Yield of non-invasive imaging in MRI-negative focal epilepsy

Article Article scientifique Article Yield of non-invasive imaging in MRI-negative focal epilepsy eng 2023-11-01 2024-02 author Czarnetzki Christian André 0000-0003-2872-3246 EEG & Epilepsy Unit, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, University of Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland. czarnetzkichris@gmail.com. 839370 author Spinelli Laurent EEG & Epilepsy Unit, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, University of Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland. 105795 author Huppertz Hans-Jürgen Swiss Epilepsy Clinic, Klinik Lengg, Zurich, Switzerland. author Schaller Karl Lothard Department of Clinical Neurosciences, Neurosurgery Clinic, University Hospital of Geneva, Geneva, Switzerland. 658606 Département des neurosciences cliniques (OTONO) author Momjian Shahan Marc 0000-0002-3886-0159 Department of Clinical Neurosciences, Neurosurgery Clinic, University Hospital of Geneva, Geneva, Switzerland. 84022 Département des neurosciences cliniques (OTONO) author Lobrinus Johannes Alexander Department of Clinical Pathology, Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland. 647649 author Vargas Gomez Maria Isabel Department of Radiology, Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland. 503296 Département de radiologie et informatique médicale (RADIO) author Garibotto Valentina 0000-0003-2422-698X Department of Radiology, Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland. 704817 Département de radiologie et informatique médicale (RADIO) author Vulliemoz Serge 0000-0002-1877-8625 EEG & Epilepsy Unit, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, University of Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland. 712268 Département des neurosciences cliniques (OTONO) author Seeck Margitta EEG & Epilepsy Unit, Department of Clinical Neurosciences, University Hospital and Faculty of Medicine, University of Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland. Margitta.Seeck@hcuge.ch. 133679 Département des neurosciences cliniques (OTONO) 995-1003 10.1007/s00415-023-11987-6 37907727 0340-5354 PMC10827933 https://link.springer.com/article/10.1007/s00415-023-11987-6 Objective: The absence of MRI-lesion reduces considerably the probability of having an excellent outcome (International League Against Epilepsies [ILAE] class I-II) after epilepsy surgery. Surgical success in magnetic-resonance imaging (MRI)-negative cases relies therefore mainly on non-invasive techniques such as positron-emission tomography (PET), subtraction ictal/inter-ictal single-photon-emission-computed-tomography co-registered to MRI (SISCOM), electric source imaging (ESI) and morphometric MRI analysis (MAP). We were interested in identifying the optimal imaging technique or combination to achieve post-operative class I-II in patients with MRI-negative focal epilepsy. Methods: We identified 168 epileptic patients without MRI lesion. Thirty-three (19.6%) were diagnosed with unifocal epilepsy, underwent surgical resection and follow-up ⩾ 2 years. Sensitivity, specificity, predictive values, and diagnostic odds ratio (OR) were calculated for each technique individually and in combination (after co-registration). Results: 23/33 (70%) were free of disabling seizures (75.0% with temporal and 61.5% extratemporal lobe epilepsy). None of the individual modalities presented an OR > 1.5, except ESI if only patients with interictal epileptiform discharges (IEDs) were considered (OR 3.2). On a dual combination, SISCOM with ESI presented the highest outcome (OR = 6). MAP contributed to detecting indistinguishable focal cortical dysplasia in particular in extratemporal epilepsies with a sensitivity of 75%. Concordance of PET, ESI on interictal epileptic discharges, and SISCOM was associated with the highest chance for post-operative seizure control (OR = 11). Conclusion: If MRI is negative, the chances to benefit from epilepsy surgery are almost as high as in lesional epilepsy, provided that multiple established non-invasive imaging tools are rigorously applied and co-registered together. Adults Children ESI Epilepsy surgery Focal epilepsy MRI-negative Morphometry Non-lesional PET SISCOM SPECT Humans Electroencephalography / methods Epilepsies, Partial / diagnostic imaging Epilepsies, Partial / surgery Epilepsy / surgery Magnetic Resonance Imaging / methods Tomography, Emission-Computed, Single-Photon / methods Seizures Dewey 616.8 Dewey 616.0757 Dewey 616.07 Swiss National Science Foundation Predict and Monitor Epilepsy After a First Seizure: The Swiss-First Study 180365 CH Programmes Swiss National Science Foundation Network Diagnosis for Epilepsy 192749 CH Projects Swiss National Science Foundation Precision mapping of electrical brain network dynamics with application to epilepsy 209470 CH Programmes 62 Département de radiologie et informatique médicale 227 61 Département des neurosciences cliniques 226 137 Département de pathologie et immunologie 21F false 1222 Laboratoire de neuroimagerie et de traceurs moléculaires innovants 984 119 Epilepsie et Chirurgie 149 1279 Epilepsie et réseaux cérébraux 1002 1231 Optimisations des techniques avancés en neuroimagerie 985 513 Groupe Schaller Karl Lothard (neurochirurgie) 851 Journal of neurology 271 2 c0761bf3-1e27-4fc5-9fac-2ce12871f475 Article (Published version) Public Article-scientifique-from-europePmc.pdf 955506 application/pdf CC BY-4.0 afaa01a19fd9c6842e159403a85f01571b2a5aa2c2a25b52cc36ee646dd52e5a d6c2c4bb-915e-4d90-9bd6-273d907beef7 Appendix Public 415_2023_11987_MOESM1_ESM.docx 31789 application/vnd.openxmlformats-officedocument.wordprocessingml.document 60660d1753e023da181f20a4afd347cc782fb07e95521c556ede947a5b5b3ba1 openAccess Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie

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Yield of non-invasive imaging in MRI-negative focal epilepsy	Journal of neurology			2024	92	228

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Czarnetzki, Christian André