Integrating multi-modal quantitative MRI and histology for improving surgical treatment of epilepsy

Ali Khan (March 21, 2014)

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Drug-resistant epilepsy occurs in over one third of epilepsy patients, and surgical excision of the affected brain region is often necessary to achieve seizure control. However, precise delineation of the seizure onset zone can be challenging, and can lead to poor surgical outcomes when incorrect. In many of these cases, the underlying pathology consists of subtle architectural abnormalities at the microscopic scale. Improved imaging of these lesions at a macroscopic scale thus requires integration of in-vivo MRI modalities that can probe the tissue microarchitecture, along with rigorous validation against histology. This talk will present our work on correlating quantitative relaxometry and diffusion imaging of temporal lobe epilepsy patients with histology of surgical specimens. I will highlight the challenges faced in spatial alignment of anatomy at vastly different scales, steps taken towards quantitative characterization of pathology in epilepsy, and how intrinsic MRI parameters can be used to improve our understanding of the excitotoxic effects of seizures.