The Role of the Temporal Pole in Temporal Lobe Epilepsy: A Diffusion Kurtosis Imaging Study

Objective: This study aims to evaluate the use of diffusion kurtosis imaging (DKI) to detect microstructural abnormalities within the temporal pole (TP) in temporal lobe epilepsy (TLE) patients. Methods: DKI quantitative maps were obtained from fourteen lesional (MRI+) and ten non-lesional (MRI-) TLE patients, along with twenty-one healthy controls. This included mean (MK); radial (RK) and axial kurtosis (AK); mean diffusivity (MD) and axonal water fraction (AWF). Automated fiber quantification (AFQ) was used to quantify DKI measurements along the inferior longitudinal (ILF) and uncinate fasciculus (Unc). ILF and Unc tract profiles were compared between groups and tested for correlation with seizure duration. To characterize temporopolar cortex (TC) microstructure, DKI maps were sampled at varying depths from superficial white matter (WM) towards the pial surface. Each patient group was separated according to side ipsilateral to the epileptogenic temporal lobe and their AFQ results were used as input for statistical analyses. Results: Significant differences were observed between MRI+ and controls (p < 0.005), towards the most anterior of ILF and Unc proximal to the TP of the left (not right) ipsilateral temporal lobe for MK, RK, AWK and MD. Noticeable differences were also observed mostly towards the TP for MK, RK and AWK in the MRI- group. DKI measurements correlated with seizure duration, mostly towards the anterior segments of the WM bundles. Stronger differences in MK, RK and AWF within the TC were observed in the MRI+ and noticeable differences (except for MD) in MRI- groups compared to controls. Significance: The study demonstrates that DKI has potential to detect subtle microstructural alterations within the anterior segments of the ILF and Unc and the connected TC in TLE patients including MRI- subjects. This could aid our understanding of the extrahippocampal areas involved in seizure generation in TLE and might inform surgical planning, leading to better seizure outcomes.

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Diffusion kurtosis imaging study on temporal lobe after nasopharyngeal carcinoma radiotherapy

Brain Research ◽

10.1016/j.brainres.2016.07.041 ◽

2016 ◽

Vol 1648 ◽

pp. 387-393 ◽

Cited By ~ 9

Author(s):

Dan Wang ◽

Yue-Hua Li ◽

Jie Fu ◽

He Wang

Keyword(s):

Nasopharyngeal Carcinoma ◽

Temporal Lobe ◽

Imaging Study ◽

Diffusion Kurtosis Imaging ◽

Diffusion Kurtosis

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Magnetic resonance diffusion kurtosis imaging in differential diagnosis of benign and malignant renal tumors

Cancer Imaging ◽

10.1186/s40644-020-00369-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jianxiong Fu ◽

Jing Ye ◽

Wenrong Zhu ◽

Jingtao Wu ◽

Wenxin Chen ◽

...

Keyword(s):

Differential Diagnosis ◽

Mean Diffusivity ◽

Threshold Value ◽

Renal Tumors ◽

Diffusion Kurtosis Imaging ◽

Renal Oncocytoma ◽

Renal Angiomyolipoma ◽

Planar Imaging ◽

Cell Renal Cell Carcinoma ◽

Diffusion Kurtosis

Abstract Background Benign and malignant renal tumors share similar some imaging findings. Methods Sixty-six patients with clear cell renal cell carcinoma (CCRCC), 13 patients with renal angiomyolipoma with minimal fat (RAMF) and 7 patients with renal oncocytoma (RO) were examined. For diffusion kurtosis imaging (DKI), respiratory triggered echo-planar imaging sequences were acquired in axial plane (3 b-values: 0, 500, 1000s/mm2). Mean Diffusivity (MD), fractional Anisotropy (FA), mean kurtosis (MK), kurtosis anisotropy (KA) and radial kurtosis (RK) were performed. Results For MD, a significant higher value was shown in CCRCC (3.08 ± 0.23) than the rest renal tumors (2.93 ± 0.30 for RO, 1.52 ± 0.24 for AML, P < 0.05). The MD values were higher for RO than for AML (2.93 ± 0.30 vs.1.52 ± 0.24, P < 0.05), while comparable MD values were found between CCRCC and RO (3.08 ± 0.23 vs. 2.93 ± 0.30, P > 0.05). For MK, KA and RK, a significant higher value was shown in AML (1.32 ± 0.16, 1.42 ± 0.23, 1.41 ± 0.29) than CCRCC (0.43 ± 0.08, 0.57 ± 0.16, 0.37 ± 0.11) and RO (0.81 ± 0.08, 0.86 ± 0.16, 0.69 ± 0.08) (P < 0.05). The MK, KA and RK values were higher for RO than for CCRCC (0.81 ± 0.08 vs. 0.43 ± 0.08, 0.86 ± 0.16 vs. 0.57 ± 0.16, 0.69 ± 0.08 vs. 0.37 ± 0.11, P < 0.05). Using MD values of 2.86 as the threshold value for differentiating CCRCC from RO and AML, the best result obtained had a sensitivity of 76.1%, specificity of 72.6%. Using MK, KA and RK values of 1.19,1.13 and 1.11 as the threshold value for differentiating AML from CCRCC and RO, the best result obtained had a sensitivity of 91.2, 86.7, 82.1%, and specificity of 86.7, 83.2, 72.8%. Conclusion DKI can be used as another noninvasive biomarker for benign and malignant renal tumors’ differential diagnosis.

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Temporal pole abnormalities detected by 3 T MRI in temporal lobe epilepsy due to hippocampal sclerosis: No influence on seizure outcome after surgery

Seizure ◽

10.1016/j.seizure.2017.04.006 ◽

2017 ◽

Vol 48 ◽

pp. 74-78 ◽

Cited By ~ 4

Author(s):

Sara Casciato ◽

Angelo Picardi ◽

Alfredo D’Aniello ◽

Marco De Risi ◽

Giovanni Grillea ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Hippocampal Sclerosis ◽

Seizure Outcome ◽

Temporal Pole

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Multiple hippocampal transections for mesial temporal lobe epilepsy

Surgical Neurology International ◽

10.25259/sni_350_2021 ◽

2021 ◽

Vol 12 ◽

pp. 372

Author(s):

David Pitskhelauri ◽

Elina Kudieva ◽

Maria Kamenetskaya ◽

Antonina Kozlova ◽

Pavel Vlasov ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Verbal Memory ◽

Visual Memory ◽

Focal Cortical Dysplasia ◽

Mesial Temporal Lobe Epilepsy ◽

Drug Resistant ◽

Preoperative Level ◽

Temporal Pole ◽

Mesial Temporal Lobe

Background: The purpose of this study was to evaluate the effectiveness of multiple hippocampal transections (MHT) in the treatment of drug-resistant mesial temporal lobe epilepsy. Methods: Six patients underwent MHT at Burdenko Neurosurgery Center in 2018. The age of the patients varied from 18 to 43 years. All patients suffered from refractory epilepsy caused by focal lesions of the mesial temporal complex or temporal pole in dominant side. Postoperative pathology revealed neuronal-glial tumors in two patients, focal cortical dysplasia (FCD) of the temporal pole – in two patients, cavernous angioma – in one patient, and encephalocele of the preuncal area – in one patient. Results: All patients underwent surgery satisfactorily. There were no postoperative complications except for homonymous superior quadrantanopia. This kind of visual field loss was noted in four cases out of six. During the follow-up period five patients out of six had Engel Class I outcome (83.3%). In one case, seizures developed after 1 month in a patient with FCD in the uncus (Engel IVA). After surgery, three out of six patients developed significant nominative aphasia. Two patients relative to the preoperative level demonstrated improvement in delayed verbal memory after MHT. Two patients showed a decrease level in delayed verbal memory. In preoperative period, visual memory was below the normal in one patient. Delayed visual memory in two cases impaired compared to the preoperative level. Conclusion: MHT can be considered as an effective method of drug-resistant mesial temporal lobe epilepsy caused by tumors of the medial temporal complex. At the same time, MHT makes it possible to preserve memory in patients with structurally preserved hippocampus. However, MHT do not guarantee the preservation of memory after surgery.

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Diffusion Kurtosis Imaging as a Prognostic Marker in Osteosarcoma Patients with Preoperative Chemotherapy

BioMed Research International ◽

10.1155/2020/3268138 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Chenglei Liu ◽

Yue Xing ◽

Dongmin Wei ◽

Qiong Jiao ◽

Qingcheng Yang ◽

...

Keyword(s):

Preoperative Chemotherapy ◽

Tumor Resection ◽

Mean Diffusivity ◽

Cox Proportional Hazards ◽

Diffusion Kurtosis Imaging ◽

Rank Test ◽

Poor Responders ◽

Risk Of Death ◽

Increased Risk ◽

Diffusion Kurtosis

Background. The accurate prediction of prognosis is key to prompt therapy adjustment. The purpose of our study was to investigate the efficacy of diffusion kurtosis imaging (DKI) in predicting progression-free survival (PFS) and overall survival (OS) in osteosarcoma patients with preoperative chemotherapy. Methods. Thirty patients who underwent DKI before and after chemotherapy, followed by tumor resection, were retrospectively enrolled. The patients were grouped into good responders (GRs) and poor responders (PRs). The Kaplan-Meier and log-rank test were used for survival analysis. The association between the DKI parameters and OS and PFS was performed by univariate and multivariate Cox proportional hazards models. Results. Significantly worse OS and PFS were associated with a lower mean diffusivity (MD) after chemotherapy (HR, 5.8; 95% CI, 1.5-23.1; P=0.012 and HR, 3.5; 95% CI, 1.2-10.1: P=0.028, respectively) and a higher mean kurtosis (MK) after chemotherapy (HR, 0.3; 95% CI, 0.1-0.9; P=0.041 and HR, 0.3; 95% CI, 0.1-0.8; P=0.049, respectively). Likewise, shorter OS and PFS were also significantly associated with a change rate in MD (CR MD) of less than 13.53% (HR, 8.6; 95% CI, 1.8-41.8; P=0.007 and HR, 2.9; 95% CI, 1.0-8.2; P=0.045, respectively). Compared to GRs, PRs had an approximately 9- and 4-fold increased risk of death (HR, 9.4; 95% CI, 1.2-75; P=0.034) and progression (HR, 4.2; 95% CI, 1.2-15; P=0.026), respectively. Conclusions. DKI has a potential to be a prognostic tool in osteosarcoma. Low MK and high MD after chemotherapy or high CR MD indicates favorite outcome, while prospective studies with large sample sizes are warranted.

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