[18F]FDG PET/MRI and magnetoencephalography may improve presurgical localization of temporal lobe epilepsy.
Eur Radiol
; 32(5): 3024-3034, 2022 May.
Article
em En
| MEDLINE
| ID: mdl-34651211
ABSTRACT
OBJECTIVES:
To evaluate the clinical value of the combination of [18F]FDG PET/MRI and magnetoencephalography (MEG) ([18F]FDG PET/MRI/MEG) in localizing the epileptogenic zone (EZ) in temporal lobe epilepsy (TLE) patients.METHODS:
Seventy-three patients with localization-related TLE who underwent [18F]FDG PET/MRI and MEG were enrolled retrospectively. PET/MRI images were interpreted by two radiologists; the focal hypometabolism on PET was identified using statistical parametric mapping (SPM). MEG spike sources were co-registered onto T1-weighted sequence and analyzed by Neuromag software. The clinical value of [18F]FDG PET/MRI, MEG, and PET/MRI/MEG in locating the EZ was assessed using cortical resection and surgical outcomes as criteria. The correlations between surgical outcomes and modalities concordant or non-concordant with cortical resection were analyzed.RESULTS:
For 46.6% (34/73) of patients, MRI showed definitely structural abnormality concordant with surgical resection. SPM results of [18F]FDG PET showed focal temporal lobe hypometabolism concordant with surgical resection in 67.1% (49/73) of patients, while the concordant cases increased to 82.2% (60/73) patients with simultaneous MRI co-registration. MEG was concordant with surgical resection in 71.2% (52/73) of patients. The lobar localization was defined in 94.5% (69/73) of patients by the [18F]FDG PET/MRI/MEG. The results of PET/MRI/MEG concordance with surgical resection were significantly higher than that of PET/MRI or MEG (χ2 = 13.948, p < 0.001; χ2 = 5.393, p = 0.020). The results of PET/MRI/MEG cortical resection concordance with surgical outcome were shown to be better than PET/MRI or MEG (χ2 = 6.695, p = 0.012; χ2 = 16.991, p < 0.0001).CONCLUSIONS:
Presurgical evaluation by [18F]FDG PET/MRI/MEG could improve the identification of the EZ in TLE and may further guide surgical decision-making. KEY POINTS ⢠Lobar localization was defined in 94.5% of patients by the [18F]FDG PET/MRI/MEG. ⢠The results of PET/MRI/MEG concordance with surgical resection were significantly higher than that of PET/MRI or MEG alone. ⢠The results of PET/MRI/MEG cortical resection concordance with surgical outcome were shown to be better than that of PET/MRI or MEG alone.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fluordesoxiglucose F18
/
Epilepsia do Lobo Temporal
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
China