Multi-modal brain imaging software for guiding invasive treatment of epilepsy

Purpose:The surgical treatment of patients with complex epilepsies ischanging more and more from open, invasive surgery towards minimallyinvasive, image guided treatment. Multi-modal brain imaging proceduresare developed to delineate preoperatively the region of the brain which isresponsible for the epilepsy of a patient and delimit the functional areasrelative to this region. The ultimate aim is to provide the neurosurgeonwith a clear and intuitive image of the targeted epileptogenic region inorder to render the patient seizure free, while avoiding damage to elo-quent cortex.Method:A software product (SP) is developed for multi-modality map-ping of the analysis results of non-invasive and invasive epilepsy record-ings and visualization of these results against brain anatomy. The SPcontains several pre-programmed sequences for creating the most com-monly used multi-modality brain images that can be used to delineate theepileptic tissue versus functional areas, like visualization of inverse solu-tions of high density EEG and MEG, EEG informed functional MRI(fMRI) visualizations and functional Near-Infrared Spectroscopy(fNIRS) projections.Results:The SP is optimized for intuitive and clinical usage to interac-tively explore the different modalities in relation to the available anatom-ical and structural MRI data. The distinct modalities can be combined by3D-fusion of the images and visualized in 2D- and 3D-MRI viewportsagainst the implanted depth electrodes and the brain mapping results ofthe invasive EEG recordings.Conclusion:Multi-modal functional and structural brain imagingapplied on data of the individual patient can be used for guiding surgicalresections with minimal disruption of brain anatomy, while rendering apatient seizure free.Acknowledgement:This study is part of the project“Advancing SmartOptical Imaging and Sensing for Health (ASTONISH)”that has receivedfunding from ECSEL Joint Undertaking (grant no. 692470).