The Utility of Positron Emission Tomography in Epilepsy

Burneo, Jorge G.; Poon, Raymond; Kellett, Sarah; Snead, O. Carter

doi:10.1017/cjn.2015.279

Cited by 36 publications

(28 citation statements)

References 35 publications

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“…Overall, the percentage of patients in whom PET correctly localized a seizure focus and had a good surgical outcome ranged from 36 to 89%, and it was higher (71-89%) in those with temporal lobe epilepsy. 11 Our results demonstrate a favorable surgical outcome in patients with Figure 1: PET images depicting hypometabolism in the mesial aspect of both temporal lobes anteriorly. (Arrows) There is subtle asymmetry, with the right side being slightly more severely affected.…”

Section: Discussionsupporting

confidence: 52%

“…The performance of PET imaging in our population would appear to reflect the heterogeneity of epilepsy in our study population, which included a significant number of extratemporal lobe epilepsy patients. 12,13 In a systematic review, 11 PET demonstrated 56-90% agreement with seizure onset localized by iEEG, and the sensitivity increased to 70-90% in those with temporal lobe hypometabolism. There is less information available regarding the usefulness of PET in eTLE, but it appears somewhat less sensitive in these cases.…”

Section: Discussionmentioning

confidence: 99%

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Refractory Epilepsy: The Role of Positron Emission Tomography

Chan

Romsa

Steven

et al. 2017

Can. J. Neurol. Sci.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Refractory Epilepsy: The Role of Positron Emission Tomography

Chan

Romsa

Steven

et al. 2017

Can. J. Neurol. Sci.

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“…Recently, interictal PET with 18 F-FDG has been used as a powerful neuroimaging technology for presurgical evaluation of epileptogenic foci (7)(8)(9) and has demonstrated a sensitivity of 70%-90% in TLE and 33%-67% in extra-TLE patients, depending on the localization of the focus (10)(11)(12). The highest clinical benefit of 18 F-FDG PET can be achieved in patients with MRI-negative TLE, for whom 18 F-FDG PET correctly lateralized the lesion in 80% of the cases (13).…”

mentioning

confidence: 99%

Glucose Metabolic Profile by Visual Assessment Combined with Statistical Parametric Mapping Analysis in Pediatric Patients with Epilepsy

Zhu

Feng

et al. 2017

J Nucl Med

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PET with 18 F-FDG has been used for presurgical localization of epileptogenic foci; however, in nonsurgical patients, the correlation between cerebral glucose metabolism and clinical severity has not been fully understood. The aim of this study was to evaluate the glucose metabolic profile using 18 F-FDG PET/CT imaging in patients with epilepsy. Methods: One hundred pediatric epilepsy patients who underwent 18 F-FDG PET/CT, MRI, and electroencephalography examinations were included. Fifteen age-matched controls were also included. 18 F-FDG PET images were analyzed by visual assessment combined with statistical parametric mapping (SPM) analysis. The absolute asymmetry index (jAIj) was calculated in patients with regional abnormal glucose metabolism. Results: Visual assessment combined with SPM analysis of 18 F-FDG PET images detected more patients with abnormal glucose metabolism than visual assessment only. The jAIj significantly positively correlated with seizure frequency (P , 0.01) but negatively correlated with the time since last seizure (P , 0.01) in patients with abnormal glucose metabolism. The only significant contributing variable to the jAIj was the time since last seizure, in patients both with hypometabolism (P 5 0.001) and with hypermetabolism (P 5 0.005). For patients with either hypometabolism (P , 0.01) or hypermetabolism (P 5 0.209), higher jAIj values were found in those with drug resistance than with seizure remission. In the post-1-y follow-up PET studies, a significant change of jAIj (%) was found in patients with clinical improvement compared with those with persistence or progression (P , 0.01). Conclusion: 18 F-FDG PET imaging with visual assessment combined with SPM analysis could provide cerebral glucose metabolic profiles in nonsurgical epilepsy patients. jAIj might be used for evaluation of clinical severity and progress in these patients. Patients with a prolonged period of seizure freedom may have more subtle (or no) metabolic abnormalities on PET. The clinical value of PET might be enhanced by timing the scan closer to clinical seizures.

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“…45) represent the focus and the projection areas of seizure activity. 52) This could determine the extent of resection difficulty. FDG PET is also a useful tool for predicting seizure control after epilepsy surgery; the extent of resection of the hypometabolism on FDGPET may be associated with better a postoperative seizure outcome.…”

Section: Localization Of Epileptic Activitymentioning

confidence: 99%

Advanced neuroimaging techniques for evaluating pediatric epilepsy

Lee

2020

Clin Exp Pediatr

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Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone, particularly when it is interpreted by experienced neuroradiologists. Ultra-high-field imaging and postprocessing analysis with automated machine learning algorithms can detect subtle structural abnormalities in MRI-negative patients. Tractography derived from diffusion tensor imaging can delineate white matter connections associated with epilepsy or eloquent function, thus, preventing deficits after epilepsy surgery. Arterial spin-labeling perfusion MRI, simultaneous electroencephalography (EEG)-functional MRI (fMRI), and magnetoencephalography (MEG) are noinvasive imaging modalities that can be used to localize the epileptogenic foci and assist in planning epilepsy surgery with positron emission tomography, ictal single-photon emission computed tomography, and intracranial EEG monitoring. MEG and fMRI can localize and lateralize the area of the cortex that is essential for language, motor, and memory function and identify its relationship with planned surgical resection sites to reduce the risk of neurological impairments. These advanced structural and functional imaging modalities can be combined with postprocessing methods to better understand the epileptic network and obtain valuable clinical information for predicting long-term outcomes in pediatric epilepsy.

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The Utility of Positron Emission Tomography in Epilepsy

Cited by 36 publications

References 35 publications

Refractory Epilepsy: The Role of Positron Emission Tomography

Refractory Epilepsy: The Role of Positron Emission Tomography

Glucose Metabolic Profile by Visual Assessment Combined with Statistical Parametric Mapping Analysis in Pediatric Patients with Epilepsy

Advanced neuroimaging techniques for evaluating pediatric epilepsy

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