Focal Cortical Dysplasia

Purpose

To use AI to detect focal cortical dysplasias on MRI scans of the brain in children

Tag(s)

 

Panel

Neuroradiology Panel

Define-AI ID

19020013

Originator

Laura Hayes
Lead Laura Hayes

Panel Chair

Alex Norbash

Panel Reviewers

Neuroradiology Panel

License

Creative Commons 4.0 
Status Public Commenting 
RadElement Set RDES100
                               

Clinical Implementation


Value Proposition


In every child with seizures, it is important to exclude congenital focal cortical dysplasias (FCDs) as an etiology for the seizure activity. If they are resected, the child can be cured of the seizures. Unfortunately, it is often difficult to detect subtle FCDs on MRI scans of the brain. If AI can help detect subtle changes in the cortex and subcortical white matter of the brain, it would be of great benefit to radiologists and of course the children and their caregivers as well.

Narrative(s)


5 year-old boy intractable seizures has MRI scan of the brain. AI detects subtle thickening of the cortex and subcortical white matter and directs the radiologist to that area of possible concern. The radiologist then recognizes that there does appear to be a subtle area of FCD. This correlates with the EEG findings. The FCD is resected, and the patient is cured of his seizures. This technology could prevent invasive surgeries like risky intracranial grid placements and other unnecessary tests that may never even detect the FCD leaving the patient with life-long intractable seizures.

Workflow Description


The images are obtained by the MRI scanner and sent to PACS and the AI engine. The images are analyzed by the engine. The system then detects the area of cortical thickening and blurring of the grey-white junction. An alert message is sent to PACS from the engine with the identification and highlighting of the area of possible focal cortical dysplasia for the radiologist to review.


Considerations for Dataset Development



Cortical Thickness

Varied

T2/FLAIR signal hyperintensity of white matter

with and without the transmantle sign

Location

Outside and inside temporal lobe

Age

All

Comorbidities

Epilepsy, mental retardation, early seizure onset

Focal Cortical Dysplasia

Type I, II , III

Technical Specifications


Inputs

 

DICOM Study

Procedure

Brain MRI

Views

Volumetric FLAIR sequence

Data Type

DICOM

Modality

MRI

Body Region

Head

Anatomic Focus

Brain



Primary Outputs


Focal Cortical Dysplasia

RadElement ID

RDE623

Definition

Detection of focal cortical dysplasia

Data Type

Categorical

Value Set

  • Absent
  • Present
  • Unknown

Units

N/A



Secondary Outputs


Focal Cortical Thickness

RadElement ID

RDE621

Definition

Thickness of the focal cortical. Thickening or thinning may suggest focal cortical dysplasia.

Data Type

Numeric

Value Set

N/A

Units

mm



Focal Brain Atrophy

RadElement ID

RDE624

Definition

Focal brain atrophy

Data Type

Categorical

Value Set

  • No Atrophy
  • Atrophy
  • Unknown

Units

N/A


Gray- White Junction Blurring

RadElement ID

RDE625

Definition

Blurring of the gray-white junction

Data Type

Categorical

Value Set

  • No blurring of the gray-white junction
  • Blurring of the gray-white junction
  • Unknown

Units

N/A



Increased signal on T2/FLAIR in gray and subcortical white matter

RadElement ID

RDE626

Definition

Increased signal on T2/FLAIR in gray and subcortical white matter

Data Type

Categorical

Value Set

  • No signal increase
  • Signal increase
  • Unknown

Units

N/A