Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy

Purpose: A prospective study of individual and combined quantitative imaging applications for lateralizing epileptogenicity was performed in a cohort of consecutive patients with a putative diagnosis of mesial temporal lobe epilepsy (mTLE).Methods: Quantitative metrics were applied to MRI and nuclea...

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Autores principales:	Kost Elisevich, Esmaeil Davoodi-Bojd, John G. Heredia, Hamid Soltanian-Zadeh
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	neuroimaging temporal lobe epilepsy MRI lateralization multimodal analysis Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/166bceaab87a413e90ff2ca90d7d1044
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spelling	oai:doaj.org-article:166bceaab87a413e90ff2ca90d7d10442021-11-05T07:28:47ZProspective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy1664-229510.3389/fneur.2021.747580https://doaj.org/article/166bceaab87a413e90ff2ca90d7d10442021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.747580/fullhttps://doaj.org/toc/1664-2295Purpose: A prospective study of individual and combined quantitative imaging applications for lateralizing epileptogenicity was performed in a cohort of consecutive patients with a putative diagnosis of mesial temporal lobe epilepsy (mTLE).Methods: Quantitative metrics were applied to MRI and nuclear medicine imaging studies as part of a comprehensive presurgical investigation. The neuroimaging analytics were conducted remotely to remove bias. All quantitative lateralizing tools were trained using a separate dataset. Outcomes were determined after 2 years. Of those treated, some underwent resection, and others were implanted with a responsive neurostimulation (RNS) device.Results: Forty-eight consecutive cases underwent evaluation using nine attributes of individual or combinations of neuroimaging modalities: 1) hippocampal volume, 2) FLAIR signal, 3) PET profile, 4) multistructural analysis (MSA), 5) multimodal model analysis (MMM), 6) DTI uncertainty analysis, 7) DTI connectivity, and 9) fMRI connectivity. Of the 24 patients undergoing resection, MSA, MMM, and PET proved most effective in predicting an Engel class 1 outcome (>80% accuracy). Both hippocampal volume and FLAIR signal analysis showed 76% and 69% concordance with an Engel class 1 outcome, respectively.Conclusion: Quantitative multimodal neuroimaging in the context of a putative mTLE aids in declaring laterality. The degree to which there is disagreement among the various quantitative neuroimaging metrics will judge whether epileptogenicity can be confined sufficiently to a particular temporal lobe to warrant further study and choice of therapy. Prediction models will improve with continued exploration of combined optimal neuroimaging metrics.Kost ElisevichKost ElisevichEsmaeil Davoodi-BojdJohn G. HerediaHamid Soltanian-ZadehHamid Soltanian-ZadehFrontiers Media S.A.articleneuroimagingtemporal lobe epilepsyMRIlateralizationmultimodal analysisNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	neuroimaging temporal lobe epilepsy MRI lateralization multimodal analysis Neurology. Diseases of the nervous system RC346-429
spellingShingle	neuroimaging temporal lobe epilepsy MRI lateralization multimodal analysis Neurology. Diseases of the nervous system RC346-429 Kost Elisevich Kost Elisevich Esmaeil Davoodi-Bojd John G. Heredia Hamid Soltanian-Zadeh Hamid Soltanian-Zadeh Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy
description	Purpose: A prospective study of individual and combined quantitative imaging applications for lateralizing epileptogenicity was performed in a cohort of consecutive patients with a putative diagnosis of mesial temporal lobe epilepsy (mTLE).Methods: Quantitative metrics were applied to MRI and nuclear medicine imaging studies as part of a comprehensive presurgical investigation. The neuroimaging analytics were conducted remotely to remove bias. All quantitative lateralizing tools were trained using a separate dataset. Outcomes were determined after 2 years. Of those treated, some underwent resection, and others were implanted with a responsive neurostimulation (RNS) device.Results: Forty-eight consecutive cases underwent evaluation using nine attributes of individual or combinations of neuroimaging modalities: 1) hippocampal volume, 2) FLAIR signal, 3) PET profile, 4) multistructural analysis (MSA), 5) multimodal model analysis (MMM), 6) DTI uncertainty analysis, 7) DTI connectivity, and 9) fMRI connectivity. Of the 24 patients undergoing resection, MSA, MMM, and PET proved most effective in predicting an Engel class 1 outcome (>80% accuracy). Both hippocampal volume and FLAIR signal analysis showed 76% and 69% concordance with an Engel class 1 outcome, respectively.Conclusion: Quantitative multimodal neuroimaging in the context of a putative mTLE aids in declaring laterality. The degree to which there is disagreement among the various quantitative neuroimaging metrics will judge whether epileptogenicity can be confined sufficiently to a particular temporal lobe to warrant further study and choice of therapy. Prediction models will improve with continued exploration of combined optimal neuroimaging metrics.
format	article
author	Kost Elisevich Kost Elisevich Esmaeil Davoodi-Bojd John G. Heredia Hamid Soltanian-Zadeh Hamid Soltanian-Zadeh
author_facet	Kost Elisevich Kost Elisevich Esmaeil Davoodi-Bojd John G. Heredia Hamid Soltanian-Zadeh Hamid Soltanian-Zadeh
author_sort	Kost Elisevich
title	Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy
title_short	Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy
title_full	Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy
title_fullStr	Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy
title_full_unstemmed	Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy
title_sort	prospective quantitative neuroimaging analysis of putative temporal lobe epilepsy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/166bceaab87a413e90ff2ca90d7d1044
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Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy

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