FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

Salamon, Noriko; Kung, Justin W.; Shaw, Susan; Koo, Jae-Mean; Koh, Susan; Wu, Joyce; Lerner, Jason T.; Sankar, Raman; Shields, W. Donald; Engel, Jerome; Fried, Itzhak; Miyata, Hajime; Yong, William H.; Vinters, Harry V.; Mathern, Gary W.

doi:10.1212/01.wnl.0000334752.41807.2f

Cited by 287 publications

(192 citation statements)

References 41 publications

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“…Among the multimodal imaging, the interictal FDG-PET, ictal SPECT, ictal/interictal subtraction of SPECT scans, PET/MRI co-registration, multiplanar reconstruction and curvilinear reformatting represent noninvasive methods to evaluate patients with focal seizures (Figure 8). [30][31][32] The most common lesions causing neocortical epilepsies …”

Section: Extra-temporal Lobe Epilepsymentioning

confidence: 99%

Neuroimaging in Focal Epilepsies: An Update

Cendes¹

2016

Epilepsi

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SummaryEpilepsy is a common neurologic disorder with diverse etiologies. Appropriate MRI investigation has an important role in the assessment of epilepsy. Specific protocols are required for recognition of epileptogenic lesions, particularly for recognition of subtle lesions. In patients with refractory epilepsy and "normal MRI, " multimodal imaging techniques are crucial in the definition of epilepsy etiology, including those that combine metabolic and functional investigation, such as fluorodeoxyglucose positron emission tomography (FDG-PET), single-photonemission computed tomography (SPECT), diffusion MRI and magnetic resonance spectroscopy (MRS). Familiarity with various protocols of imaging studies is required for optimized investigation of seizure etiology. Main features found in MRIs of patients with focal epilepsies are discussed in the present review, as are alternative protocols and techniques of imaging that may optimize neuroimaging investigation in patients with epilepsy. The findings described have a direct impact on treatment and prognosis counseling of patients with focal epilepsies.Keywords: Focal epilepsies; neuroimaging. ÖzetEpilepsi, çeşitli etiyolojileri olan yaygın bir nörolojik rahatsızlıktır. Epilepsi değerlendirmesinde uygun manyetik rezonans görüntüleme (MRG) incelemeleri önemli bir role sahiptir. Epileptojenik lezyonların, özellikle güç alıgılanılan lezyonların teşhisi için spesifik protokollere ihtiyaç vardır. Dirençli epilepsisi olan ve "normal MRG" sonuçlarına sahip hastalarda florodeoksiglikoz-pozitron emsiyon tomografisi (FG-PET), tek föton emisyon bilgisayarlı tomografi (SPECT), difüzyon MRG ve manyetik rezonans spektroskopisi (MRS) gibi metabolik ve fonksiyonel incelemeleri de birleştiren multimodal görüntüleme yöntemleri epilepsi etiyolojisini tanımlamada önem taşımaktadır. Görüntüleme yöntemlerinin farklı protokollerine aşina olmak nöbet etiyolojisinin optimize incelemesi açısından gereklidir. Biz bu çalışmada, fokal epilepsisi olan hastaların MRG incelemesinde bulunan başlıca özellikleri tartışacağız. Ayrıca, epilepsisi olan hastaların nörolojik görüntüleme ile yapılan incelemelerini en uygun hale getirebilecek farklı görüntüleme yöntemleri ve alternatif protokolleri de tartışacağız. Burada tanımlanan bulguların, fokal epilepsisi olan hastaların tedavisi ve prognoz danışmanlığı üzerine doğrudan bir etkisi olacaktır.Anahtar sözcükler: Fokal epilepsi; nörolojik görüntüleme.

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Section: Extra-temporal Lobe Epilepsymentioning

confidence: 99%

Neuroimaging in Focal Epilepsies: An Update

Cendes¹

2016

Epilepsi

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“…PET-MRI fusion has helped to localize these very subtle structural abnormalities (20). Ictal SPECT has also been useful in localizing hard-to-characterize areas of ictal onset, particularly when co-registered with MRI (21).…”

Section: Presurgical Evaluationmentioning

confidence: 99%

Why is There Still Doubt to Cut it Out?

Engel

2013

Epilepsy Curr

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The modern era of surgical treatment for epilepsy began in the late nineteenth century. The epileptogenic region was originally localized on the basis of seizure semiology and identification of a structural lesion, which was then superseded by the advent of EEG in the mid-twentieth century (1). Introduction of advanced neuroimaging by the end of the twentieth century-first PET and then MRI-returned presurgical evaluation to a more lesion-directed approach, with EEG often playing a confirmatory role. SPECT, MEG, and fMRI also contribute to the identification of previously invisible lesions, such as hippocampal sclerosis in patients with mesial temporal lobe epilepsy (MTLE), as well as malformations of cortical development (MCD), particularly in infants and young children. Advances in operative techniques have greatly improved the safety, as well as the efficacy, of epilepsy surgery. As a result, not only are we achieving better outcomes today, but many patients are receiving surgery who would not have been considered surgical candidates a decade ago. Furthermore, procedures are now sufficiently cost-effective to permit establishment of epilepsy surgery programs in countries with limited resources (2). A major remaining challenge is establishment of biomarkers that reliably localize and determine the extent of the epileptogenic region, particularly in patients without obvious structural lesions (3). Surgical ApproachesVarious therapeutic surgical procedures are performed for intractable epilepsy today (Table 1), depending upon the type of epilepsy and the location of the epileptogenic region. Approaches to presurgical evaluation vary according to the type of surgical procedure to be performed. These procedures can be categorized into standardized resections, tailored resections, disconnections, and stereotactic ablations. Deep-brain stimulation (4) and responsive cortical stimulation (5) are beyond the scope of this discussion.The most common standardized surgical resection and, indeed, the most common type of surgery performed for Surgical treatment for epilepsy has made tremendous strides in the past few decades as a result of advances in neurodiagnostics-particularly structural and functional neuroimaging-and improved surgical techniques. This has not only resulted in better outcomes with respect to epileptic seizures and quality of life, and reduced surgical morbidity and mortality, but it has also increased the population of patients now considered as surgical candidates, particularly in the pediatric age range, and enhanced cost-effectiveness sufficient to make surgical treatment available to countries with limited resources. Yet surgical treatment for epilepsy remains arguably the most underutilized of all accepted medical interventions. In the United States, less than 1% of patients with pharmacoresistant epilepsy are referred to epilepsy centers.Although the number of epilepsy surgery centers has increased appreciably over the past two decades, the number of therapeutic surgical procedures performed for e...

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“…Anti-NMDA antibody, Anti-GABAB antibody, Anti-AMPA antibody, Anti-LGI1 antibody, Anti-CASPR2 antibody, Anti-contactin-2 antibody, Anti-GAD antibody, Anti-VGKC antibody [32][33][34][35][36][37][38].…”

Section: Autoimmune Epilepsiesmentioning

confidence: 99%

Review of Epilepsy - Etiology, Diagnostic Evaluation and Treatment

Shin¹,

Jewells²,

Hadar³

et al. 2014

Int J Neurorehabilitation Eng

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Epilepsy is the fourth most common neurological disorder in the US, affecting nearly 2.5 million Americans. The economic impact of epilepsy represents estimated direct and indirect costs of 12.5 billion dollars per year. Patients with this disorder experience increased morbidity and mortality with long term fatality rates of 24%. Multiple diagnostic tools are used to identify and classify the seizure type/syndrome, etiology and localization of seizures, including electroencephalogram (EEG), magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT), magneto encephalogram (MEG), and neuropsychiatric testing. Despite 29 different antiepileptic medications that are available in the US, one third of patients remain refractory to pharmacological treatment. In these intractable epilepsy patients, non-pharmacological treatments can be considered. Commonly used non-pharmacological treatment options for epilepsy include epilepsy surgery, neurostimulation therapy, and diet therapy. Review of Epilepsy -Etiology, Diagnostic Evaluation and Treatment

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FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

Cited by 287 publications

References 41 publications

Neuroimaging in Focal Epilepsies: An Update

Neuroimaging in Focal Epilepsies: An Update

Why is There Still Doubt to Cut it Out?

Review of Epilepsy - Etiology, Diagnostic Evaluation and Treatment

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