Fingerprint of in vivo histology MRI in drug-resistant temporal lobe epilepsy patients

Motivation: In drug-resistant temporal-lobe epilepsy (dTLE) clear identification of lesions in standard clinical MRI is advantageous for successful surgical planning, but non-invasive access to microstructure via in-vivo histology MRI (hMRI) remains unassessed. Goal(s): To test whether the hMRI fingerprint reveals information beyond standard clinical MRI in neurosurgery target regions. Approach: In two patients (one MR-atrophic, the other MR-hyperintense), we used interhemispheric differences as a proxy for asymmetric dTLE-relevant abnormalities and assess their profile across hMRI metrics. We tested consistency of hMRI fingerprints across patients. Results: hMRI fingerprint shows a significant correlation across patients in the amygdala, with a stronger profile in the MR-hyperintense patient. Impact: Novel MRI contrasts can improve our understanding of lesion microstructure in epilepsy. This study shows consistent fingerprints of hMRI metrics across two patients with different MR-clinical findings, indicating that hMRI might complement clinical MRI by revealing information about tissue microstructure.