Evidence map›Paper›PMID 40303886›Full record

ArticleFrontiers in neurology2025

Quantitative SISCOM assessment for epileptogenic zone localization: insights from a multicenter study comparing two software platforms in temporal lobe epilepsy.

Carla Oliveira Young, Brunno Machado de Campos, Edna Marina de Souza, Sergio Querino Brunetto, Maria Julia de Oliveira Santos Gualberto, Leonardo Alexandre-Santos, Marcos Geraldo Merichelo de Oliveira, Marina Koutsodontis Machado Alvim, Fernando Cendes, Elba Etchebehere and 2 more

Abstract read
In one paragraph

Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Carla Oliveira YoungDivision of Nuclear Medicine, Department of Radiology and Oncology, University of Campinas (UNICAMP), Campinas, Brazil.
Brunno Machado de CamposDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil.
Edna Marina de SouzaCentre of Biomedical Engineering, University of Campinas (UNICAMP), Campinas, Brazil.
Sergio Querino BrunettoCentre of Biomedical Engineering, University of Campinas (UNICAMP), Campinas, Brazil.
Maria Julia de Oliveira Santos GualbertoNuclear Medicine and PET/CT Laboratory, Department of Medical Imaging, Haematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Leonardo Alexandre-SantosNuclear Medicine and PET/CT Laboratory, Department of Medical Imaging, Haematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Marcos Geraldo Merichelo de OliveiraNuclear Medicine and PET/CT Laboratory, Department of Medical Imaging, Haematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Marina Koutsodontis Machado AlvimDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil.
Fernando CendesDivision of Epilepsy, Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil.
Elba EtchebehereDivision of Nuclear Medicine, Department of Radiology and Oncology, University of Campinas (UNICAMP), Campinas, Brazil.
Lauro Wichert-AnaNuclear Medicine and PET/CT Laboratory, Department of Medical Imaging, Haematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Bárbara Juarez AmorimDivision of Nuclear Medicine, Department of Radiology and Oncology, University of Campinas (UNICAMP), Campinas, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Pharmacoresistant epilepsy affects around one-third of individuals with epilepsy, requiring precise diagnosis, particularly in cases where surgical resection of the epileptogenic zone (EZ) is an option. Functional imaging techniques, such as ictal-interictal subtraction SPECT coregistered to MRI (SISCOM), have proven useful in pre-surgical evaluation by improving EZ localization accuracy. However, the widespread use of SISCOM is limited by the high costs and technical complexity of commercial software. Statistical Parametric Mapping (SPM) has been demonstrated to be a viable alternative for SISCOM analysis, displaying the potential for cost-effective EZ localization. Materials and methods: In this retrospective study, we evaluated patients with pharmacoresistant temporal lobe epilepsy from two reference centers of epilepsy in Brazil, who underwent ictal and interictal SPECT imaging as part of their pre-surgical evaluation, achieving favorable outcomes (Engel I or II) after surgical resection. The EZ reference standard was determined according to anatomopathological findings and good clinical outcomes. SISCOM was performed using a semi-automated approach with Statistical Parametric Mapping (SPM) and a proprietary software - Analyze. Data from each method were compared to the EZ reference standard and classified as concordant, partially concordant, or discordant. Results: We included 20 patients, 14 (70%) with left temporal lobe epilepsy and six (30%) with right temporal lobe epilepsy. Hippocampal sclerosis was the most common pathology (80%). Both SPM and Analyze were concordant with the EZ reference standard in 14 cases (70%), showing no difference in sensitivity between the methods. However, SPM generated smaller, more localized clusters, while Analyze produced larger clusters with broader spatial coverage. Concordance between the two methods was poor (Kappa = 0.0179), reflecting methodological differences. Conclusion: This study evidences technical differences between SISCOM performed with SPM and Analyze, but with similar sensitivity (70%) for EZ localization. Further studies with larger sample sizes are required to confirm these findings. The data presented here suggest that SISCOM-SPM, due to its rapid and semi-automated workflow, may offer a practical and accessible alternative to proprietary software for epilepsy surgical planning.

Indexed as

epileptogenic zonepharmacoresistant epilepsyquantitative analysisSISCOMSPECTtemporal lobe epilepsy

Identifiers

PMID40303886
PMCPMC12037379

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.