Improved segmentation of focal cortical dysplasia lesions on MRI using expansion towards cortical boundaries

Focal cortical dysplasia (FCD), a malformation of cortical development, is an important cause of intractable epilepsy. On magnetic resonance images (MRI), FCD lesions are difficult to distinguish from healthy cortex and defining their spatial extent is challenging. We previously introduced a method to segment FCD lesions on MRI, relying on a 3D deformable model driven by MR features of FCD. In the present paper, we propose to improve our approach by adding a second evolution step which expands the result towards the cortical boundaries. A quantitative evaluation was performed in 18 FCD patients by comparison with manually traced lesion labels. The proposed approach achieved a strong agreement with the manual labels and substantially improved the results obtained with our previous method.