Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone
Introduction: Subtraction of ictal-interictal SPECT co-registered to MRI (SISCOM) is a quantification tool that can improve the sensitivity and specificity of the epileptogenic zone (EZ) localization. Commercially available image analysis software packages for SISCOM are costly, and Statistical Para...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00467/full |
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| author | Carla Oliveira Young Elba C. S. C. Etchbehere Edna Marina Souza Sergio Querino Brunetto Allan de Oliveira Santos Mariana C. L. Lima Sebastian Ortiz-De la Rosa Marina Alvim Clarissa Lin Yasuda Celso Darío Ramos Fernando Cendes Barbara Juarez Amorim |
| author_facet | Carla Oliveira Young Elba C. S. C. Etchbehere Edna Marina Souza Sergio Querino Brunetto Allan de Oliveira Santos Mariana C. L. Lima Sebastian Ortiz-De la Rosa Marina Alvim Clarissa Lin Yasuda Celso Darío Ramos Fernando Cendes Barbara Juarez Amorim |
| author_sort | Carla Oliveira Young |
| collection | DOAJ |
| description | Introduction: Subtraction of ictal-interictal SPECT co-registered to MRI (SISCOM) is a quantification tool that can improve the sensitivity and specificity of the epileptogenic zone (EZ) localization. Commercially available image analysis software packages for SISCOM are costly, and Statistical Parametric Mapping (SPM) could be an alternative free software for the definition of the EZ. There are only a few studies that compare SISCOM using SPM (SISCOM-SPM) with visual analysis.Aim: To compare SISCOM-SPM vs. visual analysis for localization of the EZ in patients with pharmacoresistant focal epilepsies.Materials and methods: We evaluated all our patients with focal epilepsies that underwent ictal and interictal SPECT. We defined the reference standard to locate the EZ by pathology and follow-up (in patients submitted to surgery), or seizure semiology, serial EEG, long-term video-EEG, 18F-FDG PET/CT, and MRI (in patients who were not operated). We compared the location of the EZ by visual analysis of SPECT images and by SISCOM-SPM to the reference standard and classified as concordant, discordant, or partially concordant.Results: We included 23 patients. Visual analysis was concordant with the EZ reference standard in only 13 patients (56.5%), while SISCOM-SPM was concordant in 18 cases (78.3%), providing a 21.8% increase in the location of EZ. However, this difference was not significant due to the small sample size (p = 0.0856).Conclusion: Our preliminary results demonstrate that, in clinical practice, SISCOM-SPM has the potential to add information that might help localize the EZ compared to visual analysis. SISCOM-SPM has a lower cost than other commercially available SISCOM software packages, which is an advantage for developing countries. Studies with more patients are necessary to confirm our findings. |
| first_indexed | 2024-12-12T13:00:53Z |
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| id | doaj.art-83c4d165438747db9f5a6301284613d2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-12T13:00:53Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-83c4d165438747db9f5a6301284613d22022-12-22T00:23:48ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-05-011110.3389/fneur.2020.00467519751Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic ZoneCarla Oliveira Young0Elba C. S. C. Etchbehere1Edna Marina Souza2Sergio Querino Brunetto3Allan de Oliveira Santos4Mariana C. L. Lima5Sebastian Ortiz-De la Rosa6Marina Alvim7Clarissa Lin Yasuda8Celso Darío Ramos9Fernando Cendes10Barbara Juarez Amorim11Division of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, BrazilCenter of Biomedical Engineering, University of Campinas (UNICAMP), Campinas, BrazilCenter of Biomedical Engineering, University of Campinas (UNICAMP), Campinas, BrazilDivision of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, BrazilDivision of Nuclear Medicine, Department of Radiology, University of Campinas (UNICAMP), Campinas, BrazilIntroduction: Subtraction of ictal-interictal SPECT co-registered to MRI (SISCOM) is a quantification tool that can improve the sensitivity and specificity of the epileptogenic zone (EZ) localization. Commercially available image analysis software packages for SISCOM are costly, and Statistical Parametric Mapping (SPM) could be an alternative free software for the definition of the EZ. There are only a few studies that compare SISCOM using SPM (SISCOM-SPM) with visual analysis.Aim: To compare SISCOM-SPM vs. visual analysis for localization of the EZ in patients with pharmacoresistant focal epilepsies.Materials and methods: We evaluated all our patients with focal epilepsies that underwent ictal and interictal SPECT. We defined the reference standard to locate the EZ by pathology and follow-up (in patients submitted to surgery), or seizure semiology, serial EEG, long-term video-EEG, 18F-FDG PET/CT, and MRI (in patients who were not operated). We compared the location of the EZ by visual analysis of SPECT images and by SISCOM-SPM to the reference standard and classified as concordant, discordant, or partially concordant.Results: We included 23 patients. Visual analysis was concordant with the EZ reference standard in only 13 patients (56.5%), while SISCOM-SPM was concordant in 18 cases (78.3%), providing a 21.8% increase in the location of EZ. However, this difference was not significant due to the small sample size (p = 0.0856).Conclusion: Our preliminary results demonstrate that, in clinical practice, SISCOM-SPM has the potential to add information that might help localize the EZ compared to visual analysis. SISCOM-SPM has a lower cost than other commercially available SISCOM software packages, which is an advantage for developing countries. Studies with more patients are necessary to confirm our findings.https://www.frontiersin.org/article/10.3389/fneur.2020.00467/fullbrain perfusionSPECTSISCOMSPMseizuresepilepsy |
| spellingShingle | Carla Oliveira Young Elba C. S. C. Etchbehere Edna Marina Souza Sergio Querino Brunetto Allan de Oliveira Santos Mariana C. L. Lima Sebastian Ortiz-De la Rosa Marina Alvim Clarissa Lin Yasuda Celso Darío Ramos Fernando Cendes Barbara Juarez Amorim Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone Frontiers in Neurology brain perfusion SPECT SISCOM SPM seizures epilepsy |
| title | Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone |
| title_full | Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone |
| title_fullStr | Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone |
| title_full_unstemmed | Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone |
| title_short | Clinical Usefulness of SISCOM-SPM Compared to Visual Analysis to Locate the Epileptogenic Zone |
| title_sort | clinical usefulness of siscom spm compared to visual analysis to locate the epileptogenic zone |
| topic | brain perfusion SPECT SISCOM SPM seizures epilepsy |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00467/full |
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