Parallel transmit 7T MRI improves epileptogenic lesion detection compared to circularly polarized 7T MRI

Motivation: 7T MRI offers high sensitivity and sub-millimetre resolution which may be valuable for pre-surgical assessment of drug-resistant focal epilepsy (DRFE) patients. Yet single transmit studies have been limited by signal-dropouts especially in temporal lobes. Goal(s): To assess whether parallel transmit (7T-pTx) MRI improves the diagnostic quality of the ILAE 7T Epilepsy Task Force Consensus Recommended protocols. Approach: Prospective study of 31 adult DRFE patients whose prior 3T MRI was inconclusive scanned with pTx and CP 7T MRI. Results: Detection of new lesions in 29% of cases. Neuroradiologists report better quality for pTx acquisitions which is supported by quantitative metrices. Impact: This study confirms that 7T-pTx MRI is more effective for detection of lesions in drug-resistant focal epilepsy patients than CP 7T MRI. We are now seeking funding for a multisite study to prove cost-effectiveness within the NHS epilepsy surgery pathway.