Enhanced focal cortical dysplasia detection in pediatric frontal lobe epilepsy with asymmetric radiomic and morphological features

Manli Zhang; Hao Yu; Gongpeng Cao; Jinguo Huang; Yanzhu Lu; Jing Zhang; Nana Liu; Wenjing Zhang; Yintao Cheng; Guixia Kang; Lixin Cai

doi:10.3389/fnins.2023.1289897

Enhanced focal cortical dysplasia detection in pediatric frontal lobe epilepsy with asymmetric radiomic and morphological features

Front Neurosci. 2023 Nov 15:17:1289897. doi: 10.3389/fnins.2023.1289897. eCollection 2023.

Authors

Manli Zhang^#¹, Hao Yu^#², Gongpeng Cao¹, Jinguo Huang^{1

3}, Yanzhu Lu¹, Jing Zhang¹, Nana Liu¹, Wenjing Zhang¹, Yintao Cheng¹, Guixia Kang¹, Lixin Cai²

Affiliations

¹ Key Laboratory of Universal Wireless Communications, Ministry of Education, School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Beijing, China.
² Department of Pediatric Epilepsy Center, Peking University First Hospital, Beijing, China.
³ School of Automation, Beijing University of Posts and Telecommunications, Beijing, China.

^# Contributed equally.

Abstract

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.

Keywords: FCD lesion localization; MRI; PET; children; morphological; radiomics.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the State Key Program of the National Natural Science Foundation of China (82030037) and Fundamental Research Funds for the Central Universities (2020XD-A06-1).