title: Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe.
abstract: OBJECTIVE
  In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers.
  
  
  METHODS
  A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations.
  
  
  RESULTS
  Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used.
  
  
  CONCLUSIONS
  We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods.
authors.affiliation: Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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authors.initials: BE
authors.lastname: Mouthaan
authors.affiliation: Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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authors.lastname: Rados
authors.affiliation: MR Research Center, Semmelweis University, Budapest, Hungary.
authors.forename: Péter
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authors.affiliation: Department of Neurology, Reference Center for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium.
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authors.lastname: Boon
authors.affiliation: University College London Institute of Child Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
authors.forename: David W
authors.initials: DW
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authors.affiliation: Department of Neurology, Reference Center for Refractory Epilepsy, Ghent University Hospital, Ghent, Belgium.
authors.forename: Evelien
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authors.lastname: Carrette
authors.affiliation: Pediatric Neurology Clinic, "Alexandru Obregia" Clinical Psychiatric Hospital, Bucharest, Romania.|Department 6, Pediatric Neurology Clinic, "Carol Davila" University of Medicine, Bucharest, Romania.
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authors.lastname: Craiu
authors.affiliation: University College London Institute of Child Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
authors.forename: J Helen
authors.initials: JH
authors.lastname: Cross
authors.affiliation: National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom.|Department of Clinical and Experimental Epilepsy, University College London, London, United Kingdom.
authors.forename: Beate
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authors.lastname: Diehl
authors.affiliation: Department of Neurosurgery, Epilepsy Surgery Center, St. Ivan Rilski University Hospital, Sofia, Bulgaria.
authors.forename: Petia
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authors.lastname: Dimova
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Daniel
authors.initials: D
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authors.affiliation: Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
authors.forename: Stefano
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authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department of Moscow, Moscow, Russia.|Department of Neurology and Neurosurgery of Russian National Research Medical University, Moscow, Russia.
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authors.affiliation: Department of Neuroimaging, Center for Biomedical Technology, Technical University of Madrid, Pozuelo de Alarcón, Spain.
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authors.affiliation: Scientific Research Institute of Emergency Care named after N.V. Sklifosovsky, Moscow, Russia.
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authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department of Moscow, Moscow, Russia.|Department of Neurology and Neurosurgery of Russian National Research Medical University, Moscow, Russia.
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authors.affiliation: Medical and Surgical Epilepsy Unit, Hautepierre Hospital, University of Strasbourg, Strasbourg, France.
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authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
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authors.affiliation: Laboratory of Clinical Neurophysiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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authors.affiliation: Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Center for Cognitive Neuroscience, Salzburg, Austria.
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authors.affiliation: Department of Pediatric Neurology, 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
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authors.affiliation: Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Center for Cognitive Neuroscience, Salzburg, Austria.|Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Giorgi
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authors.affiliation: Department of Neurosurgery, Clinic of Surgery and Neuroscience, Oslo University Hospital, Oslo, Norway.
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authors.affiliation: Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Center for Cognitive Neuroscience, Salzburg, Austria.
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authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department of Moscow, Moscow, Russia.|Department of Neurology and Neurosurgery of Russian National Research Medical University, Moscow, Russia.
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authors.affiliation: Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kristina
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authors.affiliation: Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.|Center of Neurology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
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authors.affiliation: Department of Neurology, 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
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authors.affiliation: Department of Neurology, Zagreb Epilepsy Center, University Hospital, Zagreb, Croatia.
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authors.affiliation: Department of Epileptology, University Medical Center, University of Bonn, Bonn, Germany.
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authors.initials: CM
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authors.forename: Fergus
authors.initials: F
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authors.affiliation: Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.|Center of Neurology, Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
authors.forename: Bertil
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authors.affiliation: Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland.
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authors.affiliation: Scientific Research Institute of Emergency Care named after N.V. Sklifosovsky, Moscow, Russia.
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authors.affiliation: Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, and Center for Cognitive Neuroscience, Salzburg, Austria.
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authors.affiliation: Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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authors.affiliation: Department of (Child) Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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mesh_terms: D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007391:International Cooperation; D008297:Male; D059906:Neuroimaging / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D011795:Surveys and Questionnaires
keywords: Electromagnetic source imaging; Epilepsy surgery; Magnetic resonance imaging; Positron emission tomography; Single-photon emission computed tomography