Figure 1.

Case P15. Quantitative neuroimaging analysis in a patient who underwent Phase I study followed by a left temporal resection and achieved an Engel class I outcome. The epileptogenic site was predicted accurately by models for this case. The prospective case is shown (O). (A) Scatter plot of normalized hippocampal volumes showing distribution of control subjects (C) and study cases by their laterality for epileptogenicity (i.e., left vs. right). The volumes of control subjects are clustered and define the boundary domain (blue lines) within which the separation of a right- or left-sided mesial temporal lobe epilepsy (mTLE), to either side of the decision line (red line), may not be possible. (B) Scatter plot of mean and standard deviation ratios (right/left) of fluid-attenuated inversion recovery (FLAIR) MR signal intensity with control subjects (C) clustered in the boundary domain and study cases distinguished by their laterality for epileptogenicity (i.e., left vs. right). (C) The logistic decision plane of the multistructural analysis (MSA) model uses the normalized bilateral volume change [i.e., 100(vL – vR)/(Vl + vR)] of thalamic, amygdalar and hippocampal volumes to lateralize the prospective (O) case. Note that the decision plane is parallel to the angle of view; hence, it is seen as a line in two dimensions.