Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe

Brian E Mouthaan; Matea Rados; Péter Barsi; Paul Boon; David W Carmichael; Evelien Carrette; Dana Craiu; J Helen Cross; Beate Diehl; Petia Dimova; Daniel Fabo; Stefano Francione; Vladislav Gaskin; Antonio Gil-Nagel; Elena Grigoreva; Alla Guekht; Edouard Hirsch; Hrvoje Hecimovic; Christoph Helmstaedter; Julien Jung; Reetta Kalviainen; Anna Kelemen; Vasilios Kimiskidis; Teia Kobulashvili; Pavel Krsek; Giorgi Kuchukhidze; Pål G Larsson; Markus Leitinger; Morten I Lossius; Roman Luzin; Kristina Malmgren; Ruta Mameniskiene; Petr Marusic; Baris Metin; Cigdem Özkara; Hrvoje Pecina; Carlos M Quesada; Fergus Rugg-Gunn; Bertil Rydenhag; Philippe Ryvlin; Julia Scholly; Margitta Seeck; Anke M Staack; Bernhard J Steinhoff; Valentin Stepanov; Oana Tarta-Arsene; Eugen Trinka; Mustafa Uzan; Viola L Vogt; Sjoerd B Vos; Serge Vulliémoz; Geertjan Huiskamp; Frans S S Leijten; Pieter Van Eijsden; Kees P J Braun; E-PILEPSY consortium

doi:10.1111/epi.13347

Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe

Epilepsia. 2016 May;57(5):770-6. doi: 10.1111/epi.13347. Epub 2016 Mar 25.

Authors

Brian E Mouthaan¹, Matea Rados¹, Péter Barsi², Paul Boon³, David W Carmichael⁴, Evelien Carrette³, Dana Craiu^{5

6}, J Helen Cross⁴, Beate Diehl^{7

8}, Petia Dimova⁹, Daniel Fabo¹⁰, Stefano Francione¹¹, Vladislav Gaskin^{12

13}, Antonio Gil-Nagel¹⁴, Elena Grigoreva¹⁵, Alla Guekht^{12

13}, Edouard Hirsch¹⁶, Hrvoje Hecimovic¹⁷, Christoph Helmstaedter¹⁸, Julien Jung¹⁹, Reetta Kalviainen^{20

21}, Anna Kelemen¹⁰, Vasilios Kimiskidis²², Teia Kobulashvili²³, Pavel Krsek²⁴, Giorgi Kuchukhidze^{23

25}, Pål G Larsson²⁶, Markus Leitinger²³, Morten I Lossius²⁷, Roman Luzin^{12

13}, Kristina Malmgren²⁸, Ruta Mameniskiene^{29

30}, Petr Marusic³¹, Baris Metin³², Cigdem Özkara³³, Hrvoje Pecina¹⁷, Carlos M Quesada¹⁸, Fergus Rugg-Gunn^{7

8}, Bertil Rydenhag^{29

30}, Philippe Ryvlin³⁴, Julia Scholly¹⁶, Margitta Seeck³⁵, Anke M Staack³⁶, Bernhard J Steinhoff³⁶, Valentin Stepanov¹⁵, Oana Tarta-Arsene^{5

6}, Eugen Trinka²³, Mustafa Uzan³³, Viola L Vogt¹⁸, Sjoerd B Vos^{37

38}, Serge Vulliémoz³⁵, Geertjan Huiskamp¹, Frans S S Leijten¹, Pieter Van Eijsden¹, Kees P J Braun¹; E-PILEPSY consortium

Affiliations

¹ Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
² MR Research Center, Semmelweis University, Budapest, Hungary.
³ Department of Neurology, Reference Center for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium.
⁴ University College London Institute of Child Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
⁵ Pediatric Neurology Clinic, "Alexandru Obregia" Clinical Psychiatric Hospital, Bucharest, Romania.
⁶ Department 6, Pediatric Neurology Clinic, "Carol Davila" University of Medicine, Bucharest, Romania.
⁷ National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom.
⁸ Department of Clinical and Experimental Epilepsy, University College London, London, United Kingdom.
⁹ Department of Neurosurgery, Epilepsy Surgery Center, St. Ivan Rilski University Hospital, Sofia, Bulgaria.
¹⁰ National Institute of Clinical Neurosciences, Budapest, Hungary.
¹¹ Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
¹² Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department of Moscow, Moscow, Russia.
¹³ Department of Neurology and Neurosurgery of Russian National Research Medical University, Moscow, Russia.
¹⁴ Department of Neuroimaging, Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain.
¹⁵ Scientific Research Institute of Emergency Care named after N.V. Sklifosovsky, Moscow, Russia.
¹⁶ Medical and Surgical Epilepsy Unit, Hautepierre Hospital, University of Strasbourg, Strasbourg, France.
¹⁷ Department of Neurology, Zagreb Epilepsy Center, University Hospital, Zagreb, Croatia.
¹⁸ Department of Epileptology, University Medical Center, University of Bonn, Bonn, Germany.
¹⁹ Department of Functional Neurology and Epileptology, Institute of Epilepsies (IDEE), Hospices Civils de Lyon, Lyon, France.
²⁰ Department of Neurology, Kuopio University Hospital, Kuopio, Finland.
²¹ School of Medicine, University of Eastern Finland, Kuopio, Finland.
²² Laboratory of Clinical Neurophysiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
²³ Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Center for Cognitive Neuroscience, Salzburg, Austria.
²⁴ Department of Pediatric Neurology, 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
²⁵ Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
²⁶ Department of Neurosurgery, Clinic of Surgery and Neuroscience, Oslo University Hospital, Oslo, Norway.
²⁷ Department of Complex Epilepsy, National Center for Epilepsy (SSE), Oslo, Norway.
²⁸ Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
²⁹ Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
³⁰ Center of Neurology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
³¹ Department of Neurology, 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
³² Department of Psychology, Uskudar University, Uskudar, Istanbul, Turkey.
³³ Division of Clinical Electro-Neurophysiology, Department of Neurology, Cerrahpaa Medical Faculty, Istanbul University, Istanbul, Turkey.
³⁴ Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland.
³⁵ EEG and Epilepsy Unit, Department of Clinical Neurosciences, University Hospital of Geneva, Geneva, Switzerland.
³⁶ Kork Epilepsy Center, Kehl-Kork, Germany.
³⁷ Translational Imaging Group, CMIC, University College London, London, United Kingdom.
³⁸ MRI Unit, Epilepsy Society, Chalfont St Peter, United Kingdom.

PMID: 27012361
DOI: 10.1111/epi.13347

Abstract

Objective: In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers.

Methods: A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations.

Results: Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used.

Significance: We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods.

Keywords: Electromagnetic source imaging; Epilepsy surgery; Magnetic resonance imaging; Positron emission tomography; Single-photon emission computed tomography.

Publication types

Multicenter Study

MeSH terms

Epilepsy / diagnostic imaging*
Epilepsy / physiopathology*
Epilepsy / surgery
Europe / epidemiology
Female
Humans
Image Processing, Computer-Assisted
International Cooperation
Male
Neuroimaging* / methods
Neuroimaging* / statistics & numerical data
Neuroimaging* / trends
Surveys and Questionnaires