Comparison of various imaging modalities in localization of epileptogenic lesion using epilepsy surgery outcome in pediatric patients

Jeong Tae Kim, Sun Joon Bai, Keum Ok Choi, Yoon Jin Lee, Hae Jeong Park, Dong Seok Kim, HeungDong Kim, Joon Soo Lee

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Purpose: We employed the results of imaging modalities from pediatric patients who received successful epilepsy surgery to determine the accuracy of each imaging tool in identifying epileptic zones in youngsters. Methods: All Engel class I pediatric patients who received epilepsy surgery between October 2003 and April 2008 were selected. Their pathology, EEG, MRI, PET, and subtraction ictal SPECT coregistered to MRI (SISCOM) results were compared for accuracy in locating the epileptic foci, defined as "area that resulted in seizure ablation after resection". Results: Forty-two patients were enrolled (23 temporal lobectomy, 19 extratemporal resections). MRI showed concordance in 84.2% of extratemporal cases, all of which had precise localization of lesions. In temporal cases, lateralization was 91.3% and localization was 82.6%. PET showed a concordance rate of 95.5% and localization was 72.7% for temporal lesions. For extratemporal lesions, concordance was only 68.4%. SISCOM showed concordance in 100% of temporal and 92.3% of extratemporal cases, with localization in 66.7% of temporal and 84.6% of extratemporal cases. Most temporal lobe cases had hippocampal sclerosis, and cortical dysplasia was observed in extratemporal cases. Discussion: MRI was invariably reliable in all cases. PET results were as reliable in lateralizing the temporal epileptic area, while its efficacy was lower for extratemporal cases. SISCOM effectively localized lesions in extratemporal cases, but its efficacy was lower in temporal lesions. In cases of conflicting pre-surgical results, MRI, with supplementary data from PET, helped to establish correct decisions in temporal epilepsies, while utilization of SISCOM and MRI data is advised for extratemporal cases.

Original languageEnglish
Pages (from-to)504-510
Number of pages7
JournalSeizure
Volume18
Issue number7
DOIs
Publication statusPublished - 2009 Sep 1

Fingerprint

Epilepsy
Pediatrics
Single-Photon Emission-Computed Tomography
Stroke
Malformations of Cortical Development
Sclerosis
Temporal Lobe
Electroencephalography
Seizures
Pathology

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Kim, Jeong Tae ; Bai, Sun Joon ; Choi, Keum Ok ; Lee, Yoon Jin ; Park, Hae Jeong ; Kim, Dong Seok ; Kim, HeungDong ; Lee, Joon Soo. / Comparison of various imaging modalities in localization of epileptogenic lesion using epilepsy surgery outcome in pediatric patients. In: Seizure. 2009 ; Vol. 18, No. 7. pp. 504-510.
@article{99e88e2dedb34c339d9a51ed138161d3,
title = "Comparison of various imaging modalities in localization of epileptogenic lesion using epilepsy surgery outcome in pediatric patients",
abstract = "Purpose: We employed the results of imaging modalities from pediatric patients who received successful epilepsy surgery to determine the accuracy of each imaging tool in identifying epileptic zones in youngsters. Methods: All Engel class I pediatric patients who received epilepsy surgery between October 2003 and April 2008 were selected. Their pathology, EEG, MRI, PET, and subtraction ictal SPECT coregistered to MRI (SISCOM) results were compared for accuracy in locating the epileptic foci, defined as {"}area that resulted in seizure ablation after resection{"}. Results: Forty-two patients were enrolled (23 temporal lobectomy, 19 extratemporal resections). MRI showed concordance in 84.2{\%} of extratemporal cases, all of which had precise localization of lesions. In temporal cases, lateralization was 91.3{\%} and localization was 82.6{\%}. PET showed a concordance rate of 95.5{\%} and localization was 72.7{\%} for temporal lesions. For extratemporal lesions, concordance was only 68.4{\%}. SISCOM showed concordance in 100{\%} of temporal and 92.3{\%} of extratemporal cases, with localization in 66.7{\%} of temporal and 84.6{\%} of extratemporal cases. Most temporal lobe cases had hippocampal sclerosis, and cortical dysplasia was observed in extratemporal cases. Discussion: MRI was invariably reliable in all cases. PET results were as reliable in lateralizing the temporal epileptic area, while its efficacy was lower for extratemporal cases. SISCOM effectively localized lesions in extratemporal cases, but its efficacy was lower in temporal lesions. In cases of conflicting pre-surgical results, MRI, with supplementary data from PET, helped to establish correct decisions in temporal epilepsies, while utilization of SISCOM and MRI data is advised for extratemporal cases.",
author = "Kim, {Jeong Tae} and Bai, {Sun Joon} and Choi, {Keum Ok} and Lee, {Yoon Jin} and Park, {Hae Jeong} and Kim, {Dong Seok} and HeungDong Kim and Lee, {Joon Soo}",
year = "2009",
month = "9",
day = "1",
doi = "10.1016/j.seizure.2009.04.012",
language = "English",
volume = "18",
pages = "504--510",
journal = "Seizure : the journal of the British Epilepsy Association",
issn = "1059-1311",
publisher = "W.B. Saunders Ltd",
number = "7",

}

Comparison of various imaging modalities in localization of epileptogenic lesion using epilepsy surgery outcome in pediatric patients. / Kim, Jeong Tae; Bai, Sun Joon; Choi, Keum Ok; Lee, Yoon Jin; Park, Hae Jeong; Kim, Dong Seok; Kim, HeungDong; Lee, Joon Soo.

In: Seizure, Vol. 18, No. 7, 01.09.2009, p. 504-510.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of various imaging modalities in localization of epileptogenic lesion using epilepsy surgery outcome in pediatric patients

AU - Kim, Jeong Tae

AU - Bai, Sun Joon

AU - Choi, Keum Ok

AU - Lee, Yoon Jin

AU - Park, Hae Jeong

AU - Kim, Dong Seok

AU - Kim, HeungDong

AU - Lee, Joon Soo

PY - 2009/9/1

Y1 - 2009/9/1

N2 - Purpose: We employed the results of imaging modalities from pediatric patients who received successful epilepsy surgery to determine the accuracy of each imaging tool in identifying epileptic zones in youngsters. Methods: All Engel class I pediatric patients who received epilepsy surgery between October 2003 and April 2008 were selected. Their pathology, EEG, MRI, PET, and subtraction ictal SPECT coregistered to MRI (SISCOM) results were compared for accuracy in locating the epileptic foci, defined as "area that resulted in seizure ablation after resection". Results: Forty-two patients were enrolled (23 temporal lobectomy, 19 extratemporal resections). MRI showed concordance in 84.2% of extratemporal cases, all of which had precise localization of lesions. In temporal cases, lateralization was 91.3% and localization was 82.6%. PET showed a concordance rate of 95.5% and localization was 72.7% for temporal lesions. For extratemporal lesions, concordance was only 68.4%. SISCOM showed concordance in 100% of temporal and 92.3% of extratemporal cases, with localization in 66.7% of temporal and 84.6% of extratemporal cases. Most temporal lobe cases had hippocampal sclerosis, and cortical dysplasia was observed in extratemporal cases. Discussion: MRI was invariably reliable in all cases. PET results were as reliable in lateralizing the temporal epileptic area, while its efficacy was lower for extratemporal cases. SISCOM effectively localized lesions in extratemporal cases, but its efficacy was lower in temporal lesions. In cases of conflicting pre-surgical results, MRI, with supplementary data from PET, helped to establish correct decisions in temporal epilepsies, while utilization of SISCOM and MRI data is advised for extratemporal cases.

AB - Purpose: We employed the results of imaging modalities from pediatric patients who received successful epilepsy surgery to determine the accuracy of each imaging tool in identifying epileptic zones in youngsters. Methods: All Engel class I pediatric patients who received epilepsy surgery between October 2003 and April 2008 were selected. Their pathology, EEG, MRI, PET, and subtraction ictal SPECT coregistered to MRI (SISCOM) results were compared for accuracy in locating the epileptic foci, defined as "area that resulted in seizure ablation after resection". Results: Forty-two patients were enrolled (23 temporal lobectomy, 19 extratemporal resections). MRI showed concordance in 84.2% of extratemporal cases, all of which had precise localization of lesions. In temporal cases, lateralization was 91.3% and localization was 82.6%. PET showed a concordance rate of 95.5% and localization was 72.7% for temporal lesions. For extratemporal lesions, concordance was only 68.4%. SISCOM showed concordance in 100% of temporal and 92.3% of extratemporal cases, with localization in 66.7% of temporal and 84.6% of extratemporal cases. Most temporal lobe cases had hippocampal sclerosis, and cortical dysplasia was observed in extratemporal cases. Discussion: MRI was invariably reliable in all cases. PET results were as reliable in lateralizing the temporal epileptic area, while its efficacy was lower for extratemporal cases. SISCOM effectively localized lesions in extratemporal cases, but its efficacy was lower in temporal lesions. In cases of conflicting pre-surgical results, MRI, with supplementary data from PET, helped to establish correct decisions in temporal epilepsies, while utilization of SISCOM and MRI data is advised for extratemporal cases.

UR - http://www.scopus.com/inward/record.url?scp=68049116945&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68049116945&partnerID=8YFLogxK

U2 - 10.1016/j.seizure.2009.04.012

DO - 10.1016/j.seizure.2009.04.012

M3 - Article

VL - 18

SP - 504

EP - 510

JO - Seizure : the journal of the British Epilepsy Association

JF - Seizure : the journal of the British Epilepsy Association

SN - 1059-1311

IS - 7

ER -