The present study proposes a novel diffusion weighted imaging (DWI) tract classification methodology which integrates DWI-maximum a posteriori probability (DWI-MAP) analysis with Kalman filter in order to predict an optimal margin of cortical resection balancing postoperative benefit (seizure freedom) and risk (motor deficit in face, hand and leg) in pediatric epilepsy surgery. The predicted margins provided high Fisher’s exact test probability, 0.92 (0.94) of successful avoidance of motor deficits with (or without) seizure freedom. This finding demonstrates the translational value of a DWI tract classification approach in quantitative benefit-risk assessment to achieve ultimate goal of pediatric epilepsy surgery.
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