Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis

Introduction: [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is part of the regular preoperative work-up in medically refractory epilepsy. As a complement to visual evaluation of PET, statistical parametric maps can help in the detection of the epileptogenic zone (EZ). However,...

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Autores: Mayoral Peñalva, Maria, Niñerola Baizán, Aida, Marti Fuster, Berta, Donaire Pedraza, Antonio Jesús, Perissinotti, Andrés, Rumià, Jordi, Bargalló Alabart, Núria, Sala Llonch, Roser, Pavía Segura, Javier, Ros Puig, Domènec, Carreño, Mar, Pons Pons, Francisca, Setoain Perego, Xavier
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/163163
Acesso em linha:https://hdl.handle.net/2445/163163
Access Level:acceso abierto
Palavra-chave:Tomografia computada per emissió de fotó simple
Epilèpsia
Neurocirurgia
Single-photon emission computed tomography
Epilepsy
Neurosurgery
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spelling Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysisMayoral Peñalva, MariaNiñerola Baizán, AidaMarti Fuster, BertaDonaire Pedraza, Antonio JesúsPerissinotti, AndrésRumià, JordiBargalló Alabart, NúriaSala Llonch, RoserPavía Segura, JavierRos Puig, DomènecCarreño, MarPons Pons, FranciscaSetoain Perego, XavierTomografia computada per emissió de fotó simpleEpilèpsiaNeurocirurgiaSingle-photon emission computed tomographyEpilepsyNeurosurgeryIntroduction: [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is part of the regular preoperative work-up in medically refractory epilepsy. As a complement to visual evaluation of PET, statistical parametric maps can help in the detection of the epileptogenic zone (EZ). However, software packages currently available are time-consuming and little intuitive for physicians. We develop a user-friendly software (referred as PET-analysis) for EZ localization in PET studies that allows dynamic real-time statistical parametric analysis. To evaluate its performance, the outcome of PET-analysis was compared with the results obtained by visual assessment and Statistical Parametric Mapping (SPM). Methods: Thirty patients with medically refractory epilepsy who underwent presurgical 18F-FDG PET with good post-operative outcomes were included. The 18F-FDG PET studies were evaluated by visual assessment, with SPM8 and PET-analysis. In SPM, parametric T-maps were thresholded at corrected p < 0.05 and cluster size k = 50 and at uncorrected p < 0.001 and k = 100 (the most used parameters in the literature). Since PET-analysis rapidly processes different threshold combinations, T-maps were thresholded with multiple p-value and different clusters sizes. The presurgical EZ identified by visual assessment, SPM and PET-analysis was compared to the confirmed EZ according to post-surgical follow-up. Results: PET-analysis obtained 66.7% (20/30) of correctly localizing studies, comparable to the 70.0% (21/30) achieved by visual assessment and significantly higher (p < 0.05) than that obtained with the SPM threshold p < 0.001/k = 100, of 36.7% (11/30). Only one study was positive, albeit non-localizing, with the SPM threshold corrected p < 0.05/k = 50. Concordance was substantial for PET-analysis (κ = 0.643) and visual interpretation (κ = 0.622), being fair for SPM (κ = 0.242). Conclusion: Compared to SPM with the fixed standard parameters, PET-analysis may be superior in EZ localization with its easy and rapid processing of different threshold combinations. The results of this initial proof-of-concept study validate the clinical use of PET-analysis as a robust objective complementary tool to visual assessment for EZ localization.Frontiers Media2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/163163Articles publicats en revistes (Biomedicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.3389/fneur.2019.00380Frontiers In Neurology, 2019, vol. 10, num. 380https://doi.org/10.3389/fneur.2019.00380cc-by (c) Mayoral Peñalva, Maria et al., 2019http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1631632026-05-27T06:46:51Z
dc.title.none.fl_str_mv Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
title Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
spellingShingle Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
Mayoral Peñalva, Maria
Tomografia computada per emissió de fotó simple
Epilèpsia
Neurocirurgia
Single-photon emission computed tomography
Epilepsy
Neurosurgery
title_short Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
title_full Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
title_fullStr Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
title_full_unstemmed Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
title_sort Epileptogenic zone localization with (18)FDG PET using a new dynamic parametric analysis
dc.creator.none.fl_str_mv Mayoral Peñalva, Maria
Niñerola Baizán, Aida
Marti Fuster, Berta
Donaire Pedraza, Antonio Jesús
Perissinotti, Andrés
Rumià, Jordi
Bargalló Alabart, Núria
Sala Llonch, Roser
Pavía Segura, Javier
Ros Puig, Domènec
Carreño, Mar
Pons Pons, Francisca
Setoain Perego, Xavier
author Mayoral Peñalva, Maria
author_facet Mayoral Peñalva, Maria
Niñerola Baizán, Aida
Marti Fuster, Berta
Donaire Pedraza, Antonio Jesús
Perissinotti, Andrés
Rumià, Jordi
Bargalló Alabart, Núria
Sala Llonch, Roser
Pavía Segura, Javier
Ros Puig, Domènec
Carreño, Mar
Pons Pons, Francisca
Setoain Perego, Xavier
author_role author
author2 Niñerola Baizán, Aida
Marti Fuster, Berta
Donaire Pedraza, Antonio Jesús
Perissinotti, Andrés
Rumià, Jordi
Bargalló Alabart, Núria
Sala Llonch, Roser
Pavía Segura, Javier
Ros Puig, Domènec
Carreño, Mar
Pons Pons, Francisca
Setoain Perego, Xavier
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Tomografia computada per emissió de fotó simple
Epilèpsia
Neurocirurgia
Single-photon emission computed tomography
Epilepsy
Neurosurgery
topic Tomografia computada per emissió de fotó simple
Epilèpsia
Neurocirurgia
Single-photon emission computed tomography
Epilepsy
Neurosurgery
description Introduction: [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is part of the regular preoperative work-up in medically refractory epilepsy. As a complement to visual evaluation of PET, statistical parametric maps can help in the detection of the epileptogenic zone (EZ). However, software packages currently available are time-consuming and little intuitive for physicians. We develop a user-friendly software (referred as PET-analysis) for EZ localization in PET studies that allows dynamic real-time statistical parametric analysis. To evaluate its performance, the outcome of PET-analysis was compared with the results obtained by visual assessment and Statistical Parametric Mapping (SPM). Methods: Thirty patients with medically refractory epilepsy who underwent presurgical 18F-FDG PET with good post-operative outcomes were included. The 18F-FDG PET studies were evaluated by visual assessment, with SPM8 and PET-analysis. In SPM, parametric T-maps were thresholded at corrected p < 0.05 and cluster size k = 50 and at uncorrected p < 0.001 and k = 100 (the most used parameters in the literature). Since PET-analysis rapidly processes different threshold combinations, T-maps were thresholded with multiple p-value and different clusters sizes. The presurgical EZ identified by visual assessment, SPM and PET-analysis was compared to the confirmed EZ according to post-surgical follow-up. Results: PET-analysis obtained 66.7% (20/30) of correctly localizing studies, comparable to the 70.0% (21/30) achieved by visual assessment and significantly higher (p < 0.05) than that obtained with the SPM threshold p < 0.001/k = 100, of 36.7% (11/30). Only one study was positive, albeit non-localizing, with the SPM threshold corrected p < 0.05/k = 50. Concordance was substantial for PET-analysis (κ = 0.643) and visual interpretation (κ = 0.622), being fair for SPM (κ = 0.242). Conclusion: Compared to SPM with the fixed standard parameters, PET-analysis may be superior in EZ localization with its easy and rapid processing of different threshold combinations. The results of this initial proof-of-concept study validate the clinical use of PET-analysis as a robust objective complementary tool to visual assessment for EZ localization.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/163163
url https://hdl.handle.net/2445/163163
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3389/fneur.2019.00380
Frontiers In Neurology, 2019, vol. 10, num. 380
https://doi.org/10.3389/fneur.2019.00380
dc.rights.none.fl_str_mv cc-by (c) Mayoral Peñalva, Maria et al., 2019
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Mayoral Peñalva, Maria et al., 2019
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv Articles publicats en revistes (Biomedicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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