RESUMO
We seek to examine the use of an image processing pipeline on Magnetic Resonance Imaging (MRI) to identify features of Focal Cortical Dysplasia (FCD) in children who were suspected to have FCD on MRI (MRI-positive) and those with MRI-negative epilepsy. We aim to use a computer-aided diagnosis system to identify epileptogenic lesions with a combination of established morphometric features and textural analysis using Gray-Level Co-occurrence Matrices (GLCM) on MRI sequences. We implemented a modified version of the 2-Step Bayesian classifier method to a paediatric cohort with medically intractable epilepsy with MRI-positive and MRI-negative epilepsy, and evaluated the performance of the algorithm trained on textural features derived from T1-weighted (T1-w), T2-weighted (T2-w), and FLAIR (Fluid Attenuated Inversion Recovery) sequences. For MRI-positive cases, T1-w has the highest subjectwise sensitivity relative to T2-w and FLAIR (94% vs. 90% vs. 71% respectively), and also the highest lesional sensitivity (63% vs. 60% vs. 42% respectively), but the lowest lesional specificity (75% vs. 80% vs. 89% respectively). Combination of all three sequences improved the performance of the algorithm, with 97% subjectwise sensitivity. For MRI-negative cases, T1-w has the highest subjectwise sensitivity relative to T2-w and FLAIR (48% vs. 30% vs. 39% respectively), and also the highest lesional sensitivity (31% vs. 22% vs. 28% respectively). However, T2-w has the highest lesional specificity relative to T1-w and FLAIR (95% vs. 94% vs. 92% respectively) for MRI-negative cases. Combination of all three sequences improved the performance of the algorithm, with 70% subjectwise sensitivity. The 2-Step Naïve Bayes classifier correctly rejected 100% of the healthy subjects for all three sequences. Using combined morphometric and textural analysis in a 2-Step Bayesian classifier, applied to multiple MRI sequences, can assist with lesion detection in children with intractable epilepsy.
Assuntos
Epilepsias Parciais/diagnóstico por imagem , Epilepsia/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Malformações do Desenvolvimento Cortical/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Diagnóstico por Computador/métodos , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
Cardiac magnetic resonance perfusion examinations enable noninvasive quantification of myocardial blood flow. However, motion between frames due to breathing must be corrected for quantitative analysis. Although several methods have been proposed, there is a lack of widely available benchmarks to compare different algorithms. We sought to compare many algorithms from several groups in an open benchmark challenge. Nine clinical studies from two different centers comprising normal and diseased myocardium at both rest and stress were made available for this study. The primary validation measure was regional myocardial blood flow based on the transfer coefficient (Ktrans), which was computed using a compartment model and the myocardial perfusion reserve (MPR) index. The ground truth was calculated using contours drawn manually on all frames by a single observer, and visually inspected by a second observer. Six groups participated and 19 different motion correction algorithms were compared. Each method used one of three different motion models: rigid, global affine, or local deformation. The similarity metric also varied with methods employing either sum-of-squared differences, mutual information, or cross correlation. There were no significant differences in Ktrans or MPR compared across different motion models or similarity metrics. Compared with the ground truth, only Ktrans for the sum-of-squared differences metric, and for local deformation motion models, had significant bias. In conclusion, the open benchmark enabled evaluation of clinical perfusion indices over a wide range of methods. In particular, there was no benefit of nonrigid registration techniques over the other methods evaluated in this study. The benchmark data and results are available from the Cardiac Atlas Project ( www.cardiacatlas.org).