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Wang H, Hu Z, Jiang D, Lin R, Zhao C, Zhao X, Zhou Y, Zhu Y, Zeng H, Liang D, Liao J, Li Z. Predicting Antiseizure Medication Treatment in Children with Rare Tuberous Sclerosis Complex-Related Epilepsy Using Deep Learning. AJNR Am J Neuroradiol 2023; 44:1373-1383. [PMID: 38081677 PMCID: PMC10714846 DOI: 10.3174/ajnr.a8053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/03/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND AND PURPOSE Tuberous sclerosis complex disease is a rare, multisystem genetic disease, but appropriate drug treatment allows many pediatric patients to have positive outcomes. The purpose of this study was to predict the effectiveness of antiseizure medication treatment in children with tuberous sclerosis complex-related epilepsy. MATERIALS AND METHODS We conducted a retrospective study involving 300 children with tuberous sclerosis complex-related epilepsy. The study included the analysis of clinical data and T2WI and FLAIR images. The clinical data consisted of sex, age of onset, age at imaging, infantile spasms, and antiseizure medication numbers. To forecast antiseizure medication treatment, we developed a multitechnique deep learning method called WAE-Net. This method used multicontrast MR imaging and clinical data. The T2WI and FLAIR images were combined as FLAIR3 to enhance the contrast between tuberous sclerosis complex lesions and normal brain tissues. We trained a clinical data-based model using a fully connected network with the above-mentioned variables. After that, a weighted-average ensemble network built from the ResNet3D architecture was created as the final model. RESULTS The experiments had shown that age of onset, age at imaging, infantile spasms, and antiseizure medication numbers were significantly different between the 2 drug-treatment outcomes (P < .05). The hybrid technique of FLAIR3 could accurately localize tuberous sclerosis complex lesions, and the proposed method achieved the best performance (area under the curve = 0.908 and accuracy of 0.847) in the testing cohort among the compared methods. CONCLUSIONS The proposed method could predict antiseizure medication treatment of children with rare tuberous sclerosis complex-related epilepsy and could be a strong baseline for future studies.
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Affiliation(s)
- Haifeng Wang
- From the Research Center for Medical Artificial Intelligence (H.W., D.J., Y. Zhou, D.L., Z.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Shenzhen College of Advanced Technology (H.W., D.J., Y.Zhu, D.L., Z.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Zhanqi Hu
- Department of Neurology (Z.H., R.L., X.Z., J.L.), Shenzhen Children's Hospital, Shenzhen, Guangdong, China
- Department of Pediatric Neurology (Z.H.), Boston Children's Hospital, Boston, Massachusetts
| | - Dian Jiang
- From the Research Center for Medical Artificial Intelligence (H.W., D.J., Y. Zhou, D.L., Z.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Shenzhen College of Advanced Technology (H.W., D.J., Y.Zhu, D.L., Z.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Rongbo Lin
- Department of Neurology (Z.H., R.L., X.Z., J.L.), Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Cailei Zhao
- Department of Radiology (C.Z., H.Z.), Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Xia Zhao
- Department of Neurology (Z.H., R.L., X.Z., J.L.), Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Yihang Zhou
- From the Research Center for Medical Artificial Intelligence (H.W., D.J., Y. Zhou, D.L., Z.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Research Department (Y. Zhou), Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Yanjie Zhu
- Shenzhen College of Advanced Technology (H.W., D.J., Y.Zhu, D.L., Z.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Paul C. Lauterbur Research Center for Biomedical Imaging (Y.Zhu, D.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Hongwu Zeng
- Department of Radiology (C.Z., H.Z.), Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Dong Liang
- From the Research Center for Medical Artificial Intelligence (H.W., D.J., Y. Zhou, D.L., Z.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Shenzhen College of Advanced Technology (H.W., D.J., Y.Zhu, D.L., Z.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Paul C. Lauterbur Research Center for Biomedical Imaging (Y.Zhu, D.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jianxiang Liao
- Department of Neurology (Z.H., R.L., X.Z., J.L.), Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Zhicheng Li
- From the Research Center for Medical Artificial Intelligence (H.W., D.J., Y. Zhou, D.L., Z.L.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Shenzhen College of Advanced Technology (H.W., D.J., Y.Zhu, D.L., Z.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
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Jiang D, Liao J, Zhao C, Zhao X, Lin R, Yang J, Li Z, Zhou Y, Zhu Y, Liang D, Hu Z, Wang H. Recognizing Pediatric Tuberous Sclerosis Complex Based on Multi-Contrast MRI and Deep Weighted Fusion Network. Bioengineering (Basel) 2023; 10:870. [PMID: 37508897 PMCID: PMC10375986 DOI: 10.3390/bioengineering10070870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/24/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Multi-contrast magnetic resonance imaging (MRI) is wildly applied to identify tuberous sclerosis complex (TSC) children in a clinic. In this work, a deep convolutional neural network with multi-contrast MRI is proposed to diagnose pediatric TSC. Firstly, by combining T2W and FLAIR images, a new synthesis modality named FLAIR3 was created to enhance the contrast between TSC lesions and normal brain tissues. After that, a deep weighted fusion network (DWF-net) using a late fusion strategy is proposed to diagnose TSC children. In experiments, a total of 680 children were enrolled, including 331 healthy children and 349 TSC children. The experimental results indicate that FLAIR3 successfully enhances the visibility of TSC lesions and improves the classification performance. Additionally, the proposed DWF-net delivers a superior classification performance compared to previous methods, achieving an AUC of 0.998 and an accuracy of 0.985. The proposed method has the potential to be a reliable computer-aided diagnostic tool for assisting radiologists in diagnosing TSC children.
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Affiliation(s)
- Dian Jiang
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Jianxiang Liao
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518000, China; (J.L.); (X.Z.)
| | - Cailei Zhao
- Department of Radiology, Shenzhen Children’s Hospital, Shenzhen 518000, China;
| | - Xia Zhao
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518000, China; (J.L.); (X.Z.)
| | - Rongbo Lin
- Department of Emergency, Shenzhen Children’s Hospital, Shenzhen 518000, China;
| | - Jun Yang
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Zhichen Li
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Yihang Zhou
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- Research Department, Hong Kong Sanatorium & Hospital, Hong Kong 999077, China
| | - Yanjie Zhu
- University of Chinese Academy of Sciences, Beijing 100049, China;
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China
| | - Dong Liang
- Research Centre for Medical AI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China; (D.J.); (J.Y.); (Z.L.); (Y.Z.); (D.L.)
- University of Chinese Academy of Sciences, Beijing 100049, China;
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China
| | - Zhanqi Hu
- Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518000, China; (J.L.); (X.Z.)
| | - Haifeng Wang
- University of Chinese Academy of Sciences, Beijing 100049, China;
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518000, China
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Hu Z, Jiang D, Zhao X, Yang J, Liang D, Wang H, Zhao C, Liao J. Predicting Drug Treatment Outcomes in Childrens with Tuberous Sclerosis Complex-Related Epilepsy: A Clinical Radiomics Study. AJNR Am J Neuroradiol 2023; 44:853-860. [PMID: 37348968 PMCID: PMC10337615 DOI: 10.3174/ajnr.a7911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 05/22/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND PURPOSE Highly predictive markers of drug treatment outcomes of tuberous sclerosis complex-related epilepsy are a key unmet clinical need. The objective of this study was to identify meaningful clinical and radiomic predictors of outcomes of epilepsy drug treatment in patients with tuberous sclerosis complex. MATERIALS AND METHODS A total of 105 children with tuberous sclerosis complex-related epilepsy were enrolled in this retrospective study. The pretreatment baseline predictors that were used to predict drug treatment outcomes included patient demographic and clinical information, gene data, electroencephalogram data, and radiomic features that were extracted from pretreatment MR imaging scans. The Spearman correlation coefficient and least absolute shrinkage and selection operator were calculated to select the most relevant features for the drug treatment outcome to build a comprehensive model with radiomic and clinical features for clinical application. RESULTS Four MR imaging-based radiomic features and 5 key clinical features were selected to predict the drug treatment outcome. Good discriminative performances were achieved in testing cohorts (area under the curve = 0.85, accuracy = 80.0%, sensitivity = 0.75, and specificity = 0.83) for the epilepsy drug treatment outcome. The model of radiomic and clinical features resulted in favorable calibration curves in all cohorts. CONCLUSIONS Our results suggested that the radiomic and clinical features model may predict the epilepsy drug treatment outcome. Age of onset, infantile spasms, antiseizure medication numbers, epileptiform discharge in left parieto-occipital area of electroencephalography, and gene mutation type are the key clinical factors to predict the epilepsy drug treatment outcome. The texture and first-order statistic features are the most valuable radiomic features for predicting drug treatment outcomes.
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Affiliation(s)
- Z Hu
- From the Departments of Neurology (Z.H., X.Z., J.L.)
| | - D Jiang
- Research Centre for Medical AI (D.J., J.Y., D.L.)
- Shenzhen College of Advanced Technology (D.J., J.Y., D.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - X Zhao
- From the Departments of Neurology (Z.H., X.Z., J.L.)
| | - J Yang
- Research Centre for Medical AI (D.J., J.Y., D.L.)
- Shenzhen College of Advanced Technology (D.J., J.Y., D.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - D Liang
- Research Centre for Medical AI (D.J., J.Y., D.L.)
- Paul C. Lauterbur Research Center for Biomedical Imaging (D.L., H.W.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
- Shenzhen College of Advanced Technology (D.J., J.Y., D.L.), University of Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - H Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging (D.L., H.W.), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - C Zhao
- Radiology (C.Z.), Shenzhen Children's Hospital, Shenzhen, China
| | - J Liao
- From the Departments of Neurology (Z.H., X.Z., J.L.)
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