Focal Cortical Dysplasia: Comparison of MRI and FDG-PET

Kim, Seung Kwon; Na, Dong Gyu; Byun, Hong Sik; Kim, Sang Eun; Suh, Yeon Lim; Choi, Joon Young; Yoon, Hyeonseok; Han, Bing

doi:10.1097/00004728-200003000-00022

Cited by 78 publications

(49 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…28 Like MRI, however, interpretation of grayscale FDG-PET scans is less sensitive for type I compared with type II CD. 15,[29][30][31][32] Furthermore, intracranial EEG ictal onset zones are often diffuse and illdefined in patients with CD. 33,34 Consequently, determining the location and borders of the surgical resection is challenging in CD patients to completely remove the lesion, especially for patients with type I CD, where the area generating seizures often overlaps with functional cortex and the structural brain abnormalities are relatively subtle.…”

Section: Correlations Between Neuroimaging and Clinical Vari-mentioning

confidence: 99%

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

Salamon¹,

et al. 2008

View full text Add to dashboard Cite

Objective: Patients with cortical dysplasia (CD) are difficult to treat because the MRI abnormality may be undetectable. This study determined whether fluorodeoxyglucose (FDG)-PET/MRI coregistration enhanced the recognition of CD in epilepsy surgery patients. UCLA MRI identified CD in 78% of patients, and 37% of type I CD cases had normal UCLA scans. EEG and neuroimaging findings were concordant in 52% of type I CD patients, compared with 89% of type II CD patients. FDG-PET scans were positive in 71% of CD cases, and type I CD patients had less hypometabolism compared with type II CD patients. Postoperative seizure freedom occurred in 82% of patients, without differences between type I and type II CD cases. Cortical dysplasia (CD), first described in 1971, 1 is the most common malformation of cortical development identified in surgically treated patients with therapy-resistant epilepsy. Methods: Conclusions:2,3 The histopathology of CD is classified into mild Palmini type I and severe Palmini type II.4,5 Type I CD is characterized by cortical dyslamination and columnar disorganization often associated with excessive subcortical white matter neurons. Type II CD shows cortical disorganization plus abnormal dysmorphic or cytomegalic neurons with or without balloon cells. 6 In the past decade, improvements in MRI have increased awareness that CD is a frequent substrate causing epilepsy. This is especially true for patients with type II CD in whom structural MRI and functional neuroimaging often identify the lesion. 7-10 However, patients with type I CD are a challenge in that they often have negative MRI scans, making surgical treatment difficult without knowing the exact location and borders necessary for complete lesion removal.

show abstract

Section: Correlations Between Neuroimaging and Clinical Vari-mentioning

confidence: 99%

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

Salamon¹,

et al. 2008

View full text Add to dashboard Cite

show abstract

“…[22][23][24][25] In comparison, FDG-PET can identify FCD despite normal MR imaging findings. 7,26 One study found that MR imaging detected 83% of severe FCD, whereas FDG-PET detected 90%. 26 However, for subtle FCD, MR imaging identified only 13% compared with 86% with FDG-PET.…”

mentioning

confidence: 99%

“…7,26 One study found that MR imaging detected 83% of severe FCD, whereas FDG-PET detected 90%. 26 However, for subtle FCD, MR imaging identified only 13% compared with 86% with FDG-PET. This suggests that FDG-PET is more sensitive than MR imaging and that it is particularly useful when MR imaging findings are normal.…”

mentioning

confidence: 99%

See 1 more Smart Citation

[¹⁸F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

Lee¹,

Salamon²

2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY:Epilepsy is a chronic disorder affecting approximately 1% of the population of the world. Approximately one third of patients with epilepsy remain refractory to medical therapy. For these patients, surgery is a curative option. In order for surgery to be considered, precise localization of the structural abnormality is needed. When MR imaging findings are normal, more sensitive techniques such as positron-emission tomography (PET) can help find the abnormality. Combining MR imaging and PET information increases the sensitivity of the presurgical evaluation. In this review, we discuss the clinical applications of coregistration of [18 F] fluorodeoxyglucose (FDG)-PET with MR imaging for medically refractory epilepsy. Because FDG-PET/MR imaging coregistration has been a routine component of the presurgical evaluation for patients with epilepsy at our institution since 2004, we also included cases from our data base that exemplify the utility of this technology to obtain better postsurgical outcomes.

show abstract

“…3). 37 Findings suggestive of Type II FCDs include focal cortical thickening, blurring of the gray-white matter junction, and T2-weighted hyperintensity of subcortical white matter often tapering toward the ventricle (Fig. 2).…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Surgical treatment of intractable epilepsy associated with focal cortical dysplasia

Diaz¹,

Sherman²,

Hader³

2008

FOC

View full text Add to dashboard Cite

Focal cortical dysplasias (FCDs) are congenital malformations of cortical development that are a frequent cause of refractory epilepsy in both children and adults. With advances in structural and functional neuroimaging, these lesions are increasingly being identified as a cause of intractable epilepsy in patients undergoing surgical management for intractable epilepsy. Comprehensive histological classification of FCDs with the establishment of uniform terminology and reproducible pathological features has aided in our understanding of FCDs as an epilepsy substrate. Complete resection of FCDs and the associated epileptogenic zone can result in a good surgical outcome in the majority of patients.

show abstract

Focal Cortical Dysplasia: Comparison of MRI and FDG-PET

Abstract: FDG-PET is more useful in delineating the cortical abnormality in patients with mild degrees of FCD. The extent of the lesion was larger or similar on FDG-PET compared with that of the MRI.

Cited by 78 publications

References 24 publications

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

[¹⁸F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

Surgical treatment of intractable epilepsy associated with focal cortical dysplasia

Contact Info

Product

Resources

About

Focal Cortical Dysplasia: Comparison of MRI and FDG-PET

Abstract: FDG-PET is more useful in delineating the cortical abnormality in patients with mild degrees of FCD. The extent of the lesion was larger or similar on FDG-PET compared with that of the MRI.

Cited by 78 publications

References 24 publications

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy

[18F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

Surgical treatment of intractable epilepsy associated with focal cortical dysplasia

Contact Info

Product

Resources

About

[¹⁸F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy