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MRI\u2010negative epilepsy is associated with poorer seizure freedom prognosis and has therefore motivated the development of structural post\u2010processing methods to \u201cconvert\u201d MRI\u2010negative to MRI\u2010positive cases. In this article, we review the principles, advances, and challenges of voxel\u2010 and surface\u2010based cortical morphometric MRI techniques in detecting the epileptogenic zone. The ground truth for the presumed epileptogenic zone in imaging studies can be classified into lesion\u2010based (MRI lesion mask or histopathology) or epileptogenicity\u2010based ground truth (anatomical\u2010electroclinical correlations or resections that lead to seizure freedom). Voxel\u2010based techniques are reported to have a 13%\u201397% concordance rate, while surface\u2010based techniques have 67%\u201392% compared to lesion\u2010based ground truths. Epileptogenicity\u2010based ground truth may be more relevant in the case of MRI\u2010negative cases; however, the sensitivity and concordance rate (voxel\u2010based technique 7.1%\u201366.7%, and surface\u2010based technique 62%) are limited by the reliance on scalp EEG and qualitative analysis of seizure\u2010onset pattern. The use of stereo\u2010EEG and quantitative EEG analysis may fill this gap to evaluate the correlation between cortical morphometry results and electrophysiological epileptogenic biomarkers of the epileptogenic zone and help improve the yield of structural post\u2010processing tools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Locating the epileptogenic zone (the brain area that is responsible for seizure generation) is important to diagnose and plan epilepsy treatments. An abnormal brain imaging (MRI) result can help clinical decision\u2010making; however, around 40% of patients have normal MRI results (MRI\u2010negative). We are reviewing the potential of two advanced MRI methods (voxel\u2010 and surface\u2010based cortical morphometry) to localize the epileptogenic zone in the presence or absence of visible MRI abnormalities. We also describe the current challenge of applying the above methods in daily clinical practice and propose using advanced brain recording analysis to aid this translation process.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.70012","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T13:41:38Z","timestamp":1741700498000},"page":"380-397","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Voxel\u2010based and surface\u2010based cortical morphometric <scp>MRI<\/scp> applications for identifying the epileptogenic zone: A narrative review"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9641-0976","authenticated-orcid":false,"given":"Jacob","family":"Bunyamin","sequence":"first","affiliation":[{"name":"Department of Neuroscience, The School of Translational Research Monash University  Melbourne Victoria 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