High Resolution Magnetic Resonance Imaging and Spectroscopy of Epilepsy at 7T

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DESCRIPTION (provided by applicant): Neurosurgery may be the only option for the 15%-30% of people suffering from epilepsy who are refractory to drug therapy. Due to excellent soft tissue contrast and high-resolution visualization of brain anatomy, magnetic resonance imaging (MRI) plays a vital role in the preoperative localization and characterization of brain abnormalities for patients undergoing epilepsy surgery. 7 Tesla (7T) MR has the potential to be a powerful noninvasive tool to 1) in- crease conspicuity of epileptogenic abnormalities resulting in improved detection efficiency and reduced use of invasive electrophysiological evaluation and 2) provide more accurate delineation of lesion boundaries aiding in neurosurgical planning and leading to better patient outcomes. Unfortunately, multiple technical issues including inhomogeneity of the main magnetic and applied RF fields as well as frequency-dependent spatial shifts in the selected volume, result in artifacts for imaging and spectroscopy, limiting the utility of current high-field scanners. Our objective is to design innovative RF pulses and pulse sequences to overcome these limitations in order to fully utilize the signal-to-noise ratio and novel contrast mechanisms offered by high-field MR magnets for imaging and spectroscopy of epilepsy. Specifically, we aim to 1) develop tools for high-resolution structural MR imaging of the brain at 7T, 2) develop tools for high spatial-resolution proton spectroscopic imaging of the medial temporal lobe at 7T and 3) combine these tools to com- pose a comprehensive 7T epilepsy imaging protocol which we will evaluate in a pilot study of epilepsy patients who are candidates for surgical intervention. My career goal is to establish an independent research program focused on MR technique development for high- field neuroimaging and spectroscopy to improve diagnosis, treatment and monitoring of neurological diseases as well as advance our understanding of the healthy brain. My career development plan includes gaining expertise in identifying clinical needs and developing new MR technologies to meet these needs. As training, I will expand my background in neuroscience, with a focus on pathophysiology of neurological diseases, particularly epilepsy. In addition, I will acquire the necessary scientific management skills required to become a successful independent investigator. Stanford University offers the complete set of physical and intellectual resources as well as a thoroughly collaborative research environment required to obtain this training. During the independent phase of this award, I will have the opportunity to continue development of innovative MR technology and evaluation in patients, while building my own research program. As an independent investigator, I will endeavor to make a fundamental impact on the care of patients with neurological diseases and disorders through the pursuit of clinically relevant research in the field of magnetic resonance imaging. PUBLIC HEALTH RELEVANCE: Epilepsy adversely affects almost 3 million people in the United States. 15%-30% of these individuals do not respond to medication and may be candidates for surgical intervention. High-resolution magnetic resonance imaging (MRI) and spectroscopy (MRS) of the brain using ultrahigh-field MR scanners, such as those operating at 7 Tesla, have the potential to provide significant improvement in the preoperative localization of the source of seizures and, as a result, enhance healthcare and quality of life for those suffering from this disease. In this work, we propose to develop some innovative techniques to overcome the technical limitations associated with 7 Tesla MRI and MRS and combine these techniques to create a comprehensive 7 Tesla epilepsy imaging protocol.