In Epilepsia
Focal Cortical Dysplasias (FCDs) are malformations of cortical development and one of the most common pathologies causing pharmacoresistant focal epilepsy. Resective neurosurgery yields high success rates, especially if the full extent of the lesion is correctly identified and completely removed. The visual assessment of MRI does not pinpoint the FCD in 30% to 50% of cases, and half of all patients with FCD are not amenable to epilepsy surgery, partly because the FCD could not be sufficiently localized. Computational approaches to FCD detection are an active area of research, benefitting from advancements in computer vision. Automatic FCD detection is a significant challenge and one of the first clinical grounds where the application of Artificial Intelligence (AI) may translate into a gain for patients' health. The emergence of new methods from the combination of health and computer sciences creates novel challenges. Imaging data needs to be organized into structured, well-annotated datasets and combined with other clinical information, such as histopathological subtypes or neuroimaging characteristics. Algorithmic output, i.e., model prediction, requires a technically correct evaluation with adequate metrics which are understandable and usable for clinicians. Publication of code and data is necessary to make research accessible and reproducible. This critical review introduces the field of automatic FCD detection, explaining underlying medical and technical concepts, highlighting its challenges and current limitations, and providing a perspective for a novel research environment.
Walger Lennart, Adler Sophie, Wagstyl Konrad, Henschel Leonie, David Bastian, Borger Valeri, Hattingen Elke, Vatter Hartmut, Elger Christian E, Baldeweg Torsten, Rosenow Felix, Urbach Horst, Becker Albert, Radbruch Alexander, Surges Rainer, Reuter Martin, Cendes Fernando, Wang Zhong Irene, Huppertz Hans-Jürgen, Rüber Theodor
2023-Jan-31
Digitalization in Medicine, Focal Epilepsy, Image Processing, Neuroimaging, Presurgical Evaluation
