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Scientific article
English

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

Published inClinical Neurophysiology, vol. 130, no. 5, p. 845-855
Publication date2019
Abstract

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.

Keywords
  • Electroencephalography
  • Magnetoencephalography
  • Sensitivity
  • Source localization
  • Specificity
  • Surgery
Citation (ISO format)
MOUTHAAN, Brian E et al. Diagnostic accuracy of interictal source imaging in presurgical epilepsy evaluation: A systematic review from the E-PILEPSY consortium. In: Clinical Neurophysiology, 2019, vol. 130, n° 5, p. 845–855. doi: 10.1016/j.clinph.2018.12.016
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ISSN of the journal1388-2457
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Creation10/14/2019 12:22:00 PM
First validation10/14/2019 12:22:00 PM
Update time03/15/2023 6:20:45 PM
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