.), Cleveland Clinic, OH; Department of Neurology and Radiology (J.W.P.), University of Pittsburg, PA; Department of Neurosurgery (K.R.), Medical University of Vienna, Austria; Departments of Neurology and Clinical Sciences (M.C.S.), Lund University Hospital, Sweden; Department of Biomedical Imaging and Image Guided Therapy (S.T.), High Field MR Center, Medical University of Vienna, Austria; Neuroradiology Division, Diagnostic Unit (M.I.V.), University Hospitals and Faculty of Medicine of Geneva, Switzerland; Epileptology Department - INS (F.B.) and CRMBM - CEMEREM (J.-P.R., M.G.), Timone Hospital APHM, Aix Marseille Univ, INSERM, CNRS, France; Neuroimaging of Epilepsy Laboratory (NOEL) (N.B., A.B.), Montreal Neurological Institute (B.B.), and McConnell Brain Imaging Centre (N.B., A.B.), McGill University, Montreal, Canada; Department of Radiology (I.B.-B.), Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Translational Research and New Technologies in Medicine and Surgery (M.C.), University of Pisa, Italy; Department of Neurology (S.R.D.), University of Pennsylvania, Philadelphia; NeuroSpin (L.H.-P., A.V.), Paris-Saclay University, CEA, CNRS, BAOBAB, Gif-sur-Yvette, France; UMR 1141 (L.H.-P), University of Paris, France; EEG Section (S.I.), NINDS, NIH, Bethesda, MD; Department of Medical Imaging (M.T.J.), Children's Hospital at London Health Sciences Centre; Department of Medical Biophysics (M.T.J., A.R.K.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada; Imaging Research Laboratories (A.R.K.), Robarts Research Institute, London, ON, Canada; Functional Neurosurgery Department (S.L.), Beijing Children's Hospital of Capital Medical University, Beijing, China; Department of Radiology (S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; NYU Grossman School of Medicine (H.P.), New York; Harvard MIT Division of Health Sciences and Technology (J.R.P., S.S.), Massachusetts Institute of Technology, Cambridge; Athinoula A. Martinos Center for Biomedical Imaging (J.R.P., S.S.), Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA; Scannexus Ultrahigh Field MRI Research Center (E.S., C.J.W.), Maastricht; Department of Radiology and Nuclear Medicine (T.J.V.), Meander Medical Center, Amersfoort, the Netherlands; Wellcome Centre for Integrative Neuroimaging (N.V.), FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; EEG and Epilepsy Unit (S.V.), Neurology, Department of Clinical Neurosciences, University Hospitals and Faculty of Medicine of Geneva, Switzerland; State Key Lab of Brain and Cognitive Science (R.X.), Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, China; Neuroscience Department (R.G.), Children's Hospital A. Meyer-University of Florence; and IMAGO 7 Foundation (R.G.), Florence, Italy giskeopheim@nru.dk.
² From the Neurobiology Research Unit (G.O., L.H.P.), and Epilepsy Clinic (L.H.P.), Department of Neurology, Rigshospitalet Copenhagen University Hospital; Faculty of Health and Medical Sciences (G.O.), UCPH, Denmark; Departments of Neurology and Neurosurgery (T.J.V.), UMC Utrecht Brain Center, and Department of Radiology (A.v.d.K.), University Medical Center Utrecht, Utrecht University; Department of Radiology (A.v.d.K.), Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam; Lund University Bioimaging Center (K.M.B.), Lund University, Sweden; Department of Neurology (A.J.C.), Neurophysiology and Neurosurgery, ACE Kempenhaeghe/MUMC, Heeze/Maastricht, the Netherlands; Department of Radiology (J.M.S.) and Penn Epilepsy Center (K.D.), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (T.R.H.) and Center for Magnetic Resonance Research (P.-F.V.d.M., R.E.M.), University of Minnesota, Minneapolis; Department of Radiology and Nuclear Medicine (J.F.A.J.), Maastricht University Medical Center; School for Mental Health and Neuroscience (J.F.A.J.), Maastricht University; Department of Electrical Engineering (J.F.A.J.), Eindhoven University of Technology, the Netherlands; Imaging Institute (S.E.J.) and Epilepsy Center (I.W.), Cleveland Clinic, OH; Department of Neurology and Radiology (J.W.P.), University of Pittsburg, PA; Department of Neurosurgery (K.R.), Medical University of Vienna, Austria; Departments of Neurology and Clinical Sciences (M.C.S.), Lund University Hospital, Sweden; Department of Biomedical Imaging and Image Guided Therapy (S.T.), High Field MR Center, Medical University of Vienna, Austria; Neuroradiology Division, Diagnostic Unit (M.I.V.), University Hospitals and Faculty of Medicine of Geneva, Switzerland; Epileptology Department - INS (F.B.) and CRMBM - CEMEREM (J.-P.R., M.G.), Timone Hospital APHM, Aix Marseille Univ, INSERM, CNRS, France; Neuroimaging of Epilepsy Laboratory (NOEL) (N.B., A.B.), Montreal Neurological Institute (B.B.), and McConnell Brain Imaging Centre (N.B., A.B.), McGill University, Montreal, Canada; Department of Radiology (I.B.-B.), Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Translational Research and New Technologies in Medicine and Surgery (M.C.), University of Pisa, Italy; Department of Neurology (S.R.D.), University of Pennsylvania, Philadelphia; NeuroSpin (L.H.-P., A.V.), Paris-Saclay University, CEA, CNRS, BAOBAB, Gif-sur-Yvette, France; UMR 1141 (L.H.-P), University of Paris, France; EEG Section (S.I.), NINDS, NIH, Bethesda, MD; Department of Medical Imaging (M.T.J.), Children's Hospital at London Health Sciences Centre; Department of Medical Biophysics (M.T.J., A.R.K.), Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada; Imaging Research Laboratories (A.R.K.), Robarts Research Institute, London, ON, Canada; Functional Neurosurgery Department (S.L.), Beijing Children's Hospital of Capital Medical University, Beijing, China; Department of Radiology (S.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; NYU Grossman School of Medicine (H.P.), New York; Harvard MIT Division of Health Sciences and Technology (J.R.P., S.S.), Massachusetts Institute of Technology, Cambridge; Athinoula A. Martinos Center for Biomedical Imaging (J.R.P., S.S.), Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA; Scannexus Ultrahigh Field MRI Research Center (E.S., C.J.W.), Maastricht; Department of Radiology and Nuclear Medicine (T.J.V.), Meander Medical Center, Amersfoort, the Netherlands; Wellcome Centre for Integrative Neuroimaging (N.V.), FMRIB Division, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; EEG and Epilepsy Unit (S.V.), Neurology, Department of Clinical Neurosciences, University Hospitals and Faculty of Medicine of Geneva, Switzerland; State Key Lab of Brain and Cognitive Science (R.X.), Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, China; Neuroscience Department (R.G.), Children's Hospital A. Meyer-University of Florence; and IMAGO 7 Foundation (R.G.), Florence, Italy.

Abstract

Identifying a structural brain lesion on MRI has important implications in epilepsy and is the most important factor that correlates with seizure freedom after surgery in patients with drug-resistant focal onset epilepsy. However, at conventional magnetic field strengths (1.5 and 3T), only approximately 60%-85% of MRI examinations reveal such lesions. Over the last decade, studies have demonstrated the added value of 7T MRI in patients with and without known epileptogenic lesions from 1.5 and/or 3T. However, translation of 7T MRI to clinical practice is still challenging, particularly in centers new to 7T, and there is a need for practical recommendations on targeted use of 7T MRI in the clinical management of patients with epilepsy. The 7T Epilepsy Task Force-an international group representing 21 7T MRI centers with experience from scanning over 2,000 patients with epilepsy-would hereby like to share its experience with the neurology community regarding the appropriate clinical indications, patient selection and preparation, acquisition protocols and setup, technical challenges, and radiologic guidelines for 7T MRI in patients with epilepsy. This article mainly addresses structural imaging; in addition, it presents multiple nonstructural MRI techniques that benefit from 7T and hold promise as future directions in epilepsy. Answering to the increased availability of 7T MRI as an approved tool for diagnostic purposes, this article aims to provide guidance on clinical 7T MRI epilepsy management by giving recommendations on referral, suitable 7T MRI protocols, and image interpretation.

Publication types

Review

MeSH terms

Brain / diagnostic imaging*
Consensus
Epilepsy / diagnostic imaging*
Humans
Magnetic Resonance Imaging*

Abstract

Publication types

MeSH terms

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