False positive clusters in normal control samples at different z-scores and different quantitative measures (gwc = grey-white contrast; sulc = sulcal depth; lgi = local gyrification index; curv = curvature; jacobia = jacobian distance).

<p>Calculations were performed for all controls (n = 41, 82 hemispheres).</p

Summary of patient demographics and clinical profile.

<p><b>Clinical MRI:</b> diagnosis based on visual inspection of routine clinical MRI (FCD: focal cortical dysplasia; EM: encephalomalacia; PMG: polymicrogyria; HT: heterotopia); <b>Location:</b> (Lobe, R =  right hemisphere, L =  left hemisphere, B =  bilateral); <b>Scalp EEG:</b> seizure onset location based on scalp video-EEG monitoring.</p

Multimodal results for Patient 4.

<p><b>A.</b> Sagittal T1 with pial and white matter surface tracings used for calculating cortical thickness and G–W contrast. Green circle marks area of visually identified focal cortical dysplasia. <b>B.</b> Patient's reconstructed white matter surface with area of significant cortical thickening marked in red/yellow (z>3.5, cluster-corrected) within the expert-delineated lesion margin (green tracing). <b>C.</b> Mean cortical thickness of the true positive cluster for patient (red cross, top left) and all normal control subjects in blue. <b>D.</b> Same as B, but for gray-white matter contrast. The significant cluster shows an area of significant blurring of the gray-white matter junction. EEG traces from intracranial electrodes near the dysplastic area showing focal interictal and ictal discharges (orange), compared to slightly more distant electrode locations (white), showing a co-localization of detected lesion and pathological electrophysiology. <b>E.</b> Mean gray-white matter contrast for the single patient and all control subjects. More positive values denote increased gray-white boundary blurring. <b>F.</b> Resected area after surgery (in white). Crosshair marks area of maximum thickness increase within the detected lesion. This patient is seizure free one year after surgery.</p

Sensitivity and specificity for quantitatively derived areas of abnormality compared to expert-delineated lesion margins for different thresholds.

<p>Sensitivity and specificity for quantitatively derived areas of abnormality compared to expert-delineated lesion margins for different thresholds.</p

Sensitivity and specificity measures for the union (logical OR) of cortical thickness and grey-white contrast, and area-under-the-receiver-operator-curve (AuROC) calculations showing discriminability between patients and normal controls.

<p>Union measure combining thickness and contrast show superior performance.</p

Detection sensitivity and specificity calculations for cortical surface measures calculated across patients and normal controls for different statistical thresholds (at FWHM = 5 mm).

<p>Detection sensitivity and specificity calculations for cortical surface measures calculated across patients and normal controls for different statistical thresholds (at FWHM  = 5 mm).</p

Receiver Operator Characteristics (ROC) curve showing effects of smoothing (smoothing level [sm] in FWHM [mm]) on sensitivity and specificity for thickness at different smoothing levels.

<p>Larger area under the curve shows higher discriminability.</p

Cortical dysplasia marked by cortical thickening and gray-white boundary blurring in Patient 3.

<p><b>A.</b> Significantly increased thickening of the cortical ribbon (in red/yellow) detected by the automated quantitative approach falls within the expert-delineated area of focal cortical dysplasia (green tracing on the inflated pial surface). The area with highest z-score shows cortical thickness measures of up to 6.5 mm between white matter and pial surfaces. <b>B.</b> Calculating the T1-signal contrast at .5 mm above vs below the gray/white interface shows an area of significant blurring within the lesion. The green circle on the left shows the area of maximum blurring on a coronal volumetric MRI slice.</p