{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:28:12Z","timestamp":1792618092857,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006117","name":"Epilepsiefonds","doi-asserted-by":"publisher","award":["2020\u201009"],"award-info":[{"award-number":["2020\u201009"]}],"id":[{"id":"10.13039\/501100006117","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Resective epilepsy surgery is an evidence\u2010based treatment option for patients with focal drug\u2010resistant epilepsy (DRE). Seizure outcome after surgery is largely dependent on detection and delineation of an epileptogenic lesion on magnetic resonance imaging (MRI). However, detection fails in 30% of patients at 3 Tesla (T) MRI, thereby limiting surgical options. Diagnostic and therapeutic gain of ultra\u2010high\u2010field MRI in patients with 3T MRI\u2010negative DRE is evaluated in the EpiUltraStudy. Here we report the diagnostic gain of structural 7T MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Inclusion criteria were age \u226512\u2009years and DRE with a suspected epileptogenic focus and negative conventional 3T MRI during pre\u2010surgical workup. Images were evaluated independently by two neuroradiologists and a neurologist or neurosurgeon in two runs: blinded (Run 1) and with the results of additional clinical investigations (Run 2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty patients underwent 7T MRI. No persistent adverse events were reported. Visual assessment of 7T MRI identified lesions in 9 cases (15%), undetected on prior 3T MRI. Possible positive scan rates increased from 17% (10\/60) in the blinded run to 47% (28\/60) in the informed run. However, after consensus review, many of these were reclassified as negative. Eight of nine positive 7T MRI scans were initially identified by only one or two assessors. After reassessment, a total of 56% (5\/9) of 7T lesions were retrospectively identified on 3T.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Our data suggest a benefit of 7T MRI for the detection of subtle epileptogenic lesions in patients with DRE and negative 3T MRI. Although the detection rate may appear modest compared to other reports, we present a nuanced discussion of our methodology and patient population, contributing meaningful context to the current literature. The availability of multimodal information and consensus reviews enhanced diagnostic accuracy but with higher rates of false positives, underscoring the importance of multidisciplinary cooperation in the clinical care for patients with DRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration Number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.trialregister.nl\">www.trialregister.nl<\/jats:ext-link>\n                      : NTR7536.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18682","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T15:40:22Z","timestamp":1760715622000},"page":"791-804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Value of ultra\u2010high\u2010field\n                    <scp>MRI<\/scp>\n                    in patients with drug\u2010resistant focal epilepsy and negative\n                    <scp>3T MRI<\/scp>\n                    (\n                    <scp>EpiUltraStudy<\/scp>\n                    ): Diagnostic gain of\n                    <scp>7T<\/scp>\n                    structural analysis"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6557-9127","authenticated-orcid":false,"given":"Rick H. G. J.","family":"van Lanen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Uher","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Department of Radiology &amp; Nuclear Medicine Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne M. C.","family":"Hoeberigs","sequence":"additional","affiliation":[{"name":"Department of Radiology &amp; Nuclear Medicine Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A. M.","family":"Hofman","sequence":"additional","affiliation":[{"name":"Department of Radiology Horatio Oduber Hospital  Oranjestad Aruba"},{"name":"CAPHRI \u2013 Care and Public Health Research Institute, Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remco","family":"Santegoeds","sequence":"additional","affiliation":[{"name":"Department of Radiology &amp; Nuclear Medicine Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Wiggins","sequence":"additional","affiliation":[{"name":"Imaging Core Facility, Institute of Neuroscience and Medicine Forschungzentrum Juelich  Juelich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond H. Y.","family":"Tse","sequence":"additional","affiliation":[{"name":"Scannexus, Ultra\u2010High Field MRI Research Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0790-9260","authenticated-orcid":false,"given":"Esther G. M.","family":"Steijvers","sequence":"additional","affiliation":[{"name":"Scannexus, Ultra\u2010High Field MRI Research Center  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobus F. A.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Department of Radiology &amp; Nuclear Medicine Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Department of Electrical Engineering Eindhoven University of Technology  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7708-8501","authenticated-orcid":false,"given":"Gerald S.","family":"Drenthen","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Department of Radiology &amp; Nuclear Medicine Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alard","family":"Roebroeck","sequence":"additional","affiliation":[{"name":"Department of Cognitive Neuroscience Faculty of Psychology and Neuroscience, Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimo","family":"Ivanov","sequence":"additional","affiliation":[{"name":"Department of Cognitive Neuroscience Faculty of Psychology and Neuroscience, Maastricht University  Maastricht The Netherlands"},{"name":"Max Planck Institute for Empirical Aesthetics and Cooperative Brain Imaging Center \u2013 CoBIC  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt A.","family":"Poser","sequence":"additional","affiliation":[{"name":"Department of Cognitive Neuroscience Faculty of Psychology and Neuroscience, Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander M. J.","family":"van Kuijk","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govert","family":"Hoogland","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Rijkers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis G. L.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Widman","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Beckervordersandforth","sequence":"additional","affiliation":[{"name":"Department of Pathology Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Klinkenberg","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob P. W.","family":"Rouhl","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"},{"name":"Department of Neurology Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Delev","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University Hospital Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Clusmann","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery RWTH Aachen University Hospital  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1460-6623","authenticated-orcid":false,"given":"Stefan","family":"Wolking","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology RWTH Aachen University Hospital  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-5592","authenticated-orcid":false,"given":"Yvonne","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology RWTH Aachen University Hospital  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurien K.","family":"Dhaenens\u2010Meyer","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology RWTH Aachen University Hospital  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Schriewer","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology RWTH Aachen University Hospital  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Meurs","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology UZ Ghent  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrien","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology UZ Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Theys","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery UZ Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"van Paesschen","sequence":"additional","affiliation":[{"name":"Department of Epileptology and Neurology UZ Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"van Roost","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ghent University Hospital  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter H.","family":"Backes","sequence":"additional","affiliation":[{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Department of Radiology &amp; Nuclear Medicine Maastricht University Medical Center+  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Colon","sequence":"additional","affiliation":[{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"},{"name":"Centre des Etudes et Traitements de l'Epilepsie aux Cara\u00efbes  Fort\u2010de\u2010France Martinique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf E. M. G.","family":"Schijns","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"Mental Health and Neuroscience Research Institute (MHeNs) Maastricht University  Maastricht The Netherlands"},{"name":"Academic Center for Epileptology, Kempenhaeghe (Maastricht University Medical Center+)  Heeze The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ACE Epilepsy Surgery group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"issue":"6","key":"e_1_2_15_2_1","article-title":"Surgery for epilepsy","volume":"6","author":"West S","year":"2019","journal-title":"Cochrane Database Syst 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