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Abstract #0702

Microstructural characterisation of focal cortical dysplasia in paediatric epilepsy patients using clinical MRI

Sila Genc1,2, Emma Macdonald-Laurs3,4, Michael Kean2,5, and Joseph Yuan-Mou Yang1,4
1Department of Neurosurgery, The Royal Children's Hospital, Parkville, Australia, 2Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia, 3Department of Neurology, The Royal Children's Hospital, Parkville, Australia, 4Neuroscience Research, Murdoch Children's Research Institute, Parkville, Australia, 5Department of Medical Imaging, The Royal Children's Hospital, Parkville, Australia

Synopsis

Keywords: Diffusion Analysis & Visualization, Epilepsy

Motivation: Brain surgery is the most effective treatment for drug-resistant epilepsy, as children with ongoing seizures often have poor outcomes. New non-invasive imaging methods are needed to enhance the detection of subtle lesions thought to occur in 33% of these children.

Goal(s): We implemented a clinically feasible diffusion MRI protocol to characterise cortical microstructure in children with drug-resistant epilepsy.

Approach: We applied biophysical modelling and compared the microstructure of dysplastic cortex with normal appearing cortex.

Results: Our observations of higher apparent soma radius in areas of dysplastic cortex was consistent with the expected pathology of enlarged dysmorphic neurons in type-II focal cortical dysplasia (FCD).

Impact: Our findings highlight the utility of a new imaging marker, the apparent soma radius, in characterising FCD. By combining this measure into clinical work-ups we can increase confidence in radiological diagnoses of subtle FCDs and in turn assess surgical candidacy.

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