Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: A consensus report from the International League Against Epilepsy Neuroimaging Task Force.

2019-06

Bernasconi, Andrea

Cendes, Fernando

Theodore, William H

Gill, Ravnoor S

Koepp, Matthias J

Hogan, Robert Edward

Jackson, Graeme D

Federico, Paolo

Labate, Angelo

Vaudano, Anna Elisabetta

Blümcke, Ingmar

Ryvlin, Philippe

Bernasconi, Neda

adults

epilepsy

pediatrics

structural magnetic resonance imaging

Journal Article

0000-0001-9358-5703

0000-0001-9336-9568

0000-0002-4669-5747

0000-0002-8827-7324

0000-0001-7775-6576

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10.1111/epi.15612

Structural magnetic resonance imaging (MRI) is of fundamental importance to the diagnosis and treatment of epilepsy, particularly when surgery is being considered. Despite previous recommendations and guidelines, practices for the use of MRI are variable worldwide and may not harness the full potential of recent technological advances for the benefit of people with epilepsy. The International League Against Epilepsy Diagnostic Methods Commission has thus charged the 2013-2017 Neuroimaging Task Force to develop a set of recommendations addressing the following questions: (1) Who should have an MRI? (2) What are the minimum requirements for an MRI epilepsy protocol? (3) How should magnetic resonance (MR) images be evaluated? (4) How to optimize lesion detection? These recommendations target clinicians in established epilepsy centers and neurologists in general/district hospitals. They endorse routine structural imaging in new onset generalized and focal epilepsy alike and describe the range of situations when detailed assessment is indicated. The Neuroimaging Task Force identified a set of sequences, with three-dimensional acquisitions at its core, the harmonized neuroimaging of epilepsy structural sequences-HARNESS-MRI protocol. As these sequences are available on most MR scanners, the HARNESS-MRI protocol is generalizable, regardless of the clinical setting and country. The Neuroimaging Task Force also endorses the use of computer-aided image postprocessing methods to provide an objective account of an individual's brain anatomy and pathology. By discussing the breadth and depth of scope of MRI, this report emphasizes the unique role of this noninvasive investigation in the care of people with epilepsy.

link

Epilepsia 2019; 60(6): 1054-1068

Epilepsia