Deuterium metabolic imaging in epilepsy patients at 7T

Motivation: Identifying the epileptogenic zone (EZ) in MRI-negative epilepsy patients is crucial for surgical success. Goal(s): To investigate whether dynamic deuterium metabolic imaging (DMI) can detect subtle metabolic disturbances in MRI-negative epilepsy patients. Approach: Five patients consumed [6,6'-2H2]glucose, and underwent dynamic DMI at 7 Tesla to track 2H-Glc (glucose) and 2H-Glx (glutamate/glutamine) levels in the epileptogenic zone (EZ) and non-epileptogenic contralateral region. Results: Both 2H-Glc and 2H-Glx levels increased over time, but no significant metabolic differences were observed between EZ and the contralateral region in the interictal phase. Impact: Dynamic DMI offers a non-invasive approach to assess epilepsy metabolism. Although this study observed no metabolic differences between the epileptogenic-zone and contralateral normal-appearing brain tissue interictally, DMI should be considered for direct post-ictal imaging, potentially aiding diagnosis in MRI-negative epilepsy.