The Role of Radionuclide Imaging in Epilepsy, Part 2: Epilepsy Syndromes

Kumar, Ajay; Chugani, Harry T.

doi:10.2967/jnumed.113.129593

Cited by 27 publications

(15 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several reviews on PET and SPECT in presurgical evaluation were published during this period [ 31 ▪▪ , 56 ▪▪ – 59 ▪▪ , 60 ▪ ].…”

Section: Reviewsmentioning

confidence: 99%

PET and ictal SPECT can be helpful for localizing epileptic foci

Oertzen

2018

Current Opinion in Neurology

View full text Add to dashboard Cite

Purpose of reviewFunctional neuroimaging with PET and SPECT is a commonly used tool in presurgical evaluation. The following article reviews the literature of PET and SPECT in presurgical assessment of epilepsies published in the last year.Recent findingsFDG-PET adds concomitant information in temporal and extratemporal lobe epilepsy in adults and children. The pattern of hypometabolism in FDG-PET is a good additional predictor or seizure outcome in TLE with mesial temporal sclerosis or negative MRI. There is growing evidence that diagnostic value of FDG-PET increases with postprocessing. Although several methods were applied in the reviewed literature, all of them seem to outperform the visual analysis. Imaging of the epileptic focus with ictal SPECT is depending on short injection latencies. It is particularly useful in patients with nonlesional MRI and mostly of extratemporal localization. Areas of hyperperfusion remote of SOZ are reflecting the epileptic network. Combining more concordant investigations including PET and SPECT in MRI-negative evaluation adds to better presurgical stratification and therefore, better postsurgical outcome. FET-PET shows increased uptake in status epilepticus.SummaryPET and SPECT are important investigations to localize the epileptic focus in temporal lobe and nonlesional extratemporal epilepsies. Postprocessing for both modalities is important to increase diagnostic value.

show abstract

“…Several reviews on PET and SPECT in presurgical evaluation were published during this period [ 31 ▪▪ , 56 ▪▪ – 59 ▪▪ , 60 ▪ ].…”

Section: Reviewsmentioning

confidence: 99%

PET and ictal SPECT can be helpful for localizing epileptic foci

Oertzen

2018

Current Opinion in Neurology

View full text Add to dashboard Cite

show abstract

“…This result underlines the value of a multimodal neuroimaging evaluation prior to hemispherotomy as already recommended by others. 12,13 Most interestingly, seizure freedom was also achieved in 100% of the patients with unilateral PET despite bilateral MRI (Group AII; Fig. 2) but only in 87.5% of the patients with bilateral PET and unilateral MRI (Group BI; Table 2).…”

Section: Discussionmentioning

confidence: 94%

“…16 PET-based and SPECT-based techniques have also been investigated with respect to their value for both a better delineation of the functional deficit zone prior to surgery and the prediction of possible functional deficits after surgery. 13 The largest outcome study after hemispheric surgery (based on 170 patients) was published in 2013. 15 In this retrospective study, 18 F-FDG PET as well as MRI findings were found to be of prognostic value for postsurgical seizure outcomes.…”

Section: Discussionmentioning

confidence: 99%

Presurgical evaluation of pediatric epilepsy patients prior to hemispherotomy: the prognostic value of 18F-FDG PET

Traub-Weidinger

Weidinger

Gröppel

et al. 2016

PED

View full text Add to dashboard Cite

OBJECTIVE The objective of this study was to investigate whether fluorine-18 fluorodeoxyglucose PET (F-FDG PET) can help to predict seizure outcome after hemispherotomy and therefore may be useful in decision making and patient selection. METHODS Children and adolescents less than 18 years of age who underwent F-FDG PET studies during presurgical evaluation prior to hemispherotomy and had follow-up data of at least 12 months after surgery were included. Seizure outcome was classified according to the recommendations of the International League Against Epilepsy. PET data were reevaluated by two specialists in nuclear medicine blinded to clinical data and to MRI. MRI studies were also reinterpreted visually by an experienced neuroradiologist blinded to clinical data and PET findings. RESULTS Thirty-five patients (17 girls) with a median age of 5 years (range 0.4-17.8 years) were evaluable. Of the 35 patients, 91.4% were seizure free after surgery, including 100% of those with unilateralF-FDG-PET hypometabolism compared with only 75% of those with bilateral hypometabolism. With respect to MRI, seizure freedom after surgery was observed in 96.4% of the patients with unilateral lesions compared with only 71.4% in those with bilateral MRI lesions. The best seizure outcomes were noted in patients with unilateral findings in both PET and MRI (100% seizure freedom) whereas only 50% of those with bilateral findings in both imaging techniques were seizure free. Furthermore, 100% of the patients with unilateral PET hypometabolism and bilateral MRI findings were also seizure free, but only 87.5% of those with bilateral PET hypometabolism and unilateral MRI findings. CONCLUSIONS According to these results, candidate selection for hemispherotomy can be optimized by the use of F-FDG PET as part of a multimodal presurgical evaluation program, especially in patients with inconsistent (bilateral) MRI findings.

show abstract

“…Molecular imaging by positron emission tomography [16] with 11 C-flumazenil (FMZ) has been useful in the assessment of patients having neural damage, including epilepsy, because FMZ binds to the benzodiazepine site of the GABA A receptor complex in humans [17][18][19][20]. We also have investigated neural damage in patients with cerebrovascular diseases using the specific parameter of the binding potential (BP) of FMZ to the GABA A receptor complex in the human brain [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

FMZ-PET to assess the efficacy and the mechanism of ketogenic diet in patients with intractable epilepsy

Nishii¹,

Hirai²,

Fujii³

et al. 2018

Imaging-Medicine

View full text Add to dashboard Cite

FMZ-PET to assess the efficacy and the mechanism of ketogenic diet in patients with intractable epilepsy Methods: Six patients with intractable epilepsy (two females/four males; seizure-onset age: 0-30 months) were enrolled in this study. Medication-refractory seizures continued in all patients despite treatment with the anti-epilepsy drugs (AEDs), followed by two types of KD therapy; the classical KD menu or the MAD regimen. All patients underwent FMZ-PET before KD and at 1-5 months after induction of KD. Dynamic FMZ-PET scanning was acquired, followed by assessment of the BP images using the graphic plot method of Logan. Results: In KD-effective patients, the BPs of FMZ before KD were 1.31, 1.60 and 1.50 and those after induction of KD were 1.89, 2.13 and 2.07, respectively. In KD-partially effective patients, the BPs of FMZ before KD was 1.95 and 2.47 and those after induction of KD were 2.10 and 2.71, respectively. Conversely, in KD-ineffective case, the BP of FMZ was decreased from 3.91 before KD to 3.58. The BPchange ratios were 1.44, 1.33 and 1.38 in the KD-effective patients, 1.08 and 1.10 in the KD-partially effective patients, and 0.92 in the KD-ineffective one. Conclusion: The results of current study suggested that KD may control seizures by increasing BP of BZR and that FMZ-PET imaging would be useful to assess the efficacy of KD therapy in patients with intractable epilepsy.

show abstract

The Role of Radionuclide Imaging in Epilepsy, Part 2: Epilepsy Syndromes

Cited by 27 publications

References 76 publications

PET and ictal SPECT can be helpful for localizing epileptic foci

PET and ictal SPECT can be helpful for localizing epileptic foci

Presurgical evaluation of pediatric epilepsy patients prior to hemispherotomy: the prognostic value of 18F-FDG PET

FMZ-PET to assess the efficacy and the mechanism of ketogenic diet in patients with intractable epilepsy

Contact Info

Product

Resources

About