Quantitative [18]FDG PET asymmetry features predict long-term seizure recurrence in refractory epilepsy.
Epilepsy Behav
; 116: 107714, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-33485794
ABSTRACT
OBJECTIVE:
Fluorodeoxyglucose-positron emission tomography (FDG-PET) is an established, independent, strong predictor of surgical outcome in refractory epilepsy. In this study, we explored the added value of quantitative [18F]FDG-PET features combined with clinical variables, including electroencephalography (EEG), [18F]FDG-PET, and magnetic resonance imaging (MRI) qualitative interpretations, to predict long-term seizure recurrence (mean post-op follow-up of 5.85⯱â¯3.77â¯years).METHODS:
Machine learning predictive models of surgical outcome were created using a random forest classifier trained on quantitative features in 89 patients with drug-refractory temporal lobe epilepsy evaluated at the Hospital of the University of Pennsylvania epilepsy surgery program (2003-2016). Quantitative features were calculated from asymmetry features derived from image processing using Advanced Normalization Tools (ANTs).RESULTS:
The best-performing model used quantification and had an out-of-bag accuracy of 0.71 in identifying patients with seizure recurrence (Engel IB or worse) which outperformed that using qualitative clinical data by 10%. This model is shared through open-source software for research use. In addition, several asymmetry features in temporal and extratemporal regions that were significantly associated with seizure freedom are identified for future study.SIGNIFICANCE:
Complex quantitative [18F]FDG-PET imaging features can predict seizure recurrence in patients with refractory temporal lobe epilepsy. These initial retrospective results in a cohort with long-term follow-up suggest that using quantitative imaging features from regions in the epileptogenic network can inform the clinical decision-making process.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Epilepsia do Lobo Temporal
/
Epilepsia Resistente a Medicamentos
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Epilepsy Behav
Assunto da revista:
CIENCIAS DO COMPORTAMENTO
/
NEUROLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos