Detection of Hippocampal Sclerosis in Epilepsy using GRAPPATINI T2-relaxometry

Motivation: Detecting hippocampal sclerosis (HS) makes effective surgical treatment a possibility for people with drug-resistant epilepsy. However, use of conventional hippocampal T2 relaxometry has been hampered by long acquisition times and complex post-processing. Goal(s): To apply GRAPPATINI, an accelerated acquisition and T2 map reconstruction method, in the Australian Epilepsy Project for improved detection of HS. Approach: Prospective observational cohort study in 206 people with epilepsy and 69 controls. Results: GRAPPATINI hippocampal T2 values showed low variance in healthy controls, and marked increases with HS at the group-level. Inclusion in a binary classifier improved detection of HS over using volumetric data alone. Impact: Measurement of hippocampal T2 in people with epilepsy, using GRAPPATINI and automated processing, enables improved quantitative assessment of hippocampal sclerosis. This study demonstrates the feasibility and potential additive benefit of this method in a real-world clinical population.