ArticleNeuroradiology2026
Enhanced detection of subtle cortical abnormalities in focal epilepsy using 7 T MRI surface-based models and graph neural networks.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeMRI detection of subtle focal cortical dysplasia (FCD)-like abnormalities remains challenging in focal epilepsy. Higher signal-to-noise ratio and spatial resolution offered by ultra-high-field 7T MRI and surface-based graph-neural-network (GNN) analysis may improve detection of subtle cortical abnormalities. We evaluated whether combining 7T MRI with a surface-based GNN classifier improves lesion detection in focal epilepsy of suspected structural origin.
methodsWe analyzed paired 7T and 3T MRI datasets from 87 patients with focal epilepsy (78.1% pediatric) and 10 internal healthy control individuals. We processed T1-weighted and Fluid-Attenuated-Inversion-Recovery MRI using a surface-based framework and a pre-trained GNN classifier developed within the Multi-centre-Epilepsy-Lesion-Detection project. We compared classifier outputs with expert visual MRI assessment, clinical and surface electroencephalography (EEG) localization (all patients), stereo-EEG (ten patients) and histopathological (17 patients) findings. We evaluated diagnostic yield and lesion conspicuity, and performed within-subject comparisons between 7T and 3T.
resultsFollowing quality controls, we included 70 patients. The 7T MRI-based classifier identified lesion clusters concordant with visual 3T MRI and electroclinical localization in 25/37 (67.6%) MRI-positive patients, electroclinical-concordant clusters in 15/33 (45.4%) 3T MRI-negatives, stereo-EEG-concordant clusters in 7/10 (70.0%) patients and surgically-concordant clusters in 11/17 (64.7%). Among classifier-positive patients (40/70, 57.1%), 7T allowed detection of previously hidden lesions in 15/40 (37.5%) patients, and improved detection of known lesions in 11/40 (27.5%).
conclusionCombining 7T MRI with surface-based GNN analysis improves detection and characterization of FCD-like abnormalities in focal epilepsy, particularly in patients with unrevealing 3T MRI, supporting the adoption of advanced neuroimaging in presurgical epilepsy assessment.
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