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041 _afre
042 _adc
100 1 0 _aRados, Matea
_eauthor
700 1 0 _a Mouthaan, Brian
_eauthor
700 1 0 _a Barsi, Peter
_eauthor
700 1 0 _a Carmichael, David
_eauthor
700 1 0 _a Heckemann, Rolf A.
_eauthor
700 1 0 _a Kelemen, Anna
_eauthor
700 1 0 _a Kobulashvili, Teia
_eauthor
700 1 0 _a Kuchukhidze, Giorgi
_eauthor
700 1 0 _a Marusic, Petr
_eauthor
700 1 0 _a Minkin, Krasimir
_eauthor
700 1 0 _a Tisdall, Martin
_eauthor
700 1 0 _a Trinka, Eugen
_eauthor
700 1 0 _a Veersema, Tim
_eauthor
700 1 0 _a Vos, Sjoerd B.
_eauthor
700 1 0 _a Wagner, Jan
_eauthor
700 1 0 _a Braun, Kees P.J.
_eauthor
700 1 0 _a van Eijsden, Pieter
_eauthor
245 0 0 _aDiagnostic value of MRI in the presurgical evaluation of patients with epilepsy: influence of field strength and sequence selection: a systematic review and meta-analysis from the E-PILEPSY Consortium
260 _c2022.
500 _a40
520 _aObjectiveMRI is a cornerstone in presurgical evaluation of epilepsy. Despite guidelines, clinical practice varies. In light of the E-PILEPSY pilot reference network, we conducted a systematic review and meta-analysis on the diagnostic value of MRI in the presurgical evaluation of epilepsy patients.MethodsWe included original research articles on diagnostic value of higher MRI field strength and guideline-recommended and additional MRI sequences in detecting an epileptogenic lesion in adult or paediatric epilepsy surgery candidates. Lesion detection rate was used as a metric in meta-analysis.ResultsEighteen studies were included for MRI field strength and 25 for MRI sequences, none were free from bias. In patients with normal MRI at lower-field strength, 3T improved lesion detection rate by 18% and 7T by 23%. Field strengths higher than 1.5T did not have higher lesion detection rates in patients with hippocampal sclerosis (HS). The lesion detection rate of epilepsy-specific MRI protocols was 83% for temporal lobe epilepsy (TLE) patients. Dedicated MRI protocols and evaluation by an experienced epilepsy neuroradiologist increased lesion detection. For HS, 3DT1, T2, and FLAIR each had a lesion detection rate at around 90%. Apparent diffusion coefficient indices had a lateralizing value of 33% for TLE. DTI fractional anisotropy and mean diffusivity had a localizing value of 8% and 34%.SignificanceA dedicated MRI protocol and expert evaluation benefits lesion detection rate in epilepsy surgery candidates. If patients remain MRI negative, imaging at higher-field strength may reveal lesions. In HS, apparent diffusion coefficient indices may aid lateralization and localization more than increasing field strength. DTI can add further diagnostic information. For other additional sequences, the quality and number of studies is insufficient to draw solid conclusions. Our findings may be used as evidence base for developing new high-quality MRI studies and clinical guidelines.
690 _alesion
690 _arefractory epilepsy
690 _amagnetic resonance imaging
690 _adiagnostic imaging
786 0 _nEpileptic Disorders | Vol 24 | 2 | 2022-02-01 | p. 323-342 | 1294-9361
856 4 1 _uhttps://shs.cairn.info/revue-epileptic-disorders-2022-2-page-323?lang=en&redirect-ssocas=7080
999 _c612147
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