Objective: We evaluated four imaging techniques, i.e. Electroencephalography (EEG)-functional Magnetic Resonance Imaging (MRI) (EEG-fMRI), High-resolution EEG (HR-EEG), Magnetoencephalography (MEG) and 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (PET), for the identification of the epileptogenic zone (EZ) in 41 patients with negative MRI, candidate to neurosurgery. Methods: For each technique, results were compared to the Stereo-EEG. Diagnostic measures were calculated with respect to the post-surgical outcome, either for all the patients (39/41, two patients excluded) and for the subgroup of patients with the EZ involving more than one lobe (20/41). Results: When considered individually, each functional technique showed accuracy values ranging 54,6%–63,2%, having PET, MEG and HR-EEG higher sensitivity, and EEG-fMRI higher specificity. In patients with multilobar epileptogenic zone, functional techniques achieved the best accuracies (up to 80%) when three techniques, including EEG-fMRI, were considered together. Conclusions: The study highlights the accuracy of a combination of functional imaging techniques in the identification of EZ in MRI negative focal epilepsy. The best diagnostic yield was obtained if the combination of PET, MEG (or HR-EEG as alternative), EEG-fMRI were considered together. Significance: The functional imaging techniques may improve the presurgical workup of MRI negative focal epilepsy, if epileptogenic zone involves more than one lobe.
Identifying the epileptogenic zone by four non-invasive imaging techniques versus stereo-EEG in MRI-negative pre-surgery epilepsy patients / D. Rossi Sebastiano, L. Tassi, D. Duran, E. Visani, F. Gozzo, F. Cardinale, L. Nobili, A. Del Sole, A. Rubino, S. Dotta, E. Schiaffi, R. Garbelli, S. Franceschetti, R. Spreafico, F. Panzica. - In: CLINICAL NEUROPHYSIOLOGY. - ISSN 1388-2457. - 131:8(2020 Jun 03), pp. 1815-1823.
|Titolo:||Identifying the epileptogenic zone by four non-invasive imaging techniques versus stereo-EEG in MRI-negative pre-surgery epilepsy patients|
|Parole Chiave:||EEG-fMRI; Epilepsy surgery; HR-EEG; MEG; PET|
|Settore Scientifico Disciplinare:||Settore MED/26 - Neurologia|
Settore MED/36 - Diagnostica per Immagini e Radioterapia
|Data di pubblicazione:||3-giu-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.clinph.2020.05.015|
|Appare nelle tipologie:||01 - Articolo su periodico|