{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:54:58Z","timestamp":1790949298191,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:00:00Z","timestamp":1750464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:00:00Z","timestamp":1750464000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study was undertaken to develop and validate an automatic, artificial intelligence\u2010enhanced software tool for hippocampal sclerosis (HS) detection, using a variety of standard magnetic resonance imaging (MRI) protocols from different MRI scanners for routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      First, MRI scans of 36 epilepsy patients with unilateral HS and 36 control patients with epilepsy of other etiologies were analyzed. MRI features, including hippocampal subfield volumes from three\u2010dimensional (3D) magnetization\u2010prepared rapid acquisition gradient echo (MPRAGE) scans and fluid\u2010attenuated inversion recovery (FLAIR) intensities, were calculated. Hippocampal subfield volumes were corrected for total brain volume and\n                      <jats:italic>z<\/jats:italic>\n                      \u2010scored using a dataset of 256 healthy controls. Hippocampal subfield FLAIR intensities were\n                      <jats:italic>z<\/jats:italic>\n                      \u2010scored in relation to each subject's mean cortical FLAIR signal. Additionally, left\u2013right ratios of FLAIR intensities and volume features were obtained. Support vector classifiers were trained on the above features to predict HS presence and laterality. In a second step, the algorithm was validated using two independent, external cohorts, including 118 patients and 116 controls in sum, scanned with different MRI scanners and acquisition protocols.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Classifiers demonstrated high accuracy in HS detection and lateralization, with slight variations depending on the input image availability. The best cross\u2010validation accuracy was achieved using both 3D MPRAGE and 3D FLAIR scans (mean accuracy\u2009=\u20091.0, confidence interval [CI]\u2009=\u2009.939\u20131.0). External validation of trained classifiers in two independent cohorts yielded accuracies of .951 (CI\u2009=\u2009.902\u2013.980) and .889 (CI\u2009=\u2009.805\u2013.945), respectively. In both validation cohorts, the additional use of FLAIR scans led to significantly better classification performance than the use of MPRAGE data alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.016 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.031, respectively). A further model was trained on both validation cohorts and tested on the former training cohort, providing additional evidence for good validation performance. Comparison to a previously published algorithm showed no significant difference in performance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The method presented achieves accurate automated HS detection using standard clinical MRI protocols. It is robust and flexible and requires no image processing expertise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18514","type":"journal-article","created":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T11:40:03Z","timestamp":1750506003000},"page":"3852-3864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Automatic detection of hippocampal sclerosis in patients with epilepsy"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-1579","authenticated-orcid":false,"given":"Marcus","family":"Belke","sequence":"first","affiliation":[{"name":"Department of Neurology, Epilepsy Center Hessen Philipps Universit\u00e4t Marburg  Marburg Germany"},{"name":"Landes\u2010Offensive zur Entwicklung Wissenschaftlich\u2010\u00f6konomischer Exzellenz (LOEWE) Research Cluster for Advanced Medical Physics in Imaging and Therapy Technische Hochschule (TH)\u2010Mittelhessen University of Applied Sciences  Giessen Germany"},{"name":"Center for Personalized Translational Epilepsy Research, Goethe Universit\u00e4t Frankfurt  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0366-6724","authenticated-orcid":false,"given":"Felix","family":"Zahnert","sequence":"additional","affiliation":[{"name":"Department of Neurology, Epilepsy Center Hessen Philipps Universit\u00e4t Marburg  Marburg Germany"},{"name":"Landes\u2010Offensive zur Entwicklung Wissenschaftlich\u2010\u00f6konomischer Exzellenz (LOEWE) Research Cluster for Advanced Medical Physics in Imaging and Therapy Technische Hochschule (TH)\u2010Mittelhessen University of Applied Sciences  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-4709","authenticated-orcid":false,"given":"Mirja","family":"Steinbrenner","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology Computational Neurology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Halimeh","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology Computational Neurology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Berlin Institute of Health at Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0842-1806","authenticated-orcid":false,"given":"Gadi","family":"Miron","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology Computational Neurology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Berlin Institute of Health at Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota\u2010Eleni","family":"Tsalouchidou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Epilepsy Center Hessen Philipps Universit\u00e4t Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1711-7072","authenticated-orcid":false,"given":"Louise","family":"Linka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Epilepsy Center Hessen Philipps Universit\u00e4t Marburg  Marburg 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