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UNIVERSITY OF BUCHAREST
FACULTY OF PHYSICS Guest
2024-11-22 1:36 |
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Conference: Bucharest University Faculty of Physics 2018 Meeting
Section: Biophysics; Medical Physics
Title:
Surface projected FLAIR for localizing focal cortical dysplasia in patients with drug-resistant epilepsy
Authors:
Cătălina BRATU (1), Andrei BARBORICĂ (1), Cristian DONOS (1), Ioana MÎNDRUȚĂ (2)
Affiliation:
1) Physics Department, Bucharest University, Bucharest, Romania
2) Epilepsy Unit, Neurology Department, University Hospital Bucharest, Romania
E-mail
catalina.bratu96@gmail.com
Keywords:
epilepsy, FLAIR
Abstract:
The objective of this study is to present and describe the algorithms used to reconstruct the cortical surface and the SUrface-PRojected FLuid-Attenuation-Inversion-Recovery (SUPR-FLAIR, Cardinale et al., 2017) analysis and apply the method to localize focal cortical dysplasia in patients with drug-resistant epilepsy. Focal cortical dysplasia is a congenital abnormality of cortical development and the leading cause of surgically remediable drug-resistant. FLAIR is an MRI sequence with an inversion recovery set to null fluids. The FLAIR sequence is used to suppress the signal from the cerebrospinal fluid. Images from patients suffering from drug-resistant epilepsy were processed. FreeSurfer was used to generate the cortical surface reconstructions and to co-register the FLAIR scans to T1-weighted images. The process of reconstruction begins with a skull-stripping algorithm based on a hybrid approach that combines watershed algorithms and deformable surface models. The goal of this algorithm is to extract an initial brain volume, removing most of the nonbrain tissue,such as scalp,skull and neck tissue(Ségonne et al., 2004). After that the hemispheres are separated,tessellated and deformed to create accurate smooth mesh representations of the grey-white matter interface and pial surface.Next we established measures, such as cortical thickness, grey-white matter blurring, FLAIR signal intensity, sulcal depth and curvature. The cortical thickness, grey-white matter intensity contrast and FLAIR signal intensity were smoothed using a 10 mm FWHM Gaussian kernel. The hyper-intense areas located in cortical sulci was visualized on the inflated brain surface by selecting appropriate thresholds and windows for the intensities. A focal dysplasia of one of the patients undergoing presurgical evaluation for drug-resistant epilepsy was evidenced on the inflated brain surface to be in the posterior cingulate cortex. In conclusion, SUPR-FLAIR analysis is a noninvasive technique that is helpful in the localization of the lesional zone in drug-resistant epileptic patients.
References:
Cardinale F., Francione S., SUrface-PRojected FLuid-Attenuation-Inversion-Recovery Analysis: A Novel Tool for Advanced Imaging of Epilepsy, 2016
Ségonne F., Dale A. M., Busa E., Glessner M., Salat D., Hahn H. K. et al., A hybrid approach to the skull stripping problem in MRI. NeuroImage 22, 1060–1075, 2004
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