Refractory Epilepsy: The Role of Positron Emission Tomography

Chan, Timothy M.; Romsa, Jonathan; Steven, David; Burneo, Jorge G.

doi:10.1017/cjn.2017.244

Cited by 4 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study by Chan and colleagues showed that patients with concordant results between the PET and video scalp EEG findings were either seizure free or had improvement in their seizure frequency at three months' postsurgical resection of the seizure focus. 18 Another study by Fujimoto et al evaluated concordance between PET and iomazenil SPECT imaging with postsurgical outcomes of surgical resection. They found a significant correlation in a univariate analysis between the PET, SPECT, both PET/SPECT findings, and favorable postsurgical outcome, with p equal to .017, .03, and .006, respectively.…”

Section: Discussionmentioning

confidence: 99%

Refractory seizures: Prediction of outcome of surgical intervention based on results from PET-CT, PET-MRI and electroencephaolography

et al. 2019

View full text Add to dashboard Cite

Purpose The purpose of this article is to evaluate the effectiveness of fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography (CT) and PET-magnetic resonance imaging (MRI) with scalp and intracranial electroencephalogram (EEG) in predicting surgical outcomes in patients with refractory seizures. Methods Patients who underwent PET-CT and MRI fusion, scalp and intracranial EEG, and subsequent surgical intervention were retrospectively included. PET-CT were fused with MRI and interpreted by an experienced blinded reader. An area of hypometabolism on PET was identified as the location of the epileptic focus. The site of seizure focus was correlated with scalp and intracranial EEG findings. Surgical outcomes were evaluated. Thirty-six patients were included; all had presurgical PET-CT, scalp EEG, and PET-MRI fusion, and 28 of these patients had intracranial EEGs. Results PET-CT showed concordance of epileptic foci with scalp EEG in 7/36 patients (19%) and with intracranial EEG in 9/28 patients (32%). PET-MRI was concordant with scalp EEG in 6/36 patients (17%) and with intracranial EEG in 8/28 patients (29%). All patients with concordance of epileptic foci between PET-CT and PET-MRI and scalp EEG had improvement or resolution of seizures postintervention, and 89% of patients had concordance between intracranial EEG and PET studies. However, 45% of patients with discordant PET-CT and scalp EEG, 37% with discordance PET-CT and intracranial EEG, 43% with discordant PET-MRI and scalp EEG, and 35% of patients with discordant PET-MRI and intracranial EEG did not improve postsurgically. Conclusion Concordance of epileptic foci localization between PET imaging and EEG yields favorable postoperative outcome in nearly all patients, whereas discordance has an equal probability of favorable vs unfavorable outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Refractory seizures: Prediction of outcome of surgical intervention based on results from PET-CT, PET-MRI and electroencephaolography

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Aside from cases of neoplasia, PET is utilized to evaluate neurodegenerative diseases such as idiopathic normal pressure hydrocephalus and Parkinson's disease [44,45] . Additionally, its use extends to inflammatory diseases, such as Rasmussen's encephalitis and refractory epilepsy [46][47][48] . PET has applications beyond cranial imaging, as well.…”

Section: Petmentioning

confidence: 99%

The Role of Advanced Imaging in Neurosurgical Diagnosis

et al. 2023

View full text Add to dashboard Cite

Neurosurgery as a specialty has developed at a rapid pace as a result of the continual advancements in neuroimaging modalities. With more sophisticated imaging options available to the modern neurosurgeon, diagnoses become more accurate and at a faster rate, allowing for greater surgical planning and precision. Herein, the authors review the current heavily used imaging modalities within neurosurgery, weighing their strengths and weaknesses, and provide a look into new advances and imaging options within the field. Of the many imaging modalities currently available to the practicing neurosurgeon, magnetic resonance imaging (MRI), computed tomography, positron emission tomography, and ultrasonography are used most heavily within the field for appropriate diagnosis of neuropathologies in question. For each, their strengths are weighed regarding appropriate capabilities in accurate diagnosis of cranial or spinal lesions. Reasoning for choosing one over the other for various pathologies is also reviewed. Current limitations of each is also assessed, providing insight for possible improvement for each. New advancements in imaging options are subsequently reviewed for best uses within neurosurgery, including the new utilization of FIESTA sequencing, glymphatic mapping, black-blood MRI, and functional MRI. The specialty of neurosurgery will continue to heavily rely on improvements within imaging options available for improved diagnosis and greater surgical outcomes for the patients treated. The synthesis of techniques provided herein may provide meaningful guidance for neurosurgeons in effectively diagnosing neurological pathologies while also helping guide future efforts in neuroimaging developments.

show abstract