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Differential Features of Metabolic Abnormalities Between Medial and Lateral Temporal Lobe Epilepsy: Quantitative Analysis of 18F-FDG PET Using SPM

Yu Kyeong Kim, MD1, Dong Soo Lee, MD, PhD1, Sang Kun Lee, MD2, Seok-Ki Kim, MD1, Chun Kee Chung, MD3, Ki Hyun Chang, MD4, Ki Young Choi, MD5, June-Key Chung, MD1 and Myung Chul Lee, MD1

1 Department of Nuclear Medicine, Seoul National University, College of Medicine, Seoul, Korea
2 Department of Neurology, Seoul National University, College of Medicine, Seoul, Korea
3 Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea
4 Department of Diagnostic Radiology, Seoul National University, College of Medicine, Seoul, Korea
5 Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea



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  		FIGURE 1. Six pairs of VOI representing medial and lateral temporal structures. (Top) From left to right, VOIs for superior temporal gyrus, middle temporal gyrus, and inferior temporal gyrus are representative of lateral temporal cortical structure. (Bottom) From left to right, VOIs for amygdala, hippocampus, and parahippocampal gyrus were used as medial temporal structure. Size of each VOI is shown as several voxels. These ranged from 1,344 to 5,411 voxels for lateral structures and from 110 to 894 voxels for medial structures.

 


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  		FIGURE 2. Sensitivity and specificity of SPM analysis of 18F-FDG PET for localization of seizure focus in TLE. Solid bars show sensitivity and specificity using simple comparison test. Each value was calculated at uncorrected P value < 0.001. After considering interhemispheric temporal asymmetry, sensitivity and specificity were increased.

 


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  		FIGURE 3. Group analysis between lateral TLE (n = 35) and medial TLE (n = 78). Regions identified by SPM were superimposed on average T1-weighted MRI template. Compared with medial TLE group, lateral TLE group showed relatively preserved metabolism at ipsilateral medial temporal structure and anterior part of superior temporal gyrus. Maximum Z value of this cluster was 4.45 and cluster (k= 2,113) was significant at P = 0.002 (corrected).

 




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