| 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 the literature. Therefore, this comprehensive 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 |
