HQ Team
February 25, 2025: King’s and University College of London researchers have developed an artificial intelligence tool that can detect 64% of brain abnormalities, that radiologists miss, in epileptic child patients.
The tool called the MELD Graph can detect focal cortical dysplasia (FCD), a leading cause of epilepsy. These are areas of the brain that have developed abnormally and often cause drug-resistant epilepsy.
It is typically treated with surgery, however, identifying the structural abnormalities (lesions) from magnetic resonance imaging (MRI) is an ongoing challenge for clinicians, as the scans in FCDs can look normal, the researchers said in a statement.
In children who have had surgery to control their epilepsy, FCD is the most common cause, and in adults, it is the third most common cause.
Delays to diagnosis and surgery mean more seizures, more visits to accidents and emergency care departments, and more disruption to school, work and home life.
Speed up diagnosis
Researchers believe that the new tool will speed up diagnosis times, get patients the surgical treatment they need quicker, and reduce costs to the National Health Service in the UK by up to £55,000 per patient.
In the UK there are 30,000 FCD patients and globally there are four million epileptic patients who have FCD.
The researchers pooled MRI data from 1,185 participants – including 703 people with FCD and 482 controls – from 23 epilepsy centres around the world in the Multicentre Epilepsy Lesion Detection project (MELD). Half of the dataset was from children.
They then trained MELD Graph on the scans to detect subtle brain abnormalities that might otherwise go undetected.
‘Inundated with images’
“Radiologists are currently inundated with images they have to review,” said project lead author, Dr Konrad Wagstyl, from King’s College London.
“Using an AI-powered tool like MELD Graph can support them with their decisions, making the NHS more efficient, speeding time to treatment for patients and relieving them of unnecessary and costly tests and procedures,” he said.
Around 1% of the world’s population have the serious neurological condition epilepsy, which is characterised by frequent seizures. In the UK, some 600,000 people are affected. While drug treatments are available for the majority of people with epilepsy, 20-30% do not respond to medications.
“Many of the children I see have experienced years of seizures and investigations before we find a lesion. The epilepsy community is searching for ways to speed up diagnosis and treatment. Initiatives such as MELD have the potential to rapidly identify abnormalities that can be removed and potentially cure the epilepsy,” said co-author Professor Helen Cross OBE and Consultant Epileptologist at Great Ormond Street Hospital).
Of the patients who have epilepsy that have an abnormality in the brain that cannot be found on MRI scans, FCD is the most common cause.
Open-source software
While MELD Graph is not yet clinically available, the research team have released the AI tool as open-source software.
They are running workshops to train clinicians and researchers around the world, including Great Ormond Street Hospital and the Cleveland Clinic, in how to use it.
“This type of research is only possible with international collaboration. We were privileged to work with 75 researchers and clinicians towards this common goal of ‘no missed epilepsy lesions worldwide’,” said co-lead Dr Sophie Adler at the UCL Great Ormond Street Institute of Child Health.
