Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs

While the etiology of hippocampal sclerosis (HS) in epilepsy patients remains unknown, distinct phenotypes of hippocampal subfield atrophy have been associated with different clinical presentations and surgical outcomes. The advent of novel techniques including ultra-high field 7T magnetic resonance...

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Autores principales:	Akila Pai, Lara V. Marcuse, Judy Alper, Bradley N. Delman, John W. Rutland, Rebecca E. Feldman, Patrick R. Hof, Madeline Fields, James Young, Priti Balchandani
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	7T MRI epilepsy hippocampus subfield volumetry asymmetry Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6d12af6941bc4c389a3e240e1b0fc705
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spelling	oai:doaj.org-article:6d12af6941bc4c389a3e240e1b0fc7052021-11-15T13:32:42ZDetection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs1664-229510.3389/fneur.2021.682615https://doaj.org/article/6d12af6941bc4c389a3e240e1b0fc7052021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.682615/fullhttps://doaj.org/toc/1664-2295While the etiology of hippocampal sclerosis (HS) in epilepsy patients remains unknown, distinct phenotypes of hippocampal subfield atrophy have been associated with different clinical presentations and surgical outcomes. The advent of novel techniques including ultra-high field 7T magnetic resonance imaging (MRI) and automated subfield volumetry have further enabled detection of hippocampal pathology in patients with epilepsy, however, studies combining both 7T MRI and automated segmentation in epilepsy patients with normal-appearing clinical MRI are limited. In this study, we present a novel application of the automated segmentation of hippocampal subfields (ASHS) software to determine subfield volumes of the CA1, CA2/3, CA4/DG, and the subiculum using ultra high-field 7T MRI scans, including T1-weighted MP2RAGE and T2-TSE sequences, in 27 patients with either mesial temporal lobe epilepsy (mTLE) or neocortical epilepsy (NE) compared to age and gender matched healthy controls. We found that 7T improved visualization of structural abnormalities not otherwise seen on clinical strength MRIs in patients with unilateral mTLE. Additionally, our automated segmentation algorithm was able to detect structural differences in volume and asymmetry across hippocampal subfields in unilateral mTLE patients compared to controls. Specifically, amongst unilateral mTLE patients with longer disease durations, volume loss was observed in the ipsilateral CA1 and CA2/3 subfields and contralateral CA1. There were no differences in subfield volumes in patients with NE compared to controls. We report the first application of 7T with automated segmentation to characterize the relationship between disease duration burden and asymmetry across specific hippocampal subfields in this population. Disease duration was found to have a statistically significant positive relationship with subfield asymmetry within the unilateral mTLE cohort. These findings highlight the ability of 7T MRI and automated segmentation to provide novel qualitative and quantitative information in epilepsy patients who are otherwise MRI-negative at clinical field strengths.Akila PaiLara V. MarcuseJudy AlperBradley N. DelmanJohn W. RutlandRebecca E. FeldmanPatrick R. HofMadeline FieldsJames YoungPriti BalchandaniFrontiers Media S.A.article7T MRIepilepsyhippocampussubfieldvolumetryasymmetryNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	7T MRI epilepsy hippocampus subfield volumetry asymmetry Neurology. Diseases of the nervous system RC346-429
spellingShingle	7T MRI epilepsy hippocampus subfield volumetry asymmetry Neurology. Diseases of the nervous system RC346-429 Akila Pai Lara V. Marcuse Judy Alper Bradley N. Delman John W. Rutland Rebecca E. Feldman Patrick R. Hof Madeline Fields James Young Priti Balchandani Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs
description	While the etiology of hippocampal sclerosis (HS) in epilepsy patients remains unknown, distinct phenotypes of hippocampal subfield atrophy have been associated with different clinical presentations and surgical outcomes. The advent of novel techniques including ultra-high field 7T magnetic resonance imaging (MRI) and automated subfield volumetry have further enabled detection of hippocampal pathology in patients with epilepsy, however, studies combining both 7T MRI and automated segmentation in epilepsy patients with normal-appearing clinical MRI are limited. In this study, we present a novel application of the automated segmentation of hippocampal subfields (ASHS) software to determine subfield volumes of the CA1, CA2/3, CA4/DG, and the subiculum using ultra high-field 7T MRI scans, including T1-weighted MP2RAGE and T2-TSE sequences, in 27 patients with either mesial temporal lobe epilepsy (mTLE) or neocortical epilepsy (NE) compared to age and gender matched healthy controls. We found that 7T improved visualization of structural abnormalities not otherwise seen on clinical strength MRIs in patients with unilateral mTLE. Additionally, our automated segmentation algorithm was able to detect structural differences in volume and asymmetry across hippocampal subfields in unilateral mTLE patients compared to controls. Specifically, amongst unilateral mTLE patients with longer disease durations, volume loss was observed in the ipsilateral CA1 and CA2/3 subfields and contralateral CA1. There were no differences in subfield volumes in patients with NE compared to controls. We report the first application of 7T with automated segmentation to characterize the relationship between disease duration burden and asymmetry across specific hippocampal subfields in this population. Disease duration was found to have a statistically significant positive relationship with subfield asymmetry within the unilateral mTLE cohort. These findings highlight the ability of 7T MRI and automated segmentation to provide novel qualitative and quantitative information in epilepsy patients who are otherwise MRI-negative at clinical field strengths.
format	article
author	Akila Pai Lara V. Marcuse Judy Alper Bradley N. Delman John W. Rutland Rebecca E. Feldman Patrick R. Hof Madeline Fields James Young Priti Balchandani
author_facet	Akila Pai Lara V. Marcuse Judy Alper Bradley N. Delman John W. Rutland Rebecca E. Feldman Patrick R. Hof Madeline Fields James Young Priti Balchandani
author_sort	Akila Pai
title	Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs
title_short	Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs
title_full	Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs
title_fullStr	Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs
title_full_unstemmed	Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs
title_sort	detection of hippocampal subfield asymmetry at 7t with automated segmentation in epilepsy patients with normal clinical strength mris
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/6d12af6941bc4c389a3e240e1b0fc705
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Detection of Hippocampal Subfield Asymmetry at 7T With Automated Segmentation in Epilepsy Patients With Normal Clinical Strength MRIs

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