Automated interictal epileptic spike detection from simple and noisy annotations in MEG data

In drug-resistant epilepsy, presurgical evaluation of epilepsy can be considered. Magnetoencephalography (MEG) has been shown to be an effective exam to inform the localization of the epileptogenic zone through the localization of interictal epileptic spikes. Manual detection of these pathological biomarkers remains a fastidious and error-prone task due to the high dimensionality of MEG recordings, and interrater agreement has been reported to be only moderate. Current automated methods are unsuitable for clinical practice, either requiring extensively annotated data or lacking robustness on non-typical data. In this work, we demonstrate that deep learning models can be used for detecting interictal spikes in MEG recordings, even when only temporal and single-expert annotations are available, which represents real-world clinical practice. We propose two model architectures: a feature-based artificial neural network (ANN) and a convolutional neural network (CNN), trained on a database of 59 patients, and evaluated against a state-of-the-art model to classify short time windows of signal. In addition, we employ an interactive machine learning strategy to iteratively improve our data annotation quality using intermediary model outputs. Both proposed models outperform the state-of-the-art model (F1-scores: CNN=0.46, ANN=0.44) when tested on 10 holdout test patients. The interactive machine learning strategy demonstrates that our models are robust to noisy annotations. Overall, results highlight the robustness of models with simple architectures when analyzing complex and imperfectly annotated data. Our method of interactive machine learning offers great potential for faster data annotation, while our models represent useful and efficient tools for automated interictal spikes detection.

GAN-based synthetic FDG PET images from T1 brain MRI can serve to improve performance of deep unsupervised anomaly detection models

Background and Objective. Research in the cross-modal medical image translation domain has been very productive over the past few years in tackling the scarce availability of large curated multimodality datasets with the promising performance of GAN-based architectures. However, only a few of these studies assessed task-based related performance of these synthetic data, especially for the training of deep models. Method. We design and compare different GAN-based frameworks for generating synthetic brain [18F]fluorodeoxyglucose (FDG) PET images from T1 weighted MRI data. We first perform standard qualitative and quantitative visual quality evaluation. Then, we explore further impact of using these fake PET data in the training of a deep unsupervised anomaly detection (UAD) model designed to detect subtle epilepsy lesions in T1 MRI and FDG PET images. We introduce novel diagnostic task-oriented quality metrics of the synthetic FDG PET data tailored to our unsupervised detection task, then use these fake data to train a use case UAD model combining a deep representation learning based on siamese autoencoders with a OC-SVM density support estimation model. This model is trained on normal subjects only and allows the detection of any variation from the pattern of the normal population. We compare the detection performance of models trained on 35 paired real MR T1 of normal subjects paired either on 35 true PET images or on 35 synthetic PET images generated from the best performing generative models. Performance analysis is conducted on 17 exams of epilepsy patients undergoing surgery. Results. The best performing GAN-based models allow generating realistic fake PET images of control subject with SSIM and PSNR values around 0.9 and 23.8, respectively and in distribution (ID) with regard to the true control dataset. The best UAD model trained on these synthetic normative PET data allows reaching 74% sensitivity. Conclusion. Our results confirm that GAN-based models are the best suited for MR T1 to FDG PET translation, outperforming transformer or diffusion models. We also demonstrate the diagnostic value of these synthetic data for the training of UAD models and evaluation on clinical exams of epilepsy patients. Our code and the normative image dataset are available.

Time CNN and Graph Convolution Network for Epileptic Spike Detection in MEG Data

Magnetoencephalography (MEG) recordings of patients with epilepsy exhibit spikes, a typical biomarker of the pathology. Detecting those spikes allows accurate localization of brain regions triggering seizures. Spike detection is often performed manually. However, it is a burdensome and error prone task due to the complexity of MEG data. To address this problem, we propose a 1D temporal convolutional neural network (Time CNN) coupled with a graph convolutional network (GCN) to classify short time frames of MEG recording as containing a spike or not. Compared to other recent approaches, our models have fewer parameters to train and we propose to use a GCN to account for MEG sensors spatial relationships. Our models produce clinically relevant results and outperform deep learning-based state-of-the-art methods reaching a classification f1-score of 76.7% on a balanced dataset and of 25.5% on a realistic, highly imbalanced dataset, for the spike class.