title: Diffusion tensor tractography imaging in pediatric epilepsy - A systematic review.
abstract: OBJECTIVE
  Recent years brought several experimental and clinical reports applying diffusion tensor tractography imaging (DTI) of the brain in epilepsy. This study was aimed to evaluate current evidence for adding the DTI sequence to the standard diagnostic magnetic resonance imaging (MRI) protocol in pediatric epilepsy.
  
  
  METHODS
  Rapid and qualitative systematic review (RAE, Rapid Evidence Assessment), aggregating relevant studies from the recent 7 years. The PubMed database was hand searched for records containing terms "tractography AND epilepsy." Only studies referring to children were included; studies were rated using "final quality of evidence."
  
  
  RESULTS
  Out of 144 screened records, relevant 101 were aggregated and reviewed. The synthesis was based on 73 studies. Case-control clinical studies were the majority of the material and comprised 43.8% of the material. Low 'confirmability' and low 'applicability' referred to 18 and 17 articles (29.5% and 27.9%), respectively. The sufficient quality of evidence supported performing DTI in temporal lobe epilepsy, malformations of cortical development and prior to a neurosurgery of epilepsy.
  
  
  CONCLUSIONS
  The qualitative RAE provides an interim estimate of the clinical relevance of quickly developing diagnostic methods. Based on the critical appraisal of current knowledge, adding the DTI sequence to the standard MRI protocol may be clinically beneficial in selected patient groups with childhood temporal lobe epilepsy or as a part of planning for an epilepsy surgery.
authors: Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: mgkgs@wp.pl.
authors: Marta
authors: M
authors: Szmuda
authors: Department of Neurosurgery, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: tszmuda@gumed.edu.pl.
authors: Tomasz
authors: T
authors: Szmuda
authors: Department of Preventive Medicine and Education, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: janusz.springer@gumed.edu.pl.
authors: Janusz
authors: J
authors: Springer
authors: Department of Neurosurgery, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: marianna.rogowska@gmail.com.
authors: Marianna
authors: M
authors: Rogowska
authors: Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: agnieszkasabisz@gmail.com.
authors: Agnieszka
authors: A
authors: Sabisz
authors: Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: mduba@gumed.edu.pl.
authors: Mirosława
authors: M
authors: Dubaniewicz
authors: Department of Developmental Neurology, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: mmazur@gumed.edu.pl.
authors: Maria
authors: M
authors: Mazurkiewicz-Bełdzińska
mesh_terms: D002648:Child; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis*; D006801:Humans
keywords: Diffusion tensor tractography; Pediatric epilepsy; Systematic review