EBSCO Logo
Connecting you to content on EBSCOhost
Results
Title

Resection of the piriform cortex for temporal lobe epilepsy: a Novel approach on imaging segmentation and surgical application.

Authors

Leon-Rojas, Jose E.; Iqbal, Sabahat; Vos, Sjoerd B.; Rodionov, Roman; Miserocchi, Anna; McEvoy, Andrew W; Vakharia, Vejay N; Mancini, Laura; Galovic, Marian; Sparks, Rachel E; Ourselin, Sebastien; Cardoso, Jorge M; Koepp, Matthias J; Duncan, John S

Abstract

The piriform cortex (PC) occupies both banks of the endorhinal sulcus and has an important role in the pathophysiology of temporal lobe epilepsy (TLE). A recent study showed that resection of more than 50% of PC increased the odds of becoming seizure free by a factor of 16. We report the feasibility of manual segmentation of PC and application of the Geodesic Information Flows (GIF) algorithm to automated segmentation, to guide resection. Manual segmentation of PC was performed by two blinded independent examiners in 60 patients with TLE (55% Left TLE, 52% female) with a median age of 35 years (IQR, 29–47 years) and 20 controls (60% Women) with a median age of 39.5 years (IQR, 31–49). The GIF algorithm was used to create an automated pipeline for parcellating PC which was used to guide excision as part of temporal lobe resection for TLE. Right PC was larger in patients and controls. Parcellation of PC was used to guide anterior temporal lobe resection, with subsequent seizure freedom and no visual field or language deficit. Reliable segmentation of PC is feasible and can be applied prospectively to guide neurosurgical resection that increases the chances of a good outcome from temporal lobe resection for TLE.

Subjects

TEMPORAL lobe epilepsy; TEMPORAL lobectomy; TEMPORAL lobe; IMAGE segmentation; GEODESIC flows; VISUAL fields

Publication

British Journal of Neurosurgery, 2024, Vol 38, Issue 3, p716

ISSN

0268-8697

Publication type

Academic Journal

DOI

10.1080/02688697.2021.1966385

EBSCO Connect | Privacy policy | Terms of use | Copyright | Manage my cookies
Journals | Subjects | Sitemap
© 2025 EBSCO Industries, Inc. All rights reserved