Combining magnetic resonance fingerprinting with voxel-based morphometric analysis to reduce false positives for focal cortical dysplasia detection

© 2024 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy..

OBJECTIVE: We aim to improve focal cortical dysplasia (FCD) detection by combining high-resolution, three-dimensional (3D) magnetic resonance fingerprinting (MRF) with voxel-based morphometric magnetic resonance imaging (MRI) analysis.

METHODS: We included 37 patients with pharmacoresistant focal epilepsy and FCD (10 IIa, 15 IIb, 10 mild Malformation of Cortical Development [mMCD], and 2 mMCD with oligodendroglial hyperplasia and epilepsy [MOGHE]). Fifty-nine healthy controls (HCs) were also included. 3D lesion labels were manually created. Whole-brain MRF scans were obtained with 1 mm3 isotropic resolution, from which quantitative T1 and T2 maps were reconstructed. Voxel-based MRI postprocessing, implemented with the morphometric analysis program (MAP18), was performed for FCD detection using clinical T1w images, outputting clusters with voxel-wise lesion probabilities. Average MRF T1 and T2 were calculated in each cluster from MAP18 output for gray matter (GM) and white matter (WM) separately. Normalized MRF T1 and T2 were calculated by z-scores using HCs. Clusters that overlapped with the lesion labels were considered true positives (TPs); clusters with no overlap were considered false positives (FPs). Two-sample t-tests were performed to compare MRF measures between TP/FP clusters. A neural network model was trained using MRF values and cluster volume to distinguish TP/FP clusters. Ten-fold cross-validation was used to evaluate model performance at the cluster level. Leave-one-patient-out cross-validation was used to evaluate performance at the patient level.

RESULTS: MRF metrics were significantly higher in TP than FP clusters, including GM T1, normalized WM T1, and normalized WM T2. The neural network model with normalized MRF measures and cluster volume as input achieved mean area under the curve (AUC) of .83, sensitivity of 82.1%, and specificity of 71.7%. This model showed superior performance over direct thresholding of MAP18 FCD probability map at both the cluster and patient levels, eliminating ≥75% FP clusters in 30% of patients and ≥50% of FP clusters in 91% of patients.

SIGNIFICANCE: This pilot study suggests the efficacy of MRF for reducing FPs in FCD detection, due to its quantitative values reflecting in vivo pathological changes. © 2024 International League Against Epilepsy.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Epilepsia - (2024) vom: 21. März

Sprache:

Englisch

Beteiligte Personen:

Ding, Zheng [VerfasserIn]
Hu, Siyuan [VerfasserIn]
Su, Ting-Yu [VerfasserIn]
Choi, Joon Yul [VerfasserIn]
Morris, Spencer [VerfasserIn]
Wang, Xiaofeng [VerfasserIn]
Sakaie, Ken [VerfasserIn]
Murakami, Hiroatsu [VerfasserIn]
Huppertz, Hans-Jürgen [VerfasserIn]
Blümcke, Ingmar [VerfasserIn]
Jones, Stephen [VerfasserIn]
Najm, Imad [VerfasserIn]
Ma, Dan [VerfasserIn]
Wang, Zhong Irene [VerfasserIn]

Links:

Volltext

Themen:

Epilepsy
Focal cortical dysplasia
Journal Article
MR fingerprinting
Pre‐surgical evaluation
Quantitative MRI
Relaxometry

Anmerkungen:

Date Revised 30.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1111/epi.17951

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370014820