Department of Radiology, Mayo Clinic, Rochester, MN.
Biomedical Imaging Resources, Mayo Clinic, Rochester, MN.
J Neuroimaging. 2018 May;28(3):307-312. doi: 10.1111/jon.12496. Epub 2018 Jan 10.
SISCOM and STATISCOM were clinically proved to be effective for ictal/inter-ictal single-photon emission computed tomography (SPECT) analysis coregistered with magnetic resonance imaging (MRI) for seizure localization. Recently, a software package also became available for this analysis. This study aimed to investigate and compare the performance of these analysis methods for seizure localization.
A total of 378 patients who underwent Tc-ethyl cysteinate dimer (ECD) SPECT scans were retrospectively reviewed and 28 remained after applying exclusion criteria. Their SPECT and MRI images were analyzed with SISCOM (with z-score of 1.5 and 2), STATISCOM, and MIMneuro, resulting in a total of 112 image data sets. Two experienced radiologists participated in the blind review process using a custom tool and they can mark up to two hyper- and/or hypoperfusion regions. Their review results were analyzed using the Jackknife Free Response Receiver-Operating Characteristics (JAFROC) test and the JAFROC figure-of-merit (FoM) was reported for each method. The interobserver agreement was also assessed using Cohen's kappa test.
Based on the readers' two choices, averaged FoM was 85.7%, 83.9%, 66.1%, and 51.8% for STATISCOM, MIMneuro, SISCOM (z-score = 2), and SISCOM (z-score = 1.5), respectively. The average confidence rating was 2.5, 2.3, 1.6, and 1.1 for STATISCOM, MIMneuro, SISCOM (z-score = 2), and SISCOM (z-score = 1.5), respectively. For interobserver agreement, kappa was .742 for STATISCOM, .816 for MIMneuro, .517 for SISCOM (z-score = 2), and .441 for SISCOM (z-score = 1.5; all P < .001).
Our study demonstrated that STATISCOM showed the best performance for seizure localization, which was closely followed by MIMneuro. In addition, MIMneuro was not inferior to SISCOM with either z-score.
SISCOM 和 STATISCOM 已被临床证明可有效分析癫痫发作期/发作间期单光子发射计算机断层扫描（SPECT）与磁共振成像（MRI）的同机配准，以定位癫痫灶。最近，也出现了一种用于该分析的软件包。本研究旨在调查和比较这些分析方法在癫痫灶定位中的性能。
回顾性分析了 378 例接受 Tc-乙基半胱氨酸二聚体（ECD）SPECT 扫描的患者，应用排除标准后有 28 例患者纳入研究。使用 SISCOM（z 值为 1.5 和 2）、STATISCOM 和 MIMneuro 对他们的 SPECT 和 MRI 图像进行分析，总共产生了 112 组图像数据。两名有经验的放射科医生使用定制工具参与了盲法审查，并可以标记多达两个高灌注和/或低灌注区域。使用 Jackknife Free Response Receiver-Operating Characteristics（JAFROC）检验分析他们的审查结果，并报告每种方法的 JAFROC 特征值（FoM）。还使用 Cohen's kappa 检验评估了观察者间的一致性。
根据读者的两个选择，STATISCOM、MIMneuro、SISCOM（z 值=2）和 SISCOM（z 值=1.5）的平均 FoM 分别为 85.7%、83.9%、66.1%和 51.8%。平均置信度评分分别为 2.5、2.3、1.6 和 1.1。对于观察者间的一致性，STATISCOM 的 kappa 值为.742，MIMneuro 的 kappa 值为.816，SISCOM（z 值=2）的 kappa 值为.517，SISCOM（z 值=1.5）的 kappa 值为.441（均 P<.001）。
本研究表明，STATISCOM 在癫痫灶定位中的表现最佳，其次是 MIMneuro。此外，MIMneuro 与任何 z 值的 SISCOM 相比均不逊色。
