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Published in: Neuroradiology 4/2022

Open Access 01-04-2022 | Epilepsy | Diagnostic Neuroradiology

“Within a minute” detection of focal cortical dysplasia

Authors: Horst Urbach, Marcel Heers, Dirk-Matthias Altenmueller, Andreas Schulze-Bonhage, Anke Maren Staack, Thomas Bast, Marco Reisert, Ralf Schwarzwald, Christoph P. Kaller, Hans-Juergen Huppertz, Theo Demerath

Published in: Neuroradiology | Issue 4/2022

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Abstract

Purpose

To evaluate a MRI postprocessing tool for the enhanced and rapid detection of focal cortical dysplasia (FCD).

Methods

MP2RAGE sequences of 40 consecutive, so far MRI-negative patients and of 32 healthy controls were morphometrically analyzed to highlight typical FCD features. The resulting morphometric maps served as input for an artificial neural network generating a FCD probability map. The FCD probability map was inversely normalized, co-registered to the MPRAGE2 sequence, and re-transferred into the PACS system. Co-registered images were scrolled through “within a minute” to determine whether a FCD was present or not.

Results

Fifteen FCD, three subcortical band heterotopias (SBH), and one periventricular nodular heterotopia were identified. Of those, four FCD and one SBH were only detected by MRI postprocessing while one FCD and one focal polymicrogryia were missed, respectively. False-positive results occurred in 21 patients and 22 healthy controls. However, true positive cluster volumes were significantly larger than volumes of false-positive clusters (p < 0.001). The area under the curve of the receiver operating curve was 0.851 with a cut-off volume of 0.05 ml best indicating a FCD.

Conclusion

Automated MRI postprocessing and presentation of co-registered output maps in the PACS allowed for rapid (i.e., “within a minute”) identification of FCDs in our clinical setting. The presence of false-positive findings currently requires a careful comparison of postprocessing results with conventional MR images but may be reduced in the future using a neural network better adapted to MP2RAGE images.
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Metadata
Title
“Within a minute” detection of focal cortical dysplasia
Authors
Horst Urbach
Marcel Heers
Dirk-Matthias Altenmueller
Andreas Schulze-Bonhage
Anke Maren Staack
Thomas Bast
Marco Reisert
Ralf Schwarzwald
Christoph P. Kaller
Hans-Juergen Huppertz
Theo Demerath
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Keywords
Epilepsy
Aura
Published in
Neuroradiology / Issue 4/2022
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-021-02823-7

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