Abstract
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Objectives: We aimed to investigate the usefulness of hybrid TOF-PET-MRI in localizing the epileptogenic zone in patients with MRI-negative temporal lobe epilepsy.
Methods: Sixteen patients with MRI-negative temporal lobe epilepsy who underwent preoperative evaluation and nine healthy controls were imaged using hybrid TOF-PET-MRI with simultaneous acquisition of PET and arterial spin labeling (ASL). All PET and ASL images were evaluated in a blind manner by two neuroradiologists with long-term experience. A semi-quantitative analysis was performed using the standardized uptake value (SUV) and cerebral blood flow (CBF) on the PET and ASL images respectively, in order to identify the brain regions with metabolic and perfusion abnormalities. All statistical analyses derived from the voxelwise normalization methods. The values of SUV and CBF as well as the asymmetries of metabolism and perfusion were compared between the two groups. The histopathological results were used as reference.
Results: Visually, 14/16 (87.5%) and 12/16 (75%) patients were detected hypometabolism and hypoperfusion on the PET and ASL images respectively, including a complete and partial concordance with the histopathological results. Compared the metabolic and perfusion abnormalities in patients with healthy controls, the temporal lobe with hypometabolism and hypoperfusion were detected (p<0.01), in line with histopathological results(Figure 1 and 2). Moreover, compared with the healthy control group, the metabolism and perfusion asymmetries were also located in the temporal lobe (p<0.01), which were agreement with the histopathological results.
Conclusion: Our initial hybrid TOF-PET-MRI experience increased diagnostic accuracy and prognostic value of localizing seizure focus in patients with MRI-negative temporal lobe epilepsy. Research Support: