Enhanced focal cortical dysplasia detection in pediatric frontal lobe epilepsy with asymmetric radiomic and
Manli Zhang1, Hao Yu2, Gongpeng Cao1
1Key Laboratory of Universal Wireless Communications, Ministry of Education, School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Beijing, China.
Insights
Radiomic and morphological MRI analysis effectively detects focal cortical dysplasia (FCD) in children with frontal lobe epilepsy (FLE). Asymmetric features in gray and white matter significantly improve lesion detection accuracy.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Medical Diagnostics
Background:
- Focal cortical dysplasia (FCD) is the leading pathological cause of pediatric epilepsy.
- Frontal lobe epilepsy (FLE) is the most common epilepsy syndrome in children.
- Accurate detection of FCD is crucial for effective treatment of pediatric epilepsy.
Purpose of the Study:
- To evaluate the efficacy of radiomic and morphological MRI methods for detecting FCD in children with FLE.
- To assess the performance of a two-stage detection approach incorporating asymmetric features.
Main Methods:
- A cohort of 37 children with FLE and 20 controls underwent MRI and PET scans.
- A five-fold cross-validation was performed, with validation in an independent cohort of 12 FLE children.
- Radiomic features were extracted from gray matter (GM), white matter (WM), and GM-WM boundary regions, utilizing asymmetric features between hemispheres. A Multi-Layer Perceptron classifier was employed for lesion localization.
Main Results:
- The Multi-Layer Perceptron model using asymmetric features demonstrated excellent performance in both the frontal lobe and subregions.
- Radiomics analysis incorporating GM and WM asymmetric features achieved high sensitivity (89.2-91.7%) and AUC (98.9-99.3%) in the frontal lobe.
- GM asymmetric features showed the highest sensitivity (85.6-79.7%) in subregions, with integrated approaches showing significant overlap with radiomic and morphological asymmetric features.
Conclusions:
- A two-stage detection strategy leveraging asymmetry in radiomic and morphological features significantly enhances FCD detection in pediatric FLE.
- Incorporating specific regions of interest, including GM, WM, and the gray-white matter boundary, improves the localization capabilities of radiomic analysis.
- This approach offers a promising tool for improving the diagnosis and management of FCD in children with epilepsy.
Objective:
Focal cortical dysplasia (FCD) is the most common pathological cause for pediatric epilepsy, with frontal lobe epilepsy (FLE) being the most prevalent in the pediatric population. We attempted to utilize radiomic and morphological methods on MRI and PET to detect FCD in children with FLE.
Methods:
Thirty-seven children with FLE and 20 controls were included in the primary cohort, and a five-fold cross-validation was performed. In addition, we validated the performance in an independent site of 12 FLE children. A two-stage experiments including frontal lobe and subregions were employed to detect the lesion area of FCD, incorporating the asymmetric feature between the left and right hemispheres. Specifically, for the radiomics approach, we used gray matter (GM), white matter (WM), GM and WM, and the gray-white matter boundary regions of interest to extract features. Then, we employed a Multi-Layer Perceptron classifier to achieve FCD lesion localization based on both radiomic and morphological methods.
Results:
The Multi-Layer Perceptron model based on the asymmetric feature exhibited excellent performance both in the frontal lobe and subregions. In the primary cohort and independent site, the radiomics analysis with GM and WM asymmetric features had the highest sensitivity (89.2 and 91.7%) and AUC (98.9 and 99.3%) in frontal lobe. While in the subregions, the GM asymmetric features had the highest sensitivity (85.6 and 79.7%). Furthermore, relying on the highest sensitivity of GM and WM asymmetric features in frontal lobe, when integrated with the subregions results, our approach exhibited overlaps with GM asymmetric features (55.4 and 52.4%), as well as morphological asymmetric features (54.4 and 53.8%), both in the primary cohort and at the independent site.
Significance:
This study demonstrates that a two-stage design based on the asymmetry of radiomic and morphological features can improve FCD detection. Specifically, incorporating regions of interest for GM, WM, GM, and WM, and the gray-white matter boundary significantly enhances the localization capabilities for lesion detection within the radiomics approach.
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