Temporal lobe epilepsy: Qualitative reading of 1H MR spectroscopic images for presurgical evaluation

A. A. Capizzano, P. Vermathen, K. D. Laxer, G. R. Ende, D. Norman, H. Rowley, G. B. Matson, Andrew A Maudsley, M. R. Segal, M. W. Weiner

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To study the feasibility and clinical potential of visual inspection of hydrogen 1 magnetic resonance (MR) spectroscopic metabolite images for the lateralization of unilateral nonlesional temporal lobe epilepsy (TLE). Materials and Methods: MR imaging and 1H MR spectroscopic imaging were performed of the temporal lobes in 50 patients with TLE and 23 age-matched healthy volunteers. N-acetylaspartate (NAA) and creatine plus choline metabolite images were read by two neuroradiologists who determined lateralization according to the side of lower NAA signal intensity. Quantitative estimates of NAA were calculated by using an automated fitting program. Results: Agreement in lateralization between readers was significant with a κ score of 0.53 for all patients with TLE and 0.63 for patients displaying mild or marked NAA asymmetry. Among the 50 patients with TLE, lateralization was determined correctly by reader 1 in 38 (76%) patients and by reader 2 in 31 (62%) patients. If limited to patients with mild or marked NAA asymmetry, correct lateralization improved to 30 (77%) of 39 and 16 (80%) of 20 patients, respectively. Combined qualitative reading and quantitative spectral fitting enabled lateralization in 34 (85%) of 40 patients with TLE for reader 1 and 30 (77%) of 39 for reader 2, including nine of 14 patients with TLE with negative MR images. Conclusion: Reading of metabolite images is a feasible and fast means for noninvasive evaluation of patients with TLE who are candidates for surgery and enables lateralization in some patients with negative MR images.

Original languageEnglish
Pages (from-to)144-151
Number of pages8
JournalRadiology
Volume218
Issue number1
StatePublished - Feb 24 2001
Externally publishedYes

Fingerprint

Temporal Lobe Epilepsy
Reading
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Creatine
Feasibility Studies
Temporal Lobe
Choline
Hydrogen
Healthy Volunteers
N-acetylaspartate

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Capizzano, A. A., Vermathen, P., Laxer, K. D., Ende, G. R., Norman, D., Rowley, H., ... Weiner, M. W. (2001). Temporal lobe epilepsy: Qualitative reading of 1H MR spectroscopic images for presurgical evaluation. Radiology, 218(1), 144-151.

Temporal lobe epilepsy : Qualitative reading of 1H MR spectroscopic images for presurgical evaluation. / Capizzano, A. A.; Vermathen, P.; Laxer, K. D.; Ende, G. R.; Norman, D.; Rowley, H.; Matson, G. B.; Maudsley, Andrew A; Segal, M. R.; Weiner, M. W.

In: Radiology, Vol. 218, No. 1, 24.02.2001, p. 144-151.

Research output: Contribution to journalArticle

Capizzano, AA, Vermathen, P, Laxer, KD, Ende, GR, Norman, D, Rowley, H, Matson, GB, Maudsley, AA, Segal, MR & Weiner, MW 2001, 'Temporal lobe epilepsy: Qualitative reading of 1H MR spectroscopic images for presurgical evaluation', Radiology, vol. 218, no. 1, pp. 144-151.
Capizzano AA, Vermathen P, Laxer KD, Ende GR, Norman D, Rowley H et al. Temporal lobe epilepsy: Qualitative reading of 1H MR spectroscopic images for presurgical evaluation. Radiology. 2001 Feb 24;218(1):144-151.
Capizzano, A. A. ; Vermathen, P. ; Laxer, K. D. ; Ende, G. R. ; Norman, D. ; Rowley, H. ; Matson, G. B. ; Maudsley, Andrew A ; Segal, M. R. ; Weiner, M. W. / Temporal lobe epilepsy : Qualitative reading of 1H MR spectroscopic images for presurgical evaluation. In: Radiology. 2001 ; Vol. 218, No. 1. pp. 144-151.
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abstract = "Purpose: To study the feasibility and clinical potential of visual inspection of hydrogen 1 magnetic resonance (MR) spectroscopic metabolite images for the lateralization of unilateral nonlesional temporal lobe epilepsy (TLE). Materials and Methods: MR imaging and 1H MR spectroscopic imaging were performed of the temporal lobes in 50 patients with TLE and 23 age-matched healthy volunteers. N-acetylaspartate (NAA) and creatine plus choline metabolite images were read by two neuroradiologists who determined lateralization according to the side of lower NAA signal intensity. Quantitative estimates of NAA were calculated by using an automated fitting program. Results: Agreement in lateralization between readers was significant with a κ score of 0.53 for all patients with TLE and 0.63 for patients displaying mild or marked NAA asymmetry. Among the 50 patients with TLE, lateralization was determined correctly by reader 1 in 38 (76{\%}) patients and by reader 2 in 31 (62{\%}) patients. If limited to patients with mild or marked NAA asymmetry, correct lateralization improved to 30 (77{\%}) of 39 and 16 (80{\%}) of 20 patients, respectively. Combined qualitative reading and quantitative spectral fitting enabled lateralization in 34 (85{\%}) of 40 patients with TLE for reader 1 and 30 (77{\%}) of 39 for reader 2, including nine of 14 patients with TLE with negative MR images. Conclusion: Reading of metabolite images is a feasible and fast means for noninvasive evaluation of patients with TLE who are candidates for surgery and enables lateralization in some patients with negative MR images.",
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