Change in presurgical diagnostic imaging evaluation affects subsequent pediatric epilepsy surgery outcome.
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| Title: | Change in presurgical diagnostic imaging evaluation affects subsequent pediatric epilepsy surgery outcome. |
|---|---|
| Authors: | Rubinger, Luc, Chan, Carol, D'Arco, Felice, Moineddin, Rahim, Muthaffar, Osama, Rutka, James T., Snead, O. Carter, Smith, Mary Lou, Widjaja, Elysa |
| Source: | Epilepsia (Series 4). Jan2016, Vol. 57 Issue 1, p32-40. 9p. |
| Subjects: | Childhood epilepsy, Diagnostic imaging, Epilepsy surgery, Magnetic resonance imaging of the brain, Magnetoencephalography, Therapeutics |
| Abstract: | Objective Since 2008, we have changed our presurgical diagnostic imaging evaluation for medically refractory focal epilepsy to include high-resolution epilepsy protocol on 3 T magnetic resonance imaging ( MRI), and combined magnetoencephalography and 18-fluorodeoxyglucose-positron emission tomography ( FDG- PET) in selected patients with normal or subtle changes on MRI or discordant diagnostic tests. The aim of this study was to evaluate the effectiveness of the change in imaging practice on epilepsy surgery outcome in a tertiary pediatric epilepsy surgery center. Methods The change in practice occurred in early 2008, and patients were classified based on old or new practice. The patient characteristics, surgical variables, and seizure-free surgical outcome were compared, and the trend in seizure-free outcome over time was assessed. Results There was a trend for increased abnormal MRI (92% vs. 86%, respectively, p = 0.062), and increased utilization of FDG- PET (34% vs. 3% respectively, p < 0.001) with new relative to old practice. There were no statistically significant differences in invasive monitoring, location, and type of surgery and histology between the two periods (all p > 0.05). During the old practice, there was no statistically significant change in yearly trend of seizure-free outcome (odds ratio [ OR] 0.960, 95% confidence interval [ CI] 0.875-1.053, p = 0.386). The change in practice in 2008 was associated with a significant improvement in seizure-free outcome ( OR 1.535, 95% CI 1.100-2.142, p = 0.012). During the new practice, there was a significant positive trend in yearly seizure-free outcome ( OR 1.219, 95% CI 1.053-1.411, p = 0.008), after adjusting for age at seizure onset, invasive monitoring, location and type of surgery, histology, MRI, magnetoencephalography, and FDG- PET. Significance We have found an improvement in seizure-free surgical outcome following the change in imaging practice. This study highlights the importance of optimizing and improving presurgical diagnostic imaging evaluation to improve surgical outcome. [ABSTRACT FROM AUTHOR] |
| Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 112190927 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Change in presurgical diagnostic imaging evaluation affects subsequent pediatric epilepsy surgery outcome. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Rubinger%2C+Luc%22">Rubinger, Luc</searchLink><br /><searchLink fieldCode="AR" term="%22Chan%2C+Carol%22">Chan, Carol</searchLink><br /><searchLink fieldCode="AR" term="%22D'Arco%2C+Felice%22">D'Arco, Felice</searchLink><br /><searchLink fieldCode="AR" term="%22Moineddin%2C+Rahim%22">Moineddin, Rahim</searchLink><br /><searchLink fieldCode="AR" term="%22Muthaffar%2C+Osama%22">Muthaffar, Osama</searchLink><br /><searchLink fieldCode="AR" term="%22Rutka%2C+James+T%2E%22">Rutka, James T.</searchLink><br /><searchLink fieldCode="AR" term="%22Snead%2C+O%2E+Carter%22">Snead, O. Carter</searchLink><br /><searchLink fieldCode="AR" term="%22Smith%2C+Mary+Lou%22">Smith, Mary Lou</searchLink><br /><searchLink fieldCode="AR" term="%22Widjaja%2C+Elysa%22">Widjaja, Elysa</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Jan2016, Vol. 57 Issue 1, p32-40. 9p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Childhood+epilepsy%22">Childhood epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging+of+the+brain%22">Magnetic resonance imaging of the brain</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetoencephalography%22">Magnetoencephalography</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective Since 2008, we have changed our presurgical diagnostic imaging evaluation for medically refractory focal epilepsy to include high-resolution epilepsy protocol on 3 T magnetic resonance imaging ( MRI), and combined magnetoencephalography and 18-fluorodeoxyglucose-positron emission tomography ( FDG- PET) in selected patients with normal or subtle changes on MRI or discordant diagnostic tests. The aim of this study was to evaluate the effectiveness of the change in imaging practice on epilepsy surgery outcome in a tertiary pediatric epilepsy surgery center. Methods The change in practice occurred in early 2008, and patients were classified based on old or new practice. The patient characteristics, surgical variables, and seizure-free surgical outcome were compared, and the trend in seizure-free outcome over time was assessed. Results There was a trend for increased abnormal MRI (92% vs. 86%, respectively, p = 0.062), and increased utilization of FDG- PET (34% vs. 3% respectively, p < 0.001) with new relative to old practice. There were no statistically significant differences in invasive monitoring, location, and type of surgery and histology between the two periods (all p > 0.05). During the old practice, there was no statistically significant change in yearly trend of seizure-free outcome (odds ratio [ OR] 0.960, 95% confidence interval [ CI] 0.875-1.053, p = 0.386). The change in practice in 2008 was associated with a significant improvement in seizure-free outcome ( OR 1.535, 95% CI 1.100-2.142, p = 0.012). During the new practice, there was a significant positive trend in yearly seizure-free outcome ( OR 1.219, 95% CI 1.053-1.411, p = 0.008), after adjusting for age at seizure onset, invasive monitoring, location and type of surgery, histology, MRI, magnetoencephalography, and FDG- PET. Significance We have found an improvement in seizure-free surgical outcome following the change in imaging practice. This study highlights the importance of optimizing and improving presurgical diagnostic imaging evaluation to improve surgical outcome. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/epi.13229 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 32 Subjects: – SubjectFull: Childhood epilepsy Type: general – SubjectFull: Diagnostic imaging Type: general – SubjectFull: Epilepsy surgery Type: general – SubjectFull: Magnetic resonance imaging of the brain Type: general – SubjectFull: Magnetoencephalography Type: general – SubjectFull: Therapeutics Type: general Titles: – TitleFull: Change in presurgical diagnostic imaging evaluation affects subsequent pediatric epilepsy surgery outcome. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Rubinger, Luc – PersonEntity: Name: NameFull: Chan, Carol – PersonEntity: Name: NameFull: D'Arco, Felice – PersonEntity: Name: NameFull: Moineddin, Rahim – PersonEntity: Name: NameFull: Muthaffar, Osama – PersonEntity: Name: NameFull: Rutka, James T. – PersonEntity: Name: NameFull: Snead, O. Carter – PersonEntity: Name: NameFull: Smith, Mary Lou – PersonEntity: Name: NameFull: Widjaja, Elysa IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: Jan2016 Type: published Y: 2016 Identifiers: – Type: issn-print Value: 00139580 Numbering: – Type: volume Value: 57 – Type: issue Value: 1 Titles: – TitleFull: Epilepsia (Series 4) Type: main |
| ResultId | 1 |
