Diagnostic accuracy of interictal source imaging in presurgical epilepsy evaluation: A systematic review from the E-PILEPSY consortium.

Autor: Mouthaan BE; Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands., Rados M; Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands., Boon P; Reference Center for Refractory Epilepsy, Department of Neurology, Ghent University Hospital, Belgium., Carrette E; Reference Center for Refractory Epilepsy, Department of Neurology, Ghent University Hospital, Belgium., Diehl B; National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Department of Clinical and Experimental Epilepsy, University College, London, UK., Jung J; Department of Functional Neurology and Epileptology, Institute of Epilepsies (IDEE), Hospices Civils de Lyon, Lyon, France., Kimiskidis V; Laboratory of Clinical Neurophysiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece., Kobulashvili T; Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, and Centre for Cognitive Neuroscience, Salzburg, Austria., Kuchukhidze G; Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, and Centre for Cognitive Neuroscience, Salzburg, Austria., Larsson PG; Department of Neurosurgery, Clinic of Surgery and Neuroscience, Oslo University Hospital, Norway., Leitinger M; Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, and Centre for Cognitive Neuroscience, Salzburg, Austria., Ryvlin P; Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland., Rugg-Gunn F; National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Department of Clinical and Experimental Epilepsy, University College, London, UK., Seeck M; EEG and Epilepsy Unit, Department of Clinical Neurosciences, University Hospital of Geneva, Switzerland., Vulliémoz S; EEG and Epilepsy Unit, Department of Clinical Neurosciences, University Hospital of Geneva, Switzerland., Huiskamp G; Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands., Leijten FSS; Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands., Van Eijsden P; Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands., Trinka E; Department of Neurology, Christian-Doppler University Hospital, Paracelsus Medical University, and Centre for Cognitive Neuroscience, Salzburg, Austria; Institute of Public Health, Medical Decision Making and HTA, UMIT, Private University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria., Braun KPJ; Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands. Electronic address: k.braun@umcutrecht.nl.
Jazyk: angličtina
Zdroj: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2019 May; Vol. 130 (5), pp. 845-855. Date of Electronic Publication: 2019 Feb 08.
DOI: 10.1016/j.clinph.2018.12.016
Abstrakt: Objective: Interictal high resolution (HR-) electric source imaging (ESI) and magnetic source imaging (MSI) are non-invasive tools to aid epileptogenic zone localization in epilepsy surgery candidates. We carried out a systematic review on the diagnostic accuracy and quality of evidence of these modalities.
Methods: Embase, Pubmed and the Cochrane database were searched on 13 February 2017. Diagnostic accuracy studies taking post-surgical seizure outcome as reference standard were selected. Quality appraisal was based on the QUADAS-2 framework.
Results: Eleven studies were included: eight MSI (n = 267), three HR-ESI (n = 127) studies. None was free from bias. This mostly involved: selection of operated patients only, interference of source imaging with surgical decision, and exclusion of indeterminate results. Summary sensitivity and specificity estimates were 82% (95% CI: 75-88%) and 53% (95% CI: 37-68%) for overall source imaging, with no statistical difference between MSI and HR-ESI. Specificity is higher when partially concordant results were included as non-concordant (p < 0.05). Inclusion of indeterminate test results as non-concordant lowered sensitivity (p < 0.05).
Conclusions: Source imaging has a relatively high sensitivity but low specificity for identification of the epileptogenic zone.
Significance: We need higher quality studies allowing unbiased test evaluation to determine the added value and diagnostic accuracy of source imaging in the presurgical workup of refractory focal epilepsy.
(Copyright © 2019 International Federation of Clinical Neurophysiology. All rights reserved.)
Databáze: MEDLINE
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