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Clinical practice of language fMRI in epilepsy centers: a European survey and conclusions by the ESNR Epilepsy Working Group.
Bargalló, N; Cano-López, I; Rosazza, C; Vernooij, M W; Smits, M; Vitali, P; Alvarez-Linera, J; Urbach, H; Mancini, L; Ramos, A; Yousry, T.
Afiliação
  • Bargalló N; Magnetic Resonance Image Core Facility, IDIBAPS and Center of Diagnostic Image (CDIC), Hospital Clinic, Barcelona, Spain. bargallo@clinic.cat.
  • Cano-López I; Valencian International University, Valencia, Spain.
  • Rosazza C; Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy.
  • Vernooij MW; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
  • Smits M; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
  • Vitali P; Neuroradiology and Brain MRI 3T Mondino Research Center, IRCCS Mondino Foundation, Pavia, Italy.
  • Alvarez-Linera J; Neuroradiology Department, Hospital Ruber Internacional, Madrid, Spain.
  • Urbach H; Department of Neuroradiology, Freiburg University Medical Center, Freiburg (i.Br.), Germany.
  • Mancini L; Lysholm Department of Neuro-radiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK.
  • Ramos A; Departments Radiology (A.H., A.R.), Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Yousry T; Lysholm Department of Neuro-radiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK.
Neuroradiology ; 62(5): 549-562, 2020 May.
Article em En | MEDLINE | ID: mdl-32170372
ABSTRACT

PURPOSE:

To assess current clinical practices throughout Europe with respect to acquisition, implementation, evaluation, and interpretation of language functional MRI (fMRI) in epilepsy patients.

METHODS:

An online survey was emailed to all European Society of Neuroradiology members (n = 1662), known associates (n = 6400), and 64 members of European Epilepsy network. The questionnaire featured 40 individual items on demographic data, clinical practice and indications, fMRI paradigms, radiological workflow, data post-processing protocol, and reporting.

RESULTS:

A total of 49 non-duplicate entries from European centers were received from 20 countries. Of these, 73.5% were board-certified neuroradiologists and 69.4% had an in-house epilepsy surgery program. Seventy-one percent of centers performed fewer than five scans per month for epilepsy. The most frequently used paradigms were phonemic verbal fluency (47.7%) and auditory comprehension (55.6%), but variants of 13 paradigms were described. Most centers assessed the fMRI task performance (75.5%), ensured cognitive-task adjustment (77.6%), trained the patient before scanning (85.7%), and assessed handedness (77.6%), but only 28.6% had special paradigms for patients with cognitive impairments. fMRI was post-processed mainly by neuroradiologists (42.1%), using open-source software (55.0%). Reporting was done primarily by neuroradiologists (74.2%). Interpretation was done mainly by visual inspection (65.3%). Most specialists (81.6%) were able to determine the hemisphere dominance for language in more than 75% of exams, attributing failure to the patient not performing the task correctly.

CONCLUSION:

This survey shows that language fMRI is firmly embedded in the preoperative management of epilepsy patients. The wide variety of paradigms and the use of non-CE-marked software underline the need for establishing reference standards.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Padrões de Prática Médica / Imageamento por Ressonância Magnética / Epilepsia / Testes de Linguagem Tipo de estudo: Clinical_trials / Guideline Limite: Humans País/Região como assunto: Europa Idioma: En Revista: Neuroradiology Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Espanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Padrões de Prática Médica / Imageamento por Ressonância Magnética / Epilepsia / Testes de Linguagem Tipo de estudo: Clinical_trials / Guideline Limite: Humans País/Região como assunto: Europa Idioma: En Revista: Neuroradiology Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Espanha