Epileptogenic zone detection in MRI negative epilepsy using adaptive thresholding of arterial spin labeling data

Warning

This publication doesn't include Faculty of Medicine. It includes Central European Institute of Technology. Official publication website can be found on muni.cz.

Authors

GAJDOŠ Martin ŘÍHA Pavel KOJAN Martin DOLEŽALOVÁ Irena MUTSAERTS H.J.M.M. PETR J. REKTOR Ivan

Year of publication 2021
Type Article in Periodical
Magazine / Source Nature Scientific Reports
MU Faculty or unit

Central European Institute of Technology

Citation
Web https://www.nature.com/articles/s41598-021-89774-4.pdf
Doi http://dx.doi.org/10.1038/s41598-021-89774-4
Keywords TEMPORAL-LOBE EPILEPSY; CONSENSUS CLASSIFICATION; TASK-FORCE; PERFUSION; HYPOPERFUSION
Description Drug-resistant epilepsy is a diagnostic and therapeutic challenge, mainly in patients with negative MRI findings. State-of-the-art imaging methods complement standard epilepsy protocols with new information and help epileptologists to increase the reliability of their decisions. In this study, we investigate whether arterial spin labeling (ASL) perfusion MRI can help localize the epileptogenic zone (EZ). To that end, we developed an image processing method to detect the EZ as an area with hypoperfusion relative to the contralateral unaffected side, using subject-specific thresholding of the asymmetry index in ASL images. We demonstrated three thresholding criteria (termed minimal product criterion, minimal distance criterion, and elbow criterion) on 29 patients with MRI-negative epilepsy (age 32.98 +/- 10.4 years). The minimal product criterion showed optimal results in terms of positive predictive value (mean 0.12 in postoperative group and 0.22 in preoperative group) and true positive rate (mean 0.71 in postoperative group and 1.82 in preoperative group). Additionally, we found high accuracy in determining the EZ side (mean 0.86 in postoperative group and 0.73 in preoperative group out of 1.00). ASL can be easily incorporated into the standard presurgical MR protocol, and it provides an additional benefit in EZ localization.
Related projects:

You are running an old browser version. We recommend updating your browser to its latest version.

More info