Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study
Abstract Objective To investigate cost in working hours for initial integration of interictal EEG source localization (ESL) into clinical practice of a tertiary epilepsy center, and to examine concordance of results obtained with three different ESL pipelines. Methods This prospective study covered...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Epilepsia Open |
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| Online Access: | https://doi.org/10.1002/epi4.12754 |
| _version_ | 1797729190360907776 |
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| author | Gadi Miron Thomas Baag Kara Götz Martin Holtkamp Bernd J. Vorderwülbecke |
| author_facet | Gadi Miron Thomas Baag Kara Götz Martin Holtkamp Bernd J. Vorderwülbecke |
| author_sort | Gadi Miron |
| collection | DOAJ |
| description | Abstract Objective To investigate cost in working hours for initial integration of interictal EEG source localization (ESL) into clinical practice of a tertiary epilepsy center, and to examine concordance of results obtained with three different ESL pipelines. Methods This prospective study covered the first year of using ESL in the Epilepsy‐Center Berlin‐Brandenburg. Patients aged ≥14 years with drug‐resistant focal epilepsy referred for noninvasive presurgical evaluation were included. Interictal ESL was based on low‐density EEG and individual head models. Source maxima were obtained from two freely available software packages and one commercial provider. One physician and computer scientist documented their working hours for setting up and processing ESL. Additionally, a survey was conducted among epilepsy centers in Germany to assess the current role of ESL in presurgical evaluation. Results Of 40 patients included, 22 (55%) had enough interictal spikes for ESL. The physician's working times decreased from median 4.7 hours [interquartile range 3.9‐6.4] in the first third of cases to 2.0 hours [1.9‐2.4] in the remaining two thirds; P < 0.01. In addition, computer scientist and physician spent a total of 35.5 and 33.0 working hours on setting up the digital infrastructure, and on training and testing. Sublobar agreement between all three pipelines was 20%, mean measurement of agreement (kappa) 0.13. Finally, the survey revealed that 53% of epilepsy centers in Germany currently use ESL for presurgical evaluation. Significance This study provides information regarding expected effort and costs for integration of ESL into an epilepsy surgery program. Low result agreement across different ESL pipelines calls for further standardization. |
| first_indexed | 2024-03-12T11:25:26Z |
| format | Article |
| id | doaj.art-c0e5cf07f2144de7976643692cdf1ebb |
| institution | Directory Open Access Journal |
| issn | 2470-9239 |
| language | English |
| last_indexed | 2024-03-12T11:25:26Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj.art-c0e5cf07f2144de7976643692cdf1ebb2023-09-01T09:39:50ZengWileyEpilepsia Open2470-92392023-09-018387788710.1002/epi4.12754Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective studyGadi Miron0Thomas Baag1Kara Götz2Martin Holtkamp3Bernd J. Vorderwülbecke4Epilepsy‐Center Berlin‐Brandenburg Institute for Diagnostics of Epilepsy Berlin GermanyEpilepsy‐Center Berlin‐Brandenburg Institute for Diagnostics of Epilepsy Berlin GermanyEpilepsy‐Center Berlin‐Brandenburg Institute for Diagnostics of Epilepsy Berlin GermanyEpilepsy‐Center Berlin‐Brandenburg Institute for Diagnostics of Epilepsy Berlin GermanyEpilepsy‐Center Berlin‐Brandenburg Institute for Diagnostics of Epilepsy Berlin GermanyAbstract Objective To investigate cost in working hours for initial integration of interictal EEG source localization (ESL) into clinical practice of a tertiary epilepsy center, and to examine concordance of results obtained with three different ESL pipelines. Methods This prospective study covered the first year of using ESL in the Epilepsy‐Center Berlin‐Brandenburg. Patients aged ≥14 years with drug‐resistant focal epilepsy referred for noninvasive presurgical evaluation were included. Interictal ESL was based on low‐density EEG and individual head models. Source maxima were obtained from two freely available software packages and one commercial provider. One physician and computer scientist documented their working hours for setting up and processing ESL. Additionally, a survey was conducted among epilepsy centers in Germany to assess the current role of ESL in presurgical evaluation. Results Of 40 patients included, 22 (55%) had enough interictal spikes for ESL. The physician's working times decreased from median 4.7 hours [interquartile range 3.9‐6.4] in the first third of cases to 2.0 hours [1.9‐2.4] in the remaining two thirds; P < 0.01. In addition, computer scientist and physician spent a total of 35.5 and 33.0 working hours on setting up the digital infrastructure, and on training and testing. Sublobar agreement between all three pipelines was 20%, mean measurement of agreement (kappa) 0.13. Finally, the survey revealed that 53% of epilepsy centers in Germany currently use ESL for presurgical evaluation. Significance This study provides information regarding expected effort and costs for integration of ESL into an epilepsy surgery program. Low result agreement across different ESL pipelines calls for further standardization.https://doi.org/10.1002/epi4.12754drug‐resistant focal epilepsyelectric source imagingepilepsy surgery |
| spellingShingle | Gadi Miron Thomas Baag Kara Götz Martin Holtkamp Bernd J. Vorderwülbecke Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study Epilepsia Open drug‐resistant focal epilepsy electric source imaging epilepsy surgery |
| title | Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study |
| title_full | Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study |
| title_fullStr | Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study |
| title_full_unstemmed | Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study |
| title_short | Integration of interictal EEG source localization in presurgical epilepsy evaluation – A single‐center prospective study |
| title_sort | integration of interictal eeg source localization in presurgical epilepsy evaluation a single center prospective study |
| topic | drug‐resistant focal epilepsy electric source imaging epilepsy surgery |
| url | https://doi.org/10.1002/epi4.12754 |
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