Epileptogenic Zone Localization With 18FDG PET Using a New Dynamic Parametric Analysis

Conclusion: Compared to SPM with the fixed standard parameters, PET-analysis may be superior in EZ localization with its easy and rapid processing of different threshold combinations. The results of this initial proof-of-concept study validate the clinical use of PET-analysis as a robust objective complementary tool to visual assessment for EZ localization. Introduction Surgical resection is the potentially curative treatment option in one third of epileptic patients who remain uncontrolled despite polytherapy with antiepileptic drugs. Interictal [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) has traditionally been regarded as a complementary imaging modality in epilepsy, although some studies have reported similar post-operative outcomes based on PET in comparison with magnetic resonance imaging (MRI) (1–4). However, the sensitivity of PET on visual assessment to detect the epileptogenic zone (EZ) is moderate, being around 80% in temporal lobe epilepsy (TLE) and 60–70% in extratemporal lobe epilepsy (5–7). Visual interpretation of brain PET imaging can be improved by means of objective complementary software tools which compare each study to a normal control group using statistical parametric analysis. This is essential in epilepsy in which subtle hypometabolic changes may be overlooked by the naked eye. Software packages currently available for interpretation of brain imaging studies such as Statistical Parametric Mapping ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research