title: Cortical feature analysis and machine learning improves detection of "MRI-negative" focal cortical dysplasia.
abstract: Focal cortical dysplasia (FCD) is the most common cause of pediatric epilepsy and the third most common lesion in adults with treatment-resistant epilepsy. Advances in MRI have revolutionized the diagnosis of FCD, resulting in higher success rates for resective epilepsy surgery. However, many patients with histologically confirmed FCD have normal presurgical MRI studies ('MRI-negative'), making presurgical diagnosis difficult. The purpose of this study was to test whether a novel MRI postprocessing method successfully detects histopathologically verified FCD in a sample of patients without visually appreciable lesions. We applied an automated quantitative morphometry approach which computed five surface-based MRI features and combined them in a machine learning model to classify lesional and nonlesional vertices. Accuracy was defined by classifying contiguous vertices as "lesional" when they fell within the surgical resection region. Our multivariate method correctly detected the lesion in 6 of 7 MRI-positive patients, which is comparable with the detection rates that have been reported in univariate vertex-based morphometry studies. More significantly, in patients that were MRI-negative, machine learning correctly identified 14 out of 24 FCD lesions (58%). This was achieved after separating abnormal thickness and thinness into distinct classifiers, as well as separating sulcal and gyral regions. Results demonstrate that MRI-negative images contain sufficient information to aid in the in vivo detection of visually elusive FCD lesions.
authors.affiliation: Department of Computer Science, Tufts University, Medford, MA, USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Ahmed
authors.affiliation: Department of Computer Science, Tufts University, Medford, MA, USA.
authors.forename: Carla E
authors.initials: CE
authors.lastname: Brodley
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Blackmon
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Ruben
authors.initials: R
authors.lastname: Kuzniecky
authors.affiliation: Department of Computer Science, Tufts University, Medford, MA, USA.
authors.forename: Gilad
authors.initials: G
authors.lastname: Barash
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Carlson
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Quinn
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Werner
authors.initials: W
authors.lastname: Doyle
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: French
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA.
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, School of Medicine, New York University, New York, USA; Department of Radiology, School of Medicine, New York University, New York, USA. Electronic address: thomas.thesen@med.nyu.edu.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thesen
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006257:Head / Q000473:pathology; D006801:Humans; D000069550:Machine Learning; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D054220:Malformations of Cortical Development / Q000473:pathology*; D055815:Young Adult
keywords: Epilepsy; Focal cortical dysplasia; Machine learning; Structural MRI