| dc.description.abstract | Epilepsy is a chronic neurological disease. The mainstay of
treatment of epilepsy is Anti-Seizure Medication (ASM).
Thirty per cent of individuals develop Drug-Resistant
Epilepsy (DRE), necessitating the use of Epilepsy Surgery
(ES) or other alternative therapies. Precise anatomical and
functional localization of the area of the brain generating
seizures— Epileptogenic Zone (EZ) is essential to proceed
with ES. Magnetic Resonance Imaging (MRI) can be used to
identify anatomic lesions in the brain. However, MRI
findings can be inconclusive in some, and cerebral perfusion
scans are used in such cases to complement. This
comprehensive review focused on the use of Arterial Spin
Labelling (ASL) perfusion MRI- paradigm as a highly
efficient,
noninvasive, non-ionizing, less expensive,
imaging technique that is a potential alternative to Positron
Emission Tomography (PET). ASL determines Cerebral
Blood Flow (CBF) which is altered in the EZ. Compared to
PET, ASL does not use radioactive substances, offering a
higher safety profile to the patient. Previous research using
ASL-derived CBF maps has shown that quantitative
analysis provides more accurate EZ localization than
qualitative
analysis.
ASL quantification can be
amalgamated with other presurgical investigations in the
multimodal reconstruction of the surgical map.
Unfortunately, larger studies on the presurgical use of ASL
quantification with solid scientific data are currently
unavailable
in
comprehensive
the
literature.
Therefore,
this
review highlights the increasing
importance of ASL perfusion MRI as a valuable and safe
method for EZ identification in DRE patients with negative
MRI findings, providing a detailed comparison with
existing imaging techniques. | en_US |
