Radiomics features of hippocampal regions in magnetic resonance imaging can differentiate medial temporal lobe epilepsy patients from healthy controls

Hyang Woon Lee,Sol-Ah Kim,Dongmin Choi,Kyunghwa Han,Hyeon Jin Kim,Hwiyoung Kim,Yae Won Park,Sung Soo Ahn,Song E Kim,Seung-Koo Lee,Yun Seo Choi

doi:10.1038/s41598-020-76283-z

Hyang Woon Lee, Sol-Ah Kim + Show 9 more

Open Access

https://doi.org/10.1038/s41598-020-76283-z

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Abstract

To investigative whether radiomics features in bilateral hippocampi from MRI can identify temporal lobe epilepsy (TLE). A total of 131 subjects with MRI (66 TLE patients [35 right and 31 left TLE] and 65 healthy controls [HC]) were allocated to training (n = 90) and test (n = 41) sets. Radiomics features (n = 186) from the bilateral hippocampi were extracted from T1-weighted images. After feature selection, machine learning models were trained. The performance of the classifier was validated in the test set to differentiate TLE from HC and ipsilateral TLE from HC. Identical processes were performed to differentiate right TLE from HC (training set, n = 69; test set; n = 31) and left TLE from HC (training set, n = 66; test set, n = 30). The best-performing model for identifying TLE showed an AUC, accuracy, sensitivity, and specificity of 0.848, 84.8%, 76.2%, and 75.0% in the test set, respectively. The best-performing radiomics models for identifying right TLE and left TLE subgroups showed AUCs of 0.845 and 0.840 in the test set, respectively. In addition, multiple radiomics features significantly correlated with neuropsychological test scores (false discovery rate-corrected p-values < 0.05). The radiomics model from hippocampus can be a potential biomarker for identifying TLE.

Highlights

To investigative whether radiomics features in bilateral hippocampi from MRI can identify temporal lobe epilepsy (TLE)
Written informed consent was obtained from legally authorized representatives of TLE patients and healthy controls (HCs), and the study protocol was approved by the local Ethical Committee at Ewha Medical Center
The baseline characteristics and neuropsychological test results of TLE patients and HCs are summarized in Supplementary Table S2

Summary

Introduction

To investigative whether radiomics features in bilateral hippocampi from MRI can identify temporal lobe epilepsy (TLE). The best-performing radiomics models for identifying right TLE and left TLE subgroups showed AUCs of 0.845 and 0.840 in the test set, respectively. Temporal lobe epilepsy (TLE) is the most frequent type of focal epilepsy, and the type which is most refractory to drug t reatment[1] For many of these patients, surgical resection of the epileptic focus offers a viable treatment option to eliminate seizures, and noninvasive imaging plays a pivotal role in precisely identifying the epileptogenic zone[2,3]. Volumetric analyses revealed abnormalities in the hippocampus ipsilateral to the seizure focus, which is the hallmark imaging finding in TLE9–11 These studies focused on single parameters such as mean apparent diffusion coefficient, mean fractional anisotropy, or volume rather than focusing on the spatial distribution of heterogeneity. We assessed whether these radiomics features were correlated with cognitive impairments in these TLE patients

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