Automated detection of cortical dysplasia type II in MRI-negative epilepsy

Hong, Seok‐Jun; Kim, Ho‐Sung; Schrader, Dewi; Bernhardt, Boris C.; Bernasconi, Andrea

doi:10.1212/wnl.0000000000000543

Cited by 161 publications

(184 citation statements)

References 39 publications

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“…Normalized intensity. We divided voxel-wise T1-weighted and FLAIR intensity by the average GM-WM boundary intensity; this value was normalized with respect to the mode of the T1-weighted and FLAIR intensity histogram 18 and mapped on each intracortical/subcortical surface. We did not sample intensity on the GM-CSF surface to avoid CSF contamination 14 ; at remaining surfaces, we corrected intensities for CSF partial volume effects.…”

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confidence: 99%

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Multimodal MRI profiling of focal cortical dysplasia type II

Hong¹,

Bernhardt²,

Caldairou³

et al. 2017

Neurology

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Objective: To characterize in vivo MRI signatures of focal cortical dysplasia (FCD) type IIA and type IIB through combined analysis of morphology, intensity, microstructure, and function. Methods:We carried out a multimodal 3T MRI profiling of 33 histologically proven FCD type IIA (9) and IIB (24) lesions. A multisurface approach operating on manual consensus labels systematically sampled intracortical and subcortical lesional features. Geodesic distance mapping quantified the same features in the lesion perimeter. Logistic regression assessed the relationship between MRI and histology, while supervised pattern learning was used for individualized subtype prediction.Results: FCD type IIB was characterized by abnormal morphology, intensity, diffusivity, and function across all surfaces, while type IIA lesions presented only with increased fluid-attenuated inversion recovery signal and reduced diffusion anisotropy close to the gray-white matter interface. Similar to lesional patterns, perilesional anomalies were more marked in type IIB extending up to 16 mm. Structural MRI markers correlated with categorical histologic characteristics. A profile-based classifier predicted FCD subtypes with equal sensitivity of 85%, while maintaining a high specificity of 94% against healthy and disease controls. Conclusions:Image processing applied to widely available MRI contrasts has the ability to dissociate FCD subtypes at a mesoscopic level. Integrating in vivo staging of pathologic traits with automated lesion detection is likely to provide an objective definition of lesional boundary and assist emerging approaches, such as minimally invasive thermal ablation, which do not supply tissue specimen. Neurology ® 2017;88:734-742 GLOSSARY ALFF 5 amplitude of low-frequency fluctuations; d-MRI 5 diffusion-weighted MRI; FA 5 fractional anisotropy; FCD 5 focal cortical dysplasia; FLAIR 5 fluid-attenuated inversion recovery; FWHM 5 full width at half maximum; GM 5 gray matter; MD 5 mean diffusivity; MNI 5 Montreal Neurological Institute; ReHo 5 regional homogeneity; rs-fMRI 5 resting-state functional MRI; SVM 5 support vector machine; TE 5 echo time; TR 5 repetition time; WM 5 white matter.

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confidence: 99%

“…Decreased vertical gradient at the GM-WM interface modeled blurring. 18 Diffusion parameters. FA and MD are surrogate markers of fiber architecture and tissue microstructure.…”

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confidence: 99%

Multimodal MRI profiling of focal cortical dysplasia type II

Hong¹,

Bernhardt²,

Caldairou³

et al. 2017

Neurology

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“…Typically, the presurgical evaluation was performed using MRI, SPECT, PET, fMRI, or MEG [17]- [19]. Although developed in brain glioma cases, our SPAM-assisted presurgical mapping technique could apply to presurgical mapping for epilepsy surgery as well.…”

Section: Discussionmentioning

confidence: 99%

Presurgical Mapping of Brain Tumors Using Statistical Probabilistic Anatomical Maps

Kim¹,

Cheon²,

Lim³

2015

JBiSE

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Purpose: Multi-tracer neuroimaging is widely used for the diagnosis, radiotherapy, and neurosurgery of brain gliomas. Anatomical and functional information is important to avoid having neurological deficits induced during the resection or radiation therapy of brain gliomas. The aim of this study was to investigate presurgical anatomical labeling of brain gliomas on FLT and FET using statistical probabilistic anatomic maps (SPAM), which are images of cerebral cortical, cerebellar, and subcortical volumes of interest (VOIs). Methods: FDG, FLT, and FET PET scans were acquired. FLT and FET PET images were coregistered to the FDG PET images, which were then spatially normalized onto the target brain. An inverse spatial normalization parameter was calculated and applied to SPAM. For the anatomical labeling of brain glioma regions, the volumes of brain gliomason FLT and FET images were extracted using segmentation. Probabilistic information of the glioma region was then calculated using SPAM and the segmented glioma volumes. SPM and an in-house program were used for image processing. Results: The probability of SPAM labeling a brain glioma region could be extracted using the inverse normalized SPAM and segmented glioma regions. In a sample case, the probabilistic anatomical region of the glioma included 21% of the postcentral gyrus, 12% of the superior parietal gyrus, and 6% of the angular gyrus. Conclusion: Anatomical information about brain gliomas could be extracted using SPAM. This proposed method would be optional for presurgical mapping, to avoid an additional functional mapping study that might otherwise be necessary to avoid producing neurological deficits.

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“…Further, overlap of the epileptogenic region with areas of eloquent cortex may complicate surgical resection, resulting in lower rates of seizure freedom (76). Invasive monitoring with intracranial electrodes is often necessary to map the ictal onset zone and functionally eloquent cortex to guide surgical resection (77). …”

Section: Extratemporal Resectionmentioning

confidence: 99%

Surgical strategies for pediatric epilepsy

Guan

Karsy

Ducis³

et al. 2016

Transl. Pediatr.

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Pediatric epilepsy is a debilitating condition that impacts millions of patients throughout the world. Approximately 20-30% of children with recurrent seizures have drug-resistant epilepsy (DRE).For these patients, surgery offers the possibility of not just seizure freedom but significantly improved neurocognitive and behavioral outcomes. The spectrum of surgical options is vast, ranging from outpatient procedures such as vagus nerve stimulation to radical interventions including hemispherectomy. The thread connecting all of these interventions is a common goal-seizure freedom, an outcome that can be achieved safely and durably in a large proportion of patients. In this review, we discuss many of the most commonly performed surgical interventions and describe the indications, complications, and outcomes specific to each.

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Automated detection of cortical dysplasia type II in MRI-negative epilepsy

Cited by 161 publications

References 39 publications

Multimodal MRI profiling of focal cortical dysplasia type II

Multimodal MRI profiling of focal cortical dysplasia type II

Presurgical Mapping of Brain Tumors Using Statistical Probabilistic Anatomical Maps

Surgical strategies for pediatric epilepsy

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