title: 3-T magnetic resonance imaging simultaneous automated multimodal approach improves detection of ambiguous visual hippocampal sclerosis.
abstract: OBJECTIVE
  To evaluate if an automatic magnetic resonance imaging (MRI) processing system may improve detection of hippocampal sclerosis (Hs) in patients with mesial temporal lobe epilepsy (MTLE).
  
  
  METHODS
  Eighty consecutive patients with a diagnosis of MTLE and 20 age- and sex-matched controls were prospectively recruited and included in our study. The entire group had 3-T MRI visual assessment of Hs analysed by two blinded imaging epilepsy experts. Logistic regression was used to evaluate the performances of neuroradiologists and multimodal analysis.
  
  
  RESULTS
  The multimodal automated tool gave no evidence of Hs in all 20 controls and classified the 80 MTLE patients as follows: normal MRI (54/80), left Hs (14/80), right Hs (11/80) and bilateral Hs (1/80). Of note, this multimodal automated tool was always concordant with the side of MTLE, as determined by a comprehensive electroclinical evaluation. In comparison with standard visual assessment, the multimodal automated tool resolved five ambiguous cases, being able to lateralize Hs in four patients and detecting one case of bilateral Hs. Moreover, comparing the performances of the three logistic regression models, the multimodal approach overcame performances obtained with a single image modality for both the hemispheres, reaching a global accuracy value of 0.97 for the right and 0.98 for the left hemisphere.
  
  
  CONCLUSIONS
  Multimodal quantitative automated MRI is a reliable and useful tool to depict and lateralize Hs in patients with MTLE, and may help to lateralize the side of MTLE especially in subtle and uncertain cases.
authors.affiliation: Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Vasta
authors.forename: M E
authors.initials: ME
authors.lastname: Caligiuri
authors.forename: A
authors.initials: A
authors.lastname: Labate
authors.forename: A
authors.initials: A
authors.lastname: Cherubini
authors.forename: L
authors.initials: L
authors.lastname: Mumoli
authors.forename: E
authors.initials: E
authors.lastname: Ferlazzo
authors.forename: P
authors.initials: P
authors.lastname: Perrotta
authors.forename: P L
authors.initials: PL
authors.lastname: Lanza
authors.forename: A
authors.initials: A
authors.lastname: Augimeri
authors.forename: U
authors.initials: U
authors.lastname: Aguglia
authors.forename: A
authors.initials: A
authors.lastname: Quattrone
authors.forename: A
authors.initials: A
authors.lastname: Gambardella
mesh_terms: D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012598:Sclerosis / Q000175:diagnosis; D016037:Single-Blind Method
keywords: hippocampal sclerosis; imaging; medial temporal lobe epilepsy