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

Giske Opheim (1, 2) , Anja van Der Kolk (3, 4) , Karin Markenroth Bloch (5) , Albert Colon (6) , Kathryn Davis (7) , Thomas Henry (8) , Jacobus F.A. Jansen (9, 10) , Stephen Jones (11) , Jullie Pan (12) , Karl Rössler (13) , Joel Stein (14) , Maria Strandberg (15) , Siegfried Trattnig (16, 17) , Pierre-Francois van de Moortele (18) , Maria Isabel Vargas (19) , Irene Wang (20) , Fabrice Bartolomei (21, 22) , Neda Bernasconi (23) , Andrea Bernasconi (23) , Boris Bernhardt (23) , Isabella Björkman-Burtscher (24) , Mirco Cosottini (25) , Sandhitsu Das (26) , Lucie Hertz-Pannier (27) , Sara Inati (28) , Michael Jurkiewicz (29) , Ali Khan (30) , Shuli Liang (31) , Ruoyun Emily Ma (18) , Srinivasan Mukundan (32) , Heath Pardoe , Lars Pinborg (33, 1) , Jonathan Polimeni (34, 35) , Jean-Philippe Ranjeva (36, 37) , Esther Steijvers (38) , Steven Stufflebeam (34, 35) , Tim Veersema (39) , Alexandre Vignaud (40) , Natalie Voets (41) , Serge Vulliemoz (42) , Christopher Wiggins (38) , Rong Xue (43) , Renzo Guerrini (44, 45) , Maxime Guye (36, 37)

1 Neurobiology Research Unit, Department of Neurology Rigshospitalet Copenhagen University Hospital, UCPH
2 Faculty of Health and Medical Sciences, UCPH
3 Utrecht Brain Center [UMC]
4 Department of Radiology University Medical Center Utrecht
5 Lund University [Lund]
6 Department of Neurology Neurophysiology and Neurosurgery, ACE Kempenhaeghe/MUMC, Heeze/Maastricht
7 PENN Epilepsy Center
8 Department of Neurology University of Minnesota, Minneapolis
9 Department of Radiology and Nuclear Medicine Maastricht University Medical Center
10 MHeNs - School for Mental Health and Neuroscience [Maastricht]
11 Imaging Institute [Cleveland]
12 Department of Neurology and Radiology University of Pittsburg
13 Department of Neurosurgery Medical University of Vienna
14 Department of Radiology Hospital of the University of Pennsylvania, Philadelphia
15 Departments of Neurology and Clinical Sciences Lund University Hospital
16 Department of Biomedical Imaging and Image-guided Therapy [Medical University of Vienna]
17 High Field MR Center, Medical University of Vienna
18 CMRR - Center for Magnetic Resonance Research [Minneapolis]
19 Neuroradiology Division, Diagnostic Unit University Hospitals and Faculty of Medicine of Geneva
20 Epilepsy Center Cleveland Clinic
21 INS - Institut de Neurosciences des Systèmes
22 Service de neurophysiologie clinique [Hôpital de la Timone - APHM]
23 MNI - McConnell Brain Imaging Centre
24 GU - University of Gothenburg
25 Department of Translational Research on New Technologies in Medicine and Surgery
26 Department of Neurology University of Pennsylvania, Philadelphia
27 BAOBAB - Unité Baobab
28 EEG Section, NINDS, NIH, Bethesda
29 Department of Medical Imaging Children's Hospital at London Health Sciences Centre, Schulich School of Medicine and Dentistry, The University of Western Ontario, London
30 Imaging Research Laboratories, Robarts Research Institute, London
31 Functional Neurosurgery Department Beijing Children's Hospital of Capital Medical University, Beijing
32 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston
33 Epilepsy Clinic, Department of Neurology, Rigshospitalet Copenhagen University Hospital
34 Harvard-MIT Division of Health Sciences and Technology [Cambridge]
35 Athinoula A. Martinos Center for Biomedical Imaging
36 CRMBM - Centre de résonance magnétique biologique et médicale
37 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - AP-HM]
38 Scannexus Ultrahigh Field MRI Research Center, Maastricht
39 Department of Radiology and Nuclear Medicine Meander Medical Center, Amersfoort
40 LRMN - Laboratoire d'Imagerie et de Spectroscopie
41 WIN - FMRIB - Wellcome Trust Centre for Integrative Neuroimaging
42 UNIGE - Université de Genève = University of Geneva
43 State Key Laboratory of Cognitive Neuroscience and Learning, International Data Group/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
44 UniFI - Università degli Studi di Firenze = University of Florence
45 IMAGO 7 Foundation, Florence

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.

Domains: Life Sciences [q-bio]; Bioengineering; Imaging

Giske Opheim, Anja van Der Kolk, Karin Markenroth Bloch, Albert Colon, Kathryn Davis, et al.. 7T Epilepsy Task Force Consensus Recommendations on the Use of 7T MRI in Clinical Practice. Neurology, 2021, 96 (7), pp.327-341. ⟨10.1212/WNL.0000000000011413⟩. ⟨hal-03501353⟩