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Beyond structural MRI: combined diffusion metric improve delineation of epileptogenic tissue in focal cortical dysplasia.

Overview

Authors: David Kala1,2, Timur Abragimovich1,3, Radek Janča3,2, Nora Profantová1,2, Miroslav Koblížek4, Adam Kalina5,2, Martin Kudr6,2, Yeva Prysiazhniuk1,2, Lukáš Michal1,2, Jan Šanda7,2, Zuzana Holubová7,2, Kateřina Jiránková1, Petr Marusič5,2, Pavel Kršek6,2, Martin Kynčl7,2, Jakub Otáhal1,2
  1. Department of Pathophysiology, Second Faculty of Medicine, Charles University, Plzeňská 311, 150 06 Prague 5, Czech Republic
  2. Epilepsy Research Centre Prague, EpiReC, Prague, Czech Republic
  3. Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
  4. Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
  5. Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
  6. Department of Paediatric Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
  7. Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
Institutions: Charles University (Czechia); Czech Technical University in Prague (Czechia); University Hospital in Motol (Czechia)
Journal: Scientific reports, volume 16, issue 1, article 26247
Dates: received 17 April 2026; accepted 5 June 2026; published online 9 June 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1038/s41598-026-57292-w · PMID 42265264 · PMCID PMC13493953 · OpenAlex W7164052995
Open access: gold, a free copy (OpenAlex)
Status: data only
Categories: structural MRI / diffusion (modality), human (organism), epilepsy (population), clinical / translational (subfield)
Methods: Connectivity, Statistics, Machine learning, Preprocessing, fMRI & imaging, Physiology & signal measures
Keywords: Focal cortical dysplasia, Drug-resistant epilepsy, Diffusion MRI, Combined diffusion metric, Epileptogenic tissue, Presurgical mapping, Diseases, Medical research
MeSH: Diffusion Magnetic Resonance Imaging*, Epilepsy*, Focal Cortical Dysplasia*, Adolescent, Adult, Child, Female, Humans, Male, Prospective Studies, Young Adult (* major topic)
Topic: Epilepsy research and treatment (Psychiatry and Mental health, Medicine), according to OpenAlex
Funding: European Regional Development Fund (CZ.02.01.01/00/22_008/0004643); Ministerstvo Školství, Mládeže a Tělovýchovy (LX22NPO5107); Agentura Pro Zdravotnický Výzkum České Republiky (NU23-08-00528, NU21-08-00228)
Citations: not cited yet (Europe PMC); 61 references in the paper

Abstract

Accurate delineation of the epileptogenic zone in focal cortical dysplasia (FCD) remains challenging, as structural MRI often underestimates the extent of dysplastic tissue. Diffusion MRI can probe microstructural alterations, yet individual diffusion models provide limited sensitivity and clinical interpretability. We prospectively studied 19 patients with histologically confirmed FCD who underwent presurgical evaluation, surgical resection, and postsurgical MRI. Fourteen diffusion metrics derived from complementary diffusion models were integrated using logistic regression to generate a single combined diffusion metric (CDM). Spatial correspondence among structural MRI, resected tissue, perilesional cortex, and contralateral homologues was assessed using Dice similarity and ROC analyses. Histological cellularity and multimodal imaging data were used for biological validation. Individual diffusion metrics identified microstructural abnormalities within MRI-visible lesions, including reduced anisotropy, lower fibre density, and increased isotropic diffusion. Integration into the CDM improved discrimination between lesional and healthy tissue (p < 0.03), detected abnormalities extending beyond radiological borders, and showed spatial concordance with FDG-PET hypometabolism and epileptiform activity in 90% of patients. CDM-guided delineation increased agreement with resected regions and reduced unresected perilesional volume. CDM provides a biologically grounded and clinically interpretable representation of epileptogenic tissue in FCD, refining presurgical mapping beyond conventional MRI and potentially improving surgical targeting.

Supplementary Information: The online version contains supplementary material available at 10.1038/s41598-026-57292-w.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

The paper links to its data, not to its authors' code: see the Data section.

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Data

Datasets cited

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. Due to the sensitive nature of the clinical data and applicable data protection regulations, the data are not publicly available. Access may be granted to qualified researchers subject to institutional approval and compliance with relevant ethical and legal requirements.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 16 authors, 8 keywords, 11 MeSH terms, 3 funders, 57 references.

Cite

This paper

Kala, D., Abragimovich, T., Janča, R., Profantová, N., Koblížek, M., Kalina, A., Kudr, M., Prysiazhniuk, Y., Michal, L., Šanda, J., Holubová, Z., Jiránková, K., Marusič, P., Kršek, P., Kynčl, M., & Otáhal, J. (2026). Beyond structural MRI: combined diffusion metric improve delineation of epileptogenic tissue in focal cortical dysplasia. Scientific reports, 16(1), 26247. https://doi.org/10.1038/s41598-026-57292-w

BibTeX

@article{kala2026beyond,
author = {Kala, David and Abragimovich, Timur and Janča, Radek and Profantová, Nora and Koblížek, Miroslav and Kalina, Adam and Kudr, Martin and Prysiazhniuk, Yeva and Michal, Lukáš and Šanda, Jan and Holubová, Zuzana and Jiránková, Kateřina and Marusič, Petr and Kršek, Pavel and Kynčl, Martin and Otáhal, Jakub},
title = {{Beyond structural MRI: combined diffusion metric improve delineation of epileptogenic tissue in focal cortical dysplasia}},
journal = {Scientific reports},
year = {2026},
month = jun,
volume = {16},
number = {1},
pages = {26247},
publisher = {Nature Publishing Group},
issn = {2045-2322},
doi = {10.1038/s41598-026-57292-w},
url = {https://doi.org/10.1038/s41598-026-57292-w},
pmid = {42265264},
pmcid = {PMC13493953}
}

RIS

TY - JOUR
AU - Kala, David
AU - Abragimovich, Timur
AU - Janča, Radek
AU - Profantová, Nora
AU - Koblížek, Miroslav
AU - Kalina, Adam
AU - Kudr, Martin
AU - Prysiazhniuk, Yeva
AU - Michal, Lukáš
AU - Šanda, Jan
AU - Holubová, Zuzana
AU - Jiránková, Kateřina
AU - Marusič, Petr
AU - Kršek, Pavel
AU - Kynčl, Martin
AU - Otáhal, Jakub
TI - Beyond structural MRI: combined diffusion metric improve delineation of epileptogenic tissue in focal cortical dysplasia
T2 - Scientific reports
J2 - Sci Rep
PY - 2026
DA - 2026/06/09
VL - 16
IS - 1
SP - 26247
SN - 2045-2322
PB - Nature Publishing Group
DO - 10.1038/s41598-026-57292-w
UR - https://doi.org/10.1038/s41598-026-57292-w
LA - en
ER -

CSL-JSON

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