Clinical value of 18F-DPA-714 PET/MR imaging in localization of epileptogenic zone in refractory epilepsy
10.3760/cma.j.cn321828-20241028-00369
- VernacularTitle:18F－DPA－714 PET/MR成像对药物难治性癫痫致痫灶的定位价值
- Author:
Siqi ZHANG
1
;
Jie HU
1
;
Bixiao CUI
1
;
Chenyang YAO
1
;
Jingjuan WANG
1
;
Jie LU
1
Author Information
1. 首都医科大学宣武医院放射与核医学科、 磁共振成像脑信息学北京市重点实验室，北京 100053
- Publication Type:Journal Article
- Keywords:
Drug resistant epilepsy;
Receptors, GABA-A;
Isotope labeling;
Fluorine radioisotopes;
Positron-emission tomography;
Magnetic resonance imaging;
DPA-714
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(7):411-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical value of translocator protein (TSPO, 18kDa) radiotracer 18F- N, N-diethyl-2-(2-(4-(2-fluoroethoxy)-phenyl)-5, 7-dimethyl-pyrazolo[1, 5-a]pyrimidin-3-yl)-acetamide (DPA-714) PET/MR imaging for precise localization of epileptogenic zone in patients with drug-resistant epilepsy. Methods:From December 2022 to October 2023, 24 refractory epilepsy patients (12 males and 12 females, age (27.5±8.1) years) who underwent surgery in Xuanwu Hospital, Capital Medical University were retrospectively enrolled. All patients received hybrid 18F-DPA-714 PET/MR before surgery, with the surgical resection site and stereoelectroencephalography recordings of the seizure focus serving as the gold standard. Initial qualitative analysis of the images was performed, followed by semi-quantitative analysis using the ROI method to calculate the asymmetry index (AI) of the proposed epileptogenic zone, assessing the degree of increased abnormal uptake (area with AI>10% was considered as the epileptogenic zone). Follow-up assessment using the Engel classification was conducted at least one year postoperatively. Differences of lesion detection efficiency of conventional MRI and PET/MR were evaluated using McNemar test. Results:Among 24 enrolled patients, 13 cases (54.2%) showed positive findings on conventional MRI, while 21 cases (87.5%) exhibited single or multiple foci of abnormally increased tracer uptake on PET/MR imaging, indicating an improved lesion detection rate ( χ2=4.90, P=0.021). Of the MRI-positive patients, 12/13 also had positive findings on PET/MR, with a localization accuracy of 10/13. Among the MRI-negative patients, 9/11 showed positive PET/MR findings, with a localization accuracy of 6/11. At one year post-surgery, 75.0%(18/24) of patients had a favorable outcome (Engel Ⅰ). Conclusion:18F-DPA-714 PET/MR imaging can accurately locate epileptogenic foci, especially for MRI-negative lesions, providing reliable information for surgical planning to improve postoperative outcomes.
