Evidence map›Paper›PMID 41317206›Full record

ReviewNeuroradiology2026

Advanced neuroimaging in pediatric epilepsy surgery: state of the art and future perspectives.

Domenico Tortora, Rosa Couto, Sofia Panzeri, Costanza Parodi, Martina Resaz, Antonia Ramaglia, Mattia Pacetti, Giulia Nobile, Stefano Francione, Alessandro Consales and 2 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Domenico TortoraNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. domenicotortora@gaslini.org.
Rosa CoutoNeuroradiology Department, Hospital Garcia de Orta, Almada, Portugal.
Sofia PanzeriNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Costanza ParodiNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Martina ResazNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Antonia RamagliaNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Mattia PacettiNeurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Giulia NobileChild Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Stefano FrancioneChild Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Alessandro ConsalesNeurosurgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Mariasavina SeverinoNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy. mariasavinaseverino@gaslini.org.
Andrea RossiNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo review recent advances in structural MRI post-processing for pediatric drug-resistant epilepsy, with emphasis on artificial intelligence-driven and quantitative techniques, including MELD-Graph, MAP18, FLAT1, and SUPR-FLAIR, and to evaluate their impact on lesion detection, epileptogenic zone localization, and presurgical planning.

methodsNovel post-processing approaches were examined with respect to their computational foundations, imaging requirements, and diagnostic performance. Techniques employing machine learning, deep learning, voxel-based morphometry, cortical surface projection, and FLAIR/T1 ratio mapping were assessed for their applicability in children and their integration into multimodal evaluation pathways alongside electrophysiology and functional imaging.

resultsAdvanced post-processing tools substantially increase sensitivity for detecting subtle cortical abnormalities, particularly in MRI-negative pediatric epilepsy. MELD-Graph identify features of focal cortical dysplasia through automated surface-based analysis and deep neural network classification, achieving notable lesion detection even when conventional MRI findings are normal. MAP18 provides complementary voxel-wise morphometric assessment, improving specificity and benefiting from optimized structural sequences. FLAT1 enhances lesion conspicuity by quantifying FLAIR/T1 signal relationships, while SUPR-FLAIR improves visualization of cortical signal abnormalities through normalized FLAIR intensity projection onto the cortical surface. When incorporated into multimodal diagnostic workflows, these methods refine epileptogenic zone localization, inform individualized surgical strategies, and can reduce reliance on invasive testing.

conclusionAdvanced structural MRI post-processing is transforming the neuroradiological evaluation of pediatric drug-resistant epilepsy. By revealing subtle cortical abnormalities not visible on conventional imaging, these tools support more precise lesion characterization and surgical planning. Ongoing efforts toward standardization, clinical validation, and workflow integration will be essential to ensure widespread adoption and maximize clinical impact within precision-medicine approaches to pediatric epilepsy.

Indexed as

Drug Resistant EpilepsyEpilepsyMagnetic Resonance ImagingNeuroimagingChildHumansArtificial intelligenceFocal cortical dysplasiaMRI post-processingPediatric epilepsyPediatric epilepsy surgerySurgical planning

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.