PURPOSE To assess current clinical practices throughout Europe with respect to acquisition, implementation, evaluation, and interpretation of language functional MRI (fMRI) in epilepsy patients. METHODS An online survey was emailed to all European Society of Neuroradiology members (n = 1662), known associates (n = 6400), and 64 members of European Epilepsy network. The questionnaire featured 40 individual items on demographic data, clinical practice and indications, fMRI paradigms, radiological workflow, data post-processing protocol, and reporting. RESULTS A total of 49 non-duplicate entries from European centers were received from 20 countries. Of these, 73.5% were board-certified neuroradiologists and 69.4% had an in-house epilepsy surgery program. Seventy-one percent of centers performed fewer than five scans per month for epilepsy. The most frequently used paradigms were phonemic verbal fluency (47.7%) and auditory comprehension (55.6%), but variants of 13 paradigms were described. Most centers assessed the fMRI task performance (75.5%), ensured cognitive-task adjustment (77.6%), trained the patient before scanning (85.7%), and assessed handedness (77.6%), but only 28.6% had special paradigms for patients with cognitive impairments. fMRI was post-processed mainly by neuroradiologists (42.1%), using open-source software (55.0%). Reporting was done primarily by neuroradiologists (74.2%). Interpretation was done mainly by visual inspection (65.3%). Most specialists (81.6%) were able to determine the hemisphere dominance for language in more than 75% of exams, attributing failure to the patient not performing the task correctly. CONCLUSION This survey shows that language fMRI is firmly embedded in the preoperative management of epilepsy patients. The wide variety of paradigms and the use of non-CE-marked software underline the need for establishing reference standards.

中文翻译：

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癫痫中心语言功能磁共振成像的临床实践：欧洲ESNR癫痫病工作组的调查和结论。

目的评估整个欧洲有关癫痫患者语言功能性MRI（fMRI）的获取，实施，评估和解释的临床实践。方法通过在线调查将电子邮件发送给所有欧洲神经放射学会会员（n = 1662），已知同伙（n = 6400）和欧洲癫痫网络的64位成员。该问卷包含40项关于人口统计学数据，临床实践和适应症，fMRI范例，放射学工作流程，数据后处理方案和报告的项目。结果从20个国家/地区共收到了来自欧洲中心的49份重复记录。其中，有73.5％是获得董事会认证的神经放射科医生，有69.4％拥有内部癫痫手术计划。百分之七十一的中心每月进行少于五次的癫痫扫描。最常用的范例是语音口语流利度（47.7％）和听觉理解（55.6％），但是描述了13种范例的变体。大多数中心评估fMRI任务表现（75.5％），确保认知任务调整（77.6％），在扫描前对患者进行培训（85.7％）和评估手感（77.6％），但只有28.6％的患者具有特殊的范例认知障碍。fMRI主要由神经放射科医生（42.1％）使用开源软件（55.0％）进行后处理。报告主要由神经放射科医生完成（74.2％）。解释主要通过目视检查（65.3％）进行。大多数专家（81.6％）能够在超过75％的考试中确定语言在半球的优势地位，这归因于患者未能正确执行任务。结论这项调查表明，语言功能磁共振成像已牢固地植入癫痫患者的术前管理中。各种各样的范例和未使用CE标记的软件的使用突显了建立参考标准的必要性。