Clinical value of 18F-FDG PET/MR in localizing epileptogenic foci in refractory epilepsy
10.3760/cma.j.cn321828-20240117-00022
- VernacularTitle:18F－FDG PET/MR在难治性癫痫精准定位诊断中的价值
- Author:
Jin WANG
1
;
Hongping MENG
;
Xinyun HUANG
;
Miao ZHANG
;
Biao LI
;
Xiaozhe ZHANG
Author Information
1. 上海交通大学医学院附属瑞金医院核医学科，上海 200025
- Keywords:
Drug resistant epilepsy;
Positron-emission tomography;
Fluorodeoxyglucose F18;
Magnetic resonance imaging;
Electroencephalography
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(4):202-206
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical value of 18F-FDG PET/MR for precise localization of epileptogenic foci in patients with refractory epilepsy. Methods:From February 2019 to December 2021, 81 patients (52 males, 29 females; age (30.0±10.9) years) with refractory epilepsy confirmed in Ruijin Hospital Shanghai Jiao Tong University School of Medicine were retrospectively enrolled. All patients underwent preoperative PET/MR exam, and the possible position of the epileptogenic foci were determined by PET/MR imaging and pre-surgical evaluation, then the stereoelectroencephalography (SEEG) electrodes were implanted. Surgery was performed, and outcome was assessed by using a modified Engel classification two years after surgery. χ2 test was used to compare the detection rates of MRI and PET/MR fusion imaging in localizing epileptogenic foci and the detection rates of epileptogenic foci in temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE) by PET/MR. Results:MRI correctly localized seizure foci in 38 patients, with the detection rate of 46.91%(38/81), while PET/MR detected seizure foci in 73 patients, with the detection rate of 90.12%(73/81; χ2=35.05, P<0.001). There were 63 TLE and 18 ETLE patients. The detection rate of PET/MR in localizing seizure foci in TLE patients was 95.24%(60/63), which was significantly higher than that in ETLE patients (13/18; χ2=5.94, P=0.015). After 2 years follow-up, the postoperative efficacy rate of TLE patients with Engel grades Ⅰ-Ⅱ was 76.19%(48/63), which was 13/18 of ETLE patients ( χ2=0.12, P=0.731). Conclusion:Hybrid PET/MR imaging can accurately locate epileptogenic foci, especially for MRI negative lesions, which provides precision imaging information for surgical planning and improves surgical success rate.
