The Clinical Value of Simultaneous 18F-FDG PET/DIR Imaging in Localizing Seizure Focus in Intractable Focal Epilepsy Patients
Abstract number :
2.197
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2022
Submission ID :
2204652
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
YANG CAI, Doctor – Zhongshan Hospital; siwei Liu, Doctor – Nuclear Medicine – Zhongshan Hospital; Lingyan Mao, Doctor – Neurology – Zhongshan Hospital; Yu Feng, Doctor – Neurology – Zhongshan Hospital; Weifeng Peng, Doctor – Neurology – Zhongshan Hospital; Fan Hu, Professor – Neurosurgery – Zhongshan Hospital; hongcheng Shi, Professor – Nuclear Medicine – Zhongshan Hospital; Jing Ding, Professor – Neurology – Zhongshan Hospital; Xin Wang, Professor – Neurology – Zhongshan Hospital
Rationale: To evaluate the clinical value of simultaneous 18F-fluorodeoxyglucose positron emission tomography/double inversion recovery (18F-FDG PET/DIR) in detecting the epileptogenic lesion. _x000D_
Methods: Twenty-eight patients diagnosed with refractory focal epilepsy were recruited in this study since 2018. All the participants underwent 18F-FDG PET/MRI scanning, including PET/T1WI, PET/FLAIR and PET/DIR. Among them, twelve patients underwent the surgical resection of the seizure focus, with at least one-year post-surgery follow-up. The concordance of PET/DIR and the ictal electroencephalogram on the localization of the seizure of focus was evaluated. In addition, the sensitivity and specificity of PET/DIR in detecting the epileptogenic focus was analyzed based on the postsurgical outcome with Engel class I as the gold standard. The predication value of PET/DIR and EEG on the postsurgical outcome was also compared between PET/DIR and other MRI or PET/MRI sequences. _x000D_
Results: PET/DIR showed the highest concordance with ictal EEG on the detection of the seizure focus, compared with PET/FLAIR, PET/T1WI, PET, DIR, FLAIR, or T1WI, with a concordance rate up to 71.43%. The concordance rate between PET/DIR and ictal EEG increased to 85.71% among patients with post-surgical outcome of Engel class I after one-year follow-up. The sensitivity, specificity and accuracy of PET/DIR was respectively 85.71%, 40%, and 66.67% based on the post-surgical evaluation. The concordance rate of PET/DIR and the EEG was significantly higher in the post-surgical patients with Engel class I-III than the group with Engel class IV after one-year follow-up (P＜0.05).
Conclusions:18F-FDG PET/DIR increased the detection rate of the seizure focus, with a higher sensitivity and accuracy. The concordance of the PET/DIR and EEG acted as a potential prediction factor for an improved post-surgical outcome for intractable focal epilepsy patients.
Funding: Shanghai Natural Scientific Fund
Neuro Imaging