title: Multimodal MRI profiling of focal cortical dysplasia type II.
abstract: 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.
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Seok-Jun
authors.initials: SJ
authors.lastname: Hong
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Boris C
authors.initials: BC
authors.lastname: Bernhardt
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Benoit
authors.initials: B
authors.lastname: Caldairou
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Hall
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Marie C
authors.initials: MC
authors.lastname: Guiot
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Dewi
authors.initials: D
authors.lastname: Schrader
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada.
authors.forename: Neda
authors.initials: N
authors.lastname: Bernasconi
authors.affiliation: From the Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital (S.-J.H., B.C.B., B.C., J.A.H., M.C.G., N.B., A.B.), Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre (S.-J.H., B.C.B., B.C., D.S., N.B., A.B.), and Department of Pathology (M.C.G.), McGill University, Montreal, Canada. andrea@bic.mni.mcgill.ca.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bernasconi
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D003937:Diagnosis, Differential; D000069279:Drug Resistant Epilepsy / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D004827:Epilepsy / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D065703:Malformations of Cortical Development, Group I / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D064847:Multimodal Imaging; D010363:Pattern Recognition, Automated; D012680:Sensitivity and Specificity; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery