Multi-Scale Deep Learning of Clinically Acquired Multi-Modal MRI Improves the Localization of Seizure Onset Zone in Children With Drug-Resistant Epilepsy.
Multi-Scale Deep Learning of Clinically Acquired Multi-Modal MRI Improves the Localization of Seizure Onset Zone in Children With Drug-Resistant Epilepsy.
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DOI：
10.1109/jbhi.2022.3196330
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发表时间：
2022-11
影响因子：
7.7
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中科院分区：
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本研究使用临床上从耐药癫痫儿童身上获得的多模式MRI数据，研究深度学习神经网络在非侵入性定位癫痫起始区(SOZ)中的有效性。用皮质切片定位致痫半球皮质结节内的SOZ。在每个结点进行层状表面分析：1)多模式MRI灰质和白质的相对强度；2)利用扩散束成像边缘强度测量邻近白质的连通性。采用交叉验证的方法训练和测试了多尺度残差神经网络(MsResNet)的所有层，该网络能够以端到端的方式对SOZ节点进行分类。属于SOZ类别的给定节点的预测概率被认为是癫痫发作可能性的无创性MRI标记。在一个独立的验证队列中，所提出的MRI标记物在SOZ和非SOZ之间提供了非常大的Cohen‘s d=1.21的效应量，并且以0.75的平衡准确度和0.67的平衡准确率对SOZ进行分类。随后的多因素Logistic回归分析发现，将所提出的MRI标记物整合到发作间期的颅内EEG(IEEG)标记物中，进一步提高了非损伤性MRI组致痫灶(定义为手术中切除的SOZ)和非致痫部位(即手术中保留的非SOZ部位)之间的区分度高达15%，提示所提出的MRI标记物可以为成功的儿童癫痫手术改善致痫灶的定位。
The present study investigates the effectiveness of a deep learning neural network for non-invasively localizing the seizure onset zone (SOZ) using multi-modal MRI data that are clinically acquired from children with drug-resistant epilepsy. A cortical parcellation was applied to localize the SOZ in cortical nodes of the epileptogenic hemisphere. At each node, the laminar surface analysis was followed to sample 1) the relative intensity of gray matter and white matter in multi-modal MRI and 2) the neighboring white matter connectivity using diffusion tractography edge strengths. A cross-validation was employed to train and test all layers of a multi-scale residual neural network (msResNet) that can classify SOZ node in an end-to-end fashion. A prediction probability of a given node belonging to the SOZ class was proposed as a non-invasive MRI marker of seizure onset likelihood. In an independent validation cohort, the proposed MRI marker provided a very large effect size of Cohen’s d = 1.21 between SOZ and non-SOZ, and classified SOZ with a balanced accuracy of 0.75 in lesional and 0.67 in non-lesional MRI groups. The subsequent multi-variate logistic regression found the incorporation of the proposed MRI marker into interictal intracranial EEG (iEEG) markers further improves the differentiation between the epileptogenic focus (defined as SOZ resected during surgery) and non-epileptogenic sites (i.e., non-SOZ sites preserved during surgery) up to 15% in non-lesional MRI group, suggesting that the proposed MRI marker could improve the localization of epileptogenic foci for successful pediatric epilepsy surgery.