Heterogeneity of TSPO-PET Distribution Patterns Among Patients with Temporal Lobe Epilepsy
Abstract number :
3.373
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2024
Submission ID :
430
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Yuncan Chen, PhD – Department of Neurology, Huashan Hospital, Fudan University
Jing Wang, PhD – Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University
Yiqiao Wang, PhD – Department of Neurology, Huashan Hospital, Fudan University
Qinyue Wang, PhD – Department of Neurology, Huashan Hospital, Fudan University
Jiaying Lu, PhD – Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University
Shimin Xu, MD,PhD – Department of Neurology, Huashan Hospital, Fudan University
Huamei Lin, PhD – Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University
Dongyan Wu, MD, PhD – Department of Neurology, Huashan Hospital, Fudan University
Chuantao Zuo, MD, PhD – Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University
Yihui Guan, MD, PhD – Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University
Jingjie Ge, PhD – Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University
Xunyi Wu, MD, PhD – Department of Neurology, Huashan Hospital, Fudan University
Rationale: Localization of epileptic foci using non-invasive methods is crucial in the diagnosis and treatment of epilepsy. This study aimed to reveal the heterogeneous distribution pattern of translocator protein 18 kDa-positron emission tomography (TSPO-PET) among patients with temporal lobe epilepsy (TLE) and investigate clinical factors which affect the outcome.
Methods: Twenty-one patients diagnosed with TLE underwent TSPO-PET scans. Clinical factors such as age at onset, seizure types, frequency, and interval from last seizure to PET scan were detailedly documented. Visual evaluation of TSPO-PET scans was performed by three independent radiologists, followed by quantitative analysis of the uptake of [18F]DPA-714 using the asymmetry index (AI). TSPO uptake and AI of each brain region were presented as heat maps. Logistic regression analysis was employed to investigate clinical factors associated with TSPO-PET outcomes.
Results: Visual evaluation revealed increased [18F]DPA-714 uptake in fifteen patients. The hemisphere with clinically-defined epileptic foci was entirely consistent with visual TSPO-PET evaluation. Quantitative analysis with AI showed that 71.4% (15/21) of patients had at least one brain area with AI exceeding 15%, predominantly in the temporal lobe (57.1%, 12/21), including the hippocampus and parahippocampus (41.7%, 5/12) and amygdala (66.7%, 8/12). A high AI could also be observed outside the temporal lobe, such as in the parietal lobe (9.5%, 2/21) and occipital lobe (23.8%, 5/21). Logistic regression analysis indicated a significant association between TSPO-PET outcome and interval from last seizure to PET scan (P=0.041, OR=11.073), suggesting a higher uptake rate with a shorter interval.
Conclusions: The majority of TLE patients exhibit higher uptake of [18F]DPA-714 in the ipsilateral hemisphere with the clinically-defined epileptic focus, indicating ongoing neuroinflammation. But its distribution patterns may vary among patients. The outcome of TSPO-PET may be influenced by some clinical factors such as interval from last seizure to PET scan and seizure frequency.
Funding: This work was supported by grants from the National Key R&D Program of China (2022YFC2503803); medical Innovation Research Project of Shanghai Science and Technology Commission (21Y11903300); grants from the National Natural Science Foundation of China (No. 81902282); grants from the National Natural Science Foundation of China (No. 82272039, 82021002, 82394434 and 81971641); STI2030-Major Projects (2022ZD0211600).
Neuro Imaging