“Neurologists and other referring physicians are sophisticated in their specialties and subspecialties, and it’s important how we, as radiologists, look at individual cases,” continued Mettenburg. “Volumetric software provides quantitative and objective assessment independent of initial impressions. It nuances my interpretation to make my assessment more actionable, and in turn, may help speed up treatment decision-making.”

One area where volumetric software has demonstrated significant and practical application is in the assessment of temporal lobe epilepsy. Here, mesial temporal sclerosis, which is characterized by volume loss that is time- and severity-dependent, may be revealed.


“Sometimes the differences in volume are subtle and that’s where volumetric software comes in. The goal is to confidently identify temporal lobe volume loss, so neurosurgeons may not need to perform surgery that is both highly invasive and expensive. The data provided through volumetric software, in combination with other variables, may help patients avoid invasive procedures, be taken off their seizure medication and hospitalized for about a week, while their neurologist waits for a seizure to occur. Our study, using Neuroreader™ software, showed how some of the more invasive procedures may be avoided,” said Dr. Mettenburg.

In this study, Dr. Mettenburg was part of a UPMC research team investigating patterns of regional, preoperative volumetric differences that may be associated with postoperative outcomes in patients with medically refractory temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomies (ATL).

The results of the study may have important clinical implications for identifying which patients may respond well to an ATL procedure versus those who won’t. “Approximately 40 percent of patients who undergo temporal lobectomy for TLE may continue to experience seizures postoperatively. Thus, further stratification of potential surgical candidates using preoperative data may improve outcomes.”

He noted that, “Epilepsy medications have massive side effects, so even getting patients off even one of them can be life-changing. Patients and families are at their wits' end. When we can confidently describe temporal lobe volume, either normal or abnormal, we are able to provide value-added information to inform the most appropriate treatment plan and potentially avoid unnecessary invasive procedures or surgery.”

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