A new scanning technique is giving hope to people with epilepsy who haven’t been helped by medication.
Scientists in the UK and France have found a way to improve powerful MRI brain scans so that doctors can better see the parts of the brain causing seizures.
This improvement is already helping doctors in Cambridge offer brain surgery to patients who were previously told it wasn’t possible.
Epilepsy is a condition that affects how the brain works, causing seizures. About 360,000 people in the UK have a type called focal epilepsy, which starts in one part of the brain. For many people, medicines can stop the seizures.
But for about one-third of them, the seizures continue no matter what medication they try. In these cases, brain surgery is often the only chance for a cure.
But here’s the problem: in order to operate, surgeons need to clearly see the part of the brain where the seizures start. If the scans don’t show that area properly, doctors can’t safely do the surgery.
MRI scans are used to look at the brain, but until now, even the strongest MRI machines had blind spots—areas that didn’t show up well on the scans, especially in the brain’s temporal lobes, which are often where seizures begin.
The newest and most powerful MRI scanners are called 7T scanners. The “7T” stands for seven Tesla, a measure of magnetic strength. They’re more than twice as powerful as the best scanners commonly used in NHS hospitals, which are usually 3T or even weaker (1.5T).
These 7T scanners can show extremely detailed images of the brain, and studies in other countries have shown that they are better at spotting problem areas in patients with difficult-to-treat epilepsy.
But until recently, 7T scanners had a major problem: they often left dark patches in important parts of the brain. These black spots—called signal dropouts—made it hard for doctors to see if there was a lesion (a bit of damaged brain tissue) causing the seizures.
Researchers at the University of Cambridge, working with scientists in Paris, have now solved this problem using a method called parallel transmit. Instead of using just one transmitter to send signals into the brain, the new method uses eight transmitters placed around the patient’s head.
Think of it like Wi-Fi: one router might not cover your whole house, but several routers placed around the house can give you better signal everywhere. The same idea works here, giving doctors a clearer view of the entire brain.
In their study, the researchers used the new scanner on 31 patients at Addenbrooke’s Hospital in Cambridge, all of whom had epilepsy that didn’t improve with medication. The results were impressive.
In nine people, the new scan found brain lesions that had never been seen before. In four others, it confirmed lesions doctors thought they saw on regular scans. In four more, it showed that earlier suspicions of lesions were incorrect.
Overall, the new scans gave doctors more accurate information in over half of the cases. The improved images helped them decide on the best next steps for each patient.
Thanks to the better scans, 18 out of the 31 patients had their treatment plans changed. Nine were able to have surgery to remove the lesion. One person was offered a newer treatment using heat to destroy the problem area in the brain.
Five people were given a special test called sEEG, which places thin wires into the brain to better locate the seizure source. This test is usually only done in certain cases because it’s expensive and involves surgery, but the clearer scans helped doctors decide who would benefit from it.
Some patients learned they were not good candidates for surgery because the problem areas were too complex or too close to important parts of the brain. But having this knowledge is still helpful because it prevents unnecessary or risky procedures.
Patients who used the new scanner mostly reported only minor issues, such as feeling dizzy or a bit uncomfortable. This shows that the new scanning method is safe and acceptable for patients.
This breakthrough shows how combining powerful technology with smart problem-solving can make a big difference in healthcare. The ability to see the brain more clearly means doctors can offer life-changing treatments to more people. And for those living with seizures that disrupt their daily lives, that’s a very big deal.
Review and Analysis of the Study
The study shows how the parallel transmit method can solve one of the biggest problems with 7T MRI scanners: black spots that hide important parts of the brain.
By using multiple transmitters, the researchers created clearer images, especially in areas where seizures often begin. This meant that doctors could finally see brain lesions in many patients who had gone undiagnosed for years.
This research is important because it shows a real benefit for patients, not just an improvement in technology. More than half of the patients had changes in their treatment plans, and many were able to receive surgery or other advanced care. That’s a major step forward for people with treatment-resistant epilepsy.
The study also shows that this technique is ready for real-world use. It doesn’t require difficult setup or long calibration times, and patients tolerate the scans well. While more research is still needed to see how widely this can be used, it’s clear that this is a promising and practical advancement in brain imaging and epilepsy treatment.
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The research findings can be found in Epilepsia.
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