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Impact of radiotracer injection latency and seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) performance in children.
Clin Neurophysiol 2018; 129(9):1842-1848CN

Abstract

OBJECTIVE

We evaluated the impact of radiotracer injection latency and post-injection seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) test performance in identifying the epileptogenic zone (EZ) in children with drug-resistant epilepsy who had undergone a resective epilepsy surgery.

METHODS

SISCOM concordance with the EZ was retrospectively reviewed to evaluate its performance in 113 children. The impact of radiotracer injection latency and post-injection seizure duration was evaluated for their predictive value of SISCOM localization accuracy.

RESULTS

The overall sensitivity and specificity of SISCOM in identifying an EZ was 64.8% (95%CI = 50.6-77.3) and 40.7% (95%CI = 28.1-54.3). The positive likelihood ratio and diagnostic odd ratio was 1.09 (95%CI = 0.80-1.48) and 1.26 (95%CI = 0.59-2.71), respectively. Logistic regression showed that injection latency and post-injection seizure duration did not significantly predict the probability of true positive SISCOM (p-value = 0.45 and 0.29, respectively).

CONCLUSION

Radiotracer injection latency and post-injection seizure duration were not shown to have a statistical significant impact on SISCOM performance in identifying the EZ.

SIGNIFICANCE

This study demonstrates that further study of factors contributing to the performance of SISCOM in EZ identification in children is needed.

Authors+Show Affiliations

Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: Gewalin.aungaroon@cchmc.org.Division of Pediatric Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Division of Pediatric Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Division of Pediatric Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29981959

Citation

Aungaroon, Gewalin, et al. "Impact of Radiotracer Injection Latency and Seizure Duration On Subtraction Ictal SPECT Co-registered to MRI (SISCOM) Performance in Children." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 129, no. 9, 2018, pp. 1842-1848.
Aungaroon G, Trout A, Radhakrishnan R, et al. Impact of radiotracer injection latency and seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) performance in children. Clin Neurophysiol. 2018;129(9):1842-1848.
Aungaroon, G., Trout, A., Radhakrishnan, R., Horn, P. S., Arya, R., Tenney, J. R., ... Greiner, H. M. (2018). Impact of radiotracer injection latency and seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) performance in children. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 129(9), pp. 1842-1848. doi:10.1016/j.clinph.2018.06.010.
Aungaroon G, et al. Impact of Radiotracer Injection Latency and Seizure Duration On Subtraction Ictal SPECT Co-registered to MRI (SISCOM) Performance in Children. Clin Neurophysiol. 2018;129(9):1842-1848. PubMed PMID: 29981959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of radiotracer injection latency and seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) performance in children. AU - Aungaroon,Gewalin, AU - Trout,Andrew, AU - Radhakrishnan,Rupa, AU - Horn,Paul S, AU - Arya,Ravindra, AU - Tenney,Jeffrey R, AU - Arthur,Todd M, AU - Holland,Katherine D, AU - Mangano,Francesco T, AU - Leach,James L, AU - Rozhkov,Leonid, AU - Greiner,Hansel M, Y1 - 2018/06/23/ PY - 2018/03/06/received PY - 2018/05/16/revised PY - 2018/06/13/accepted PY - 2018/7/10/pubmed PY - 2019/8/23/medline PY - 2018/7/9/entrez KW - Drug-resistant epilepsy KW - Epilepsy surgery KW - Pediatric KW - SISCOM SP - 1842 EP - 1848 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 129 IS - 9 N2 - OBJECTIVE: We evaluated the impact of radiotracer injection latency and post-injection seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) test performance in identifying the epileptogenic zone (EZ) in children with drug-resistant epilepsy who had undergone a resective epilepsy surgery. METHODS: SISCOM concordance with the EZ was retrospectively reviewed to evaluate its performance in 113 children. The impact of radiotracer injection latency and post-injection seizure duration was evaluated for their predictive value of SISCOM localization accuracy. RESULTS: The overall sensitivity and specificity of SISCOM in identifying an EZ was 64.8% (95%CI = 50.6-77.3) and 40.7% (95%CI = 28.1-54.3). The positive likelihood ratio and diagnostic odd ratio was 1.09 (95%CI = 0.80-1.48) and 1.26 (95%CI = 0.59-2.71), respectively. Logistic regression showed that injection latency and post-injection seizure duration did not significantly predict the probability of true positive SISCOM (p-value = 0.45 and 0.29, respectively). CONCLUSION: Radiotracer injection latency and post-injection seizure duration were not shown to have a statistical significant impact on SISCOM performance in identifying the EZ. SIGNIFICANCE: This study demonstrates that further study of factors contributing to the performance of SISCOM in EZ identification in children is needed. SN - 1872-8952 UR - https://www.unboundmedicine.com/medline/citation/29981959/Impact_of_radiotracer_injection_latency_and_seizure_duration_on_subtraction_ictal_SPECT_co_registered_to_MRI__SISCOM__performance_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1388-2457(18)31120-9 DB - PRIME DP - Unbound Medicine ER -