Presurgical evaluation of drug-resistant paediatric focal epilepsy with PISCOM compared to SISCOM and FDG-PET*
Por:
Aparicio J, Niñerola-Baizán A, Perissinotti A, Rubí S, Muchart-Lopez J, Candela-Cantó SA, Campistol-Plana J and Setoain X
Publicada:
1 abr 2022
Ahead of Print:
1 mar 2022
Resumen:
Purpose: Children with drug-resistant focal epilepsy have a compromised quality of life. Epilepsy surgery can control or significantly reduce the seizures. We assessed and compared the usefulness of PISCOM, a new nuclear imaging processing technique, with SISCOM and 18F-FDG PET (FDG-PET) in pre-surgical evaluation of paediatric drug-resistant focal epilepsy. Methods: Twenty-two children with pharmcorefractory epilepsy, mainly extratemporal, who had undergone presurgical assessment including SISCOM and FDG-PET and with postsurgical favorable outcome (Engel class I or II) for at least two years, were included in this proof-of-concept study. All abnormalities observed in SISCOM, FDGPET and PISCOM were compared with each other and with the known epileptogenic zone (EZ) based on surgical treatment, histopathologic and surgical outcome results. Global interobserver agreement, Cohen's Kappa coeficient and PABAK statistic were calculated for each technique. Results: PISCOM concordance with the known EZ was significantly higher than SISCOM (p<0.05), and no statistically differences were found with FDG-PET. PISCOM showed successful identification in 19 of 22 cases (86%), successful concordant with FDG-PET in 17 (77%), and SISCOM in 11 (50%). If we consider PISCOM and FDG-PET results together, both techniques successfully localized the known EZ in all cases. The measures of agreement between two experts in nuclear medicine were higher in PISCOM than in SISCOM and FDG-PET. Conclusion: PISCOM could provide complementary presurgical information in drug-resistant paediatric focal epilepsy, particularly in cases in which FDG-PET is doubtful or negative, replacing SISCOM and sparing the use of interictal SPECT.
Filiaciones:
Aparicio J:
Neurology Department, Sant Joan de Déu Barcelona Children's Hospital, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, Barcelona 08950, Spain
Epilepsy Unit, Member of ERN-EpiCARE, Sant Joan de Déu Barcelona Children's Hospital, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, Barcelona 08950, Spain
Niñerola-Baizán A:
Nuclear Medicine Department, Hospital Clínic, C/Villarroel 170, Barcelona 08036, Spain
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
Perissinotti A:
Nuclear Medicine Department, Hospital Clínic, C/Villarroel 170, Barcelona 08036, Spain
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
Rubí S:
Nuclear Medicine Department, Hospital Universitari Son Espases, Palma 07010, Spain
Health Research Institute of the Balearic Islands (IdISBa), Palma 07010, Spain
Muchart-Lopez J:
Diagnostic Imaging Department, Sant Joan de Déu Barcelona Children's Hospital, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, Barcelona 08950, Spain
Candela-Cantó SA:
Neurosurgery Department, Sant Joan de Déu Barcelona Children's Hospital, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, Barcelona 08950, Spain
Campistol-Plana J:
Neurology Department, Sant Joan de Déu Barcelona Children's Hospital, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, Barcelona 08950, Spain
Setoain X:
Nuclear Medicine Department, Hospital Clínic, C/Villarroel 170, Barcelona 08036, Spain
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
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