The performance of SISCOM and STATISCOM for ictal/inter-ictal single-photon emission computed tomography (SPECT) analysis coregistered with magnetic resonance imaging (MRI) for seizure localization has been proven effective. Researchers sought to compare these tools with a recently available software package for seizure localization. Data demonstrated that STATISCOM presented with the best performance for seizure localization, followed closely by MIMneuro. Furthermore, MIMneuro did not appear to be inferior to SISCOM with either z-score.

Methods

• A retrospective appraisal was performed on 378 patients who underwent ^99mTc-ethyl cysteinate dimer (ECD) SPECT scans, with 28 remaining after exclusion criteria.
• There were 112 image data sets produced after SPECT and MRI images were assessed with SISCOM (with z-score of 1.5 and 2), STATISCOM, and MIMneuro.
• Using a custom tool, two experienced radiologists took part in the blind review process, marking up to 2 hyper- and/or hypoperfusion regions.
• Yielded outcomes were examined via the Jackknife Free Response Receiver-Operating Characteristics (JAFROC) test and the JAFROC figure-of-merit (FoM) was reported for each method.
• Using Cohen's kappa test, the interobserver agreement was evaluated.

Results

• The 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 based on the readers’ two choices.
• 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).