Proposed Standardization to AUSTN: A Universal Stereoencephalography Nomenclature
Abstract number :
2.269
Submission category :
9. Surgery / 9C. All Ages
Year :
2021
Submission ID :
1826316
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Clifford Calley, MD - The University of Texas Dell Medical School; Winson Ho – The University of Texas Dell Medical School; Abbas Babajani-Feremi – The University of Texas Dell Medical School; Carla Bodden – The University of Texas Dell Medical School; Elizabeth Tyler-Kabara – The University of Texas Dell Medical School; Dave Clarke – The University of Texas Dell Medical School
Rationale: Between 20-40% of patients with epilepsy are considered pharmacoresistant, and roughly 400,000 of these patients are living in the US. Stereoencephalography (sEEG) is frequently used as an invasive method for localizing seizures in patients with pharmacoresistant epilepsy, however electrode nomenclature varies widely both within and across institutions. This lack of standardization can have many downstream consequences, including misidentification of electrodes by clinicians after placement and difficulty with inter or intra-center neurophysiological interpretation and reliability.
Methods: Here we propose a novel sEEG nomenclature that is both intuitive and comprehensive. Considerations included clearly identifiable entry-target labels, abbreviations that respect commonly accepted neuroanatomy, relevant divisions of deep structure targets, functional mapping, distinction between left and right hemisphere electrodes, and relative locations of electrodes in close proximity to each other. Special consideration was also given to electrodes approximating lesions. The accuracy of electrode identification and the use of correct entry-target labels after reconstruction were assessed by neurosurgeons and epileptologists not directly involved in each case.
Results: Our nomenclature was used in 12 consecutive sEEG cases (147 electrodes total) by three separate neurosurgeons and two separate epileptologists. After reconstruction was complete, the accuracy of labeling was 100%, and the correct use of entry-target labels was 94%. The last nine sEEG cases had 100% correct use of entry-target labels.
Conclusions: Our proposed sEEG nomenclature demonstrated both high accuracy in electrode identification as well as consistent use of entry-target labeling. We submit this nomenclature as a model for standardization across epilepsy surgery centers. We intend to improve practicability, ease of use, and specificity of this nomenclature through collaboration with at least two additional surgical epilepsy centers.
Funding: Please list any funding that was received in support of this abstract.: none.
Surgery