Evaluation of 1H magnetic resonance spectroscopic imaging as a diagnostic tool for the lateralization of epileptogenic seizure foci
The purpose of this study was to assess whether a visual examination of 1H spectroscopic images could correctly lateralize patients with intractable temporal lobe epilepsy. 20 patients with intractable temporal lobe epilepsy and 10 volunteers were included in this study. Spectroscopic images were an...
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| Veröffentlicht in: | British journal of radiology 1996, Vol.69 (817), p.15-24 |
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| container_title | British journal of radiology |
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| creator | CONSTANTINIDIS, I MALKO, J. A PETERMAN, S. B LONG, R. C EPSTEIN, C. M BOOR, D HOFFMAN, J. C SHUTTER, L WEISSMAN, J. D |
| description | The purpose of this study was to assess whether a visual examination of 1H spectroscopic images could correctly lateralize patients with intractable temporal lobe epilepsy. 20 patients with intractable temporal lobe epilepsy and 10 volunteers were included in this study. Spectroscopic images were analysed using a protocol based on visual inspection. Images of the metabolites N-acetyl aspartate (NAA), choline (Cho), creatine (Cr) and lactate were obtained from a transverse plane oriented along the sylvian fissure. Images from each individual were evaluated independently by six reviewers. Results of the lateralization procedure obtained from the visual examinations were compared with those obtained from quantitative analysis of the spectra and with those obtained by magnetic resonance imaging (MRI), positron emission tomography (PET), neuropsychological examinations, and electroencephalographic (EEG) recordings. NAA images were found to be the most effective, amongst metabolite images, in lateralizing the epileptogenic lobe. Using the site selected for resection as the definition of the correct lateralization, 70% of the patients who underwent temporal lobectomy were correctly lateralized by the majority of the examiners using the visual inspection protocol. Based on the results of this study it is concluded that visual examination of 1H spectroscopic images is potentially valid in lateralizing patients with intractable temporal lobe seizures. Confidence in the visual interpretation increased as the difference in NAA signal intensity between the temporal lobes increased. The threshold above which the majority of the examiners correctly lateralized the patients was approximately 15% in NAA signal loss in the ipsilateral lobe. |
| doi_str_mv | 10.1259/0007-1285-69-817-15 |
| format | Article |
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A ; PETERMAN, S. B ; LONG, R. C ; EPSTEIN, C. M ; BOOR, D ; HOFFMAN, J. C ; SHUTTER, L ; WEISSMAN, J. D</creator><creatorcontrib>CONSTANTINIDIS, I ; MALKO, J. A ; PETERMAN, S. B ; LONG, R. C ; EPSTEIN, C. M ; BOOR, D ; HOFFMAN, J. C ; SHUTTER, L ; WEISSMAN, J. D</creatorcontrib><description>The purpose of this study was to assess whether a visual examination of 1H spectroscopic images could correctly lateralize patients with intractable temporal lobe epilepsy. 20 patients with intractable temporal lobe epilepsy and 10 volunteers were included in this study. Spectroscopic images were analysed using a protocol based on visual inspection. Images of the metabolites N-acetyl aspartate (NAA), choline (Cho), creatine (Cr) and lactate were obtained from a transverse plane oriented along the sylvian fissure. Images from each individual were evaluated independently by six reviewers. Results of the lateralization procedure obtained from the visual examinations were compared with those obtained from quantitative analysis of the spectra and with those obtained by magnetic resonance imaging (MRI), positron emission tomography (PET), neuropsychological examinations, and electroencephalographic (EEG) recordings. NAA images were found to be the most effective, amongst metabolite images, in lateralizing the epileptogenic lobe. Using the site selected for resection as the definition of the correct lateralization, 70% of the patients who underwent temporal lobectomy were correctly lateralized by the majority of the examiners using the visual inspection protocol. Based on the results of this study it is concluded that visual examination of 1H spectroscopic images is potentially valid in lateralizing patients with intractable temporal lobe seizures. Confidence in the visual interpretation increased as the difference in NAA signal intensity between the temporal lobes increased. The threshold above which the majority of the examiners correctly lateralized the patients was approximately 15% in NAA signal loss in the ipsilateral lobe.</description><identifier>ISSN: 0007-1285</identifier><identifier>EISSN: 1748-880X</identifier><identifier>DOI: 10.1259/0007-1285-69-817-15</identifier><identifier>PMID: 8785617</identifier><identifier>CODEN: BJRAAP</identifier><language>eng</language><publisher>London: British Institute of Radiology</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Case-Control Studies ; Chronic Disease ; Clinical Protocols ; Epilepsy, Temporal Lobe - diagnosis ; Epilepsy, Temporal Lobe - physiopathology ; Epilepsy, Temporal Lobe - therapy ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Spectroscopy ; Medical sciences ; Middle Aged ; Nervous system ; Observer Variation ; Protons ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Treatment Failure</subject><ispartof>British journal of radiology, 1996, Vol.69 (817), p.15-24</ispartof><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1767-d6ca90527221f932424a2c425e2664a8ebb172cb6edc327678f70712fdc71ee23</citedby><cites>FETCH-LOGICAL-c1767-d6ca90527221f932424a2c425e2664a8ebb172cb6edc327678f70712fdc71ee23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,4025,27928,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2984654$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8785617$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CONSTANTINIDIS, I</creatorcontrib><creatorcontrib>MALKO, J. A</creatorcontrib><creatorcontrib>PETERMAN, S. B</creatorcontrib><creatorcontrib>LONG, R. C</creatorcontrib><creatorcontrib>EPSTEIN, C. M</creatorcontrib><creatorcontrib>BOOR, D</creatorcontrib><creatorcontrib>HOFFMAN, J. C</creatorcontrib><creatorcontrib>SHUTTER, L</creatorcontrib><creatorcontrib>WEISSMAN, J. D</creatorcontrib><title>Evaluation of 1H magnetic resonance spectroscopic imaging as a diagnostic tool for the lateralization of epileptogenic seizure foci</title><title>British journal of radiology</title><addtitle>Br J Radiol</addtitle><description>The purpose of this study was to assess whether a visual examination of 1H spectroscopic images could correctly lateralize patients with intractable temporal lobe epilepsy. 20 patients with intractable temporal lobe epilepsy and 10 volunteers were included in this study. Spectroscopic images were analysed using a protocol based on visual inspection. Images of the metabolites N-acetyl aspartate (NAA), choline (Cho), creatine (Cr) and lactate were obtained from a transverse plane oriented along the sylvian fissure. Images from each individual were evaluated independently by six reviewers. Results of the lateralization procedure obtained from the visual examinations were compared with those obtained from quantitative analysis of the spectra and with those obtained by magnetic resonance imaging (MRI), positron emission tomography (PET), neuropsychological examinations, and electroencephalographic (EEG) recordings. NAA images were found to be the most effective, amongst metabolite images, in lateralizing the epileptogenic lobe. Using the site selected for resection as the definition of the correct lateralization, 70% of the patients who underwent temporal lobectomy were correctly lateralized by the majority of the examiners using the visual inspection protocol. Based on the results of this study it is concluded that visual examination of 1H spectroscopic images is potentially valid in lateralizing patients with intractable temporal lobe seizures. Confidence in the visual interpretation increased as the difference in NAA signal intensity between the temporal lobes increased. The threshold above which the majority of the examiners correctly lateralized the patients was approximately 15% in NAA signal loss in the ipsilateral lobe.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Chronic Disease</subject><subject>Clinical Protocols</subject><subject>Epilepsy, Temporal Lobe - diagnosis</subject><subject>Epilepsy, Temporal Lobe - physiopathology</subject><subject>Epilepsy, Temporal Lobe - therapy</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Spectroscopy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>Observer Variation</subject><subject>Protons</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Treatment Failure</subject><issn>0007-1285</issn><issn>1748-880X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kMtKxDAUhoMoOl6eQIQsxF01SZvbUsQbCG4U3IVMejpGMk1NWkG3vrgpDrPK5Xz_D-dD6JSSS8q4viKEyIoyxSuhK0XLne-gBZWNqpQib7tosSUO0GHOH_OTa7KP9pVUXFC5QL-3XzZMdvSxx7HD9AGv7aqH0TucIMfe9g5wHsCNKWYXh_LvC-H7FbYZW9z6gsc882OMAXcx4fEdcLAjJBv8z7YaBh9gGOMK-gJn8D9TgsI7f4z2OhsynGzOI_R6d_ty81A9Pd8_3lw_VY5KIatWOKsJZ5Ix2umaNayxzDWMAxOisQqWSyqZWwpoXc1KQnWSSMq61kkKwOojdPHfO6T4OUEezdpnByHYHuKUjVREal3XBaz_QVeWzgk6M6Sydfo2lJhZvZlNmlmsEdoU9Ybykjrb1E_LNbTbzMZ1mZ9v5jY7G7pU3Pq8xZhWjeBN_QeY-421</recordid><startdate>1996</startdate><enddate>1996</enddate><creator>CONSTANTINIDIS, I</creator><creator>MALKO, J. A</creator><creator>PETERMAN, S. B</creator><creator>LONG, R. C</creator><creator>EPSTEIN, C. M</creator><creator>BOOR, D</creator><creator>HOFFMAN, J. C</creator><creator>SHUTTER, L</creator><creator>WEISSMAN, J. D</creator><general>British Institute of Radiology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1996</creationdate><title>Evaluation of 1H magnetic resonance spectroscopic imaging as a diagnostic tool for the lateralization of epileptogenic seizure foci</title><author>CONSTANTINIDIS, I ; MALKO, J. A ; PETERMAN, S. B ; LONG, R. C ; EPSTEIN, C. M ; BOOR, D ; HOFFMAN, J. C ; SHUTTER, L ; WEISSMAN, J. D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1767-d6ca90527221f932424a2c425e2664a8ebb172cb6edc327678f70712fdc71ee23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Chronic Disease</topic><topic>Clinical Protocols</topic><topic>Epilepsy, Temporal Lobe - diagnosis</topic><topic>Epilepsy, Temporal Lobe - physiopathology</topic><topic>Epilepsy, Temporal Lobe - therapy</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Spectroscopy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>Observer Variation</topic><topic>Protons</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CONSTANTINIDIS, I</creatorcontrib><creatorcontrib>MALKO, J. A</creatorcontrib><creatorcontrib>PETERMAN, S. B</creatorcontrib><creatorcontrib>LONG, R. C</creatorcontrib><creatorcontrib>EPSTEIN, C. M</creatorcontrib><creatorcontrib>BOOR, D</creatorcontrib><creatorcontrib>HOFFMAN, J. C</creatorcontrib><creatorcontrib>SHUTTER, L</creatorcontrib><creatorcontrib>WEISSMAN, J. 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D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of 1H magnetic resonance spectroscopic imaging as a diagnostic tool for the lateralization of epileptogenic seizure foci</atitle><jtitle>British journal of radiology</jtitle><addtitle>Br J Radiol</addtitle><date>1996</date><risdate>1996</risdate><volume>69</volume><issue>817</issue><spage>15</spage><epage>24</epage><pages>15-24</pages><issn>0007-1285</issn><eissn>1748-880X</eissn><coden>BJRAAP</coden><abstract>The purpose of this study was to assess whether a visual examination of 1H spectroscopic images could correctly lateralize patients with intractable temporal lobe epilepsy. 20 patients with intractable temporal lobe epilepsy and 10 volunteers were included in this study. Spectroscopic images were analysed using a protocol based on visual inspection. Images of the metabolites N-acetyl aspartate (NAA), choline (Cho), creatine (Cr) and lactate were obtained from a transverse plane oriented along the sylvian fissure. Images from each individual were evaluated independently by six reviewers. Results of the lateralization procedure obtained from the visual examinations were compared with those obtained from quantitative analysis of the spectra and with those obtained by magnetic resonance imaging (MRI), positron emission tomography (PET), neuropsychological examinations, and electroencephalographic (EEG) recordings. NAA images were found to be the most effective, amongst metabolite images, in lateralizing the epileptogenic lobe. Using the site selected for resection as the definition of the correct lateralization, 70% of the patients who underwent temporal lobectomy were correctly lateralized by the majority of the examiners using the visual inspection protocol. Based on the results of this study it is concluded that visual examination of 1H spectroscopic images is potentially valid in lateralizing patients with intractable temporal lobe seizures. Confidence in the visual interpretation increased as the difference in NAA signal intensity between the temporal lobes increased. The threshold above which the majority of the examiners correctly lateralized the patients was approximately 15% in NAA signal loss in the ipsilateral lobe.</abstract><cop>London</cop><pub>British Institute of Radiology</pub><pmid>8785617</pmid><doi>10.1259/0007-1285-69-817-15</doi><tpages>10</tpages></addata></record> |
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| ispartof | British journal of radiology, 1996, Vol.69 (817), p.15-24 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adolescent Adult Biological and medical sciences Case-Control Studies Chronic Disease Clinical Protocols Epilepsy, Temporal Lobe - diagnosis Epilepsy, Temporal Lobe - physiopathology Epilepsy, Temporal Lobe - therapy Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Spectroscopy Medical sciences Middle Aged Nervous system Observer Variation Protons Radiodiagnosis. Nmr imagery. Nmr spectrometry Treatment Failure |
| title | Evaluation of 1H magnetic resonance spectroscopic imaging as a diagnostic tool for the lateralization of epileptogenic seizure foci |
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