Abstract #0384

Electrocorticography-combined diffusion tract quantification model to improve benefit-risk assessment in pediatric epilepsy surgery

Min-Hee Lee¹, Nolan Baird O'Hara², Csaba Juhasz³, Eishi Asano⁴, and Jeong-Won Jeong³

¹Pediatrics and Translational Imaging Laboratory, Wayne State University School of Medicine, Detroit, MI, United States, ²Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI, United States, ³Pediatrics, Neurology and Translational Imaging Laboratory, Wayne State University School of Medicine, Detroit, MI, United States, ⁴Pediatrics and Neurology, Wayne State University School of Medicine, Detroit, MI, United States

The present study proposes a novel diffusion weighted imaging (DWI) tract classification methodology which integrates DWI-maximum a posteriori probability (DWI-MAP) analysis with Kalman filter in order to predict an optimal margin of cortical resection balancing postoperative benefit (seizure freedom) and risk (motor deficit in face, hand and leg) in pediatric epilepsy surgery. The predicted margins provided high Fisher’s exact test probability, 0.92 (0.94) of successful avoidance of motor deficits with (or without) seizure freedom. This finding demonstrates the translational value of a DWI tract classification approach in quantitative benefit-risk assessment to achieve ultimate goal of pediatric epilepsy surgery.

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