Abstract
We assessed the applicability of MP2RAGE for voxel‐based morphometry. To this end, we analyzed its brain tissue segmentation characteristics in healthy subjects and the potential for detecting focal epileptogenic lesions (previously visible and nonvisible). Automated results and expert visual interpretations were compared with conventional VBM variants (i.e., T1 and T1 + FLAIR). Thirty‐one healthy controls and 21 patients with focal epilepsy were recruited. 3D T1‐, T2‐FLAIR, and MP2RAGE images (consisting of INV1, INV2, and MP2 maps) were acquired on a 3T MRI. The effects of brain tissue segmentation and lesion detection rates were analyzed among single‐ and multispectral VBM variants. MP2‐single‐contrast gave better delineation of deep, subcortical nuclei but was prone to misclassification of dura/vessels as gray matter, even more than conventional‐T1. The addition of multispectral combinations (INV1, INV2, or FLAIR) could markedly reduce such misclassifications. MP2 + INV1 yielded generally clearer gray matter segmentation allowing better differentiation of white matter and neighboring gyri. Different models detected known lesions with a sensitivity between 60 and 100%. In non lesional cases, MP2 + INV1 was found to be best with a concordant rate of 37.5%, specificity of 51.6% and concordant to discordant ratio of 0.60. In summary, we show that multispectral MP2RAGE VBM (e.g., MP2 + INV1, MP2 + INV2) can improve brain tissue segmentation and lesion detection in epilepsy.
Highlights
Focal epilepsy constitutes ~60% of all epilepsies (Rosenow & Luders, 2001), and is characterized by “focal onset,” that is, seizures originating in a local brain region (Scheffer et al, 2017)
We have systematically compared existing singlecontrast and multispectral segmentation models T1 and T1 + FLAIR with newer models based on MP2RAGE
We have compared the performance across these models for Voxel-based morphometry (VBM) in focal epilepsy patients with and without a negative conventional MRI
Summary
Focal epilepsy constitutes ~60% of all epilepsies (Rosenow & Luders, 2001), and is characterized by “focal onset,” that is, seizures originating in a local brain region (Scheffer et al, 2017). Focal epilepsy patients experience disabling seizures medically refractory/resistant to anticonvulsants (Kwan & Brodie, 2000). For these patients, epilepsy surgery can be very beneficial, provided a resectable, focal area of seizure onset is identifiable (Wiebe et al, 2001). Epilepsy surgery can be very beneficial, provided a resectable, focal area of seizure onset is identifiable (Wiebe et al, 2001) Before surgery in these patients, a presurgical evaluation is conducted, which includes brain MRI as an important modality. Mainly focal cortical dysplasias (FCD), are one of
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