Ultra high resolution imaging in paediatric epilepsy
Current MRI brain scans to detect lesions in patients with epilepsy uses images with T1- and T2-contrast, which are reviewed by radiologists. If a lesion is found on MRI consistent with clinical aspects of their epilepsy the chances of successful surgical treatment are dramatically increased. Despite imaging advances a large number of children (and adults) do not have MRI visible abnormalities using conventional imaging estimated at over 50% by some. Focal Cortical Dysplasia is a very common abnormality in drug resistant focal epilepsy especially in children (50%) and is characterised by alterations in cortical cell type, organisation and structure when examined histologically. Given the histological findings, MRI of sufficient resolution to sample the cortical structure may well reveal abnormalities in lesion negative patients, giving them the chance of effective surgery to stop their seizures. Increased image resolution comes at a cost of reduced signal. There are two ways to increase signal, the first is to increase the magnetic field strength of the scanner which is limited to 3T for clinical paediatric imaging. The second possibility is to scan for longer. Long scan durations are limited by subject tolerance and motion. In this project we will push the boundaries of resolution using long scan durations made possible by making MRI more child friendly and prospective motion correction.
In this project we will aim to
- Develop very high resolution imaging protocols imaging voxel volumes up to an order of magnitude smaller than those previously achieved clinically.
- Apply these protocols in a group of patients with focal epilepsy that are MRI negative
This research project sits in the middle of the CDT remit. The focus of the project is to develop and optimise new MRI imaging techniques that can provide very high resolution imaging in the brain, well beyond the image resolution that is currently available clinically. This will be developed in healthy controls with the clear aim of improving paediatric imaging focused on lesion detection in drug resistant focal epilepsy. The scans that are developed will then be tested in group of patients. The student will therefore gain an in-depth knowledge of MRI, sequence development, motion correction and image processing in addition to a firm grounding in epilepsy and paediatric imaging.