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Multimodal Image Fusion for Noninvasive Epilepsy Surgery Planning
January 1996 (vol. 16 no. 1)
pp. 30-38
A quarter of epilepsy patients in the United States, approximately 125,000 with an estimated annual increase of 5,000, have seizures uncontrolled by medication and are candidates for surgical treatment. Planning of epilepsy surgery often includes invasive, intracranial EEG recordings to localize the region of seizure onset for resection. Such invasive procedures impose considerable costs and definite risks, ranging from $40,000 to $80,000 per session and 6 to 8 percent morbidity rate. In this article, we propose an alternative approach that is noninvasive and costs about $3,000 to $4,000 per patient. This article describes computing tools developed to quantitate and combine different biomedical information of four neuroimaging modalities, that is, magnetic resonance imaging (MRI), positron emission tomography (PET), magnetic resonance spectroscopy (MRS), and magnetoencephalography (MEG). Multimodal image fusion aims to decrease the need for invasive intracranial EEG monitoring. As a result, it provides major cost savings, reduced patient risks, and increased availablility for epilepsy surgery. Selected patient cases from the Northern California Comprehensive Epilepsy Center are also provided to illustrate the clinical application of these techniques.

1. "NIH Consensus Conference—Surgery for Epilepsy," JAMA, Vol. 264, No. 6, 1990, pp. 729-733.
2. J. Engel ed., Surgical Treatment of the Epilepsies, Appendix II: Presurgical Evaluation Protocols, Raven Press, New York, 1993.
3. H.K. Huang et al., eds., Picture Archiving and Communication System (PACS). J. Digital Imaging. Vol. 5, No. 1, 1992, pp. 22-25.
4. S.T.C. Wong, H.U. Lemke, and H.K. Huang, "Applicability of ATM to distributed PACS Environment," SPIE Medical Imaging Conference: PACS Design and Evaluation, Feb. 26-Mar. 2, San Diego, 1995, 430-439.
5. S. Zink and C.C. Jaffe, "Medical Image Databases," Investigative Radiology, Vol. 28, No. 4, 1993, pp. 366-372.
6. S.T.C. Wong et al., "Integrating Multidimensional Imaging, Multimodality Registration, and Multimedia Database for Epilepsy Diagnosis," SPIE Medical Imaging Conference: Image Display, Feb. 26-Mar. 2, San Diego, 1995.
7. K.D. Laxer et al., "Experimental Technologies," in Surgical Treatment of the Epilepsies, J. Engel (ed.), Raven Press, 1993, pp. 291-308.
8. R.P. Woods, J.C. Mazziotta, and S.R. Cherry, "MRI-PET Registration with Automated Algorithm," J Computer Assisted Tomography, Vol. 17, No. 4, 1993, pp. 536-546.
9. S.C. Strother et al., "Quantitative Comparisons of Image Registration Techniques Based on High-Resolution MRI of the Brain," J Computer Assisted Tomography, Vol. 18, No. 6, 1994, pp. 954-962.
10. A. Connelly et al., "Magnetic Resonance Spectroscopy and Temporal Lobe Epilepsy," Neurology, Vol. 44, 1994, pp. 1,411-1,417.

Index Terms:
Multimodal brain imaging, image registration, noninvasive surgical planning, minimum invasive medicine, medical image databases, PACS
Stephen T.C. Wong, Robert C. Knowlton, Randy A. Hawkins, Kenneth D. Laxer, "Multimodal Image Fusion for Noninvasive Epilepsy Surgery Planning," IEEE Computer Graphics and Applications, vol. 16, no. 1, pp. 30-38, Jan. 1996, doi:10.1109/38.481564
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