Electromagnetic source imaging in presurgical workup of patients with epilepsy: A prospective study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › fagfællebedømt
Standard
Electromagnetic source imaging in presurgical workup of patients with epilepsy : A prospective study. / Duez, Lene; Tankisi, Hatice; Hansen, Peter Orm; Sidenius, Per; Sabers, Anne; Pinborg, Lars H; Fabricius, Martin; Rásonyi, György; Rubboli, Guido; Pedersen, Birthe; Leffers, Anne-Mette; Uldall, Peter; Jespersen, Bo; Brennum, Jannick; Henriksen, Otto Mølby; Fuglsang-Frederiksen, Anders; Beniczky, Sándor.
I: Neurology, Bind 92, Nr. 6, 2019, s. e576-e586.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Electromagnetic source imaging in presurgical workup of patients with epilepsy
T2 - A prospective study
AU - Duez, Lene
AU - Tankisi, Hatice
AU - Hansen, Peter Orm
AU - Sidenius, Per
AU - Sabers, Anne
AU - Pinborg, Lars H
AU - Fabricius, Martin
AU - Rásonyi, György
AU - Rubboli, Guido
AU - Pedersen, Birthe
AU - Leffers, Anne-Mette
AU - Uldall, Peter
AU - Jespersen, Bo
AU - Brennum, Jannick
AU - Henriksen, Otto Mølby
AU - Fuglsang-Frederiksen, Anders
AU - Beniczky, Sándor
N1 - Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
PY - 2019
Y1 - 2019
N2 - OBJECTIVE: To determine the diagnostic accuracy and clinical utility of electromagnetic source imaging (EMSI) in presurgical evaluation of patients with epilepsy.METHODS: We prospectively recorded magnetoencephalography (MEG) simultaneously with EEG and performed EMSI, comprising electric source imaging, magnetic source imaging, and analysis of combined MEG-EEG datasets, using 2 different software packages. As reference standard for irritative zone (IZ) and seizure onset zone (SOZ), we used intracranial recordings and for localization accuracy, outcome 1 year after operation.RESULTS: We included 141 consecutive patients. EMSI showed localized epileptiform discharges in 94 patients (67%). Most of the epileptiform discharge clusters (72%) were identified by both modalities, 15% only by EEG, and 14% only by MEG. Agreement was substantial between inverse solutions and moderate between software packages. EMSI provided new information that changed the management plan in 34% of the patients, and these changes were useful in 80%. Depending on the method, EMSI had a concordance of 53% to 89% with IZ and 35% to 73% with SOZ. Localization accuracy of EMSI was between 44% and 57%, which was not significantly different from MRI (49%-76%) and PET (54%-85%). Combined EMSI achieved significantly higher odds ratio compared to electric source imaging and magnetic source imaging.CONCLUSION: EMSI has accuracy similar to established imaging methods and provides clinically useful, new information in 34% of the patients.CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that EMSI had a concordance of 53%-89% and 35%-73% (depending on analysis) for the localization of epileptic focus as compared with intracranial recordings-IZ and SOZ, respectively.
AB - OBJECTIVE: To determine the diagnostic accuracy and clinical utility of electromagnetic source imaging (EMSI) in presurgical evaluation of patients with epilepsy.METHODS: We prospectively recorded magnetoencephalography (MEG) simultaneously with EEG and performed EMSI, comprising electric source imaging, magnetic source imaging, and analysis of combined MEG-EEG datasets, using 2 different software packages. As reference standard for irritative zone (IZ) and seizure onset zone (SOZ), we used intracranial recordings and for localization accuracy, outcome 1 year after operation.RESULTS: We included 141 consecutive patients. EMSI showed localized epileptiform discharges in 94 patients (67%). Most of the epileptiform discharge clusters (72%) were identified by both modalities, 15% only by EEG, and 14% only by MEG. Agreement was substantial between inverse solutions and moderate between software packages. EMSI provided new information that changed the management plan in 34% of the patients, and these changes were useful in 80%. Depending on the method, EMSI had a concordance of 53% to 89% with IZ and 35% to 73% with SOZ. Localization accuracy of EMSI was between 44% and 57%, which was not significantly different from MRI (49%-76%) and PET (54%-85%). Combined EMSI achieved significantly higher odds ratio compared to electric source imaging and magnetic source imaging.CONCLUSION: EMSI has accuracy similar to established imaging methods and provides clinically useful, new information in 34% of the patients.CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that EMSI had a concordance of 53%-89% and 35%-73% (depending on analysis) for the localization of epileptic focus as compared with intracranial recordings-IZ and SOZ, respectively.
U2 - 10.1212/WNL.0000000000006877
DO - 10.1212/WNL.0000000000006877
M3 - Journal article
C2 - 30610090
VL - 92
SP - e576-e586
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 6
ER -
ID: 224386306