Deep Convolutional Networks for Automated Detection of Epileptogenic Brain Malformations

Gill RS, Hong SJ, Fadaie F, Caldairou B, Bernhardt BC, Barba C, Brandt A, Coelho VC, d’Incerti L, Lenge M, Semmelroch M, Bartolomei F, Cendes F, Deleo F,Guerrini R, Guye M, Jackson G, Schulze-Bonhage A, Mansi T, Bernasconi N, Bernasconi A. MICCAI 2018 490-497


Focal cortical dysplasia (FCD) is a prevalent surgically-amenable epileptogenic malformation of cortical development. On MRI, FCD typically presents with cortical thickening, hyperintensity, and blurring of the gray-white matter interface. These changes may be visible to the naked eye, or subtle and be easily overlooked. Despite advances in MRI analytics, current surface-based algorithms fail to detect FCD in 50% of cases. Moreover, arduous data pre-processing and specialized expertise preclude widespread use. Here we propose a novel algorithm that harnesses feature-learning capability of convolutional neural networks (CNNs) with minimal data pre-processing. Our classifier, trained on a patch-based augmented dataset derived from patients with histologically-validated FCD operates directly on MRI voxels to distinguish the lesion from healthy tissue. The algorithm was trained and cross-validated on multimodal MRI data from a single site (S1) and evaluated on independent data from S1 and six other sites worldwide (S2–S7; 3 scanner manufacturers and 2 field strengths) for a total of 107 subjects. The classifier showed excellent sensitivity (S1: 87%, 35/40 lesions detected; S2–S7: 91%, 61/67 lesions detected) and specificity (S1: 95%, no findings in 36/38 healthy controls; 90%, no findings in 57/63 disease controls). Easy implementation, minimal pre-processing, high performance and generalizability make this classifier an ideal platform for large-scale clinical use, particularly in "MRI-negative" FCD.