Motion Compensated fMRI for Pre-Surgical Planning in Epilepsy

项目摘要 约1%的人患有癫痫，三分之一的病例对药物治疗没有有效反应。 耐药癫痫患者是外科手术切除致痫区域的候选对象。 潜在的根治疗法。临床功能磁共振在神经外科手术计划中起着至关重要的作用 癫痫。功能磁共振成像提供了定位口才皮质的数据，以评估计划中的手术的风险和好处 切除，并允许为个别患者量身定做切除。收购的主要挑战是 高质量的功能磁共振成像是参与者的运动。运动降低了时间信噪比 (TSNR)通过错位粗体信号，运动会创建旋转历史伪影，并且运动可以移动部分 大脑不在成像视野内。这些伪影依次导致假阳性和假阴性。 检测功能活动，这损害了功能定位的保真度。这通常会被检测到 并通过丢弃运动损坏的数据并仅使用非运动的数据来尽可能地纠正 细分市场。由于要进行这样的分析，必须获取可靠的fi数据，因此功能磁共振成像采集旨在 获取冗余数据，以避免运动造成的损失。在我们的机构和其他机构，这一额外的成像时间 据估计，仅此一项就是功能磁共振成像研究成本的两倍多。失去保真度和 运动导致的成本增加影响了功能磁共振成像在手术计划中的效用。这是特别的 对于难以遵循指示的患者，如老年人、病人或儿科受试者来说，这是至关重要的。有一个 对改进运动监测、功能磁共振运动的前瞻性和回溯性校正的需求未得到满足。至 为了提高功能磁共振成像的实用性，降低成本，我们建议开发、应用和评估新技术 要启用实时自导航运动监控和改进的fMRI校正，请通过以下方式 四个具体目标：目标1：开发和评估由实时逐片运动实现的运动减少 功能磁共振成像期间的监测；目标2：开发和评估逐层减少运动伪影 回溯性运动矫正；目标3：开发和评估实时运动伪影的减少 逐层前瞻性运动矫正(PMC)；目标4：评估运动监测的效用，回顾 运动矫正法和前瞻性运动矫正法改善功能性MRI对癫痫的治疗效果 做手术。

Project Summary Epilepsy affects about 1% of people, and one-third of cases do not respond effectively to drug treatment. Patients with drug-resistant epilepsy are candidates for surgical resection of the epileptogenic zone, a potentially curative treatment. Clinical functional MRI plays a critical role in planning for neurosurgery in epilepsy. FMRI provides data to localize eloquent cortex, to assess the risks and benefits of a planned surgical resection, and to allow a resection to be tailored to the individual patient. The primary challenge to acquiring high quality functional MRI is motion of the participant. Motion reduces the temporal signal-to-noise ratio (tSNR) by misaligning the BOLD signal, motion creates spin history artifact, and motion can move parts of the brain out of the imaging field of view. These artifacts in turn lead to both false positive and false negative detections of functional activity, which compromise the fidelity of functional localization. This is usually detected and corrected to the extent possible, by discarding motion corrupted data, and using only motion-free segments. Since sufficient data must be acquired for such an analysis, fMRI acquisitions are designed to acquire redundant data to allow for loss to motion. At our institution, and others, this additional imaging time alone has been estimated to more than double the cost of fMRI imaging studies. The loss of fidelity and increased cost due to motion compromises the utility of the fMRI in planning for surgery. This is especially critical in patients who have difficulty following instructions, such as elderly, ill, or pediatric subjects. There is an unmet need for improved motion monitoring, prospective and retrospective correction for motion for fMRI. To improve the utility and decrease the cost of fMRI, we propose to develop, apply and evaluate novel technology to enable real-time self-navigated motion monitoring and improved correction for fMRI, through the following four specific aims: Aim 1: Develop and evaluate reduction of motion enabled by real-time slice-by-slice motion monitoring during fMRI; Aim 2: Develop and evaluate the reduction of motion artifact from slice by slice retrospective motion correction; Aim 3: Develop and evaluate the reduction of motion artifact from real-time slice by slice prospective motion correction (PMC); Aim 4: Assess the utility of motion monitoring, retrospective motion correction and prospective motion correction for improving functional MRI for planning for epilepsy surgery.