Novel multimodality imaging techniques for neurosurgical planning and stereotactic navigation in epilepsy surgery. (360G-Wellcome-097914_Z_11_Z)

a) There is poor neurosurgical precision for treating refractory focal epilepsy, resulting in risk of causing deficits and restricting potentially curative surgery. b) A software package, the StealthEpilepsy module , integrated into the Medtronic StealthViz product will enable interactive 3D-display of processed multi-modality brain imaging: including brain structure, lesions, arteries, veins, white matter tracts, and eloquent cortex (motor, language, vision), and markers of abnormal function that localize epileptic foci (glucose metabolism, blood flow and electrical and magnetic source imaging). These data will be used to interactively determine the optimal placement of intracranial electrodes and subsequent cerebral resection, with integration into the Stealth neuronavigation system used in the operating room. c) Brain imaging methods that will result in safer, more effective neurosurgery and which could be rolled out to all Neurosurgery Centres in the UK within three years. Production of a new StealthViz module StealthEpilepsy dedicated to epilepsy surgery, in collaboration with Medtronic. Demonstration of utility of StealthEpilepsy , with modification of surgical plans and good outcomes from surgery. d) Safer epilepsy surgery, reduced risk of damaging eloquent structures, and improved chance of seizure freedom. These advances will be applied across the UK and globally, and will also be relevant to tumour surgery.